Dr. Arturo M. Volpe

This interesting editorial article published in the American Journal of Clinical Nutrition (2001;73:353-354) covers a wide range of topics. First, it notes that individuals living a hunter-gatherer lifestyle are free from chronic diseases that plague the modern world, and this holds true even in cases where the diet is high in fat. The editorial explains that, in today’s traditional rural African societies, heart disease, diabetes and obesity are virtually absent and most elderly individuals still die of infection. The rural African diet does not contain large amounts of processed foods and sugar, smoking is rare in those areas and people engage in significant amounts of daily physical activity. From reviewing hospital records in Massachusetts from 1910 to 1920, the author infers that heart disease was once much more rare in this country.

The article goes on to point out that, if the current trend continues, all American will be obese by the year 2230. In conclusion, the author states that “no matter what efficacious lifestyle changes are recommended, they seem almost irrelevant because they will be very largely ignored.” Personally, I have seen many people regain their health by making courageous lifestyle and diet changes, and I would not be so quick to discount people’s willingness to make changes if given proper information.

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A study published this year (J N Am Menopause Soc, 2001;8(1):3-4) looked at how natural progesterone and medroxyprogesterone (Provera) affect sleep in post-menopausal women. The study concluded that, when women take natural progesterone, they fall asleep faster and wake up less frequently during the night. The average sleep time increases by more than 40 minutes, which is similar to the effects of many prescription sleeping pills, but with no daytime drowsiness or other side effects. In contrast, no improvement in the quality or duration of sleep is observed in women taking Provera.

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A recent double-blind study published in the journal Clinical & Experimental Allergy (2001;31:265-273) found that food additives such as tartrazine, benzoate, nitrite and food colors can aggravate eczema (atopic dermatitis). It has been my consistent observation that individuals with eczema improve greatly when they avoid foods they are allergic to as well as food additives, and it is helpful to see this at least partially confirmed in the medical literature.

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As many of you have probably read, Synthroid (levothyroxine) is under scrutiny by the FDA and may be recalled. Synthroid had never been approved by the FDA but was nevertheless considered as the “gold standard” for thyroid hormone replacement. In recent years, questions have been raised about the reliability of this medication and lawsuits have been filed against its manufacturer.

Armour Thyroid and similar products are the natural equivalents of Synthroid. Extracted from pig thyroid, they are not perfectly identical to human thyroid hormone but are the closest to it that we have available. Many naturally oriented practitioners recommend that patients switch from Synthroid to Armour or a similar preparation. For some this switch makes no difference, but others feel considerably better and/or are able to reduce their dosage.

A study published in the New England Journal of Medicine in 1999 (Vol. 340:424-429) compared the effects of these two medications. Although patients in each of the two groups had similar laboratory test results, those receiving natural thyroid extract scored better on tests for cognitive performance, including memory, language and learning. In addition, those receiving the natural product scored significantly better on scales relating to mood and physical status.

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Do you still believe HRT will protect you from heart disease? Think again. The American Heart Association, in an open letter to physicians published in the journal Circulation (July 24, 2001;104:499-503), recommends that heart health should be left out of HRT decisions.

Although HRT has been shown to lower cholesterol levels, preventing heart disease is obviously a far more complex issue. The well-known Heart and Estrogen/Progestin Replacement Study (HERS), a 4-year trial, showed that conventional HRT actually raised the risk of recurrent heart attack and death during the first year, and then lowered it only slightly. Detailed review of this same study suggests that, over longer periods of time, conventional HRT may further increase the risk of heart disease because it promotes inflammation (JAMA 1998;280:605-613). Another study (Circulation 1999;100:717-722) also found that women on HRT had elevated markers for inflammation and, although cholesterol was down, fibrinogen – a protein associated with blood clots – was elevated.

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An excellent review article recently published in the journal Allergy (2001;56:91-102) discusses the current epidemic of allergic disorders in children and its possible causes. In its introduction, the article points out that the prevalence of asthma in children and young adults has tripled or quadrupled over the last two decades.

Although air pollution is frequently blamed, the authors found little evidence in the research literature to support this hypothesis. They also reported that there is insufficient data to conclude that hormones in the food supply or chemicals in the environment play a role.

However, the authors did find evidence that excessive antibiotics and vaccines are likely causes. Though antibiotics clearly have their place and vaccines have helped eliminate such dreaded diseases as polio, the issue is the indiscriminate use of antibiotics and the trend to inoculate infants and small children with every vaccine available.

