Sep
24
2014

Two Approaches To Heart Disease

By | Anti-aging medicine, Fitness, heart attack, Heart Disease, Hormones, Nutrition, Prevention, Stroke, Vitamins and supplements

Over the years I noticed that there are two approaches to heart disease that people and physicians seems to subscribe to.

1.The conventional approach to heart disease

The patient essentially ignores health advice, may smoke cigarettes and eat in a lot of fast food restaurants. People who do not care about their heart drink sodas, eat lots of sugar, starch and processed foods. They may think that they are invincible. Famous politicians have subscribed to this type of approach including former vice president, Dick Cheney.

But the big surprise comes when acute chest pain hits and an ambulance has to be called. We are lucky in the industrial countries where a 911 service is available. You call that number when in distress and an ambulance with all the modern equipment will rush to you. The problem though is that you have neglected your arteries for all those years and it is likely that one or two of the three coronary heart vessels are severely narrowed so much that your heart reported chest pain. This pain signals that one area of the heart muscle was not getting enough oxygen and nutrients.

On arrival at the hospital the emergency physician sees you. Nurses put monitors up, attach electrodes to you, and IV-lines are put into your veins, just in case things get worse and they would need to give you quick life-saving medicine intravenously. They have also given you an oxygen mask, and after 30 minutes or so you feel much better. A cardiologist has been called in by the emergency physician and will assess you.

This will very likely be the verdict: “We have to do a coronary arteriogram where I advance a thin catheter through your femoral artery backwards to where the coronary arteries originate from. We can then study each coronary artery separately and determine whether an angioplasty needs to be done.” Upon your questioning he explains that an angioplasty is a procedure where a catheter is advanced through a new clot that often forms during a heart attack and a stent is left behind that will keep the previously blocked off coronary artery open.

Within an hour the procedure will be completed. The cardiologist will explain that he found significant narrowing, such a san 85% narrowing in the anterior descending coronary artery and a second lesion in the right coronary artery with maybe 55% narrowing. He has stented both of these arteries successfully. But he warns you that the stents may close off, if you are unable (or rather unwilling) to change your lifestyle. He also will be very specific with what he meant: Quit smoking immediately, get into a regular exercise program and adopt a strict heart healthy diet like the Mediterranean diet. They would keep you overnight just to observe your heart rhythm and blood pressure. In the morning, if everything is OK he will likely discharge you.

Comment: Unfortunately this scenario is all too familiar to me having worked as a family physician doing my rotations as an emergency physician in a community hospital for 16 years. I found that people tended to NOT think preventatively unless they were forced to. When an acute event like a heart attack happens, a higher percentage of people is committed to prevention, but medical people call this “secondary prevention” as this prevention was only started after a close call. Our sample patient above could have developed a serious arrhythmia (irregular heart beats after a heart attack) and suddenly slipped into a coma and died before the interventional cardiologist could have placed the stents.

Primary prevention is much more powerful and this is what I like to cover next.

Two Approaches To Heart Disease

Two Approaches To Heart Disease (Placement Of Stent Shown)

2. The preventative approach to heart disease

Most people never have to be rushed to the hospital with chest pain. They engage in various ways of “primary prevention”.  So, what exactly is this?

They keep very active, like walking or jogging, dancing, working out in a gym, biking or swimming etc.

They also like a healthier than normal lifestyle: eat at home as much as possible, and many adopt to buy only organic food. Why, you may ask? Organic food does not contain insecticide residues that resemble estrogenic substances (so-called “xenoestrogens” which accelerate hardening of the arteries). But organic food also does not contain GMO (genetically modified food). We know enough about GMO now to indicate to us that autoimmune diseases with inflammation of the arteries and the gut can occur. But the full impact on people’s health will not be known for several more decades. So why experiment with yourself? Buy organic instead. It is known to be safe.

Vitamins and minerals can be very useful supplements that also prevent premature aging of our blood vessels.

Anti-aging research has shown that with aging come various hormone defects. Melatonin is one of the first to go (in your twenties). But melatonin tables that are widely available in drug stores and health food stores can come to your rescue:  3mg of melatonin at bedtime will give you a good night sleep and provide powerful anti-oxidant effects. DHEA is an adrenal gland hormone that can be measured in your blood (or in saliva). In case it is low, it can be easily replaced with supplements. In the 50’s or 60’s women and to a lesser degree men will start to show thyroid under-functions. We call this hypothyroidism. Have your TSH and T4 levels checked and talk to you doctor about whether you need thyroid replacement, if the values are off.

It is somewhat more difficult to explain the rest of the hormones. But you know that women get into menopause and men about 10 to 15 years later will hit andropause, which is the male equivalent of menopause in women.  An easy way to check this out is by doing a hormone panel from just one tube of spit. Yes, it is a saliva hormone panel I am talking about. For women it is estrogen, progesterone, cortisol, DHEA and testosterone that should be analyzed. For men it is testosterone, DHEA, cortisol, estrogen and progesterone. I am aware that these are the same 5 hormones, but I listed them in the order of importance for women and men. In this blog you find more details about bio-identical hormone replacement.

I have followed a primary heart attack prevention program since 2001 and it seems to suit me well.  Just to check things out I had a carotid intima test, which showed no hardening of the arteries. Just two weeks ago my optician took images of the retinal vessels and found hardly any hardening of my retinal arteries. I scored high on a Bruce treadmill protocol in March of 2013 and my lipid VAT values were excellent indicating a low risk for a heart attack.

I have delved into this subject in more detail in my book entitled “A Survivor’s Guide to Successful Aging” (Ref. 1).

Conclusion

Prevention of a disease is always better than curing a disease, this applies to heart attacks as well. While you do something good for your heart, you are at the same time preventing strokes and many degenerative conditions like Parkinson’s disease, Alzheimer’s disease. In addition you also prevent cancer. It really is a good deal!

More information on prevention of heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/prevention-heart-attack/

Reference:

1. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Sep
03
2014

Probiotics Are Important For Your Health

By | Abdominal Pain, Cancer, Diabetes, Gastrointestinal Disease, Heart Disease, Infectious Disease, Nutrition, Obesity, Stroke

We need to be aware that probiotics are important for your health. Growing up in Germany after World War II I remember that occasionally there were interesting newspaper headings. It  showed an older person in the nineties when the average life expectancy was in the late 60’s. The reporter asked, “What did you do to turn that old?” The answer was that the person always ate a lot of yogurt.

This did not sink into mainstream medicine at that time and people did not really believe this statement. How could eating yogurt make a person live longer?

Fast forward to 2014. You read about probiotics in magazines, on the Internet, and even TV commercials expose you to it.

