Letter from Dr. Janson
Exercise for the Heart and Diabetes
Yoga -- More Than Stretching
The Scoop on SAMe
Maitake Mushroom Supports Immunity
In the Health News
Recipe of the Month: An Autumn Meal
I happened across a TV cooking show on Sunday and was both
entertained and saddened by what I saw. Two extremely large
women were demonstrating the preparation of a ham.
I came in when they were patting a thick layer of brown sugar
on the top of this large chunk of meat, covering every square
inch with about a one-inch thick layer. They used over a pound
of sugar, and then, with great delight, started to pour, ever
so carefully, a whole bottle of Karo syrup on top of the brown
Naturally, when it came out of the oven they could not resist
grabbing their bites, adding further to their already serious
weight problems. Americans do not need any education about
how to overload themselves with fatty meat and sugar, and
the combination was perfect if you wanted to hear their arteries
slam shut (they must have cut that section when they edited
We all pay the price for health habits like this, as health
care costs and insurance rates rise for all of us when others
take such poor care of themselves.
We need to encourage people to eat a healthful diet, and
the best way to teach is to set a good example. I try to give
you some simple healthy recipes, but I dont recommend
sacrificing pleasure for healthbecause you dont
have to! If you want more guidelines to diet and healthy cooking,
send me a note or an Email, and I will let you know what is
available. I am collecting some of my own cooking habits (I
almost never use recipes) that I will make available as a
monograph as soon as it is done.
My recommendations for health programs include regular
physical activity. While some people with heart problems have
difficulty exercising, it is almost always beneficial. A recent
study showed that even people with congestive heart failure
benefit from a fitness program. In heart failure, the heart
muscle is damaged or weakened (viruses and heart attacks can
do this) and it cant pump efficiently, so blood accumulates
and fluid pressure leads to edema in the legs or lungs. When
the lungs fill up with fluid it leads to shortness of breath.
In this study the patients, who averaged 64 years old, were
put on a supervised exercise program for 12 weeks, but they
were not worked to exhaustionyou dont have to
overdo it to do it well. They worked out only three times
a week, and always within their physical abilities. By the
end of the study, their exercise capacity had increased 14
percent, and respiratory muscle endurance by 20 percent. While
some participants had heart arrhythmias, the overall experience
was improved performance and endurance, with less shortness
of breath and better ability to go about their daily tasks.
In another exercise study, diabetic patients improved with
regular physical activity. After a nine-month program of moderate
exercise, the participants had reduced abdominal fat, they
lost weight, had a lower insulin response to a sugar load
(of course, none of my readers ever experience a sugar load!),
and increased their aerobic capacity.
Again, it did not require excessive effort. At the beginning
of the study, the subjects only had to raise their heart rates
to 50 to 60 percent of their reserve rate for 30 to 40 minutes,
three or four times per week. As they felt more fit, they
raised their heart rates to 80 to 85 percent of reserve, for
45 to 60 minutes. (The advantage of regular training is that
you can exercise more intensely without feeling that it is
The advantage of reduced insulin response may prevent or
lessen abnormal blood lipids, high blood pressure, and atherosclerosis.
In addition, regular exercise improves immunity, memory, and
brain function, and lowers the risk of stroke. It also makes
you feel good.
Whenever I make exercise suggestions, I also recommend stretching
as a complementary fitness activity. However, specific training
in yoga, which includes breathing and relaxation components,
has benefits that go beyond stretching. When I was running
long distances, yoga therapy helped me to heal minor but pesky
injuries, such as pulled hamstrings and plantar fasciitis
(inflammation of the connective tissue on the sole of the
Although yoga may bring up images of ancient-looking Indian
men lying on a bed of nails, it is not a religious cult or
a gimmicky way to reach Nirvana. It is an age-old practice
of breathing combined with body positions and movements that
promotes health, fitness, peace of mind, and spiritual growth,
without any particular religious affiliation (even though
it is derived from Hindu practice). It is practiced world
wide by people from many walks of life.
Scientific research supports the health benefits of yoga
for cardiac rehabilitation programs (when combined with diet
and other exercises), high blood pressure (for which it can
be as effective as medication), depression, arthritis, asthma,
healing injuries, and carpal tunnel syndrome. Asthma patients
are able to reduce their need for medication when they practice
One of my favorite yoga exercises is called the rainbow.
Sitting erect or standing with hands by your sides, gradually
stretch your hands out to your sides in wide arcs with your
palms up and fingers outstretched as far away from your body
as is comfortable. Do this while breathing in for a count
of ten until your fingertips meet over your head, and you
have inhaled fully. Then slowly lower your hands in the same
arc, to a count of 30, while breathing out slowly until your
hands are by your sides and you have fully exhaled.
Do several rainbows to help open up the chest and abdomen,
stretch the spine, shoulders and neck, and encourage better
posture, deep breathing, and relaxation, all with little expenditure
Many books and videos can help you get started, or you might
want a teacher either in a group or individually (this is
especially important if you are recovering from an injury).
Many of you have heard of this dietary supplement, but you
may wonder if all the hype is justified. SAMe stands for S-adenosyl
methionine, a derivative of the amino acid methionine that
is essential in some metabolic pathways that rely on methyl
transfer (methyl is a carbon atom and three hydrogens).
