Aug
12
2017

Curcumin And Cancer

By | breast cancer, Cancer, diet, Mortality

Many clinicians give their attention to curcumin and cancer. Physicians may use curcumin not as a primary treatment, but may add it as an adjunct to other cancer treatments. Curcumin is the effective ingredient of the old Indian spice, turmeric. The question is how effective curcumin is against cancer? Is it safe to use? What is the evidence?

Frequency of cancer

According to the American Cancer Society there will be 1,688,780 new cancer cases in 2017 and 600,920 cancer deaths will occur in the US.

Causes of cancer

There are many different causes for cancer. Hidden in the many causes may be the possible solution to new cures.

Lack of exercise

A lack of exercise may contribute to the development of cancer because of a lack of tissue circulation. And exercise will help to support your normal cell metabolism (explained below). Wrong foods may or may not have a contributory role regarding cancer development (a high sugar and starch diet causing insulin response, which changes the metabolism). The Mediterranean diet is an anti-inflammatory diet and has been credited to prevent a lot of cancers.

Carcinogens

Chemicals, called carcinogens can cause cancer. But oncoviruses can also cause it. Genetic mutations can also cause cancer. That’s why it tends to run more often in certain cancer prone families. But Warburg has researched the metabolism of cancer almost 100 years ago, even got the Nobel price for it in 1931 and yet the elusive cancer cure has not materialized yet.

DNA mutations, tumor suppressor genes metabolic difference between cancer cells and normal cells

Following Warburg’s research Watson/Crick detected DNA in our cells. Ever since geneticists found this fascinating by it. They also found that a cancer suppressive gene, regulated by the p53 gene could develop mutations and then cancer would occur: tumor suppressor genes. For decades this was the “in” thing. But in the last 5 to 10 years there is a revitalization of the original Warburg idea that one should concentrate on the metabolic differences between cancer cells and normal cells. This is starting to show some timid results. Cancer cells are more acidic from lactic acid and burn glucose for energy without requiring oxygen (anaerobic pathway), while normal cells burn glucose in the aerobic pathway in the mitochondria. This difference is important. Certain manipulations are more likely to kill cancer cells.

Cryoablation therapy for prostate cancer

Take cryoablation therapy for prostate cancer. Cryosurgery for prostate cancer. A local deep freeze method like cryoablation therapy kills the more vulnerable cancer cells preferentially leaving  the normal cells intact. Another example is photodynamic therapy for cancer that has been used for lung cancer and esophageal cancer.  This method may be a lot more universally applicable than believed so far. The physician injects a photosensitized dye, which is normal cells eliminate, but cancer cells retain.  Next the physician uses a laser beam that kills the cancer cells preferentially by absorbing the specific laser wavelength that is specific for the dye.

Consumer driven cancer therapies

Nobody knows which way cancer research is going. But I think that consumers will drive this: consumers want better cures. When new methods have better cure rates, consumers will demand treatments with these. Less effective methods will become history. I think that researchers will revitalize Warburg’s ideas and develop new therapies from this as I indicated.

Curcumin and cancer: malignant conversion

There are three development stages for any cancer to develop.

Originally cancer researchers used skin cancers a model. Later they could confirm that initiation, promotion and progression also were present with the development of cervical cancer. The name for this is “malignant conversion”. This needs to happen before a normal cell transforms into a cancer cell. Here are the three stages.

  • Initiation
  • Promotion
  • Progression

This is important to know in the context of curcumin. Basic research has shown that curcumin interferes with all of these stages of tumor development, both in terms of prevention as well as in terms of being curative. Here is a link that points out the complex multiple steps of cancer growth that curcumin interferes with.

Multiple actions of curcumin

As can be seen from it, curcumin interferes with the initiation of multiple cancers, reduces inflammation, and interferes with angiogenesis and this reduces the amount of metastases that can form. But curcumin further interferes with proliferation of cancer cells, reduces invasion, prevents resistance and improves survival. The underlying molecular and genetic reasons for curcumin’s actions are all contained in that link.

Curcumin and cancer: research in tissue culture and animal experiments

When it comes to cancer research, you usually hear about in vitro culture experiments and animal experiments. This type of research is used to establish that there is an anti-cancer effect, that it is reproducible and non-toxic. The September issue of the 2016 Life Extension Magazine reviewed this in detail. It was entitled “How Curcumin Targets Cancer”.

But as a former clinician I am more interested in seeing cancer patients cured. This has to be verified by clinical trials first. When I looked through PubMed.com for objective evidence of the effects of curcumin in cancer patients, this type of information was more difficult to find. But in the following there are a number of examples that I did find.

Curcumin and cancer: clinical trials

1. Reduction of tumor necrosis factor-alpha

A 2016 meta-analysis of eight randomized studies investigated the effect of curcumin in patients with various inflammatory diseases including cancer. They found that curcumin consistently reduced tumor necrosis factor-alpha. In cancer patients this inflammatory substance is responsible for further cancer growth and developments of metastases.

2. Poor bioavailability of curcumin

A study with increasing amounts of curcumin showed poor absorption of curcumin into the blood. In this study researchers were giving dosages between 500 mg up to 12,000 mg per day of curcumin. 500 mg to 8000 mg of curcumin did not result in any positive serum level of curcumin. Only the higher dosages, 10,000 and 12,000 mg of curcumin, caused positive curcumin levels in the blood.  Patients have to take higher amounts of curcumin to have a clinical response. Toxicity studies were done when using higher amounts of curcumin. The results showed taht it was safe and patients tolerated high dose curcumin fairly well.

3. Precancerous colonic polyps reduced in number and size

A smaller study consisted of 5 subjects with familial adenomatous polyposis (FAP). This is an autosomal-dominant disorder where hundreds of colorectal adenomas develop in the lining of the colon. From these colorectal cancer can arise. Five patients received 480 mg of curcumin and 20 mg quercetin orally three times per day. After 6 months the number of polyps and the size had reduced by 60.4%.

4. Premalignant colonic lesions suppressed by curcumin

44 eligible smoker subjects received a baseline colonoscopy where aberrant crypt foci (ACF) were determined. ACI are the very first focal areas in the colon that lead to colon cancer. Smokers have more of these lesions, which was the reason that researchers chose smoker subjects for this trial. The patients received either a supplement of 2000 mg of curcumin or 4000 mg of curcumin for 30 days. These are fairly high doses. They were used to overcome the poor absorption of curcumin. Colonoscopies were done again after one month of curcumin supplementation. 41 subjects completed the study. In the 4000 mg curcumin group the ACF numbers were reduced significantly by 40% compared to the 2000 mg group, which showed no reduction. The 4000 mg group showed a 5-fold increase of curcumin blood levels compared to baseline. The 2000 mg group had no change in blood levels.

5. Reduction of radiation dermatitis with radiation therapy in breast cancer patients

30 breast cancer patients were divided into an experimental group and a placebo group. All of them had a mastectomy first and subsequently radiation therapy. The experimental group received 6 grams (2 grams three times per day) of curcumin during the time of radiotherapy following mastectomy. The experimental group had  significantly reduced radiation dermatitis following radiotherapy when compared to the placebo group. Only 28.6% had significant radiation dermatitis in the curcumin group versus 87.5% in the placebo group.

6. Chronic multiple myeloma patients

An Australian study involving chronic multiple myeloma patients found that curcumin at 4 Grams per day and even more so at 8 Grams per day stabilized the disease and improved kidney function.

7. Descriptive studies

Descriptive studies investigating the effect of various doses of curcumin have been done regarding breast cancer,  and advanced pancreatic cancer. But these clinical trials were all rather small.

8. Chemoprevention of cancer

A phase II trial enrolled 21 patients with end-stage pancreatic cancer patients. The only FDA approved treatments for this are gemcitabine and erlotinib, but this would normally only lead to clinical responses in less than10% of patients. In this study the investigators used curcumin to enhance the anti-tumor response of either gemcitabine or erlotinib. The study summary stated: “Oral curcumin is well tolerated and, despite its limited absorption, has biological activity in some patients with pancreatic cancer.” 2 of the 21 patients had stable disease for more than 18 months; one of the 21 patients had a brief tumor regression of 78%, but then relapsed and died.

9. Chemoprevention of prostate cancer

Chemoprevention of prostate cancer is discussed in this publication: There was specific reference made to prevention of prostate cancer and the opinion of the researchers was: “At present, there is no convincing clinical proof or evidence that the cited phytochemicals might be used in an attempt to cure cancer of the prostate.”

