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March 2005

Food Honesty and Lawsuits
Lipoic Acid and CoQ10 Updates
Aging Heart Support
Flu Vaccine May Not Help
Ask Dr. J: Liquid Vitamins
References
In The Health News
Diet and Disease
Recipe of the Month: Almond-Apricot Tofu Dessert

Food Honesty and Lawsuits

Dear Friends,

I was pleased to see a small news story on the two activists in England who lost a libel suit by McDonald’s after they distributed leaflets accusing the company back in 1984 of causing rainforest destruction, starving people in developing countries, and selling products that cause disease. The good news was that the European Court of Human Rights overturned their libel conviction, which led me to breathe a sigh of relief.

I certainly do not need a lawsuit by McDonald’s because I write honestly about the relationship of fast foods to hypertension, obesity, diabetes, heart disease, and other human ailments. Aside from ruling that they had inadequate representation to take on the McDonald’s legal behemoth, the appeals court also noted that there was a strong public interest in having non-mainstream sources contribute to open debate.

A few years ago, Oprah Winfrey was sued for libel because she said on her show that she would not eat hamburgers again, after hearing from a guest that the cattle industry routinely fed animal parts to cattle when raising beef, increasing the risk of Mad Cow disease. At the time, Oprah said that this “just stopped her cold from eating another hamburger.” (I could give her a lot of other reasons.) Cattle ranchers sued her in Texas, in the middle of cattle country, but even there the jury found in favor of Oprah, reaffirming the right of individuals to speak out freely regardless of the harm that might be done to industry by honest exposure of the truth about their products. (One cattleman said he lost seven million dollars as a result of Oprah’s comments; he had, of course, far more than that to lose!)

When public figures, journalists, authors, and interested parties from the public decry the negative effects of sugar, white flour, meat, pesticides, artificial flavors, colors, preservatives, genetically engineered foods, synthetic hormones, and other food additives, they should not fear retaliation from the industries. Most of the time these industries do not want a court case, because then they would have the lack of quality of their products exposed (it was somewhat of a surprise when Oprah was sued, as they would have been smarter to let the comment fade away).

The food industry is extremely powerful, financially and politically, but if scientific data shows that what they are selling is doing harm to human health or the environment, the information should be available to the public, not buried away in scientific journals, limiting it to the relatively few professionals who have access to these sources and understanding of what they mean. Honest and complete labeling of foods (food additives, trans fats, sugar and fat content, salt levels) is a start in the right direction, so people can make informed choices about their dietary habits. The value of healthy foods should be available right in the market where people buy them.

Lipoic Acid and CoQ10 Updates

Two of the most important antioxidant supplements that help protect the heart, the brain, and other tissues are alpha-lipoic acid and coenzyme Q10. Research continues to expand our knowledge of these two nutrients. While they are not exactly vitamins, as they are manufactured in the body, with stress or aging the need for them increases while the production declines.

Aging is accelerated by oxidative stress, DNA deterioration, mitochondrial decline, inflammation, and sugar-protein complexes called advanced glycation endproducts (AGE), all of which are increased by a number of chronic health conditions, such as diabetes. With the right diet, exercise, and supplements, you can slow down this process and preserve physiological functions for many extra years of vigorous activity.

Alpha-lipoic acid (ALA) is a sulfur-containing molecule and a potent antioxidant that is both water and fat soluble It protects against free radicals that are related to both oxygen and nitrogen. As part of the antioxidant network of molecules, it helps to regenerate other antioxidants, such as vitamins C and E.

ALA is also a cofactor for enzymatic functions involved in mitochondrial energy production, amino acid metabolism, and production of both DNA and RNA in ways that might reduce chronic inflammation. Some laboratory tests suggest more far-reaching benefits from large amounts of ALA. Oxidative damage to certain enzymes reduces the elasticity of lung tissue, associated with chronic obstructive lung disease. ALA helps to preserve the elastin protein.

In the normal course of producing energy, mitochondria create oxygen free radicals that damage the mitochondria if they are not neutralized. This damage from oxidation leads to inefficiency of energy production with age. High doses of ALA can prevent some of this deterioration by mopping up those free radicals. Animal studies support this protective role for ALA.

A recent scientific review shows that cancer patients treated with oxaliplatin (Eloxatin) who develop neuropathy (a common side effect) can be effectively treated with supplements of ALA. Earlier researchers used 600 mg of ALA intravenously once a week for 3 to 5 weeks, followed by 1800 mg daily orally for up to six months total. The neuropathy was significantly improved in 53 percent of the patients. Diabetic neuropathy is also helped by high doses of ALA, and it helps to reduce insulin resistance.

