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July 2009

Red yeast rice lowers cholesterol
Veggie amino acid and blood pressure
Nettle helps allergic rhinitis
Testosterone and HGH help elderly
Lifestyle and diet prevent heart failure
Niacin for lipids and heart disease

Red yeast rice lowers cholesterol

Red yeast rice is helpful in lowering cholesterol. It has long been used in Asia as food and medicine. It is produced when a specific yeast is grown on rice and produces a deep red color. It was available as a dietary supplement in the standardized form until the FDA found that it naturally contained a substance that is in a patented drug, lovastatin (Mevacor), as which time the FDA banned the standardized product.

Recent evidence shows that red yeast rice is effective at lowering LDL cholesterol levels. In a study of 62 patients who had stopped statin therapy because of muscle pain, in addition to lifestyle changes, half were given red yeast rice and half were given a placebo. (Becker DJ, et al., Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med. 2009 Jun 16;150(12):830-9, W147-9.)

All participants who made lifestyle changes had a drop in their LDL cholesterol levels, but at the end of 12 weeks, those on the red yeast rice had an average 43 mg/dL drop in their level while those on placebo dropped only 11 mg/dL. At the end of 24 weeks, the drops were 35 and 15, respectively. It appears that after the 12 weeks, some of those on the red yeast rice dropped off of their treatment, so the benefits diminished, while the lifestyle changes helped to continue the improvement in the placebo group.

Because the standardized red yeast rice is not available, the participants were given 1800 mg twice a day to achieve adequate doses. There were few side effects, possibly because the dose of monocolin K (the substance in lovastatin) is very low, and could not account for the benefits but neither did it cause harm. A number of similar substances in the product might account for the benefits. Still, people taking red yeast rice should have liver tests to be sure no problems arise.

Veggie amino acid and blood pressure

An amino acid that is found most commonly in vegetable proteins appears to help lower blood pressure, perhaps partly accounting for the fact that vegetarians have lower blood pressure than meat eaters. (Stamler J, et al., Glutamic Acid, the Main Dietary Amino Acid, and Blood Pressure. The INTERMAP Study (International Collaborative Study of Macronutrients, Micronutrients and Blood Pressure). Circulation. 2009 Jul 6. [Epub ahead of print])

This international study of 4680 subjects 40 to 59 years old evaluated blood pressures eight times at four different visits. To analyze their diets, they used standard dietary questionnaires. Those subjects with a 4.7 percent higher intake of glutamic acid had an average decrease in systolic blood pressure of 1.5 to 3 points. Diastolic pressure was down by an average of 1 to 1.6 points. These are significant decreases because each point makes a difference in the risk of heart disease and stroke.

Several other vegetable protein amino acids had similar but smaller effects. Glutamic acid is the most prominent protein amino acid. It is about five percent higher in vegetable protein than in animal protein. Because blood pressure is influenced by many factors, eating more vegetable-source protein is one of the ways to help keep it healthy.

Vegetable protein is found in many foods, such as nuts, seeds, beans, and whole grains, and also in green vegetables, potatoes, and squashes, among others. The amount in some of these latter sources is small, but if you eat enough of them and combine them with the first group, you can easily satisfy your protein needs while getting many other benefits..

Nettle helps allergic rhinitis

Stinging nettle (Urtica dioica) has long been used for medicinal purposes. (The plant itself causes a stinging rash on skin contact due to hairs on the surface that contain irritants, but this effect is lost when the plant is cooked or processed into supplements). A laboratory study shows why it might be helpful in controlling allergy symptoms such as allergic rhinitis and sinus congestion. (Roschek B Jr, et al., Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009 Jul;23(7):920-6.)

Nettle has several beneficial effects, including blocking of histamine receptors and inhibiting tryptase. This is an enzyme in mast cells (those associated with skin and mucous membrane allergies) that leads to their release of histamine. This also reduces the release of a number of other substances that promote inflammation. These are the common substances that lead to the symptoms of hay fever.
I have found in my practice that allergy patients benefit greatly from supplements of nettle (usually 250 to 500 mg of standardized extract) up to several times a day with no side effects. I have helped patients eliminate or greatly reduce their need for allergy medications. I usually combine this treatment with supplements of quercetin and vitamin C, and often proanthocyanidins (from grape seeds or pine bark).

