Thursday, December 28, 2006

Neil is going to be on the radio Tuesday morning

The Deborah Ray show: Healthy Talk Radio http://www.healthytalkradio.com/ Click on "Listen to Deborah" You then have a choice of listening to live or archive shows. Airing 8:30 am - 9 am Central TimeTuesday, January 2nd. Topic: black cohosh

Neil on TV 12/27/06 (Asthma)

the piece can be viewed for the next several weeks on CBN's Previous Broadcasts page -- http://www.cbn.com/700club/showinfo/schedule/previousbroadcasts.aspx?WT.svl=menu -- go to the "Play Now" button for Wednesday, Dec. 27 -- in the window that comes up, click on "Player Only" so that you can fast forward to 2:27 on your Windows Media Player -- the piece runs to 5:20. The print version is at http://www.cbn.com/cbnnews/78309.aspx as well as a low resolution viewing option.

Thursday, November 30, 2006

Vegetarian Dietary Supplements

Vegetarian Dietary Supplements By Neil E. Levin, CCN, DANLA 


Most dietary supplement manufacturers use the term “vegetarian” to include “vegan” and one even recently began adding the word “vegan” to their product labels to assure users that they are offering products without any animal-derived ingredients. 

However, some products are always animal-derived. These include: Fish Oil, Gelatin, Chondroitin sulfate, Vitamin D3, Hydroxyapatite calcium, collagen, Chitosan fiber, Celadrin oils, Pancreatin, Pepsin, Trypsin, Chymotrypsin, ImmunoLin® immunoglobulin complex, Bovine or Shark Cartilage, Sea Cucumber, Sea Mussel, Liver products that contain actual liver tissue, IGF-1 deer velvet and glandular substances. Other products are sourced from milk or dairy products: Whey proteins, Casein, Colostrum, and MicroLactin™. 

Probiotics are typically made by growing bacterial cultures on dairy products. Some strains are weaned off of the dairy and are harvested with only traces of dairy protein (casein) remaining. The growers will not certify these probiotics as non-dairy, dairy free or vegetarian, but tell us that most manufacturers do label their probiotics with these claims. 

 Yet another class of products is considered non-vegan because of the honeybee source: Bee Pollen (collected by, but not made by, bees), Honey, and Royal Jelly. This is an interesting distinction because bees also are essential for pollination and increasing the yields of many fruits, vegetables and nuts eaten by vegans. 

 Some dietary supplements may come from either animal or vegetarian sources. One example is Glucosamine, a structural component of the joints normally extracted from clam shells. While most glucosamine products are from shellfish, there is a vegetarian version that can be combined with MSM to provide the sulfur needed for the body to turn glucosamine hydrochloride into glucosamine sulfate. This vegetarian form is obtained by fermentation. Still, the vast majority of glucosamine supplements on the market use the shellfish-derived form, including the supplement called NAG (N-acetyl glucosamine) that is used for GI health and as an “essential sugar”. 

HA (Hyaluronic acid), used to aid the moisture-holding, cushioning ability of the joints, is often extracted from poultry. There is a vegetarian form, produced by fermentation. 

The digestive enzymes amylase, lipase and protease are found in the animal product called Pancreatin. But there are also plant-derived enzymes. These plant enzymes include amylase, lipase and protease, but they work in a much wider pH range over a longer period of time than Pancreatin enzymes, which work only in the alkaline pH of the intestine. Beginning digestion of fats and carbohydrates in the stomach can improve even good digestion. 

Look for vegetable-derived excipients such as magnesium stearate, stearic acid, rice flour, maltodextrin, etc. The stearates can also be sourced from beef fat, so it pays to check! 

Gelatin has long been the substance that capsules are made from. Originally, all capsules were gelatin caps. Two-piece capsules are normally derived from beef and pork gelatin, whereas the gelatin in softgel capsules is normally exclusively derived from beef gelatin. More recently, Vcaps have become a preferred form. In the past ten years or so there have also been Vcaps® as a vegetarian alternative, made from vegetable cellulose. A newer version, called NP Caps or Vcaps®, is made from non-GMO corn polysaccharides. Some considerations in the choice of which type of capsule to use revolve around the technical differences in filling and storing gelatin versus Vcaps. These differences include different moisture barrier characteristics, different transparency of the capsule, different speeds at which these capsules can be filled on our production line, whether only vegetarian materials are used in the formula, etc. There is a way to fill two-piece vegetarian capsules with liquids, but the resulting product has an air bubble in the capsule and is typically a much lower dose and much more expensive than softgels made from gelatin. So this form has not been fast to catch on. 

One softgel that is available in a vegetarian capsule is Vegetarian E-400. But this form is not yet widely used for other supplements. Most vitamin E softgel caps are primarily made from beef gelatin. There is often hidden gelatin (often from fish) in beta-carotene, lutein, and other oil-based ingredients. Companies should scrupulously ensure that they use only non-gelatin bases for ingredients in their vegetarian/vegan products. It is unknown how aware vegetarian shoppers are of this hidden, tricky issue. Often, these problems apply to carotene or lutein in multiple vitamin formulas, which could get mislabeled as “vegetarian” if a manufacturer does not take the care to pay attention to these important ingredient details. 

Other common names for animal-derived ingredients include Porcine (from pork/pigs), Bovine (beef/cows), and Ovine (lamb/sheep). Consumers can contact the vitamin companies directly to ask about their vegetarian products. Knowledgeable health food store personnel, especially certified nutritionists or vitamin specialists familiar with their inventory, can be very helpful. Often an employee at a store who is a vegetarian will be familiar with the products from that perspective. And please be aware that the availability of vegetarian options is always increasing! 

In many cases, there is no functional difference between differently sourced ingredients; for example, glucosamine or HA. It is only when the actual form of the active constituent is physically/chemically different that a difference in the actions and efficacy of a substance is likely. There may be some differences in efficacy between plant and animal sourced ingredients, as we have seen with plant enzymes having a wider range of action than the same types of animal enzymes. 

Fish oil is far more effective than flax oil in terms of providing the maximum EPA and DHA per serving. Flax oil contains ALA, which is poorly converted into EPA and DHA (5-10% and 2-5%, respectively). 

One good example is melatonin, usually sold as a synthesized ‘nature-identical’ molecule. It can also be extracted from the pineal gland, but considerations of Mad Cow Disease and animal ingredient issues have pretty much sunk that source, which was the original form available. While glandulars may have other, subtle effects on the body, the actual melatonin produced either way is the exact same molecule with identical actions. 

Phosphatidyl Serine (PS) is normally produced from lecithin, with additional sources more rarely available (bovine, egg). Most of the research is on the soy-derived source, so its efficacy should not be in question. In the human body PS is synthesized from phosphatidylcholine; a similar process is used commercially to produce PS. 

Wednesday, November 22, 2006

Honey Quality and Control of Pests in Beehives

Honey Quality and Control of Pests in Beehives 11/22/06 By Neil E. Levin, CCN, DANLA For a decade our American beekeepers have suffered from a plague of mites, which are tiny bugs that infest beehives. They have helplessly watched as a certain percentage of their hives die off every year (sometimes as many as 80%), with the main alternative being to use long-lasting chemicals that can affect the quality of their honey. Neither one is a completely satisfactory option for a nature-loving beekeeper. Mites are believed to have originated in South Africa prior to 1977. Loss of hives and weak hives do affect pollination rates, which in turn affect the size of harvests. For example, during one recent year in one German region, the size of the cherry harvest declined by nearly two-thirds and the apple harvest declined by 25% as a result of mite infestations destroying beehives, according to Dr. Josef Heine, a veterinarian and bee specialist working for the Animal Health division of Bayer HealthCare. Common chemicals used to control mites are fluvalinate (Apistan®), coumaphos (Bayer’s CheckMite™), and formic acid. These are often applied by hanging strips in the hives that release fumes for several weeks. Even most Integrated Pest Management techniques include the use of chemicals; warning that if a beekeeper doesn’t use any chemicals, he or she will probably lose some hives: http://www.beeculture.com/storycms/index.cfm?cat=Story&recordID=123 One mite-control technique is to use a food-grade mineral oil with an added plant oil fraction called thymol (from thyme leaves), dispensing them by means of a propane fogger to create a mist. Here is a link to more information on this method: http://www.beesource.com/pov/rodriguez/abjdec2004.htm Some beekeepers are now treating beehives with acetic acid, which is basically like a concentrated form of vinegar. This natural chemical is vaporized by a specialized piece of equipment that blows the vapor into each hive entrance for only 30 seconds once a week for three weeks in a row. That’s all it takes. A friend of mine (my former beekeeping partner some 25 years ago) reports 100% survival of his over-wintered hives for the first time in ten years simply by utilizing this method! He is thrilled with once again having mite-free bee colonies without resorting to the use of chemical agents. If you are a beekeeper and want to get more information about this new process, please contact me with a comment to this posting. This report is intended to increase awareness of the issues and options involved for controlling mites in beehives. Please note that I cannot specifically endorse any of these techniques or companies, and that honey used in many food products undergoes screening by Quality Control specialists utilizing modern equipment and techniques to avoid adulterants.

Friday, November 10, 2006

More evidence of vitamin E safety!

