Organic
Vegetarian
Travel
Too
Many Vitamins??
Multivitamins-Multi-Benefits
Tap
Water & Bladder
Cancer
Ask
Dr. J:
Melatonin & Diabetes
References
In
the Health
News
Diet
and Disease
Recipe
of The Month:
Noodles,
Greens, and
Beans
Dear Friends,
On a recent
trip to England
to see friends
in London
and attend
a wedding
in Bath,
I was pleasantly
surprised
at how easy
it was to
eat according
to the healthy
principles
that I have
followed
for the past
31 years.
I always
make special
efforts when
traveling,
taking my
own food
on the plane,
for example,
but I know
it can be
difficult
to eat healthfully
in some circumstances.
Before I
left, I learned
that Whole
Foods Market
had taken
over seven
health stores
in England,
including
six in London.
Also in London,
I found a
large health
store called
Planet Organic
(with three
stores in
London).
At their
deli they
served prepared
foods, from
salads and
soups to
entrées,
all made
with whole,
organic ingredients.
(Unfortunately,
Whole Foods
Markets deli
foods are
usually not
whole, as
they are
often made
with white
rice and
white flour,
and organic
foods are
unusual.)
At Planet
Organic,
I was able
to sit down
to eat some
delicious
foods and
take some
home to share
with the
friends at
whose house
I was staying.
I also found
some healthy
food at Neal’s
Yard, a quaint
little shopping
area in Covent
Garden. Two
restaurants
served whole,
vegetarian
fare, including
a selection
of salads,
and one also
had a variety
of wheat-free
baked goods
for food-allergic
people. The
food was
not organic,
but this
is a compromise
that travel
sometimes
requires.
An occasional
compromise
is not my
concern,
but rather
the everyday
practices
that are
with us all
the time.
The food
was delicious
and healthful;
I never recommend
giving up
pleasure
for health,
as I know
people won’t
do it, and
they don’t
have to.
It is interesting
that in England
even many
of the supermarkets
carry a variety
of organic
foods, and
one department
store (Marks
and Spencer’s)
has a food
section with
both fresh,
organic produce
and a selection
of prepared
salads (on
my last day,
I stopped
at a gas
station that
carried these
fresh salads
in their
food section,
an experience
that would
shock me
here).
Bath is
a beautiful
city, with
Roman baths,
elegant architecture,
a magnificent
cathedral,
and the wonderful
meandering
Avon river.
It also has
a good health
food store,
two supermarkets
with organic
foods, and
a superb
organic vegetarian
restaurant
(Demuth’s),
in business
since 1970
(they do
serve white
rice, but
will serve
brown rice
if you call
a day ahead
and request
it). On a
day trip
to Stonehenge,
the tour
stopped in
Avebury,
and a small
village called
Lacock (voted
the prettiest
village in
England),
where we
stopped at
a pub for
lunch. Having
prepared
for the trip
by making
food, I was
delighted
to find that
the pub had
three different
vegetarian
selections
(it seems
that the
demand for
this is strong
in England),
and they
offered at
least part
whole wheat
in one of
the meals.
I was able
to save the
food I had
made for
dinner that
evening.
While staying
healthy during
travel can
be difficult,
it is by
no means
impossible
with a little
effort—less
effort in
England than
I have found
elsewhere.
According
to a report
released
by the Institute
of Medicine,
Americans
may be taking
too many
vitamins.
A panel of
13 “experts” suggested
that while
over half
of Americans
take vitamins,
hoping to
live longer,
healthier
lives, “we
don’t
know for
sure that
they’re
benefiting
from them.” This
is part of
a recent
spate of
journal articles
and journalistic
reports criticizing
many common
supplements
that have
good data
supporting
their use
for various
conditions.
The data
supporting
the value
of many supplements
is quite
clear, whether
for treating
disease,
preventing
disease,
or simply
feeling better.
The report
noted that
the most
likely vitamin
consumers
were better
nourished,
in a higher
socio-economic
group, and
better educated,
and thus
less likely
to need the
supplements.
More poorly
nourished
people are
least likely
to take supplements.
Of course,
the fact
that people
who are more
likely to
need supplements
are less
likely to
take them
is due in
part to misleading
reports like
this one.
