Danika was of a young woman of African American descent who had been adopted by a Caucasian couple shortly after birth. She was a happy, bright child who was healthy overall except when it came to eating. "We are concerned about her appetite," her mother reported obviously uncomfortable. "We don't want to make a big deal out of it, but we are worried she might be getting rather too large," she tentatively concluded. She was going for tact but Danika was having none of it.
"I'm huge," she stated matter of factly.
I generally appreciate when people are blunt because it saves a lot of time and trouble figuring out how to approach a situation. So I liked Danika immediately. She was a big girl heightwise, too, making her look more like a fourteen year old. I would have to remind myself not to expect behavior beyond her actual years especially because she was so articulate.
"Don't say that about yourself," her mother protested, cutting her off and fidgeting in her seat. I stopped for a second and took in the situation. Here sat two thin Caucasian parents raising a non-thin child of African decent. They were trying so hard not to let any cultural preconceived notions prejudice them that they were practically sweating from the stress of not being judgmental. This could get dicey.
"What do you think is going on?" I inquired.
"I try to eat healthy," she explained, "but I am hungry a lot."
Looking at her food diary it was clear she had a good appetite but was not eating the quantity of food I would have expected given her size. Her thyroid had been checked and she was in otherwise perfect health. She was partial to pasta and bread so I suggested a gluten free diet for 6 weeks to see if that helped her feel less hungry. If a reaction to a food is causing excessive hunger, that food usually contains gluten or sugar. It is almost impossible to help someone lose weight if they feel hungry all the time so I thought it was a good place to start. Danika groaned. Her parents groaned but the deal was struck. Six weeks: no gluten.
What does this all have to do with genetics? I could pretend I am trying to build up some suspense, but in truth, it is just complicated so the answer will take a little while. The six weeks passed and Danika’s parents checked in. They were pleased to report her appetite had calmed down and she was eating less. Nonetheless, they were very unhappy because despite her food reduction she had gained of three pounds. It was that old medical joke where the doctor announces the treatment was successful but the patient died.
The laws of physics states this is not possible. In my profession, this phenomenon has only one accepted explanation: the client is fibbing. Nobody wants to blame the client because of course, they do not mean to fib but if there is weight gain, there must be a cookie somewhere nobody is copping to. But after much poking around and having run into this situation before, I concluded Danika was not eating in secret but is likely suffering the results of unfavorable epigenetics.
Recall that epigenetics is how the genes change in response to the environment. When big adaptations occur during pregnancy, the child’s gene expression changes and that child passes that adjustment on to their child and so on for many generations. What may have been useful and adaptive given your grandmother’s environment when she was pregnant, may not be so useful for you now. One of the strongest epigenetic trends has been high rates of obesity in the offspring of pregnant women suffering from starvation. This tendency has been documented to continue through four generations.
Danika’s birth mother’s history was murky. In adoption where the health history is not clear, there is a good chance it involves poverty or other social issues where food is not plentiful or eating is restricted (to hide weight gain, for example). I have also noticed through the years that Africian American women can have a particularly hard time losing weight even on severely restricted diets. I ran into this situation so many times that I developed a theory about it.
From an epigenetic perspective, the best body type for surviving in Africa would be one that conserves calories well. The growing conditions are harsh in many areas and there can be long periods of drought when food is scarce. While in the womb, the smart, adaptive baby would naturally shift its metabolism so it could survive on very little food. And as long as the person lived in Africa, all would be well. But transplant that same metabolism here where most people can get all the food they want, drought or no drought and that same baby will put on weight.
A full figured woman once consulted with me because she had been on a 1,200 calorie diet and had not lost an ounce. She was understandably very discouraged. She insisted that calorie restriction never helped her lose weight and wanted some new ideas. We tried a low carbohydrate version of the low calorie diet with no success. On the plus side, she was an amazingly vibrant woman. She was strong and healthy and probably could survive well on a few turnips a week but her epigenetics was not geared for a plentiful food environment. I could not bring myself to reduce her calories further so I asked her to make a difficult decision. I explained epigenetics. Then I told her she would either have to accept the fact that she needed very little food compared to others to maintain weight or she would have to accept herself as a bigger woman. She chose the later.
I often wonder if this is the situation Oprah faces. Even with a trainer, a chef and 42 personal assistants, does she have an epigenetic situation where she can only lose weight eating ridiculously few calories? It is hard to live in this country on a severely calorie restricted diet and it would make sense that she would hang in there for awhile but periodically eat an extra cracker and gain 3 pounds. That sounds like an exaggeration but the small amount of food people with this epigenetic profile can eat is no joke.
Danika was another strong individual who needed very little food to maintain weight. In fact, when she reduced her calories by going on a gluten free diet, her body immediately interpreted this as starvation. Applying epigenetic theory, Danika’s body was highly adaptive for dealing with starvation and so it went immediately into conservation mode. She was not going to need much food to maintain weight. A tough reality at any age but I thought it might be a good thing for her and her parents to know.
“So, what are we suppose to do?” her mother asked.
“Well, here is the situation…….” I started.
Saturday, January 15, 2011
Sunday, January 2, 2011
Blog #24 What You Got from Grandma that Wasn't in the Will
There has been a lot of talk in the medical media lately about genetics. After reading and listening to a number of interesting pieces there seems to be two main points….
1. Genes are not nearly as important/predictive as we have been told
2. Genes are significant in more subtle and profound ways then previously thought.
Media messages are nothing if not abundantly clear.
According to one article (The Great DNA Data Deficit: Are genes for disease a mirage? By Jonathan Latham and Allison Wilson in The Bioscience Resource Project, Dec. 8, 2010), knowing the make-up of your genes helps you predict your chances of getting an illness at about the same accuracy rate as reading an insurance company chart with population statistics of getting a disease and finding your demographic. Forty year old, normal weight black female who does not smoke? You can look up your group on a disease risk chart and find your chances of getting dementia and save yourself the trouble of cracking your personal genetic code.
