diabetes

  • A Healthy Heart At Every Age

    A Healthy Heart At Every Age Ann Louise Gittleman

    Even if heart disease “doesn't run in your family,” this article is for you. Even if you have low cholesterol levels and your blood pressure is normal, this article is for you, too. This information doubles as both prevention and treatment— and its knowledge is critical for us all.

    In the past, you may have thought of heart disease as an illness that you associated predominately with men. These days, we know that more than one in three women have some form of cardiovascular disease. As of the 2016 fact sheet from the American Heart Association, 398,086 females passed away from cardiovascular disease or congenital cardiovascular disease, with 402,851 males passing away from the same. Further, they've found that 90 percent of women have one or more risk factors for heart disease or stoke and that fewer women survive their first heart attack than men. This illness clearly does not favor one gender.

    So, what causes heart disease? Simply put, cardiovascular disease results when the lumens of the coronary arteries, which carry blood, oxygen, and nutrients to the heart, become smaller. This constriction can be caused by excess salt in the blood pulling fluid from the arteries. Arteries are further constricted by a buildup of fats, oxidized cholesterol, excess calcium, and plaque in the artery walls. Angina, or chest pain, occurs when the heart fails to receive enough oxygen through these narrowed arteries. When these arteries become obstructed, a heart attack can occur, resulting in damage to the heart tissue. This process of plaque buildup and obstruction is known as atherosclerosis, or hardening of the arteries.

    What Are the Risks?
    There are over 250 risk factors for heart disease that have been identified. However, you'll be relieved to know that a large number of these factors—including many that are especially dangerous—can be lowered with lifestyle choices and changes. However, two risk factors associated with heart disease are beyond your control: heredity and age. For both men and women, the closer your blood-tie to a relative who suffered from heart disease, the greater your risk of developing it. In addition, age is a factor for women. As women reach menopause, their risk factor of developing heart disease rises significantly. Regardless if your family history predisposes you to a higher risk or not or your current age, there are certain risk factors that you should be mindful to pay close attention to. Let's touch on a few that you can begin making changes to reduce today.

    High Blood Pressure
    Hypertension, or high blood pressure, is both a cause and an effect of cardiovascular disease. The exact cause of hypertension is generally unknown, but what we do know is that high blood pressure often accompanies heart disease. The excessive force of the blood against the arteries weakens the cellular walls, allowing LDL (“bad”) cholesterol, excess calcium, and other toxic substances to form deposits that eventually block the arteries. Almost 50 percent of all midlife women are diagnosed with hypertension by age 50. Most who have hypertension are unaware of it because it usually produces no physical symptoms. Routine blood pressure checks, at least every two years, can detect potential hypertension; blood pressure readings above 140/90 may spell danger. Because so many test results have shown a direct relationship between high salt intake and hypertension, removing the salt shaker from your table would be wise. Sodium is a factor in hypertension because it causes fluid retention, which adds stress to both the heart and the circulatory system. Hypertension, left undiagnosed or untreated, can result in stroke, heart attack, kidney failure, and other serious diseases.

    Smoking
    Let's face facts: if you still smoke, your chances of dying from heart disease are almost three times as great as those of dying from lung cancer. The negative effects of smoking on your cardiovascular system are related to several actions. Nicotine causes blood platelets to become sticky, increasing plaque formation. Smoking also has been shown to decrease levels of HDL (“good”) cholesterol and increase LDL (“bad”) cholesterol. Cigarettes are high in cadmium, a toxic mineral that damages heart tissue. The Nurses' Health Study, conducted by Harvard researchers, found that women who smoked just one to four cigarettes a day had nearly two and one-half times the rate of heart disease of nonsmokers. Keep in mind that even secondhand smoke increases your risk of heart disease, so make your home and car smoke-free environments.

    Obesity
    Unfortunately for us, weight appears to be a more significant risk factor for women than it is for men. A study by Harvard researcher JoAnn Manson, MD, found that in obese women, seven out of ten cases of heart disease resulted from their excess weight. Even women who are at the high end of their “normal” range seem to have an increased risk. To compound the problem, overweight women tend to be sedentary; they are also more likely to develop hypertension, high LDL cholesterol and triglycerides, and type 2 diabetes, all of which increase the likelihood of heart disease. How the weight is distributed on your body also seems to have an impact.

    Women with an apple body shape—who have a proportionally higher amount of fat around their abdomen than elsewhere on their body—have higher rates of heart disease, hypertension, and diabetes than their pear-shaped sisters, who carry their excess fat in their hips and thighs. Scientists believe this association relates to the hormone cortisol, which causes fatty acids to be released into the bloodstream from the central fat cells. These cells are located close to your liver; the released fatty acids stress the liver, causing cholesterol, blood pressure, and insulin levels to rise. Psychology researcher Elissa S. Epel has also discovered that apple-shaped women feel stress more and produce more cortisol as a result than do pear-shaped women.

    Diabetes
    For us women, diabetes is an additional risk factor for heart disease. Blood platelets in diabetics seem to stick together more readily than in non-diabetics, causing clogging of the arteries. Diabetics also have higher total cholesterol and lower HDL cholesterol levels. Research shows that women over the age of 45 are twice as likely as men to develop type 2 (formerly known as adult-onset) diabetes, and female diabetics are at double the risk of heart disease of male diabetics. The good news is that type 2 diabetes can be managed with diet and exercise.

    A Sedentary Lifestyle
    Movies depicting life on the nineteenth-century American frontier and Canadian wilderness are harsh reminders of just how physically demanding everyday life once was. We might enjoy watching someone else chop wood, carry buckets of water long distances, and walk behind a plow horse, but few of us would trade in our computers, microwave ovens, and central heating to live that life. All our muscles, including our heart, need exercise, however. Exercise helps lower LDL cholesterol and raise HDL cholesterol. Regular aerobic exercise—such as walking, running, jumping rope, and dancing—reduces the risk of heart disease by about 30 percent in postmenopausal women. It also influences several other risk factors.

    People who exercise regularly have a 35 percent lower risk of hypertension, as well as a lower risk of diabetes. Exercise stimulates production of serotonin, endorphins, and other brain chemicals that reduce anxiety and stress and create a balanced sleep-wake cycle, helping to control cortisol levels. When you exercise, you also aid calcium metabolism, triggering the calcification process within your bones so excess calcium does not build up in your blood vessels. And you don't even need to spend one to two hours a day in strenuous activity to achieve cardiovascular benefits. Do keep in mind that over exercising can be just as harmful as being a couch potato. Moderate exercise, performed regularly, significantly decreases your risk of heart disease.

    No matter your age, stage, and gender, it's import to make daily choices that love your heart and your health.

  • Aging and the Mitochondria

    Aging and the Mitochondria Dallas Clouatre

    In aging and many disease states, the energy production capacity of the body’s cells is diminished. The mitochondria are the structures within the cell responsible for generating energy from oxygen and nutrients. If their number is reduced or their function is impaired, free radicals are produced and damaging toxins accumulate in the cells. These toxins further damage the mitochondria and impair other aspects of cellular function. Many of the most common health problems, such as obesity, diabetes, and many problems associated with aging, arise from problems in cellular energy production. As one group of researchers has put this, "[a]ging is associated with an overall loss of function at the level of the whole organism that has origins in cellular deterioration. Most cellular components, including mitochondria, require continuous recycling and regeneration throughout the lifespan."1 Another has observed, "[m]itochondrial biogenesis [the creation of new mitochondria] is a key physiological process that is required for normal growth and development and for maintenance of ongoing cellular energy requirements during aging."2 These observations link two key aspects of mitochondrial health, preventing and removing damaged mitochondria (mitophagy) and creating new mitochondria (mitogenesis).

    Although the importance of the mitochondria as a central point of health has been accepted for decades, over the last few years the understanding of the mechanisms involved has changed significantly. Twenty or ten years ago, antioxidants and the free radical theory of aging largely dominated thinking. Today, the importance of mitochondrial biology linking basic aspects of aging and the pathogenesis of age-related diseases remains strong, yet the emphasis has changed. The focus has moved to mitochondrial biogenesis and turnover, energy sensing, apoptosis, senescence, and calcium dynamics.3

    What Promotes Mitochondrial Biogenesis?
    The body maintains a complex network of sensors and signaling functions to maintain stability despite a constantly changing environment and numerous challenges. Of special note is the concept of hormesis, meaning a state in which mild stress leads to compensation that improves the ability of the body to respond in the future to similar challenges. It turns out that many of the approaches that are associated with longevity and healthy aging promote hormesis. In terms of mitochondria biogenesis, these include caloric restriction, certain nutrient restrictions or shortages, caloric restriction mimetics, and exercise.

    Many of the mechanisms that activate mitochondrial biogenesis in the face of hormesis have been elucidated. Keeping in mind that there always must be a balance between the elimination of worn-out and defective mitochondria and the generation of new ones, the activators of both actions can overlap. For instance, low energy levels (caloric restriction) and increased reactive oxygen species/free radicals can promote the activity of special cellular control points. These include activating metabolic sensors such as AMP kinase/ AMPK (adenosine monophosphate kinase) and the protein known as SIRT1 (sirtuin 1, i.e., silent mating type information regulation 2 homolog 1). Activated AMPK is an indicator that cellular energy is low and serves as a trigger to increase energy production. It inhibits insulin/IGF-1/mTOR signaling, all of which are anabolic and can lead not just to tissue production, such as muscle growth, but also to fat storage. Along with SIRT1, AMPK activates the biogenesis of new mitochondria to enable the cell to generate more energy. At the same time, activated AMPK and SIRT1 increase the activity of a tumor suppressor that induces mitophagy. The balance of the dual activations replaces defective mitochondria with newly formed functionally competent mitochondria.

    A key to health and healthy aging is to regulate the catabolic processes via controlled amounts and types of stressors such that worn out mitochondria are removed without overshooting the mark and reducing overall cellular and tissue functionality. The most successful way to maintain this balance is to follow the body’s own natural metabolic signals rather than to attempt to override the body’s checkpoints. AMPK and SIRT1 ultimately are energy/nutrient sensors or control points. Hence rather than attempting to manipulate these directly, it likely is safer and ultimately more effective to address the factors in the cell that these sensors sense. The recent attention in the issue of aging to the role of NAD+ (the oxidized form of nicotinamide adenine dinucleotide) is a good example of this principle. Directions coming from the nucleus of the cell that help to regulate the normal production of NAD+ and the ratio between distinct pools found in the cytoplasm and in the mitochondria decline with age. The changes in the NAD+ from the nucleus lead to a disruption on the mitochondrial side. In terms of energy production, it is a bit like losing a link or two in the timing chain on your car engine with a resultant reduction in engine efficiency. To date, attempts to increase NAD+ in cells via supplementation with precursors have not proven particularly successful. Major benefits have been demonstrated in animal models only in the already seriously metabolically impaired or the relatively old. Recent research on oral supplementation has led to at least one extremely difficult article which, at least in this author’s opinion, delivers more smoke than heat.4,5 There is, however, an argument to the effect that supplementing together both nicotinamide riboside (a NAD+ precursor) and a sirtuin activator, such as pterostilbene, may prove to be more successful.

    It turns out that there are key points in normal cellular energy generation processes that strongly influence the NAD+ pools available for the cell to draw upon and the rate at which NAD+ can be replaced in these pools. Aging has been shown to promote the decline of nuclear and mitochondrial NAD+ levels and to increase the risk of cancer along with components of the metabolic syndrome. It is significant that the risks of these conditions can be reduced in tandem. Three places to start are 1) the pyruvate dehydrogenase complex, 2) the tricarboxylic acid cycle (TCA cycle) also known as the Krebs Cycle, and 3) the malate shuttle. A fourth junction is Complex I of the electron transport system, again, in the mitochondria.6 Manipulation of steps (1) and (2) already is being used in cancer treatment.7 Readily available dietary supplements can influence all four of these metabolic bottlenecks.

    Supplements for Promoting Mitochondrial Biogenesis
    Medicine has started to pay a great deal of attention to effecting mitochondrial biogenesis through not just drugs, but also dietary supplements. Those interested should go online and look up "Mitochondrial Biogenesis: Pharmacological Approaches" in Current Pharmaceutical Design, 2014, Vol. 20, No. 35. Quite a few options are mentioned, including well known compounds, such as R-lipoic acid (including with L-carnitine), quercetin and resveratrol, along with still obscure supplements, including various triterpenoids and the Indian herb Bacopa monnieri.

