Nutrition Update/NSAIDS

Wow! I did not realize I have been silent for so long-November. I guess business just got in the way. Generally, I try to keep nutrition and health information in the forefront on a monthly basis.

General stuff: With the constantly increasing cost of energy I will periodically comment on my efforts to reduce my impact on the environment. One of the easiest ways to cut your costs is to switch out your incandescent bulbs for CFLs (compact fluorescent). I did this at home all at once. Prior to switching out, my electrical bills have never been under $200 a month even during non-AC months. Since I have light switch challenged members in my family, I switched all of my lights to CFLs one weekend. I have had 3 successive months of electrical bills under $100 and last month it was $49.50. It was a little expensive doing them all at once (over $200), but I paid for the extra cost in 2 months of use. I am looking for ways to do this at the office as well since my summer electrical bills are over $600/month. Other things one can do to minimize electrical usage is to turn off electrical strips to TVs, VCRs, etc. when they are not being used. Motion sensors in rooms is also another trick if you have light switched challenged family.

Just as a point of interest: a 150 watt equivalent CFL is the same as a 40 watt incandescent, a 90 watt CFL is 23 watts. As you can see that's a big difference in wattage.

Nutrition/Health News:
NSAIDs-Non-steroidal anti-inflammatories. These include things like ibuprofen, ketoprofen, Orudis, aspirin, Aleve, Celebrex, mobic, Advil, Naprosen, Indomethacin, etc.

• NSAIDs can lead to gastrointestinal bleeding in the form of ulcers by eroding the protective lining of the stomach and GI tract. This can cause acute gastritis.
• Rebound pain can result from prolonged use of NSAIDs.
• Nutritional approaches to controlling pain and inflammation and alternative can be used. Tylenol with nutritional anti-inflammatories (dietary-avoid red meat and high carb diets, eat more cold-water fish or take Fish Oil Supplements, use nutritional anti-inflammatories such as curcumin, boswellic acids, etc.).
• NSAIDs only treat the symptoms. Yes, they are quick fixes.
• I for one cannot use NSAIDs due to causing a erosive gastritis (pre-ulcer) by avoiding knee surgery by popping aspirin. I reaggravated that later with ibuprofen.
• The World Health Organization (WHO) notes that up to half of chronic NSAID users experience stomach and GI erosions and ulcers.
• Risks increase with poor health, getting older, taking corticosteroids and anti-coagulants, smoking, and long term use.
• NSAIDs should never be taken on an empty stomach.

Nutritional Highlights:

