Letter from Dr. Janson
New Heart Drug -- Do We Need It?
Coenzyme Q10 and L-Carnitine
Soy Foods are Beneficial
In the Health News
Recipe of the Month: Spicy Curried Cauliflower
Recent reports of the crisis in Europe from foot and mouth
disease have misrepresented the nature of the problem. I dont
mean the admittedly devastating effect the disease has on
animals, the extremely contagious nature of the illness, or
the ruin faced by some farmers who depend on their cattle,
pigs, and sheep for their livelihoodanimals that are
being slaughtered in vast numbers to prevent the spread of
the disease (even zoo animals are at risk.)
Foot and mouth disease is caused by a virus that only rarely
affects humans, but causes serious disease in animals, which
lose the ability to eat, drink, and walk due to blisters on
the lips, mouth, throat, feet, and legs.
The media reports all refer to this as a food
crisis. In reality it is not a food crisis, but an economic
crisis. There is no lack of healthy foods or calories available
to the European population, as they are turning increasingly
to vegetarian sources of nutrition plus fish. It reminds me
somewhat of the crisis that occurred in Russia during the
breakup of the Soviet Union.
At that time, everyone was complaining about the shortages.
What were they missing? Not potatoes, carrots, cabbage, onions,
kasha or beans; according to the media, they were devastated
by the lack of sausage, meats, sugar, alcohol, and tobacco.
What foods they did have were at least healthier than the
items they were missing. (This is not to belittle the reality
of their social crisis and the perceived devastation from
the shortages that they had to endure. And they were also
likely short of some fresh fruits and green vegetables.)
Coming as it does on top of the fear of bovine spongiform
encephalopathy (BSE, or mad cow disease), which does affect
humans in the form called Creutzfeld-Jacob disease, the current
European crisis is turning increasing numbers of the population
toward healthier vegetarian diets. This is not a food crisisencouraging
people to choose better diets, for whatever reason, is a health
benefit. At the same time these people will be avoiding the
hormones, antibiotic residues, and the accumulated pesticides
that are found in animal foods in higher amounts than in plant-based
The serious human risks from a high-meat diet are far more
devastating to the population as a whole than mad cow diseasefar
more people die of heart disease and cancer (in the hundreds
of thousands every year) than of Creutzfeld-Jacob disease,
and those illnesses are partly related to meat consumption.
That true health crisis does not lead to explosive headlines
in the mass media. Even the economic crisis is of unclear
significance. As people choose healthier lifestyles, the risk
of chronic, degenerative disease goes down, and the corresponding
cost of health care will also decline. This crisis could easily
result in a lower overall associated cost to society when
the entire picture is considered.
Patients with acute chest pain are often treated with
aspirin to reduce the risk of a heart attack within the next
few days or in the near future. Plavix, a new drug with similar
effects, has now been shown to prevent heart attacks in those
patients with acute coronary syndrome (ACS).
Angina is heart-related pain on exercise, but ACS is recurrent,
unstable angina in patients who have had a mild heart attack,
and develop unmanageable pain even at rest.
I was impressed with one news reporter who was awaiting the
results of the trial, which was reported to the American College
of Cardiology in March. This reporter was so eager to say
that it would be great if we could now have a pill to
take instead of surgery or angioplasty.
Well, we do have such pills. They have been available for
decades (but relatively cheap and not patentable). I am referring,
of course to vitamin E (400 IU), garlic (500-1000 mg), ginkgo
biloba (60-120 mg), and other natural products that reduce
The author of the study, a Dr. Yusuf, said, The widespread
use of [Plavix] in addition to aspirin in ACS could prevent
about 50,000-100,000 heart attacks, strokes, or deaths every
year in North America. However, this is at a cost of
three dollars a day for this one pill.
Compare this to about ten cents a day for vitamin E, 20-40
cents for ginkgo,and 20 cents for garlic pills, and you can
see why the drug companies want to research and sell the patentable
Platelet aggregation or stickiness (partly a result
of high dietary levels of animal fat, hydrogenated oils, such
as margarine, and stress), is the first step in blood clotting,
so any reduction helps to lower the risk of a blood clot inside
the vessels that might lead to a heart attack or stroke.
Many natural substances control excessive platelet aggregation.
Essential fatty acidsGLA from borage or evening primrose
oil (240 mg daily), and EPA and DHA from fish oil (600-2400
mg); ginger (250-500 mg); ginseng (200-400 mg); curcumin (turmeric
extract, 300-600 mg) are among many that reduce platelet aggregation.