Curcumin And Cancer

Curcumin And Cancer

Conclusion

For years there have been reports to indicate that curcumin was a promising natural supplement that can improve cancer survival. Many clinical trials regarding the effects of curcumin on colorectal cancer, pancreas cancer, prostate cancer, breast cancer, ovarian cancer and others had a poor design. But on closer look the hype seems to come mostly from in vitro studies (tissue culture experiments) or from animal studies. Clinicians, however, demand well-constructed randomized clinical trials with clear research objectives before they can accept a new agent like curcumin to be effective. These clinical trials are missing! Instead there are many in-between trials of questionable quality as listed above.

Problems with bioavailability of curcumin

There have been problems of bioavailability due to poor absorption of curcumin. Pushing the dosage to 6000 to 8000 mg per day succeeded in overcoming this limitation to a certain extent. But a significant percentage of people (around 30%) suffered from abdominal cramps and nausea and had to discontinue these high doses of curcumin. Researchers have developed newer curcumin compounds, but at this point it is unknown what the bioequivalent dosage is of these newer curcumin agents in comparison to the original curcumin dosages.

It is quite possible that researchers will one day design clinical trials  that will bring better news on survival rates of various cancer patients involving curcumin therapy. But in my opinion right now it is not yet prime time for curcumin!

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Aug
05
2017

Death From Heartburn Drugs

By | Cardiovascular disease, fractures, Gastrointestinal Disease, heart attack, Mortality, ulcers

A study was recently published showing that death from heartburn drugs can come early, when compared to controls. The study was published in June 2017 in the online British Medical Journal Open. The researchers were located at the Washington University School of Medicine, Saint Louis, Missouri, USA.

They compared 349, 312 US veterans on proton pump inhibitors (PPI) to an equal amount of veterans on conventional H2 blockers. Over a follow-up period of 5.71 years there was an increased risk of death of 25% when patients took PPI drugs. No matter to what the researchers compared the PPI group to, there were always more deaths in the PPI group versus other control groups.

Causes of death

According to the senior author, Dr. Ziyad Al-Aly many deaths were due to kidney disease, dementia, fractures, pneumonia, Clostridium difficile infections and cardiovascular disease. Out of 500 patients who took the PPI drug there was one death within one year. But over the years the deaths increased. Dr. Al-Aly thinks that the PPI drug is interfering in some way with the genetic expression of some genes and suppressing others. These genetic differences may explain the early deaths.

As this was a retrospective study, it can only show an association of PPI drugs with earlier deaths, but this does not prove causation. It would require a prospective random study to prove causation.

Other studies regarding the risk of PPI drugs

An Icelandic study from May 2017 showed that there was a 30% increased risk of fractures in males and females following PPI drugs when observed over 10 years. Opiates had a risk of almost 50%, sedatives a 40% risk of increased fractures. Control groups of NSAIDs, statins and beta-blockers showed no increased fracture risk, nor did histamine H2-antagonists.

Side effects of PPI’s

An article from March 2017 is a critical review of the safety of PPI drugs. It notices that with long-term use there are adverse effects like fractures of the long bones, enteric infections and hypomagnesemia. PPI’s can increase the risk for heart attacks and can cause kidney disease and dementia. One of the problems is that gastroesophageal reflux usually dictates the long term use of anti acid drugs like PPI’s, but the longer patients are taking these drugs, the higher the death rate and side-effect rate. The physician should only use PPI drugs initially and after a few weeks switch to the less potent histamine H2-antagonists (like ranitidine).

Listeriosis as side effect of PPI’s

A Danish study from April 2017 noted an increased risk for listeriosis in patients who were on PPI drugs. Over 5 years there was a 2.81-fold higher risk of developing listeriosis in patients on PPI’s compared to a control group. If patients were on corticosteroids and a PPI the risk was even higher, namely 4.61-fold increase to develop listeriosis. In contrast, using histamine H2-antagonists had a risk of only 1.82-fold of developing listeriosis.

Poor prescribing habits for PPI’s

A Dec. 2016 study from Dublin, Ireland with patients older than 65 examined their PPI drug use. The comparison of data occurred between 1997 and for 2012. The researchers noted that the maximal PPI dose for long-term use was 0.8% of individuals in 1997 and 23.6% in 2012. The risk of prescribing high dose PPI drugs in 2012 was 6.3-fold in comparison to the risk in 1997. Examination of the health records showed that the indication for prescribing PPI drugs had no correlation with significant gastrointestinal bleeding risk factors. The study concluded that there was definitely room for improving prescribing habits.

Triple therapy

This January 2016 paper describes the standard treatment of H. pylori and gastric and duodenal ulcer treatment, which involves the triple therapy consisting of a PPI and two antibiotics. It pointed out that this treatment protocol “improves healing and prevents complications and recurrences”.

PPI’s causing risk for fractures

A paper from Leipzig, Germany dated July 2016 reviews the usage of PPIs. It mentions that there has been a significant increase of prescriptions in the past 25 years. Patients on PPI’ are at a greater risk for fractures. There is also a risk of low B12 levels from malabsorption of B12. The physician should check this from time to time, and if necessary give B12 injections.

Clostridium difficile infections

A Canadian study from May 2015 found that Clostridium difficile infections (CDI) were linked to chronic antibiotic use or to prolonged use of high doses of PPI drugs. There was a 1.5-fold risk of recurrent CDI in patients older than 75 years who were taking PPI drugs continuously. There was a 1.3-fold recurrence of CDI after antibiotic re-exposure.

Alternative remedies for heartburn

  • Dr. Weil recommends the use of deglycyrrhizinated licorice (DGL) for heartburn or early ulcers.
  • Here is a clinical study with 56 patients with duodenal and gastric ulcers that was published in 1968. Both radiographic evidence as well as clinical findings showed that the ulcers healed and that stomach spasms subsided with DGL treatment. Nobody knew at that time that DGL had antibacterial effects and that often chronic heartburn, stomach and duodenal ulcers can be due to H. pylori infections that are simultaneously present.
  • A December 2016 study showed that probiotics could be a valuable adjunct in triple therapy for H. pylori infection. The study also points out that H. pylori is present in about 50% of the world’s population.

Antibacterial effects of DGL

  • A paper of December of 2012 shows that an important tooth decay bacterium responds to DGL.
  • In a 1989 study 20 patients with aphthous mouth ulcers were followed. DGL mouthwash led to a 50 to 75% improvement in 15 patients within one day of treatment and by the 3rd day there was complete resolution.
  • Here is a suggestion of a four-step approach against H. pylori.
  • DGL has been shown to be useful in gut regeneration in patients with Clostridium difficile infection.

Discussion

I started with a review of a recent paper that pointed out the side effects of PPI drugs. PPI’s are common medications for acid reflux disease, stomach and duodenal ulcers, either alone or as part of the triple therapy. Chronic infection of H. pylori is often the cause of these problems. I reviewed the literature surrounding deglycyrrhizinated licorice (DGL), a natural antacid remedy. It turns out that DGL can be quite useful either as a parallel treatment or instead of the triple therapy.

The problem over the past 25 years is that physicians have been treating acid problems with higher and higher doses of PPI’s. They are also using ASA prophylaxis against heart attacks and strokes more often. This has caused gastric erosions that are bleeding, which in turn caused physicians to prescribe more PPI’s. The side effects of PPI’s belongs to the iatrogenic (doctor- induced) diseases. This is an artificial disease that occurs from the side effects of overprescribed medicine. PPI’s are a very useful short-term anti-acid medication. However, do not use this medication for more than 4 to 8 weeks. But as patients receive years and years of this medication, serious problems like heart attacks, fractures, kidney disease, dementia, and pneumonia as well as Clostridium difficile infections become the consequence. Overall there was an increase of the death rate of 25%.

It sounds quite reasonable that doctors should return to a more conservative approach as the FDA has suggested. This includes alternative natural methods including DGL and probiotics.

Death From Heartburn Drugs

Death From Heartburn Drugs

Conclusion

A recent study from the online British Medical Journal Open has pointed out a high death rate among long-term proton pump inhibitor (PPI) drug users. The se drugs are used to suppress acid formation in the stomach. They are helpful, if there are significant gastrointestinal bleeding risk factors present. But prolonged use of PPIs causes severe side effects as described, including a chronic persistent Clostridium difficile infection (CDI) of the gut that can become resistant to antibiotic therapy. In cases of recurrent CDI one important step is to discontinue PPIs. The physician should consider switching to one of the conventional histamine H2-antagonist drugs (like ranitidine). Overusing PPIs in an older population is not responsible, as this leads to disease that is caused by a physician! There is no need for this to happen.

