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.
Monday, September 7, 2009
Tuesday, September 1, 2009
Glutathione reduced in brains of MS patients
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.
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.
Tuesday, August 18, 2009
Battling Inflammation Through Food Hits Mainstream Press
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
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
Monday, August 3, 2009
Paying for health care
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
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
Sunday, July 26, 2009
Research up date
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.
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
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.
I apologize to those of you who were wondering what happened to me.
Iodine and MS
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/
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/
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