Favorite
Five Articles from Recent Medical Journals
Swine
Flu Alert: Do Not Take Aspirin or Other NSAIDs
Two
letters to the editor in the June 17, 2009 issue of the
British Medical Journal warned of an increased risk of
death with influenza from taking non-steroidal
anti-inflammatory drugs (NSAIDs), which include aspirin (Bufferin,
Bayer, Excedrin), ibuprofen (Advil, Motrin, Nuprin),
ketoprofen (Actron, Orudis), and naproxen (Aleve). Death
from influenza is from multi-organ failure (liver and kidney
failure) and brain involvement (encephalopathy). In the
first letter, Rokuro Hama, points out NSAIDs are well known
to aggravate organ failure and there is evidence that the
restriction of use of these medications is associated with a
reduction of death from the flu.1 In the second
letter, Tsunetoshi Shimazu, reminds the reader that during
the 18 months of the 1918-9 influenza pandemic, 27 million
people
died
worldwide.2 When treated with a homoeopathic
medicine (without aspirin),
mortality
was 1% or less, but 5-30% of patients
treated with aspirin in hospitals or in the
armed forces died.
Comment:
I have always recommended (and personally used) aspirin
during bouts of influenza for symptom relief (fever, chills,
body aches, and headaches.). However, with the appearance
of more virulent viral strains, such as the swine flu, which
in many ways resembles the flu of 1918, I am changing my
recommendation.* Do Not Use NSAIDs (including aspirin)
with influenza infections. For three decades doctors have
known that when aspirin is given to children with viral
infections they have an increased chance of developing an
often-fatal condition of multi-organ failure called Reyes
Syndrome. (I saw two young boys die from this condition
during my early training.) With the restriction of aspirin
use in children, Reyes Syndrome has become very rare.
So, what
can be done for the flu? Not much. I hesitate to recommend
any medications because they all have side effects and
risks. Tylenol (acetaminophen) is likely the safest symptom
reliever, but this medication is also not without risks.
The safest advice would be to suffer through the flu rather
than risk the medications. Antibiotics do not fight off
viruses and should not be given unless there are
bacteria-caused complications. Antiviral drugs, such as
Tamiflu and Relenza, are of limited value because resistance
has developed to them. The body has many ways of fighting
off the invading viruses and repairing damage on its own.
“Fluids and food” as needed is my conservative advice. Your
thirst drive and appetite will take proper care of your
needs. If you become very ill you will need medical care.
Advice on preventing infection is offered in my May 2009
newsletter.
A healthy
person will be much more likely to survive the flu than
someone burdened with chronic illnesses, like obesity, heart
failure, and diabetes. So now is the time to prepare for
your future and the future of your family. Get as much
health stored up as you can by following a starch-based
diet, moderately exercising, and getting adequate sunshine.
* I
reserve the right to change my recommendations on any drug
or surgical therapy, because the “facts” are always changing
and the limited data available on these treatments are
heavily tainted by money from special interests. However,
you will never find me changing my recommendations on diet,
exercise, sunshine, clean air, clean water, and rest.
1) Hama R.
NSAIDs and flu. BMJ. 2009 Jun 15;338:b2345.
2) Shimazu
T. Aspirin in the 1918 pandemic. BMJ. 2009 Jun
15;338:b2398.
Red Yeast
Rice Is an Alternative to Statins for Cholesterol-Lowering
Red yeast
rice for dyslipidemia in statin-intolerant patients: a
randomized trial
by David
J. Becker published in June 2009 issue of the Annals of
Internal Medicine found, “Red yeast rice and therapeutic
lifestyle change decrease LDL cholesterol level without
increasing CPK or pain levels and may be a treatment option
for dyslipidemic patients who cannot tolerate statin
therapy.”1 In this study, 62 patients with
elevated cholesterol and a history of discontinuing statin
therapy because of muscle pains (myalgias) were assigned to
receive red yeast rice, 1800 mg, or placebo, twice daily for
24 weeks. All patients were also enrolled in a 12-week
therapeutic lifestyle change program. In the red yeast rice
group, the total cholesterol decreased from 245 mg/dL to 209
/dL and LDL “bad” cholesterol decreased from 163 mg/dL to
128 mg/dL in 24 weeks. In the placebo group the change was
less (246 to 230 mg/dL and 165 to 150 mg/dL, respectively).
