PCOS and Diet

January 25th, 2012

A recent study in the American Journal of Clinical Nutrition (Jan 2012) showed that women with PCOS who followed a higher protein diet (>40% of energy from protein), as opposed to women who consumed the “standard” amount of protein (<15% of energy from protein), were able to lose weight more effectively. The study also showed that the women on a higher protein diet were also able to maintain healthier blood sugar levels, even after adjusting for changes in weight.

This is the type of diet I’ve always emphasized with PCOS patients, and have found this to be one of the most effective means of helping these women lose weight. Clinically, I’ve also found that this diet is the single most important factor when it comes to controlling other PCOS-related symptoms, such as hirsutism and menstrual irregularities. In fact, most women are able to discontinue metformin and related prescription medications upon adhering to a higher protein diet. Other nutritional interventions (chromium, fiber, etc.) can also be incorporated, with the main emphasis being that of blood sugar control.

If you’re currently undergoing treatment with prescription interventions, and not responding well, don’t be discouraged. Seek out a practitioner who can guide you through a high protein diet, and offer some of the many other nutritional options that will be effective in the management of PCOS.

 

 

 

Dairy Officially Deemed Unhealthy

January 5th, 2012

The Harvard School of Public Health sent a strong message to the United States Department of Agriculture (USDA) and nutrition experts everywhere with the recent release of its “Healthy Eating Plate” food guide.  The university was responding to the USDA’s new MyPlate guide for healthy eating, which replaced the outdated and misguided food pyramid.

Harvard’s nutrition experts did not pull punches, declaring that the university’s food guide was based on sound nutrition research. The greatest evidence of its research focus is the absence of dairy products from the “Healthy Eating Plate” based on Harvard’s assessment that “…high intake can increase the risk of prostate cancer and possibly ovarian cancer.”  The Harvard experts also referred to the high levels of saturated fat in most dairy products and suggested that collards, bok choy, fortified soy milk, and baked beans are safer choices than dairy for obtaining calcium, as are high quality supplements.

In my practice, I try to emphasize to people how “duped” we’ve been by the dairy industry, and that dairy products aren’t indeed the most nutritious source of calcium, as we’ve been brainwashed to believe in our society. Of course, this report doesn’t mean that you should avoid dairy entirely, especially when you can acquire local or non-commercial organic sources. Mainly, the take-away message here is that both past and present food recommendations from the government have emphasized dairy as a requirement, and this is clearly not the case!

Drug Overdoses Responsible for More Deaths Than Car Accidents

December 20th, 2011

More Americans now die from drug overdoses than in car accidents, according to a new government report released Tuesday.

In 2008, poisoning deaths became the number one cause of accidental deaths in the United States and the leading cause of injury death in 30 states, according to the report from the U.S. Centers for Disease Control and Prevention. Ninety percent of these poisonings were linked to drugs, with a surge in deaths from prescription painkiller overdoses reported.

“During the past three decades, the number of drug poisoning deaths has increased sixfold, from about 6,000 deaths in 1980 to over 36,500 in 2008,” said report author Margaret Warner, an injury epidemiologist at CDC’s National Center for Health Statistics, who added that this trend is only expected to continue.

The authors of the report found a 90 percent increase in poisoning deaths since 1999, while deaths from car accidents have dropped 15 percent in the same period.

By 2008, nine out of every 10 poisoning deaths were due to drugs. In that year, some 77 percent of these deaths were unintentional, 13 percent were suicides and 9 percent were of undetermined intent, according to the report.

Over the last 10 years, these increases were seen among both men and women and in all age and race/ethnic groups, Warner said. In 2008, the highest rates were among males and those aged 45 to 54.

In 2008, more than 40 percent of poisoning deaths were due to opioid painkillers. That’s way up from 1999 when these drugs were involved in only 25 percent of these deaths, Warner said. “CDC has called this an epidemic,” she noted.

In 1999, there were 4,000 deaths related to painkillers, but by 2008 that number had tripled, to almost 15,000 deaths, according to the CDC.

These deaths also vary by state. Although it isn’t clear why drug deaths vary across the country, one reason might be the different laws states have for controlling the use of prescription painkillers, Warner said.

Deaths are an accurate way to get a handle on the size of the problem, because these are definitive data, Warner said.

Dr. Jeffrey Bernstein, medical director of the Florida Poison Information Center at the University of Miami Miller School of Medicine, said “we knew this was coming; it shouldn’t shock anybody. It’s disturbing though.”

