Up From the Chair - Defeating MS www.terrywahls.com

UPDATE

2010-05-27T20:12:00.000-07:00

May 23, 2010

It has been a while since I've posted on the blog. Most of my work is on my web sites. www.terrywahls.com and www.mindingmymitochondria.com I have brought some of the information here to share with you.

Great Grandma's Liver and Onions

Liver, heart, tongue, gizzards, sweetbreads (thymus) and kidneys were eaten regularly by my grandmother and my great grandmother's generation. They knew that liver was packed with nutrition and that one should eat organ meat once a week. We have forgotten that ancient wisdom.

Liver is packed with B vitamins, coenzyme Q and choline, all of which support healthy function of mitochondria. So are all of the organ meats. We get more of the nutrition from those organ meats the rarer the meat is. Thus when I cook the liver, or any of the organ meats, I use low temperature and leave the meat medium rare.

I went to my great grandmother's cook book: A Compendium of Cooker and Book of Knowledge with an 1890 copyright to look for a recipe using liver. I made the liver according to their instructions and it was fabulous. Here is it translated into modern time.

Ingredients

A pound of Liver

One half pound of Bacon

Sliced onions (one or two)

Sliced mushrooms (optional but very nice)

½ teaspoon powdered kelp (optional)

½ teaspoon coarse black pepper

½ teaspoon sea salt

Slice the onions and mushrooms and place in the bottom of an iron Dutch oven (or any covered casserole will do). Slice the liver and place a slice of bacon between the liver strips. Add one tablespoon of water. Sprinkle with 1/2 teaspoon of powdered kelp (good for minerals). Cover the casserole and place in an oven at 180 degrees and bake for 60 minutes and check. The liver is best when it is still slightly pink. If not done enough, continue baking and check every fifteen minutes. If you cook liver until it is completely done, it is more likely to be tough and much less tasty. If you take it out when it is still slightly pink, it will be tender, and at least according to my family, quite delicious.

Check out Nourishing Traditions for a great cookbook which builds on the wisdom of generations on how to use food to maximize your nutrition and therefore your health. A link to that book is provided here.

http://www.amazon.com/Nourishing-Traditions-Challenges-Politically-ebook/dp/B00276HAWG

May 4, 2010

Vitamin D

We have an epidemic of vitamin D deficiency afflicting Americans. The reasons are that we are spending more time indoors year round because of air conditioning, television, computers and other indoor entertainment options. Furthermore, when we go outside, the public has been advised to wear sunscreen to block the 'damaging effects from ultraviolet radiation' contained within the sun light. The consequence is that our skin does not receive the ultraviolet radiation which allows our skin to manufacture vitamin D. Because we live so far north, even if we do go outside at high noon between September and March, the sun is too low in the sky for use to receive sufficient ultraviolet light to manufacture vitamin D. As a result study after study has documented that Americans have a low Vitamin D level, ranging from25 to 75% of Caucasians to 85% or more for those with darker complexions such as an African American or persons of Middle Eastern descent.

The health consequences of low vitamin D are huge. More and more studies are documenting the many adverse health impacts of low vitamin D levels. Many labs set the normal values at 20 to 70. I prefer to use a definition of what level of vitamin D is associated with the best health. To do this, one looks at the many studies looking at the epidemiology of illness risk associated with the levels of vitamin D in the blood. Then it is apparent that the best health outcomes are achieved when the vitamin D levels are between 50 and 100. If the level is less than 20, the likelihood of a bone fracture is dramatically increased. If the levels are between 20 and 30 the risk of schizophrenia, bipolar, depression, high blood pressure, premature birth, infertility, heart disease, cancer and autoimmune disease is increased. At levels between 30 and 40 there is still an increased risk in high blood pressure, aortic stenosis, abdominal aortic aneurysm, cancer and 4 times the risk of multiple sclerosis. At 40 to 50 there is still an increased risk of multiple sclerosis. But between 50 and 100 there is a lower risk of cancer, heart attack, high blood pressure and autoimmune disease. At levels over 150 there is an increased risk of excessive calcium in the blood, hallucinations, psychosis, and kidney damage. Next month I will discuss steps you can take to improve your vitamin D status.

April 20, 2010

Kelp Kelp

Seaweed

Many with MS have an excessive amount of mercury, lead or other toxins. Eating seaweed daily provides iodine and many trace minerals that are important to brain health and support the liver's ability to excrete toxins. I highly recommend the book SEAWEED. The Seaweed Man has been an excellent source of organic, sustainably farmed seaweed. A link to his web site is provided below. A link to more information about the book is also provided.

http://www.theseaweedman.com/

http://www.theseaweedman.com/seaweed/health

Seaweed recipes

http://www.theseaweedman.com/recipes

April 12, 2010

Chronic Venous Blockages and MS

There is a 90 minute webcast on chronic venous blockages and MS on April 14th sponsored by the MS society. More information on how to register is at the following link.

http://www.nationalmssociety.org/research/intriguing-leads-on-the-horizon/ccsvi/index.aspx

This is an interesting news report about individuals who underwent procedures to open up blocked vessels in an effort to improve MS related symptoms (based on Zamboni's finding that chronic low level blockages of veins draining the brain occur more frequently in MS patients than in normal controls.

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20100409/w5_liberation_update_100409/20100410?s_name=W5

April 8, 2010

IODINE, TOXIC LOAD and MULTIPLE SCLEROSIS

I spent the last three weeks teaching another Food as Medicine series. Tonight the topic was Poisons in Our Food. The quick message I'd like to reinforce to all of you is that toxic load is the amount of toxins you absorb minus the toxins you excrete each day.

Unrecognized toxic load is a driver for many chronic diseases, including multiple sclerosis. If you have been doing a great job at eating a diet that is low allergen and still having gradually worsening MS -- excessive toxic load may be a factor.

You can look into having an assessment - but you would need to have some kind of provocation test. Most of our toxins are stored in our fat and our brain. Unless you have some kind of challenge test, you will not be aware of the total load of toxins resting in your brain.
Iodine deficiency is a common problem when you have excess toxic load and may be a factor in underlying worsening MS. I suggest visiting the following site for more information on toxic load, iodine and multiple sclerosis.

http://iodine4health.com/disease/disease.htm

March 4, 3009

This is a TED Talks Lecture that I recommend highly.

It is the best 18 minutes you'll spend thinking about the links between what we eat and the epidemic of food related illness that is disabling and killing us and our children .

http://www.ted.com/talks/lang/eng/jamie_oliver.html

NIH Grant submitted

February 1, 2010

I have spent the last 6 weeks writing grants, making budgets and making multiple revisions. We have now submitted a grant to the NIH asking for funding to test my interventions in a population of secondary progressive MS, primary progressive Ms and advanced Parkinson's disease patients. It was a huge effort, especially since it was my first major grant. As a result I've not written anything for the web pages.

Once the grant was submitted, I went off to study with the Institute of Functional Medicine, once again reviewing biochemistry, physiology and hormones and more. I am more and more impressed that Functional Medicine physician and practitioners are best equipped to help those suffering from refractory and progressive MS and identify what are the key nutritional deficiencies, infections, toxins and genetic vulnerabilities that are driving the disease.

FOOD /SUPPLEMENTS

While the intensive nutrition - that is eating greens, sulfur rich foods, colors and high quality protein ( and omitting grains, dairy and eggs) is a huge step, a functional medicine doctor may help you focus your interventions.

If you are copying my protocols --- PLEASE -- consider participating in the longitudinal survey EACH MONTH so that we can follow your progress. I have a handful of people thus far -- and this data helps our grant writing very much. It is a huge benefit to have some early data on what people are doing, how they are responding so that we can project how large the study will need to be to detect the benefits.

Nutrition and MS Survey

Electrical therapy and MS survey

January 3, 2010

This is an excellent on line entry by Dr. Mark Hyman on the dangers of gluten sensitivity. More physicians are recognizing that gluten sensitivity is driving many diseases - cancers, heart disease, autoimmune disease and irritable bowel.

Dr. Mark Hyman and Gluten

December 15, 2009

Voices of MS

Voices of Multiple Sclerosis

Today's post is about a book, titled Voices of Multiple Sclerosis. I am one of the featured authors, in which I recall 'Telling the World'. It was about acquiring a tilt-recline wheelchair due to progressively severe fatigue. In it I recall the challenges of encountering friends and colleagues who were stunned to see me sitting in a wheelchair. My greatest healing came when I learned to laugh at my clumsiness at driving via a joy stick. It was my laughter that signaled to my staff, my family and myself that I was not defeated by my illness.

The book has 33 other wonderful essays about the losses, the gifts, the tragedies and the triumphs which are embedded in having a progressive chronic disease. I recommend the book highly to those have been recently diagnosed as well as those who have known about their disease for years.

The link http://lpbooks.myshopify.com/ will take you to the LaChance publishing page where you can purchase the book.

November 24, 2009
Chronic venous blockages

I've been asked by many individuals to comment upon the issue of the chronic venous blockages found in the brains of MS patients and whether it is worthwhile to investigate one's venous status.

I have chosen not to do so. I do note that numerous studies have demonstrated than an increased consumption of brassica (cabbage family) or allicin (garlic and onion family) vegetables make blood more fluid and our white blood cells less sticky. The result is that the problems of sluggish blood flow are greatly reduced. This lowers significantly the risk of heart disease and stroke.

In theory one could have significant improvement in blood flow to the brain by consuming 300 to 600 grams of sulfur rich vegetables (cabbage, onion and mushroom family) vegetables. That is the route that I advocate in my clinical practice. Each person must make their own decision regarding what is in their best interest. In general the long term effect from intensive nutrition is often superior to procedures -- because traumatizing blood vessels with stents and other instrument is not without risk. The other benefit to aggressively using intensive nutrition is it under the individual's control.
T
November 8, 2009
The Poisons in Our Foods

I recently completed a toxicology profile on myself. Keep in mind that I have been eating 6 plus cups of kale / collards/ onion family vegetables every day for nearly two years. Along with that I have been eating bright colors to maximize my antioxidant intake too. In short I have been following a reasonable detoxification diet.

However I did expect that I'd have some evidence of heavy metals, just because I have come to recognize that heavy metals in the body are often drivers of autoimmune diseases, including multiple sclerosis. I've been taking additional iodine for three months, again to help support my iodine intake.

I took the test through the FFP laboratory (J. D. Flechas, MD) because I wanted to get a status on my iodine and heavy metals. I just go my results and I was surprised.

Here they are
Flouride: normal range
Iodine: provocation 78% when the goal is 90% so iodine stores are low - I probably need another 3 to 6 months of replacement iodine to get my iodine levels in the fully replaced range)
Bromide spot low - but provocation was 38 (3X normal) - which means I have bromide in my body. Bromide competes with iodine, driving up the amount of iodine I need. Bromine will be excreted via urine. But I need a lot of iodine to do so.

Other heavy metals that were toxic
aluminum 2X normal
Barium 20X normal
cadmium slight elevation
cesium 2 X normla
Gadolinium 100 X normal
rubidium slight elevation
thalium 10X normal
tungsten slight elevation
Uraniaum 2 X normal
mercury slight elevation

The big questions --
Where did I get these compounds? \
Am I still taking more into my body?
How do I increase my ability to get rid of them?
Notably, I probably had much higher levels two years ago.
Since cruciferous, onions and sulfur amino acids induce more enzymes that are used in detoxification -- I have been following a good detox protocol.
But now I want to do even more..
I went out looking for more information on detoxification and came across this site.
I found the following web site helpful.
http://www.radiationdetox.com/ebook/0707RadiationDetox.pdf

Other sources of information include Dr. Mark Hyman who has several books. Going to his website would provide some information as well.
http://www.drhyman.com/

More information can be found about iodine at

Sources for my heavy metals were probably related to growing up on an Iowa farm, living in communities that used treated river water and living in a home with a shallow well.
Now I have a reverse osmosis water filter. I take a sauna most days, and a clay foot soak. And I take chlorella, spirulina and green tea each day in my morning smoothie.

For those of you with an autoimmune disease, consider the possibility that heavy metals in your fat and brain are adding to your disease.

October 22, 2009

Nutrition and cancer: A review of the evidence for an anti-cancer diet

Michael S Donaldson email

Director of Research, Hallelujah Acres Foundation, 13553 Vantage Hwy, Ellensburg, WA 98926, USA

author email corresponding author email

Nutrition Journal 2004, 3:19doi:10.1186/1475-2891-3-19

The electronic version of this article is the complete one and can be found online at: http://www.nutritionj.com/content/3/1/19
Received: 28 September 2004
Accepted: 20 October 2004
Published: 20 October 2004

© 2004 Donaldson; licensee BioMed Central Ltd.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

It has been estimated that 30—40 percent of all cancers can be prevented by lifestyle and dietary measures alone. Obesity, nutrient sparse foods such as concentrated sugars and refined flour products that contribute to impaired glucose metabolism (which leads to diabetes), low fiber intake, consumption of red meat, and imbalance of omega 3 and omega 6 fats all contribute to excess cancer risk. Intake of flax seed, especially its lignan fraction, and abundant portions of fruits and vegetables will lower cancer risk. Allium and cruciferous vegetables are especially beneficial, with broccoli sprouts being the densest source of sulforophane. Protective elements in a cancer prevention diet include selenium, folic acid, vitamin B-12, vitamin D, chlorophyll, and antioxidants such as the carotenoids (α-carotene, β-carotene, lycopene, lutein, cryptoxanthin). Ascorbic acid has limited benefits orally, but could be very beneficial intravenously. Supplementary use of oral digestive enzymes and probiotics also has merit as anticancer dietary measures. When a diet is compiled according to the guidelines here it is likely that there would be at least a 60—70 percent decrease in breast, colorectal, and prostate cancers, and even a 40—50 percent decrease in lung cancer, along with similar reductions in cancers at other sites. Such a diet would be conducive to preventing cancer and would favor recovery from cancer as well.

from the article --

Conclusions
What is the result when all of these things are put
together? What if all of these factors reviewed here were
taken into account and put into practice? This anticancer
diet would have:
• adequate, but not excessive calories,
• 10 or more servings of vegetables a day, including cruciferous
and allium vegetables; vegetable juice could meet
part of this goal,
• 4 or more servings of fruits a day,
• high in fiber,
• no refined sugar,
• no refined flour,
• low in total fat, but containing necessary essential fatty
acids,
• no red meat,
• a balanced ratio of omega 3 and omega 6 fats and would
include DHA,
• flax seed as a source of phytoestrogens,
• supplemented with ~200 μg/day selenium,
• supplemented with 1,000 μg/day methylcobalamin (B-
12),
• very rich in folic acid (from dark green vegetables),
• adequate sunshine to get vitamin D, or use 1,000 IU/day
supplement,
• very rich in antioxidants and phytochemicals from fruits
and vegetables, including α-carotene, β-carotene, β-cryptoxanthin,
vitamin C (from foods), vitamin E (from
foods),
• very rich in chlorophyll,
• supplemented with beneficial probiotics,
• supplemented with oral enzymes
As reviewed above, reductions of 60 percent in breast cancer
rates have already been seen in human diet studies,
and a 71 percent reduction in colon cancer for men without
the known modifiable risk factors. These reductions
are without taking into account many of the other factors
considered in this review, such as markedly increased fruit
and vegetable intake, balanced omega 3 and 6 fats, vitamin
D, reduced sugar intake, probiotics, and enzymes —
factors which all are likely to have an impact on cancer.
Certainly cancer prevention would be possible, and cancer
reversal in some cases is quite likely.

Oral sulforaphane increases Phase II antioxidant enzymes in the human upper airway.
Clinical Immunology, 2009 Mar;130(3):244-51.
Riedl MA, Saxon A, Diaz-Sanchez D.
doi:10.1016/j.clim.2008.10.007
PubMed ID: 19028145

A study from UCLA shows that sulforaphane triggers an increase of antioxidant enzymes in the human airway that offers protection against free radicals that we breathe in every day in polluted air and pollen. Free radicals can cause oxidative tissue damage, which leads to inflammation and respiratory conditions like asthma. The team fed 65 individuals varying amounts of broccoli sprouts or alfalfa sprouts (which acted as a placebo) for three days. Rinses of nasal passages were collected at the beginning and end of the study to evaluate the gene expression of antioxidant enzymes in cells of the upper airways. "Researchers found significant increases of antioxidant enzymes at broccoli sprout doses of 100 grams and higher, compared with the placebo group."

Poisons in Our

2009-11-08T20:24:00.001-08:00

November 8, 2009
The Poisons in Our Foods

I recently completed a toxicology profile on myself. Keep in mind that I have been eating 6 plus cups of kale / collards/ onion family vegetables every day for nearly two years. Along with that I have been eating bright colors to maximize my antioxidant intake too. In short I have been following a reasonable detoxification diet.

however I did expect that I'd have some evidence of heavy metals, just because I have come to recognize that heavy metals in the body are often drivers of autoimmune diseases, including multiple sclerosis. I've been taking additional iodine for three months, again to help support my iodine intake.

