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January 2011

Exercise helps irritable bowel
Antioxidants help male fertility
HEPA filters for wood stove air
Fried fish may increase stroke risk
Fruits/veggies lower heart deaths
Leafy greens/olive oil cut heart attacks

Exercise helps irritable bowel

Irritable bowel symptoms include gas, bloating, cramps, and alternating diarrhea and constipation. It is not associated with fevers or intestinal inflammation and bleeding as is seen with inflammatory bowel disease. It can be quite uncomfortable and interfere with daily life, and it is often associated with specific foods to which someone is sensitive, and a healthy whole, natural-foods diet is often beneficial for these subjects.

New research suggests that exercise can also help with the symptoms. In a study of 102 adults with irritable bowel syndrome, those who were told to get more exercise were more likely to see improvement than those who maintained their usual lifestyle (which commonly does not include regular exercise, not only in the USA, but also in Sweden where the study was done).

In this randomized, controlled study, half of the patients were instructed by a physiotherapist to increase their physical activity and half were instructed to maintain their usual activities. A total of 38 women in the control group and 37 in the activity group completed the study. The activity group symptom scores declined by 51 points, while the control group declined by just 5 points. The number of patients with increased symptoms was much greater in the control group than in the exercise group. (Johannesson E, et al., Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol. 2011 Jan 4. [Epub ahead of print])

This is a much better way to treat than giving medications. Combined with a healthy, high-fiber diet, this may completely eliminate the condition. The authors noted that exercise had already been shown to help with the treatment of fibromyalgia and depression (in addition to prevention of heart disease and hypertension).

Antioxidants help male fertility

Couples who have trouble conceiving a baby might benefit from antioxidant supplements. A group of New Zealand researchers looked at 34 research trials of men who were “sub-fertile,” meaning they were less fertile than average but still able to contribute to conception. The researchers wrote that between 30 and 80 percent of male subfertility cases were apparently due to the damaging effects of oxidative stress on sperm.

The studies they evaluated included randomized controlled trials of any type of antioxidant supplements taken by the male partner of the couple seeking fertility assistance. They had a total of 2876 couples. The couples with men taking antioxidants had a nearly five-fold higher rate of live births than the controls. The use of antioxidants by men was associated with a more than four-fold increase in pregnancies for those couples.

None of the studies reported any side effects from the supplements, which included nutrients such as vitamin E and zinc. This review did not compare one antioxidant with another, and it is not clear that the only benefit was due to the effect on the quality of the sperm. (Showell MG, et al., Antioxidants for male subfertility. Cochrane Database Syst Rev. 2011 Jan 19;1:CD007411.)

HEPA filters for wood stove air

Air pollution is a likely contributor to many diseases of the lungs and heart. One hypothetical mechanism is the relationship of particulate air pollution to oxidative stress, systemic inflammation, and endothelial dysfunction. Researchers evaluated a community with high exposure to wood stove smoke (indoor air pollution), and tested the effects of air filtration on 45 healthy adults in a crossover study.

Half of the subjects were exposed to seven days of filtered air and half had the air filtration system installed but without the filters in place. For the second week, the subjects were reversed (without them knowing whether the filters were in place). At the end of each period, the subjects were evaluated for arterial function, markers of inflammation (such as C-reactive protein, or CRP, and interleukin-6), and lipid peroxidation (an indicator of oxidative stress).

The air filters reduced the indoor air particulates by 60 percent. The filtration led to a 9.4 percent improvement in arterial function and a 32 percent decrease in CRP levels. The lipid peroxides appeared unaffected by the air filtration. The benefits were greatest in males, overweight participants, and those with wood stoves in their homes. (Allen RW, et al., An air filter intervention study of endothelial function among healthy adults in a woodsmoke-impacted community. Am J Respir Crit Care Med. 2011 Jan 21. [Epub ahead of print])

HEPA air filters are readily available, and it is worth using them if you are exposed to wood stoves in your home. It might also be beneficial to use vacuum cleaners that have HEPA filters installed. Be sure to change the filters as often as recommended, or more often if your air is especially high in particulate pollutants.

