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Vitamin D

  • First, I believe in women making choices regarding their own health care (for that matter, I believe EVERYONE should decide the best course of therapy for an illness). While our doctors serve as a primary source of information, they should NEVER have the final say about OUR health care choices and decisions.

    As a doctor, I readily admit I don’t know everything! I don’t have time to know everything, so I’m always thankful when my own patients provide me with research they have found that might positively influence the outcome of their diseases. I’ve done the hard research for you on the topic of breast cancer, and it is my hope that when properly used, the information in Breast Choices for the Best Chances: Your Breasts, Your Life, and How You Can Win the Battle! will save lives.

  • EWG's 2015 Sunscreen Report

    What exactly does it mean when you see sunscreen or sunblock on a product label? The store shelves offer so many to choose from, no wonder it can get a bit frustrating. Federal Food and Drug Administration (FDA) has not updated their sunscreen safety standards since 1978. In June of 2011, FDA posted new rules for sunscreen products to help clear up some of the confusion. The new stricter guidelines mandate products to describe how well the product protects your skin.

    Ultraviolet B testing is currently the only one required from manufacturers. UVB rays are the ones that cause sunburn. The new regulations also require sunscreens that don’t protect against both UVA and UVB rays or offer SPF under 15, to carry a warning label: “This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”

    Other new regulations include requirements to prohibit claims like “waterproof ” and “sweatproof.” FDA has said these claims are exaggerations. If a product has proof of “water & sweat proofing,” they also need to show how much time you can expect to get SPF protection before having to reapply.

    What is the SPF?
    “Sun protection factor” lets you know the amount of sun exposure needed to cause sunburn on sunscreen-protected skin compared to unprotected skin. For example, an SPF of 30, allows you to get sun exposure thirty times longer than without any sunscreen, before sunburn. Over the years, the definition of just how high the factor needs to be has changed and gone up and down many times.

    The reason for the yo-yo reports on SPF needed is that studies have not proven what amount is effective. The FDA is now proposing to set a high SPF value to 50 and a low of 15. Companies that want to set SPF levels of 75 and 100 on their labels must show testing to back up their claims. As of now, there are no studies substantiating any SPF higher than 50 is more effective or beneficial. In fact, the higher SPFs contain more chemicals, which could cause more harm than good.

    Another problem with high SPF such as 100, is it falsely indicates you can stay in the sun a hundred times longer before causing the skin to burn. However, studies report users of high- SPF sunscreens have similar or higher exposures to harmful UV rays. One reason could be they trust the product and do not reapply as needed, while extending sun exposure.

    FDA is also banning the term “sunblock” under the new rules, because it does not exist. You can’t block the sun with creams or lotions. The only real way to block the sun is with a hat, umbrella or whatever physical means of not exposing your skin to direct sun.

    Ultraviolet A Rays and Cancer
    UVB rays only penetrate the outer skin layer, which results in sunburn or in some cases, non-melanoma skin cancer such as squamous cell carcinoma. Although current regulations require testing for UVB rays, it is the UVA rays that are of concern. These rays are far more dangerous. They penetrate deeper into the skin, where it can cause DNA damage. They are linked to wrinkles, skin cancer and can even penetrate glass.

    The new FDA ruling mandates products have “broad spectrum” protection, which means sunscreen for both UVA and UVB rays.

    Sun worshipers should not, however, get too secure, even with this new “broad spectrum” rule. Skin cancer has been on the rise since the early 1990s. The FDA 2007 draft of sunscreen safety regulations reported: “FDA is not aware of data demonstrating that sunscreen use alone helps prevent skin cancer.”

    Truth be told, clothing, hats, and shade are the only true barriers to UV radiation and prevention of skin cancer. This fact is echoed by the International Agency for Research on Cancer (IARC).

    Some reports have found an increase in melanoma (the deadliest form of skin cancer) among sunscreen users. The reason could be these individuals feel they are being protected and that the product they are using is blocking dangerous UV radiation. We know now this is not true.

    1. Frequent sunscreen users do show a lower incidence of squamous cell carcinoma, which is a slow-growing tumor that is treatable by surgery.
    2. Sunscreen use has no demonstrated influence on basal cell carcinoma.
    3. Long-term exposure to the sun, may increase the risk of melanoma.

    Physicians are more concerned about malignant melanoma. Children who are exposed to intermittent, severe sunburns are at greatest risk.

    Ingredients to Avoid in Sunscreen
    Dermatologists recommend sunscreen should only be used on exposed skin areas, like the hands and face. There is concern that problems of potential hormonal toxicity of sunscreen active ingredients with frequent applications on the whole body. This could lead to increase systemic absorption of these ingredients with resulting risk of adverse health effects.

    Vitamin A, retinyl palmitate, in some sunscreens, has been recently shown in FDA studies to speed development of skin cancer and lesions. Currently, 30 percent of sunscreens, according to Environmental Working Group (EWG), contain retinyl palmitate. This ingredient is effective for anti-aging when used in creams or lotions for indoor use, but when exposed to sunlight, free radicals can form, that can damage DNA.

    In 2009, a study by the Center for Disease Control found the common UVA blocker oxybenzone in the urine of 2,500 people who regularly used sunscreens. Oxybenzone has been reported to have hormone-like activity and is not recommended by EWG.

    After testing 1,000 brands of sunscreen, EWG found many with potentially toxic ingredients, including oxybenzone.

    FDA Allowable Ingredients in Sunscreens, and Results for Safety

    • Padimate O—not supported by European Union (EU), may be delisted by FDA
    • p-Aminobenzoic Acid (PABA)—shown to increase DNA defects
    • Cinoxate—not tested for safety
    • Dioxybenzone—not tested for safety
    • Oxybenzone—not tested for safety
    • Homosalate—not tested for safety
    • Menthyl Anthranilate—not tested for safety
    • Octocrylene—increases reactive oxygen in skin, advancing aging
    • Octyl Salicylate—not tested for safety
    • Trolamine Salicylate—not tested for safety
    • Zinc Oxide—protects skin against tumors in mice

    How to Protect Yourself in Summer or Winter
    Sunshine is vital to our health and well-being. The main source of vitamin D in the body is sunshine. Vitamin D strengthens bones and our immune system, reduces the risk of certain cancers and is important in regulation of genes involved in many tissues of the body.

    Vitamin D supplements are the alternative to maintaining needed levels, however, how much is needed is still debated by scientists. Dermatologists and researchers do agree on the following:

    1. Keep sunscreen and lip balm with you at all time, in your car and purse.
    2. Use a natural sunscreen, preferably with zinc oxide and titanium dioxide.
    3. Keep a broad-rimmed hat in your car and wear it during sun exposure, especially between the hours of 10 a.m. and 4p.m., when ultraviolet rays are strongest.
    4. Children have sensitive, delicate skin and should especially be protected with proper clothing to cover sun-exposed areas. Sunscreens with zinc oxide and titanium dioxide are the best recommended for babies and children.
    5. Wear sunglasses to help prevent damage like cataracts or vision loss at older age.
    6. Your lips also need sun cream. Protect your lips with natural lip balm with shea butter, which has natural sunscreen properties.
    7. Apply sunscreen approximately 30 minutes before exposure. Re-apply often.
    8. Make sure to apply to face, hands, neck, ears, hands and arms.

    Best Sunscreens to Buy
    Consumer watchdog groups like the Environmental Working Group, offer education and health and eco-friendly sun protection recommendations. They also recommend not giving up on sunscreens altogether. But they do summarize that the best first line of defense against harmful radiation should be shade, protective clothing and avoiding the noontime sun.

