INTEGRATIVE HEALTH EDUCATION
A monthly review of 100 medical journals
Volume 10  Number 11  November 2009
EDITOR’S NOTE
The 2009 Nobel Prize in Medicine was awarded to 3 American researchers
working on the Telomere, the tail end of chromosomes; it controls gene copying. Their
findings are likely to lead to new pharmaceutical products to lengthen the telomere,
which could treat problems like prostate cancer. While this is a great accomplishment, I
am disappointed, yet, not surprised, that the findings are automatically directed to the
creation of a symptomatic treatment. The present paradigm driving our health care
industry (yes, money) seems unable or unwilling to see past their narrow self-interests.
We could focus on a more proactive angle; the articles “Multivitamin Use and
Telomere Length in Women”1 and “Leukocyte Telomere Length: the telomere tale
continues”2 tell us that the longer the telomere the longer we live; antioxidants keep the
telomere from getting oxidized, or shortened. This means that a diet high in
antioxidants and cleaner environments that don’t require as many antioxidants to
detoxify, increase longevity by preserving the length of the telomere. In other words, our
environment affects genetic expression.3
The same may be said about emotional-spiritual stress, which also burns up
antioxidants. The article “A Complex Relationship: psychosocial stress, pollution, and
health”4 tells us that psychosocial stress may exacerbate our susceptibility to adverse
effects of pollutants such as lead, polychlorinated biphenyls, and combustion emissions.
If we could educate people about these simple concepts they may assume more
responsibility for their health;5 we would then see longer lives and less atherosclerotic
diseases. Dr. Ornish would agree; in the article “Increased Telomere Activity and
Comprehensive Lifestyle Changes”6 he showed that a longer telomere is associated
with less prostate cancer. In another study, “Clinical Events in Prostate Cancer Lifestyle
Trial: results from 2 years follow up,” Ornish proved that lifestyle changes for 2 years
may be able to avoid or delay conventional prostate cancer treatment.7 After all,
conservative treatment of prostate cancer has better survival.8
Will we pay attention to these articles as we continue to argue about financing our
broken health care system? (See related blog, “Why We Hurt.”) Will we start looking at
our health as a holistic concept that involves our entire communities?9
Hugo Rodier, MD
1
American J. Clinical Nutrition 2009;89:1857
AJNC 2009;89:1721
3
“The Origin of Mutants,” J. Nature 1988;335:142
4
J. Environmental Health Perspectives 2009;117:A407
5
Book review: “Patient, Heal Thyself: how the new medicine puts the patient in charge,”
JAMA 2009;301:1388
6
J. Lancet Oncology 2008;9:1048
7
J. Urology 2008;72:1319
8
“Conservative Management on Prostate Cancer,” JAMA 2009;302:1202
9
“Structural Interventions for Addressing Chronic Health Problems,”
2
Heart to Heart on Sugar
“The American Heart Association is finally taking aim at our nation's sweet
tooth, urging consumers to significantly cut back on the amount of sugar they get from
such foods as soft drinks, cookies and ice cream. The AHA says most women should limit
their sugar intake to 100 calories, or about six teaspoons, a day; for men, the
recommendation is 150 calories, or nine teaspoons. The recommendations are likely to
prove challenging for many consumers to meet. Just one 12-ounce can of cola has about
130 calories, or eight teaspoons of sugar. Data gathered during a national nutrition
survey between 2001 and 2004 suggest that Americans consume on average 355 calories,
or more than 22 teaspoons, of sugar a day.”10
And why would it be hard to comply with the AHA’s suggestions? Our national
addiction to refined sugars, which is made worse by stress, the Farm Bill, Big Food’s
processing of food for profits and social contagion.11
“Therapeutic Uses of Magnesium”12
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75% of Americans don’t get RDA. Poor nutrition, alcohol in excess and
diuretics contribute to low levels and need for supplementation.
Magnesium is needed for 300+ metabolic reactions in the body: protein
synthesis, cellular energy production and storage, cell growth and reproduction,
DNA/RNA synthesis, stabilization of mitochondrial membranes, bone
metabolism, nerve transmission, cardiac excitability, neuromuscular conduction,
vasomotor tone, blood pressure and insulin metabolism
Early signs of low magnesium: loss of appetite, nausea, vomiting, fatigue,
weakness; then, numbness, tingling, muscle contractions, crams, seizures,
personality changes, abnormal heart beats and coronary spasms.
Diseases that contribute to low magnesium: diabetes, gut inflammation and
malabsorption.
Magnesium deficiency diagnosed by checking inside cells. Low CoQ10 levels
may inhibit cell uptake of magnesium.
Useful supplementation: eclampsia/preeclampsia, heart arrhythmias, asthma,
indigestion, constipation, headaches, bone density, insulin resistance and
dysmenorrhea.
Contraindications: renal problems. Cautious use with prescription drugs
(calcitonin, diuretics, calcium channel blockers, antibiotics and muscle relaxants)
since magnesium may alter their blood levels.
Dose: adults 350 mg; children 65 mg 1-3 yrs old, 110 mg < 8 yrs old.