    Pomegranate, French White Oak and Walnuts
    The pomegranate, with its distinctive scarlet rind (pericarp) and vibrantly colored seed cases (arils), is one of the oldest cultivated fruits in the world. This exotic fruit features prominently in religious texts and mythological tales and has been revered through the ages for its medicinal properties. An image of a pomegranate even can be found on the shield of the British Royal College of Medicine. Numerous studies have demonstrated the benefits of the fruit for cardiovascular health with other benefits suggested in areas ranging from arthritis to stability of cell replication to bone health. Now a study in Nature Medicine (July 2016) has uncovered perhaps the most important benefit of all, the ability of pomegranate compounds (ellagitannins) transformed by gut bacteria to protect the mitochondria of the muscles and perhaps other tissues against the ravages of aging. The mitochondria are the energy generators of the cells and the weakening of this energy generating function in an increasing percentage of mitochondria as we age is a primary source of physical decline over the years. Urolithin A, a byproduct of gut bacterial action on pomegranate compounds, allows the body to recycle defective mitochondria and thereby slow or even reverse for a time some of the major aspects of aging. The lifespan in a nematode model of aging was increased by more than 45 percent. Older mice in a rodent model of aging exhibited 42 percent better exercise endurance. Younger mice also realized several significant benefits.8

    Beginning almost three decades ago, there were numerous speculations in the research world regarding the so-called "French Paradox" in which the French consumed quite large amounts of saturated fat in the form of butter and cheese, yet consistently experienced much lower rates of cardiovascular disease than did Americans. Not only that, the French, especially in the southwest of the country, typically led longer lives even in the areas noted for consuming large amounts of goose fat and pate de foie gras, which is to say, not just the Mediterranean diet based on olive oil, etc. One hypothesis put forth very early on was that it was the French consumption of red wine that protected them. It was thought that red wine components, including anthocyanidins, proanthocyanidins and resveratrol, are the protective compounds. Not considered until recently is that French red wines traditionally have been aged in casks made from white oak (Quercus robur). White oak contains roburin A, a dimeric ellagitannin related chemically to punicalagin. Human data show relatively good absorption and conversion of roburins into substances including urolithin A and ellagic acid—as compared with ellagitannins in general, which evidence only poor absorption. Hence, the benefits of good red wine traditionally produced and good cognac (also aged in oak barrels) involve urolithin A. Notably, the benefits of roburins, most likely derived from the conversion to urolithin A, go beyond mitophagy to include ribosomes, referring to cell components that translate DNA instructions into specific cellular proteins.9,10,11,12

    Other sources of ellagitannins have been shown to lead to the production of urolithin A by bacteria in the human gut. Not surprisingly, sources of ellagitannins are foods long associated with good health longevity, including not just pomegranate and oak-aged red wine, but also walnuts (and a smattering of other nuts), strawberries, raspberries, blackberries, cloudberries and even black tea in small amounts.

    Exercise and Pyrroloquinoline Quinone (PQQ)
    Peroxisome proliferator-activated receptor gamma coactivator (PGC-1á) is the master regulator of mitochondrial biogenesis.13 Exercise is perhaps the most significant activator of PGC-1á that most individuals can access. Exercise, furthermore promotes mitochondrial biogenesis through a number of other pathways, especially endurance and interval training.14

    There are non-exercise options. You can’t take PGC-1á orally because it is a large protein molecule which does not survive digestion. PQQ is a small molecule that is available when ingested and that increases circulating PGC-1á. PQQ supplementation leads to more mitochondria and more functional mitochondria.15

    Fasting, Ketogenic Diets and Fasting-Mimicking Supplements As already discussed, fasting promotes mitochondrial biogenesis by AMPK activation.16 AMPK senses the energy status of the cell and responds both to acute shortages, such as that induced by exercise, and to chronic shortages, such as from fasting. Probably due to an overall reduction in metabolic rate, chronic caloric restriction (as opposed to intermittent fasting) contributes to the health of mitochondria rather than biogenesis.17 The robustness of AMPK response decreases with age.18

    Ketogenic diets (very low carbohydrate diets) also promote increases in mitochondria.19 Few individuals are willing or able to follow ketogenic diets chronically just as few individuals are willing to undergo routine fasts. Fasting-mimicking supplements offer an alternative approach. The dietary supplement (-)–hydroxycitric acid (HCA) is the best researched of these compounds. (Keep in mind that there is a vast difference in the efficacy of commercially available forms.20) Researchers have proposed that HCA used properly can activate mitochondrial uncoupling proteins and related effects.21

    Furthermore, according to a study published in the journal Free Radical Research in 2014, HCA improves antioxidant status and mitochondrial function plus reduces inflammation in fat cells.22 Inflammation is linked to the metabolic syndrome at the cellular level by way of damage to the antioxidant enzyme system (e.g., superoxide dismutase, glutathione peroxidase, glutathione reductase) and mitochondria. This damage, in turn, propagates further production of pro-inflammatory mediators (e.g., TNF-á, MCP-1, IFN-ã, IL-10, IL-6, IL-1â). HCA protected fat cells from ER stress by improving the antioxidant status to reduce oxidative stress (i.e., reduce ROS) and improve the function of the mitochondria to short circuit an ER stress—inflammation loop in these cells. Reducing TNF-á is important in that doing so removes a major impediment to mitochondrial biogenesis.23

    Other Supplements to Promote Mitochondrial Biogenesis

    Scholarly reviews looking at natural compounds such as those that are found in anti-aging diets suggest yet other supplements to promote mitobiogenesis. For instance, it turns out that hydroxytyrosol, the most potent and abundant antioxidant polyphenol in olives and virgin olive oil, is a potent activator of AMPK and an effective nutrient for stimulating mitochondrial biogenesis and function via what is known as the PGC-1á pathway.24 Another herb with anti-aging effect, this time by activating the malate shuttle mechanism mentioned above, is rock lotus (Shi Lian Hua). This herb has been described in detail in this magazine in the article, "Uncovering the Longevity Secrets of the ROCK LOTUS."25

    Conclusion
    It is possible to improve the functional capacity of the mitochondria through dietary practices, exercise and supplements. Indeed, a number of compounds have been identified by researchers as mitochondrial nutrients. These compounds work together to increase the efficiency of energy production, to reduce the generation of free radicals, and so forth and so on. Likewise, these nutrients have been shown to improve the age-associated decline of memory, improve mitochondrial structure and function, inhibit the ageassociated increase of oxidative damage, elevate the levels of antioxidants, and restore the activity of key enzymes. Perhaps best of all, the body can be encouraged both to remove damaged mitochondria (mitophagy) and to create new ones, which is to say, mitochondrial biogenesis.

    References:

    1. López-Lluch G, Irusta PM, Navas P, de Cabo R. Mitochondrial biogenesis and healthy aging. Exp Gerontol. 2008 Sep;43(9):813–9.
    2. Stefano GB, Kim C, Mantione K, Casares F, Kream RM. Targeting mitochondrial biogenesis for promoting health. Med Sci Monit. 2012 Mar;18(3):SC1-
    3. Gonzalez-Freire M, de Cabo R, Bernier M, Sollott SJ, Fabbri E, Navas P, Ferrucci L. Reconsidering the Role of Mitochondria in Aging. J Gerontol A Biol Sci Med Sci. 2015 Nov;70(11):1334-42.
    4. Trammell SA, Schmidt MS, Weidemann BJ, Redpath P, Jaksch F, Dellinger RW, Li Z, Abel ED, Migaud ME, Brenner C. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nat Commun. 2016 Oct 10;7:12948.
    5. Mitteldorf J. Nicotinamide Riboside —Where’s the Beef? http://joshmitteldorf.scienceblog.com/2014/11/17/nicotinamide-riboside-wheres-thebeef/.
    6. Yang Y, Sauve AA. NAD+ metabolism: Bioenergetics, signaling and manipulation for therapy. Biochim Biophys Acta. 2016 Dec;1864(12):1787– 1800.
    7. Schwartz L, Buhler L, Icard P, Lincet H, Steyaert JM. Metabolic treatment of cancer: intermediate results of a prospective case series. Anticancer Res.2014 Feb;34(2):973–80.
    8. Ryu D, Mouchiroud L, Andreux PA, Katsyuba E, Moullan N, Nicolet-Dit-Félix AA, Williams EG, Jha P, Lo Sasso G, Huzard D, Aebischer P, Sandi C, Rinsch C, Auwerx J. Urolithin A induces mitophagy and prolongs lifespan in C. elegans and increases muscle function in rodents. Nat Med.2016 Aug;22(8):879-88.
    9. Pellegrini L, Belcaro G, Dugall M, Corsi M, Luzzi R, Hosoi M. Supplementary management of functional, temporary alcoholic hepatic damage with Robuvit® (French oak wood extract). Minerva Gastroenterol Dietol. 2016 Sep;62(3):245–52.
    10. Vinciguerra MG, Belcaro G, Cacchio M. Robuvit® and endurance in triathlon: improvements in training performance, recovery and oxidative stress. Minerva Cardioangiol. 2015 Oct;63(5):403–9.
    11. Országhová Z, Waczulíková I, Burki C, Rohdewald P, Ïuraèková Z. An Effect of Oak-Wood Extract (Robuvit®) on Energy State of Healthy Adults-A Pilot Study. Phytother Res. 2015 Aug;29(8):1219–24.
    12. Natella F, Leoni G, Maldini M, Natarelli L, Comitato R, Schonlau F, Virgili F, Canali R. Absorption, metabolism, and effects at transcriptome level of a standardized French oak wood extract, Robuvit, in healthy volunteers: pilot study. J Agric Food Chem. 2014 Jan 15;62(2):443–53.
    13. Ventura-Clapier R, Garnier A, Veksler V. Transcriptional control of mitochondrial biogenesis: the central role of PGC-1alpha. Cardiovasc Res. 2008 Jul 15;79(2):208–17.
    14. Wright DC, Han DH, Garcia-Roves PM, Geiger PC, Jones TE, Holloszy JO. Exercise-induced mitochondrial biogenesis begins before the increase in muscle PGC-1alpha expression. J Biol Chem. 2007 Jan 5;282(1):194–9.
    15. Bauerly K, Harris C, Chowanadisai W, Graham J, Havel PJ, Tchaparian E, Satre M, Karliner JS, Rucker RB. Altering pyrroloquinoline quinone nutritional status modulates mitochondrial, lipid, and energy metabolism in rats. PLoS One.2011;6(7):e21779.
    16. Zong H, Ren JM, Young LH, Pypaert M, Mu J, Birnbaum MJ, Shulman GI. AMP kinase is required for mitochondrial biogenesis in skeletal muscle in response to chronic energy deprivation. Proc Natl Acad Sci U S A. 2002 Dec 10;99(25):15983–7.
    17. Lee CM, Aspnes LE, Chung SS, Weindruch R, Aiken JM. Influences of caloric restriction on age-associated skeletal muscle fiber characteristics and mitochondrial changes in rats and mice. Ann N Y Acad Sci. 1998 Nov 20;854:182–91.
    18. Jornayvaz FR, Shulman GI. Regulation of mitochondrial biogenesis. Essays Biochem. 2010;47:69–84.
    19. Bough KJ, Rho JM. Anticonvulsant mechanisms of the ketogenic diet. Epilepsia. 2007 Jan;48(1):43–58.
    20. Louter-van de Haar J, Wielinga PY, Scheurink AJ, Nieuwenhuizen AG. Comparison of the effects of three different (-)-hydroxycitric acid preparations on food intake in rats. Nutr Metab(Lond). 2005 Sep 13;2:23.
    21. McCarty MF. High mitochondrial redox potential may promote induction and activation of UCP2 in hepatocytes during hepatothermic therapy. Med Hypotheses.2005;64(6):1216–9.
    22. Nisha VM, Priyanka A, Anusree SS, Raghu KG. (-)–Hydroxycitric acid attenuates endoplasmic reticulum stress-mediated alterations in 3T3-L1 adipocytes by protecting mitochondria and downregulating inflammatory markers. Free Radic Res.2014 Nov;48(11):1386-96.
    23. Valerio A, Cardile A, Cozzi V, Bracale R, Tedesco L, Pisconti A, Palomba L, Cantoni O, Clementi E, Moncada S, Carruba MO, Nisoli E. TNFalpha downregulates eNOS expression and mitochondrial biogenesis in fat and muscle of obese rodents. J Clin Invest. 2006 Oct;116(10):2791–8.
    24. Liu J, Shen W, Zhao B, Wang Y, Wertz K, Weber P, Zhang P. Targeting mitochondrial biogenesis for preventing and treating insulin resistance in diabetes and obesity: Hope from natural mitochondrial nutrients. Adv Drug Deliv Rev. 2009 Nov 30;61(14):1343–52.
    25. http://www.totalhealthmagazine.com/Anti-Aging/Uncovering-the-Longevity-Secrets-of-the-ROCK-LOTUS.html.
  • Avoiding Diabetes

    Too much weight gain, too little exercise, bad eating habits, etc. account for the preponderance of cases of diabetes in Western countries.

