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It's Been an Omega-3 Kind of Week! Sorting Through the Benefits & Hype. Why I've Become a Fan of Algal DHA for the Brain

 

 

 

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DHA May Help the Brain By Improving Blood Flow, Reducing Plaque Aggregation, & Reducing Inflammation

 

Fotuhi, M. et al.  Nature Clinical Practice.  Neurology.  5(3):140-152, March 2009.  "Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association."   Click on drawing to enlarge.

 

"Omega-3's in the brain do three things:

• They reduce inflammation
• They increase blood flow
• They're important for improving the structure & integrity of the brain's cellular membranes, and they reduce proteins associated with Alzheimer's disease. 

I think the best source [of omega-3's], in my opinion, is algal DHA, which is where fish get their omega-3's.    Algal is the most pure form, and algal DHA is a supplement that people can take.

[I] personally prefer DHA because it has been associated with reduced blood pressure, better HDL, better brain function.  And I have seen in some studies that there is plenty [of] compelling evidence that I would take it myself.

 My wife & I take 900 mg of algal DHA. 

And, you know, we're talking about children with ADHD.  I give it to my two daughters, who are five and seven--100 mg each.  It's like a dessert after dinner. We have our little DHA supplement. They have smaller amounts, obviously, than I do."

Dr. Majid Fotuhi chair of the Neurology Institute for Brain Health and Fitness, and assistant professor of neurology at Johns Hopkins University School of Medicine, interviewed on Diane Rehm's NPR 10/3/12 radio show, "Assessing the Health Benefits of Omega-3's".  Click here for the transcript

 

Oh, baby!  Omega 3's are back in the news again!  Big time.

But, if you only looked at the three "big news" articles highlighted below,  you may have decided to throw your hands up in the air & just quit worrying about this whole omega-3 business altogether.  One week they're good.  The next week they're not.

Not so fast! 

As always--there's more to the story.  Right?

It's high time to do a little omega-3 recap & pitch the benefits, in spite of these recent nay-saying studies.

• JAMA meta-analysis, September 12, 2012:  The latest meta-analysis of 20 clinical trials, involving 70,000 people concluded that supplementing with omega-3's won't reduce deaths from heart disease, sudden death, myocardial infarction or strokes.  This study has been criticized by many because it combined different trials, using different doses & sources of omega-3s; and most of the subjects already had heart disease & were on serious heart medications.  Hey, it's a supplement, a food, not a miracle worker.
  
• Archives of Internal Medicine meta-analysis, May 14, 2012:  Insufficient evidence that omega-3's can prevent a second cardiovascular event in people with a history of heart disease.  Hey, it's a supplement, a food, not a miracle worker.
• New England Journal of Medicine double-blind study, July 26, 2012:  1 gram of fish oil didn't reduce the risk of cardiovascular events in diabetics.  Hey, it's a supplement, a food, not a miracle worker.

Bottom line:  Omega-3's don't have super powers. They can't make up for years of eating a high-fat Western diet that's high in saturated fats, sugar, & omega-6's.   They can't make up for diabetes, a previous heart attack, being overweight, & sitting most of the day.

Prescribing omega-3 supplements without first measuring an individual's baseline level of omega-3 or their ratio of omega-6's to omega-3's is like giving someone a baby aspirin for a migraine---or a prescription pain pill for a hangnail.  It's dancing in the dark. 

But, you probably knew all that.

Omega-3's are essential fatty acids.   We need them.  We can't manufacture them in our bodies.  They curb inflammation.  They've shown benefits to the brain, blood pressure, the cardiovascular system, vision, mood, and learning.  But, more on that later.

BIG POINT TO REMEMBER:  The more grain-fed animals, fried foods, seed oils (like corn, soy & safflower), nuts & seeds, junk & snack food you're eating--the more inflammatory omega-6's you'll have stored in your body--and the more omega-3's you will need to consume.   If you eat less of the omega-6's, you'll need less omega-3's.  It's that simple.  Omega-3 & omega-6's compete for the same enzymes & position in our cells.  Susan Allport does a nice job explaining this:

 

"[W]hen a person on the normal American diet has plenty of extra fat around, let's say, 20 pounds, a huge amount of that is going to be these omega-6's.

And when they go on fish oil, [they're] not going to see that fish oil showing up in their membranes for a long time, because it's competing with those stored  omega-6's."

-Susan Allport, journalist & author of "The Queen of Fats", interviewed on Diane Rehm's NPR 10/3/12 radio show, "Assessing the Health Benefits of Omega-3's".  Click here for the transcript-

 

 

"..if you understand that food energy causes transient inflammatory insults and omega-6s amplify that into chronic injury and omega-3s moderate it, then you can tell people that the take home message is:

• Eat more omega-3s
• Eat less omega-6s
• Eat fewer calories per meal and stop smoking.  That's it."

 

-William Lands, PhD., a pioneer in the study of lipids, omega-3 fatty acids, and the effects of diet on disease, University of Michigan & NIH-

 

 

 

Before You Toss the Chia & Flax, Ditch Your Omega-3 Supplements, or Lose Confidence in Salmon -  Give a Listen to Dr. Melina Jampolis

 

Dr. Melina Jampolis is one of the few physician nutrition specialists in the country.  

She's not happy with the quality & conclusions of the latest JAMA study that minimizes the benefits of omega-3's.  Jampolis looked over all the 20 clinical trials in the JAMA meta-analysis & strongly disputes the authors' conclusions.

Don't miss her short rebuttal of the September JAMA omega-3 meta-analysis. 

 

Click Here for the Jampolis video if you don't see it on your screen

 

 

 

It's Been an Omega-3 Kind of Week

 

Here's what I've been reading this week to help me get a handle on the benefits (or the hype) of omega-3's. 

 

• "Assessing the Health Benefits of Omega-3"--Diane Rehm's October 3, 2012 NPR broadcast.    Rehm interviews four experts:  Dr. Majid Fotuhi, chair of the Neurology Institute for Brain Health and Fitness, and assistant professor of neurology at Johns Hopkins University School of Medicine (my personal fave--showing my omega-3 biases, here); Paul Coates, director of the Office of Dietary Supplements at National Institutes of Health; Thomas Sherman, associate professor of pharmacology at Georgetown University Medical Center; and Susan Allport, journalist and author of "The Queen of Fats".   Fascinating discussion--that confirmed my own admitted bias towards the importance of DHA for brain health--and the superiority of taking an algal supplement.   
• Can Omega-3's Slow Aging?  Hot-Off-The-Press Ohio State University research,  "Omega-3 supplements may slow a biological effect of aging."  In Dr. Janice Kiecolt-Glaser's study, published in Brain, Behavior, & Immunity, 106 healthy-but-overweight-50-somethings supplemented with 2 different doses of high-quality omega-3's for 4 months, lowered their inflammation levels by 15%, increased their telomere length (a biomarker of aging), & improved their omega-6 to omega-3 ratios.  The lower their ratios--the greater the increase in telomere length.  Translation: Longer telomeres=longer healthier life--or at least that's the theory.  Kiecolt-Glaser says that while the U.S. average ratio of omega-6's to omega-3's is 15-to-1,  a ratio of 4-to-1 or even 2-to-1 would be ideal.   Read more about omega-3's, slowing down aging, & telomeres below.
• "Questioning the Superpowers of Omega-3 in Diets", Melinda Beck in the October 1, 2012 Wall Street Journal.  Mostly good, but some questionable misinformation.  Beck examines the benefits of omega-3's in light of three recent studies that questioned their benefit in reducing deaths or cardiovascular events in people who had previous heart attacks or were at high risk for having one.  Beck, also takes a look at some of the recent omega-3 research & offers "a tantalizing mix of healing possibilities".
• Supplementing with algal DHA improves learning & memory function only in healthy middle-aged individuals.  It will not benefit or reverse dementia, cognitive dysfunction, or Alzheimer's.  Adults 55+: The Memory Improvement with Docosahexaenoic Acid (DHA) Study, or MIDAS, was the first large, randomized, double-blind and placebo-controlled study demonstrating the benefits of algal DHA in maintaining and improving brain health in older adults. The study indicated that the use of DHA improves learning and memory recall in healthy older adults with mild memory complaints.  485 healthy individuals ≥55  participated in the trial for 24 weeks, in 19 U.S. clinical sites.  This is the study that turned Dr. Majid Fotuhi into an algal DHA booster.  