The article does not discuss this issue, but limits itself to reviewing various studies that have shown a significant relationship between increased antibiotic and vaccine use and the prevalence of allergic disorders.

For example, a Swedish study found a positive correlation between the MMR vaccine and allergies. Numerous other studies have shown that exposure to infectious agents early in life seems to prime the immune system and prevent the development of allergies later on, and both antibiotics and vaccines limit this exposure. It has also been shown that repeated or long-term antibiotics disrupt the normal bacterial balance of the intestinal tract. This bacteria helps us digest foods, absorb nutrients and has the effect of balancing the immune system, thus preventing the onset of allergies.

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We have all heard that weight-bearing exercise helps build stronger bones. A new study published in Medicine & Science in Sports & Exercise (2001;33:873-880) confirms this but also reveals that oral contraceptives may hinder this benefit. The study monitored bone density in young women aged 18 to 31 who engaged in regular resistance exercise and weight training over a period of two years. Bone strength increased in all but those who were taking oral contraceptives.

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The first of these studies was published in the British Medical Journal (BMJ 2001;322:1-5). It followed 594 children who attended different day care centers in Helsinki over a period of seven months. The children were divided in two groups, one receiving plain milk, and the other milk with Lactobacillus GG (LGG) in it. Lactobacillus is a dietary supplement consisting of bacteria that is beneficial for the intestinal tract and the immune system. LGG is a special strain of this bacteria found in a product called Culturelle.

The group receiving LGG in their milk had significantly fewer days away from day care due to illness and they were free from respiratory tract symptoms for longer periods of time. More complicated infections, such as sinus or ear infections, bronchitis and pneumonia were also reduced in the group receiving LGG.

The second study (Allergy, 2001;56:425-8) found that children who consumed higher amounts of margarine were more likely to develop allergic diseases, including eczema, asthma and hay fever. Children who remained free of these diseases typically consumed more butter than margarine. Here’s one more good reason to avoid margarine!

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Crohn’s disease is a serious condition that can cause a wide range of symptoms, including severe cramping pain, diarrhea and irreversible damage to the intestinal tract. Various studies have focused on the links between this disease and diet. One study (Am J Clin Nutr, 1996;63:741-745) revealed that 69% of patients with Crohn’s disease were allergic to wheat products and 48% to dairy. Another study (Aliment Pharmacol Ther, 1997;11(4):735-740) showed that eliminating foods to which Crohn’s patients were allergic was at least as effective as steroids in producing remission. Other studies have shown that certain dietary supplements, including vitamin A (Lancet, April 5, 1980:766) and S.boulardii (Gastroenterol, 1993;31(2):129-134), can help in reducing diarrhea and healing the intestinal lining.

Many of the people who suffer from this crippling disease, or the side effects of steroid treatments, probably wish they had been told that medical research supports dietary change as a viable treatment option.

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A study (Med Sci Sports Exercise 2000;32(12):2024-2028) looked at the effects of halothane anesthesia, which is known to be toxic to the liver and can cause liver damage.

Experimental animals who were exercised regularly were better able to detoxify the chemical compound and had a reduced incidence of liver damage. Today’s toxic environment

taxes our livers like never before in the history of the human race. Chemicals enter our bodies through air, water and food and end up in our liver, which has the job of breaking them down. Regular moderate exercise can help rid our bodies of environmental toxins and preserve our health.

