Plant Sterols and Coke
Emotions and Heart Health
Exercise and Breast Cancer
Nutrition and Diabetes
Ask Dr. J: Varicose Veins
Heart disease remains the number one cause of death in the
United States and other developed countries. It is clearly
due to lifestyle issues, including poor diet, lack of regular
exercise, smoking, and a combination of high stress with negative
emotional states. Cholesterol also plays a role, but I find
it tragically laughable that the Coca Cola company, a purveyor
of some of the most unhealthy consumables throughout the world,
is now introducing an orange juice that contains cholesterol-lowering
substances called plant sterols.
Phytosterols are indeed healthful contributions to the diet,
and they are already added to otherwise unhealthful margarines.
Coca Cola is introducing them into an orange juice with 110
calories per serving, and recommending two servings a day.
Undiluted juice is too high in sugar, which is why I always
suggest diluting such drinks by at least half to two thirds.
Dilution would reduce the sterols to less than recommended
amounts for cholesterol lowering. (Coca Cola, by the way,
also owns and markets Odwalla and Samantha juices.)
This news from Coke comes at a time when we also learn that
infants from four months to two years old are consuming unhealthy
“junk,” such as french fries and soft drinks,
including colas, at an alarming rate. The research shows that
on the survey day 25 percent of children eat no healthy vegetables
or fruits. It is not surprising that even among toddlers the
proportion who are overweight is up to 15 percent, and this
helps explain why so many older children are obese. These
parental decisions, usually made for convenience or out of
ignorance, lead to early health problems, especially when
children carry these habits into adulthood.
Although it is a major contributor, poor diet is not the
only influence on heart health. Emotional states (at least
in men, in the latest study) play a significant role in the
development of cardiovascular heart disease, according to
a new study that confirms earlier data. Researchers found
that hostility, depression, pessimism, and anxiety increased
the risk of heart disease by 6 percent for each increase of
one point on the survey score. They also noted that poor concentration
contributed to the heart-disease link. The risks were independent
of obesity, insulin resistance, or high blood pressure.
It is not yet clear that psychological or drug treatment
for emotional states makes any difference in the association
with heart disease. However, numerous other studies show that
relaxation, yoga, meditation, and related practices can be
beneficial for health. In any case, it is always helpful to
cultivate the positive feelings and attitudes that enhance
the value of living every day.
The newsletter is abbreviated this month because of my relocation
to Florida, but here are some valuable health news articles.
Exercise reduces breast cancer risk, even if it is only
recreational activity for a few hours a week. Evaluating over
500 women with breast carcinoma in situ (an early cancer)
and comparing them with 600 comparable women without cancer,
showed that “any” reported physical activity lowered
the cancer risk by 35 percent. The activities were walking,
jogging, dancing, bicycling, and similar exercises.
Previous studies have shown the value of exercise in cancer
prevention, as well as heart health, diabetes, immune function,
and more. These researchers already found that exercise helps
reduce invasive cancers, with increasing levels of exercise
further reducing the risk.
For some exercise benefits, you have to do more than the
minimum, but even small amounts of activity are helpful. This
is in addition to the sense of well being, higher energy,
lessened back pain, and improved sleep that exercise provides.
Patel AV, et al., Recreational physical
activity and risk of postmenopausal breast cancer in a large
cohort of US women. Cancer Causes Control 2003 Aug;14(6):519-29.
Patel A, et al., Lifetime recreational
exercise activity and risk of breast carcinoma in situ. Cancer
15 November 2003;98(10):2861-9. (Online publication 6 October
A group at Harvard reviewed the nutrition literature to determine
the value of different carbohydrates and fats in preventing
type II diabetes. They concluded that saturated fat and trans
fats (from partially hydrogenated vegetable oils –
margarine and shortening) increased the risk. Polyunsaturated
fats, and especially omega-3 oils (from fish, flaxseeds, walnuts,
and a few other nut or seed sources) reduced the risk.
They also urged increases in healthy unrefined carbohydrates
that are high in fiber, including unprocessed grains. These
foods reduce sugar responses in the blood and lower insulin
levels. They were careful to make the distinction between
these whole foods and refined, processed carbohydrates. This
is important when making dietary choices. Diet fads that lump
all carbohydrates together, and restrict them as a whole,
are likely to be too low in fiber to be beneficial in the
long term. In addition, whole grains and beans provide valuable
essential fatty acids. Saturated fats come mainly from meat,
whole dairy products, and chicken.
Hu FB, van Dam RM, Liu S, Diet and risk
of Type II diabetes: the role of types of fat and carbohydrate.
Diabetologia. 2001 Jul;44(7):805-17.
Q. I have varicose veins, and surgery has
been recommended. Do you have any suggestions to help me avoid
the operating room?
-- VP, by Email.
A. Varicose veins are those in which blood pools as a result
of damage to the valves that maintain one-way blood flow back
to the heart, and weakness of the vein walls. The damage usually
comes from vein pressure in susceptible vessels due to constipation,
obesity, inactivity, or pregnancy. It is unlikely that anything
could repair the damaged valves, but you may be able to reduce
varicosities, especially prominent small veins.
While it is possible that you can help reduce varicose veins
with non-surgical methods, it is not clear that any one method
will succeed. However, if you do not improve, you can always
get surgery later.
I have found it helpful for patients to eat a high fiber
diet to prevent further excess pressure on the veins. Fiber
retains water in the bowel, and keeps the stool soft and bulky
to prevent straining. In addition, it helps to wear support
stockings that keep pressure on the outside of the leg, which
may prevent pooling of blood in the damaged vessels.
I recommend some supplements that strengthen the vein walls,
and others that help reduce the risk of blood clots (thrombi)
in the vessels and inflammation (phlebitis). Thrombophlebitis,
can lead to dangerous clots traveling to the lungs.
Bioflavonoids (1000 to 2000 mg, daily) help strengthen vessel
walls and enhance the value of vitamin C (2000 to 4000 mg),
which reduces inflammation and improves vessel strength. The
standardized herbs: butcher’s broom ((100 mg), horse
chestnut (500 mg), and gotu kola (120 mg) are also helpful,
and are available in some combination formulas. Among others,
curcumin (600 mg) and fish oil (600 to 1200 mg of EPA/DHA)
help to reduce inflammation.
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