It’s already that time of month again…… April’s Top Reads is here!

…I know, it’s hard to believe the end of another Spring month has occurred, especially for those in Upstate NY. Snow in April…REALLY??!!

Still, I hope you have fun with this post’s summaries, whether you are reading along with hot or cold tea!

In the Health Section, some highlights you may  want to explore  in their entirety are:

• Metametrix’s link to Dr. Lord’s video on Autism and Spectrum Disorders and Dr. Mercola’s article on some controversial contributors to these disorders

• Dr. Mercola’s highlight on the dangers of mercury

In the Nutrigenomic Portion, I provided some exciting Medscape summaries in the field of genomics.

• In the first abstract, the scientific wording is a little hard to interpret for the non-physician. The key point is that it displays how environmental factors such as lifestyle changes and dietary choices can affect DNA expression. Specifically, the Pan-oraic Study highlights how exercise and lifestyle can affect gene expression that can change over time!

• There are also other various abstracts that discuss the connection of how food constituents modulate diseases and biological processes in the brain.

• Scroll to the end, and fellow coffee lovers will find scientific evidence that will bring a smile to their Starbuck-guilty faces.

• You may also want to click the links to read the full articles from Dr. Hyman’s summary on the power of food and Dr. D’Adamo’s summary on Lectins

The Drug Update Section provides some thought provoking evidence on how various blood pressure medications can be helpful or harmful with certain predisposing conditions.

• There is also information on the latest on weight loss drugs (a re-patented formula formerly removed from the market due to adverse effects), and antibiotic resistance.

• A link for more information on antidepressant side effects from Dr. Mercola is provided.

++++BONUS READS:

Be sure to check out weekly Naturopathic Fun Facts at my saratoga.com blog!

What’s New and More:

• On the left hand side of my website  is a link to Dr. Oz’s Sharecare.  This little widget is a fun tool for information in an instant! Just type in your health-related question and viola, the answers appear. I am very honored to be included amongst many of my mentors and other health experts.

• Summer reading is around the corner. Click here for a suggested and an updated reading list

• My next Holistic Health Forum will be in Rexford, NY on May 18th

• Look for my future blog that highlights my latest interview with Tom Petrie and reviews his latest book, Anti-Vitamin Baloney. This book puts the myths that vitamins are bad medicine to rest!

  • I’ll also be providing a link on my homepage to the actual call!

HEALTH

A Naturopathic Approach to IBS (Dr. Rubman)

Be picky about what you eat and drink. Avoid sodas and other sugary treats, caffeine, alcohol and fried or processed foods, all of which impede digestion. Try to eat more whole foods, healthy fats (e.g., found in salmon, olive oil, avocado, nuts and seeds) and complex carbohydrates, such as whole grains and steamed veggies. What about yogurt that contains live cultures, which is often recommended to encourage bacterial balance in the intestines? According to Dr. Rubman it’s fine, but don’t expect a miracle cure. In his view, this promise is yet another marketing scam. A better alternative is the use of other probiotics.

Monitor food combinations, as these directly influence how quickly and efficiently food is digested, explains Dr. Rubman. For example, don’t combine “white” foods (such as white sugar, white flour, white bread, white potatoes, etc.) with saturated fats (for example, red meat or dairy products). Taken together, these can require as long as two to three hours to digest, during which time microorganisms in the food can colonize the stomach lining and cause digestive disturbances.

Keep fluids with meals to a minimum, and chew food thoroughly. The natural process by which saliva is added to food as it is chewed, to break it down thoroughly in the mouth, sets the rest of the digestive process in motion. So, our habit of washing down food with water or other beverages turns out to be counter-productive. Fluids may also dilute stomach acid, making digestion less efficient.

If you are 35 or older, consider taking supplemental digestive enzymes. Since aging tends to diminish our digestive enzymes, taking a them as a supplement helps the body break down foods into compounds that make nutrients easier to digest, and also work to decrease the number of colonized microorganisms in the stomach. Other digestive aids Dr. Rubman prescribes for his patients include hydrochloric acid supplements, which act as a tonic to the upper GI tract, soothing inflammation and allowing for restoration of normal function and cellular health. (Note: As always, it is important to consult a qualified expert to determine which supplements are appropriate for you, and to provide oversight for your health and safety.)

