Reporting Research Statistics
Nutrition and Brain Function
Antioxidant Brain Protection
Ask Dr. J: Peptic Ulcers
Ask Dr. J: Carotid atherosclerosis
In the Health News
Diet and Disease
Recipe of the Month: Guacamole and Gazpacho
If you know how to manipulate statistics, you can appear to
prove or disprove almost anything. I am particularly interested
in recent articles that appear to show that ginkgo biloba
does not work to help improve memory and that vitamin E is
In similar articles that I have already discussed, they suggested
that vitamin C was either risky for arteries or a cancer promoter
(both untrue), or that St. Johns wort did not help depression
(but was as good as Prozac relatives!).
There is a fascinating little book by Darrell Huff, first
printed in 1953, called How to Lie with Statistics. He notes
that the death rate in the Navy during the Spanish American
war was 9 per thousand, while in New York it was 16 per thousand.
Navy recruiters used the figures to show that it was safer
to be in the Navy than in New York.
They neglected to mention that the Navy is made up of young,
fit, carefully selected men, while the New York population
included the elderly, the infirm, infants, and hospitalized
patients, so the two groups were hardly comparable.
Data manipulation still takes place in medical science, when
a researcher or a reporter wants to make a point. A study
may be too small or too short to reach significance. Researchers
can then claim that they found no evidence of effectiveness.
Authors may also draw conclusions that are not justified by
their own data.
The recent study on ginkgo biloba is an example of misleading
conclusions. Many studies have shown that as people age, and
memory starts to fail, they can restore and maintain their
mental function with supplements of ginkgo biloba. Research
supports a daily dose of 120 to 240 mg of standardized extract.
In this study, the subjects had normal memory function, and
in six weeks they had no improvement with 120 mg daily. One
can only conclude from this that taking ginkgo at a typical
dose (but not high doses) for a short time may not help people
with normal memory.
News reporters may mislead readers with their headlines and
opening paragraphs, even if later in the article they temper
those remarks. Many readers do not venture deeply into the
text. When the first scientific article showing benefits from
ginkgo appears, that is news. The next nine are not. Then
one appears that shows no benefit, and that is news again.
Tempting material for reporters. We must draw our conclusions
from the weight of evidence, not one study. Right now, the
evidence shows that ginkgo biloba, St. Johns wort, vitamin
C, vitamin E, and numerous other dietary supplements and herbs
are safe and effective in the treatment and prevention of
Last month I reported that adequate dietary linoleic acid
(an omega-6 polyunsaturated fatty acid, or PUFA), is an essential
fatty acid (EFA), found in sunflower, corn, and soy oils that
reduces the risk of stroke. However, when consuming PUFAs,
you must take adequate antioxidants.
PUFAs are highly subject to oxidation. A high intake
of omega-6 PUFA is associated with impairment of brain function,
perhaps because of oxidation or the production of arachidonic
acid, a precursor that can lead to increased inflammation
and reduced blood flow.
Other studies point out that the issue is complex. Research
shows that a high intake of total fat, saturated fat, and
cholesterol can nearly double the risk of dementia, while
a high intake of fish with omega-3 EFAs decreases the
risk of developing dementia (flaxseeds and walnuts are other
sources of omega-3 fatty acids).
The authors speculate on the mechanisms by which fat consumption
might increase the risk of brain degeneration. They include
atherosclerosis and thrombosis, inflammation, impaired brain
development, abnormal membrane functioning, or an accumulation
of beta-amyloid, a protein found in excess in Alzheimers
Although the Western diet is rich in omega-6 oils, and relatively
deficient in omega-3 oils, much of the omega-6 oil comes from
highly processed sources and margarines, of which the former
may already be oxidized, and the latter compromised by high
levels of trans fatty acids. Trans fatty acids are found in
hydrogenated oils, and they interfere with normal fat metabolism,
prostaglandin production, and membrane structure.
