Supesize the USA,
et al.
Protecting Your Skin
Lifestyle/Supplements
for Skin
Topical Skin Treatments
Ask Dr. J: Bursitis
References
In the Health News
Diet and Disease
Recipe of the Month:
Mexican Bean-Stuffed Tortilla
Dear Friends,
Dear Friends,
The success of the recent film
“Supersize Me” has
brought wide attention to the
problem of fast foods and obesity.
Although McDonald’s claims
that their nearly simultaneous
elimination of supersize portions
had nothing to do with the film,
the timing would make this a “supersize”
coincidence. The rise of obesity
in the US and in other countries
was revealied as parallel to the
increase in fast food outlets
in the book, Fast Food Nation,
just a couple of years ago.
Now, Congress is reviewing legislation
to control what kinds of foods
are served in schools as an effort
to stem the tide of obesity, diabetes,
and degenerative diseases that
are increasingly seen in young
people. In fact, by the time kids
are 15 to 19 years old, they already
have atherosclerotic plaque in
their arteries (50 percent of
their right coronaries and 100
percent of their aortas). This
is not genetic. It is the result
of lifestyle, particularly sedentary
lives in cars and in front of
televisions and computer games,
combined with high-calorie junk
in the diet instead of food.
Even though the government and
many health organizations have
been sounding the alarm in the
past decade about the serious
problem posed by rampant obesity,
the government has contributed
to the problem through the school
lunch program. They have done
little in the way of education
or financing to promote healthier
eating or to limit the amount
of fat, sugar, and other junk
that dominate the caloric intake
of kids.
The only way to prevent this
accelerating decline in health,
and consequent increase in health
care costs, is through education.
As long as people choose harmful
products from the marketplace,
the companies who make them will
continue to do so. It is encouraging
that organic foods are the fastest
growing segment of the grocery
industry. However, this is not
enough when dietary junk is also
growing and infiltrating other
countries. (As these western habits
invade other countries, it becomes
apparent that one of the most
successful exports from the US
is disease.)
We can help by choosing whole,
natural foods in our own diets
and setting the example for others.
Choosing lots of vegetables, fresh
fruits, and other high fiber foods
is a good start. The more we choose
better foods, the more the industry
will provide them for us. We can
also help by being active in schools
to promote the availability of
healthier foods in the school
meals and limiting the vending
machine junk and soft drinks that
are little more than “liquid
candy.”
It is also important to encourage
increased physical activity in
children. That way they will not
wake up at 30 years old realizing
that they are 30 to 50 pounds
or more overweight and having
the difficult task of starting
so late on the path to health.
It is easier to start early, but
it is never too late.
The skin is a remarkable organ
and the largest in the body. It
provides a protective barrier
from the elements, helps to regulate
body temperature, and blocks infectious
organisms. It also eliminates
toxins, acts as a sensory organ,
and very importantly, allows exposure
of cholesterol derivatives to
ultraviolet for the manufacture
of vitamin D (cholecalciferol).
Each square inch of skin has
up to 650 sweat glands, sebaceous
glands, numerous nerves and blood
vessels, 65 hair follicles, and
melanocytes– the pigment
cells. It also contains fat and
connective tissue that is both
structural and elastic, allowing
the skin to stretch. Men tend
to have somewhat thicker skin
than women.
Because the skin is highly exposed,
it is also subject to numerous
degenerative problems. This is
partly because in acting as the
defense barrier for our internal
organs the skin itself is readily
affected by toxins and radiant
energy. In addition, the skin
is a rapidly growing tissue, so
it is particularly vulnerable
to some toxins, such as chemotherapy
drugs.
With aging and exposure to the
elements, the skin is less able
to retain water and is damaged
by oxidation and ultraviolet light,
becoming wrinkled and dry. It
also loses elasticity due to poor
nutrition, such as lack of zinc
and adequate vitamin C, which
may lead to poor collagen and
elastin production.
The leathery skin of people who
have spent their lives outdoors,
and the dry, wrinkled appearance
of those who smoke is evidence
of the damage of ultraviolet and
free radical exposure. Other sources
of free radicals damage the skin
as well as internal organs, so
the skin is only the most visible
evidence of the aging process.