Abstract: We have previously reported that the nuclear receptor peroxisome proliferator activated receptor-? (PPAR?) regulates the transcription of ?-secretase (BACE1), a key enzyme involved in amyloid-? (A?) generation. Here, we aimed to investigate the role of PPAR? coactivator-1? (PGC-1?), which controls major metabolic functions through the co-activation of PPAR? and other transcription factors. Western blotting experiments with nuclear extracts from brain cortex of AD cases and controls showed a reduction in the levels of PGC-1? in AD patients. PGC-1? overexpression in N2a neuroblastoma cells induced a decrease in the levels of secreted A? and an increase in the levels of non-amyloidogenic soluble A?PP?. The decrease in A? after exogenous expression of PGC-1? was a consequence of reduced BACE1 expression and transcription, together with a decrease in BACE1 promoter activity. In addition, we detected a significant reduction in ?-secretase activity by measuring the levels of ?-carboxy terminus fragment (?-CTFs) and by using a commercial assay for ?-secretase. In contrast, down-regulation of PGC-1? levels by transfection with PGC-1? siRNA increased BACE1 expression. These effects appeared to be dependent on PPAR?, because PGC-1? did not affect A? and BACE1 levels in N2a cells transfected with PPAR? siRNA or in PPAR? knockout fibroblasts. In conclusion, since PGC-1? appears to decrease A? generation, therapeutic modulation of PGC-1? could have real potential as a treatment for AD. PMID:21358044

Watch this Video by Dr. Lord from Metametrix on Alternative Testing for Autism (Metametrix)

This 8 minute video explains the gut-brain connection and how inflammation in the brain can affect the features of autism.

Mercury Dangers (Mercola)

• Studies show that mercury is the MOST toxic heavy metal to your body; this excellent new documentary film, Mercury Undercover, exposes the dangers of mercury contamination to human health and to the environment
• The number one source of mercury pollution is coal-fired power plants. Second position is held by dental practices due to amalgam fillings, which are 50 percent mercury
• Dental amalgams, used for more than 150 years, continue to be used by half of the dentists in North America despite a mountain of evidence they slowly leak toxic mercury into your body, and are particularly dangerous for children and pregnant women
• Mercury becomes a “biochemical train wreck in your body,” causing your cell membranes to leak, and inhibit key enzymes your body needs for energy production and removal of toxins. Mercury toxicity can lead to major inflammation and chronic illnesses such as Alzheimer’s disease and Parkinson’s disease
• The FDA, in partnership with the ADA, have been successful for many years in concealing the dangers of amalgam from the public, but organizations such as the Consumers for Dental Choice are making inroads toward getting mercury banned from dentistry worldwide—but they need your help

Chemicals and Cancer (Mercola)

Recent research has detected the presence of paraben esters in 99 percent of breast cancer tissues sampled. In 60 percent of cases, all five esters were detected. Parabens are chemicals that have been shown to have estrogen-like properties, and estrogen is one of the hormones involved in the development of breast cancer

Anything you ingest, inhale, or spread on your skin can be absorbed into your body and potentially cause damage over time. Parabens can be found in a wide variety of consumer products, such as deodorants, shampoos, lotions, cosmetics, drugs, and food additives

Recent research has confirmed the existence of a previously unknown class of cancer-causing materials that can be found in thousands of consumer products.  A broad range of metals have been shown to act as “metalloestrogens” with the potential to add to the estrogenic burden of the human breast

According to recent research, women with the highest intakes of cadmium were 21 percent more likely to develop breast cancer compared to those with the lowest dietary intake. Cadmium is a carcinogenic heavy metal identified as a metal that can bind to estrogen receptors, effectively mimicking the female hormone estrogen. Food crops such as potatoes and whole grains are primary sources cadmium, but it’s also an air pollutant

Exercise…no matter how little….for Health! (Dr. Mercola)

• Recent research shows that as little as three minutes of intense exertion per week can deliver many of the health- and fitness benefits you get from hours of conventional exercise, including improved insulin sensitivity by an average of 24 percent in four weeks
• How well high intensity training actually works may in large part depend on your genetic makeup. Researchers have developed a genetic test to predict who will quickly improve their aerobic fitness, and who will not
• Recent research also shows that when healthy but inactive people exercise intensely, even if the exercise is brief, it produces an immediate change in their DNA. It appears this contraction-induced gene activation promotes genetic reprogramming of muscles for strength and other structural and metabolic benefits associated with exercise
• Ideally, you’ll want to do high intensity exercises two or three times a week for a total of four minutes of intense exertion with recovery periods in between. For optimal health, you’d also be wise to incorporate aerobic, strength training, core exercises and stretching, for a well-rounded fitness program

Sleep-Weight Connection (Dr. Hyman)

Your body has a finely tuned appetite control system that is governed by certain hormones. These hormones are affected by sleep. One group of researchers has found that depriving healthy men of sleep leads to increases in grehlin, the hormone that makes you feel hungry, and decreases in leptin, the hormone that makes you feel full.

How does that affect your body? You stay hungry and start craving high-calorie, high-carbohydrate foods. After many nights of sleep deprivation while working in the emergency room, I can tell you that this is true! We also need sleep to keep our levels of Cortisol — the stress hormone that makes us fat — low. (See Chapter 10 of Ultrametabolism for more.)

Not sleeping enough is a big problem in this country: Over the last 40 years Americans on average, sleep 2 hours less. But it’s not just about quantity. Our quality of sleep is also suffering.