The report
says that “there
are no good
studies showing
people who
take multivitamin
or mineral
supplements
can prevent
chronic diseases
such as cancer
and heart
disease.” This
is simply
untrue. The
large Nurses’ Health
Study showed
that subjects
who consumed
the most
vitamin E
(primarily
from supplements)
had a 34
percent lower
heart disease
mortality
than those
with the
lowest intake,
and for those
who took
vitamin E
supplements
for more
than two
years, mortality
was reduced
by 41 percent.
A 2004 journal
article suggested
that certain
nutrients
protect the
heart from
stress and
age-associated
decline in
function.
These include
coenzyme
Q10, alpha-lipoic
acid, magnesium,
and omega-3
fatty acids.
A previous
report by
these same
researchers
showed protection
of the heart
with supplements
of coenzyme
Q10.
Other research
shows benefits
from taking
multivitamins
and multiminerals.
For example,
a study of
178 patients
with small-cell
lung cancer,
a very aggressive
tumor, showed
that those
who took
multivitamin-mineral
supplements
survived
40 percent
longer than
those who
did not.
This tumor
has 99 percent
mortality
at one year.
This does
not mean
that supplements
were a cure,
but that
they prolonged
survival.
In other
tumors and
with other
dietary supplements,
cures may
be possible,
as I noted
last month.
A previous
study of
patients
with the
same tumor
showed that
if they were
given high-dose
antioxidants,
trace minerals,
and essential
fatty acids
that survival
was dramatically
increased.
The expected
survival
was one percent
at the end
of one year,
but 8 of
these 18
patients
were alive
when the
study concluded
at almost
3 years.
Maybe the
evidence
is not conclusive
(it rarely
is for almost
any treatment),
but it is
so strongly
suggestive,
and supplements
are so safe
and relatively
cheap, that
it is sufficient
evidence
for those “educated
and better
nourished” people
who have
decided to
take supplements.
A prospective
study of
over a million
adult Americans
showed that
those who
took a combination
of multivitamins
and vitamins
A, C, or
E had a 15
percent reduction
in mortality
among non-smoking
men. Supplements
of L-carnitine
can dramatically
help patients
with heart
attacks.
In a study
of 101 heart
attack patients,
the group
given 2 gms
of L-carnitine
per day had
half as many
deaths and
half as many
recurrent
heart attacks
as those
given a placebo,
and they
had far less
heart failure
and fewer
arrhythmias.
Research
showed that
in patients
with AIDS
supplements
of multivitamins
slowed the
progression
of the disease
and delayed
the need
for anti-retroviral
drugs. Among
1078 women
in this double-blind,
placebo-controlled
study, multivitamins
improved
T-cell counts
and lowered
levels of
viruses.
Other research
has also
showed benefits
in AIDS patients
from taking
multivitamins.
In pregnant
women, fetal
death was
2/3 higher
among those
not taking
supplements.
A study
of age-related
eye disorders
(AREDS) showed
that supplements
of vitamins
C, E, zinc,
and beta-carotene
prevent or
delay the
progression
of macular
degeneration
(ARMD). Another
study showed
that people
with the
highest levels
of lycopene
(a carotenoid
antioxidant)
have the
lowest rate
of ARMD.
No conventional
medical treatment
is available
for macular
degeneration.
In addition,
those with
ARMD have
a higher
mortality
than those
without the
disease.
Loss of vision
is the most
feared disability,
so anything
that might
help would
be of great
value. Telling
people that
they may
be taking “too
many” vitamins
may deprive
large numbers
of people
of the benefits
that are
likely with
virtually
no risk.
In recent
months, medical
and news
reports have
made it appear
that many
supplements
are ineffective.
Policosanol
for cholesterol,
St. John’s
wort for
depression,
ginkgo for
memory, vitamin
E for the
heart, glucosamine
sulfate for
arthritis,
saw palmetto
for the prostate,
and antioxidants
have all
come under
attack. It
is hard to
avoid the
thought that
these are
all competing
with expensive,
highly touted
drugs, and
that this
has something
to do with
the reports.
Now even
multivitamin-mineral
supplements
have been
assailed.
