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January 2001

Letter from Dr. Janson
Cholesterol Risks
Lifestyle and Pets for Depression
Organic Standards
In the Health News
Recipe of the Month: Bean Chili for Winter

Letter from Dr. Janson
Dear Friends,
I am glad I waited until after the holidays to report to you about the relationship of large meals to heart attacks! Recent reports confirm what many have known for a long time–large meals trigger heart attacks. In fact, people who eat a large meal are four times more likely to have a heart attack in the next two hours (and within the first hour, the risk is increased 10-fold).

The researchers did not take into account whether a large meal of vegetables, brown rice, and tofu, with some garlic and onions would have the same effect, but no matter what you choose to eat it is best not to overdo it. Even healthy foods, in large amounts,are stressful on your arteries and digestion.

Now that the holidays are over, it is time to take stock of your health habits if you want to decrease your risks of developing chronic degenerative diseases. Modifying those health habits is also the best way to make yourself feel good, look good, and have more energy, and help yourself both physically and mentally.

Too Many Drugs
On another note, while drug therapies are often necessary and sometimes lifesaving, we put far too much faith in their safety and effectiveness. Depending on the FDA to protect us from the risks is unreliable, and medicines cause many side effects and deaths. Often, they are pulled from the market after patients (guinea pigs?) have unexpected side effects.

For example, calcium channel blockers are commonly used to treat hypertension. They do lower blood pressure, but do not reduce the risk of heart attacks and heart failure compared to other medications that are less expensive and more effective.

Diuretics, beta-blockers, and ACE inhibitors help with both the blood pressure and heart disease, but it is even better to try non-drug therapies. Diet and weight loss can help many people avoid drugs. Add stress management and dietary supplements, such as vitamin C, magnesium, coenzyme Q10, garlic, and hawthorn berry, and you may be able to avoid drugs and the risk of drug side effects.

The side effects of drugs, even when taken correctly, cause over 100,000 deaths annually, and if you add the dangers of errors in prescribing and administering drugs, it is easy to see how important it is to find alternatives whenever possible. Even with serious diseases, it is not always necessary to take drugs, yet many physicians do not look for the non-drug treatments that are available. Antibiotics are also greatly overused for conditions that don’t warrant them.

Increasing public demand has led to greater awareness in the medical community of alternatives–keep up the good work. Taking charge of your lifestyle choices is the real way to manage your health and avoid the need for medical care.

Chromium and Diabetes
A new study confirms the value of chromium in managing diabetes (adult onset, now more properly called Type II diabetes, as it is now common at earlier ages due to overweight and poor diet).
Earlier studies reported that up to 90 percent of diabetics could get off medication with chromium supplements, if they took 1000 mcg of chromium daily. Chromium enhances insulin sensitivity. This report confirms the value of chromium in an elderly population, using only 400 mcg daily.

Of course, chromium is only a part of the solution to diabetes. A high fiber diet, weight loss, and regular exercise are extremely effective lifestyle changes that help control diabetes. James Anderson, MD, at the University of Kentucky, has shown that diabetics do better following such a diet and exercise program.

In addition, other supplements help both to control sugar levels and prevent the complications of diabetes, related to circulatory disorders, visual problems, and neurological symptoms. Bioflavonoids, alpha-lipoic acid, coenzyme Q10, bilberry, proanthocyanidins, magnesium, gamma-linolenic acid, vitamins C and E, B complex, and others are all beneficial for diabetics.

Cholesterol Risks
Recent research suggests that cholesterol is not only a problem when it builds up as part of the plaque inside the arteries. High blood cholesterol levels may impede oxygen delivery to all body tissues, and impair their function.

The cholesterol that you eat from animal products should be limited, especially from flesh foods, (I do recommend some organic eggs in the diet). However, the cholesterol that you produce in the liver is a greater contributor to blood cholesterol levels than diet. You produce more cholesterol when you are under oxidative stress and free radical exposure, which may be why antioxidants can lower cholesterol levels.

Although cholesterol is a component of all cell membranes, when too much builds up in red blood cell membranes, it blocks the transport of oxygen, which is carried by the hemoglobin in the red cells. This could starve tissues of oxygen, and in heart muscles this could lead to increased pain on exertion (angina).

In this study, patients with high cholesterol had an 18 percent lower oxygen level in the tissues than patients with low cholesterol.