  • Research released by the Women’s Health Initiative ( WHI ) that showed that 1,000 mg calcium and 400 IU vitamin D in healthy postmenopausal women (between the ages of 50 to 79 years) did not reduce the risk of bone fractures. The study did show that the supplementation of calcium and vitamin D, combined with the recommended amount of calcium from the diet, significantly improved hipbone density. This study was a bit discouraging for many women who bank their bone health on just a daily calcium supplement product. There is so much more to do for bone health, including eating a wholesome diet, exercise and a healthy lifestyle. In addition, there is a branded ingredient compound called Ostivone®, known in the research as ipriflavone, which when combined with calcium has been shown to significantly increase bone density.

  • Progesterone

    The sex hormone Progesterone is also balanced by estrogen's sexy Smart Fats:

    • High lignan flax seeds and flax oil
    • Chia
    • Walnuts

    If there was ever a "magic bullet" hormone therapy on the planet, natural progesterone comes really close. Many women's bodies are simply not producing enough. Either because they are not ovulating regularly—although many are still menstruating—so there is no corpus luteum to create progesterone, or because their bodies are converting progesterone into other hormones like cortisol, estrogen or testosterone.

    It is deficient in practically EVERY female I test from 18 to 80. Whether you decide to use a topical progesterone cream or nutrient precursors, like zinc, vitamin C and vitamin B6, or herbs like chaste berry or wild yam, you owe it to your brain to make sure your progesterone is in place.

    Progesterone is well recognized as the "feel good" hormone because we have 20 times more of it in the brain than in the bloodstream. As a natural anti-depressant and diuretic, it helps to stabilize blood sugar levels, control mood swings and can prevent those whiskers on your chin.

    If you do have an excess of facial hair, chances are you do not have enough progesterone. When your levels are raised, the facial hair can start to disappear. Without sufficient progesterone, the adrenal cortex can secrete the androgen hormone androstenedione as an alternative chemical precursor for the manufacture of progesterone. This steroid is associated with some male characteristics, one of which is male pattern baldness. But when your progesterone level is raised with natural progesterone cream, your androstenedione level will gradually decline and the excess facial hair will become finer and begin to disappear.

    Progesterone also contributes to activating osteoblasts, the bone builders critical for a strong stature and graceful appearance.

    Smart Tips: Progesterone

    How do you build up your progesterone levels?

    1. Jump on the flax bandwagon. Whatever you do to modulate estrogen will have an equalizing effect on progesterone too.
    2. Think zinc! Eating zinc-rich foods like pumpkin seeds, pastured eggs, and grass-fed beef can help shore up progesterone levels while the vitamin B6 in non-gluten grains and beans and vitamin C in citrus, squash, tomatoes, and potatoes can also help.
    3. Avoid stress. Easier said than done, I know. Coping with stress successfully will negate the possibility that precious progesterone will be used to make stress-managing cortisol. That's why I don't leave home without my Bach Flower Rescue Remedy!

    Testosterone

    The sex hormone testosterone can be reset with more sexy Smart Fats:

    • Saturated fats
    • Monounsaturated fats
    • Saw Palmetto Oil, Even though "low T" is generally thought of as a male issue, both men and women need the hormone of desire for many reasons. This potent sex regulator governs sex drive, bone mass, fat distribution, muscle size and strength, and red blood cell production. And it starts to drop by about two percent each year, beginning at age 30, for both sexes.

    In men, low-T is characterized by erectile dysfunction, libido drop, hair loss, and weight gain. In women, flabby muscles, as well as low sex drive and even osteoporosis, can rear its ugly head. Regardless of gender, excess fat turns muscle-generating testosterone into estrogen, which only causes a nasty cycle of more fat to be stored, usually in your abdomen. Since overweight men are more likely to have low testosterone levels, it is crucial to increase hormone levels for maximum weight loss results.

    Too Much Testosterone

    Elevated testosterone may signal insulin resistance, metabolic syndrome and/or polycystic ovary syndrome (PCOS), so I suggest that you follow a well-balanced diet to keep blood sugar levels steady and allow passion to return to the bedroom. Traditional testosterone replacement therapy is laden with alarming side effects, which include prostate cancer, increased risk of stroke and heart attack, and liver toxicity. Thanks, but no thanks.

    Smart Tips: Testosterone

    Here is a better way to keep your testosterone levels at an even keel.

    1. Consume saturated and mono-unsaturated fats. Research shows that in order to have healthy testosterone levels, men need a diet of at least 40 percent fat, and saturated fats, as well as monounsaturated fats, are the best sources. Since I have already covered many of the benefits and sources of these Smart Fats in other articles, I am simply including a list of the best ones to boost testosterone levels: pastured butter and ghee, coconut and coconut oil, olives and olive oil, avocados and avocado oil, raw nuts such as almonds or pecans, grass-fed meats.

    2. Saw Palmetto Oil. Saw palmetto is a remarkable supplement best known to support prostate health, but it can also even out testosterone. As a thyroid balancer, it stimulates metabolism. And, it has been shown to both decrease estrogen and increase testosterone. Saw Palmetto is filled with beneficial fatty acids and contains chlorophyll, lutein, and lycopene. With this power charged supplement, you will receive the lipophilic benefits of oleic acid and lauric acid with beta-sitosterol as the base ingredient.

    3. Do note that excess progesterone (which is not the norm, but does occur) can be converted into testosterone. If you are using a topical bio-identical progesterone cream or taking herbs such as wild yam or chaste berry, you will need to temporarily discontinue use to bring your progesterone and testosterone levels into balance together.

    4. If levels are too high, drink spearmint tea. One to two cups a day should suffice.

    5. Testing, testing, testing. Consider a salivary hormone test to keep tabs on your T levels.

    6. Consume plenty of zinc if you have lower than normal T levels. This mineral is just as important for testosterone production as it is for progesterone. In studies, it has been shown that taking zinc supplementation for as little as six weeks will cause a great improvement in testosterone among men whose levels were previously low. Zinc, of course, is also crucial to proper immunity and reproductive health in both men and women.

      What you need to know about zinc is, it is associated with both progesterone and testosterone as a precursor. Zinc is related to these hormones the way copper is connected to estrogen levels. In tissue mineral analysis, we like to see an eight-to-one ratio in favor of zinc.

      Elevated copper levels and a zinc deficiency have been associated with hyperactivity, attention deficit disorder, violence, and depression. Lack of zinc can also produce acne, eczema, sensitive skin, sunburn, headaches and white spots on the fingernails.

      Enjoy plenty of these protein-packed foods to get more zinc in addition to the zinc-rich eggs, pumpkin seeds, grass-fed beef, oysters, lamb, kelp, sunflower seeds, mushrooms, raw cheese, poultry, seafood, beans, yogurt or kefir.

    7. Increase Your Vitamin D. This steroid hormone (yes, you read that right) increases levels of testosterone. According to one study, overweight men who were given vitamin D supplements for one year had a significant increase in testosterone levels.

      The best way to optimize your vitamin D levels is to get a healthy amount of sun exposure. If getting out and playing in the sunlight is not an option, then vitamin D3 should be taken as a supplement. Research shows that you will need to take about 8,000 IUs of vitamin D per day in order to increase testosterone.

