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November 2000

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
References

Letter from Dr. Janson
Dear Friends,
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 sugar!

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 the tape).

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 don’t recommend sacrificing pleasure for health–because you don’t 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.

Exercise for the Heart and Diabetes
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 can’t 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 exhaustion–you don’t 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 more effort.)

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.

Yoga–More Than Stretching
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 foot.

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 yoga regularly.

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 of time.

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).

The Scoop on SAMe
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.

Protection Against Aging
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 methylation.

SAMe for Depression
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.

SAMe and Arthritis
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 liver.

Other Benefits of SAMe
SAMe may also be useful in the prevention of Alzheimer’s 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. John’s wort, are less expensive, as is glucosamine sulfate for arthritis. However, some people respond better to different treatments, so if these don’t 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.

Maitake Mushroom Supports Immunity
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 the Health News
•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.

Diet and Disease
• 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.

Recipe of the Month
An Autumn Meal

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 vegetable–Swiss chard goes well in soup.

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 won’t have to cook every day.

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References

Exercise for The Heart and Diabetes:
McConnell TR, Presented at the meeting of the
American Physiological Society as reported in
Reuters Health, Sep 25, 2000.

Aerobic exercise training-induced reductions in
abdominal fat and glucose-stimulated insulin responses
in middle-aged and older men.
J Am Geriatr Soc 2000;48:1055-1061.

Yoga and Health:
Jain SC, et al., Effect of yoga training on exercise
tolerance in adolescents with childhood asthma.
J Asthma 1991;28(6):437-42.

Vedanthan PK, et al., Clinical study of yoga techniques
in university students with asthma: a controlled study.
Allergy Asthma Proc 1998 Jan-Feb;19(1):3-9.

Murugesan R, et al., Effect of selected yogic practices
on the management of hypertension.
Indian J Physiol Pharmacol 2000 Apr;44(2):207-10.

SAMe:
Salmaggi P, et al., Double-blind, placebo-controlled
study of S-adenosyl-L-methionine in depressed
postmenopausal women.
Psychother Psychosom 1993;59(1):34-40.

Kagan BL, et al., Oral S-adenosylmethionine in depression:
a randomized, double-blind, placebo-controlled trial.
Am J Psychiatry 1990 May;147(5):591-5.

di Padova C, S-adenosylmethionine in the treatment
of osteoarthritis. Review of the clinical studies.
Am J Med 1987 Nov 20;83(5A):60-5.

Vetter G, Double-blind comparative clinical trial with
S-adenosylmethionine and indomethacin in the
treatment of osteoarthritis.
Am J Med 1987 Nov 20;83(5A):78-80.

Chawla RK, et al., Biochemistry and pharmacology
of S-adenosyl-L-methionine and rationale for its
use in liver disease.
Drugs 1990;40 Suppl 3:98-110.

Jacobsen S, et al., Oral S-adenosylmethionine in
primary fibromyalgia. Double-blind clinical evaluation.
Scand J Rheumatol 1991;20(4):294-302.

Maitake Mushroom:
Nanba H, Activity of maitake D-fraction to inhibit
carcinogenesis and metastasis.
Ann N Y Acad Sci 1995 Sep 30;768:243-5.

 


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CONSULTATIONS:

From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.


Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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