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Saturday 26 March 2022

Is taking a daily Aspirin a good idea?

What was recommended years ago might no longer apply today for many people. Here's why.



This article was originally published in the Montreal Gazette


I have been asked a lot lately about the recent draft recommendation from the United States Preventive Services Task Force that adults over 60 do not need to take a daily Aspirin. 

While this might be surprising to some, it is actually based on nearly a decade of research and is not really news to most medical people. But, before people start throwing away their medication, we should remember that there is a difference between people who are trying to prevent a heart attack and those who have already had one.

In the medical world, we make a distinction between primary prevention and secondary prevention. In primary prevention, you are trying to prevent a healthy person from getting sick, whereas in secondary prevention you are dealing with someone who is already sick and trying to prevent them from getting worse. In secondary prevention — people who have had a heart attack or stroke or some other form of vascular disease in the past — Aspirin therapy is clearly beneficial.

But many of the people taking Aspirin do not have prior cardiovascular disease. These primary prevention patients were probably told to start Aspirin at some point or might have even started it themselves because of the often-repeated maxim that everyone over the age of 50 should take a daily Aspirin. 

In the past, some studies did suggest a benefit for a baby Aspirin once a day. Studies like the Physicians’ Health Study and the Hypertension Optimal Treatment trial showed a benefit to daily Aspirin and are likely responsible for the common perception that people, especially those with risk factors, should be taking it for primary prevention.

But the reality is that these studies are decades old and the evidence base has not held up over time. More contemporary studies have not shown a benefit to daily Aspirin for primary prevention, and a 2009 meta-analysis by the Antithrombotic Trialists Collaboration as well as a more recent 2019 meta-analysis in JAMA both showed the benefit to Aspirin therapy was minimal and largely offset by the increased risk of bleeding.

It is important to remember that these studies are not suggesting that Aspirin does not work or that the prior evidence is wrong. But Aspirin does increase the risk of bleeding, and for most patients, the benefit they draw from Aspirin is too small to justify the risk. 

Patients with prior heart disease are at higher risk and therefore draw more benefit from it. But patients with no history of cardiovascular disease, even those with risk factors, are too low-risk to benefit.

It might seem curious to people that earlier studies showed a benefit while more recent studies did not. The reality is that the medical landscape was very different in the late 1980s and early ’90s. Most medications we use today did not exist back then and those in use were not that good by today’s standards. People smoked more and many were walking around with blood pressure, blood sugar and cholesterol values that were much higher than we consider normal today.

So it isn’t that Aspirin stopped working, or that the earlier studies were wrong. The reality is that people today are at much lower risk for heart disease and stroke than they used to be because we are now better and more aggressive at treating their risk factors. Patients are lower-risk today and simply draw much less benefit from a baby Aspirin, hence the USPSTF recommendation.

There might be some primary prevention patients who are at particularly high risk for whom the cardiovascular benefit of Aspirin outweighs the bleeding risk. But for the majority of people, this is not the case. Given that patients often complain about taking too many pills, if they are truly primary prevention patients, the daily baby Aspirin could be one pill their physicians can stop.


@DrLabos


https://www.mcgill.ca/oss/article/health-and-nutrition/taking-daily-aspirin-good-idea

Is there any point in drinking oxygenated water? Simple answer. No!








Oxygen is critical for life and that also makes is susceptible to chicanery. If oxygen is so essential that the brain is permanently injured after just four minutes of deprivation, then surely more must be better! That’s the argument used by sellers of “oxygenated water” who often target athletes with claims that their product can improve athletic performance. 

Well, all water is actually oxygenated water because oxygen from the air dissolves in water, although not to a great extent since its solubility is only about 25 mL per liter. 

Still, this is enough for fish to extract with their gills to sustain life. More oxygen can be squeezed into water under pressure, which is exactly what the “oxygenated water” people do. 

However, most of this oxygen escapes into the air as soon as the pressure is released by opening the bottle.

Whatever dissolved oxygen remains is inconsequential since we do not breathe through our gut. Only a trace of the trivial amount of oxygen in the water will pass through the intestinal lining into the bloodstream, which is already saturated with oxygen anyway. 

The most salient point is that a single breath of air contains more oxygen than a liter of oxygenated water. A single breath is about 500 mL of air, of which is roughly 20% or 100 mL is oxygen. 

A sampling of a variety of oxygenated waters reveals an average of about 10 mL oxygen per 100 ml of water. 

Clearly, even if the oxygen from the water were absorbed, it would be less than taking an extra breath.

Of course, in science we do not go by theory, but by experimental evidence. And a number of studies clearly show that drinking oxygenated water has no effect on any sort of performance. 

Subjects performing standard maximal cardiopulmonary exercise tests drank either regular water or oxygenated water and there were no significant differences in results. Furthermore, participants were unable to identify the type of water they had consumed.

Often there is even more absurd hype piled on oxygenated water. There are claims that the oxygen content of the atmosphere is decreasing due to pollution, so we must supplement our intake with “superoxygenated water.” Total nonsense. 