    What’s the Next Step?
    Now that you can better appreciate the way food and environmental toxins evoke a hormonal response, it’s time to maximize your weight loss results. In the upcoming articles, you will find some helpful tips and recipes for integrating Smart Fats, powerful proteins, friendly carbs, fiber-rich seeds, and Smart Sweeteners, Sips and Seasonings into your daily meals, or adapting your current regimen to the Eat Fat Lose Weight approach and philosophy.

    All of this is designed to help you accomplish basic nurturing of your body for painless weight control and lasting hormonal balance. Give yourself permission to enjoy the full gamut of self-care, from stress relief to proper sleep and targeted exercise, as well as satisfying food. As my grandfather Aaron liked to say, “May you live and thrive ‘til 120—but only in the very best of health.”

  • Many medical organizations advise against routine supplementation of vitamins and minerals (citing “safety concerns,” lack of evidence of benefit,” or that they are simply “unnecessary”) and recommend a focus on acquiring nutrients from the diet. Which, for the most part, is a good suggestion: no combination of supplemental vitamins, minerals, or other nutrients could possibly emulate the diversity of known (and unknown) beneficial compounds found in the diet. However, general dismissals of dietary supplements often fail to acknowledge the significant portion of micronutrients in the average diet that may come from the fortification of foodstuffs. Food fortification (addition of nutrients to foodstuffs for commercial benefit or as a part of public health policy) has been credited for the eradication of several diseases of nutrient deficiency in the U.S.

    If both fortification and supplementation similarly involve the addition of vitamins or minerals to the diet (often achieved using the exact same chemical “additives”), why is there such a disparity in the perceptions of each?

    In the United States, foods were being fortified even before the concept of recommended daily intake had been established. Beginning with the addition of iodine to table salt in the 1920s to stem the prevalence of goiter, the enrichment of common dietary foodstuffs with vitamins or minerals became the preferred means to abate nutrient deficiency epidemics through the 1930s, such as pellegra (vitamin B3 deficiency) in the South, and rickets (vitamin D deficiency) in the Northeast. Around this time, one-third of Americans had poor diets, with over 10 percent showing signs of vitamin deficiency. This frequency of nutrient deficiency motivated the creation of the first recommended daily allowances (RDAs) for iron, calcium, vitamins A, B1, B2, B3, C, and D by the Committee on Food and Nutrition of the National Research Council (the predecessor to the modern Food and Nutrition Board). RDAs served as the guidance for fortification of low-cost “staple” foodstuffs; by the end of the 1950s, breads, flour, pasta, cornmeal, and white rice (enriched with iron, vitamins B1, 2, and 3), as well as milk (enriched with vitamin D and optionally vitamin A) all had formal standards for fortification that were encouraged and regulated by the FDA. Folic acid was added to the list of grain product enrichments in 1996, as a measure for the prevention of neural tube defects. This addition represented a change in paradigm for the FDA, in which they considered the benefits of fortification for a small, poorly-defined group (women who may be pregnant), over the potential for excessive intake by the rest of the population.

    Nowadays, fortified foods are prevalent in the American food supply. Fortification of foods is no longer only by government encouragement or mandate, but often provides a competitive advantage for food manufacturers, and has expanded to include nearly all essential and several non-essential nutrients (such as phytosterols, or fatty acids from fish oil). Ready-to-eat cereals and vitamin-C fortified drinks are the largest contributors of fortified nutrients to the U.S. food supply. Ninety-two percent of breakfast cereals are fortified, and contribute up to 30 percent of the daily intake of many vitamins and minerals for adults and children; many cereals are fortified up to 100 percent of nearly all the essential vitamins and minerals.

    While food fortification has been viewed by some as a nutritional triumph (and to be fair, it has resulted in significant decreases in several nutrient deficiency diseases that were common in the early twentieth century), individual supplementation with vitamins or minerals has at best been deemed unnecessary without underlying deficiency, and at worst been called potentially hazardous. So what are the differences between supplementation and fortification, which makes one more acceptable than the other?

    In reality, there is little difference between these two schemes for improving nutrient intake. Food fortification uses many of the same ingredients as supplements; comparing the ingredient lists on a cereal box and multivitamin bottle will reveal several of the same chemical compounds. Baking these vitamins or minerals into a loaf of bread doesn’t make them any more effective than if they were compressed into a tablet. While there is a pervasive assumption that “food nutrients” are more effective than “supplemental nutrients,” this theory is of little relevance to the added vitamins and minerals of fortified foods. The argument that supplemental vitamins or minerals may lead to unnecessarily high, potentially detrimental daily nutrient intakes may have some merit (one could imagine it is probably easier to “overdose” on multivitamins than to eat a dangerous amount of fortified bran flakes), although excessive vitamin intake is also possible through fortified foods (the possible link between long-term excessive folic acid intake and the risk of colon cancer is a recent concern).

    Unfortunately, many organizations do not recognize the parity between the fortification and supplementation, or simply fail to acknowledge that a substantial portion of nutrients from a “healthy diet” (even diets based on their own recommendations) may actually be supplemental (“fortified”). For example, consider the TLC diet, the heart-healthy eating plan recommended by the American Heart Association in its Third Report of the National Cholesterol Education Program. The TLC plan meets most conventional definitions of “healthy eating,” it encourages a diet low in calories and saturated fats, high in fiber, fruits, and vegetables. Looking at the sample TLC menus, however, one begins to realize a significant percentage of several essential nutrients comes from fortification, and not necessarily from the foods themselves. In one menu (“Traditional American Cuisine”), for example, almost half of the iron, B1, B2 and B3, 40 percent of the folate and calcium, and all of the vitamin D may come from fortified foods (including enriched flour products, rice, milk, and calcium-fortified orange juice), based on analysis of the menu choices using the USDA National Nutrient Database for Standard Reference. Without fortification, these meals could be deficient for all but one of the above nutrients.

    Therefore, the blanket characterization of dietary supplements as “unnecessary” really ignores the prevalence of supplemental vitamins (“food fortification”) in the diet. Whether as an added food ingredient, capsule, or tablet, supplemental vitamins can, and have, played a recognized role in prevention of disease, when their intakes are properly balanced. Take any statements to the contrary with a grain of (iodized) salt.

  • 1. Eat only whole foods such as vegetables, fruits, nuts, seeds, chicken, fish and whole grains (not wheat). Eat organic if you can, no junk food, no fried food, no cow dairy products and nothing with sugar added.

    2. Eat three small meals and two healthy snacks each day. Eat no starches, breads or sugar after 3:00 PM and eat enough calories to equal ten times your body weight to maintain your current weight. Use herbs and spices liberally and eat 50 percent of your plant foods raw.

    3. If you want to lose weight never cut your calories by more than 10 percent of the amount suggested in item #2 above. Your metabolism will slow down and cause you to gain weight if you try to cut your calories by more than 10 percent.

    4. Drink a green powdered drink every day. Use vegetables, fruits, nuts, seeds and rice milk, coconut milk, or almond milk to make a shake and then add a scoop of green powder and a scoop of protein powder. This drink will provide over ten helpings of vegetables and fruits.

    5. Take the following nutritional supplements every day.

    Consider www.allstarhealth.com and order the brand Source Naturals. High quality/low price.

    6. Exercise 45 to 60 minutes every day, enough to sweat and raise your heart rate by 50 percent above normal. Do aerobics, resistance and flexibility type exercises. Consult with your doctor before beginning your program so he/she can help you take into account your age, weight and medical condition.

    7. Practice yoga, meditation or deep breathing for at least 30 minutes each day. These are proven ways to reduce and manage stress.