• Polyphenols: especially cocoa polyphenols, reduces insulin resistance and blood pressure in humans. It also improves arterial damage and may reduce overall mortality. It improves blood flow via vasodilation (opening vessels) reducing blood pressure, increasing circulating nitric oxide and lower vascular cell adhesion; reduces sticky platelets (modest) and has an additive effect with 81 mg aspirin; improves insulin sensitivity; increases blood flow to the brain improving cognitive performance; and serves as a source of anti-oxidants. How do you get cocoa polyphenols-dark chocolate is one source but it is rife with sugar and fat and inconsistent levels of polyphenols. Life Extension Foundation is one source of nutritional supplements with cocoa polyphenols.
• CoQ10 (ubiquinol is preferred)- this substance should be taken by those taking statin drugs (lipitor, zocor, etc.) due to statins reducing CoQ1o in the body. CoQ10 is important for cardiac function and benefits other organs such as the brain and kidneys that require high level energy metabolism.
• Atherosclerosis-SOD (superoxide dismutase) and pommegranate juice extract helps prevent and may reverse deadly atherosclerotic plaque (clogged arteries).
• Stress and Anxiety Relief without Tranquilizers: natural botanical extracts are available, one of which is as effective as the leading prescription drug to relieve anxiety and stress. Stress and anxiety lead to insomnia and impaired concentration. Medications generally produce unwanted side effects from sedation to memory problems. Theanine (derived from green tea) supports relaxation while allowing clear thinking. It may also supports healthy blood pressure, healthy weight management, and may provide support for some cancer therapies. Theanine dosages range from 100-400 mg/day with no know adverse reactions. Lemon balm extract is effective in relieving anxiousness and insomnia and helps boost cognitive performance and improves learning and retention. Dosages of lemon balm extract are 300 mg 1-2 times a day. There are no know contraindications.
• FISH OIL: Omega 3 fatty acids is the only dietary supplement the American Heart Association recommends people consider taking. EPA and DHA in fish oils are the key ingredients. A recent study found that the risk of unstable angina or heart attack was reduced by 62% for every 1.24% increase in whole blood EPA/DHA. In a 2002 NEJM study lower levels of EPA/DHA were found in people dying suddenly of a heart attack.
• Vitamin D: Numerous studies show greater vitamin D levels could reduce cancers of the breast, prostate, colon, esophagus, pancreas, ovary, rectum, bladder, kidney, lung and uterus as well as non-Hodgkin's lymphoma and multiple myeloma. Additional research on vitamin D shows reduction in Type 1 diabetes with children, type 2 diabetes with calcium, decreased falls in elderly, decreased multiple sclerosis in women taking 400 IU/day. Government recommendations are: 200 IU/day for children, 400 IU/day 51-70 years of age, and 600 IU/day over 70 are considered out of date. Blood levels should be in the area of 30-50 ng/mL which ideal intake may be in the area of 1000 to 4000 IU/day depending on what your baseline level is already. Toxicity occurs above 150 ng/mL in the blood.
• Joint Support- in addition to glucosamine and chondroitan sulfate, joint support may be helped with newly developed compounds from keratin, Hyaluronic acid and Korean Angelica. Angelica has anti-inflammatory characteristics as well as beneficial affects for the brain and Alzheimer's, potent pain relief and may help in treating some cancers. Decursinol-50 is the specialized extract. Angelica acts on the central nervous system to suppress inflammation. Oral hyaluronic acid helps with joint pain from arthritis and may improve joint lubrication and alleviate inflammation. Keratin acts as a powerful anti-oxidant and supports production of a protective anti-oxidant enzyme. It is a source of sulfur essential for joint resilience.

Thanksgiving Schedule-Nutrition Updates

Holiday schedule is as follows: Closed on Thanksgiving Day. Open normal hours Friday and Saturday.

Nutrition News:

• High fructose carbonated soft-drink sweetners linked to diabetes.
• Calcium supplementation in adults over 50 can result in reduced fracture risk.
• Pectin used in making homemade jellies may protect from prostate cancer highlighting the importance of eating fruits and vegetables.
• Vitamin D may prevent premature death due to its ability to inhibit cancer cell proliferation, improve blood vessel function and boost the immune system.
• Calcium and vitamin D may protect against breast cancer.
• High homocysteine levels linked to cognitive impairment (mild) and doubles heart disease risk.
• A household spice curcumin reduces inflammation and improves exercise performance
• Ground flaxseed reduces hot flashes.
• Vitamin E supplementation helps prevent venous thromboembolism.

Dangers of Acetaminophen (Tylenol)

• PRESCRIPTION DRUGS with acetaminophen-Tylenol 2, 3 and 4, Vicodin, Lorcet, Lortab, Maxidone, Zydone, Percocet, Roxicet, Fioricet, Darvocet-N, Wygesic.
• The leading cause of acute liver failure even at recommended doses.
• Results in 10s of thousands of poison control costs.
• Alcohol consumption and fasting greatly increase liver injury risk.
• Overdoses (OD) occur frequently due to pain control efforts or combining medications with acetaminophen

PREVENTING Acetaminophen OD

• Read your labels.
• Avoid alcohol when taking acetaminophen
• Avoid acetaminophen when vomiting or with loss of apetite.
• Consider supplementing with anti-oxidants which counteract oxidant by-products and preserve glutathion which is essential for detoxifying some drugs and is depleted by acetaminophen.
• The following can be used with acetaminophen under supervision: N-acetylcysteine (NAC), vitamine C and E, SAM-e, whey protein, milk thistle extracts (silymarin and silibinin), polyenylphosphatidlycholine.