ASD on the Rise (Mercola)

• According to the most recent statistics, an average of 1 in 88 children is now diagnosed with an autism spectrum disorder (ASD). This number represents a 78 percent increase in autism over the past five years.
• ASDs are nearly five times more common among boys than girls
• Research is now clearly showing that environmental factors play a primary role in the epidemic of autism spectrum diseases. Toxic overload appears to be at the core of the problem
• Possible environmental factors for autism are incredibly diverse and include excessive exposure to electromagnetic radiation, mercury toxicity, vaccine damage, phthalates and other common household chemicals, vitamin D deficiency, and brain toxicity stemming from gut toxicity
• In children with Gut and Psychology Syndrome (GAPS), toxicity flowing from their gut throughout their bodies and into their brains literally clogs the brain with toxicity, preventing it from performing its normal function and processing sensory information. Inexpensive tests can identify GAPS within the first weeks of your baby’s life, which can help you make better-informed decisions about how to proceed to set your child on the path to a healthy life

Regulatory Capacity to Ensure That Imported Foods and Drugs Are Safe (National Academies)

WASHINGTON — Many low- and middle-income nations do not have technologically advanced regulatory systems, which limits their oversight of food and drug safety, says a new report from the Institute of Medicine.  The discovery of a counterfeit version of the cancer drug Avastin earlier this year underscores the challenges for U.S. regulators as imports increasingly dominate the American market.

The report recommends 13 steps that the U.S. Food and Drug Administration and other organizations can take over the next three to five years to bolster the safety systems in developing nations.  Partners in this effort include other federal agencies, international organizations, the regulated industries, and regulators in developing countries.   Recommended steps include encouraging the development of low-cost technologies to prevent fraud and assessing whether the pilot Secure Supply Chain program can be expanded.  The report also urges the regulatory agencies in developed nations and industry associations to devise ways to share inspection results and emphasizes the importance of donor investment in developing countries’ regulatory systems.

More than 80 percent of active pharmaceutical ingredients and 40 percent of finished drugs come from abroad as does 85 percent of the seafood consumed in America, according to federal estimates.  Congress has charged FDA to inspect more foreign producers as the volume of imports grows, but given its modest budget, the agency cannot do its job well without substantial improvement in the capacity of its counterpart agencies in emerging economies, said the committee that wrote the report.

GMOs Labeling Backing in CT (Bloomerang)

Connecticut took the first step requiring producers to label genetically modified food Wednesday, as a legislative committee overwhelmingly backed a measure promoted as giving consumers more information while avoiding the debate over health concerns.

The legislature’s Environment Committee voted 23-6 to approve the measure, allowing supporters to prevail over opponents who said the measure would lead to higher packaging costs.

“It’s something that’s coming, and I think we can be in the forefront in helping shape how it’s done,” said Democratic Rep. Richard Roy, the committee’s House chairman. “Think of us as the mouse that roared.”

The federal government and states do not require labeling for all genetically modified foods. Connecticut is among nearly 20 states considering a requirement, with backers saying genetically engineered foods pose allergy and other health risks and that labels give consumers valuable information.

The state Department of Agriculture opposes the legislation, saying that the federal government is responsible for setting national standards and that Connecticut would be at a competitive disadvantage with other states if it alone sets standards.

Why Do Doctors Keep Doing Treatments that Don’t Work (Medscape)

Dr. Smith: If you go to your doctor at the moment with lower back pain, there is a pretty good likelihood that you will get some imaging for that, and there are pretty good data that say that no subsequent decisions hinge on the observations made in that imaging, or that those decisions will happen at some incredibly low likelihood. But it goes much deeper than the instances of known waste. We do a lot of things, as Eric [Topol] pointed out, that are population-based when we fully know that 30%-40% of the people to whom we provide such therapies derive no benefit but experience all the costs and all the adverse consequences. All it takes is understanding the genetic determinants, the historical determinants, or the epigenetic determinants that say, “In you, this therapy won’t work, so skip it.” The opportunity to take potentially life-saving therapies and give them only to the 30%-50% of a cohort that deserves them, by virtue of having some positive impact, saves half of the expense.

Estimates of known waste are $700-$800 billion a year. The things we don’t yet know are larger because we are doing things that are in the guidelines. But when you peel back a layer, those guidelines are derived largely from apocryphal suggestions in remote history, right? So, there is a tremendous opportunity, as we put pressure on the system, to justify why we do what we do.

Importantly, we have a system with a bandwidth limitation living at the doctor. We can’t keep up with the onslaught of information. We can’t keep up with the patients we have to see. We are not really good at even figuring out which of the patients we are responsible for need to be seen at a particular time. We realize that “maybe I shouldn’t be making those decisions because I can’t comprehend all the diseases that my patients have. They are presenting information I don’t yet know how to interpret.” Maybe we need to offload that to smart systems.

