May 27, 2009
Research --
we are getting closer- one last committee has to give its approval - the VA research and development committee. If all goes well we will be able to begin recruitment this summer.
This is a from a physician colleague with MS who has noted the similarity between MS and other types of neuro-degenerative types of brain disorders. With his permission I've copied his correspondence below.
Re DIET and MS/ Other Neuro-degenerative Brain Diseases
Dear Dr. Wahls:
I was diagnosed with MS 14 years ago after having about 4 relapses over a 32 month period. These involved loss of sensation in my legs, forearms, hands, and the left side of my face. I also had patellar hyperreflexia, altered proprioception in my legs, and bladder spasticity. I was diagnosed by Dr. Doug Williams in Bristol, TN, after an MRI showed a lesion at T10 and an LP showed elevated monoclonal bands.
Doug told me about a friend’s father who had practiced OB/GYN until 65 years of age while having MS. Doug quoted him as saying “Stay away from doctors; they will kill you.” Doug said that he was very upset when his son became a neurologist. Doug told me that he was not very impressed with Beta-Seron and did not prescribe it for me. He said to stay away from steroids, since they seemed to worsen the long-term rate of relapses. He said to avoid getting overheated. Most important, he said to limit my total fat intake to 20 grams a day – he said that this treatment was recommended in England and France even though it was not recognized in the USA.
I have complied with his recommendation for a low-fat diet for the past 14 years. Initially I could find nothing in the adult neurology texts or the NMSS web site to support its use. I felt that this must be cutting edge research that had not had time to make it into the textbooks. I initially felt that it was unlikely that the diet would have much effect of the MS, but that at least it would be good for my heart, as shown by Dean Ornish, MD. After about 2 years without further relapses or progression I started searching for more information about dietary treatment of MS. I found a mention of using a low-fat diet in Menkes’ Textbook of Child Neurology, 2nd edition. It gave a reference for an article published in 1970 by Dr. Roy Swank “20 years on the low fat diet.”
This article reported on a group of patients who had been told to limit their saturated fat intake to less than 20 grams a day, starting in 1950. An initial attempt at having a control group failed because the patients would talk with each other about their results while in the waiting room waiting for appointments, and after less than a year all the patients had gone on the low-fat diet. Swank had to use historical controls – how the patients had been doing before starting the diet and how other MS patient typically progressed. He found that the relapse rate dropped from 1 a year to less than 0.1 yearly (a 90% reduction), and that the rate of progression slowed.
Swank continued his study until about 1984. Not all of his patients remained in compliance with the diet. Among those who had minimal disability at the start of the study, there was a 5% death rate from MS among those who remained compliant with the diet, while there was an 80% death rate among those who were noncompliant.
Studies that show a benefit from a low-fat diet include:
1. Swank, RL. Multiple Sclerosis: Fat-Oil Relationship. Nutrition 1991; 7:368-376
2. Nordvik, I, et al. Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand 2000; 102:143-149
3. Weinstock-Guttman, B, et al. Low fat dietary intervention with w-3 fatty acid supplementation in multiple sclerosis patients. J.plefa 2005; 73:397-404
Your results with diet and exercise are like those reported by Joan Seliger Sidney in J Clin Epidemiol 1994 47:953-954. She went from using a rolling walker to being able to cross country ski 15 km after strictly following the Kousmine Diet (virgin oils, organic wholegrains, fruit, vegetables, nuts).
Your diet is very similar to the one that I have been on for 14 years. Others who use a similar diet include Ann Romney and Montel Williams.
Other discussion of the diet for MS is given in The China Study by Colin Campbell, Diet for a New America by John Robbins, The McDougall Program by John McDougall MD, Taking Control of Multiple Sclerosis by George Jelinek MD, and The Multiple Sclerosis Diet Book by Roy Swank MD.
Web sites that include information about dietary therapy for MS include www.swankmsdiet.org, www.drmcdougall.com, and www.hacres.com.
Since starting a low fat diet for MS in 1995 I have had no further relapses or progression. I have not missed any work due to MS since I started the diet. I am a pediatrician in solo practice in Bristol, TN.
Good luck in getting your results publicized. The benefits of a low-fat diet have been hidden for way too long.
John Hovious, MD
John Hovious, MD
You are welcome to use this note on your blog.
Follow up message
I have included 3 articles from Swank; the 1991 article is the most complete report of his study, and the 2003 article gives a 50 year follow-up on several of his patients. The 2003 Weinstock-Guttman article is an early abstract of the article that came out in 2005; I think that it is easier to follow than the abstract in the 2005 article. The neuropsychology and the breakdown of the BBB articles both state that BBB breakdown occurs before demyelination, which goes against the autoimmune hypothesis. The adrenoleukodystrophy and the nervonic acid articles show some similarity between ALD and MS.
Wednesday, May 27, 2009
Saturday, May 9, 2009
Research opportunity.
May 6, 2009
If you are considering adopting any of the nutritional and or electrical therapy which I used so successfully I encourage you to visit my research opportunity page and participate in the on-line survey. Visit my webpage www.terrywahls.com and visit the research opportunity page. There you will find more information about the survey and a link to the survey itself.
Also my eBook and Food as Medicine lecture are one step closer to being available.
Watch my website fore details.
t
If you are considering adopting any of the nutritional and or electrical therapy which I used so successfully I encourage you to visit my research opportunity page and participate in the on-line survey. Visit my webpage www.terrywahls.com and visit the research opportunity page. There you will find more information about the survey and a link to the survey itself.
Also my eBook and Food as Medicine lecture are one step closer to being available.
Watch my website fore details.
t
Fixing Health Care the Right Way
h care the right way
Terry L. Wahls
Guest Opinion
As an internal medicine physician, I see it every day. Americans have serious chronic diseases and younger and younger ages. In our schools, we have ever higher rates of autism, severe behavior problems, obesity and pre-diabetes. The productivity of the American worker is falling because of declining worker health. Despite all the money spent on health care, we, and our children, are progressively less well. How did we get this way?
I think the explanation can be found in the corn fields of Iowa.