Then there are these stupefying statements: “The oxygen is stabilized in micro-encapsulated water clusters.” “Our patented method of expansion and contraction of the water molecules several times per minute allows more oxygen consumption while taking on donor electrons.” “We use monoatomic oxygen in addition to other salutary forms of oxygen: O2, O4, O5, O6 and O7 which is less than half the diameter of regular diatomic oxygen.” Absolute mind-boggling gobbledigook!

For the cherry on top, these oxygenated waters are often sold in health food stores in an aisle next to dozens of types of antioxidants that claim to confer eternal health by neutralizing those dastardly free radicals generated by the body’s use of oxygen. 

I hope we have now thrown enough cold water on the hot hype of oxygenated water.


@JoeSchwarcz

https://www.mcgill.ca/oss/article/health-and-nutrition-you-asked/there-any-point-drinking-oxygenated-water

Some things to know about COVID rapid tests

They are not perfect, but a test doesn’t have to be perfect in order to be useful.












This article was originally posted in the Montreal Gazette


Christopher Labos MD, MSc | 30 Dec 2021 

Starting this week, Quebecers are able to get rapid test kits from pharmacies so that they can test themselves at home. Compared to going to a test centre where lineups are starting to stretch into hours-long waits, the convenience of an at-home kit is obvious. 

The tests can be done anywhere and are easy to perform. Everything you need is in the testing kit. They are less expensive than PCR tests and provide results in 15 minutes. 

On the surface, the appeal of these tests should be obvious, and yet their rollout here has been slow compared to other countries, especially in Europe, where they have been widely used for months.

The fear has been that these rapid tests would be less accurate than standard PCR tests. But to truly evaluate their usefulness we have to look at both their sensitivity and their specificity. 

A sensitive test would correctly identify everyone with COVID-19 as positive. A specific test would correctly identify everyone without COVID-19 as negative. 

Ideally, you would want a test to be both sensitive and specific, but practically speaking you often must sacrifice one for the other. 

The issue with rapid tests is an issue of sensitivity. In other words, some people with COVID-19 do not test positive.

There are multiple reasons why this might happen. The rapid antigen tests detect a protein that makes up part of the virus and can tell you whether you have an active infection. 

But if you test too early in the course of the infection there may not be enough replicating virus in your nose for the test to detect it. 

Similarly, if you test too late after symptoms start, then the viral load may be decreasing and also be undetectable. 

Reviews of various rapid antigen tests show they perform better if done in the first week of infection. 

Technique also matters. If the swab gets an inadequate sample, then the test may be inconclusive or falsely negative. 

So while the procedures may be daunting for people unfamiliar with them, explanatory videos of rapid tests should go a long way toward demystifying the procedure, which actually is fairly simple.

The other issue that can affect the sensitivity of the test is whether someone is symptomatic. Because you need to need a certain amount of virus to be detectable by the test, asymptomatic individuals are more likely to have either mild infections or be too early in the disease course for the test to pick them up. 

In the Cochrane review of rapid antigen tests, sensitivity was higher in symptomatic vs. asymptomatic individuals (78 per cent vs. 58 per cent) whereas specificity was high for both groups (99 per cent vs. 98 per cent). 

In short, the tests are good at ruling in the disease, but perform less well at ruling it out, especially in asymptomatic individuals.

One final wrinkle is that the accuracy of these tests changes depending on the epidemiological situation. If one uses a different branch of statistics, called Bayesian statistics, one can see the probability of false positive and false negatives can change depending on how much COVID is circulating in the community. 

When the prevalence of COVID-positive people goes up, the positive predictive value of the test goes up while negative predictive value goes down. With a test positivity rate of 7.4 per cent as of Monday, the likelihood of a rapid test being wrong is quite low , but not zero.

A negative rapid test is not a licence for carelessness and should not be used as a justification to throw caution to the wind and start holding large parties. But if used properly in tandem with all other public health measures, they can help reduce viral spread. We must remember that they are not perfect, but a test doesn’t have to be perfect in order to be useful.


@DrLabos

https://www.mcgill.ca/oss/article/covid-19/some-things-know-about-covid-rapid-tests

Non-smoker’s lung cancer and the hidden link

How does one contract the so-called non-smoker’s lung cancer? The answer, one might say, is blowing in the wind.

The link between cigarette smoking and lung cancer is widely acknowledged. But not everyone who smokes gets lung cancer and not everyone who gets lung cancer is a smoker. How does one contract the so-called non-smoker’s lung cancer? The answer, one might say, is blowing in the wind. And that wind may be blowing a gas called radon.     

Radon is a naturally occurring colourless and odourless radioactive gas that according to the World Health Organization (WHO) is responsible for up to 14% of all cases of lung cancer.  The source of radon is uranium, a radioactive element found in soil and rocks.  

The term “radioactive” alarms many people. Justifiably so. Atoms of radioactive elements are unstable and spontaneously disintegrate into other elements, in the process giving off rays of energetic particles that can damage tissues and cause disease. When uranium undergoes radioactive decay, one of the products it forms is radon, which is itself radioactive and gives off dangerous high-energy rays. The gas can seep into basements and crawl spaces wherever uranium is present in the soil. Whether it does, depends on how fissures are structured in the ground underneath homes. It is possible for the basement of one house to be contaminated with radon while an adjacent home is unaffected. Granite, a stone that is composed mostly of silicon dioxide (quartz) can harbour trace amounts of uranium compounds and can therefore also be a source of radon.  

