|
Hysteria over Listeria
Coenzyme Q10 and Parkinson's
Disease
How Coenzyme Q10 Might Work
Other Treatments for PD
Ask Dr. J: Lithium and Mood
In the Health News
Diet and Disease
Recipe of the Month: Wild
Rice and Mushrooms
References
Dear Friends,
Recent warnings have made people aware of the
risk of infection from eating contaminated meat
products, and many of them have been recalled
because of the presence of E. coli, Listeria
monocytogenes, and other infectious agents.
Much news was made of the 23 deaths and 120
illnesses from listeriosis this summer in the
Northeast.
Since then, another recall of processed meats,
this time of 27 million pounds of potentially
contaminated poultry products from a factory
of Pilgrim’s Pride (Wampler brand) in Pennsylvania,
has reignited the concern over the potential
for lethal infections.
Listeriosis is a serious disease. Symptoms
may include fever, muscle aches, nausea or diarrhea.
Spread of the infection to the nervous system
may lead to headache, confusion, stiff neck,
and loss of balance, and even convulsions and
death. Of those infected with the disease, about
25 percent will die.
Listeria is more serious in the elderly, the
frail, those who are immune compromised, or
people ill with diabetes, cancer, or kidney
disease. Pregnant women are much more susceptible
to the infection, but the most serious effects
are in the newborns of these infected women.
With the many other reasons to avoid meat and
chicken in the diet (last month I wrote about
the salmonella contamination in sausages), and
to say nothing of mad cow disease, this is just
one further indication that you have to be diligent
in your food choices.
It is curious to me that the 23 deaths from
listeriosis have created such a stir in the
news, when it is possible to relate the consumption
of meat and poultry to hundreds of thousands
of deaths every year from coronary heart disease,
cancer, hypertension, strokes, non-Hodgkins
lymphoma, kidney disease, and other conditions,
plus increases in rheumatoid disease and gall
stones. Without diminishing the importance to
public health of acute infections, the real
problem with western dietary choices are the
chronic, degenerative diseases from foods that
are not contaminated with bacteria and parasites.
Although the disease picture in China is changing
(as the diet is westernized), when T. Colin
Campbell reported in 1998 on the Cornell-China
study, it was clear that in rural areas of China
consumption of animal protein was about 10 percent
of the US intake, and dietary fat was about
half of that in the US. Among men, coronary
disease was only one-sixteenth(!) that in the
US. High intake of plant protein, legumes, and
vegetables was associated with lower rates of
these diseases. Further benefits accumulated
with every increase in the proportion of plant-based
foods in the diet.
Parkinson’s disease (PD) is a disease
of neurons in the area of the brain that affects
muscle movement. Symptoms include tremors, difficulty
with walking and balance, rigidity, and poor
coordination. The incidence is greater in people
over 50, and increases with age (certain drugs
can cause these symptoms in younger people).
PD is a degenerative disease, and the deterioration
progresses with time. The cells in one region
of the brain, called the substantia nigra,
are affected and the production of the neurotransmitter
dopamine is reduced. So far, no treatments have
been able to slow the progression of the disease.
A number of drugs can temporarily reduce the
symptoms. The medications that help control
PD may have side effects, including excessive
episodes of sleepiness (somnolence) or involuntary
writhing movements (dyskinesia).
It was widely reported in the news recently
that coenzyme Q10 could help delay the development
of symptoms in patients with early signs of
Parkinson’s disease. The researchers tested
unusually high doses of 300, 600, and 1200 mg
daily, and compared them to placebo over a period
of 16 months.
Although there was some trend toward benefit
from doses of 300 and 600 mg daily, the most
(and statistically significant) benefits were
seen with doses of 1200 mg. This is far more
than is usually given for heart disease, cancer,
and immune enhancement (common doses being from
100 to 400 mg daily).
Coenzyme Q10 is normally manufactured in the
body, but the amount produced declines with
age. It is an essential cofactor for the production
of energy in the cell components called mitochondria.
These mitochondria make the energy-storage molecule
called ATP.
The health of the mitochondria is reflected
in the proper function of many organs, including
the heart and the brain. PD patients have both
poor mitochondrial function and particularly
low levels of coQ10.
Now it appears that health of the neurons affected
in PD may be maintained longer in people who
take coenzyme Q10 supplements. Two years ago,
it was shown that neuronal degeneration was
related to oxidative damage. In addition to
the production of energy and maintaining mitochondrial
health, coenzyme Q10 is also a potent antioxidant,
so this may be one of the mechanisms by which
it helps protect the nervous tissue in patients
with PD.
Damage to mitochondria from pesticides has
also been linked to PD in animal studies, particularly
in the cells that produce dopamine. Coenzyme
Q10 may protect the mitochondria from such toxic
substances.