When you buy seed corn, all the kernels have essentially the same DNA -- this is the way farmers know what kind of crop to expect in the fall. Plant half of the bag of seed corn in black Iowa soil and the other half in a trash heap of clay, plastic debris and rock. Return in the fall. The black dirt corn will have a bumper crop. But the trash heap corn will be yellowed and sickly with no ears of corn at all. The same DNA was in both fields, but the black Iowa dirt was filled with the nutrients the corn's DNA needed. The trash heap lacked nutrients, and you can see the results.
All moving things, including our bodies, break down with time. Fortunately, our bodies have tiny little maintenance workers who are busy repairing all the little wear-and-tear damage that occurs each day. Our DNA provides the blueprint for all the proteins and other stuff that needs to be replaced. But if those little maintenance workers don't have all the building blocks, that is, the correct minerals, amino acids and omega 3 fatty acids, trouble happens. They can't make things according to the DNA blueprints. Those replacement molecules and structures get made not at all, or incorrectly, and we begin to deteriorate, developing chronic diseases like diabetes, high blood pressure, heart disease, arthritis, mood disorders and many others.
Thousands of years ago, our ancestors ate what they could find or catch -- mostly green leaves, fruit and some fish or meat. It was packed with the vitamins, minerals and omega 3 fatty acids that cells need to follow the DNA blueprint instructions. Each day, they easily ate nine cups of vegetables and fruit.
The standard American diet is very poor by comparison. Our children drink sugared beverages throughout the day. Rarely do they eat even one cup of vegetables or fruit with a meal. The adults do no better. Most Americans do not have the necessary building blocks to make the structures outlined by their DNA. Molecules don't get made, or they get made incorrectly. As a result our society gradually becomes stunted and sickly, filled with chronic diseases, just like the corn planted in the trash heap.
It will not matter how many trillions of dollars we spend on health care. The solution to our crushing health care costs is not free medicines or universal health care. It is better health and greater vitality. Unless we teach our nation, especially our children, the critical importance of vegetables and fruit to health and vitality, we as a nation are doomed to become more and more sickly and diseased.
Having America's athletic heroes, pop stars and politicians all proclaiming that eating six to nine cups of non-starchy vegetables and fruit each day is necessary to be cool, sexy, healthy and fully alive would be a powerful beginning to restoring America's health. If we don't collectively begin eating our spinach and kale, no matter how many trillions we spend, we as a nation will continue to be ever more sickly and diseased.
t
Terry L. Wahls
Guest Opinion
As an internal medicine physician, I see it every day. Americans have serious chronic diseases and younger and younger ages. In our schools, we have ever higher rates of autism, severe behavior problems, obesity and pre-diabetes. The productivity of the American worker is falling because of declining worker health. Despite all the money spent on health care, we, and our children, are progressively less well. How did we get this way?
I think the explanation can be found in the corn fields of Iowa.
When you buy seed corn, all the kernels have essentially the same DNA -- this is the way farmers know what kind of crop to expect in the fall. Plant half of the bag of seed corn in black Iowa soil and the other half in a trash heap of clay, plastic debris and rock. Return in the fall. The black dirt corn will have a bumper crop. But the trash heap corn will be yellowed and sickly with no ears of corn at all. The same DNA was in both fields, but the black Iowa dirt was filled with the nutrients the corn's DNA needed. The trash heap lacked nutrients, and you can see the results.
All moving things, including our bodies, break down with time. Fortunately, our bodies have tiny little maintenance workers who are busy repairing all the little wear-and-tear damage that occurs each day. Our DNA provides the blueprint for all the proteins and other stuff that needs to be replaced. But if those little maintenance workers don't have all the building blocks, that is, the correct minerals, amino acids and omega 3 fatty acids, trouble happens. They can't make things according to the DNA blueprints. Those replacement molecules and structures get made not at all, or incorrectly, and we begin to deteriorate, developing chronic diseases like diabetes, high blood pressure, heart disease, arthritis, mood disorders and many others.
Thousands of years ago, our ancestors ate what they could find or catch -- mostly green leaves, fruit and some fish or meat. It was packed with the vitamins, minerals and omega 3 fatty acids that cells need to follow the DNA blueprint instructions. Each day, they easily ate nine cups of vegetables and fruit.
The standard American diet is very poor by comparison. Our children drink sugared beverages throughout the day. Rarely do they eat even one cup of vegetables or fruit with a meal. The adults do no better. Most Americans do not have the necessary building blocks to make the structures outlined by their DNA. Molecules don't get made, or they get made incorrectly. As a result our society gradually becomes stunted and sickly, filled with chronic diseases, just like the corn planted in the trash heap.
It will not matter how many trillions of dollars we spend on health care. The solution to our crushing health care costs is not free medicines or universal health care. It is better health and greater vitality. Unless we teach our nation, especially our children, the critical importance of vegetables and fruit to health and vitality, we as a nation are doomed to become more and more sickly and diseased.
Having America's athletic heroes, pop stars and politicians all proclaiming that eating six to nine cups of non-starchy vegetables and fruit each day is necessary to be cool, sexy, healthy and fully alive would be a powerful beginning to restoring America's health. If we don't collectively begin eating our spinach and kale, no matter how many trillions we spend, we as a nation will continue to be ever more sickly and diseased.
t
Book Update - the steps I took....
April 26, 2009
Book Update
I am working with my sound engineer to create a DVD which captures the audio and handouts for the food as medicine course which I've been teaching this winter and spring. Hopefully I'll be able to get that finished and available by the end of May. I am also working with my editor to have an electronic copy of my book which talks in more detail about my interventions, and the theories I have about why they have been so successful for me. The target is to have the ebook with the DVD available yet this spring, but of course things never go quite as smoothly we expect.
Book Update
I am working with my sound engineer to create a DVD which captures the audio and handouts for the food as medicine course which I've been teaching this winter and spring. Hopefully I'll be able to get that finished and available by the end of May. I am also working with my editor to have an electronic copy of my book which talks in more detail about my interventions, and the theories I have about why they have been so successful for me. The target is to have the ebook with the DVD available yet this spring, but of course things never go quite as smoothly we expect.
