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June 2009

Broccoli for gastritis and ulcers
Cancer research conflicts of interest
Health practices reduce cancer risk
Vitamins A, C, and E help asthma
Coenzyme Q10 helps asthma
Alpha lipoic acid controls triglycerides

Broccoli for gastritis and ulcers

Broccoli has many health benefits, and a new study reveals yet another. In both mice and humans, substances in broccoli can help prevent gastritis and peptic ulcers. Sulforaphane is an isothiocyanate that has both antioxidant properties and is a powerful bactericidal agent that kills Helicobacter pylori, the common bacterium associated with ulcers and gastric cancer.

Oral treatment with sulforaphane in mice reduced inflammation in the stomach mucosa and protected against atrophy of the cells, which is associated with cancer risk. (Yanaka A, et al., Dietary sulforaphane-rich broccoli sprouts reduce colonization and attenuate gastritis in Helicobacter pylori-infected mice and humans. Cancer Prev Res (Phila Pa). 2009 Apr;2(4):353-60). Other information in the study strongly suggested that the benefits were related to both the anti-inflammatory and antioxidant functions of sulforaphane.

In the part of the study in humans, 48 patients with H. pylori infection were fed either broccoli sprouts (a rich source of sulforaphane) or placebo. In the treatment group, both stool and urine biomarkers of gastric inflammation and H. pylori infection were reduced. Two months of the treatment lowered the level of H. pylori colonization in mice and improved the consequences of infection in both mice and humans.

Cancer research conflicts of interest

It is sad to note that researchers in cancer treatment often have a conflict of interest, and may be influenced by drug companies in producing their results. Chemotherapy for many cancers is notoriously ineffective. While some cancers are very responsive to chemotherapy drugs or radiation, these are not the most common cancers, such as lung, colorectal, ovarian, and breast cancers.

In a review of 1534 studies from the medical literature, researchers evaluated articles published in eight journals in 2006 and identified 29 percent with conflicts of interest, mostly with funding from the industry. Those trials with industry funding were more likely to report positive survival outcomes. (Jagsi R, et al., Frequency, nature, effects, and correlates of conflicts of interest in published clinical cancer research. Cancer. 2009 Jun 15;115(12):2783-91.)

The reviews included articles in prestigious journals such as Cancer, the Lancet, and the New England Journal of Medicine. The conflicts included taking a consulting fee with a company or simply owning stock, whether knowingly or not (which is not a conflict if they don’t know). While 47 percent of all the studies evaluated epidemiology and prevention, industry funded studies looked mainly at treatment, and examined prevention only 20 percent of the time. Only 17 percent of the studies actually declared an industry connection.

Cancer treatment is a big business, and only a few successful treatments have resulted from an enormous amount of research. These successes tend to get a lot of press, but for the majority of common tumors, advances have mainly been made in prevention and early detection (which is not the same as prevention). This does not get as much media attention. (Another conflict of interest in cancer therapy is that oncologists’ incomes are related to the administration of chemotherapy, which in some cases might influence their treatment recommendations.)

Diet, exercise, and other lifestyle factors are important parts of the overall cancer prevention strategy (as you will see in the next article), and these may also help with treatment. They are not as dramatic as high-tech medical intervention, but they are far more valuable in the long run.

Health practices reduce cancer risk

Many people think that most cancers are genetic or related to toxic exposures over which they have little or no control, but this is not the case. At least ⅔ of cancers are preventable with lifestyle changes, according to a report from two major organizations (World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR, 2007).

This international team evaluated more than 7000 cancer studies. As a result, they came up with a number of recommendations for lifestyle choices that prevent cancer. Among them are to get regular moderate exercise of 30 to 60 minutes a day, maintain normal body weight, and to eat a healthy diet. This consists of unprocessed foods that are mostly plant based, with lots of fruits, vegetables, beans, and whole grains, while avoiding sugary drinks and fast foods and most meats. They also recommend reducing salt consumption to 5 grams a day (less than a teaspoon from all sources) and limiting alcohol intake.