I took the test through the FFP laboratory (J. D. Flechas, MD) because I wanted to get a status on my iodine and heavy metals. I just go my results and I was surprised.

Here they are
Flouride: normal range
Iodine: provocation 78% when the goal is 90% so iodine stores are low - I probably need another 3 to 6 months of replacement iodine to get my iodine levels in the fully replaced range)
Bromide spot low - but provocation was 38 (3X normal) - which means I have bromide in my body. Bromide competes with iodine, driving up the amount of iodine I need. Bromine will be excreted via urine. But I need a lot of iodine to do so.

Other heavy metals that were toxic
aluminum 2X normal
Barium 20X normal
cadmium slight elevation
cesium 2 X normla
Gadolinium 100 X normal
rubidium slight elevation
thalium 10X normal
tungsten slight elevation
Uraniaum 2 X normal
mercury slight elevation

The big questions --
Where did I get these compounds? \
Am I still taking more into my body?
How do I increase my ability to get rid of them?
Notably, I probably had much higher levels two years ago.
Since cruciferous, onions and sulfur amino acids induce more enzymes that are used in detoxification -- I have been following a good detox protocol.
But now I want to do even more..
I went out looking for more information on detoxification and came across this site.
I found it useful.
http://www.radiationdetox.com/ebook/0707RadiationDetox.pdf

Other sources of information include Dr. Mark Hyman who has several books. Going to his website would provide some information as well.
http://www.drhyman.com/

More information can be found about iodine at
http://www.iodine4health.com/ortho/flechas_ortho.htm
Sources for my heavy metals were probably related to growing up on an Iowa farm, living in communities that used treated river water and living in a home with a shallow well.
Now I have a reverse osmosis water filter. I take a sauna most days, and a clay foot soak. And I take chlorella, spirulina and green tea each day in my morning smoothie.

For those of you with an autoimmune disease, consider the possibility that heavy metals in your fat and brain are adding to your disease.

E stim and Incontinence

2009-09-09T05:48:00.001-07:00

**********************************************************************
E stim for incontinenc e
**********************************************************************
Here are the abstracts for two articles about estim and leaky
bladders.
The bottom line is that a rectal probe or a vaginal probe to deliver
electrical stimulation to help strengthen pelvic floor muscles works.
It is like an electrified kegel exercise. It is uncomfortable, but
one controls how much electricity is delivered. I have used it, and
am using it now each day and have found it to be quite helpful.

A second method uses electrical stimulation to skin over the posterior
tibiliais nerve (by the ankle). That has been quite helpful as well,
but I have not personallly tried that version. I've pasted copies of
the abstracts from two articles talking about estim and incontinence.
You could take the abstracts to your physician and discuss possible
treatments with estim for your leaky bladdder if that is an issue for
you.
Although it is not yet approved for strengthening muscles to walk,
electrical stimulation of muscles is approved for strengthening
muscles to control one’s bladder. Treating a leaky bladder with
electrical stimulation works using a vaginal or rectal probe to
increase the strength of pelvic muscle works. Multiple studies have
shown this to be effective. The FDA has approved the use of such
devices. Minnova, manufactured by EMPI is one such device. If you
want to learn more – go to the EMPI web page.
Below is an abstract which one could take their physician or physical
therapist for more information to support the request to try e-stim
for incontence.

Treatment of urinary stress incontinence by intravaginal electrical
stimulation and pelvic floor physiotherapy
Amaro,J.L.
Int.Urogynecol.J.Pelvic.Floor.Dysfunct.
.Treatment of urinary stress incontinence (USI) by intravaginal
electrical stimulation (IES) and pelvic floor physiotherapy represents
an alternative to other therapies. The purpose of this work was to
evaluate the effectiveness of this treatment inpatients with urinary
incontinence. From January 1998 to May 2000, 30 women (mean age 54
years) were studied. All patients had USI and 70% urge incontinence;
average follow-up was 7 months. Selection criteria were based on
clinical history, objective evaluation of perineal musculature by
perineometry, and urodynamics. The treatment protocol consisted of
three sessions of IES per week for 14 weeks using INNOVA equipment.
Physiotherapy was initiated in the fifth week of IES. A significant
decrease in the number of micturitions and urgency was observed after
treatment ( P<0.01). The pad test showed a reduction in urinary
leakage from 13.9 to 5.9 g after treatment ( P<0.01). Objective
evaluation of perineal muscle strength showed a significant
improvement in all patients after treatment ( P<0.01). A positive
correlation was observed between maximum flow rate (Qmax) and all
three variables: urethral pressure profile at rest and on straining
(stop test), and abdominal leak-point pressure (ALPP). A positive
correlation was also observed between ALPP and the stop test. Over 100
different surgical and conservative treatments have been tried to
manage USI. The majority of these procedures reveal that despite
progress already made in this area, there is no ideal treatment.
Satisfactory results can be achieved with this method, especially with
patients who are reluctant to undergo surgery because of personal or
clinical problems.

Urodynamic effect of acute transcutaneous posterior tibial nerve
stimulation in overactive bladder

J.Urol. Amarenco,G 2003
PURPOSE: Of the various treatments proposed for urge incontinence,
frequency and urgency electrostimulation has been widely tested.
Different techniques have been used with the necessity of surgical
implantation (S3 neuromodulation or sacral root stimulation) or
without requiring surgery (perineal transcutaneous
electrostimulation). Recently peripheral electrical stimulation of the
posterior tibial nerve was proposed for irritative symptoms in first
intention or for intractable incontinence. Clinical studies have
demonstrated good results and urodynamic parameters were improved
after chronic treatment. However, to our knowledge no data concerning
acute stimulation and immediate cystometry modifications have been
reported. We verified urodynamic changes during acute posterior tibial
nerve stimulation. MATERIALS AND METHODS: A total of 44 consecutive
patients with urge incontinence, frequency and urgency secondary to
overactive bladder were studied. There were 29 women and 15 men with a
mean age +/-SD of 53.3 +/- 18.2 years. Of the patients 37 had detrusor
hyperreflexia due to multiple sclerosis (13), spinal cord injury (15)
or Parkinson's disease (9), and 7 had idiopathic detrusor instability.
Routine cystometry at 50 ml. per minute was done to select the
patients with involuntary detrusor contractions appearing before 400
ml. maximum filling volume. Repeat cystometry was performed
immediately after the first study during left posterior tibial nerve
stimulation using a surface self-adhesive electrode on the ankle skin
behind the internal malleolus with shocks in continuous mode at 10 Hz.
frequency and 200 milliseconds wide. Volume comparison was done at the
first involuntary detrusor contraction and at maximum cystometric
capacity. The test was considered positive if volume at the first
involuntary detrusor contraction and/or at maximum cystometric
capacity increased 100 ml. or 50% during stimulation in compared with
standard cystometry volumes. RESULTS: Mean first involuntary detrusor
contraction volume on standard cystometry was 162.9 +/- 96.4 ml. and
it was 232.1 +/- 115.3 ml. during posterior tibial nerve stimulation.
Mean maximum cystometric capacity on standard cystometry was 221 +/-
129.5 ml. and it was 277.4 +/- 117.9 ml. during stimulation. Posterior
tibial nerve stimulation was associated with significant improvement
in first involuntary detrusor contraction volume (p <0.0001) and
significant improvement in maximum cystometric capacity (p
<0.0001). The test was considered positive in 22 of the 44
patients. CONCLUSIONS: These results suggest an objective acute effect
of posterior tibial nerve stimulation on urodynamic parameters.
Improved bladder overactivity is an encouraging argument to propose
posterior tibial nerve stimulation as a noninvasive treatment modality
in clinical practice

Acrylamide - kills brain cells

2009-09-09T05:38:00.001-07:00

We are getting too many toxins in our food.
I thought you would want to hear about Acrylamide.

Acrylamide - kills brain cells

Acrylamide is a potent neurotoxin. It is used experimentally to induce damage to brain and spinal cord in animal models of brain disorders. It is also present in our food. See the links to the National Cancer Institute.

It is used primarily in industrial process – especially making plastics. Most important to recognize is that it is also in our food, especially foods that are cooked at high temperature – such as fried foods. French fries, potato chips and other fried foods are at particular risk. This adds to the growing list of toxins in our food which are capable of damaging brain tissues.
Eating organic, and NOT frying one’s food is a good thing to do for your brain. Eating for your mitochondria will make it easier to for your body to excrete the toxins which show up in your food.

Venous Insufficiency and MS

2009-09-09T05:34:00.001-07:00

This a copy of press release on a meeting convened this week about the dramatic improvement in MS patients treated for venous sufficiency. The results suggest that venous blockages occur prior to the onset of symptoms and the severity of the blockages are strongly associated with the severity of the MS symptoms and rate of decline.
I knew you would want to know about this exciting news.

Venous blockages and MS

This is long - but it is a copy of the press release from a scientific meeting convened to discuss venous blockages in the setting of MS.

The bottom line is that maybe having procedures to evaluate for the presence of blockages in the blood vessels and repairing those blockages will someday soon replace taking immune modulating drugs like Tysabri. I still think nutrition will be very important. Although we may be born with the predisposition to develop blockages -- our diets, and our mother's diet coupled with the toxins in our environment may play a strong role in turning on the genes that cause blood vessels to be twisty and at risk of blockages. This is breaking news. Yet - genetics take hundreds of thousands of years to shift how our bodies are made. Shifts in diet and toxins can shift which genes are on and how our bodies are made in one generation. As dramatic as this news is, it does not change the critical role of feeding one's mitochondria and our brain cells with all the nutrients they need.

PRESS RELEASE
Bologna, Tuesday Sept. 8, 2009
FONDAZIONE HILARESCERE
Venous Function And Multiple Sclerosis
International Coterie
Four main points concerning the relationship between CCSVI and
MULTIPLE SCLEROSIS were covered by several experts at a Meeting in
Bologna. All the investigations that gave an answer to these 4
fundamental points were coordinated by Prof Paolo Zamboni who discovered CCSVI and its association with Multiple Sclerosis; in some other cases, research was carried out in cooperation between Prof Zamboni and major foreign Universities.
1) What is the origin of the extracranial cerebral vein stenoses which
characterize CCSVI?
2) Are there advanced diagnostic systems capable of identifying which
changes are caused by CCSVI in the central nervous system?
3) Can CCSVI be treated and how?
4) Can CCSVI therapy improve the clinical outcomes of MS and affect its
prognosis?
Venous Function And Multiple Sclerosis is an international coterie of
experts who met in Bologna on September 8 to discuss these issues from the
perspective of neurologists – who have developed the scientific body of
knowledge on MS – and the vascular and neurological surgeons who have
further investigated these topics following the discovery of CCSVI. All
investigations were coordinated by Professor Paolo Zamboni who discovered CCSVI and its association with multiple sclerosis.
This first study was conducted by an Italian research team composed of the
vascular surgeons’ group headed by Professor Paolo Zamboni from the
University of Ferrara and the neurologists’ group from the Department of
Neurosciences of the Bellaria Hospital in Bologna headed by Dr. Fabrizio
Salvi.
Fondazione Hilarescere is a foundation specially set up to provide adequate
means and resources for research into medical and scientific insights aimed at
fully understanding and curing diseases which are still partly unknown.
Fondazione HILARESCERE, chaired by Professor Fabio Roversi-Monaco, was
set up on an initiative of Fondazione Cassa di Risparmio in Bologna.
THE MOST IMPORTANT ANSWER OF ALL:
endovascular therapy has led to a decrease in the number of disease
relapses, a marked reduction in the number of active brain and spinal
lesions and also a clear-cut improvement in the patients’ quality of life.
Prof. Paolo Zamboni headed a study where, together with Dr. Fabrizio Salvi,
he was able to show that in patients with the clinical form of Relapsing-
Remitting MS – which is the most common – there is a drop in the number of
active lesions which persists up to 18 months after surgery. The percentage of
active lesions falls from 50% to 12%, thus showing that the additional
treatment of CCSVI reduces the aggressiveness of the disease. This finding is
further confirmed by the number of patients who showed no relapses after
endovascular surgery. In the 2 years before surgery, acute multiple sclerosis
attacks were found in 50% of the recruited patients, while in the 2 years
following surgery 73% of the patients had no more attacks, with a change in
the clinical course of the disease. In all these patients also cognitive and motor
activities – assessed by means of an outcome measure called MSFC - are
significantly and persistently improved while the same is not true for patients
with the progressive forms of the disease. In the latter, however, progression
was stopped and the patients’ quality of life improved.
________________
The experts discussed, provided data and gave an answer to all 4
fundamental questions:
1) What is the origin of the extracranial cerebral vein stenoses which
characterize CCSVI?
3 scientists answered this question from different perspectives: Professor
Byung B. Lee, Georgetown University School of Medicine di Washington DC,
showed that the malformations found in CCSVI are congenital truncular
malformations which therefore certainly precede the development of Multiple
Sclerosis. For this reason they cannot be regarded as a consequence of
Multiple Sclerosis. Prof. Lee showed in which phases of the venous system
development the malformations observed in CCSVI may appear. Byung B. Lee
is the Chairman of the World Consensus Conference which gathers vascular
experts from 47 countries and recently approved a scientific update on venous
malformations in Montecarlo. (1)Professor Giulio Gabbiani, Centre Médical Universitaire di Ginevra,demonstrated that there are no auto-immune phenomena in diseased veins thus excluding that the malformations found in CCSVI result from Multiple Sclerosis. He showed the results of a study which provides a histologic
comparison between the walls of the veins affected by CCSVI-MS and those of
normal subjects. Furthermore, at molecular level, CCSVI veins are structurally
different from those of the control subjects, thus confirming the approach of the
Montecarlo Consensus Conference. Prof. Gabbiani is one of the most important
world experts in microscopic vessel wall morphology. (2)
The third presentation was about whether – genetically speaking – these
malformations have any correlation with the findings so far obtained from the
genetic study of MS. Prof. Alessandra Ferlini, Director of the Institute of
Genetics at the University of Ferrara, discussed this point by presenting the
promising results of a pilot study. (3)2) Are there advanced diagnostic systems capable of identifying which changes are caused by CCSVI in the central nervous system? This is the second question addressed at the Meeting. Professor Mark Haacke,
Director of the MRI Istitute for Biomedical Research in Detroit (4,5,6) and
Professor Bianca Weinstock-Guttman, Neurologist at the Jacobs Neurological
Institute (7) showed new magnetic resonance (MRI) parameters linked to CCSVI which might in the future bring about a true revolution in the way of diagnosing MS. These new parameters include: quantification of iron deposits and volume assessment of intracranial veins and CSF. 3) The third question that was answered at the Meeting was: Can CCSVI be treated and how? Innovative minimally-invasive endovascular repair
techniques were discussed on account of the findings obtained by Dr. Roberto
Galeotti (8), Head of the Interventional Radiology Section at the University
Hospital of Ferrara who was the first in the world to perform this type of surgery,
and Dr. Michael Dake, Chief of Cardiovascular and Interventional Radiology at
Stanford University School of Medicine (California), who was the first to treat
CCSVI outside Italy. The most important finding is safety. At 2-year follow-up no major complications were observed. All surgical procedures were performed on a day hospital basis. Statistically, this treatment decreases pressure in the cerebral veins in a highly significant way, thus showing its enormous anti-inflammatory potential.(8)The risk of re-stenosis is 16 times higher in the jugular veins than in the azygos vein, thus pointing to the need for more sophisticated and efficient tools
to approach the former. Research will make such tools available during 2010.
4) The fourth and fundamental point is whether CCSVI therapy can improve
the clinical conditions of MS and affect its prognosis.
Dr. Fabrizio Salvi from the Bellaria Hospital in Bologna was the first
Neurologist who studied the clinical correlations of CCSVI treatment in
MS patients together with Prof. Paolo Zamboni. The patients enrolled in this
study were 120 from all clinical classes, but only the results of the 65 subjects
who are over 18 months from surgery will be reported in order to describe the
outcome with the greatest possible accuracy. Generally speaking, patients
treated with endovascular therapy showed a decrease in the number of
disease relapses, a marked reduction in the number of active brain and
spinal lesions and also a clear-cut improvement in the patients’ quality of
life. The findings of this investigations will soon be published in detail on the
Journal of Vascular Surgery (8).
Finally, Dr. Robert Zivadinov, Jacobs Neurogical Institute di Buffalo, discussed
the results of a revolutionary pilot study performed last year where both
American and Italian patients were blindly assessed in the USA by means of
advanced MRI technology, then submitted to vascular surgery in Italy and
followed up during the following year (9). This study was defined by the patients
who volunteered to participate as the study of the 50,000 miles for treatment,
because of the many trips they had to take overseas. This study was sponsored
by Fondazione Hilarescere.
References
(1) World Consensus Conference on Venous Malformations, Montecarlo
September 4th 2009. This document was approved by experts from 47 different
countries and will be published on all most important vascular surgery journals.
(2) G. Gabbiani, M. Coen, F. Mascoli, P. Zamboni. Manuscript in
preparation.
(3) A. Ferlini, M. Bovolenta, M. Neri, F. Gualandi, A.Yuryev, F. Salvi, A.
Liboni and P. Zamboni. Manuscript in preparation.
(4) Haacke EM, Makki M, Ge Y, Maheshwari M, Sehgal V, Hu J, Selvan M,
Wu Z, Latif Z, Xuan Y, Khan O, Garbern J, Grossman RI. Characterizing iron
deposition in multiple sclerosis lesions using susceptibility weighted imaging. J
Magn Reson Imaging. 2009;29:537-44.
(5) A. V. Singh and P. Zamboni Anomalous venous blood flow and iron
deposition in multiple sclerosis. J Cereb Blood Flow Metab. 2009 Sep 2. [Epub
ahead of print]
(6) P. Zamboni, E. Menegatti, B. Weinstock-Guttman, C. Schirda, J. L. Cox,
A. M. Malagoni, D. Hojnacki, C. Kennedy, E. Carl, M. G. Dwyer, N. Bergsland,
R. Galeotti, Sara Hussein, I. Bartolomei, F. Salvi, R. Zivadinov. The severity of
altered venous haemodynamics is related to CSF dynamics in chronic
cerebrospinal venous insufficiency Submitted To Current Neurovascular
Research
(7) P. Zamboni, E. Menegatti, B. Weinstock-Guttman, C. Schirda, J. L. Cox,
A. M Malagoni, D. Hojnacki, C. Kennedy, M. G. Dwyer, N. Bergsland, R.
Galeotti, I. Bartolomei, F. Salvi, M. Ramanathan, R. Zivadinov. Csf flow and
brain volume in multiple sclerosis are associated with altered cerebral venous
doppler haemodynamics. Study presented at the European Multiple Sclerosis
Congress ECTRIMS Düsseldorf, 9-12 September 2009
(8) P. Zamboni, R. Galeotti; E. Menegatti; A. M. Malagoni, S. Gianesini, I.
Bartolomei, F. Mascoli, F. Salvi Endovascular treatment of chronic
cerebrospinal venous insufficency. A prospective opern-label study. Journal of
Vascular Surgery, 2009, in press.
(9) P. Zamboni, R. Galeotti, B. Weinstock-Guttman, G. Cutter, E. Menegatti,
A. M. Malagoni, D. Hojnacki, J. L. Cox, C. Kennedy, I. Bartolomei, F. Salvi, R.
Zivadinov Endovascular Treatment for Chronic Cerebrospinal Venous
Insufficiency in Multiple Sclerosis . A longitudinal pilot study. Study presented at
the European Multiple Sclerosis Congress ECTRIMS Düsseldorf, 9-12
September 2009
Bologna, 8 September 2009
Press Office: Laboratorio delle idee – Francesca Rossini –