Vitamin B12
The B12 article below was taken from Dr. Nancy Lonsdorf's web page. She practices integrative medicine in Fairfield, Iowa. B12 is an essential nutrient for making cell membranes and myelin. It is often low in those who have MS.
by Dr. Nancy Lonsdorf
Forgetting names lately? Battling brain fog? Lost your "edge?" Don't write it off to just "getting older." It could be something as simple—and curable—as vitamin B12 deficiency.
Once thought to occur only in vegetarians or the elderly, suboptimal B12 levels are found in nearly 40 percent of Americans of all ages, according to the recent Framingham Offspring Study. That puts virtually everyone at risk.
What Does B12 Do?
Known as the "energy vitamin," vitamin B12 is essential for many critical functions in the body, including energy production, DNA synthesis, and blood formation. However, B12 is most critically needed to form myelin, the protective "insulation" that surrounds nerve endings and helps nerves "talk" to each other efficiently.
Without adequate B12, myelin can break down and cause symptoms that mimic multiple sclerosis, depression, or dementia. Other common symptoms include poor memory and mental fogginess, loss of motivation, apathy, mood swings, low energy, fatigue, muscle weakness, soreness or redness of the tongue, tingling, numbness or crawling sensations in the arms, legs, or feet, lack of coordination, and hair loss.
Here are several real-life cases of B12 deficiency—out of several dozen—that I have treated in the past few years:
• Suzanne is a 57-year-old teacher who came to me worried that she was developing multiple sclerosis like her brother. She was experiencing "cramps" in her legs, along with numbness in her hands and feet while walking. Fortunately, low B12 was the cause and her symptoms disappeared within three months of starting B12 supplements.
• Bruce, a 52-year-old broker, had tried "everything" for his recalcitrant depression. His B12 tested low, and within days of beginning B12 supplements, his mood improved dramatically.
• Rob, a usually tireless globe-trotting reporter, felt unusually fatigued after completing a big project. He also felt uncharacteristically lacking in motivation. A B12 test showed a level of nearly zero. Within a few weeks of supplementation, his usual drive and energy returned.
Are You B12 Deficient?
Anyone can have B12 deficiency. The Framingham study found that taking supplements, eating fortified cereal, or drinking milk helps protect against deficiency, but interestingly, meat consumption does not. In my clinical practice, I find that many vegetarians who get plenty of milk and dairy still have low B12, so lacto-vegetarians should not feel they are protected.
If you are over 50, mainly vegetarian, have digestive problems, do not take vitamin supplements or eat fortified cereal containing B12 regularly, or you take 500 mg or more of vitamin C with your food daily (which blocks B12 absorption), you are at increased risk of B12 deficiency.
The best way to find out is to ask your doctor for a B12 blood test. Experts give various opinions on the "gold standard" test, but a simple B12 blood level will do.
Do keep in mind (and challenge your doctor if needed) that the low "normal" limit of about 200 pg/ml is not enough. Levels below 300 double your risk of Alzheimer's disease and increase your risk of hearing loss with age. Children and teenagers with low B12 are at risk for reduced learning ability and intelligence. Your B12 level should be above 350 or 400 to be safe.
If you can't afford a test, and do not have symptoms, you may simply take a supplement of 100 to 500 mcg per day, but do it regularly for effective prevention.
How to Replenish Your B12
Vitamin B12 is found naturally only in animal products, including dairy, and in certain seaweeds, tempeh, and nutritional yeasts. However, B12 in non-animal products may not be active in the human body and may even block the effects of active vitamin B12, so it's safest not to rely on non-animal sources. Keep in mind that if you are deficient, it is not possible to correct it with food alone.
Fortunately, oral supplements are as effective for most people as getting shots. Methylcobalamin, the form naturally in your body, is preferable to the more prevalent cyanocobalamin tablets (which contain toxic cyanide, albeit in trace amounts). Over-the-counter B12 patches, sublingual tablets, and nasal sprays are available and may enhance absorption.
B12 deficiency is common today in all age groups, whether you are vegetarian or not. If you are at increased risk, take supplements regularly to prevent future health problems. If you have symptoms now, see your doctor for a check-up and blood test. B12 deficiency is preventable and treatable, and correcting a deficiency may be just what you need to perk up your memory, mood, and overall well-being.
Nancy Lonsdorf, M.D., practices Maharishi Ayurveda and integrative medicine for women in Maharishi Vedic City, IA. Call (641) 469-3174.
http://gesundheitsvorsorge.blog.de/2009/04/08/vitamin-b12-deficiency-5908794/
April 6, 2009
Research survey about nutrition and electrical stimulation
The survey is being modified based on your feedback. It is being split into two brief (10 to 15 minute) surveys. Once it is approved the new shorter survey will be available online. Typically such approvals may take a month to happen.
by Dr. Nancy Lonsdorf
Forgetting names lately? Battling brain fog? Lost your "edge?" Don't write it off to just "getting older." It could be something as simple—and curable—as vitamin B12 deficiency.
Once thought to occur only in vegetarians or the elderly, suboptimal B12 levels are found in nearly 40 percent of Americans of all ages, according to the recent Framingham Offspring Study. That puts virtually everyone at risk.
What Does B12 Do?
Known as the "energy vitamin," vitamin B12 is essential for many critical functions in the body, including energy production, DNA synthesis, and blood formation. However, B12 is most critically needed to form myelin, the protective "insulation" that surrounds nerve endings and helps nerves "talk" to each other efficiently.
Without adequate B12, myelin can break down and cause symptoms that mimic multiple sclerosis, depression, or dementia. Other common symptoms include poor memory and mental fogginess, loss of motivation, apathy, mood swings, low energy, fatigue, muscle weakness, soreness or redness of the tongue, tingling, numbness or crawling sensations in the arms, legs, or feet, lack of coordination, and hair loss.
Here are several real-life cases of B12 deficiency—out of several dozen—that I have treated in the past few years:
• Suzanne is a 57-year-old teacher who came to me worried that she was developing multiple sclerosis like her brother. She was experiencing "cramps" in her legs, along with numbness in her hands and feet while walking. Fortunately, low B12 was the cause and her symptoms disappeared within three months of starting B12 supplements.
