Letter from Dr. Janson
Ask Dr. J.
In the Health News
A Simple Quick Breakfast
Several of my patients have recently asked me for a supply
of Cipro to have on hand just in case. I have
advised against it, and I do not have a supply for myself.
It is not because I dont believe in the value of antibiotics,
and not out of concern for the public supply of the product.
And it is not because anthrax is not a potentially serious
disease that can be spread through the mail. (Some patients
have also asked me for natural methods to protect them from
My concern is with people living their everyday lives trying
to protect themselves from all dangers, however remote. There
is an old saying that you cant protect yourself
against the world. This means that if you focus on all
the dangers simply associated with life, you will imprison
yourself seeking protection against every possibility. This
is futile, a waste of energy, and a waste of time.
It is also spiritually draining because it takes you away
from the real meaning of life and your ability to find richness,
happiness, and personal growth every day. If you are depressed
because the sun sets in the evening, you are destined to miss
out on lifes great opportunities, because the sun will
come up tomorrow for many millions of years. Real concern
about immediate dangers is important, but exaggerated concern
cultivates a habit of fear and a life of anxiety related to
things that you cannot control. Peace of mind comes from letting
go of worry about world events that you cannot alter, and
taking reasonable precautions with everyday matters.
Anxiety about the remote dangers of life leads you to focus
less energy on the important everyday health issues that you
really can do something about. You can reduce your risks of
heart disease. You can reduce your risks of cancer. You can
reduce your risk of other degenerative diseases, such as hypertension,
strokes, brain deterioration, diabetes, macular degeneration
and other eye diseases, arthritis, and digestive disorders,
and you can enhance your immunity to prevent influenza, which
kills over 20,000 people per year. Most of these conditions
can be avoided or delayed by simple lifestyle changes and
a positive attitude. You can help yourself by letting go of
anxiety and depression about things that are out of your power,
and not let them prevent you from acting positively.
Every day, over a thousand people die prematurely from preventable
diseases because of their health choices. You dont have
to be one of them. I was intrigued to see a cleanup person
during the recent anthrax cases wearing protective gear but
at break had a cigarette dangling from his mouth. I am convinced
that he was in far more danger from the chronic abuse of the
lungs than from the possibility that he might contract anthrax.
You can beat the odds by taking good care of yourself, and
rest without fear, knowing that you have done your best to
prevent what you can and ignore what you cannot.
Polls suggest that loss of vision is the most feared disability.
The most common cause of visual decline is age-related macular
degeneration (ARMD), the deterioration of the macula, the
central area of the retina near the optic nerve. In fact,
in the aged, it is the leading cause of blindness. The macula
is the focal point of the sharpest vision.
The disease occurs in a wet and dryform.
In the dry form, the macular cells simply deteriorate, while
in the wet form the retinal blood vessels rupture and leak
blood into the macular area. As the vision in the macula declines,
a person first loses a small area of central vision. About
30 percent of those over 75 years old have the condition.
In time, the central visual loss spreads outward, and eventually
the loss of function makes it impossible to drive or to read,
especially if the print is small and light, or to do other
everyday tasks. It appears that prolonged or excessive exposure
to sunlight as well as oxygen free-radical damage contribute
to the development of the condition.
Most of the medical community has thought that there were
no treatments or even ways to prevent the development or progression
of macular degeneration. However, some doctors have suggested
that sunglasses (or regular glasses) with 100 percent UV blocking
could significantly reduce the deterioration of the macula
associated with aging.
Minerals and Antioxidants
Now a new study published in the Archives of Ophthalmology
shows that high doses of the trace minerals and antioxidants
that alternative medical doctors have been suggesting for
years are indeed helpful in preventing and treating this eye
disease. This stands to reason if the degeneration is due
to oxygen free-radical damage, induced in part by sunlight,
because that is just the protection these dietary supplements
Researchers in the Age-Related Eye Disease Study (AREDS)
gave over 3600 subjects in 11 medical centers around the US
supplements of zinc, vitamin E, vitamin C, and beta-carotene
in what they considered to be high doses (high by conventional
medical standards). The actual doses were 80 mg of zinc with
2 mg of copper, 400 IU of vitamin E, 25,000 IU of beta-carotene,
and 500 mg of vitamin C. (These are significant doses, especially
of zinc, although larger amounts of vitamins C and E are not
unusual among those who take supplements.)
