Green Cheese Claims and Needless Dietary Chaos
The front cover item of today’s Newsweek Magazine concerns the confused and confusing state of dietary advice in America, and indeed around the world. So much of the advice on offer is based on political considerations and a fundamental misunderstanding about the way in which knowledge grows.
People outside the academic world are often astonished to discover that it is not a world of quiet painstaking investigation and careful intellectual deliberation, but is instead a hot bed of neo-Darwinian competitive frenzy. Every academic is under constant pressure to publish or perish. There are constant and intense demands to bring in grant money. This pressure can lead to huge problems. Data is often published before it is ready.
As regular readers of my columns know already, I have been vigorous in exposing scientific misconduct, but I am also concerned about raising false hopes or giving false guidance on the basis of single studies. Any study, however well designed and executed and however many subjects it contained, still needs to be confirmed and confirmed again. If somebody at NASA produced evidence that the moon was made of green cheese, I doubt that they would be believed. Not unless the observation could be confirmed by hundreds of independent investigators around the world.
Yet every day I see people who have fallen victim to green cheese claims. People who have been persuaded to part with millions of dollars to buy supplements to help them lose weight, on the basis of very limited data and sometimes wild extrapolations. Often they are just not needed. As an example, people are usually not told that ten minutes in the sun and a glass of low fat milk will give them all the calcium and vitamin D that they need for a day.
The Newsweek article does a great job of teasing apart many of the competing claims.
A year ago Mike Johanns, the Secretary of Agriculture, launched the new MyPyramid initiative to highlight the 2005 Government Guidelines for healthy eating, which for the first time emphasized the importance of individualizing any approach to diet and exercise. Although there were all the usual allegations that the guidelines were simply a confection designed for the health of American farmers rather than the health of the American population, I really cannot agree with those comments. The guidelines represent a considerable advance on the old food pyramid, but as I have pointed out in previous postings, the problem with weight management is not just what you leave out, but also what to include in any healthy eating plan. I really do suggest that if you haven’t already, you look back at some of the suggestions that I’ve made previously on this blog.
Let me also direct you to another resource: The Psychiatric Resource Forum’s article “Nutrition for Americans” will point you toward other good sources of information that we have carefully vetted for accuracy. Although this blog was created for healthcare professionals, it also contains a lot of information of value to readers of this blog.
Later this year, we plan to publish a short book on the precise approach to healthy eating that I have been using with great success for many years now.
Technorati tags: green cheese, diet advice, MyPyramid, Newsweek
Integrated Health and Aging
An important principle of the emerging laws of health and healing is that anything helpful should help more than one system of the body at a time. So a diet that might help mitigate the effects of aging in the skin should also have beneficial effects on the major organs of the body.
So I was encouraged to see a new report indicating that cardiovascular health and a healthy lifestyle are associated with maintaining the health of our brains as we age. This is, of course, intuitively obvious, but it is always nice to see such things confirmed by empirical research.
The new report is from a multi-Institute collaboration of the National Institutes of Health (NIH) published online in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The chair of the committee was Hugh Hendrie, the Scottish-born professor of psychiatry from the University of Indiana, and the committee members were many of the most eminent people in the fields of aging and Alzheimer’s disease.
What is encouraging about this new report is that many of the factors associated with cognitive decline as we get older are eminently remediable: we have within our reach a set of potential interventions that could significantly reduce our personal risk of developing cognitive problems later in life. These are the things that we need to work on if we want to reduce our risk of developing cognitive decline later in life:
- Hypertension: There is excellent evidence that inadequately treated hypertension correlates strongly with cognitive decline.
- Physical activity: There is good evidence that elders who exercise regularly are less likely to experience cognitive decline. This is over and above the general improvement in quality of life that accompanies regular exercise. The earlier in life that we start, the easier it is to continue.
- Increased mental activity throughout life, including learning new things and going through higher education may benefit the health of the brain.
- Moderate alcohol use and the use of vitamin supplements also seem to be brain protectors, though the report does not specify which supplements.
- Social disengagement and depressed mood are both associated with poorer cognitive functioning, so it is important to be alert to signs of depression, and to maintain a social network. I discuss this in more detail in my book Healing Meaning and Purpose.
