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December 2000

Letter from Dr. Janson
Inflammation and Heart Disease
Lycopene and Lung Cancer
FDA, Red-Yeast-Rice, and Cholesterol
In the Health News
Recipe of the Month: Tasty Tofu -- Believe it or not!
References

Letter from Dr. Janson
Dear Friends,
On a recent radio show during the election campaigns, the cost of health care came up, and one Medicare recipient was complaining about her annual $6,000 bill for medications. That’s right, over $500 every month. She was lamenting the situation saying something like “I have heart disease, and high blood pressure. I’ve had open heart surgery, and I am diabetic. I’m tired; and I have arthritis–doesn’t everybody?”

It is no wonder that costs of medical care are so high; it is taken for granted that as people age they develop degenerative diseases, leading to extensive use of the medical care system; and it is getting to the breaking point.

I can tell you with some confidence that it is not necessary to get increasingly sick as you age, if you take proper care of yourself. The reason people do get sick is that they have little conception of how to follow healthy lifestyles.

To paint some analogies, if you constantly slam down the gas pedal in your car, jam on the brakes, use the wrong fuel and the wrong oil, and you don’t change the air filter, or the spark plugs, or maintain proper air pressure in the tires, would you wonder why your car maintenance costs are so high?

Well, this is exactly the way most people take care of their bodies. They jolt themselves awake with caffeine, calm down with alcohol, eat junk that is high in sugar and white flour, consume the wrong oils (hydrogenated oils and too much animal fat), drink tap water if they drink enough at all, and don’t exercise (akin to tuning up with new spark plugs). Is it any wonder that 3/4 of Americans are above their ideal weight, and 1/3 are obese. With this lifestyle, yes, everybody will have the problems of that Medicare patient, even though she was only 67 years old.

These problems are not genetic! The claim that they are is simply an excuse to avoid the responsibility for our own health. Most of the time, genetic tendencies are manifest only when lifestyle choices enhance their expression. What influences the genes to express themselves or not are health choices. When people move to the United States, their genes don’t change, but their illnesses do, as soon as they change their diet and exercise patterns to mimic the diet known as SAD (Standard American Diet).

You have the power to change your health, and you do not have to anticipate being dependent on drugs for heart disease, arthritis, diabetes, high blood pressure and other conditions, all of which are strongly influenced by what you eat, how much you exercise, and whether you are able to relax and focus on your spiritual center. You are in charge of your health, and by taking that responsibility, you can reduce the cost of health care for yourself, and for everyone else. The government cannot afford current levels of disease care, and it doesn’t provide health. Health is something you give yourself.

Inflammation and Heart Disease
One of the common denominators in the risk of developing coronary artery disease appears to be chronic inflammation from a variety of causes. I have previously reported on the cardiac risk indicator called CRP, or C-Reactive Protein. This is only one general indicator of inflammation, but its presence in high amounts is more closely associated with heart disease than cholesterol.

Other information is coming out about specific associations of chronic infections, such as gum disease (periodontal infection); Chlamydia pneumoniae; Herpes simplex virus; cytomegalovirus (CMV); and Helicobacter pylori(associated with stomach ulcers), with arterial disease.

The common denominator may be the high levels of CRP. This protein may not be just a marker for arterial disease, but it now appears to directly damage the lining of the arteries. High white blood counts, another sign of infection, are also associated with increased mortality from heart attacks, and with less response to the clot-busting medications.

Protection from Inflammation
With all this information, what can you do to protect yourself from infection and inflammation. Most of the time, low resistance is related to poor diet, high stress, lack of sleep, and inadequate nutrition, including dietary supplements. My regular dietary guidelines, with low sugar, high intake of fresh vegetables and fruits, whole grains, beans, and elimination of hydrogenated fats, are the first line of defense.

Fat intake has an interesting relationship to heart disease in this regard. High animal fat appears to lead to more inflammation. It contains high levels of arachidonic acid, a fatty acid that increases prostaglandin E2 (PGE2), associated with inflammation, platelet aggregation, and spasm of blood vessels. Hydrogenated oils interfere with the other prostaglandins that might counteract the PGE2.

You can reduce these effects by avoiding animal fat and taking supplements of gamma-linolenic acid (GLA) and omega-3 oils such as flax seeds and fish oil (EPA and DHA). The researchers suggest that cholesterol is pro-inflammatory, which is one reason they give for the apparent benefits of cholesterol-lowering “statin” drugs. Niacin (vitamin B3) is also of value, not only because it lowers cholesterol, but because it favorably affects other risk factors, for example, lowering serum fibrinogen to reduce excessive clotting. (See page 3, on red-rice-yeast.)