More evidence of vitamin E safety! According to a new study published in the American Journal of Clinical Nutrition1, male smokers in a study population who had the highest blood levels of vitamin E suffered significantly fewer deaths than comparable male smokers who had lower blood levels of this essential vitamin. Researchers from the National Cancer Institute at the National Institutes of Health teamed up with their counterparts in Finland to review the relationship of blood levels of vitamin E (alpha tocopherol) and all-cause mortality in male smokers age 50-69 in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. The study included 29,092 men, with follow-ups continuing over a period of up to 19 years. For those in the groups with the highest blood levels of alpha-tocopherol, there was an 18% lower risk of deaths from all causes. Included in this figure are results relating to specific causes of death, including a 21% reduction in deaths from cancer, a 19% reduction in deaths from cardiovascular disease and a whopping 30% reduction in deaths from all other causes. The report reached this conclusion: “Higher circulating concentrations of alpha-tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers.” A non-reproduced meta-analysis6 warning of the largely theoretical dangers of taking vitamin E supplements has generated a lot of concern and a large decline in vitamin E usage, though this flies in the face of other, more rigorous studies showing that higher levels of serum vitamin E are associated with lower mortality numbers.1, 3-4, 7 These largely unsubstantiated warnings may be doing a disservice to figures showing that “93% of men and 96% of women in the United States do not consume the recommended daily amount of dietary vitamin E”.2, 5 In another study, ALS (amyotrophic lateral sclerosis) mortality was 62% lower among long-term users of vitamin E than among nonusers.8 Also, in a study of cancer patients done for the US Dept. of Health and Human Services, “Subgroup analysis did identify a statistically significant 9% reduction in all cause mortality” and “13% reduction in all-cancer mortality associated with supplemental vitamin E in combination with other micro-nutrients.”9 REFERENCES: Margaret E Wright, Karla A Lawson, Stephanie J Weinstein, Pirjo Pietinen, Philip R Taylor, Jarmo Virtamo and Demetrius Albanes. Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. American Journal of Clinical Nutrition, Vol. 84, No. 5, 1200-1207, November 2006. (Researchers were from the Nutritional Epidemiology and the Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, and the Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, and the Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland) Maras JE, Bermudez OI, Qiao N, Bakun PJ, Boody-Alter EL, Tucker KL. Intake of alpha-tocopherol is limited among US adults. J Am Diet Assoc2004; 104 :567 –75. Traber MG. How much vitamin E? ... Just enough! Am J Clin Nutr. 2006 Nov;84(5):959-960. PMID: 17093143 Wright ME, Lawson KA, Weinstein SJ, et al. Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Clin Nutr2006; 84 :1200–7. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, DC: National Academy Press, 2000. Edgar R. Miller, III, MD, PhD; et al. High-dose vitamin E supplementation may increase all-cause mortality, a dose response meta-analysis of randomized trials. Annals of Internal Medicine: Online: Nov. 10, 2004: Print: 4 January 2005 Volume 142 Issue 1 John N Hathcock, et al. REVIEW ARTICLE: Vitamins E and C are safe across a broad range of intakes. American Journal of Clinical Nutrition, Vol. 81, No. 4, 736-745, April 2005. Vitamin E intake and risk of amyotrophic lateral sclerosis. Ann Neurol. 2005 Jan;57(1):104-10. PMID: 15529299 Shekelle P, et al. Effect of the supplemental use of antioxidants vitamin C, vitamin E, and coenzyme Q10 for the prevention and treatment of cancer. Evid Rep Technol Assess (Summ). 2003 Oct;(75):1-3. Review. PMID: 15523748

Monday, October 23, 2006

Cleveland Clinic makes untrue statement regarding natural vs synthetic vitamins

On August 17, 2006 I submitted this request to the Cleveland Clinic for a correction to its web site, specifically regarding their claim that "There is no difference between natural vitamins and synthetic vitamins". My reference relates to a known difference between natural and synthetic vitamin E (to date, no correction has been made): On your web page (http://www.clevelandclinic.org/health/health-info/docs/0900/0955.asp?index=5429 regarding Diet, Exercise, Stress, and the Immune System) you make a false statement that "There is no difference between natural vitamins and synthetic vitamins." On the NIH Office of Dietary Supplements website (http://ods.od.nih.gov/factsheets/vitamine.asp) they clearly state that "The synthetic form is only half as active as the natural form [4]. [4} U.S. Department of Agriculture, Agricultural Research Service. 2004. USDA National Nutrient Database for Standard Reference, Release 16-1. Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp Please correct this error.