Avoiding toxic drug levels of PPI’s

The prescribing physician has to exercise caution and restraint and the patients, and their loved ones need to be aware of multidrug interactions. PPIs belong to the drugs that are eliminated in the liver through the cytochrome P450 enzyme system (CYP2C19). But this enzyme system interfering with the drug elimination process may also eliminate other drugs taken by the patient. The end results can be toxic drug levels of PPIs. It can potentiate the side effects and become responsible for the 25% increased risk of death when the patient takes PPI drugs chronically. Even though PPIs are the newer medication, newer does not always mean better.

Jul
22
2017

Relaxation Reduces Inflammation

By | breast cancer, depression, Gastrointestinal Disease, High Blood Pressure, immune system, Inflammation, mitochondria, Mortality, sleep, Stress management, telomeres

Relaxation can calm your mind, but new research has shown that relaxation reduces inflammation as well.

This article is based on a research paper in Frontiers in Immunology in June of 2017.

It concentrated on the calming effect of meditation on the nuclear factor kappa B (NF-κB), which causes inflammation. We know that overstimulation of the sympathetic nervous system activates the inflammatory pathway by expressing the genes responsible for NF-κB. These authors showed that the reverse is true also, namely that  meditation suppresses inflammation.

This metaanalysis of 18 research papers included 846 participants.

Here are brief summary findings of these 18 studies. Note that diverse relaxation methods had very similar results on the genes expressing inflammatory markers.

1. Qigong practitioners

First of all, a group of Qigong practitioners had 132 downregulated genes and 118 upregulated genes when compared to non-meditating controls. Meditation strengthens the immune system and delays cell death.

2. Sudarshan Kriya yoga

Also, one form of yoga breathing is Sudarshan Kriya yoga. Subjects who practiced this form of breathing yoga for 1 hour per day did not have the stress-related response on white blood cells. In contrast, the controls who did not meditate this way showed no change in the white blood cell response to stress. Those practicing yoga had a strengthened immune system. The meditators also showed strengthening of genes that inhibit cell death.

3. Chronic lymphocytic leukemia

Furthermore, eight patients with chronic lymphocytic leukemia were practicing the “seven yoga breathing patterns”; the popular Indian yoga teacher, Swami Ramdev, developed these. Those patients practicing the breathing yoga technique activated 4,428 genes compared to controls. They showed an up to twofold upregulation, which strengthened their immune system.

4. Loneliness in older people

Another study noted that loneliness in older people causes inflammation, morbidity and mortality. 55-85 year old volunteers were taking a course of mindfulness-based stress reduction. The researchers wanted to find out whether it was due to increased inflammation that older people were more susceptible to disease. The physicians tested blood mononuclear cells for genome-wide transcriptional profiling. Those older persons who had reported loneliness had more transcription factors for nuclear factor kappa B (NF-κB) than controls without feelings of loneliness. After an 8-week course those who no longer felt loneliness had a reversal of proinflammatory gene expression. The genes that had changed expression were located on monocytes and B-lymphocytes; these are cells of the immune system.

5. Care workers for patients with mental health problems

Care workers who looked after patients with mental health problems or chronic physical problems often have stress-induced chronic inflammation markers in their blood. A study involving 23 caregivers used a practice of Kirtan Kriya Meditation (KKM) assisted by an audio recording every day for 8 weeks. The subjects filled in questionnaires for depression and mental health before and after the 8-week trial. Physicians also took blood samples for transcriptional profiling before and after the KKM trial.

Meditation effects genes and reduces inflammation

The KKM meditation group had significantly less depressive symptoms and showed improvements in mental health. There were down-regulations in 49 genes and up-regulations in 19 genes compared to the controls. The pro-inflammatory NF-κB expression showed a decrease; the anti-viral gene expression showed an increase. This was measured using the IRF-1 gene. This gene controls the expression of the interferon-regulatory factor 1 (IRF-1 gene), which controls the immune response to viral infections. The interesting observation here was that a time of only 8 weeks of meditation was able to reduce inflammatory substances in the blood and could activate the immune system to fight viruses better. Further tests showed that it was meditation that stimulated the B cells and the dendritic cells.

6. Younger breast cancer patients

Younger breast cancer patients taking a mindfulness meditation course: Another study involved younger stable breast cancer patients after treatment that also had insomnia. Patients with both breast cancer and insomnia often have a lot of inflammatory markers in the blood. In a study with 80 patients 40 underwent treatment with Tai-Chi exercises, the other group of 40 with cognitive-behavioral therapy. Tai-Chi exercises reduced IL-6 marginally and TNF (tumor necrosis factor) significantly. There was a 9% reduction with regard to the expression of 19 genes that were pro-inflammatory; there was also a 3.4% increase with regard to 34 genes involved in regulating the antiviral and anti-tumor activity in the Tai-Chi group when compared to the cognitive-behavioral therapy group.

Measurable results of mindfulness meditation course

While cognitive therapy has its benefits, the winner was the Tai-Chi group where there was down-regulation of 68 genes and up-regulation of 19 genes. As in the prior study there was a decrease of the pro-inflammatory NF-κB expression, which reduced the inflammatory response.

7.  Study with fatigued breast cancer patients

In another breast cancer study with fatigued breast cancer patients the patients practiced 3 months of Iyengar yoga. After 3 months of yoga 282 genes showed up-regulation and 153 genes showed down-regulation. There was significant lowering of the expression of NF-κB. This suggests a lowering of inflammation. At the same time questionnaires showed that the fatigue factors experienced a reduction 3 months after initiating yoga exercises.

8. Mindful meditation used in younger breast cancer patients

A group of 39 breast cancer patients diagnosed before the age of 50 received six weekly 2-hour sessions of mindful awareness practices (MAP). This program is very suitable for cancer survivors. In addition to the group sessions the patients also did daily exercises of between 5 minutes and 20 minutes by themselves. The control group consisted of patients on a wait list. The investigators used several psychological measure (depression and stress) and physical measures (fatigue, hot flashes and pain) to assess their progress. Gene expression in the genome and inflammatory proteins were measured at baseline and after the intervention.

Effects of mindful awareness practices

Mindful practices showed clear benefits: they reduced stress, and sleep disturbances, hot flashes and fatigue showed improvement. Depression also shoed a marginal reduction. There were 19 pro-inflammatory genes that were mad ineffective, but not in the control group that did not do mindful practices. Gene tests revealed that transcription factor NF-κB had significant down-regulation. Conversely the anti-inflammatory glucocorticoid receptor and the interferon regulatory factors showed higher values. Genes with down-regulation came from monocytes and dendritic cells while genes with up-regulation came from B lymphocytes.

9. Telomerase gene expression

Lifestyle modification changes telomerase gene expression: 48 patients with high blood pressure enrolled in an extensive lifestyle program teaching them about losing weight, eating less sodium, exercising, adopting a healthy diet and drinking less alcohol. The other choice was to use transcendental meditation (TM) combined with health education with weekly sessions for 4 months. It turned out that both programs led to an increased expression of telomerase genes. Both groups did not show telomerase changes, but the authors stated that the observation time was too short for that to occur. The extensive health education program turned out to be better for patients with high blood pressure as it decreased the diastolic blood pressure more and resulted in healthier lifestyles.

10. Older patients with insomnia

Mind-body interventions for older patients with insomnia: Examiners divided a sample of 120 older adults with insomnia into two groups. They treated one group with cognitive-behavioral therapy (CBT), the other group with Tai Chi. The control group consisted of a group of people participating in a sleep seminar. 4 months after the intervention the CBT group had a significantly reduced C-reactive protein (CRP). The pro-inflammatory markers were lower in both groups after 2 months and in the Tai Chi group this remained low until 16 months. Gene expression profiling showed that CBT downregulated 347 genes and upregulated 191 genes; the Tai Chi group had downregulated 202 genes and upregulated 52 genes. The downregulated genes were mostly inflammatory genes while the upregulated genes controlled mostly interferon and antibody responses.

11. Patients with bowel disease

19 patients with irritable bowel syndrome (IBS) and 29 patients with inflammatory bowel disease (IBD) were treated with a relaxation response-based mind-body intervention. This consisted of 9 weekly meetings, each lasting 1.5 hours and practices a home for 15-20 minutes. The participants were taught breathing exercises and cognitive skills designed to help manage stress. At the end of the mind-body intervention and at a follow-up visit 3 weeks later participants of both the IBS and IBD groups scored higher in quality of life and lower in the level of anxiety they had before. They had reduced symptoms of their conditions.