• Bruce, a 52-year-old broker, had tried "everything" for his recalcitrant depression. His B12 tested low, and within days of beginning B12 supplements, his mood improved dramatically.
• Rob, a usually tireless globe-trotting reporter, felt unusually fatigued after completing a big project. He also felt uncharacteristically lacking in motivation. A B12 test showed a level of nearly zero. Within a few weeks of supplementation, his usual drive and energy returned.
Are You B12 Deficient?
Anyone can have B12 deficiency. The Framingham study found that taking supplements, eating fortified cereal, or drinking milk helps protect against deficiency, but interestingly, meat consumption does not. In my clinical practice, I find that many vegetarians who get plenty of milk and dairy still have low B12, so lacto-vegetarians should not feel they are protected.
If you are over 50, mainly vegetarian, have digestive problems, do not take vitamin supplements or eat fortified cereal containing B12 regularly, or you take 500 mg or more of vitamin C with your food daily (which blocks B12 absorption), you are at increased risk of B12 deficiency.
The best way to find out is to ask your doctor for a B12 blood test. Experts give various opinions on the "gold standard" test, but a simple B12 blood level will do.
Do keep in mind (and challenge your doctor if needed) that the low "normal" limit of about 200 pg/ml is not enough. Levels below 300 double your risk of Alzheimer's disease and increase your risk of hearing loss with age. Children and teenagers with low B12 are at risk for reduced learning ability and intelligence. Your B12 level should be above 350 or 400 to be safe.
If you can't afford a test, and do not have symptoms, you may simply take a supplement of 100 to 500 mcg per day, but do it regularly for effective prevention.
How to Replenish Your B12
Vitamin B12 is found naturally only in animal products, including dairy, and in certain seaweeds, tempeh, and nutritional yeasts. However, B12 in non-animal products may not be active in the human body and may even block the effects of active vitamin B12, so it's safest not to rely on non-animal sources. Keep in mind that if you are deficient, it is not possible to correct it with food alone.
Fortunately, oral supplements are as effective for most people as getting shots. Methylcobalamin, the form naturally in your body, is preferable to the more prevalent cyanocobalamin tablets (which contain toxic cyanide, albeit in trace amounts). Over-the-counter B12 patches, sublingual tablets, and nasal sprays are available and may enhance absorption.
B12 deficiency is common today in all age groups, whether you are vegetarian or not. If you are at increased risk, take supplements regularly to prevent future health problems. If you have symptoms now, see your doctor for a check-up and blood test. B12 deficiency is preventable and treatable, and correcting a deficiency may be just what you need to perk up your memory, mood, and overall well-being.
Nancy Lonsdorf, M.D., practices Maharishi Ayurveda and integrative medicine for women in Maharishi Vedic City, IA. Call (641) 469-3174.
http://gesundheitsvorsorge.blog.de/2009/04/08/vitamin-b12-deficiency-5908794/
April 6, 2009
Research survey about nutrition and electrical stimulation
The survey is being modified based on your feedback. It is being split into two brief (10 to 15 minute) surveys. Once it is approved the new shorter survey will be available online. Typically such approvals may take a month to happen.
Food versus supplements - why food is more important
April 6, 2009
200 grams of Broccoli spouts markedly improve mitochondrial function and reduce oxidative stress
I am often asked about what supplements provide the most protection against oxidative stress. It is my impression that food is much more important than the supplements. When I first started traveling again I noticed a big difference in my energy that was associated with what I was eating. I took my supplements ands my electrical stimulator with me, but I did not take all of my kale with me. What I noticed was an erosion of my energy and clarity of my thinking which quickly resolved when I returned home and ate 6 to 9 cups of kale each day.
A study conducted by David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and the Environmental Protection Agency (EPA) may explain why. They studied how sulforaphane (SFN) — a compound that is found in cruciferous vegetables and is especially high in broccoli sprouts affected the mitochondria and the cells lining the airways in the lung. This placebo-controlled clinical study demonstrated the positive effects of oral SFN administration on up-regulation of a variety of antioxidant enzymes. Inflammation caused during oxidative stress is seen in patients with multiple sclerosis.
Our Phase II enzymes are made in the mitochondria and are known to reduce oxidative stress. Animal studies had shown that SFN is a potent inducer of Phase II enzymes. “This study provides support for the concept that we can enhance the body's own natural antioxidant and cytoprotective mechanisms,” Because oxidative stress is a critical pathway in multiple sclerosis this may explain why I experience noticeably better energy and clarity in my thinking when I eat a lot of kale which is a cruciferous vegetable rich in SFN.
What is notable is that the researchers used a homogenate (food run through a blender) of broccoli sprouts to deliver the SFN. The doses that they used ranged from 25, 50, 75, 100, 125, 150, 175 and 200 grams once daily for three days. The control subjects received a placebo, alfalfa sprout homogenate, which is similar in taste and appearance but does not have high levels of SFN. There was no apparent toxicity in administering the broccoli sprouts orally, and it was well tolerated by the subjects. For comparison I weighed one cup of my finely shredded kale: 200 grams.
At doses of 100g daily, the broccoli sprouts induced expression of several important Phase II enzyme genes (glutathione s-transferase M1 (GSTM1), glutathione S-transferase P1 (GSTP1), heme-oxygenase-1 (HO-1) and NADPH quinone oxidoreductase 1 (NQO1) — in the cells. There was also a dose-dependent increase in the expression of the enzymes. The maximum BSH dosage of 200 grams generated a doubling of helpful 101 percent increase in GSTP1 and a 199 percent increase in NQO1. Expression of GSTM1 and HO-1 also increased by more than 100 percent at the maximum dosage. To get a comparison of how much kale this would be I weighed one cup of finely shredded kale that I eat. It weighed 180 grams. If you don’t mince the kale - and the cup is more loosely filled it is only 70 grams. Since I eat two platefuls of kale most days (6 cups), the amount that I’m eating is approximately over 1000 grams. If you compare the kale I eat each day then to taking 2 grams of N acetylcysteine (which is a sulfur containing amino acid that also increases the same enzymes) each day you can see why eating six cups of kale delivers more benefits to the function of our mitochondria than taking supplements.
