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November-December 2012

Topics:

Dr. Oz errs on organic foods
Exercise helps cancer-related fatigue
Quercetin blocks allergy and inflammation
Exercise reduces dementia risk
Carotenoids lower breast cancer risk
Melatonin helps sleep in patients on beta-blockers


Dr. Oz errs on organic foods

Recently, the popular TV doctor Mehmet Oz, MD, reversed his position taken only weeks earlier on the health value of organic foods. This is related to the study from Stanford that reviewed research that compared the nutrient density of conventionally grown fruits and vegetables with their organic counterparts. That study claimed that organic foods were no better for you than conventional, and they were more expensive. The study was flawed and misleading, as were the headlines it generated. The authors narrowly defined “better for you” based on the amounts of vitamins and minerals in the foods, ignoring non-vitamin nutrients such as flavonoids and other phyto-chemicals, and the dangers of toxic pesticides.

Back in September when the Stanford study appeared, Dr. Oz had quite a different position on the value of organic foods. He said (and that September 6th article is still up on Dr. Oz’s website) that non-organic produce had a 30 percent higher risk for pesticide contamination (toxic for humans, animals, and the environment). He also noted that children who switched to organic foods for 5 days had significantly lower pesticide residues in their urine. He noted that organic foods provide lower levels of pesticides and other toxins, less likelihood of exposure to antibiotic resistant bacteria, less damage to the air, water, and soil, and lower energy consumption. On October 19th, he said that organic food is “worth the investment” in order to avoid pesticides.

In his most recent editorial in Time Magazine (December 3, 2012), according to the Organic Consumers Association (organicconsumers.org), and based on my review of the article, he described organic food consumers as “elitist” and part of the “1%” and claimed that conventional foods were nutritionally equivalent to organic foods. I find this personally offensive, and I am sure many of my patients would also. They are almost never part of the “1%” of the United States population. Many of my patients are on the economically lower end of the scale, but they still choose to eat organic because of the concerns listed above and others. Consumers also choose organic foods to avoid the as yet unknown risks from genetically modified organisms (in most of the conventional corn and soybeans and an increasing variety of crops). Organic standards do not allow these organisms in food that is labeled as “USDA organic.” (And, by the way, while organic foods are the fastest growing segment of the grocery market, the “1%” are no more likely to be among those consumers.)

The costs that Dr. Oz condemns (I know him and his family and I am pretty sure they eat organics when possible) are nothing compared to the costs of caring for the cancers and other chronic diseases, infections with antibiotic-resistant bacteria, and brain, liver, and kidney toxicity that can result from the farm toxins. I choose to avoid those by eating organic whenever possible (about 95 percent of my diet). The Organic Consumers Association editorial says: “The Stanford study also completely ignored the horrendous damage to the environment by non-organic industrial farms and feedlots, including the devastating consequences to the planet of carbon dioxide, methane, and nitrous oxides emissions from chemical fertilizers and huge factory farm operations. Recent statistics indicate that the direct (greenhouse gas pollution) and indirect (tropical deforestation) impacts of industrial food and farms are the largest contributor to global warming.”

Another problem with conventional farming is the dangerous exposure of the farm workers who mix and apply the pesticides. This is where the toxins are most concentrated. They are poisoning the soil, the water, the food supply, the workers, as well as the consumers. I can’t say why Dr. Oz flip-flopped on his position in favor of organic foods. Some people have suggested the influence of advertisers, but I could not possibly comment on that. I hope at some point Dr. Oz reconsiders his position, or his misinformation condemns a large number of his followers to an increased risk of chronic diseases.

I believe Dr. Oz also erred in recommending meat that is grilled (known to increase cancer risks even more than the increase related to any meat) and in recommending dairy-based ice cream (even in small amounts contributing too much fat and sugar to the already-rich American diet). I strongly urge you to read the editorial by Mark Bittman in the New York Times: http://opinionator.blogs.nytimes.com/2012/10/02/that-flawed-stanford-study, which gives an in depth analysis of the study flaws, including mistaken conclusions, inaccurate analysis, and conflicts of interest. Organic food demand is increasing around the world, in the United Kingdom, France, Germany, Japan, and other countries, people are increasingly aware of the environmental dangers of conventional farming and the health risks. It has nothing to do with being elitist.

Exercise helps cancer-related fatigue

Fatigue related to cancer is a common symptom, both from the tumor itself and from the treatments (chemotherapy and radiation) administered to treat it (often with minimal benefits or for most tumors more harm than good). Managing this fatigue is an important part of disease management. This can be helped by better nutrition and by exercise. A new analysis shows the value of physical activity in alleviating cancer-related fatigue.

Researchers found 56 studies that met their criteria (randomized controlled trials without evidence of bias) including 4068 total participants, most of whom had breast cancer. Other cancers were prostate cancers and blood cancers. They did a meta-analysis of all the fatigue data and ended up with an analysis of 1461 participants who received exercise intervention and 1187 controls. The intervention periods varied, but at the end of the study the exercising subjects had a 27 percent lower level of fatigue than those who did not exercise.

Exercise was found to be beneficial for both breast and prostate cancer patients, but not for those with blood cancers, and it was effective both during and after the cancer medical treatments. In this review, aerobic exercise (including brisk walking and bicycling) was the only form of physical activity that had a beneficial effect. Results for resistance training and other activities did not reach significance. (Cramp F, Byron-Daniel J, Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012 Nov 14;11:CD006145.doi:10.1002/14651858.CD006145.pub3.) Further studies are needed to see if these other forms of activity might also contribute to lower levels of fatigue.