Results of relaxation response-based mind-body intervention on IBS patients

The IBS group showed an improvement in 1059 genes. These were mostly improvements in inflammatory responses, in cell growth, regarding proliferation, and also improvements in oxidative stress-related pathways. The IBD group showed improvements in 119 genes that were related to cell cycle regulation and DNA damages. Other genetic tests showed that NF-κB was a key molecule for both IBS and IBD. The main finding was that relaxation response-based mind-body intervention was able to down regulate inflammation in both IBD and IBS.

12. Caregivers for Alzheimer’s patients receiving a course of MBSR

25 caregivers participated in a course of mindfulness based stress reduction (MBSR). Using 194 differently expressed genes the investigators could predict who would be a poor, moderate or good responder to the MBSR intervention. These genes related to inflammation, depression and stress response. 91 genes could identify with an accuracy of 94.7% at baseline whether the person would receive psychological benefits from the MBSR program.

13. Higher state of consciousness in two experienced Buddha meditators

Genetic tests showed, similar to the description of other cases that genes affecting the immune system, cell death and the stress response experienced stimulation. EEG studies in both individuals during deep meditation were almost identical with an increase of theta and alpha frequency ranges.

14. Rapid gene expression in immune cells (lymphocytes) in the blood

One study used gentle yoga postures, meditation and breathing exercises. 10 participants recruited at a yoga camp had yoga experience between 1.5 months and 5 years. Their response resulted in 3-fold more gene changes than that of controls. Otherwise the findings were very similar to the other studies.

15. Genomic changes with the relaxation response

The relaxation response (RR) is the opposite of the stress response.  One study examined how various modes of entering into the relaxation response like yoga, Qi Gong, Tai Chi, breathing exercises, progressive muscle relaxation, meditation, and repetitive prayer would lead to beneficial gene effects. As in other studies inflammation was reduced and the immune system was stimulated from the relaxation response. This was verified with detailed gene studies. The authors noted that different genes were activated in people who had done long-term RR practice versus people who practiced RR only for a shorter time. There were distinctly different gene expressions.

16.  Energy metabolism and inflammation control

Relaxation responses beneficial for energy metabolism and inflammation control: Experts with experience in RR were compared with a group of novice RR practitioners. Experts and short-term practitioners expressed their genes differently at baseline. But after relaxation both experts and novices had gene changes in the area of energy metabolism, electron transport within the mitochondria, insulin secretion and cell aging. The upregulated genes are responsible for ATP synthase and insulin production. ATP synthase is responsible for energy production in the mitochondria and down regulates NF-κB pathway genes. Inflammation was reduced by these changes. All these beneficial gene changes were more prominent in expert RR practitioners. Other beneficial changes noted were telomere maintenance and nitric oxide production in both expert and novice RR practitioners.

17. Relaxation changes stress recovery and silences two inflammatory genes

Mindfulness meditation changes stress recovery and silences two inflammatory genes: Experienced meditators were tested after an intensive 8-h mindfulness meditation retreat workshop. Two inflammatory genes were silenced by mindfulness meditation compared to controls. Other genes that are involved in gene regulation were found to be downregulated as well. These experienced meditators had a faster cortisol recovery to social stress compared to controls.

18. Vacation and meditation effect on healing from disease

This last study investigated the effect of a 6-day holiday retreat. One group was offered a 4-day meditation course, one group was the control group just holidaying and the third group was an experienced meditation group who also took the retreat meditation course. Depression, stress, vitality, and mindfulness were measured with questionnaires. All groups were positively changed after the holiday and remained this way at 1 month after the retreat. 10 months after the retreat novice meditators were less depressed than the vacation control group. At the center of the experiment was the gene expression study.

Effects of holiday and meditation

390 genes had changed in all of the groups. The authors assumed that this was due to the relaxation experience of the retreat. The genes involved related to the stress response, wound healing, and injury. Other genes measured inflammation (control of tumor necrosis factor alpha). Another set of genes measured the control of protein synthesis of amyloid beta (Aβ) metabolism, which causes Alzheimer’s disease and dementia. All groups had markers that indicated less risk of dementia, depression and mortality, which was likely due to the relaxation from the retreat.

Relaxation Reduces Inflammation

Relaxation Reduces Inflammation

Conclusion

This study is a meta-analysis of 18 research papers. The authors found that very different approaches to relax the mind have fairly consistent universal effects on reducing inflammation. Most of this work was done with genetic markers. No matter what type of relaxation method you use, you will have beneficial effects from it. But the beneficial effect is not only strengthening the immune system, it also improves sleep, depression, anxiety and blood pressure. In addition it is improving your stress response, wound healing, risk of dementia and it reduces mortality. We don’t quite understand all of the details yet.

What is definitely documented is the effect of the mind-body interaction. It also points clearly to the relaxation response from meditation and similar relaxation methods. This has been proven beyond any doubt through genetic tests.

May
20
2017

Prevention Of Telomere Shortening

By | Alzheimer’s disease, breast cancer, Cancer, Cardiovascular disease, Dementia, depression, Diabetes, exercise, Inflammation, leukemia, lifestyle, lung cancer, Mortality, telomeres

Dr. Mark Rosenberg gave a talk on prevention of telomere shortening. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Clinical Value of Telomere Testing”.

What are telomeres?

Telomeres are the caps at the end of chromosomes. They are very important in the aging process. Prematurely shortened telomeres are linked closely to all major diseases like cardiovascular disease, cancer, diabetes and more. Telomeres are also a measure of the aging process. Aging occurs due to a decrease of the number of cells in organs and/or because of a lack of functioning of these organs. Telomeres get shortened every time a cell divides. But when the telomeres are used up, there comes a time when cells can no longer divide. These cells become senescent cells or they enter apoptosis (programmed cell death).

The senescent cells can become a problem when they get transformed into cancer cells and their telomeres lengthen again. These cancer cells divide rapidly and this can become the reason why cancer patients to die.

What is the significance of telomeres?

Telomere dysfunction is the first sign that the telomeres are getting shorter in a person compared to the average telomere length in a comparable age group. This is not only important for aging, but also has clinical implications. The shorter telomeres are, the higher the risk for cardiovascular disease. Telomere length also provides prognostic information about the mortality risk (risk of dying) with type 2 diabetes and for many cancers. Many physicians incorporate a telomere blood test into periodic health checks, if the patient can afford it.

Interventions that help telomere length

Here are a number of things we can do to lengthen our telomeres.

  1. Rosenberg mentioned that the strongest effect on telomere lengthening comes from caloric restriction and weight loss. 80 years ago they showed at the Cornell University that rats put on calorie restriction had a 30% increase in their mean and maximum lifespan. Many research papers have confirmed that the same is true in man and that the common denominator is telomere lengthening.
  2. Next are regular physical activity, meditation, reduction of alcohol consumption and stopping to smoke.
  3. Taking antioxidants and omega-3 fatty acids regularly will also lengthen telomeres.
  4. Improving one’s dietary pattern by adopting a Mediterranean type diet that contains cold-pressed, virgin olive oil.
  5. Telomerase activators. Here is some background on the TA-65 telomerase activator, which is based on Chinese medicine. A one year trial was completed with 250 units and 1000 units of TA-65 per day. The lower dose (250 units) showed effective telomere lengthening, while the placebo dose did not. The 1000 unit dose did not show statistical significance.

Should you wish to take TA-65, only take 250 units per day, not more.

Cancer and telomeres

There is a strong correlation between cancer and telomere shortening. When cells are at the brink of dying toward the end of their life cycle the telomeres get shorter and shorter. This is the point where the cells can turn malignant. Certain genetic abnormalities help the malignant transformation, like 11q or 17q deletions or a p53-dependent apoptosis response. Once cancer cells have established themselves they activate telomerase in 85% of cases. In the remaining 15% of cancer cases telomeres are activated through telomerase-independent mechanisms. Here are a few examples.

CLL

CLL stands for chronic lymphocytic leukemia. It is a disease of the aging population. At age 90 people’s bone marrow cells have a telomere length of only 50% of the length at birth. This is the reason that in older age CLL is more common. Researchers observed a population segment and found that the shorter telomeres were, the poorer the overall prognosis and overall survival for CLL was.

Lung cancer

Researchers examined the telomerase activity in patients with non-small cell lung cancer. When telomerase activity was present, the 5-year survival was only 55%. When telomerase activity was absent, the prognosis was 90% survival after 5 years.

Prostate cancer

  1. Prostate cancer risk correlated with telomere shortening in stromal cells. Men with shorter telomere length in stromal cells had a 266% higher risk of death compared to men with normal telomere length.
  2. Another study took blood samples and determined the telomere length in lymphocytes (the immune cells). Those men who came down with prostate cancer within a year after they had their blood sample, had short telomeres. The risk for prostate cancer in these patients was 355% higher than in the prostate cancer negative controls.