Science needs to do our experiments compound by compound to improve our understanding of cellular physiology. The studies therefore typically talk about specific micronutrients. However when comparing eating a plateful of greens to taking the equivalent of 200 one gram capsules of a specific amino acid like N acetylcysteine you can see why eating the food is so much better. That is why I stress the importance of food: 9 cups of vegetables and fruits (3 cups of shredded kale, collards or other dark green leaves each day, 3 cups of bright colors and 3 more of your choice) each day.
If you don’t eat the food, taking anti-inflammatory and anti-oxidant supplements will have a relatively small effect on your health. Greatly reducing the carbohydrates, and maximizing the vegetables and fruits provides your cellular machinery the building blocks they need to make the necessary molecules, enzymes and neurotransmitters that your brains need.
Citation: Riedl MA, Saxon A, Diaz-Sanchez D. 2009. Oral sulforaphane increases Phase II antioxidant enzymes in the human upper airway. Clin. Immunol. 130(3):244-251.
(Shweta Trivedi, Ph.D., is a postdoctoral fellow in the Laboratory of Respiratory Biology Environmental Genetics Group.)
http://www.ncbi.nlm.nih.gov/pubmed/19028145?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
published in Clinical Immunolog.
T
200 grams of Broccoli spouts markedly improve mitochondrial function and reduce oxidative stress
I am often asked about what supplements provide the most protection against oxidative stress. It is my impression that food is much more important than the supplements. When I first started traveling again I noticed a big difference in my energy that was associated with what I was eating. I took my supplements ands my electrical stimulator with me, but I did not take all of my kale with me. What I noticed was an erosion of my energy and clarity of my thinking which quickly resolved when I returned home and ate 6 to 9 cups of kale each day.
A study conducted by David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and the Environmental Protection Agency (EPA) may explain why. They studied how sulforaphane (SFN) — a compound that is found in cruciferous vegetables and is especially high in broccoli sprouts affected the mitochondria and the cells lining the airways in the lung. This placebo-controlled clinical study demonstrated the positive effects of oral SFN administration on up-regulation of a variety of antioxidant enzymes. Inflammation caused during oxidative stress is seen in patients with multiple sclerosis.
Our Phase II enzymes are made in the mitochondria and are known to reduce oxidative stress. Animal studies had shown that SFN is a potent inducer of Phase II enzymes. “This study provides support for the concept that we can enhance the body's own natural antioxidant and cytoprotective mechanisms,” Because oxidative stress is a critical pathway in multiple sclerosis this may explain why I experience noticeably better energy and clarity in my thinking when I eat a lot of kale which is a cruciferous vegetable rich in SFN.
What is notable is that the researchers used a homogenate (food run through a blender) of broccoli sprouts to deliver the SFN. The doses that they used ranged from 25, 50, 75, 100, 125, 150, 175 and 200 grams once daily for three days. The control subjects received a placebo, alfalfa sprout homogenate, which is similar in taste and appearance but does not have high levels of SFN. There was no apparent toxicity in administering the broccoli sprouts orally, and it was well tolerated by the subjects. For comparison I weighed one cup of my finely shredded kale: 200 grams.
At doses of 100g daily, the broccoli sprouts induced expression of several important Phase II enzyme genes (glutathione s-transferase M1 (GSTM1), glutathione S-transferase P1 (GSTP1), heme-oxygenase-1 (HO-1) and NADPH quinone oxidoreductase 1 (NQO1) — in the cells. There was also a dose-dependent increase in the expression of the enzymes. The maximum BSH dosage of 200 grams generated a doubling of helpful 101 percent increase in GSTP1 and a 199 percent increase in NQO1. Expression of GSTM1 and HO-1 also increased by more than 100 percent at the maximum dosage. To get a comparison of how much kale this would be I weighed one cup of finely shredded kale that I eat. It weighed 180 grams. If you don’t mince the kale - and the cup is more loosely filled it is only 70 grams. Since I eat two platefuls of kale most days (6 cups), the amount that I’m eating is approximately over 1000 grams. If you compare the kale I eat each day then to taking 2 grams of N acetylcysteine (which is a sulfur containing amino acid that also increases the same enzymes) each day you can see why eating six cups of kale delivers more benefits to the function of our mitochondria than taking supplements.
Science needs to do our experiments compound by compound to improve our understanding of cellular physiology. The studies therefore typically talk about specific micronutrients. However when comparing eating a plateful of greens to taking the equivalent of 200 one gram capsules of a specific amino acid like N acetylcysteine you can see why eating the food is so much better. That is why I stress the importance of food: 9 cups of vegetables and fruits (3 cups of shredded kale, collards or other dark green leaves each day, 3 cups of bright colors and 3 more of your choice) each day.
If you don’t eat the food, taking anti-inflammatory and anti-oxidant supplements will have a relatively small effect on your health. Greatly reducing the carbohydrates, and maximizing the vegetables and fruits provides your cellular machinery the building blocks they need to make the necessary molecules, enzymes and neurotransmitters that your brains need.
Citation: Riedl MA, Saxon A, Diaz-Sanchez D. 2009. Oral sulforaphane increases Phase II antioxidant enzymes in the human upper airway. Clin. Immunol. 130(3):244-251.
(Shweta Trivedi, Ph.D., is a postdoctoral fellow in the Laboratory of Respiratory Biology Environmental Genetics Group.)
http://www.ncbi.nlm.nih.gov/pubmed/19028145?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
published in Clinical Immunolog.
T
Neuroelectrical stimulation of muscles
March 23, 2009
From my last post I have had several people contact me wondering if I am saying that electrical stimulation is not helpful and am actively discouraging its use. This is intended to clarify my thoughts.
Electrical stimulation has been shown to increase muscle mass in paralyzed individuals. Thus it is likely to be able to increase mass in people with MS. But I predict that stim alone will not be enough to restore walking. It is a long slow process to restore strength. The stim should help produce more muscle mass -- but without the exercise program the gait is less likely to return -
Application of both is likely to be the most beneficial -having a base of slowly growing the muscles should allow the gradual increase of volitional exercise. Having a PT can help identify which exercises to add to get the most benefit for the effort expended.