Uranium was first discovered by the German chemist Martin Henrich Klaproth in 1789, but its radioactive property was not identified until 1896 by French physicist Henri Becquerel. Polish-French physicist/chemist Marie Curie subsequently coined the term “radioactivity” after discovering two additional elements, radium and polonium, that like uranium fragmented into other elements accompanied by the emission of “rays” of energy.  

Every element has a nucleus composed of positively charged particles called protons, and neutral particles termed neutrons. Like charges repel each other, but proton-proton repulsion is reduced by neutrons squeezing in-between the protons. Negatively charged electrons roam about the nucleus in different shells, with the outer-most shell referred to as the valence shell.   

Elements with large nuclei, such as uranium, tend to be unstable. To achieve stability, they undergo spontaneous radioactive decay. Uranium-238, so-called because it has 92 protons and 146 neutrons in its nucleus, undergoes radioactive decay through 14 steps, eventually yielding lead-206, a stable nucleus. One of the nuclei produced in this lengthy chain is that of radon. As soon as radon forms, it begins to undergo radioactive decay into lighter elements by giving off alpha particles that are composed of two protons and two neutrons. When radon is inhaled, alpha particles become trapped in lung tissues and can damage DNA. Such damage can result in cancer over time.  

How does this happen? Alpha particles are a type of “ionizing radiation,” defined as radiation that is energetic enough to break chemical bonds in molecules. When water, which makes up 70% of human cells, is the target if such radiation, one of the breakdown products formed is a hydroxyl radical. This species is “electron hungry” and can steal electrons from other molecules such as DNA. Since electrons are the “glue” holding atoms together in molecules, their loss leads to molecular damage such as a change in a DNA sequence. Such a “mutation,” if uncorrected by the body’s DNA repair processes, can be passed on to generations of daughter cells which over time can transform into cancer cells. Mutations can also occur without the involvement of water. Radioactive emissions can attack DNA directly and disrupt its structure.   

Radioactivity is measured in picocuries per litre of air (pCi/L). On average, in North America, outdoor levels are around 0.4 pCi/L whereas indoor levels are higher, at roughly 1.3 pCi/L. It is recommended that protective measures be taken if indoor radon levels are above 4 pCi/L.  Smokers and former smokers are at greater risk than non-smokers. 

Various types of radon tests are available. The simplest ones, readily available at a reasonable cost, feature a canister filled with activated charcoal that absorbs radon as air passes through it. The canister is then sent to a laboratory where instruments detect and count the radioactive particles emitted. Another type of device contains a plastic film that is etched by alpha particles leaving tracks that can be visualized and counted in a lab. Also available are electronic detectors that require installation but can monitor radon levels continuously.  

Health Canada recommends a kit that collects radon for three months as the most accurate way of testing for the gas. As a general rule, the longer the time during which air is sampled, the more accurate the results. Detailed information on radon is available from Health Canada at https://www.canada.ca/en/health-canada/services/health-risks-safety/radiation/radon.html as well as the Environmental Protection Agency (EPA) website, or by calling 1-800-SOS-RADON.  

Takeaway: Measure your household radon levels and fix if needed. As for that beautifully polished granite countertop in your kitchen, no worries, as the traces of radon gas emitted are negligible relative to ambient amounts in the air, especially in properly ventilated homes. Bon Appétit and Happy Holidays!


Dr. Nancy Liu-Sullivan holds a Ph.D. in biology and served as a senior research scientist at Memorial Sloan Kettering Cancer Center. She currently teaches biology at the College of Staten Island, City University of New York.

https://www.mcgill.ca/oss/article/health-and-nutrition/non-smokers-lung-cancer-and-hidden-link


What is modified palm oil?

There is no genetic modification involved here, rather the term refers to altering the molecular structure of the naturally occurring fats in palm oil to produce fats with the desired melting point, consistency and mouthfeel.

This is a term you will see on the ingredients list of numerous products ranging from margarine and shortening to chocolate bars. I’ve been repeatedly asked about the presence of modified palm oil in Nutella, the popular chocolate hazelnut spread. Let’s squash one misconception right away. There is no genetic modification involved here, rather the term refers to altering the molecular structure of the naturally occurring fats in palm oil to produce fats with the desired melting point, consistency and mouthfeel.  

First, we need to tackle a bit of chemistry and then a touch of history. A comb with three teeth serves as an analogy for the molecular structure of fats. The teeth represent fatty acids that are attached to a backbone of three carbon atoms, which is a molecule called glycerol. (In chemical parlance this “comb” is a “triglyceride”.) The fatty acids can be “saturated,” meaning that they are composed of a chain of carbon atoms linked by single bonds, “monounsaturated,” in which there is one double bond in the chain or “polyunsaturated” in which multiple double bonds are present. In each case, the number of carbon atoms in the chain can also vary.  

Now for the history. When saturated fats, such as those found in butter and shortening, were first linked with cardiovascular disease back in the 1950s, the food industry took steps to give consumers a means to reduce their intake. 