 

 

 My Omega-3 Adventures - It's All About the Brain

Look, I'm serious about getting my daily supply of omega-3's.

I don't leave my "getting enough" up to chance.  Honestly, if you are eating a plant-based diet, like I am, you might not be getting enough omega-3's.  You have to be methodical about it.  Eat enough chia, hemp seed, or flax.   Greens help--but, they don't provide a significant amount.   Consider taking an algal omega-3 supplement.  Think about getting your blood levels tested.  I did.  That's why I now take an algal DHA supplement.

 

Credit:  Dr. Joanne L. Mumola Williams' blog, Foods for Long Life

 

It's a complicated process--and it's a good bet that you'll need a whole lot less of the omega-3's if you're plant-based & have ditched oils. 

But, bottom line, our bodies aren't so efficient at converting the plant-versions of omega-3's (ALA)--like chia, flax, greens, & walnuts--into DHA or EPA, the long-chain most benefiical omega-3's. 

And, even if you're eating enough very expensive wild salmon (the farmed won't quite do the job--it's grain-fed & high in omega-6's according to Thomas Sherman, professor of pharmacology at Georgetown Medical Center) to boost your levels, your likely taking in more mercury, toxins, heavy metals, pesticides, &  PCB's than you should. 

According to fish expert, Paul Greenberg, the only really safe source of salmon right now is from Bristol Bay, Alaska,  and those fisheries are now being threatened by copper mines that want to operate in that region--threatening to pollute those safe waters.

 

Here's what I'm taking to boost my omega-3's:

I add 1 1/2 tablespoons of chia to my morning oatmeal--about 3 grams of omega-3 ALA.  Nothing wrong with flax--I just like the taste & texture of chia better. 

On most days I also take an algal DHA/EPA (omega-3) supplement--320 mg DHA/130 mg EPA. I'm currently taking Ovega Algal Supplement--which is recommended by ConsumerLabs, the independent lab that tests supplements.  I've also taken Spectrum's Agal DHA.

Just by eating plant-based & no-added-oil I drastically lower the amount of omega-3's (in a supplement) I need to take--because I've cut out the biggest sources of omega-6's that compete for "cell-space" with omega-3's.  No need for those mega-prescription-strength fish oil capsules.  I'm not eating the typical omega-6 heavy Western diet.

 

Credit:  Dr. Joanne L. Mumola Williams' blog, Foods for Long Life

Sure, I know there's a whole laundry list of omega-3 benefits.  But, honestly, the only benefit that I can physically point to, is that I'm now free from joint aches, pains, & stiffness.  That wasn't always the case.  And maybe those omega-3's are part of the reason I'm almost always in a good mood. 

But, here's the REAL REASON, I'm religious about getting omega-3's into my diet. 

It's all about keeping my brain in working order.

Read on.  This study got my attention last year.

Low Levels of Omega-3 Fatty Acids May Cause Memory Problems

ST. PAUL, Minn. – A diet lacking in omega-3 fatty acids, nutrients commonly found in fish, may cause your brain to age faster and lose some of its memory and thinking abilities, according to a study published in the February 28, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology. Omega-3 fatty acids include the nutrients called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

“People with lower blood levels of omega-3 fatty acids had lower brain volumes that were equivalent to about two years of structural brain aging,” said study author Zaldy S. Tan, MD, MPH, of the Easton Center for Alzheimer’s Disease Research and the Division of Geriatrics, University of California at Los Angeles.

For the study, 1,575 people with an average age of 67 and free of dementia underwent MRI brain scans. They were also given tests that measured mental function, body mass and the omega-3 fatty acid levels in their red blood cells.

The researchers found that people whose DHA levels were among the bottom 25 percent of the participants had lower brain volume compared to people who had higher DHA levels. Similarly, participants with levels of all omega-3 fatty acids in the bottom 25 percent also scored lower on tests of visual memory and executive function, such as problem solving and multi-tasking and abstract thinking.

The study was supported by the Framingham Heart Study’s National Heart, Lung, and Blood Institute and the National Institute on Aging.  

Tan, ZS et al.  "Red Blood Cell Omega-3 Fatty Acid Levels & Markers of Accelerated Brain Aging,"  Neurology 2012 Feb. 28; 78(9):658-64.

 

The "Best Brains" in the Neurology Study Had a DHA/EPA Level of 6.5%

 

When my omega-3 levels  were tested last March as part of a pilot omega-3 study, --without taking any kind of a supplement--& only using chia--my DHA/EPA levels were similar to the 75% "healthy brain" levels in the Neurology study--at 6.6%.  Pretty darn good.  Check out the chart below.

But, l'm still shooting to get that level up to the "low heart disease risk level" of 8%.   For comparison--the omega-3 levels of most Americans are at 4 to 5%.  And, honestly, my DHA levels could stand for a bit of a boost.

Although my omega 6 to omega 3 ratio of 5.8:1 was a lot better than the US average which ranges from 8.11:1 to 17:1---getting down to a ratio of 4:1 is my goal.

I hope to get retested after sticking to a daily algal supplement for 3 months.  Stay tuned.

 

The Neurology Study's DHA+EPA Omega-3 Index Levels

 

 

Ditch the Sugar & Go for the Omega-3s 

 

Like I said--it's been quite a week for omega-3 studies, and here's another one to help convince you that the 3's are good for the brain.

Ditch the sugar/fructose  & eat a diet sufficient in omega-3's for brain health!!  It worked for rats trying to find their way through a maze--maybe it will help us find our keys or glasses.  (And check out the Rat Race video at the bottom of this post.  See if that doesn't convince you.)

All the rats in this study were first trained to get through the Barnes Maze, before they started on their special diets. 

After just six weeks on the four respective diets, the rats on a high-fructose and omega-3 deficient diet (RED) took 6 times as long to get through the maze compared to rats on a diet sufficient in omega-3 and without fructose (GREEN).

This study was led by my fave UCLA brain/food researcher, Dr. Fernando Gomez-Pinilla, "'Metabolic syndrome' in the brain: deficiency in omega-3 fatty acid exacerbates dysfunctions in insulin receptor signalling and cognition" Journal of Physiology  2012 May 1;590(Pt 10):2485-99.  For a copy of the article, click here. 

 

Key Points in the article:

•We provide novel evidence for the effects of metabolic dysfunctions on brain function using the rat model of metabolic syndrome induced by high fructose intake.

•We describe that the deleterious consequences of unhealthy dietary habits can be partially counteracted by dietary supplementation of n-3 fatty acid.

•High sugar consumption impaired cognitive abilities and disrupted insulin signalling by engaging molecules associated with energy metabolism and synaptic plasticity; in turn, the presence of docosahexaenoic acid (DHA), an n-3 fatty acid, restored metabolic homeostasis.

•These findings expand the concept of metabolic syndrome affecting the brain and provide the mechanistic evidence of how dietary habits can interact to regulate brain functions, which can further alter lifelong susceptibility to the metabolic disorders.

 

 Rats on Diets - A Little Sugar (Fru) - And a Side of Omega-3's

 

 

 

What's Up With Telomeres & Aging?  The Studies Keep Showing an Omega-3 Connection

Ohio State University's Research is Just the Latest

 

Originally posted on January 23, 2010

A New Role for Omega-3? Lengthening Our Telomeres--A Key Marker for Aging, Longer Life, and Health. From JAMA & UCSF

 

 

 

 

 

"The main result of our study is that patients with high levels of Omega-3 fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length. It's also the first study that shows that a dietary factor may be able to slow down telomere shortening."   

 

-Ramin Farzaneh-Far, M.D., of the University of California at San Francisco, lead author of "Association of Marine Omega-3 Fatty Acid Levels with Telomeric Aging in Patients with Coronary Heart Disease"  JAMA 2010;303(3):250-257.

This week's big medical news story appeared in JAMA and it is one more reason why you want to be sure to get your Omega-3s everyday--while lowering your intake of the Omega-6s.

We already knew that the Omega-3s were amazing.

• They're anti-inflammatory and anti-clotting
• They prevent age-related cognitive decline
• They lower triglycerides
• They lower blood pressure
• They slow age-related macular degeneration
• They keep blood vessels flexible
• They lower depression
• They decrease joint stiffness in rheumatoid and osteo-arthritis
• They're necessary for fetal and infant brain development

 

So What Did The JAMA Heart And Soul Study Tell Us That We Didn't Already Know?