While it
is true that
not all studies
support extensive
benefits
of multivitamin
supplements,
the evidence
of benefit
is significant,
and they
are incredibly
safe. Most
people would
benefit by
taking a
variety of
supplements,
and it is
unwise to
wait for
the government
to say it
is OK.
A new review
shows that
consumption
of tap water
increases
the risk
of bladder
cancer. People
who consumed
more than
two liters
of tap water
had a 46
percent higher
risk of bladder
cancer than
those who
consumed
less than
a half liter
per day (and
it was even
higher among
men). Chlorine
in tap water
combines
with organic
matter to
create harmful
substances,
including
trihalomethane
(THM).
Researchers
evaluated
2729 patients
with bladder
cancer and
5150 controls.
The researchers
found that
total fluid
intake was
not associated
with any
increase
in risk,
including
other sources
of water,
such as filtered
or bottled
waters. In
this study,
THM exposure
was independent
of the increased
risk of bladder
cancer, so
other contaminants
that are
carcinogenic
must be present.
As in some
other studies,
this research
showed a
greater risk
of bladder
cancer associated
with coffee
consumption.
More than
five cups
a day significantly
increased
the risk.
Previous
studies have
shown that
THM is an
independent
risk for
bladder cancer.
The level
of THM in
tap waters
of developed
countries
is directly
related to
chlorination,
and cumulative
exposure
increases
the risk.
Bottled and
filtered
waters are
better choices.
Q. Can I
take melatonin
if I am being
treated for
adult-onset
diabetes?
Can I use
it to help
sleep?
MH, California,
via internet
A. Melatonin
is the pineal
gland hormone
that regulates
the body
clock, promotes
sleep, prevents
jet lag,
and helps
mood. As
an antioxidant,
it also protects
the brain
and other
tissues.
While one
small study
suggests
a possible
negative
effect of
melatonin
on insulin
activity,
the bulk
of the evidence
indicates
that melatonin
is actually
helpful for
diabetics.
It protects
the beta
cells in
the pancreas
by reducing
oxidative
stress.
Typical
doses of
melatonin
range from
1 to 3 mg
just before
bedtime,
using timed
release tablets
if you fall
asleep easily
and wake
up too early.
You can monitor
your blood
sugar to
make sure
it does not
cause problems
for you.
Other natural
sleep aids
include magnesium
(300-800
mg), valerian
(200-400
mg of standardized
extract),
5-hydroxy
tryptophan
(5-HTP, 50-100
mg), and
possibly
passion flower,
hops, or
skullcap.
Stampfer
MJ, et al.,
Vitamin E
consumption
and the risk
of coronary
disease in
women. N
Engl J Med.
1993 May
20;328(20):1444-9.
Rosenfeldt
FL, et
al., Coenzyme
Q10 protects
the aging
heart against
stress: studies
in rats,
human tissues,
and patients.
Ann N Y Acad
Sci. 2002
Apr;959:355-9;
discussion
463-5.
Rosenfeldt
F, et al.,
Response
of the senescent
heart to
stress: clinical
therapeutic
strategies
and quest
for mitochondrial
predictors
of biological
age. Ann
N Y Acad
Sci. 2004
Jun;1019:78-84.
Singh
RB, et al.,
A randomised,
double-blind,
placebo-controlled
trial of
L-carnitine
in suspected
acute myocardial
infarction.
Postgrad
Med J. 1996
Jan;72(843):45-50.
Jatoi
A, et al.,
Exploring
vitamin and
mineral supplementation
and purported
clinical
effects in
patients
with small
cell lung
cancer...
Nutr Cancer.
2005;51(1):7-12.
Jaakkola
K, Treatment
with antioxidant
and other
nutrients
in combination
with chemotherapy
and irradiation
in patients
with small-cell
lung cancer.
Anticancer
Res. 1992
May-Jun;12(3):599-606.
Watkins
ML, Multivitamin
use and mortality
in a large
prospective
study. Am
J Epidemiol.
2000 Jul
15;152(2):149-62.
Fawzi
WW, et al.,
A randomized
trial of
multivitamin
supplements
and HIV disease
progression
and mortality.