An obvious approach was to replace some of the animal-derived saturated fats with vegetable fats that were mostly unsaturated and were deemed to be heart-healthy. 

The problem, though, was that these fats were too “liquidy” for most applications. However, “partial hydrogenation,” achieved by passing hydrogen gas into the vegetable oils, converted some of the unsaturated fats into the saturated variety and produced a consistency and mouthfeel similar to butter. 

A problem, only recognized later, was that hydrogenation also produced some “trans fats” as a side product. When these were linked to heart disease, the industry geared up to find a way to produce vegetable fats with the desired consistency without resorting to hydrogenation. Another way to “modify” the vegetable oils had to be found. 

Palm oil is the most widely produced vegetable oil in the world, derived from the fruit of the oil palm, distinct from palm kernel oil which is extracted from the fruit’s kernel. Palm kernel oil is composed of roughly 80% saturated fats, while palm oil is composed of 50% saturates, 40% monounsaturates and 10% polyunsaturates. It is the high unsaturated content of palm oil that is responsible for its low melting point and fluidity.  

The challenge then was to replace one or two of the polyunsaturated “teeth” in the “comb” with saturated fatty acids. The basic idea was to first dissociate the fatty acids from the glycerol backbone and then allow them to recombine with the glycerol in a process known as “interesterification” hoping that the recombination would result is a formation of novel “combs,” including some in which the middle “tooth” is the monounsaturated oleic acid, and the other two “teeth” are saturated palmitic or stearic acids. Such an arrangement was expected to have the right consistency for food applications. Enzymes (lipases) can catalyze both the disassociation and recombination reactions, as can some simple chemicals such as sodium methoxide. Indeed, some of the desired product was formed and various “fractionating” methods were developed to separate out this desirable component. Presto, food chemists had produced “modified palm oil” that was capable of replacing partially hydrogenated fats. 

Of course, this modified oil still contains some saturated fatty acids, but less than butter. In any case, current scientific opinion is that saturated fats are not quite as villainous as once believed. When it comes to Nutella, I’d be more concerned about the sugar content (58%) than the inclusion of modified palm oil.


@JoeSchwarcz

https://www.mcgill.ca/oss/article/health-and-nutrition-you-asked/what-modified-palm-oil

In Defence of the Maligned Root Canal

 Root canals are safe and effective, and by eliminating bacteria from the infected roots of teeth, prevent infection from spreading into the jaw and beyond.


Over the course of my thirty-five-plus years of practicing dentistry, I have been asked many questions concerning the safety of various dental agents and materials, most notably silver fillings and fluoride. Undoubtedly, the internet has provided the masses with a plethora of sound information at their fingertips. Conversely, accompanied by its social media counterpart, it has become the primary gateway to the spread of misinformation and conspiracy theories. Dentistry, being an evidence-based profession, is not immune to the dissemination of pseudoscientific claims promoting alternative treatments “not taught in dental school.” Typically advocated by so-called “Holistic” and “Biological” dentists, these therapies fly in the face of conventional dentistry.  

Perhaps the most egregious claim made by some of these practitioners is regarding root canal treatments. While representing only a minority, these dentists argue against the use of conventional endodontic therapy, opting instead for extraction and replacement by implants. Others advocate extracting asymptomatic root canal-treated teeth. Not only is this approach scientifically unfounded, but it also violates a dentist’s Hippocratic oath to “do no harm.”  

The Maligned Root Canal, So Misunderstood 

So what exactly is a root canal, a term that strikes fear in the heart of so many? Some people think it involves removing the roots of teeth, but most have no clue. Many have heard horror stories from friends about how painful they are, but like many other myths attributed to dentistry, this is generally false. 

Essentially the teeth that are visible in our mouths are just the tip of the iceberg, for lurking far beneath the gum line anchoring them into jaw bone are the roots. Typically, front teeth have a single root, while the ones further back have two or three. Filling the hollow inner chamber of teeth and traveling down through the roots via canal systems is the spongy pulp, comprising a tooth’s blood and nerve supply. It allows us to sense temperature, or let us know when a dentist's freezing hasn't taken effect!

When a pulp gets inflamed, often due to a deep cavity or trauma, a tooth can become sensitive and if irreversibly harmed, extremely painful. Left untreated the pulp can die, becoming necrotic with bacteria potentially exiting the end of roots into the jaw causing a dental abscess. A root canal treatment removes the diseased pulp from the tooth, disinfects, and then seals the hollowed-out canal spaces most typically with a biocompatible thermoplastic material called gutta-percha. When performed by a skilled practitioner, root canals have a success rate of 95%, are generally painless, and when feasible much preferable to extraction. 

The Price is Not Right 

Recently, when not discussing the pandemic, some patients have asked me about the safety of root canal treatment. Typically they may have read something on the internet or heard through a friend that root canals are dangerous. 

Where does this misinformation originate? Back in the 1920s, dentist Dr. Weston Price conducted some poorly designed studies based in large part on the previously developed “focal infection theory” asserting that asymptomatic root canal treated teeth leak bacteria and their toxins into the body, causing a variety of chronic systemic diseases such as cancer, heart disease, and arthritis. 