 

The UCSF researchers followed 608 outpatients with stable coronary artery disease for 5-8 years.  At the start of the study they measured everyone's levels of Omega-3's and the length of their leukocyte telomeres--which is a marker of aging.  Remember though--this was an observational study, not a gold-standard double-blind randomized controlled study.

Here's how the lead researcher Dr. Ramin Farzaneh-Far explains the results:

"The main result from our study is that patients with high levels of Omega-3's fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length."

"Patients with the highest levels of Omega-3 fish oils were found to display the slowest decrease in telomere length, whereas those with the lowest levels of Omega-3 fish oils in the blood had the fastest rate of telomere shortening, suggesting that these patients were aging faster than those with the higher fish oil levels in their blood."

"By measuring telomere length at two different times we are able to see the speed at which the telomeres are shortening and that gives us some indication of how rapidly the biological aging process is taking place in these patients."

What Are Telomeres And How Exactly Do They Affect The Aging Process?

 

 

PLASTIC TIPS ON SHOELACES—that’s the analogy often used to describe telomeres. They are the red caps sitting on the ends of these blue chromosomes. 

Just like plastic shoelace tips that keep the laces from fraying--the telomeres protect valuable genetic material needed for our cells to divide properly, and to repair worn-out cells.

They are also strong markers for aging (see the graph below and get depressed).  Not only do they shorten as we age, over time the telomeres can become damaged and shorten because of inflammation, smoking, obesity, or lack of exercise. 

Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,

"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."

 

This week's JAMA study is just one more bit of evidence that shows how our lifestyle choices can affect telomere length--and promote healthy aging.

• A 2008 twin study published in the Archives of Internal Medicine compared the telomere length of exercising twins versus couch-potato twins.  After only 12 months, the telomere's of the exercising  showed the equivalent of being 10 years younger than their couch-potato siblings.  Click here to read about the study.
• A 2008 study led by Dr. Dean Ornish followed a group of men with early prostate cancer who made these lifestyle changes:  increased their fruit & vegetable consumption; limited their fat consumption to 10%; lowered their consumption of refined sugar; took vitamin supplements & fish oil; exercised for 30 minutes a day; and either meditated or did yoga for stress relief.  After only 3 months, 24 out of 30 men showed significant increases in their telomerase levels.  Click here to read about the study.
• A number of studies have also shown how stress can accelerate telomere shrinking, especially in caregivers of chronically ill children and the spouses of Alzheimer's patients.  One study even suggested that you can accelerate your biological age by as much as 17 years if you're exposed to what you perceive as high psychological stress!

 

All About Omega-3's.  Does It Really Have To Be Fish Oil?

Yes, the JAMA study used Omega-3 fish oil, but Omega-3s really originate in green leafy plants--not in fish.

MUST READ ARTICLE ALERT!  REALLY.  Susan Allport is a medical journalist/researcher who is an expert in "all things Omega-3".  She has written a brilliant article in the September 2009 issue of Prevention, "The Vanishing Youth Nutrient" that does an excellent job of explaining why we need Omega-3s in our diet, why so many physicians equate Omega-3 with fish, and why Omega-3 is sorely lacking in our diets.  Click here for the article.

• We can only obtain the Omega-3s through our diet. 
• They are essential to the healthy development of our brains--and they are found in the highest concentrations in our most active tissues: brains, eyes, hearts, the tails of sperm.
• The metabolism of every species on the planet is a function of the amount of Omega-3s in its tissues, according the Dr. Tony Hulbert of the University of Wollongong in Australia.  Think: Omega-3=growth, activity, energy.  Omega-6=hibernation, fat storage, belly fat.   Athletes take note:  high concentrations of omega-3s in muscle cells lead to improved athletic performance.
  
• Research from the 1980s showed fish-eating populations of Greenland and Japan had the lowest rates of heart disease.  That's why the Omega-3s became associated with fish--instead of with green plants.  And that's why the American Heart Association recommends fish or fish oil as our main source of Omega-3s.  Big Problem:  Fish are not a sustainable source of Omega-3s--there are simply not enough fish in the world's oceans.
• Big Point:  "Omega-3s are found in the green leaves of plants.  Fish are full of omega-3s because they eat phytoplankton (the microscopic green plants of the ocean) and seaweed.  They are what turn sunlight into sugars, the basis of life on Earth."
• You can get all your Omega-3s from green leafy vegetables, legumes, flax seeds, chia seeds (they have the highest level of any plant-click here to read more), or walnuts, grass-fed animals and their milk, or eggs, wild cold-water fish like salmon, highly purified fish oil supplements, or algae-sourced Omega-3 supplements.
• Big Point:  If you cut back on vegetable oils, processed foods, trans-fats, corn-fed meat, chicken and milk you will actually lower the amount of Omega-3s you need in your diet to balance the negative effects of the inflammatory, fat-promoting Omega-6s we are getting in our Western Diet.
• The ratio of Omega 6's to 3's should be between 4:1 and 2:1, or ideally 1:1.  Currently, for most Americans, the range for the ratio is anywhere between 8:1 and 17:1, in favor of heart-disease-causing Omega 6's. 
  

Why Is Our Diet So High in Omega-6s, And So Low In Healthy Omega 3's?

• Omega-6 fats come from the seeds of plants.  We need them--but we need far less of them than we are consuming--and we need them in just the right ratio to Omega-3s.  They promote blood clotting, inflammation, and cause us to "pack on the pounds".  Just like corn-fed beef.  Grass-fed or plant-fed animals and humans are naturally lower in fat!
• Big Point:  Omega-6s and Omega-3s are in constant competition to enter our cells.  Eat too many Omega-6s in the form of meat, oil, or processed food--and you'll be seriously deficient in Omega-3s.  Eat less Omega-6s, and your body won't need as many Omega-3s to function properly.
• Omega-3s began to disappear from our food supply when previously grass-fed animals began eating corn and soybeans, which are high in Omega-6s.  The factory-farm and feedlots replaced the family farm, and grass-fed meat, milk, and eggs became history.  Click here to read about King Corn's effect on our health.
• With farm subsidies for corn and soybeans, companies like Archer Daniels Midland figured out how to extract oil from these and other seed plants--giving us even more Omega-6s in our diet.
• The AHA and other health agencies encouraged us to use oil and margarine because they assumed these cholesterol-free oils were good for the heart.  Wrong!
• "Food chemists discovered that rancidity in packaged food was caused by the oxidation of some minor but pesky  fats: the Omega-3s."  So they removed them and extended the shelf-life of packaged food.
• Fewer and fewer of us are eating enough green leafy vegetables, fish, or flax to even put a dent into the "out-of-whack" Omega-6 to Omega 3 ratio.

I highly recommend you read Susan Allport's article in Prevention, as well as her book, The Queen of Fats.  She does an excellent job of explaining the good, the bad, and the ugly of the fat world.

If you need any more convincing on the wonders of Omega-3, watch Allport's brief video, The Rat Race, comparing rats fed on diets rich in Omega-3s with those fed on diets deficient in Omega-3s.

Click here if you've received this post via email and aren't seeing the video.

 

Nutraceuticals - Evidence-Based Medicine for Vitamins & Supplements - Safety, Side Effects, Drug Interactions - How to Get Reliable Information

 

 

If you've received this via email, Click here to get to the web version of this post with all the links

Before May 12, 2010, I'd never met nor had the opportunity to hear Dr.Tom Morledge speak.  I only knew that he had a long-time interest in wellness and integrative medicine--and that he kept a close watch on the scientific literature to determine what's working--and what's not. Definitely, my kind of physician.

Earlier this month I had a chance to attend a Wellness Grand Rounds where Morledge spoke on,  "Nutraceuticals from A-Z".  Tom had so much information to fit into one hour that he was forced to speak at mach speed--and only got as far as H!

Morledge does his homework.  When it comes to using nutritional supplements in medical practice, he wants to know their mechanism of action, the evidence for their efficacy, and how they might interact with other pharmaceutical drugs--as well as their potential side effects.   And quality control of nutraceuticals is of prime importance to him--knowing which companies have the highest standards--because unlike drugs, vitamins & supplements are not regulated by the FDA.

Use my notes only as a spring-board for your own research--and certainly consult your own physician!  I could have missed some key points.  I could have misheard something.  I don't have transcripts, Power Point slides, or even a recording with which to double-check my notes. 