In the Wikipedia it is accepted that yogurt can help seniors who have a lower bifidus bacteria population in their colon to rebalance their gut flora, which will prevent colon cancer. It also describes that yogurt can help yeast infections in women.

In the meantime probiotics have been developed and concentrations like 20 to 80 billion bacteria per capsule with a mix of Lactobacillus and Bifidobacterium species are available in the health food store for prevention.

The medical profession has studied the effects of higher potency probiotics and came to the conclusion that probiotics have indeed effects on the body far beyond the gut.

Here are a few highlights.

Bowel disease improves

In cases of bacterial or viral diarrhea the frequency of bowel movements and the intensity of bowel cramps gets helped within a few days, and recovery from the diarrhea is much faster with probiotic than without. Patient with irritable bowel syndrome and ulcerative colitis are helped with probiotics. Probiotics help both constipation and diarrhea in otherwise healthy people as well.

Immune system booster

The small bowel contains clusters of immune cells within the bowel wall. Together they are a formidable immune organ in the gut, which connects to the blood and the rest of the immune system throughout the body (lymph glands, spleen, bone marrow). Specifically it has been proven in humans that macrophages, natural killer (NK) cells and cytotoxic T-lymphocytes, which are the working horses of the immune system, are all stimulated by probiotics.

Less respiratory infections

School children who were given 1 capsule of probiotics twice per day for 3 months and flu symptoms and absenteeism were observed due to colds and flus. When they did get a viral infection, the illness had a shorter course, resulting in much less school absenteeism over the course of the trial when compared to a placebo group. It seems that a healthy gut flora stimulates the immune system to work at its best.

Cancer prevention

To a certain degree cancer can be prevented by probiotics and other nutritional factors. Breast cancer is one of the cancers where probiotics have been shown to be effective in reducing disease.

Apparently the probiotic bacteria bind to the cancer causing factors (carcinogens) that some of the bad gut bacteria produce. Probiotics also suppress other bacteria that convert pro-carcinogens into carcinogens. This is not all: the probiotics also interfere with enzymes involved in the production of carcinogens in the gut. This stimulates the gut immune cells to produce cytokines that are needed in the battle against early cancer. Probiotics play a role in multiple processes that help the body to fight cancer, not only in the gut, but also in the rest of the body!

Helps diabetes get better

How can gut bacteria help diabetes, which is an endocrinological disease? Both human and animal studies have shown that insulin resistance is improved by probiotics. In a 6-week study both blood sugar levels and hemoglobin A1C values (that measure long-term control of diabetes) dropped significantly by eating 300 grams of yoghurt per day when compared to a control group who did not.

Obesity

Probiotics given to mothers at least one month prior to birth and at least up to 6 months after birth prevented excessive weight gain in both the mothers and their children. In addition, probiotics can suppress a lot of the inflammatory substances in obesity.

Probiotics reduce cardiovascular risk

Several studies have shown that probiotics lower LDL cholesterol, total cholesterol and inflammatory markers in the blood stream resulting in lower risk for hardening of the arteries.

One should not look at probiotics as a single factor for prevention of heart attacks and strokes. Combine probiotics with exercise and a low refined carbohydrate diet. High sugar and starch diets lead to absorption of sugar in the stomach and small intestine. This results in a lack of nutrients to support the gut flora. Combine probiotics with vegetables and lettuce. Then you have the proper mix of fiber, minerals and other nutrients to sustain balanced bacteria in the bowels. This prevents heart attacks and strokes and keeps inflammatory markers down. I have blogged about this before and stated that the combination of organic food (to avoid antibiotic residues in our diet), fruit and vegetables combined with probiotics will protect you from heart attacks and strokes.

Probiotics Important For Your Health

Probiotics Are Important For Your Health

Conclusion

Maybe the newspaper articles in Germany after the Second World War were right. There is something in yogurt (Lactobacillus and Bifidobacterium species) that can make you live longer. The explanation seems simple: add probiotics to your diet.  You will have a better immune system and get less respiratory infections. But you also prevent heart attacks, strokes and prevent obesity and cancer. All of this in combination will lead to healthier lives, and more people will live to tell about it.

Last edited Sept. 3, 2014

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

By | Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Lung Disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

May
10
2014

The Full Story About Testosterone

By | Heart Disease, Hormones, Men's Health, Obesity, Osteoporosis, Prevention, Stroke

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014

Apr
19
2014

Measuring Your Heart Function

By | Anti-aging medicine, Fitness, heart attack, Heart Disease, Nutrition, Prevention, Stroke

Recently I came across a book by Dr. Steven Masley, cardiologist (fellow of the American Heart Association, see Ref.1). The heart’s function is to pump your blood reliably all your life. It is a complicated organ, but it works well, if we treat it well. Western medicine has taught us that with complicated machinery and tests we can assess how the heart is doing. But until recently there was no reliable easier way to assess our cardiac health function. The purpose of this blog is to summarize a three-pronged approach to measure your heart and blood vessel health. It is described in detail in Ref.1, but I doubt that many people have yet read this important reference book. It is also important to FIRST see your doctor whether you are able to do the Bruce protocol (treadmill test, the third component below). If you neglect to be cleared by your doctor you run the risk of possibly getting angina pains or getting a heart attack.

1. Carotid IMT or carotid intimal-medial thickness test: You measure the degree to which there is hardening of the coronary arteries indirectly by measuring the thickness of the lining of the carotid arteries (carotid IMT or carotid intimal-medial thickness test). Dr. Masley has showed over a period of 10 years and more in many patients at his Health Center that there is a close correlation between the degree of coronary artery hardening and the degree of hardening of the carotid arteries. He stated that his research has shown that “90% of the time, the carotid arteries, the coronary arteries, and even the arteries of your legs all grow plaque at the same time”. The gold standard for checking the condition of your coronary arteries is a heart catheterization as Dr. Masley explains (page 58). But he adds: “IMT testing should be the new gold standard for cardiovascular plaque testing. However, this is not yet the case. Despite its usefulness, 95% of doctors are not ordering this screening test for their patients. You can rest assured that this is a situation I am to change“.

Measuring Your Heart Function

Measuring Your Heart Function

2. A detailed lipid analysis called the VAP test: A detailed laboratory test analyzing your lipid fractions (LDL, HDL, total cholesterol and VAP test). The buoyant HDL fraction, called HDL2 is the key to having a low risk for hardening of the arteries. HDL2 is large, fluffy and is designed to remove garbage from within the lining of the arteries. Also, the cholesterol ratio is another measurement for a low risk for hardening of the arteries when it is less than 3.0. The first two tests assess how much hardening of the arteries there is present and when they are normal, there is a relative reassurance that nothing drastic (like a heart attack or stroke) should happen within the next 10 years provided you keep up a regular exercise program and healthy food intake.