The subjects in the study were between 55 and 80 years old,
and they were followed for over six years. They had a range
of disorders, from mild changes in the retinal pigment cells
to advanced macular degeneration. In the treatment group that
received both the antioxidants and the zinc, there was a highly
significant 25 to 35 percent reduction in the progression
of the disease, especially in those who had more advanced
disease. The groups that took the zinc alone and the antioxidants
alone both were helped, but the most benefit was in the group
that took both treatments together.
Although the vitamin C and beta-carotene were given in doses
that can be achieved with very nutritious diets, the doses
of vitamin E and zinc are impossible to get from diet alone.
However, none of the supplements caused any sided effects
or toxicity during the entire study, including kidney stones,
of which subjects were warned.
Other Supplements for ARMD
The researchers in this study mention the potential
benefits of two other carotenoids, lutein and zeaxanthin,
but they did not evaluate them because there were no supplements
commercially available at the time. They did note that these
nutrients are concentrated in the central retina.
Other studies suggested that these two carotenoids could
reduce the incidence of cataracts, and they are the only carotenoids
found in the lens of the eye, but these studies had not been
reported when the AREDS study was started.
Other research doctors claim benefits from other supplements,
such as chromium and selenium, possibly because of the free-radical
protection effects of selenium and the sugar regulation support
from chromium. I also suggest bioflavonoids, bilberry, quercetin,
and taurine for eye health.
It is important to keep in mind the benefits of obtaining
these nutrients as much as possible from the diet, and the
best way to do this is with a large intake of fresh fruits
Patients and readers often ask me what they can eat
when they are in a hurry, as we lead such busy lifestyles
today. This seems more difficult for some people when I ask
them to eliminate from their diets the highly processed foods
containing sugar, white flour, artificial flavors, colors,
preservatives, and hydrogenated oils.
However, it is not as difficult as it may seem. Many foods
that are healthy are also fast. Nothing seems quicker than
a banana, an apple, a pear, or a handful of almonds or cashews
(unsalted, please), or a combination of these. I sometimes
have almond butter on apple slices. A peeled carrot or a celery
stick is easy if you plan in advance, and you can find fresh
fruit in any town.
I also prepare in advance so that I have leftovers that are
easy to manage when Im out. I like hummusa chick
pea, sesame, lemon, and garlic spreadon a slice of whole
wheat pita bread, a brown rice cake, or a whole rye cracker.
It is available at health food stores or ethnic groceries,
or to go from Middle Eastern and Greek restaurants if you
dont want to make your own.
I travel frequently, and I usually take snacks with me because
they are hard to find at the common fast food
restaurants. Trail mix with nuts, seeds, and dried fruits
travel well, and they have lots of nutritional value, but
try to avoid those with processed food ingredients, or lots
of salt and sugar.
For plane flights, I take some of these snacks, and veggie
burgers with lettuce and tomato on whole wheat bread. I garnish
it with mustard or soy mayonnaise and some pepper and other
herbs. I also have sandwiches with my white bean patéthe
recipe is in the July, 2001 issue.
Q. What do you recommend as a supplement for anxiety
A. This is one of the most common problems I see, often associated
with allergies, hypoglycemia, fibromyalgia, or other conditions.
Before I review supplements, it is important to realize that
diet, exercise, and relaxation play a large role in managing
anxiety. Avoid sugar, caffeine, and alcohol, and consider
possible food allergens that might contribute to your symptoms.
Exercise can relieve anxiety, but start slowly if you are
not in shape. Try to work up a sweat without getting out of
breath. Also, regularly practice some form of relaxation,
such as deep breathing, meditation, yoga, or visualization.
Supplements can be very effective as part of this program.
B complex vitamins make a difference for many people, especially
if they are not eating well. Niacinamide helps to calm the
central nervous system, similar to some anti-anxiety drugs.
Magnesium (500 to 1000 mg daily) is a calming agent, and
it has many other benefits as well. Chromium helps to control
blood sugar, so if that is the problem 200 to 600 mcg a day
might work. The amino acid 5-hydroxytryptophan affects serotonin
levels and helps anxiety and insomnia, as well as headaches.
Two herbs are very useful. Kava kava, a Polynesian root used
for anxiety and mood elevation (250 to 750 mg) and St. Johns
wort, especially if depression is involved (900 mg daily).