In a study of the effect of ALA in diabetics, 1200 mg daily for six weeks improved blood flow in a marker of capillary circulation. Poor microcirculation to the nerves may be the root cause of the neuropathy. ALA also inhibits the formation of AGEs that damage tissues and cause aging unrelated to oxidation. Animal studies suggest that ALA supplements may help with weight control and appetite suppression.

ALA acts as a metal chelator (reducing arsenic and mercury toxicity), helps maintain brain function, and reduces skin aging. It is rapidly absorbed and metabolized, so it is best to divide the daily dose. Evidence suggests taking at least 400 to 600 mg for prevention, and higher doses for treatment.

Aging Heart Support

As the heart ages, its ability to respond to stress declines. Supplements of ALA and coenzyme Q10 work together to help preserve heart function as aging occurs. Australian researchers have shown heart benefits from supplements of ALA, coQ10, omega-3 oil, plus exercise, and stress reduction. These protect the mitochondrial DNA and improve recovery from stress.

CoQ10 is a fat-soluble antioxidant, but it is also essential for mitochondrial energy production and recycling of other antioxidants, such as vitamin E. Inside cells, enzymes that are essential for digestion of cellular debris depend on coQ10 for optimal function.

Statin drugs such as Lipitor are widely used to lower cholesterol, but they deplete coenzyme Q10 levels, leading to worsening of congestive heart failure. A recent study shows that supplements of coenzyme Q10 are able to reverse this effect and improve cardiac function.

Doses of coenzyme Q10 range from 100-1200 mg, for prevention and treatment. Recent studies suggest that larger doses are beneficial for preserving heart and brain function. Because it is fat soluble, it is important to take it either mixed with oil-containing foods, or in a well absorbed chewable tablet or oil-based capsule.

Flu Vaccine May Not Help

It has been “common knowledge” that flu vaccinations in susceptible populations, such as the elderly, can significantly reduce mortality related to influenza infection. However, a recent analysis of mortality data surprisingly concluded that flu vaccinations have not led to a reduction in mortality, in spite of a great increase in the number of people being vaccinated. Since 1980, the vaccination rate in people over 65 jumped from 15 to 20 percent of this age group to more than 65 percent in 2001.

Mortality related to the flu also unexpectedly jumped during this period. The authors tried to reconcile the differences between the observations and their data, saying perhaps the population studied was older, or the prevalence of the flu virus was greater, but they concluded that the observational data significantly overestimated the benefits of flu vaccination.

This makes it all the more important to do what you can to protect yourself from exposure by frequent hand washing and the use of alcohol-based hand sanitizers. You also need to enhance your immunity with good health practices, such as exercising regularly, avoiding sugar and trans fats in the diet, and eating lots of fresh fruits and vegetables, including garlic and onions. Take supplements of vitamins C and E, zinc, coenzyme Q10, and proanthocyanidins, and perhaps standardized echinacea and elderberry extracts.

Ask Dr. J: Liquid Vitamins

Q. I have been told that supplement tablets do not dissolve, and that I should take liquid supplements instead. What’s the truth?
—HR, Rhode Island via Email

Purveyors of liquid vitamins generally put small amounts of individual supplements in their products and then tout how their lower-doses are more valuable than higher doses in pill form. Unfortunately, research does not back up these claims, and almost all research on oral dietary supplements use some sort of pill.

Vitamin manufacturers do vary in the care with which they make their products, and some pills are compressed too much or they might be mixed with unhealthy additives, or coated with colors and glazes that are undesirable.

The claims that the pills do not break down, or that they are passed through the intestinal tract and excreted whole is just not true as a rule. The majority of health-oriented manufacturers of high-quality dietary supplements are carefully produced by good manufacturing practices (GMP). They have to be tested for disintegration and dissolution, so it is untrue that liquid supplements are better for you, and they are generally much more expensive than comparable doses of ingredients as pills, either capsules or tablets.

This is true for most supplements, such as vitamins, minerals, amino acids, fatty acids, flavonoids, phytochemicals, herbs, and metabolic cofactors, such as coenzyme Q10, and alpha-lipoic acid. In some cases, such as coQ10, the form of the pill does make some difference (it is fat soluble, so a pill mixed with oil or lecithin is better absorbed), but this is unusual. The claims that liquid vitamins are better and thus worth their inflated prices are just sales pitches. You would be better off buying tablets or capsules from health food or quality mail-order sources.

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References

Food Honesty and Lawsuits:

Court Backs Activists in ‘McLibel’ Case, Reuters, February 15, 2005.