Friday, October 20, 2006

Text of Speech on Nutrition Given to a Diabetic Support Group

Diabetic Support Group-St. Alexander’s Church. 300 S. Cornell, Villa Park, IL 1/22/2002 Healthy Living Through Nutrition – presented by Neil E. Levin, Certified Clinical Nutritionist What is Diabetes? People with diabetes can’t properly process glucose, the main sugar that the body uses for energy. So glucose stays in the blood, making blood glucose rise. Ironically, at the same time the cells of the body can be starved for glucose. Diabetes can lead to wounds not healing, more infections, and problems involving the eyes, kidneys, nerves, and heart. Neuropathy from diabetic complications may lead to amputation of extremities, especially the feet. There are two types of diabetes mellitus. Childhood-onset diabetes is also called type 1 (insulin-dependent) diabetes. In type 1 diabetes, the pancreas can’t make insulin needed to process glucose. This is theorized to be an autoimmune disease, where the pancreatic cells are attacked and destroyed by the immune system. Natural therapies can’t cure type 1 diabetes, but they may help by making the body more receptive to injected insulin. It is critical for people with type 1 diabetes to work carefully with the doctor prescribing insulin before contemplating the use of any herbs, supplements, or dietary changes. Any change that makes the body more receptive to insulin could require critical changes in insulin dosage that must be determined by the treating physician. Adult-onset diabetes is also called type 2, or non-insulin-dependent, diabetes. With type 2 diabetes, the pancreas may make enough insulin, but the body has trouble using the insulin at the cellular level. Type 2 diabetes responds well to natural therapies. Again, medications may need to be adjusted to provide safety if you change your diet or dietary supplement program. People with diabetes have a higher risk for heart disease and atherosclerosis. Diabetics especially have a higher mortality rate if they also have high levels of homocysteine, associated with low intake of certain B vitamins. What causes insulin resistance? It is estimated that 1 in 4 people non-diabetic have genetic predisposition to insulin resistance. Whether or not the insulin resistance develops may depend on your eating and exercise habits. Low physical activity is the main reason why insulin resistance develops. Gaining weight/body fat around the mid-section is a common trigger. With insulin resistance it’s more difficult to lose weight. So, obesity and insulin resistance becomes a viscous cycle--obesity contributes to insulin resistance, and insulin resistance contributes to weight gain! People who maintain a healthy weight and enjoy regular physical activity rarely develop insulin resistance, even if they have an underlying genetic predisposition. NOTE: Some medications (like Depakote, an anti-seizure medication) and some disease states (like PolyCystic Ovarian Syndrome, or PCOS) have also been associated with insulin resistance and weight gain. It’s always important to rule-out these non-diet/non-exercise related problems with your doctor. Syndrome X can increase symptoms of aging, increasing your risk of developing heart disease, diabetes, Alzheimer's, cancer, and other age-related diseases. Many of these diseases have an oxidative or inflammatory component and may be mitigated by antioxidant and anti-inflammatory nutrients or drugs. Syndrome X refers specifically to a group of health problems that can include insulin resistance (the inability to properly deal with dietary carbohydrates and sugars), abnormal blood fats (such as elevated cholesterol and triglycerides), being overweight, and having high blood pressure; leading to nervous system disorders, eye disease, diabetes, cardiovascular disease, cancer, and Alzheimer's disease. In addition to physical symptoms, you may feel exhausted, spacey, depressed, irritable, or angry when you shouldn't be. Doctors have known for years that each of these health problems can increase the risk of other diseases, such as heart disease and diabetes. However, until relatively recently, they failed to see these health problems as part of a syndrome. We now know that eating large amounts of certain dietary carbohydrates can raise cholesterol, triglyceride, and insulin levels. Insulin resistance and Syndrome X are caused primarily by a diet high in refined carbohydrates, which probably include many of your favorite and frequently eaten foods, such as cereals, muffins, breads and rolls, pastas, cookies, donuts, and soft drinks. These refined carbohydrates not only raise glucose and insulin to unhealthy levels, but they also are devoid of the many vitamins, minerals, and vitamin-like nutrients our bodies need to properly utilize these foods. Two of the key players in this life-and-death drama affecting you are substances regarded as absolutely essential for health: glucose (also known as blood sugar) and the hormone insulin. Because of the foods we, as a population, now eat, our bodies' levels of glucose and insulin have gone out of control. Quite simply, we are overdosing on glucose and insulin. Both substances in high doses accelerate the aging of our bodies and encourage the development of disease. We know also that elevated insulin can promote obesity and high blood pressure. Because these problems are related and tend to occur in clusters, they form a syndrome. Syndrome X is primarily a nutritional disease caused by eating the wrong types of foods. You have the power to easily modify your lifestyle to protect yourself against Syndrome X. It is a disease caused by your body's inability to make the most of the food you eat. Doctors who recognize the underlying cause of this epidemic call it by one of several, often overlapping names: insulin resistance, metabolic syndrome, glucose intolerance, prediabetes, or Syndrome X. But few people have recognized the full scope of this disorder: it affects, to one degree or another, the majority of people in the country. If you are over the age of 35, you may be more familiar with some of the early signs and symptoms than the names of this condition: feeling sluggish, physically and mentally, after you eat and at many other times as well. Gaining a pound here and a pound there-and having increasing difficulty in losing them. Having your blood pressure creep up year and after year. And finding that your cholesterol, triglycerides, and blood sugar levels are doing the same. These are all accepted signs of getting older, but they are all easily reversible. Such symptoms indicate that something is fundamentally wrong with your health, and they have an "additive" effect, meaning that two or three of these symptoms (such as obesity plus high blood pressure) increase your risk of serious disease far more than just one symptom. Reducing Insulin Sensitivity the Natural Way There are many healthy lifestyle choices that you can make to improve your insulin sensitivity. These healthy choices are important whether or not you have diabetes and whether or not you are also taking medication for your condition. 1) Exercise! -- Regular physical activity (both aerobics and strength training) increase your cells' sensitivity to insulin. Aim for 20-60 minutes of aerobic activity (e.g. brisk walking, jogging, swimming, or cycling) 3-5 days per week. In addition, aim for 30 minutes of strength training (with free weights, machines, resistance bands, or your own body’s resistance) 2-3 times per week. Gradually work up to these exercise goals, and discover a variety of different activities that you enjoy and can fit into your busy life. 2) Maintain normal weight -- Even as little as a 10% reduction in weight can help improve your cells' insulin sensitivity. To lose weight safely and effectively, reduce your total calorie intake by about 500 calories each day (that’s equal to about one candy bar and one 16 oz. glass of juice or soda). Aim for a 1-2 pound weight loss per week. NOTE: Restrictive dieting (<> 2 pounds per week) are NOT recommended. Both can contribute to nutrient deficiencies, excessive loss of lean body mass vs. fat, reduced metabolic rate, food preoccupation, depression, fatigue, irritability, binge eating, and rapid weight re-gain. 3) Eat a moderate carbohydrate diet (about 45% of total calories)! -- Carbohydrates (especially low fiber, refined white grains and sugary foods/beverages) stimulate the most insulin secretion after you eat them. Your insulin levels are already high, so eating a diet that further increases insulin is not desirable. • Choose a diet rich in mostly nonstarchy vegetables (leafy greens, broccoli, cabbage, cauliflower, zucchini, etc.). Aim for about 3 cups of chopped veggies per day (6 servings per day). • Choose a diet with whole fruits instead of juices, most of the time. Aim for about 3 small pieces of fruit per day (3 servings per day). • Choose mostly high fiber, whole grains and legumes (brown rice, whole wheat pasta, beans, whole wheat bread, whole grain cereals), and keep portion sizes moderate. Aim for about 5-7 servings per day. One serving equals one slice of bread, one 6” tortilla, ½ cup grains, legumes, or starchy vegetables, or ½ small bagel. • If you enjoy sweet desserts on occasion, just balance them out by eating fewer amounts of other carbohydrate-rich foods (like bread, pasta, and rice) at that meal. 4) Replace excess carbs with more heart healthy monounsaturated fats! (nuts, peanut butter, olive/canola oil, avocados) These fats don't affect your insulin levels, and they are good for your heart! But, like all foods high in fat, they have a lot of calories, so be sensible about your serving sizes. For instance, enjoy 1/4 cup of nuts for a snack instead of "bready" things. Enjoy 1-2 Tbsp. oil/vinegar dressings on your salads. Add a couple slices of avocado to sandwiches/salads. 5) Consume adequate protein with meals! Protein-rich foods (like tofu, fish, chicken, lean meat, low fat cottage cheese, and eggs) will help promote satiety so you don't feel hungry all the time. 6) Manage stress, and get enough sleep! Stress and inadequate sleep increase stress hormones (like cortisol) that increase insulin levels. Again, your goal is to lessen your already high insulin levels, so be sure to practice daily relaxation exercises and get to bed at a reasonable hour. Nutrition is Your Best Medicine One of the problems people face in reversing insulin resistance and Syndrome X is perceptual: the long-held belief that food has relatively little to do with the development and progression of disease and the maintenance of health. We believe-and are supported with overwhelming scientific evidence-that the quality of our foods has a direct and fundamental bearing on the quality of our health, more so even than the genes that we inherit. from Syndrome X: The Complete Nutritional Program to Preventing and Reversing Insulin Resistance. Copyright © 2000 by Jack Challem, Burt Berkson, and Melissa Diane Smith. Syndrome X: The Complete Nutritional Program to Preventing and Reversing Insulin Resistance ($24.95) is available at all bookstores, online booksellers, and from the Wiley web site at www.wiley.com. To order, call John Wiley & Sons publishers at 1-800-225-5945, or go to www.amazon.com. Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance Jack Challem Burt Berkson, M.D., Ph.D. Melissa Diane Smith Glycemic Index of Foods: Eating carbohydrate-containing foods, whether high in sugar or starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels. The blood sugar-raising effect of a food, called its “glycemic index,” depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to sucrose (table sugar). People eating large amounts of foods with high glycemic indices (such as those mentioned above), have been reported to be at increased risk of type 2 diabetes. On the other hand, eating a diet high in carbohydrate-rich foods with low glycemic indices is associated with a low risk of type 2 diabetes. Beans, peas, fruit, and oats, have low glycemic indices, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber. Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes. Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar, as long as the goals of normalizing blood levels of glucose, triglycerides, and cholesterol are being achieved. Most doctors recommend that people with diabetes cut intake of sugar from snacks and processed foods, and replace these foods with high-fiber, whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes. Other Diets: FIBER: A high-fiber diet has been shown to work better in controlling diabetes than the diet recommended by the ADA, and may control blood sugar levels as well as oral diabetes drugs. In this study, the increase in dietary fiber was accomplished exclusively through the consumption of foods naturally high in fiber—such as leafy green vegetables, granola, and fruit—to a level beyond that recommended by the ADA. No fiber supplements were given. All participants received both the ADA diet (providing 24 grams of fiber per day) and the high-fiber diet (providing 50 grams of fiber per day), for a period of six weeks. After six weeks of following each diet, tests were performed to determine blood glucose, insulin, cholesterol, triglyceride, and other values. When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet. Insulin levels were 12% lower in the group eating the high-fiber diet compared to the group eating the ADA diet, indicating a beneficial increase in the body’s sensitivity to insulin. Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (“bad”) cholesterol compared to those eating the ADA diet. They also had slight decreases in glycosylated hemoglobin, a measure of chronically high blood glucose levels. High-fiber supplements, such as psyllium, guar gum (found in beans), pectin (from fruit), oat bran, and glucomannan have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1–3 ounces of powdered fenugreek seeds per day. A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes. Still, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats, and whole-grain products. OTHER RESTRICTED DIETS: Eating fish also may afford some protection from diabetes. Incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol. Vegetarians have been reported to have a low risk of type 2 diabetes. When people with diabetic nerve damage switch to a vegan diet (no meat, dairy, or eggs), improvements have been reported after several days. In one trial, pain completely disappeared in 17 of 21 people. Fats from meat and dairy also contribute to heart disease, the leading killer of people with diabetes. Some of these benefits may be due to the better food and oils consumed by health-conscious people plus the lack of animal fats in their diet. Vegetarians eat less protein than do meat eaters. The reduction of protein intake has lowered kidney damage caused by diabetes and may also improve glucose tolerance. However, in a group of 13 obese males with high blood-insulin levels (as is often seen in diabetes), a high-protein, low-carbohydrate diet (like the Atkins Diet) resulted in greater weight loss and control of insulin levels, compared with that of a low-carbohydrate diet. Switching to either a high- or low-protein diet should be discussed with a doctor. The high protein diets seem to be better suited to people with Type O Blood types than for others. Diets high in fat, especially saturated fat, worsen glucose tolerance and increase the risk of type 2 diabetes, an effect that is not simply the result of weight gain caused by eating high-fat foods. Saturated fat is found primarily in meat, dairy fat, and the dark meat and skins of poultry. In contrast, glucose intolerance has been improved by diets high in monounsaturated oils, which may be good for people with diabetes.47 There is often difficulty in changing the overall percentage of calories from fat and carbohydrates in the diets of people with type 1 diabetes. However, modifying the quality of the dietary fat is achievable. In adolescents with type 1 diabetes, increasing monounsaturated fats relative to other fats in the diet is associated with better control over blood sugar and cholesterol levels. The easiest way to incorporate monounsaturates into the diet is to use oils containing olive oil. However, those who are overweight need to be aware—olive oil is high in calories. Glucose tolerance improves in healthy people taking omega-3 fatty acid supplements. Some studies have found that fish oil supplementation improves glucose tolerance, high triglycerides, and cholesterol levels in people with diabetes. In one trial, people with diabetic neuropathy and diabetic nephropathy experienced significant improvement when given 600 mg three times per day of purified EPA—one of the two major omega-3 fatty acids found in fish oil supplements—for 48 weeks. Another consideration regards the inflammatory nature of certain oils. Inflammations are associated with animal fats and most vegetable oils, especially the refined and hydrogenated types. The Omega-3 oils are actually anti-inflammatory. These are mostly from cold water fish and from flaxseed oil. Those with inflammatory conditions, including arthritis, Parkinson’s, cancer and other chronic ailments, should seriously consider getting the vast bulk of their oil intake from only quality Omega-3 oils as a means to stop conditions that promote inflammation in the body. Should children avoid milk to prevent type 1 diabetes? Worldwide, children whose dietary energy comes primarily from dairy (or meat) products have a significantly higher chance of developing type 1 diabetes than do children whose dietary energy comes primarily from vegetable sources. Countries with high milk consumption have a high risk of type 1 (insulin-dependent) diabetes. Animal research also indicates that avoiding milk affords protection from type 1 diabetes. Milk contains a protein related to a protein in the pancreas, the organ where insulin is made. Some researchers believe that children who are allergic to milk may develop antibodies that attack the pancreas, causing type 1 diabetes. Several studies have linked cows’ milk consumption to the occurrence of type 1 diabetes in children. Different genetic strains of cows’ milk protein (casein) are associated with different levels of risk. Some children who drink cows’ milk produce antibodies to the milk, and it has been hypothesized that these antibodies can cross-react with and damage the insulin-producing cells of the pancreas. Immune problems in people with type 1 diabetes have been tied to other allergies as well, and it’s important to not focus only on avoiding dairy products. Preliminary studies have found that early introduction of cows’ milk formula feeding increases the risk of developing type 1 diabetes. A study of Finnish children (including full-term children with diabetes) showed that early introduction of cows’ milk formula feeding before three months of age (vs. after three months of age) was associated with increased risk of type 1 diabetes. This research supports abstaining from dairy products in