Francis Collins, renowned geneticist and the head of US National Institutes of Health (NIH) encourages everyone to have their genetic disease susceptibility tested anyway. He had his own mapped and it was such a profound experience that he wrote a book. His most significant personal discovery was that instead of the average risk of developing diabetes given that he was a white male (23%), he had a 29% chance of getting the disease. Otherwise his likelihood of getting cancer, heart disease and dementia was like everyone else. The book must be very short.
Consequently, the gene mapping industry is in trouble. Most people who have done disease risk gene testing discover the same shocking fact: they are average. The exception is those with rare genetic disorders like cystic fibrosis. Of course these individuals by definition are “rare”. With consistently underwhelming findings, the monetary returns that were supposed to be generated from personalized gene mapping technology are looking bleak. At the moment, it looks like you would be better off investing in soap futures or uranium mining.
Genes are not as important and predictive as we have been told because one of the unexpected results of the human genome project was the discovery that DNA is not the most important part of the chromosome. DNA represents half of what is in the chromosome and the only material scientists were interested in until they realized how inert DNA is. Every cell has all the DNA needed for making everything in the body. In addition, there is enormous similarity between the DNA of human and all other animals. We have many fewer genes than scientists expected to explain human diversity let alone the bigger variation between people and fruit flies. DNA turns out to be mostly generic blueprint material. In other words, most of the DNA we carry looks like everyone else’s including monkeys and I don’t mean your brother-in-law.
What regulates and individualizes the DNA? The other half of the material that scientists thought was not important. Yes. It turns out that regulation is where all the action is and few scientists realized this until all the DNA was mapped and turned out to be stunningly generic. (For more on this topic see Dr. Bruce Lipton’s, The Biology of Belief.)
Which leads to point two about the ways genes may be more important than we thought. The DNA might be similar but the controlling proteins and regulation is wildly diverse. Regulation can be affected by your environment, stress, thoughts and your diet. The results are profound and can be so long lasting that what your grandmother or great grandmother ate or experienced while she was pregnant might be effecting how you are expressing your genes today. There is even emerging evidence that your grandfather’s health at the time of conception (try not to think about that part) could shift your disease risk today. This emerging field is called epigenetics and it is mind blogging.
Imagine the implications of this study. Scientists took some male rats and made them fat by feeding them a high fat diet similar to what we Americans eat today. The fat rats, who had symptoms of type 2 diabetes, were bred with non-overweight females. The pups did not become overweight (because of how they were fed) but a lot of them developed type 2 diabetes anyway! Ditto for the next generation.
We already know that pregnant women on starvation diets (due to famine or war) have children and grandchildren with much higher rates of obesity. The fetus makes decisions about gene expression in utero based on the kind of world it thinks it is coming in to. This early gene regulation has life long (and after) ramifications.
So, what practical application can this information have? The results of epigenetics walked into my office in the form of eleven year old, Danika. To be continued…….
1. Genes are not nearly as important/predictive as we have been told
2. Genes are significant in more subtle and profound ways then previously thought.
Media messages are nothing if not abundantly clear.
According to one article (The Great DNA Data Deficit: Are genes for disease a mirage? By Jonathan Latham and Allison Wilson in The Bioscience Resource Project, Dec. 8, 2010), knowing the make-up of your genes helps you predict your chances of getting an illness at about the same accuracy rate as reading an insurance company chart with population statistics of getting a disease and finding your demographic. Forty year old, normal weight black female who does not smoke? You can look up your group on a disease risk chart and find your chances of getting dementia and save yourself the trouble of cracking your personal genetic code.
Francis Collins, renowned geneticist and the head of US National Institutes of Health (NIH) encourages everyone to have their genetic disease susceptibility tested anyway. He had his own mapped and it was such a profound experience that he wrote a book. His most significant personal discovery was that instead of the average risk of developing diabetes given that he was a white male (23%), he had a 29% chance of getting the disease. Otherwise his likelihood of getting cancer, heart disease and dementia was like everyone else. The book must be very short.
Consequently, the gene mapping industry is in trouble. Most people who have done disease risk gene testing discover the same shocking fact: they are average. The exception is those with rare genetic disorders like cystic fibrosis. Of course these individuals by definition are “rare”. With consistently underwhelming findings, the monetary returns that were supposed to be generated from personalized gene mapping technology are looking bleak. At the moment, it looks like you would be better off investing in soap futures or uranium mining.
Genes are not as important and predictive as we have been told because one of the unexpected results of the human genome project was the discovery that DNA is not the most important part of the chromosome. DNA represents half of what is in the chromosome and the only material scientists were interested in until they realized how inert DNA is. Every cell has all the DNA needed for making everything in the body. In addition, there is enormous similarity between the DNA of human and all other animals. We have many fewer genes than scientists expected to explain human diversity let alone the bigger variation between people and fruit flies. DNA turns out to be mostly generic blueprint material. In other words, most of the DNA we carry looks like everyone else’s including monkeys and I don’t mean your brother-in-law.
What regulates and individualizes the DNA? The other half of the material that scientists thought was not important. Yes. It turns out that regulation is where all the action is and few scientists realized this until all the DNA was mapped and turned out to be stunningly generic. (For more on this topic see Dr. Bruce Lipton’s, The Biology of Belief.)
Which leads to point two about the ways genes may be more important than we thought. The DNA might be similar but the controlling proteins and regulation is wildly diverse. Regulation can be affected by your environment, stress, thoughts and your diet. The results are profound and can be so long lasting that what your grandmother or great grandmother ate or experienced while she was pregnant might be effecting how you are expressing your genes today. There is even emerging evidence that your grandfather’s health at the time of conception (try not to think about that part) could shift your disease risk today. This emerging field is called epigenetics and it is mind blogging.
Imagine the implications of this study. Scientists took some male rats and made them fat by feeding them a high fat diet similar to what we Americans eat today. The fat rats, who had symptoms of type 2 diabetes, were bred with non-overweight females. The pups did not become overweight (because of how they were fed) but a lot of them developed type 2 diabetes anyway! Ditto for the next generation.
We already know that pregnant women on starvation diets (due to famine or war) have children and grandchildren with much higher rates of obesity. The fetus makes decisions about gene expression in utero based on the kind of world it thinks it is coming in to. This early gene regulation has life long (and after) ramifications.