Yet another study looked at surgical tissue samples from 596 men that

Underwent surgery for clinically localized prostate cancer. Patients whose samples showed variable telomere lengths in prostate cancer cells and shorter telomeres compared to prostate samples with less variable telomere length and longer telomeres had a much poorer prognosis. They had 8-times the risk to progress to lethal prostate cancer. And they had 14-times the risk of dying from their prostate cancer.

Breast cancer

Breast cancer is diverse and consists of cases whose origins are genetic (BRCA1 and BRCA2), but there are also cases where the cancer is local or has a higher stage. In families with mutated BRCA1 and BRCA2 telomeres are significantly shorter than in spontaneous breast cancer. Increased telomerase activity in breast cancer cases is directly related to how invasive and aggressive the breast cancer is.

  1. In one study researchers analyzed blood leukocytes in 52 patients with breast cancer for telomere length  versus 47 control patients. Average telomere length was significantly shorter in patients with a more advanced stage of breast cancer than in early breast cancer. Mutated HER patients had the shortest telomeres. It follows from this that checking for the HER status and blood telomere testing adds to the knowledge of potential cancer development and prognosis.
  2. In patients with with larger breast tumors, more lymph node metastases and more vascular invasion the researchers found short telomere length of the cancer cells.
  3. More aggressive breast cancer cells have higher telomerase activity. More than 90% of triple negative breast cancers have short telomeres.

CNS disorders and telomeres

Dr. Rosenberg presented evidence for a correlation between shorter telomeres and the development of dementia. But dementias with Lewy bodies and Alzheimer’s disease are also linked to short leukocyte telomeres. The length of blood telomeres predicts how well stroke patients will do and how people with depression will respond to antidepressants.

Cardiovascular disease and telomeres

The renin-angiotensin-aldosterone system controls our blood pressure and keeps it constant. When this system is not stable, our blood pressure shoots up and causes cardiovascular disease. This is tough for the heart, as it has to pump harder against a higher-pressure gradient. A study of 1203 individuals was examining the connection between leukocyte telomere length and renin, aldosterone and angiotensin II activity. It concluded that oxidative stress and inflammatory responses affect the telomere length of leukocytes and that the more stress there is in the renin-angiotensin-aldosterone system, the more cardiovascular disease develops. The conclusion of the study was that the overall cardiovascular stress leads to shortening of leukocyte telomeres.

Prevention Of Telomere Shortening

Prevention Of Telomere Shortening

Conclusion

Telomere length testing from a simple blood test will become a more important test in the future as hopefully the cost comes down (currently about 300$). It can predict the general aging status by comparing a single case to the general telomere length of the public. But it can also predict the cancer risk, risk for mental disease and cognitive deficits (Alzheimer’s disease). In addition your cardiovascular status correlated globally with this test. What are the options for the patient, if the test comes back with short telomeres?

It allows you to change your lifestyle and adopt a healthy diet. You can exercise regularly, take antioxidants and meditate. There are even telomerase activators that are gradually becoming more known. They lengthen the telomeres. The cost of telomerase activators will likely still be a problem for some time. All in all telomere length tests are here to stay, but healthy lifestyle choices are the only tool for effective intervention at this point. This is good news: healthy lifestyle choices like non-smoking, exercise and avoiding non-processed foods are either free or have a reasonable price tag. Telomerase activators are big business and at this point not really affordable!

Apr
15
2017

What Foods Lower Insulin Resistance?

By | Cardiovascular disease, heart attack, Heart Disease, Mortality, Nutrition, Stroke, sugar

When people get diabetes or prediabetes, what foods lower insulin resistance? You may have heard that eating too many carbs and gaining weight can cause high insulin values. This causes the body’s insulin receptors to become sluggish, a condition called insulin resistance. Continuing to eat too many refined carbs leads to a critical point. You can suddenly run out of enough insulin and would develop type 2 diabetes at this time.

So, what foods lower insulin resistance?

Low glycemic food

Insulin resistance and type 2 diabetes occur because people do not pay attention to the glycemic load of the food they choose. Many people eat bread, pasta and starchy vegetables like potatoes. They also eat excessive sugary sweets, such as cupcakes, ice cream, or chocolate bars. All the pancreas can do is keeping blood sugar stable by overproducing insulin. But you can assist your pancreas to not overwork itself.

Leave the high glycemic index foods alone. Instead eat low glycemic foods like non-starchy vegetables (peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. Have a dessert with berries that are rich in antioxidants. Blueberries, strawberries, raspberries and black berries are all low glycemic foods, rich in vitamin C and antioxidants. They are “nature’s candy”.

Research on insulin resistance

In a study from Singapore differences of insulin sensitivity were found between lean Asian Indians and Chinese and Malays, living in Singapore. The Asian Indians had less insulin sensitivity, which means they had higher insulin resistance. This occurs because of a genetic variant of insulin sensitivity.

Another lengthy publication investigated the connection between metabolic syndrome and insulin resistance. In addition it examined the connection of heart attacks and strokes to wrong diets. The researchers pointed out that the percentage of diabetes and cardiovascular disease will reduce significantly on a sensible diet. How is this achievable? By adopting a healthy diet that also leads to weight loss.

Diets in the US and in the Western world have major shortfalls, due to the fact that people consume not enough vegetables, fruit and whole grains. Instead we see a higher intake of red and processed meat. In addition there was higher intake of sugar-sweetened foods and beverages. Refined grains and flour products are another unhealthy food source. In the US and other westernized countries we see an overconsumption of sodium and saturated fat.The key to a healthy diet was adopting a Mediterranean diet. A study exists where a group of patients with metabolic syndrome consumed mostly whole grains, vegetables, fruits, nuts, and olive oil. The control group simply followed a “prudent” diet.

What foods lower insulin resistance? The Mediterranean diet does!

Two years later the group on the Mediterranean diet showed the following results: they had a higher intake of monounsaturated fat (olive oil) and polyunsaturated fat (fish oil) and fiber. Their omega-6 to omega-3 ratio had decreased. The high-sensitivity C-reactive protein, a general measure for inflammation, had decreased. Other inflammatory kinins like interleukins had also decreased. The insulin sensitivity endothelial function score showed improvement. The important part overall was that the Mediterranean diet prevented the metabolic syndrome compared to the “prudent” control diet.

In 2018 a study from Spain was looking for positive effects when supplementing with olive oil or nuts. A Mediterranean diet with extra olive oil or extra nuts reduced the risk of heart attacks in a high-risk group compared to controls. The study included 7447 persons and these were the results after 4.8 years: the Mediterranean diet group that used more olive oil had 28% fewer cardiovascular events compared to the control group. The Mediterranean diet group with nuts had 31% less events. Heart attacks, strokes or death from cardiovascular disease were these “events”!

What foods are unhealthy?

In order to be able to avoid unhealthy foods it is important to identify what harms us. Foods to avoid are listed in this link. Sweetened beverages, fountain drinks, sodas and fruit juices contain loads of sugar. They will cause an insulin response and on the long-term insulin resistance. Avoid starchy vegetables, such as potatoes, pumpkin, corn, and yams. Also avoid processed snacks and boxed foods. Starchy foods break down into sugar, which also stimulates insulin release. Your no-food list continues with excessive sugary sweets, such as cupcakes, ice cream and chocolate bars. White bread, rice, pasta, and flour are also starchy, and the body breaks down starch into sugar and stimulates insulin production.

Some saturated fats are acceptable, but hydrogenated fat must be avoided altogether.

Epigenetic factors regarding insulin resistance

A recent publication on March 14, 2017 investigated the effect of exercise on insulin sensitivity in a mouse model where the mother mouse was obese.

Pregnant, obese mice were insulin resistant and the offspring came down with diabetes. But when the pregnant mice exercised, the insulin sensitivity came back to normal. In addition the offspring were not diabetic. This effect was not due to genetic factors. Instead the authors believe it was due to epigenetic factors, in this case treating insulin resistance with exercise. When the pregnant mother turns insulin sensitive, the offspring is programmed to regulate their blood sugar metabolism normally.

An April 2017 study from Korea investigated the effects of healthy nutrition on patients with metabolic syndrome and insulin resistance. They noted that avoiding unhealthy foods could normalize markers of disease.

The authors discuss how nutritional factors can contribute to inheritance of epigenetic markers in the next generation. They also showed how dietary bioactive compounds could modify epigenetic factors. Taking dietary components that regulate epigenetic factors contribute significantly to health. The authors concluded that a healthy diet could prevent pathological processes that otherwise would cause metabolic disease.