    Most authorities argue that diabetes is largely lifestyle related. Too much weight gain, too little exercise, bad eating habits, etc. account for the preponderance of cases of diabetes in Western countries. Overall, the American diet is mineral-poor. We as a nation are not fond of green leafy vegetables or of whole grains and, as a result, a majority of all Americans consume, for example, inadequate amounts of magnesium. Supplementation with magnesium in a recent trial with overweight subjects for four weeks supported the hypothesis that dietary magnesium plays a beneficial role in the regulation of insulin and glucose homeostasis.1 Two other minerals of special importance for fending off diabetes are chromium and manganese.

  • Begin The New Year With a Full-tank of Wellness

    Are you literally running on empty after the holidays? It’s not only all those high-fat, high-salt, high-sugar celebratory over-indulgence meals, it’s most likely dehydration.

    Take the Following Facts to Heart, literally:

    Your body is composed of roughly 69 percent water. When you become even mildly dehydrated (even losing as little as two percent of water) here’s what can happen…

    1. Mood swings unrelated to other extenuating circumstances.
    2. Decreased energy levels and inability to rejuvenate stamina.
    3. Cognitive function decreases (brain-fog for example).

    The following conditions are caused or accelerated by dehydration and most people do not consider the consequences…

    • Diabetics and especially those who are not yet aware they are clinically diabetic. As blood sugar levels rise, your body attempts to eliminate excess glucose through increased urine output—causing more dehydration.
    • That female monthly menstrual cycle influences levels of body fluids, estrogen and progesterone swing up-anddown, making hydration even more important. For women who experience heavy periods, it’s not only blood they lose; it’s water as well.
    • If you must take prescription medications, be sure and check the list of side-effects before taking. Many meds actually have a diuretic effect—increased urine output puts you at higher risk of dehydration.
    • That fight-or-flight response of stress causes your adrenal glands to pump out stress hormones and can lead to chronic adrenal burnout. What most people don’t consider is that the adrenals also produce a hormone called aldosterone, which is responsible in regulating the body’s fluid and electrolyte levels. When chronic adrenal fatigue is present, the body’s production of aldosterone drops—triggering dehydration and low electrolyte levels. Keep in mind that electrolytes are the body’s “electrical system” so it’s no wonder messages get crossed or don’t communicate like in decreased cognitive function (brain-fog).
    • Irritable bowel syndrome (IBS) is a very challenging condition because its symptoms include nausea and chronic diarrhea—causing even more dehydration.

    The Way I See It…
    Hydration is SO easy and readily available…why would you deprive your body of a simple “fuel” to keep it running at optimum health and speed? The old excuse, “I don’t have time to drink all THAT water” is just that, an excuse, not a reason. Trick yourself anyway that works into drinking more water or herbal teas.

    I fill four quart-sized decanters each morning with water and/or herbal teas. I work very long hours and by the end of the day, my decanters are empty. However, the trick for me is to drink out of a “fat” straw. My sipper cup has a fat straw inserted and both are made of BPA-free material—no, bpa-free isn’t the total answer but for now at least not as toxic as the soft plastic varieties. I also have a stainless steel water bottle with built-in straw and water filter to avoid buying water in plastic, especially when traveling. When you drink out of a straw, your body craves twice as much water and you consume it with half the amount of effort—try it—it works! Remember that herbal teas and sparkling waters count as water as long as you don’t add anything like sugar. However, you can sweeten tea with a natural no-calorie alternative like Stevia or Lakanto (aka Monk Fruit).

  • Cinnamon

    A Supplement for Diabetes, Body Composition, Cardiovascular Health & Antioxidant Protection

    Don't you just love the smell and taste of cinnamon in a warm, gooey cinnamon bun? As it turns out, the cinnamon may actually provide you with some significant health benefits (although the same can't be said of the gooey bun; sorry). So let's take a closer look at cinnamon.

    Background
    The use of cinnamon for health is not new. In fact, cinnamon bark has been used for several thousand years in traditional Eastern and Western systems of medicine, for such purposes as anorexia, bloating, dyspepsia with nausea, flatulent colic, and spastic conditions of the GI tract.1 Cinnamon also has a history of traditional use in Korea, China and Russia for treating people with diabetes.2

    So what is it about cinnamon that gives it these medicinal properties? The answer is its natural constituents. Specifically, it is the volatile oils (such as eugenol and cinnamaldehyde) as well as the phenolic compounds (such as polyphenol type-A polymers).3,4

    Modern research
    In addition to traditional use, modern research has demonstrated a number of benefits resulting from cinnamon supplementation. These include improvements in blood sugar for type 2 diabetics, improvements in body composition (e.g., increased lean mass), improvements in cardiovascular parameters, and substantial antioxidant properties. Following is a brief overview of this research.

    Improvements in blood sugar
    In research by Khan et al5, subjects with type 2 diabetes who took 1, 3 or 6 grams of cinnamon per day for 40 days lowered fasting blood sugar by 18 to 29 percent. The highest dose produced the most rapid response, although the lowest dose produced the most sustained response over the course of the study.

    A more recent placebo-controlled, double-blind study6 was conducted on 79 patients with type 2 diabetes mellitus. Subjects were given 336 mg daily of a water-soluble cinnamon extract (corresponding to 3g of cinnamon powder) or a placebo for four months. Those using the cinnamon experienced a significant 10.3 percent reduction in fasting blood sugar, compared to a non-significant 3.4 percent reduction in the placebo group.

    In a placebo-controlled, double-blind study by Ziegenfuss et al7, 21 adults with metabolic syndrome (i.e., prediabetes) were given a water-soluble cinnamon extract (500 mg per day) or a placebo for 12 weeks. The results were that 83 percent of those given the extract experienced a significant decrease (about eight percent) in fasting blood sugar, compared to only 33 percent in the placebo group who experienced a decrease.

    Improvements in body composition
    In the aforementioned study by Ziegenfuss et al8, the subjects also experienced a significant alteration in body composition. Their body fat decreased by 0.7 percent, and their muscle mass increased by 1.1 percent. These changes took place without alterations in the diet or physical activity of the subjects.

    Improvements in cardiovascular parameters
    In the previously cited study by Khan et al9, type 2 diabetics who were given 1, 3 or 6 grams of cinnamon a day for 60 days experienced significant drops in triglycerides (23 to 30 percent), low-density lipoprotein (LDL) cholesterol (7 to 27 percent), and total cholesterol (12 to 26 percent).

    In the Ziegenfuss et al10 study, cinnamon resulted in a 3.8 percent reduction in systolic blood pressure. Likewise, other research11 demonstrated that cinnamon was able to reduce systolic blood pressure in spontaneously hypertensive rats.

    Substantial antioxidant properties
    As stated previously, cinnamon contains polyphenols. This is important since polyphenols are potent antioxidant compounds, which can help to reduce the oxidative damage caused by free radicals.12 According to Webb13, a recent study assessed antioxidant status and oxidative damage in 11 obese, prediabetic subjects given a water-soluble cinnamon extract, compared to10 obese, prediabetic subjects given a placebo. Those who received the cinnamon experienced a 14 percent reduction in markers of oxidative damage, as well as an increase in markers of total antioxidant capacity.

    Cinnamon Safety
    When used orally and appropriately, cinnamon is a safe supplement.14 As a matter of fact, cinnamon has Generally Recognized as Safe (GRAS) status in the United States.15 In pregnancy, cinnamon is likely safe when consumed in amounts commonly found in foods16, but may not be safe when used orally in amounts greater than those found in foods.17

    Cinnamon Dosage
    Based upon the research discussed, an appropriate dose of cinnamon would range between 500-3000 mg daily.

    References

    1. Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
    2. Kim SH, Hyun SH, Choung SY. Anti-diabetic effect of cinnamon extract on blood glucose in db/db mice. Journal of Ethnopharmacology 2006 104:119-123.
    3. Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
    4. Webb D. A scientific review: Cinnamon and its role in diabetes. Sarasota, FL: Integrity Nutraceuticals International; n.d.
    5. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26:3215-8.
    6. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. European Journal of Clinical Investigation 2006; 36:340-344
    7. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
    8. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
    9. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26:3215-8.
    10. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
    11. Preuss HG, Echard B, Polansky MM, Anderson R. Whole Cinnamon and Aqueous Extracts Ameliorate Sucrose-Induced Blood Pressure Elevations in Spontaneously Hypertensive Rats. Journal of the American College of Nutrition 2006; 25(2):144-150.
    12. Shobana S, Naidu KA. Antioxidant activity of selected Indian spices. Prostaglandins Leukot Essent Fatty Acids 2000; 62(2):107-110.
    13. Webb D. A scientific review: Cinnamon and its role in diabetes. Sarasota, FL: Integrity Nutraceuticals International; n.d.
    14. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    15. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.
    16. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.
    17. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  • Coconut Water May Help Diabetes

    Here's a surprise. Brand new research published in the February 2015 Journal of Medical Food suggests that coconut water improves diabetes. The catch is that it was a rat study, not a human study. Nevertheless, many animal model studies extrapolate to humans so don't dismiss the research just yet okay?! The rats in the study got diabetes from a potent compound called alloxan. Even though alloxan has only been proven to induce diabetes in rats, I'm bothered by the fact you're eating alloxan every single day without knowing it! Alloxan is a potent compound that destroys beta cells in rats. The question is can it do that to humans?

    Alloxan is pervasive in our food supply and there's a ton of research correlating its ability to induce diabetes in clinical trials, that's why it's used in all the studies. Trust me, they are not giving all these lab rats a plate of muffins, they are using "alloxan monohydrate" and injecting it. Then the rats get diabetes, and testing begins. Alloxan is a by-product of the flour-bleaching process that makes flour "white." You can make a choice to buy unbleached or whole wheat flour, instead of white flour that might be contaminated.

    Let me be clear, I may not like that we eat alloxan in white flour products, but it has never been tied to diabetes in humans, just critters. What should you do if you just got diagnosed with diabetes? First, eliminate carbohydrates, in particular the white flour products that have alloxan. Second, clean out your pantry and become acquainted with real food again. Third, grab a copy of my diabetes book, I tell you secrets that you deserve to know, like how statin drugs can raise blood sugar and what to do!

    Next and this is very important, you can eat nutrient-rich foods that support healthy blood sugar and counter alloxan-induced damage. Some good nutrients include vitamin C, vitamins B1, B2, B5, B6 and folate. Zinc helps with vision and skin. Lipoic acid is a supplement that helps with nerve pain. Chromium may help balance blood sugar levels.

    Now back to coconut water, we know it is an awesome electrolyte replenishment drink! But it's not just great for people with diarrhea or those who sweat. Thanks to new research, we see that coconut water reduces blood sugar levels as well as hemoglobin A1c levels (in alloxan-induced diabetic rats). It stops the glycation process that elevated blood sugar causes. That's good because glycation ages you faster and here, something so natural and tasty impedes the "rusting" in your body. Change your diet back to a more pristine and straight-forward diet. Do you want to keep eating a known poison or not? That's what it boils down to. For more information about natural cures for diabetes, visit www.DiabetesSummit.net a free, online event where you can listen to 40 world leading experts (including me) talk about diabetes and give you free advice.

  • Curcumin and Curry Spice Help Diabetes and Cancer

    As the snowy cold weather begins to roll into Colorado, I crave warmer, heartier meals like chili, stews and brisket. Juicing kale and celery when it's 4 degrees outside doesn't cut it. So at this time of year, garlic and curry go in everything I eat. Let's talk curry today. Penang, red or green curry, it's all good with me! Curry sounds like it's one spice, but it's actually a blend of spices, and it always contains some turmeric spice.

    Turmeric comes from the ginger family. This yellow-orange spice was first used as a dye until its medicinal properties were uncovered. Our research today proves turmeric positively benefits hundreds of health conditions, making it a healthy and tasty sprinkle for any dish. Do I want it right now? Yes please!

    You can buy the spice called turmeric all by itself if you don't like curry. Supplements of turmeric are sold everywhere. And you'll also find "curcumin" which is one potent extract of turmeric.

    Curcumin may prevent or improve age-related cognitive decline, dementia, and mood disorders. This is not wishful thinking, it's true. A randomized, double-blind, placebo-controlled trial observed 60 adults between the ages of 60 and 85. After about one hour of their curcumin dose, these adults enjoyed a higher attention span and better memory than those who swallowed the dud pill, the placebo. After four weeks of curcumin supplements, memory, mood, alertness, and contentedness were considerably better in the participants.

