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November 29, 2000 Research Update |
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
weight Cycling Appears to Lower Levels of HDL-C in Women
With so many diet plans being used today, it is very common for patients to try all types of diets over and over again. Almost without exception, some or all of the weight lost gets put back on. This weight cycling is dangerous and still does not achieve the end result. The only way to lose weight successfully and safely is to make permanent lifestyle changes.
J Am Coll Cardiol 2000;36:1565-1571 Women with a history of repeated cycles of weight gain and loss through dieting tend to have low levels of high-density lipoprotein (HDL) cholesterol. The degree of HDL-C reduction is associated with an increased risk of cardiac events, according to a report by the Women's Ischemic Syndrome Evaluation (WISE) study group. "Overall," the researchers found that "27% of women reported weight cycling." Among these women, HDL cholesterol levels were 7% lower than in women with no history of weight cycling (52 vs. 56 mg/dL). In addition, the researchers report in the November 1st issue of the Journal of the American College of Cardiology that HDL-cholesterol levels were directly associated with amount of weight lost and gained. Women who lost and gained 50 lb or more during cycling had HDL-cholesterol levels that were 27% below those of women who were "noncyclers." "As a physician, I would say that the implications are that we should stop talking about dieting, until we get a diet that is successful for maintaining long-term weight loss," Dr. Merz stressed. "Instead, we should start talking a whole lot more about exercise and nutritional practices."
Conflict of Interest and the Public Trust
This is a very interesting commentary on the impact that the pharmaceutical companies have on physician decision making. This "conditioning" by the pharmaceuticals begins as the physicians are students. Unfortunaely, this relationship leads to clouded judgement and future education built mainly on what the drug companies provide. Conflict of Interest and the Public Trust http://jama.ama-assn.org/issues/v284n17/ffull/jed00080.html
High-Dose Multivitamins Adversely Affect Coronary Plaque
At first glance, this article seems to put a damper on vitamin supplementation. Further introspection does reveal some additional clues. First, the author of this study considers 500 mg Vit C as a high dose. Considering that other mammals that make their own Vit C make maintenance dosages in the range of 10,000+ mg per DAY (and increase that several fold in response to stress...) 500 mg is really very low. Linus Pauling considered therapeutic dosages in the thousands of mg. Even more importantly, this is another example of man trying to better nature. Beta carotene is just one of hundreds of the carotenoids that nature provides, and Vit C found in fruits is augmented by the presence of bioflavenoids to increase the health benefits. Lets try this trial again, this time using whole fruits and vegetables...
(article) High-dose multivitamin supplements promote the development of fibrosis at the site of angioplastic intervention, according to findings presented by Montreal investigators during the Canadian Cardiovascular Congress 2000. This effect may help explain why high-dose multivitamins did not prevent restenosis or improve vascular remodeling in the Multi-vitamins and Probucol Trial (MVP), previously reported by the Montreal group. The MVP trial involved 317 patients who were randomly assigned to either probucol 500 mg b.i.d., or 700 IU vitamin E plus 500 mg vitamin C plus 30,000 IU beta carotene b.i.d., or both, or placebo. Treatment was started 30 days before undergoing angioplasty and was continued for six months following the procedure. "The changes we saw in plaque content on IVUS are compatible with an increase in fibrosis in the arterial wall at the site of angioplasty," Dr. Jean-Claude Tardif, director of clinical research, Montreal Heart Institute told Reuters Health, "and in relation to angioplasty, fibrosis prevents the process of beneficial vascular remodeling, which is not good." Dr. Tardif also noted that these observations are "entirely compatible" with their previously reported findings from the MVP trial. The doses of the vitamins used in the MVP trial were very high, but as Dr. Tardif explained, the trial was started in 1994. "At that time we did not want to be criticized for not giving high enough doses of multivitamins, so yes, you could say that the doses we used were high. But it's also important for people to realize that vitamins are not as benign as they think they are, especially when taken in high doses." Findings from the MVP trial indicated that probucol decreased the rate of stenosis by 50% and late luminal loss by 68%, which was "quite a dramatic effect," Dr. Tardif observed. However, concerns about adverse effects related to probucol, including a reduction in high density lipoprotein levels, led to its subsequent withdrawal from the market.
Glaxo Unsure of Which Patients Suitable for Lotronex
Sorry I didn't get this news out to you sooner....Lotronex was just pulled off the market by the FDA. Remember, functional medicine practioners have been treating IBS very successfully for many years now using various natural methods.
(article) Many patients with irritable bowel syndrome (IBS) alternate between the two main forms of the disease, Glaxo Wellcome said on Thursday as the US Food and Drug Administration (FDA) continued to investigate 70 reports of adverse events and five deaths in women taking the company's IBS drug Lotronex. As of October 20, the FDA had received 49 reports of ischemic colitis, a condition in which blood flow to the colon is reduced, and 21 reports of severe constipation in women taking Lotronex (alosetron) for IBS. Five of these 70 women died, FDA spokesman Jason Brodsky said. A Glaxo spokesman denied a causal link had been established between the adverse events and the drug, which has been taken by some 300,000 women in the US since its launch in March, but which has not yet been approved in Europe. The spokesman told Reuters Health that some women had been misdiagnosed and prescribed Lotronex when they had the constipation-predominant form of IBS rather than diarrhea-predominant form for which the drug is indicated. According to the spokesman, a correct diagnosis is not straightforward because many patients — possibly as many as a third of all IBS patients — alternate between the two types.