Maintaining a strong, elastic,
and youthful skin is valuable
for both cosmetic and health reasons.
Everyone wants to look their best,
but in this case, appearance is
the result of maintaining the
integrity of the connective tissue
and protecting ourselves from
free radical damage.
While we need sun exposure, it
is all too easy to overdo it.
Excessive sun exposure causes
sunburn, photodamage, and skin
cancers, as well as an aged appearance.
If you plan to be outdoors for
extended times, protect yourself
with clothing, a hat, and sunscreen
with protection from both UVB
and UVA (such as oxybenzone, avobenzone,
zinc oxide, and titanium dioxide).
It is important to have some sun
exposure in order to make vitamin
D. It is easy to be overly assiduous
in avoiding the sun or wearing
sunblock, leading to inadequate
vitamin D production.
Diet also plays a role in protecting
the skin. Actinic keratosis (AK)
is a skin cancer precursor related
to sun overexposure. In people
who are prone to develop AK, switching
to a low-fat diet can markedly
reduce the recurrence rate. In
two studies, those who changed
to 20 percent fat had less than
one third the recurrences compared
to those who stayed on their 40
percent fat diet.
Vegetables and fruits are high
in antioxidants that help protect
the skin from free radical damage
and aging. Vitamins C and E, bioflavonoids,
and omega-3 fatty acids, selenium,
and carotenoids all provide such
protection. Beta-carotene, lycopene,
tocopherol, and selenium administered
for seven weeks improved epidermal
defenses and reduced the evidence
of skin damage from ultraviolet
exposure, including redness, sunburn,
and peroxide formation.
Dietary sugar leads to sugar-protein
complexes, or advanced glycation
endproducts (AGE), and cross-linking
of collagen, contributing to skin
wrinkling. Reduction of sugar
and refined carbohydrates is important
to protect the skin and other
organs. Fiber in the diet slows
the conversion of carbohydrates
to sugar. L-carnosine supplements
reduce the production of AGEs.
L-carnosine also has antioxidant
and free-radical scavenging properties
that protect DNA. Other antioxidants
likely to be helpful in preserving
healthy skin include proanthocyanidins,
coenzyme Q10, and alpha-lipoic
acid.
Advertising for skin care products
is full of hyperbolic and unjustified
claims for restoring youthful
looks, and you should be wary
of these products. However, some
products do help preserve healthy
skin and prevent cancer. Topical
preparations that contain antioxidants
penetrate the skin and protect
deeper layers. Products containing
both vitamins C and E, as well
as N-acetyl cysteine, offer enhanced
antioxidant protection compared
to any of them alone.
Topical coenzyme Q10 has been
shown to reverse photodamage,
decrease epidermal oxidation by
UV, and reduce wrinkle depth.
It protects against the damage
from UVA and suppresses the enzyme
that breaks down collagen. Some
studies also suggest benefits
from topical application of alpha-lipoic
acid, green tea extract, silymarin
from milk thistle, and ginger.
These ingredients are found in
a variety of skin care products,
including some sunscreens, but
they need more than token amounts
to be effective.
Controversy surrounds sun protection
for several reasons. As noted
above, sun is essential for vitamin
D production, and vitamin D appears
to prevent some cancers, such
as breast, prostate, ovarian,
and colon. Sunscreens may not
protect against melanoma and basal
cell cancers. Vitamin D appears
to be important to prevent basal
cell and squamous cell cancer.
Depending somewhat on sun exposure,
I advise taking supplements of
400 to 1000 IU of vitamin D.
If a sunscreen blocks only UVB,
it allows people to stay in the
sun longer without burning, but
it allows the UVA rays to penetrate
the skin for a longer time. UVA
will cause skin aging, wrinkling,
and skin cancer. Even without
burning, excessive sun exposure
is dangerous.
In summary, wear appropriate
clothing for protection, wear
UVB and UVA sunscreen for extended
sun exposure, eat a high-antioxidant,
low-fat diet, take supplements,
and apply topical antioxidants
to the skin.
Q. I have hip
bursitis, which is painful and
limits my activitiy. I prefer
not to take steroid injections,
and I don’t want to take
Vioxx. Do you have any suggestions?