Despite well-designed studies conducted in the 1930s discrediting his findings, Price’s theory gained popularity over the following decades resulting in the needless extractions of countless healthy teeth in order to treat or prevent various systemic illnesses. 

Only in the early 1950, ’s did the paradigm shift back to the endodontic treatment of restorable teeth with non-vital pulps. Upon reviewing Price’s work from the 1920s, a 1951 article in the Journal of the American Dental Association contradicted his research noting it “lacked many aspects of modern scientific research, including the absence of proper control groups and induction of excessive doses of bacteria.” 

To date, there is no valid, scientific evidence supporting Dr. Price’s research linking endodontic treatment to disease elsewhere in the body.

“Notflix” 

Further contributing to the dissemination of misinformation concerning root canal therapy was a 2019 documentary “Root Cause” carried by Netflix. In it, the Australian filmmaker, seeking to find the cause of his own chronic health problems, alleged that serious illnesses are caused by asymptomatic infections inside root canals whose bacteria can travel throughout the body via “meridian lines.”  

Shortly following its release, upon concerns raised by various dental associations that its content could “harm the viewing public by spreading misinformation about safe medical treatments like root canals”, Netflix removed the content from its platform. 

My Tooth Sense 

Each year worldwide millions of root canals are performed, saving people the unnecessary trauma of losing their teeth. 

I find it truly perplexing and disturbing that some members of my profession continue clinging to the long-ago debunked theory advocating extraction of restorable teeth rather than saving them with endodontic therapy. 

Root canals are safe and effective, and by eliminating bacteria from the infected roots of teeth, prevent infection from spreading into the jaw and beyond. 

Furthermore, I find advising patients to extract asymptomatic endodontically treated teeth only to replace them with costly implant-supported crowns, unconscionable. 

My advice to anyone told to do so is to consider finding another dentist. And that’s the tooth and nothing but the tooth!


Dr. Mark Grossman is a practicing dentist and likes to take a bite out of nonsense when it comes to dental issues.

Dr. Oz’s Sad Trip Down the Rabbit Hole

 It is actually sad to see Dr. Oz degenerate into a pseudoscience-promoting political hack trying to gain favour with right-wing conspiracy theorists.  He could have done so much good from the pulpit gifted him by Oprah.



It seems that Dr. Mehmet Oz’s transformation from respected surgeon to deplorable pseudoscience advocate is complete. He recently slandered Dr. Fauci as a “petty tyrant” and then called him “cowardly” for not taking the bait to get into a “doctor-to-doctor debate” with the surgeon-turned TV snake oil salesman-turned politician. Oz may once have been a very competent physician, but he is way, way out of his depth when it comes to immunology, virology and epidemiology. He is just not in Dr. Fauci’s league.  

Dr. Oz has championed “energy medicine,” for which he received the James Randi Foundation’s “Pigasus Award” that recognizes achievements in pseudoscience. He has hyped diet pills devoid of any evidence,  has given credence to talking to the dead, and hit bottom with marketing “Dr. Oz’s homeopathic starter kit.” Homeopathy, based on non-existent molecules treating existing disease, is the most absurd of all the “alternative” therapies.  

If Oz didn’t quite hit the bottom with his promotion of homeopathy, he surely did so now, jumping into bed with the nutcases at Fox to gain support for his preposterous Senate candidacy. This is a man who was eviscerated at a Senate committee hearing when questioned about his shameless plugging of baseless dietary supplements, and a man who was the subject of a study in the prestigious British Medical Journal that found 15% of his recommendations on the “Dr. Oz Show” were contradicted by evidence and another 40% had no evidence to back up the claims made. 

Oz may bluster about challenging Dr. Fauci to a debate, but for Fauci, that would be like having a battle with an unarmed man. Oz can’t hold a candle to Fauci’s accomplishments, expertise or class.  

It is actually sad to see Dr. Oz degenerate into a pseudoscience-promoting political hack trying to gain favour with right-wing conspiracy theorists.  He could have done so much good from the pulpit gifted him by Oprah. 

At least so far he hasn’t promoted the hair dye he uses.


@JoeSchwarcz




https://www.mcgill.ca/oss/article/pseudoscience/dr-ozs-sad-trip-down-rabbit-hole





Extra Protein, Extra Performance? - Excess protein turns into fat

By taking large quantities of protein, athletes hope to be able to run that extra mile or lift that extra weight without failing their drug tests. But, does it work? More importantly, is it worth the risks?



Joe Schwarcz PhD | 20 Mar 2017 


No one can deny the importance of proteins in our diet. They are vital for countless body functions, especially tissue growth and repair. Proteins also provide energy to the body and help ensure a strong immune system. In striving to excel at their respective sports, many athletes subscribe to the notion that protein supplements enhance their physical performance. The existence of a multi-billion dollar supplement industry, however, does not prove that such products are necessary. Only a rigorous scientific investigation can do that.

Before delving into the science of protein supplements, let’s take a look at the differences between a supplement and a drug. Legally, dietary supplements cannot claim to cure, treat or prevent a disease, although they can convey how they potentially affect the body. Supplements do not have to go through the same regulatory process as drugs which undergo a thorough assessment for safety and efficacy before going on the market. Protein supplements therefore do not have to be proven effective before being sold. Indeed, their effectiveness continues to be a matter of ongoing debate, and with a lack of concrete evidence, many people continue to invest in this growing market.

