Sunday, April 29, 2007

Intersterified Oils: The New Trans Fats?

We have known for many years that trans fats increase risk for heart attacks and some cancers. Laws requiring trans fats or partially hydrogenated oils to be listed on nutrition labels went into effect last year, so food manufacturers are finally eliminating them from their products. One substitute that is appearing in some foods is a new type of fat made with a process called interesterification or fatty acid randomization. Interesterified oils have saturated fatty acids, usually from plants, inserted into other vegetable oils. A study from Brandeis University shows that both interesterified fats and partially hydrogenated oils raise the bad LDL and lower the good HDL cholesterol much more than the plant saturated fats found in palm, palm kernel and coconut oils.

For more than 60 years, scientists have blamed saturated fats found primarily in meat, chicken and whole milk diary products for the high incidence of heart attacks in the United States and other countries that eat the so-called "Western diet". This study supports others that show that saturated fats in plants may be safer than saturated fats in animal tissue. However, scientists generally agree that the safest fats are those that are liquid at room temperature: oils that contain primarily polyunsaturated or monouunsaturated fats. Substituting polyunsaturated fats for saturated fats lowers LDL cholesterol, and the monounsaturated fats produce a more stable LDL cholesterol that helps to prevent heart attacks. Journal reference for this article; more on trans fats; know your good and bad fats

Friday, April 27, 2007

New Key to Aging Well: Increase Mitochondria Efficiency

Why does risk for heart attacks, strokes or diabetes increase with age? A team from Yale University showed that as you age, you lose your ability to make AMP-activated protein kinase (AMPK). This enzyme functions to increase mitochondria in muscles. Anything that reduces the number or efficiency of mitochondria interferes with your body's ability to burn fat and sugar for energy. As a result, blood sugar, fat and cholesterol levels rise.

Most cells in your body contain many mitochondria, small furnaces that burn food for energy. With aging, the number and the efficiency of mitochondria both decrease. This interferes with your body's ability to turn food into energy. The extra calories that are not burned accumulate in your body as fat in your muscles, liver and fat cells. This causes you to gain weight. Extra fat in cells block their ability to take in sugar from the blood stream, so blood sugar levels rise and you are at increased risk for developing diabetes. Extra fat in the liver prevent the liver from removing extra insulin, so insulin levels rise to constrict arteries and cause heart attacks. Insulin also makes you hungry all the time to increase your chances of gaining weight.

AMPK is increased by exercise and by drugs used to treat diabetes, such as metformin, Actos or Avandia. The best way to increase the number and size of mitochondria in your cells is to exercise. If you do not have a regular exercise program, you are shortening your life. Journal reference; more

Thursday, April 26, 2007

Raising Metabolism to Burn More Calories

Vigorous exercise is one of the best ways to lose weight and keep it off. A study from University of Alabama in Birmingham shows that your body burns calories at an increased rate for up to 24 hours after you finish exercising vigorously for 40 minutes. (Obesity, November 2006). Less than 20 percent of the energy you burn during exercise drives your muscles; more than 80 percent is lost as heat. You can tell if you are exercising vigorously enough to raise your metabolism because your rising temperature usually will make you sweat. If your exercise causes you to sweat, it will keeps your metabolism elevated for several hours after you finish and you will burn more calories all day long. Exercising at a casual pace does not cause you to sweat and does not boost your metabolism.

Another study in the same issue of Obesity, from the University of California at Berkeley, shows that body fat is directly proportionate to the amount of exercise. The seven-year study followed 5417 runners who stopped running at various times during the study, 416 non-exercisers who began a running program, and 573 subjects who remained sedentary throughout the study. The researchers measured weekly running distance, weight, BMI and waistlines, and found that the gains and losses mirrored the changes in amount of exercise. If you are out of shape and want to lose weight, get a stress cardiogram and ask your doctor to clear you for an exercise program. Start slowly and then gradually increase the intensity of your exercise over several months.

Tuesday, April 24, 2007

Your Brain Can Grow Larger with Exercise

Regular exercise makes your brain larger, according to a study from the University of Illinois (Journal fo Gerontology, November 2006). With aging, your brain becomes smaller. This study showed that 60 to 79-year-old men who exercised regularly actually had their brains grow larger. Study participants who did only a stretching and toning program had their brains shrink.

If you feel you are losing your ability to reason or think clearly, or if you suffer mood disorders such as depression, ask your doctor to do blood tests for homocysteine, folic acid, pyridoxine and vitamin B12. If these tests are normal, you should get tests for thyroid function, cholesterol and other causes of arterial damage.