3. Bruce protocol (Treadmill test): The Bruce protocol (treadmill test) is often done by a cardiologists, but can also be done through many gyms, where a trainer with experience in exercise physiology will do it. This functional test measuring cardiac output has been developed many decades back and has withstood the test of time. Here is an overview what this is. As the slope of a treadmill and the speed of the belt are increased, the heart needs to do more work to maintain blood flow to your extremities and vital organs. The trainer or exercise physiologist measures the response of the heart activity in relation to the increase of the exercise load. A complicated formula allows calculating how much your maximal cardiac output is. This test has several variations and can be complicated to understand. Essentially, the higher the numbers you can create, the better. Here is a table with various results of the VaO2max from Bruce protocols and how they are interpreted.

4. Treating abnormalities found with the three basic tests: These are the necessary tools that tell you where you are in regard to your heart function. People with heart failure should not do this third test, because their heart muscle is too weak to sustain this and they would get heart failure meaning that blood gets backed up into the lungs and there could be severe breathing problems leading to a lack of oxygen (anoxia) in the heart tissue, which in turn can cause irregular heart beats (fibrillation of the heart muscle) and a heart attack. Assume that the first two tests were within the normal limit for your age, then the Bruce protocol would give you the maximum heart output at the peak level of your treadmill test. At this point you are measuring directly the cardiac output (in other words what your heart is capable of pumping for you in a certain time unit). This measurement is what physicians call the VaO2 max  or maximal oxygen consumption. This is the best index for maximal heart capacity. If your levels are higher than normal, you have extra reserves with respect to your heart as a pump for times when you need it. If this latter tolerance test shows poor results, it usually means that you were inactive and you would benefit from an exercise program. If the first test shows hardening of the arteries more than is appropriate for your age, you would need to look at your eating habits. At the same time often the VAT values and the cholesterol ratio is off meaning that you are eating the wrong foods and it shows in your blood test results.

5. Advise regarding diet, exercise and relaxation: Dr. Masley’s book has several sections that explain what needs to be done when things are not normal. For instance, the author does not mince words when it comes to eating the right fats and cutting out sugar and starchy foods. For instance on page 199 there is a neat table that lists the fiber content of different foods. We need more fiber to slow down the absorption of sugary substances, which will minimize the insulin response following a meal. Dr. Masley also mentions that omega-3-fatty acids from fish and good seafood choices will balance the omega-6-fatty acids that would lead towards the arachidonic acid pathway, which causes arthritis, inflammation and cancer. There are many more dietary recommendations, too numerous to repeat them all here. Suffice it to say that molecularly distilled omega-3 fish oil, vitamin D 1,500 to 3000 Units daily, and magnesium supplements are all good for you heart. Vitamin K2 gets calcium out of your blood vessels and into the bone (100 micrograms per day). Other worthwhile supplements mentioned in the book are CoQ-10 (50 to 200 mg twice per day), but it would be wise to have blood levels drawn, which should be above 2.5mcg/ml to which the CoQ-10 intake could be titrated. Curcumin and Resveratrol are also recommended. Most of all, it seems that regular physical exercise such as a balanced gym program is the single most effective way to reverse hardening of the arteries as measured by the carotid IMT testing.

Conclusion: Times have changed. It used to be thought that our lives were following a one-way street downwards. During periods of malnutrition, lack of exercise, being sessile and abusing alcohol and drugs this may well be the case. However, we now know that this is reversible. Change to healthier food, start smoothies with organic vegetables in a mixer, get going and walk. Jog or use a gym to get regular exercise. Physical exercise reverses the fat deposits inside the lining of the arteries. The HDL-2 fraction rises and helps counteract the elevated LDL cholesterol. Even the mood of the person who exercises regularly becomes more stabilized. Using these simpler three tests the physicians will not need the more complicated Thallium heart scans, heart catheterization etc. These three tests described above are well worth being done every two years, so that you can monitor what’s going on with your heart and blood vessels in general. What questions do you have? You could ask them below.

More information on heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

References: 1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014.

Last edited Nov. 8, 2014

Jan
25
2014

Live Your Best Life

By | Anti-aging medicine, Cancer, Fitness, Health, heart attack, Heart Disease, Hormones, Insomnia, Nutrition, Obesity, Prevention, Stress management, Stroke, Vitamins and supplements, Weight loss

While attending the 21st Annual World Congress on Anti-Aging, Regenerative & Aesthetic Medicine the audience was treated to a magnificent speech by the keynote speaker, who you all know from the TV show  “The Doctors”, namely the ER-doctor, Dr. Travis Stork.

He said that there are 4 main ingredients that are necessary to live the “best of your life”.

1. Healthy living starts in the kitchen

You want to make sure that you leave out unhealthy foods. This includes that you also need to cut out sugar. Be aware how important protein is, so you need protein with each meal. This includes legumes, fish, chicken, turkey meat and others. Saturated fat is essential, can improve your health and makes you feel full, but stay away from unhealthy, sugary snacks.

Snacks do not harm your health, but they must be healthy ones like nuts three times per day. To include nuts three times per day lowers your risk of dying by 39% and your rate of heart attacks by 52%.

In order to prove a point about cutting out junk foods, the TV producer convinced Dr. Stork to go on a junk food diet for 7 days to see what would happen. He gained 8 pounds after 6 days, his mood was getting subdued and he started to look forward to his next meal as if he was addicted to the junk foods. But suddenly he could not take it anymore and was concerned about getting sick from this experiment (rightfully so). He told his producer that he had to stop this experiment. He explained that most of his fat accumulation was happening in the abdominal area (visceral fat) and he showed a video that illustrated this further. He explained that the visceral fat is metabolically very active, produces inflammatory agents and causes changes in the heart vessels that eventually lead to heart attacks and strokes.

Live Your Best Life

Live Your Best Life

2. “I need you to start working out!”

We were designed to get moving. Our ancestors were gatherers and hunters, so they were constantly on the move. Our genetics have not changed, but our lifestyle habits are far removed: the sessile habits are not suiting us well healthwise. Translated into modern life this means: sit less; do gardening; use pacing as a technique to move when you are on the phone. Take the stairs instead of the elevator; walk (a minimum of 30 minutes three times per week). Personally, I like to add that our body never takes a holiday, so I think we should exercise 7 days per week.

3. Mind and body are connected

Stress can ruin your health. Happy people are 50% less likely to die prematurely. Laughter heals. A funny video was shared with the audience where a parent ripped a piece of paper into smaller and smaller pieces and the toddler watched with glee and laughed every time when the paper was ripped into two smaller parts. A service dog can be a great companion for disabled individuals, but pets have a positive impact on the health of any individual. They can be of help to reduce stress.