Nutrition and Autism:

Possible causes: no single cause but a cluster involving genes, inflammation, impaired GI health, increased oxidative stress, diminished ability to neutralize toxins, autoimmune processes, decreased mitochondrial function. Other proposed are vaccine preservatives and food additives.

Integrative Approach:

1. Dietary Modification: Healing the gut-eliminate allergenic foods, digestive enzymes, probiotics
2. Boost anti-oxidant protection- consider multi-vitamin and mineral supplements: B6, magnesium, A, C.
3. Enhance detoxification
4. Support brain cell structure

Health and Nutrition News

The American Heart Association has some good stuff on heart disease and diabetes: Be in the KNOW.

• Approximately 21 million Americans currently live with diabetes.
• many do not realize there is a serious connection between type 2 diabetes and cardiovascular disease.

The American Heart Association wants you to be in the KNOW. Using the following acronym, these are their recommendations:

Keep active and maintain a healthy body weight.
Even 30 minutes of moderate physical activity five days a week can help prevent diabetes, reduce blood pressure and cholesterol, maintain a healthy body weight and minimize risk of cardiovascular disease.
Normalize your numbers.
Schedule regular visits with your doctor to help monitor your blood sugar and manage your diabetes. It has been shown that you can reduce cardiovascular disease by improving your blood sugar control and controlling other risk factors. Learn to keep track of your critical health numbers, including blood pressure, cholesterol, body weight and blood sugar.
Opt for a healthy lifestyle.
Eat a healthy, balanced diet and reduce intake of saturated and trans fats, cholesterol, sodium and added sugars. Also, if you smoke, opt to quit – smoking increases the risk of cardiovascular disease.
Work with your doctor.
People living with type 2 diabetes often need multiple approaches to treatment to control the disease and its associated risks. If you live with type 2 diabetes, it is important to talk with your doctor, describe your symptoms and be persistent until you find treatment options and lifestyle changes that work for you.

NUTRITION FLASHES: The following are based on research studies.

• Vitamin C-low levels have been linked with being overweight or obese-especially in women; may protect agains knee arthritic changes.
• Aging nutrition: tumeric ( spice) helps the immune systems clear Alzheimer's plaques. Daily multi-vitamin and mineral supplements boosts mental health in older adults; calorie restriction and glucose control increases longevity.
• Vitamin D: low levels are linked with increase blood pressure
• Osteoarthritis: glycine amino acid improves osteoarthritis symtoms.
• Cancer: watercress has benefits for cancer protection, vision and heart health; resveratrol supresses prostate cancer development; broccoli and cauliflower reduce aggressive prostate cancer risk.

New Health Check Lists-=evidence based

http://www.bankixsystems.com/articles/article/4020285/74632.htm

The link provided will direct you to a checklist for men and women that is evidence based . This is worthwhile having. From the Bankix website announcement: "The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) has released two new evidence-based checklists aimed at helping men and women understand which medical checkup tests they need to remain healthy at any age. The men's and women's versions of Your Checklist for Health show at a glance the recommendations of the U.S. Preventive Services Task Force regarding screening tests, preventive medicine, and other healthy lifestyle behaviors."

Nutritional News, etc.