There were no adverse effects, such as a rise in liver or
muscle enzymes (CPK) indicating tissue damage, and no
increase in muscle pain with the red yeast rice regime
compared to placebo. Due to the diet and exercise program
both groups attained and maintained a weight loss of about 8
pounds (3.6 Kg) over 24 weeks.
Comment:
Red yeast rice is the product of a yeast (Monascus
purpureus) grown on rice, which contains several active
compounds. One of these, monacolin K, is a potent inhibitor
of cholesterol synthesis in the liver, and is also known as
mevinolin or the prescription drug, lovastatin (Mevacor®).
One month’s supply of red yeast rice (1800 mg twice daily)
can cost $20 to $30.
The
Mediterranean style diet taught to both groups lowered the
cholesterol by an average of 16 mg/dL in the placebo group.
Therefore, the red yeast rice caused an additional reduction
of 20 mg/dL in 24 weeks (total reduction of 36 mg/dL with
diet and drug). The amount of active ingredient in the red
yeast rice was equivalent to 6 mg of lovastatin.1
The usual dose of lovastatin prescribed by physicians is 20
to 40 mg. This study confirms what other studies have
shown; red yeast rice is an effective cholesterol-lowering
medication.
The unique
finding in this study was that red yeast rice did not cause
adverse effects in patients who had previously stopped
taking a statin because of adverse effects, including muscle
pains. In general practice, about 10% of patients stop
taking this kind of medication because of muscle pain. More
severe muscle inflammation (called myositis) occurs in 1% to
5% of people on these medications. The more potent the
statin, the greater the risk of muscle damage. A recent
study, using an electron microscope and biochemical tests,
examined the muscle tissues of patients on statins, and
found evidence of muscle cell damage in over 70% of people
on statins, even when they had no complaints of muscle pain.2
One
important conclusion of this study in which 31 people took
red yeast rice, is that it is effective and safe. The
effectiveness is clear, but the proof for safety is not
unquestionable. The number of people tested was small and
so was the dosage of medication used (6 mg vs. 20 to 40 mg
of lovastatin). There have been previous reports of severe
muscle and liver damage with the use of red yeast rice.1
Therefore, you should not believe that this “natural”
product is without risk, but it may be an alternative for
people reacting adversely to prescription medication and who
do need treatment.
One recent
study of a partially purified extract of red yeast rice on
Chinese patients who had suffered a previous heart attack
showed an absolute 4.7% reduction in nonfatal heart attacks
and death from coronary heart disease compared to placebo.3
The effects of very powerful doctor-prescribed statins (Mevacor,
Zocor, Lipitor, and Crestor) have been tested in thousands
of people and the general finding is that the benefits are
primarily limited to people with a high risk of future heart
attacks or stroke.4,5 People who are otherwise
healthy do not significantly benefit from these medications,
but still do suffer the usual side effects and costs from
statins. Cholesterol-lowering medications must be taken for
years and many times for life; when statins, even red yeast
rice, are stopped the cholesterol quickly rises to
pretreatment levels (unless the patient has changed their
diet since starting the medication).
Red yeast
rice is effective and appears to be better tolerated by some
patients than doctor-prescribed statins. But it is not
necessarily cheaper. Prescriptions are often covered by
insurance, and at Walmart a 30-day supply of lovastatin (10
and 20 mg) or pravastatin (10, 20, and 40 mg) can be
purchased for $4; compared to $20 to $30 for a month’s
supply of much less potent red yeast rice. In favor of red
yeast rice, prescriptions require your time and money for a
doctor’s visit.
Like other
cholesterol-lowering statins, use should be limited to those
likely to attain more good than harm—and these are people at
high risk of a future vascular tragedy (for example,
people with a previous history of a heart attack,
angioplasty, bypass surgery, TIA, or a stroke).
Sufficient amounts of cholesterol-lowering medication should
be taken in order to reduce the blood cholesterol level to
below 150 mg/dL. The reason for a goal of 150 mg/dL or less
is that this level is associated with a low risk of vascular
disease and a very good chance of healing the arteries. If
side effects, like muscle pain, occur, then the medication
should be stopped immediately (under doctor’s supervision).
Above all, medication should not be considered as a
replacement to correcting the underlying cause of the
problem—in this case, the rich Western diet causes artery
disease (atherosclerosis).
1) Becker
DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ.
Red yeast rice for dyslipidemia in statin-intolerant
patients: a randomized trial. Ann Intern Med. 2009
Jun 16;150(12):830-9, W147-9.