There are doubtless some genetic and environmental factors about which we can do little. But the idea that we now have a list of things that we can do to protect our brains is very exciting.
This report also signals another important change. In recent years we have seen the growth of Positive Psychology, the study of how to improve ourselves rather than the constant focus on psychopathology. This report calls for the research community to study health maintenance of the brain with the same energy that it has brought to bear on the study of diseases of the brain. To which I would add, that we must not just focus on how to maintain the health of the brain, but how we can enhance it’s function so that we can all reach and exceed our full potential.
Technorati tags: aging, Integrated health, Positive Psychology, healthy lifestyle,
Fat Facts
I was very pleased to see that Dean Ornish is now writing a column for Newsweek magazine, and that Andrew Weil will be contributing to Time. This is good news: both of them have made original contributions to holistic health care, and have always been very reasonable in their pronouncements.
Dean’s debut column has just come out. As you might expect, given his long history of making valuables contributions to the diet debate, he has called his article The Facts About Fat, and he reports on an important article published earlier this month in The Journal of the American Medical Association. The study presents some of the results of the Women’s Health Initiative dietary modification study, which followed nearly 49,000 middle-aged women for more than eight years. The study compared those on a regular diet to those on a low-fat diet, to see if dietary modification could help prevent heart disease and cancer. The women in the “dietary change” group were asked to eat less fat and more fruits, vegetables, and whole grains each day to see if it. The women in the comparison group were asked to continue on their usual diets.
The results of the study have caused some consternation, because low-fat diets did not appear to protect against heart disease, or stroke, or breast cancer, or colon cancer. But here we come back to a point that I have made in other articles. We must not take studies at face value, but instead analyze the data in detail. It is hard work to extract the real message from published data, but it is incredibly important to do so.
So what were the limitations of this study?
1. The reduction in dietary fat was very small.
2. People are not good at keeping diet diaries, and often think that they are eating more healthily than they are. (Some years ago we did an experiment in which we estimated our daily calorie intake and also kept diet diaries. We were all experts in human nutrition, but each of us under-estimated out intake by about 300-500 calories per day)
3. The increase in consumption of fruit and vegetables was small.
4. The control group that was supposed to stay on their regular diet actually did not. Most of us know something about healthy eating, and most people are making some changes toward better diets.
5. Eight years is actually quite a short duration for a cancer prevention study.
Dean then returns to a favorite and important theme: the study didn’t distinguish between beneficial and harmful fats. Several previous studies have shown that the omega-3 fatty acids found in salmon, halibut, mackerel, walnuts, and flax seed oil may reduce your risk of a heart attack by 50 percent or more, as well as perhaps reducing the risk of inflammation and some forms of cancer.
I am certainly persuaded by the data on omega-3 fatty acids, as well as recent evidence indicating that reducing overall dietary fat to around 33 grams of fat per day, reduces the risk of breast cancer recurrence by 42%.
Dean also endorses another comment that I have made in previous posts: what you include in your diet is as important as what you leave out.
Technorati tags: Dean Ornish, Newsweek, Nutrition, low-fat diet
Lectins, Leptin and the China Study
I have just reviewed a most interesting book called The China Study at Amazon.
This book, touted as the most comprehensive study of nutrition ever conducted, is indeed a treasure trove of useful information. The first point that I particularly liked is that the author is not a reductionist. He understands that the idea of trying to reduce the value of foods to one food type or one nutrient is deeply flawed. Let me give you an example: there is some good evidence that tomato-derived lycopene has a great many health benefits, but that does not mean that the solution to all that ails us is a diet consisting solely of tomatoes. I was once asked to see a person who had a genuine problem with a series of food sensitivities: a well-meaning but poorly educated practitioner had put her on a diet of lettuce leaves, rice and spring water. Several months later I saw her because of profound weight loss and malnutrition. The problem was a lack of balance in the dietary approach, and failing to see the big picture.
T. Colin Campbell is definitely one who sees the big picture, both in terms of his own research, and the broader context. He rightly points out that trying to divorce nutrition from the whole diet and lifestyle is a fundamental mistake.