You can suffer from B12 deficiency even if your blood levels are normal. When you body lacks B12, your red blood cells do not mature properly and are much larger than normal, and homocysteine accumulates in your bloodstream, damaging your arteries and brain cells. Having low levels of B12 can damage every nerve in your body including your brain, to make you forgetful and impair your ability to reason and solve problems. If you are low on B12, taking folic acid supplements or eating food heavily fortified with folic acid may cost you IQ points. A study from Tufts University showed that people who have low blood levels of B12 can suffer nerve damage, and those who also had high blood levels of folic acid had far more nerve damage than those with normal levels (American Journal of Clinical Nutrition, January 2007).

Your doctor should also check for diabetes, which can damage blood vessels that supply the brain, heart and other organs. Diabetics may suffer loss of memory long before they are diagnosed as having diabetes. While we await further studies, protect your memory with a lifestyle that will help you avoid diabetes, heart attacks and strokes. Control your weight, eat a wide variety of plants, limit refined carbohydrates and get plenty of exercise. More

Monday, April 23, 2007

Coffee Has More Soluble Fiber than Orange Juice

Coffee contains more soluble fiber than orange juice, according to a study from the Instituto del Frío in Spain (Journal of Agricultural and Food Chemistry, February 2007). Many people start the day with a glass of orange juice because they believe it is a health food, but it contains the same amount of sugar as a glass of Coca Cola.

Soluble fiber is beneficial because it is not absorbed in the upper intestinal tract. It goes to your colon where bacteria ferment it to form short chain fatty acids that are absorbed through your colon into your bloodstream. The short chain fatty acids travel to the liver to block the formation of cholesterol, and also lower high blood pressure by widening arteries. Better dietary sources of soluble fiber include oatmeal, barley, beans, and many whole fruits and vegetables. More on soluble fiber

Since fruit juices contain as much sugar and calories as soft drinks, it makes no sense to substitute juices for soft drinks. It’s far better to learn to drink water to quench thirst, and get calories, vitamins and other nutrients from solid foods. Researchers at the University of Houston reviewed scientific studies to explain why sugared drinks make people fat (Nutrition Review, April 2006). They concluded that sugared drinks do not fill people up as much as solid food does, so calories in drinks do not suppress appetite as effectively as calories in food.
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Sunday, April 22, 2007

Heart Attack Prevention with Strength Training

A study from the University of Tsukuba in Japan shows that strength training for the legs of older men may help to prevent heart attacks. Men over 60 performed 12 weeks of resistance training involving bending and straightening the knees against resistance, three sets of 10 repetitions a day, two days a week. They increased their ability to move heavy weights by 16 percent.

Most measures of heart attack risk in the participants did not change, but their blood concentration of nitric oxide increased. Nitric oxide relaxes and opens arteries to increase blood flow to the heart and helps prevent heart attacks. This paper shows that resistance training may increase nitric oxide without stiffening arteries in healthy older men.

The vast majority of older people are so weak that they can't get out of a chair without using their hands, can't walk up stairs without holding a railing and can't even lift a 25-pound package. Virtually all recent research show that people can become stronger by exercising against progressively greater resistance, no matter how old they are. Strength training usually doesn't enlarge the muscles of older people enough to be measured, but we now know that you can become much stronger, even if your muscles do not look larger. Journal reference for this article; more on strength training.

Saturday, April 21, 2007

How to Increase the Good Bacteria in Your Intestines

Normal intestinal bacteria are so numerous that they make up approximately 95 percent of the total number of cells in the human body. They help prevent bad bacteria from infecting you, and may help prevent intestinal diseases such as ulcerative colitis, Crohn's disease and cancer.

When you eat, enzymes from your intestines, stomach, liver and pancreas break down your food into its building blocks that can be absorbed into your bloodstream. Carbohydrates are broken down into sugars; proteins into amino acids; and fats into glycerol, fatty acids and monoglycerides. However, many foods contain undigestible starches that cannot be broken down into sugars, so they cannot be absorbed in the upper intestinal tract. When they reach the colon, the "good" bacteria ferment these undigestible starches to form other chemicals including short chain fatty acids that protect your intestinal lining from irritation and cancer, and are absorbed into your bloodstream to lower cholesterol and prevent heart tacks. These same "good" bacteria, such a lactobacillus, are used to ferment and preserve some foods made from milk or plants. So eating yogurt may help you maintain or increase the number of good bacteria you have in your gut. Not all yogurt contains live bacteria; read the label to make sure yours is "active."