2) Draeger
A, Monastyrskaya K, Mohaupt M, Hoppeler H, Savolainen H,
Allemann C, Babiychuk EB. Statin therapy induces
ultrastructural damage in skeletal muscle in patients
without myalgia. J Pathol. 2006 Sep;210(1):94-102.
3) Lu Z,
Kou W, Du B, Wu Y, Zhao S, Brusco OA, Morgan JM, Capuzzi DM;
Chinese Coronary Secondary Prevention Study Group, Li S.
Effect of Xuezhikang, an extract from red yeast Chinese
rice, on coronary events in a Chinese population with
previous myocardial infarction. Am J Cardiol. 2008
Jun 15;101(12):1689-93.
4)
Abramson J, Wright JM. Are lipid-lowering guidelines
evidence-based? Lancet. 2007 Jan 20;369(9557):168-9.
5)
Kendrick M. Should women be offered cholesterol lowering
drugs to prevent cardiovascular disease? No. BMJ.
2007 May 12;334(7601):983.
Meat Kills
People and Planet Earth
Meat
intake and mortality: a prospective study of over half a
million people
by Sinha Rashmi in the March 23, 2009 issue of the
Archives of Internal Medicine reported that, “Red and
processed meat intakes were associated with modest increases
in total mortality, cancer mortality, and cardiovascular
disease mortality,” after studying the illnesses of a half
million people aged 50 to 71 years and their diets based on
a food frequency questionnaire.1 The authors
postulated several mechanisms for the harms from red and
processed meat. In relation to cancer, meat is a source of
cancer causing chemicals (carcinogens), and a major source
of saturated fat, which has been positively associated with
breast and colorectal cancer. In relation to heart attacks
and strokes, red and processed meat are causally related to
elevated blood pressure, cholesterol, artery disease, and a
tendency to form blood clots.
An
accompanying editorial, Reducing meat consumption has
multiple benefits for the world's health, by Barry M.
Popkin, who identifies himself as “not a vegetarian,” went
much further.2 He points out the catastrophic
effects of meat consumption on people all over the world and
to the planet Earth. China, India, and Brazil are rapidly
increasing their intake of animal-foods, more than doubling
consumption between 2000 and 2005. The result is a rising
price of food and particularly the cost of
population-sustaining starches (rice, corn and wheat).
Livestock production has placed great demands on water
resources and creates 18% of our greenhouse gasses. The
polluting effects of animal foods are earthshaking: “In the
United States, livestock production accounts for 55% of the
erosion process, 37% of pesticides applied, 50% of
antibiotics consumed, and a third of total discharge of
nitrogen and phosphorus to surface water.” His
recommendations are: Elimination of the current system of
subsidies (for animal foods) and major investments in
healthier legumes, vegetables, and other selected crops are
needed to undo these massive distortions…pricing all
petroleum products at much higher levels, removing all
subsidies from them, and considering water and energy use in
taxation and subsidy policies…(And for doctors) Primarily,
they have the role of advising their clients to consume
small to moderate amounts of red meat and processed meats as
a way to reduce the risk of a large number of chronic
diseases.
Comment:
If he knows all these facts, why is Barry Popkin not a
vegetarian? Why does he recommend that doctors keep
prescribing small amounts of poisonous food to people? Is he
embarrassed to be a vegetarian? Does he want to appear
sensible, not radical, professionally proper, and
politically correct? He seems unwilling to stand up for what
he obviously knows to be right. This is no time to act
meek.
This
article and the accompanying editorial made worldwide
headlines and hopefully will make a major contribution to
people’s health and to saving our planet. Two decades ago
almost no one understood the damaging role that meat played.
Now most people are aware. The US government has finally
recognized the importance of global warming and has begun
serious discussions about removing subsidies and changing
tax policies that favor the polluters. Healthcare is
currently one of the hottest political topics in the US—I
predict the insurance and pharmaceutical companies will be
the big losers—and we will be the winners. Hopefully, Mr.
Obama will find my recommendations from my
November 2008 Newsletter worthwhile:
1)
Identify the livestock and processed food industries as the
major cause of death and disability in the US.
2) Levy
taxes on health-damaging foods.
3) Require
product-warning labels on meat, dairy and other hazardous
foods, like the warnings that are now on tobacco products.
“Meat Pollutes Streams, Rivers, and Oceans” and “Cheese
Causes Heart Disease.”
4) Educate
doctors and dietitians about diet-therapy, and how to take
people off medications.
5) Require
all hospitals to serve healthful foods.