Who is Dr. Thomas Morledge?   He's a board certified physician in Internal Medicine and Pediatrics--and he's certified with the American Board of Holistic Medicine.  He's a clinician in the Cleveland Clinic's Center for Integrative Medicine, as well as the Medical Director for their Wellness Enterprise.  He walks his talk.  He's a spare-time farmer & gardener, a triathlete, with a passion for healthy cuisine, spirituality, and music.  Plus, he's easy-going, incredibly knowledgeable, with a sense of humor, to boot!

Alpha-Lipoic-Acid

This is an anti-oxidant that also helps the body to recycle other anti-oxidants--definitely a good thing!  It dampens damaging free-radicals, and has been successfully used to treat diabetic neuropathy.   In clinical studies of its use for the treatment of diabetic neuropathy, 53% of people with diabetic peripheral neuropathy experienced improvement.

Neurontin is the standard medical treatment for diabetic neuropathy--and it comes with serious side effects.  And the stats for Neurontin aren't as good as ALA--1 out of 3 patients improve. 

ALA is the definite winner in this match-up.  It also has low toxicity, and minimal drug interactions.  There is some theoretical concern about its use in cancer patients--a situation where you don't want anti-oxidants to interfere with chemotherapy.

Bottom Line:  It's an excellent anti-oxidant, with an optimal recommended dose of 300 mg/ 2-3 times a day.  I'm a personal fan of Juvenon--the ALA/acetyl L-Carnitine supplement developed by Dr. Bruce Ames of UC Berkeley. 

Art of Medicine

This is the concept of personalized medicine--how to figure out what's best for an individual.  Morledge prefers to consult evidence-based-medical literature when it's available--but it doesn't exist for every drug, nutraceutical, or condition.  The same goes for the gold standard in medicine--the randomized controlled trial.  They aren't always available--and because of the high costs involved in running these trials--they're often scarce when it comes to nutraceuticals.  Meta-analysis--when a researcher looks at all the clinical trials for a particular treatment or condition to determine what's working and what's not-- is an even better resource--but not often available. 

Something else to consider:  According to Morledge, medicine is good at figuring out mortality statistics (lives saved by a treatment)--but it isn't very good at measuring VITALITY.

One measure or marker of vitality is how much muscle mass is preserved as one ages.  After age 40 we start to lose 10% of our muscle mass per decade--resulting in the physical frailty of the elderly, and loss of organ reserve.  Decline often starts in the 50's & 60's--and according to Morledge, it's possible to prevent disability for 7 years--which bottom line, is the "name of the game", & more important than just extending years.  Another good reason to exercise, and weight train as we age.  Use it or lose it.

Another newer measure of vitality is telomere size.  Telomeres are similar to the protective plastic caps on shoelaces.  They protect valuable genetic material needed for our cells to divide properly, and to repair worn-out cells. The greater the size of the telomeres as we age, the better the chances for longevity.  In fact, increased telomere size is a marker for decelerated aging.  I've written often about telomeres--and it should be no surprise that exercise, diet, and omega 3's have all been shown to preserve & increase telomere size.  Click here to read more.

Boswellia

This was a new one for me.  It's a nutraceutical that comes from tree resin--and is well known for its anti-inflammatory properties.  It's been used for asthma, Crohn's disease, and osteoarthritis.

Here's how it works:  Boswellia inhibits arachidonic acid--an inflammation precursor commonly found in meat, eggs, & dairy.

5-Loxin is the standard nutraceutical product name for Boswellia, and that's what you want to look for.

Osteoarthritis and the knee:  In a 65 person study, 250 mg of 5-Loxin showed benefit in relieving stiffness, function, and pain.  Measurements of knee inflammation also decreased significantly.

5-Loxin/Boswellia is safe, with no identified drug interactions, and its anti-inflammatory benefits have been documented through biomarker measurments.

It has few reported adverse effects, and they're minor:  nausea & heartburn.

Since 5-Loxin is not well-absorbed it should be taken with a fatty meal. 

Dose:  250 mg/day--it comes typically in 50 & 75 mg capsules.

Bioavailability

How do we know if a nutraceutical works?  How available is it to the body after it's ingested?  This is a complex & difficult question.  First of all, it has to go into the small intestine, and it has to be a,bsorbed.  

Take the ORAC Index for example--the measure of foods by their anti-oxidant capacities.  Even if a food is known to have a high anti-oxidant ranking (ORAC index) it's still difficult to know how "bioavailable" its anti-oxidants will be after the food is eaten. Are its anti-oxidants actually making their way into the bloodstream--and at what levels?   We have to judge by other markers of improvement.  To read more about ORAC & antioxidants, click here.

Consumer Labs

This is a recommended online resource that evaluates nutraceuticals and vitamins for their active ingredient content, safety and purity.  But here's a little known fact about this group that's important to be aware of.

If Consumer Labs, acting as an independent "watch-dog agency" pulls products off the shelf to measure and analyze--you'll find the results on their website.  But, if a company pays them to evaluate and analyze their product--and it gets a negative evaluation--it won't be found on their website.  Something to keep in mind.  

Morledge thinks that the low-cost online membership to Consumer Labs is worth the price for the assurance it provides about the content & safety of vitamins & supplements.  Click here for that link.

Morledge has personally made visits to three nutriceutical companies.  Two he found to be stellar--following all the proper safe manufacturing practices--while  the third one he described as a "nightmare".  He declined to mention the names of these companies publicly, but if you want to know which companies have passed his quality tests, take a look at Cleveland Clinic's 360 Wellness site for trustworthy manufacturers & their supplements.  Click here

Vitamin C

There have been a lot of proposed benefits and uses for vitamin C over the years--but bottom line, the research hasn't lived up to the claims.

Treatment and prevention of colds:  only 8% of people will reduce the duration of a cold, and only by one day by taking vitamin C--and that doesn't take into account the "placebo effect".

But...there is one proven benefit for vitamin C.  Its best indication is for the prevention of colds in endurance athletes--because their extreme exercise training can suppress their immune system.  Vitamin C has been shown to prevent colds in athletes only.  And, not with mega-doses.  The most beneficial dose has been 125-250 mg twice a day.

Vitamin C has a low toxicity profile, and it's cheap.

Vitamin D

If you live in the Northern latitudes, between October through April, ultraviolet rays are just not available, and 70-80% of people living in Northern communities are found to be deficient in vitamin D.  The levels don't get much better in the summer either, because so many of us don't venture outside often enough--and when we do, we're often slathered with sunscreen.

Quick history:  The original RDA for vitamin D was based solely on the amount needed to prevent rickets.  As it turns out, that is a woefully low amount, 400 IUs.  Today, research studies are showing that low D is associated with osteoporosis, falls in the elderly, upper respiratory infections, breast cancer, multiple sclerosis, and more.

Morledge mentioned that the obstetric and gynecologic associations have recently raised their recommended levels of vitamin D to 2000-4000 IUs/day--but I was not able to substantiate this recommendation--except for the recent NIH study completed by Drs. Bruce Hollis & Carole Wagner that I've posted about in the past.  Cick here.

So, what's the optimal blood level for vitamin D, according to Morledge?  Definitely a score of 30 or more on the 25-hydroxy-vitamin D test--but he says aiming for 40 is reasonable.  He advised 1000 IUs as the upper limit for infants, and 2000 IUs for everyone else.  To read more about vitamin D, and what the vitamin D experts recommend click here.

Drug interactions:  Certain drugs may increase or decrease the absorption of vitamin D, including St. John's Wort, which has many potential interactions with drugs.  Other drugs known to interfere with vitamin D absorption include:  anticonvulsants, bile acid sequestrants (for cholesterol), Tagamet, corticosteroids, and heparin.

Morledge recommends consulting the Natural Standard Index--the Authority on Integrative Medicine to check for drug interactions with any nutriceuticals.  I feel fortunate that my library has this excellent resource available online--but check with your local medical or public library to see if they have access to this valuable resource.  Click here

Vitamin E

There are definitely issues concerning taking vitamin E in its natural form--and its synthetic form.  Some adverse effects have been associated with taking vitamin E at levels over 400 IUs--namely, increased mortality for those who are taking statins, and potential adverse effects for those with bleeding disorders or head & neck cancers. 

Morledge wouldn't take vitamin E over 200 IUs/day.  He advises getting vitamin E from food sources like avocados, wheat germ, nuts, & seeds.

