Friday, July 27, 2007

Diabetes Drugs Doubles the Risk of Heart Failure

Today's press is all over a study published in the August 2007 journal, Diabetes Care. The study collected data on more than 78,000 type2 diabetic patients taking either Avandia (rosigilazone) or Actos (pioglitazone) - drugs used by more than 3 million people in this country. The researchers found that these drugs doubled the risk of heart failure. The average time for heart failure to develop was 24 weeks after starting either one of these drugs. The heart failures occured at even the lowest dosage and among young patients.

Apparently the press has forgotten about similar results published in the same journal in 2005 based on study findings on 25,690 patients. That study clearly suggested that the use of any pharmacological therapy for type2 diabetes dramatically increased the risk of heart failure during the first year after diagnosis.

The FDA has been in negotiation with Big Pharma over "black-box" warnings about heart failure risk on the labels of diabetic drugs for a long time.

To our knowledge, black box warnings for these drugs have yet to be mandated.

Thursday, July 26, 2007

Triglycerides levels and fat

I was having a discussion with another doc about his having to take Tricor to reduce his triglyceride level. When asking him about his diet, he said that he's been doing a low fat diet, working out 3-4 days a week and his dad and brother had the same problem. He just assumed it was "poor genetics".

Here is my response:

Well, maybe....We all tend to think that the cholesterol thing requires a "low fat" solution. Not necessarily, in my view. First, there are different types o fats and most are REQUIRED by the body. While I don't totally agree with Atkins, I do think that simple carbs are more destructive than fats are. Remember, only 25% of cholesterol comes from the diet.

Yes, genetics give you a running start at this problem (me too!). But something tells me that there might be something in the diet that is not "clicking". Of course, I'm not the dietician or the biochemist but I'm also not a fan of artificially lowering cholesterol- just hits me wrong....
I just reviewed a website and found this:

Contrary to popular belief, a low fat diet is NOT the solution to lowering high triglycerides levels. The researchers Van Horn and Lichtenstein extensively reviewed the low-fat approach a few years ago. Their research suggests that a low-fat diet will produce a result opposite to the desired effect: triglyceride levels will actually increase.

This phenomenon is not surprising if one considers that insulin resistance may be one of the driving factors behind elevated triglyceride levels. In fact, insulin resistance may be the cause of many of the problems observed in high-triglyceride states. Fortunately, elevated triglycerides is one of the easiest problems to correct with the appropriate diet. Simple restriction of all sugars and grains.Sugars and grains and require insulin secretion, which is a potent stimulus to the liver to produce triglycerides, and sugars and grains must be reduced if you are looking to lower your triglycerides.

Again, I can relate- my triglycerides were out of sight as well but I reduced them by cutting out (down) sugars significantly. WORKED! and hasn't been a problem since!!!

Vitamin C's Ability to Fight Colds Insignificant!

Maybe someone should tell the uninformed journalist who wrote that recent headline to not suggest that to animals that make their own vitamin C naturally and don't ever get colds and flu.

Humans lost the ability to synthesize vitamin C generations ago when a gene mutation ceased production of a liver enzyme needed to convert circulating blood sugar into ascorbate.

Science suggests that hunter gatherers consumed over 600 mgs of vitamin C per day. The adverage intake from our modern diet alone is around 100 mgs per day. This low intake explains why scurvy continues to be a frequently misdiagnosed disease, particularly in this country.

Vitamin C is rapidly depleted in the human body from a whole host of events including sun exposure, tobacco smoke (including second hand smoke), most meds, allergies, stress, infections, silent inflammation, pregnancy - and certainly the common viral cold.

Wednesday, July 25, 2007

Folate and Liver Cancer

A study published in the June 2007 peer-reviewed issue of Cancer Epidemiology Biomarkers suggests that those with low levels of folate may have an increased risk of developing liver damage and liver cancer.

The study established a statistically significant link between serum folate levels and Alanine aminotransferase (ALT), a blood test marker for liver damage. The study subjects with the highest average levels of folate had a 14% reduction in ALT compared to those subjects with the lowest levels of serum folate.

This study should be particularly interesting to those who have ever had hepatitis B, or other illnesses or lifestyle habits that are known to stress the liver (think nightly cocktail hour).

Folate is best metabolized when taken as part of the entire complex of B vitamins - particularly vitamin B12 and B6. That's why the folate in fortified bread has not been as bioavailable to the consumer as the government originally thought it would be, although there is a reported 50% reduction in birth defects related to folate deficiency (spina bifida) since the government recommended that flour products be fortified with folic acid.

We aren't sure whether that reduction relates to fortification or supplementation, since a large population of young women have now been educated about the need to supplement with folic acid if they plan to become pregnant.

We recommend that you get your supplemental folate, 800 mcg per day preferably, as part of a biochemically-balanced full-spectrum multiple.

Remember that too much supplemental folate can mask a vitamin B12 deficiency. B12 deficiencies are rare in young people, but fairly common in the older population.

Tuesday, July 24, 2007

How should you choose a fish oil supplement?

It's vitally important that you only purchase molecularly distilled fish oil. The process removes any possible contaminants including mercury and PCBs.


Ignore the total milligrams (mg) of fish oil, and focus instead on the combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Also ignore overly-hyped fish oils that include worthless amounts of lutein and zeaxanthin just to get the attention of the vision focused patient - you will be paying way too much for the EPA and DHA included in the product.

You want a supplement that contains 500 mg of EPA /DHA per dose or serving. If you're on blood thinners, talk to your doctor about the best dosage for you.


Your choice is basically capsules or a liquid. They're equally effective at delivering omega-3 fatty acids to your bloodstream, so go with the form you think you'll take on a daily basis. Most folks prefer capsules.


The ratio of EPA to DHA used in research varies, but most pharmaceutical grade supplements are made with a 3:2 split. This translates to 300 mg EPA and 200 mg DHA in each capsule.


Any quality fish oil will do, be it from mackerel, salmon or sardines. Do remember that supplements made from algae oil contain only DHA, and those made from flaxseed oil have alpha-linolenic acid (ALA), only a little of which is ever converted into EPA and DHA by your body.


Omega-3 fatty acids can quickly become rancid and lose their power due to oxidation. Look for supplements that include at least 5 IUs of vitamin E per capsule, (as tocopherol, not soy oil), because Vitamin E helps prevent free radical oxidation, in the capsule and in the body.

Fish Burp

A few people experience this as their stomachs dissolve the fish-oil capsule. A number of nutrition savvy folks recommend freezing your fish oil capsules to beat the burp. This will cause the fish oil to be released in your intestine instead of your stomach.

Diabetes 'complicates recovery' risk, study says

Researchers at the Penn State College of Medicine looked at nearly 26,000 patients who were hospitalised after trauma injuries between 1984 and 2002.

Those with diabetes were nearly twice as likely to pick up an infection and spent two days longer on a ventilator.

New Cancer Prevention Studies

A study published in the June 2007 American Journal of Clinical Nutrition suggested that vitamin D and calcium supplements may help reduce the risk of all types of cancer, not just breast cancer.

A second study, published in the June 2007 American Journal of Clinical Nutrition suggested that vitamin D and calcium supplements may help reduce the risk of all types of cancer by up to 77 percent in those women who supplement on a daily basis.