What Foods Lower Insulin Resistance?

What Foods Lower Insulin Resistance?

Conclusion

It is interesting to note that insulin resistance can be reversed into insulin sensitivity by eating healthy foods. Research papers are now describing how a healthy diet of the mother can affect her offspring positively. These effects are due to epigenetic factors, as genetic factors have not changed.

We are already hearing that diseases like heart attacks, high blood pressure, strokes, diabetes and others can largely be prevented by a proper diet. The key is to avoid high glycemic foods and eat low glycemic foods instead. It is not complicated. Eat non-starchy vegetables (leafy greens, peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. The end result is that insulin resistance disappears and metabolic processes return to normal. This was what Hippocrates had in mind when he stated “Let food be thy medicine and medicine be thy food.”

Mar
04
2017

Weight Loss Surgery Is Unnecessary

By | Cosmetic surgery, depression, Diabetes, Mortality, Nutrition, Obesity

Dr. Flavio A. Cadegiani gave a talk saying that weight loss surgery is unnecessary. Dr. Cadegiani is the director of a weight loss clinic with the name Corpometria Institute in Brasilia, Brazil. He is board certified in endocrinology and metabolism and in internal medicine. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended.

Here are the main topics that he presented.

Weight measurements are wrong when based on the BMI

Dr. Cadegiani stated that we do not understand obesity, because we look at it from the wrong angle. Current dietary approaches have failed. But obesity research is still proceeding in the wrong way. If all else fails, weight loss surgery is finally the last resort. But this is wrong.

The problem with body mass index (BMI) is that people would consider an athletic body type “obese”, because the BMI exceeds 30.0. However in a very muscular person the reason for the elevated BMI is an increased muscles mass, not fat. Body composition scales reveal that, but a simple weight measurement does not.

Dr. Cadegiani recommended measuring waist circumference with <94 cm (37 inches) for men and <88 cm (34.65 inches) for women being normal.

10 reasons why we are misled by the BMI

  1. The inventor of the BMI was a mathematician. He explicitly stated that the BMI would not predict the level of fatness of an individual. The other factors are bone mass and muscle mass.
  2. Because the BMI ignores the waist size, it is scientifically invalid.
  3. There are physiological reasons why it is wrong: studies did not factor in the relative proportion of the bone, muscle and fat content.
  4. The BMI gets the logic wrong: the CDC site claims that the BMI “is a reliable indicator of body fatness for people”. This is simply not true!
  5. The BMI is based on bad mathematics: the formula assumes low muscle mass and high fat content.
  6. The BMI is lying by scientific authority: Dr. Cadegiani said it has an “air of scientific authority, but it is mathematical snake oil.”
  7. The BMI suggests that there are distinct categories of underweight, ideal, overweight and obese. It assumes sharp boundaries that hinge on a decimal place. All of this is nonsense.
  8. Cynical people could suspect that medical insurance companies lobby for the continued use of the BMI as it keeps their profits high. Sometimes insurance companies charge higher fees for people with an elevated BMI.
  9. Doctors can contribute to the continued use of the BMI, if they don’t feel the need to use another way of assessing their obese patients.
  10. It is embarrassing that we still base the assessment of obesity on a 200-year-old mathematical formula when we know of  more reliable measures.

Bariatric surgery done too easily

Dr. Cadegiani noted that publications on bariatric surgery (=weight loss surgery)

underreport surgical complications and deaths. The bariatric industry is rich, and 90% of the booths during obesity conferences belong to bariatric-related companies. Long-term follow-up studies are lacking. Those who do follow-ups report an increase of pancreatic tumors after 10 years following bariatric surgery.

Long-term follow-ups also describe a 70% increase of psychiatric disorders including depression and alcoholism. Those who had bariatric surgery experience a 200% increase in suicides.

Overcoming weight centered approach

Here is how to avoid the weight-centered approach that would lead the clinician to wrong conclusions.

There are four factors that need consideration:

  1. The assessment includes metabolic blood markers
  2. The assessment incorporates body composition scales
  3. The patient participates by measuring waist circumference and body weight
  4. The clinician incorporates clinical signs and symptoms

Classic metabolic markers are liver enzymes and hormone levels like testosterone, Thyroid (T3) LH and IGF-1. Apo B and triglyceride levels have to come into consideration  for a lipid metabolism assessment. The physician monitors inflammation through a combination of uric acid levels, ferritin and C-reactive protein (CRP). An oral glucose tolerance test and fasting insulin level can predict diabetes 5 to 10 years before it will occur clinically. Other metabolic markers are homocysteine and metalloproteinases. There are newer tests to measure insulin resistance.

Oxidized LDLc is the only marker that is linked to diabetic retinopathy. Another marker, resistin is an independent marker for obesity-related cancer, cardiovascular disease and overall mortality. A triglyceride glucose-waist circumference index has been found to be the best predictor for future development of diabetes.

Body composition analysis

The patient measures his/her own waist circumference and body weight on body composition scales. This gives additional information about fat and muscle composition. Dr. Cadegiani’s team likes to understand what is really going on in terms of what triggers fat excess.

Questions are: what is the level of emotional overeating? How much anxiety is there in the patient’s life that leads to overeating? What is the social and cultural environment? What were previous weight loss attempts? And what is the family history in term of excessive weight?

Other important factors are to check for binge eating disorders or night eating syndrome. In addition any patient planning to go for weight loss therapy should be checked for depression, mood disorders and suicide potential.

Otherwise body composition scales by electrical bioimpedance were found to be very useful in assessing fat and muscle percentage as well as visceral fat percentage.

Aggressive clinical approach improves metabolism

Dr. Cadegiani and his group have published their own research paper in February 2017 showing that an aggressive clinical approach can prevent the need for bariatric surgery.  This publication describes that in a group of 43 subjects who were thought to be bariatric surgery candidates only 3 patients (7%) went on to have the procedure done. 93% of the subjects were able to shed pounds with the method offered and avoided bariatric surgery.

They documented that clinical parameters and blood tests all improved on their program. The researchers focused on triggers that caused obesity in their patients. The measured markers were oxidized LDL cholesterol, triglycerides, the liver enzymes ALT and μGT, fasting glucose, Hemoglobin A1C, uric acid and CRP. All of these parameters improved with the modification in food intake. 81.2% of the weight loss was from the reduction of fat mass. 46.5% of patients had a normal waist circumference measurement at the end of the trial. They also achieved normal body fat and visceral fat percentages. As already stated 93% of all the patients in this trial avoided weight loss surgery, called bariatric surgery.

Dr. Cadegiani suggested that obesity should be approached with a scientifically based and responsible method. This will change the way we manage obesity.

Weight Loss Surgery Is Unnecessary

Weight Loss Surgery Is Unnecessary

Conclusion

Attention to detail of the patient with weight problems will allow the patient to reduce fat percentage. Waist measurements should be regularly performed as well as body composition scales measurements. This way the physician can follow the fat and muscle percentages. Key to success is to reduce the refined carb contents of food intake (sugar and starchy foods) and have a calorie deficit diet. Exercise is also an important component. An aggressive clinical approach to obesity can improve the clinical outcome and can prevent bariatric surgery.

Feb
25
2017

Heart Health Improves With Hormone Replacement

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cardiovascular disease, Diabetes, Health, heart attack, Heart Disease, High Blood Pressure, Hormones, Inflammation, Menopause, mitochondria, Mortality, Obesity, Prevention, prostate cancer, stress, Stress management, Stroke

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

First of all, estrogens are the main female hormones in women that protects them from heart attacks.

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. Postmenopausal women who do estrogen replacement therapy (ERT) are helping to reduce their heart attack rates.

Difference between oral and transdermal estrogen replacement

The liver metabolizes estrogen taken by mouth. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained using many slides how estrogen prevents heart attacks. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. The production of Premarin involved pregnant mares. In other words, it is not human estrogen and it does not fit the human estrogen receptors. Also the liver metabolizes estrogen taken as tablet form, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. Postmenopausal women on ERT reduce their physical and emotional stress response compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. No proinflammatory metabolites occur in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. There was an increase of venous thromboembolism in women who took oral estrogen.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Furthermore, progesterone is the second most important female hormone, the importance of which has been neglected in the past. Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Finally, testosterone is the third sex hormone that is present in women. In men it is the main hormone, but women benefit from just a small amounts of it for libido, clarity of thought and muscle endurance.