So, what practical application can this information have? The results of epigenetics walked into my office in the form of eleven year old, Danika. To be continued…….
Wednesday, December 22, 2010
Blog #23 Men with Rashes Continues....
Returning to Alan’s skin of many irritations, I thought briefly about all the possible causes of rashes. In the almost 30 years I have been a nutrition detective, I have seen rashes caused by all manner of substances.
Here is a list of the ones I can remember:
• Food reactions to chicken, eggs, olive oil, nuts, fish, grains (especially wheat and sometimes rice), potatoes, seeds, most fruits, a few vegetables….any food can do it but vegetables and lamb react the least.
• Medicines especially anti-depressants, mood stabilizers, anti-seizure meds and antibiotics.
• Bad stuff added to foods including preservatives, additives, colors, pesticides and genetically modified organisms (GMOs) which is actually bacteria DNA spliced in to food.
• Contact rashes from creams, sun screen, soap, bubble bath, shampoo, dryer sheets, laundry detergent, pollen, swimming pool water, leaves, wool, animals (all sorts including a guinea pig).
• Molds (either outdoor varieties or from a sick house).
• Yeast problems.
• Touching water (true story). This was probably from the chlorine in tap water.
• Mites and other bug bite reactions.
• Essential fatty deficiency.
The list is long and basically includes almost anything you can think of but I had ten minutes to make a good guess. Most people can figure out topical contact irritants on their own unless it is something in the environment like pollen or mold. Once I saw a child with extensive eczema. The referring doctor and I tried all sorts of elimination diets and environmental changes but nothing helped. Finally, the family went to Italy for a month and the child’s skin completely cleared up. We then realized (through an additional process of elimination) that the problem was likely an environmental mold though we never knew exactly which one. Allergy testing also could not pinpoint it. Wouldn’t it be nice if your doctor recommended an extended European vacation for unresponsive eczema? Besides his wife had worked that angle pretty hard by eliminating the usual suspects without success. So, I ruled out topical culprits and circled in on the diet and family history.
If a food is causing such a complex ongoing rash it would have to be one that is commonly consumed. It cannot be mangos or pork chops because people do not eat enough of them through out the year to cause this much skin trouble. The number one frequently eaten food irritant responsible for bizarre, extensive rashes is gluten. I already knew his son was doing better off gluten. That made it very easy to ask the father to go on the same diet. For good measure, I added some supplemental fish oils to deal with the papules (or chicken skin) which are often a sign of essential fat deficiency. Those two steps are straight forward and will probably help. He readily agreed because he confessed after I suggested a gluten-free diet that eating too much bread gave him gas anyway.
You may be thinking, “oh come on!” After you go through all of this he admits that he thinks gluten bothers him. The answer was sooooo obvious all along. Why didn’t he figure out gluten was bothering him if his son could not tolerate it and he got gas when he ate it? Why most of us miss the obvious things about ourselves is one mystery I cannot figure out.
Here is a list of the ones I can remember:
• Food reactions to chicken, eggs, olive oil, nuts, fish, grains (especially wheat and sometimes rice), potatoes, seeds, most fruits, a few vegetables….any food can do it but vegetables and lamb react the least.
• Medicines especially anti-depressants, mood stabilizers, anti-seizure meds and antibiotics.
• Bad stuff added to foods including preservatives, additives, colors, pesticides and genetically modified organisms (GMOs) which is actually bacteria DNA spliced in to food.
• Contact rashes from creams, sun screen, soap, bubble bath, shampoo, dryer sheets, laundry detergent, pollen, swimming pool water, leaves, wool, animals (all sorts including a guinea pig).
• Molds (either outdoor varieties or from a sick house).
• Yeast problems.
• Touching water (true story). This was probably from the chlorine in tap water.
• Mites and other bug bite reactions.
• Essential fatty deficiency.
The list is long and basically includes almost anything you can think of but I had ten minutes to make a good guess. Most people can figure out topical contact irritants on their own unless it is something in the environment like pollen or mold. Once I saw a child with extensive eczema. The referring doctor and I tried all sorts of elimination diets and environmental changes but nothing helped. Finally, the family went to Italy for a month and the child’s skin completely cleared up. We then realized (through an additional process of elimination) that the problem was likely an environmental mold though we never knew exactly which one. Allergy testing also could not pinpoint it. Wouldn’t it be nice if your doctor recommended an extended European vacation for unresponsive eczema? Besides his wife had worked that angle pretty hard by eliminating the usual suspects without success. So, I ruled out topical culprits and circled in on the diet and family history.
If a food is causing such a complex ongoing rash it would have to be one that is commonly consumed. It cannot be mangos or pork chops because people do not eat enough of them through out the year to cause this much skin trouble. The number one frequently eaten food irritant responsible for bizarre, extensive rashes is gluten. I already knew his son was doing better off gluten. That made it very easy to ask the father to go on the same diet. For good measure, I added some supplemental fish oils to deal with the papules (or chicken skin) which are often a sign of essential fat deficiency. Those two steps are straight forward and will probably help. He readily agreed because he confessed after I suggested a gluten-free diet that eating too much bread gave him gas anyway.
You may be thinking, “oh come on!” After you go through all of this he admits that he thinks gluten bothers him. The answer was sooooo obvious all along. Why didn’t he figure out gluten was bothering him if his son could not tolerate it and he got gas when he ate it? Why most of us miss the obvious things about ourselves is one mystery I cannot figure out.
Tuesday, December 14, 2010
Blog #22 An Afternoon at a Different Conference
I decided I needed to understand hormones better, being menopausal and all. Getting good information on natural hormone replacement is much harder than you would think and as a result, I found myself on a plane to Las Vegas heading for the American Academy of Anti-Aging Medicine (A4M) conference.
Las Vegas, I discovered is not for anyone suffering from sensory processing disorder or a low tolerance to cigarette smoke. The hotels are designed so you have to walk through miles of underground casinos to get anywhere, including the registration desk or conference center. Casinos appear to be the only indoor facilities left in the country where cigarette smoking is not only allowed but possibly necessary so the calming effect of nicotine can help people deal with the stress of losing their nest eggs to computerized slot machines. “Gee, what are the chances of winning against a computer that sets the odds and makes up the rules?” I commented to my roommate, Victoria.
