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July 2001

Letter from Dr. Janson
What is the Truth about Vitamin C?
Herbal Quality
More Support for Prostate Cancer
In the Health News
Recipe of the Month: Vegetarian Bean Paté

Letter from Dr. Janson
Dear Friends,
I see a persistent pattern of negative reports about dietary supplements in the media, usually based on incomplete or defective studies, or reports that are irrelevant to the way supplements are used and the mechanisms by which they have their effects. The recent study on vitamin C perhaps causing DNA abnormalities is another example. Every media report I have seen suggested that vitamin C is a “two-edged sword” when it comes to health.

While vitamin C is an antioxidant, in certain conditions (when it is oxidized) it can become an oxidant. This was shown in an in vitro (test tube) study that was heavily reported in the media. Sensational headlines read: “Vitamin C Can Damage DNA,” “Lab Study Finds Vitamin C Dangers,” and “Vitamin C Found to Promote Cancer-Causing Agents.” Such reports might make you think twice about taking vitamin C. Don’t!

What Is The Truth About Vitamin C?
Concluding from this study that vitamin C is dangerous is unwarranted. In almost every clinical study (real people, real conditions, as opposed to test tubes), higher vitamin C intake is associated with better health and lower mortality from all causes. Specific benefits of vitamin C, from food and supplements, range from protection from cataracts and macular degeneration, reduction of arterial disease, whether in the legs, the heart, or the brain, less inflammation, and decreased angina (heart pain due to arterial constriction), to a decreased risk of gastric (and other) cancer.

In addition, a study in volunteers showed that vitamin C could protect the stomach lining from the damaging effects of aspirin. Typically, aspirin and the non-steroidal anti-inflammatory drugs can cause stomach ulcers and bleeding, and these are among leading serious side effects of such drugs, causing many deaths per year. Researchers gave almost 1000 mg daily of vitamin C, and found that the erosions they could see with a gastroscope were markedly decreased, suggesting that the side effect is due to free-radical damage, and that vitamin C is therapeutic. Other studies have shown that vitamin C (and vitamin E) supplements are protective against brain degeneration. It preserves cognitive function in those subjects without dementia, and reduces vascular dementia by 88 percent. The longer the men used the supplements, the greater the effect, so don’t wait for conservative scientists and the media to give you “permission”to supplement.

Even in other in vitro studies, vitamin C shows real benefits. For example, vitamin C and B12 can decrease cancer cell growth in tissue culture. High levels of vitamin C alone or with other antioxidants are toxic to cancer cells, and it protects heart muscle cells against oxidation. Do not make health decisions on sensational media reports that belittle the benefits of dietary supplements.

More Benefits of Vitamin C
Studies abound on the benefits of a high intake of vitamin C, whether from fruits and vegetables or from supplements. Researchers in California studied 994 women, of whom 277 took regular vitamin supplements including vitamin C ranging from 100 to 5000 mg daily. The average intake among these women was 745 mg.
In this study the average duration of taking vitamin C was over 12 years, and over 85 percent of the women took the vitamin C for at least three years. What they found was better bone density with higher vitamin C intake.

The women taking vitamin C with estrogen had even better bone density, and those taking additional calcium had an even better result. In fact, they found a three percent higher bone density when vitamin C was considered independently of the other variables.

Vitamin C is known to be necessary for collagen formation, and collagen is the connective tissue at the foundation of bone formation. It also appears to stimulate bone forming cells called osteoblasts.

In supplementing for bone preservation and increasing bone density, I recommend other supplements in addition to vitamin C and calcium. Ipriflavone, an isoflavone similar to those found in soybeans, helps to build bone density, and natural progesterone helps even more than estrogen.

Other minerals that play a role in bone formation include magnesium, manganese, and boron, so I usually recommend a multiple vitamin-mineral complex with good amounts of each of these.

Vitamin C and Other Conditions
Another study showed that higher vitamin C intake could reduce gall bladder disease by 35 to 40 percent. Vitamin C affects bile acid production, which may be its mechanism of reducing gall bladder symptoms and stones.

In addition to vitamin C, a low-fat, mostly vegetarian diet can also help, as can adding supplements of the amino acid taurine. I often recommend adding 1000 mg of taurine twice a day.

Higher vitamin C levels are also associated with lower blood lead levels. Recent information shows that lead, even in low levels, is not safe, especially for children. Maintaining high levels of vitamin C is important for detoxification among its many other benefits. Other nutrition that helps to lower lead levels comes from a high fiber diet, and dietary and supplemental sources of zinc, vitamin D, and calcium. A high tofu intake lowers lead levels, possibly because it is rich in calcium.