The good bacteria break down soluble fiber to form chemicals such as short chain fatty acids that are absorbed into your bloodstream and travel to your liver where they block the liver from making cholesterol and help to prevent heart attacks. These short chain fatty acids also reduce inflammation, so they help to control the diarrhea and ulcers caused by Crohn's disease, and the swelling and pain of arthritis, psoriasis or diabetes. Some studies show they may even improve your immunity to help you to kill germs.

The lactobacilli that are in live cultures of yogurt will not remain in your intestines, so they disappear quickly if you stop eating your daily yogurt. Another way to increase the good bacteria is to eat whole grains, beans, nuts and other seeds, fruits and vegetables. Portions of these foods that cannot be absorbed in your upper intestinal tract, so they pass to your colon and provide the medium for a flourishing colony of good bacteria to grow there. The most likely component of these foods to encourage the growth of good bacteria is soluble fiber. Researchers call these foods "Prebiotics", and the beneficial bacteria are called "Probiotics." Journal references for this article; more on soluble fiber and probiotics.

Friday, April 20, 2007

Insulin Resistance: Treat with Lifestyle Changes

Most people who develop diabetes in later life can be controlled so that they are not at increased risk for the many complications of diabetes such as heart attacks, strokes, blindness, deafness, amputations, kidney failure, burning foot syndrome, venous insufficiency with ulceration and stasis dermatitis. Late onset diabetes usually means that a person has too much insulin because his cells cannot respond to insulin. Too much insulin constricts arteries to cause heart attacks, and stimulates your brain and liver to make you hungry and manufacture fat. The insulin resistance syndrome (IRS) puts you at very high risk for a heart attack and is associated with storing fat in the belly, rather than the hips; having high blood triglyceride levels and low level of the good HDL cholesterol; high blood pressure and an increased tendency to form clots.


If you have any of these signs, check with your doctor who will order a blood test called HBA1C. If it is high, you have diabetes and can usually be controlled with diet and/or medication. You should learn how to avoid foods that give the highest rise in blood sugar. When you eat, blood sugar level rises. The higher it rises, the more sugar sticks on cells. Once stuck on a cell membrane, sugar can never detach itself. It is converted to a poison called sorbitol that damages the cell to cause all the side effects of diabetes mentioned above.

Avoid the foods that cause your blood sugar to rise quickly. These include all types of flour products: bread, spaghetti, macaroni, bagels, rolls, crackers, cookies and pretzels; refined corn products and white rice; and all sugar added products. Eat lots of vegetables, un-ground whole grains, beans, seeds and nuts. Eat fruits and root vegetables (potatoes, carrots and beets) only with other foods.

Exercise helps to prevent blood sugar from rising too high after meals. The only places that your body can store sugar are in blood, liver and muscles. When a diabetic’s muscles are full of sugar, dietary sugar goes from the intestines into the bloodstream, causing high spikes in blood sugar levels. On the other hand, when the muscles are empty, sugars go from the intestines into the bloodstream and then directly into muscles to prevent the spike. Several studies show that it doesn’t make any difference when you empty your muscle cells. Blood sugar spikes are prevented by exercising both before and after meals. Exercise is a potent treatment for both Type I and Type II diabetics. Any diabetic or pre-diabetic who does not exercise regularly should check with his or her doctor and get started. Journal references for this article; more on prevention and treatment of diabetes.

Wednesday, April 18, 2007

High blood pressure during exercise: what it means and what you should do

People who develop very high blood pressure during exercise are the ones most likely to develop high blood pressure in later years, according to a study reported in the American Journal of Hypertension. These people have arteries that do not expand as much as normal arteries when blood is pumped to them.

When your heart beats, it squeezes blood from inside its chambers to the large arteries. This sudden bolus of blood causes normal arteries to expand like balloons do when they fill with air. The walls of arteries have sensors that allow arteries to expand with each pulse of blood. If the arteries do not expand enough when blood enters them, blood pressure can rise very high. Blood pressure is determined by the force of the heart's contraction times the resistance in the blood vessels. Normal blood pressure is 120 when the heart contracts and 80 when it relaxes. During exercise, the heart beats with increased force to raise blood pressure. It is normal for blood pressure to rise up to 200 over 80 during running, and to 300 over 200 while doing a leg press with very heavy weights.