He knows of no clinical trials that used natural mixed tocopherols (vitamin E)--most trials have used the synthetic form. 

SAMe

This supplement has been successfully used for osteoarthritis pain.  The journal BMC Musculoskeletal Disorders looked at how SAMe matched up against celecoxib (Celebrex) in the treatment of osteoarthritis.  Click here for the article.

The researchers found that  SAMe was as effective as Celebrex for improving pain relief in osteoarthritis--the only difference was that it took a few weeks longer for SAMe to work.  

The added bonus:  It has limited side effects--unlike other anti-inflammatories.

Downside:  The cost.  The SAMe dose that relieves osteoarthritis pain is 1600 mg/a day--which amounts to about $8/day--and is obviously very  expensive.

SAMe and depression.  Here's another use for SAMe.  In reviews of the medical literature SAMe turns out to be as effective for the treatment of depression as prescription anti-depressants--and with very limited side effects.  Click here for the review.  Dosage is the same:  1600 mg/day

Functional Medicine

What's this?  It's basically integrative medicine--looking at each person's story before deciding on a course of treatment.  It's looking at an individual's level of oxidative stress, energy, fitness, stressors, sleep, support system, and diet.

We're obviously not all the same--and some of us will  need more or less of some things than someone else.  That might mean removing foods that we are sensitive or allergic to--or adding prebiotics.  You get the idea. 

Ginger

For nausea & vomiting--think ginger--and I don't mean ginger ale.  It's been studied for use in a variety of settings: pre-op, obstetrics, and for motion sickness. 

Morledge says you can't base nutriceutical usage on one study--you need many--a basic rule of medical research.

As for ginger, it looks like it's a good treatment for nausea & vomiting.  It's inexpensive, it has limited side effects, and limited drug interactions.

Recommendations:  A total of 1 gram a day--taken as 250 mg/ 4 times a day for pregnancy.  My note: Definitely consult your doctor on this one--especially for pregnancy!

Glucosamine

A recent UK Health Technology Assessment Report looked at the medical literature, and the esteemed Cochrane Systematic Reviews Database to assess the benefit of glucosamine.  Click here for that report.

Bottom line:  Glucosamine provides a little bit of pain relief for knee pain.  Its pain relief is slightly better than that of a placebo--but, and this is a big but...the placebo was 40% effective!  Its toxicity level is also low.  1500 mg/day is the recommended dose.

"To market a medication (pharmaceutical drugs), all you have to do is prove that it's better, on average, than a sugar pill.  A drug that works 20% of the time, for instance, may be considered effective--even though it does nothing for 80% of patients."

--Mark Gibson, deputy director of the Center for Evidence-Based Policy at Oregon Health & Sciences University--

Matched against non-steroidal anti-inflammatories--glucosamine might be the better choice, because it is safer, and has less side effects than NSAIDS. 

It has a half-life of 16 hours, which means you can take it once a day and still get relief.

How does it work?  Glucosamine is absorbed into the cartilage and it helps repair the cartilage, as well as decreasing cartilage degradation.

Hot Flashes

According to the Cochrane Database for Systematic Reviews, the gold standard for systematic reviews, there is no conclusive evidence for the benefit of soy isoflavones in alleviating hot flashes. Click here for the abstract.

High doses of isoflavones seem to do a better job than low doses.  And there is no evidence of adverse side effects.  Here's an interesting point to consider when it comes to the soy-hot flash question.  The women who were given the placebo quit right away--because there was clearly no relief for them!

Morledge says that a nutriceutical made from soy (specifically fermented daidzein), known as S-(-)Equol, is excellent for the relief of hot flashes.  A dose of 3 times a day (sorry, that's all I jotted down) has shown statistically significant benefit in the relief of vasomotor (hot flashes) and somatic (physical) symptoms of menopause.  Click hereto read more.  

I wasn't able to find out much about this, however, a number of just published "ahead of print" articles about S-Equol have just appeared in May 2010 in the Journal of Nutrition, including, "Equol Improves Menopausal Symptoms in Japanese Women" by Takeshi Aso.  In Aso's study women taking 10 mg of an S-Equol supplement experienced significant relief of their menopausal symptoms.  The supplement was developed by Otsuka Pharmaceuticals.

So there you have it.  Nutriceuticals from A-H.  I-Z should be coming in November, 2010.  Please consult your own physician before starting any supplements. This post is just a transcription of my lecture notes--and may be incomplete or misinterpreted.

I'd love to hear if anyone has any personal experience with any of these supplements--pro or con. Please let me know.

 

 

 

 

 

 

 

 

 

 

Saturday Shares: Brain Science Podcast on the Myth of Alzheimers, Alkalol for Cold Control, Too Much Alcohol Shortens Telomeres, Entertaining without Cheese or Cake, and Kathryn Stockett's "The Help"

Click here to go to the web version of this post with all the links if you've received this via email.

What a terrific Saturday it was.  Jam-packed with finishing-up reading Kathryn Stockett's, The Help, for book club.

Then about a 1/2 hour on my computer to catch up on a couple of new health studies that grabbed my attention. 

Followed up with an hour long walk in light rain--while I listened to Dr. Ginger Campbell's interview with Alzheimer's expert, Dr. Peter Whitehouse--before heading off to an all-afternoon bridal shower.

Then it was stopping off at Trader Joe's to load up on healthy fare--to feed the book club crew who were coming to my house at 7:30 pm.

Get home--unload groceries--straighten up the house--bring more chairs into the family room--quickly down some black bean soup for "dinner"--and set-up the book club smorgasbord on my kitchen/family room island.

By then I was definitely starting to feel a bit of a cold coming on--and I had just enough time to get in a quick neti pot saline/Alkalol nasal cleansing to nip that cold in the bud.

So there you have it. 

My Saturday.  And my show-and-tell for the day.

• From my walk: Dr. Peter Whitehouse's not-to-be-missed interview about Alzheimer's and brain aging.
• From my computer reading: A study just-presented at the annual meeting of the American Association of Cancer Research about the negative effects of too much alcohol on our telomeres--which are strong markers for aging.
• Alkalol--my new favorite 1897 pharmacist-developed "nasal douche" to ward off colds
• From my book club smorgasbord:  My first-ever book club "hosting" where I didn't serve any food that I wouldn't eat myself.  No cookies.  No soda pop.  No cheese.  No junk.
• The Help, by Kathryn Stockett.  This is only the 3rd time in the 17 years since this book club has been meeting that all ten of us--men & women--liked the book.  Not everyone LOVED it--but everyone finished it--enjoyed reading it--and we had so much to talk about.

My Saturday Share Number One:  Brain Science Podcast - Dr. Peter Whitehouse on The Myth of Alzheimer's: What you aren't being told about today's most dreaded diagnosis

I'm a big fan of Dr. Peter Whitehouse--he's the real deal--a geriatrician, Alzheimer's expert, researcher, clinician--and he tells it like it is.  Alzheimer's is just a label for a constellation of dozens of different brain conditions that all add up to brain aging.  Whitehouse doubts that we're ever going to find a "one shot" magic bullet to "make it go away"--and throwing money looking for a cure isn't the best use of resources.

I wrote about Whitehouse's book two years ago when I first started this blog--so here's my handy "Cliff Notes" synopsis of what he's all about:

Dr. Peter Whitehouse, one of the leading experts on Alzheimers has pulled down the Alzheimer's curtain in his new book, The Alzheimers Myth.   He frankly charges that the advocacy groups, the researchers, and the pharmaceutical industry all have a vested interest in raising funds for a disease that will be impossible to "cure".  The hope lies in prevention and care.  Be sure to check out his web site.

Why is a cure so elusive:

1. Alzheimers is not one singular disease.  It's impossible to differentiate it from brain aging - it is brain aging.  At age 85-95 it's normal for the brain to age.  If you've seen one Alzheimers patient, you've seen one Alzheimers patient.  There's no one biological profile.

2. What we call Alzheimers is caused by multiple assaults to our brains; including vascular dementia (caused by silent, tiny or large strokes) or atherosclerosis; inflammation; environmental toxins like lead, poor diet, head injuries and just plain normal aging.  Many of these processes start early in life.

3. We don't really know how to diagnose this disease. We all get some of the so-called characteristic plaques and tangles of the brain--it's just a symptom of aging, not  the cause of Alzheimers.  Autopsies of perfectly normal functioning adults have shown the same plaques and tangles as seen in Alzheimers patients.

