Health Care Business
Folic Acid Update
Macular Degeneration
Update
Pesticides and Parkinson’s
Disease
Ask Dr. J: Sulfa
and Sulfate
References
In The Health News
Diet and Disease
Recipe of the Month:
Yams and Black Bean Salsa
Dear Friends,
I was recently listening to some
business analysis regarding the
state of the economy in the United
States and predictions for its
future. Prominent in the report
were the comments that one of
the “stellar performers”
in the economy was the business
of health care, with the implication
that this was a positive contributor
to national economic growth, and
therefore good.
My mind immediately jumped to
the economist Henry Hazlitt who
noted that it is a common belief
that destruction, such as a vandal
throwing a brick through a shop
window, is a good business stimulant.
After all, he points out, the
shopkeeper then has to spend money
to clean up the mess, buy plywood
to cover the opening until he
can hire the glazier to replace
the glass, the plasterer to repair
the wall, and the painter to finish
the job. This flurry of business
puts money into the hands of each
contractor that they then spend
on other things and the economy
grows.
The fallacy is in ignoring that
the shopkeeper would have spent
that money on other things–a
new suit, a home improvement,
a bicycle for his child–which
would have been just as good for
the economy, without the destruction
of resources (and the associated
headaches and lost time). I am
all for innovation, research,
the development of new devices,
procedures, and safe, effective
medications. However, in the overall
picture, expansion of health care
as a business is an indication
that the health of the population
is worsening, which can’t
be desirable. In addition to the
strain on resources, from hospital
beds, nursing care, physician
time, and medical supplies, as
well as the side effects of expensive
and often unnecessary drugs, this
economic and resource loss in
no way reflects the human tragedy
of illness.
The medical-pharmaceutical complex
in the United States is already
a more than 1.5 trillion dollar
industry, making up a far greater
percentage of overall business
activity (GDP) than in any other
country, but neither health nor
health care is better here than
in many other developed nations
that spend less. High health care
costs result in part from the
high cost of drugs, doctors practicing
defensive medicine (ordering extra
tests, visits, and expert consultations
to protect themselves from lawsuits),
and the high expense of end-of-life
care. However, for the most part,
the expansion of health as a business
reflects the unhealthy lifestyles
that people follow, resulting
in obesity, diabetes, heart disease,
cancer, and other chronic, degenerative
diseases, as well as accelerated
aging.
Controlling health care costs
through health education and lifestyle
change would not be harmful to
the economy, even though the medical
industry would contract. On the
contrary, we would see a more
productive work force and a redirection
of resources toward life-enhancing
activities.
Folic acid (or folate) at doses
that are above what is found in
the typical diet (from greens,
beans and citrus fruits) has many
health benefits, reducing birth
defects, cancer, heart disease,
and other atherosclerotic circulatory
disorders, such as strokes. New
research shows that folate is
also valuable for preserving brain
function in elderly people, and
at a dose that is most likely
to come from supplements rather
than food alone.
Folic acid supplements lower
serum homocysteine levels. Homocysteine
has been associated with an increased
risk of atherosclerosis, strokes,
and congestive heart failure.
In addition, in patients who have
had balloon angioplasty, the likelihood
of those vessels closing up again
(restenosis) is much greater if
homocysteine levels are high,
and this risk is reduced by folate
supplements (along with B6 and
B12, which also help to lower
serum homocysteine levels). Other
research shows that low folate
is associated with arterial damage
independent of homocysteine.
Earlier studies have shown an
association of low levels of folate
with an increased incidence of
Alzheimer’s disease (AD).
These patients have a higher level
of homocysteine (a neurotoxin),
indicating that this is a risk
factor for AD as well as heart
disease. One study showed that
patients with the lowest folate
levels had triple the risk of
AD compared to those with the
highest levels, and low levels
were associated with faster progression
of the disease. The researchers
suggested that people take 500
to 5000 mcg (5 mg) of folate supplementation.
(Vitamin B12, which also lowers
homocysteine levels, showed a
similar association with AD.)
Research also suggests that folate
can prevent and treat depression.
People with low folate levels
are more likely to have clinical
depression. Depressed patients
treated with Prozac respond sooner
and they are less likely to have
relapses if they have adequate
folate levels. A study of 123
patients with acute psychiatric
disorders, including depression
and schizophrenia showed a significant
response if they were given high
dose supplements (15 mg) of a
form of folate.
The new study shows that folate
supplements can enhance memory
and slow the decline seen with
aging. Researchers studied 818
people with normal brain function,
aged 50 to 75 years old, and gave
them either a placebo or 800 mcg
of folate for three years. Those
on the supplements, (well above
the usual recommended amount)
had better memory scores, comparable
to people 5.5 years younger. (To
prevent memory decline, it also
helps to keep the brain active,
do regular physical exercise,
and maintain social interactions.)