She informed me that I was missing the point and that it was all about the dopamine rush. Given the crowds, I would have to say she was right and I should probably learn more about dopamine since it is clearly popular. I made some mental adjustments to accommodate the environment and enjoy the conference.
For the next three days I immersed myself along with 4000 other physicians and practitioners in the latest research on maintaining/regaining vitality with aging. One speaker summed up the challenges of getting older with the Phillip Roth quote, “Aging isn’t a battle, it’s a massacre”. While it can certainly feel and look like that, there are many strategies people can use to manage the ravishes of time more effectively.
The hardest thing about an intensive conference, beyond the sitting, is information overload. Luckily, for me, I have a solid background and very specific questions I wanted answered which made the potential overwhelm manageable. There was so much generally interesting information that I compiled a list of the more fascinating little pearls.
So, here are:
The Top Ten Fascinating Facts and Observations Gleaned from the Anti-Aging Conference
1. Low testosterone is a common problem in aging men and reduces quality of life. The symptoms are low vitality (fatigue), passivity, low sex drive, weak erections, declining muscle tone and general grumpiness. It is also associated with increased mortality, cancer levels and heart disease. This condition is easy to diagnose and correct though it is generally considered to be vague and hard to treat.
2. Giving testosterone to men with low testosterone levels has never been proven to increase prostate cancer risk. The only time giving testosterone appears to feed prostate tumors is when a man’s testosterone level is extremely low (that is, at castration level which is very, very low).
Harvard urologist Abraham Morgentaler addressed this in great detail and prescribes testosterone even to men who have/had prostate cancer. In general, their PSA levels go down and their cancer growth is generally slower! He presented gobs of research. It took him 45 minutes to explain why there has been such general misunderstanding of the relationship between testosterone and cancer. For more info see his popular book: Testosterone for Life.
3. If you want to slow the aging and deterioration process, balance your hormones. Balanced hormones reduce the inflammation process and inflammation is associated with deterioration and most diseases.
4. Maintaining ideal weight is the best way to reduce inflammation, assuming you are doing this with a balanced diet. The short explanation is that gaining weight increases inflammation. Something about adiponectin inhibiting TNF-alpha (an inflammation marker that can now be measured in the blood) and dozens of other pathways that get thrown off as you put on the extra pounds. There were at least ten sessions on obesity and why it is bad for you. One presenter claimed Type 2 diabetes (usually from obesity) is now being called type 3 Alzheimer’s Disease.
5. Vitamin B-12 shots tied with correcting stomach issues can significantly reduce asthma attacks in adults and children. The theory is that most people with asthma have low stomach acid and absorption issues. When you think about it, the stomach and lungs and sinuses are all connected through a series of tubes. Something that affects one of them can bother the rest.
In children who are allergic or reactive to dairy products, a single exposure to milk can measurably reduce nutrient absorption capacity leading to low hydrochloric acid which causes vitamin B12 deficiency. Giving B-12 in a way that bypasses the stomach may help.
6. Synthetic progesterone (called progestins) does not have the diuretic and other beneficial properties of natural progesterone. Progestins also have more androgenic (testosterone) and pro-inflammation properties though they still appear to protect against uterine cancer. Increased inflammation leads to increased crankiness and headaches both of which are common side effects of the progestins.
7. Bioindentical hormones are well studied, especially in Europe. They are chemically and functionally completely different from the horse estrogen (Premarin) and synthetic estrogens given to most women seeking hormone replacement therapy. Studies have found the risk to breast cancer is significantly different depending on the estrogen being used. Estriol (found in bioidentical hormones) reduces breast cancer risk while high levels of estrones (found in synthetic estrogens) increase it.
8. Growth hormone treatment does not increase cancer risk. One study followed children treated for brain cancer who were later given growth hormone. The recurrence rate of cancer actually went down! This research was a pleasant surprise to hear and there was a lot of it. Once the presenter explained the biological link between growth hormone and immune function it made me wonder why so many people have been worried about growth hormone and cancer. (Probably because many of the early studies involved pouring growth hormone on a tumor in a dish and watching what happened.)
9. Hormone imbalances of all sorts contribute to the susceptibility to cancer. Higher cancer risk (in separate research presented over the course of the conference) was associated with low estriol, low testosterone, low oxytocin, low melatonin, low progesterone, low thyroid and low growth hormone. It does not take a rocket scientist to see the pattern there.
10. Information backed up with research is always sited as the thing practitioners most desire but nonetheless, the most popular speaker was Suzanne Somers. She was described as the most exciting event of the conference. She spoke about her personal experiences and quite the inspirational speaker. I developed a deeper appreciation for how much she has contributed to increasing awareness about alternative medicine. At 64, Somers is a walking testimonial to the wonders of bioidentical hormone replacement, alternative cancer treatment and plastic surgery though that last one was discreetly unmentioned.
In truth, there was nothing alternative about the research presented at this conference with the possible exception of the “aesthetic” courses. There was a whole tract, which I did not attend involving a bunch of frightening looking laser machines and Star Trek inspired apparatus for filing, zapping, exfoliating and otherwise revitalizing the skin and muscles. I did get a sample of the $250 a jar resveratrol rejuvenation cream. While I admit the claims are hard to swallow, wouldn’t it be nice if looking younger was as easy as putting on some really expensive cream?
Las Vegas, I discovered is not for anyone suffering from sensory processing disorder or a low tolerance to cigarette smoke. The hotels are designed so you have to walk through miles of underground casinos to get anywhere, including the registration desk or conference center. Casinos appear to be the only indoor facilities left in the country where cigarette smoking is not only allowed but possibly necessary so the calming effect of nicotine can help people deal with the stress of losing their nest eggs to computerized slot machines. “Gee, what are the chances of winning against a computer that sets the odds and makes up the rules?” I commented to my roommate, Victoria.