4. To cure Alzheimers, we'd have to arrest the process of brain aging.

If brain aging and dementia is a concern or interest of yours, be sure to take a look at the link to the Brain Science Podcast's April 14, 2010 eye-opening interview with Dr. Whitehouse that I listened to--along with a helpful transcript.  Click here for that link--which contains additional links to Whitehouse's blog

The Whitehouse Interview Highlights:

1.  What about the genetics of Alzheimer's?  What if you've inherited the "dread Apo E4" gene? Genes Aren't Destiny.

Dr. Whitehouse:  Now, we are increasingly realizing genes modify our risk for diseases—they’re called genetic susceptibilities—that aren’t causative.

And so, there are genes that, if you have them, can modify your risk for getting a late-life dementia, but don’t necessarily cause it. I’ll illustrate that with the strongest associated one—apolipoprotein E4.

Apolipoprotein is a fat-related protein that relates to cholesterol transport. We all have one version of it—either a 2, or a 3, or a 4 (1 went away somehow).

If you have the 4 kind, everybody can transport their cholesterol OK, but that kind makes you more at risk for bad things to your brain as you get older.

And I put it that way because it’s not only so-called Alzheimer’s and memory problems, it’s stroke and it’s other diseases. It’s also bad for your heart. So, if you’re an ApoE 4, you may be more at risk for various heart conditions.

That’s a susceptibility gene.

Dr. Campbell: So, it’s very important, I think, to emphasize that increased risk
is not the same as predicting disease. Genes are not destiny.

2.  What Can You Do to Reduce Your Risk of "Alzheimer's" or Brain Aging? (from the transcript)

• Keep Your Mind Active Doing Something You're Passionately Interested In--That Benefits Your Community.  There are computer programs you can try. Do you do crossword puzzles? Do you
  do Sudoku? I don’t think what you do with your brain is really that important, as long as you enjoy it and do it. I would have a caveat to that, and say if you use your brain to help other people, that’s probably best, because every sage, every religious leader says helping other people is the best way to help yourself. So, keeping your brain active in a community helping other people, I think, is the most important thing.
• The Importance of Exercise.  People have a sense that being physically fit is important for your health in general. But I think it’s important to emphasize it’s particularly important for your brain, not only because it supports your heart and the pump to the brain, but also because of a lot of evidence that exercise, itself, helps brain function.
• Low Glycemic Mediterranean Diet.  I’m (Dr. Whitehouse) personally a believer in something like the Mediterranean diet, which is not what most of us follow, and getting rid of too much red meat, too many processed foods, foods that are high in sugar. So, a low glycemic index, roughage, fruits and vegetables, that’s the way to go.  A just published (early release) Columbia University study in the Archives of Neurology shows a 40% reduction in the risk of developing Alzheimer's with a plant-heavy Mediterranean diet--including omega-3s, nuts, cruciferous vegetables, fruits, and dark leafy greens.  Click here for the Columbia study and my earlier post with Dr. Gomez-Pinilla's advice on "feeding" the brain.
• A Good Healthcare Provider.  I would add number four is have a good healthcare provider that you trust to have a relationship with, because there obviously are things that go along with brain aging where you need a doctor’s attention occasionally, and you should have that relationship to build on.

3.  Making Money on Alzheimer's Disease

Dr. Peter Whitehouse:  I think we have amazingly distorted our notions of health because of an unholy alliance between two isms—scientism and capitalism.

Now, I’m a scientist, and I believe that science can do powerful things. Scientism is the religion that science can do more than perhaps we are right to believe that it can. So, it’s the faith that science, with enough money, can do anything.

And, of course, short-term capitalistic approaches to health have led to the dominance of multinational pharmaceutical companies, and to the "commodification"—to use that word—of everything medical.

So, doctors do what they get paid for, and drug companies use direct-to-consumer marketing to convince people that their pills are wonderful. Frankly, I think we should get rid of direct-to-consumer marketing in this country.

We’re only one of two countries in the world that have it, and I think it is basically a social harm.

Dr. Campbell: Related to that is the fact that every time we see a patient, because of the way reimbursement works, we are forced to label them with a diagnosis, because we have these thick books full of codes for diagnoses. And so,doctors are sort of pushed into labeling people ‘Alzheimer’s disease,’ to a certain extent, aren’t they?  Even the doctors who don’t have any financial rewards from, say, prescribing drugs or whatever, still are sort of being cornered.

My Saturday Share Number Two:  Cutting Back On Alcohol Can Prevent Your Cells From Aging Before Their Time.  Too Much Alcohol Damages Our Telomeres--The Protectors of Our DNA--Speeding Up Aging & Cancer Risk

I'm fascinating by the whole science of telomeres.  They are markers of how fast (or how well) we are aging--they normally shorten the older we get.  But "good behavior" has been shown to lengthen them: Like eating lots of omega-3s and exercising regularly.  So, now we know to watch out for drinking too much alcohol--because it shortens telomeres--speeding up aging--and increasing cancer risks.  Definitely something to share with any teen-agers or twenty-somethings you happen to know who are tipping a few too many.  For the NPR summary click here.  For the American Association of Cancer Research press release click here. To read my earlier posts on telomeres, click here here and here.

My Saturday Share Number Three:  Alkalol--My New Favorite Cold Crusher/Cure

 

Back in December, when I was moaning about how I missed my now-off-the-market Zicam Nasal Gel, a New York reader wrote to tell me:  "Also try using Alkalol with your Neti pot. It's a very popular remedy in our neck of the woods here in NY!"

I passed his recommendation on to a friend when she had a terrible cold--and her neti pot was not doing the trick.  She was an instant fan.  So, one day when I felt a cold coming on--in spite of using a neti pot to "nip it in the bud"--I headed over to CVS to give Alkalol a try.  OMG!  It's amazing.  It opened my sinuses, and it kicked any newbie cold germs right out of my nasal passages. In other words--the cold vanished.

It was developed by a Massachusetts pharmacist, James P. Whitters, back in 1896--and it's still family-owned by Whitters' grandson, James P. Whitters III.

It's made with methol, eucalyptus, thymol, camphor, and oils of wintergreen, spearmint, pine, and cinnamon.  Its "an alkaline saline solution specifically formulated to clean and moisturize the nasal passages, dissolve mucus, kill germs and bacteria, and provide natural relief from the symptoms of sinusitis and allergies."  You can even use Alkalol as a mouthwash or gargle.

You definitely need to dilute it with water--or you'll get the same strong sinus popping sensation you can get when you eat strong horseradish or wasabi.  I mix 1 ounce of Alkalol with 7 ounces of warm water, together with my neti pot mixture of 1/2 tsp. salt, and 1/4 tsp. of baking soda.  Click here for my neti pot/cold prevention post.  Click here to read more about Alkalol.

One last thing: I had to ask the 70-something pharmacist for Alkalol--it was behind the counter and he was the only one in the store who even knew what it was.  They keep a very small supply.  My friend had to have her pharmacist order a bottle--but it was there the next day.  I paid about $5.00 for a 16 ounce bottle.

Saturday Share Number Four:  My Book Club Smorgasbord Goes Healthy.  No Cheese.  No Cookies. No Brownies. No Soft Drinks.

My "Old" Unhealthy Book Club Smorgasbord

Feeding the 5 couples that make up this over-17-years-standing book club has always been a "piece of cake".  Just pick up some good cheese, hummus, baba ganoush, fruit, veggies, crackers, cookies, brownies, candy, nuts, sugar-free Fresca & Coke, and a bottle of wine.  Spread it all out on the island in my family room & Voila! Easiest entertaining you can imagine.

Last Saturday I decided that I couldn't feed this kind of junk to my friends any longer.  Enough already. 

This time I spread the family room island with strawberries, blackberries, clementines, crusty bread, healthy blue corn chips, "homemade" guacamole, salsa, Dr. Kracker Klassic 3 Seed Flatbreads, hummus, Trader Joe's Red Pepper Spread with Eggplant & Garlic, Trader Joe's Bruschetta, Trader Joe's Roasted Red Pepper & Artichoke Tapenade, miniature red, yellow, & orange sweet peppers, and as a concession to giving up the cookies,  I broke up bars of Trader Joe's Swiss 71% Dark Chocolate.