Some high-potency multivitamin
formulas contain 800 mcg of folate.
Doses of 5 to 20 mg of folate
may have additional benefits.
Macular degeneration, an age-related
deterioration of the retina with
declining visual function, can
be reduced with better nutrition
and dietary supplements, such
as the carotenoid lutein, trace
minerals, and vitamins C and E
and beta-carotene. It may also
be beneficial to take supplements
that help small vessel circulation,
such as ginkgo biloba.
New research shows that in combination
even small doses of coenzyme Q10,
acetyl L-carnitine, and omega-3
oils can reverse some early signs
of macular degeneration and prevent
progression. These nutrients all
influence mitochondrial function
and enhance cellular energy production.
Also, macular degeneration might
result from compromised circulation
to the retina, and these supplements
may help circulation.
In this double-blind study of
106 patients, half were given
the supplement combination and
half a placebo and they were followed
for one year. The subjects given
the supplement improved in every
parameter that was evaluated,
including changes in visual field
defects, visual acuity, sensitivity
of the retina in the most sensitive
area, and the anatomical appearance
of the retina.
In the supplement group, only
one patient had disease progression,
while nine patients in the placebo
group worsened. An earlier pilot
study had suggested these benefits,
but this was the first controlled
study to show these results.
These nutrients have a number
of other health benefits, including
benefits for the heart, the brain,
circulation, and immune function.
Combining them with other antioxidants
and trace minerals as part of
a total health program will help
to preserve and restore eyesight.
Pesticides are not confined to
commercial farms and gardens.
They are commonly used in and
around the home, and particularly
in both flower and vegetable gardens.
However, you don’t have
to be a farmer to be damaged by
exposure to these toxic compounds.
A team of researchers studying
2756 people in five European countries
published their findings in New
Scientist (www.newscientist.com/channel/health/mg18625014.900).
They found that exposure to pesticides
was directly related to the risk
of developing Parkinson’s
disease.
The researchers suggested that
people using pesticides should
wear protective clothing, but
a far better choice would be to
practice organic gardening, eliminating
the use of toxic pesticides entirely.
These substances are neurotoxins
and likely carcinogens, and they
also damage the soil and the beneficial
organisms in the soil that help
to control pests. In addition,
residues of pesticides get into
the food supply, poisoning consumers,
and children playing in the garden
are even more likely to be exposed
to high levels.
People concerned about Parkinson’s
disease, especially those with
a family history of the condition,
should consider eating organic
foods and especially legumes,
which are protective. They should
also take supplements of vitamins
C and E, and particularly high
doses of coenzyme Q10, which have
been shown to protect the brain.
Q. I am beginning
to have osteoarthritis, but I
am allergic to sulfa drugs. Can
I still take glucosamine sulfate?
—TW, via email
This is a common confusion. Sulfa
drugs (a class of antibiotics
more properly called sulfonamides)
contain sulfur deeply embedded
in a complex structure that also
contains nitrogen, carbon and
other elements. They are effective
for many bacterial urinary tract
and other infections, but many
bacteria are now resistant to
these medications. They are also
often used to treat inflammatory
bowel disease.
Sulfa drugs do have side effects
though, and many people are allergic
to them. However, it is not the
sulfur itself that causes allergies
to these drugs but the entire
complex molecule to which some
people react.
Sulfur is a required nutrient
present in many foods, such as
beans, eggs, dairy products, fish,
garlic, and onions, and it is
essential for protein production
(hair, skin, muscles, collagen),
bone formation, and bile production
to aid digestion. It is a component
of many important nutrients, such
as glutathione, taurine, cysteine,
and alpha-lipoic acid with its
antioxidant activity and support
in detoxifying heavy metals.
Glucosamine sulfate is unrelated
to sulfa drugs other than having
sulfur as one component. You should
still be able to take it safely
for arthritis (typically 1500
to 2000 mg daily). Some people
report hypersensitivity to this
and other dietary supplements.
If that is your situation, try
any combination of alternatives
such as vitamin B3 (niacinamide,
1500 to 3000 mg), SAMe (200 to
800 mg), fish oil containing omega-3
oil (1200 to 2400 mg of EPA/DHA),
and MSM, another sulfur source
(1500 to 3000 mg) that helps arthritis.
Hazlitt, Henry,
Economics in One Lesson, Harper
& Brothers, 1946
President Bill
Clinton Interview, Talk of The
Nation Science Friday, National
Public Radio, June 3, 2005
Study: Folic
Acid May Aid Seniors’ Memory,
Alzheimer’s Association
International Conference on Prevention
of Dementia, Washington, D.C.,
June 18-21, 2005, as reported
in WebMD Health
Durga J, Low
concentrations of folate, not
hyperhomocysteinemia, are associated
with carotid intima-media thickness.