NUTRIGENOMICS

THE ENVIRONMENT_GENETIC LINK Enters Mainstream Research:

Panor-omic Study entails clues on genes-environment interactions (Medscape)

Basically, what this entailed was a serial examination of 20 different blood draws that Michael Snyder had over a 14-month period. During that time, virtually everything you could imagine was assessed. Not only was there DNA sequencing at very high, deep coverage, high accuracy and resolution, but also there was gene expression. There was RNA seq to detect any issues in RNA. There were protein and metabolite assays that were comprehensive, along with autoantibody, along with micro RNAs — all of this over a 14-month period.

As you would expect, the susceptibility to some diseases through, not just common variations, but rare variations were detected, including a key rare variant associated with diabetes mellitus and another rare variant with high penetrance for aplastic anemia.

But what was interesting during this study that spanned over 14 months was that Michael Snyder had two viral infections. Right around 300 days, he had a viral infection that led to a marked increase in genes that were associated with inflammation, interferon, and the conventional serum CRP that we measure. With that, his glucoses shot up, as well as his HbA1C, even up to about 6.7% from what had been normal, with fasting glucoses that were in the mid-100s. Then he went on to a lifestyle program to lose weight and exercise more, and was able to reverse the clinical manifestations of diabetes.

This is a remarkable paper. It is an N of 1 study with an exceptional amount of billions and billions of data points across all the different ‘omics, and even expanding into autoantibody formation. It also tells us about how gene pathways and gene expression change over time. It’s not just a measurement once, it’s dynamic — the variants in one’s genome, as they can be expressed differently in different tissues, they also can be expressed differently as a function of time. It’s highly instructive.

Genomics and Environment Signal Diabetic Risk (Medscape)

Dr. Patay: We know that about 50% of the genomic risk of type 1 diabetes involves the part of chromosome 6 where the HLA genes are, but half comes from other parts of the genome…. We have an environment that can potentially increase or decrease the prevalence of disease — type 2 diabetes is a classic example, and you could even argue type 1 is. Then we have this DNA or code or software that runs to tell the body how to operate. A certain combination of “software” might lead to type 1 diabetes in this environment.

For type 2 diabetes, maybe in starvation environments where there’s not a lot of food, that genome might potentially increase or benefit your health. What we’re learning is that the pathway to type 1 diabetes isn’t just one route; there are multiple pathways that can get you to type 1. If we can alter some of those pathways, we may be able to alleviate or prevent type 1 diabetes.

Diet Reduces Diabetes in One Week (Diabetologia)

Conclusions/interpretation Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake.

Rosemary EO for mood (Therapeutic)

Here we show for the first time that performance on cognitive tasks is significantly related to concentration of absorbed 1,8-cineole following exposure to rosemary aroma, with improved performance at higher concentrations. Furthermore, these effects were found for speed and accuracy outcomes, indicating that the relationship is not describing a speed–accuracy trade off.  The relationships between 1,8-cineole levels and mood were less pronounced, but did reveal a significant negative correlation between change in contentment and plasma 1,8-cineole levels.

Conclusion: These findings suggest that compounds absorbed from rosemary aroma affect cognition and subjective state independently through different neurochemical pathways. (Moss, M. Plasma 1,8-cineole correlates with cognitive performance following exposure to rosemary essential oil aroma (abstract). Therapeutic Advances in Psychopharmacology. February 24, 2012. 2045125312436573.)

More info here.

The Power of Food (Dr. Hyman)

Beyond simply being a mechanism for conveying calories, food is a source of special ingredients than can prevent and treat disease and transform your health. These are called phytonutrients – special plant chemicals that are not calories, protein, fat, carbohydrates, vitamins and minerals, but special molecules that interact with your biology, special molecules that act like switches on your DNA to heal your body.

Food contributes to your experiences of taste, texture, delight, energy and nourishment. In China, food is all that, and a source of medicinal healing compounds known to support well-being and health.

Curcumin Affects DNA modification (at the Androgen Receptor (AR)) in Prostate Cancer (Cancer Research)

Together, our results demonstrate the combinatorial impact of targeting AR and histone modification in prostate cancer, setting the stage for further development of curcumin as a novel agent to target AR signaling.

For the Love of Coffee

Cuppa joe: friend or foe? Effects of chronic coffee consumption on cardiovascular and brain health.  [Link]
(Mo Med. 2011 Nov-Dec;108(6):431-8).

Caffeine is the most widely consumed psychoactive drug worldwide. Indeed the majority of adults consume caffeine on a daily basis, most commonly in the forms of coffee and tea. Coffee, in particular, is the favored caffeine source in the United States, where more than 150 million people drink coffee on a daily basis. Coffee, one of the richest sources of antioxidants in the average American’s diet, contains caffeine and other antioxidants that have the potential to confer both beneficial and adverse health effects. A growing body of research shows that coffee drinkers, compared to nondrinkers, may be less likely to develop type 2 diabetes, stroke, depression, death from any cause, and neurodegenerative diseases, including Parkinson’s and Alzheimer’s. Coffee appears to have a neutral effect on cardiovascular health. Although more research is clearly needed, coffee, when consumed without added cream or sugar, is a calorie-free beverage that may confer health benefits, especially when used in individuals who do not have adverse subjective effects due to its stimulating effects, and when coffee is substituted for less healthy, unnatural, and/or high-calorie beverages, such as colas and other sugary and artificially sweetened sodas and soft drinks.