This new study only involved 80 subjects, but
the results are very provocative because of
the authors’ conclusion that there was
a reduction in disease progression. Because
patients did not improve in the first month,
but were better at later evaluations, the authors
suggested that this is a sign of prevention
of neuronal degeneration, rather than just symptom
relief. This study is also important because
even administration of these high doses was
effective, but caused no significant side effects.
In spite of this, one of the authors of the
study suggested that the information was too
limited, and it would be “premature”
to recommend that patients start taking coenzyme
Q10 because it was such a small study. The research
team is planning to expand the study and add
specific evaluation of neuronal degeneration.
Based on previous information, it is likely
that the new study will show that the neurons
are protected by coQ10. If you or a loved one
has PD, is it really wise to wait for the further
research? This is a particularly poignant question,
considering the safety of the treatment.
Previous studies have shown that high doses
of vitamin E can help PD. In 1992, a pilot study
showed benefits in delaying symptom progression
with 3000 mg of vitamin C and 3200 IU of vitamin
E. Lower doses did not work. High doses may
be essential for benefits because of the difficulty
of getting antioxidants into the brain.
Other nutrients that protect the brain include
alpha-lipoic acid, acetyl L-carnitine, and proanthocyanidins,
which I have discussed previously. A combination
of these nutrients may make a significant difference
to PD patients and their families.
Dietary supplements are not the only natural
treatments that can help people with Parkinson’s
disease. Exercise has been shown to help reduce
depression as well as improve motor skills,
and general signs of well being. In the 1999
study, intensive exercise was performed twice
a week by patients with moderate PD symptoms.
Diet may also play a role. For patients who
respond to the drug Sinemet, very low protein
diets improve their response to the drug. The
benefits are seen within one week, and it appears
to be even better if most of the protein intake
is toward the end of the day. It appears that
protein interferes with the absorption of the
medication.
To prevent PD, reduce your exposure to pesticides
by eating organic foods, eat a wide variety
of foods with antioxidants (vegetables, fruits,
and legumes), and take brain-protecting antioxidant
supplements, including coQ10. For treatment,
take high doses of coenzyme Q10 and other antioxidants,
get regular exercise, and eat a low protein
diet, with most of the protein in the evening.
|
|
Q. I have been having problems with mood swings
and a Dr. suggested lithium carbonate. He said
it’s a natural mineral and may help. Is
this safe? JY, New Jersey, via Internet
A. Although lithium is a natural mineral, it
is not free of side effects when used to treat
“bipolar disorder” or manic-depressive
illness. The amounts in the diet (and it is
not clearly essential) are in the range of 100
mcg per day, and doses for treatment
are 500 mg daily.
Side effects include drowsiness, weakness,
tremors, blurry vision, ringing in the ears,
loss of appetite, heart arrhythmias, low blood
pressure, abnormal kidney function, headaches,
and others. Also, they can occur close to the
therapeutic level of the drug, but it can help
some patients.
If you need treatment for mood swings, you
may benefit from some nutritional alternatives
to lithium. One is to try a diet for blood sugar
regulation as hypoglycemia can also cause mood
swings. I recommend small meals spread through
the day, with a high fiber content. Avoid sugar
and white flour, caffeine, alcohol, and hydrogenated
oils.
Regular exercise can help stabilize mood and
relieve depression. Aerobic exercise, such as
brisk walking, jogging, cycling, or swimming
may be effective. Some evidence also supports
the value of resistance exercise (weights).
A number of supplements can help. St. John’s
wort is as effective as antidepressant medications
for mild to moderate depression. You can try
300 mg of standardized extract 3 times a day
for 6 to 8 weeks. Be careful to avoid excessive
sun exposure while taking St. John’s wort,
as it can cause sun sensitivity.
Omega-3 oils (9 gms a day, equal to 9 oz of
oily fish) can also help manic depression. Other
supplements that may be beneficial include 5-HTP,
a precursor to the neurotransmitter serotonin
(100 to 200 mg daily), and melatonin, the hormone
from the pineal gland that regulates the body
clock ( 3 mg at bedtime). In my clinical experience,
vitamin B3 (I usually recommend inositol hexaniacinate,
800 to 1200 mg daily) and vitamin C (3000 to
4000 mg) can also help.