She informed me that I was missing the point and that it was all about the dopamine rush. Given the crowds, I would have to say she was right and I should probably learn more about dopamine since it is clearly popular. I made some mental adjustments to accommodate the environment and enjoy the conference.
For the next three days I immersed myself along with 4000 other physicians and practitioners in the latest research on maintaining/regaining vitality with aging. One speaker summed up the challenges of getting older with the Phillip Roth quote, “Aging isn’t a battle, it’s a massacre”. While it can certainly feel and look like that, there are many strategies people can use to manage the ravishes of time more effectively.
The hardest thing about an intensive conference, beyond the sitting, is information overload. Luckily, for me, I have a solid background and very specific questions I wanted answered which made the potential overwhelm manageable. There was so much generally interesting information that I compiled a list of the more fascinating little pearls.
So, here are:
The Top Ten Fascinating Facts and Observations Gleaned from the Anti-Aging Conference
1. Low testosterone is a common problem in aging men and reduces quality of life. The symptoms are low vitality (fatigue), passivity, low sex drive, weak erections, declining muscle tone and general grumpiness. It is also associated with increased mortality, cancer levels and heart disease. This condition is easy to diagnose and correct though it is generally considered to be vague and hard to treat.
2. Giving testosterone to men with low testosterone levels has never been proven to increase prostate cancer risk. The only time giving testosterone appears to feed prostate tumors is when a man’s testosterone level is extremely low (that is, at castration level which is very, very low).
Harvard urologist Abraham Morgentaler addressed this in great detail and prescribes testosterone even to men who have/had prostate cancer. In general, their PSA levels go down and their cancer growth is generally slower! He presented gobs of research. It took him 45 minutes to explain why there has been such general misunderstanding of the relationship between testosterone and cancer. For more info see his popular book: Testosterone for Life.
3. If you want to slow the aging and deterioration process, balance your hormones. Balanced hormones reduce the inflammation process and inflammation is associated with deterioration and most diseases.
4. Maintaining ideal weight is the best way to reduce inflammation, assuming you are doing this with a balanced diet. The short explanation is that gaining weight increases inflammation. Something about adiponectin inhibiting TNF-alpha (an inflammation marker that can now be measured in the blood) and dozens of other pathways that get thrown off as you put on the extra pounds. There were at least ten sessions on obesity and why it is bad for you. One presenter claimed Type 2 diabetes (usually from obesity) is now being called type 3 Alzheimer’s Disease.
5. Vitamin B-12 shots tied with correcting stomach issues can significantly reduce asthma attacks in adults and children. The theory is that most people with asthma have low stomach acid and absorption issues. When you think about it, the stomach and lungs and sinuses are all connected through a series of tubes. Something that affects one of them can bother the rest.
In children who are allergic or reactive to dairy products, a single exposure to milk can measurably reduce nutrient absorption capacity leading to low hydrochloric acid which causes vitamin B12 deficiency. Giving B-12 in a way that bypasses the stomach may help.
6. Synthetic progesterone (called progestins) does not have the diuretic and other beneficial properties of natural progesterone. Progestins also have more androgenic (testosterone) and pro-inflammation properties though they still appear to protect against uterine cancer. Increased inflammation leads to increased crankiness and headaches both of which are common side effects of the progestins.
7. Bioindentical hormones are well studied, especially in Europe. They are chemically and functionally completely different from the horse estrogen (Premarin) and synthetic estrogens given to most women seeking hormone replacement therapy. Studies have found the risk to breast cancer is significantly different depending on the estrogen being used. Estriol (found in bioidentical hormones) reduces breast cancer risk while high levels of estrones (found in synthetic estrogens) increase it.
8. Growth hormone treatment does not increase cancer risk. One study followed children treated for brain cancer who were later given growth hormone. The recurrence rate of cancer actually went down! This research was a pleasant surprise to hear and there was a lot of it. Once the presenter explained the biological link between growth hormone and immune function it made me wonder why so many people have been worried about growth hormone and cancer. (Probably because many of the early studies involved pouring growth hormone on a tumor in a dish and watching what happened.)
9. Hormone imbalances of all sorts contribute to the susceptibility to cancer. Higher cancer risk (in separate research presented over the course of the conference) was associated with low estriol, low testosterone, low oxytocin, low melatonin, low progesterone, low thyroid and low growth hormone. It does not take a rocket scientist to see the pattern there.
10. Information backed up with research is always sited as the thing practitioners most desire but nonetheless, the most popular speaker was Suzanne Somers. She was described as the most exciting event of the conference. She spoke about her personal experiences and quite the inspirational speaker. I developed a deeper appreciation for how much she has contributed to increasing awareness about alternative medicine. At 64, Somers is a walking testimonial to the wonders of bioidentical hormone replacement, alternative cancer treatment and plastic surgery though that last one was discreetly unmentioned.
In truth, there was nothing alternative about the research presented at this conference with the possible exception of the “aesthetic” courses. There was a whole tract, which I did not attend involving a bunch of frightening looking laser machines and Star Trek inspired apparatus for filing, zapping, exfoliating and otherwise revitalizing the skin and muscles. I did get a sample of the $250 a jar resveratrol rejuvenation cream. While I admit the claims are hard to swallow, wouldn’t it be nice if looking younger was as easy as putting on some really expensive cream?
Monday, December 6, 2010
Blog #21 Men with Rashes
If statistics are to be believed, men as a group, prefer to avoid doctors and perhaps more generally all of us in medically related fields. This has certainly also been my experience. A few times a year a man (or if the truth be told, a woman) will come in to see me just so I can look over what he is eating and taking to be sure he is up to date and doing the best for himself. I often catch myself looking at these people adoringly thinking this is so wonderful. They are taking care of themselves and being proactive. How rare. How inspirational. Prevention is so much more fun then disaster relief.
Sadly, most of us do not operate this way, especially those of the male persuasion. There was a book about this written a number of years ago by a physician’s wife. She relayed the story of how she had to force her husband, who was a cardiologist to go to the hospital because it was clear to her that he was having a heart attack. “I am fine,” he argued. But she was correct.