Interestingly, an earlier study in animals showed that nettle extract was beneficial in preventing chronic colitis, another inflammatory condition._ Konrad A, et al., Ameliorative effect of IDS 30, a stinging nettle leaf extract, on chronic colitis. Int J Colorectal Dis. 2005 Jan;20(1):9-17.) Mice with chronic colitis that were treated with nettle had far fewer signs of inflammation and its chemical mediators than untreated mice. This may help humans with inflammatory bowel disease.

Testosterone and HGH help elderly

While controversy surrounds supplements of testosterone and growth hormone because of their association with sports doping, they do have benefits when administered appropriately. A new study shows that in aging men, declining levels of both testosterone and growth hormone (HGH) can be corrected with supplements (injections in the case of HGH) with great benefits in function. (Sattler FR, et al., Testosterone and growth hormone improve body composition and muscle performance in older men. J Clin Endocrinol Metab. 2009 Jun;94(6):1991-2001.)

In this study, 122 men with an average age of 71 years received various doses of testosterone with or without injections of different doses of HGH. All of the groups gained muscle mass and lost body fat. Those men who received the highest doses of both testosterone and HGH achieved the best results.

After 16 weeks, the greatest gain of lean body mass (muscle) was 16.5 pounds and body fat decreased by as much as 5.1 pounds, most of it around the trunk. In addition, aerobic endurance increased, as did upper and lower body muscle strength. However, there was some increase in blood pressure with treatment and some men reported muscle aches. The benefits were seen even if testosterone and HGH levels were normal but in the low range of normal.

Lifestyle and diet prevent heart failure

Two new reports from the Nurses’ Health Study and the Physicians’ Health Study suggest easy ways to markedly reduce the risk of developing hypertension and congestive heart failure through diet and lifestyle. In the Nurses’ Health Study, 83,882 women aged 27 to 44 years were followed for 14 years. Six lifestyle choices were associated with reducing hypertension, including low body mass index (less than 25), 30 minutes daily of vigorous exercise, healthy diet, modest alcohol intake, little use of pain medication, and supplements of folic acid. (Forman JP, et al., Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009 Jul 22;302(4):401-11.)

Each modifiable lifestyle factor was independently associated with lower hypertension risk, but those women who followed all six healthy choices had a 78 percent lower risk than those who had no low-risk factors. Each additional healthy lifestyle choice lowered the risk cumulatively.

In the other study, 20,900 men averaging 53.6 years old were assessed for six slightly different lifestyle factors, including body weight, smoking, exercise, alcohol intake, breakfast cereal consumption, and fruit and vegetable intake. They were followed for an average of 22.4 years and evaluated for the development of heart failure. (Djoussé L, et al., Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA. 2009 Jul 22;302(4):394-400.)

All six lifestyle factors were individually associated with a lower risk of heart failure. The lowest risk was found in men who adhered to at least four of these health practices. I presume that at least some of the breakfast cereals that they consumed were whole grains (such as oatmeal, shredded wheat, or granolas). It is interesting (but not surprising) that in both studies the more healthy-lifestyle choices the lower the risk of disease. It is clear that these conditions are not primarily genetic, but lifestyle related.

Niacin for lipids and heart disease

Niacin, a form of vitamin B3, is known, in high doses, to be an excellent treatment for high cholesterol levels. It has not been much prescribed by doctors because of a temporary flushing reaction (usually 20 to 30 minutes) that it causes (which is harmless and usually stops happening with consistent use). It is also little used because most doctors are ingrained in the habit of prescribing drugs.

A new review article reports that niacin is the most potent treatment for lowering LDL cholesterol and raising the good HDL cholesterol. This article from the University of Oxford in England says that niacin reduces cardiovascular events and the progression of atherosclerosis. It also has anti-inflammatory effects, which contribute to heart health. (Digby JE, et al., Nicotinic acid and the prevention of coronary artery disease. Curr Opin Lipidol. 2009 Aug;20(4):321-6.)

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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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