www.terrywahls.com

Although this is dramatic news, there are also press releases that indicate foods from the cabbage family influence how our blood vessels are shaped. That tells me that our nutrients influence how likely we are to develop chronic blockages which may lead to more aggressive MS. Once again, I think it is very important to have 3 cups of greens, cabbage family and onion family vegetables each day. To learn more about nutrition for mitochondria and brain check out my web site.

School lunch changes to make it healthier

2009-09-09T05:32:00.000-07:00

This is from the Slow Foods movement --
While not directly related to MS -- the issue of how we feed our children has direct impact on their future risk of MS.
See the notes below.

Dear members, supporters and friends,

On Labor Day, more than 20,000 people came together in all 50 states to tell Congress it's time to give kids real food at school. If you went to an Eat-In, we'd like to say thank you. And if you're one of the Slow Food Chapter Leaders and Eat-In Organizers who put incredible time and energy into the 300 Eat-Ins that took place nationwide, we'd like to shout thank you -- you made the day possible.

Check out some of the incredible photos: http://www.flickr.com/photos/ tags/timeforlunch/.

The momentum helped us surpass our Labor Day petition goal - there are more than 20,000 signatures online, another 10,000 on paper, and many more still coming in. That's a huge show of support. When Congress starts debating the Child Nutrition Act this fall, we'll be able to take those signatures to legislators and make a strong case for reform.

In the meantime, please take a moment to share some of the photos and stories of the Eat-Ins with your friends, and invite them to get involved. This movement is growing stronger by the day, and there will be plenty to do in the next phase of the Time for Lunch campaign.

P.S. The Day of Action is over, but the "Give More If You Can, Less If You Can't"membership offer lasts through the month of September. Make sure to tell your friends why it's a good time to be joining our movement for change.

Thank you,

Josh, Brian, Jerusha, Gordon, Deena, Emily
The Time for Lunch Team
timeforlunch@slowfoodusa.org

MInding My Mitochondria

2009-09-07T12:48:00.001-07:00

Minding My Mitochondria

By Dr. Terry L. Wahls

Dr. Wahls is an academic general internal medicine physician who has secondary progressive multiple sclerosis. Her MS confined her to a life of dependence on a tilt-recline wheelchair for four years. Eighteen months after starting her intensive, focused nutrition and electrical therapy to strengthen her muscles, Dr. Wahls now commutes to work five miles each day on her bicycle.

Minding My Mitochondria is a clear and concise explanation of the biochemistry that drives our brains and how the food we eat is linked to the health we do or do not have. Dr. Wahls teaches us how our brain cells work, the building blocks our cells need to do the work of living, and how to eat to ensure you have enough of them.

If you have a neurological or a psychological problem improving the health of your mitochondria will help your brain. If you have a chronic medical problem, improving the health of your mitochondria will help your body.

This book reveals the interventions, and the science behind them, that Dr. Wahls has used to restore her own health and the physical and mental health of her patients. Over 40 brain health recipes are included!

I.S.B.N. 13: 978-0-9821750-9-5

I.S.B.N. 10: 0-9821750-9-4

Publisher: TZ Press

119 pages

CONTENTS

Chapter 1. The Beginning

Chapter 2. Mitochondria

Chapter 3. Cellular Function and Brain Health

Chapter 4. Micronutrients, Supplements, and Food sources

Chapter 5. Neuro-protection

Chapter 6. Food Matters and MS

Chapter 7. Recipes

Chapter 8. The Synergy between Neuromuscular Electrical Stimulation and Nutrition

Chapter 9. Frequently Asked Questions--and Answers

Chapter 10. Conclusion

Photographs

Nutrient and Function Chart

Abbreviations

Glossary

References
Excerpt
Chapter 1. The Beginning

Rising costs of health care is crushing us. It’s not just old people getting diabetes, heart disease, arthritis, and cancers that are adding the cost of healthcare. Nearly a third of our children have serious medical problems like autism, depression, learning disabilities, obesity, or pre-diabetes. In addition to the exploding costs of health care, 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.

Why is this happening to us? Have our genes gone bad? After all scientists are identifying more genes associated with chronic disease each day. Are mutations transforming our strong, lean bodies into obese, chronically diseased ones, or is there something else going on that is causing this change in the health our country?

I think the explanation for what has happening can be found in the corn fields of Iowa. When you buy seed corn, all the kernels have essentially the same DNA. The way farmers know what kind of crop to expect in the fall. Say the farmer plants half of the bag of seed corn in black Iowa soil and the other half in a trash heap filled with clay, plastic debris, and rock. Return in the fall to harvest the corn. The corn planted in the black dirt will be tall with three ears of corn on every plant. But the corn in the trash heap will look diseased. Instead of being dark green, the corn stalks will yellowed, stunted and barely three feet tall. Very few will have an ear of corn. If they do, only a few kernels will be present on tiny nubbins. It was the same DNA 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 saw 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. If those little maintenance workers don’t have the all the building blocks, that is, the correct minerals, amino acids, and fatty acids, then 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.

Glutathione reduced in brains of MS patients

2009-09-01T15:03:00.000-07:00

More articles are confirming my theory that oxidative stress, a marker for sick mitochondria, are an important driver in progressive or worsening MS. A recent article was published in "Science Direct" which found that glutathione is present in statistically smaller amounts in the brains of people with MS than age matched controls. That is consistent with my theory that oxidative stress is a problem for many with MS.

The abstact is posted below.
Detection of glutathione (GSH) is technically challenging at clinical field strengths of 1.5 or 3 T due to its low concentration in the human brain coupled with the fact that conventional single-echo acquisitions, typically used for magnetic resonance (MR) spectroscopy acquisitions, cannot be used to resolve GSH given its overlap with other resonances. In this study, an MR spectral editing scheme was used to generate an unobstructed detection of GSH at 7 T. This technique was used to obtain normative white (WM) and gray matter (GM) GSH concentrations over a two-dimensional region. Results indicated that GSH was significantly higher (P<.001) in GM relative to WM in normal subjects. This finding is consistent with previous radionuclide experiments and histochemical staining and validates this 7 T MR spectroscopy technique. To our knowledge, this is the first study to report normative differences in WM and GM glutathione concentrations in the human brain. Glutathione is a biomarker for oxidative status and this non-invasive in vivo measurement of GSH was used to explore its sensitivity to oxidative state in multiple sclerosis (MS) patients. There was a significant reduction (P<.001) of GSH between the GM in MS patients and normal controls. No statistically significant GSH differences were found between the WM in controls and MS patients. Reduced GSH was also observed in a MS WM lesion. This preliminary investigation demonstrates the potential of this marker to probe oxidative state in MS.

How does one reduce oxidative stress? Eat 9 cups of vegetables and fruit. Three cups of cruciferous vegetables (especially kale or collards), 1 to 2 cups of onion, garlic and or mushrooms and 3 cups of brightly colored vegetables and fruit.

More details on how to improve one's oxidative status and health of one's mitochondria can be found in my book, Minding My Mitochondria. I've have just gotten it back from the printers and so it is now available on my web site www.terrywahls.com. The book reviews how the mitochondria support brain health, remove toxins and the key nutrients needed for optimal mitochondrial health. It also has 40 plus recipes which are mitochondria and brain healthy.

Battling Inflammation Through Food Hits Mainstream Press

2009-08-18T18:45:00.000-07:00

August 18, 2009

This is a copy of an article published in the LA Times which is devoted to battling inflammation through food. Many of the concepts discussed in this article mirror what I've been discussing in my blog.

latimes.com/features/health/la-he-anti-inflammation17-2009aug17,0,3196484.story
latimes.com
Battling inflammation through food
Though it's an emerging field, proponents of anti-inflammatory diets point to growing evidence that foods like vegetables and fish can ease an overactive immune system.

By Shara Yurkiewicz

August 17, 2009
Click Here

If you want to live longer -- avoid heart disease, Alzheimer's disease and cancer -- then pick and choose your foods with care to quiet down parts of your immune system.

That's the principle promoted by the founders and followers of anti-inflammatory diets, designed to reduce chronic inflammation in the body.

Dozens of books filled with diets and recipes have flooded the market in the last few years, including popular ones by dermatologist Dr. Nicholas Perricone and Zone Diet creator Barry Sears.

Those who frequent message boards that discuss arthritis or acne trade tips on which pro- or anti-inflammatory foods may help or trigger their symptoms -- urging co-sufferers to try cherries for their rheumatoid arthritis or avoid gluten for their psoriasis.

But proponents claim the benefits go far beyond that, fighting not just pain from inflamed joints or skin flare-ups but also life-threatening diseases.

"If your future currently looks bleak because of high levels of silent inflammation, don't worry, because you can change it within thirty days," Barry Sears promises in his book, "The Anti-Inflammation Zone."

There's still a lot of science to be done. And should you try such a diet, you probably shouldn't expect any 30-day miracles. But there may be something to eating in an anti-inflammatory way.

"[Chronic inflammation] is an emerging field," says Dr. David Heber, a UCLA professor of medicine and director of the university's Center for Human Nutrition. "It's a new concept for medicine."

The point of an anti-inflammation diet is not to lose weight, although it is not uncommon for its followers to shed pounds. The goal: to combat what proponents call "chronic silent inflammation" in the body, the result of an immune system that doesn't know when to shut off.

The theory goes that long after the invading bacteria or viruses from some infection are gone, the body's defenses remain active. The activated immune cells and hormones then turn on the body itself, damaging tissues. The process continues indefinitely, occurring at low enough levels that a person doesn't feel pain or realize anything is wrong. Years later, proponents say, the damage contributes to illnesses such as heart disease, neurological disorders like Alzheimer's disease or cancer.

In general terms, following an anti-inflammatory diet means increasing intake of foods that have anti-inflammatory and antioxidant properties. (Antioxidants reduce the activity of tissue-damaging free radicals at sites of inflammation.) The diet includes vegetables, whole grains, nuts, oily fish, protein sources, spices such as ginger and turmeric and brightly colored fruits such as blueberries, cherries and pomegranates.

Foods that promote inflammation -- saturated fats, trans fats, corn and soybean oil, refined carbohydrates, sugars, red meat and dairy -- are reduced or eliminated.

It would seem logical that a diet that could dampen an overactive immune system could help prevent or slow diseases that are caused or exacerbated by inflammation. And evidence is certainly mounting that such diseases include heart disease, cancer and Alzheimer's. (See related story online.)

Studies with animals suggest that the diet's followers may be on to something.

"If you feed rodents different diets, you can very strongly modulate inflammation," says Dr. Andrew Greenberg, the director of the Obesity and Metabolism Laboratory at the Human Nutrition Research Center on Aging at Tufts University in Boston. "Fish oil, for example, ameliorates inflammation in rodents."

Resveratrol, found in grape skin and red wine, has been shown to improve blood vessel function and slow aging in rats.

Pomegranate juice decreases atherosclerosis development in mice with high cholesterol. Garlic improves blood vessel functioning in the hearts of rats with high blood pressure.

And curcumin (an antioxidant chemical found in turmeric) improves ulcerative colitis, rheumatoid arthritis and pancreatitis in mice and has anti-cancer effects in the animals too.

Curcumin has also been shown to ease the symptoms of rheumatoid arthritis in people, reducing joint swelling, morning stiffness and walking time. In India, turmeric is used to promote wound healing and reduce inflammation. But though curcumin's effects are being tested in several clinical trials addressing various diseases, rigorous human results are lacking -- as is the case for most anti-inflammatory foods.

Large, careful human clinical trials are expensive and few have been designed to test dietary interventions. Small trials on individual supplements have been done, though. And scientists have learned a lot from studying populations -- chronicling the natural habits of people and seeing what diseases they get and which they don't.

The drug factor

It makes sense that anti-inflammatory methods might help the heart, says Dr. Robert H. Eckel, a past president of the American Heart Assn. and professor of physiology and biophysics at University of Colorado Denver's Health Sciences Center.

Statin drugs, for example, are known to cut heart disease risk by reducing cholesterol levels -- among other things, these meds fight inflammation.

"We don't know how much of statins' effect are due to their anti-inflammatory effects," Eckel says. But, he adds, a growing number of researchers suspect that this property is important.

Fish oil, rich in anti-inflammatory omega-3 fatty acids and derived from oily fish such as tuna, salmon and mackerel -- is already recommended by the American Heart Assn. to help prevent cardiovascular disease. It has been shown to reduce blood triglyceride levels and slightly lower blood pressure, lowering the risk for heart attacks and strokes.

There is also reason to believe that anti-inflammatory substances would help to ward off cancers. Non-steroidal anti-inflammatory drugs have been shown to prevent tumors with people with inherited colorectal cancer, for example.

And population studies have shown that people who had been taking non-steroidal anti-inflammatory meds for other conditions were less likely to develop Alzheimer's disease.

In trials, such drugs have failed to treat already-developed Alzheimer's, but the studies suggest that it might be possible to prevent the disease by reducing inflammation, says Greg Cole, a professor of medicine and neurology at UCLA and associate director of the UCLA Alzheimer's Disease Research Center.

But it is not safe to take non-steroidal anti-inflammatory drugs for years because of harmful side effects, such as gastrointestinal bleeding. What about anti-inflammatory foods? Several clinical trials, in the U.S. and abroad, have shown that people with mild memory complaints related to aging (not necessarily Alzheimer's disease) showed significant improvement when given the omega-3 fatty acid docosahexaenoic acid, Cole says.

And in an 18-month study released in June sponsored by the National Institutes of Health, treating Alzheimer's disease with docosahexaenoic acid slowed its progression in a subgroup of the study population.

There are other trials with positive results for fish oil in early Alzheimer's cases, but they are not large enough to be definitive, Cole says.

But, he adds, "the real utility is not to slow the progression of someone who's already demented, but it's to treat before dementia happens. We'd like to turn off or keep down [the inflammation] with something that doesn't cause gastrointestinal bleeding or other side effects."