It is known that mind and body are connected. As a result, if your mind and body are balanced, your hormones get balanced and this helps to keep your metabolism in check. If your metabolism is balanced, you will avoid getting diseases like heart attacks, strokes, arthritis, and even cancer.

4. Make sure you get enough sleep

40% of people do not get enough sleep. You can change your sleep behavior. How do you do it?

a)    Have a consistent bedtime/waking time. Set your alarm clock to the same time every morning. Aim for 7 to 8 hours of sleep per night.

b)    Avoid late night caffeine as it prevents a good night’s sleep.

c)    Get active throughout the day; this will prepare you to get tired in the evening.

d)    Towards the end of the day have a to-do-list ready for the next day. This prevents tossing and turning and thinking about what you want to do the following day. You know that it is all written down on the list, so you can relax and get to sleep.

e)    No bright lights in the bedroom, no bright alarm clocks, no control lights of electronic gadgets and have light-blocking window coverings in place. Do not have a TV in the bedroom, also no cell phone, and stay away from the computer for 1 hour before your bedtime.

After you re-programmed your body and mind to a regular sleep rhythm, you automatically get tired when you should and your hormones and body chemistry find a new balance, which contributes to good health.

Dr. Stork stated that we all need to prevent disease. We do this by making health our hobby. There is no need to be obsessed about it. “Just live your best life!”

Conclusion

I summarized Dr. Stork’s presentation from the anti-aging conference, as it struck me how simple it really is to live a healthier life. If we all follow these simple steps, we are a long way into anti-aging, because it gives us the footing we need to further refine it from there.

In many previous blogs I have mentioned these 4 factors that are needed to slow down aging. However, there are other factors that may be needed like bioidentical hormone replacement when there are hormone deficiencies; detoxification, if there is evidence of toxicity; and vitamins and other supplements. Anti-inflammatory and antioxidant vitamins and supplements like CoQ10, vitamin D3 and omega3-fatty acid/DHA supplements are needed to keep LDL from getting oxidized as this is the reason why people die of heart attacks and strokes and get cancer.

I have recently written a book entitled “A Survivor’s Guide To Successful Aging” (being published at Amazon.com in March 2014), which explains the science behind why it is important to cut out sugar and starch. Sugar and starchy foods are the foods that oxidize LDL cholesterol, and ultimately it is the oxidized LDL cholesterol that causes deaths from heart attacks and strokes. In this text I have explained how proper nutrition, exercise, hormone rebalancing, supplements and lifestyle changes will allow you to prevent the major illnesses from setting in thus extending your life expectancy considerably. Included in the book is a chapter (written by my wife, Christina Schilling) that contains 7 days of recipes for breakfasts, lunches, dinners and desserts as well as snacks.

Last edited Oct. 25, 2014

Jan
11
2014

From Inflammation To Heart Attacks, Strokes And Arthritis

By | Arthritis, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Medical Condition, Nutrition, Obesity, Osteoporosis, Prevention, Stroke, Vitamins and supplements

This article describes the development from inflammation to heart attacks, strokes and arthritis. Have you ever wondered why people who limp from arthritis in their hip also often get heart attacks? And have you ever wondered why people with high blood pressure get strokes and/or heart attacks? It is not that difficult to understand, although many people do not like to hear the truth. After the holidays with lots of sweet presents and rich food it is a good time to reflect about the internal connections between our organs. Let’s follow what foods can do to our system, then you will understand what to do to get out of the rich food trap, where food is not friendly but damaging to your body.

1. Sugar, omega-6 fatty acids and trans fats enter your system

When you opened the cheap chocolate bars, ate the pastas, the turkey gravy and the ice cream for dessert, your stomach faithfully digested all that food and broke it down into glucose (a simple sugar), omega-6 fatty acids and highly reactive trans fat with free radicals (from deep fried foods, margarine, shortening, pie crusts, cake mixes, frostings and non dairy coffee creamers just to mention a few).  Within ½ hour the sugar molecules from the digested meal will enter your blood stream.

2. The metabolism sets in

We know from years and years of research that the glucose in the blood triggers the release of insulin from the pancreas, which facilitates absorption of sugar into your liver and muscles where it is stored as glycogen. This is meant to be a storage form of sugar, just in case you do not eat for a few hours, but need energy to burn for your physical activity. When you have saturated the glycogen storage in liver and muscles, your liver metabolizes sugar into fatty acids and triglycerides. There is the transport LDL cholesterol that is supposed to supply the brain and heart with healthy cholesterol for these organs to replace cell membranes.

Oxidized LDL cholesterol attacks your arteries

Instead, the LDL cholesterol that is supposed to be balanced by the protective HDL cholesterol gets oxidized from the extra sugar and from the free radicals of the TRANS fats that are now being outlawed by the FDA for exactly that reason. So, the oxidized LDL cholesterol turns into the vicious VDLDL particles, which can be measured as a special blood test by your doctor. The overabundance of omega-6 fatty acids start an internal fire by stimulating the arachidonic acid pathway, which causes inflammation in your arteries, your joints and your immune system.

From Inflammation To Heart Attacks, Strokes And Arthritis

From Inflammation To Heart Attacks, Strokes And Arthritis

3.  The consequences of eating foods which spike your blood sugar levels

The end result is hardening of your arteries and the beginning of arthritis in your joints. Mind you, this does not happen overnight, but when you eat this way decade after decade it takes its toll. Typically in your forties or fifties you will notice some swollen knuckles. Don’t just let this happen. Think that this is a sign that something is festering in you! If you don’t interfere, there could be one wrong move, when you play sports and a meniscal tear in your knee could put an end to the fun. Sure, you will find a reason that the angle of your jump was unfortunate and this was simply enough for your meniscus to tear.

Inflammatory changes in the meniscus

But could it be that there were inflammatory changes in your meniscus long before this incident, the meniscal material softened up, dried up because of a lack of proper nourishing synovial fluid? I found when I was in primary care practice that this was what caused the majority of meniscal tears. A normal meniscus does not tear easily, but decades of malnutrition will lead to these hidden changes, where a meniscus can be softened and is prone to damage without a warning.

Arthritis in your joints is similar to the process of what I described regarding meniscal degeneration. An imbalance of the omega-6/omega-3 ratio where people take in 12 to 16 times as much omega-6 fatty acids from processed food compared to omega-3 fatty acids from fish oil or fish consumed, causes inflammation of the joints via the arachidonic acid metabolism.