I noticed something rather interesting, which I have just seen picked up by another reviewer: there seems to be a strongly positive correlation between wheat consumption and the risk of sustaining a myocardial infarction.
The reason that I perked up on seeing this is that I have just been analyzing a paper from Lund in Sweden. The investigators’ fundamental premise is that the rise of agriculture and the consumption of cereals might be the underlying explanation for many of the diseases of affluence. The researchers did a study of pigs, and showed that by putting them on a cereal-free diet, the pigs’ insulin resistance, blood pressure and C-reactive protein all fell, which are excellent markers of cardiovascular health. They went even further and provided a biochemical explanation, pointing out that for all its many benefits, agriculture is exposing our bodies to novel lectins: plant proteins that bind to specific carbohydrate groups on cell membranes. (We met lectins in my previous posting on blood types). These lectins seem to have the worst type of biochemical properties that enable them to block the action of a key metabolic hormone called leptin. First discovered in 1994, leptin produces a satiety signal, telling your brain to stop eating. In some animals it may also cause insulin resistance. Leptin was very hot news a few years ago, because if an animal or a person is resistant to leptin, they become morbidly obese. So a number of pharmaceutical companies tried to develop obesity treatments based on leptin. Sadly, to date all of them have failed. It is not surprising that nutritional interventions based on modulating leptin have also been disappointing. At last count there were over 260 hormones and neurotransmitters involved in the maintenance of body-weight. So trying to manipulate just one of them is hardly likely to be crowned with success.
As I have said in other posts, there will always be someone, somewhere, who will respond to any kind of eating or life plan. The trick is in predicting who will respond to what, and in that we are still scratching our heads. So if you want an approach that has the highest overall chance of success at maintaining and improving your health, rather than just focusing on pounds, I’m going to repeat my advice from an earlier posting:
1. It is important for you to maintain your energy balance, between input and output
2. Calories do count
3. What you include in your diet is as important as what you exclude: we are designed to consume not just rice and lettuce, but an array of other nutrients.
4. Make only moderate dietary changes at any time: making big dietary changes can be a pretty violent attack on your body and your mind
5. Avoid the “trans-fatty acids”
6. Try to consume some omega-3 fatty acids every single day
7. Eat fewer simple carbohydrates
8. Use weight management and exercise strategies that enhance your overall health and well-being
9. Take more exercise: even small amounts can have a big effect.
And now I am going to add a tentative number 10:
10. If your weight and metabolic parameters are still not as they should be, discuss a gradual reduction of cereal intake with your health care provider, and how to ensure that you still get the amount of fiber that you need. Depending upon your own genetic make-up that may be the missing piece.
Technorati tags: The China Study, T. Colin Campbell, diet, lifestyle change, nutrition
The Four Percent Solution
In this week’s edition of the Journal of the American Medical Association, is a study of 11,701 American over the age of 50, who participated in a national health survey in 1998 funded by the National Institute on Aging. The researchers analyzed participants’ outcomes during a four- year follow-up and examined the health characteristics that seemed to predict death within four years.
These were the questions that were asked, and this is a bit like golf: you want to have the lowest score possible. Zero would be best. The score is supposed to tell you your chance of dying within the next four years.
1. Age: 60-64 years old = 1 point; 65-69 = 2 points; 70-74 = 3 points; 75-79 = 4 points; 80-84 = 5 points; 85 and older = 7 points.
2. Male or Female: Male = 2 points.
3. Body-Mass Index: Less than 25 (normal weight or less) = 1 point. (BMI = weight in pounds divided by height in inches squared, multiplied by 703.)
4. Diabetes: 2 points.
5. Cancer (excluding minor skin cancers): 2 points.
6. Chronic lung disease that limits activities or requires oxygen use at home: 2 points.
7. Congestive heart failure: 2 points.
8. Cigarette smoking in the past week: 2 points.
9. Difficulty bathing/showering because of a health or memory problem: 2 points.
10. Difficulty managing money, paying bills, keeping track of expenses because of a health or memory problem: 2 points.
11. Difficulty walking several blocks because of a health problem: 2 points.
12. Difficulty pushing or pulling large objects like a living room chair because of a health problem: 1 point.
Score:
- 0 to 5 points = less than a 4 percent risk of dying;
- 6-9 points = 15 percent risk;
- 10-13 points = 42 percent risk;
- 14 or more points = 64 percent risk.