—RB, Florida, via Internet
A. A bursa is
a fluid-filled sac between a tendon
and a bone or a tendon and skin
that helps to reduce friction
and aid movement. Trochanteric
bursitis is inflammation of the
bursa of the hip.
Bursitis can be painful and debilitating,
restricting motion of the involved
joint, with tenderness and swelling.
It can be brought on by injury
from falls or contact sports,
overuse, as in tennis elbow, by
infection, or rheumatiod arthritis.
It can be acute, or can persist
as chronic bursitis.
In hip bursitis, the pain can
radiate down the thigh and it
can also interfere with sleep.
Typical treatments include rest,
caution when getting up or down
in chairs, and anti-inflammatory
drugs or steroid injections. I
prefer to start with natural anti-inflammatories,
such as standardized curcumin,
(300 to 600 mg twice a day), standardized
ginger (250 to 500 mg), and bromelain
enzyme (10,000 mcu 2 to 3 times
daily).
Fish oil, as a source of omega-3
EPA and DHA, is also an effective
anti-inflammatory. Capsules with
300 mg of omega-3 (from 1000 mg
of fish oil) are commonly available.
Typical doses range from 2 to
4 capsules, 2 to 3 times per day.
GLA from borage oil may also help.
I also recommend high doses of
vitamin C (4000 to 8000 mg per
day). You mentioned heartburn
from some of your supplements,
so I suggest taking L-glutamine
(1000 to 2000 mg) along with your
herbs and vitamins, and being
careful to avoid sugar, caffeine,
and alcohol.
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Metabolic syndrome consists of
insulin resistance with abdominal
obesity, high blood pressure,
elevated blood sugar, and high
cholesterol, and contributes to
an increased risk of diabetes,heart
disease, and early death. Regular
exercise reduces this mortality.
In a sample of 19,223 men, all-cause
and cardiac mortality was much
higher among those with metabolic
syndrome. However, high fitness
levels eliminated the difference.
(Katzmarzyk PT, et al., Cardiorespiratory
fitness attenuates the effects
of the metabolic syndrome on all-cause
and cardiovascular disease mortality
in men. Arch Intern Med. 2004
May 24;164(10):1092-7.) This indicates
that exercise can overcome the
effects of insulin resistance.
a. Age-related macular degeneration
is a leading cause of blindness
in the elderly. The risk of macular
degeneration is greatly reduced
by increasing fruit consumption.
In two large studies of over 100,000
subjects followed for 12 to 18
years, researchers found that
those who consumed three or more
fruits per day had a 36 percent
lower incidence of neovascular
macular degeneration compared
to those who consumed less than
1.5 fruits per day. (Cho E, et
al., Prospective study of intake
of fruits, vegetables, vitamins,
and carotenoids and risk of age-related
maculopathy. Arch Ophthalmol.
2004 Jun;122(6):883-92).
b. A recent analysis of the overall
(lipophilic and hydrophilic) antioxidant
capacity of foods shows a very
high value for blueberries, other
berries, pears, plums, and apples.
Nuts (pecans and walnuts), beans
(kidney, pinto, and red), and
spices were also very high. Somewhat
surprisingly, perhaps due to vitamin
C, russet potatoes are rich in
antioxidant activity, diminished
only a little by cooking. (Wu
X, et al., Lipophilic and hydrophilic
antioxidant capacities of common
foods in the United States. J
Agric Food Chem. 2004 Jun 16;52(12):4026-37.)
Pressure-cook some red, kidney,
or pinto beans (with that high
antioxidant activity) for 20 minutes,
and then sauté them until
well mixed with garlic and onions,
chili powder, cayenne pepper to
taste, olive oil, soy sauce, and
some crushed tomatoes. (Alternatively,
you can buy cans of organic refried
beans.) Make some guacamole with
mashed ripe avocado, blending
in some fresh crushed garlic,
fresh lemon or lime juice, and
minced onion and tomato. Spread
some of the beans and guacamole
on a warmed whole-wheat or corn
tortilla, and then add some shredded
lettuce, minced cilantro, diced
fresh bell peppers, and tomatoes.
(If you like, you can top this
with a sprinkle of organic grated
cheddar cheese.) Fold it over
and enjoy a Mexican “sandwich.”
The last time I made this, I had
some freshly cooked brown and
wild rice that I added to the
filling.