    8. Go to bed at least one hour before midnight and sleep seven to nine hours depending on your need, to awaken refreshed and energized. When you sleep your body detoxifies, rebuilds and balances your biochemistry.

    9. Get the right tests to ensure your body is within healthy ranges for bio-markers. Use the following tests beyond the normal ones, if you can afford them.

    • Vitamin D levels
    • Homocysteine
    • Serotonin levels -
    • Dopamine levels
    • Thermography (for breast health)
    • Glucose challenge test
    • C-reactive protein

    10.As you age (40+) you may need to add digestive enzymes, probiotics, co-enzyme Q10 and other nutrients, which diminish with age.

  • THE FOOD—MOOD CONNECTION PLAYS A MASSIVE ROLE IN HOW WE FEEL.

    The nutritionally depleted wasteland we call the Standard American Diet is causing widespread nutritional deficiencies, along with an epidemic of anxiety and depression. The solution is simple, and it's NOT more Prozac. Instead, simply eating a diet high in fish, meat, fruits and vegetables, and low in processed foods and added sugar, can help you feel dramatically better. To make this easier, low cost nutritional and herbal support can also give people their lives back, without the toxicity of psychiatric medications.

    Here are the key ones, which I take myself each day to turbocharge energy and optimize health, while also leaving me being a calm, happy soul:

    1. B vitamins and folate. These are critical for proper brain function. Research has shown that supplementing with vitamin B1 improved mood, likely by increasing a brain neurotransmitter called acetylcholine. It also decreases anxiety. A side benefit? Improving memory at the same time. Vitamin B1 deficiency was also shown to worsen learning disorders in young children, and increase aggressive behavior to the point where some had to enter a mental hospital. This problem resolved with vitamin B1 supplementation. Vitamin B2 has been associated with decreasing risk of postpartum depression, while also decreasing migraine frequency by an astounding 69 percent! B12 and folic acid have also been shown to be helpful for depression. Ignore the RDAs, which I call Ridiculous Dietary Allowances, and instead take a 50 mg B complex each day. Make sure that some of folic acid is in a form called 5MTHF.
    2. Magnesium is critical in hundreds of reactions in the body, and deficiency is present in the majority of Americans. Low magnesium will put you on a hair trigger for anxiety, as well as for pain. Take 200 mg a day.
    3. NAC, which our bodies use to make the critical antioxidant called glutathione, has been shown to be helpful in a wide array of psychological problems. For day-to-day supplementation, I recommend 250 mg.
    4. Vitamin D* deficiency is associated with many autoimmune problems as well as with depression. As this is the "sunshine vitamin," the insane advice to avoid sunshine has triggered an epidemic of vitamin D deficiency. Take 1000 units daily. To make this simple and low-cost, all of the above can be found for about $.60 a day in a single drink called the Energy Revitalization System by Enzymatic Therapy. Another key cause of depression and anxiety is deficiency of omega-3 fish oils. Unfortunately, it takes seven large capsules a day of most forms to get the proper therapeutic effect. A simpler low-cost solution? A special form of pure omega-3's that have been vectorized (which is another way of saying that they remain bioidentical) can be found in a product called Vectomega by Terry Naturally. One a day replaces seven fish oil pills.
    5. Got depression? Repeated studies have shown that a special highly absorbed form of curcumin called CuraMed (also by Terry Naturally) 750 mg 2x day was more effective than antidepressants in head on studies. In addition, instead of the side effects of the medications, curcumin is associated with side benefits, including less pain, optimizing immunity to decrease cancer risk, and likely lower risk of Alzheimer's.
    6. For anxiety, it is not necessary to be addicted to Xanax. A special herbal called AnxioCalm, two twice a day, was shown to be as effective at restoring calm as the Valium family medications after six weeks of use. With no addiction or side effects.

    This simple regimen can leave you feeling fantastic, at lowcost. Give it six weeks to see the full effect. It can also safely be combined with mood medications. It's easy to feel calm and happy—naturally!


    *Editor's Note: We strongly recommend you visit GrassrootsHealth.net to learn more about Vitamin D, its importance, how to determine what dosage is right for you, and most of all, why it is so darn important you have sufficient levels of Vitamin D. Did you know serum levels greater than 40 ng/ml are associated with > 65% lower risk of cancer?1 Or that serum levels of 40-60 ng/ml may provide a significant reduction in breast cancer risk? Or lower risk for type 2 diabetes, colorectal cancer and much, much more.

    GrassrootsHealth is a nonprofit public health research organization dedicated to moving public health messages regarding vitamin D from research into practice. It has a panel of 48 senior vitamin D researchers from around the world contributing to its operations. GrassrootsHealth is currently running the D*action field trial to solve the vitamin D deficiency epidemic worldwide. Under the D*action umbrella, there are also targeted programs for breast cancer prevention and a ‘Protect Our Children NOW!’ program to stop vitamin D deficiency where it starts, in utero.

    End Notes:

    1. Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml Are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study
  • Obesity has gone prime time. We Find evidence of its presence where ever we look: in every neighborhood, every mall, every school and every workplace. Hardly a day goes by without the news reporting on some aspect of the looming obesity crisis. However, the epidemic is not confined to just the wealthy developed world. Even desperately poor countries such as Nigeria and Uganda are wrestling with the dilemma of obesity. China, which was once one of the world’s leanest countries, is not immune. In fact, it has one of the fastest-growing obesity rates in the world and one quarter of its urban youth is presently overweight. It is projected that by 2015, 200 million Chinese will be not just obese, but morbidly obese. The looming obesity epidemic is sending chills through the global community. Worldwide, more than 1.3 billion people are overweight, whereas only 800 million are underweight—and these statistics are diverging rapidly.

    The problem of expanding waistlines is more than merely a vanity concern. There are serious health consequences from sporting that beer belly. Being overweight can radically change the course of a person’s life. Fat is toxic and potentially lethal. Just carrying as few as an extra 4.5 kilos (10 pounds), over your ideal weight is considered a serious risk factor for heart disease, diabetes, high blood pressure, dementia and Alzheimer’s disease, liver disease, hormonal imbalances depression and cancer. In fact, at least 30 different diseases are related to being overweight. So, what’s going on here? If people were to follow the advice offered by medical professional, public health officials and the experts from the weight loss industry, the problem should be easily solved. Their call to action basically involves turning your back on all those sugary, high carbohydrate, processed, junk foods and switch to a low calorie diet fortified by plenty of exercise. They say it all boils down to a very simple equation: take in fewer calories and burn more.

    Sounds logical. The only problem is that this decades old approach is a dismal failure. For the vast majority of people, it doesn’t work. In fact, long-term success for attaining permanent weight loss is only achieved by a mere 2–5 percent of those very determined and lucky dieters.

    A definition of insanity is doing the same thing over and over again and expecting a different outcome. It certainly appears that the traditional approach to winning the battle of the bulge does indeed, seem insane.

    If there are answers and successful strategies to stem the tide of this serious health epidemic, they will need to be sought elsewhere.

    It’s time to discover some of the missing pieces of the weight loss puzzle.

    Secrets of the Brain-Belly Connection
    Do you value your brainpower? Certainly the one faculty that everyone wants to hold onto throughout a life’s lifetime is a fully functioning, intact brain. Unfortunately belly fat can deliver a serious blow to your aspirations.

    Overwhelming evidence now reveals that your expanding waistline will put a serious crimp on your brain size as well as brainpower.