Methyl transfer is a critical reaction in liver function,
and the brain. SAMe also contains sulfur, and is involved
in reactions requiring sulfur transfer for detoxification.
SAMe is converted to glutathione, an important antioxidant
in the liver and brain. As a result of these properties, SAMe
protects the liver from toxicity and free-radical damage,
and it can treat depression. It also contributes to the formation
and repair of cartilage, and can relieve arthritis symptoms.
Aging of cells is partly the result of loss of methyl
groups. SAMe supports DNA repair through re-methylation, helping
to reverse or slow the aging process in the brain, liver,
and other tissues.
Production of melatonin (a brain and liver antioxidant that
helps slow and reverse the aging process) also depends on
SAMe is as effective as antidepressant medication,
with more rapid relief and fewer side effects. In one placebo-controlled
study of 80 depressed postmenopausal women, 1600 mg daily
produced relief within ten days, with only mild, transient
side effects. Smaller doses are also effective, ranging from
400 to 1200 mg daily.
Another controlled study on 15 hospitalized psychiatric patients
with major depression showed that SAMe was safe and effective,
with rapid onset of activity, and few side effects.
Arthritis studies show similar effectiveness for SAMe.
It is safer than the NSAID drugs, such as Advil and Naprosyn,
which can cause gastrointestinal bleeding. It relieves symptoms
and stimulates the repair of joint cartilage.In one study,
it was as effective as indomethacin, a drug that can cause
GI bleeding, and damages the liver and kidneys. In contrast,
SAMe helps the liver. It supports its detoxification functions,
can treat cirrhosis, and reduce fatty infiltration of the
SAMe may also be useful in the prevention of Alzheimers
disease and the treatment of fibromyalgia. Because SAMe is
relatively expensive, I usually recommend starting treatment
for arthritis or depression with 200 mg twice a day, moving
up from there, if necessary. For fibromyalgia, sometimes doses
as high as 1200 to 1600 mg are needed. SAMe works better when
taken with extra folate, B6, and B12.
Other treatments for depression, such as 5-HTP and St. Johns
wort, are less expensive, as is glucosamine sulfate for arthritis.
However, some people respond better to different treatments,
so if these dont work for you, you should consider SAMe
as an alternative.
For liver disease, such as cirrhosis, hepatitis, or alcohol
induced liver damage, SAMe works with silymarin and L-glutamine.
L-glutamine is precursor of the antioxidant glutathione.
I have recently started recommending supplements of maitake
mushroom to help enhance immunity, especially for cancer patients.
Medicinal mushrooms have a long history of health benefit,
and I have written about beta 1-3 glucan, a derivative of
shiitake mushroom, in a previous edition.
Studies show that maitake extract reduces the spread of cancer,
and increases tolerance of other treatments. It increases
the activity of macrophages, natural killer cells, and certain
T-cells. This would help destroy cells infected with pathogens
such as viruses and prevent tumor recurrence.
Dr. Harry Preuss, a researcher at Georgetown University,
has shown that maitake can help lower blood pressure and control
diabetes in animal models. Typical doses of maitake range
from 500 to 1000 mg twice a day of whole mushroom.
In an animal study, feeding a diet high in fat and sugar,
simulating the American diet, induced hypertension. Within
18 months, the animals in the fat-sugar group became hypertensive
on this diet, compared to the control group on a low fat,
complex carboyhdrate diet. The test diet leads to increased
levels of oxygen free radicals, inactivating nitric oxide,
and leading to restricted blood flow. Interestingly, after
two years, reverting to the low-fat, complex carbohydrate
diet reversed the hypertension, meaning it is never too late
to improve your diet.
A full 80 percent of elderly patients on blood pressure
medication can safely come off their drugs if they follow
a lifestyle change with diet change (low salt) and weight
loss. (Espeland MA, Arch Fam Med 1999 May-Jun;8(3):228-36)
The extent of the weight loss and salt restriction were directly
proportional to the success in staying off medication, and
the combination was better than individual changes. Add fruits,
vegetables, and whole grains to your diet, exercise regularly,
and do some yoga for the best chance to be successful.
I reported in the last issue that whole grains
reduce the risk of type II diabetes, and the same authors
now report that whole grains also significantly reduce the
risk of stroke (Liu S, et al., JAMA 2000;284:1534-1540). The
risk was lowered by 30 to 40 percent in the group with the
highest intake of whole grains compared to those with the
lowest. This information is in accord with most of the data
collected over the past 40 years. Refined grains (mainly white
flour), however, are still as risky as ever.
Nothing quite matches a hearty soup in November, and a pressure
cooker or crock pot makes it easy (the pressure cooker also
makes it quick). I put in two kinds of soaked beans (pinto
and black-eyed peas are favorites), plus lots of onions, garlic,
celery, carrots, herbs (thyme, rosemary, and cayenne, for
examples), and a green vegetableSwiss chard goes well
When soaking the beans, after 6 to 8 hours discard the soaking
water to reduce any intestinal gas that beans may cause in
some people. A serving of this soup with some whole grain
toast makes a complete meal, is hearty and delicious. Make
enough for leftovers you wont have to cook every
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