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician replaces first with bioidentical estrogen; only then does he consider replacing missing testosterone in women. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone ca cause high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone can cause diabetes and metabolic syndrome, which in turn can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. This may be due to rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Researchers sh0wed that bioidentical testosterone does not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

The adrenal glands produce the hormone dehydroepiandrosterone (DHEA). It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial.

Hormone effects on heart muscle

Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart. Physicians can  use them therapeutically in chronic heart failure patients. When people age, their hormone glands will produce less hormones, but blood tests will show this. Replacing hormones that are missing can add years of active life. Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

Dec
17
2016

Magnesium Is Essential To Life

By | Alzheimer’s disease, Cancer, Cardiovascular disease, Diabetes, headache, Health, heart attack, Heart Disease, High Blood Pressure, immune system, Inflammation, kidney disease, Mortality, Nutrition, Obesity, Osteoporosis, Prevention, Stroke

Magnesium is an important co-factor in many biochemical reactions, so magnesium is essential to life.

Many diverse diseases and cancers can develop from magnesium deficiency. The key is to supplement with magnesium regularly to get more than the government recommended daily allowance (RDA). The RDA for magnesium is 420 mg a day for males and 320 mg a day for females.

In the following I will review the diseases that occur without enough magnesium on board.

A lack of magnesium can cause heart disease

In this 2014 study 7216 men and women aged 55-80 with at high risk for heart attacks were followed for 4.8 years. The risk of death from a heart attack was found to be 34% lower in the high tertile magnesium group when compared to the lower magnesium tertile group.

The protective mechanism of magnesium was found to be as follows. Magnesium counteracts calcium and stabilizes heart rhythms. Magnesium helps to maintain regular heart beats and prevents irregular heart beats (arrhythmias). It also prevents the accumulation of calcium in the coronary artery walls. This in turn is known to lower the risk of heart attacks and strokes.

Another study, which was part of the Framingham Heart Study, examined calcification of the heart vessels and the aorta as a function of magnesium intake.

There were 2,695 participants in this study. For each increase of 50 mg of magnesium per day there was a 22% decrease in calcification of the coronary arteries. For the same increase of magnesium the calcification of the body’s main artery, the aorta, fell by 12%. Those with the highest magnesium intake were 58% less likely to have calcifications in their coronary arteries. At the same time they were 34% less likely to have calcifications of the aorta.

In a Korean study a group with low magnesium levels was at a 2.1-fold higher risk of developing coronary artery calcifications compared to a group with normal magnesium levels.

Low magnesium increases your stroke risk

In a 2015 study 4443 subjects, men and women aged 40-75 were followed along.

928 stroke cases developed. The researchers compared the group with the highest 30% of magnesium intake with the lowest 10% of magnesium intake. They had significantly lower blood pressure (7 mm mercury) and lower total cholesterol levels. They also had 41% less strokes than those with low magnesium intake.

In a 2015 study that lasted 24 years the authors investigated 43,000 men.

Those with the highest magnesium supplement had a 26% lower stroke risk. Those with the lowest magnesium intake served as a control.

Among women low magnesium levels were shown to cause 34% more ischemic strokes than in controls.

This study included 32,826 participants in the Nurses’ Health Study. Examiners followed them for 11 years.

It is clear from all these studies that supplementation with magnesium can prevent strokes.

Magnesium protects kidney function

This study examined 13,000 adults for 20 years to see how kidney function was dependent on magnesium levels. Those with the lowest magnesium levels had a 58% higher risk of developing chronic kidney disease. It makes sense when you consider that magnesium is necessary to keep arteries healthy, blood pressure low, and blood sugars stable. When diabetics do not control their blood sugars optimally their kidneys develop kidney disease. The term for this is diabetic nephropathy. In the presence of magnesium supplementation and a low sugar diet people are less likely to develop diabetes or kidney disease.

Magnesium helps blood sugar control

A metaanalysis showed that magnesium supplementation was able to improve blood sugar control. This occurred in both diabetics and borderline non-diabetics within 4 months of supplementing with magnesium.

An important factor in helping control blood sugar is magnesium. Here is an article as an example.

Magnesium good for bones and teeth

Magnesium is important for calcium metabolism and this is helping your bones and teeth to stay strong. The bones store half of the body’s magnesium. Another location for magnesium are in our teeth.

Low levels of magnesium lead to osteoporosis, because one of the two structural components of bone (calcium and magnesium) is missing. In addition low magnesium causes inflammatory cytokines to increase. These break down bones. The Women’s Health Initiative showed that when daily magnesium intake exceeded 422.5 mg their hip and whole-body bone mineral density was significantly greater than in those who consumed less than 206.6 mg daily.

With regard to healthy teeth magnesium is important as it prevents periodontal disease.

This study found that there was less tooth loss and there were healthier periodontal tissues in 4290 subjects between 20 and 80.

Those who took magnesium supplements had healthier teeth.

Migraine sufferers improve with magnesium

A double blind randomized study showed that magnesium supplementation can reduce migraines. The researchers in this trial used 600 mg of magnesium supplementation for 4 weeks.

This reduced migraines by 41.6% in the magnesium group compared to the non-supplemented control group.

Another study showed that both intravenous and oral magnesium are effective in reducing migraine headaches.

Intravenous magnesium showed effects on improving migraines within 15 – 45 minutes. The authors concluded that one could supplement other migraine treatments with both oral and intravenous magnesium.

Too little magnesium can cause cancer

It may surprise you to hear that magnesium can even prevent some cancers. Two cancers have been studied in detail. I will limit my discussion to these two.

Pancreatic cancer

One study found that pancreatic cancer was reduced. Researchers recruited 142,203 men and 334,999 women between 1992 and 2000 and included them in the study. After 11.3 years on average 396 men and 469 women came down with pancreatic cancer. On the male side they found that when the body mass index (BMI) was greater than 25.0 there was a 21% reduction of pancreatic cancer for every 100 mg of added magnesium per day. There were a lot of smokers on the female side, which interfered with the study as confounding factors undermined statistical validity.

In another study, the US male Health Professionals Follow-up Study was examined after 20 years of follow-up. Those with a BMI of above 25.0 on magnesium supplementation had a reduced risk of pancreatic cancer. The pancreatic cancer rate in the higher magnesium group was 33% lower than in the lower magnesium group. The higher group consumed 423 mg of magnesium daily, the lower group 281 mg per day. It is significant that in both studies it was the heavier patients who came down with pancreatic cancer. It is common knowledge that obesity is a pancreatic risk factor.

Colorectal cancer

A study done on Japanese men showed that magnesium could protect them significantly from colon cancer.

Men who consumed the highest amount of magnesium developed 52% less colon cancer over 7.9 years. Researchers compared them to the group with the lowest 20% intake of magnesium. The women in this study did not reach statistical significance.

A study from the Netherlands examined colon cancer in patients. They found that only in patients with a BMI of greater than 25.0 magnesium did have protective effects. For every 100 mg of magnesium per day increase there was a 19% reduction of colon polyps. And there was also a 12% reduction of colorectal cancer for every 100 mg increase of magnesium per day.

Magnesium plays an important role in genome stability, DNA maintenance and repair. It also prevents chronic inflammation and reduces insulin resistance, all factors contributing to cancer reduction.

Live longer with magnesium

Consider that magnesium is the fourth most common mineral in the body. Add to this that magnesium is a co-factor of more than 300 enzymes in the body. Magnesium is an important co-factor in the conversion of chemical energy from food that we ingest. Magnesium is regulating blood sugar, blood vessel health and our brain electrical activity. 50% of our stored magnesium is located in our bones, which helps the strength and integrity of them.

Because of the distribution of the enzymes to which magnesium is a co-factor, virtually every cell in the body depends on our regular intake of magnesium.

Magnesium deficiency develops in older age

Since the 1950’s soils have lost magnesium where farmers grow vegetables and raise fruit trees. We simply do not get enough magnesium from food.

But chelated magnesium is freely available in health food stores. Take 250 mg twice per day, and you will have enough.

Because our metabolism slows down, there is a critical age where magnesium deficiency becomes more obvious than when we are younger. By the age of 70 there are 80% of men and 70% of women who do not get the minimum of magnesium-required amount they should get (350 mg for men and 265 mg for women).

Proton pump inhibitors lowering magnesium levels

At this age many people are on multiple drugs. For many proton pump inhibitors (PPI) are used to suppress acid production in the stomach. PPI’s have been associated with low magnesium blood levels. This link explains that when a patient takes PPI’s the total time of taking the medication should not exceed 1 year.

Low magnesium levels accelerate the aging process on a cellular level. Low magnesium levels increase senescent cells that can no longer multiply. Some of them could cause the development of cancer. These senescent cells also can no longer contribute to the immune system. This causes more infections with an adverse outcome.

