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Plant Sterols and Coke
Emotions and Heart Health
Exercise and Breast Cancer
Nutrition and Diabetes
Ask Dr. J: Varicose Veins
Dear Friends,
Heart disease remains the number one cause
of death in the United States and other developed
countries. It is clearly due to lifestyle issues,
including poor diet, lack of regular exercise,
smoking, and a combination of high stress with
negative emotional states. Cholesterol also
plays a role, but I find it tragically laughable
that the Coca Cola company, a purveyor of some
of the most unhealthy consumables throughout
the world, is now introducing an orange juice
that contains cholesterol-lowering substances
called plant sterols.
Phytosterols are indeed healthful contributions
to the diet, and they are already added to otherwise
unhealthful margarines. Coca Cola is introducing
them into an orange juice with 110 calories
per serving, and recommending two servings a
day. Undiluted juice is too high in sugar, which
is why I always suggest diluting such drinks
by at least half to two thirds. Dilution would
reduce the sterols to less than recommended
amounts for cholesterol lowering. (Coca Cola,
by the way, also owns and markets Odwalla and
Samantha juices.)
This news from Coke comes at a time when we
also learn that infants from four months to
two years old are consuming unhealthy “junk,”
such as french fries and soft drinks, including
colas, at an alarming rate. The research shows
that on the survey day 25 percent of children
eat no healthy vegetables or fruits. It is not
surprising that even among toddlers the proportion
who are overweight is up to 15 percent, and
this helps explain why so many older children
are obese. These parental decisions, usually
made for convenience or out of ignorance, lead
to early health problems, especially when children
carry these habits into adulthood.
Although it is a major contributor, poor diet
is not the only influence on heart health. Emotional
states (at least in men, in the latest study)
play a significant role in the development of
cardiovascular heart disease, according to a
new study that confirms earlier data. Researchers
found that hostility, depression, pessimism,
and anxiety increased the risk of heart disease
by 6 percent for each increase of one point
on the survey score. They also noted that poor
concentration contributed to the heart-disease
link. The risks were independent of obesity,
insulin resistance, or high blood pressure.
It is not yet clear that psychological or drug
treatment for emotional states makes any difference
in the association with heart disease. However,
numerous other studies show that relaxation,
yoga, meditation, and related practices can
be beneficial for health. In any case, it is
always helpful to cultivate the positive feelings
and attitudes that enhance the value of living
every day.
The newsletter is abbreviated this month because
of my relocation to Florida, but here are some
valuable health news articles.
Exercise reduces breast cancer risk, even
if it is only recreational activity for a few
hours a week. Evaluating over 500 women with
breast carcinoma in situ (an early cancer) and
comparing them with 600 comparable women without
cancer, showed that “any” reported
physical activity lowered the cancer risk by
35 percent. The activities were walking, jogging,
dancing, bicycling, and similar exercises.
Previous studies have shown the value of exercise
in cancer prevention, as well as heart health,
diabetes, immune function, and more. These researchers
already found that exercise helps reduce invasive
cancers, with increasing levels of exercise
further reducing the risk.
For some exercise benefits, you have to do
more than the minimum, but even small amounts
of activity are helpful. This is in addition
to the sense of well being, higher energy, lessened
back pain, and improved sleep that exercise
provides.
Patel AV, et al., Recreational
physical activity and risk of postmenopausal
breast cancer in a large cohort of US women.
Cancer Causes Control 2003 Aug;14(6):519-29.
Patel A, et al., Lifetime
recreational exercise activity and risk of breast
carcinoma in situ. Cancer 15 November 2003;98(10):2861-9.
(Online publication 6 October 2003)
A group at Harvard reviewed the nutrition
literature to determine the value of different
carbohydrates and fats in preventing type II
diabetes. They concluded that saturated fat
and trans fats (from partially hydrogenated
vegetable oils – margarine and shortening)
increased the risk. Polyunsaturated fats, and
especially omega-3 oils (from fish, flaxseeds,
walnuts, and a few other nut or seed sources)
reduced the risk.
They also urged increases in healthy unrefined
carbohydrates that are high in fiber, including
unprocessed grains. These foods reduce sugar
responses in the blood and lower insulin levels.
They were careful to make the distinction between
these whole foods and refined, processed carbohydrates.
This is important when making dietary choices.
Diet fads that lump all carbohydrates together,
and restrict them as a whole, are likely to
be too low in fiber to be beneficial in the
long term. In addition, whole grains and beans
provide valuable essential fatty acids. Saturated
fats come mainly from meat, whole dairy products,
and chicken.
Hu FB, van Dam RM, Liu S,
Diet and risk of Type II diabetes: the role
of types of fat and carbohydrate. Diabetologia.
2001 Jul;44(7):805-17.
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Q. I have varicose veins,
and surgery has been recommended. Do you have
any suggestions to help me avoid the operating
room?
-- VP, by Email.
A. Varicose veins are those in which blood
pools as a result of damage to the valves that
maintain one-way blood flow back to the heart,
and weakness of the vein walls. The damage usually
comes from vein pressure in susceptible vessels
due to constipation, obesity, inactivity, or
pregnancy. It is unlikely that anything could
repair the damaged valves, but you may be able
to reduce varicosities, especially prominent
small veins.
While it is possible that you can help reduce
varicose veins with non-surgical methods, it
is not clear that any one method will succeed.
However, if you do not improve, you can always
get surgery later.
I have found it helpful for patients to eat
a high fiber diet to prevent further excess
pressure on the veins. Fiber retains water in
the bowel, and keeps the stool soft and bulky
to prevent straining. In addition, it helps
to wear support stockings that keep pressure
on the outside of the leg, which may prevent
pooling of blood in the damaged vessels.
I recommend some supplements that strengthen
the vein walls, and others that help reduce
the risk of blood clots (thrombi) in the vessels
and inflammation (phlebitis). Thrombophlebitis,
can lead to dangerous clots traveling to the
lungs.
Bioflavonoids (1000 to 2000 mg, daily) help
strengthen vessel walls and enhance the value
of vitamin C (2000 to 4000 mg), which reduces
inflammation and improves vessel strength. The
standardized herbs: butcher’s broom ((100
mg), horse chestnut (500 mg), and gotu kola
(120 mg) are also helpful, and are available
in some combination formulas. Among others,
curcumin (600 mg) and fish oil (600 to 1200
mg of EPA/DHA) help to reduce inflammation. |