Evidence-based/Science-based healthcare: Okay, so here's one of my rants about alternative healthcare. I am unusual in the alternative healthcare arena! I am a strong proponent and user of evidence-based or best evidence available healthcare. In the alternative healthcare arena there are a lot of fads and questionable practices. Chiropractic healthcare is no exception. Many of my colleagues make claims and do things that have little basis in science and evolve out of a philosophical point of view in the profession that has little validity. It's a problem for the profession and its image. However, there are many DCs (doctors of chiropractic) that focus on practicing with the best evidence available and avoid questionable practices. Why is this important? Money for one. Nobody wants to spend money on things that have not been shown to work, or at least appear to with the best evidence available. Here is one example. Using muscle testing to determine vitamin deficiencies and even worse-what is referred to as surrogate testing. In other words, having you hold a vial (glass bottle) of a low dose of a substance (heavily diluted) while another person touches you and then the "doctor" muscle tests the person touching you. There is absolutely no evidence whatsoever that I am aware of that shows this being a valid diagnostic tool. It's only known benefit is to increase the income of the person selling the vitamins. Laboratory blood tests are the gold standard in determining nutritional deficiencies. Caveat Emptor-buyer beware. PhD nutritionist told us when I was in school that we needed to abandon this useless practice-little has changed.

Why am I commenting on something like this which is definitely not favorable to my profession? The reason is I have seen many of my elderly patients on fixed income who can ill afford to waste money get duped. The people doing these things really do believe it works. However, without evidence that it does, the practice should be treated as experimental at best and in my opinion they should not charge for it. Don't get me wrong. Vitamin supplementation or what is sometimes referred to as nutraceuticals is valid for many cases. Modern diets generally do not provide adequate nutrition. However, muscle testing to establish vitamin deficiency has not shown to be valid. There are too many ways to skew the results and it is very subjective.

Calcium and Osteoporosis: It's in the bones.

As the population continues to live longer, the issue of bone loss or osteoporosis becomes important for both men and women. Failure to maintain bone loss can cause collapse of vertebrae, hip fractures, and other fractures. In addition to exercise, supplementation may help slow or stop the loss. Medication may be needed in some cases.

• According to Lancet-People aged 50 and older who take calcium supplements are 12% less likely to fracture a bone than their peers who don't take those pills.
• That protection rate doubles when calcium supplements are taken correctly, report the researchers, who included Benjamin Tang, MD, of the Centre for Complementary Medicine Research at Australia's University of Western Sydney
• "For best therapeutic effect, we recommend minimum doses of 1200 milligrams [mg] of calcium, and 800 IU [international units] of vitamin D (for combined calcium plus vitamin D supplementation)," Tang's team writes. The studies used 64,000 people.
• People aged 70 and older, those who didn't get much calcium from their diets, thin people, and those at high risk of bone fractures were particularly likely to benefit from taking calcium supplements.
• A February American Journal of Clinical Nutrition new study shows that women who took a red clover-derived dietary supplement containing substances called isoflavones (Promensil) experienced significantly slower bone loss in the spine compared with women who took a placebo. The supplement also appeared to have protective effects on bones in the hip, but these effects were not statistically significant.

More on Vitamin D Supplementation: New England Journal of Medicine review article July 19, 2007 information.

• Between 40% and 100% of elderly in US & Europe have insufficient or deficient levels of Vitamin D.
• Rates of Diseases affected by vitamin D status
• 78% reduction in Type I diabetes in children taking 2000 IU/day in 1st year of life
• 200% increase in Type I diabetes in Vitamin D deficient children.
• 33% reduction in Type II in those taking 800 IU/day of D plus calcium
• 72% reduction in number of falls in elderly people taking higher-dose vitamin D
• 30-50% more cancers in vitamin D deficient people
• 42% reduction in multiple sclerosis in women taking more than 400 IU/day of D.
• Increased incidences of autoimmune diseases, osteoarthritis, depression, hypertension, pulmonary disorders, schizophrenia and cardiovascular diseases in those with less optimal Vitamin D status.
• Human diets don't provide sufficient vitamin D
• Minimum vitamin D blood levels needed to reduce disease risk are 30 ng/dl.

