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January 2006

Lifestyle Resolutions
Shedding Light on Mushrooms
Health Benefits of Mushrooms
Homocysteine and Memory
Ask Dr. J: Vegan Candida diet
In The Health News
Diet and Disease
Stuffed Portabella Mushrooms

Lifestyle Resolutions

Dear Friends,

Many people make New Year’s Resolutions to improve their lifestyles but have difficulty following through with them, sometimes not starting at all, and sometimes starting with great enthusiasm, only to fail because of waning motivation and the intrusion of all the life events that led to avoiding these things in the first place. A new study of children and young teens sheds some light on the problem.

In a study published in the Archives of Pediatrics & Adolescent Medicine, researchers report that for kids, fun and fitness are more likely to provide motivation to exercise than concerns about weight. What is true for children and adolescents in this regard is also true for the vast majority of people. They know they should exercise (and eat better and reduce their stress), but they do not do so because they see it as a struggle or a sacrifice (of time, energy, or other pleasures) rather than a pleasure in itself.

Most people will not maintain a healthy lifestyle simply because it is healthy; they have to experience real pleasure from their foods, exercise activities, and relaxation efforts or they will abandon them. They need to learn that healthy foods are delicious, and can be prepared in a wide variety of interesting combinations, without too much work. The foods that other higher animals eat, and that most people in less industrialized countries have eaten for millennia, are those that are not only healthful, but also give them pleasurable experiences.

People also need to recognize that many exercises can be fun rather than a chore. Hiking, bicycling, tennis, basketball, handball, rollerblading, kayaking, skiing, and dancing are examples of activities that most people enjoyed when they were younger but abandoned because of the obligations of work, family, and other responsibilities, and failure to appreciate their importance. You do not have to be an endurance athlete to achieve better health through physical activity, although nothing is wrong with athletic training if you like to do that. The important thing is to find an activity that you enjoy and do it regularly, just as you would brush your teeth.

Even though we all feel that our schedules are tight, it is surprising how much time we can find when we are committed to something (for example, you can ride a stationary bike while watching the news). While change is difficult, it is easier if you see healthy changes as adding pleasures to your life. I have a friend who had tried to quit smoking many times. Then one day he just stopped (without “quitting,” and the psychological pressures that such artificial goals engender) and with no process, technique, or plan. His “inner being” was just ready for the change. I tell patients not to sacrifice pleasure for health, not only because I know they won’t do it, but also because I know they don’t have to.

Shedding Light on Mushrooms

Mushrooms and other fungi have a long history of both culinary and medicinal use. In China and Japan and other Asian countries, some mushrooms have been revered for thousands of years for their health benefits. They are also traditional foods in other parts of the world. Mushrooms have had a mystique in many cultures, thought to provide immortality, sexual prowess, and strength, or to convey spirituality. Perhaps some of this reputation derives from varieties of psychedelic mushrooms containing psilocybin (often called “magic” or “sacred” mushrooms).

Although some toxic species of mushrooms get a lot of attention, and you do have to be extremely careful if you decide to pick wild mushrooms, those in the food markets are not a problem. A wide variety of common and exotic or specialty mushrooms are now available for cooking and as dietary supplements for both medicinal purposes and preventive medicine. (If you do pick your own, you should definitely take them to an expert for evaluation unless you are very experienced. I have picked cepes, or porcini, mushrooms while hiking in the Pyrenees Mountains, but I had a guide who knew mushrooms well.)

In many markets, in addition to the usual white button mushrooms, you can also find a wider variety of edible mushrooms. These may include portabella, crimini (baby versions of the portabella), shiitake, oyster mushrooms, chanterelles, maitake (also called “hen of the woods”), and morels. In Chinese recipes, they often use “wood ears” or “tree ears” which grow right out of the trunks of dead trees and look like ears.

Mushrooms are nutritious. For example, 100 grams of raw portabella mushroom (about 3 ounces) contain only 26 calories, but 2.5 grams of protein, 5 grams of carbohydrate, virtually no fat, 484 mg of potassium, and significant amounts of copper, manganese, and zinc. Because they are 90 percent water, when mushrooms are cooked down this would be a small portion, so typical portions of cooked mushrooms can be significant sources of nutrients and fiber.

Portabella mushrooms contain 1.5 grams of dietary fiber per 100 grams. Fiber is one of the most neglected nutrients. Although it is not digested or absorbed, it is quite important for intestinal health, cholesterol control, and appetite suppression. Compare mushrooms with meat (which has zero fiber), and you find that mushrooms have more protein per calorie than typical cuts of meat (19 grams of protein for 239 calories, to say nothing of the 153 calories from fat).