So what should we make of this?
The first thing is that the study is just looking at the physical aspect of life. It asks nothing about diet or family history. It also says nothing about psychological and spiritual factors that can buttress health and well-being.
So what should it mean if somebody gets a high score? Does it mean that they should expect the end and stop reading long novels? Absolutely not! A high score should be a very good indicator that you should have a talk with your health care provider and get to work on all the reversible factors on the list. And as I have pointed out before, a positive psychological outlook and regular spiritual practice have been shown to extend the length and quality of your life.
It is not given to us to know the length of our lives and plenty of people live on and on despite breaking all the rules while others die young despite a lifetime of temperance. I had an aunt who smoked heavily throughout her adult life, yet lived to be well over ninety, while one of my former students died of lung cancer in his thirties, having never smoked a single cigarette.
Genes and lifestyle are important in determining our life span, but so are the quality and integrity of our relationships, our own sense of meaning and purpose, the clarity of the subtle systems of the body and our spirituality.
So use this study not as a death sentence, but as a wake-up call.
Technorati tags: health quiz, aging, longevity
Diet and Blood Types
One of my earlier posts entitled “What in Your Blood?” elicited a most interesting and important question from a reader:
“Does any of this have to do with the research that Dr. Peter D’Adamo has in his "Blood Type Diet" book? I have had clients tell me diseases and pains vanished when they followed his diet, while others had no effect. I would be interested in hearing your take on it all.”
This is a great question that gives me the opportunity to comment about this whole issue. I think that many of us have made similar observations to the reader who asked the question.
For people not familiar with this theory, D’Adamo’s notion is that our ancestors originally all had type O blood group, and that the appearance of agriculture was associated with the appearance of type A blood group, and then as recently as 10,000 B.C.E. – A.D. 1000, types B and AB started to evolve.
In this scheme, people with Type O blood group are the descendents of Hunters, the dominant, hunter-caveman types that require meat in their diet and should avoid wheat and beans. They are supposed to be most likely to suffer from asthma, hay fever, and other allergies. People with Type A blood are originally the Cultivators, and they should eat a vegetarian diet since they are predisposed to heart disease, cancer and diabetes; Type B blood group people were allegedly Nomads, and are dairy-eating omnivores who are susceptible to chronic fatigue and autoimmune disorders, such as systemic lupus erythematosus and multiple sclerosis. The rare individuals who have the AB blood group require a mixed diet, but should avoid chicken. They are supposed to be at risk of heart disease, cancer, and anemia, but tend to have the fewest problems with allergies. So D’Adamo decided that we should eat according to our blood types.
Like a lot of simple models, it is attractive and can be seductive. Yet the underlying concepts are deeply flawed. There are some weak associations between some blood groups and some physical ailments: to name just two, blood type A and coronary artery disease, and type O and gastric ulcers. That second one we now understand: people with blood group O are not able to mount a strong immune response to the usual causative organism: Helicobacter pylori. I did a literature review and dug up over 700 research papers on the subject of blood groups, disease and lectins (the adhesion molecules found, amongst other places, on red blood cells). There was nothing whatsoever to confirm D’Adamo’s claims. Indeed I think that some of his claims are potentially risky. Few people would agree with the idea of feeding some people high fat diets, and the theory takes no account of ethnic differences in food tolerability. For instance the high rates of insulin resistance amongst most people of Indian heritage, or the dairy intolerance common in much of the Asia-Pacific rim.
