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May 2004

Natural Gardens
Healthy Sleep Benefits
Lifestyle for Better Sleep
Dietary Supplements for Insomnia
Ask Dr. J: Carnosine Benefits
References
In the Health News
Diet and Disease
Recipe of the Month: Three Bean Salad with Corn

Natural Gardens

Dear Friends,

In the process of remodeling our new house in Florida, we also decided to overhaul the “garden,” which consisted only of grass and one old palm tree set in the middle of the lawn. St. Augustine grass, which is so common in Florida lawns, is extremely water hungry, coarse, and not particularly attractive.

Eliminating the lawn was an environmental as well as an aesthetic decision. The aquifers in Florida are being depleted by excessive water use, partly to keep up the lush green lawns. In addition, lawns here are difficult to maintain without pesticides. Even though their use can be minimized, these chemicals leach into the aquifers, pollute the waterways, and lower the quality of drinking water. Choosing to garden organically stops this cycle.

We decided to have a “waterwise” garden. Many landscape plants need lots of water to survive, especially in hot, sunny Florida. Planting mainly native, drought-tolerant plants means that once established they will rarely need watering. We also chose plants to attract birds, bees, and butterflies. It was amazing to see just days after planting the birds and butterflies found us and were singing and fluttering around the shrubs. Pesticides are detrimental to wildlife–yet another reason to garden organically.

Our choice of mulch was yet another environmental decision. We chose melaleuca (the source of tea-tree oil, but an invasive pest in south Florida), not cypress (which is endangered), or “red mulch”–artificially-dyed, shredded pallets. We chose plants for color and scent, and made sure there were plenty of edibles, such as fruits and berries. We already have papaya, paw paw, and guava, and plan to put in loquat trees, strawberries, and a variety of citrus. In the vegetable garden, we have already picked tomatoes and basil, and soon some butternut squash will be on the way. Next year we plan a wider variety of vegetables.

All of these plants help to improve our personal environment, and they bring us closer to nature in our everyday life. Staying in touch with our own environment and taking small steps to enhance the general ecology can also make us healthier (it also helps to be minutes from a beautiful beach walk).

Gardening is a wonderful activity (literally adding to our sense of wonder) that provides physical exercise and at the same time a connection to the earth which, with our busy lives, offers a chance to slow down, watch things grow, and appreciate the world of nature. Our neighbors have been watching with great interest as we have transformed a sterile lawn with a lonely palm tree into an oasis of tranquility that is a habitat for wildlife and in tune with nature. If you have any opportunity to garden, give it a try. I think it helps elevate the mood and relieve anxiety, and learning new activities is one way to preserve brain function well into old age.

Healthy Sleep Benefits

For many people living at the fast pace of modern society, getting adequate and restful sleep is an elusive dream. With late nights, early workdays, long commutes, caring for children and elderly parents, and job stress, it is often impossible to allow time for sleep that is so important not only for rest and replenishment, but also maintenance of strong immunity and prevention of chronic disease. In addition, chronic pain or illness may interfere with sleep.

Insomnia may be the inability to fall asleep, or waking in the middle of the night and not being able to go back to sleep. In a condition called sleep apnea, breathing is briefly interrupted, for up to a minute, sometimes hundreds of times a night. This is more common in overweight and middle-aged people, but can happen in others, resulting in poor quality sleep.

Sleep apnea is often associated with loud snoring. It may be helped by supplements and a treatment called continuous positive airway pressure, or CPAP, administered by a small machine by the bed through a mask worn during sleep.

No matter what kind of insomnia someone has, the result is often daytime fatigue and sleepiness, mood disorders, irritability, headaches, and proneness to accidents. It is also associated with heart disease and sexual dysfunction. While typical sleep needs are between seven and eight hours a night, some people need more or less. The number of hours is not as important as whether sleep is restful and restorative.

You do need to set aside enough time for sleep, but people are so busy that they chronically fail to do this. Occasional lack of sleep is not a significant health issue. Everyone will experience this with some stresses, such as a death in the family, business difficulties, marital problems, jet lag, or a loud, late-night party at a neighbors house or apartment.

If the problem is persistent or unrelated to temporary difficulties, it is important to do something about it. In the Nurses’ Health Study, heart disease rates were found to be 50 percent greater in the group reporting less than 5 hours of sleep compared to those reporting 8 hours or more. Those who reported 7 hours had no greater risk than those reporting 8 hours. Interestingly, those who were getting 9 hours or more also had increased risks, and a large Swedish study showed a direct relationship of increasing sleep difficulties with higher risk of heart disease.