Mushrooms have a unique nutty, savory flavor, and can be combined in many different recipes. I recommend many ways to prepare mushrooms, including grilled or pan fried, sautéed with onions and garlic, minced up as part of a mushroom-bean pâté, stir-fried with oriental vegetables, and stuffed caps with brown rice and walnuts. They are also great in soups, such as miso or mushroom-barley, or simply sliced and added to a salad. Some of these recipes are found in my earlier newsletters (and this one), and you can find many on the Internet or recipe books.

Health Benefits of Mushrooms

While many mushrooms may have the same or similar healthful properties, some have been specifically studied and reported in medical literature. Mushrooms can boost immunity, reduce cardiovascular disease, lower blood pressure, and fight infections, and they may help to treat cancer. Shiitakes have specific antibacterial effects, killing some pathogenic bacteria while not harming the normal intestinal flora that are needed for digestive health.

Maitake extract (D-fraction, a polysaccharide) activates macrophages, natural killer cells, and T-cells, and inhibits tumor growth. In mice with breast cancer, treatment with chemotherapy was reduced and survival was 100 percent when they were given maitake extract along with the drug. In a study of 10 cancer patients, maitake D-fraction reduced metastases, inhibited tumor growth, lessened the expression of tumor markers, and enhanced NK cell activity. Reishi mushroom extracts have similar effects.

Polysaccharide immune modulators (beta glucans) found in mushrooms are probably responsible for many of their healthful properties. They lower LDL-cholesterol and triglyceride levels, reducing heart risk. Other components of reishi and others help to lower blood pressure. Mushrooms may benefit HIV patients because of their immune support and effect on natural killer cells and T-cell balance and function.

Homocysteine and Memory

New research ties high serum homocysteine (Hcy) level with an increased risk of memory loss. In memory testing on 2189 adults over six years, those who developed memory loss were found to have higher Hcy levels and lower folate levels than those without memory loss. In subjects who had a high Hcy and low folate at the beginning, if these levels had improved by the end of the study, their memory scores increased.

Homocysteine is a metabolite known to be associated with vascular disease risk, and may itself be directly toxic to the blood vessels, rather than just a marker. Dementias are often associated with vascular disease, so doing what is possible to reduce the vascular risk may well help to improve brain function. It may also be that Hcy is toxic to the brain as well as blood vessels.

Earlier studies have shown a relationship between Hcy levels and the risk of developing Alzheimer’s disease and other forms of dementia. In a study of 816 subjects followed for four years, those with high Hcy had twice the risk of dementia. Independently of Hcy, low folate levels were associated with almost double the risk of both dementia and Alzheimer’s disease.

Homocysteine elevation is also associated with an increased risk of strokes. In a study of 1015 men, those with the highest Hcy levels had almost triple the risk of strokes compared with men with the lowest levels. Again, men with the highest folate levels had a 60-65 percent reduction in stroke risk. Hcy can be reduced by a high intake of fruits, vegetables (including mushrooms), whole grains, and supplements. In addition to folic acid, supplements of vitamins B6 and B12 also lower homocysteine.

Ask Dr. J: Vegan Candida Diet

Q. I have yeast overgrowth, and want to follow an anti-Candida diet, but I am vegan. Can a vegan follow this diet?
—DH, via Internet

Yes, you can. Yeast overgrowth in the intestinal tract can cause a variety of symptoms from either allergic reactions or the toxins that yeasts produce. Symptoms may include digestive disturbances, anxiety, depression, headaches, skin disorders, recurrent yeast infections, immune dysfunction, allergies, and chemical sensitivities. It is usually preceded by excessive antibiotic use, high sugar diets, or hormone therapies, all of which increase yeast growth.

Candidiasis diets commonly eliminate refined carbohydrates, such as sugar and white flour, and are low in natural sweets such as dried fruits, honey, and maple syrup. Some doctors restrict all fruits, which is unhealthful and usually unnecessary. The anti-Candida diet is quite compatible with vegetarianism. You may have to avoid yeast-related foods, such as bread, cheese, pickles, vinegar, and soy sauce, among others (not all Candida patients are sensitive to yeast foods). However, a vegan diet of whole grains, beans, vegetables, fresh fruits, seeds, and nuts is quite compatible with Candidiasis treatment.

You might also need some supplements, including grapefruit seed extract, garlic, and probiotics (acidophilus and bifidobacteria), as part of your treatment program, or some medications, such as Nystatin or other anti-fungal drugs.

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Composition: Mushrooms, portabella, raw, USDA National Nutrient Database for Standard Reference, Release 18 (2005).