More attention needs to be devoted to this problem, Bernstein noted. “It needs to be attacked from multiple angles and multiple levels in the way we have made headway in trauma,” he said.

“There are newer and better drugs and that’s great for treating people’s pain, but they come with a price,” Bernstein pointed out. “There is addiction and interactions with other drugs, and potential for overdose and misuse.”

The number of users and abusers of these drugs is much greater than those who die from them, Warner added. “This is the tip of the iceberg,” she said.

By 2010, 12 million Americans said they were using opioid painkillers without a prescription. In 2009, almost 500,000 emergency room visits were for abuse of these painkillers. This costs health insurance companies as much as $72 billion a year in direct costs, the CDC said in a November report.

Dr. Chris Jones, a CDC health scientist who was not involved in the latest report, said that deaths from opioid painkillers have “increased significantly over the last decade. We have also seen an increase in people who have nonfatal overdoses who are showing up in emergency departments.”

In fact, there was a 98 percent increase in emergency room visits due to these painkillers between 2004 and 2009, he said. These emergency room visits are greater than those seen for overdoses of heroin and cocaine, Jones added.

The dramatic increase in deaths and overdoses from prescription drugs is due to a vastly increased use of these drugs by doctors. “Between 1999 and 2010, the sales of these drugs increased fourfold,” he explained.

“Part of this is an attempt to better treat pain. As we have seen the medical use go up, we have also seen the abuse of these products go up,” Jones said.

This doesn’t have to be as widespread of a problem as it has become. There are plenty of alternative methods that can be used to reduce pain, including acupuncture, naturopathic manipulation, and nutritional/herbal interventions.  The data here is pretty clear-the use of prescription painkillers is seriously risky business, and puts you at a much higher risk for long-term complications, especially addiction.  Please consider all other options before agreeing to take painkillers, and consult with your local naturopathic physician for the appropriate guidance.

Rethinking the Risk of Low HDL

December 5th, 2011

Despite plenty of evidence that people with low levels of “good”cholesterol are more prone to heart attacks, a large new study suggests that the lacking lipid is not to blame.

The analysis of data on nearly 70,000 people in Denmark affirmed the link between low levels of high-density lipoprotein (HDL), the so-called “good” cholesterol, and raised heart attack risk in the general population. But in people with a gene mutation that lowers HDL, heart attack risk was not found to be higher at all.

“Association itself doesn’t mean causality,” said lead author Dr. Ruth Frikke-Schmidt, a consultant in the Department of Clinical Biochemistry at Rigshospitalet in Copenhagen.

The results, published in the Journal of Clinical Endocrinology and Metabolism, indicate that just having low HDL is not what raises the likelihood of a heart attack.

“People with low ‘good’ cholesterol also have a whole bunch of other factors that relate to heart disease,” said Dr. Christopher Cannon, professor of medicine at Harvard Medical School and editor of the American College of Cardiology’s website.

It’s difficult to study and isolate “good” cholesterol, added Cannon, who was not involved in the new study. People with low HDL often suffer from obesity, high blood pressure and diabetes and sometimes have higher levels of LDL, or “bad” cholesterol, he said.

To try to isolate the effects of HDL itself, Frikke-Schmidt and her colleagues focused on people with a well-known variant of a gene called LCAT, which lowers HDL levels and occurs in about four percent of the population.

The variant gene is used as a stand-in for low HDL, she noted, but people with the variant don’t necessarily have the other risk factors that usually affect HDL levels in the larger population.

In the new study, a 13 percent decrease in HDL relative to average levels in the population was linked to an 18 percent increase in heart attack risk — if the low HDL was not explained by a gene variant. For people with the variant gene, the same HDL reduction was not linked to any increased risk of heart attack.

The findings fit in with Frikke-Schmidt’s earlier research showing that two other genetic variants that lower “good” cholesterol levels are not associated with an increased risk of heart disease.

According to both Frikke-Schmidt and Cannon, the debate is particularly important, because there are currently drugs in trials that would raise “good” cholesterol.

If low HDL is not a cause of heart attacks, raising HDL may not be protective, they point out.

Ruling out low levels of “good” cholesterol, Frikke-Schmidt said the most likely cause of the increased risk is so-called remnant lipoproteins, which are like “bad” cholesterol and carry fats through the blood.

Until the real mechanisms are sorted out, Cannon said it’s still important for people to try and raise their “good” cholesterol by exercising and losing weight.