infancy and early childhood, particularly for children with a family history of type 1 diabetes. Recent research also suggests a possible link between milk consumption in infancy and an increased risk of type 2 (non-insulin-dependent) diabetes. The risk seems to be associated with milk proteins rather than sugars. Eye Problems (Retinopathy): Some sugars are actually potentially harmful to the eyes, especially for those with diabetic neuropathies that may affect vision. Animal studies suggest that dietary fructose may contribute to the development of retinopathy. Although such an association has not been demonstrated in humans, some doctors advise their diabetic patients to avoid foods containing added fructose or high-fructose corn syrup. Fructose that occurs naturally in fruit has not been found to be harmful. The accumulation of another sugar alcohol called sorbitol is another risk factor. In a study of people with diabetes, cigarette smoking was found to be a risk factor for the development of retinopathy. In a study of people with type 1 (insulin-dependent) diabetes, those who maintained their blood sugar levels close to the normal range had less severe retinopathy, compared with those whose blood sugar levels were higher. Tighter control of blood-sugar levels can be achieved with a medically supervised program of diet, exercise, and, when appropriate, medication. Nutritional supplements that may be helpful: Free radicals have been implicated in the development and progression of several forms of retinopathy. Retrolental fibroplasia, a retinopathy that occurs in some premature infants who have been exposed to high levels of oxygen, is an example of free radical-induced damage to the retina. In an analysis of the best published trials, large amounts of vitamin E were found to reduce the incidence of severe retinopathy in premature infants by over 50%. Some of the evidence supporting the use of vitamin E in the prevention of retrolental fibroplasia comes from trials that have used 100 IU of vitamin E per 2.2 pounds of body weight in the form of oral supplementation. Use of large amounts of vitamin E in the prevention of retrolental fibroplasia requires the supervision of a pediatrician. Vitamin E has also been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia. People with this disorder lack a protein that transports fat-soluble nutrients, and can therefore develop deficiencies of vitamin E and other nutrients. In one trial, vitamin E failed to improve vision in people with diabetic retinopathy, although in a double-blind trial, people with type 1 diabetes given very high amounts of vitamin E were reported to show a normalization of blood flow to the retina. This finding has made researchers hopeful that vitamin E might help prevent diabetic retinopathy. However, no long-term trials have yet been conducted with vitamin E in the actual prevention of diabetic retinopathy. Because oxidation damage is believed to play a role in the development of retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy. People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner. Low blood levels of magnesium have been found to be a risk factor for retinopathy for some people with diabetes. One study investigated the effect of adding 100 mcg per day of vitamin B12 to the insulin injections of 15 children with diabetic retinopathy. After one year, signs of retinopathy disappeared in 7 of 15 cases; after two years, 8 of 15 were free of retinopathy. Adults with diabetic retinopathy did not benefit from vitamin B12 injections. Consultation with a physician is necessary before adding injectable vitamin B12 to insulin. Quercetin (a flavonoid) has been shown to inhibit the enzyme, aldose reductase. This enzyme appears to contribute to worsening of diabetic retinopathy.. Although human studies have not been done using quercetin to treat retinopathy, some doctors prescribe 400 mg of quercetin three times per day. Another flavonoid, rutin, has been used with success to treat retinopathy in preliminary research. Proanthocyanidins (OPCs), a group of flavonoids found in pine bark, grape seed, and other plant sources have been reported in preliminary French trials to help limit the progression of retinopathy. Nutritional supplements that may be helpful: Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating diabetes. In recent years, chromium has been shown to improve glucose and related variables in people with glucose intolerance and type 1, type 2, gestational, and steroid-induced diabetes. Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance. Chromium supplements improve glucose tolerance in people with both type 2 and type 1 diabetes, apparently by increasing sensitivity to insulin. Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy. Chromium even helps healthy people, although one such report found chromium useful only when accompanied by 100 mg of niacin. Chromium may also lower total cholesterol, LDL cholesterol, and triglycerides (risk factors in heart disease). A few trials that reported no beneficial effects from chromium supplementation. used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a poorly absorbed form. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used. Many doctors recommend up to 1,000 mcg per day for people with diabetes. Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia. Therefore, people with diabetes taking these medications should supplement chromium or brewer’s yeast only under the supervision of a doctor. People with diabetes tend to have low magnesium levels. Double-blind research indicates that supplementing with magnesium overcomes this problem. Magnesium supplementation has improved insulin production in elderly people with type 2 diabetes. Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some trials. Insulin requirements are often lower in people with type 1 diabetes who supplement with magnesium. Diabetes-induced damage to the eyes is more likely to occur in magnesium-deficient people with type 1 diabetes. In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with type 1 diabetes. The American Diabetes Association admits “strong associations...between magnesium deficiency and insulin resistance”. Many doctors recommend that people with diabetes and normal kidney function supplement with 200–600 mg of magnesium per day. Alpha lipoic acid is a powerful natural antioxidant. Preliminary and double-blind trials have found that supplementing 600–1,200 mg of lipoic acid per day improves insulin sensitivity and the symptoms of diabetic neuropathy. Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy. Glucomannan is a water-soluble dietary fiber that is derived from konjac root (Amorphophallus konjac). Glucomannan delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. After-meal blood sugar levels are lower in people with diabetes given glucomannan in their food, and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled clinical trials. One preliminary report suggested that glucomannan may also be helpful in pregnancy-related diabetes. For controlling blood sugar, 500–700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research. People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes. Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most, but not all, double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes. Three months or more of supplementation may be required for benefits to become apparent. The amount used is at least 900 IU of vitamin E per day. In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy, serious complications of diabetes involving the eyes and kidneys. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Vitamin E supplementation reduces this problem in many, although not all, studies. Vitamin E appears to lower the risk of cerebral infarction, a type of stroke, in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension) represent a subset population that can benefit from small amounts of vitamin E (50 IU per day) without experiencing an increased risk of bleeding. People with type 1 diabetes appear to have low vitamin C levels. As with vitamin E, vitamin C may reduce glycosylation. Vitamin C also lowers sorbitol in people with diabetes. Sorbitol is a sugar that can accumulate and damage the eyes, nerves, and kidneys of people with diabetes. Vitamin C may improve glucose tolerance in type 2 diabetes, although not every study confirms this benefit. Vitamin C supplementation (500 mg twice daily for one year) has significantly reduced urinary protein loss in people with diabetes. Urinary protein loss (also called proteinuria) is associated with poor prognosis in diabetes. Many doctors suggest that people with diabetes supplement with 1–3 grams per day of vitamin C. Higher amounts could be problematic, however. In one person, 4.5 grams per day was reported to increase blood sugar levels. Many people with diabetes have low blood levels of vitamin B6. Levels are even lower in people with diabetes who also have nerve damage (neuropathy). Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy. Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills. For other people with diabetes, 1,800 mg per day of a special form of vitamin B6—pyridoxine alpha-ketoglutarate—has improved glucose tolerance dramatically in some research. Standard vitamin B6 has helped in some, but not all, trials. Biotin is a B vitamin needed to process glucose. When people with type 1 diabetes were given 16 mg of biotin per day for one week, their fasting glucose levels dropped by 50%. Similar results have been reported using 9 mg per day for two months in people with type 2 diabetes.186 Biotin may also reduce pain from diabetic nerve damage. Some doctors try 16 mg of biotin for a few weeks to see if blood sugar levels will fall. Blood levels of vitamin B1 (thiamine) have been found to be low in people with type 1 diabetes. In the 1930s, a trial using 10 mg of vitamin B1 per day for four weeks reported reduced blood sugar levels in six of eleven people with diabetes. More recently, administration of both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks. However, this was a trial conducted among people in a vitamin B1-deficient developing country. Therefore, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts, led to improvement in some aspects of diabetic neuropathy in 12 weeks. As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown. Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. Animals with diabetes have been reported to be CoQ10 deficient. People with type 2 diabetes have been found to have significantly lower blood levels of CoQ10 compared with healthy people. CoQ10 is lowered by all “statin” drugs to control cholesterol. L-carnitine is an amino acid needed to properly utilize fat for energy. When people with diabetes were given L-carnitine (1 mg per 2.2 pounds of body weight), high blood levels of fats—both cholesterol and triglycerides—dropped 25–39% in just ten days in one trial. In higher amounts (1 gram per day by injection), L-carnitine has been reported to reduce pain from diabetic nerve damage as well. Zinc supplements have lowered blood sugar levels in people with type 1 diabetes, though some evidence indicates that zinc supplementation in people with type 2 diabetes does not improve their ability to process sugar. Nonetheless, people with type 2 diabetes also have low zinc levels, caused by excess loss of zinc in their urine. Many doctors recommend that people with type 2 diabetes supplement with moderate amounts of zinc (15–25 mg per day) as a way to correct for the deficit. Some doctors are concerned about having people with type 1 diabetes supplement with zinc because of a report that zinc supplementation increased glycosylation, generally a sign of deterioration of the condition. This trial is hard to evaluate because zinc supplementation increases the life of blood cells and such an effect artificially increases the lab test results for glycosylation. Until this issue is resolved, those with type 1 diabetes should consult a doctor before considering supplementation with zinc. Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally, intravenously, or by injection has reduced nerve damage caused by diabetes in most people studied. In a preliminary trial, people with nerve damage due to kidney disease or to diabetes plus kidney disease received intravenous injections of 500 mcg of methylcobalamin (the main form of vitamin B12 found in the blood) three times a day for six months in addition to kidney dialysis. Nerve pain was significantly reduced and nerve function significantly improved in those who received the injections. Oral vitamin B12 up to 500 mcg three times per day is recommended by some practitioners. The intake of large amounts of niacin (a form of vitamin B3), such as 2–3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision. Smaller amounts (500–750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes, though this research remains preliminary. Vitamin D is needed to maintain adequate blood levels of insulin. Vitamin D receptors have been found in the pancreas where insulin is made and preliminary evidence suggests that supplementation can increase insulin levels in some people with type 2 diabetes; prolonged supplementation might also help reduce blood sugar levels. Not enough is known about optimal amounts of vitamin D for people with diabetes, and high amounts of vitamin D may be somewhat toxic. However, newer studies indicate that our use of large doses of naturally-occurring Vitamin D from sunlight is much higher than previously thought. Statin drugs also may lower body levels of other substances made from cholesterol, such as Vitamin D and hormones that help our bodies deal with sex, repair and stress. Diabetics considering vitamin D supplementation should talk with, and have vitamin D status assessed by, a doctor. Inositol is needed for normal nerve function. Diabetes can cause a type of nerve damage known as diabetic neuropathy. This condition has been reported in some, but not all, trials to improve with inositol supplementation (500 mg taken twice per day). Taurine is an amino acid found in protein-rich food. People with type 1 diabetes have been reported to have low blood taurine levels, a condition that increases the risk of heart disease by altering blood viscosity. Supplementing with taurine (1.5 grams per day) has restored blood taurine to normal levels and corrected the problem of blood viscosity within three months. Taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes. Doctors have suggested that quercetin might help people with diabetes because of its ability to reduce levels of sorbitol—a sugar that accumulates in nerve cells, kidney cells, and cells within the eyes of people with diabetes—and has been linked to damage to those organs. Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes, though it may not help people with type 1 diabetes. Groups receiving 150 mg or 300 mg had glucose metabolism improve, fasting blood sugar decrease, and another marker for chronic high blood sugar reduced. At the 300 mg level, total cholesterol decreased, although not without an accompanying reduction in the protective HDL cholesterol. Vanadium doe not improve insulin sensitivity. Gastrointestinal side effects were experienced by some of the participants taking 150 mg per day and by all of the participants taking 300 mg per day. People with diabetes may have low blood levels of manganese. Animal research suggests that manganese deficiency can contribute to glucose intolerance and may be reversed by supplementation. Herbs that may be helpful: Double-blind trials have shown that topical application of creams containing 0.025–0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes). Four or more applications per day may be required to relieve severe pain. This should be done only under a doctor’s supervision. Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11% to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared to a placebo. Asian ginseng is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and to increase the number of insulin receptors. Animal research has also revealed a direct blood sugar-lowering effect of ginseng. A double-blind trial found that 200 mg of ginseng extract per day improved blood sugar control, as well as energy levels in people with type 2 diabetes. In a small preliminary trial, 3 grams of American ginseng was found to lower the rise in blood sugar following the consumption of a drink high in glucose by people with type 2 diabetes. The study found no difference in blood sugar-lowering effect if the herb was taken either 40 minutes before the drink or at the same time. A follow-up to this study found that increasing the amount of American ginseng to either 6 or 9 grams did not increase the effect on blood sugar following the high-glucose drink in people with type 2 diabetes. This study also found that American ginseng was equally effective in controlling the rise in blood sugar whether it was given together with the drink or up to two hours before. Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes. One preliminary trial found that 400 mg of gymnema extract per day could reduce or eliminate the need for oral blood sugar-lowering drugs in some people with type 2 diabetes. Another preliminary trial suggested the same amount of the extract could allow for use of less insulin in people with type 1 diabetes. Gymnema is not a substitute for insulin. Two preliminary trials found that aloe vera juice (containing 80% aloe gel) helps lower blood sugar levels in people with type 2 diabetes. One trial found that 1 Tbsp (15 grams) twice daily reduced the amount of the blood sugar-lowering drug glibenclamide required to manage blood sugar levels.260 The other trial found the juice by itself was effective. Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes, according to preliminary trials. However, double-blind trials are needed to confirm this potential benefit. Preliminary trials and at least one double-blind trial have shown that large amounts of onions can lower blood sugar levels in people with diabetes. The mechanism of onion’s blood sugar-lowering action is not precisely known, though there is evidence that constituents in onions block the breakdown of insulin in the liver. This would lead to higher levels of insulin in the body. Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy. One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy. Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area. Other herbs that may help are fenugreek seeds and eleuthero (Siberian ginseng). Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and animal research found that it reduces symptoms of diabetes. No research in humans has yet been published; however, given mistletoe’s worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Olive leaf extracts have been used experimentally to lower elevated blood-sugar levels in diabetic animals. Animal studies and some very preliminary trials in humans suggest reishi may have some beneficial action in people with diabetes.