    Researchers set out to discover if being overweight posed a danger to the brain. They scanned the brains of 94 people over the age of 70. They were looking to see the differences in the brains of people who were of normal weight (BMI under 25), overweight (BMI 25–30), and obese (BMI over 30). (BMI stands for body mass index, an approximation of body fat based on height and weight.)

    Their results were quit shocking. Overweight people have 4 percent less brain tissue than people of normal weight. And, for obese people, the findings were even worse. They had 8 percent less brain tissue than people of normal weight.

    The study not only showed that carrying extra weight degenerated the brain but it also accelerated its aging. Researcher Paul Thompson shared his observation, “The brains of overweight people looked eight years older than the brains of those who were lean, and 16 years older in obese people. Type 2 diabetes, which is common in the overweight, is known to accelerate the aging of the brain and the onset of dementia. But the relationship between brain size and weight still stood when the researchers accounted for this, suggesting it is the fat itself that is causing the problem. It is thought that high levels of fat raise the odds of the arteries clogging up, cutting the flow of blood and oxygen to the brain. This could cause brain cells to die and the organ to shrink.” The high demands put on these brain areas may make them more sensitive to changes in oxygen levels.

    Another study used magnetic resonance imaging to compare the brains of 44 obese individuals with those of 19 lean people of similar age and background. The obese individuals had more water in the amygdale—a part of the brain involved in eating behavior. It also showed smaller orbitofrontal cortices in obese individuals, important for impulse control and also involved in eating behavior. These findings strengthen the “slippery slope” theory of obesity. The neural changes that occur when you are overweight, affects the parts of your brain that influence and control so many behaviors necessary to make healthy choices.

    Further studies indicate that those with the most belly fat (visceral fat mass) suffer the greatest mental declines over time—and that central or abdominal obesity, in particular, accounts for more than a three-fold increase in dementia risk.

    What’s even more worrying is that increased belly fat is linked to decreases in total brain volume, independent of BMI. This can cause changes in another area of the brain, called the hippocampus, which is responsible for long-term memory, spatial memory and navigation. Finally, excess belly fat also appears to contribute to lesions in the brain’s white matter, especially in diabetic patients—linking it not just to memory loss, but also to increased risk of stroke.

    Obesity is also causes changes to the immune system, which are fanning the flames of inflammation throughout the body. This increased inflammation can impact the brain and lead to a vicious cycle of gaining more and more weight: obesity leads to inflammation, which damages certain parts of the brain, which in turn leads to more uncontrolled eating and more obesity.

    There are many areas of the brain that are affected by being overweight.

    • Frontal and temporal lobes—critical for planning, memory and impulse control
    • Anterior cingulate gyrus—responsible for attention and executive functions
    • Hippocampus—important for long-term memory, spatial memory and navigation
    • Basal ganglia—essential for proper movement and coordination

    Here is the catch-22. Those extra kilos impair brain function and compromise the particular areas of brain that impact a person’s ability to have a keen memory, control impulses and follow through on any kind of planning. It, therefore, becomes more difficult to successfully commit to any kind of program, especially a weight loss program. Since the impulse control part of the brain is affected, controlling those urges to help yourself to another donut or a second helping of mashed potatoes is a Herculean effort and generally doomed to fail.

    Vitamin D —A Key to a Healthy Metabolism
    There is one really important nutritional player when it comes to our health. This superstar nutrient is the sunshine hormone, vitamin D. (Vitamin D is really a steroid hormone rather than an actual vitamin.)

    Vitamin D truly deserves the title of superstar. Each year, vitamin D research discovers additional health benefits conferred by this sunshine vitamin. Vitamin D receptors are found throughout the body including the brain. Optimal levels are absolutely necessary to insure healthy bones, healthy arteries, a robust immune system, balanced moods, optimal cognitive function, protection from hypertension, allergies, multiple sclerosis, Alzheimer’s disease, autoimmune conditions, and fertility and PMS. Most significantly, vitamin D has been proven to be protective against 13 different kinds of cancer.

    Optimal Levels of Vitamin D Are Critical for Health Here are some basic facts you need to know about vitamin D. It is a fat-soluble steroid hormone that is both made by the body and from our diet. In order for the body to produce vitamin D (cholecalciferol), the skin must be exposed to ultraviolet light, primarily from the sun. Vitamin D is further metabolized in the liver and kidneys to create the fully active form of vitamin D. Thus variations in sun exposure due to latitude, season, time of day, sunscreen use, skin pigmentation, and age will determine how much vitamin D the body makes.

    Although it is known that vitamin D play a vital role for the well-being of infants, children, adults and the elderly, we presently have a global pandemic of chronically low vitamin D levels. It’s estimated that 85 percent of the American public are deficient, and as much as 95 percent of all its senior citizens. Vitamin D deficiencies are also widespread throughout the UK, with 86 percent of the population deficient in the winter and 57 percent in the summer.

    Even though Australia’s is described as “sun burnt” country and is one of the sunniest countries in the world, a surprising number of its citizens are severely lacking in vitamin D. A recent report stated that as many as 1 in 3 Australians may have low vitamin D levels.

    For all those on a weight loss quest, vitamin D is one of those missing pieces you have been searching for. There is overwhelming evidence that confirms the importance of keeping your vitamin D levels up to get your extra kilos down. Not only does it help achieve weight loss, it also improves other risk factors such as insulin resistance, metabolic syndrome and blood sugar imbalances. If you are feeling hungry all the time no matter how much you eat, you might want to have your vitamin D levels checked. What drives insatiable hunger is the relationship between low vitamin D levels and a hormone called leptin. Leptin is a messenger molecule made in fat cells that communicates to the hypothalamus, letting it know how much fat is stored in the body. It is the hormone that communicates that you are full.

    Low vitamin D levels interfere with the effectiveness of leptin. Researchers at Aberdeen University, Scotland found that obese people produced 10 per cent less vitamin D than people of average weight. The study discovered that low levels of the vitamin in blood interfered with the function of leptin, which tells the brain when the stomach is full. The study also found that excess body fat absorbs vitamin D, stopping it from entering the bloodstream. Dr Helen MacDonald, of Aberdeen University’s department of medicine and therapeutics, said: “Obese people had less vitamin D and the link between obesity and vitamin D deficiency was statistically significant.” Overweight people, shirking the sun or not taking adequate vitamin D supplementation thwart their dieting efforts in another way. Low vitamin D levels have been shown to increases fat storage. A 2009 Canadian study found that weight and body fat were significantly lower in women with normal vitamin D levels than women with insufficient levels.

    It seems that fat people may be less able to convert vitamin D into its hormonally active form. A Norway study found that the more participants weighed, the lower their vitamin D levels tended to be. The researcher, Zoya Lagunova, MD, believes that obesity is associated with lower vitamin D levels since vitamin D is a fat-soluble vitamin. “Much of the vitamin D produced in the skin or ingested is distributed in fat tissue, so obese people may take in as much vitamin D from the sun, food, or supplements as people who are not obese, but their [blood] levels will tend to be lower. Obese people may need more vitamin D to end up with the same levels as a person whose weight is normal.”

    How much less vitamin does an overweight person make? As it turns out, increased fatty cells can decrease the ability to make vitamin D by a factor of 4. That means that if you are carry extra weight, you may make only one quarter the amount of vitamin D compared to a leaner person. Vitamin D is also an important factor in diabetes. Low levels of vitamin D has been linked to an increased risk of developing type 2 diabetes. After following more than 5,000 people for five years, an Australian research team found that those with lower than average vitamin D levels had a 57 percent increased risk of developing diabetes, compared to those within the recommended range.