Cole's laboratory is looking at the potential for Alzheimer's prevention by controlling inflammation with omega-3 fatty acids and curcumin. Other food substances -- such as resveratrol in red wine and flavonoids in fruits -- may have anti-inflammatory effects by acting along the same pathway that curcumin does, he says.

Cole suspects that people are more likely to take a supplement or two than to radically change their diets. "Nutritionists, they'll tell you to eat right. It is good, sound advice, but you can't always get people to do it," he says. "The question is, can you find an easier supplement approach that doesn't require a restricted diet?"

Supplements do have their drawbacks. "Many Alzheimer's researchers were prescribing vitamin E [an antioxidant] to all their patients," says Debra Cherry, a clinical psychologist and the executive vice president of the Alzheimer's Assn. of the California Southland. "But some data came out that people had high bleeds and suffered from cardiovascular problems."

Dietary revamp

Perhaps a complete diet overhaul -- difficult though that may be -- would be a better strategy. The Mediterranean diet, named for the region in which it originated, has many anti-inflammatory features.

It includes fruits, vegetables, nuts, fish, whole grains, alcohol, and healthful fats like olive and canola oil. It has been shown to lower LDL cholesterol and triglyceride levels and reduce the risk of blood clots. Studies have shown that diets high in fish, olive oil and cooked vegetables reduce the symptoms of rheumatoid arthritis. A Mediterranean diet or elements of it seems linked to reduced risk for a number of chronic conditions, including cardiovascular disease, cancer, diabetes and Alzheimer's. (See related story online.)

"If people noticed they're slightly overweight, or if blood pressure is starting to creep up, or if blood sugar [increases], and they went on a Mediterranean-type diet, they might be able to decrease inflammation and stop the progression of disease," says Dr. Wadie Najm, a clinical professor of family medicine and geriatrics at UC Irvine who directs an integrated medicine clinic at UCI that focuses on complementary and alternative medicine.

Many patients visiting his clinic have chronic inflammatory conditions, including autoimmune diseases such as arthritis and gastrointestinal problems such as Crohn's disease. Patients begin a specialized diet and exercise, and make other lifestyle changes to decrease inflammation.

"In three weeks, if [patients] follow the protocol, we see great results in improvement in symptomology and reduction in flare-ups," says Bianca Garilli, a naturopathic doctor at the clinic.

Of course, these dietary and other lifestyle changes might help treat pain conditions through the placebo effect -- a belief in a treatment rather than the treatment itself, says Dr. Roger Chao, an associate professor of medicine at Oregon Health and Science University and director of clinical guidelines development for the American Pain Society.

"You're giving something for people to focus on and do something good for themselves," Chao says.

At the end of the day, there is evidence to suggest that your best bet at curbing inflammation is to eat a healthful diet -- and keep your weight in check -- without specifically thinking about anti-inflammatory foods.

"There is no doubt that if you lose weight, inflammation is dramatically improved," Greenberg says. When a person is overweight or obese, body fat breaks down into fatty acids, which circulate in the blood. These fatty acids promote an immune response in the same way that infection does, increasing inflammation.

It will take time to tease apart the effects of anti-inflammatory diets and supplements. But Cole thinks the effort is well worth it. "The alternative to these kinds of things aimed at prevention is to pay for treatments," he says. "And we can't always afford them."

health@latimes.com

Copyright © 2009, The Los Angeles Times

Paying for health care

2009-08-03T17:32:00.001-07:00

August 3, 2009

Funding health care reform in the US.

I received this note from the center for science in the public interest which is a non-profit group that publishes an excellent newsletter. It also provides important update on issues that relate to science nad politics. Because I am convinced that much of athe epidemic of neurological/ psychological diseases are linked to eating diets so devoid of nutrition courtesy all the junk food I vigorously support their call for taxing junk food to help pay for the damage / chronic disease which results from eating the junk food. Please take a few minutes to contact your political leaders in which ever country you reside. These same issues affect you whether or not you are in the US.

Dear Terry Wahls,

Although moving more slowly than the President hoped, legislation to enact comprehensive health insurance reform has inched forward this week and is very likely to be considered by the full House of Representatives and the Senate when Congress reconvenes after the August recess. Among the many issues still to be fully resolved is how to fund the large expansion of health care coverage, and the degree to which the legislation will prioritize prevention-oriented measures to reduce health care costs and improve the health of Americans.

Members of Congress need to hear from you about prevention-oriented revenue raisers like alcohol and sugar-sweetened beverage taxes that can provide more than $250 billion over the next ten years in new money for health care reform, as they work to reduce the staggering health and social costs associated with obesity and excessive use of alcohol.

Please write your Senators and U.S. Representative NOW to encourage their consideration of health taxes on alcohol and sugar-sweetened beverages to help make real health care reform a reality.

Send a letter to the following decision maker(s):
Your Congressperson
Your Senators

Below is the sample letter:

Subject: Looking for Revenue for Health Care Reform?

Dear [decision maker name automatically inserted here],

As a consumer of health care and a taxpayer, I am writing to urge you to include higher taxes on alcoholic beverages and new taxes on sugar-sweetened beverages in health care reform legislation that will be considered in Congress during the fall. Such action can raise substantial new revenue to support expanded access to and delivery of health care services and will help this country reduce the significant harms and costs of alcohol problems and obesity, which impose unsustainable burdens on our health care system and our economic productivity.

Even modest taxes (a nickel a drink extra on alcohol and 3 cents per can on soft drinks) would raise more than $100 billion over ten years; larger taxes could raise as much as $250 billion over that period. Alcohol taxes haven't been raised since 1991, and inflation has eaten up some 40% of their value. That erosion in tax has meant that alcoholic beverages have become cheaper relative to other consumer products, and much more available to underage persons.

Low prices for alcohol fuel excessive consumption, as they have for sugar-sweetened beverages, which are the only food or beverage with a direct link to obesity. Since the 1990s, consumption of soft drinks has exceeded consumption of milk, and that has contributed to widespread obesity in this country. More than two-thirds of Americans are overweight or obese. Medical expenditures related to obesity total more than $147 billion per year, of which half is paid with Medicare and Medicaid dollars. One way or another, we all pay a lot of those unnecessary bills.

The economic costs of alcohol are also astronomical, more than $200 billion per year, on top of 85,000 deaths from accidents, homicides, diseases, and suicides. Current federal taxes on alcohol, which bring in $9.3 billion per year, are woefully inadequate to compensate society for all that harm.

Imposing meaningful taxes on unhealthy sugar-sweetened be verages and on intoxicating and potentially addictive alcoholic drinks will have the added benefit of reducing their use and some of the associated harms. That's a perfect fit for health care reform- helping us become a healthier nation and helping to reduce health care, public safety, and social costs.

I urge you to include these health taxes in pending legislation to reform our health care system. Please let me know your views on this subject. Thank you for your consideration.

Sincerely,

Terry Wahls

Research up date

2009-07-26T20:48:00.001-07:00

The pharmacy and therapeutics committee requested more documented safety data on the nutrition and vitamins I proposed in the study protocol. As a result the study was not approved. I have continued to meet with the pharmacists to review the published literature which is what inspired me to design the nutritional approach which I have taken. These meetings and requests for more information to prove the safety of what I propose in the pilot take time, and patience and a lot of cajoling. As a result I am back to not knowing when the study will be approved, nor do I know how many people we'll be able to enroll in a pilot when it is approved.

In the interim we are getting close to having the original case report accepted for publication. Because we chose to put it into a journal that has open access when it is published I will be able to put a link to the article on this web site so that it can be accessed more readily. Although the pilot study is not approved, the research survey studies about the nutrition and the use of electrical therapy are ongoing. We have 42 responses in the nutritional study and 22 responses in the electrical stimulation study. While I can't talk about the data from those studies in any kind of detail I will comment on what people have reported about the presence of adverse event or complications from nutrition / e stim.

No significant adverse problems associated with the nutrition were reported. For the estim a couple of individuals have reported skin burns and discomfort as problems. One person reported their MS worsened and they discontinued the estim. Although this is not enough to prove safety or efficacy, I consider this good news.

The other thing that is happening is that my physical therapist is writing up a case series reporting on his first 9 patients that he's treated with electrical stimulation. Unfortunately doing a scientific article usually takes several months to a year to go from start to being in print. Science is like that, painfully, arduously slow. I find it maddening too, but that is the nature of the beast.

Like everyone else in the world the recession is affecting the academic world too. We are also being asked to do more for less. That means that we are all picking up more clinic time and have less time to work on unfunded research. The consequence to that is that my partners who are doing this research are also being asked to do more. We have less time to devote to trying find the answers to the questions raised by the pharmacists. So we work at it. That means I choose between putting some time on the blog, or time on getting the pilot going. I've been prioritizing getting the pilot study approved. Of the two, I think that is the more important task. Getting a pilot study so we have preliminary data and can submit a grant for a larger study -- which could then be recognized by the medical community has the greatest impact for everyone.

For those of you who are dismayed that I'm not blogging more frequently I apologize. I also apologize for creating the hope that I'd have a pilot study open in the near future. I do not know when or if it will ever be approved.

That is not in my control, although I do tell myself it can't be harder than getting out of the wheelchair (some days I wonder however!). In the interim I'm working, seeing patients, teaching a couple times each month, working with my team on trying to get a pilot protocol through the review process so it can be approved.

Re my absence from posting / face book

2009-07-26T20:47:00.000-07:00

Two things happened - one was that my personal ilfe became hectic as my son finished high school. Then my digital passwords for my face book and other internet accounts were compromised. Those problems have me locked out of my email accounts, facebook and my financial institutions and more which is why I have not been posting to anything. I couldn't access most of my digital word - and still cannot. At this point my priority is resolving the havoc it's created. If I have to rebuild all of the digital content that will take many months - and I am much more interested in trying to move the pilot study forward and doing the classes to which I've already committed this summer and fall.

I apologize to those of you who were wondering what happened to me.

Iodine and MS

2009-07-26T20:46:00.000-07:00

July 26, 2009
Update
Iodine

Over 70 percent of Americans do not take in a sufficient amount of iodine in their diet to meet the daily recommended dietary allowance for Iodine. This is because the North American soils are Iodine depleted and we physicians have advised our patients to not use table salt. Since most of us were getting our daily Iodine through the use of Iodized table salt instead of consuming sea weed, the majority of Americans now consume less than 1/3 of the recommended daily intake for Iodine.

That is important for those who suffer from MS because Iodine is an important nutrient for making myelin. It is also an important nutrient for removing toxins.
The best food sources for iodine include sea weed (especially kelp), iodized sea salt, sea salt and iodized salt. Also because kale and other cruciferous (cabbage family) vegetables compete with iodine receptors - those of us who eat a lot of cabbage family vegetables need to eat more iodine than those who do not. I can't find a specific dietary recommendation on how much much iodine we need however. My personal approach has been to add a teaspoon of powdered kelp to my kale salads.

Ideally to determine whether or not one has iodine deficiency would be to work with a physician who is expert in Iodine. More information about iodine can be found at http://iodine4health.com/

Diet MS and Neurodegeneration

2009-05-27T19:02:00.000-07:00

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.

Research opportunity.

2009-05-09T18:41:00.000-07:00

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

Fixing Health Care the Right Way

2009-05-09T18:40:00.001-07:00

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

Book Update - the steps I took....

2009-05-09T18:38:00.002-07:00

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.

Vitamin B12

2009-05-09T18:38:00.001-07:00

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.

Food versus supplements - why food is more important

2009-05-09T18:37:00.000-07:00

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

Neuroelectrical stimulation of muscles

2009-05-09T18:36:00.001-07:00

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

More on Vitamin D

2009-05-09T18:35:00.000-07:00

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

Neurostim - is it safe for me to try on my own?

2009-05-09T18:33:00.000-07:00

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.

Researchers Find Link Between Oxidative Stress and MS in the spinal fluid of MS patients

2009-02-22T05:15:00.000-08:00

Link between MS and oxidative stress documented in spinal fluid

This article was published December 2008

the link below should take you to the article --
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2584157#id409706%23id409706

J Neurol Sci. Author manuscript; available in PMC 2008 December 15.
Published in final edited form as:
J Neurol Sci. 2008 December 15; 275(1-2): 106–112.
Published online 2008 September 9. doi: 10.1016/j.jns.2008.07.032.

Copyright notice and Disclaimer

Cerebrospinal fluid evidence of increased extra-mitochondrial glucose metabolism implicates mitochondrial dysfunction in multiple sclerosis disease progression
William T. Regenold,1 Pornima Phatak,1 Michael J. Makley,2 Roger D. Stone,3 and Mitchel A. Kling4
1University of Maryland School of Medicine, Department of Psychiatry, Division of Geriatric Psychiatry, and the Baltimore Veterans Affairs Medical Center, Research Service, Baltimore, MD 21201, USA
2University of Maryland School of Medicine, Department of Neurology, Comprehensive Multiple Sclerosis Center Baltimore, MD 21201, USA
3National Institute of Neurological Disorders and Stroke, Neuroimmunology Branch, Bethesda, MD, USA
4Wyeth Pharmaceuticals, Division of Clinical Translational Medicine. Formerly, National Institute of Mental Health, Clinical Neuroendocrinology Branch, Bethesda, MD, USA

This was published in the Journal of Neurological Sciences in December 2008. These authors talk about the evidence of mitochondrial dysfunction in those with progressive MS. Quoting from their abstract: "... the extra-mitochondrial glucose metabolism increases with impaired mitochondrial metabolism of glucose, these findings implicate mitochondrial dysfunction in the pathogenesis of MS disease progression. CSF metabolic profiling may be useful in clarifying the role of mitochondrial pathology in progression and in targeting and monitoring therapies for disease progression that aim to preserve or boost mitochondrial glucose metabolism."

This is yet another bit of evidence which supports my theory that mitochondrial health have a large role to play in progressive multiple sclerosis. It may not be the whole story - inflammation is probably a factor also. But fixing one's mitochondria is probably a very important long term strategy.

T

Mitochondria and chronic fatigue link found

2009-02-22T05:12:00.000-08:00

This article was forwarded to me - and I am providing a link below. It adds more credence to the importance of mitochondria as a factor contributing to fatigue.

Quick summary - link to full text is below.
Mitochondrial dysfunction noted in individuals with chronic fatigue syndrome. Those with more severe dysfunction had more severe fatigue.
See an attached PDF of the actual article. While this is not a multiple sclerosis patient population - it does lend credence to theory that mitochondrial dysfunction has a role in the disabling fatigue in worsening MS.

My advice -- eat specifically for your mitochondria. Be sure you've got a rich source of B vitamins (mushrooms, dark green leafy vegetables), co-enzyme Q (wheat germ or organic liver), and antioxidants (intense colors, preferably some purple-black, red, and yellow-orange each day). Spending most of your calories each day on organic vegetables, fruit, seeds/ nuts is a great way to add to your micro-nutrient content.

Coming soon –I will soon have a DVD which features lectures with an audio link to power points slides. These lectures include my food as medicine lectures to the medical students, and pharmacy students and separate food as medicine lectures to the public. I am currently teaching a six week food as medicine course to the public and will be converting that to an audio series as well.

The link below should get you to the article

Int J Clin Exp Med (2009) 2, 1-16
www.ijcem.com/IJCEM812001
Original Article
Chronic fatigue syndrome and mitochondrial dysfunction

Sarah Myhill1, Norman E. Booth2, John McLaren-Howard3
1Sarah Myhill Limited, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK; 2Department of Physics and Mansfield College, University of Oxford, Oxford OX1 3RH, UK; 3Acumen, PO Box 129, Tiverton, Devon EX16 0AJ, UK

http://www.ijcem.com/files/IJCEM812001.pdf

Food Matters in MS

2009-02-22T05:10:00.000-08:00

Food Matters in MS

The etiology of multiple sclerosis remains unknown. Likely there are several different pathways to developing multiple sclerosis of MS. The factors which are likely playing roles in MS are the interaction of the following: 1) DNA, 2) Toxin exposures (eaten, inhaled or absorbed through skin), 3) Infection 4) Micronutrient intake (food), 5) Allergy or sensitization (to food), 6) Stress level (physical, psychological and spiritual) and 7) Insulin production each day. The cause of injury has been identified as antibody complexes which destroy myelin. The loss of myelin leads to breaks in the communication between the brain (and spinal cord) and the body. The result is weakness and or disturbed sensation (blind, dizziness, pain).

In this blog I will talk food and multiple sclerosis. There are three main ways food can get individuals into trouble. First – is toxins from the use of herbicides and pesticides. Second is micronutrient intake and third is food allergy and sensitization. Third is the effect of maintaining high insulin levels on the level of inflammation in our body. I’ll conclude the article with a brief synopsis of what I have done personally regarding food.