Calcifying arteries in patients with vitamin D and K2 deficiencies

What about the arteries? It is no secret that many people in their 60’s have suddenly an episode of chest pain that leads to a referral to a cardiologist who will do a heart catheterization. The physician may have to place a stent or two because of hardening and narrowing of the coronary arteries. In many trials where people with coronary artery disease were followed laboratory tests showed that these individuals had low 25-hydroxy-vitamin D levels in their blood and the calcium that was meant to make their bones strong, ended up in the arteries. Vitamin K2 is often also missing because of malnutrition.

Faulty diet and lack of regular exercise can cause coronary artery hardening

People with high blood pressure often do not have enough nitric oxide production from their arteries, because they do not eat enough vegetables, they are too sessile and they eat too many sweets and starchy foods. As a result, the liver overproduces triglycerides and fat, and oxidized LDL cholesterol damages the lining of the arteries. Just treating high blood pressure with blood pressure lowering medications will not correct the underlying metabolic disbalance. This is why people who had 2 or three stents for coronary artery hardening will come back 5 or 10 years later and need more stents until they die of a full-blown heart attack. You must stop the underlying metabolic derangement, if you want to prevent further deterioration.

4.  Inflammation takes its toll

But what do the lining of the arteries, the inflamed joints, a degenerative meniscus and heart attacks and strokes have in common? It is the INFLAMMATION that changes the body chemistry. It gets even more complicated, because the extra calories that we consume get stored as visceral fat. This is done automatically when you eat too much sugar and starchy foods as you may have done over the holidays. Remember, our ancestors were hunters and gatherers, and our genetic make-up is still the same. So, when the glycogen stores are full, any surplus sugar gets metabolized by the liver into triglycerides, fatty acids and LDL cholesterol and gets stored as body fat.

The most active fat is the visceral fat

The most active fat is the visceral fat between our guts and around our body organs. This produces interleukins and other inflammatory cytokines that circulate in the blood causing inflammation in all our arteries.

This is the link between the various manifestations of inflammatory conditions in our bodies. We rarely think that there is a link between all of these various conditions. Physicians concentrate on each disaster as it strikes, but think that it is only a one-point-in-time event. Patients do not see the years of abuse of our bodies that have preceded any of these events.

5.    Disaster strikes in different ways

We usually hear about a person who just got a heart attack. Now it is an emergency!  Nobody thinks about the years of inappropriate food intake and the lack of exercise that led up to this heart attack event.

The same is true for a sudden stroke. The patient arrives at the hospital in an ambulance and cannot move one arm and one leg. Initially the patient may be unconscious. The emergency personnel is too busy with medical procedures, so they cannot ask the question why it had to come to this. The truth though is that the blood vessel deterioration in the brain vessels that led to the stroke have quietly happened years before the acute event.

Arthritis in older patients

And then there is the aging 75-year-old man with a stiffening hip and arthritis in the hands. The inflammation has been quietly developing in the synovial membranes of the joints for more than a decade. The patient probably swallowed anti-inflammatory medications for years for arthritis symptoms, which as you guessed has not changed the underlying biochemistry. But now it has come to the point where a total hip replacement is necessary, just to be able to continue to walk. I have experienced that scenario in the hospital setting many times. Many patients went through the total hip replacement surgery with no problems.

Some patients develop a heart attack during their surgery for a total hip replacement

But other patients had their total hip replacement done and they developed a heart attack under the general anesthetic. Unbeknown to the orthopedic surgeon the patient also had severe hardening of the arteries. However,  this did not show up on the pre-surgical electrocardiogram. A stress test or a Thallium heart scan when the patient still could exercise would have shown this hidden cardiac condition before the surgery, so that a cardiologist could have addressed this condition before the surgery. After that the total hip replacement would most likely have been uneventful.

6. Prevention is the key

The lesson we need to learn from all of this is: prevent these disasters from happening in the first place. Do the following:

1) Good, balanced nutrition

2) Regular exercise.

3) Take vitamins and mineral supplements for bone health.

4) As you age, have your hormones measured and replace what is missing.

5) Avoid toxins. Use detoxification.

6) Avoid junk foods.

I have covered these topics in many blogs before as indicated in the above links.

Conclusion

Health disasters are mostly not accidental. Rather they originate by not paying attention to the silent metabolic changes due to improper nutrition. In addition, a lack of exercise is important as well.  You can call this a lack of prevention. It takes some time, often even some suffering to understand the deeper meaning of what I discussed above. In the final analysis prevention is much more powerful on the long-term than curative medicine. I speak from experience having worked in the medical field for more than 30 years. Curative medicine will take care of an emergency. However, the underlying inflammation and metabolic derangement persists, if the physician cannot change this through the steps mentioned above. Treat inflammation and LDL oxidation by modifying your lifestyle. Think prevention!

More information on inflammation medicine: https://www.askdrray.com/chronic-inflammation-causes-cancer-heart-attacks-and-more/

Nov
30
2013

Statins Can Hurt The Consumer

By | Anti-aging medicine, Arthritis, Diabetes, Fitness, heart attack, Heart Disease, High Blood Pressure, Hormones, kidney disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): https://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

Nov
23
2013

Stop Obesity

By | Arthritis, Cancer, Diabetes, Health, heart attack, Heart Disease, High Blood Pressure, Nutrition, Obesity, Prevention, Stroke, Weight loss

Introduction

This article is about “stop obesity”. Being obese is not just a problem that is known as “middle age spread’. It has become an alarming condition that affects all age groups, children, adolescents and adults; it has escalated into a health problem that affects a large percentage of the US population. As this link shows, in 2020 the obesity rate among adults in the US was 42.4%. Another third was obese. That means that more than two thirds of the population exceeded the upper limit of a normal body weight (a body mass index of less than 25.0). Other countries in the Western world share in the record of being the fattest nations: they are Mexico, New Zealand, Chile, Australia, Canada, The United Kingdom, Ireland and Finland. Not every country with high living standards has high obesity rates. Japan and Korea by comparison have obesity rates of 3 to 4%.

Health consequences

The diseases resulting from obesity include high blood pressure, cardio-vascular problems (heart attacks and strokes), and type II diabetes. This results in health expenses spiraling upwards. The excessive weight creates additional problems. Not only the heart and blood vessels face an overload, but the joints are also bearing the brunt in the form of joint diseases like arthritis or back pain. These conditions are not fatal, but they account for less productivity at the work place and they create disabilities. In the public sector obesity presents more problems: how can an obese individual be accommodated in a standard airline seat? How can nursing personnel in a hospital manage to lift or transfer a very heavy patient without a mechanical lift? Obesity can be compared to a snowball that is on a downhill run and if it is not stopped in time, will turn into a deadly avalanche.