6) Allow
lawsuits to go forward against food industries.
7) Require
the meals served to the military, schools, and all
government subsidized programs to be starch-based.
8) Require
the treatments provided under the new government insurance
plan be proved effective and safe. (Overnight, this act will
stop most heart surgeries and aggressive diabetic treatments
for type-2 diabetics.)
9) Require
diet-therapy to be the first line of therapy for all dietary
diseases (heart disease, diabetes, arthritis, multiple
sclerosis, indigestion, constipation, etc.)
10) Launch
a massive advertising campaign on the truth about food,
drugs, and devices to counteract the years of lies taught to
us by industry.
1) Sinha
R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A. Meat
intake and mortality: a prospective study of over half a
million people. Arch Intern Med. 2009 Mar
23;169(6):562-71.
2) Popkin
BM. Reducing meat consumption has multiple benefits for the
world's health. Arch Intern Med. 2009 Mar
23;169(6):543-5.
Fish Is
Not Brain Food
Dietary
intake of fish and omega-3 fatty acids in relation to
long-term dementia risk
by Elizabeth E Devore published in the July 2009 issue of
the American Journal of Clinical Nutrition found, “In
this Dutch cohort, who had a moderate consumption of fish
and omega-3 PUFAs, these dietary factors do not appear to be
associated with long-term dementia risk.”1 This
study of 5395 people, 55 years of age or older, for 10
years, found people who never ate fish had a similar risk of
developing dementia, including Alzheimer’s Disease, as those
people who had a high fish intake (on average, one
ounce—29.6 grams—daily). In the same issue of this journal,
researchers reported on the findings of the Canadian Study
of Health and Aging.2 Blood samples of a
population of 642 people were analyzed for substances found
in fish: total n-3 PUFAs, docosahexaenoic acid (DHA),
eicosapentaenoic acid (EPA), and mercury. The results were
then compared with the incidence of dementia and Alzheimer
disease. No associations between n-3 PUFAs and dementia or
AD were found.
A
disturbing report was released on June 17, 2009: Bovine
Spongiform Encephalopathy and Aquaculture by Robert P.
Friedland published in the Journal of Alzheimer’s Disease.3
Scraps from slaughterhouses are used as food in the fish
farming industries, and the authors of this report are
concerned that consumption of farmed fish may provide a
means of transmission of infectious prions from cows with
bovine spongiform encephalopathy to humans, causing variant
Creutzfeldt Jakob disease—commonly known as “mad cow
disease.” These scientists urged government regulators to
ban feeding cow meat or bone meal to fish until the safety
of this common practice can be confirmed. The publication of
this important news comes before a new FDA rule that would
block the feeding of rendered cows to certain animals, but
not fish.
Comment:
Fish is not health food. The truth is fish is an animal
muscle made up primarily of proteins and fats, with no
carbohydrates or dietary fibers—fish muscles are
nutritionally just like the muscles of cows and chickens.
They are all loaded with cholesterol and chemical
contaminants, and deficient in vitamin C. Fish-fat easily
accumulates in the human buttocks, thighs, and abdomen,
leading to obesity and type-2 diabetes. All that excess
animal protein will cause bone loss (osteoporosis), and the
pharmacological activity of the fats (omega-3) will suppress
the immune system (cancer and infection) and cause
bleeding.
Fostering
the myth that fish is a miracle food is a slogan many of us
grew up with, “better living through chemistry.” In the case
of fish, the miracle chemical is omega-3 fatty acids, which
have been advertised to prevent and treat diseases ranging
from Alzheimer’s disease to strokes. The most thorough
review ever conducted (48 randomized controlled studies of
36,913 subjects) of fish and omega 3 fats on health was
published in the April 2009 issue of the British Medical
Journal and the authors reported, “Long chain and
shorter chain omega 3 fats do not have a clear effect on
total mortality, combined cardiovascular events, or cancer.”4
Other research explains the origin of the felonious belief
that fish is health food: people who choose fish are the
same people who choose an overall healthier diet,
consciously avoiding coronary-artery-damaging saturated
fats—eating the fish does not prevent heart attacks, it is
the not eating beef, chicken, and cheese that saves lives.5
The
erroneous belief that these magnificent swimming animals
will improve the health of people is at the root of the
decimation of our oceans. People are eating more food from
the sea every year and the result is industrial fishing has
depleted the world’s fish stocks by 90% since the 1950s.6
I love the ocean and am saddened by this loss. Fortunately,
I am not demented (from lack of fish consumption) and
neither are you. We can stop this runaway destruction of
planet Earth and return health to its entire species—but we
must act quickly. One major step is to reintroduce the
natural human diet of starches to people. If you want to
know more about this one big simple solution then read the
first chapter of my new book,
The Starch Solution (to be published in about a
year).
