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April 2005

Changing Health Habits
Organic Food Update
Protect Yourself
Vitamin E Attacked Again
Ask Dr. J: Migraines/Insomnia
References
In The Health News
Diet and Disease
Recipe of the Month: Pesto Bean Stew (or Soup)

Changing Health Habits

Dear Friends,

Some of my recent lectures have given me an interesting insight into human behavior. While my listeners often are impressed with the extent of the data showing the relationship between good health habits (including dietary supplements) to better health they often do not put what they have learned into practice. This is often in spite of their great need (from my perspective) for them to do something about their poor health.

While some people do, many do not make changes in their ingrained lifestyle habits simply based on information. That is the nature of habits—they are hard to change. Results are much better in my practice when I have the chance to personally encourage people to make helpful changes, although this success may partly be due to the higher motivation of people who decide to consult with me as opposed to just hearing a lecture.

It is clear that many influences go into the development of habits and make them hard to break. Social pressures (“Oh, come on, one piece of cake won’t hurt you!”), advertising, and convenience, and sometimes the perceived cost are among these influences. It is an uphill educational battle to convince people that healthier eating habits can be fun, convenient (although not as convenient as “convenience” foods), inexpensive, and tasty. And it is impossible to make exercise a routine without devoting some time to it, which is seen as an obstacle no matter how much benefit this provides.

A recent article showed that you do not have to exercise an enormous amount to derive some benefits, although how much a person needs may depend on their weight and how much they have to lose. For many people, getting 30 minutes per day will help ward off chronic, degenerative diseases, but heavier people might need to do more in order to lose weight and keep it off. Perhaps this seems like a lot. However, the time spent pays not only health dividends, but also improved productivity, better sleep, more energy, and a sense of well being, providing more effective use of time. The exercise can also be beneficial even if broken up into shorter sessions during the day.

A common sarcastic criticism of exercise (“one has a finite number of heartbeats during life, and why waste them on exercise”) misses an important point—regular exercise for a short time that elevates the heart rate leads to a “training effect” that reduces the heart rate for the remainder of the day with an overall “saving” of heartbeats. This is in addition to the many other benefits. Similarly, a healthy diet may take more time at first (less so with some experience in healthier food preparation techniques and the right equipment), but the resulting better health will contribute to an increase in productivity and time savings. Inspiring people to do better for themselves is always competing with other pressures on people to stay the way they are, but the successes make it worthwhile.

Organic Food Update

Organic foods were the only ones available a hundred years ago, and somehow millions of people were fed. Today, in agricultural products, we have to deal with pesticides, herbicides, fungicides, growth stimulants, mold retardants, anti-sprouting agents, and other chemicals in the food supply (and this is before all the artificial flavors, colors, preservatives, and sugars and artificial sweeteners are added during processing.) Animal products are also a problem.

One organization, the Environmental Working Group (www.ewg.org), recently revised its lists of the most and least contaminated produce, so it is important to know these to make informed choices. Strawberries used to be the worst contaminated, but now peaches have moved up to first place. Others include apples, bell peppers, celery, cherries, imported grapes, nectarines, pears, potatoes, red raspberries, and spinach.

Their report notes that government testing found that 91 percent of apples were contaminated with pesticides, with 45 percent having 3 or more toxins, and some samples having seven or eight different residues, including carcinogens, nervous, immune, and hormonal system toxins, and chemicals that cause birth defects. Of the 94 percent of peaches that were contaminated, 55 percent of them had three or more toxins.

Vegetables (other than spinach, celery, peppers, and potatoes) were generally less contaminated than fruits. The least contaminated produce, and the ones to choose when organic sources are not available, are asparagus, avocados, bananas, broccoli, cauliflower, corn, kiwi, mangos, onions, papaya, pineapples, and peas.

These government tests are done on foods that are already prepared for eating by washing, coring, etc., so washing will not change which foods are highest in contamination. Washing will affect the pesticide level in some foods, but some of them are not only on the surface, but also throughout the fruit or vegetable and can’t be washed off.

It is not only that pesticides and other chemicals are problems when they are present in large amounts, but also that they may be far more toxic when they are combined. Small amounts in one food may not be as much of a problem as eating a wide variety of foods, each with supposedly acceptable levels of these chemicals. This is especially an issue for children and pregnant women, who are more susceptible to such toxins.