    Low levels of vitamin D are also known to nearly double the risk of cardiovascular disease if you already have diabetes. Diabetics, who are deficient in vitamin D and cannot process cholesterol normally, tend to have it build up in their blood vessels, hence increasing the risk of heart attack and stroke.

    Vitamin D also helps keep blood sugar levels under control. In type 2 diabetes the body can’t use insulin it produces efficiently to control blood sugar levels. Vitamin D plays a role by increasing the release of insulin. In one study, researchers evaluated the vitamin D levels and the chance of developing unbalanced blood sugar metabolism. In this study, subjects were evaluated for serum vitamin D levels and followed for 7 years to determine the effects on blood sugar metabolism. The study showed that the subjects with the highest vitamin D levels had a 40 percent increase in supporting optimal future blood sugar balance.

    If you want to lose weight and keep it off, it is critical to check your vitamin D levels. The higher your vitamin D levels the higher your leptin levels and the more your blood sugar will remain balanced. Vitamin D helps your body respond to the correct metabolic messages. High vitamin D levels increase your ability to lose weight and losing weight will increase your vitamin D levels. All of which will reduce your risk of metabolic syndrome, insulin resistance, diabetes, and cardiovascular disease, not to mention most chronic illnesses.

    While it is important for most people to take vitamin D supplementation, especially the overweight, children and elderly, it is critically important to check your vitamin D levels. Taking a vitamin D supplement may not get you into optimal range, which is where you want to be. Its optimal blood vitamin D levels that count. The proper blood test is called 25-hydroxyvitamin D (25-OH), which is included in the basic blood workup. In Australia optimal levels should be 150–200 nmol/L. In the U.S., optimal levels should be between 70–100 ng/mL. Do not settle for less than optimal levels if your goal is the best health possible.

  • Editor's Note:
    This is the first in a series of articles drawn from The Sinatra Solution, Metabolic Cardiology by Stephen T Sinatra, M.D.

    In his introduction to this landmark work, James C. Roberts, M.D., FACC states the following: "Nutritional science provides answers to many lingering questions in medicine. It's the difference between natural science and the man-made science of drug therapy.
    Pharmaceuticals do play an important role in medicine and Dr. Sinatra and I study their use, but more drugs are not the only answer. A better answer is for physicians and patients to learn more about the biology of disease and the biochemical keys to energy production. This knowledge provides the insight needed to support the heart and the recovery of our health, well beyond what drug and surgical therapies can provide. That is why I'm so passionate about metabolic cardiology and that's what you will learn about in this important book.
    "

    Whether you are a practicing cardiologist, afflicted with a heart disease or simply the responsible owner of an adult body, we are confident you will find The Sinatra Solution an invaluable asset to achieving and maintaining optimum health.


    My journey as an integrative cardiologist has been an exciting period in my life, and it has brought me endless moments of satisfaction and joy. Yes, it is joyful when you can reduce human suffering and improve the quality of life for someone else. l have shared many moments of sublime satisfaction with my patients and their families, after their life has been improved or spared through the many alternative, pharmaceutical and technical tools of modern cardiology. But the specialty I hold so close to my own heart still has considerable limitations.

    Pharmaceutical drugs, bypass surgery, angioplasty, stent emplacements, pacemakers and implantable defibrillators all have their place, and many lives would be lost without these high-tech interventions. Cardiologists face a daily dilemma concerning the best diagnostic procedures to refer for their patients and then, based on those test results, which surgical and/or pharmaceutical interventions to select. To complicate the choice, the evaluations we order and the treatments we select may actually create unnecessary risks for patients-risks that are out of proportion to the benefits they will experience. Continuing technological advances, although necessary, add to the complexity of the decision-making process.

    Cardiologists have grown reliant upon these sophisticated medical processes. But somewhere along the way, something has gone amiss. There has been much mistrust of the conventional medical model among the public recently. Starving for new information, massive numbers of patients are consulting alternative therapy practitioners and are visiting book and health food stores in record numbers, creating a multibillion dollar industry outside of the mainstream medical community.

    What is driving even our most conservative patients to look at other forms of therapies? There are many reasons for the increased popularity of alternative medicine, including patient dissatisfaction with ineffective conventional treatments, pharmacologic drug side effects and the high price of medications. Perhaps most important is the fact that traditional medicine has become too impersonal with the involvement of high-tech modalities and time-limited office visits.

    Obviously, the medical consumer is searching for less invasive, safer and lower cost interventions. Some of this comes out of necessity; managed care plans have driven our patients into seeking cost-effective medical care delivery, as more of their health care dollars are coming out of their own pockets.

    Many patients are now questioning the need for potentially life threatening drugs and invasive interventions that carry considerable risk of side effects, complications and even mortality.

    Recent research has suggested that 2 million lives are lost each year as a result of complications from" standard-of-care" interventions, medical errors and complications. When we consider that the fourth leading cause of death in the United States is properly prescribed medications in a hospital setting, something's gotta give!

    Even in 2005, coronary artery bypass surgeries (CABS) are performed on the basis of clogged arteries alone with no regard to quality of life issues. This is not smart medicine. Rates of complications from CABS-such as heart attack, infection, stroke, and central nervous system (CNS) dysfunction-are disturbing. It is important to note that CNS dysfunction was observed in an alarming 61 percent of patients six months after CABS. People are naturally looking for less risky and fewer surgical alternatives in lieu of such downsides.

    During my 30 years of practicing cardiology I have seen a slow paradigm shift regarding the perceived availability of effective, natural alternatives for the treatment of a wide range of cardiovascular disorders-problems like angina, arrhythmia, high blood pressure and congestive heart failure (CHF). More physicians have expanded their approach to heart disease and accept and recommend complementary therapies as equally judicious treatment interventions. However, invasive CABS is a sound approach to improve quality of life and possibly advance longevity when alternative or medical therapy fails to correct a patient's symptoms of refractory angina (chest pain, shortness of breath and so on).

    An integrative cardiologist is one who brings conventional methodologies to the table and also offers complementary and alternative interventions that can boost patients to an even better quality of life. Integrative cardiologists are as comfortable prescribing diet and lifestyle changes, a vast array of nutritional therapies and mind/body approaches as they are scheduling a treadmill stress test, recommending angioplasty and handing out a medication. They integrate the best of both worlds when caring for their patients.

    For example, I have encountered an endless number of patients awaiting heart transplants-those with the most seriously compromised heart function-who have been literally "cured" by nutritional therapies. Those who want to improve the quality of their lives through both conventional and alternative approaches.

    Getting well requires that the physician and the patient share in the healing process. I believe that we physicians don't really "cure" anyone. We merely coach, care for and support our patients . . . only nature heals.

    A good physician assists patients in finding and stimulating their own healing capabilities. Over the years I've learned that real healing takes place when the intention of the healer matches the intention of the patient.

    The real essence of "doctoring" employs elements from physical, emotional and spiritual realms to reduce human suffering and enhance quality of life. Integrative physicians who use whatever it takes to help heal the patient, are practicing good medicine, as well as what I refer to as smart medicine. And physicians who listen to "the messengers" around them are open enough, and wise enough, to understand that not only can they can learn from their teachers and colleagues, but also from their own patients as well.

    I know that many of my own patients are interested in how I became involved in nutritional and other non-conventional therapies. Most tell me how hard it is to find a physician comfortable with what (I'm sorry to say) we still call "alternative" approaches, and ask how I "fell into it." First of all, many of the practices we now call alternative are actually mainstream healing methods that we've abandoned in our age of technology. Indigenous and advanced cultures alike still use these therapies appropriately and with good results.