Of course, one of the advantages of taking natural products
instead of drugs is that they usually have other benefits
besides the ones you are expecting. For example, vitamin E
also enhances immunity and has antioxidant properties; ginkgo
biloba helps memory, small blood vessel circulation, and headaches;
ginger and curcumin are natural anti-inflammatory agents;
and fish oil reduces triglyceride levels and heart disease.
The drugs, however, usually have negative side effects (as
opposed to side benefits) and interactions with other drugs
that are undesirable and often unexpected. Plavix, for example,
is associated with increased gastrointestinal bleeding, similar
to aspirin but a little less common. It also causes skin rashes,
digestive upset, and, rarely, a few more serious conditions.
My recommendations would be to try the natural products first,
adding magnesium, coenzyme Q10 and L-carnitine, along with
a healthy diet. In addition, I strongly urge my patients with
heart disease to have chelation therapy, a safe intravenous
treatment for heart and other circulatory disorders. It has
been used successfully for the past 50 years. I have practiced
it since 1983. A recent report from Canada is contrary to
prior studies, and not yet analyzed. I doubt the results from
cardiologists with a bias against chelation.
You can find a chelation therapy practitioner in your area
by going to the website of the American College for Advancement
in Medicine (www.acam.org).
ACAM puts on scientific conferences twice a year: some of
the best medical meetings in the country. It is run by practitioners
experienced in all areas of alternative and complementary
medicine. (The next meeting is in Nashville, May 9-13, also
open to the public.)
Some people are unclear about the relationship between
coenzyme Q10 and L-carnitine, and how they are both important
for energy production, heart disease, and management of fatigue.
They work together in metabolism, so you may need to take
both of them, especially as you get older.
As you age, the production of both coenzyme Q10 and L-carnitine
declines (as it does with many other substances, such as DHEA,
progesterone, testosterone, melatonin, and pregnenolone, to
name a few). You make L-carnitine from the amino acids L-lysine
and L-methionine, and CoQ10 is made from other coenzymes in
Your body stores energy in a molecule called ATP, or adenosine
triphosphate. The three phosphate bonds of ATP have high potential
energy, so it takes energy to make them, and then they release
energy when they are broken down, letting go of one phosphate
at a time.
In order to make ATP, you need both CoQ10 and L-carnitine.
Little cellular organelles (organs that are small enough to
be inside cells), called mitochondria are the location of
ATP production. They are the cellular engines, or powerhouses,
and they make ATP from free fatty acids (FFA). The reaction
requires the presence of coenzyme Q10, but it also needs those
FFA from the blood stream.
L-carnitine is the transport molecule that carries the FFA
across the membrane of the mitochondria. In order to have
adequate production of ATP, you need enough L-carnitine to
carry the fatty acids to the CoQ10. Of course, you need the
FFA also, but it is rare to have significant total fat deficiency.
However, you should be sure your diet has adequate amounts
of the essential fatty acids to meet your needs. Improvement
in fat burning leads to lower triglyceride levels in the blood,
and L-carnitine also helps to reduce the amount of lipoprotein
(a), a risk factor for heart disease.
For heart patients and those who suffer from frequent or
severe fatigue, I recommend both L-carnitine and CoQ10. Typical
daily doses are from 1000 to 2000 mg of L-carnitine, and 100
to 200 mg of CoQ10. For more severe heart patients, it is
often beneficial to take higher doses of both, in combination
with diet and other supplements, and other lifestyle changes,
such as relaxation techniques and a graded exercise program.
Some articles have appeared recently in magazines and
newsletters saying that foods derived from soybeans are not
as healthy as once thought. Of course, it is only recently
that major health organizations and government agencies were
willing to take any stand against the meat and dairy industries,
and began recognizing the health value of eating soyfoods
to replace meat.
Soy foods (such as soymilk, tofu, and tempeh) are very nutritious,
but like almost all foods, you can eat too much of them, and
I do not recommend the highly processed TVP (texturized vegetable
protein). In a double blind study, subjects who ate biscuits
with added soy protein had a 5 percent rise in their good
HDL cholesterol, and no change in their LDL cholesterol. Similar
studies showed improved lipids in normal and diabetic subjects.
In another study, young women (30-40 years old) in China
who had the highest intake of soymilk and tofu had only one
third the rate of bone loss as those who ate the least soy.
Supplements of soy isoflavones are available for those who
do not like soyfoods (a typical daily dose is 20 to 80 mg
of the actual isoflavones from soy protein).