“Zinc, an Essential Micronutrient”13
This is another mineral found lacking in many people when they don’t eat enough
JAMA 2009;302(6):683
10
www.american-heart.org/nutrition/sugar, Aug 25th 2009-10-05
New York Times magazine, September 13th 2009, page 28
12
J. American Family Physician 2009;80:157
13
J. American Family Physician 2009 ;79 :768
11
veggies. There is good evidence that Zinc helps in the treatment of acute and chronic
diarrhea, Wilson’s disease (liver problems due to copper,) and macular
degeneration. The evidence that Zinc helps taste problems and colds is not as good. The
best dose is 20 mg and it should be coupled with 2-5 mg of Copper. Avoid Zinc in
pregnant and lactating women and in patients taking penicillamine.
Update on the brain-gut connection
“Although many people are aware of the communication that occurs between the
gastrointestinal (GI) tract and the central nervous system, fewer know about the
ability of the central nervous system to influence the microbiota or of the
microbiota's influence on the brain and behavior. Within the GI tract, the
microbiota have a mutually beneficial relationship with their host that maintains
normal mucosal immune function, epithelial barrier integrity, motility, and
nutrient absorption. Disruption of this relationship alters GI function and disease
susceptibility.”
“Animal studies suggest that perturbations of behavior, such as stress, can
change the composition of the microbiota; these changes are associated with
increased vulnerability to inflammatory stimuli in the GI tract. [See blog “Why
We Hurt”] The mechanisms that underlie these alterations are likely to involve
stress-induced changes in GI physiology that alter the habitat of enteric bacteria.
Furthermore, experimental perturbation of the microbiota can alter behavior,
and the behavior of germ-free mice differs from that of colonized mice. Gaining a
better understanding of the relationship between behavior and the microbiota
could provide insight into the pathogenesis of functional and inflammatory
bowel disorders.”
I quoted from the article “The Relationship Between Intestinal Microbiota and the
Central nervous System in Normal Gastrointestinal Function and Disease”14 so that
readers may get a feeling for the strength of the scientific data on the brain-gut
connection. This newsletter and many scientists have been highlighting this concept for
sometime. Dr. Gershon pioneered this concept over 45 years.
I can attest to the dramatic improvement my patients see in their cognitive and
mood issues when they eat better and improve the quality of their intestinal environment.
After all, our microbiota, which outnumber our 50 trillion body cells carry more genes
than we do. Linus Pauling would like this article. He coined the term “Orthomolecular
Psychiatry,” meaning that a significant number of psychological disorders may be
treated with good nutrition.15 Food for thought….
“Rethinking Screening for Breast Cancer and Prostate Cancer”16
This is a game-changing article. Don’t shoot the messenger:
14
J. Gastroenterology 2009;136:2003
J. Science 1968;160:265
16
JAMA 2009;302:1685
15
“After 20 years of screening for breast and prostate cancer, several observations
can be made. First, the incidence of these cancers increased after the
introduction of screening but has never returned to prescreening levels. Second,
the increase in the relative fraction of early stage cancers has increased. Third,
the incidence of regional cancers has not decreased at a commensurate rate. One
possible explanation is that screening may be increasing the burden of low-risk
cancers without significantly reducing the burden of more aggressively growing
cancers and therefore not resulting in the anticipated reduction in cancer
mortality. To reduce morbidity and mortality from prostate cancer and breast
cancer, new approaches for screening, early detection, and prevention for both
diseases should be considered.”
Translation: screening may be discovering cancers that would have been OK to
leave alone. This article vindicates doctors who maintain that the most reasonable
approach to cancer is to boost one’s immune system. The rub is when to be more
aggressive with screening and treatment: welcome to the world of uncertainty. No doctor
will ever be able to give you 100% assurance on anything. The best we can do is to
clearly outline your choices so that you decide and assume responsibility for that
decision. Of course, some people may call such a discussion a “death panel…”
Telegraphed articles
“Half of Texas Physicians Don't Recommend HPV Vaccine,”
J. Skin Allergy News 2009;40:23
“The Alzheimer’s Disease-Diabetes Angle: inevitable fate of aging or metabolic
imbalance limiting successful aging.” Translation: high-sugar diets increase the risk of
dementia
J. Alzheimer’s Disease 2009;16:67
“Anti-RAGE and Immunoglobulin Levels Are Related to Dementia Level and
Cognitive Performance” supports the above article
J. Gerontology Biology Science Med Sci 2009;64:264
“Association Between 25-Hydroxy-Vitamin D Levels and Cognitive Performance in
Middle Aged and Older European Men.” Get your levels above 80 for best function.
J. Neurology Neurosurgery Psychiatry 2009;80:722
“Lipid Peroxidation and Atherosclerosis.” The problem is oxidized cholesterol
J. Lipids Research 2009;50:599
“Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive
Hormones in Infertile Men,”
J. Urology 2009;182:237
“Acupuncture for Pain,”
J. American Family Physician 2009;80:481
“Sexual Abuse and Lifetime Diagnosis of Somatic Disorders,” like fibromyalgia, chronic
pain and gut problems
JAMA 2009;302:550
“Stimulant (ie Adderall) Linked to Sudden Death in Children Without Heart Problems,”
JAMA 2009;302:613