One area of disagreement that I have is their recommendation to avoid dietary supplements. They base this on the few studies on beta-carotene and lung cancer in smokers (which is a concern), and the mixed evidence on some other supplements and cancer prevention. I think their general recommendation against supplements is unjustified with only this evidence. They do note, however, that foods may not always meet everyone’s nutritional needs, in which case supplements “may be valuable.”

Vitamins A, C, and E help asthma

A review that included 40 studies over a period of 27 years showed that vitamins A, C, and E were all low in patients with asthma. In this report from British researchers, people with mild asthma had significantly less vitamin A in their diets than people without asthma (182 mcg less), and those with severe asthma had 344 mcg less than people with mild asthma. (Allen S, et al., Association between antioxidant vitamins and asthma outcomes: Systematic review and meta-analysis. Thorax. 2009 Apr 30. [Epub ahead of print])

A lower intake and lower serum levels of vitamin C were both associated with a significant 12 percent increased risk of asthma. Although vitamin E intake was not clearly related to asthma, the authors did note that serum vitamin E levels were much lower in patients with severe asthma than in those with mild asthma.

This research does not provide any information regarding supplements of vitamins A, C, or E. Other research has shown reduced asthma symptoms in people who took vitamin C supplements. (Biltagi MA, et al., Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study. Acta Paediatr. 2009 Apr;98(4):737-42), and this is what I have seen in my clinical experience. In this latter study, omega-3 fatty acids and zinc also helped individually, and were even better when all three supplements were given in combination.

Another report showed that vitamin C reduces exercise-induced asthma. In this study of eight subjects who served as their own controls in a double-blind, crossover trial, supplements of 1500 mg/day for 2 weeks led to improved pulmonary function tests and asthma symptoms. (Tecklenburg SL, et al., Ascorbic acid supplement-ation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med. 2007 Aug;101(8):1770-8.)

Coenzyme Q10 helps asthma

Bronchial asthma can also be helped by supplements of coenzyme Q10 (as well as vitamins C and E). Asthma patients taking steroids for the long term develop mitochondrial dysfunction and oxidative damage to mitochondrial and nuclear DNA. They also have a decrease in coQ10 and vitamin E levels in the plasma.

In an open study of 41 patients with mild to moderate asthma, half received standard therapy and the others received the same plus daily antioxidant supplementation with 120 mg of coQ10 (in a soluble form), 400 IU of alpha-tocopherol, and 250 mg of vitamin C. (Gvozdjáková A, et al., Coenzyme Q10 supplementation reduces corticosteroids dosage in patients with bronchial asthma. Biofactors. 2005;25(1-4):235-40.)

After 16 weeks, the groups were crossed over to serve as their own controls. Those who were taking the treatment supplements were able to reduce their requirements for steroids with no increase in symptoms. Low plasma levels of these nutrients are associated with antioxidant imbalance and increased oxidative stress.

Alpha lipoic acid controls triglycerides

Alpha-lipoic acid (ALA) can help with diabetic neuropathy when given in high enough doses (1000 mg daily). A new study shows that it can also help with a number of other health problems that are commonly seen in obese patients. At Oregon State University, researchers at the Linus Pauling Institute have shown in an animal study that ALA can help control high blood triglyceride levels (TG). Elevated TG is thought to be a significant contributor to obesity-related health disorders, such as type-2 diabetes, heart disease, and fatty liver.

In mice, large doses of ALA (200 mg/Kg body weight) inhibited the gene that leads to lipid genesis and it stimulated the clearance of TG-rich lipoproteins. It also decreased TG secretion by the liver. (Butler JA, et al., Lipoic acid improves hypertriglyceridemia by stimulating triacylglycerol clearance and downregulating liver triacylglycerol secretion. Arch Biochem Biophys. 2009 May 1;485(1):63-71.)

ALA is a sulfur-containing antioxidant with a number of health benefits. Because obesity, diabetes and heart disease are so common, it is likely that supplemental ALA could considerably reduce chronic, degenerative diseases.

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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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