    Curcumin is a hot supplement, not spicy hot, but "hot" in the sense that research is conducted frequently. I found more than 900 published research papers pertaining to curcumin's anti-cancer activity. One of these papers found that curcumin has the ability to make some cancer cells commit suicide. Basically, curcumin programs the cell to die! That's a good thing, you want those cancer cells to go bye-bye! Technically, we call this "apoptosis." Cancers that are resistant to multiple chemotherapeutic agents seem to still respond to curcumin, at least in mouse studies. Because of curcumin's long-term record of safety and low risk of side effects, I think it's a great natural adjunct to many protocols, especially for breast and prostate cancer. It's a strong anti-inflammatory.

    Type 2 diabetes has reached epidemic proportions. Diabetes Care, the journal of the American Diabetes Association, published a study about curcumin's ability to prevent pre-diabetic patients from becoming full-blown diabetics. Results after 9 months showed 100% success! No one progressed. Further, curcumin-treated patients had better pancreatic beta cell function and higher adiponectinin. Excellent! You know, I'm a pharmacist and I'll tell you there isn't one drug behind the counter that competes.

    Curcumin is the 'Kardashian' of herbs. It's spicy, notorious, and a little goes a long way if you know what I mean. Too much is not good, it's a laxative. Most importantly, curry, and curcumin are considered effective and safe by most physicians. I'd ask about supplementing with it if you have inflammatory conditions, especially autoimmune ones like rheumatoid, ulcerative colitis, Crohn's and psoriasis.

  • DiaMetrix Blood Sugar Support

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  • Macronutrients Part 2 - Carbohydrates and Fiber

    Carbohydrates are the most abundant biomolecules on our planet and in our food supply. They exhibit some of the largest differences in their metabolism by different members of the animal kingdom. At one extreme, herbivores can almost completely break down dietary plant material with the help of beneficial bacteria that dwell within their gastrointestinal tract; at the other extreme, true carnivores can’t process most dietary carbohydrates. Humans fall somewhere in between; we derive a great deal of nutrition out of some dietary carbohydrates, but are unable to process others.

    In our diets, digestible carbohydrates consist of sugars and starches, while the indigestible carbohydrates are the fibers and resistant starches1. Dietary sugars are predominantly monosaccharides (sugars consisting of a single unit, such as glucose and fructose) or disaccharides (sugars consisting of two monosaccharides linked together, such as sucrose and lactose). Starches are long chains (polymers) of many linked monosaccharide molecules, usually glucose.

    Monosaccharides are the preferred form by which sugars are absorbed from the intestines, therefore, starches and disaccharide sugars (sucrose, lactose) must be broken down by digestive enzymes before assimilation. Starches are fairly easily digested by the action of pancreatic enzymes, while disaccharide sugars are degraded by enzymes that dwell on the surface of the small intestines. The familiar lactose maldigestion (“lactose intolerance”) experienced by many individuals actually results from the lack of one of these intestinal enzymes (lactase, the enzyme that breaks down lactose into glucose and galactose).

    Fibers and resistant starches are carbohydrates as well. Like starches, fiber is composed of polymers of linked monosaccharide sugars. Unlike starches, however, fibers and resistant starches are not used as a source of calories; humans lack the necessary enzymes to break down resistant starches and fibers, therefore, they are not absorbed. Some soluble fiber and resistant starch is broken down by intestinal bacteria, the rest passes through the gastrointestinal tract intact.

    The majority of dietary carbohydrates are obtained from plant sources (fruits, vegetables, grains). In contrast to animal tissues, which are held together by mostly proteins, plants cells are held together by cellulose and lignin, two types of dietary fiber. The edible portions of plants are usually those that contain large amounts of storage carbohydrates, such as the kernels of grains (which store starches) or fruits (which store sugars). Smaller amounts of carbohydrates are found in animal products; carbohydrates constitute only about one percent of the mammalian body2.

    ROLES OF DIETARY CARBOHYDRATES AND FIBER IN NORMAL METABOLISM
    Although they do not have the diversity in human metabolism as do proteins, dietary carbohydrates and fibers still have a number of fates:
    Fuel Source and Fuel Storage.

    As versatile as humans are in obtaining energy from a variety of macronutrients, the preferred energy source in our metabolism is the carbohydrate glucose. Under normal conditions, the brain uses glucose as an energy source almost exclusively, and most other tissues rely heavily on it. To accommodate the body’s need for glucose, most sugars and starches can be converted into glucose as they are absorbed and distributed amongst various tissue following a meal. Additionally, some amino acids from digested protein can also be converted into glucose (in true carnivores like cats, this is where most glucose comes from).

    Unlike other cellular energy sources (amino acids and fatty acids), glucose can be converted into energy in the absence of oxygen (anaerobic glycolysis). This makes glucose a critical source of quick energy during times when oxygen is scarce, such as during intense exercise.

    Glucose can also be stored for later usage, in the form of glycogen (“animal starch”). Glycogen is abundant in the liver, which stores about a day’s worth of glucose in order to provide enough energy to fuel the brain during periods between meals. Glycogen is also used to store glucose for use in muscles, which rely on it for quickly generating energy. If the dietary intake of carbohydrates exceeds what is needed for immediate energy and glycogen reserves, then the excess is converted to fat for long-term storage.

    Precursors to other biomolecules. Carbohydrates are used to make other important biomolecules. These include: glycosaminoglycans (such as chondroitin, keratin, and hyaluronic acid), important constituents of joints and connective tissues; nucleic acids (DNA and RNA are partially constructed from the sugar ribose); as well as other amino acids and fatty acids for making new cellular proteins and cell membranes.

    Stimulation of digestion. Fiber, despite its non-nutritive value, still has evolved important roles in human physiology. The bulk of insoluble fibers helps digested food to move more easily through the intestines and be readily eliminated from the body. Soluble fibers and resistant starches can provide a source of energy for intestinal bacteria, which themselves provide a number of health benefits, including the stimulation of immunity, protection from pathogenic bacteria, and enhanced absorption of minerals from the diet. Prebiotics, a subset of soluble fiber, have gained attention in recent years in their ability to be selectively fermented by gut flora for a diversity of potential health-promoting benefits3.

    SPECIFIC HEALTH BENEFITS OF CARBOHYDRATES AND FIBER
    Many of the health benefits realized by modifying carbohydrate intake involve altering patterns of consumption: reducing intake of sugars, and increasing intake of fiber. For example, recent emphasis on increased intake of whole grains (which contain significantly more fiber, phytonutrients, and protein than do refined cereal flours) has resulted from several studies which suggest that its consumption may reduce the risk of certain cancers, diabetes, and cardiovascular disease4. Fiber intake, in particular, has been the subject of thousands of studies in humans and animals, in part for its ability to successfully reduce the risk of several diseases by different mechanisms:

    Reducing Chronic Low-level Inflammation. In contrast to the conspicuous inflammation that is characteristic of an injury or infection, chronic low-level inflammation can progress unnoticed. This potentially silent affliction has been associated with the progression of several diseases, including cancer, diabetes, cardiovascular, and kidney diseases. In an analysis of 7 studies on the relationship between weight loss and inflammation, increased fiber consumption correlated with significantly greater reductions in C-reactive protein (CRP), one indicator of low-level inflammation5. In these studies, daily fiber intakes ranging from 3.3 to 7.8 g/MJ (equivalent to about 27 to 64 g/day for a standard 2000 kcal diet) reduced CRP from 25–54 percent in a dose-dependent fashion. The Women’s Health Initiative Study also found significant inverse relationships with dietary soluble and insoluble fiber (over 24 g/day) and certain markers of chronic inflammation6.

    Promoting Healthy Blood Pressure. It is not clear how dietary fiber reduces blood pressure, but many studies have observed this trend. Fiber, when taken with a meal, may by reducing the glycemic index of foods and lowering the response of insulin following a meal (insulin may play a role in blood pressure regulation). Soluble fibers may also increase mineral absorption (such as calcium, magnesium, and potassium; all important for healthy blood pressure) by feeding intestinal flora, which lowers intestinal pH and establish a favorable acidic environment for mineral absorption7. Whatever the cause, at least thirty randomized, controlled clinical trials examined the effects of fiber in both hypertensive and normotensive patients. Across all participants, increased fiber intake demonstrated modest average reductions in systolic (1.13–1.15 mm Hg), and diastolic (1.26–1.65 mm Hg) blood pressure89. Amongst hypertensive patients, the average blood pressure reductions were much larger: A significant average reduction in both systolic (-5.95 mm Hg) and diastolic (-4.20 mm Hg) blood pressure was observed over 8 weeks in trials where hypertensive participants increased their daily fiber intake9.

    Promoting Healthy Levels of Blood Lipids. High-fiber diets have been associated with lower prevalence of cardiovascular disease (10). When included as part of a low-saturated fat/low cholesterol diet, dietary fiber can lower low-density lipoprotein cholesterol (LDL-C) by 5–10 percent in persons with high cholesterol, and may reduce LDL-C in healthy individuals as well10. Dozens of controlled clinical trials have shown the cholesterol-lowering potential of dietary fibers including soluble oat fiber, psyllium, pectin, guar gum, b-glucans from barley, and chitosan3,12,13.

    Soluble fibers lower cholesterol by several potential mechanisms (3). They may directly bind cholesterol in the gut, preventing its absorption. The high viscosity of soluble fiber and its ability to slow intestinal motility may help to limit cholesterol and fat uptake as well. Fiber can also increase satiety, which can limit overall energy intake14,15. Lowering Uric Acid. Elevated blood uric acid (hyperuricemia) is a risk factor for kidney disease, cardiovascular diseases, and diabetes; it is also a primary cause for gout16. Fiber intake may lower blood uric acid levels. A significant inverse relationship between fiber intake and hyperuricemia risk was established by analyzing dietary fiber intake data from over 9000 otherwise healthy adults participating in the National Health and Nutrition Examination Survey (NHANES) from 1999–2004. Based on these data, participants with high fiber diets (over about 19 grams fiber/day for the average 2000 kcal diet) had a 55 percent reduction in hyperuricemia risk compared to those on lower fiber diets (<9.2 g fiber/day)17. While these mechanisms for this reduction is unknown, dietary fiber may reduce the absorption of purines from the diet, one of the inciting factors for hyperuricemia.

    HOW MUCH CARBOHYDRATES AND FIBER SHOULD I BE GETTING?
    The amount and composition of carbohydrates in the “ideal” diet is amongst the most heavily debated topics in nutrition. There are scientifically-substantiated merits to both the “low-carb” and “low-fat, high-carb” diets in terms of reducing disease risk and maintaining a healthy body mass index (these will be discussed in greater detail in a future article). The common ground between the two schools of thought is that the average Western diet probably contains too little fiber, and too much refined grains and added sugar. A low-fiber/high-sugar diet, when coupled with excessive caloric intake, has been associated with significant increases in the risk for a number of ailments, including obesity, insulin resistance/type II diabetes, and cardiovascular disease.

    As mentioned previously, the benefits of dietary fiber are numerous. The average daily fiber intake in the American diet, based on data from 2007–2008 NHANEs survey, is about half of the 28 grams/day recommendation by the Institute of Medicine (IOM). Significant numbers of people consume even less than the national average. The highest intakes of dietary fiber are associated with the lowest disease risks; for several observational studies, the greatest risk reductions required intakes exceeding the IOM recommendations.

    In contrast, the American diet contains no shortage of refined grains or sugars. The U.S. Department of Agriculture estimates average grain consumption at about 33 percent more than 6 oz./day recommended in its Dietary Guidelines for Americans. Most of this grain is refined; the same group estimates Americans consume only one-third of the recommended 3 oz./day of whole grains18,19.

    Analysis of data from the last NHANEs survey (2007–2008) determined that Americans consume an average of 120 grams/day of total sugars (about 30 teaspoons), most of which are added sugars. This amounts to approximately 480 kilocalories of energy per day. Most of these sugars come from sweetened carbonated beverages (~37 percent); other top sources include desserts and fruit drinks (fruitades and fruit punches). While arguments can be made that it is the added fructose or corn syrup are particularly dangerous to health (there is evidence that supports and refutes this hypothesis), or that sugar is additive and contributes to overeating (animal models may support this claim), added sugar clearly contributes a significant amount of calories to the average diet, and in many cases displaces essential nutrients20,21.