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If you keep up with the news, you may have read or heard about the newly publicized “war on cholesterol”. It was announced that, in a shift in policy, the National Institutes of Health (NIH) is recommending that cholesterol-lowering drugs be prescribed more aggressively to individuals with a history or other risk factors for heart disease, even if they do not have particularly elevated cholesterol levels. This could potentially triple the number of adults in this country taking cholesterol-lowering drugs. But is this new policy based on science alone, or on drug companies’ skillful marketing and vast profit potential? Interestingly, this announcement did not follow any new breakthrough studies showing that cholesterol is the ultimate cause of heart disease. In an interesting op/ed article published in the May 23, 2001 edition of the Houston Chronicle and other leading newspapers, Robert Atkins, MD pointed out that the new policy fails to address serious side effects of these drugs, including potentially severe liver damage and increased risk of cancer. In addition, these prescriptions have a high financial cost to individuals and/or insurers. The NIH also disregards a mounting body of evidence indicating that, through a controlled-carbohydrate diet, exercise and dietary supplements, cholesterol and other risk factors for heart disease can be effectively corrected. Dr. Atkins is a board-certified cardiologist and the author of several books on the benefits of a low-carbohydrate diet. Numerous studies spanning a decade or more point to a complex set of causes that lead to heart disease, rather than implicating cholesterol alone. Some of these causes are strongly linked to lifestyle, diet and nutrient deficiencies. They include chronic inflammation, elevated insulin levels in the blood, pro-oxidants and so-called free radicals, as well as low testosterone in men and low estrogen in women1. Elevated blood levels of a chemical called homocysteine have also been shown conclusively to be associated with a higher risk of heart disease even in the absence of elevated cholesterol2. Homocysteine buildup in the blood is caused by a deficiency of certain B vitamins.

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Diane Schwarzbein, MD is an endocrinologist and the author of an excellent book, “The Schwarzbein Principle.” In a recent interview she related the remarkable story of how she went from being a conventional physician to embracing nutritional medicine. Dr. Schwarzbein worked with a group of adult diabetics who were highly motivated to control their disease and their increased risk of heart disease through diet. Gradually, through trial and error – and very cautiously at first – she came to realize that the high-carbohydrate/low-fat diets commonly recommended today were counterproductive. Her patients were actually getting worse. Although “low-fat” may sound good (many of us are trying to lose fat, after all), carbohydrates such as pasta, breads and other starches are nothing other than sugar molecules bound together in long chains. They are broken down and converted back to their sugar building blocks through the digestive process. Sugar has a dual action in the body: it raises insulin levels in the blood and promotes inflammation, thereby aggravating two known risk factors for heart disease. In addition, the body can only store minute amounts of sugar once its immediate energy needs have been met. Excess sugars are converted in the liver to triglycerides or cholesterol, and particularly to LDL, the “bad” cholesterol. Triglycerides are the type of fat that is stored in the body and are, themselves, a risk factor for heart disease. Once Dr. Scwharzbein began to recommend a more balanced diet that restricted carbohydrates and included more fat and protein, her patients began to improve. They lost weight, their cholesterol levels normalized, their diabetes was controlled and their risk of developing heart disease was lowered. Other factors, including exercise and nutritional supplements, also proved beneficial.

1. N Engl J Med 2000;343:1139-1147, 1148-1155 and 1179-1182; Free Rad Biol Med 2000;28(12):1717-1725; Diabetes Care 1991;14:173-194.

2. A great deal of the research on homocysteine is reviewed in the book “The Homocysteine Revolution” by Kilmer McCully, M.D.. According to some experts, the recent decline in heart disease may be attributable to the increased use of multivitamin supplements that may help lower homocysteine levels by supplying adequate amounts of B vitamins

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Could autoimmune diseases such as rheumatoid arthritis, lupus, Crohn’s disease or even ankylosing spondylitis really start in the gut? Many naturally minded physicians and nutritionists have held this opinion for some time. New research (Ann Rheum Dis 2001;60:65-66) seems to confirm it.

Researchers evaluated indicators of excessive intestinal permeability, so-called “leaky gut syndrome”, in patients suffering from a variety of autoimmune disorders. They found much higher rates of permeability in these patients as compared with healthy individuals. This held true even when there were no digestive symptoms, and the patients had not been taking anti-inflammatory medications (NSAIDS) that are known to damage the lining of the intestinal tract. This study confirms the importance of checking the health of the digestive tract in many immune disorders, something I frequently recommend for my patients.

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A recent study published in the British medical journal The Lancet (April 7, 2001;357:1076-1079) looked at the effects of Lactobacillus GG on childhood allergies. Lactobacillus GG is a supplement containing beneficial bacteria. It is found in Culturelle, a product that many of my patients are very familiar with. Researchers in Finland gave this product to a group of pregnant women and continued giving it for six months after delivery if the women were breast-feeding. If the infant was bottle-fed, the supplement was given directly to the newborn. By age two, the children who had received the Lactobacillus were found to be half as likely to develop allergies, the most remarkable result ever seen in allergy prevention research. Researchers believe that exposure to beneficial bacteria ear ly in life may train the immune system to defend from disease instead of overreacting to normally benign substances.

