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Letter from Dr. Janson
New Heart Drug -- Do We Need
It?
Coenzyme Q10 and L-Carnitine
Soy Foods are Beneficial
In the Health News
Recipe of the Month: Spicy
Curried Cauliflower and Chickpeas
Dear Friends,
Recent reports of the crisis in Europe from
foot and mouth disease have misrepresented the
nature of the problem. I don’t mean the admittedly
devastating effect the disease has on animals,
the extremely contagious nature of the illness,
or the ruin faced by some farmers who depend
on their cattle, pigs, and sheep for their livelihood–animals
that are being slaughtered in vast numbers to
prevent the spread of the disease (even zoo
animals are at risk.)
Foot and mouth disease is caused by a virus
that only rarely affects humans, but causes
serious disease in animals, which lose the ability
to eat, drink, and walk due to blisters on the
lips, mouth, throat, feet, and legs.
The media reports all refer to this as a “food”
crisis. In reality it is not a food crisis,
but an economic crisis. There is no lack of
healthy foods or calories available to the European
population, as they are turning increasingly
to vegetarian sources of nutrition plus fish.
It reminds me somewhat of the crisis that occurred
in Russia during the breakup of the Soviet Union.
At that time, everyone was complaining about
the shortages. What were they missing? Not potatoes,
carrots, cabbage, onions, kasha or beans; according
to the media, they were devastated by the lack
of sausage, meats, sugar, alcohol, and tobacco.
What foods they did have were at least healthier
than the items they were missing. (This is not
to belittle the reality of their social crisis
and the perceived devastation from the shortages
that they had to endure. And they were also
likely short of some fresh fruits and green
vegetables.)
Coming as it does on top of the fear of bovine
spongiform encephalopathy (BSE, or mad cow disease),
which does affect humans in the form called
Creutzfeld-Jacob disease, the current European
crisis is turning increasing numbers of the
population toward healthier vegetarian diets.
This is not a food crisis–encouraging people
to choose better diets, for whatever reason,
is a health benefit. At the same time these
people will be avoiding the hormones, antibiotic
residues, and the accumulated pesticides that
are found in animal foods in higher amounts
than in plant-based diets.
The serious human risks from a high-meat diet
are far more devastating to the population as
a whole than mad cow disease—far more people
die of heart disease and cancer (in the hundreds
of thousands every year) than of Creutzfeld-Jacob
disease, and those illnesses are partly related
to meat consumption. That true health crisis
does not lead to explosive headlines in the
mass media. Even the economic crisis is of unclear
significance. As people choose healthier lifestyles,
the risk of chronic, degenerative disease goes
down, and the corresponding cost of health care
will also decline. This crisis could easily
result in a lower overall associated cost to
society when the entire picture is considered.
Patients with acute chest pain are often
treated with aspirin to reduce the risk of a
heart attack within the next few days or in
the near future. Plavix, a new drug with similar
effects, has now been shown to prevent heart
attacks in those patients with “acute coronary
syndrome” (ACS).
Angina is heart-related pain on exercise, but
ACS is recurrent, unstable angina in patients
who have had a mild heart attack, and develop
unmanageable pain even at rest.
I was impressed with one news reporter who
was awaiting the results of the trial, which
was reported to the American College of Cardiology
in March. This reporter was so eager to say
that it would be great if we could now have
“a pill to take instead of surgery or angioplasty.”
Well, we do have such pills. They have been
available for decades (but relatively cheap
and not patentable). I am referring, of course
to vitamin E (400 IU), garlic (500-1000 mg),
ginkgo biloba (60-120 mg), and other natural
products that reduce platelet aggregation.
The author of the study, a Dr. Yusuf, said,
“The widespread use of [Plavix] in addition
to aspirin in ACS could prevent about 50,000-100,000
heart attacks, strokes, or deaths every year
in North America.” However, this is at a cost
of three dollars a day for this one pill.