I don't know what happens with stim alone - there would be some rationale to think the biochemistry in the brain would be improved even without exercise -- but restoring more normal walking, sitting or other muscle functions probably requires exercise and re-education of the brain - muscle pathways.
Re the food/ micronutrient/ supplement questions
I can only report my observations on my own experience. Food - will have more micronutrient content than supplements alone -- But there may be benefits from targeted augmentation with supplements in addition to food - particularly if tailored to the individual based on medical family history etc.
Your observations about the dilemma for most who are struggling to get by is unfortunately too common - and I am sure makes it frustrating for anyone who is trying to regain their health.
Food alone -- won't solve MS - because it is multifactorial - with toxic exposures, micronutrient deficiencies, food allergies, genetic differences and infection exposures and current infections all adding up to each person's unique experience with the disease. That makes providing and finding a generalizable solution so elusive. Finding out what are you own contributions to the disease state -- requires finding someone who can unpeel the onion of all these factors.
From my own experience -- very few physicians understand this -- and I am unraveling the onion slowly myself. An organization -- institute for functional medicine has international membership of physicians and other health professionals who view chronic disease including MS through this lens. Going to there web site - you can find the pages for providers and look under the international provider listings to find someone who does.
Unfortunately I don't have many answers - only questions and my personal observations/ experiences which may or may not be generalizable to others -- I wish that I did -- and I wish that we'd get the study approved so that we could begin accumulating experience with others.
March 22, 2009
Powdered Greens, Wheat Grass and Gluten Sensitivity
For two months I believed that I was experiencing a decline in my back strength and stamina despite continued exercise, NMES and intensive nutrition. I had been using KYOGREEN to provide additional green intake during the day for the prior six months.
I had presumed that wheat grass would not have significant levels of gliadin or gluten, particularly since acutely I believed the Kyogreen improved my energy while traveling.
I have since discontinued the KYOGREEN, and have made no other changes in my routines. Now after three weeks without the KYOGREEN my stamina, and strength are back on the rebound.
I’ve decided to use my Vitamix to create my own green beverages to have at work instead of using the instant greens. I’ve been rotation between blending cilantro, parsley or kale with water and ice. It’s worked well for me. I have more energy immediately following the glass of greens. And my energy levels are better off the wheat grass.
My conclusion is that the cereal grasses likely contain the same antigens as the grain. If you have food sensitivity to gluten, likely you’ll have sensitivity to the wheat and other cereal grasses as well.
I think greens are still incredibly good for us. But it is likely preferable make your own green beverage using a blender and greens leafs that you know you can tolerate. Its a great energy boost to one's day.
tw
March 20, 2009
Home exercise program is superior to electrical stimulation.
An article on the use of functional electrical stimulation in the setting of secondary progressive multiple sclerosis was recently published in Multiple Sclerosis.
A recent study demonstrates that a physiotherapy home exercise program provides statistically more improvement to walking ability than the use of functional electrical stimulation or FES in patients with secondary progressive MS.
A randomized trial comparing the use of functional electrical stimulation (FES) to home exercise therapy for individuals with secondary progressive MS and foot drop was recently published in Multiple Sclerosis. Twenty individuals received FES to flex ankle during the swing phase of walking. Twenty four received a home exercise program. At the end of 18 weeks the home exercise group had a statistically significantly greater level of gait improvement as compared to the group using FES.
The way I interpret these findings is that exercise is a very important component of the rehabilitation of gait. FES maybe beneficial as an intervention that is equivalent to an ankle foot orthosis (AFO), but greater levels of gait rehabilitation can be achieved by using a home exercise program. NMES is the stimulation of muscles directly and is to be coupled with volitional contraction during the electrical contraction. It is also intended to be coupled with an exercise program to re-educate the muscle firing patterns to improve functional use of the muscles. While the hypertrophy of muscles may be achieved without an exercise program, re-education of the muscles important to the rehabilitation of gait
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 20090
Multiple Sclerosis
A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis
CL Barrett, GE Mann, PN Taylor*, and P Strike
The National Clinical FES Centre, Department of Clinical Sciences and Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, UK
A randomized trial comparing the use of functional electrical stimulation to
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 2009
Multiple Sclerosis March 2009
doi:10.1177/1352458508101320
* To whom correspondence should be addressed.
Background
Functional electrical stimulation (FES), is a means of producing a contraction in a paralyzed or weak muscle to enable function through electrical excitation of the innervating nerve.
Objective
This two-group randomized trial assessed the effects of single channel common peroneal nerve stimulation on objective aspects of gait relative to exercise therapy for people with secondary progressive multiple sclerosis (SPMS).
Methods
Forty-four people with a diagnosis of SPMS and unilateral dropped foot completed the trial. Twenty patients were randomly allocated to a group receiving FES and the remaining 24 to a group receiving a physiotherapy home exercise program for a period of 18 weeks.
Results
The exercise group showed a statistically significant increase in 10 m walking speed and distance walked in 3 min, relative to the FES group who showed no significant change in walking performance without stimulation. At each stage of the trial, the FES group performed to a significantly higher level with FES than without for the same outcome measures.
Conclusion
Exercise may provide a greater training effect on walking speed and endurance than FES for people with SPMS. FES may provide an orthotic benefit when outcome is measured using the same parameters. More research is required to investigate the combined therapeutic effects of FES and exercise for this patient group.
t
From my last post I have had several people contact me wondering if I am saying that electrical stimulation is not helpful and am actively discouraging its use. This is intended to clarify my thoughts.
Electrical stimulation has been shown to increase muscle mass in paralyzed individuals. Thus it is likely to be able to increase mass in people with MS. But I predict that stim alone will not be enough to restore walking. It is a long slow process to restore strength. The stim should help produce more muscle mass -- but without the exercise program the gait is less likely to return -
Application of both is likely to be the most beneficial -having a base of slowly growing the muscles should allow the gradual increase of volitional exercise. Having a PT can help identify which exercises to add to get the most benefit for the effort expended.