D’Adamo’s theory of blood group evolution is not correct. Far from having developed new blood groups with the arrival of agriculture, there is solid molecular evidence that the different blood groups were already present at least 5 million years ago. Gorillas and chimpanzees possess similar blood groups. One of the scientists quoted on the D’Adamo website is Winifred Watkins, who was one of the team that first described the structure of the molecules determining blood group types. She was only 29 at the time, and later she became a Fellow of the Royal Society and a mentor of mine. She passed away about three years ago. She was the person who first told me about the evolution of blood groups, and there’s now a fair bit written about it. The last great African Diaspora occurred long before the development of agriculture, and the migrants took their diverse blood groups with them. That is one of the ways in which migration patterns have been tracked. So there is no link between blood groups and “professions.” It is still possible that there is some other arcane link between optimum nutrition and blood groups, but it is now ten years since D’Adamo’s book came out, and we have to ask why there is no published research to support the claims. His website contains a lot of references to research papers on blood groups. Many are quite old, and there is no critical evaluation of the papers.
Yes, some people will benefit from any kind of diet or intervention, which is why some of your clients have benefited, but the predictive value of the four major blood group types is clearly very low.
Technorati tags: blood type diet,
Coffee and Sex
These two may seem strange bed fellows(!)
But a study published in November 2005, was picked up by a lot of the news media, and probably lead a lot of people to encourage their wives and girlfriends to have an extra cup of coffee. The reason? Because this study, from Southwestern University had the title “Coffee, Tea and Me: Moderate doses of caffeine affect sexual behavior in female rats.” The research showed that at least in rats, coffee stimulated regions of the brain regulating arousal. It was immediately reported around the world that coffee drinking would raise a woman’s libido.
I don’t know what the report did for sales of coffee, but sadly, once again, the devil is in the details. Not only is human sexuality a lot more complex than it is in rats, but there is also this. In order for an adult woman to get the same amount of caffeine, she would have to drink at least ten large cups of coffee at once.
And coffee is a pretty good diuretic…..
Technorati tags: coffee, sex drive, human sexuality
Some Suggestions for Dealing with Insomnia
“I seem not to have the shut down switch in my brain.” She is worried about taking medications, and wonders if there is anything else that she can do to help herself.
It is always unwise to make specific recommendations about someone without seeing them face-to-face, and the evaluation of a problem like this will normally take several hours. But the points that she raises have a great deal of relevance for so many people that I thought that a few comments would be helpful and equip everyone reading this with some information to discuss with their healthcare providers.
As usual, I think that it is a good idea to look at the question from the multiple dimensions of physical, psychological, social, subtle and spiritual. They are all inter-related, so dividing them up is simply a convenient way to help us think through the problem.
Before we do anything, we have to try and find out why someone has problems with sleep, and that may need investigations up to and including a sleep study.
The first thing is that my correspondent is female and likely either menopausal or perimenopausal. That is important, because as most women know, hormones have potent effects on sleep. It is not just that uncomfortable hot flashes can wake a person; it is also a direct effect of estrogen and probably of some of the releasing hormones in the hypothalamus. Hormone replacement therapy alone, does help some women but by no means all. Even at the physical level we see the general principle that there is rarely one cause for one problem. Typical menopausal sleep disturbances include a difficulty in falling asleep, and around 20% of menopausal women report that they sleep less than six hours a night. There is also some degradation in what we call sleep efficacy and an increase in deep slow wave sleep. Estrogen has effects on nasal mucosa, and when estrogen levels fall obstructive sleep apnea is more likely to occur. A major physical and psychological issue is that insomnia may become a learned habit that can persist even in the face of the best treatments.
This leads me to the second dimension, and that is psychological. The writer of the letter mentioned that she couldn’t turn off her thoughts. You would be amazed at how frequently I have been asked to consult on someone with a sleep problem and the individual has never been asked the question, “What is it that stops you falling asleep?” I have seen countless people prescribed sleeping tablets, when the real problem was anxiety or some other nasty problem that needed to be tackled first. In a moment I am going to make some suggestions that will try and help with both sleep and the ruminations and anxieties that may be contributing to its disturbance. Similarly, I have known a great many people whose sleep problems were the result of relationship difficulties or of something as simple as one person being a night owl and the other an early morning riser.