“Beyond that there are so many question marks,” he said. “We’re kind of in a wait and see mode.”

SOURCE: http://bit.ly/sWrkZo The Journal of Clinical Endocrinology and Metabolism, online November 16, 2011.

ADHD and Essential Fatty Acids

November 22nd, 2011

In an observational study involving 810 children between the ages of 5 and 12 years of age who were referred for medical advice for “attention deficit hyperactivity disorder” (ADHD), supplementation with a combination of omega-3 and omega-6 fatty acids in combination with zinc and magnesium for a period of 3 months was found to be reduce symptoms of ADHD, as assessed via the SNAP-IV, reduce emotional problems, and reduce problems falling asleep. The authors conclude, “…considering the behavioural benefit in combination with the low risk due to a good safety profile, the dietary supplementation with PUFA in combination with zinc and magnesium can be recommended,” to children labeled as having “ADHD.”

With ADHD, there are also more extensive testing options available to assess nutritional and neurotransmitter status, allowing for more specific treatment options, and ultimately not having to depend on pharmaceutical interventions. The bottom line is that many “alternative” treatment options have been proven effective in the management of ADHD, and that medications aren’t the only option out there.

Allergies-Understanding Causes and Risks

November 9th, 2011
The incidence of allergic rhinitis seems to be increasing every year, among both infants and adults. Most doctors will simply treat the symptoms, but it’s important to look more closely at some of the underlying causes, and how you can prevent allergies from affecting your quality of life.

Benefits of pets, siblings, and farms

To look at this question, researchers questioned 8,486 adults, aged 20 to 40, from 13 countries, about their childhoods and their current respiratory health. After nine years, the study participants completed these questionnaires again and also were asked whether and when they developed nasal allergies or hay fever.

After taking into account other things that may affect allergies, including family history of allergies and whether their parents smoked, the researchers identified several childhood factors linked with later developing allergies:

  • Contact with children, either siblings or in daycare, decreased the risk of developing allergies.
  • The more siblings a person had, the lower his or her likelihood of developing rhinitis.
  • Sharing a bedroom with an older sibling was protective against developing allergies.
  • Having pets in the home or living on a farm as a child significantly decreased the likelihood of developing allergies.
  • Having a mother who smoked while they were in utero and when they were a child increased allergy risk.
  • Women had fewer allergies than men as kids, but more allergies as adults.

The balance between clean and not-so-clean

Some of these results may be surprising because they suggest that childhood exposure to more “dirt and germs” can keep allergies at bay. On the other hand, other studies suggest that for children growing up in urban environments, being exposed to urban pests such as cockroaches may increase allergy and asthma risk. Read on for tips on finding the right “balance of clean” to keep your family healthy.

  • If your child has been begging for a pet, don’t let the “dirt and germ factor” dissuade you. Of course, only consider adding a pet to your family if you know you can care for it properly, and pick one that fits your lifestyle. For example, cats tend to be lower maintenance than dogs.
  • Periodically taking your child out to a farm to see where our food comes from is a terrific learning experience, and it may just offer the added benefit of reducing your child’s risk of developing allergies.
  • Some parents of kids who have to share bedrooms feel they aren’t giving their kids the best of everything. But having siblings share a bedroom may be one of the best ways to allergy-proof your little ones.
I also recommend blood testing to identify potential environmental and food allergies, as this can also help to narrow down treatment options, making it more likely that you’ll experience longer term relief from hay fever symptoms.

School Lunch Reform

November 2nd, 2011

This article discusses how corporations are willing to sell out the health of our kids for financial interests. “Food companies have spent more than 5.6 million so far lobbying against the proposed rules.” Really, food companies? I’m sure you can find other ways to make money without promoting obesity and illness-disgusting!

http://www.nytimes.com/2011/11/02/us/school-lunch-proposals-set-off-a-dispute.html?scp=1&sq=school%20lunch&st=cse

Vitamins and Death? Not So Fast . . .

October 25th, 2011
A lot of hype and negative press has been surrounding the recent study that demonstrated the supposed risks of taking supplements.  This is a reprint of an editorial written by Alan Gaby, M.D. that exposes the faults of this study, and why it should be taken with a grain of salt!
An observational study published in the Archives of Internal Medicine found that women using multivitamins or certain other common vitamin and mineral supplements had higher mortality risk over 22 years. However, while it achieved widespread media coverage, it did not provide any convincing evidence that nutritional supplements are harmful. Researchers calculated the mortality rates were by manipulating the data, and nothing in the study contradicts decades of controlled research showing healthful benefits of these vitamins and minerals.