Treatments that lower cholesterol include diet and some drugs, but there are alternatives to the drugs that are much safer. For example, a form of vitamin B3 called inositol hexaniacinate lowers cholesterol, but does not cause the flush that is typical of plain niacin, and it does not affect the liver, which can occasionally happen with high doses of other niacin forms (niacinamide does not cause a flush either, but it does not lower cholesterol).

Other supplements that help include garlic, chromium, vitamins C and E, gugulipids (an Indian herb), and the red-yeast rice that I wrote about in the last issue. Antioxidants also help because oxidized cholesterol is the most dangerous form.

A healthy diet plays the greatest and most comprehensive role in protecting you from heart disease. As you know by now, my diet guidelines include lots of fresh vegetables and fruits, whole grains, legumes, nuts, seeds, and small amounts of fish and organic eggs and low-fat yogurt. Medical literature consistently supports this diet as the most healthful for most people, including most diabetics.

However, I do recognize that some diabetics and insulin resistant people might need modification of this diet until they get their situation under control. Health practices that reduce insulin resistance are chromium, exercise and weight loss.

Lifestyle and Pets for Depression
Although I write often about the benefits of good nutrition and dietary supplements in the treatment of depression, non-nutritional influences can also make a big difference.

For example, having a pet may provide relief from depression. Pets offer unconditional affection, while the responsibility of caring for a pet, can give a sense of purpose and joy in life. Pets provide physical contact and emotional comfort, which are frequently lacking in the lives of people experiencing depression. Dogs or cats can also be wonderful companions, and thus reduce feelings of loneliness that often accompany depression.

If you have to go out to walk a dog every day, you will get more physical activity yourself, and sustained exercise can produce endorphins, brain chemicals that give a mild sense of euphoria (the so-called “runner’s high,” though the exercise does not have to be running).

Aerobic exercise (the level that you can do without getting short of breath but works up a sweat) is enough to release endorphins, if you keep it up long enough. This is usually 30 to 40 minutes, but every individual is different, and you have to find the level at which it happens for you.

Light and Depression
Having a dog that requires outdoor activity or getting outdoors for exercise may provide further relief because of increased light exposure. The low level of natural light in winter is one cause of a form of depression called Seasonal Affective Disorder (SAD).
Light decreases the daytime production of melatonin, a hormone produced by the pituitary gland that influences the body clock. Exposure to powerful light sources early in the morning (the timing is important) will suppress melatonin production at the right time, and can help reset the body clock and reduce depression.

Special “light boxes” (small collections of fluorescent bulbs) can provide adequate light when it is needed. Light boxes are available from a variety of sources at a range of prices. You don’t have to spend a fortune to find one that works for you.

Melatonin supplements at bedtime can also help (well, I suppose I could not get away from supplements altogether). Doses are usually in the range of 1 to 3 mg of melatonin, but some people respond to more or less. These doses usually help sleep as well as helping depression. One study used as much as 10 mg of melatonin to achieve results, and after a time they were able to reduce the dose and maintain the benefits.

You can take a sublingual melatonin dissolved in the mouth if you have trouble falling asleep. You can take a timed release tablet if your habit is to fall asleep easily but wake up in the middle of the night and find yourself unable to go back to sleep.

Organic Standards
The USDA, always more friendly to the conventional food industry, has produced their own version of national organic food standards. Labels should appear next summer, but some questions still remain about these standards.

After public outcry, they eliminated irradiated foods, genetically modified foods, and those fertilized with sewage sludge, but many in the natural products industry worry that they will not be as strict as current standards. We will have to wait to see how this influences the supply and purity of organic foods.

Industrial food producers want to claim that “organic” is just a marketing gimmick, and they want the public “informed” that organic foods are not better than conventional foods. They’re wrong. Organic foods are better for your health and the environment. Pesticides are not healthy.

In the Health News

•We know that saw palmetto berry extract helps benign prostate enlargement, but now there is evidence from the laboratory that saw palmetto also helps prevent and treat prostate cancer (American Society for Cell Biology meeting, Reuters Health, Dec 2000). Saw palmetto decreased growth of cancer cells in culture. It killed other cancer cells, but it was five times more potent against prostate cancer cells. The researchers noted that because it inhibited the inflammatory substance known as COX-2, which is high in prostate cancer cells, long-term usage of saw palmetto could help to prevent prostate cancer as well as treat it. The usual dose of saw palmetto is 160 mg of standardized extract, 2 to 3 times a day.