FDA Says Evidence of Omega-3 Health Benefits Unclear
They were probably saying the same thing about folic acid and neural tube defects in the late fifties when the evidence started to show a benefit in the reduction of defects w/ folic acid supplementation. I'm not sure where the FDA looked (possibly under their own rock??), but I could easily come up with a few hundred articles on Omega-3 fatty acids and numerous diseases such as Crohn's, Rheumatoid arthritis, osteoporosis and heart disease.
(article) The scientific evidence that omega-3 fatty acids protect against heart disease is not definitive, the US Food and Drug Administration said on Thursday. The agency ruled that food manufacturers can use only a limited claim about the relationship between the oils, found in fish and other foods, and cardiac illness. The approved claim reads, "The scientific evidence about whether omega-3 fatty acids may reduce the risk of coronary heart disease (CHD) is suggestive, but not conclusive. Studies in the general population have looked at diets containing fish and it is not known whether diets or omega-3 fatty acids in fish may have a possible effect on a reduced risk of CHD. It is not known what effect omega-3 fatty acids may or may not have on risk of CHD in the general population."
Soybean Extract Found Protective in Alcoholic Liver Disease
Liver disease is a disorder that is managed poorly by Western medicine. Many patients who have been diagnosed with liver disease are basically given a "watch and wait" therapy plan. Luckily, the liver is a primary focus of functional/alternative medicine. Milk thistle, B vitamins, SAMe and N-acetyl cysteine are all well known and researched for their hepato-protective properties. Now we have another tool to use--soybeans. And remember, the liver can actually begin to destroy itself if the two phases of detoxification are not in harmony (termed metabolic activation), and a detox liver profile (NOT the supposed "liver function tests" commonly run--these check for actual structural liver damage, NOT function) can help identify areas that need work.
(article) An extract from soybeans has been found to halt, or perhaps even reverse, progression of liver fibrosis in alcoholics in a randomized, double-blind, placebo controlled trial. Eighteen alcoholic patients were randomized to receive either placebo or the extract polyenylphosphatidylcholine (PPC). Five of the nine on placebo showed fibrotic progression on liver biopsies 2 years later. For the nine on PPC, liver histology was unchanged or slightly improved, reported Dr. Charles S. Lieber, of the VA Medical Center and Mount Sinai School of Medicine, Bronx, New York. Dr. Lieber described his group's study at the annual meeting of the American Association for the Study of Liver Diseases. There is a need for an effective therapy in these patients because their current prognosis is dismal. "In patients with alcoholic cirrhosis who are over 60 years old, there is a 50% mortality at 1 year," Dr. Lieber said. "Much of this toxicity is because alcohol is metabolized preferentially in the liver." The extract PPC is a 95% pure mixture of polyunsaturated phosphatidylcholines, about half of which is dilinoleoylphosphatidylcholine (DLPC). Dr. Lieber's earlier work in nonhuman primates suggested that DLPC opposes oxidative stress, one of several mechanisms thought responsible for alcohol's hepatotoxicity. Patients who were taking PPC had higher plasma levels of DLPC than controls, further suggesting that DLPC may be the active, antioxidant ingredient, he said. additional reading: Entrez-PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10940340&dopt=Abstract
High-Dose Vit E Reduces Serum Levels of CRP in Diabetes
It is not surprising that Vit E may have the potential to lower the risk of heart disease in diabetics. What is surprising is that this study actually used levels considered therapeutic by researchers...1200 IU/day.
Free Radic Biol Med 2000;8:790-792 Results of a new study of type-2 diabetics indicate that high-dose vitamin E reduces levels of C-reactive protein (CRP), a marker of inflammation and a predictor of cardiovascular disease. "High dose vitamin E in all three groups reduced inflammation as seen by low levels of C-reactive protein, which we measured by a new highly sensitive assay," Dr. Jialal told Reuters Health. The researchers also saw lower levels of the pro-inflammatory cytokine, interleuken-6, which drives CRP. Both markers, Dr. Jialal explained, have previously been shown to be predictors of heart disease and stroke. "We have shown that you can modulate these markers in diabetics, which has great implications, given that in diabetes you have at least a 2-fold increased prevalence of stroke and heart attacks," he added.
Depression in medical illness
This is a very interesting article outlining the interactions between the immune system and our mental health. Chronic infections and chronic immune stimulation can actually produce depression in patients. This depression can then, in turn, lead to additional physical complaints. This may be why certain antidepressants actually lower complaints in certain patients with syndromes such as fibromyalgia. The drugs do not actually get to the cause of the original complaint (the immune activation) but do help with the secondary effects of the depression. Unfortunately, without contolling the underlying immune activation, any therapy will not be very effective.
wjm -- Yirmiya 173 (5): 333 http://www.ewjm.com/cgi/content/full/173/5/333