According to my husband, a self appointed expert on all guy things, being male and all, this attitude is completely understandable. “Men do not like to be seen as weak,” he explained as if it was patently obvious. “They will put up with a lot to keep up the appearance of strength.”
“How do they feel about dead?” I asked innocently at which point he suddenly developed an acute hearing problem.
Over the years I have noticed that most men come to see me for one of three reasons. First, and most popular, they are dragged kicking and screaming by a concerned loved one. Second, they have big complicated situations that have gotten so out of hand even they realize they have to do something. And my personal favorite, they come in with someone else and three minutes before the end of the session they want to know if they ask a “quick” question, really it is just a little thing they assure me. Is there anything they can do about the diarrhea they have had for the last ten years or this rash that covers their whole body and has confounded a gaggle of dermatologists?
You think I am exaggerating but this last situation happened recently. Alan came in with his wife who was the designated patient. I thought I was being clever and a full ten minutes before the end of the session, I anticipated there might be an issue and inquired if I could ask the gentleman a question. “Sure,” Alan replied.
“What are you doing about that rash?” I asked.
“Which one?” his wife cut in. “Lift up your shirt and show her, honey,” she cajoled apparently very happy that I had opened the subject.
I am not a dermatologist, but could see at least three different types of rashes. “If this was not so clearly irritating to you, “ I commented, “this would be fascinating. Look there is a ring worm,” I said pointing to a perfectly round red circle with a clear center. And there were hundreds, possibly thousands of little papules. “I wonder what they are from?” I mumbled thinking out loud. “These rough spots look like essential fatty acid deficiency,” I remarked pointing to several sand paper areas. “Though I bet that was diagnosed as keratosis pilaris.”
Keratosis pilaris (“chicken skin”) was indeed one of many diagnoses he had received over the years. Apparently, the numerous dermatologists and specialists he had consulted through the years were no longer fascinated and had given up on trying to unravel the situation, as had he.
Luckily, I am not a doctor and this allows me the freedom to take chances and say things that otherwise I would have to keep to myself to maintain decorum. “You must be miserable,” I blurted out. Alan responded with a shrug. “We have to do something about this,” I continued as if he had not been trying to fix the situation for years.
I assumed he had been tested for allergies. Alan confirmed he had and nothing significant had been found. I next asked if he ever found anything that had made it better or worse. His skin was obviously sensitive and his wife was careful with soaps and detergents she bought. Unfortunately, while some products used topically could make him worse, nothing he avoided in particular made him better. He had tried great numbers of ointments and salves through the years but nothing corrected the problem. Presently, he used moisturizers when he remembered or was particularly dry.
Since there were no clues in his dermatology history, I started asking about other symptoms (that might be related) and reviewed his children's medical histories. The original person I saw in his family was his son and he turned out to hold the answer to the mystery. To be continued……
Sadly, most of us do not operate this way, especially those of the male persuasion. There was a book about this written a number of years ago by a physician’s wife. She relayed the story of how she had to force her husband, who was a cardiologist to go to the hospital because it was clear to her that he was having a heart attack. “I am fine,” he argued. But she was correct.
According to my husband, a self appointed expert on all guy things, being male and all, this attitude is completely understandable. “Men do not like to be seen as weak,” he explained as if it was patently obvious. “They will put up with a lot to keep up the appearance of strength.”
“How do they feel about dead?” I asked innocently at which point he suddenly developed an acute hearing problem.
Over the years I have noticed that most men come to see me for one of three reasons. First, and most popular, they are dragged kicking and screaming by a concerned loved one. Second, they have big complicated situations that have gotten so out of hand even they realize they have to do something. And my personal favorite, they come in with someone else and three minutes before the end of the session they want to know if they ask a “quick” question, really it is just a little thing they assure me. Is there anything they can do about the diarrhea they have had for the last ten years or this rash that covers their whole body and has confounded a gaggle of dermatologists?
You think I am exaggerating but this last situation happened recently. Alan came in with his wife who was the designated patient. I thought I was being clever and a full ten minutes before the end of the session, I anticipated there might be an issue and inquired if I could ask the gentleman a question. “Sure,” Alan replied.
“What are you doing about that rash?” I asked.
“Which one?” his wife cut in. “Lift up your shirt and show her, honey,” she cajoled apparently very happy that I had opened the subject.
I am not a dermatologist, but could see at least three different types of rashes. “If this was not so clearly irritating to you, “ I commented, “this would be fascinating. Look there is a ring worm,” I said pointing to a perfectly round red circle with a clear center. And there were hundreds, possibly thousands of little papules. “I wonder what they are from?” I mumbled thinking out loud. “These rough spots look like essential fatty acid deficiency,” I remarked pointing to several sand paper areas. “Though I bet that was diagnosed as keratosis pilaris.”
Keratosis pilaris (“chicken skin”) was indeed one of many diagnoses he had received over the years. Apparently, the numerous dermatologists and specialists he had consulted through the years were no longer fascinated and had given up on trying to unravel the situation, as had he.
Luckily, I am not a doctor and this allows me the freedom to take chances and say things that otherwise I would have to keep to myself to maintain decorum. “You must be miserable,” I blurted out. Alan responded with a shrug. “We have to do something about this,” I continued as if he had not been trying to fix the situation for years.
I assumed he had been tested for allergies. Alan confirmed he had and nothing significant had been found. I next asked if he ever found anything that had made it better or worse. His skin was obviously sensitive and his wife was careful with soaps and detergents she bought. Unfortunately, while some products used topically could make him worse, nothing he avoided in particular made him better. He had tried great numbers of ointments and salves through the years but nothing corrected the problem. Presently, he used moisturizers when he remembered or was particularly dry.
Since there were no clues in his dermatology history, I started asking about other symptoms (that might be related) and reviewed his children's medical histories. The original person I saw in his family was his son and he turned out to hold the answer to the mystery. To be continued……
Sunday, November 28, 2010
Blog #20 Toddler Crack
This week three parents asked me how to stop their second child from becoming a picky eater. In two of the cases, I am helping deal with said picky eating older child and the third was the mother of a baby with other red flags for developmental issues. Is there anything they could do to prevent the picky eating debacle?