Chronic infections can increase your risk of developing
atherosclerosis and heart disease. Respiratory, dental, and
urinary tract infections lead to increased production of C-reactive
protein (CRP), and other markers of inflammation. CRP is not
only a marker of risk, but may contribute to arterial damage.
Natural reduction of inflammation and infection is better
than chronic use of antibiotics. Supplements of vitamins C
and E, garlic, lactobacilli, and transfer factor (from colostrum),
as well as curcumin and ginger, help reduce infection and
inflammation. Kiechl S, et al., Chronic infections and the
risk of carotid atherosclerosis...Circulation 2001 Feb 27;103(8):1064-70.
Small increases in the level of vitamin C in the blood
can significantly reduce the risk of mortality from all causes,
including heart disease and strokes. Increasing the amount
of fruits and vegetables by one serving per day can reduce
mortality by 20 percent. The highest level of vitamin C in
the blood can cut mortality from these serious diseases in
half. It is true that vitamin C may just be a marker for better
nutrition with more fruits and vegetables, but the evidence
continues to mount that good nutrition, including vitamin
C, is beneficial. (Khaw KT, et al., Lancet 2001 Mar 3;357(9257):657-63.)
Flavonoids, or bioflavonoids, are an important part
of a healthy diet. All sources of flavonoids help to reduce
disease. These antioxidant pigments, found in fruits, vegetables,
grains, beans, wine (or grape juice), and tea, are effective
free radical scavengers, metal chelators, and antithrombotic
agents (platelet antagonists), reducing the risk of heart
attacks and mortality from heart disease, even in smokers.
(Hirvonen T, et al., Intake of flavonols and flavones and
risk of coronary heart disease in male smokers. Epidemiology
This is one of my favorite meals. Pressure cook some chick
peas, steam some potatoes and cauliflower, then saute some
garlic, onions, curry powder, cumin, and black mustard seeds
(ginger is another option) in a non-stick pan with a bit of
olive oil. Continue cooking while folding in the chick peas,
potatoes, and cauliflower until they are well mixed. Add enough
water from the chick peas to make a sauce, and mash a few
of the potatoes and chick peas to thicken it . Add chopped
green chard to cook for just a minute or two, and a small
amount of sea salt or tamari soy sauce. Garnish this with
some chopped cilantro, which always tastes best if you mix
it in at the end, after the heat is off. Serve this over some
brown rice or with some whole wheat flatbread.
Click here to receive the Healthy Living newsletter free.
Piper E, World Governments
Scramble to Halt Foot-And-Mouth
Reuters (London) March 15, 2001.
Tavani A, Red meat intake and cancer risk:
a study in Italy.
Int J Cancer 2000 May 1;86(3):425-8.
Key TJ, et al., Health benefits of a vegetarian
Proc Nutr Soc 1999 May;58(2):271-5.
Kerr M, Aspirin-Drug Combo
Lowers Heart Attack Risk
Reuters Health March 19, 2001.
Diamond BJ, et al., Ginkgo biloba extract:
clinical indications. Arch Phys Med Rehabil 2000
Das I, et al., Potent activation of nitric
oxide synthase by
garlic: a basis for its therapeutic applications.
Curr Med Res Opin 1995;13(5):257-63.
Sirtori CR, et al., L-carnitine
reduces plasma lipoprotein(a)
levels in patients with hyper Lp(a). Nutr Metab Cardiovasc
Dis 2000 Oct;10(5):247-51.
Singh RB, Aslam M, L-carnitine administration
in coronary artery
disease and cardiomyopathy. J Assoc Physicians India 1998
Brevetti G, et al., European multicenter
study on propionyl
L-carnitine in intermittent claudication.
J Am Coll Cardiol 1999 Nov 1;34(5):1618-24.
Morisco C, et al., Effect of coenzyme Q10
therapy in patients
with congestive heart failure. Clin Investig 1993;7
Hermansen K, et al., Beneficial
effects of a soy-based dietary
supplement on lipid levels and cardiovascular risk markers
type 2 diabetic subjects. Diabetes Care 2001 Feb;24(2):228-33.
Wangen KE, et al., Soy isoflavones improve
plasma lipids ....
Am J Clin Nutr 2001 Feb;73(2):225-31.
Soy beneficial even for individuals with
levels, Reuters Health, March 5, 2001.
Somekawa Y, et al., Soy intake related
to menopausal symptoms,
serum lipids, and bone mineral density in postmenopausal
Japanese women. Obstet Gynecol 2001 Jan;97(1):109-15.