Instead of Fresca & Diet Coke, I had sparkling water with cut-up lemons & limes--and a great pinot noir called:  Cloudline.

No one complained a bit--they loved the spread (I think) and we ate almost everything up!

My Saturday Share Number Five:  Kathyrn Stockett's The Help.  When 10 men & women with diverse reading tastes all like a book--it's got to be good.

Rarely does everyone in my book club unanimously like a book.  We've got our distinct camps: those who like the dysfunctional family stories; those who like non-fiction--biographies, current events, science, history--and those who just want a "rattlin' good yarn".

This book filled the bill for all of us.  Who couldn't resist a novel set in 1962-64 pre-civil rights Jackson, Mississippi--with a story told from the perspective of the maids who work for the bridge-party Junior League set, raising & loving their children and keeping their family secrets?

It's was the time of Jim Crow laws--Medgar Evers' bullet-in-the-back assassination by the Ku Klux Klan--a time when a maid could go to jail on the accusation that she stole a piece of silverware from her employer--and a time when a young man could get his face bashed in if he used a toilet reserved for whites.

Lots to talk about.  And for me, this was one of the most enjoyable reads I've had in a year--and when I finished, I was reading through tears.

The book is more than a story of pre-civil rights Mississippi.  It's about taking risks to move forward--and change your life.  It's about strong friendship--how women support one another--and how it makes life's worst bearable.  It's about how we're unknowingly shaped by the culture and companions that surround us.  And it's about how easy it is to make assumptions about someone else's life--and be dead wrong.

"There is so much you don't know about a person. I wonder if I could've made her days a little bit easier, if I'd tried.  If I'd treated her a little nicer.  Wasn't that the point of the book?  For women to realize, We are just two people.  Not that much separates us.  Not nearly as much as I'd thought."

A New Role for Omega-3? Lengthening Our Telomeres--A Key Marker for Aging, Longer Life, and Health. From JAMA & UCSF.

  

 

"The main result of our study is that patients with high levels of Omega-3 fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length. It's also the first study that shows that a dietary factor may be able to slow down telomere shortening."   

-Ramin Farzaneh-Far, M.D., of the University of California at San Francisco, lead author of "Association of Marine Omega-3 Fatty Acid Levels with Telomeric Aging in Patients with Coronary Heart Disease"  JAMA 2010;303(3):250-257.

Click here to see the web version of this post if you are receiving this via email.

This week's big medical news story appeared in JAMA and it is one more reason why you want to be sure to get your Omega-3s everyday--while lowering your intake of the Omega-6s.

We already knew that the Omega-3s were amazing.

• They're anti-inflammatory and anti-clotting
• They prevent age-related cognitive decline
• They lower triglycerides
• They lower blood pressure
• They slow age-related macular degeneration
• They keep blood vessels flexible
• They lower depression
• They decrease joint stiffness in rheumatoid and osteo-arthritis
• They're necessary for fetal and infant brain development

So What Did The JAMA Heart And Soul Study Tell Us That We Didn't Already Know?

The UCSF researchers followed 608 outpatients with stable coronary artery disease for 5-8 years.  At the start of the study they measured everyone's levels of Omega-3's and the length of their leukocyte telomeres--which is a marker of aging.  Remember though--this was an observational study, not a gold-standard double-blind randomized controlled study.

Here's how the lead researcher Dr. Ramin Farzaneh-Far explains the results:

"The main result from our study is that patients with high levels of Omega-3's fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length."

"Patients with the highest levels of Omega-3 fish oils were found to display the slowest decrease in telomere length, whereas those with the lowest levels of Omega-3 fish oils in the blood had the fastest rate of telomere shortening, suggesting that these patients were aging faster than those with the higher fish oil levels in their blood."

"By measuring telomere length at two different times we are able to see the speed at which the telomeres are shortening and that gives us some indication of how rapidly the biological aging process is taking place in these patients."

What Are Telomeres And How Exactly Do They Affect The Aging Process?

 

 

PLASTIC TIPS ON SHOELACES—that’s the analogy often used to describe telomeres. They are the red caps sitting on the ends of these blue chromosomes. 

Just like plastic shoelace tips that keep the laces from fraying--the telomeres protect valuable genetic material needed for our cells to divide properly, and to repair worn-out cells.

They are also strong markers for aging (see the graph below and get depressed).  Not only do they shorten as we age, over time the telomeres can become damaged and shorten because of inflammation, smoking, obesity, or lack of exercise. 

Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,

"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."

This week's JAMA study is just one more bit of evidence that shows how our lifestyle choices can affect telomere length--and promote healthy aging.

• A 2008 twin study published in the Archives of Internal Medicine compared the telomere length of exercising twins versus couch-potato twins.  After only 12 months, the telomere's of the exercising  showed the equivalent of being 10 years younger than their couch-potato siblings.  Click here to read about the study.
• A 2008 study led by Dr. Dean Ornish followed a group of men with early prostate cancer who made these lifestyle changes:  increased their fruit & vegetable consumption; limited their fat consumption to 10%; lowered their consumption of refined sugar; took vitamin supplements & fish oil; exercised for 30 minutes a day; and either meditated or did yoga for stress relief.  After only 3 months, 24 out of 30 men showed significant increases in their telomerase levels.  Click here to read about the study.
• A number of studies have also shown how stress can accelerate telomere shrinking, especially in caregivers of chronically ill children and the spouses of Alzheimer's patients.  One study even suggested that you can accelerate your biological age by as much as 17 years if you're exposed to what you perceive as high psychological stress!

All About Omega-3's.  Does It Really Have To Be Fish Oil?

Yes, the JAMA study used Omega-3 fish oil, but Omega-3s really originate in green leafy plants--not in fish.

Susan Allport is a medical researcher who is an expert in "all things Omega-3".  She has written a brilliant article in the September 2009 issue of Prevention, "The Vanishing Youth Nutrient" that does an excellent job of explaining why we need Omega-3s in our diet, why so many physicians equate Omega-3 with fish, and why Omega-3 is sorely lacking in our diets.  Click here for the article.

• We can only obtain the Omega-3s through our diet. 
• They are essential to the healthy development of our brains--and they are found in the highest concentrations in our most active tissues: brains, eyes, hearts, the tails of sperm.
• The metabolism of every species on the planet is a function of the amount of Omega-3s in its tissues, according the Dr. Tony Hulbert of the University of Wollongong in Australia.  Think: Omega-3=growth, activity, energy.  Omega-6=hibernation, fat storage, belly fat.   Athletes take note:  high concentrations of omega-3s in muscle cells lead to improved athletic performance.
  
• Research from the 1980s showed fish-eating populations of Greenland and Japan had the lowest rates of heart disease.  That's why the Omega-3s became associated with fish--instead of with green plants.  And that's why the American Heart Association recommends fish or fish oil as our main source of Omega-3s.  Big Problem:  Fish are not a sustainable source of Omega-3s--there are simply not enough fish in the world's oceans.
• Big Point:  "Omega-3s are found in the green leaves of plants.  Fish are full of omega-3s because they eat phytoplankton (the microscopic green plants of the ocean) and seaweed.  They are what turn sunlight into sugars, the basis of life on Earth."
• You can get all your Omega-3s from green leafy vegetables, legumes, flax seeds, chia seeds (they have the highest level of any plant-click here to read more), or walnuts, grass-fed animals and their milk, or eggs, wild cold-water fish like salmon, highly purified fish oil supplements, or algae-sourced Omega-3 supplements.
• Big Point:  If you cut back on vegetable oils, processed foods, trans-fats, corn-fed meat, chicken and milk you will actually lower the amount of Omega-3s you need in your diet to balance the negative effects of the inflammatory, fat-promoting Omega-6s we are getting in our Western Diet.
• The ratio of Omega 6's to 3's should be 2:1, or ideally 1:1.  Currently, for most Americans, the ratio is 17:1 in favor of heart-disease-causing Omega 6's.

Why Is Our Diet So High in Omega-6s, And So Low In Healthy Omega 3's?