Stop Obesity

Stop Obesity

Causes of obesity

In the last few years it has become clearer how obesity was created. It originated from the perfect storm that a number of practices of the food industry brought about:

  1. Processed food has become more prominent in the super market, laden with salt (creating high blood pressure) and sugar (causing diabetes).
  2. Wheat and wheat products are contained in a lot of processed foods, and if they are not in it directly, food manufacturers add MSG (mono sodium glutamate) to stimulate your taste buds. This leads to food addictions encouraging you to eat bigger portions and to eat more sweet, calorie-laden foods.

Gliadin and sugar stimulate your appetite

  1. Wheat has undergone forced hybridization in the 1970’s changing the genetic make-up of wheat significantly. The result is much more gliadin, the gooey substance that stimulates your opiate receptors and makes you addicted to food and sweets (Ref. 1).
  2. Sugar and high fructose corn syrup are a huge problem for our bodies: sugar consumption in any form leads to overproduction of insulin, insulin resistance and diabetes. 10 to 15 years of life can be lost from premature death due to sugar overconsumption. The causes are accelerated hardening of the arteries with premature heart attacks, strokes and kidney damage. Alcohol in its many disguises is also a problem. The body metabolizes it similar to sugar, excess calories from alcoholic drinks are stored as fat.

Oil with omega-6 fatty acids, bovine growth hormone in milk and antibiotic residues in beef

  1. The oils that are now used to produce baked goods are the cheaper omega-6-fatty acid containing oils derived from safflower, sunflower, soybean, cottonseed and canola. The result is a disbalance of the omega-3/omega-6 ratio in our diet, which causes inflammation in our bodies. This in turn causes heart attacks, strokes, arthritis, asthma, inflammatory bowel disease and Alzheimer’s disease (Ref. 2).
  2. In the US there are problems with bovine growth hormone in milk and milk products unless you buy organic milk and milk products. This too causes your fat to accumulate as it blocks your own growth hormone receptors. Antibiotic residues in beef from feedlots also contribute to obesity in humans.

We are more sessile

  1. Add to this the fact that we have become more sessile, driving cars, watching games rather than playing games, watching TV and sitting in front of the computer for hours on end. All this burns up less calories than if you work out in a gym.

Knowing the enemy helps us to fight the causes of obesity. Here is my recipe to counter what the agro-industry has been doing to us.

What can be done to stop obesity?

Cut wheat out of your diet

1. The biggest factor is to cut out genetically modified wheat that is now the only source of wheat around the world. When you cut out all wheat and wheat products from your diet, you will lose 400 calories every day. Ref. 1 describes this in detail and provides 150 recipes of tasty foods. Dr. Davis allows you a fair amount of monounsaturated fatty acids, which makes dieting a lot easier and you will find that once you have lost the necessary pounds, you will keep your weight down easily. How come I know? Because I have done this myself since 2001. Why does it work?

Gliadin from wheat stimulates your opiate receptors

Because gliadin from wheat is an addictive protein that stimulates your opiate receptors in the brain and makes you want to eat more wheat and wheat products, which means taking in more and more calories (Ref.1). It also stimulates your taste buds to eat more sugar and starchy foods. So, you need to cut out wheat.

Watch the glycemic index of your food

2. Next you need to look at the glycemic index of your food. Low and medium glycemic foods are OK to eat, but not the high glycemic index foods. It is clear from this link that white bread, pasta, rice, low-fiber cereals and baked goods are not desirable, because they are high glycemic on the index. On the other hand fruit, vegetables and legumes are desirable food choices, as they are low glycemic index foods. Legumes are higher in their carbohydrate content, and a helping of ca. ½ a cup should not be exceeded. Fruit that are high in fruit sugar (grapes, pineapple, mangoes, papayas, bananas) should be consumed in moderation. Fruit juices present an overload of sugar; just remember that it takes several apples to make one serving of apple juice! The same goes for alcoholic drinks. It likely is responsible for much of the obesity wave.

Eliminate all monosodium glutamate (MSD)

3. Perhaps the most important step is to look at the food that goes into your mouth, eliminate all MSG (monosodium glutamate) and then switch to organic food. I remember that 1/3 of the items on the kitchen shelf and in the fridge had to be thrown out when my wife and I first learnt about this in 2001. We studied the food labels of every food item that was in our kitchen. We added the switch to organic food in the last three years, after hearing about it from Suzanne Somers’ books and at several A4M anti-aging conferences in Las Vegas. Take the time to prepare most of your food that you eat yourself at home from natural, organic ingredients. This way you can avoid sugar and extra salt, which would be present in processed foods.

Watch your oils, cook with extra virgin, cold pressed organic olive oil

4. Watch oils and fat when you cook: extra virgin, cold pressed organic olive oil is your best friend when it comes to cooking Mediterranean type food. Lately there is a trend of cooking with coconut oil, but I think this is a marketing hype (if you decide on coconut oil, make sure it is virgin and fresh pressed, not processed).  Ref. 2 explains that it is important to avoid all polyunsaturated oils as they turn rancid and lead to free radicals in your blood and in your fatty organs like the brain. In order to reintroduce the balance between omega-3 and omega-6 fats, it is useful to take 3 capsules or more (up to 6 or 7 per day in persons with arthritis) of a strong, molecularly distilled EPA/DHA supplement daily that will restore your prostaglandins.

Certain fish is healthy

This ensures that no inflammatory reactions take place in your tissues preventing heart attacks, strokes, arthritis, asthma, inflammatory bowel disease and Alzheimer’s disease.

Nutritionists recommend fish as highly desirable as it is a good source of omega-3 fatty acids, which have anti-inflammatory qualities. But unfortunately, there is mercury contamination in predatory fish. I find it difficult to recommend it as healthy unless you are willing to undergo chelation therapy on an ongoing intermittent basis to remove heavy metals. Fish like sardines or wild salmon are the better choices. Tuna, swordfish or shark should never be consumed as their toxic mercury load is dangerously high.

Exercise keeps you healthy

5. Finally, a word about reintroducing exercise. As kids we were more active. You may have played games as a youth. What our bodies need at all times is movement, walking, dancing, in short some form of activity every day. The easiest is to work out in a gym for 1 hour every day (30 minutes of aerobics like a treadmill or elliptical for 30 minutes and isometric exercises like working with machines or weights). Add on top of this whatever you can. This stimulates your metabolism, your blood circulation and rebalances your hormones.

Conclusion

Obesity is a national concern and a concern that affects nations internationally. Bear in mind that the food processors are not on a mission to increase the well being of the consumer, but have the motivation to increase their profits. In the past bad dietary advice added more injury to this situation, when the food science behind diets lacked development. But now we know that a low fat high carb diet does not work; instead a balanced fat, low glycemic index diet as in a Mediterranean diet is what is beneficial. The large amounts of sugar that food processors are currently adding have no place in sensible human nutrition.