Coffee and its consumption: benefits and risks.  [Link] (Crit Rev Food Sci Nutr. 2011 Apr;51(4):363-73).

Coffee is the leading worldwide beverage after water and its trade exceeds US $10 billion worldwide. Controversies regarding its benefits and risks still exist as reliable evidence is becoming available supporting its health promoting potential; however, some researchers have argued about the association of coffee consumption with cardiovascular complications and cancer insurgence. The health-promoting properties of coffee are often attributed to its rich phytochemistry, including caffeine, chlorogenic acid, caffeic acid, hydroxyhydroquinone (HHQ), etc. Many research investigations, epidemiological studies, and meta-analyses regarding coffee consumption revealed its inverse correlation with that of diabetes mellitus, various cancer lines, Parkinsonism, and Alzheimer’s disease. Moreover, it ameliorates oxidative stress because of its ability to induce mRNA and protein expression, and mediates Nrf2-ARE pathway stimulation. Furthermore, caffeine and its metabolites help in proper cognitive functionality. Coffee lipid fraction containing cafestol and kahweol act as a safeguard against some malignant cells by modulating the detoxifying enzymes. On the other hand, their higher levels raise serum cholesterol, posing a possible threat to coronary health, for example, myocardial and cerebral infarction, insomnia, and cardiovascular complications. Caffeine also affects adenosine receptors and its withdrawal is accompanied with muscle fatigue and allied problems in those addicted to coffee. An array of evidence showed that pregnant women or those with postmenopausal problems should avoid excessive consumption of coffee because of its interference with oral contraceptives or postmenopausal hormones. This review article is an attempt to disseminate general information, health claims, and obviously the risk factors associated with coffee consumption to scientists, allied stakeholders, and certainly readers.

Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity.  [Link]
(Lipids. 2009 Jul;44(7):593-601. Epub 2009 May 13. )

The effects of dietary supplementation with coconut oil on the biochemical and anthropometric profiles of women presenting waist circumferences (WC) >88 cm (abdominal obesity) were investigated. The randomised, double-blind, clinical trial involved 40 women aged 20-40 years. Groups received daily dietary supplements comprising 30 mL of either soy bean oil (group S; n = 20) or coconut oil (group C; n = 20) over a 12-week period, during which all subjects were instructed to follow a balanced hypocaloric diet and to walk for 50 min per day. Data were collected 1 week before (T1) and 1 week after (T2) dietary intervention. Energy intake and amount of carbohydrate ingested by both groups diminished over the trial, whereas the consumption of protein and fibre increased and lipid ingestion remained unchanged. At T1 there were no differences in biochemical or anthropometric characteristics between the groups, whereas at T2 group C presented a higher level of HDL (48.7 +/- 2.4 vs. 45.00 +/- 5.6; P = 0.01) and a lower LDL:HDL ratio (2.41 +/- 0.8 vs. 3.1 +/- 0.8; P = 0.04). Reductions in BMI were observed in both groups at T2 (P < 0.05), but only group C exhibited a reduction in WC (P = 0.005). Group S presented an increase (P < 0.05) in total cholesterol, LDL and LDL:HDL ratio, whilst HDL diminished (P = 0.03). Such alterations were not observed in group C. It appears that dietetic supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity.

Magnesium and Aging (Clin Interv in Aging)

The aging process is associated with progressive shortening of telomeres, repetitive DNA sequences, and proteins that cap and protect the ends of chromosomes. Telomerase can elongate pre-existing telomeres to maintain length and chromosome stability. Low telomerase triggers increased catecholamines while the sensitivity of telomere synthesis to Mg ions is primarily seen for the longer elongation products. Mg stabilizes DNA and promotes DNA replication and transcription, whereas low Mg might accelerate cellular senescence by reducing DNA stability, protein synthesis, and function of mitochondria. Telomerase, in binding to short DNAs, is Mg dependent.

Herbs & Alzheimer’s (Neurosignals. 2005;14(1-2):34-45. Search for natural products related to regeneration of the neuronal network).