Quercetin blocks allergy and inflammation

Mast cells are immune-related cells found in abundance in the skin, mucous membranes, and other tissues. They are related to a certain kind of white blood cell, called a basophil, and contain a large amount of histamine bound up in granules. Mast cells play a major role in eczema, asthma, itching, and allergic rhinitis. They degranulate in response to various stimuli and release histamine and other pro-inflammatory chemicals in to the surrounding tissue. This stimulates both the allergic and inflammatory responses.

One drug called cromolyn (disodium cromoglycate) is used to stabilize the mast cell granules so they do not release histamine as readily. However, it is not particularly effective. A number of studies have shown that the nutrient quercetin is able to stabilize the mast cell granules. Quercetin is a bright, lemon-yellow flavonoid found in apples, yellow and red onions, citrus fruits, and parsley, and in smaller amounts in other foods, such as berries, cherries, and leafy greens. In higher amounts than you can get from diet alone, it helps to stabilize mast cell granules and relieve inflammatory and allergic symptoms.

A recent study of quercetin compared it to cromolyn and found it superior in its ability to block degranulation of mast cells and the release of pro-inflammatory chemicals (cytokines). The study was done on cells in culture. The release of histamine and cytokines is triggered by chemical and immune stimuli. In this study, it turns out that the cromolyn must be given at the same time as the trigger stimulus in order to be effective. On the other hand, quercetin is effective prophylactically. (Weng Z, et al., Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PLoS One. 2012;7(3):e33805. Epub 2012 Mar 28.)

These authors report that in two pilot clinical trials, quercetin significantly decreased contact dermatitis and photosensitivity. In previous studies, quercetin has inhibited the growth of pancreatic cancer in both tissue studies and in mouse in vivo studies. It is an antioxidant and can lower blood pressure in hypertensive subjects. Quercetin is available in supplement form. Effective doses are 400 to 1200 mg daily, and it is without side effects.

Exercise reduces dementia risk

In addition to the value of exercise for cancer patients, it has a number of other benefits. Last month I noted that exercise lowers some of the structural biomarkers associated with dementia risk. These were anatomical changes (changes in brain atrophy and lesions in both gray and white matter), but not direct measures of dementia. A new study shows clinical evidence of the value of exercise in maintaining cognitive function and avoidance of dementia.

In a prospective multinational European study called LADIS, researchers evaluated 639 subjects annually for three years. They used a comprehensive clinical protocol to classify cognitive impairment and dementia. At the same time, they evaluated their level of physical activity. The average age was 74 years, and 55 percent of the subjects were women. At the end of the follow-up, 90 patients had dementia, of which 54 had vascular dementia, 34 had Alzheimer’s disease, and 2 had frontotemporal dementia. An additional 147 subjects had cognitive impairment that did not reach the level of dementia.

On statistical analysis, physical activity reduced the overall risk of mild and severe impairment by 36 percent. For dementia, the risk reduction was 39 percent. The risk for vascular dementia by itself was reduced by 58 percent with physical activity, independent of age, white matter changes, atrophy, a history of stroke, or diabetes. (Verdelho A, et al., Physical activity prevents progression for cognitive impairment and vascular dementia: results from the LADIS (Leukoaraiosis and Disability) Study. Stroke. 2012 Dec;43(12):3331-3335. Epub 2012 Nov 1.)

Carotenoids lower breast cancer risk

A diet high in carotene-rich fruits and vegetables helps to reduce the risk of breast cancer. These foods include carrots, tomatoes, dark leafy greens, such as spinach and kale, sweet potatoes, bell peppers, and tomatoes. Carotenoids include alpha-carotene, beta-carotene (the one most people know about), lutein, lycopene, and zeaxanthin. Beta-carotene is converted into vitamin A in the body. These are antioxidant nutrients with numerous benefits.

In an analysis of eight studies including 3055 case subjects and 3956 matched controls, researchers evaluated the effects of individual and combined carotene levels on both estrogen-receptor-positive and –negative breast cancers. They found that for alpha-carotene those with the highest circulating level of alpha-carotene had a 13 percent lower risk of breast cancer compared with the lowest levels. For beta-carotene the risk reduction was 17 percent, for lutein + zeaxanthin, the reduction was 16 percent, and for lycopene it was 22 percent. (Eliassen AH, et al., Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. JNCI J Natl Cancer Inst (2012)
doi: 10.1093/jnci/djs461.)

Foods that contain carotenoids also contain a lot of other beneficial nutrients and phytochemicals. Natural sources of supplemental carotenoids contain alpha- and beta-carotene and small amounts of the others. Supplements of synthetic beta-carotene are not as desirable as the natural carotenoid combinations.

Melatonin helps sleep in patients on beta-blockers

Beta-blockers are commonly used to treat hypertension. Among them are atenolol (Tenormin) and metoprolol (Toprol). In the Unites States, about 22 million people take these medications. People who take these medications often have sleep disturbances, including difficulty falling asleep and waking during the night. A small study from the Brigham and Women’s Hospital in Boston shows that melatonin supplements might improve sleep in patients on beta-blockers.

Melatonin is a hormone produced in the pineal gland, and it influences our “biological clock,” including our sleep-wake cycles. In a randomized, double-blind trial, 16 patients with hypertension treated with the above beta –blockers were assigned to take either 2.5 mg of melatonin or a placebo for three weeks. At the start and at the end of the study, they spent time in the sleep laboratory and were tested with recording equipment. (Scheer FA, et al., Repeated melatonin supplementation improves sleep in hypertensive patients treated with beta-blockers: a randomized controlled trial. Sleep. 2012 Oct 1;35(10):1395-402.)

In comparison with placebo, those who took melatonin had significantly improved total sleep time (36 minutes more), and they fell asleep faster (by 14 minutes). They also had an increase in the time spent in stage 2 sleep (the longest stage of sleep). The benefits were seen even the night after they stopped taking the melatonin.

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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.

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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.

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