1) Devore
EE, Grodstein F, van Rooij FJ, Hofman A, Rosner B, Stampfer
MJ, Witteman JC, Breteler MM. Dietary intake of fish and
omega-3 fatty acids in relation to long-term dementia risk.
Am J Clin Nutr. 2009 Jul;90(1):170-6.
2) Kröger
E, Verreault R, Carmichael PH, Lindsay J, Julien P, Dewailly
E, Ayotte P, Laurin D. Omega-3 fatty acids and risk of
dementia: the Canadian Study of Health and Aging. Am J
Clin Nutr. 2009 Jul;90(1):184-92.
3)
Friedland RP, Petersen RB, Rubenstein R. Bovine Spongiform
Encephalopathy and Aquaculture. J Alzheimers Dis.
2009 Mar 6. [Epub ahead of print]
4) Hooper
L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore
HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE,
Riemersma RA, Ebrahim SB, Davey Smith G. Risks and benefits
of omega 3 fats for mortality, cardiovascular disease, and
cancer: systematic review.
BMJ.
2006 Apr 1;332(7544):752-60.
5) Cundiff
DK, Lanou AJ, Nigg CR. Relation of omega-3 Fatty Acid intake
to other dietary factors known to reduce coronary heart
disease risk. Am J Cardiol. 2007 May 1;99(9):1230-3.
6) Myers
RA, Worm B. Rapid worldwide depletion of predatory fish
communities. Nature. 2003 May 15;423(6937):280-3.
A Vegan
(No Milk) Diet Is Healthy for Bones
Veganism,
bone mineral density, and body composition: a study in
Buddhist nuns
by L.T.
Ho-Pham published in the April 2009 issue of the journal
Osteoporosis International found, “…although vegans have
much lower intakes of dietary calcium and protein than
omnivores, veganism does not have (an) adverse effect on
bone mineral density and does not alter body composition.”
This study examined 105 postmenopausal Mahayana Buddhist
nuns, and compared them to 105 omnivorous women (average age
of women in both groups was 62 years-old). The nuns were
randomly sampled from monasteries in Ho Chi Minh City,
Vietnam; they had been on a vegan diet, on average, for 33
years. The density of the nuns’ lumbar spine and femoral
neck (hip) bones were found to be similar to those of the
animal-food-eating women (omnivores).
The
animal-food-eating women consumed twice the calcium as the
nuns (682 vs. 330 mg/day). Total protein intake was twice as
great in the animal-food-eaters (62.6 vs. 35.4 grams/day),
and they ate 17 times more animal protein (34.6 vs. 2.1
grams/day). There was no significant difference in weight,
height, body mass index, or exercise between the two
groups. However, the nuns went through menopause almost 2
years earlier (47.8 vs. 49.6 years). Most important, but not
commented on by the authors, was the finding that the
animal-food-eating women consumed far more calories (1486
vs. 1130 Calories/day).
Comment:
The greater calorie intake of the
animal-food-eating women indicates they were much more
physically active and that extra activity alone should have
caused significantly greater bone mineral density than the
less active nuns. But that was not the case. The observation
that the bone density was equal in both groups is testimony
for the bone-building (bone-preserving) effects of a vegan
diet. The greater physical activity in the
animal-food-eating women partially compensated for the bone
losing effects of the animal protein in their diet.
Osteoporosis is primarily due to the rich Western diet.
Highly acidic proteins found in animal foods tear down the
skeleton over decades.
Bone loss
is reversible by fixing the cause. Everyone, and especially
people with osteoporosis and a lesser condition, osteopenia,
should eat a low-acid starch-based diet (with some
restriction on grains and legumes, which are slightly
acidic) and exercise. Focus on a diet plentiful in sweet
potatoes, potatoes, winter squashes, with the addition of
fruits and green and yellow vegetables. For more information
on
osteoporosis see my Hot Topics.
Ho-Pham
LT, Nguyen PL, Le TT, Doan TA, Tran NT, Le TA, Nguyen TV.
Veganism, bone mineral density, and body composition: a
study in Buddhist nuns. Osteoporos Int. 2009 Apr 7.
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