Thursday, October 12, 2006

Wrong TIME

Wrong TIME By Neil E. Levin, CCN, DANLA The Time article “State of Reliefs: HOW THE CONTROVERSIAL YET POPULAR SUPPLEMENT BUSINESS EMERGED IN UTAH” (10/1/06) mostly deals with MLMs (multi-level marketers) rather than other types of dietary supplement companies, but there are a few problems with the reporting. Time relies on quotes from notorious anti-supplement partisans who do not often admit to the peer-reviewed science of supplements: the Mayo Clinic and Dan Hurley. It is not even possible that Mr. Hurley's claim could be true ("the vast majority of supplements taken by Americans have been proven to be unsafe, ineffective or both"). If so, the FDA and the majority of companies that really do care about consumers' health would have already voluntarily or forcibly pulled them off the market. The mainstream dietary supplement industry's primary motivation is to provide safe, effective natural products, not to hurt or scam people. Most dietary supplement companies are science-driven and their labels and claims are scrutinized for accuracy and compliance with federal laws, such as the law (DSHEA) that the article falsely accuses of reducing FDA authority. Even the FDA itself denies this on their own website, as well as in the Congressional testimony of several FDA commissioners. DSHEA disallows any dietary supplement claims related to disease, so companies only offer documented structure-function claims as to how the supplements may affect the individual. These claims are submitted to the FDA for scrutiny and the agency has the power to ask for changes to these claims. The law also provides that any ingredient introduced to the market after October of 1994 must have a New Dietary Ingredient packet submitted to the FDA with evidence of safety, as well as allowing the FDA to set rules for good manufacturing practices, so the article's claim that DSHEA "released manufacturers from demonstrating that products were safe before being sold" is not quite accurate. In my personal opinion, Ephedra was only banned because of the FDA's misrepresentation of this herb’s safety record and an arbitrary dismissal of all of its proven benefits to produce a slightly negative risk/benefit ratio. (1,2) Rand Corporation researchers actually reported that up to 155 reported deaths possibly linked to Ephedra were contradicted by its own review of published Ephedra studies that found no deaths, strokes or any serious side effects reported from using the herb, yet the Time report only reports the association of Ephedra to these deaths, despite a complete lack of evidence of cause and effect. (3) The Rand report also stated that Ephedra, with or without caffeine, provided a statistically significant increase in short-term weight loss compared to placebo: about 2 pounds per month for up to 6 months, which contradicts the FDA's decision that Ephedra has only risks and no benefits. Several other review studies have also concluded that Ephedra is safe when properly used. (4,5) And while the Time article implies that an appeals court rejected the safety record of Ephedra ("Utah company Neutraceutical Corp. [sic] is still arguing that lower doses are safe, but in August the firm was overruled by an appeals court"). But the court did not really rule on whether or not the herb is safe because it was narrowly focused on the FDA's authority to implement DSHEA. To read the original Time article, click on this link: http://www.time.com/time/insidebiz/article/0,9171,1541294-2,00.html REFERENCES: 1. 21 C.F.R. Pt. 119, Final Rule Declaring Dietary Supplements Containing Ephedrine Alkaloids Adulterated Because They Present an Unreasonable Risk (Published February 11, 2004) (Effective April 12, 2004) available at http://www.fda.gov/ohrms/dockets/98fr/1995n-0304-nfr0001.pdf 2. Federal Register: February 11, 2004 (Volume 69, Number 28). 3. Shekelle PG, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003 Mar 26;289(12):1537-45. Epub 2003 Mar 10. PMID: 12672771 4. Morgenstern LB. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology. 2003 Jan 4;60(1):132-5. Erratum in: Neurology. 2003 Mar 25;60(6):1055. PMID: 12525737 5. Soni MG, Carabin IG, Griffiths JC, Burdock GA. Safety of ephedra: lessons learned. Toxicol Lett. 2004 Apr 15;150(1):97-110. Review. PMID: 15068827

Wednesday, October 11, 2006

Without a Trace: Neil is quoted in article published in Vitamin Retailer magazine

Click on title above to read original article in VR mag on trace minerals.