An understanding of protein’s role in the body allows us to make an attempt at assessing the role of supplements. A normal adult requires only forty to fifty grams of protein per day in order to supply essential amino acids and replace the nitrogen eliminated in urea as waste. Essential amino acids are the nine out of twenty amino acids that the body requires but cannot produce on its own. When an amino acid is broken down, the nitrogen it contains is converted into urea by the liver which then is excreted via the kidneys. 

Many athletes, body builders, or teenage boys who are looking to “bulk up” turn to protein supplements or high protein diets to enhance their performance or accelerate muscle growth. Supposedly, the amino acids arginine and ornithine promote release of growth hormone, a natural hormone that stimulates muscle development. Glutamine and carnitine have also been marketed as strength-enhancing amino acids. By taking large quantities of these proteins, athletes hope to be able to run that extra mile or lift that extra weight without failing their drug tests. But, does it work? More importantly, is it worth the risks? 

A typical American diet contains approximately seventy to ninety grams of protein per day, meaning that most individuals far surpass their daily protein requirements. Dietary protein is used to replace proteins which were previously broken down and used by the body. Extra protein does not get stored. Instead, excess amino acids get converted to carbohydrate or fat. Thus, it seems that additional protein intake will not directly increase muscle growth, strength or physical performance and could even lead to weight gain and fat deposition, which are surely negative consequences for any athlete.

As a matter of fact, many health experts question the efficiency and safety of ingesting large amounts of proteins. In one study of elite junior weightlifters, consumption of protein supplements including glutamine and carnitine before workout did not result in changes in blood hormone levels during heavy training. Another study with bodybuilders found no change in blood growth hormones after consuming various mixtures of amino acids. Not only that, excess protein intake can have deleterious effects on the body. The recommended dose of protein intake for a normal adult is 0.8 g per kg of body weight per day. That’s 54 g for a person weighing 150 lb. High level athletes (and we are talking about those who compete at the national and international level, not your fifteen year-old who wants to impress a girl) require a bit more than that to compensate for their high energy output. According to one study, athletes competing in power or strength sports need about 1.6 g of protein per kg of body weight, while endurance-trained athletes need about 1.3 g per kg. There is still debate about the exact amount of proteins athletes should consume, but the consensus is that anything over 2.0 g per kg of body weight per day is excessive and no scientific evidence supports beneficial effects above this level. High protein diets on the other hand advocate protein intake on the order of 200 to 400 g a day! Too much protein intake can lead to liver and kidney overload; the liver cannot convert nitrogen into urea fast enough and the kidney has to deal with extra urea. Too much urea results in higher demand for water, which leads to dehydration. And we all know how important it is for athletes to stay hydrated. More serious problems include hyperaminoacidemia (excess amino acid in blood), hyperammonemia (excess ammonia), hyperinsulinemia (excess insulin), calcium loss and overreaction within the immune system.

All you need, really, is a balanced diet and healthy lifestyle. No need to wreak havoc in your body with excessive supplementation. A 3-oz. portion of roast white chicken meat already contains 26g of protein. Beans average about 15g per cup, and pasta contains 5g per cup. While there is evidence that extra protein can be beneficial for athletes, you really don’t need much. A double-blind study with judoists showed that a daily protein supplement of 0.5 g per kg of body weight improved the maximum oxygen uptake. The effects disappeared when judoists stopped taking the supplements. However, such amounts can be obtained from a healthy diet. The body cannot tell the difference between proteins coming from foods and proteins coming from bottles. Proponents of supplements claim that they are more readily absorbed than the protein from food and that certain amino acids increase muscle mass and decrease body fat. The fact is, there is no reason to believe that faster absorption is better; after all, muscles don’t just grow from one second to the next. The best way to gain muscle mass is to add body weight by increasing calorie intake from low fat carbohydrate sources.

Endurance or strength exercise does increase the body’s dietary protein requirement, therefore athletes who are generally more physically active than the average person, require more dietary protein. Just how much more is hard to determine but needs can certainly be met without resorting to protein supplements. Furthermore excessive protein intake is not without problems. Potential side effects include dehydration, which is secondary to high urea excretion, gout, liver and kidney damage, calcium loss, bloating and diarrhea. Yes, athletes do need more protein, but not in gargantuan amounts. And supplements are great, for those who sell them. There is nothing you cannot obtain from a healthy diet. As for bulking up... exercise by itself already significantly increases growth hormone levels, so leave the health food stores alone and head for the gym!

https://www.mcgill.ca/oss/article/health-you-asked/extra-protein-extra-performance

16 Medical Tests and LEPTIN and INSULIN RESISTANCE

 LEPTIN TEST and Other Medical Tests That Can Save Your Life....by Dr Ron Rosedale


Are you aware that you may have metabolic dysfunctions ? What about LEPTIN RESISTANCE and INSULIN RESISTANCE? Most probably. Just sharing.....

Dr Ron Rosedale: Founder of the North Carolina Center of Metabolic Medicine; Rosedale Metabolic Medicine in Dencer, Colarado.