I always start with some simple sleep hygiene:
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Stress management
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Exercise a couple of hours before retiring
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Keeping mentally stimulated until it is time for bed
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Don’t go to bed until you are tired
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No caffeine, alcohol or nicotine after 6pm. (Preferably, of course, no nicotine ever!!) {Remember that many over the counter painkillers contain caffeine, as does chocolate}
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There are some specific dietary recommendations for helping with sleep, and I shall write about those on a future occasion
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Try to keep the bedroom atmosphere relaxing, and establish a sleep ritual
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If you cannot sleep, get up and do something relaxing: struggling to go to sleep is virtually impossible.
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Always get up at the same time in the morning, to try and re-set your brain, and as soon as you get up, be exposed to as much bright light as possible.
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Start by lying on your left side for 5-10 minutes and then roll onto your right side. This appears to work by exploiting the so-called nasal cycle, which I shall write more about on a future occasion.
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Still on the subject of the nose, one of the reasons that aromatherapy can be helpful, is because smell is unique amongst our senses, in that it is the only one that is not filtered by the thalamus. The regions of the brain that respond to smells are also directly related to some of the memory centers. The result is that smells can evoke memories extremely rapidly. You will probably have had the experience of smelling a perfume or cologne and instantly remembering someone who wore it in the past. This close linkage of smell and memory has enormous survival advantages: the smell of a predator can cause us to respond extremely rapidly. We can also use this knowledge to our advantage. Lavender has been used as a sleep aid for centuries. You can try putting a few drops of lavender oil on a cloth on your night-stand. Or you can use an electric diffuser or aromatherapy lamp. When I was growing up, we grew lavender and would put sprigs of it in the bed linens. It certainly seemed to help.
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Some people have found that melatonin can be very helpful, and it is readily available. Discuss it with your health care provider.
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Here is an old trick from traditional Chinese medicine. If you cannot sleep, soak a washcloth in cold water, lie down and put it on your abdomen for about ten minutes. I was taught that this works by pulling excess energy out of your head and neck down into the abdomen. There’s not a shred of scientific evidence that the technique works, but it does surprisingly often.
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If people who are good at visualization, some have reported great success by creating a picture of a warm, calm and relaxing place. And not just a picture, but also a five senses experience. It has to be personal, and perhaps even a place to go back to on a regular basis. When I first learned to do hypnotherapy I was put into a light trance by one of my teachers. To this day, more than 25 years later I can still vividly recall the experience of being told that I was drowsing on a grassy knoll on a warm summer’s day on the Downs of Southern England, and actually feeling that I was there. I can still evoke the memory at will and I’ve made it more detailed over time. If you are a visualizer, try that.
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Another technique that I learned from an early teacher, is to review the day backwards. Remembering what you did immediately before going to bed, and before that and so on. A simpler and often effective technique is just to start slowly counting backwards from 100.
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Herbs: There are three that are widely used, and for which there is some research base. There is good evidence that the herb Valerian can induce drowsiness, and it is widely used – even by doctors – in France and Germany. An important point about valerian is that it is poorly absorbed and chemically and thermally unstable. So it needs to be kept cool, and used fairly soon after it is prepared. As with all herbs, Valerian has side effects and can interact with prescription medications and alcohol, so it really is essential to discuss its use with your health care provider. The same goes for the other two widely used herbs: Hops and Passionflower.
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There is some evidence, though it’s not that strong, that taking a combined calcium/magnesium supplement (500mg calcium and 250-500mg magnesium) an hour before bed helps some people.
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I recommend massaging your facial muscles before lying down to sleep. Not only does this reduce muscle tension, but also the face is covered in acupuncture points, and so that may be another reason why it can help.
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Do not read or watch television in bed, but listen to a little calming music before retiring.
I do hope that will help you in your discussions with your health care provider. And I am always interested in hearing other suggestions, particularly if there is some research to back them up.