Tuesday, October 03, 2006

BMJ finding on calcium and D "failure" questionable

A 25% reduction in the number of fractures was not considered significant in this study, calling into question the statistical model and study design. They did not find "no evidence" of the supplements' effectiveness, as cited, but rather found no significant evidence. Why? Thus creating the "failure" of the supplements. (Click on title to read the journal article.)

Monday, September 25, 2006

Helping Asthma Patients Breathe Easier

Click on the title above to read a news story featuring an interview with me about childhood asthma. Featured on the CBN Network: A CBN News Science and Medical Report.

Wednesday, September 13, 2006

ODE TO THE INTESTINE

ODE TO THE INTESTINE © 2006 by Neil Levin

The bowel ain’t a sunny place
A dirty, dark, disgusting space

It’s full of microbes, bad and good
And yucky, decomposing food

It has a brain, just like your head
To guide digestion of our bread

It separates “us” from “not us”
And is home to acidophilus

It harbors other creatures, too
And immune cells to protect you

If you develop leaky gut
Food particles will be in a rut

“Chew your liquids, drink your food”
Means masticate it really good

Reduce stress to aid digestion
And increase GI immune cell function

Avoiding allergens is best
And helps you to absorb the rest

A body system we should invest in
Hence this ‘Ode To The Intestine’

Tuesday, August 29, 2006

LAND OF CONFUSION: How Poor Science and Misleading Media Coverage Create Public Confusion About How Dietary Supplements Affect Health

Click on title above to read full article

Flax Oil Health Scares not credible!

I submitted this response to Dr. Mercola' website today regarding his assumption that flax oil would be covered by an article regarding the risks of dietary ALA. For more information on this issue, please see this article: http://www.udoerasmus.com/articles/udo/flax_prostate.htm My submission to Mercola.com regarding his posting: http://www.mercola.com/2004/jul/21/flax_seed_oil.htm Your headline is misleading. In the article in question: http://www.ajcn.org/cgi/content/full/80/1/204/T1 it appears that you extrapolated the conclusion to include flax oil without any documentation in the study data, since flax was not listed as one of the major sources of ALA. Neil Levin, CCN, DANLA

Tuesday, August 22, 2006

Say No To GMO's (biotech food)

http://www.saynotogmos.org/ud2005/ujun05b.html#afraid Very interesting REFERENCES available below, not in published article (click on title above for link to full article without references as published by a newsletter): WORLD HUNGER: UNITED NATIONS: THE WORLD FOOD PROGRAMME http://www.wfp.org/aboutwfp/introduction/hunger_causes.asp?section=1&sub_section=1 UN Food and Agriculture Organization (FAO)http://www.fao.org/newsroom/en/news/2005/89259/index.htmlhttp://www.fao.org/DOCREP/FIELD/006/AD690E/AD690E00.HTM FAO: 'Agricultural production could probably meet expected demand until 2030 even without major advances in modern biotechnology.' " (The New Scientist, by Debora MacKenzie, March 4, 2003.) EXPERT CAUTIONS: USA TODAY/REUTERS report on European attitudes toward GMOs: http://www.cnr.berkeley.edu/~steggall/10Jan-18May2000.html More on European distrust of government food regulations based on mishandling of other food crises: New Scientist, "Young, not Mad", July 8, 2000, p.5. The editors of the respected UK medical journal The Lancet have strongly criticized the presumption that GE foods entail no greater risks of unexpected effects. They stated there are "good reasons to believe that specific risks may exist" and that "governments should never have allowed these products into the food chain without insisting on rigorous testing for effects on health." Vol. 353, No. 9167, p. 1811 (May 29, 1999). The January 2001 report of the expert panel of the Royal Society of Canada states that (a) it is "scientifically unjustifiable" to presume that GE foods are safe and (b) the "default presumption" for every GE food should be that the genetic alteration has induced unintended and potentially hazardous side effects. The Royal Society of Canada: Expert Panel on the Future of Food Biotechnology: Elements of Precaution: Recommendations for the Regulation of Food Biotechnology in Canada www.rsc.ca/foodbiotechnology/indexEN.html and http://www.rsc.ca//files/publications/expert_panels/foodbiotechnology/GMreportEN.pdf DO GMO CROPS LOWER CHEMICAL USE? Herbicides lose effectiveness only 2-3 years after planting herbicide-resistant biotech crops:'Resistance is useless', New Scientist, 19 February 2000, p. .21. Extensive evidence shows that farmers who plant crops that are genetically engineered to resist the herbicide Roundup are now applying more of it to their fields. (Dr. Charles Benbrook, Pesticide Outlook, October 2001, Pages 204-207.) NUTRIENT DIFFERENCES IN GMOS: Lappe MA, Bailey EB, Childress C, Setchell C. Alterations in clinically important phytoestrogens in genetically modified herbicide-tolerant soybeans. J Medic Food 1999; 1: 241-43. The Monsanto analyses of glyphosate-resistant soya showed that the GM-line contained about 28% more Kunitz trypsin inhibitor, a known antinutrient and allergen: "GM Food Debate" Letters re: the Pusztai and Ewen publication, The Lancet. Volume 354, Number 9191. November 13, 1998 Recent investigation by scientists at Japan's Nagoya University reveals that Monsanto's data on the "Roundup Ready" soybean actually shows important differences between it and its conventional counterpart. For instance, after heat processing of both the GE and non-GE beans, the concentrations of three harmful substances were significantly higher in the GE samples.(Technology and Human Beings, Nov.2000, p24-33) CROP YIELD AND QUALITY: A dramatic increase in root-knot nematode susceptibility was seen in the transgenic cultivar:Patrick D. Colyer,* Terrence L. Kirkpatrick, W. David Caldwell, and Philip R. Vernon. Plant Pathology and Nematology: Root-Knot Nematode Reproduction and Root Galling Severity on Related Conventional and Transgenic Cotton Cultivars. The Journal of Cotton Science 4:232-236 (2000) Anthan, George. “Genetic Changes Affect More Than Yield.” Des Moines Register. June 18, 2000. The Independent, London, June 11/ Geoffrey Lean Elmore et al, "Glyphosate-Resistant Soybean Cultivar Yields Compared with Sister Lines", Agron J 2001 93: 408-412 Evidence of the Magnitude and Consequences of the Roundup Ready Soybean Yield Drag from University-Based Varietal Trials in 1998. By Dr. Charles Benbrook, Benbrook Consulting Services, Sandpoint, Idaho http://www.biotech-info.net/RR_yield_drag_98.pdf UNRESOLVED SAFETY ISSUES: Playing God in the Garden' by Michael Pollan The New York Times Sunday Magazine (October 25th 1998). http://www.organics.org/features/god_garden.htm Genetically modified foods & health: a second interim statement. British Medical Association Board of Science and Education. March 2004 http://www.bma.org.uk/ap.nsf/Content/GMFoods Ho MW, Ryan A and Cummins J. Cauliflower mosaic viral promoter – a recipe for Disaster? Microbial Ecology in Health and Disease 1999 11, 194-7. Ho MW, Ryan A and Cummins J. Hazards of transgenic plants with the cauliflower mosaic viral promoter. Microbial Ecology in Health and Disease 2000, 12, 6-11. "Astonishing denial of transgenic contamination" by Mae-Wan Ho, Science in Society 2002, 15, 13-14. Netherwood T, Martin-Orue SM, O'Donnell AG, Gockling S, Gilbert HJ and Mathers JC. Transgenes in genetically modified Soya survive passage through the small bowel but are completely degraded in the colon. Technical report on the Food Standards Agency project G010008 "Evaluating the risks associated with using GMOs in human foods"- University of Newcastle. Doerfler, W. and Schubbert, R. (1998). Uptake of foreign DNA from the environment: the gastroinestinal tract and the placenta as portals of entry, Wien Klin Wochenschr. 110, 40-44.p. 40. Ferguson GC and Heinemann JA. Recent history of trans-kingdom conjugation. In Horizontal Gene Transfer 2nd ed. (ed. M Syvanen & CI Kado), pp 3-17, Academic Press, San Diego, 2002. UK Food Standards Agency: GM crop DNA found in human gut bugs http://www.food.gov.uk/multimedia/pdfs/rowett1.pdf Cellini F, Chesson A, Colquhoun I, Constable A, Davies HV, Engel KH, Gatehouse AM, Karenlampi S, Kok EJ, Leguay JJ, Lehesranta S, Noteborn HP, Pedersen J, Smith M. Unintended effects and their detection in genetically modified crops. Food Chem Toxicol. 2004 Jul;42(7):1089-125. Review. PMID: 15123383 Taylor SL, Hefle SL. Will genetically modified foods be allergenic? J Allergy Clin Immunol. 2001 May;107(5):765-71. Review. PMID: 11344340 ENVIRONMENTAL CONCERNS: Herbicide tolerance can spread from biotech crops to weeds:Sample, Ian, "Modified crops could corrupt weedy cousins", New Scientist, 15 July 2000, p.6. Calif. county voters ban biotech crops, animals. The Associated Press http://msnbc.msn.com/id/4438280/ Vacher C, Weis AE, Hermann D, Kossler T, Young C, Hochberg ME. Impact of ecological factors on the initial invasion of Bt transgenes into wild populations of birdseed rape (Brassica rapa). Theor Appl Genet. 2004 Aug;109(4):806-14. Epub 2004 May 5. PMID: 15340690 Haygood R, Ives AR, Andow DA. Consequences of recurrent gene flow from crops to wild relatives.Proc Biol Sci. 2003 Sep 22;270(1527):1879-86. PMID: 14561300 Gepts P, Papa R. Possible effects of (trans)gene flow from crops on the genetic diversity from landraces and wild relatives. Environ Biosafety Res. 2003 Apr-Jun;2(2):89-103. PMID: 15612275 Arnaud JF, Viard F, Delescluse M, Cuguen J. Evidence for gene flow via seed dispersal from crop to wild relatives in Beta vulgaris (Chenopodiaceae): consequences for the release of genetically modified crop species with weedy lineages. Proc Biol Sci. 2003 Aug 7;270(1524):1565-71. PMID: 12908976 Spencer LJ, Snow AA. Fecundity of transgenic wild-crop hybrids of Cucurbita pepo (Cucurbitaceae): implications for crop-to-wild gene flow. Heredity. 2001 Jun;86(Pt 6):694-702. PMID: 11595050 Ellstrand NC. Current knowledge of gene flow in plants: implications for transgene flow. Philos Trans R Soc Lond B Biol Sci. 2003 Jun 29;358(1434):1163-70. Review. PMID: 12831483 Jenczewski E, Ronfort J, Chevre AM. Crop-to-wild gene flow, introgression and possible fitness effects of transgenes. Environ Biosafety Res. 2003 Jan-Mar;2(1):9-24. Review. PMID: 15615064 Gressel J. Tandem constructs: preventing the rise of superweeds. Trends Biotechnol. 1999 Sep;17(9):361-6. Review. PMID: 10461182 Dunfield KE, Germida JJ. Impact of genetically modified crops on soil- and plant-associated microbial communities. J Environ Qual. 2004 May-Jun;33(3):806-15. Review. PMID: 15224914 Giovannetti M. The ecological risks of transgenic plants. Riv Biol. 2003 May-Aug;96(2):207-23. Review. PMID: 14595899 ETHICAL CONCERNS & MISC. DANGERS: The USDA co-owned the original patent on Terminator genes:http://www.nal.usda.gov/bic/monsan~1.htm USDA regulations on introducing new biotech crops:http://www.aphis.usda.gov/brs/notgen.html