Toxins are present in and on the food that has been grown with the help of pesticides and insecticides. Best options to deal with this is grown your own food, or buy local organic when you can. Wash all food carefully. If you buy non-organic wash carefully. The more gently you have to wash something, such as berries, the more likely it is that you can’t get the pesticides off the food. Lettuce, berries, and celery have high amounts of pesticide residue. If you can – go organic for those.

Micronutrients have been discussed previously. The standard American diet (SAD) is below the recommended daily intake for many vitamins, minerals and phytonutrients that our brains need. We often do eat enough omega 3 fatty acids (fish & fish oil, flax & flax oil) for making a key myelin. Neither do we eat enough of the correct amino acids (especially sulfur) for making key neurotransmitters. Diets with 9 cups of fruits and vegetables, 3 of which are rich in sulfur such as the onion and cruciferous family of vegetables will greatly improve the micronutrient content of the diet.

Food allergies and sensitivities are also a contributor. Celiac disease which is gluten (found in wheat, rye and barley) sensitivity causes the body to make antibodies against gluten. The symptoms are not just belly stuff. People can have skin problems, joint problems, fatigue, personality changes, mood problems, weakness, and pain. People have come in with severe neurological problems, severe changes on their brain MRIs and have been diagnoses with multiple sclerosis. But when someone considered the possibility of gluten sensitivity and had the patient faithfully follow gluten-free diet, their neurological problems began to resolve over the next year. The brain MRI improved. The large white scars on the MRI disappeared. The patient actually had gluten sensitivity, not multiple sclerosis. That is why anyone who has been diagnosed with multiple sclerosis would benefit from eating a very stringent gluten-free diet for at least a month to help determine what role gluten-sensitivity has in their disease.

If we can have that level of damage and response in the brain to sensitivity to wheat, it is logical to consider sensitivity to other foods can likely generate similar levels of damage to the body and brain. That means that anyone with MS who is not doing well would likely benefit from considering the possibility of food sensitivities as a factor that keeps their disease active.

That is a complex issue to solve because people can end up sensitized to multiple food items. We know that in those with gluten sensitivity, 70% have their symptoms completely resolved with gluten avoidance. The other 30% have additional food sensitivities which must be identified and also eliminated to do well. So how do we figure out who is sensitive to what foods? That is not easy for several reasons. 1) The blood tests can capture some of the sensitivities, but not all, and 2) Although most reactions occur quickly, some reactions to food occur up to 72 hours after ingestion. As a result the most effective way to confirm food sensitivities is through an elimination diet, food diary and symptom diary for a minimum of one month. The next several paragraphs describe two approaches to identifying what sensitivities a person may have.

Gradual food reintroduction is the most stringent application of a food diet asks the individual to eat only the most non-sensitizing food available in America for a week, and then gradually reintroduces one food item per week. The individual keeps a symptom record. If no symptoms of any type occur in that week, the food item is identified as safe and added to the list of allowed foods. Gradually over several months food items are gradually returned to the diet. Because of the gradual process, it is possible to identify with precision what causes symptoms and eliminate that particular food from the diet. Many are not willing or capable of doing that kind of protocol. , 3) Elimination diets require planning ahead.

Elimination diets are a more moderate approach. The person with MS is advised to eliminate the most common sources of food allergy from their diet initially. These include: wheat, eggs, milk, and legumes (which includes peanuts and cashews). They are then given a chart which lays out a 4 day rotation plan and menu suggestions. The goal here is to have the individual eat from different food families every day so that you do not eat a food more frequently than every 4 days. The individual is to keep a food and symptom diary. Because symptoms occur within 72 hours, the individual who has kept their food diary knows all of the food items they have eaten in the prior 3 days. They can identify what foods have been safe in the past, and what foods were new in that time period. They are advised to eliminate that food from their diet. If the person wishes, they could try that food again in 4 to 6 months. It turns out that for some people we have a few severe food allergies that we can never eat, and others which are milder allergy. If we eliminate the mild allergy food for 6 months, the lining of our gut heals. Then if our gut sees the mild allergy food only on occasion the gut cells can tolerate it without causing a major antibody response. The other benefit of an elimination diet is that it tends to increase the variety in our food intake often improving the micronutrient content in the long run.

Books are available on the issue of food sensitivities and micronutrients to help you design menus that can work for you. These include The Worlds’ Healthiest Foods http://www.whfoods.com/, The MS Recovery Diet http://msrecoverydiet.com/ and Restoring Your Digestive Health http://www.amazon.com/Restoring-Your-Digestive-Health-Transfom/dp/07582028220 . Gluten-free diet resources can be found at http://www.celiac.com/catalog/index.php?cPath=48_50. Asthon Embry has written extensively on connections between diet and MS and has a web site http://www.direct-ms.org/bestbet.html.

Insulin is a pro-inflammatory hormone. The more insulin our bodies need to make to control our blood sugar levels, the more inflammation molecules we make. If we eat a diet that does not generate rapid climbs in blood sugar, we do not need to generate as much insulin. Sugar makes our blood sugar rise very rapidly. Eating white potatoes makes blood sugar rise rapidly. So does drinking juice that has had the pulp and fiber removed from the juice. So does eating things made with white flour like bread, pastries, and pasta. If you want to lower the insulin levels then the best diet focuses on the non-starchy vegetables, protein sources, whole fruit, and avoids or minimizes grains. Whole grains are absorbed more slowly and therefore generate less insulin.

Celiac Disease and gluten-free diets have a larger collection of books devoted to that topic. Google the terms and you will find many sources of additional information.

Eating out and processed foods are a challenge for those who are using an elimination diet. You need to read labels carefully, and ask the waiter about what food item may be included in the dish you are ordering. The simplest approach is to avoid eating processed food, or eating out, particularly while you are first going through the elimination diet.

What did I do regarding my food consumption? In 2003 I began the Paleolithic diet. I eliminated grains, milk and legumes. I continued to eat meat, poultry, fish, vegetables (including white potatoes), fruit, and eggs. By 2007 I had gone back to eating rice, and occasional beans. Summer of 2007 I took a blood test for food allergies which identified marked sensitivity to eggs, pinto beans, and milk. I eliminated those from my diet in October. I started the four day rotation diet but did not maintain it. I was not keeping a food symptom diary. November 2007 I started neurostim. At the end of December I started the intensive diet rich with 9 cups fruits and vegetables a day minimum. I ate 4-6 cups of cruciferous or onion family vegetables each day, and 3 cups of brightly colored vegetables or fruits. January 2009 I went back to creating a food, symptom diary and began the elimination diet with the four day rotation of foods.

Why was I able to go from four years dependent on a scooter, back to walking, bicycling and skiing?

Since I don’t have serial blood tests to identify how much nutritional status changed, the inflammatory status, or biological changes that were occurring it is hard to say what precisely what happened as I got stronger. I do have several theories which I’ll share.

First – the neurostimulation that I started in November 2007 coupled with exercise produced stronger larger muscles and generated growth factors in the brain which stimulates repair of myelin, and growing new connections between brain cells. That priming made my brain more ready to do the repair work. The food made it possible for the brain cells to use the growth factors.

Second – I eliminated more vigorously the foods to which I had documented food sensitivity on the blood tests in the summer of 2007.

Third – I greatly increased the intake of B vitamins, co-enzyme Q, antioxidants and organic sulfur though food. This resulted in a big boost of the micronutrients I was eating.

Fourth – I switched to entirely organic foods.

Fifth – I focused on getting every color each day.

Sixth – Because I eliminated white potatoes, grains etc, - the amount of insulin my body makes each day is quite low.

Seventh – I now keep a food / symptom diary and follow a four day food rotation.

What about supplements?

While there may be benefits in supplements – they are not without risks. Supplements are not regulated by the FDA. There are many reports of supplements not containing what they label claims to be inside. In addition there are problems with the purity and contamination. If the herbs or foods listed on the label are not grown on organic farms, there is a risk of heavy metal contamination (also present in our food). But since the food is concentrated to very high levels for the supplement – the previously trace levels of contamination can become quite high. Another important difference is that nearly every study has shown that the whole food is associated with superior outcomes to specific nutrients. That is likely because we absorb nutrients better when they are in food. Higher blood levels are consistently seen in comparison to food versus supplementation. Also we get the additional hundreds of other phytonutrients in food all of which are likely playing contributory roles in health. My recommendation is to focus first on using an elimination diet and food/ symptom diary to maximize your micronutrient intake and lower inflammation.

Summary

Food matters. If you can, grow some of your own food. Buy organic. Try eliminating the most common offenders – gluten, eggs, milk, and legumes. Keep a food, symptom diary. Try an elimination diet with a four day food rotation. Consult with a nutritionist or other healthcare provider familiar with elimination diets. Exercise can help increase the brain growth factors and speed healing. But without the needed micronutrients and lower levels of inflammation – you wont’ get far. The quality of the good and the avoidance of foods to which you are sensitive can make a big difference in your ability to improve.

Cross country skiing once again

2009-01-01T09:52:00.000-08:00

December 26th, 2008

Back to the woods

I had skied a couple of times in the prior two weeks in our backyard. I wondered if I could ski in the woods again. The day after Christmas I decided to try. It was a beautiful winter day in Wisconsin. The temperature was a few degrees below freezing, 10 centimeters of fresh snow had fallen, and the sun was shining. I went with my family to 9 Mile Swamp which has many kilometers of groomed ski trails. I knew skating was impossible and used my classic cross country skis. Then my seventeen-year old son and I started down the trail. I loved listening to the crunch of the snow as we glided through the white pine, birch and maple woods. I could handle the flats, and the gentle uphill grades. After fifteen minutes of skiing my thigh muscles were fatigued and it was difficult to hold the tuck position and I fell. I sat in the snow, resting. A few minutes later my son gave me a hand standing up. Ninety minutes later we returned to the lodge. I'm not sure how far Zach I had skied, but it would have been unimaginable, that I would be back in the woods on my skis a year ago.

December 20, 2008

My tilt-recline wheelchair is gone.

This was a day which I had not thought would ever come. I donated my tilt-recline wheelchair to charity. They picked it up. Jackie took a picture of me waving good-bye to it.

For the past couple of weeks I have not been changing much. It could be the recent bout of vomiting and diarrhea that has gone through our household!

I also got out my cross country ski boots, and my cross country skis. It was just a few loops around our back yard, but I skied. Snow was falling. Fresh rabbit tracks were in the yard. Bright red berries were on the winter berry shrubs. The tall ornamental grasses swayed in the breeze. It was beautiful.

Thiamin Vitamin B1

2008-12-14T18:57:00.000-08:00

Thiamin, vitamin B1 is another key nutrient for brain health. In this newsletter I will briefly review the role of thiamine in the brain and some food sources for this important vitamin.

I have stated earlier that mitochondrial health is critical to brain health. Without mitochondria making ATP molecules from the food we eat, the brain cells do not have the energy to so their work. They can’t make myelin, they make few neurotransmitters and are unable to repair damage done to the myelin sheath.

Thiamin is involved in supporting mitochondrial function in the brain. Without thiamin mitochondria have more difficulty generating ATP molecules or energy from sugar and carbohydrates. Thiamin is also an important co-factor to help the brain cells make myelin to insulate the nerve.

Ensuring plenty of thiamin in one’s diet is important for anyone with MS. Thiamin is secreted by the kidneys and is generally not stored in the body. It is important to have a steady supply in your diet. Good food sources include sunflower seeds, mushrooms, yeast, asparagus, black beans, cabbage and kale.

How much thiamin can one take safely? Because the body can easily get red of the excess thiamin an upper limit for safe amount of thiamin has not been established.
Physicians have used thiamin to treat alcoholic-related brain damage. Excessive alcohol use can cause severe thiamin deficiency. As a result they develop brain damage causing problems with memory, coordination, balance and problems with heart failure. The typical dose of thiamine given to alcoholics is 100mg per day. Thus it is likely that 100 mg of thiamin each day would generally be safe.

Physicians in the past have advocated high dose thiamin for people with degenerative brain conditions like Parkinson’s, Alzheimer’s and multiple sclerosis. Dr. Frederich R. Klenner and the Canadian physician, Dr. H.T. Mount, both reported success using nutritional approaches to treat MS based upon liver extract which is a potent source of B vitamins. They believed that high dose thiamin, riboflavin (vitamin B2) and niacinamide (vitamin B3) were beneficial for those suffering from poor brain health.

Unfortunately, few who eat the western diet consume adequate amounts of vitamins and minerals, including the B vitamins. While taking extra thiamin may be very helpful, improving the micronutrient content of your diet overall is a better solution. Eat more mushrooms, nutritional yeast, vegetables and fruit with a goal of consuming at least 9 cups a day is a better solution. That way you get more of the many essential vitamins and minerals that are necessary for a healthy brain and a healthy body.

Radio interview podcast

2008-12-09T21:46:00.001-08:00

This link will take you the Iowa Public radio station which has an MP3 file of interview with Ben Kieffer on "The Exchange" December 8th, 2008.

http://www.publicbroadcasting.net/kuni/.jukebox?action=featured

Scroll down to find the pod cast for December 8.

MIcronutrients and Improved Function in MS

2008-12-04T20:40:00.000-08:00

Progressive multiple sclerosis and micronutrients – is raw food superior to cooked food?

I am often asked whether raw food is superior to cooked food for micronutrient availability for patients with MS. The basic guide I provide is that food taken directly from the plant is the very best for you. If you cook food, the lower temper in steaming or a very low (180 degree) roast is the next best. The other key item is to eat any fluid or juice from the cooking (which is where all the water soluble nutrients have gone.

Micronutrients are critical for brain health. Unfortunately the average western diet is deficient in most vitamins, minerals, essential fatty acids and amino acids which have recommended daily allowances. The reason for this is the reliance on cheap sources of calories in grains which have most often had the germ and husk of the grain removed.
Very few vegetables are consumed. The animals are increasingly raised in high density farm factories with minimal exposure to green grass or sunshine. The consequence is that the meat has minimal omega 3 fatty acid, vitamin and mineral content.

Are nutrients lost with cooking? That depends on high the cooking temperature and how long. Immediately fresh and still raw when you eat the food means that cooking has not leached any of the micronutrients out of it. But some of the micronutrients may not be available to you because our bodies can’t digest all of the cell walls in plants. If you cook below the boiling point and drink all the juice – the food is generally more digestible and you have not lost much of the micronutrients. However – some of the compounds that are very helpful to us will gradually be lost with prolonged cooking. Cooking above the boiling point of water, particularly frying tends to oxidize many of the compounds in food. When that occurs many of the anti-oxidants in food have become oxidized – and therefore their anti-oxidant benefit to us is gone.

Bottom line – Raw retains the nutrients in the food. Cooking gently makes the nutrients more available because the food has been partially digested by cooking. Frying oxidizes many of the helpful compounds. Prolonged high temperatures cooking likewise can breakdown micronutrients. My advice is to increase your micronutrients through more vegetables and fruits. Eat them raw or cooked according to your personal preference. But if you cook, always drink the juice. Never throw it away.

Media Events

2008-11-28T14:25:00.001-08:00

Radio interview December 8th 2008
10 a.m. with Ben Keiffer
910 AM

We will be talking about the use of neuromuscular electrical stimulation and nutrition in the setting of MS.

Vitamin D and MS disease activity

2008-11-26T23:22:00.000-08:00

In this blog I will comment on the role of vitamin D in multiple sclerosis. Multiple studies have demonstrated an association of low vitamin D levels and increased risk of multiple sclerosis diagnosis and greater severity of symptoms.

We also have more and more evidence that vitamin D is important to health immune function. Furthermore there is an epidemic of vitamin D deficiency. People spend less time outdoors. When they do go outside people apply sun screen to protect them from the sun to decrease the risk of skin cancer. The problem is that sun screen also blocks the skin's ability to make vitamin D. That explains why we have an epidemic of vitamin D deficiency in our children, young adults and those over sixty-five. Thus far every group that has been measured has had an alarming rate of vitamin D deficiency.

If someone has MS or has a family member with MS it is likely that they would benefit by taking supplemental vitamin D. What dose should they take? The recommended daily allowance for vitamin D has been set for only 400 international units (IU). That was when scientists had believed vitamin D's only role was related to bone health. The dose of 400IU was the dose of vitamin D which prevented spontaneous bone fractures. However vitamin D affects more than bones. The brain is filled with Vitamin D receptors and vitamin D is important to normal immune function.

There is increasing evidence the recommended daily allowance is much too low. If one was outside during the summer long enough so that their skin was slightly pink, but not enough to have even a mild sun burn, 20,000 IU of vitamin D would have been made in the skin. Researchers have recently given MS patients higher doses of vitamin D and then examined the patients for evidence of toxicity and of decreased MS disease activity. Their conclusion was that doses of 10,000 IU each day were well tolerated. Furthermore patients who had been given 10,000 IU experienced less disease activity as measured by the ability to tasks of daily living and the molecular markers of MS related inflammation.