Supplements Against Inflammation
A number of dietary supplements play a role in battling infection and reducing inflammation, in addition to niacin and essential fatty acids. Vitamin C helps reduce inflammation and enhance immunity, and it is particularly valuable against viruses if taken in high doses. I recommend 4000 to 6000 mg daily for viral susceptibility, as that amount maintains white blood cell levels when they would otherwise drop during an infection. It also increases production of interferon , a natural antiviral substance.

Vitamin E, 800 IU daily, has been shown to enhance immunity in the elderly. Zinc is an essential mineral for proper immune function, supporting both antibody production and white blood cell activity.
A number of herbs reduce inflammation, including ginger, curcumin (from turmeric), nettle, feverfew, Siberian and American ginseng, and the pineapple enzyme, bromelain.

The herbs that help immunity are echinacea, astragalus, beta 1,3 glucan, maitake mushroom, and a number of others.

You can also protect yourself from viruses and bacteria with supplements of transfer factor, the colostrum derivative that I have written about in previous newsletters.

Heart and vascular diseases result from complex combinations of risk factors, almost all of them strongly controlled by our own habits and actions. You don’t have to be an unwitting victim, as long as you realize that you are in charge.

Lycopene and Lung Cancer
The large Nurses’ Health Study and the Physicians’ Health Study provide further evidence of the value of diets high in fruits and vegetables.

Lycopene, the carotenoid concentrated in tomatoes, protects both smokers and non-smokers from lung cancer, while other carotenoids, such as alpha-carotene and lutein seem to be protective only in non-smokers. This relationship might be related to the other vitamins and phytochemicals found in abundance in the same foods that are the sources of carotenoids, but there does seem to be a protective effect from many nutrients, including supplements. Some other beneficial phytochemicals: indole-3 carbinol, phenethyl-isothiocyanate, ellagic acid, and capsaicin.

A study on lung cancer patients who took large doses of antioxidants showed that they survived far better than expected. In fact, although the kind of lung cancer studied usually has a 99 percent mortality after one year, 40 percent of these patients lived almost three years, and some even longer.

Other dietary supplements that protect against cancer or help support the treatment include vitamin C, folic acid, coenzyme Q10, vitamin E, calcium D-glucarate, and beta 1,3 glucan. The same transfer factor mentioned above also improves lung and prostate cancer survival, likely because of its immune enhancing properties.

FDA, Red-Yeast-Rice, and Cholesterol
Recently the FDA ruled that a natural substance found in red-yeast-rice (Cholestin) could not be marketed as a cholesterol-lowering agent. It turns out that this food source supplement contains a naturally occuring component (monacolin K) that the FDA has already allowed to go on the market as a patented drug called Mevacor (lovastatin).

The statin drugs do lower cholesterol, but the reason drug companies spend so much money to market synthetic or modified substances is that they cannot patent natural substances. When it was discovered that the statin-like molecule in red-yeast-rice occurred naturally, the patent on Mevacor should have been withdrawn.

Instead, the FDA ruled that the red-yeast-rice should be withdrawn, even though it is a natural substance and falls under the protection of the Dietary Supplement Health and Education Act.

Of course, the FDA can remove any substance that poses a health risk from the market , natural or otherwise, but their actions on this product clearly shows their bias against dietary supplements and their favorable treatment of drugs.

The lead author of the article on Cholestin points out in a letter to the editor that dietary supplements are not unpurified drugs–they are natural substances. Synthesis of drugs by crystallization and purification of plant sources makes the resulting medical treatment more expensive, more risky, and less accessible, and if natural dietary supplements were available instead, public health would be more affordable and safer.

As is common with natural products, Cholestin contains a variety of compounds related to monacolin K, all of which may have an effect on cholesterol levels. It also appears to be quite safe.

Unfortunately, after a victory of the manufacturer over the FDA in District Court, the Appeals Court ruled that the FDA could regulate Cholestin (this court often sides with FDA). This threatens to deprive you of easy access to this beneficial supplement for heart health.