Fried fish may increase stroke risk

Fried fish appears to be related to an increased risk of stroke. While fish that are rich in omega-3 fatty acids seem to help with vascular disease, fried fish may have the opposite effect. The “stroke belt” states include South Carolina, Georgia, Mississippi, Alabama, Arkansas, Tennessee, and Louisiana. Residents of these states consume about twice as much fried fish as people in other parts of the country, and they have a 30 percent higher risk of stroke death.

While omega-3 fatty acids from fish have favorable effects on platelet aggregation, blood pressure, lipid profile, and endothelial function, as well as ischemic stroke risk (from arterial blockage), unhealthy preparation of the fish by frying, especially in commonly used shortening or hydrogenated oils may negate these benefits. (Commercial cooking oils in restaurants are commonly re-heated multiple times after skimming off the cooking debris and adding more oil, and frying may also be done in animal fat.)

In a new study, researchers analyzed 21,675 participants over 45 years old, half of whom lived in the stroke belt. They found that only 23 percent of the participants consumed two or more servings of non-fried fish per week. African Americans in the study were 3.5 times as likely to consume two or more servings of fried fish per week compared to the rest of the country. (Nahab F, et al., Racial and geographic differences in fish consumption: The REGARDS Study. Neurology. 2011 Jan 11;76(2):154-8. Epub 2010 Dec 22.)

Overall, the participants consumed twice as much fried fish as people in the rest of the country, which the authors suggested might be the cause of their increased stroke risk. This may not be the entire explanation, as this population also eats more butter, bacon, and eggs. Fish rich in omega-3 oils include salmon, sardines, herring and mackerel. Non-fish sources of omega-3 oils include flaxseeds, walnuts, and soybeans.

Fruits/veggies lower heart deaths

A new study confirms that consuming more fruits and vegetables is good for your heart. In the European Prospective Investigation into Cancer (EPIC)-Heart study, 313,074  men and women were followed for an average of 8.4 years. Overall, there were 1636 deaths from ischemic heart disease (arterial blockage). The subjects had no history of heart attack or stroke at the start of the study.

Those participants consuming at least eight portions of fruits and vegetables per day had a 22 percent lower risk of fatal heart disease than those consuming less than three servings per day. A serving was considered to be 80 grams (just under three ounces). The authors calculated that each portion increase of fruit and vegetable intake led to a four percent lower risk of fatal heart disease. (Crowe FL, et al., Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Eur Heart J. 2011 Jan 18. [Epub ahead of print])

This does not prove cause and effect. It is possible that those subjects who consumed more fruits and vegetables had other lifestyle habits that contributed (perhaps more exercise). It is also possible that the higher consumption of fruits and vegetables meant a lower intake of fatty foods and refined foods. However, a more reliable diet intervention study is difficult to do for many years with some subjects on a healthy diet and others designated to eat an unhealthy diet (it would not be ethical, and it is hard to get people to stay on specific diets for the long term). Thus we need to draw the best conclusions possible from the available studies.

Leafy greens/olive oil cut heart attacks

More information from an Italian segment of the same European study evaluated the benefits from consuming fruits and vegetables and olive oil to protect the heart. It included 29,689 women evaluated over 7.85 years. Many variables were considered, including physical activity, weight, caloric consumption, alcohol intake,  and total dietary meat, as well as fruit and vegetable intake.

During the follow-up period, 144 major coronary events were identified. Those women with the highest leafy green vegetable intake and those with the highest olive oil intake had about half the risk of coronary events compared to those with the lowest consumption of either leafy greens or olive oil. They did not find any relationship to fruit intake. (Bendinelli B, et al., Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: the EPICOR Study. Am J Clin Nutr. 2011 Feb;93(2):275-83. Epub 2010 Dec 22.)

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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.

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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.