Abstract :The reconstruction of neuronal networks in the damaged brain is necessary for the therapeutic treatment of neurodegenerative diseases. We have screened the neurite outgrowth activity of herbal drugs, and identified several active constituents. In each compound, neurite outgrowth activity was investigated under amyloid-beta-induced neuritic atrophy. Most of the compounds with neurite regenerative activity also demonstrated memory improvement activity in Alzheimer’s disease-model mice. Protopanaxadiol-type saponins in Ginseng drugs and their metabolite, M1 (20-O-beta-D-glucopyranosyl-(20S)-protopanaxadiol), showed potent regeneration activity for axons and synapses, and amelioration of memory impairment. Withanolide derivatives (withanolide A, withanoside IV, and withanoside VI) isolated from the Indian herbal drug Ashwagandha, also showed neurite extension in normal and damaged cortical neurons. Trigonelline, a constituent of coffee beans, demonstrated the regeneration of dendrites and axons, in addition to memory improvement.Tohda C, Kuboyama T, Komatsu K. PMID:15956813

Curcumin, Vitamin D and Alzheimer’s (1alpha,25-dihydroxyvitamin D3 interacts with curcuminoids to stimulate amyloid-beta clearance by macrophages of Alzheimer’s disease patients.Masoumi A, et al.J Alzheimers Dis. 2009;17(3):703-17).

Abstract: Patients with Alzheimer’s disease (AD) suffer from brain amyloidosis related to defective clearance of amyloid-beta (Abeta) by the innate immune system. To improve the innate immune system of AD patients, we studied immune stimulation of macrophages by 1alpha,25(OH)2-vitamin D3(1,25D3) in combination with curcuminoids. AD patients’ macrophages segregate into Type I (positively stimulated by curcuminoids regarding MGAT-III transcription) and Type II (not stimulated). In both Type I and Type II macrophages, 1,25D3 strongly stimulated Abeta phagocytosis and clearance while protecting against apoptosis. Certain synthetic curcuminoids in combination with 1,25D3 had additive effects on phagocytosis in Type I but not Type II macrophages. In addition, we investigated the mechanisms of 1,25D3 and curcuminoids in macrophages. The 1,25D3 genomic antagonist analog MK inhibited 1,25D3 but not curcuminoid effects, suggesting that 1,25D3 acts through the genomic pathway. In silico, 1,25D3 showed preferential binding to the genomic pocket of the vitamin D receptor, whereas bisdemethoxycurcumin showed preference for the non-genomic pocket. 1,25D3 is a promising hormone for AD immunoprophylaxis because in Type I macrophages combined treatment with 1,25D3 and curcuminoids has additive effects, and in Type II macrophages 1,25D3 treatment is effective alone. Human macrophages are a new paradigm for testing immune therapies for AD. PMID:19433889

Green and Roobios Tea affect Blood Pressure (Holistic Primary Care)

A recent study from researchers at Linköping University in Sweden investigated the effects of green tea, black tea, and Rooibos tea on angiotensin-converting enzyme (ACE) and nitric oxide (NO).

Angiotensins are peptides that act as vasoconstrictors. ACE converts angiotensin to its activated form and enables it to function. The ACE gene polymorphic sites are an insertion/deletion consisting of 3 genotypes: II and DD homozygotes, and ID heterozygote.1 ACE levels are two- to three-folds higher in people with the DD genotype than in those with the II genotype; people with the ID genotype have an intermediate level of ACE.1,2
Green tea and black tea are derived from the leaves of Camellia sinensis. Caffeine-free Rooibos tea is derived from the leaves and stems of Aspalathus linearis. It does not contain catechins but does contain dihydrochalcones, flavones, and flavonols.

What is a Lectin (D’Adamo)

Typically, lectins can bind to many of the carbohydrate antigens found in the gut and immune system, causing a variety of health problems. These can include  intestinal dysbiosis, bowel hyperpermiability, immune dysfunction, food  sensitivities and systemic inflammation. This is usually accomplished by direct  agglutination of the target cells. Lectins can occur in very common foods in the diet, and the majority are specific for the carbohydrates of the ABO blood  typing system. In one study, the edible parts of 29 of 88 foods tested,  including common salad ingredients, fresh fruits, roasted nuts, and processed  cereals were found to possess significant lectin-like activity as assessed by  hemagglutination and bacterial agglutination assays.

Several common  lectins, in particular, wheat germ agglutinin, are known to bind to the insulin  receptor and mimic the hormonal effects of insulin on adipose tissue, an  under-appreciated action that can account for why individuals on high carbohydrate diets often have difficulty controlling their weight. Thus, lectin blocking is a safe and rational method for enhancing weight loss.

 

DRUGS

Antibiotic Overuse Contributing to C.Diff Infections in Hospitals (Medscape)

With the conviction that transmission of C difficile is avoidable but that no single action will be sufficient, the Centers for Disease Control and Prevention (CDC) outlined the 6 strategies that have the best chance of eradicating C difficile from healthcare. These strategies involve elements of antibiotic stewardship, testing for C difficile, isolation and infection control procedures, environmental cleaning, and communication^[2]:

1. Prescribe and use antibiotics carefully. About 50% of antibiotics that are given are not needed.
2. Test for C difficile when patients have diarrhea while taking antibiotics or within several months of taking them.
3. Isolate patients with C difficile immediately.
4. Wear gloves and gown when treating patients with C difficile, even during short visits. Hand sanitizer does not kill C difficile, and handwashing may not be sufficient.
5. Clean room surfaces with bleach or another Environmental Protection Agency (EPA)-approved spore-killing disinfectant after a patient with C difficile has been treated there.
6. When a patient transfers to another facility, notify the new facility if the patient has CDI.