    To read the series on Macronutrients:

    References:

    1. Fardet A. New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutr Res Rev 2010 Jun.;23(1):65–134.
    2. Engelking L. Textbook of Veterinary Physiological Chemistry. Updated 2nd ed. Burlington, MA: Academic Press; 2011.
    3. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999 Jan.;69(1):30–42.
    4. Higgins JA. Whole grains, legumes, and the subsequent meal effect: implications for blood glucose control and the role of fermentation. J Nutr Metab 2012;2012:829238.
    5. North CJ, Venter CS, Jerling JC. The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr 2009 Aug.;63(8):921–33.
    6. Ma Y, Hébert J, Li W, Bertone-Johnson E. Association between dietary fiber and markers of systemic inflammation in the Women’s Health Initiative Observational Study. Nutrition 2008;
    7. Greger J. Nondigestible carbohydrates and mineral bioavailability. J Nutr 1999.
    8. Streppel MT, Arends LR, van t Veer P, Grobbee DE, Geleijnse JM. Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med 2005 Jan.;165(2):150–6.
    9. Whelton SP, Hyre AD, Pedersen B, Yi Y, Whelton PK, He J. Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. J. Hypertens 2005 Mar.;23(3):475–81.
    10. Badimon L, Vilahur G, Padro T. Nutraceuticals and atherosclerosis: human trials. Cardiovasc Ther 2010 Aug.;28(4):202–15.
    11. Anderson J, Randles K. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr 2004.
    12. AbuMweis SS, Jew S, Ames NP. -glucan from barley and its lipid-lowering capacity: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr 2010 Dec.;64(12):1472–80.
    13. Baker WL, Tercius A, Anglade M, White CM, Coleman CI. A meta-analysis evaluating the impact of chitosan on serum lipids in hypercholesterolemic patients. Ann Nutr Metab 2009;55(4):368–74.
    14. Brighenti F, Casiraghi M, Canzi E. Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood lipids in healthy male volunteers. Eur J Clin Nutr 1999; Pages 726–33.
    15. Li S, Guerin-Deremaux L, Pochat M, Wils D, Reifer C, Miller LE. NUTRIOSE dietary fiber supplementation improves insulin resistance and determinants of metabolic syndrome in overweight men: a double-blind, randomized, placebo-controlled study. Appl Physiol Nutr Metab 2010 Dec.;35(6):773–82.
    16. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum 2011 Oct.;63(10):3136–41.
    17. Sun SZ, Flickinger BD, Williamson-Hughes PS, Empie MW. Lack of association between dietary fructose and hyperuricemia risk in adults. Nutr Metab 2010;7(1):16.
    18. Grotto D, Zied E. The Standard American Diet and its relationship to the health status of Americans. Nutr Clin Pract 2010 Dec.;25(6):603–12.
    19. U. S. Department of Agricuture USDOHAHS. Dietary Guidelines for Americans 2010. 2011 Jan.;:1–112.
    20. Avena NM, Rada P, Hoebel BG. Sugar and fat bingeing have notable differences in addictive-like behavior. Journal of Nutrition 2009 Mar.;139(3):623–8.
    21. Berner LA, Avena NM, Hoebel BG. Bingeing, self-restriction, and increased body weight in rats with limited access to a sweet-fat diet. Obesity (Silver Spring) 2008 Sep.;16(9):1998–2002.

  • Moducare: For a strong immune system

    Moducare® is a patented blend of plant sterols and sterolins, and the only sterol/sterolin product clinically proven to be effective in immune modulation. Moducare can be considered an adjunct to help shift immune responses to a more balanced state. It enhances the activity of various immune cells and increases the killing ability of specialized cells, called Natural Killer cells, responsible for immune surveillance. Moducare also has anti-inflammatory properties and helps reduce the effects of stress on the immune system by managing the release of cortisol, a stress hormone. Moducare is well-tolerated, with no known interactions with either prescribed medications or natural supplements. Plus, long-term studies have found that it has no significant negative side effects.

    Human Research Proves Plant Sterols Action
    We call sterols the forgotten nutrient because although thousands of research studies have been preformed on this nutrient, it has not been given the recognition it deserves.

    Over 4,000 published studies to date have examined phytosterols and 140 of these studies are double-blind, placebo-controlled human trials. Rheumatoid arthritis, cervical cancer, diabetes, immune function, prostate problems, HI V, herpes, hepatitis C, allergies, stress-induced immune suppression, chronic fatigue, tuberculosis, breast cancer, and high cholesterol are only some of the diseases where sterols and sterolins have been shown to be extremely effective.

    Plant sterols and sterolins are essential for modulating (balancing) the immune system, enhancing it if it is under active, and reducing it when it is over stimulated. They perform the balancing act very effectively. Patrick J.D. Bouic, Ph.D., has shown in his research that plant sterols and sterolins are effective in enhancing an under active immune system and/or decreasing an overactive one. This happens without the side effects associated with pharmaceutical substances such as interferon, prednisone or methotrexate. Sterols and sterolins have been evaluated in a 25,000-person safety study and found to have no side effects, no drug interactions, and no toxicity. It is safe for children, as well as pregnant and nursing mothers. Only those who have had an organ transplant cannot take plant sterols because they may stimulate rejection.

    Plant sterols and sterolins also increase the number and action of natural killer cells (our cancer fighters) and increase our DHE A levels naturally. They are also able to reduce the stress hormone cortisol and the proinflammatory immune factor, interleukin-6, and tumor necrosis factor alpha (TN F-a). Interleukin-6 and (TN F-a) are increased in autoimmune disorders, osteoporosis, over exercising, fibromyalgia, and osteoarthritis. Reduction of this inflammatory agent is the key to halting symptoms and pain. This is exactly what plant sterols and sterolins do.

    Sterols—Great Stress Busters
    Chronic stress is so negative that it can promote and exacerbate most disease. Numerous studies have linked our ability to deal with stress to our susceptibility to the common cold as well as more serious diseases such as cancer. Adults who have recently lost a loved one or have been divorced or separated tend to have the highest cancer rates. Unrelieved stress gradually weakens and suppresses our immune system, causing disease. Stressful situations promote the release of cortisol, the stress hormone which in turn causes the secretion of a negative immune factor interleukin-6. Abnormal levels of IL-6 are associated with osteoporosis, autoimmune disease, asthma, inflammatory diseases including arthritis, and more. We know that phytosterols are effective in reducing IL-6, cortisol and other negative immune factors. They also improve DHEA, a hormone known to help fight the effects of stress.

    An overview follows of a few of the outstanding studies published.

    Sterols Lower Cholesterol
    The rapid cholesterol-lowering effects of phytosterols have been reported in over 400 studies. Beta-sitosterol is very similar in structure to cholesterol except that it has an extra ethyl group on the side chain. Due to this similarity, it interferes with the absorption of the cholesterol found in our foods as well as the cholesterol produced by the body. By including phytosterol-rich foods or supplements containing sterols, we can normalize cholesterol much faster than with the common cholesterol-lowering drugs.

    Sterols Halt Hepatitis C
    Hepatitis C is now occurring in epidemic proportions. Over four million North Americans are infected with hepatitis C. Liver specialists are overwhelmed as they struggle to deal with the increase in the incidence of this disease. Hepatitis C is the leading cause of liver transplants in North America. Physicians using sterols and sterolins to treat hepatitis C have already shown that with 90 days of the sterols and sterolins treatment liver enzymes and viral load normalize.

    Sterols, Heart Disease and DHEA
    A team of Canadian researchers discovered that an error in the regulation of certain immune cells that fight bacterial infections may be implicated in heart attacks and strokes. In a study published in the International Journal of Immunopharmacology, plant sterols and sterolins are shown to improve the ability of the immune system to fight bacterial infections. Sterols and sterolins, not antibiotics, may be the way to treat bacterial-induced heart disease.

    Prostate Problems Eliminated
    Urologists in Germany have been using plant sterols and sterolins for over two decades for the treatment of enlarged prostate. In one double-blind, placebo-controlled study of 200 patients with an average age of 65 and with BPH, subjects were given sterols and sterolins for six months. The treatment group showed a rapid reduction of the symptoms mentioned above and an increase in peak urinary flow and a decrease in inflammation. When does a health food product become mainstream? Do 4,000 medical studies constitute good scientific evidence of a nutrient’s effectiveness? We believe plant sterols and sterolins will change the way we treat disease in the future. Instead of treating symptoms, we will get directly to the source of the symptoms and repair the cause of the disease.

  • Nutraceuticals for Diabetes

    There are two primary types of diabetes: type 1 and type 2. Both types result in high levels of blood sugar levels, which may manifest itself through any of the following symptoms: increased thirst and an increased need to urinate; feeling edgy, tired, and sick to your stomach; and having an increased appetite (but loss of weight). In addition, other symptoms may include: repeated or hard-to-heal infections of the skin, gums, vagina, or bladder; blurred vision; tingling or loss of feeling in the hands or feet; and dry, itchy skin. If left uncontrolled, high blood sugar may result in a variety of serious complications.

    Glycosylated Protein
    Many of these complications are the result of glycosylated protein (GP). GP simply means that sugar (glucose) has attached itself to protein. For example, blood sugar can attach itself to the protein in your red blood cells’ hemoglobin and form glycosylated hemoglobin (HbA1c). Virtually all proteins are glycosylated to some degree. However, if this process continues to excess, eventually you end up with compounds called Advanced Glycosylation End Products (AGE). These AGE become permanent fixtures in our cells. AGE impregnated cells are very reactive and react with one another, and other proteins. In the case of blood capillaries, they can result in the walls of the capillaries thickening, eventually causing the vessels to be blocked off. This is the underlying cause of kidney complications (nephropathy) and eye complications (retinopathy). Unfortunately, the more blood sugar, the more glycosylated proteins.

    Sorbitol
    Another mechanism by which complications in diabetes result is excessive cellular sorbitol (a type of sugar-alcohol). Many cells in the body do not rely on insulin for glucose uptake. When you have hyperglycemia, you actually get high sugar levels inside these cells, which cause sorbitol to be produced in high concentrations. Intracellular sorbitol disrupts the pressure balance between the inside and outside of the cell, causing water to enter. This swelling of nerve cells is what is believed to be, at least in part, responsible for the nerve damage (neuropathy) caused by diabetes. (This does not mean that if you consume sorbitol in foods that it will have the same effect—it won’t.)

    Type 1 Diabetes
    Type 1, immune-mediated diabetes (formerly called insulin-dependent diabetes), is a disease that affects the way your body uses food. In type 1 diabetes your body destroys the cells in the pancreas that produce insulin, usually leading to a total failure to produce insulin. It typically starts in children or young adults who are slim, but can start at any age. Without insulin, your body cannot control blood levels of sugar. And without insulin, you would die. So people with type 1 diabetes give themselves at least one shot of insulin every day. An estimated 500,000 to one million Americans have this type of diabetes today. Conventional medical treatment for type 1 diabetes includes insulin injections, and diet regulation.

    Type 2 Diabetes
    Type 2 diabetes used to be called non-insulin-dependent diabetes. The most common type of diabetes, it affects about 15 million Americans. Nine out of ten cases of diabetes are type 2. It usually occurs in people over 45 and overweight, among other factors. When you have type 2 diabetes, your body does not make enough insulin—or your body still makes insulin but can’t properly use it. Without enough insulin, your body cannot move blood sugar into the cells. Sugar builds up in the bloodstream. Conventional medical treatment for type 2 diabetes includes any of the following, alone or in combination: insulin injections, oral drugs, or diet alone.

    Following is a discussion about dietary supplements that may help diabetics to gain greater control over their blood sugar levels, reduce the long-term detrimental effects of high blood sugar levels, or both.

    Chromium
    Chromium levels can be below normal in patients with diabetes.1,2 In a randomized, placebo-controlled study3, 180 men and women with type 2 diabetes were divided into three groups and supplemented with: 1) placebo, 2) 200 mcg chromium daily, or 3) 1,000 mcg chromium daily (from chromium picolinate for both doses). Subjects continued to take their normal medications and were instructed not to change their normal eating and living habits. The results were that both doses of supplemental chromium had significant beneficial effects on HbA1c, glucose, insulin, and cholesterol variables, although the benefits were greater with the higher dose.