    I didn't "fall" into practicing and endorsing complementary forms of healing at all. I truly believe that I was led here. Within a year after passing my cardiovascular boards and becoming a credentialed invasive cardiologist, I began to realize something was missing. For instance, I started asking myself why I saw the same patients coming back into the emergency room with the exact same problems that had brought them there just months earlier-after we thought we'd "fixed" them. Too many times I would take care of a medical crisis, patch the patient up and send him back out, only to see them return again. Surely something was amiss.

    I didn't quite get it. I sincerely thought that I was doing the right things, but I wasn't really helping anyone's body heal itself. Instead, I was performing in the hospital like that proverbial boy desperately sticking his finger in a hole to patch up a dike doomed to break down. I was prescribing drugs and different therapies aimed at directly "fixing the problem," and they did-in the short term. Then I realized what I was failing to see was the bigger picture: I was doing nothing to actually help prevent or even cure the real, complex, underlying problems.

    MY JOURNEY
    At that juncture, I decided I needed to enter a psychotherapy training program to become more open to other modalities of healing, including mind-body medicine. Over the next decade I studied mind-body interactions, became a certified psychoanalyst and read all I could about nutritional medicine. I spent nine years studying bio-energetic psychotherapy, an approach that confirmed my experience and belief that stress in the psyche can translate into physiological processes that create "dis"-ease in the body. Eventually, I coupled this approach with learning all I could about providing better care for the psyche and the body. The latter brought me into the field of nutritional approaches as well as to cellular healing.

    It was at this point that I had my first encounter with coenzyme Q10. It seems no accident that I came across an article in the Annals of Thoracic Surgery reporting how patients taking coenzyme Q10 were able to be weaned more quickly from the heart-lung bypass machine we use during open heart surgeries. I'd recently lost a dear patient after a successful mitral valve replacement operation because he had failed over and over to come off that same pump-a nightmare scenario that happens on extremely rare occasions. So that article really grabbed me and made a strong impression. What regrets! What if I had known about coenzyme Q10 before I'd sent that kind man to a surgeon? His death had been a real heartbreak for me and one that still strays into my thoughts.

    I couldn't bring that one gentleman back, but from then on I could, and did, tell patients awaiting open heart surgeries to start taking a daily dose of 30 milligrams (mg) of coenzyme Q10 two weeks in advance. Thanks to the lessons from one patient, they all came off the heart-lung bypass machine without a problem.

    All through the 1980s I found myself driven to learn all I could about mind-body and nutritional medicine. It consumed most of my spare time. By 1986, I was convinced enough to start using coenzyme Q10 for more cardiac situations, like arrhythmias, hypertension, coronary artery disease, CHF and angina. In 1990 I actually began to develop my own vitamin and mineral formulas using coenzyme Q10, B vitamins, vitamins C, E, and D, carotenoids, flavonoids, calcium, fish oil, green tea and so on, and I believe that they all have merit in the treatment and prevention of heart disease.

    I read reams of research, and even authored several books and journal articles to share the success stories I was observing with my own patients, many of whom were transcending the kind of improvements I had only hoped and prayed for. As I watched those tears of joy and enjoyed hugs from my patients and their family members, it was obvious that we were onto something . . . something big! I didn't realize it, but in the future I would become a metabolic cardiologist.

    A few years later I started using L-carnitine and was truly amazed at how this combination of two nutraceuticals (coenzyme Q10 and L-carnitine) provided an even bigger quality of life boost for people. Frankly, when I look back I don't know how I ever practiced cardiovascular medicine without them. Now it's unthinkable not to recommend them to my patients with heart failure, arrhythmia, angina and hypertension. Knowing what I know now, withholding information about these nutraceuticals would be tantamount to malpractice for me.

    It was a new beginning in my practice of medicine to be able to offer my patients alternative therapies that were safe and efficient-and that truly worked. Because nutrition had not been a part of the curriculum when I went to medical school, I had to make time to study it at great length, but my physician colleagues were often skeptical that I knew what I was talking about. So to be sure that I was qualified, I dug in, learned more and took the board examination given by the American College of Nutrition (ACN). I studied for two years, passed the exam and added CNS (Certified Nutrition Specialist) to my credentials.

    MITOCHONDRIAL DEFENSE
    In the 1990s I was recommending nutraceuticals to support the mitochondrial defense system in the cell. You may recall from high school biology that the mitochondria is nicknamed the "powerhouse of the cell" because it's primary function is to generate ATP, that complex energy substrate generated by the Krebs cycle (a long chemical process I hope you never had to memorize for a test question.) I serendipitously came to learn that preserving the mitochondrial adenosine triphosphate in our precious heart cells was really the answer in sustaining the pulsation of cells and life itself.

    I learned that pulsation in the body is the key to vibrancy and life itself in my bioenergetic training for certification. Even prehistoric man knew that life depended upon the pulsating heart. Another light bulb went off! I realized that the health of the heart cell's mitochondria was the key to pulsation and contraction. I became driven to devote my energies to studying the relationships among mitochondria, the heart and cardiological diseases.

    This complex relationship is the essence of metabolic cardiology.

    In 2002 I met Dr. James Roberts at a conference in Las Vegas and listened to his research on the utilization of D-ribose in the cardiac patient. D-ribose is a five-sided sugar that is the missing link in energy transformation. I was truly amazed by Dr. Roberts' presentation and we have become colleagues over the past few years. I have such a genuine respect for Dr. Roberts that I asked him to write the introduction to my book. A well-credentialed integrative cardiologist himself, Dr. Roberts knows the vital importance of D-ribose in providing and sustaining energy, particularly in hearts that are compromised.

    After using D-ribose dozens and dozens of times and becoming convinced of its efficacy, I wrote a newsletter article about it in my "Sinatra Health Report." I wanted to give this new and vital information to my 50,000-plus subscribers describing the emerging field I call "Metabolic Cardiology."

    As my knowledge and experience evolved, I came to realize that when you treat the mitochondria and nurture the heart on a cellular level, then you can improve the health of the whole organism. The study of mitochondrial energy and pharmacokinetics became such a passion that I wanted to write this book to get this life-saving information out to more and more people.

  • There is a vitamin revolution brewing, and it is important to the health of young and old alike as researchers respond to what has been called the “vitamin D deficiency epidemic.” More than a dozen scientists at leading universities both in the United States and abroad have minced no words about it: many of us need more vitamin D. (See “Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic.”)1 The issue of deficiency may be especially true of children, yet it is also applicable to adults. Quite surprisingly as far as vitamin D is concerned, the suggested intakes in recent decades have fallen rather wide of the mark. Not only are the recommendations of 400 IU/day as an adequate intake (100 percent of U.S. Daily Value) and 2,000 IU/day as an upper limit too low, but also recommendations may have been more realistic 70 years ago. As detailed below, in a tale of two vitamins, A and D, scientists initially bet on the wrong one.