Part of this is education of prescribors. There are 3 key steps:

1. Always record the name; dose; intended duration of therapy; and, of importance, the reason for the antibiotic.
2. Order the appropriate cultures before treatment with antibiotics is started.
3. Take an antibiotic “time-out.” Reassess the patient after he or she has taken antibiotics for a day or 2 — does the patient still need it? Whenever possible, stop treatment with antibiotics that are no longer needed.

These things have to happen in hospitals, as well as in the community — doctor’s offices, nursing homes — across the entire healthcare spectrum.

Remember, Alcohol sanitizers don’t kill C.diff…wash your hands! 🙂

New Guidelines for Rhinosinusitis (Medscape)

Although rhinosinusitis is quite common — affecting nearly 1 in 7 adults each year — the prevalence of bacterial infection during acute rhinosinusitis is estimated to be only 2%-10% of all patients with symptoms of sinusitis.^[2,3] Antibiotics are significantly overprescribed for rhinosinusitis, which is the fifth leading indication for antimicrobial prescriptions by physicians in office practice.^[4] One national survey conducted during 1998-2003 revealed that 81% of adults presenting with symptoms of sinusitis in an outpatient setting received an antibiotic prescription.^[5] Overprescription of antibiotics is a serious concern because it is costly, exposes patients to unnecessary side effects, and fosters drug resistance.

Due to the lack of precision and practicality of current diagnostic methods, clinicians must rely on clinical presentations to distinguish bacterial from viral rhinosinusitis. The guidelines suggest that the infection is probably bacterial if any of the following are true:

• Onset with persistent symptoms or signs compatible with acute rhinosinusitis lasting for ? 10 days without any evidence of clinical improvement;
• Onset with severe symptoms or signs of high fever (? 39°C or 102°F) and purulent nasal discharge or facial pain lasting for at least 3-4 consecutive days at the beginning of an illness; or
• Onset with worsening symptoms or signs characterized by new onset of fever, headache, or increase in nasal discharge following a typical viral upper respiratory infection that lasted 5-6 days and initially improved (“double-sickening”).

Blood Pressure medications and Risks (Medscape)

Amlodipine has been the comparator drug in a large number of studies, including the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) and the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Amlodipine does very well when it comes to preventing problems, but it seems to cause heart failure, reasonably commonly. If a patient has heart failure, clearly you are not going to be using amlodipine. In the ALLHAT study, when it came to any number of issues, especially for stroke prevention, amlodipine was almost as good as chlorthalidone was.

Beta-Blockers? (Medscape)

For a compelling indication like heart failure, angina, arrhythmias, or myocardial infarction, there is no question that beta-blockers should be part of the regimen. But beta-blockers are not indicated as initial therapy for hypertension, and that is an important distinction.Dr. Morrow: We are hearing a lot of talk about sympathetic nervous system activation and lability of blood pressure as a problem for stroke. I have seen a lot of back-and-forth about this, but it would seem more intuitive to use something that blocks sympathetic nerve activity directly in prevention of stroke.

Dr. Black: When you look at stroke as an outcome, beta-blockers are actually worse. In fact, that was the main finding of Lars Lindholm’s research.

Sales of Drugs (Medscape)

Humira Tops Sales as Lipitor, Plavix Era Ends

By Ben Hirschler

LONDON (Reuters) Apr 11 – Abbott Laboratories’ $9-billion arthritis drug Humira (adalimumab) is set to take the crown as the world’s top-selling medicine this year, highlighting the dominance of costly biotechnology products as revenues from old-style pills decline.

Neither of last year’s biggest sellers – Pfizer’s cholesterol fighter Lipitor (atorvastatin) or blood thinner Plavix (clopidogrel) from Sanofi and Bristol-Myers Squibb – will even make it into the top 10 in 2012, according to consensus forecasts compiled by Thomson Reuters Pharma.

The dramatic shift in the sales landscape, triggered by a record wave of patent expiries, will be centre-stage during the forthcoming quarterly results season as investors weigh up how leading pharmaceutical companies are adapting.

“They’ve all seen this coming but their ability to maneuver is limited,” said Simon Friend, global pharmaceutical leader at PricewaterhouseCoopers.

“It’s a tale of two worlds … there is certainly a rush to streamline costs and step up looking for new products.”

Roche, the first Big Pharma to report sales figures on April 12, is relatively well-placed in the new era, given its leading position in biotech and cancer drugs, which it hopes to consolidate by buying gene sequencing firm Illumina.