Atherosclerosis. 2005 Apr;179(2):285-92.
Seshadri S,
et al., Plasma homocysteine as
a risk factor for dementia and
Alzheimer’s disease. N Engl
J Med. 2002 Feb 14;346(7):476-83.
Wang HX, et
al., Vitamin B(12) and folate
in relation to...Alzheimer’s
disease. Neurology. 2001 May 8;56(9):1188-94.
Snowdon DA,
et al., Serum folate and the severity
of atrophy of the neocortex in
Alzheimer disease: findings from
the Nun study. Am J Clin Nutr.
2000 Apr;71(4):993-8.
Clarke R, et
al., Folate, vitamin B12, and
serum total homocysteine levels
in confirmed Alzheimer disease.
Arch Neurol. 1998 Nov;55(11):1449-55.
Godfrey PS,
et al., Enhancement of recovery
from psychiatric illness by methylfolate.
Lancet. 1990 Aug 18;336(8712):392-5.
Papakostas
GI, et al., The relationship between
serum folate, vitamin B12, and
homocysteine levels in major depressive
disorder... Int J Neuropsychopharmacol.
2005 May 9;1-6 [Epub ahead of
print]
Papakostas
GI, et al., Serum folate, vitamin
B12, and homocysteine in major
depressive disorder... J Clin
Psychiatry. 2004 Aug;65(8):1096-8.
Feher J, et
al., Improvement of visual functions
and fundus alterations in early
age-related macular degeneration
treated with a combination of
acetyl-L-carnitine, n-3 fatty
acids, and coenzyme Q10. Ophthalmologica.
2005 May-Jun;219(3):154-66.
Age-Related
Eye Disease Study Research Group.
A...trial of high-dose supplementation...for
age-related macular degeneration
and vision loss: Arch Ophthalmol.
2001 Oct;119(10):1417-36.
Weight loss of even moderate
amounts reduces the likelihood
of developing high blood pressure.
Obese middle aged subjects who
lost 15 pounds decreased the risk
by 21 percent, while older subjects
fared even better, with a 29 percent
risk reduction. (Moore LL, et
al., Weight loss in overweight
adults and the long-term risk
of hypertension: the Framingham
study. Arch Intern Med. 2005 Jun
13;165(11):1298-303.) Even as
little as 4 pounds reduction in
weight made a significant difference.
The data were derived from the
Framingham study, and evaluated
1228 overweight adults.
Hypertension increases heart
and kidney disease and strokes
and shortens life. It reduces
lifespan by five years, and adds
seven years of heart disease.
Researchers followed 3128 subjects
for 28 years. (Franco OH, et al.,
Blood Pressure in Adulthood and
Life Expectancy With Cardiovascular
Disease...Hypertension 2005 August;
online 27 June.) These effects
were much greater than previously
thought. Blood pressure rises
with poor diet, obesity, and lack
of exercise, and is helped with
many dietary supplements, including
coQ10, vitamins C and E, and magnesium,
among others.
Eating more than 5 to 6 ounces
of red meat per day increases
the risk of developing bowel cancer,
according to a large study of
478,040 men and women from 10
European countries followed for
five years. Fish consumption in
the same group was associated
with a reduction in risk. The
researchers estimated that the
risk was about 40 percent increased
in the meat eaters and 30 percent
reduced in the fish eaters. Processed
meat consumption was associated
with an even higher risk. (Norat
T, et al., Meat, fish, and colorectal
cancer risk: the European Prospective
Investigation into cancer and
nutrition. J Natl Cancer Inst.
2005 Jun 15;97(12):906-16.)
After cutting into 1-inch cubes,
steam some sweet potatoes or garnet
yams until soft. Make salsa with
diced tomatoes, organic fresh
or frozen sweet corn, chopped
onions, crushed garlic, minced
fresh cilantro, cumin, fresh diced
hot peppers or powdered cayenne,
chili powder, and a small amount
of olive oil, lemon or lime juice
(or cider vinegar), and a pinch
of salt if you choose. Add a small
amount of cooked black beans (pressure
cook them for 20-25 minutes to
save hours of cooking time; or
you can use organic canned beans).
You can vary any of the amounts
to taste. (In a pinch, you can
buy jars of organic black bean
and corn salsa.) Mix the salsa
and yams and let it sit in the
refrigerator for a while to infuse
the flavors. This can be served
chilled with some organic whole
wheat or corn tacos, or as a side
dish for those summer cookouts.