One study on fat and brain function showed that the risk
of AD was doubled for subjects with the highest level of dietary
fat compared to those with the lowest. The same relationship
was noted between total caloric intake and AD. These are particular
problems in the US, where fat consumption and total caloric
intake are both high.
In other research, investigators studied the effects of omega-3
oils and saturated fat on cognitive function in animals. They
found that if brain blood flow was already low, increased
saturated fat led to further cognitive decline. On the other
hand, in the same study, omega-3 fish oil improved the brain
function in animals. They evaluated the animals by maze testing
and other behavioral measurements.
One of my concerns is that many people are choosing low carbohydrate
diets for weight loss and other reasons. I agree that refined,
simple carbohydrates (especially sugars and white flour) are
significant problems in the western diet, and increasingly
in other countries, including China and Japan. However, complex
carbohydrates from whole, unrefined foods are healthy.
Whole, unrefined foods include whole grains, potatoes, yams
or sweet potatoes, winter squashes, beans, and fresh vegetables
and fruits. With low carbohydrate diets, the only alternative
sources of calories are protein and fats. If calories are
restricted, active people will lose weight. High fat intake
is not healthy, and loss of brain function is only one of
the risks. (The surest and safest way to lose weight is to
increase exercise while eating whole, healthy, natural foods.)
Because of the risk of oxidation of dietary fats, high levels
of fruits and vegetables, particularly those very rich in
antioxidants (such as berries, which I wrote about last month)
are apparently protective of brain function (as well as reducing
heart disease, cancer, eye disease, and more). Other antioxidant
nutrients that protect the brain include coenzyme Q10, acetyl
L-carnitine, alpha-lipoic acid, N-acetyl cysteine, ginkgo,
bioflavonoids, and proanthocyanidins.
Vitamin E is one antioxidant that helps preserve brain function.
Beta-amyloid is toxic in part due to free radical damage,
which can be controlled to some extent by vitamin E. In tissue
culture, vitamin E protects brain cells.
However, the study I mentioned on page 1 showed that supplements
of 200 IU of vitamin E, might prolong respiratory infections
or increase symptoms. While such a study is of concern, many
other human and animal studies suggest the opposite for influenza,
hepatitis, and other infections, and enhancement of immune
I suggest a low-fat diet with adequate amounts of the EFAs,
with specific EFAs added as needed, and nutrient and
herb antioxidant supplements.
Q. What is the alternative for the treatment of ulcers? RB,
A. Peptic ulcers are erosions in the stomach or the duodenum,
the first part of the small intestine, and the disease is
often related to the presence in the stomach of a bacterium
called Helicobacter pylori. Treatment includes antacid drugs
and antibiotic therapy to eliminate the bacteria. Pepcid,
Axid, and Prilosec are examples of antihistamine antacids,
but they have side effects, and reducing stomach acid may
increase the growth of Helicobacter.
It is important to eliminate the bacteria, but many other
lifestyle changes and dietary supplements can also help relieve
symptoms and heal the ulcer. Avoid aspirin and other non-steroidal
anti-inflammatory drugs, such as ibuprofen (Advil or Motrin),
which are stomach irritants.
Stress plays a role in hyperacidity and predisposition to
ulcers. Stress reduction, through visualization, breathing
exercises, yoga, meditation, or the relaxation response may
Dietary changes that help include elimination of caffeine,
alcohol, sugar, salt, and white flour foods, as well as fried
foods and highly processed fast foods. High dietary fiber
helps to absorb stomach acid and reduce damage to the duodenum,
and it prevents the recurrence of ulcers.
Dietary supplements are very important. L-glutamine, the
main source of energy for intestinal cells, promotes healing
of any gastric inflammation (2-4000 mg daily). Arginine, another
amino acid, also helps ulcer healing (3-5000 mg).
Heartburn or pain in the upper abdomen or chest can be relieved
with a licorice extract called DGL (deglycyrrhinizated licorice),
which coats the stomach lining. It also helps relieve acid
reflux symptoms. It must be chewed to be effective.