Compare this to about ten cents a day for vitamin
E, 20-40 cents for ginkgo,and 20 cents for garlic
pills, and you can see why the drug companies
want to research and sell the patentable drugs.
Platelet aggregation or “stickiness” (partly
a result of high dietary levels of animal fat,
hydrogenated oils, such as margarine, and stress),
is the first step in blood clotting, so any
reduction helps to lower the risk of a blood
clot inside the vessels that might lead to a
heart attack or stroke.
Many natural substances control excessive platelet
aggregation. Essential fatty acids—GLA from
borage or evening primrose oil (240 mg daily),
and EPA and DHA from fish oil (600-2400 mg);
ginger (250-500 mg); ginseng (200-400 mg); curcumin
(turmeric extract, 300-600 mg) are among many
that reduce platelet aggregation.
Of course, one of the advantages of taking
natural products instead of drugs is that they
usually have other benefits besides the ones
you are expecting. For example, vitamin E also
enhances immunity and has antioxidant properties;
ginkgo biloba helps memory, small blood vessel
circulation, and headaches; ginger and curcumin
are natural anti-inflammatory agents; and fish
oil reduces triglyceride levels and heart disease.
The drugs, however, usually have negative side
effects (as opposed to side benefits) and interactions
with other drugs that are undesirable and often
unexpected. Plavix, for example, is associated
with increased gastrointestinal bleeding, similar
to aspirin but a little less common. It also
causes skin rashes, digestive upset, and, rarely,
a few more serious conditions.
My recommendations would be to try the natural
products first, adding magnesium, coenzyme Q10
and L-carnitine, along with a healthy diet.
In addition, I strongly urge my patients with
heart disease to have chelation therapy, a safe
intravenous treatment for heart and other circulatory
disorders. It has been used successfully for
the past 50 years. I have practiced it since
1983. A recent report from Canada is contrary
to prior studies, and not yet analyzed. I doubt
the results from cardiologists with a bias against
chelation.
You can find a chelation therapy practitioner
in your area by going to the website of the
American College for Advancement in Medicine
(www.acam.org).
ACAM puts on scientific conferences twice a
year: some of the best medical meetings in the
country. It is run by practitioners experienced
in all areas of alternative and complementary
medicine. (The next meeting is in Nashville,
May 9-13, also open to the public.)
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Some people are unclear about the relationship
between coenzyme Q10 and L-carnitine, and how
they are both important for energy production,
heart disease, and management of fatigue. They
work together in metabolism, so you may need
to take both of them, especially as you get
older.
As you age, the production of both coenzyme
Q10 and L-carnitine declines (as it does with
many other substances, such as DHEA, progesterone,
testosterone, melatonin, and pregnenolone, to
name a few). You make L-carnitine from the amino
acids L-lysine and L-methionine, and CoQ10 is
made from other coenzymes in the diet.
Your body stores energy in a molecule called
ATP, or adenosine triphosphate. The three phosphate
bonds of ATP have high potential energy, so
it takes energy to make them, and then they
release energy when they are broken down, letting
go of one phosphate at a time.
In order to make ATP, you need both CoQ10 and
L-carnitine. Little cellular organelles (organs
that are small enough to be inside cells), called
mitochondria are the location of ATP production.
They are the cellular engines, or powerhouses,
and they make ATP from free fatty acids (FFA).
The reaction requires the presence of coenzyme
Q10, but it also needs those FFA from the blood
stream.
L-carnitine is the transport molecule that carries
the FFA across the membrane of the mitochondria.
In order to have adequate production of ATP,
you need enough L-carnitine to carry the fatty
acids to the CoQ10. Of course, you need the
FFA also, but it is rare to have significant
total fat deficiency. However, you should be
sure your diet has adequate amounts of the essential
fatty acids to meet your needs. Improvement
in fat burning leads to lower triglyceride levels
in the blood, and L-carnitine also helps to
reduce the amount of lipoprotein (a), a risk
factor for heart disease.