Technorati tags: Insomnia, menopause, herbal medicine, sleep hygiene, insomnia remedies, women’s health
Brazilian Diet Pill
My colleagues over at the Psychiatric Resource Forum just got this FDA warning and asked me what I thought. I am reproducing in its entirety:
“MedWatch – The FDA Safety Information and Adverse Event Reporting Program The FDA warned consumers not to use two unapproved drug products that are being marketed as dietary supplements for weight loss. Emagrece Sim Dietary Supplement, also known as the Brazilian Diet Pill, and Herbathin Dietary Supplement may contain several active ingredients, including controlled substances, found in prescription drugs that could lead to serious side effects or injury. They contain chlordiazepoxide HCl (the active ingredient in Librium), and fluoxetine HCl (the active ingredient in Prozac). Emagrece Sim and Herbathin were also found to contain Fenproporex, a stimulant that is not approved for marketing in the United States. Consumers are advised not to use the Emagrece Sim and Herbathin products and to return them to the suppliers. There may be other manufacturers or suppliers of imported Emagrece Sim and Herbathin, and consumers should exercise caution in using any of these imported products.
Read the complete MedWatch 2006 Safety summary, by using the following link: FDA news release
My Comments: Sadly this sort of thing is not uncommon. An unknown but clinically significant proportion of the Ayurvedic and Chinese herbs that are imported into the United States and Europe contain steroids and other drugs. I once diagnosed two cases of Cushing’s syndrome that were the result of people taking imported Indian herbs. One of them was an Indian man who was referred for weakness of his proximal muscles, which prevented him from walking up the stairs. He also add other classic symptoms of Cushing’s syndrome: he had gained weight, particularly in the face and around the abdomen, he had high blood pressure and diabetes mellitus. The other had a less florid presentation. There have been quite a number of publications on the subject of adulteration of herbal remedies.
Several years ago I became involved in an investigation of some apparently miraculous cures of eczema with Chinese herbal remedies, and sadly some of these had also been adulterated with corticosteroids. This was a real shame, because some of the herbal remedies actually helped eczema even if they did not contain steroids. These cases are all the more sad, because there are also large numbers of companies that make Indian and Chinese herbs to the highest possible standards, yet the bad apples have put even these under scrutiny.
The message must be that just because something is natural does not guarantee that it is safe. I have said before, but it bears repeating that arsenic, deadly nightshade and hurricanes are all natural. It is essential to obtain any herbals from a reputable source and to ensure that your health care provider knows exactly what you are taking: apart form the topic of adulteration, there are hundreds of potential interactions between herbal and prescription medicines.
Within the last three months, I have written an educational program for professionals that explores these issues in considerable detail, and makes recommendations about reliable suppliers of herbs.
Technorati tags: brazilian diet, diet pills, herbal medicines
Appetite Suppression
Appetite is a complex phenomenon controlled by many neurochemical and hormonal signals, as well as psychological and social factors.
An article by a group of investigators lead by Gilles Mithieux from the French research body, INSERM, published in the journal Cell Metabolism, may explain why many people on high protein diets, like Atkins, report a reduction in their hunger pangs.
The study was done in rats that were fed a high protein diet. It was found that this diet increased the activity of genes involved in glucose production in the animals’ small intestine. This increased glucose production was sensed by the liver and then chemical signals were relayed to the brain indicating that the stomach was full, and thus causing the animals to reduce their food intake.
Previous research has indicated that high protein diets do not seem to do anything magical to metabolism, but may work by reducing the overall intake of calories. The same effect on intestinal glucose production can be achieved with a low carbohydrate diet, showing us that both types of diet are probably working by the same mechanism. There are some interesting points here:
1. This study re-affirms the importance of calorie reduction as the key to weight loss, and it answers the “how” question: how do some of these diets work?
2. It illustrates something that is not widely known: glucose is produced in many parts of the body and glucose is a key regulator of appetite. The vast majority of the glucose circulating in your blood has come from the liver, and not directly from what you eat. It is only if you soak yourself in simple carbohydrates, as might happen if you drink something containing a lot of sugar, that your blood glucose may rise. But in most people who have healthy metabolism, the body rapidly corrects the elevated glucose.
3. The types of genes being stimulated to work in the intestine cannot be stimulated indefinitely. Eventually they will stop responding. You can only fool the body for a limited amount of time. That would explain why so many people who lose a lot of weight on one of the popular diets, find that the weight does not stay off. The lesson must be to make small but significant dietary changes, with the emphasis on keeping your food intake balanced. (You might like to have another look at my entry from January 6th)
Technorati tags: appetite, diet, high-protein