Neil to give talk to prostate cancer support group on 8/30/06

Click on title to see the information about the talk.

Another study proving that the FDA is wrong and that ephedra is safe!

Click on title, which is a link to an abstract of the 9-month, double-blind, randomized controlled study done by the Department of Nutrition at the University of California (Davis). This is a gold standard, American university study of the highest quality.

Saturday, August 19, 2006

Land of Confusion

Click on title above , which is a link to see the full article "Land of Confusion"

Friday, August 11, 2006

Thursday, August 10, 2006

Alternative Med: Second Opinion (Reply to Wall Street Journal article titled No 'Alternative' )

Alternative Med: Second Opinion By Neil E. Levin, CCN, DANLA The op-ed piece on August 7 titled “No Alternative” leaves me with no alternative but to critique the selective facts presented. That article does not accurately represent the facts involved in these studies. The author begins by claiming that rigorous assessments of glucosamine and saw palmetto “failed to show clinical efficacy”. That statement is so over-generalized that it is demonstrably untrue. In the case of glucosamine, long term studies have shown that it helps to prevent narrowing of the spaces between joint structures. This is an important clinical determination of whether or not a joint is disintegrating or maintaining its cushioning structures. I have been told by leading physicians at Northwestern University’s Medical Center that glucosamine is an important component of their arthritis protocol for this reason, and the scientific evidence is convincing to these professionals. In the study cited in the article, the author was incorrect in saying that “there was no statistical benefit” for glucosamine. The actual study did note a statistically significant benefit, saying, “For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy (glucosamine and chondroitin sulfate) than with placebo…” In other words, the supplements were effective for those with the worst arthritis pain! This was only a 24 week trial, and although longer term studies show that maintaining joint structure distances is not directly related to reducing joint pain, in this study glucosamine and chondroitin did help those suffering the most from arthritis pain. Other studies have shown the long term joint structure protection for patients given glucosamine. Another study was cited as proof that the herb Saw Palmetto “failed to show clinical efficacy”. That is not an accurate statement, as the herb was used only on those with more severe forms of benign prostatic hyperplasia (BPH), while it has historically only been used on milder forms. One study testing a dietary supplement on the sickest patients, when the herb has not even been previously thought to work on severe cases, is not in any way representative of the body of science that has found this herb to be successful in mild cases of BPH. Yet another example given was of the herb St. John’s wort. Yes, it was not successful against major depression, a use which no one had ever claimed. The previous science successfully used the herb against mild depression. More telling, a prescription drug –tested and officially approved for use against depression – was equally ineffective against major depression, a fact that was curiously absent in the article, implying a pro-pharmaceutical bias combined with a bias against dietary supplements and other alternative modalities. The study went far beyond known uses of either of these therapies, and no one should use the results as “proof” that the herb (or the drug) is ineffective for typical uses. The journal American Family Physician reviewed the medical literature and reported, “St. John's wort has been found to be superior to placebo and equivalent to standard antidepressants for the treatment of mild to moderate depression.” I find the unrepresentative samples of negative data used in the article to be extremely misleading, creating a false impression that natural products never work. It calls into question the objectivity of the author that there is no appropriate context to these few examples, and that large bodies of science are ignored in order to make his point. That is unscientific, not the tens of thousands of published studies on nutrition, dietary supplements and complementary medicine that were too unimportant to mention. It would be unfortunate if people do not consider the well-documented uses of alternative medicine and instead believe that the magic of conventional medicine can cure all. The good doctors at Northwestern are enlightened enough to endorse a science-based complementary care model that seems to work. I urge the Journal’s readers to check the facts for themselves before accepting this prescription for ignorance. Get a second opinion. REFERENCES: Clegg DO, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808. PMID: 16495392 Rovati LC, et al. Assessment of joint space narrowing with conventional standing antero-posterior radiographs: relief in mild-to-moderate pain is not a confounder in recent osteoarthritis structure-modifying drug trials. Osteoarthritis Cartilage. 2006;14 Suppl A:A14-8. Epub 2006 May 5. PMID: 16678450 Pavelka K, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002 Oct 14;162(18):2113-23. PMID: 12374520 McAlindon TE, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. 2000 Mar 15;283(11):1469-75. Review. PMID: 10732937 Wilt T, et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;(3):CD001423. Review. PMID: 12137626 Bent S, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med. 2006 Feb 9;354(6):557-66. PMID: 16467543 Fong YK, et al. Role of phytotherapy in men with lower urinary tract symptoms. Curr Opin Urol. 2005 Jan;15(1):45-8. Review. PMID: 15586030 Wilt TJ, et al. Phytotherapy for benign prostatic hyperplasia. Public Health Nutr. 2000 Dec;3(4A):459-72. PMID: 11276294 Wilt TJ, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998 Nov 11;280(18):1604-9. Erratum in: JAMA 1999 Feb 10;281(6):515. PMID: 9820264 Szegedi A, et al. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine. BMJ. 2005 Mar 5;330(7490):503. Epub 2005 Feb 11. Erratum in: BMJ. 2005 Apr 2;330(7494):759. dosage error in text. PMID: 15708844 Lecrubier Y, et al. Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial. Am J Psychiatry. 2002 Aug;159(8):1361-6. PMID: 12153829 Kasper S, et al. Superior efficacy of St Johns wort extract WS(R) 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298]. BMC Med. 2006 Jun 23;4(1):14 [Epub ahead of print] PMID: 16796730 Schulz V. Safety of St. John's Wort extract compared to synthetic antidepressants. Phytomedicine. 2006 Feb;13(3):199-204. Epub 2005 Nov 2. Review. PMID: 16428030 Lawvere S, Mahoney MC. St. John's wort. Am Fam Physician. 2005 Dec 1;72(11):2249-54. Review. PMID: 16342849

Monday, August 07, 2006

Antioxidant supplements – myth or misunderstood?

This is a link to an article quoting me about the New Scientist magazine article that was critical of antioxidants. Link to news report citing me in NutraIngredients-USA: http://www.nutraingredients-usa.com/news/ng.asp?n=69668&m=1NIU807&c=bbimgilqonrtbqy Link to original article in New Scientist: http://www.newscientist.com/channel/health/mg19125631.500 (Full text of my comments to New Scientist are shown below, in posting of August 6, 2006.)

