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Fooled by
Fad Diets
Prevent and
Treat Dementias
Lifestyle and
Dementias
Supplements
for Dementias
Ask Dr. J:
Crohn's Disease
References
In the Health
News
Diet and Disease
Recipe of the
Month: Hearty Three-Bean
Soup
Dear Friends,
Don’t be fooled by
fad diets, no matter how
long they have been around
nor how much popular press
they receive. What you need
to protect your health and
prevent chronic disease
and suffering is legitimate,
reproducible, scientific
evidence for any proposed
diet guideline. The high-protein/fat
diets that have been proposed
for weight loss fail on
these issues (as well as
weight loss).
I am concerned that fast
food establishments are
now putting the Atkins logo
on what they call “low
carb” products. All
this means is that you can
now get low-carb junk with
all of the other junk that
they sell. This is not to
say that you can’t
lose weight on high protein
diets. You can, possibly
because eating a high proportion
of protein and fat curbs
the appetite.
However, the evidence is
pretty clear that these
fad diets (whether the Zone,
Blood Type, or No-Grain
diets), all too high in
protein and fat, do not
lead to long-term weight
loss or health. Reports
are consistent that whole
grains, complex carbohydrates,
fresh fruits, vegetables,
beans, seeds, nuts, and
uncontaminated fish are
the healthiest dietary choices.
In addition, proponents
of low carbohydrate diets
mislead people into thinking
that all carbohydrates are
the same, lumping simple
refined sugar and white
flour with complex carbohydrates
from whole grains (whole
wheat, oatmeal, and brown
rice for examples), beans,
squashes, and potatoes.
The effect of complex carbohydrates
on physiology is not the
same as a donut!
Some of the proponents
of high protein diets insist
that high carb diets always
lead to diabetes and insulin
resistance (a risk factor
for heart disease). They
fail to explain the fact
that on primitive diets,
such as the native African
or Asian diets, which are
very high in unrefined carbohydrates,
obesity and diabetes are
rare, or the scientific
research showing that whole
grains reduce insulin resistance.
The recent studies in the
New England Journal of Medicine
that I reported on briefly
in June were popularly reported
as supporting the Atkins
diet for weight loss (though
it said nothing about the
long-term consequences).
However, even for weight
loss, the differences between
the Atkins diet and what
they called a low-fat diet
were small, and short-lived.
People had trouble staying
on any of the diets, but
those on the low-carbohydrate
diets had more difficulty
than the others. More of
them dropped out and strayed
from the diet than in the
other group. In addition,
and most importantly, the
risk of heart disease, cancer,
diabetes, stroke, hypertension
and other diseases is lower
with mostly vegetarian choices.
I write about this a lot
because it is one of the
areas in which the public
is misled, and in which
many of my colleagues lose
their scientific perspective,
which is so important to
maintain for those of us
in integrative medicine.
A primary concern of our
aging population is the
increase in the incidence
of senile dementia, whether
caused by atherosclerosis
of the arteries to the brain,
Alzheimer’s disease
(AD), or other causes. Symptoms
of Alzheimer’s include
memory loss, loss of the
ability to reason, disorientation,
and personality changes,
such as depression, irritability,
anxiety, and agitation,
and eventual death.
Dementia is also associated
with Parkinson’s disease
(PD) and, of course, Creutzfeldt-Jacob
disease (CJD), also known
as “mad cow”
disease. Regardless of the
cause, dementia results
from damage to brain cells.
With vascular disease, brain
degeneration can be the
result of a sudden large
stroke, or repeated small
strokes.
In AD, a substance called
“amyloid” is
associated with brain cell
degeneration. Amyloid is
a collection of protein
fragments that clump together
and deposit in the brain,
inducing free radical damage
to neurons. Why amyloid
is deposited is not clear.
Other protein fragments
accumulate inside brain
cells and cause damage.
Researchers have developed
a new radioactive dye that
reveals amyloid deposits,
and this may allow an earlier
diagnosis of AD, provide
the ability to follow the
progression or regression
with treatment.
Dememtias progress at different
rates, and may take a few
years to many years to become
severe and lead to death.
What is becoming increasingly
apparent is that oxidative
free-radical damage is involved
in dementias, including
AD and PD, but lifestyle
choices also play a role.
Dietary intake of omega-3
oils from fish is associated
with an increased ability
to perform mental tasks,
while cholesterol, total
fat, and saturated fat consumption
are linked to decreased
brain function. High total
caloric intake leads to
a greater risk of developing
dementia.
Exercise is also beneficial
to the brain. In a study
of 5925 women over 65, the
greater their physical activity
level the less likely they
were to experience cognitive
decline. Researchers used
blocks walked, stairs climbed,
and total calories expended
to evaluate activity. Those
at the highest exercise
level had a 37 percent lower
risk of a decline in brain
function than those who
had the least physical activity.
Leisure activities, such
as playing board games or
a musical instrument, reading,
and dancing are all associated
with a lower risk of dementia.