(This article was originally posted on this blog on 5th April 2013. Because of its relevance and interest, I am re-posting it today)

....If there is a known single marker for a longer life span, as they are finding in the centenarian and laboratory animal studies, it is insulin sensitivity, or low insulin levels. When your cells are not sensitive to insulin, your insulin levels go up.
 
What is the purpose of insulin? If you ask your doctor, he or she will tell you that it's to lower blood sugar, but I believe that's a trivial side effect. Insulin's evolutionary purpose is to store excess energy for future times of need. It lowers blood glucose levels for the purpose of storing it away, not regulating it. For our ancestors, this was a good thing. Remember, our ancestors survived on whatever food they could find, and they did not typically find food that elevated glucose. They ate some fruits when it was in season, but much of the sugar was burned in gathering it. High glucose wasn't a big problem back then! Very often, they were forced to survive for days, weeks or even months on little food. Insulin helped our ancestors store away nutrients for the proverbial rainy day when they would need it.


Our diet is completely different today. Food is plentiful, and high glucose is the norm, not the exception. As a result, our insulin levels are typically much higher than they were among our ancestors. When your cells are constantly bombarded with insulin, they become insulin resistant, meaning they stop hearing insulin's important message.....you are insulin resistance....creates a hormonal derangement that has a catastrophic effect on your metabolism.....Makes you fat; bad for your heart; cancer link; bad for your bones; ages you; memory problems; suppresses immune system; higher basal body temperature; high triglycerides; obesity; IR & LR;....and more.

...I lecture frequently to medical groups and I am passionate about teaching other physicians that food is indeed the most powerful medicine. I believe that physicians should strive to get patients on a good diet and off drugs, whenever possible. It has become fashionable these days to quote Hippocrates, who said, " Let food be your medicine and medicine be your food." In my case, that philosophy is the cornerstone of my medical practice.

...I am also a well-known specialist in the field of aging, and lecture on that topic as well. It is not unrelated to diabetes. In fact, my interest in diabetes was sparked by the observation that diabetics suffered from so-called diseases of aging, such as arthritis, heart disease, cataracts, and even dementia at a much earlier age than normal. They even look older at an early age. From that realization, it dawned on me that the metabolic disorder of diabetes is a disease of rapid aging, and what we consider to be the " normal " diseases of aging are in reality due to an underlying disease of metabolic dysfunction.

...I have come to believe that leptin resistance is at least related to, if not at the foundation of the majority of disorders related to aging, including heart disease, diabetes, obesity, osteoporosis, arthritis, and even aging itself. I know that many of you are probably thinking, how could one hormone --- let alone a hormone that most of you have probably never heard before --- be so important to health and longevity?

...Modern medicine has focused on merely treating symptoms, such as high cholesterol or elevated blood sugar, and not the true disease that underlies those symptoms, for that is far easier.... and therefore more lucrative. My experience has taught me that treating symptoms simply masks problems, and will almost make them worst, not better. If you lower leptin ( and also insulin ) to healthy levels, you will go a long way towards preventing and treating a main root of what we call the disease of aging and, in fact, aging itself. I believe that the disease of aging are not inevitable, and that they are aggravated, if not caused, by the typically poor American diet.

De-Age Your Body With The Rosedale Diet


...I am a metabolic specialist who has devoted my career to treating diseases such as obesity, heart disease , and diabetes.
 
Until then, the medical establishment had all but ignored the role of diet in disease. It was already thought that a high fat diet could increase cholesterol levels in the body, and after his research ( Dr. Jeremiah Stamler, one of the first to study the correlation between elevated cholesterol and heart disease. I had the privilege of working with him ) everyone jumped on the " no fat-no cholesterol " bandwagon. We were told that the ideal diet was low in fat and cholesterol, and high in carbohydrates, especially for diabetics, who were at greater risk of heat disease. We didn't know about leptin yet, nor did we understand the role of insulin in metabolic disease, nor did we differentiate between good fats and bad fats. I saw diabetic patients on this so-called ideal diet get worse, not better. Worst of all they were always hungry and couldn't stay on that diet. I asked myself why the standard diet wasn't working? Why did most of them require more, not less medicine on this diet? Why were they so unhappy and so hungry?

....One day it dawned on me that the high carb -- low fat diet that was being prescribed to diabetic patients was precisely the wrong therapeutic approach. The reason why now seems obvious, but a decade ago, it was revolutionary bordering on heretical. Carbohydrate in any form other than fiber is eventually metabolized by the body into sugar. In fact, it starts turning into sugar as soon as it hits the saliva in your mouth. It doesn't matter if it is a piece of fruit, a brownie, or a bowl of whole grain cereal, it still turns to sugar. ( There are some carbs that are better for you than others, but nevertheless, any carb that is not fiber eventually ends up as sugar. )

Excess Protein Is Just As Bad
 
...If high carb wasn't the right approach, that left two other major food categories on which to base a diet: protein and fat. It may surprise you to learn that the protein that the body doesn't quickly use to repair or make new cells is largely broken down into simple sugar, which increases sugar and promotes insulin resistance. Furthermore, protein itself triggers insulin production, which can worsen insulin resistance. ( That is why diabetics should never go on a very high protein diet. )