    Other studies show that taking chromium picolinate orally can decrease fasting blood glucose, decrease HbA1c levels, decrease triglyceride levels, and increase insulin sensitivity in people with type 2 diabetes.4,5 Some evidence also suggests that chromium picolinate might decrease weight gain and fat accumulation in type 2 diabetes patients who are taking a sulfonylurea.6 Higher chromium doses (1,000 mcg) might be more effective and work more quickly.7 Higher doses might also reduce triglyceride and total serum cholesterol levels in some patients.8,9 Additional research demonstrated that chromium picolinate might have the same benefits in patients with type 1 diabetes10 and in patients who have diabetes secondary to corticosteroid use.11

    Banaba
    Banaba is the common name for Lagerstroemia speciosa, a traditional herbal medicine used among diabetics in the Philippines.12 Research done on Banaba extract has demonstrated that it has an “insulin-like principle” as well as an ability to reduce blood sugar. At least one component of this insulin-like principle is thought to be corosolic acid, although Banaba also contains other like candidates including ellagitannins, lagerstroemin, flosin B, reginin A. As a matter of fact, a recent study identified ellagitannins from Banaba as activators of glucose transport.13

    One of the Banaba studies was conducted on hereditary diabetic mice. The results showed blood sugar increases were suppressed, and the level of serum insulin and the amount of urinary excreted glucose were also lowered in mice fed Banaba extract. The researchers suggested Banaba extract has beneficial effects on control of blood levels of glucose in non-insulin dependent diabetes mellitus.14

    Twelve diabetic subjects taking 48 mg of the Banaba extract were tested in a randomized, double-blind crossover study. This study confirmed that a Banaba extract promotes normal blood glucose metabolism in people with type 2 diabetes, and also showed that Banaba extract’s benefits were sustained for several weeks even after discontinuation of the supplement.15

    Another crossover, placebo-controlled clinical study with 24 subjects found similar results. Specifically, Banaba extract was effective in reducing blood glucose levels even in short-term (4 weeks) treatment, with no signs of adverse effects. Furthermore, even a one-time dose leaves a memory-effect for blood glucose control. Compared to the placebo group, a statistically significant drop in the average blood glucose level is observed with the administration of Banaba extract.16

    Gymnema Sylvestre
    Animal studies have demonstrated that the herb Gymnema sylvestre is capable of lowering blood glucose levels, improving glucose utilization, and increasing insulin levels in diabetes.17,18,19,20

    The latter benefit was found to be a function of Gymnema’s apparent ability to repair/regenerate beta cells, the parts of the pancreas responsible for producing insulin.21

    Of greater significance to diabetic patients is the research conducted on humans. In one study, 22 type 2 diabetic patients received Gymnema for 18–20 months, as a supplement to the conventional oral drugs. During Gymnema supplementation, the patients showed a significant reduction in blood glucose, glycosylated hemoglobin and glycosylated blood proteins; and conventional drug dosage could be decreased. As a matter of fact, five of the 22 diabetic patients were able to discontinue their conventional drug and maintain their blood glucose homeostasis with Gymnema alone. The researchers concluded, “These data suggest that the beta cells may be regenerated/repaired in type 2 diabetic patients on [Gymnema] supplementation. This is supported by the appearance of raised insulin levels in the serum of patients after [Gymnema] supplementation.”22

    In a similar study, Gymnema was administered to 27 patients with type 1 diabetes, who were also on insulin therapy. The results were that insulin requirements came down together with blood glucose and glycosylated hemoglobin and glycosylated blood protein levels. Blood fats also returned to near normal levels with Gymnema therapy. Type 1 diabetic patients who were just on insulin therapy (no Gymnema), showed no significant reduction in serum lipids, glycosylated hemoglobin or glycosylated blood protein when followed up after 10–12 months. The researchers of this study concluded, “Gymnema therapy appears to enhance endogenous insulin, possibly by regeneration/revitalization of the residual beta cells in insulindependent diabetes mellitus.23

    Bitter Melon
    Bitter melon (Momordica charantia) is a tropical vegetable widely cultivated in Asia, Africa and South America, and has been used extensively in traditional folk medicine as a remedy for diabetes. This traditional use has also been validated by clinical research. In one study, Bitter melon was found to significantly improve the glucose tolerance of 73 percent of patients with adult-onset diabetes (type 2).24 During another study, Bitter Melon significantly reduced blood glucose concentrations during a glucose tolerance test in type 2 diabetics.25 Other research has identified the protein component of Bitter Melon that have the blood sugar lowering effects, and those researchers have stated that it is very effective for that purpose when administered to “gerbils, langurs, and humans.”26

    Alpha Lipoic Acid
    A significant amount of research has been conducted on the natural antioxidant Alpha Lipoic Acid (ALA) in the treatment of diabetes. In one study, seventy-four patients with type-2 diabetes were given either a placebo, or ALA. When compared to the placebo group, those receiving the ALA had significantly greater insulin-sensitivity, and improvement in insulin-stimulated glucose disposal. The researchers logically concluded, “The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes.”27 Another benefit of ALA use in diabetics has to do with diabetic neuropathy. In one study on type 2 diabetics, ALA treatment was associated with “a favorable effect on neuropathic deficits without causing significant adverse reactions.”28 In another two-year study, ALA “appeared to have a beneficial effect on several attributes of nerve conduction” in a group of type 2 diabetic patients.29 Additional research on diabetics has shown that ALA has been able to improve other aspects of diabetic neuropathy, 30,31 including improvements in neuropathy symptoms.32,33,34

    Another important consideration is that oxidative stress caused by free radicals can exacerbate the diabetic condition. Research provides evidence that, in type 2 diabetics, treatment with ALA significantly improves antioxidant defense35—even in patients with poor blood sugar control and albuminuria (i.e., too many serum proteins in the urine).36

    Finally, one of the most important benefits offered to diabetics by ALA is the fact that it has been shown to enhance the disposal of blood sugar in patients with type 2 diabetes, which gives it great potential as a blood sugar lowering agent.37 In a related study of lean and obese diabetic patients treated with ALA, the ALA prevented increases in metabolites that are typically associated with high blood sugar, and also increased blood sugar effectiveness.38

    Co-enzyme Q10
    Research has shown that some diabetic patients who use diet to control their blood sugar may have a deficiency of Co-enzyme Q10 (CoQ10), which may be further exacerbated by certain commonly used antidiabetic drugs. Such a deficiency of CoQ10 in the pancreas could impair aspects of energy metabolism, and the biosynthesis of insulin. Other research has also demonstrated that CoQ10 levels are lower in diabetic patients, which can cause diabetic cardiomyopathy. That same research, however, also showed that the diabetic cardiomyopathy can also be reversed by CoQ10 supplementation.40 And speaking of a cardiac condition, research has also demonstrated that CoQ10 exhibits an effective antiarrhythmic (i.e., prevents abnormal heart beat) in patients with diabetes.41

    A newly discovered form of diabetes is referred to as maternally inherited diabetes mellitus and deafness (MIDD). The characteristic clinical features of MIDD are progressive worsening of insulin secretion and, as the name would suggest, neurosensory deafness and maternal inheritance. After three years of treatment with CoQ10 therapy on MIDD patients, progressive hearing loss was prevented and blood sugar metabolites improved after exercise. Furthermore, there were no side effects during therapy.42

    Bilberry
    One clinician/researcher had this to say about Bilberry (a European relative of the American Blueberry): “Perhaps the most significant clinical applications for bilberry extracts are in the field of ophthalmology.” The health of the eye depends on a rich supply of nutrients and oxygen, and, “Relatively speaking, the amount of blood blow through the eye is the greatest in the body.” Bilberry appears to support vision by improving the delivery of oxygen and blood, “as well as exerting other important pharmacological effects,” including acting as an antioxidant. Among other benefits, Bilberry has proven effective in treating or preventing diabetic retinopathy, and macular degeneration. Bilberry’s strengthening effect on collagen may explain its benefit in helping to treat diabetic retinopathy. It also effectively regulates blood sugar levels in diabetic subjects.43

    Inositol
    An altered metabolism of inositol, a natural substance associated with the B complex group of vitamins, has been documented in patients with diabetes.44 In fact, over 20 years ago, researchers found that high blood sugar levels in diabetes “may condition a widespread relative intracellular inositol deficiency, and suggest that restoration of normal intracellular inositol concentrations might prove to be of benefit in the prevention and treatment of certain of the complications associated with human diabetes mellitus.”45 As it turned out, supplementation with inositol has indeed proven beneficial for diabetics. For example, low levels of inositol have been associated with neuropathy in diabetic patients, 46and inositol supplementation has been demonstrated to be effective in treating diabetic neuropathy.47 Another benefit is that supplementation with inositol can help prevent the premature aging of certain cells in the diabetic which is caused by elevated concentrations of blood sugar.48 Other research suggests that inositol may exert a protective effect on slowly developing diabetic cataracts.49

    Finally, consider that the incidence of major congenital malformations is approximately 6–9 percent in pregnancies complicated by diabetes mellitus. This incidence is 3–4-fold higher than that in the general population. Congenital malformations are now ranked as the leading cause of death in the offspring of women with diabetes. This particular type of congenital malformation in the offspring of diabetic women is referred to as diabetic embryopathy. Dietary supplementation of inositol has been shown to reduce the incidence of diabetes-related malformations in offspring of diabetic pregnant animals.50 Researchers have indicated that supplementation with inositol offers great promise, in addition to blood sugar control, as a dietary preventive measure against diabetic embryopathy.51

    A Word Of Caution
    If you are diabetic and controlled on medication, make your health professional aware of any changes you intend to make in your lifestyle. Diet, exercise, and supplements may affect your blood sugar levels. Make your doctor a participant in any changes you would like to make in your health management. This will assure that you are being properly monitored and that you will keep yourself out of trouble.

    References:

    1. Davies S, Howard JM, Hunnisett A, et al. Age-related decreases in chromium levels in 51,665 hair, sweat, and serum samples from 40,872 patients—implications for the prevention of cardiovascular disease and type II diabetes. Metabolism1997;46:469–73.
    2. Morris BW, Kemp GJ, Hardisty CA. Plasma chromium and chromium excretion in diabetes. Clin Chem 1985;31:334–5.
    3. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997;46:1786–91.
    4. Rabinovitz H, Friedensohn A, Leibovitz A, et al. Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. Int J Vitam Nutr Res 2004;74:178–82.
    5. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006;29:1826–32.
    6. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006;29:1826–32.
    7. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes1997;46:1786–91.
    8. Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994;17:1449–52.
    9. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes1997;46:1786–91.
    10. Fox GN, Sabovic Z. Chromium picolinate supplementation for diabetes mellitus. J Fam Pract 1998;46:83–6.
    11. Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroidinduced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164–7.
    12. Suzuki Y, Unno T, Ushitani M, et al. Antiobesity activity of extracts from Lagerstroemia speciosa L. leaves on female KKAy mice. Journal of Nutritional Science and Vitaminology 1999; 45(6):791–5.
    13. Hayashi T, Maruyama H, Kasai R, et al. Ellagitannins from Lagerstroemia speciosa as activators of glucose transport in fat cells. Planta medica 2002; 68(2):173–5.
    14. Kakuda T, Sakane I, Takihara T, et al. Hypoglycemic effect of extracts from Lagerstroemia speciosa L. leaves in genetically diabetic KK-AY mice. Bioscience, biotechnology, and biochemistry 1996; 60(2):204–8.
    15. Judy, W. V. Glucosol™ Clinical Study Synopsis (1999) Report from Soft Gel Technologies, Inc.
    16. Judy, W. V. Glucosol™ Clinical Study Synopsis (1999) Report from Soft Gel Technologies, Inc.
    17. Shimizu K, et al, J Vet Med Sci (1997) 59(9):753–7.
    18. Okabayashi Y, et al, Diabetes Res Clin Pract (1990) 9 (2):143–8.
    19. Shanmugasundaram KR, J Ethnopharmacol (1983) 7(2):205–34.
    20. Shanmugasundaram ER, et al, J Ethnopharmacol (1990) 30(3):265–79.
    21. Ibid.
    22. Baskaran K, et al, J Ethnopharmacol (1990) 30(3):295–300.
    23. Shanmugasundaram ER, et al, J Ethnopharmacol (1990) 30(3):281–94.
    24. Welihinda J, et al, J Ethnopharmacol (1986) 17(3):277–82.
    25. Leatherdale BA, et al, Br Med J (1981) 282(6279):1823–4.
    26. Khanna P, et al, J Nat Prod(1981) 44(6):648–55.
    27. Jacob S, et al, Free Radic Biol Med (1999) 27(3-4):309–14.
    28. Ziegler D, et al, Diabetes Care (1999) 22(8):1296–301.
    29. Reljanovic M, et al, Free Radic Res (1999) 31(3):171–9.
    30. Haak ES, et al, Microvasc Res (1999) 58(1):28–34.
    31. Ziegler D, et al, Diabetes Care (1997) 20(3):369–73.
    32. Strokov IA, et al, Zh Nevrol Psikhiatr Im S S Korsakova (1999) 99(6):18–22.
    33. Ziegler D, et al, Diabetes (1997) 46 Suppl 2:S62–6.
    34. Ziegler D, et al, Diabetologia (1995) 38(12):1425–33.
    35. Roy S, et al, Biochem Pharmacol (1997) 53(3):393–9.
    36. Borcea V, et al, Free Radic Biol Med (1999) 26(11-12):1495–500.
    37. Jacob S, et al, Arzneimittelforschung (1995) 45(8):872–4.
    38. Konrad T, et al, Diabetes Care (1999) 22 (2):280–7.
    39. Kishi T, et al, J Med (1976) 7(3-4):307–21.
    40. Miyake Y, et al, Arzneimittelforschung (1999) 49(4):324–9.
    41. Fujioka T, Sakamoto Y, Mimura G, Tohoku J Exp Med (1983) 141 Suppl:453–63.
    42. Suzuki S, Diabetologia (1998) 41(5):584–8.
    43. Murray M, American Journal of Natural Medicine (1997) 4(1):18–22.
    44. Holub BJ, Adv Nutr Res (1982) 4:107–41.
    45. Clements RS Jr, Reynertson R, Diabetes (1977) 26(3):215–21.
    46. Servo C, Bergstrom L, Fogelholm R, Acta Med Scand (1977) 202(4):301–4.
    47. Pfeifer MA, Schumer MP, Diabetes (1995) 44(12):1355–61.
    48. Sibbitt WL Jr, et al, Mech Ageing Dev (1989) 47(3):265–79.
    49. Beyer-Mears A, et al, Pharmacology (1989) 39(1):59–68.
    50. Reece EA, et al, J Soc Gynecol Investig (1998) 5(4):178–87.
    51. Reece EA, Homko CJ, Wu YK, Teratology (1996) 54(4):171–82.
  • Nutraceuticals For Diabetic Neuropathies