Roche has three anti-cancer drugs in the global top 10 with Rituxan (rituximab), Avastin (bevacizumab) and Herceptin(trastuzumab). Others are less fortunate. Pfizer is already feeling the loss of Lipitor, after the U.S. patent ran out in November, while for Sanofi and Bristol the first three months of 2012 were the last full quarter of U.S. Plavix sales before cheap generics hit.

Bottom of the pack is AstraZeneca, trading on just seven times this year’s expected earnings. It has already warned that earnings will fall by more than 10% in 2012 as its antipsychotic Seroquel (quetiapine) and other drugs face generic competition.

Weight Gain and Weight Loss Drugs (Medscape)

Dr. Black: Which are the medications that make you gain weight?

Dr. Aronne: There are dozens of medicines, primarily in the area of psychiatry and neurology, and also some of the cardiovascular drugs. Beta-blockers can make it difficult to lose weight; alpha-blockers can make it difficult. Sleep medicines, over-the-counter sleep medications, can make it difficult, as well as a variety of hormonal therapies. And in the diabetes drug areas, if you follow the standard weight-gaining algorithms, you go from metformin to either insulin or thiazolidinediones and sulfonylurea; that’s the most common scenario we see. It’s very difficult to get that patient to lose weight. If we switch them over to either a dipeptidyl peptidase 4 inhibitor or, even better, a glucagon-like peptide-1 agonist, we’ll often see weight loss right away, because you’re taking away a weight-gaining medicine and you’re starting a weight-losing medication.

Dr. Black: There was a recent study about the value of 2 different types of bariatric surgery compared with usual medical therapy, which showed after just a year that hemoglobin A1c went down and people lost as much as 25 or 30 kilos with the surgery.^[1] What was your opinion of that study?

Dr. Aronne: People have criticized the study as not being as good as it could have been, but it’s very, very tough to do these studies and to randomize people. I give credit to the authors of the studies^[1,2] that were done, both of the studies that were done. One of the authors, Francesco Rubino, is from our institution, I should mention. I want to point out that, given the difficulties of doing a good trial in that setting, where you’re trying to randomize someone to a surgical procedure or medical therapy, I believe the results — that people do better with surgery. That being said, is there more risk in surgery? Sure.

Antipsychotics Off-label Use Soars, Not without Adverse Effects (Dr. Mercola)

In recent years, there has been a massive increase in off-label use of atypical antipsychotics. While most are only approved for the treatment of serious mental illnesses such as schizophrenia, this class of drugs is now increasingly prescribed for ailments such as anxiety, insomnia, and behavioral problems in children

Off-label prescriptions for antipsychotic drugs doubled between 1995 and 2008, from 4.4 million to 9 million prescriptions. In 2008, an estimated $6 billion was spent on off-label antipsychotics in the US, of which $5.4 billion was for uses based on uncertain evidence

In 2007 alone, half a million children and teenagers were given at least one prescription for an antipsychotic, including 20,500 under the age of 6. American children are the most medicated children in the world; getting three times more prescriptions for antidepressants and stimulants, and up to double the amount of antipsychotic drugs than kids from Germany and the Netherlands

Antidepressant Side Effects (Mercola)

• One in 10 American adults suffer from depression, and 11 percent of the US population over the age of 12 is taking at least one antidepressant medication
• Antidepressant use has been linked to thicker arteries, which could contribute to the risk of heart disease and stroke. In one study, the thickness of the main neck arteries in men taking antidepressants was about five percent thicker than that of those who were not using the drugs
• Last year, the FDA issued a safety alert on the antidepressant Celexa, warning it can cause abnormal changes in the electrical activity of your heart, which can lead to abnormal heart rhythm and fatal heart attacks
• In another large study, menopausal women taking tricyclic antidepressants and SSRIs were 45 percent more likely to suffer a fatal stroke than those not taking an antidepressant. Their overall mortality rate was also 32 percent higher
• Other serious side effects of antidepressants include: suicide, violence and homicidal tendencies, type 2 diabetes, brittle bones, stillbirths, immune problems, conversion from unipolar depression to the more severe diagnosis of bipolar illness, and cognitive decline with long-term use
• “Antidepressants’ effects on blood vessels may come from changes in serotonin, a chemical that helps some brain cells communicate but also functions outside the brain… Most of the serotonin in the body is found outside the brain, especially in the intestines… In addition, serotonin is stored by platelets, the cells that promote blood clotting, and is released when they bind to a clot. However, serotonin’s effects on blood vessels are complex and act in multiple ways. It can either constrict or relax blood vessels, depending on whether the vessels are damaged or not.”
• People with underlying heart conditions and low potassium and magnesium levels in their blood are particularly at risk for this, and the drug should no longer be used at doses greater than 40 mg per day, the FDA said. While the drug’s label indicates that “certain patients may require a dose of 60 mg per day,” studies have shown that there’s no benefit in the treatment of depression with doses higher than 40 mg, the FDA added.

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