People with normal resting blood pressures who develop very high blood pressure during exercise are the ones most likely to develop high blood pressure later on. If your blood pressure rises much above 200 during running, you are at increased risk for developing high blood pressure.

Ninety percent of Americans will develop high blood pressure, which increases risk for heart attacks, strokes, kidney damage and sudden death. High blood pressure usually occurs in people who have normal blood pressures when they were young. If you have an exaggerated blood pressure rise during exercise, you should go on a heart attack prevention program that includes a diet that is high in plants and low in saturated fats and refined carbohydrates, regular exercise, losing weight if you are overweight, not smoking, and avoiding stimulants and drugs that raise blood pressure. More on blood pressureduring weight lifting; journal reference for this article; diet to lower blood pressure.

Tuesday, April 17, 2007

Inflammation Can Cause Heart Attacks and Strokes

When a germ gets into your bloodstream, you are supposed to produce white blood cells and antibodies that help kill these germs. The white blood cells produce chemicals that cause swelling to bring fluid to carry body defense mechanisms, and other chemicals to call out other cells that increase swelling, redness and pain. So inflammation is good because it helps to protect you from infection. However, if you allow the inflammation to continue, or if your produce inflammation when you don't need it, swelling damages your tissues and you may suffer heart attacks, strokes, cancers, Crohn's disease, psoriasis, different types of arthritis, or even Alzheimer's disease.

The fatty plaque buildup that lines blood vessels often becomes inflamed because your white blood cells attack your own tissue rather than just germs. Fat cells are also known to turn out these inflammatory proteins. Other causes of inflamation include high blood pressure, smoking, obesity, and lingering low-level infections such as chronic gum disease. Inflammation is thought to weaken the fatty buildups, or plaques, making them more likely to burst. A piece of plaque can then lead to a clot that can choke off the blood flow and cause a heart attack.

Cholesterol-lowering drugs called statins can reduce the inflammation and so does a daily dose of aspirin. People who are given antibiotics immediately after suffering a heart attack or severe chest pains have 40 per cent fewer repeat attacks over the next year. Several studies suggest that you prevent heart attacks by preventing inflammation, which can be caused by infections anywhere in your body, gum disease, diabetes, overweight, lack of exercise, obesity, smoking or high blood cholesterol levels. More information on these and other studies; journal references

Sunday, April 15, 2007

Leg Clots in Healthy People

Leg clots occur without warning with sudden pain and swelling in a leg muscle, usually the calf. This is a particularly dangerous condition because the clot can break lose from the veins in the leg, travel to the lungs and block blood flow to kill a person. In a report in the British medical journal, Lancet, doctors at the London School of Hygiene and Tropical Medicine showed that infections may cause sudden clotting in the leg muscles called Deep Vein Thrombosis. They showed a 20 percent increase in infections, particularly urinary and respiratory, one to two weeks before a person develops clots. This report supports the current theory of inflammation causing heart attacks, strokes, and clotting. Your immunity is good because it is supposed to kill germs when they enter your body. However, if your immunity keeps on being active, it attacks your own body to damage arteries and other tissues.

People at the highest risk for clots are those who are sedentary for a long time, such as in long distance plane flights, and those who suffer cancers. Since infections are common and deep vein clots are not, you should not worry about clots every time you get an infection. However, if after a urinary or respiratory infection, you suffer sudden pain in a leg without any other explanation, check with a doctor immediately to rule out a clot. Journal reference

We've been on vacation for the past week, riding our tandem bike and staying on a steamboat from Memphis to New Orleans.

Thursday, April 05, 2007

Total Body Scans Not Recommended

I never recommend the full body CAT scans for healthy people. You've seen the advertisements. They tell you to come in, get a scan of your entire body, pay your thousand dollars and find out what's wrong with you before you have symptoms.

CAT scans of the body are high-speed, highly sensitive X-rays that can find tiny tumors, weak spots on blood vessels that make them bulge out like balloons, and calcified areas that may be indicative of heart disease. As a result of intense competition, prices are dropping, from $1,000 or more to a few hundred dollars. New centers are springing up in cities and strip malls across the country. They advertise in newspapers, on the radio, on billboards and in fliers sent by mail. There are even mobile units that travel from state to state in huge buses, make contacts with churches and other groups and then charge a reduced price of $200 to scan any of three regions of the body, or $500 for all three.