Miscellaneous Nutritional News

• Eating more magnesium-rich foods, like green leafy vegetables and nuts, may reduce diabetes risk
• A Women's Health Initiative study found estrogen therapy associated with less coronary plaque.
• Cinnamon prevents blood sugar spikes.
• Omega 3 FAs may protect against prostate cancer. They also relieve depression and agitation in Alzheimer's patients.
• Flavinoid consumption slows cognitive decline.
• Low levels of folate (B vitamin) is associated with depression risk
• Pomegranate shows promise in averting lung cancer.
• Genistein (soy phytoestrogen) boosts bone mineral density
• Tumeric or Curcumin a spice has many potential health benefits: antibacterial, antifungal, antiviral, anti-inflammatory, anti-cancer, cardiovascular protection, neurodegenerative protection (Alzheimer's and Parkinson's), reversing damage from high blood sugar, potential treatment for multiple sclerosis, may protect against cataracts, shows promise for skin disorders such as psoriasis and in wound treatment.

News From Nutrition & Peripheral Artery Disease

Peripheral Artery Disease (PAD):
What is it? PAD is the build up of fatty deposits (plaque) and cholesterol in the arteries outside the heart.

Who is at Risk?

• Increasing age
• Cigarette smokers (5-10 times more likely and experience more leg symptoms are more likely to suffer heart attack, stroke, amputation and death, doubles risk if you have diabetes).
• Diabetes
• High Blood Pressure
• Abnormal Cholesterol
• Past history of heart attack or stroke

How do I know if I have it?

• Most don't have obvious symptoms
• Leg muscle discomfort or pain caused by walking and disappearing with rest (claudication)
• Foot or toe pain at rest that often disturbs sleep
• Slow healing skin wounds or ulcers (8-12 weeks)

Diagnoses:

• History and physical examination of feet and leg pulses.
• Ankle Brachial index (ABI)
• Other diagnostic studies (Doppler ultrasound)

What you can do!

• If you smoke, quit. There are no known medical benefits to smoking.
• Lower blood pressure and cholesterol
• Manage blood glucose if diabetic and practice proper foot care
• Use prescribed antiplatelet medications to reduce risk for stroke and heart attack

With Claudication:

• Exercise (may need to be supervised). Walk slowly until discomfort, rest, repeat. Do 35 minutes a day 3 times a week increase time, distance and endurance.
• Meds may be needed to reduce symptom.
• Non responsive cases may need angioplasty, stenting or surgery.

Source: www.PADcoalition.org

NUTRITION NEWS BITES:

• A study by the American Cancer Society suggest an aspirin (adult strength) a day may keep cancer away.
• A study in the World Journal of Surgery suggests DHEA may offer a new strategy for certain breast cancers.
• Studies in Phytotherapy Resources and Journal of Psychopharmacology suggest Rhodiola (herb) may help offset stress effects.
• A study suggests vitamin D deficiency may decrease physical performance in older adults.
• Depression symptoms in older adults may indicate a risk for type 2 diabetes.
• Green tea may help fight the joint destruction of Rheumatoid arthritis.
• Salk Institute scientists found a gene linking calorie restriction to longevity-live longer by eating less calories.
• Age spots can be improved by topical N-acetylglucosamine and niacinamide (non-itch B3).
• A single fast food meal increases blood pressure in a study by Journal of Nutrition (McDonald's breakfast or a low-fat meal).
• Isothiocyanates in cruciferous veggies (broccoli, e.g) help fight prostate cancer by inhibiting blood vessel growth.
• Zelnorm (anti-constipation drug) suspended due to cardiovascular risk
• Fish oil and exercise reduce body fat and improve cardiovascular health. American Journal of Clinical Nutrition.
• Pomegranate, CoQ10, tea tree oil, lactoferrin, folica acid, squalene and hydrogen peroxide help fight bacteria in the mouth and maintain good dental health.
• Theonine and lemon balm may help with anxiety and stress.
• Life Extension pharmacy. Significant cost savings can be realized by purchasing statin drugs through the Life Extension Pharmacy-especially generic Zocor (simvastatin) and Pravachol (pravastatin). Statins provide about 30% protection against heart attacks.
• CoQ10 may be helpful in offsetting the muscle damage which is a rare complication of statin drugs.
• Nutrients to take care of aging skin: hyaluronic acid, matrixyl, argireline, jojoba oil, concentrated antioxidant tea blend in a mask blend may help offset age damage. Zinc, chamomile, aloe vera, cucumber, grapefruit oils, arnica, squalene (from natural olive oil), seaweed extract, copper peptide complex, zinc oxide, and sulfur are also used in healing. See Life Extension article August 2007.
• Diabetics taking metformin can experience a B12 (cobalamine) deficiency as a side effect. It may also interfere with calcium metabolism and supplementation may be necessary.