A test for CRP, an inflammatory marker and a known risk factor for heart disese, showed that complete deprivation of sleep for three days elevated both CRP and blood pressure. The researchers did a related study, allowing only 4 hours of sleep a night for 10 days, and showed that both CRP levels and heart rate went up.

Sleep disturbance is a particular problem in the elderly. It is estimated that it occurs in one half of people over 65, and results in sleepiness, depression, falls, and poor memory. It may be that other disorders lead to insomnia, but it is also clear that insomnia itself contributes to a worsening of these health problems.

Lifestyle for Better Sleep

While many people resort to drugs to help sleep, these may not leave one feeling rested, and often have many side effects. It is better to practice good sleep habits. Eat a healthy diet low in sugar and processed foods, avoid alcohol and stimulants such as caffeine, and get regular exercise.

Make your bedroom comfortable and peaceful, with a good, firm bed. Keep the TV out of the bedroom, and not to watch anything stimulating or depressing just before bed. Try listening to relaxing music at a reasonable volume. It may help you to exercise up to two hours before bedtime, but not later than that. It helps to keep your bedroom as dark as possible, and quiet.

While some people thrive on a few hours of sleep plus regular naps, most people do better if they establish a regular pattern of going to bed and waking. For them, napping too much can interfere with nighttime sleep.

However, you have to find the schedule that works for you so that you feel rested, do not fall asleep at movies or concerts, can do your work competently, are not accident prone, and can drive safely. Supplements may help with this.

Dietary Supplements for Insomnia

Supplements that help sleep and anxiety include vitamins, hormones, amino acids, and herbs. While they may not be adequate for the more persistent cases of insomnia or sleep apnea, they can be very helpful with insomnia related to stress, anxiety, depression and other causes.

Niacinamide (vitamin B3) is a relaxant and often helps with anxiety and depression. Earlier studies showed that it attaches to the same receptors in the brain as the benzodiazepine drugs used to treat anxiety. Typical doses are from 500 to 1000 mg at bedtime.

Melatonin is a hormone produced in the pineal gland, and it is a regulator of the body clock. It is useful for shift workers and to treat jet lag. Taking 1 to 6 mg at bedtime can be helpful for sleep induction and depression, and it helps people wean off anti-anxiety drugs (Valium).

The herb valerian reduces anxiety and it promotes sleep but without the side effects seen with medication. The typical dose is 500 to 1000 mg of standardized extract. Treatment of depression with St. John’s wort, 300 mg 3 times a day, often helps relieve anxiety and insomnia.

5-hydroxytryptophan (5-HTP), a precursor to the neurotransmitter serotonin, helps treat fatigue, migraines, and depression, while it promotes better sleep. The usual dose is 50 to 100 mg at bedtime. Of course, nothing works if you don’t take the time to sleep.

Ask Dr. J: Carnosine Benefits

Q. Is carnosine as good as I’ve heard for reversing skin aging and cataracts?
-- PD, via Internet.

Carnosine is a dipeptide (consists of two amino acids, alanine and histidine) that acts as an antioxidant free radical scavenger and as a metal chelator. It is present in brain and other neurological tissues, and also in both skeletal and heart muscle and the lens of the eye.

Oxidative free radicals are associated with accelerated aging, so carnosine is likely to be protective. In tissue culture it has been shown to slow down cellular aging. In animals, carnosine slows down age-related degeneration and blocks Alzheimer’s-related beta-amyloid cell damage.

Carnosine inhibits the formation of age-inducing substances called "advanced glycation end products" (AGEs). These occur when sugar molecules attach to proteins and block their normal metabolic function.

AGEs are a particular problem for diabetics, as their high sugar levels lead to increased formation of AGEs, and lead to numerous complications. For example, AGEs cause dysfunction of the endothelium (arterial lining cells), leading to atherosclerosis, so carnosine is likely to protect against arterial disease due to both its antioxidant activity and AGE inhibition.

Studies also suggest that carnosine protects DNA and proteins from cross-linking. This reaction inhibits enzyme activity, and it leads to abnormal cell reproduction and membrane function. Because age-related skin damage is due to both free-radical activity and protein cross linking, carnosine should help protect the skin from the aging process and wrinkling. The typical dose of carnosine is from 500 to 1000 mg per day.

Carnosine speeds wound healing after surgery, and helps to heal peptic ulcers, enhancing the effect of antibiotics in treatment of Helicobacter pylori, the bacteria associated with ulcers. It is also helpful in treatment of hepatitis C. Human and animal studies show that topical N-acetyl carnosine helps to prevent and reverse cataract formation in the lens of the eye.