The best suggestion I have is to not introduce the three C’s or what I call toddler crack. Everybody knows these three oh-so-friendly kid foods. One of them is in a container in practically every diaper bag/mommy purse in the country because they are universally adored. They are crackers, cookies and cereal and once kids discover them, they are as addicting as crack.
And why shouldn’t they prefer salty or sweet crunchy foods they can pick up with their own hands verses a non-descript mush mix spooned in by daddy? At two, the toddler has just discovered there is a connection between action and consequences and he wants to see what he controls. Eating looks promising so he wants to feed himself when possible. Utensils can be challenging so finger foods are better. Crackers, cereal and cookies fit the bill perfectly.
Once in the mouth, baby mouths can find the crackers because they are crunchy but as soon as the saliva hits them, they dissolve without much chewing. In the feeding world, these foods are called meltables. They are extremely convenient because the little ones do not have a full component of teeth yet but want eating independence.
The final attribute sealing the addictive quality of toddler crack is the taste. Face it. Chicken and peas cannot compete with highly flavored crackers and cookies. David Kessler has written extensively about how food companies use these ingredients heavily to encourage people to prefer and overeat empty calorie food. (See, The End of Overeating.)
This is how kids get hooked right from the cradle. You are out at the park in the afternoon and two and a half year old Seth is starting to get cranky. It has been several hours since lunch so clearly he is hungry. Carrying around a bean burrito for such occasions is impractical and tough for him to eat so you hand him a container of dry cereal that is perfectly fine after a month laying at the bottom of your diaper bag. Seth calms down immediately because he can pick up the little pieces and feed himself. (“He is building self esteem and self care skills,” you tell yourself.) There is an additional bonus of keeping him occupied for a full five minutes so you can get him in the car/stroller without screaming.
Once home, you make a lovely dinner which he does not want to eat because his tiny toddler tummy is full. Twenty minutes of coercion and three bites later, you give up only to have him tell you he is hungry right before bed. You already put away the salmon and green beans so you hand him, just this once, a few fish crackers which he eats happily. It is straight downhill from here.
It all sounds so innocent but crackers and dry cereal are like crack to babies. Most toddlers love them to the exclusion of anything else given the choice. If you want to raise a child who will eat fruits, vegetables and a variety of healthy foods, DO NOT BUY CRACKERS, LITTLE COOKIES OR DRY CEREAL, period. They have little if any nutritional value.
What to do instead? You have to think ahead a little but pack up cold cooked peas and carrots, bananas, grapes cut in half, ¼ of a sandwich or little pieces of cheese. In the heat of the summer you may have to throw in an ice pack. Eating pieces of fruit and vegetables also require more supervision, as they are not meltables. Small children can choke more easily as developmentally they have not completely mastered eating skills. When planning for snacks, think real food instead of empty calorie treats.
A recent October 2010 study found that 40% of the calories in children’s diets now come from empty calorie foods. The most common was grain desserts or cookies and granola bars. According to several articles reporting on the study, despite the horrifying state of children’s diets in this country, nobody seemed surprised by the findings.
The best suggestion I have is to not introduce the three C’s or what I call toddler crack. Everybody knows these three oh-so-friendly kid foods. One of them is in a container in practically every diaper bag/mommy purse in the country because they are universally adored. They are crackers, cookies and cereal and once kids discover them, they are as addicting as crack.
And why shouldn’t they prefer salty or sweet crunchy foods they can pick up with their own hands verses a non-descript mush mix spooned in by daddy? At two, the toddler has just discovered there is a connection between action and consequences and he wants to see what he controls. Eating looks promising so he wants to feed himself when possible. Utensils can be challenging so finger foods are better. Crackers, cereal and cookies fit the bill perfectly.
Once in the mouth, baby mouths can find the crackers because they are crunchy but as soon as the saliva hits them, they dissolve without much chewing. In the feeding world, these foods are called meltables. They are extremely convenient because the little ones do not have a full component of teeth yet but want eating independence.
The final attribute sealing the addictive quality of toddler crack is the taste. Face it. Chicken and peas cannot compete with highly flavored crackers and cookies. David Kessler has written extensively about how food companies use these ingredients heavily to encourage people to prefer and overeat empty calorie food. (See, The End of Overeating.)
This is how kids get hooked right from the cradle. You are out at the park in the afternoon and two and a half year old Seth is starting to get cranky. It has been several hours since lunch so clearly he is hungry. Carrying around a bean burrito for such occasions is impractical and tough for him to eat so you hand him a container of dry cereal that is perfectly fine after a month laying at the bottom of your diaper bag. Seth calms down immediately because he can pick up the little pieces and feed himself. (“He is building self esteem and self care skills,” you tell yourself.) There is an additional bonus of keeping him occupied for a full five minutes so you can get him in the car/stroller without screaming.
Once home, you make a lovely dinner which he does not want to eat because his tiny toddler tummy is full. Twenty minutes of coercion and three bites later, you give up only to have him tell you he is hungry right before bed. You already put away the salmon and green beans so you hand him, just this once, a few fish crackers which he eats happily. It is straight downhill from here.
It all sounds so innocent but crackers and dry cereal are like crack to babies. Most toddlers love them to the exclusion of anything else given the choice. If you want to raise a child who will eat fruits, vegetables and a variety of healthy foods, DO NOT BUY CRACKERS, LITTLE COOKIES OR DRY CEREAL, period. They have little if any nutritional value.
What to do instead? You have to think ahead a little but pack up cold cooked peas and carrots, bananas, grapes cut in half, ¼ of a sandwich or little pieces of cheese. In the heat of the summer you may have to throw in an ice pack. Eating pieces of fruit and vegetables also require more supervision, as they are not meltables. Small children can choke more easily as developmentally they have not completely mastered eating skills. When planning for snacks, think real food instead of empty calorie treats.
A recent October 2010 study found that 40% of the calories in children’s diets now come from empty calorie foods. The most common was grain desserts or cookies and granola bars. According to several articles reporting on the study, despite the horrifying state of children’s diets in this country, nobody seemed surprised by the findings.