A study of 469 subjects
over 75, followed for five
years, showed that for each
day per week of activity,
there was about 7 percent
less decline of cognitive
function. (In this study
exercise did not have such
an effect.)
Evidence is accumulating
that antioxidants help to
prevent both Alzheimer’s
and Parkinson’s dementias,
and atherosclerotic brain
degeneration. In an animal
model, feeding blueberry
(a rich source of antioxidants)
early in life prevents cognitive
decline, and can reverse
age-associated brain deterioration.
In Alzheimer’s, sugar-protein
complexes contribute to
oxidative damage and deposition
of both amyloid and intracellular
protein tangles. This is
controlled by antioxidant
enzymes, such as glutathione
peroxidase, and the entire
antioxidant system requires
nutrients such as vitamins
C and E, alpha-lipoic acid,
and flavonoids.
Vitamin E can prevent the
oxidative damage to neuronal
cells caused by amyloid.
In the Nurses’ Health
Study, among 15,000 participants,
those who took high-dose
vitamins C and E for the
longest time retained the
highest level of cognitive
function compared to those
with the lowest levels of
intake.
This was a 15-year study,
and it is apparent that
long-term use is important
to get the full benefits
of the supplements. Another
study of vitamins C and
E showed that supplements
led to a 90 percent reduction
in vascular dementia.
Most recently, a study
of 4740 subjects showed
that those who were taking
combined vitamins C and
E were 78 percent less likely
to have AD at the start
of the study. Over the next
four years, those taking
the supplements were 64
percent less likely to develop
AD. The vitamin E doses
ranged from 400 to 1000
IU, and vitamin C from 500
to 1500 mg.
A small, uncontrolled study
of 10 patients with AD showed
that 600 mg of alpha-lipoic
acid, an antioxidant, helped
stop disease progression
for one year. Animal studies
show that a combination
of alpha-lipoic acid and
acetyl L-carnitine reduces
the oxidative damage to
neurological tissues and
protect the mitochondria.
I have reported earlier
that curcumin, an antioxidant
extract from the spice turmeric,
prevents the accumulation
of amyloid in the brain,
and it also improves cognitive
function in AD patients.
I have already reported
that high daily doses of
coenzyme Q10, up to 1200
mg, can reduce the progression
of Parkinson’s disease.
As an antioxidant, coQ10
is another contributor to
brain protection, and would
be expected to provide protection
from dementia.
Ginkgo biloba is also helpful.
In a controlled study of
244 patients for six months,
120 mg of standardized ginkgo
biloba led to a significant
improvement in cognitive
function, activities of
daily living, and social
behavior compared to the
the placebo group, which
worsened.
It is essential to provide
antioxidant protection for
the brain. Proanthocyanidins
and anthocyanins found in
grape seeds and skins, pine
bark, and berries, are other
antioxidants that are able
to cross into the brain.
Research in several tissue
culture studies shows that
they protect cells from
the damaging effects of
amyloid, and therefore might
protect against AD.
Reducing heavy metal exposure
also protects the brain.
Although the link between
aluminum and AD is weak,
this and other metals (lead,
mercury) damage neurons.
Removing them with oral
chelators such as N-acetyl
cysteine, DMSA (succinic
acid), and alpha-lipoic
acid is beneficial.
Although some of the researchers
who find all these benefits
from supplements will say
that they do not yet have
“enough evidence”
to recommend them, the safety
margin is so great that
you would be unwise to wait
to take them until some
researcher gives their approval.
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Q: I have
Crohn’s disease. What
supplements do you recommend?
— MB, Brazil, via
Internet
A. Inflammatory
bowel disease can be devastating,
with bloody diarrhea, abdominal
pain, bloating, fever, loss
of appetite, and malabsorption
of nutrients. Crohn’s
disease incidence is directly
related to intake of sugar,
total fat, animal fat, meat
and milk protein, and omega-6
oil (Shoda R, et al., ...fatty
acids and animal protein
[and] Crohn disease in Japan.
Am J Clin Nutr. 1996 May;63(5):741-5.).
Fiber and vegetable protein
decrease Crohn’s incidence.
Fast foods can triple the
risk! A high-fiber, complex
carbohydrate diet can help
manage this disorder, but
it is important to stay
away from food sensitivities,
including, in many cases,
wheat and other gluten sources,
and dairy products.
Supplements that help the
bowel heal include the amino
acid L-glutamine (3000 to
8000 mg), vitamin C (2000
to 6000 mg), and fish oil
(with 1200 to 2400 mg of
omega-3 oil). The fish oil
and vitamin C are anti-inflammatory,
and the L-glutamine is essential
for the regeneration of
the bowel lining cells.
Gamma linolenic acid (GLA,
240 mg) is also helpful
to reduce inflammation,
as are curcumin (standardized,
300 to 600 mg), and ginger
(standardized, 500 to 750
mg).
Liese
AD, et al., Whole-grain
intake and insulin sensitivity:
.... Am J Clin Nutr. 2003
Nov; 78(5): 965-71.