Avoid overeating with grains, watch your oil intake

The senseless overfeeding with grain has also presented its results: it has fattened up North America and other nations. We need quality fats (olive oil, omega-3-fatty acids and nuts). Organic food whenever possible is important in order to avoid poisoning ourselves with pesticides, antibiotic residues or bovine growth hormone. Add regular exercise to this and your recipe for treating and preventing obesity is complete.

More about metabolic syndrome (the metabolic changes associated with obesity): http://nethealthbook.com/hormones/metabolic-syndrome/

References

1. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

2. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

Nov
09
2013

Successful Diabetes Treatment Requires Patient’s Discipline

By | Diabetes, Fitness, heart attack, Heart Disease, Hormones, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

90% of all diabetes cases are due to type 2 diabetes, which is associated with being overweight or obese. The other 10% are due to type 1 diabetes, which is caused by an autoimmune disease within the pancreas destroying the insulin producing beta cells. Diabetes, type 1 often occurs in childhood (hence the name “juvenile diabetes”), while type 2 diabetes is a condition of the middle aged and older population. There is however an alarming trend: overweight or obese youngsters are also being diagnosed with type 2 diabetes. Here I am discussing type 2 diabetes.

Causes that trigger diabetes

There is not just one way to get diabetes; it usually is a multifactorial disease. Sure, genetics play a minor role. But you need to have epigenetic factors to trigger the genes to develop diabetes: eating too much sugar, eating wheat and wheat products, drinking soda drinks that contain sugar or high fructose corn syrup. Alcohol binges can also cause diabetes as can accumulation of excessive weight (a body mass index above 25.0). Even when there is no genetic risk in your family (your family tree has nobody that came down with diabetes and all your ancestors lived into their 90’s), you can still develop diabetes, if you are exposed to one or more of the risk factors mentioned.

What is the reason why diabetes occurs?

At a Keystone Symposium from Jan. 27 to Feb.1, 2013 in Keystone, Colorado (Ref.1) leading scientific researchers gathered to discuss exactly this question. There seem to be several mechanisms, all of which lead to diabetes. It has been known for some time that in type 2 diabetes insulin resistance develops that renders the cells incapable of absorbing blood sugar (glucose) from the blood into the cells. It is because of this insulin resistance that doctors can diagnose diabetes when blood sugar levels are high.

Successful Diabetes Treatment Requires Patient’s Discipline

Successful Diabetes Treatment Requires Patient’s Discipline

There are at least 5 mechanisms that are presently known that can cause insulin resistance (and thus diabetes) by itself or in combination. For a deeper understanding of diabetes it is crucial to be aware of these. Without knowing the enemy, you cannot fight it.

1. When a person eats too much sugar or fructose the liver converts this into excessive fat that is accumulated in the body’s cells. As a result insulin receptors are becoming inefficient in absorbing sugar from the blood, and blood sugar levels stay high. The pancreas reacts to this by making even more insulin, which after a few years will cause the pancreas to fail in producing insulin. At this point the patient requires insulin or else gets into a diabetic coma.

2. Chronic inflammation is another mechanism that has been shown to cause insulin resistance. Obesity, the metabolic syndrome and diabetes have a common inflammatory denominator that results in insulin resistance. With the aging process there is also deterioration of mitochondrial function (mitochondria are the mini batteries inside of every cell that are responsible for you having energy). This causes fat accumulation and also insulin resistance. Exercise and weight loss are effective in combatting insulin resistance. Fasting has also been shown to improve insulin sensitivity.

3. The metabolism of visceral fat (the type of fat causing the apple appearance in obesity) is highly active and is associated with an increased risk for heart attacks and developing diabetes. The pear shaped woman runs less of a risk, as the fat around the hips is not metabolically active. On the other hand when these women enter into menopause, they also develop abdominal fat (apple-like fat distribution) with a high secretion of inflammatory substances causing insulin resistance, heart attacks and strokes.

4. Another mechanism of causing inflammation comes from invasion of organs with fat cells. The development of fat toxicity from these displaced fat cells can also cause insulin resistance. Heart cells have been shown to die from fat toxicity and in the pancreas the insulin-producing cells can be killed by fat toxicity as well causing diabetes or making existing diabetes worse.

5. Interestingly another line of research, namely researching binge drinking, has revealed that there is a short-term insulin resistance that lasts for several days until the alcohol has been properly metabolized. It is of concern that adolescents who are experimenting with binge drinking are very vulnerable to develop brain damage from this habit.

Consequences of insulin resistance

We know that insulin resistance is the cause for adult onset, type 2 diabetes. It is entirely preventable. But there are powerful influences on people’s lives that will allow one or more of these factors mentioned to cause diabetes. The most common cause is putting on excessive weight. The reason for this is that people like to eat fast foods, drink sugar-containing sodas, and feast on processed foods, bagels and cookies. The end result is a change of the metabolism with an increase in triglycerides from the liver, an increase in LDL cholesterol, particularly the very low-density lipoprotein sub fractions of cholesterol. It has been known for some time that this is the connection to the high, premature death rates from heart attacks in diabetics, in people with obesity and in people with the metabolic syndrome. Hardening of the arteries is accelerated by the deposition of foam cells in the walls of arteries. These are scavenger cells (macrophages) that have engulfed noxious fats. This leads to narrowed coronary arteries and also a general narrowing of arteries all over the body including the brain vessels. In diabetics hardening of the arteries is accelerated and leads to premature strokes, heart attacks and heart failure, kidney failure, blindness and amputations of limbs.

Important tests for borderline diabetics

I you have a fasting blood sugar that is above 100 mg/dL (5.5 mmol), but less than 126 mg/dL (7 mmol) you are considered to be prediabetic or “borderline diabetic”. In this case rather than waiting for disasters in terms of cardiovascular disease, take action and ask your doctor to do the following three tests.

a) Arrange for a glucose tolerance test where you are given 75 grams of glucose; then blood tests are taken at one, two and three hours after this challenge dose. These blood tests are checked for blood glucose levels and insulin levels and tell the doctor exactly what is going on in terms of your sugar metabolism. It shows the glucose clearance and also the insulin response from your pancreas.

b) Have a hemoglobin A1c test done: it shows how your blood sugars have been controlled over the last 2 to 3 months.

c) You also need a VAP (vertical auto profile) test, which tests your lipid profile. Both prediabetics and overtly diabetics have been shown to have lipid profile disorders. Apart from low values in sub fractions of HDL cholesterol this test will also measure the very-low density lipoproteins (VLDL), which has been shown to be responsible for heart attacks and strokes.

With these three tests your doctor can  tell you more accurately what treatment protocol you require to succeed in controlling or curing your pre diabetes or diabetes.