What the study said

In this study, 38,772 women from Iowa, whose average age was 62 years, filled out questionnaires three times over an 18-year period regarding dietary supplement use.

After a total of 22 years, researchers followed up and report that the risk of dying from any cause appeared to be 6% higher among women who took a multivitamin supplement than among women who did not take a multivitamin. Additional supplemention with vitamin B6, folic acid, iron, magnesium, zinc, and copper was also said to be associated with increased mortality rates.

Two factors should be taken into consideration while interpreting these results, the method used for calculating the results and the type of study.

Interpreting mortality risk methodology

The media coverage did not note a potentially serious problem with this study: that researchers looked at “adjusted” mortality rates rather than actual mortality rates in the population of women who took supplements, adjusting for a wide range of factors including caloric intake, cigarette smoking, body mass index, blood pressure, educational level, diabetes, use of hormone-replacement therapy, physical activity, and intake of fruits and vegetables.

Studying health events to find patterns in a population (epidemiology) is a relatively inexact science, and it is quite possible that the assumptions upon which the researchers based their adjustments were not entirely correct. When they adjusted the data only for age and caloric intake, there was no statistically significant difference in mortality rate between supplement users and nonusers.

Observation only tells part of the story

The study was observational, meaning that while it might show a relationship between certain supplements and mortality, it does not provide evidence that one causes the other.

In observational studies, scientists correlate various lifestyle factors with health outcomes. Such studies help researchers develop hypotheses that can be investigated further, but the only type of study that can prove cause and effect is a randomized controlled trial, in which participants are randomly assigned to receive either a particular treatment or a placebo (an inert dummy pill) without knowing whether they are getting the treatment or not.

In the history of medical research, results of observational studies have sometimes eventually been contradicted by randomized controlled trials. In a famous example, numerous observational studies suggested that the use of hormone-replacement therapy by postmenopausal women prevents heart disease, but subsequent randomized controlled trials demonstrated that hormone-replacement therapy either has no effect or actually increases the risk of heart disease.

Should women stop taking supplements?

The new study does not negate previous research demonstrating that vitamins and minerals can have a wide range of health benefits. However, as with all substances that can affect your health, talk to your doctor about which dietary supplements are right for you.

(Arch Intern Med 2011;171:1625–33)

Anxiety, Cancer, and Music

October 10th, 2011

As some of you may know, I’m an avid music lover, so I’m always excited when I see research that confirms the therapeutic benefits of music.

A new Cochrane research review shows how music can reduce anxiety, and may also have positive effects on mood, pain and quality of life.

Evidence from 1,891 patients taking part in 30 trials was examined-13 of the trials involved trained music therapists, while the other 17 trials studied patients who listened to pre-recorded music. The results showed that in comparison to standard treatments, anxiety levels were significantly reduced by music, based on clinical anxiety scores. Music was also shown to have beneficial effects for patients with chronic pain-heart rate, respiratory rate and blood pressure saw smaller beneficial effects.

Lead researcher Joke Bradt of the Department of Creative Arts Therapies at Drexel University in Philadelphia, US., explained

“The evidence suggests that music interventions may be useful as a complementary treatment to people with cancer.

Music interventions provided by trained music therapists as well as listening to pre-recorded music both have shown positive outcomes in this review, but at this time there is not enough evidence to determine if one intervention is more effective than the other.”

Bradt continues

“It should be noted, however, that when patients can’t be blinded to an intervention, there is an opportunity for bias when they are asked to report on subjective measures like anxiety, pain mood and quality of life.”

While additional studies may be necessary to confirm some of these findings, I would emphasize incorporating some form of musical enjoyment into your daily routine, whether you’re sick or not!

Is Eating Healthy Really More Expensive?

September 27th, 2011

Time and again, I hear from patients that it’s too expensive to buy “healthy” food on a regular basis. It’s often this misconception that prevents them from following a healthy diet long-term, ultimately obstructing their ability to heal, or remain healthy. Some recent research has pretty much refuted the notion that eating healthy is more expensive than eating food that’s not so good for you-In fact, quite the contrary!

http://www.nytimes.com/2011/09/25/opinion/sunday/is-junk-food-really-cheaper.html?scp=5&sq=cheap%20food&st=cse