I suggest standardized herbs for best results.
Glucosamine sulfate is known to help relieve the symptoms
of osteoarthritis, and it has no side effects, unlike the
drugs used for treatment. The typical dose is 1500 to 2000
mg daily. Now a new report on two double-blind, controlled
three-year studies shows that not only does it relieve symptoms,
but it also slows the progression of the structural damage
to the joints. The results were presented at the North American
Menopause Society meeting (Reuters Health, October 9, 2001).
Symptom relief began within two weeks. Medications can relieve
symptoms while joint destruction continues, so glucosamine
sulfate is a far better choice.
Diet and Disease
Dairy products appear to increase the risk of
developing prostate cancer. (Chan JM, et al., Dairy products,
calcium, and prostate cancer risk in the Physicians
Health Study. Am J Clin Nutr 2001 Oct;74(4):549-54.) This
study associates consumption of dairy calcium with prostate
cancer, perhaps by lowering a form of vitamin D that suppresses
prostate cancer cell growth. Men who ate more than 2.5 dairy
servings (600 mg of calcium) had a 32 percent greater risk
of prostate cancer than men eating less than a half serving
of dairy (150 mg calcium) daily. Each additional 500 mg of
milk calcium increased the risk 16 percent. Not surprisingly,
Dairy Council representatives dismissed the findings!
Fat in the diet worsens heartburn symptoms. Researchers
put graded amounts of acid in the esophagus and then placed
fat or saline in the small intestine. The fat increased symptoms
more than the acid itself. High fat diets have other more
serious risks, but this one is an everyday concern for many
people. (Meyer JH, et al., Duodenal fat intensifies the perception
of heartburn. Gut 2001 Nov;49(5):624-8.)
Sometimes this is the hardest meal for lack of time.
A quick way to make it easy is to eat oatmeal with banana
or shredded apple or pear, and some almonds or sunflower seeds.
A timesaver is to boil water or dilute soy milk the night
before, and put it with the oatmeal in a wide-mouth thermos
jar. In the morning add the fruit and perhaps some cinnamon
and ground cardomom. Alternatively, you can put the cereal,
spices, and water in the microwave for 3 to 5 minutes, then
add the banana (the apple can be cooked with the cereal).
These methods save time in preparation and in cleanup. Other
cereals dont cook as quickly as rolled oats, but I have
had this mixture with buckwheat, millet, and brown rice. You
can use left-over rice and reheat it with the other ingredients.
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Centers for Disease Control
AREDS Research Group, A randomized,
trial of high-dose supplementation with vitamins C and E,
carotene, and zinc for age-related macular degeneration and
vision loss: AREDS report no. 8. Arch Ophthalmol 2001
AREDS Study Group, supplementation..Cataract
and Vision Loss.
AREDS report No. 9, Arch Ophthalmol. 2001 Oct;119(10):1439-1452.
Head KA, Natural therapies for ocular disorders,
cataracts and glaucoma. Altern Med Rev 2001 Apr;6(2):141-66.
Bone RA, Landrum JT, Distribution of macular
components, zeaxanthin and lutein, in human retina.
Methods Enzymol 1992;213():360-6.
Yeum KJ, et a., Measurement of carotenoids,
tocopherols in human lenses. Invest Ophthalmol Vis Sci
Snodderly DM, Evidence for protection against
macular degeneration by carotenoids and antioxidant vitamins.
Am J Clin Nutr 1995 Dec;62(6 Suppl):1448S-1461S.
Lietti A, et al., Studies on Vaccinium
I. Vasoprotective and antiinflammatory activity.
Birdsall TC, 5-Hydroxytryptophan:
serotonin precursor. Altern Med Rev 1998 Aug;3(4):271-80.
Akhundov RA, et al., [Psychoregulating
role of nicotinamide.]
Biull Eksp Biol Med 1993 May;115(5):487-91.
Pittler MH, Ernst E, Efficacy of kava extract
anxiety: systematic review and meta-analysis. J Clin
Psychopharmacol 2000 Feb;20(1):84-9.
Volz HP, Kieser M, Kava-kava extract WS
1490 versus placebo in
anxiety disorders--a randomized placebo-controlled
25-week outpatient trial. Pharmacopsychiatry 1997 Jan;30(1):1-5