Cattlemen Lose Food Slander Case Against Oprah Winfrey & Howard Lyman. Houston Chronicle, Sept. 17, 2002

Alpha-Lipoic Acid and Coenzyme Q10:

Cersosimo RJ, Oxaliplatin-associated neuropathy: a review. Ann Pharmacother. 2005 Jan;39(1):128-35.

Gedlicka C, et al., Effective treatment of oxaliplatin-induced cumulative polyneuropathy with alpha-lipoic acid. J Clin Oncol. 2002 Aug 1;20(15):3359-61.

Ziegler D, et al., Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. Diabet Med. 2004 Feb;21(2):114-21.

Haak E, et al., Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy. Exp Clin Endocrinol Diabetes. 2000;108(3):168-74.

Bitar MS, et al., Alpha-lipoic acid mitigates insulin resistance in Goto-Kakizaki rats. Horm Metab Res. 2004 Aug;36(8):542-9.

Marracci GH, et al., Alpha lipoic acid inhibits human T-cell migration: implications for multiple sclerosis. J Neurosci Res. 2004 Nov 1;78(3):362-70.

Doggrell SA, Alpha-lipoic acid, an anti-obesity agent? Expert Opin Investig Drugs. 2004 Dec;13(12):1641-3.

Rosenfeldt F, et al., Response of the senescent heart to stress: clinical therapeutic strategies and quest for mitochondrial predictors of biological age. Ann N Y Acad Sci. 2004 Jun;1019:78-84.

Rosenfeldt FL, et al., Coenzyme Q10 protects the aging heart against stress: studies in rats, human tissues, and patients. Ann N Y Acad Sci. 2002 Apr;959:355-9.

Silver MA, et al., Effect of atorvastatin on left ventricular diastolic function and ability of coenzyme Q10 to reverse that dysfunction. Am J Cardiol. 2004 Nov 15;94(10):1306-10.

Flu Vaccines:

Simonsen L, et al., Impact of influenza vaccination on seasonal mortality in the US elderly population. Arch Intern Med. 2005 Feb 14;165(3):265-72.

In The Health News

Asthma responds well to intravenous supplements of magnesium. After pooling results from five controlled studies on 182 children in emergency rooms for acute attacks of asthma, researchers found that IV magnesium improved both lung function and symptom scores. The rate of hospitalization was reduced by 70 percent in those children treated with the magnesium. (Cheuk DK, et al., A meta-analysis on intravenous magnesium sulphate for treating acute asthma. Arch Dis Child. 2005 Jan;90(1):74-7.) Magnesium treatment for asthma is safe and inexpensive compared to drugs or hospitalization.

Diet and Disease

a. In 27,017 post-menopausal women, red meat protein increased their risk of dying of heart disease, while vegetable sources of protein, such as beans, soyfoods, peanuts, and nuts, decreased the risk (Kelemen LE, Associations of dietary protein with disease and mortality in a prospective study of postmenopausal women. Am J Epidemiol. 2005 Feb 1;161(3):239-49). Over 15 years, those women who most often substituted meat or dairy protein for carbohydrates had an over 40 percent greater risk of cardiac mortality, while those who substituted vegetable protein for carbohydrates had a 30 percent reduction in heart deaths.

b. A diet rich in vegetables and high in fiber is as effective as statin drugs in lowering cholesterol. Emphasizing soy proteins, almonds, oats, barley, eggplant and psyllium seeds, the subjects had no problem following the diet and they felt more full. Statins lowered LDL-cholesterol by 33 percent and the diet by 30 percent. (Jenkins DJ, et al., Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr. 2005 Feb;81(2):380-7.) The researchers note that this treatment is good “for those who do not tolerate the drugs.”

Recipe of the Month: Almond-Apricot Tofu Dessert

This is a delicious, creamy dessert with healthy ingredients. Soak organic apricots (unsulfured) in water until they are soft and plump. Toast an equal amount of unsalted, raw almonds on a tray in the toaster oven. With the same amount of silken tofu (a creamy variety that blends easily), combine these in the food processor, and add a frozen banana broken into chunks, a touch of cinnamon, and freshly ground nutmeg. Add some vanilla and blend all of the ingredients until they are smooth. You might need some of the liquid from the apricots to blend it if it is too thick, or you may want to add some agar (seaweed gelatin) dissolved in the liquid to thicken it. You can pour the mixture into a precooked whole wheat or graham cracker pie crust and chill it—no cooking is necessary, or serve it in individual dessert cups with shredded coconut or almond on top.

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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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