    Nutraceuticals For Diabetic Neuropathies Gene Bruno

    About sixty to seventy percent of all people with diabetes have some form of nerve damage, called neuropathy (or more accurately, neuropathies, since there is more than one kind). High blood sugar levels over a long period of time damages nerves throughout the body, but those in the hands and feet are most often damaged. Symptoms of diabetic neuropathy can include pain and numbness, particularly in the hands and feet, or problems with digestion, the urinary tract, blood vessels and the heart. These symptoms can range between mild and extremely painful to the point of disability.1 This article will review some information on diabetic neuropathies (DNs), then take a look at specific dietary supplements that may help in the treatment of this problem.

    The Types Of Diabetic Neuropathies

    According to the National Institutes of Health2, DNs are most common in those who have problems controlling their blood glucose levels, those with high blood lipid levels (i.e., cholesterol and triglycerides), those with high blood pressure and those who are overweight.

    Other factors can also contribute to the cause. The risk increases with age and with the length of time a person has diabetes. Those who have had diabetes for at least 25 years have the highest rates of neuropathy.

    There are different types of DNs, with their own symptoms:3

    • Peripheral neuropathy is the most common type of DN. It causes pain or loss of feeling in the toes, feet, legs, hands, and arms.
    • Changes in digestion, bowel and bladder function, sexual response, and perspiration take place in autonomic neuropathy; the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes may be affected as well. Hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels, may also occur.
    • Proximal neuropathy results in thigh, hip, or buttocks pain, and leads to weakness in the legs.
    • Sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain, is caused by focal neuropathy. In this case, any nerve in the body can be affected.

    DIETARY SUPPLEMENTS

    There are a number of dietary supplements with potential to elp in the treatment of DN. Some of the most promising are acetyl-L-carnitine, alpha lipoic acid, benfotiamin, gamma linolenic acid and methylcobalamin.

    Acetyl-L-Carnitine
    Acetyl-L-carnitine (ALC) is a form of the amino acid L-carnitine. Both have similar roles in helping to transport fat into muscle cells where it can be burned for energy. Also, the “acetyl” part of ALC helps produce the acetylcholine, a brain chemical, which is required for various mental functions. ALC occurs naturally in the brain, liver and kidneys.

    ALC has been show to be deficient in diabetics.4 In double-blind research, type 1 or type 2 diabetics with peripheral neuropathy experienced improved symptoms after taking 1500–3000 mg ALC daily in divided doses for a year. ALC seems to increase nerve fibers, regenerate clusters of nerve fibers, and improve sensations. In patients who have pain as the most significant symptoms, taking ALC 1000 mg two to three times daily also decreases neuropathy-related pain within six months of beginning treatment. Lower doses (500 mg three times daily) do not seem to reduce pain. ALC also seems more likely to be effective for reducing pain in patients with a shorter duration of diabetes and patients with poorly-controlled type 2 diabetes.5,6,7,8 In research, the best response was associated with using 1,000 mg ALC, three times daily.

    Orally, acetyl-L-carnitine is generally well tolerated. One gram daily of L-carnitine seems to significantly increase the anticoagulant effects of acenocoumarol.9,10 Acenocoumarol is an oral anticoagulant similar to warfarin, but shorter-acting. This interaction has only been reported with L-carnitine, but theoretically could occur with acetyl-L-carnitine.

    Alpha Lipoic Acid
    Alpha lipoic acid (ALA) is a natural antioxidant manufactured by the body and similar to certain vitamins. Unlike most other antioxidants, however, it has the advantage of being soluble in both fat and water, so it can provide production both inside and outside of cells.11 ALA is also found in some foods, particularly liver and yeast.

    Giving 600 mg to 1200 mg oral or intravenous ALA daily reduced symptoms of peripheral neuropathy in diabetics. ALA improved symptoms such as burning, pain, numbness, and prickling of the feet and legs. It also seems to improve objective measures such as ratings of nerve function decline and disability. Symptom improvement occurs within three to five weeks with oral and intravenous dosing.12,13,14,15,16,17,18,19,20 Doses lower than 600 mg daily have not been shown to be effective.21 Furthermore, other research shows that ALA can also contribute toward reducing blood sugar levels and insulin sensitivity.22,23,24,25 A daily dosage range of 600 mg to 1200 mg ALA is likely to yield positive results.

    Skin rash has been reported in some individuals after using oral doses of alpha-lipoic acid.26 Theoretically, use with other hypoglycemic drugs might cause additive blood sugar lowering effects.27

    Benfotiamin
    Benfotiamin is a particularly well-absorbed form of vitamin B1. Double-blind research in diabetics demonstrated that oral doses of 400 mg daily resulted in a statistically significant improvement in neuropathy score in the treatment group compared to placebo. The most significant improvement reported was pain decrease in polyneuropathy (a type of peripheral neuropathy).28 Other research has demonstrated statistically significant effectiveness in reducing diabetic neuropathy pain with daily doses ranging between 150–320 mg benfotiamin.29 In addition, studies have also shown that benfotiamin in combination with other B vitamins is effective in the treatment of DNs.30 Best results will probably be seen with 400 mg of benfotiamin daily.

    Benfotiamin has a good tolerance profile without any adverse effects, and no established drug interactions.

    Gamma Linolenic Acid
    Gamma linolenic acid (GLA) is an omega-6 fatty acid commonly found in evening primrose oil (derived from the seeds of the evening primrose plant) as well as black currant seed oil and borage oil. The body converts GLA into an anti-inflammatory, hormone-like substance called prostaglandin E1. In addition to DN, GLA has shown benefit in the treatment of eczema31, fibrocystic breast disease32, premenstrual syndrome33 and rheumatoid arthritis.34

    In double-blind research, taking oral doses of 360 to 480 mg GLA daily for six months to one year reduced symptoms and prevents nerve deterioration in peripheral neuropathy patients who have type 1 or type 2 diabetes.35,36,37,38 It seems to be more effective in patients with better glucose control compared to patients with poor glucose control.39 Take 360 to 480 mg GLA daily. It may take six months or longer for results.

    Orally, gamma linolenic acid (GLA) can cause mild gastrointestinal effects such as nausea, vomiting, soft stools, diarrhea, flatulence, and belching.40,41,42 GLA might prolong bleeding time.43 GLA appears to have anticoagulant effects.44 Theoretically, taking GLA with other anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.

    Methylcobalamin
    Methylcobalamin is a well-absorbed form of vitamin B12. In double-blind research, daily oral supplementation of 1500 mcg methylcobalamin by diabetics resulted in significant improvements in autonomic neuropathy compared to placebo.45 Other research also demonstrated similar benefits and improvements in autonomic neuropathy when methylcobalamin was given orally or as an injection.46,47

    Orally and intramuscularly, vitamin B12 does not usually cause adverse effects, even in large doses. Limited case reports suggest that chloramphenicol (an antimicrobial drug) can delay or interrupt the response of immature red blood cells to supplemental vitamin B12 in some patients.48 A daily dose of 1500 mcg methylcobalamin is appropriate.

    Conclusion
    Just in case you’re wondering, you can use any or all of these dietary supplements indicated at the same time. Other than the adverse reactions listed, there are none associated with the concurrent use of more than one supplement.

    References:
    1. Diabetic Neuropathies: The Nerve Damage of Diabetes. NIH Publication No. 08–3185. Bethesda, MD: National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. February 2008. Retrieved October 3, 2008 from http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/
    2. Ibid. Diabetic Neuropathies.
    3. Ibid. Diabetic Neuropathies.
    4. Sima AAF, Calvani M, Mehra M, et al. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: An analysis of two randomized, placebo-controlled trials. Diabetes Care 2005;28:89–94.
    5. Onofrj M, Fulgente T, Melchionda D, et al. L-acetylcarnitine as a new therapeutic approach for peripheral neuropathies with pain. Int J Clin Pharmacol Res 1995;15:9–15.
    6. De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R D 2002;3:223-31.
    7. Quatraro A, Roca P, Donzella C, et al. Acetyl-L-carnitine for symptomatic diabetic neuropathy. Diabetologia 1995;38:123.
    8. Sima op. cit.
    9. Martinez E, Domingo P, Roca-Cusachs A. Potentiation of acenocoumarol action by L-carnitine. J Intern Med 1993;233:94.
    10. Bachmann HU, Hoffmann A. Interaction of food supplement L-carnitine with oral anticoagulant acenocoumarol. Swiss Med Wkly 2004;134:385.
    11. Kagan V, Khan S, Swanson C, et al. Antioxidant action of thioctic acid and dihydrolipoic acid. Free Radic Biol Med 1990;9S:15.
    12. Ziegler D, Hanefeld M, Ruhnau K, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: A 7-month, multicenter, randomized, controlled trial (ALADIN III Study). Diabetes Care 1999;22:1296–301.
    13. Reljanovic M, Reichel G, Rett K, et al. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alphalipoic acid): A 2-year, multicenter, randomized, double-blind, placebo-controlled trial (ALADIN II). Alpha Lipoic Acid in Diabetic Neuropathy. Free Radic Res1999;31:171–7.
    14. Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipoic acid: A 3-week, multicenter, randomized, controlled trial (ALADIN Study). Diabetologia 1995;38:1425–33. 15. Ruhnau KJ, Meissner HP, Finn JR, et al. Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy. Diabet Med 1999;16:1040–3.
    15. Ametov AS, Barinov A, Dyck PJ, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid. Diabetes Care2003;26:770-6.
    16. Ziegler D, Nowak H, Kemplert P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: A meta-analysis. Diabet Med 2004;21:114–21.
    17. Negrisanu G, Rosu M, Bolte B, Lefter D, Dabelea D. Effects of 3-month treatment with the antioxidant alpha-lipoic acid in diabetic peripheral neuropathy. Rom J Intern Med 1999;37:297–306.
    18. Zeigler D, Schatz H, Conrad F, Gries FA, Ulrich H, Reichel G. Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Deutsche Kardiale Autonome Neuropathie. Diabetes Care 1997;20:369–373.
    19. Tankova T, Cherninkova S, Koev D. Treatment for diabetic mononeuropathy with alpha-lipoic acid. Int J Clin Pract 2005;59:645–650.
    20. Sachse G, Willms B. Efficacy of thioctic acid in the therapy of peripheral diabetic neuropathy. Hormone Metab Res Suppl 1980;9:105–7.
    21. Konrad T, Vicini P, Kusterer K, et al. Alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with Type 2 diabetes. Diabetes Care 1999;22:280–7.
    22. Jacob S, Henriksen EJ, Tritschler HJ, et al. Improvement of insulin-stimulated glucose-disposal in type 2 diabetes after repeated parenteral administration of thioctic acid. Exp Clin Endocrinol Diabet 1996;104:284–8.
    23. Jacob S, Henriksen EJ, Schiemann AL, et al. Enhancement of glucose disposal in patients with type 2 diabetes by alphalipoic cid. Arzneimittelforschung 1995;45:872–4.
    24. Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled, pilot trial. Free Rad Biol Med 1999;27:309–14.
    25. Vincent HK, Bourguignon CM, Vincent KR, Taylor AG. Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot study. J Alt Complement Med 2007;13:577–84.
    26. Konrad, op. cit.
    27. Haupt E, Ledermann H, Kopcke W. Benfotiamine in the treatment of diabetic polyneuropathy—a three-week randomized, controlled pilot study (BEDIP study). Int J Clin Pharmacol Ther 2005;43:71–77.
    28. Winkler G, Pál B, Nagybéganyi E, Ory I, Porochnavec M, Kempler P. Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy. Arzneimittelforschung 1999;49(3):220–4.
    29. Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Altern Med Rev 2006; 11(4):294–329.
    30. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.
    31. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557–66.
    32. Puolakka J, Makarainen L, Viinikka L, Ylikorkola O. Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors. J Reprod Med 1985;30:149–53.
    33. Pullman-Mooar S, Laposata M, Lem D, et al. Alteration of the cellular fatty acid profile and the production of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis Rheum 1990;33:1526–33.
    34. Jamal GA. The use of gamma linolenic acid in the prevention and treatment of diabetic neuropathy. Diabet Med 1994;11:145–9.
    35. Horrobin DF. The use of gamma-linolenic acid in diabetic neuropathy. Agents Actions Suppl 1992;37:120–44.
    36. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med 1990;7:319–23.
    37. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care 1993;16:8–15.
    38. Ibid.
    39. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med 1993;119:867-73.
    40. Zurier RB, Rossetti RG, Jacobson EW, et al. Gamma-linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum 1996;39:1808-17.
    41. Keen op. cit.
    42. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty Acids 1994;51:311–6.
    43. Ibid.
    44. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy. Clin Neurol Neurosurg 1992; 94:105–111.
    45. Yoshioka K, Tanaka K. Effect of methylcobalamin on diabetic autonomic neuropathy as assessed by power spectral analysis of heart rate variations. Horm Metab Res 1995; 27:4–44.
    46. Ide H, Fujiya S, Asanuma Y, et al. Clinical usefulness of intrathecal injection of methylcobalamin in patients with diabetic neuropathy. Clin Ther 1987; 9:183–192.
    47. Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
  • Superfoods To Supercharge Fall