Liu S,
et al., ...dietary fiber
and grain products and ...development
of obesity ... Am J Clin
Nutr. 2003 Nov; 78(5): 920-7.
Kalmijn
S, et al., Dietary intake
of fatty acids and fish
in relation to cognitive
performance... Neurology.
2004 Jan 27;62(2):275-80.
Kalmijn
S, Fatty acid intake and
the risk of dementia and
cognitive decline:... J
Nutr Health Aging. 2000;4(4):202-7.
Laurin
D, et al., Physical activity
and risk of cognitive impairment
and dementia ... Arch Neurol
2001 Mar;58(3):498-504.
Joseph
JA, et al., Blueberry ...
prevents behavioral deficits
in an Alzheimer disease
model. Nutr Neurosci. 2003
Jun;6(3):153-62.
Verghese
J, et al., Leisure activities
and the risk of dementia
in the elderly. N Engl J
Med. 2003 Jun 19;348(25):2508-16.
Yaffe
K, et al., A prospective
study of physical activity
and cognitive decline in...women...
Arch Intern Med 2001 Jul
23;161(14):1703-8.
Munch
G, et al., Anti-AGEing defences
against Alzheimer’s
disease. Biochem Soc Trans.
2003 Dec; 31(Pt 6): 1397-9.
Yatin
SM, et al., Vitamin E Prevents
Alzheimer’s Amyloid
..Oxidation ... J Alzheimers
Dis 2000 Jun;2(2):123-131.
Masaki
KH, et al., Association
of vitamin E and C supplement
use with cognitive function...
Neurology 2000 Mar 28;54(6):1265-72.
Zandi
PP, et al., Reduced risk
of Alzheimer disease in
users of antioxidant vitamin
supplements... Arch Neurol.
2004 Jan;61(1):82-8.
Hager
K, et al., Alpha-lipoic
acid...for Azheimer type
dementia. Arch Gerontol
Geriatr. 2001 Jun;32(3):275-282.
Liu J,
et al., Memory loss...reversal
by feeding acetyl-L-carnitine
and/or...lipoic acid. Proc
Natl Acad Sci U S A 2002
Feb 19;99(4):2356-61.
Le Bars
PL, A...controlled trial
of the ginkgo biloba extract
EGb 761 in dementia. Dement
Geriatr Cogn Disord 2000
Jul-Aug;11(4):230-7.
Persson
PG, et al., Diet and inflammatory
bowel disease: a case-control
study. Epidemiology. 1992
Jan;3(1):47-52.
- Hospitals are no place
to go for a restful vacation,
as I found out when I
had surgery in March.
A recent study (Reuters,
Feb 4, 2004) showed that
hospital wards could be
as noisy as a rock concert,
or as loud as a chain
saw, preventing patients
from getting adequate
sleep. Sleep is essential
for the healing process,
but it is not easy to
sleep when nurses are
talking, blood tests and
X-rays are being taken,
or equipment is being
banged around. One solution
is to close the door to
the room, which will provide
some help, and politely
ask the staff to be more
quiet.
- The World Health Organization
suggests steps to reduce
obesity in the world’s
population: reducing advertising
of junk to children, and
limiting sodas, other
sugary foods, salt, and
fat. The food industry
dislikes this publicity,
as it might affect the
sales of these deleterious
products. The US government
took issue with this report,
siding with the junk-food
industry. They claim that
“all foods”
can be part of a good
diet (how Twinkies or
Oreos fit in I’ll
never understand). How
can government give support
to junk food and still
fight obesity?
Compared to wild salmon,
most farmed salmon has 40
times the level of toxic
polychlorinated biphenyls
(PCB’s), dioxin, dieldrin,
chlordane, DDT, and other
poisons (Hites RA, et al.,
Global assessment of organic
contaminants in farmed salmon.
Science. 2004 Jan 9;303(5655):226-9).
Researchers took samples
from 16 cities in Europe
and America and found that
contamination was widely
distributed. The benefits
of omega-3 fish oils are
worthwhile, so be sure to
choose wild salmon. (Alaska
does not permit fish farming,
but most fish at the market
is farmed.)
The cold northeast winter
calls for a hearty (and
heart healthy) soup that
is easy and delicious. After
soaking for 4 to 8 hours,
discard the soaking water
(to diminish intestinal
gas), and pressure cook
a combination of chick peas,
black beans, and pinto beans
for about 25 minutes (or
cook until soft in a large
pot). Sauté onions
and garlic in olive oil,
with cumin, cayenne pepper,
thyme, and diced carrots
and celery stalks with the
leaves. Put this mix into
the bean pot with enough
water to make it soup rather
than stew (although either
will be fine) and add chopped
Swiss chard or spinach and
a small amount of soy sauce.
I prefer more veggies than
beans, and I add a large
can or two of organic, Muir
Glen Fire-Roasted tomatoes,
but this depends on your
taste. Simmer all this until
the flavors are well mixed,
and serve with whole wheat
bread.
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