Friday, August 04, 2006

Antioxidants Misunderstood (New Scientist)

Antioxidants Misunderstood By Neil E. Levin, CCN, DANLACertified Clinical Nutritionist, Diplomate in Advanced Nutritional Laboratory Assessment In the August 5, 2006 issue of New Scientist the article, “The Antioxidant Myth” somehow failed to uncover some of the truths about antioxidants, raising questions about the depth of the reporting and the lack of understanding of the interactions between antioxidants that is so critical to their functioning. It is telling that much of the criticism of antioxidants comes from science that is testing single nutrients, using a drug model. But knowledgeable antioxidant researchers are aware that this is a “family” of nutrients that can synergistically “recharge” each other, making single nutrient studies fairly irrelevant as to the holistic interaction of these substances in vivo. For example, a study in Finland was halted early because of a widely reported increase in cancer rates among male smokers taking beta-carotene. (1) A more complete analysis published in July 2004 took another look at data from that same study, but now taking into account total antioxidant intake, which exonerated beta-carotene as a cause of the cancers/deaths. The smokers’ risk of getting lung cancer was strongly associated with low total antioxidants in the diet. (2) Another large study has noted that high carotenoid intake, confirmed by measures of blood levels, was associated with lower mortality rates among the elderly over a ten year period. (3) Still, news reports continue to refer to beta-carotene as harmful, and even the NIH has failed to consider the evolution of the data showing that low total antioxidant status is the key risk factor, one that even supplementation with beta carotene alone cannot be expected to correct. Vitamin E is another example. The New Scientist article says that “There is even some evidence that vitamin E supplements can be harmful”, right before quoting a scientist as saying that a re-analysis of the data showed “no change in mortality”, asserting that the “evidence” of the vitamin causing harm was “flawed”. This was due to the use of a poor statistical model (4) that was corrected in a later publication (5) and should not reflect on Vitamin E’s fine safety record (6). The article also questioned the use of Vitamin E and other antioxidants as dietary supplements, rather than from food, though published studies have shown that Vitamin E from dietary supplements is clinically effective. (7-8, 13-17) Levels of Vitamin E above 100 IU daily are associated with decreased risk of coronary heart disease and certain types of cancer, as well as enhancement of immune function. These vitamin E intakes are considerably above levels obtainable from diet alone. (9-11) Antioxidants are also shown to help against aging. Lutein supplements have been shown to be useful against age-related macular degeneration, a leading cause of blindness in the elderly, in the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Vitamin E has been shown to reduce formation of cataracts. (12) The Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study demonstrated a 32% reduction in prostate cancer incidence in response to daily alpha-tocopherol (Vitamin E) supplementation. (13) ALS (amyotrophic lateral sclerosis) mortality was 62% lower among long-term users of vitamin E than among nonusers. (14) In a study of cancer patients done for the US Dept. of Health and Human Services, “Subgroup analysis did identify a statistically significant 9% reduction in all cause mortality” and “13% reduction in all-cancer mortality associated with supplemental vitamin E in combination with other micro-nutrients.” (15) In a study done by Tufts University, the USDA and the National Institute on Aging, published in JAMA, it was reported that with 200 IU per day of vitamin E given to elderly people, “we observed a protective effect of vitamin E supplementation on upper respiratory tract infections, particularly the common cold, that merits further investigation”. (16) In another clinical trial, Vitamin E (VE) “strongly affected the expression of an array of genes encoding for proteins directly or indirectly involved in the clearance of amyloid beta, changes which are consistent with a protective effect of VE on Alzheimer's disease progression”. (17) Much of the negativity about antioxidants in the article comes from a single scientist in Singapore and does not accurately express the state of the science on the topic. Other problems commonly arise from the use of meta-analyses, a statistical analysis of previously published studies that often multiplies confounding variables and can produce inaccurate results if done by people unfamiliar with the intricacies of nutrition and supplementation. Unfortunately, this article in New Science uses old science that has been virtually repudiated and has not included a fair representation of the whole body of science in which antioxidants do have documented benefits for problems associated with aging. REFERENCES: 1. N Engl J Med. 1994 Apr 14;330(15):1029-35. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. 2. July 2004 American Journal of Epidemiology Development of a Comprehensive Dietary Antioxidant Index and Application to Lung Cancer Risk in a Cohort of Male Smokers. Margaret E. Wright , Susan T. Mayne, Rachael Z. Stolzenberg-Solomon, Zhaohai Li, Pirjo Pietinen, Philip R. Taylor, Jarmo Virtamo and Demetrius Albanes 3. Am J Clin Nutr 2005;82:879–886. Plasma carotene and alpha-tocopherol in relation to 10-y all-cause and cause-specific mortality in European elderly: The Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA). Buijsse B, Feskens EJ, Schlettwein-Gsell D, Ferry M, Kok FJ, Kromhout D, de Groot LC. 4. Edgar R. Miller, III, MD, PhD; et al. High-dose vitamin E supplementation may increase all-cause mortality, a dose response meta-analysis of randomized trials. Annals of Internal Medicine: Online: Nov. 10, 2004: Print: 4 January 2005 Volume 142 Issue 1 5. John N Hathcock, et al. REVIEW ARTICLE: Vitamins E and C are safe across a broad range of intakes. American Journal of Clinical Nutrition, Vol. 81, No. 4, 736-745, April 2005. 6. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. A report of the Panel on Dietary Antioxidants and Related Compounds, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC: National Academy Press, 2000. 7. Emmert DH, Kirchner JT. The role of vitamin E in the prevention of heart disease. Arch Fam Med. 1999 Nov-Dec;8(6):537-42. 8. Stampfer MJ, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993;328:1444-9 9. Bauernfeind, J. Tocopherols in Foods. In: Vitamin E: A Comprehensive Treatise. Marcel Dekker, Inc., New York and Basel, pp. 99-167, 1980. 10. Horwitt, M.K. The Promotion of Vitamin E. J. Nutr. 116:1371-1377, 1986. 11. Weber, P., Bendich, A. and Machlin, L.J. Vitamin E and Human Health: Rationale for Determining Recommended Intake Levels. Nutrition 13:450-460, 1997. 12. Annals of Ophthalmology. Vol. 123 No. 4, April 2005 13. Journal of the National Cancer Institute, Vol. 97, No. 5, 396-399, March 2, 2005 14. Ann Neurol. 2004. Volume 57, Issue 1 , Pages 104 – 110 15. Evid Rep Technol Assess (Summ). 2003 Oct;(75):1-3. Review. PMID: 15523748 16. JAMA. Vol. 292 No. 7, August 18, 2004 17. Gene study suggests vitamin E helps blocks Alzheimer's. Nutr Neurosci. 2005 Feb;8(1):21-9. PMID: 15909764

Wednesday, August 02, 2006

Green Foods

A) Most traditional cultures use green foods in the form of salads, cooked greens or wraps. An example of a wrap is the Greek dish where rice and vegetables are wrapped in grape leaves. Banana leaves have been used as a wrap in Latin American traditional cuisine. These dishes are usually baked, though some can be eaten raw. The wrap isn’t always edible, though it may still impart flavor or nutrients to the contents. Salads can vary considerably from region to region, using mostly native vegetation, often cultivated. Americans have raised salads to an art form with salad bars, where the full plates are as unique as snowflake designs. Raw greens are often eaten in fermented form, especially in Asian countries. Traditional fermented foods include cabbage (kimchee, sauerkraut) and pickles (almost any firm vegetable). Some form of fermented food (including fish eggs and dairy) is in the traditional diet of most cultures. Steamed greens are fairly widespread, worldwide, and seem to be preferred to raw salads in many Asian countries. In the American south, ham or lard is often added to cooked greens (as well as to cooked beans) to add flavor and improve ‘mouth feel’. Seaweeds are often used in the diet of many coastal cultures, and they are also used for fertilizer. These consist of varied species, with some useful eaten raw - including dried dulse, a good source of iron and trace minerals - and others toasted or added to soups or stews. Of course, sushi wraps are usually made from nori. Kelp is a traditional source of iodine and other trace elements. Juicing cereal grain leaves in their green vegetable stage is perhaps a more modern source of greens, though it is possible that people chewed leaves while working the fields. Fresh greens have long been a treasured food in temperate climates after the winter season ends. Green foods are known today as blood builders and detoxifiers. The green pigment, chlorophyll, is known for improving bad breath, being an internal deodorant, and stimulating the formation of red blood cells. In fact, the chlorophyll molecule has many similarities with the red blood cell. As a detoxifying agent, chlorophyll is associated with the reduction of harmful substances and the inhibition of cancer cells. For those who do not consume adequate amounts of a variety of green foods, there are green food supplements. These are roughly classed into land and sea vegetable sources, and are also available in combinations of the two. Algal and plankton sources, such as chlorella, spirulina and blue-green algae, are also available. These are high protein (about 60%), high carotenoid foods. Some have good levels of Vitamin B12, the anti-inflammatory fatty acid called GLA, blue pigments (good for the eyes), antioxidants, etc. These are primarily cultured in fresh water, some within controlled environments. Chlorella is usually sold with the cell walls mechanically broken, often by utilizing ultrasound, to allow digestion. Spirulina is available as US-grown natural spirulina or India-grown certified organic spirulina. The main difference is that the US-grown products use a mined nitrate that is classified as a potential environmental hazard, also being non-renewable. Certified Organic Spirulina uses a proprietary, vegan source of nitrogen as a fertilizer that is certified as being environmentally friendly. These are both high quality spirulina sources and NOW offers both sources in its product line. For land sources of green foods, there are both dried plant powders and dried juice powders. Some are freeze-dried to preserve nutrients. Some are spray-dried onto another substance to make them more soluble, or instant, using material such as maltodextrin (usually corn-derived) which are listed on the labels. Wheat grass and barley grass are two traditional cereal grasses consumed in pills, capsules or beverages. These are typically harvested young, before the grassy leaf becomes mature and could form grains. These grasses are considered gluten-free green vegetables at this stage of development. Nutritionists recommend that people eat green foods daily. Head lettuce is a poor source of iron and chlorophyll; dark-green leafy greens are by far the healthiest options. For those who need to supplement their diets, a tablet, capsule or powder may be the next best option. Chlorophyll itself is available in capsules or liquids, often mint-flavored. This allows people to consume the green pigment directly without most of the other components of the green foods. Alfalfa, Barley or Wheat grasses are also available, some coming from powdered green leaves and some from dried, pressed juices. The juices tend to be more mixable in liquids and more concentrated in nutrients, though lacking the fiber of a whole leafy green. It is best to start slowly and work up to the full recommended serving for greens. Some people may experience digestive discomfort from an abrupt change, such as adding large doses of greens. On any supplement, I recommend ramping up to full dose gradually, also adding just one new product at a time so one can tell the effects of that particular product independently of other changes. Greens are also good to enhance GI tract health, especially the environment for beneficial bacteria, known as probiotics.