High vitamin C is also associated with better lipid profiles. It increases the level of the good HDL-cholesterol, while lowering the total. In reviews such as these, the blood levels are composed of vitamin C from food and supplements. Because so many Americans take supplements of vitamin C, it has to be presumed that the higher blood levels are to some extent related to those supplements.
The fact is, so much research suggests the value of keeping your vitamin C level high, that it is irresponsible for news media and scientists to caution against supplements based on flawed studies. These warnings will lead to poorer nutritional status and increases in serious diseases.

Herbal Quality
The quality of herbal products available from different sources can vary quite a bit. Researchers took 25 different ginseng products from health food stores, and analyzed them for active compounds. (It is only recently that western medicine accepted that herbs even contain active components.) In some brands, the known active principles were quite different from what was listed on the label, and ranged in these tests from 15 to 200-fold (more than minor natural variation).
Of course, the marker compounds that they studied may not be the only active substances in the herbs, but it does suggest that you have to be careful to buy products from a reliable source. The compounds analyzed were ginsenosides and eleutherosides, thought to be responsible for the ginseng activity of Panax (American and Asian) species and Eleutherococcus (Siberian species).

None of the products were adulterated, so they were safe, but some contained more than the label claim and some less (whether it was significantly less is not clear). My recommendation is to always buy standardized herbs when they are available, whether it is for ginseng or other products. Many standardized herbs are now being sold. They have all of the components of regular herbs, plus known levels of active compounds.

Ginseng is known as an “adaptogen,” able to help cope with physical and emotional stress. They all appear to help the adrenal glands. Siberian ginseng helps stamina and immune function, while American is more relaxing and sedative. The Asian ginseng (also called Korean) helps energy and has a mild stimulant effect.

More Support for Prostate Cancer
At least one of the components of tofu is valuable in slowing the growth of prostate cancer. A team of researchers in California tested genistein in mice with prostate cancer and found that it slowed the growth of the tumors. They also tested it in tissue cultures and found that it inhibited the growth of tumor cells.

Genistein is an isoflavone with antioxidant properties and phytoestrogen activity to help reduce the risk of breast and other cancers, control menopausal symptoms, and protect against osteoporosis. Tofu also decreases the risk of lung cancer.

Adding a variety of soy foods to your diet will contribute isoflavones (which can also be taken as supplements). Tofu can be cut into chunks and added to stir-fried vegetables, or crumbled to use instead of cheese in lasagna with whole wheat pasta . I also like a marinated baked tofu such as Tofu-Lin, by SoyBoy, which I dice in salads, or slice for a sandwich with lettuce and tomato.

Tempeh is an Indonesian soyfood, made from whole soybeans. It is cultured with a mold much the way cheese is made, and it has a distinctive taste. It can be sautéed or marinated, and many ready-made patties are available grilled with lemon-pepper or barbecue flavors to be used in sandwiches as a veggie-burger.

I make a dessert with equal amounts of frozen bananas and “silken” tofu in a food processor, adding a little vanilla and maple syrup or honey, and garnished with crushed almonds. You can use soymilk in cereals–just be careful to choose the ones with the least sugar such as the plain varieties in the “milk-carton” shaped containers.

It is interesting that when the author of the study on prostate cancer presented his findings, he was quoted as saying, “it might be used in an adjuvant fashion to make radiation therapy more effective and ultimately as a chemopreventive agent. But that is a long way off.”

ell, I have news for him–it is already being used as part of effective alternative treatments, combined with saw palmetto and other herbs and supplements.

Shiitake Enhances Effects
The effects of genistein are enhanced by an extract of shiitake, a mushroom long used for its health benefits. A derivative of shiitake, beta-1,3 glucan or “lentinan,” is an immune enhancing substance that can support the treatment of immune deficiency and cancer. Beta-1,3 glucan prolongs the life of cancer patients. One report showed that patients with advanced, metastatic prostate cancer given lentinan in addition to their other therapy had a 35 to 50 percent improvement in longevity compared to the control group. The five year survival was 43 versus 29 percent.