However, most of the radiologists that I know, who have no interest in making money from these scans and are not influenced by personal gain, tell me that they are a waste of money and time. They tell me that a careful look at most CAT scans shows that almost everyone will have some abnormality. Scanners can find lumps smaller than a millimeter, or four-hundredths of an inch, and most of these lumps are harmless. So you follow up the cat scan with several thousand dollars worth of other tests only to find out that you are normal and you have been upset for the sole reason that you took a test that picked up an a normal finding in most healthy people.

Furthermore, many people are fooled by the medical profession into thinking that early treatment results in cures for everything, when the truth is that early treatment often offers nothing but worry. For some cancers, early treatment has not been proved to have any effect on their course. "We've sold ourselves the myth that getting everything early is always good," said Dr. Larry Kessler, the director of the office of surveillance and biometrics at the Food and Drug Administration.

CAT scans are relatively safe, however. Since these CAT scan tests are usually not covered by insurance, you will have to pay for them and the odds are overwhelming that they will find nothing or that they will find something that is harmless. They then may cost you more money for many other tests, and loss of sleep before you find out that you do not have a tumor or any other serious disease.

On the other hand, those who provide the scans say they are a real service. The radiologists who do them are delighted with them. They offer a huge rate of profit. Since the patients pay out of pocket, there are no insurance companies to haggle with. What would you say if you had a CAT scan and they found nodules in your liver, kidneys and lungs. Your family practitioner will tell you that half of all normal people over 50 have cysts in their liver or kidneys. However, an abnormal full body CAT scan upsets your doctor who knows that if he misses a cancer, you will sue him. So against his better judgment, he orders a liver biopsy and another doctor sticks a needle into your liver, removes a piece of your liver, and finally tells you that you are normal and have nothing to worry about. Total body scans can pick up hidden cancers, ballooning blood vessels and plaques in your arteries, but they will also pick up a host of things that will cost you thousands of dollars and lots of worry before you find out that most healthy people have these abnormalities. Weekly newsletter

Monday, April 02, 2007

Knee Surgery to Trim Cartilage Ineffective

In the United States, more than 650,000 knee surgeries called arthroscopic debridement or lavage are performed each year, at a cost of about $5,000 each. A report in the New England Journal of Medicine shows that knee surgery to remove cartilage is worse than doing nothing. The headline from Baylor Medical School, where the landmark study was performed, is "Study Finds Common Knee Surgery No Better Than Placebo." Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure. The researchers say their results challenge the usefulness of one of the most common surgical procedures performed for osteoarthritis of the knee. Lead investigator Dr. Elda P. Way states, "The fact that the effectiveness of arthroscopic lavage or debridement in patients with osteoarthritis of the knee is no greater than that of placebo surgery makes us question whether the one billion plus dollars spent on these procedures might not be put to better use."

In the study, 180 patients with knee pain were randomized into three groups. One group received debridement, in which worn, torn, or loose cartilage is cut away and removed with the aid of a pencil-thin viewing tube called an arthroscope. The second group underwent arthroscopic lavage, in which loose cartilage is flushed out. The third group underwent simulated arthroscopic surgery; small incisions were made, but no instruments were inserted and no cartilage removed. The people who did not have surgery on their cartilage did better than the people who had some of their cartilage removed.

The knee is just two sticks held together by four bands called ligaments. Bones are soft, so the ends of bones are covered with a hard gristle called cartilage. Cartilage serves as a padding to protect the ends of bones. Once cartilage is broken, it can never heal. And once you break a small amount of cartilage in your knee, your knee cartilage can never fit together properly, and every time you put force on the knee, you break off more cartilage.

When surgeons remove cartilage, they leave less cartilage than the person had before the surgery. Eventually the knee joint runs out of cartilage and when bone rubs on bone, it hurts all the time and a peson must have a knee replacement just to be able to sleep at night. Surgery to remove cartilage just hastens knee replacement. On the other hand, doctors can replace torn ligaments, which stabilizes the knee joint. They can remove a loose piece that is blocking the movement of the joint. People with loose cartilage have sudden locking of the knee when they walk or the cannot fully straighten or bend their knees.

Based on this study and my own impression from treating hundreds of damaged knees, I recommend that you do not get knee surgery unless you have a torn ligament that needs to be repaired or you have sudden locking of the knee during walking or you cannot fully straighten or bend you knee. Otherwise surgery is likely to hasten your need for another surgery, knee replacement. Journal reference for this article Knee replacement surgery