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References

Natural Gardens:

www.commonsensecare.com/content/XeriscapeSevenSteps.pdf

www.floridanativeplants.com/articles/mulch_melaleuca.shtml

edis.ifas.ufl.edu/BODY-VH019 (Univ of Fla Coop Extension Service)

Sleep and Insomnia:

Ayas NT, et al., A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003 Jan 27;163(2):205-9.

Meier-Ewert HK, et al., Effect of sleep loss on C-reactive protein, an inflammatory marker... J Am Coll Cardiol. 2004 Feb 18;43(4):678-83.

Kundermann B, et al., The effect of sleep deprivation on pain. Pain Res Manag. 2004 Spring;9(1):25-32.

Kryger M, et al., Sleep, health, and aging. Bridging the gap between science and clinical practice. Geriatrics. 2004 Jan;59(1):24-6, 29-30.

Zisapel N, The use of melatonin for the treatment of insomnia. Biol Signals Recept. 1999 Jan-Apr;8(1-2):84-9.

Garfinkel D, et al., Facilitation of benzodiazepine discontinuation by melatonin...Arch Intern Med. 1999 Nov 8;159(20):2456-60.

Ziegler G, et al., Efficacy and tolerability of valerian [in] non-organic insomnia—...Eur J Med Res. 2002 Nov 25;7(11):480-6.

Hallam KT, et al., Comparative cognitive and psychomotor effects of single doses of Valeriana... Hum Psychopharmacol. 2003 Dec;18(8):619-25.

Birdsall TC, 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Altern Med Rev. 1998 Aug;3(4):271-80.

L-Carnosine:

Quinn PJ, et al., Carnosine: its properties, functions and potential therapeutic applications. Mol Aspects Med. 1992;13(5):379-444.

Kashimura H, et al., Polaprezinc, a mucosal protective agent... increases the cure rate of Helicobacter pylori infection. Aliment Pharmacol Ther. 1999 Apr;13(4):483-7.

Hipkiss AR, Brownson C, Carnosine ...another possible role for the anti-ageing peptide? Biogerontology. 2000;1(3):217-23.

Hipkiss AR, et al., Pluripotent protective effects of carnosine... Ann N Y Acad Sci. 1998 Nov 20;854:37-53.

Babizhayev MA, et al., Efficacy of N-acetylcarnosine in the treatment of cataracts. Drugs R D. 2002;3(2):87-103.

In The Health News

Vitamin C is toxic to cancer cells, but the concentration needed is higher than oral vitamin C usually provides. Intravenous vitamin C is one way to significantly increase the plasma level (Padayatty SJ, et al., Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med. 2004 Apr 6;140(7):533-7). With the same dose, vitamin C was six times higher with an IV compared to oral administration. At higher doses, the difference was up to 140 times higher with IV doses than with oral administration. This has implications for the treatment of infectious diseases and cancer, conditions that might benefit from high plasma levels of vitamin C.

A controlled trial of ginger compared with vitamin B6 to treat nausea and vomiting of pregnancy showed that either supplement significantly reduced symptoms at 7, 14, and 21 days after starting treatment (Smith C, et al., A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol. 2004 Apr;103(4):639-45). The study involved 291 women who were given either 1 g of ginger or 75 mg of B6. Standardized extract of ginger works at doses of 250 to 500 mg.

Diet and Disease

Vegetable fiber appears to protect men from prostate cancer, according to a study in Italy (Pelucchi C, et al., Fibre intake and prostate cancer risk. Int J Cancer. 2004 Mar 20;109(2):278-80.) Among more than 2500 men studied, those with the highest fiber intake had up to a 20 percent reduction in the incidence of prostate cancer. The multi-center case-control study was conducted over 12 years. It is no surprise that vegetables protect against cancer, and for many reasons–antioxidants, vitamins, minerals, and phytochemical content, so the high fiber may only be a marker for high vegetable intake.

Recipe of the Month: Three Bean Salad with Corn

Start with any three organic beans (for example, organic chick peas, pinto beans, and navy beans). I usually pressure cook these after soaking for 4-8 hours and discarding the soaking water to reduce the gas that beans can cause. (You can also buy organic canned beans.) Add diced vegetables such as celery, tomatoes, scallions, green and red bell peppers, zucchini, cucumber, and carrots. I also like to add chopped fresh spinach. Chopped arugula and watercress add some spicy pizzazz, and you can also add chopped parsley and cilantro. I then add thawed, frozen organic sweet corn, as this is readily available. For dressing, I combine flaxseed oil or olive oil, lemon juice or apple cider vinegar, and a selection of herbs, including thyme and fresh or dried basil (I grow both in my garden), cumin, a clove or two of fresh crushed garlic. I add fresh ground pepper and another option is some prepared mustard. Serve this with whole grain bread or brown rice.

 


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CONSULTATIONS:

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.

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