In the Health News
•“Some of what we have been calling ‘normal aging’ may in fact be due to past exposures to chemicals or other agents that can affect the central nervous system,” says one researcher after examining the effects of lead exposure on mental decline with age. (Schwartz BS, et al., Neurology 2000 Oct 24;55(8):1144-50.) Exposure to many toxins may be associated with various chronic degenerative diseases, and it is important to protect yourself by drinking clean water and breathing clean air as often as possible. (I use a MultiPure solid-carbon block water filter for all drinking and cooking–it removes lead, other heavy metals, pesticides, chemical solvents, and more.) I also recommend intravenous chelation therapy for heavy metal exposure, and for all industrial lead workers.

Diet and Disease
• A new report from the American Heart Association says that soy products, such as tofu, can lower cholesterol and provide protection from heart disease (Circulation 2000 Nov 14;102(20):2555-9). Examining 38 studies led to the conclusion that substituting soy for meat and other animal protein was beneficial by lowering LDL-cholesterol and triglycerides, and raising levels of the good HDL-cholesterol. Critics of soy in the diet usually harp on the use of texturized vegetable protein (TVP), and I agree that this highly processed product is not a good source of nutrition. But the literature is clear that soy from tofu is a benefit for both cancer and heart disease. Other soyfoods, such as tempeh and soymilk contain the same beneficial isoflavones, genistein and daidzein. The recommendation is 25 to 50 grams of soy protein per day. (See the tofu recipe below.)

Recipe of the Month
Tasty Tofu--Believe it or not!

Tofu can be very healthful. Many people say that they don’t like tofu but say they like fried rice–not realizing that it usually contains slivers of tofu. I like to dice tofu into 1/2 inch cubes, then saute some onions, garlic, ginger, and a touch of cayenne in a small amount of olive oil. When sizzling, add the tofu and saute for one or two minutes, then add a mix of some cut up broccoli, spinach, cabbage, or chard. A touch of soy sauce (careful of its high salt content) or a bit of balsamic vinegar brightens it up. Mix in some cooked brown rice, and stir in for one or two minutes. Turn off the flame, and add a garnish of cut up scallions, cilantro, and a few drops of toasted sesame oil. This is a good way to get healthy while indulging in a tasty pleasure at the same time.

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References

Inflammation and The Heart:
Ridker PM, Report at meeting of Amer Coll for Advancement
in Medicine, Dallas, TX, May 2000.

Ridker PM,C-reactive protein and other markers of
inflammation in the prediction of cardiovascular disease
in women. N Engl J Med 2000 Mar 23;342(12):836-43.

Siscovick DS, et al., Chlamydia pneumoniae, herpes simplex
virus type 1, and cytomegalovirus and...heart disease
death.... Circulation 2000 Nov 7;102(19):2335-40.

Barron HV, et al., Association between white blood cell
count, epicardial blood flow, myocardial perfusion,
and clinical outcomes... Circulation 2000 Nov 7;
102(19):2329-34.

Currier NL, Miller SC, Natural killer cells from aging mice
treated with extracts from echinacea ... are ...rejuvenated.
Exp Gerontol 2000 Aug;35(5):627-39.

Chambers JC, et al., Improved vascular endothelial function
after oral B vitamins... Circulation 2000 Nov 14;
102(20):2479-83.

Lycopene and Cancer:
Michaud DS, et al., Intake of specific carotenoids and risk
of lung cancer in 2 prospective US cohorts.
Am J Clin Nutr 2000 Oct;72(4):990-7.

Kim YI, Folate and cancer prevention: a new medical
application of folate beyond hyperhomocysteinemia and
neural tube defects. Nutr Rev 1999 Oct;57(10):314-21.

Jaakkola K, et al., Treatment with antioxidant and other
nutrients in combination with chemotherapy and irradiation
in patients with small-cell lung cancer.
Anticancer Research May-Jun 1992.

Pilotti V, et al., Transfer factor as an adjuvant to
non-small cell lung cancer (NSCLC) therapy.
Biotherapy 1996;9(1-3):117-21.

FDA and Red-yeast-rice:
Heber D, et al., Cholesterol-lowering effects of a
proprietary Chinese red-yeast-rice dietary supplement.
Am J Clin Nutr 1999 Feb;69(2):231-6.

David Heber, Dietary supplement or drug? The case for
Cholestin.
Am J Clin Nutr 1999 Jul;70(1):106-8.

SoRelle R, Appeals Court says Food and Drug Administration
can regulate Cholestin.
Circulation 2000 Aug 15;102(7):E9012-3

 


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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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