N Engl J
Med. 2004
Jul 1;351(1):23-32.
Fawzi
WW, et al.,
Randomised
trial of
effects of
vitamin supplements
on pregnancy
outcomes
and T cell
counts in
HIV-1-infected
women in
Tanzania.
Lancet. 1998
May 16;351(9114):1477-82.
Mares-Perlman
JA, et al.,
Serum antioxidants
and age-related
macular degeneration.
Arch Ophthalmol
1995 Dec;113(12):1518-23.
Villanueva
CM, Total
and specific
fluid consumption
as determinants
of bladder
cancer risk.
Int J Cancer.
2006 Apr
15;118(8):2040-7.
Villanueva
CM, et al.,
Disinfection
byproducts
and bladder
cancer: a
pooled analysis.
Epidemiology.
2004 May;15(3):357-67.
Kunze
E, et al.,
Life style
and occupational
risk factors
for bladder
cancer in
Germany.
A case-control
study. Cancer.
1992 Apr
1;69(7):1776-90.
a. Some
medications
used to control
blood pressure
appear to
increase
the risk
of developing
adult onset
diabetes.
In three
studies with
75,000 subjects,
beta-blockers
and diuretic
drugs (thiazides),
led to a
20 to 45
percent higher
incidence
of diabetes
(Taylor EN,
et al., Antihypertensive
medications
and the risk
of incident
type 2 diabetes.
Diabetes
Care. 2006
May;29(5):1065-70).
Calcium channel
blockers
and ACE inhibitors
were not
associated
with this
risk. Moderate
hypertension
can usually
be controlled
with diet,
exercise,
weight loss,
and a number
of supplements,
including
magnesium,
coenzyme
Q10, vitamin
C, fish oil,
and garlic,
among others.
Unless the
blood pressure
is at crisis
levels, it
is better
to try natural
treatments
first. Diabetes
increases
cardiac risks
and speeds
aging.
b. School
lunches in
England are
taking a
turn for
the better.
The government
announced
that, starting
this year,
they will
serve no
sodas, or
chocolate,
and no “low-quality” meats,
and they
will provide
at least
two servings
of fruits
and vegetables.
They will
also limit
deep fried
foods, such
as potato
chips, to
no more than
twice a week.
Schools will
no longer
have vending
machines
selling junk.
This is a
good start,
and sets
a good example
for other
countries.
(Chips only
twice a week
for English
school kids.
Reuters,
May 19, 2006.)
High sugar
consumption
increases
the risk
of breast
cancer. Women
with the
highest levels
of sugar
intake had
1.19 times
the risk
of breast
cancer. The
relative
risk increase
is small,
but the problem
is that risks
are additive,
and people
who eat high
sugar diets
usually also
have other
dietary habits
that increase
their risks
through chemical
and animal
fat exposure.
(Tavani A,
et al., Consumption
of sweet
foods and
breast cancer
risk in Italy.
Ann Oncol.
2006 Feb;17(2):341-5.)
Soak chick
peas for
4-8 hours,
discard the
soaking water,
and pressure
cook them
in fresh
water for
22 minutes,
letting them
cool while
still under
pressure.
Boil water
in a noodle
pot and cook
soba (buckwheat)
or whole
wheat noodles
until just
tender (soba
takes about
8 minutes).
In a wok
or skillet,
sauté onions,
garlic, shredded
carrots,
and diced
bell peppers
in olive
oil with
fresh or
dried thyme,
oregano,
minced parsley,
and cayenne
to taste.
When the
onions soften,
add the juice
from one
lemon and
a small amount
of soy sauce.
Stir in,
then add
chopped fresh
chard, spinach,
or kale leaves
(not stems),
or a mixture
of any of
them. Next,
add the chick
peas, noodles,
diced fresh
tomatoes
(or fire-roasted
canned tomatoes),
and a garnish
of grated
Romano cheese.
Cook until
the flavors
are mixed
or put in
a casserole
dish and
bake covered
in the oven
at 350° for
20 minutes.Continue
simmering
to wilt the
greens. Turn
off the heat
and fold
in a bunch
of minced
cilantro
and garnish
with a few
drops of
toasted sesame
oil.