Based on those study findings taking 10,000 IU per day of vitamin D is likely safe and likely beneficial. Using tanning beds to maintain a tan without burning is an alternative strategy to maintaining adequate vitamin D levels. Having your personal physician check your calcium level would confirm that the high dose of vitamin D is not causing problems for you. Ensuring that you have sufficient vitamin D is an important strategy to minimize disease activity if one has or is at risk of having MS.

Media Events

2008-11-20T17:47:00.000-08:00

Radio interview
November 25th at 10 a.m.
I will be interviewed by Ben Keiffer on Iowa Public Radio 910 AM.
Television show
Week of November 24th
During the week of November 24th the lecture Up from the Chair - How did it happen? will air on cable access TV in Iowa City, Iowa. The 2 hour show will be broadcast multiple times through that week and the following week. Check with the cable access for specific times.

Connections Between Food, Mitochondria and Chronic Disease

2008-11-19T17:07:00.000-08:00

In this post I will review the connection between micronutrients, mitochondria and multiple sclerosis. The link between the food you eat, the micronutrient content of that food, and multiple sclerosis is reviewed. The specific micronutrients needed for optimal mitochondrial health is reviewed and general diet recommendations are provided.

The brain and spinal cord depend entirely on mitochondria to the make the molecules of adenosine tri-phosphate or ATP which are used to drive everything that our brain cells must do to function. The chemical plant which makes ATP molecules is the mitochondria. Two important cofactors are needed to make ATP. These are B vitamins and coenzyme Q10. And like all manufacturing processes there is some left over trash at the end which is free radicals. And like any other factory, when the trash is not removed the chemical plant eventually blows up. The defense against free radicals is antioxidants. When the mitochondria are short on the B vitamins and coenzyme Q less ATP is made and more trash is made per ATP molecule generated. When less antioxidants are around free radicals are not neutralized and instead begin to damage the brain cell.

There is a growing medical literature which indicates that mitochondria are not healthy in multiple sclerosis and are contributing to the damage which is occurring, particularly in progressive MS. Eating to ensure one’s mitochondria have plenty of micronutrients is something under the individual’s control and is not going to conflict your current treatment.

It is important for cells to have a ready supply of intracellular anti-oxidants. It is the colored vegetables and fruits that have the most anti-oxidants.

Our Health= Micronutrients consumed – empty calories consumed.

Which one of those most closely describes your diet, or your children’s diet?

Chronic Disease= Few micronutrients (vegetables + fruits)- empty calories (French fries, potatoes, white bread, candy, soda, pastries etc.)

Optimal mental and physical healthy= Many fruits + vegetables, some fish, occasional organ meats – no empty calories.

The more micronutrients in your diet – the minerals like iron, magnesium, copper, manganese, calcium, vitamins both known and not yet discovered, and the antioxidants to help your cells get rid of the trash- the more easily it is for the cell to do all the things the DNA wants it to do.

I am in internal medicine- occasionally I give an antibiotic that cures someone of their infection. Mostly I give medicines that control symptoms- such as lowering blood pressure, improving blood sugar control, or lowering cholesterol. If someone wants to have optimal health- then they must provide their cells with as many micronutrients as possible.

Genes turn on and off according to our diets. That means if we eat diets poor in micronutrients- genes turn on which accelerate the degeneration of our bodies- worsening of diabetes, high blood pressure or obesity for example. If we eat diets rich in micronutrients – genes turn on that often lead to regression of disease.

Bottom line= optimal health requires optimal nutrition.

Physicians mostly can only control symptoms. For your mitochondria, your cells and your body’s to work most effectively – eat more micronutrients.

Diet recommendations: Each day maximize your micronutrients-

9 cups of vegetables and fruits 3 cups should be dark green or from the cabbage family,3 cups should be deeply colored, for example red, orange, or blue, and 3 cups of your choice but do not include potatoes or corn in the 9 cups.

Organ meats once a week or wheat germ daily for coenzyme Q

Fish or seafood three times a week

When you eat –

Have 3 cups of vegetables and fruit first, then your protein source, then whatever else it is that you want to eat. Remember –unless your are doing physical activity – your body was designed to maintain itself without any grains/ starchy potatoes. If you are physically active – then additional carbohydrates make sense. If you have any chronic disease – any calorie you eat that is not packed with micronutrients is a calorie that took you farther away from your goal of optimal health.

Activity – difficult to sustain if it is not part of your daily life. People who are most successful are those who have incorporated more walking, physicality into the their routines either before or during work hours. Moving (walking or jogging) one’s body 3 miles a day is optimal.

Sustaining the effort – people who lose weight and keep eating 9 or more cups of vegetables and fruit, and walked or jogged 20 miles in a week are the most successful at maintaining weight loss.

Supplements – Food is the best. Do not think can supplements replace the micronutrients from 9 cups of vegetables and fruits. If you cannot eat fish however –take fish oil or flax oil. If you cannot eat organ meats once a week or wheat germ daily, take coenzyme Q10 supplements. If you have chronic disease – improving the health and nutrition for your mitochondria is an excellent place to start.

Terry Wahls, MD

Growing Our Food to Restore Our Health

2008-11-03T14:47:00.000-08:00

November 3, 2008

As I speak with the public and my patients -- the question comes up frequently -- "How Do Afford This Many Vegetables and Fruits?"

That is important to consider. This article - which was published in the New York Times talks about growing food and is addressed to our next president. It is an excellent read ---
What the next president can and should do to remake the way we grow and eat our food.

I recommend it highly. The most important thing that we can do to reduce the burden of chronic disease - is to teach ourselves how to grow vegetables that are packed with micronutrients and easy to grow. This article discusses the need to shift our agriculture from dependent upon fossil fuels for production and transportation to local and regional food. We also need to find ways to increase the use of our back yards for growing food, and decrease our dependence on large agribusiness factory grown foods - all in ways that are manegable given our busy schedules.
Terry

New York Times

The Food Issue
Farmer in Chief

By MICHAEL POLLAN

Published: October 9, 2008

Michael Pollan, a contributing writer for the magazine, is the Knight Professor of Journalism at the University of California, Berkeley. He is the author, most recently, of “In Defense of Food: An Eater’s Manifesto.”