I also recommend vitamins C (2-6000 mg) and E (400 IU), zinc
(30 mg), quercetin (800 mg) and other bioflavonoids, plus
some vitamin A.
Q. My dad has a blocked carotid. What
can he do without surgery? JL, W. Virginia.
A. Symptoms of blocked carotid arteries range from temporary
loss of brain function called a transient ischemic attack
(TIA, including dizziness, weakness, paralysis, or loss of
vision, to a stroke from prolonged lack of brain circulation.
Atherosclerotic carotid arteries require the same lifestyle
changes as heart disease. A low-fat, high-fiber vegetarian
diet plus fish appears to provide the best nutrition. Typical
dietary supplements include vitamins C (4-6000 mg), and E
(800 IU), magnesium (1000 mg), coenzyme Q10 (200 mg), and
a comprehensive multivitamin (such as UltraVitality from QCI
For high cholesterol, he can take octacosanol (10 mg plus
mixed polycosanols), inositol hexaniacinate (16-2400 mg),
gugulipids (500 mg), or red yeast rice (1000 mg), plus garlic,
and fish oils (both of which also help circulation).
If he has high blood pressure, coQ10 should help plus hawthorn
extract (500 mg), garlic, and gamma-linolenic acid (240 mg).
He should also start intravenous chelation therapy with EDTA,
shown since the 1950s to help circulation to the heart,
brain, and legs. Find a doctor from the American College for
Advancement in Medicine (ACAM), at www.acam.org, or 800-532-3688.
A new review of women taking hormone replacement therapy
confirms the recent reports from the Womens Health Initiative
that they appear to do more harm than good. This review is
of 20,000 women in four different studies (Beral V, et al.,
Evidence from randomised trials on the long-term effects of
hormone replacement therapy. Lancet 2002 Sep 21;360(9337):942-44).
Again, they showed an increased risk of strokes, breast cancer,
and blood clots in women on Premarin with or without medroxyprogesterone.
However, it is important to note that none of this information
applies to women taking natural (bio-identical) hormones.
Human estrogens and progesterone are not the same as the typical
prescriptions given to women. Many compounding pharmacies
will make these bio-identical hormones with a doctors
Salmonella bacteria are found in significant numbers
in sausages, according to British researchers. Even if the
sausages appear well cooked, they may still have live bacteria,
which can cause diarrhea, vomiting, and fever (Reuters Health,
September 10, 2002). The bacteria were found in just under
10 percent of sausages, particularly in cheap brands. In the
report, the public health doctors said the message is to be
sure to cook your sausages well! Well, that is one possible
A 28-year Finnish study of 10,000 people confirms
that an apple a day may keep the doctor at bay (Knekt P, et
al., Flavonoid intake and risk of chronic diseases. Am J Clin
Nutr 2002 Sep;76(3):560-8.) Many antioxidant flavonoids from
fruits and vegetables reduce the incidence of cancer, asthma,
diabetes, heart disease, and strokes. Apples, rich in quercetin,
appeared to provide the greatest risk reduction, but many
other flavonoids, such as kaempferol from onions, and hesperidin
were also beneficial.
I cant grow avocados or lemons, but I add my own garden
harvest to them for a healthy dip. Peel and mash up two ripe
avocados, juice one lemon (adjust the amount for your taste),
press one or two cloves of garlic, and mince a fresh medium
tomato and a handful of fresh cilantro. Add some minced hot
pepper if you like it spicy. Serve this with wedges of whole
wheat pita bread. While you are at the tomatoes, cilantro,
and garlic, (and fresh basil) you can make that cold gazpacho
soup I mentioned last month. Add to the above ingredients
some diced sweet peppers and cucumber, organic corn, minced
onion and fresh basil, and lemon juice, with a small amount
of tomato juice for liquid. Add a dash of cumin, pepper, and
oregano. Now, plan a larger garden for next year.
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