I don't know what happens with stim alone - there would be some rationale to think the biochemistry in the brain would be improved even without exercise -- but restoring more normal walking, sitting or other muscle functions probably requires exercise and re-education of the brain - muscle pathways.
Re the food/ micronutrient/ supplement questions
I can only report my observations on my own experience. Food - will have more micronutrient content than supplements alone -- But there may be benefits from targeted augmentation with supplements in addition to food - particularly if tailored to the individual based on medical family history etc.
Your observations about the dilemma for most who are struggling to get by is unfortunately too common - and I am sure makes it frustrating for anyone who is trying to regain their health.
Food alone -- won't solve MS - because it is multifactorial - with toxic exposures, micronutrient deficiencies, food allergies, genetic differences and infection exposures and current infections all adding up to each person's unique experience with the disease. That makes providing and finding a generalizable solution so elusive. Finding out what are you own contributions to the disease state -- requires finding someone who can unpeel the onion of all these factors.
From my own experience -- very few physicians understand this -- and I am unraveling the onion slowly myself. An organization -- institute for functional medicine has international membership of physicians and other health professionals who view chronic disease including MS through this lens. Going to there web site - you can find the pages for providers and look under the international provider listings to find someone who does.
Unfortunately I don't have many answers - only questions and my personal observations/ experiences which may or may not be generalizable to others -- I wish that I did -- and I wish that we'd get the study approved so that we could begin accumulating experience with others.
March 22, 2009
Powdered Greens, Wheat Grass and Gluten Sensitivity
For two months I believed that I was experiencing a decline in my back strength and stamina despite continued exercise, NMES and intensive nutrition. I had been using KYOGREEN to provide additional green intake during the day for the prior six months.
I had presumed that wheat grass would not have significant levels of gliadin or gluten, particularly since acutely I believed the Kyogreen improved my energy while traveling.
I have since discontinued the KYOGREEN, and have made no other changes in my routines. Now after three weeks without the KYOGREEN my stamina, and strength are back on the rebound.
I’ve decided to use my Vitamix to create my own green beverages to have at work instead of using the instant greens. I’ve been rotation between blending cilantro, parsley or kale with water and ice. It’s worked well for me. I have more energy immediately following the glass of greens. And my energy levels are better off the wheat grass.
My conclusion is that the cereal grasses likely contain the same antigens as the grain. If you have food sensitivity to gluten, likely you’ll have sensitivity to the wheat and other cereal grasses as well.
I think greens are still incredibly good for us. But it is likely preferable make your own green beverage using a blender and greens leafs that you know you can tolerate. Its a great energy boost to one's day.
tw
March 20, 2009
Home exercise program is superior to electrical stimulation.
An article on the use of functional electrical stimulation in the setting of secondary progressive multiple sclerosis was recently published in Multiple Sclerosis.
A recent study demonstrates that a physiotherapy home exercise program provides statistically more improvement to walking ability than the use of functional electrical stimulation or FES in patients with secondary progressive MS.
A randomized trial comparing the use of functional electrical stimulation (FES) to home exercise therapy for individuals with secondary progressive MS and foot drop was recently published in Multiple Sclerosis. Twenty individuals received FES to flex ankle during the swing phase of walking. Twenty four received a home exercise program. At the end of 18 weeks the home exercise group had a statistically significantly greater level of gait improvement as compared to the group using FES.
The way I interpret these findings is that exercise is a very important component of the rehabilitation of gait. FES maybe beneficial as an intervention that is equivalent to an ankle foot orthosis (AFO), but greater levels of gait rehabilitation can be achieved by using a home exercise program. NMES is the stimulation of muscles directly and is to be coupled with volitional contraction during the electrical contraction. It is also intended to be coupled with an exercise program to re-educate the muscle firing patterns to improve functional use of the muscles. While the hypertrophy of muscles may be achieved without an exercise program, re-education of the muscles important to the rehabilitation of gait
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 20090
Multiple Sclerosis
A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis
CL Barrett, GE Mann, PN Taylor*, and P Strike
The National Clinical FES Centre, Department of Clinical Sciences and Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, UK
A randomized trial comparing the use of functional electrical stimulation to
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 2009
Multiple Sclerosis March 2009
doi:10.1177/1352458508101320
* To whom correspondence should be addressed.
Background
Functional electrical stimulation (FES), is a means of producing a contraction in a paralyzed or weak muscle to enable function through electrical excitation of the innervating nerve.
Objective
This two-group randomized trial assessed the effects of single channel common peroneal nerve stimulation on objective aspects of gait relative to exercise therapy for people with secondary progressive multiple sclerosis (SPMS).
Methods
Forty-four people with a diagnosis of SPMS and unilateral dropped foot completed the trial. Twenty patients were randomly allocated to a group receiving FES and the remaining 24 to a group receiving a physiotherapy home exercise program for a period of 18 weeks.
Results
The exercise group showed a statistically significant increase in 10 m walking speed and distance walked in 3 min, relative to the FES group who showed no significant change in walking performance without stimulation. At each stage of the trial, the FES group performed to a significantly higher level with FES than without for the same outcome measures.
Conclusion
Exercise may provide a greater training effect on walking speed and endurance than FES for people with SPMS. FES may provide an orthotic benefit when outcome is measured using the same parameters. More research is required to investigate the combined therapeutic effects of FES and exercise for this patient group.
t
More on Vitamin D
March 7, 2009
Another article has been published which indicates a need to revise our recommended daily allowance for vitamin D needs to be increased.
Maintaining adequate levels of vitamin D during winter months requires a daily dose that is four times the current recommended dose, says a new study.
Source: Journal of Nutrition
2009, Volume 139, Pages 540-546, doi:10.3945/jn.108.096180
"Supplements of 20 ug/d Cholecalciferol Optimized Serum 25-Hydroxyvitamin D Concentrations in 80% of Premenopausal Women in Winter”
Authors: M.L. Nelson, J.M. Blum, B.W. Hollis, C. Rosen, S.S. Sullivan
The study, led by Susan Sullivan from the University of Maine, has important implications for ongoing consultations on vitamin D recommendations, with the current level of five milligrams (200 International Units) seen by many as insufficient.