Remember to take chelated magnesium capsules or tablets 250 mg twice per day and you will be protected from low magnesium levels in your body.

Here is why we live longer with magnesium supplementation

Our blood vessels will not calcify as early; they keep elastic for longer, preventing high blood pressure. Our kidneys will function longer with magnesium, preventing end-stage kidney disease. We need our kidneys to detoxify our system! More than 300 enzymatic reactions all over our body help that we have more energy and also help to prevent cancer. When there are fewer strokes and less heart attacks this helps reduce mortality. Magnesium supplementation helps to lessen the risk for Alzheimer’s disease and also reduces insulin resistance. Researchers have shown that this prevents Alzheimer’s disease.

The bottom line is we live longer and healthier; that is the meaning of longevity.

Magnesium Is Essential To Life

Magnesium Is Essential To Life

Conclusion

Magnesium is a key essential mineral. It balances calcium in the body and participates in many enzymatic reactions in the body as a cofactor. As long as we have enough of this mineral we won’t notice anything. It is with magnesium deficiency that things go haywire. Heart disease or a stroke could affect you . You could get kidney disease. And you could even get pancreatic cancer or colorectal cancer. If this is not enough, magnesium deficiency can cause diabetes, osteoporosis and bad teeth. You may suddenly die with no obvious cause. But, if balance your your magnesium blood level by taking regular supplements, you will carry on living and eliminate a lot of health problems.

Nov
05
2016

Health Risks Of Night Shifts

By | Cancer, Cardiovascular disease, Circadian rhythm, Diabetes, immune system, Mortality, Obesity, sleep

One of the news stories in 2016 was about health risks of night shifts. The Bureau of Labor Statistics reported in 2000 that 15 million workers (16.8 % of the working population) were doing alternative shifts (night shift work mixed with daytime shifts). In 2016 they reported 14.8% were working alternate shifts. Among blacks, Asians and Latino Americans the percentage of working alternative shifts was higher, namely 20.8%, 15.7% and 16%, respectively.

Shift work is more common in certain industries, such as protective services like the police force, food services, health services and transportation.

Evidence of health risks of night shifts

1.There are several publications that showed evidence of health risks of night shift workers. Here is a random selection to illustrate the health risks of night shifts.A study from 2015 examined the sleep patterns of 315 shift nurses and health care workers in Iranian teaching hospitals. They found that 83.2% suffered from poor sleep and half of them had moderate to excessive sleepiness when they were awake.

2.This South Korean study examined 244 male workers, aged 20 to 39 in a manufacturing plant. Researchers compared blood tests from daytime workers to blood tests from night shift workers. They also obtained inflammatory markers like the C-reactive protein and leukocyte counts. Night shift workers had significantly higher values. The investigators concluded that shift workers have increased inflammatory markers. This is a sign of a higher risk of developing cardiovascular disease in the future.

Higher mortality and higher cancer risk in nighttime workers

3. A Swedish study found that white-collar shift workers had a 2.6-fold higher mortality over a control group of daytime white-collar workers.

4. Another study compared night workers in the age group of 45 to 54 with daytime workers and found a 1.47-fold higher mortality rate in the night shift workers.

5.In a study from China 25,377 participants were included in a study that investigated cancer risk in males with more than 20 years of night shift work. They had a 2.03-fold increased risk to develop cancer compared to males working day shifts. Women with night shift work in this study showed no effect with regard to cancer development.

BMI and estrogen levels higher in women nighttime workers

6.A Polish study examined hormones and the body mass index (BMI) among 263 women who worked night shifts and 269 women who worked day shifts. When night shift workers had worked more than 15 years at nights, their estrogen levels, particularly in postmenopausal women were elevated compared to the daytime workers who served as controls. The BMI was also increased in the nighttime workers.

Risk for chronic lymphocytic leukemia higher in nighttime workers

7.Chronic lymphocytic leukemia (CLL): a study in Spain showed that working for more than 20 years in rotating night shifts was associated with a 1.77-fold higher risk of developing CLL. The authors noted that melatonin levels in that group were much lower than in controls that worked only day shifts. Working in straight night shifts did not show higher risks of CLL compared to daytime workers.

8. In a Korean study from Seoul 100 female medical technologist who worked nighttime had their melatonin levels tested, which were compared to daytime workers.  They measured 1.84 pg/mL of melatonin for the nighttime workers compared to 4.04 pg/mL of melatonin in the daytime workers. The authors felt that this is proof that the diurnal hormone system has been disrupted. Altering the melatonin level also changes the circadian hormone rhythm.

Flatter cortisol curves at night in nighttime workers, also increased diabetes risk

9.A group of 168 female hospital employees doing rotating nightshift work in Southern Ontario hospitals were compared to 160 day workers. Cortisol production was assessed. Cortisol production in day workers and in shift workers on their day shift was similar. However, shift workers on their night shift had flatter cortisol curves and produced less cortisol. The authors felt that this disruption of cortisol production would explain why rotating night shift workers have a higher risk of cardiovascular diseases.

10.A Danish study with female nurses followed 28,731 nurses between 1993 and 2015. Researchers measured the incidence of diabetes in rotating nighttime nurses in comparison to the data from daytime nurses. Night shift workers had a risk between 1.58-fold to 1.99-fold when compared to daytime workers to develop diabetes. The risk for evening shift workers was less (between 1.29-fold and 1.59-fold).

Diurnal hormone rhythm behind health risks of night shifts

Your body has its own rules. It rewards you, if you sleep 7 to 8 hours during the night, but it will penalize you severely, if you turn it upside down. The reason is our built-in diurnal hormone rhythm. A peak of melatonin regulates sleep during the night. Melatonin is released by the pineal gland (on the base of the skull) when it gets dark outside. Daytime wakefulness regulates the release of the stress hormone cortisol from the adrenal glands. These two hormones inhibit each other, cortisol inhibits melatonin and melatonin inhibits cortisol. All the other hormones are also regulated according to the diurnal rhythm: testosterone is highest in the morning, human growth hormone is highest between midnight and 3 AM etc.

Adjustment of the diurnal hormone system

When you work daytime shifts, your diurnal hormone rhythm works just fine. But if you work nighttime shifts, your hormones have to adapt. This is very similar to traveling east or west where you cross several time zones. Your internal diurnal hormone system has to adjust to these changes. Typically it takes 1 day to adjust to a 1-hour time zone difference.

Rotating shift workers have the highest risk of getting sick

In people who work permanent night shifts, the hormone changes stay adjusted and there is no further switching. But most employers want to be “fair” to everybody, so they introduced the rotating night shifts. The publications above show that this is the worst thing you can do. It messes with your diurnal hormone rhythm, and some people never switch completely to the new hours worked. They don’t get enough daytime sleep because the kids are loud during the day etc. The rotating shift workers are running the highest risk of getting sick. The get cancer, diabetes, cardiovascular diseases, obesity, cancer, leukemia, and they have low levels of melatonin.

Health Risks Of Night Shifts

Health Risks Of Night Shifts

Conclusion

Shift workers working constant night shifts is less stressful than the more common rotating shift work. This is where you work night shifts for a period of time. Then the schedule switches to day shift, and you keep on rotating. The least health risks occur with regular daytime work. People exposed to rotating night shifts suffer from poor sleep. They have a higher risk of gaining weight, getting obese and acquiring diabetes in time. They are at a higher risk for heart attacks, strokes and cancer. All-cause mortality is about twofold higher than for workers who work day shifts.

The underlying problem seems to be a disturbance of the diurnal hormone rhythm. Normally this regulates our waking/sleeping rhythm and keeps us healthy. But with nighttime work melatonin production weakens, there is less cortisol production and hormone rejuvenation during rest periods suffers greatly. This weakens the immune system, allows cancer to develop and leads to chronic inflammation causing cardiovascular disease and diabetes. The remedy to prevent this from happening is to catch little naps whenever you can during the day. And, if at all possible, work daytime shifts permanently.

Sep
17
2016

Seven Steps To Live Over 100 Years

By | alcohol, andropause, Cancer, Cardiovascular disease, Diabetes, Drugs, Fitness, Health, heart attack, Hormones, Medical Condition, Menopause, Mortality, Nutrition, Obesity, Prevention, Processed food, sleep, Substance abuse, toxins

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.

Explanation:

There are two comments I like to make. One is that when you have calm nerves, and your emotions are in balance, your stress hormones are under control. We know that people who are content and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly lack education about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. You can extend your life expectancy by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium.

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

People have had a long time fascination about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!