In addition to pesticide accumulation from pesticide-laden feed, animal products present other problems. They are often treated with growth hormones, estrogens, and antibiotics, all in an effort to increase their rate of growth. Drug residues are found in the flesh and dairy products from non-organic animals. (I wish the government were as concerned with steroid use in farm animals as they are in athletes, but instead they try to coerce other countries to accept the U.S. hormone-contaminated meats.) The antibiotics contribute to the development of antibiotic-resistant bacteria. Milk products from California are also contaminated with rocket fuel (perchlorate), with 31 of 32 samples testing positive.

Protect Yourself

Choose organic foods as much as possible. They are safer and more nutritious. The public demand for better food is growing (but unfortunately so are the sales of some fast foods). Although I am no longer close to one of the larger health food supermarkets, I can still find organic produce by choosing carefully from what is available at supermarkets (increasingly carrying organic produce) and local health food stores.

It is also valuable to have an organic garden to grow some of your own vegetables. This does not have to take much space or work, and it can be fun. It is even easier to find organic grains, beans, nuts, and seeds, as these keep longer than fresh produce and are therefore more widely available. You can get some of these online or by mail order. I am able to consume nearly 95 percent of my food from organic sources. Increasing numbers of good restaurants are carrying organic foods, and a few are going totally organic. Do not expect to be perfect in your choices, but the more you do, the lower your risks.

Supplements can also help protect you. Vitamin C helps to clear some toxins from your system. Silymarin, from milk thistle, calcium D-glucarate and antioxidants, such as vitamin E, alpha-lipoic acid, proanthocyanidins, and those found in green tea (ECGC), can help to detoxify some chemical exposures.

Vitamin E Attacked Again

A recent study published in the Journal of the American Medical Association suggested that vitamin E supplementation might increase the risk of developing congestive heart failure. It seems that some medical researchers have an inappropriate and relentless antagonism to dietary supplements. This study was flawed, and was rejected a year ago by the Lancet, a prestigious British medical publication.

The difference in heart failure rates was minor: 12.1 percent (placebo) versus 13.5 percent (vitamin E). The data also showed a small decrease in the risk of cancer that did not reach statistical significance. These changes are too small to draw firm conclusions. Aside from other benefits of vitamin E, the Nurses’ Health Study showed a 41 percent reduction in heart disease in subjects who took vitamin E supplements.

The subjects in this study were older, ill patients with cardiovascular disease and diabetes, and already on multiple drugs, including statins, beta-blockers, calcium channel blockers, anti-inflammatory drugs, and diuretics. Some of these overlap the effects of vitamin E (anti-inflammatory and anti-platelet) masking its benefits.

The National Cancer Institute is conducting a study of vitamin E and prostate cancer. They noted that the latest research gives them no cause for concern about subject safety in their study. Other studies suggest reduced prostate cancer with high intake of vitamin E.

Vitamin E inhibits blood clotting, platelet aggregation, oxidation of LDL cholesterol, and inflammation, lowers CRP, a heart risk factor, helps immunity, and brain function. No other study has suggested an association of vitamin E with heart failure, raising doubts about this conclusion. You need supplements of vitamin E to get all of its benefits (preferably mixed tocopherols high in gamma tocopherol).

Ask Dr. J: Irritable Bowel Syndrome

Q. I have a 10-year old with insomnia and migraines, what can I do?
—SW, via Email

These symptoms in children are often related to food or environmental allergies, chemical sensitivity, or poor regulation of blood sugar (from poor dietary habits), or some combination of these. It is sometimes complex to find out just what is causing the problem, but it is a good idea to eliminate sugar and food additives from the diet, and eat small meals with snacks in between in an effort to control blood sugar. Chemical and environmental exposures need investigation, and may require that you get some testing from a physician experienced in environmental medicine.

Some supplements may also help. Magnesium, chromium, and vitamins B2 and B3 (niacinamide or inositol hexaniacinate) can help with both symptoms, depending on the cause, as can the 5-hydroxy-tryptophan (usually 50 mg), and ginkgo biloba. These are all quite safe, but the doses need to be adjusted for children.

It is also important to recognize that psychological components and emotional upsets may be contributing to these symptoms, especially in children, including problems with family, friends, and school. Addressing these may be complex.

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References

Changing Health Habits:

Get Moving, United States Department of Agriculture Brochure

Organic Foods:

Epstein SS, Corporate crime: why we cannot trust industry-derived safety studies. Int J Health Serv. 1990;20(3):443-58.