Current recommended daily intakes (RDIs) of vitamin D are 200 IU for people up to 50 years of age, 400 IU for people between 51 and 70, and 600 IU for over the 70s years.
Study details
Sullivan and her co-workers recruited 112 women with an average age of 22.2 were assigned to receive a placebo from March 2005 until September 2005, and then randomly assigned to receive either placebo or a daily vitamin D3 supplement (20 micrograms) until February 2006.
“Daily supplementation with 20 micrograms (about 2000 IU)of D3 during winter achieved optimal 25(OH)D concentrations (at least 75 nmol/L) in 80 per cent of participants, indicating that this dose is adequate to optimize vitamin D status in most young women in Maine,” concluded the researchers.
Bottom line - if you have an autoimmune disease get your vitamin D levels checked and take enough vitamin D or sunshine to get your vitamin D level in the upper range of normal.
t
Another article has been published which indicates a need to revise our recommended daily allowance for vitamin D needs to be increased.
Maintaining adequate levels of vitamin D during winter months requires a daily dose that is four times the current recommended dose, says a new study.
Source: Journal of Nutrition
2009, Volume 139, Pages 540-546, doi:10.3945/jn.108.096180
"Supplements of 20 ug/d Cholecalciferol Optimized Serum 25-Hydroxyvitamin D Concentrations in 80% of Premenopausal Women in Winter”
Authors: M.L. Nelson, J.M. Blum, B.W. Hollis, C. Rosen, S.S. Sullivan
The study, led by Susan Sullivan from the University of Maine, has important implications for ongoing consultations on vitamin D recommendations, with the current level of five milligrams (200 International Units) seen by many as insufficient.
Current recommended daily intakes (RDIs) of vitamin D are 200 IU for people up to 50 years of age, 400 IU for people between 51 and 70, and 600 IU for over the 70s years.
Study details
Sullivan and her co-workers recruited 112 women with an average age of 22.2 were assigned to receive a placebo from March 2005 until September 2005, and then randomly assigned to receive either placebo or a daily vitamin D3 supplement (20 micrograms) until February 2006.
“Daily supplementation with 20 micrograms (about 2000 IU)of D3 during winter achieved optimal 25(OH)D concentrations (at least 75 nmol/L) in 80 per cent of participants, indicating that this dose is adequate to optimize vitamin D status in most young women in Maine,” concluded the researchers.
Bottom line - if you have an autoimmune disease get your vitamin D levels checked and take enough vitamin D or sunshine to get your vitamin D level in the upper range of normal.
t
Neurostim - is it safe for me to try on my own?
February 22, 2009
Neurostim - is it safe for me to try on my own?
I am often asked that question.
My answer is - No, it's not safe.
A physical therapist can analyze which muscles are weak, how your gait is abnormal and design a program specific to you. As you get stronger the therapist can advance your exercises and advance which muscles you give neurostim. It is impossible to know on your own how to restore a more normal walking pattern without someone to analyze your muscles.
My rehabilitation of walking took many months of work, with ongoing adjustments of both my exercise program, and which muscles to stimulate. I doubt that anyone can successfully get their walking rehabilitated without some level of PT support. Also, even I have managed to give myself electrical burns because I did not recognize the hazards of the electrical therapy appropriately. The initial experience my therapist has had treating others with MS indicates that about a quarter of those who try neurostim cannot continue because for them the experience appears to activate a neuropathic type of pain response.
Again, I must remind people that one positive experience is not proof that neurostim will be helpful for others with MS. Nor does one positive experience tell us what the risks are either.
TENS vs NMES
Electrical therapy is delivered at various frequencies (cycles per second), wave shapes, and intensity of current. T ENS is t ypically at a lower frequency than NMES. The waves are shaped differently and the current is typically lower in T ENS which is why NMES is much more painful than TENS.
NMES alone isn't likely to be of much long term benefit
Finally, if the reasons for the smoldering activity in the MS are not addressed - it is likely that the neurostim will have limited benefit for the individual. If you have not read the MS Recovery Diet - I suggest you look into that book. It would also be wise to look into the issues related to food sensitivies mentioned in the previous post.
In our study - we do plan to address the issues of smoldering MS activity associated with food sensitivities. I think that will be another important factor. in our study once we get it going.
MS is a complex disease - with many contributing factors. The more you an address each potential contributor, the more likely you are to cool off the fires of inflammation and begin the healing.
Neurostim - is it safe for me to try on my own?
I am often asked that question.
My answer is - No, it's not safe.
A physical therapist can analyze which muscles are weak, how your gait is abnormal and design a program specific to you. As you get stronger the therapist can advance your exercises and advance which muscles you give neurostim. It is impossible to know on your own how to restore a more normal walking pattern without someone to analyze your muscles.
My rehabilitation of walking took many months of work, with ongoing adjustments of both my exercise program, and which muscles to stimulate. I doubt that anyone can successfully get their walking rehabilitated without some level of PT support. Also, even I have managed to give myself electrical burns because I did not recognize the hazards of the electrical therapy appropriately. The initial experience my therapist has had treating others with MS indicates that about a quarter of those who try neurostim cannot continue because for them the experience appears to activate a neuropathic type of pain response.
Again, I must remind people that one positive experience is not proof that neurostim will be helpful for others with MS. Nor does one positive experience tell us what the risks are either.
TENS vs NMES
Electrical therapy is delivered at various frequencies (cycles per second), wave shapes, and intensity of current. T ENS is t ypically at a lower frequency than NMES. The waves are shaped differently and the current is typically lower in T ENS which is why NMES is much more painful than TENS.
NMES alone isn't likely to be of much long term benefit
Finally, if the reasons for the smoldering activity in the MS are not addressed - it is likely that the neurostim will have limited benefit for the individual. If you have not read the MS Recovery Diet - I suggest you look into that book. It would also be wise to look into the issues related to food sensitivies mentioned in the previous post.
In our study - we do plan to address the issues of smoldering MS activity associated with food sensitivities. I think that will be another important factor. in our study once we get it going.
MS is a complex disease - with many contributing factors. The more you an address each potential contributor, the more likely you are to cool off the fires of inflammation and begin the healing.
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