• While mentioning organic standards, we now have even further evidence that pesticides are detrimental to human health (as well as that of the environment). Household pesticides are increasingly implicated in cancer, especially childhood cancers. A study at USC (Cancer 2000;89:2315-2321) showed that household pesticide use before and during pregnancy, or while nursing, significantly increased the risk of non-Hodgkins lymphoma. Choose organic foods to further reduce pesticide exposure.

Diet and Disease
• Factory farming of animals increases the risk of “mad-cow disease” or BSE (bovine spongiform encephalopathy). This is another reason not to eat beef–the scientists claim that our testing is not accurate enough to detect this disease in order to protect the consumer, and they endorse organic farming. Even disposal of infected animals could add to the environmental contamination. (Reuters Medical News, Dec, 2000)

Recipe of the Month
Bean Chili for Winter

A hearty bean chili is just what you need to keep you warm and well nourished in the winter. I cook organic pinto beans in a pressure cooker to save time–about 20 to 25 minutes at pressure, and then I let it cool (or you can buy organic ones in a jar). Add these to sauteed garlic, onions, and mushrooms in olive oil (or dry in a non-stick pan), and add tomato sauce, chili powder to taste, oregano, cumin, and minced spinach. Add chopped cilantro at the very end to maintain its pungent flavor. I put this in an organic whole wheat or corn tortilla with some lettuce, fresh tomato, and avocado, and I serve it with some steamed broccoli or a salad. You can use another variety of bean, such as kidney beans, black beans, navy beans, or aduki beans.

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Food and Medicines:
Heart Attacks Jump After Large Meal, (American Heart Association
Meeting), Kerr M, Reuters Health, November, 2000.

He J, Whelton PK, Selection of initial antihypertensive drug
therapy. Lancet 2000 Dec 9, 356(9246):1942-3.

Pahor M, et al., Health outcomes associated with calcium
antagonists compared with other first-line antihypertensive
therapies: a meta-analysis of randomised controlled trials.
Lancet 2000 Dec 9, 356(9246):1949-54.

Blood Pressure Lowering Treatment Trialists’ Collaboration,
Effects of ACE inhibitors, calcium antagonists, and other blood-
pressure-lowering drugs: results of prospectively designed over-
views of randomised trials.Lancet 2000 Dec 9, 356(9246):1955-64.

Antibiotics often prescribed inappropriately for bronchitis in
emergency room. Research Forum of the American College of
Emergency Physicians, Reuters Health October 27, 2000.

Chromium and Diabetes:
Rabinovitz H, Presented at Gerontological Society of America
meeting, Reuters Health, Nov 20, 2000.

Anderson RA, et al., Elevated intakes of supplemental chromium
improve glucose and insulin variables in individuals with type
2 diabetes. Diabetes 1997 Nov;46(11):1786-91.

Cholesterol: New Risks:
Buchwald H, et al., Plasma cholesterol: an influencing factor in
red blood cell oxygen release and cellular oxygen availability.
J Am Coll Surg 2000 Nov;191(5):490-7.

Kummerow FA, et al., The relationship of oxidized lipids to
coronary artery stenosis. Atherosclerosis 2000 Mar;149(1):181-90.

Lifestyle and Pets for Depression:
Jennings LB, Potential benefits of pet ownership in health
promotion. J Holist Nurs 1997 Dec;15(4):358-72.

Friedmann E, Thomas SA, Pet ownership, social support, and one-
year survival after acute myocardial infarction....
Am J Cardiol 1995 Dec 15;76(17):1213-7.

Light, Melatonin, and Depression:
Garfinkel D, et al., Facilitation of benzodiazepine
discontinuation by melatonin: a new clinical approach.
Arch Intern Med. 1999 Nov 8;159(20):2393-5.

Danilenko KV, et al., Diurnal and seasonal variations of
melatonin and serotonin in women with seasonal affective
disorder. Arctic Med Res 1994 Jul;53(3):137-45

Organic Standards:
Glickman Announces National Standards for Organic Foods
USDA News Release No. 0425.00, Dec 20, 2000


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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.