Conventional treatment of diabetes

The conventional treatment of diabetes is to send the patient to a dietician, to ask the patient to do regular exercises and to either start them on hypoglycemic drugs or on insulin injections. Unfortunately the dietician often will encourage the patient to eat “healthy multigrain bread”, which will stimulate your taste buds to eat more sugar, high fructose corn syrup and starchy foods making weight loss impossible. Often the treating physician is satisfied that a hemoglobin A1c of 7% or less is good enough for the diabetic. But non-diabetic people have a hemoglobin A1c of 4% and 5.6%. This should be your goal or you will suffer the consequences of uncontrolled diabetes.

This is what I would call the conventional, symptomatic treatment approach. This may be the approach for patients who are not willing to seriously change their lifestyles, but it is more powerful on the long-term to treat diabetes by treating the underlying causes.

Alternative treatment approach for diabetes

Based on the above discussion regarding the various causes of insulin resistance, it is important to analyze what would be the main contributory factors in your particular case of diabetes.

Here are some suggestions:

1. If you are on the typical North American diet, also known as Western diet, it would be important to face the fact that wheat, wheat products in processed foods and sugar including high fructose corn syrup are the main culprits in stimulating your appetite and making you a sugar and wheat addict. Ref. 2 describes this in detail and offers 150 recipes to overcome this addiction. For more information just follow this reference text. Essentially it is a wheat-free Mediterranean type diet without rice, pasta and bread. You will shed significant amounts of pounds within a short period of time and feel a lot more energetic (due to revitalization of your mitochondria). At the same time insulin resistance is disappearing, because the insulin receptors are fully functional again. The insulin production of the pancreas will go down to normal levels and fat from the visceral fat storage gets melted away resulting in less inflammatory substances circulating in your blood.

2. A regular exercise program in a gym with an aerobic component (30 minutes of treadmill for instance and 20 to 30 minutes of isometric machine exercises) will help you to lower the triglycerides, and increase the healthy HDL cholesterol. It will also improve insulin sensitivity and control inflammation in your body. The best is to exercise 7 days per week. Remember your body works for you 7/7 every week, but for those of you who need a little rest in between 5 days per week is still very good. You may have to adjust your medication and insulin dose downwards, ask your physician about that.

3. Cut out alcohol. This may sound radical to you, but studies show this to be true. I have not mentioned cutting out smoking (it is causing inflammation and insulin resistance), because this is an absolute must that is given. When it comes to alcohol, the famous 1 drink per day for cardio protective purposes may not show up statistically as a bad effect, but your body will nevertheless get the message and let you age somewhat faster than a person who stays sober all the time. Staying sober will allow your brain to think clearly and adhere to your overall lifestyle approach in treating diabetes. Cutting out alcohol protects your brain (including the hypothalamus), liver and pancreas and prevents the prolonged periods of insulin resistance mentioned above that last for days. By keeping your hypothalamus in good working order, your hormone balance will stay stable for as long as possible until you reach menopause (for women) or andropause (for men). When you reached this milestone, I suggest you engage in bioidentical hormone replacement, which I have reviewed here. Hormones are essential to keep you younger for longer.

4. It is useful to monitor your blood sugar with a home glucometer, as this will show you when your blood sugar normalizes. Stay in touch with your doctor at all times, as this will help you in your overall management of your diabetes. Also, you will want to discuss with your doctor that you should have a blood tests called “hemoglobin A1c” measured every three months to see how well your diabetes is controlled. It should be below 7% for sure, but better below 6%. Non-diabetic people have levels of 4% and 5.6%. You may not know that hemoglobin A1c is actually measuring the amount of advanced glycation end products (“AGE”) of red blood cells. These AGE substances essentially are firmly bound sugar/protein compounds that shut down the cell metabolism wherever they are formed. In my opinion it is best to aim at a hemoglobin A1c level of non-diabetic people (4% and 5.6%) to avoid the consequences of tissue damage of all vital organs, which is the reason why long-term diabetics have a life expectancy of 15 to 20 years shorter than non-diabetic persons. Some diabetic patients may benefit from the oral hypoglycemic drug, metformin (brand name: Glucophage), which has anti-inflammatory properties and is used in patients with type 2 diabetes and a high fasting insulin level, but this is a decision requiring your physician’s input.

5. Supplements: There are some supplements that are useful to take as an adjunct, like chromium, which helps insulin to transport glucose into the cell; alpha-lipoic acid, an antioxidant, which is useful to prevent glycation (formation of a complex between sugar and protein, which prevents normal cell functioning); and coenzyme-Q10, which supports your heart (A4M recommends 400 mg per day, higher than Dr. Weil’s link). Other supplements of merit are curcumin, cinnamon, genistein and silymarin (standardized extract of milk thistle), which suppresses a pro inflammatory molecule, which in turn helps to fight insulin resistance (Ref. 1). Omega-3 fatty acid supplements are anti-inflammatory and will improve insulin resistance as well (dosage 1000mg or more per day). According to Ref. 3 vitamin D3 is useful as a supplement for diabetics, because it activates DNA, is involved in cellular repair and deficiency of it is known to lead to higher mortality rates in diabetics. Ref. 3 recommends between 1000 and 4000 IU of vitamin D3 daily and suggests doing blood tests to measure effective vitamin D3 levels (keep 25-OHD in the blood between 30 and 80 ng/mL).

6.Patients whose pancreas no longer produces insulin will need insulin injections, but instead of using long-acting insulin once per day the best results in getting blood sugar control is by injecting insulin three or more times per day using short acting insulin. It is important to always monitor the blood sugar lowering effect by glucometer readings; the injections are best given just before meals (recombinant human insulin is the preferred insulin to be used). Ask your physician or diabetic coach for more details.

Conclusion

Diabetes used to be a dreadful disease that caused premature heart attacks, strokes, blindness, kidney failure, and limb amputations. With aggressive management of diabetes as well as strict lifestyle intervention this has changed. A diabetic who treats the causes of the illness can have a normal life expectancy. In many cases the initial diagnosis of type 2 diabetes can disappear, when treatment was started early enough and insulin resistance could be stopped in its tracks. Without the patient’s full co-operation disciplining him/herself to follow through on all of these recommendations the caregiver will fail in controlling the patient’s diabetes. It is the patient who owns the problem; it is the patient who needs to make every possible effort and follow through on all of the details of dieting, exercising, blood sugar monitoring using a glucometer and taking the required supplements.

More information on diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference

1. http://www.lef.org/magazine/mag2013/oct2013_2013-Keystone-Diabetes-Symposium_01.htm

2. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Integrative Therapy; Supplements.

Last edited Dec. 17, 2014