Dehydration

It's here! Summer in full swing along with the heat. This year there seems to be a lot more humidity as well. Not only does that increase the heat index (make it feel hotter than it is) but it also puts you at risk for dehydration.

Who is at risk?

• People in countries with insufficient clean water to drink
• Children who are old enough to talk but not old enough to understand about thirst
• People who are relying on coffee, tea, soft drinks, juice, and alcohol (all dehydrators) for their liquid
• New mothers -- especially nursing mothers
• Athletes (athletes can easily burn through more water in their bodies than they replace)
• People for whom physical labor is a large part of their daily routine
• People whose work keeps them on the move and/or on their feet
• People whose daily routine (or company policy) prevents them from keeping liquid nearby
• People who are ill, feverish, vomiting, or who have diarrhea (especially people with weakened immune systems from illnesses such as cancer or AIDS)
• Babies and children who aren't given enough liquid
• People who are overheated and sweating profusely
• Diabetics
• Mentally or physically disabled children and adults
• Seniors -- especially seniors in nursing homes and seniors who don't move around well
• People with an eating disorder -- especially those using diuretics or laxatives
• People who are abusing drugs or prescription medications
• People eating an excessive amount of salt
• People traveling, working or living in an arid, humid, hot, cold or high-altitude environment
• Airplane travelers (airplane air dehydrates more quickly than outside air)

How do I know if I'm becoming dehyrated? The simplist indicator is to check the color of your urine. Urine from a well-hydrated person should be very pale yellow. Dark yellow urine is an indication you need to increase your fluid intake. Don't try to replace it all at one but take regular drinks of water. You may also need to supplement with an electrolyte drink but watch out for the high sugar content ones.

Symptoms for Dehydration

1. Mild Dehydration: is likey with the following: Thirst, dry lips, dry mouth, flushed skin, fatigue, irritability, headache, urine begins to darken in color, urine output decreases
2. Moderate Dehydration: (call a medical professional): All of the signs of mild dehydration, plus: skin doesn't bounce back quickly when pressed, very dry mouth, sunken eyes, (in infant - sunken soft spot on the head), output of urine will be limited and color of urine will be dark yellow, cramps, stiff and/or painful joints, severe irritability, fatigue, severe headache. Seek medical attention.
3. Severe Dehydration: All of the signs of mild and moderate dehydration, plus: blue lips, blotchy skin, confusion, lethargy, cold hands and feet, rapid breathing, rapid and weak pulse, low blood pressure, dizziness, fainting, high fever, inability to pee or cry tears, disinterest in drinking fluid. Call the EMTs. This can be life threatening.

Some other concerns:

Heat Cramps: brief but painful involuntary muscle spasms. They usually occur in the muscles being used during the exercise, and are a result of insufficient liquid intake

Heat Exhaustion: difficulty breathing, headache, feeling hot on head and neck, dizziness, heat cramps, chills, nausea, irritability, vomiting, extreme weakness or fatigue

Heatstroke: rapid and shallow breathing, rapid heartbeat, unusually high or low blood pressure, lack of sweating, mental confusion and disorientation, unconsciousness, physical collapse

Don't mess with the heat! If you are concerned, get help. Especially, with moderate to severe signs of dehyration.

Source: http://www.saferchild.org/dehydrat.htm