• Omega-6 fats come from the seeds of plants.  We need them--but we need far less of them than we are consuming--and we need them in just the right ratio to Omega-3s.  They promote blood clotting, inflammation, and cause us to "pack on the pounds".  Just like corn-fed beef.  Grass-fed or plant-fed animals and humans are naturally lower in fat!
• Big Point:  Omega-6s and Omega-3s are in constant competition to enter our cells.  Eat too many Omega-6s in the form of meat, oil, or processed food--and you'll be seriously deficient in Omega-3s.  Eat less Omega-6s, and your body won't need as many Omega-3s to function properly.
• Omega-3s began to disappear from our food supply when previously grass-fed animals began eating corn and soybeans, which are high in Omega-6s.  The factory-farm and feedlots replaced the family farm, and grass-fed meat, milk, and eggs became history.  Click here to read about King Corn's effect on our health.
• With farm subsidies for corn and soybeans, companies like Archer Daniels Midland figured out how to extract oil from these and other seed plants--giving us even more Omega-6s in our diet.
• The AHA and other health agencies encouraged us to use oil and margarine because they assumed these cholesterol-free oils were good for the heart.  Wrong!
• "Food chemists discovered that rancidity in packaged food was caused by the oxidation of some minor but pesky  fats: the Omega-3s."  So they removed them and extended the shelf-life of packaged food.
• Fewer and fewer of us are eating enough green leafy vegetables, fish, or flax to even put a dent into the "out-of-whack" Omega-6 to Omega 3 ratio.

I highly recommend you read Susan Allport's article in Prevention, as well as her book, The Queen of Fats.  She does an excellent job of explaining the good, the bad, and the ugly of the fat world.

If you need any more convincing on the wonders of Omega-3, watch Allport's brief video, The Rat Race, comparing rats fed on diets rich in Omega-3s with those fed on diets deficient in Omega-3s.

Click here if you've received this post via email and aren't seeing the video.

 

Live Long & Prosper - But First You Need to Boost Your Telomerase Levels. Dr. Dean Ornish Does It Without Drugs.

"This is the first study showing that anything can increase telomerase. If it were a new drug that had been shown to do this, it would be a billion-dollar drug. But this is something that people can do for free."

-Dr. Dean Ornish, Head of the Preventive Medicine Research Institute in Sausalito, CA-

LIVE LONG.  According to a small study published by  Dr. Dean Ornish  today in Lancet Oncology, it just might be possible.

PROSPER.  With the news coming out of Wall Street these days, that might be harder to accomplish!  You're on your own with that one.

What was the Ornish study?
It was a carefully limited pilot that looked at 30 men with low-risk prostate cancer who followed a prescribed Ornish-style "straight and narrow" healthy lifestyle program for 3 months. Dr. Elizabeth Blackburn, a University of California at San Francisco biochemist, was the lead investigator. The researchers propose a much larger, strictly controlled research project, but hope that this study, "..might be a powerful motivator for many people to beneficially change their diet and lifestyle." 

What lifestyle changes did the group make:

• Ate a diet rich in fruits, vegetables whole grains, legumes & soy
• Limited the fat content of their diet to 10% of the total calories
• Kept the diet low in refined sugars
• Took vitamin supplements and fish oil
• Exercised moderately for 30 minutes a day.
• Participated in an hour of a daily stress reducing activity, like meditation or yoga.

What were the study results?

After 3 months the participants' blood levels of the enzyme telomerase were 29% higher than when they began. 24 out of 30 men showed significant increases in their telomerase levels.

What do higher telomerase blood levels mean?

Looking at the graph above you can see that our telomeres keep getting smaller as we age.  They are the control center for longevity.  Shorter telomeres = shorter life.

"Shortening of telomeres is also an indicator of disease risk and premature death in some types of cancer, including breast, prostate, colon and lung cancer."

Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,

"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."

So anything that we can do--and do without drugs--to keep our telomeres long is definitely a good thing! If you can increase the enzyme telomerase, it can fix the fraying ends of the telomeres, and lengthen them as well.  This increases longevity and maintains the cells of our immune system.

Cancer promoting genes are decreased.  Cancer preventing genes are increased.

An earlier study of this same group of men, published in June in the Proceedings of the National Academy of Sciences showed they also experienced dramatic positive changes in the activity of about 500 genes.  The amazing part was that over the course of 3 short months of healthy diet, exercise & stress reduction they were able to increase the activity of the disease-preventing genes, and shut down some of the disease-promoting genes that are associated with prostate and breast cancer. Interesting that Dr. Esselstyn says "you can make yourself heart-attack proof in 3-4 weeks" with a similar diet.

Dr. Ornish wasn't the first researcher to discover a way to increase telomerase.

I disagree with Dr. Ornish that "this is the first study to show that anything can increase telomerase."  Back in the January 28, 2008 issue of Archives of Internal Medicine researchers compared the length of leukocyte telomeres (a marker of aging) between twins who exercised and those who didn't.

They chose twins for this study because they share much of the same DNA & are raised in similar environments as children.  This way they're really comparing apples to apples. They found that those who exercised, based on their telomere length, were biologically younger than those who didn't. 

Again, exercise can make you younger. In fact, those who exercised the most, putting in more than 3 hours of vigorous activity a week had the longest telomeres, which compared to the same length of the couch potatoes who were 10 years younger!

What I liked best about this study was it further confirmed that we can make positive changes to improve our lives.  And if confirms much of what Dr. David Servan-Schreiber says in his new book: Anti-Cancer - A New Way  of Life.  You can read more here.

There's No Way Around It: If You Want to Live Longer You've Just Got to Do It! Get Out There & Exercise!

We all know it's so.  Article after article tells us that exercise will make our hearts stronger, keep our brains sharper, reshape our bodies and keep depression far away. So what else is new?

Last month two new studies from prominent journals put a new spin on the old, "Get off the couch and start walking (or running or cycling or swimming). I was thrilled to hear that over in the UK, a well constructed  study in Plos Medicine following over 20,000 healthy men and women, aged 45-79 years old, for an average of 11 years, demonstrated how we can gain extra years by exercising, drinking just a little, eating at least 5 fruits & veggies, and not smoking.

Each person in the study was given a point for each of 4 healthy behaviors: not smoking, exercising, moderate alcohol intake, and eating at least 5 servings of fruits and vegetables a day.  The fruit & veggie intake was actually verified by measuring the participants' plasma levels of vitamin C.   At end the of the eleven years the authors looked at who had died, and compared the folks who were practicing all 4 healthy behaviors with those who weren't doing any of them.  The folks with a score of 0 were 4 times more likely to die (especially from cardiovascular disease) than the folks with a score of 4.  The authors concluded that a person practicing NONE of the 4 healthy behaviors  (with a score of 0) has the same risk of dying as a person practicing all 4 healthy behaviors who is 14 years older.  Take home message:  EXERCISE- EAT AT LEAST 5 FRUITS & VEGGIES A DAY-HAVE A TINY NIGHTCAP-FORGET ABOUT SMOKING.  Not much effort for an extra 14 years!

What's a telomere, why should I care, and what does it have to do with exercise?

Here's another prod to get you to JUST DO IT! In the January 28, 2008 issue of Archives of Internal Medicine researchers compared the length of leukocyte telomeres (a marker of aging) between twins who exercised and those who didn't. They chose twins for this study because they share much of the same DNA & are raised in similar environments as children.  This way they're really comparing apples to apples. They found that those who exercised, based on their telomere length, were biologically younger than those who didn't.  Again, exercise can make you younger. In fact, those who exercised the most, putting in more than 3 hours of vigorous activity had the longest telomeres, which compared to the length of the couch potatoes who were 10 years younger!

Which brings me to the telomere story.  Telomeres are like the plastic tips on our shoelaces that protect the laces from fraying.  They sit on the ends of our chromosomes, protecting our genetic data, and making it possible for the cells to divide. But the thing is, every time our cells divide (which keeps us young) the telomeres keep getting shorter, until our cells die or are damaged. Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,

"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."

Oh joy, what we have to look forward to! As the graph shows, the younger you are, the longer your telomeres.  And by the time you're 65, well, there's just not that much left.  Which is exactly why not too many of us make it past 80, 90 or 100.  Not to get you even more depressed about your rapidly shrinking telomeres, but there have been a number of studies that have shown how stress, especially in caregiver's of chronically ill children and spouses of Alzheimer's patients have accelerated telomere shrinking. One study even suggested that you can accelerate your biological age by as much as 17 years if you're exposed to what you perceive as high psychological stress!

So, how exactly does exercise lengthen our telomeres, and in effect, slow down our aging?  That's for another research study.  But until we know more, it looks as if it's a safe bet to start lengthening your telomeres now, by EXERCISING!