• You only need to look around to see
it, but scientific data now shows obesity in
adults and children has increased in recent
years. Two recent studies published in the Journal
of the AMA show about a 50 percent increase
in overweight children, from 10 percent among
teens in 1994, to 15 percent in 2000, and in
adults from 22 to 30 percent in the same time
period. (Flegal KM, et al., Prevalence and Trends
in Obesity Among US Adults, 1999-2000. JAMA
2002 Oct 9;288(14):1723-7, and Ogden CL, et
al., Prevalence and Trends in Overweight Among
US Children and Adolescents, 1999-2000. JAMA
2002 Oct 9;288(14):1728-32.) The authors point
out the serious public health problems that
this presents.
• Last year, I reported on the anti-inflammatory
and antioxidant effects of curcumin (the yellow
pigment in turmeric), and its apparent benefit
in preventing Alzheimer’s disease (but
neglected to mention it again last month in
the brain article). Earlier studies also showed
that it could decrease tumors. New information
confirms that curcumin is valuable for reducing
pancreatic cancer cell growth in cell cultures
(Hidaka H, et al., Curcumin inhibits...human
pancreatic carcinoma cell growth by autocrine
regulation. Cancer 2002 Sep 15;95(6):1206-14).
The Japanese researchers conclude that curcumin
is a potent anticancer agent.
• A study of low-carbohydrate diets showed
more weight loss compared to a diet with 30
percent fat (erroneously called a low fat diet),
and cardiac risk factors were not increased.
However, this is a six-month study, the controls
were not on a real low-fat diet (15 percent).
The weight loss itself, not the diet, could
explain the normal blood pressures and blood
sugars, but risks of cancer, heart disease,
and more make this an unhealthy long-term diet
plan. (Reuters Health, October 21, 2002.)
I buy real wild rice from Minnesota Native Americans
in a land recovery project (Native Harvest at
888-779-3577, or www.nativeharvest.com). Add
one cup of wild rice to two cups of organic
brown rice and rinse three times, then cook
in 6 cups water. Sauté onions and garlic
with marjoram, thyme, and sage for a savory
flavor. Add some diced mushrooms (I like to
mix a variety of wild mushrooms) and a small
amount of soy sauce, umeboshi plum vinegar,
or lemon juice, and cook lightly, adding enough
water to make a sauce (option: add some diced
tofu to the onions). Serve this over the rice.
Variations: add different spices, such as curry,
cumin, and cayenne pepper, or simply cumin,
turmeric (for extra color and antioxidants),
and crushed black and white pepper.
Pilgrim’s Pride
Begins Record Meat Recall (Reuters) Oct 14,
2002.
Campbell TC, et al., Diet, lifestyle, and the
etiology of coronary artery disease... Am J
Cardiol 1998 Nov 26;82(10B):18T-21T.
Sinha R, Rothman N, Role of...meat...in the
etiology of human cancer. Cancer Lett 1999 Sep
1;143(2):189-94.
Shults CW, et al., Effects
of coenzyme q10 in early Parkinson disease:
evidence of slowing of the functional decline.
Arch Neurol 2002 Oct;59(10):1541-50.
Fahn S, A pilot trial of high-dose alpha-tocopherol
and ascorbate in early Parkinson’s disease.
Ann Neurol 1992;32 Suppl:S128-32.
Fleming L, et al., Parkinson’s disease
and brain levels of organochlorine pesticides.
Ann Neurol 1994 Jul;36(1):100-3.
Betarbet R, et al., Chronic systemic pesticide
exposure reproduces features of Parkinson’s
disease. Nat Neurosci 2000Dec;3(12):1301-6.
Giasson BI, et al., Oxidative damage linked
to neurodegeneration ...Science 2000 Nov 3;290(5493):985-9.
Reuter I, et al., Therapeutic value of exercise
training in Parkinson’s disease. Med Sci
Sports Exerc 1999 Nov;31(11):1544-9.
Pincus JH, Barry K, Influence of dietary protein
on...Parkinson’s disease. Arch Neurol 1987
Mar;44(3):270-2.
Riley D, Lang AE, Practical application of a
low-protein diet for Parkinson’s disease.
Neurology 1988 Jul;38(7):1026-31.
Ahmadi J, et al., Various
types of exercise and scores on the Beck Depression
Inventory. Psychol Rep 2002 Jun;90(3 Pt 1):821-2.
Mather AS, et al., Effects of exercise on depressive
symptoms in older adults ... Br J Psychiatry
2002 May;180:411-5.
Stoll AL, et al., Omega-3 fatty acids and bipolar...
Prostaglandins Leukot Essent Fatty Acids 1999
May-Jun;60(5-6):329-37.
van Praag HM, de Haan S, ...An attempt to compare
lithium with 5-[HTP]. Acta Psychiatr Scand Suppl
1981;290:191-201.
Angst J, et al., The treatment of depression
with L-5-HTP] versus imipramine... Arch Psychiatr
Nervenkr 1977 Oct 11;224(2):175-86
|