Dear Mr. President-Elect,

It may surprise you to learn that among the issues that will occupy much of your time in the coming years is one you barely mentioned during the campaign: food. Food policy is not something American presidents have had to give much thought to, at least since the Nixon administration — the last time high food prices presented a serious political peril. Since then, federal policies to promote maximum production of the commodity crops (corn, soybeans, wheat and rice) from which most of our supermarket foods are derived have succeeded impressively in keeping prices low and food more or less off the national political agenda. But with a suddenness that has taken us all by surprise, the era of cheap and abundant food appears to be drawing to a close. What this means is that you, like so many other leaders through history, will find yourself confronting the fact — so easy to overlook these past few years — that the health of a nation’s food system is a critical issue of national security. Food is about to demand your attention.
Complicating matters is the fact that the price and abundance of food are not the only problems we face; if they were, you could simply follow Nixon’s example, appoint a latter-day Earl Butz as your secretary of agriculture and instruct him or her to do whatever it takes to boost production. But there are reasons to think that the old approach won’t work this time around; for one thing, it depends on cheap energy that we can no longer count on. For another, expanding production of industrial agriculture today would require you to sacrifice important values on which you did campaign. Which brings me to the deeper reason you will need not simply to address food prices but to make the reform of the entire food system one of the highest priorities of your administration: unless you do, you will not be able to make significant progress on the health care crisis, energy independence or climate change. Unlike food, these are issues you did campaign on — but as you try to address them you will quickly discover that the way we currently grow, process and eat food in America goes to the heart of all three problems and will have to change if we hope to solve them. Let me explain.
After cars, the food system uses more fossil fuel than any other sector of the economy — 19 percent. And while the experts disagree about the exact amount, the way we feed ourselves contributes more greenhouse gases to the atmosphere than anything else we do — as much as 37 percent, according to one study. Whenever farmers clear land for crops and till the soil, large quantities of carbon are released into the air. But the 20th-century industrialization of agriculture has increased the amount of greenhouse gases emitted by the food system by an order of magnitude; chemical fertilizers (made from natural gas), pesticides (made from petroleum), farm machinery, modern food processing and packaging and transportation have together transformed a system that in 1940 produced 2.3 calories of food energy for every calorie of fossil-fuel energy it used into one that now takes 10 calories of fossil-fuel energy to produce a single calorie of modern supermarket food. Put another way, when we eat from the industrial-food system, we are eating oil and spewing greenhouse gases. This state of affairs appears all the more absurd when you recall that every calorie we eat is ultimately the product of photosynthesis — a process based on making food energy from sunshine. There is hope and possibility in that simple fact.
In addition to the problems of climate change and America’s oil addiction, you have spoken at length on the campaign trail of the health care crisis. Spending on health care has risen from 5 percent of national income in 1960 to 16 percent today, putting a significant drag on the economy. The goal of ensuring the health of all Americans depends on getting those costs under control. There are several reasons health care has gotten so expensive, but one of the biggest, and perhaps most tractable, is the cost to the system of preventable chronic diseases. Four of the top 10 killers in America today are chronic diseases linked to diet: heart disease, stroke, Type 2 diabetes and cancer. It is no coincidence that in the years national spending on health care went from 5 percent to 16 percent of national income, spending on food has fallen by a comparable amount — from 18 percent of household income to less than 10 percent. While the surfeit of cheap calories that the U.S. food system has produced since the late 1970s may have taken food prices off the political agenda, this has come at a steep cost to public health. You cannot expect to reform the health care system, much less expand coverage, without confronting the public-health catastrophe that is the modern American diet.
The impact of the American food system on the rest of the world will have implications for your foreign and trade policies as well. In the past several months more than 30 nations have experienced food riots, and so far one government has fallen. Should high grain prices persist and shortages develop, you can expect to see the pendulum shift decisively away from free trade, at least in food. Nations that opened their markets to the global flood of cheap grain (under pressure from previous administrations as well as the World Bank and the I.M.F.) lost so many farmers that they now find their ability to feed their own populations hinges on decisions made in Washington (like your predecessor’s precipitous embrace of biofuels) and on Wall Street. They will now rush to rebuild their own agricultural sectors and then seek to protect them by erecting trade barriers. Expect to hear the phrases “food sovereignty” and “food security” on the lips of every foreign leader you meet. Not only the Doha round, but the whole cause of free trade in agriculture is probably dead, the casualty of a cheap food policy that a scant two years ago seemed like a boon for everyone. It is one of the larger paradoxes of our time that the very same food policies that have contributed to overnutrition in the first world are now contributing to undernutrition in the third. But it turns out that too much food can be nearly as big a problem as too little — a lesson we should keep in mind as we set about designing a new approach to food policy.
Rich or poor, countries struggling with soaring food prices are being forcibly reminded that food is a national-security issue. When a nation loses the ability to substantially feed itself, it is not only at the mercy of global commodity markets but of other governments as well. At issue is not only the availability of food, which may be held hostage by a hostile state, but its safety: as recent scandals in China demonstrate, we have little control over the safety of imported foods. The deliberate contamination of our food presents another national-security threat. At his valedictory press conference in 2004, Tommy Thompson, the secretary of health and human services, offered a chilling warning, saying, “I, for the life of me, cannot understand why the terrorists have not attacked our food supply, because it is so easy to do.”
This, in brief, is the bad news: the food and agriculture policies you’ve inherited — designed to maximize production at all costs and relying on cheap energy to do so — are in shambles, and the need to address the problems they have caused is acute. The good news is that the twinned crises in food and energy are creating a political environment in which real reform of the food system may actually be possible for the first time in a generation. The American people are paying more attention to food today than they have in decades, worrying not only about its price but about its safety, its provenance and its healthfulness. There is a gathering sense among the public that the industrial-food system is broken. Markets for alternative kinds of food — organic, local, pasture-based, humane — are thriving as never before. All this suggests that a political constituency for change is building and not only on the left: lately, conservative voices have also been raised in support of reform. Writing of the movement back to local food economies, traditional foods (and family meals) and more sustainable farming, The American Conservative magazine editorialized last summer that “this is a conservative cause if ever there was one.”
There are many moving parts to the new food agenda I’m urging you to adopt, but the core idea could not be simpler: we need to wean the American food system off its heavy 20th-century diet of fossil fuel and put it back on a diet of contemporary sunshine. True, this is easier said than done — fossil fuel is deeply implicated in everything about the way we currently grow food and feed ourselves. To put the food system back on sunlight will require policies to change how things work at every link in the food chain: in the farm field, in the way food is processed and sold and even in the American kitchen and at the American dinner table. Yet the sun still shines down on our land every day, and photosynthesis can still work its wonders wherever it does. If any part of the modern economy can be freed from its dependence on oil and successfully resolarized, surely it is food.
How We Got Here
Before setting out an agenda for reforming the food system, it’s important to understand how that system came to be — and also to appreciate what, for all its many problems, it has accomplished. What our food system does well is precisely what it was designed to do, which is to produce cheap calories in great abundance. It is no small thing for an American to be able to go into a fast-food restaurant and to buy a double cheeseburger, fries and a large Coke for a price equal to less than an hour of labor at the minimum wage — indeed, in the long sweep of history, this represents a remarkable achievement.
It must be recognized that the current food system — characterized by monocultures of corn and soy in the field and cheap calories of fat, sugar and feedlot meat on the table — is not simply the product of the free market. Rather, it is the product of a specific set of government policies that sponsored a shift from solar (and human) energy on the farm to fossil-fuel energy.
Did you notice when you flew over Iowa during the campaign how the land was completely bare — black — from October to April? What you were seeing is the agricultural landscape created by cheap oil. In years past, except in the dead of winter, you would have seen in those fields a checkerboard of different greens: pastures and hayfields for animals, cover crops, perhaps a block of fruit trees. Before the application of oil and natural gas to agriculture, farmers relied on crop diversity (and photosynthesis) both to replenish their soil and to combat pests, as well as to feed themselves and their neighbors. Cheap energy, however, enabled the creation of monocultures, and monocultures in turn vastly increased the productivity both of the American land and the American farmer; today the typical corn-belt farmer is single-handedly feeding 140 people.
This did not occur by happenstance. After World War II, the government encouraged the conversion of the munitions industry to fertilizer — ammonium nitrate being the main ingredient of both bombs and chemical fertilizer — and the conversion of nerve-gas research to pesticides. The government also began subsidizing commodity crops, paying farmers by the bushel for all the corn, soybeans, wheat and rice they could produce. One secretary of agriculture after another implored them to plant “fence row to fence row” and to “get big or get out.”
The chief result, especially after the Earl Butz years, was a flood of cheap grain that could be sold for substantially less than it cost farmers to grow because a government check helped make up the difference. As this artificially cheap grain worked its way up the food chain, it drove down the price of all the calories derived from that grain: the high-fructose corn syrup in the Coke, the soy oil in which the potatoes were fried, the meat and cheese in the burger.
Subsidized monocultures of grain also led directly to monocultures of animals: since factory farms could buy grain for less than it cost farmers to grow it, they could now fatten animals more cheaply than farmers could. So America’s meat and dairy animals migrated from farm to feedlot, driving down the price of animal protein to the point where an American can enjoy eating, on average, 190 pounds of meat a year — a half pound every day.
But if taking the animals off farms made a certain kind of economic sense, it made no ecological sense whatever: their waste, formerly regarded as a precious source of fertility on the farm, became a pollutant — factory farms are now one of America’s biggest sources of pollution. As Wendell Berry has tartly observed, to take animals off farms and put them on feedlots is to take an elegant solution — animals replenishing the fertility that crops deplete — and neatly divide it into two problems: a fertility problem on the farm and a pollution problem on the feedlot. The former problem is remedied with fossil-fuel fertilizer; the latter is remedied not at all.
What was once a regional food economy is now national and increasingly global in scope — thanks again to fossil fuel. Cheap energy — for trucking food as well as pumping water — is the reason New York City now gets its produce from California rather than from the “Garden State” next door, as it did before the advent of Interstate highways and national trucking networks. More recently, cheap energy has underwritten a globalized food economy in which it makes (or rather, made) economic sense to catch salmon in Alaska, ship it to China to be filleted and then ship the fillets back to California to be eaten; or one in which California and Mexico can profitably swap tomatoes back and forth across the border; or Denmark and the United States can trade sugar cookies across the Atlantic. About that particular swap the economist Herman Daly once quipped, “Exchanging recipes would surely be more efficient.”
Whatever we may have liked about the era of cheap, oil-based food, it is drawing to a close. Even if we were willing to continue paying the environmental or public-health price, we’re not going to have the cheap energy (or the water) needed to keep the system going, much less expand production. But as is so often the case, a crisis provides opportunity for reform, and the current food crisis presents opportunities that must be seized.
In drafting these proposals, I’ve adhered to a few simple principles of what a 21st-century food system needs to do. First, your administration’s food policy must strive to provide a healthful diet for all our people; this means focusing on the quality and diversity (and not merely the quantity) of the calories that American agriculture produces and American eaters consume. Second, your policies should aim to improve the resilience, safety and security of our food supply. Among other things, this means promoting regional food economies both in America and around the world. And lastly, your policies need to reconceive agriculture as part of the solution to environmental problems like climate change.
These goals are admittedly ambitious, yet they will not be difficult to align or advance as long as we keep in mind this One Big Idea: most of the problems our food system faces today are because of its reliance on fossil fuels, and to the extent that our policies wring the oil out of the system and replace it with the energy of the sun, those policies will simultaneously improve the state of our health, our environment and our security.
I. Resolarizing the American Farm
What happens in the field influences every other link of the food chain on up to our meals — if we grow monocultures of corn and soy, we will find the products of processed corn and soy on our plates. Fortunately for your initiative, the federal government has enormous leverage in determining exactly what happens on the 830 million acres of American crop and pasture land.
Today most government farm and food programs are designed to prop up the old system of maximizing production from a handful of subsidized commodity crops grown in monocultures. Even food-assistance programs like WIC and school lunch focus on maximizing quantity rather than quality, typically specifying a minimum number of calories (rather than maximums) and seldom paying more than lip service to nutritional quality. This focus on quantity may have made sense in a time of food scarcity, but today it gives us a school-lunch program that feeds chicken nuggets and Tater Tots to overweight and diabetic children.
Your challenge is to take control of this vast federal machinery and use it to drive a transition to a new solar-food economy, starting on the farm. Right now, the government actively discourages the farmers it subsidizes from growing healthful, fresh food: farmers receiving crop subsidies are prohibited from growing “specialty crops” — farm-bill speak for fruits and vegetables. (This rule was the price exacted by California and Florida produce growers in exchange for going along with subsidies for commodity crops.) Commodity farmers should instead be encouraged to grow as many different crops — including animals — as possible. Why? Because the greater the diversity of crops on a farm, the less the need for both fertilizers and pesticides.
The power of cleverly designed polycultures to produce large amounts of food from little more than soil, water and sunlight has been proved, not only by small-scale “alternative” farmers in the United States but also by large rice-and-fish farmers in China and giant-scale operations (up to 15,000 acres) in places like Argentina. There, in a geography roughly comparable to that of the American farm belt, farmers have traditionally employed an ingenious eight-year rotation of perennial pasture and annual crops: after five years grazing cattle on pasture (and producing the world’s best beef), farmers can then grow three years of grain without applying any fossil-fuel fertilizer. Or, for that matter, many pesticides: the weeds that afflict pasture can’t survive the years of tillage, and the weeds of row crops don’t survive the years of grazing, making herbicides all but unnecessary. There is no reason — save current policy and custom — that American farmers couldn’t grow both high-quality grain and grass-fed beef under such a regime through much of the Midwest. (It should be noted that today’s sky-high grain prices are causing many Argentine farmers to abandon their rotation to grow grain and soybeans exclusively, an environmental disaster in the making.)
Federal policies could do much to encourage this sort of diversified sun farming. Begin with the subsidies: payment levels should reflect the number of different crops farmers grow or the number of days of the year their fields are green — that is, taking advantage of photosynthesis, whether to grow food, replenish the soil or control erosion. If Midwestern farmers simply planted a cover crop after the fall harvest, they would significantly reduce their need for fertilizer, while cutting down on soil erosion. Why don’t farmers do this routinely? Because in recent years fossil-fuel-based fertility has been so much cheaper and easier to use than sun-based fertility.
In addition to rewarding farmers for planting cover crops, we should make it easier for them to apply compost to their fields — a practice that improves not only the fertility of the soil but also its ability to hold water and therefore withstand drought. (There is mounting evidence that it also boosts the nutritional quality of the food grown in it.) The U.S.D.A. estimates that Americans throw out 14 percent of the food they buy; much more is wasted by retailers, wholesalers and institutions. A program to make municipal composting of food and yard waste mandatory and then distributing the compost free to area farmers would shrink America’s garbage heap, cut the need for irrigation and fossil-fuel fertilizers in agriculture and improve the nutritional quality of the American diet.
Right now, most of the conservation programs run by the U.S.D.A. are designed on the zero-sum principle: land is either locked up in “conservation” or it is farmed intensively. This either-or approach reflects an outdated belief that modern farming and ranching are inherently destructive, so that the best thing for the environment is to leave land untouched. But we now know how to grow crops and graze animals in systems that will support biodiversity, soil health, clean water and carbon sequestration. The Conservation Stewardship Program, championed by Senator Tom Harkin and included in the 2008 Farm Bill, takes an important step toward rewarding these kinds of practices, but we need to move this approach from the periphery of our farm policy to the very center. Longer term, the government should back ambitious research now under way (at the Land Institute in Kansas and a handful of other places) to “perennialize” commodity agriculture: to breed varieties of wheat, rice and other staple grains that can be grown like prairie grasses — without having to till the soil every year. These perennial grains hold the promise of slashing the fossil fuel now needed to fertilize and till the soil, while protecting farmland from erosion and sequestering significant amounts of carbon.
But that is probably a 50-year project. For today’s agriculture to wean itself from fossil fuel and make optimal use of sunlight, crop plants and animals must once again be married on the farm — as in Wendell Berry’s elegant “solution.” Sunlight nourishes the grasses and grains, the plants nourish the animals, the animals then nourish the soil, which in turn nourishes the next season’s grasses and grains. Animals on pasture can also harvest their own feed and dispose of their own waste — all without our help or fossil fuel.
If this system is so sensible, you might ask, why did it succumb to Confined Animal Feeding Operations, or CAFOs? In fact there is nothing inherently efficient or economical about raising vast cities of animals in confinement. Three struts, each put into place by federal policy, support the modern CAFO, and the most important of these — the ability to buy grain for less than it costs to grow it — has just been kicked away. The second strut is F.D.A. approval for the routine use of antibiotics in feed, without which the animals in these places could not survive their crowded, filthy and miserable existence. And the third is that the government does not require CAFOs to treat their wastes as it would require human cities of comparable size to do. The F.D.A. should ban the routine use of antibiotics in livestock feed on public-health grounds, now that we have evidence that the practice is leading to the evolution of drug-resistant bacterial diseases and to outbreaks of E. coli and salmonella poisoning. CAFOs should also be regulated like the factories they are, required to clean up their waste like any other industry or municipality.
It will be argued that moving animals off feedlots and back onto farms will raise the price of meat. It probably will — as it should. You will need to make the case that paying the real cost of meat, and therefore eating less of it, is a good thing for our health, for the environment, for our dwindling reserves of fresh water and for the welfare of the animals. Meat and milk production represent the food industry’s greatest burden on the environment; a recent U.N. study estimated that the world’s livestock alone account for 18 percent of all greenhouse gases, more than all forms of transportation combined. (According to one study, a pound of feedlot beef also takes 5,000 gallons of water to produce.) And while animals living on farms will still emit their share of greenhouse gases, grazing them on grass and returning their waste to the soil will substantially offset their carbon hoof prints, as will getting ruminant animals off grain. A bushel of grain takes approximately a half gallon of oil to produce; grass can be grown with little more than sunshine.
It will be argued that sun-food agriculture will generally yield less food than fossil-fuel agriculture. This is debatable. The key question you must be prepared to answer is simply this: Can the sort of sustainable agriculture you’re proposing feed the world?
There are a couple of ways to answer this question. The simplest and most honest answer is that we don’t know, because we haven’t tried. But in the same way we now need to learn how to run an industrial economy without cheap fossil fuel, we have no choice but to find out whether sustainable agriculture can produce enough food. The fact is, during the past century, our agricultural research has been directed toward the goal of maximizing production with the help of fossil fuel. There is no reason to think that bringing the same sort of resources to the development of more complex, sun-based agricultural systems wouldn’t produce comparable yields. Today’s organic farmers, operating for the most part without benefit of public investment in research, routinely achieve 80 to 100 percent of conventional yields in grain and, in drought years, frequently exceed conventional yields. (This is because organic soils better retain moisture.) Assuming no further improvement, could the world — with a population expected to peak at 10 billion — survive on these yields?
First, bear in mind that the average yield of world agriculture today is substantially lower than that of modern sustainable farming. According to a recent University of Michigan study, merely bringing international yields up to today’s organic levels could increase the world’s food supply by 50 percent.
The second point to bear in mind is that yield isn’t everything — and growing high-yield commodities is not quite the same thing as growing food. Much of what we’re growing today is not directly eaten as food but processed into low-quality calories of fat and sugar. As the world epidemic of diet-related chronic disease has demonstrated, the sheer quantity of calories that a food system produces improves health only up to a point, but after that, quality and diversity are probably more important. We can expect that a food system that produces somewhat less food but of a higher quality will produce healthier populations.
The final point to consider is that 40 percent of the world’s grain output today is fed to animals; 11 percent of the world’s corn and soybean crop is fed to cars and trucks, in the form of biofuels. Provided the developed world can cut its consumption of grain-based animal protein and ethanol, there should be plenty of food for everyone — however we choose to grow it.
In fact, well-designed polyculture systems, incorporating not just grains but vegetables and animals, can produce more food per acre than conventional monocultures, and food of a much higher nutritional value. But this kind of farming is complicated and needs many more hands on the land to make it work. Farming without fossil fuels — performing complex rotations of plants and animals and managing pests without petrochemicals — is labor intensive and takes more skill than merely “driving and spraying,” which is how corn-belt farmers describe what they do for a living.
To grow sufficient amounts of food using sunlight will require more people growing food — millions more. This suggests that sustainable agriculture will be easier to implement in the developing world, where large rural populations remain, than in the West, where they don’t. But what about here in America, where we have only about two million farmers left to feed a population of 300 million? And where farmland is being lost to development at the rate of 2,880 acres a day? Post-oil agriculture will need a lot more people engaged in food production — as farmers and probably also as gardeners.
The sun-food agenda must include programs to train a new generation of farmers and then help put them on the land. The average American farmer today is 55 years old; we shouldn’t expect these farmers to embrace the sort of complex ecological approach to agriculture that is called for. Our focus should be on teaching ecological farming systems to students entering land-grant colleges today. For decades now, it has been federal policy to shrink the number of farmers in America by promoting capital-intensive monoculture and consolidation. As a society, we devalued farming as an occupation and encouraged the best students to leave the farm for “better” jobs in the city. We emptied America’s rural counties in order to supply workers to urban factories. To put it bluntly, we now need to reverse course. We need more highly skilled small farmers in more places all across America — not as a matter of nostalgia for the agrarian past but as a matter of national security. For nations that lose the ability to substantially feed themselves will find themselves as gravely compromised in their international dealings as nations that depend on foreign sources of oil presently do. But while there are alternatives to oil, there are no alternatives to food.
National security also argues for preserving every acre of farmland we can and then making it available to new farmers. We simply will not be able to depend on distant sources of food, and therefore need to preserve every acre of good farmland within a day’s drive of our cities. In the same way that when we came to recognize the supreme ecological value of wetlands we erected high bars to their development, we need to recognize the value of farmland to our national security and require real-estate developers to do “food-system impact statements” before development begins. We should also create tax and zoning incentives for developers to incorporate farmland (as they now do “open space”) in their subdivision plans; all those subdivisions now ringing golf courses could someday have diversified farms at their center.
The revival of farming in America, which of course draws on the abiding cultural power of our agrarian heritage, will pay many political and economic dividends. It will lead to robust economic renewal in the countryside. And it will generate tens of millions of new “green jobs,” which is precisely how we need to begin thinking of skilled solar farming: as a vital sector of the 21st-century post-fossil-fuel economy.
II. Reregionalizing the Food System
For your sun-food agenda to succeed, it will have to do a lot more than alter what happens on the farm. The government could help seed a thousand new polyculture farmers in every county in Iowa, but they would promptly fail if the grain elevator remained the only buyer in town and corn and beans were the only crops it would take. Resolarizing the food system means building the infrastructure for a regional food economy — one that can support diversified farming and, by shortening the food chain, reduce the amount of fossil fuel in the American diet.
A decentralized food system offers a great many other benefits as well. Food eaten closer to where it is grown will be fresher and require less processing, making it more nutritious. Whatever may be lost in efficiency by localizing food production is gained in resilience: regional food systems can better withstand all kinds of shocks. When a single factory is grinding 20 million hamburger patties in a week or washing 25 million servings of salad, a single terrorist armed with a canister of toxins can, at a stroke, poison millions. Such a system is equally susceptible to accidental contamination: the bigger and more global the trade in food, the more vulnerable the system is to catastrophe. The best way to protect our food system against such threats is obvious: decentralize it.
Today in America there is soaring demand for local and regional food; farmers’ markets, of which the U.S.D.A. estimates there are now 4,700, have become one of the fastest-growing segments of the food market. Community-supported agriculture is booming as well: there are now nearly 1,500 community-supported farms, to which consumers pay an annual fee in exchange for a weekly box of produce through the season. The local-food movement will continue to grow with no help from the government, especially as high fuel prices make distant and out-of-season food, as well as feedlot meat, more expensive. Yet there are several steps the government can take to nurture this market and make local foods more affordable. Here are a few:
Four-Season Farmers’ Markets. Provide grants to towns and cities to build year-round indoor farmers’ markets, on the model of Pike Place in Seattle or the Reading Terminal Market in Philadelphia. To supply these markets, the U.S.D.A. should make grants to rebuild local distribution networks in order to minimize the amount of energy used to move produce within local food sheds.
Agricultural Enterprise Zones. Today the revival of local food economies is being hobbled by a tangle of regulations originally designed to check abuses by the very largest food producers. Farmers should be able to smoke a ham and sell it to their neighbors without making a huge investment in federally approved facilities. Food-safety regulations must be made sensitive to scale and marketplace, so that a small producer selling direct off the farm or at a farmers’ market is not regulated as onerously as a multinational food manufacturer. This is not because local food won’t ever have food-safety problems — it will — only that its problems will be less catastrophic and easier to manage because local food is inherently more traceable and accountable.
Local Meat-Inspection Corps. Perhaps the single greatest impediment to the return of livestock to the land and the revival of local, grass-based meat production is the disappearance of regional slaughter facilities. The big meat processors have been buying up local abattoirs only to close them down as they consolidate, and the U.S.D.A. does little to support the ones that remain. From the department’s perspective, it is a better use of shrinking resources to dispatch its inspectors to a plant slaughtering 400 head an hour than to a regional abattoir slaughtering a dozen. The U.S.D.A. should establish a Local Meat-Inspectors Corps to serve these processors. Expanding on its successful pilot program on Lopez Island in Puget Sound, the U.S.D.A. should also introduce a fleet of mobile abattoirs that would go from farm to farm, processing animals humanely and inexpensively. Nothing would do more to make regional, grass-fed meat fully competitive in the market with feedlot meat.
Establish a Strategic Grain Reserve. In the same way the shift to alternative energy depends on keeping oil prices relatively stable, the sun-food agenda — as well as the food security of billions of people around the world — will benefit from government action to prevent huge swings in commodity prices. A strategic grain reserve, modeled on the Strategic Petroleum Reserve, would help achieve this objective and at the same time provide some cushion for world food stocks, which today stand at perilously low levels. Governments should buy and store grain when it is cheap and sell when it is dear, thereby moderating price swings in both directions and discouraging speculation.
Regionalize Federal Food Procurement. In the same way that federal procurement is often used to advance important social goals (like promoting minority-owned businesses), we should require that some minimum percentage of government food purchases — whether for school-lunch programs, military bases or federal prisons — go to producers located within 100 miles of institutions buying the food. We should create incentives for hospitals and universities receiving federal funds to buy fresh local produce. To channel even a small portion of institutional food purchasing to local food would vastly expand regional agriculture and improve the diet of the millions of people these institutions feed.
Create a Federal Definition of “Food.” It makes no sense for government food-assistance dollars, intended to improve the nutritional health of at-risk Americans, to support the consumption of products we know to be unhealthful. Yes, some people will object that for the government to specify what food stamps can and cannot buy smacks of paternalism. Yet we already prohibit the purchase of tobacco and alcohol with food stamps. So why not prohibit something like soda, which is arguably less nutritious than red wine? Because it is, nominally, a food, albeit a “junk food.” We need to stop flattering nutritionally worthless foodlike substances by calling them “junk food” — and instead make clear that such products are not in fact food of any kind. Defining what constitutes real food worthy of federal support will no doubt be controversial (you’ll recall President Reagan’s ketchup imbroglio), but defining food upward may be more politically palatable than defining it down, as Reagan sought to do. One approach would be to rule that, in order to be regarded as a food by the government, an edible substance must contain a certain minimum ratio of micronutrients per calorie of energy. At a stroke, such a definition would improve the quality of school lunch and discourage sales of unhealthful products, since typically only “food” is exempt from local sales tax.
A few other ideas: Food-stamp debit cards should double in value whenever swiped at a farmers’ markets — all of which, by the way, need to be equipped with the Electronic Benefit Transfer card readers that supermarkets already have. We should expand the WIC program that gives farmers’-market vouchers to low-income women with children; such programs help attract farmers’ markets to urban neighborhoods where access to fresh produce is often nonexistent. (We should also offer tax incentives to grocery chains willing to build supermarkets in underserved neighborhoods.) Federal food assistance for the elderly should build on a successful program pioneered by the state of Maine that buys low-income seniors a membership in a community-supported farm. All these initiatives have the virtue of advancing two objectives at once: supporting the health of at-risk Americans and the revival of local food economies.
III. Rebuilding America’s Food Culture
In the end, shifting the American diet from a foundation of imported fossil fuel to local sunshine will require changes in our daily lives, which by now are deeply implicated in the economy and culture of fast, cheap and easy food. Making available more healthful and more sustainable food does not guarantee it will be eaten, much less appreciated or enjoyed. We need to use all the tools at our disposal — not just federal policy and public education but the president’s bully pulpit and the example of the first family’s own dinner table — to promote a new culture of food that can undergird your sun-food agenda.
Changing the food culture must begin with our children, and it must begin in the schools. Nearly a half-century ago, President Kennedy announced a national initiative to improve the physical fitness of American children. He did it by elevating the importance of physical education, pressing states to make it a requirement in public schools. We need to bring the same commitment to “edible education” — in Alice Waters’s phrase — by making lunch, in all its dimensions, a mandatory part of the curriculum. On the premise that eating well is a critically important life skill, we need to teach all primary-school students the basics of growing and cooking food and then enjoying it at shared meals.
To change our children’s food culture, we’ll need to plant gardens in every primary school, build fully equipped kitchens, train a new generation of lunchroom ladies (and gentlemen) who can once again cook and teach cooking to children. We should introduce a School Lunch Corps program that forgives federal student loans to culinary-school graduates in exchange for two years of service in the public-school lunch program. And we should immediately increase school-lunch spending per pupil by $1 a day — the minimum amount food-service experts believe it will take to underwrite a shift from fast food in the cafeteria to real food freshly prepared.
But it is not only our children who stand to benefit from public education about food. Today most federal messages about food, from nutrition labeling to the food pyramid, are negotiated with the food industry. The surgeon general should take over from the Department of Agriculture the job of communicating with Americans about their diet. That way we might begin to construct a less equivocal and more effective public-health message about nutrition. Indeed, there is no reason that public-health campaigns about the dangers of obesity and Type 2 diabetes shouldn’t be as tough and as effective as public-health campaigns about the dangers of smoking. The Centers for Disease Control estimates that one in three American children born in 2000 will develop Type 2 diabetes. The public needs to know and see precisely what that sentence means: blindness; amputation; early death. All of which can be avoided by a change in diet and lifestyle. A public-health crisis of this magnitude calls for a blunt public-health message, even at the expense of offending the food industry. Judging by the success of recent antismoking campaigns, the savings to the health care system could be substantial.
There are other kinds of information about food that the government can supply or demand. In general we should push for as much transparency in the food system as possible — the other sense in which “sunlight” should be the watchword of our agenda. The F.D.A. should require that every packaged-food product include a second calorie count, indicating how many calories of fossil fuel went into its production. Oil is one of the most important ingredients in our food, and people ought to know just how much of it they’re eating. The government should also throw its support behind putting a second bar code on all food products that, when scanned either in the store or at home (or with a cellphone), brings up on a screen the whole story and pictures of how that product was produced: in the case of crops, images of the farm and lists of agrochemicals used in its production; in the case of meat and dairy, descriptions of the animals’ diet and drug regimen, as well as live video feeds of the CAFO where they live and, yes, the slaughterhouse where they die. The very length and complexity of the modern food chain breeds a culture of ignorance and indifference among eaters. Shortening the food chain is one way to create more conscious consumers, but deploying technology to pierce the veil is another.
Finally, there is the power of the example you set in the White House. If what’s needed is a change of culture in America’s thinking about food, then how America’s first household organizes its eating will set the national tone, focusing the light of public attention on the issue and communicating a simple set of values that can guide Americans toward sun-based foods and away from eating oil.
The choice of White House chef is always closely watched, and you would be wise to appoint a figure who is identified with the food movement and committed to cooking simply from fresh local ingredients. Besides feeding you and your family exceptionally well, such a chef would demonstrate how it is possible even in Washington to eat locally for much of the year, and that good food needn’t be fussy or complicated but does depend on good farming. You should make a point of the fact that every night you’re in town, you join your family for dinner in the Executive Residence — at a table. (Surely you remember the Reagans’ TV trays.) And you should also let it be known that the White House observes one meatless day a week — a step that, if all Americans followed suit, would be the equivalent, in carbon saved, of taking 20 million midsize sedans off the road for a year. Let the White House chef post daily menus on the Web, listing the farmers who supplied the food, as well as recipes.
Since enhancing the prestige of farming as an occupation is critical to developing the sun-based regional agriculture we need, the White House should appoint, in addition to a White House chef, a White House farmer. This new post would be charged with implementing what could turn out to be your most symbolically resonant step in building a new American food culture. And that is this: tear out five prime south-facing acres of the White House lawn and plant in their place an organic fruit and vegetable garden.
When Eleanor Roosevelt did something similar in 1943, she helped start a Victory Garden movement that ended up making a substantial contribution to feeding the nation in wartime. (Less well known is the fact that Roosevelt planted this garden over the objections of the U.S.D.A., which feared home gardening would hurt the American food industry.) By the end of the war, more than 20 million home gardens were supplying 40 percent of the produce consumed in America. The president should throw his support behind a new Victory Garden movement, this one seeking “victory” over three critical challenges we face today: high food prices, poor diets and a sedentary population. Eating from this, the shortest food chain of all, offers anyone with a patch of land a way to reduce their fossil-fuel consumption and help fight climate change. (We should offer grants to cities to build allotment gardens for people without access to land.) Just as important, Victory Gardens offer a way to enlist Americans, in body as well as mind, in the work of feeding themselves and changing the food system — something more ennobling, surely, than merely asking them to shop a little differently.
I don’t need to tell you that ripping out even a section of the White House lawn will be controversial: Americans love their lawns, and the South Lawn is one of the most beautiful in the country. But imagine all the energy, water and petrochemicals it takes to make it that way. (Even for the purposes of this memo, the White House would not disclose its lawn-care regimen.) Yet as deeply as Americans feel about their lawns, the agrarian ideal runs deeper still, and making this particular plot of American land productive, especially if the First Family gets out there and pulls weeds now and again, will provide an image even more stirring than that of a pretty lawn: the image of stewardship of the land, of self-reliance and of making the most of local sunlight to feed one’s family and community. The fact that surplus produce from the South Lawn Victory Garden (and there will be literally tons of it) will be offered to regional food banks will make its own eloquent statement.
You’re probably thinking that growing and eating organic food in the White House carries a certain political risk. It is true you might want to plant iceberg lettuce rather than arugula, at least to start. (Or simply call arugula by its proper American name, as generations of Midwesterners have done: “rocket.”) But it should not be difficult to deflect the charge of elitism sometimes leveled at the sustainable-food movement. Reforming the food system is not inherently a right-or-left issue: for every Whole Foods shopper with roots in the counterculture you can find a family of evangelicals intent on taking control of its family dinner and diet back from the fast-food industry — the culinary equivalent of home schooling. You should support hunting as a particularly sustainable way to eat meat — meat grown without any fossil fuels whatsoever. There is also a strong libertarian component to the sun-food agenda, which seeks to free small producers from the burden of government regulation in order to stoke rural innovation. And what is a higher “family value,” after all, than making time to sit down every night to a shared meal?
Our agenda puts the interests of America’s farmers, families and communities ahead of the fast-food industry’s. For that industry and its apologists to imply that it is somehow more “populist” or egalitarian to hand our food dollars to Burger King or General Mills than to support a struggling local farmer is absurd. Yes, sun food costs more, but the reasons why it does only undercut the charge of elitism: cheap food is only cheap because of government handouts and regulatory indulgence (both of which we will end), not to mention the exploitation of workers, animals and the environment on which its putative “economies” depend. Cheap food is food dishonestly priced — it is in fact unconscionably expensive.
Your sun-food agenda promises to win support across the aisle. It builds on America’s agrarian past, but turns it toward a more sustainable, sophisticated future. It honors the work of American farmers and enlists them in three of the 21st century’s most urgent errands: to move into the post-oil era, to improve the health of the American people and to mitigate climate change. Indeed, it enlists all of us in this great cause by turning food consumers into part-time producers, reconnecting the American people with the American land and demonstrating that we need not choose between the welfare of our families and the health of the environment — that eating less oil and more sunlight will redound to the benefit of both.