Kuznetsov OIu, et al., [Antimicrobial action of Lentinus edodes juice on human microflora] Zh Mikrobiol Epidemiol Immunobiol. 2005 Jan-Feb;(1):80-2.

Hirasawa M, et al., Three kinds of antibacterial substances from Lentinus edodes (Berk.) Sing. (Shiitake, an edible mushroom). Int J Antimicrob Agents. 1999 Feb;11(2):151-7.

Kodama N, et al., Enhancement of cytotoxicity of NK cells by D-Fraction, a polysaccharide from Grifola frondosa. Oncol Rep. 2005 Mar;13(3):497-502.

Kodama N, et al., Maitake D-Fraction enhances antitumor effects and reduces immunosuppression by mitomycin-C in tumor-bearing mice. Nutrition. 2005 May;21(5):624-9.

Kodama N, et al., Effect of Maitake (Grifola frondosa) D-Fraction on the activation of NK cells in cancer patients. J Med Food. 2003 Winter;6(4):371-7.

Kimura Y, New anticancer agents: in vitro and in vivo evaluation of the antitumor and antimetastatic actions of various compounds isolated from medicinal plants. In Vivo. 2005 Jan-Feb;19(1):37-60.

Rajewska J, et al., [Biologically active compounds of edible mushrooms and their beneficial impact on health] Postepy Hig Med Dosw (Online). 2004 Oct 5;58:352-7.

Kabir Y, et al., Effect of shiitake (Lentinus edodes) and maitake (Grifola frondosa) mushrooms on blood pressure and plasma lipids of spontaneously hypertensive rats. J Nutr Sci Vitaminol (Tokyo). 1987 Oct;33(5):341-6.

Homocysteine and Memory

Nurk E, et al., Plasma total homocysteine and memory in the elderly: The Hordaland Homocysteine study. Ann Neurol. 2005 Dec;58(6):847-57.

Ravaglia G, et al., Homocysteine and folate as risk factors for dementia and Alzheimer... Am J Clin Nutr. 2005 Sep;82(3):636-43.

Virtanen JK, et al., Serum homocysteine, folate and risk of stroke... Eur J Cardiovasc Prev Rehabil. 2005 Aug;12(4):369-75.

In The Health News

A component of green tea may help reverse or slow the progress of some leukemias. Chronic lymphocytic leukemia (CLL) is often a slow growing leukemia in adults. In a report on four patients with clear evidence of progression, supplements of EGCG (epigallocatechin gallate) or large amounts of green tea appeared to reverse the disease. (Shanafelt TD, Clinical effects of oral green tea extracts in four patients with low grade B-cell malignancies. Leuk Res. 2005 Nov 30; [Epub ahead of print].) EGCG, a green tea polyphenol, can cause programmed cell death in leukemic B-cells. One patient drank 8 cups of green tea per day, and others took green tea extract in capsules. Lymph node swelling reversed in three patients.

Antacids, such as Nexium and Zantac, double or triple the risk of potentially deadly infectious diarrhea from C. dificile, a bacterium that is difficult to treat. This was shown in a study of 1672 cases and matched controls. (Dial S, et al., Use of gastric acid–suppressive agents and the risk of community-acquired Clostridium difficile–associated disease JAMA. 21 December 2005;294(23):2989-2995.) (Instead, try licorice extract for heartburn.) Anti-inflammatory drugs (NSAIDS) also increased the risk, but by a smaller amount.

Diet and Disease

Researchers followed 4304 young adults for 15 years, and found that higher consumption of plant foods (grains, fruits, vegetables, nuts, and beans) reduced the risk of hypertension. At each increasing level of consumption, blood pressures were lowered; those in the top fifth had a 36 percent reduced risk. Increasing meat intake had the reverse effect, raising the risk of developing high blood pressure. Steffen LM, et al., Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure…Am J Clin Nutr. 2005 Dec;82(6):1169-77.

Stuffed Portabella Mushrooms

Using large portabella mushrooms, carefully take off the stems by squeezing gently near the base and rocking them back and forth. Clean all surfaces, reserving the caps, and trim and dice the stems. Sauté these in olive oil with some garlic, ginger, and onions. Add some mashed tofu, a small amount of soy sauce, and freshly ground pepper. Stir and then add some cooked brown rice or whole wheat bread crumbs (about half as much as the rest of the mix) and toasted sesame seeds, and stir until the flavors are mixed. Coat the mushroom caps with olive oil, and cook them on a grill or griddle; the surfaces should get sizzling brown on both sides, but don’t cook them completely. Stuff the caps with a mound of the sautéed mixture and set them individually in a baking dish. Put the dish in a preheated oven at 400 degrees, and bake them for 10-15 minutes.

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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.