    Vitamin D Versus Viral Respiratory Infections
    All the way back in 1926, it was theorized that a disorder in vitamin metabolism linked to a lack of sun exposure is responsible for the rise in infections experienced during the winter months.2 Experiments in the 1930s provided considerable support for this hypothesis. Using a cod liver oil much higher in vitamin D content than is typical today, one large trial involving 185 adults for four months discovered that supplementation reduced the rate of infections with colds by 50 percent.3 Another study tracking 1,561 adults found the rate of respiratory infections fell by 30 percent.4 Recent work comparing 410 teenage athletes who received vitamin-D producing radiation against 446 athletes who did not over a period of three years demonstrated the same range of benefits as was seen with cod liver oil supplementation in the 1930s: 50 percent fewer respiratory infections and 300 percent fewer lost days due to absences.5

    How does vitamin D provide protection against infections? This has been the subject of considerable work and the answer seems to be vitamin D produced in the skin in response to sunlight provides the body with the vitamin in its hormonal form known as 1,25(OH)2D, actually a type of steroid hormone. Indeed, the skin has the capacity to synthesize the biologically active vitamin D metabolite 1,25(OH)(2)D3.6 The active form of vitamin D serves both to reduce the excessive production of inflammatory factors and, yet, to increase the power of other immune elements, such as the “oxidative burst” of the macrophages, the immune system’s first line of defense. The effects of the vitamin on the immune system are particularly striking in an area that touches directly on defenses against colds and respiratory infections/flu. The lining of the respiratory tract is full of neutrophils, monocytes and natural killer cells, all of which contain anti-microbial peptides that are empowered by vitamin D.7

    These benefits are known for sun exposure. Great news for the summer months, but can the use of vitamin D supplements help to provide the same protection? Luckily, the answer is “yes.” In a randomized placebo-controlled intervention trial lasting three years, it was discovered African American women receiving vitamin D exhibited only one third the likelihood of reporting cold or flu symptoms as did controls. The amount of vitamin D needed to abolish completely the tendency towards more colds and flu in the winter months was only 800 IU/day. Increasing the intake of supplemental vitamin D to 2,000 IU/day almost entirely eliminated reports of upper respiratory tract infections.8

    Vitamin D and Vitamin A: A Conflicted Relationship
    Recent studies using cod liver oil have not produced as robust a response in preventing infections as those found in the 1930s. Why not? The answer appears to be tied to the tendency over the last few decades to overrate the importance of vitamin A and to underrate the importance of vitamin D. Cod liver oil-based studies in recent years have used supplements typically providing 3,500 to 5,000 IU vitamin A as preformed retinol and only in the neighborhood of 700 IU vitamin D. The problem in this is vitamin A and vitamin D competes against one another because they make use of common cofactors. Vitamin A acts as an antagonist to vitamin D and its active metabolite.

    That there might be an untoward interaction between vitamin A and vitamin D has been suspected for quite some time. Research at several laboratories has confirmed this suspicion. In an animal study, it was found there is an in vivo antagonism of vitamin D action on intestine and bone by retinyl acetate.9 Exactly how vitamin A antagonizes vitamin D is not entirely clear, but the fact is being ever more soundly established.10 Moreover, in human beings the amount of vitamin A needed to interfere with aspects of vitamin D metabolism is not high. For instance, one serving of liver as a vitamin A source interferes with vitamin D’s effects on the intestinal response to calcium.11 Many Americans are marginal or outright deficient in vitamin D. In such cases, the amount of vitamin A supplied by multi-vitamins and other sources is sufficient to tip matters over the edge into significant manifestations, such as reduced bone health.12 Although vitamin A deficiency is a serious issue in parts of the developing world, predominantly due to a lack of adequate fat in diet impeding absorption of this fat-soluble vitamin, once vitamin A requirements are met, there is a significant negative interaction with vitamin D.

    Cardiovascular Health and the Sunshine Vitamin
    The role of vitamin D in cardiovascular health is one of the currently “hot” topics in research circles, and for good reason. Vitamin D levels have been linked to a number of aspects of heart and circulatory health. Take blood pressure, for instance. It generally is assumed that blood pressure, primarily systolic blood pressure (the upper figure), increases naturally with age. This is the reason the elevation over time is named “age-associated increase in systolic blood pressure.” Interestingly, maintaining “optimal” vitamin D status reduces or attenuates the elevation in blood pressure that is expected with age.13 Another circulatory condition, lower-extremity peripheral arterial disease, similarly is related to vitamin D status. Nearly one third of the higher prevalence of this condition in adult blacks compared to whites is explainable by vitamin D levels being lower in blacks.14

    Another way of thinking about vitamin D and cardiovascular health is to consider the lively discussions ongoing in research circles regarding the relationship of statins and vitamin D. Cardiovascular disease has a large inflammatory component and some scientists have argued that statins act, in large part, by serving as vitamin D analogs. Moreover, another aspect of cardiovascular disease concerns vascular calcification and statins recently have begun to be touted for bone health as well as reducing calcification of the arteries.

    As is true of many substances, vitamin D is biphasic in some of its actions. Too much is a bad thing, but too little can lead to some of the same results as too much. Above it was mentioned that the vitamin plays a role in reducing inflammation. This is significant to heart health because arterial inflammation is an important step in the process leading to calcification. Hence, it is of note that in an animal model, low levels of the vitamin D hormone calcitriol are associated with massive vascular and soft tissue calcifications.15 That’s right: low levels of vitamin D-related compounds may lead to vascular and soft tissue calcification. Findings are interesting enough that researchers have begun to discuss vitamin D in the prevention and treatment of coronary heart disease.16

    So what about statins and vitamin D? Much evidence available for over a decade suggests that statin drugs are cardio-protective via anti-inflammatory effects on the artery wall and not through any impact on cholesterol levels. Hence it is of note that treatment with statins, at least over the short and medium term, increases serum vitamin D by an unknown mechanism.17 At the same time, vitamin D deficiency, which is quite common in those with cardiovascular problems, appears to play a role in the myalgia associated with statin use.18

    In other words, at least some of the benefits attributed to statin drugs, whether cardiovascular or bone-related, appear to be linked to improved vitamin D status. Likewise, at least one of the side effects of statin usage is linked to vitamin D deficiency.

    Guarding Cognitive Health
    Poor mood often is associated with advancing years. Recent data suggests that poor vitamin D status may be common in the elderly and low levels of vitamin D are associated with poor mood. There are a number of trials that have suggested a role for supplementary vitamin D in the treatment of depression.19 The impact of vitamin D status, however, appears to go far beyond merely improving mood. A large trial involving 1,766 adults over the age of 65 identified vitamin D levels as related to cognitive function and dementia. The relationship is strong enough that the researchers suggested supplementation with vitamin D as a possible way to reduce the risk of developing dementia.20

    How Much is Enough?
    As usual, the devil is in the details. How much vitamin D is enough? Quite obviously, there likely is a range and not any one figure involved. People are different, get different amounts of sun exposure, have different diets, different stresses, and so forth. One recent study argues that the amount of vitamin D intake needed to attain the desired serum 25-hydroxyvitamin D concentration may run between 3,800 and 5,000 IU per day, amounts in excess of the currently officially endorsed upper limit of intake.21 These amounts are based on the researchers’ estimate of the intake of vitamin D3 needed to raise serum 25(OH)D to equal to or greater than 75 nmol/L and is in line with long-time recommendations of many experts of 3,000 to 5,000 IU/day.22 Other researchers using a different model of sun exposure and intake from food while restricting themselves to the requirements of Caucasians only still determined that a reasonable level of intake to prevent seasonal fluctuations may be as much as approximately 1,600 IU/day.23 Again, this is a far cry from the presently recommended 400 IU/day. Moreover, some individuals have low vitamin D status even with abundant sun exposure.24 All of this suggests the recommendation for vitamin D intake may soon be revised strongly upwards and that the currently suggested upper limit of intake of 2,000 IU/day may, instead, become closer to baseline.

    For references send a SASE envelope to totalhealth magazine.