Monday, November 22, 2010
Blog #19 Topsy Turnips
My husband, Jeff, and I would not survive well as farmers. Despite having a nice organic garden, we have poor crop planning skills. Left to his own devices, Jeff plants mostly tomatoes that he loves but I cannot eat. When they failed this year, I stepped in and we attempted a second cold crop of peas, lettuce, carrots, radishes and turnips. It was too late for the peas which climbed about half way up the trellis before the cold set and arrested their development at mid adolescence. The carrots were delicious but the size and width of a fountain pen. I ate a head of lettuce a day for several weeks and Jeff had plenty of radishes but the turnips…… The turnips went wild.
They grew in crowded clumps because we did not thin them properly. Ignorant suburban farmers that we are we thought how many turnips can a few seeds produce? It turned out to be enough for an army of underfed groundhogs. There were so many that they pushed each other out of the ground where we could just scoop them up rather than pull them out. Some were the size of soft balls.
Jeff gamely ate one or two every day and I gave them away to all of our friends/neighbors who liked them which was a grand total of one person. Nobody seemed to know what to do with them and they were starting to pile up. Finally, I decided to make a big turnip dish for Thanksgiving and invite a lot of people. The first challenge was finding a decent dish. After some experimentation, I decided on pureed turnips because I had them once at a fancy restaurant and deemed them to be a potential crowd pleaser.
Playing around with several recipes, I came up with this one. It would probably taste better with a half cup of heavy cream added but too many people in my family do not eat dairy. Besides, without the cream, it has the advantage of being extremely healthy.
Cut and peel turnips and carrots and put them in a greased roasting pan. I use two parts turnips to one part carrot. The farmer’s market had yellow carrots and they worked great because the puree is yellow rather than orange like sweet potatoes and they are sweeter. Roast them for 20 minutes or until tender. Next dump them into a food processor or better yet, a Vitamixer. Then add salt (to taste), chicken broth (to get it to the thickness you like) and a tablespoon of maple syrup. The maple syrup was important because the baseball size turnip was pretty strong tasting though the little ones were not. A couple of spins around the Vitamixer and the result was creamy and tasty. Now to find more people to eat it.
I called my virtual assistant, Tania who lives a few hours away. “So, do you want to come for Thanksgiving?” I asked.
“What are you serving?” she asked warily.
“Pureed organic turnips with a hint of maple syrup,” I said in my most seductive voice.
“Gee, it looks like we will be awfully busy that day,” she retorted.
“Well, I also got a delicious turkey from the Amish farmers,” I tried again. “After which, I signed up for their e-mail list.”
“You are making that up,” she gasped appalled.
“Am not. The Amish have e-mail now. I wonder what kind of horse powered generator they use to run their computers?” I mused.
“They do not have computers,” she corrected. “They probably hire outsiders like they do for driving and things.”
“Well, they are famously adaptive business people, “ I agreed. “But I still think there might be a poor horse walking around in circles somewhere long into the night so Amish teenagers can be on Facebook.”
“I think you better cut down on your turnip consumption, it is affecting your mind,” she countered.
I would love to cut down as I do not like plain turnips very much but what am I going to do with all of them? They are such an underdog vegetable that I am afraid if I donate them to the Manna Food Bank, they will wish it was carrots or green beans instead. One of the vendors selling them at the farmer’s market said he had no clue what to do with them but I bet the Amish farmers have some ideas. Maybe I will send them an e-mail.
They grew in crowded clumps because we did not thin them properly. Ignorant suburban farmers that we are we thought how many turnips can a few seeds produce? It turned out to be enough for an army of underfed groundhogs. There were so many that they pushed each other out of the ground where we could just scoop them up rather than pull them out. Some were the size of soft balls.
Jeff gamely ate one or two every day and I gave them away to all of our friends/neighbors who liked them which was a grand total of one person. Nobody seemed to know what to do with them and they were starting to pile up. Finally, I decided to make a big turnip dish for Thanksgiving and invite a lot of people. The first challenge was finding a decent dish. After some experimentation, I decided on pureed turnips because I had them once at a fancy restaurant and deemed them to be a potential crowd pleaser.
Playing around with several recipes, I came up with this one. It would probably taste better with a half cup of heavy cream added but too many people in my family do not eat dairy. Besides, without the cream, it has the advantage of being extremely healthy.
Cut and peel turnips and carrots and put them in a greased roasting pan. I use two parts turnips to one part carrot. The farmer’s market had yellow carrots and they worked great because the puree is yellow rather than orange like sweet potatoes and they are sweeter. Roast them for 20 minutes or until tender. Next dump them into a food processor or better yet, a Vitamixer. Then add salt (to taste), chicken broth (to get it to the thickness you like) and a tablespoon of maple syrup. The maple syrup was important because the baseball size turnip was pretty strong tasting though the little ones were not. A couple of spins around the Vitamixer and the result was creamy and tasty. Now to find more people to eat it.
I called my virtual assistant, Tania who lives a few hours away. “So, do you want to come for Thanksgiving?” I asked.
“What are you serving?” she asked warily.
“Pureed organic turnips with a hint of maple syrup,” I said in my most seductive voice.
“Gee, it looks like we will be awfully busy that day,” she retorted.
“Well, I also got a delicious turkey from the Amish farmers,” I tried again. “After which, I signed up for their e-mail list.”
“You are making that up,” she gasped appalled.
“Am not. The Amish have e-mail now. I wonder what kind of horse powered generator they use to run their computers?” I mused.
“They do not have computers,” she corrected. “They probably hire outsiders like they do for driving and things.”
“Well, they are famously adaptive business people, “ I agreed. “But I still think there might be a poor horse walking around in circles somewhere long into the night so Amish teenagers can be on Facebook.”
“I think you better cut down on your turnip consumption, it is affecting your mind,” she countered.
I would love to cut down as I do not like plain turnips very much but what am I going to do with all of them? They are such an underdog vegetable that I am afraid if I donate them to the Manna Food Bank, they will wish it was carrots or green beans instead. One of the vendors selling them at the farmer’s market said he had no clue what to do with them but I bet the Amish farmers have some ideas. Maybe I will send them an e-mail.
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