From Wheelchair to Bicycle in 12 Months -- It still feels miraculous to me!

2008-10-10T20:47:00.000-07:00

Last November I needed to use my tilt-recline wheelchair or a scooter whenever I left my office. Now after 12 months of electrotherapy to my muscles and intensive diet rich with micronutrients I walk throughout the hospital. In May I started biking for the first time in 6 six years. In September I rode my bicycle 18 miles. It took me three hours. I was tired when I finished and hat to sit in my chair and read for a couple hours to recharge my energy.

It still feels miraculous -- I know that it is the consequence of hard work, electrotherapy and all those micronutrients. Our next step is working out a protocol to test in others. Hopefully we will have approval to begin the study by the first of the year.

Terry Wahls, MD

www.terrywahls.com

Food as medicine: Health versus Disease

2008-10-06T19:30:00.000-07:00

Life is a balance between processes that lead to properly organized form and function in the various tissues of the body, and factors that initiate disease and death. This balance also exists at the level of single cells. Plants use sunlight and chloroplasts to convert sunlight into energy to drive the life functions of plants. Animals, on the other hand, must use adenosine tri-phosphate (ATP) to drive chemical reactions necessary for life.

In the absence of oxygen the cell can convert one glucose molecule into two ATP molecules. However in the presence of mitochondria and the Krebs cycle, four ATP molecules can be generated from one glucose molecule. With the electron chain within the mitochondrial membranes a total of 38 ATPs can be generated from one glucose molecule. However that requires an abundant supply of riboflavin and niacinamide, both of which are B vitamins. In addition, the mitochondria need an abundant supply of ubiquinone or co-enzyme Q.
Like all manufacturing processes, there is some trash is generated as the ATP is created. The mitochondria are as efficient as our energy star appliances in our home, but three percent of the energy contained within glucose does not make ATP. Instead a few free radicals are generated. These must be quickly neutralized before they begin to oxidize the mitochondrial DNA or to diffuse into the cytoplasm or nucleus and begin damaging cellular DNA. It is important for cells to have a ready supply of intracellular anti-oxidants. It is the colored vegetables and fruits that have the most anti-oxidants.
Our Health= Micronutrients consumed – empty calories consumed.
Which one of those most closely describes your diet, or your children’s diet?
Chronic Disease= Few micronutrients (vegetables + fruits)- empty calories (French fries, potatoes, white bread, candy, soda, pastries etc.)
Optimal mental and physical healthy= Many fruits + vegetables, some fish, occasional organ meats – no empty calories.
The more micronutrients in your diet – the minerals like iron, magnesium, copper, manganese, calcium, vitamins both known and not yet discovered, and the antioxidants to help your cells get rid of the trash- the more easily it is for the cell to do all the things the DNA wants it to do.
I am in internal medicine- occasionally I give an antibiotic that cures someone of their infection. Mostly I give medicines that control symptoms- such as lowering blood pressure, improving blood sugar control, or lowering cholesterol. If someone wants to have optimal health- then they must provide their cells with as many micronutrients as possible.
Genes turn on and off according to our diets. That means if we eat diets poor in micronutrients- genes turn on which accelerate the degeneration of our bodies- worsening of diabetes, high blood pressure or obesity for example. If we eat diets rich in micronutrients – genes turn on that often lead to regression of disease.
Bottom line= optimal health requires optimal nutrition.
Physicians mostly can only control symptoms. For your mitochondria, your cells and your body’s to work most effectively – eat more micronutrients.
Diet recommendations: Each day maximize your micronutrients-
9 cups of vegetables and fruits
3 cups should be dark green or from the cabbage family,3 cups should be deeply colored, for example red, orange, or blue, and 3 cups of your choice
Organ meats once a week
Fish or seafood three times a week
When you eat –
Have 3 cups of vegetables and fruit first, then your protein source, then whatever else it is that you want to eat. Remember –unless your are doing physical activity – your body was designed to maintain itself without any grains/ starchy potatoes. If you are physically active – then additional carbohydrates make sense. If you have any chronic disease – any calorie you eat that is not packed with micronutrients is a calorie that took you farther away from your goal of optimal health.
Activity – difficult to sustain if it is not part of your daily life. People who are most successful are those who have incorporated more walking, physicality into the their routines either before or during work hours. Moving (walking or jogging) one’s body 3 miles a day is optimal.
Sustaining the effort – people who lose weight and keep eating 9 or more cups of vegetables and fruit, and walked or jogged 20 miles in a week are the most successful at maintaining weight loss.
Supplements – Food is the best. Do not think can supplements replace the micronutrients from 9 cups of vegetables and fruits. If you cannot eat fish however –take fish oil or flax oil. If you cannot eat organ meats take coenzyme Q10. If you have chronic disease – improving the health and nutrition for your mitochondria is an excellent place to start.

Terry Wahls, MD

Courage Ride

2008-09-23T22:13:00.000-07:00

Saturday September 20, 2008 I got on my Day Six Bicycle in Hills, Iowa to participate in the Courage Ride, which is a cancer fund raising bicycle tour. The ride lengths range from 18 miles up to 100 miles. While in the 1980s and 1990 I ran and skied marathons, I had not ridden my bike after 2001 because of progressive MS.

I had spent four years dependent upon a scooter or electric wheelchair. Last summer I needed one cane in the morning, and two in the afternoon. I had spent years studying night after night, trying to to understand why people became disabled in MS, in spite of minimal change on their MRIs. Eventually, I developed my own theories, which I tested upon myself.
Now, eleven months after starting the interventions which I had designed for myself my scooter has been parked in the corner for months. I ride my bicycle to and from work. And on September 20th, I rode 18 miles with my family. I walked up one hill; all others I climbed, slowly and steadily to the top.

When I was finished, I was tired but I did not need a nap. The following day I did my usual activities. None of this would have been possible a year ago.

I used to believe that progressive MS had only one direction - down hill. Now, I no longer believe that is the case. The traditional model for progressive MS does not explain what happened, why I am recovering more and more strength each day. So I am creating a new model, which I will test in others with progressive MS once we have our approval from the IRB, which is the committee that oversees research involving human subjects. It will take longer than I want it to for me to get all the necessary approvals, and find the money to do this pilot study. I have found a team of clinicians who are anxious to work with me to study this issue. We are meeting weekly to devise our plans, and shepherd them through the various approval processes.

For now, I walk around the medical school and the VA hospital. I delight in seeing colleagues who had not seen me for more than a year. They are stunned. I smile and tell them my story and invite them to my lecture to the internal medicine department October 6th, 2008. That is where I will present my case, and review the basic science literature to develop what I beleive is the likely mechanism for why I have experienced such a remarkable recovery. It will be an interesting conversastion.

Progressive Multiple Sclerosis Can Be Defeated

2008-09-14T18:36:00.000-07:00

http://terrywahls.blogspot.com/y_key_978305748b0ef6c8.html
I have a shocking morning ritual. It is a painful process. First, I wrap elastic straps around my legs, chest and waist. Next, I moisten electrodes. Then one by one, I put them over the muscles in my left leg, belly and back. As I turn the dials, electricity flows into my body. Bugs start racing across my skin. Next, the electricity causes the muscles to contract. Then I squeeze every muscle in my body. It hurts less that way.

The above is an excerpt from my audi0 book, Up from the Chair, which is a series of essays about my experiences and observations from having a chronic disease. I am an author, artist, mother and an associate professor of Medicine at the University of Iowa. I am also a patient who has had secondary progressive multiple sclerosis since 2003.

I received the best care available. But progressive MS is an ugly disease, leading to severe disability.As I became more severely disabled, I studied the basic science MS literature. I devised my own theories about what caused the progressive loss of function in MS and tested them upon myself. A year ago, I was wheelchair dependent. Today I walk throughout the hospital, and again ride my bicycle. I am like Paul on the way to Damascus. I am not the same person, nor am I the same physician, nor am I the same parent.

I have written the case report, describing what happened to me. I am working with colleagues to follow up my experience with a small research study. We need to know if my experience can be replicated in others. Science is slow, methodical, and must go step by step. It will take us a year or more to confirm this will work in others.

Here I will write about my experiences, observations and theories about medicine, mitochondria, family, and about life. There is much to share.