In another study (J Pediatr Gastroenterol Nutr, Oct 2000;31(4):453-457) the same Lacotbacillus GG was given at a rate of one capsule twice a day for six months to children suffering from Crohn’s disease, a severe intestinal disorder. This resulted in a 73% reduction in symptoms within four weeks of starting the supplement and the improvements were maintained throughout the duration of the study. Interestingly, no other treatment was used in this study. With dietary change and a few other targeted supplements, the improvement may well have been 100%.

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Two recent studies have shown that DHEA can help restore bone mass. In the first study (Clin Endocrinol, 2000;53:561-568) 10 women and 8 men in their 70’s were given 50 mg of DHEA daily for 6 months. At the end of this period, the bone mineral density of their total body, including the spine, increased; fat mass decreased; and fat-free mass increased.

A second one-year, double-blind, placebo-controlled study conducted in France (Family Practice News, Nov. 1, 2000:24) also found that in 70 women aged 60 to 69, those receiving DHEA had an increase in bone mineral density, while those on placebo suffered a loss.

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A recent study published in the Journal of Rheumatology (2000;27:2343-46) found that shifting dietary balance away from omega 6 oil (commonly found in vegetable oils) and towards omega 3 oil (found in fish oil) significantly alleviates symptoms in patients with rheumatoid arthritis.

In this study, subjects were instructed to restrict their dietary intake of omega 6 oil, then one group received fish oil supplements and another group received olive oil. Researchers found that after 15 weeks the fish oil group exhibited “statistically significant improvements in 6 of 9 measures of disease activity”. Improvements included less pain, fewer tender and swollen joints, and reduced stiffness. No significant improvements were observed in the olive oil group. Fish oil contains certain fatty acids that have been shown to have powerful anti-inflammatory action with no side effects. The best results are obtained when fish oil is used in combination with diet changes and other synergistic nutrients.

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In a 1967 study, 60 patients with obstructive emphysema and bronchitis were able to bring their symptoms under control and stop using steroid medications when they adopted a grain-free diet. The study, entitled “Food allergy = its role in the symptoms of obstructive emphysema and chronic bronchitis,” was published in the Journal of Asthma Research (9/67;5(1):11-20). Unfortunately, studies such as this have been quickly forgotten, and few follow-up studies have been made. Today, just as in 1967, food is still the single most important factor in health and disease; however, it is rarely considered as such by mainstream healthcare providers.

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A recent study published in the Journal of Rheumatology (2000;27:2343-46) found that shifting dietary balance away from omega 6 oil (commonly found in vegetable oils) and towards omega 3 oil (found in fish oil) significantly alleviates symptoms in patients with rheumatoid arthritis.

In this study, subjects were instructed to restrict their dietary intake of omega 6 oil, then one group received fish oil supplements and another group received olive oil. Researchers found that after 15 weeks the fish oil group exhibited “statistically significant improvements in 6 of 9 measures of disease activity”. Improvements included less pain, fewer tender and swollen joints, and reduced stiffness. No significant improvements were observed in the olive oil group. Fish oil contains certain fatty acids that have been shown to have powerful anti-inflammatory action with no side effects. The best results are obtained when fish oil is used in combination with diet changes and other synergistic nutrients.

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A double-blind, placebo-controlled study (J Int Med, 2000;248:377-386) looked at 52 men and 58 women who had elevated cholesterol levels and thickening of the arteries (atherosclerosis). These individuals were given a placebo, vitamin E, vitamin C, or both Vitamins E and C.

After three years, the researchers found that in individuals receiving both vitamins, the increase in thickness of the arteries was reduced by 74%, a very significant result. Those who were given only one vitamin had more modest benefits, and no side effects were noted. .

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While many people think that the lower our cholesterol the better, numerous studies have contradicted this view. Now yet another study has linked low cholesterol with adverse health effects. Published in the Journal of Behavioral Medicine (Dec. 1, 2000;23:519-529), the study found low serum cholesterol to be correlated with mood disorders, lack of cognitive efficiency and sociability.

It is theorized that low cholesterol leads to the suppression of serotonin, a condition known to cause both aggressive behavior and depression. With record numbers of Americans taking cholesterol-lowering medications, it should be noted that, as with everything else the body produces, there is a target range for cholesterol, and deviations in both directions indicate dysfunction.

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