    For plant-centric foodies like myself, fall harvest is one of the best seasons of the year, and for good reason. With fruits and vegetables taking center stage, now is the time to load up on edible powerhouses that are packed with vitamins, minerals and disease fighting antioxidants to keep you feeling strong, energized and on the top of your game all fall. These types of foods are considered the best way to reduce risk for chronic diseases, achieve and maintain a healthy weight and live a longer, healthier life.

    By now I'm sure you've heard the term 'superfoods,' and know they pack a serious punch for optimal health benefits. These types of foods are rich in phytochemicals and have a high level of nutrient value. Consider this: with superfoods, there are no side effects. And for an added bonus, they put you in a good mood, so what's the downside? That's just it-there is none. Soon, leaves will start to change color, and the wind will blow a little cooler. So now's the time to start thinking about which fresh autumn superfoods to incorporate in to your diet to boost your health.

    Half the battle is having a plan and being aware of what foods can give you the most benefit. When the food option is not available or convenient for your routine, consider the supplement counterpart to complement your diet.

    Cranberries
    Cranberries provide more disease-fighting antioxidants than any other fruit and vegetable on the table. This berry is a popular part of many Thanksgiving feasts. Best known for its ability to fight off urinary tract infections (UTIs), cranberry also has many more disease fighting qualities. Cranberries have a high concentration of phenols, which are good for fighting cancer, stomach infections, heart disease and strokes.

    Try adding cranberries to leafy green salads, sprinkle dried cranberries on cheese and cracker boards or incorporate into cookie recipes, spreads, dips and try cranberry sauce on your favorite fish or poultry.

    If you want an added boost or are simply unable to find fresh cranberries at your local farmers' market, supplement with Cran-Max, a highly concentrated whole berry cranberry ingredient found in a variety of natural supplement products. This particular cranberry ingredient has gone head-to-head against prescription antibiotics for prevention of bladder infections and was found to be equally effective and better tolerated.1,2,3

    Pumpkins

    Next on my list: pumpkins, which provide beta-carotene, potassium, vitamin C and soluble fiber. Pumpkins also contain trigonelline and nicotinic acid that can help lower blood sugar, inhibit the accumulation of triglycerides in the blood and suppresses the onset of diabetes. Furthermore, pumpkin can help support immune function and prostate health for men.4

    Incorporate pure pumpkin into pies, muffins, cookies, soups, bread, and ravioli. Roasted pumpkin seeds are a great addition to a home-made trail mix or sprinkle them on your oatmeal or breakfast cereal.

    You may also try using pumpkin seed oil. Pumpkin seed oil has been used in salad dressing, ice cream and other food products, and is believed to benefit people at risk of BPH, irritable bowel syndrome, high cholesterol and certain parasitic infestations.

    Walnuts
    Walnuts rank No. 1 for the healthiest and highest potency of antioxidants among all other popular nuts including peanuts, pecans, cashews, Brazil nuts and almonds. Walnuts are rich in polyphenols, compounds that can support heart health by lowering levels of blood cholesterol, which?improves blood flow and cools inflammation related to heart disease. Walnuts are wonderful for cheese and cracker boards, pies, stuffing, hummus, breads and dark chocolate fudge.

    If you're in need of a supplement, try English walnut. The nut of the English walnut contains chemicals called fatty acids, which might be useful as part of a cholesterol-lowering diet. It also contains chemicals that can expand blood vessels, possibly improving circulation and the way the heart works.

    Honey
    If you have a sweet tooth, then you're in luck. My next fall superfood contains various nutrients and enzymes that can help calm everything from a cough to blemishes. Honey has long been known to treat numerous health conditions and boost overall health. This amazing bee-product possesses antibacterial, antifungal, antiseptic, and antioxidant properties - making it one of the most beneficial foods to consume.

    Sticking with the antibacterial benefits of honey, one study published in the journal Microbiology found that "honey prevented a type of streptococcus pyogenes from inhibiting the healing of wounds."5

    Researchers found that only a small amount of honey was needed to kill off the majority of bacterial cells on infected skin of wound sites. More than that, honey could even be utilized to prevent wounds in the first place.

    To make it a part of your fall diet, add honey to Greek yogurt or use it in place of sugar in recipes. Be sure to try a teaspoonful of honey when suffering with a cough or sore throat. For a supplemental choice, try honey lozenges. These are an obvious choice when dealing with a cold, but these are also an excellent source for honey when you're feeling well, and would like to continue in good health.

    Butternut Squash
    Butternut Squash rounds out my list of fall superfoods. Butternut squash grows on a vine, and comes from the gourd family - a cousin of pumpkin. It is low in fat and provides a large dose of dietary fiber. Squash is packed with carotenoids, giving it its tangerine glow. This veggie is nutrient rich providing folic acid, omega 3s, potassium, and magnesium. Additionally, beta carotene, found in squash, has been shown to protect against heart disease as well as help as a deterrent against some cancers.

    Not coincidentally, most of the foods on this list provide dietary fiber. Dietary fiber is found mostly in vegetables, whole grains, fruits and legumes, and is probably best known for its correlation with constipation. However, fiber foods can provide other health benefits as well, such as lowering your risk of diabetes and heart disease and maintaining a healthy diet.

    Fall superfoods provide a cornucopia of delicious options, so dig in now.

    1. Cranberries vs antibiotics to prevent urinary tract infections. A randomized double-blind noninferiority trial in premenopausal women. Archive of Internal Medicine 2001;171(14):1270-8.
    2. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. The Canadian Journal of Urology. 2002;9(3):1558-1562.
    3. Results of a randomized, double-blind study on the prevention of recurrent cystitis with GynDelta® (500 mg Cran-Max®). The Gynecologist’s and Obstetrician’s Journal. January 2007.
    4. Vahlensieck W1, Theurer C, Pfitzer E, Patz B, Banik N, Engelmann U. Effects of pumpkin seed in men with lower urinary tract symptoms due to benign prostatic hyperplasia in the one-year, randomized, placebo-controlled GRANU study. Urol Int. 2015;94(3):286-95. doi: 10.1159/000362903.
    5. Sarah E. Maddocks, Marta Salinas Lopez, Richard S. Rowlands, Rose A. Cooper; Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins. Microbiology, March 2012 158: 781-790, doi: 10.1099/mic.0.053959-0
  • The Reality of High Fructose Corn Syrup (HFCS)…

    You've read and heard about the health-depleting effects of sugar and artificial sweeteners like aspartame, There's another sweetener that we've known scientifically is also health-depleting (especially when it's derived from genetically-modified corn), HFCS. Now research sheds an entirely new light on this sweetener as a result of a newer study from the University of Utah1 confirming why we, (especially females) should avoid it.

    You may be asking why it's used in so many prepared foods—the answer is simple—it's cheaper to produce than sugar and the manufacturers can "sell" it by claiming, "it's natural" because it's derived from corn! They're correct, it is derived from corn, but that isn't the entire equation. It can even be hidden under generic titles on labels such as "natural ingredients."

    Scientifically Speaking...
    Scientists and researchers tested the effects of sweeteners on mice, looking at a fructose-glucose mixture known as HFCS and sucrose or table sugar. At the end of their study period, they didn't see any differences in male mice regardless of the sweetener they consumed. However, something interesting was happening that is cause for great concern when it comes to how the study affected female mice.

    All the female mice that were in the HFCS group died at almost twice the rate of female mice in the sucrose group. In addition, they were producing fewer offspring by about 26 percent—a definite sign that HFCS causes reproductive damage. The researchers summed it up this way, "We speculate that the different sugars could favor different microbes in the guts of mice—possibly causing more bacteria to get across your gut than another form of sugar." Interpreted, this means that even though table sugar destroys healthy gut bacteria and causes havoc with your blood sugar, the HFCS did even more damage to overall health and reproductive processes.

    You Might NOT Know...

    High Fructose Corn Syrup (HFCS)...

    • Causes and/or accelerates Insulin Resistance/Diabetes—disrupts the way muscles make glycogen, which is a form of stored carbohydrate from food energy production;
    • Reacts with protein molecules to form "toxic, advanced glycation end-products (AGEs)"
    • Is known to be addictive;
    • Accelerates Metabolic Syndrome (high cholesterol and triglycerides) through mechanisms that create disorders called lipoprotein metabolism disorders;
    • Damages the immune system—studies prove it inhibits white blood cell action;
    • Speeds Aging Processes by inducing insulin levels;
    • Is loaded with mercury "YES" the same toxic substance used in dentistry. Scientists tested batches of HFCS and over one-third of 55 popular brand-name foods and beverages contained mercury;

    Foods Routinely Containing HFCS...

    • Jams and jellies
    • Crackers and baked goods
    • Salad dressings and sauces
    • Dairy products
    • Carbonated beverages/sweetened drinks like flavored waters

    Healthy Natural Sweeteners

    • Stevia (from herb leaves)
    • Xylitol (from birch trees)—watch carefully for gas-bloating and/or bowel changes as too much can cause those symptoms because it's a sugar alcohol
    • LoHan—also known as monk fruit is available in brown or white and is the only natural sweetener that can be used for baking in the same proportions as sugar.

    The Way I See It…
    Americans get 25 percent or more of their daily calories from added sugars, especially because they’re used in such high amounts in food processing—the same amount researchers used in the study cited above. These dangerous sweeteners are hard to avoid if you’re not making most of the food you consume. And, to make the situation worse, the manufacturers are now renaming the HFCS to appear on labels as simply “fructose,” therefore, even avid label-readers may have no idea how much HFCS is in your prepared foods. The best way to avoid HFCS and hidden ingredients is to avoid, or severely minimize, any processed foods and become an avid label-reader like I teach my clients. Instead, replace these foods with homemade high-fiber foods, quality protein, leafy greens, berries, and a natural sweetener when needed.

    References

    1. http://archive.unews.utah.edu/news_releases/fructose-more-toxic-than-table-sugar-in-mice/
  • The Special Nutritional Needs of Those Over 55

    Solving the Mystery of the Multivitamin Part IV

    This article is the fourth in the series that began with “Solving the Mystery of the Multivitamin.” The focus now shifts to reasons for taking a multivitamin/mineral as we enter the second half of life and, more importantly, the overall approach to nutrition that should inform any anti-aging program. Readers will discover that some, but not all of the gender-specific nutritionaln needs covered in earlier articles become less meaningful in later life. As individuals approach 60, overall physiology changes in ways that tend to lead to a convergence of nutritional requirements.