In the Health News
•In The Lancet, a British medical publication, the Editor accused the FDA of having too close ties with the drug industry, and not doing an adequate job of regulating drugs. He said “This story reveals... the extent to which the FDA, its Center for Drug Evaluation and Research (CDER) in particular, has become the servant of industry.” The editorial related to approval of Lotronex, a drug for irritable bowel syndrome, that caused some deaths from ischemic colitis. Irritable bowel syndrome may be debilitating in some cases, but it is not fatal. The FDA scientists who had expressed concerns about safety were ignored. Other natural treatments are often effective, using dietary change, L-glutamine supplements, and essential fatty acids, along with acidophilus and other intestinal support. Horton R, Lotronex and FDA, Lancet 2001 May 19;357(9268); 1544.

Diet and Disease
•A group of researchers has “discovered” that if you eat like early man–the diet from evolutionary times–you can reduce your risk of disease. Jenkins DJ, et al., Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001 Apr;50(4):494-503.

The diet they studied was very high in fruits, vegetables, and nuts, as well as fiber. In fact, it had about four times as much fiber as even the current USDA recommended increase. The diet also had no meat, cheese, or butter. This diet lowered cholesterol within one week, and the LDL cholesterol went down by 33 percent. The researchers said that gathering greens and fruits played a much larger role than hunting small animals, and this diet reduces the risk of heart disease and colon cancer. These benefits were far greater than from the Heart Association diet and even better than the Mediterranean diet.

Recipe of the Month
Vegetarian Bean Paté

This is a quick snack (once it is cooked) that I make as a spread for whole grain bread or chips. Sauté some minced onions, garlic, mushrooms, carrots, parsley, and herbs, especially thyme, basil, cumin, fresh coriander, soy sauce, and pepper, until well done. Add some toasted whole grain bread crumbs (about equal to half the onions), and put the mixture in a food processor with an equal amount of cooked navy beans. When the mix is a smooth, pasty texture, turn it into a baking loaf dish coated with a thin layer of olive oil. Bake it at 400 degrees covered with foil for 20 minutes, and then uncover and bake until the top is brown, about another 10 to 20 minutes and let it cool. I freeze the extra and take it with me on trips or for quick lunches with some lettuce and tomato or a salad.

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Vitamin C Research
Khaw KT, et al., Relation between plasma ascorbic acid and
mortality.... Lancet 2001 Mar 3;357(9257):657-63.

Mares-Perlman JA, et al., Vitamin supplement use and incident
cataracts ... Arch Ophthalmol 2000 Nov;118(11):1556-63.

Masaki KH, et al., Association of vitamin E and C supplement
use with cognitive function and dementia in elderly men.
Neurology 2000 Mar 28;54(6):1265-72.

Pohle T, et al., .. aspirin-induced gastric damage:
gastroprotection by vitamin C. Aliment Pharmacol
Ther 2001 May;15(5):677-87.

Casciari JJ, et al., Cytotoxicity of ascorbate, lipoic acid,
and other antioxidants.. in vitro tumours. Br J
Cancer 2001 Jun;84(11):1544-50.

Rinne T, et al., Vitamins C and E protect isolated
cardiomyocytes against oxidative damage. Int J
Cardiol 2000 Sep 15;75(2-3):275-81.

Morton DJ, et al., Vitamin C supplement use and bone mineral
density in postmenopausal women. J Bone Miner Res 2001

Simon JA, Hudes ES. Serum ascorbic acid and gallbladder
disease... Arch Intern Med 2000 Apr 10;160(7):931-6.

Simon JA, Hudes ES, Relationship of ascorbic acid to blood
lead levels. JAMA 1999 Jun 23-30;281(24):2289-93.

Herbal Quality
Harkey MR, et al., Variability in commercial ginseng products:
an analysis of 25 preparations. Am J Clin Nutr
2001 Jun;73(6):1101-6.

Soyfoods and Prostate Cancer
Soy extract slows prostate cancer growth in mice. Reuters
Health, June 5, 2001

Kolonel LN, et al., Vegetables, fruits, legumes and prostate
cancer... Cancer Epidemiol Biomarkers Prev 2000 Aug;9(8):795-804.

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.

Wakai K, et al., Risk modification in lung cancer ..preserved
foods and soyfoods: Lung Cancer 1999 Sep;25(3):147-59.

Matsuoka H, et al., Lentinan potentiates immunity and prolongs
the survival time....Anticancer Res 1997 Jul-Aug;17(4A):2751-5.

Tari K, Effect of lentinan for advanced prostate carcinoma
Hinyokika Kiyo 1994 Feb;40(2):119-23.


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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.