For heart patients and those who suffer from
frequent or severe fatigue, I recommend both
L-carnitine and CoQ10. Typical daily doses are
from 1000 to 2000 mg of L-carnitine, and 100
to 200 mg of CoQ10. For more severe heart patients,
it is often beneficial to take higher doses
of both, in combination with diet and other
supplements, and other lifestyle changes, such
as relaxation techniques and a graded exercise
program.
Some articles have appeared recently
in magazines and newsletters saying that foods
derived from soybeans are not as healthy as
once thought. Of course, it is only recently
that major health organizations and government
agencies were willing to take any stand against
the meat and dairy industries, and began recognizing
the health value of eating soyfoods to replace
meat.
Soy foods (such as soymilk, tofu, and tempeh)
are very nutritious, but like almost all foods,
you can eat too much of them, and I do not recommend
the highly processed TVP (texturized vegetable
protein). In a double blind study, subjects
who ate biscuits with added soy protein had
a 5 percent rise in their good HDL cholesterol,
and no change in their LDL cholesterol. Similar
studies showed improved lipids in normal and
diabetic subjects.
In another study, young women (30-40 years
old) in China who had the highest intake of
soymilk and tofu had only one third the rate
of bone loss as those who ate the least soy.
Supplements of soy isoflavones are available
for those who do not like soyfoods (a typical
daily dose is 20 to 80 mg of the actual isoflavones
from soy protein).
Chronic infections can increase your
risk of developing atherosclerosis and heart
disease. Respiratory, dental, and urinary tract
infections lead to increased production of C-reactive
protein (CRP), and other markers of inflammation.
CRP is not only a marker of risk, but may contribute
to arterial damage. Natural reduction of inflammation
and infection is better than chronic use of
antibiotics. Supplements of vitamins C and E,
garlic, lactobacilli, and transfer factor (from
colostrum), as well as curcumin and ginger,
help reduce infection and inflammation. Kiechl
S, et al., Chronic infections and the risk of
carotid atherosclerosis...Circulation 2001 Feb
27;103(8):1064-70.
•Small increases in the level of vitamin C in
the blood can significantly reduce the risk
of mortality from all causes, including heart
disease and strokes. Increasing the amount of
fruits and vegetables by one serving per day
can reduce mortality by 20 percent. The highest
level of vitamin C in the blood can cut mortality
from these serious diseases in half. It is true
that vitamin C may just be a marker for better
nutrition with more fruits and vegetables, but
the evidence continues to mount that good nutrition,
including vitamin C, is beneficial. (Khaw KT,
et al., Lancet 2001 Mar 3;357(9257):657-63.)
•Flavonoids, or bioflavonoids, are an important
part of a healthy diet. All sources of flavonoids
help to reduce disease. These antioxidant pigments,
found in fruits, vegetables, grains, beans,
wine (or grape juice), and tea, are effective
free radical scavengers, metal chelators, and
antithrombotic agents (platelet antagonists),
reducing the risk of heart attacks and mortality
from heart disease, even in smokers. (Hirvonen
T, et al., Intake of flavonols and flavones
and risk of coronary heart disease in male smokers.
Epidemiology 2001 Jan;12(1):62-7.)
This is one of my favorite meals. Pressure
cook some chick peas, steam some potatoes and
cauliflower, then saute some garlic, onions,
curry powder, cumin, and black mustard seeds
(ginger is another option) in a non-stick pan
with a bit of olive oil. Continue cooking while
folding in the chick peas, potatoes, and cauliflower
until they are well mixed. Add enough water
from the chick peas to make a sauce, and mash
a few of the potatoes and chick peas to thicken
it . Add chopped green chard to cook for just
a minute or two, and a small amount of sea salt
or tamari soy sauce. Garnish this with some
chopped cilantro, which always tastes best if
you mix it in at the end, after the heat is
off. Serve this over some brown rice or with
some whole wheat flatbread. |