Epstein SS, Ozonoff D, Leukemias and blood dyscrasias...chlordane and heptachlor. Teratog Carcinog Mutagen. 1987;7(6):527-40.

Colborn T, Neurodevelopment and endocrine disruption. Environ Health Perspect. 2004 Jun;112(9):944-9.

Landrigan P, et al., Assessing the effects of endocrine disruptors... Environ Health Perspect. 2003 Oct;111(13):1678-82.

FAO (2000): Food Safety and Quality as Affected by Organic Farming: www.fao.org/docrep/meeting/X4983e.htm

Minakata K, et al., Increase in production of ascorbate radical in tissues of rat treated with paraquat. Free Radic Res. 2000 Aug;33(2):179-85.

Koshiishi I, et al., Cyanate causes depletion of ascorbate in organisms. Biochim Biophys Acta. 1997 Oct 20;1336(3):566-74.

Vitamin E:

Lonn E, et al., Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005 Mar 16;293(11):1338-47.

Heinonen OP, et al., Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst. 1998 Mar 18;90(6):440-6.

National Cancer Institute: www.cancer.gov/newscenter/pressreleases/Hope-Too
Stampfer MJ, et al., Vitamin E consumption and the risk of coronary disease in women. N Engl J Med. 1993 May 20;328(20):1444-9.

Weinstein SJ, et al., Serum alpha-tocopherol and gamma-tocopherol ...prostate cancer... J Natl Cancer Inst. 2005 Mar 2;97(5):396-9.

Murphy RT, et al., Vitamin E modulation of C-reactive protein... Free Radic Biol Med. 2004 Apr 15;36(8):959-65.

Alan Gaby, MD, Personal communication

Jack Challem, The Nutrition Reporter, Personal communication

In The Health News

A study of zinc in tissues shows that a low level is associated with an increased risk of cancer of the esophagus. In a study of 132 subjects, those with the highest level of zinc in esophageal tissue had an 80 percent reduction in esophageal cancer compared to those with the lowest levels. (Abnet CC, et al., Zinc concentration in esophageal biopsy specimens measured by x-ray fluorescence and esophageal cancer risk. J Natl Cancer Inst. 2005 Feb 16;97(4):301-6.) Zinc deficiency increases the effects of some carcinogenic compounds. Zinc is available as a dietary supplement and is in many multiple vitamin-mineral formulas. Some healthy food sources include beans, grains, and tofu.

The herb feverfew contains an active component called parthenolide. New laboratory studies of parthenolide reveal that it can inhibit the growth of certain leukemia cells without harming normal cells. In addition, it gets at the root of the problem by attacking the leukemia stem cells. (Guzman ML, et al., The sesquiterpene lactone parthenolide induces apoptosis of human acute myelogenous leukemia stem and progenitor cells. Blood. 2005 Feb 1; [Epub ahead of print]. Parthenolide is apparently much more specific than the chemotherapeutic drug used in this kind of leukemia.

Diet and Disease

Green tea has anti-cancer activity. One component, EGCG (epigallocatechin gallate), is similar to some cancer drugs, but without the same side effects. It inhibits a folic acid-related enzyme, reducing growth, and promoting cancer cell death, but does not bind as strongly as the drug, making it safer. (Navarro-Peran E, et al., The antifolate activity of tea catechins. Cancer Res. 2005 Mar 15;65(6):2059-64.) The effective concentrations are similar to levels found in the serum of green tea drinkers. The EGCG level in black tea is much lower.

Recipe of the Month: Pesto Bean Stew (or Soup)

After soaking for 4-8 hours and discarding the soaking water, pressure cook some navy beans. Sauté chopped onions and diced celery in olive oil and white wine, with freshly ground black pepper and a pinch of cayenne (or to taste). Put this in a stock pot with organic vegetable broth (available from health food stores), the amount depending on whether you want soup or stew. Add the beans, diced potatoes and butternut squash (cut small to speed cooking), any chopped vegetables, such as zucchini and yellow squash, and fresh diced tomatoes or a can of fire-roasted organic tomatoes from Muir Glen. Simmer until the potatoes are soft. Combine fresh basil, garlic (to taste), walnuts, and olive oil in a food processor and puree until smooth. Add this to the other dish just before serving as a soup with whole wheat bread, or as a stew over whole wheat or buckwheat noodles.

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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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