...Having rules out carbohydrates and protein, I decided to try putting my diabetic patients on a high fat diet, but only using healthy fats, such as those you'll eat on the Rosedale Diet. When I switched my patients to this new diet, I saw vast improvements in nearly every case. In addition to losing a lot of unwanted weight, patients were able to reduce or eliminate their medication. I was so impressed with these results that I recommended the diet for my non-diabetic patients who were trying to lose weight, many of whom were insulin resistant. The weight literally melted off them, and most were able to keep it off. Years later, after the discovery of leptin ( in 1995 ), I found out why my diet worked so well. It lowered leptin levels quickly and effectively. I also discovered why the other diets had failed. They didn't lower leptin levels nearly as well or as effectively, in fact, they often raised leptin levels! ( Shockingly, most diabetics are still treated with the high carbohydrate -- low fat diet. ) ... Thus, the longtime nutritional advice of the medical profession to eat a high carb, low fat diet is an oxymoron!

That's the preliminaries.


Now for the Rosedale recommended tests. These are tests I haven't known myself but it's important especially if you have Health Challenging Issues or chronic HCIs. It may strikes you that other tests are more important than others like HbgA1c vs Glucose; Basal Temperature ( very interesting ) and lastly, you will never imagine is how not so important is Cholesterol !

Have it downloaded. Read and reread it. Keep it for the next generation. Pass it to your friends. Who else ?

I've added my comments based on my past ignorant --- hope you don't mind....any further comments welcome......Alan

Happy reading.


...I also recommend, however, that you get the laboratory tests prior to starting the Rosedale Diet and do the appropriate follow-ups after three months, six months, and one year, or as indicated. Just as your doctor periodically checks your cholesterol, I much prefer to follow other lab tests that I feel are far more indicative of your overall health. These will provide concrete, irrefutable proof of the program's beneficial effects on your overall health.

...Of the sixteen medical tests described below, at least seven can be included as part of the routine CBC, or complete blood chemistry, that should be done at your annual physical. ( An asterisk * designates the tests that can be included as part of this routine workup. )

...Because some tests require a fasting blood serum sample, you will be instructed by your doctor to avoid eating or drinking besides water for at least eight hours prior to having your blood drawn. Several of the tests described below are outside the range of the usual blood tests and should be sent to one of the handful of specialized labs for analysis. ( See section for lab recommendations. )

[ Note: Through my search in S'pore and Australia, and assistance from Rosedale's office, I finally found the nearest to Malaysia is in India for the most important test. Leptin test.]
....The tests listed below in what I consider to be their order of importance.

01) LEPTIN
 
The most reliable test for monitoring leptin levels is the radioimmunoassay ( RIA ), which utilizes an antibody that responds to leptin in a fasting blood sample. This test will tell you whether or not you have leptin resistance ( LR ). If your level is in the healthy range --- the optimal fasting leptin level is between 4 and 6 ng/dL and up to 9 is acceptable --- your cells are sensitive to leptin's signals. You're a fat burner as nature intended you to be, and it is unlikely that you will have a weight problem. ( If you lower your leptin levels to optimal levels, as you most certainly will on the R'Diet, it is highly unlikely that you will continue to have a weight problem even if you started out with one. ) Of course, we don't want leptin levels to go too low, Anything below -4 ng/dL is a sign of either malnutrition, usually accompanied by very low body fat, or a generic inability to produce leptin that results in obesity. ( If a woman's leptin level falls below 3, generally caused by very low stores of body fat due to inadequate food intake or intensive exercise, she will stop menstruating. )

If your fasting leptin level is 10 ng/dL or higher, you will most certainly benefit from the leptin-sensitizing program outlined in this book. Most obese people have extremely elevated leptin levels: 20, 30, even 40 ng/dL ! Yet within only two to three weeks on the R'Diet, almost everyone experiences a dramatic decline in leptin levels. At the same time, they eat less because they do not feel hungry as often as they used to. They no longer experience food cravings and have little difficulty following the diet. If your leptin doesn't fall as quickly as it should ( younger people often have quicker results than older people ), you need to be especially careful about following the diet and perhaps add extra nutritional supplements. But if you follow the program, I promise that your leptin sensitivity will improve and your fasting leptin level will fall.

  Leptin: 4 to 6 ng/dL optimal; up to 9 acceptable; 10+ high.  
 
02) INSULIN
 
The most important test after leptin is fasting insulin, for this hormone is also involved in how your body utilizes energy. Insulin is best known for its effect on blood sugar. Secreted by specialized cells in the pancreas, called islet cells, in response to increases blood glucose, insulin binds to receptors on the surfaces of cells throughout the body and signals them to allow glucose to enter.

Insulin regulates the energy needs of nearly every cell in your body. In addition to clearing glucose out of the blood, it determines whether that glucose will be used for immediate energy needs, whether it will be converted into glycogen for use over the next few hours, or whether it will be converted into fat for future needs. This explains why elevated insulin and leptin resistance go hand in hand in promoting weight gain. It is also involved in the synthesis of protein.

It is easy to overlook the manifold actions of insulin because its blood sugar ---- influencing properties are all you hear about from your doctor and the media. But let's look at it from the evolutionary perspective. For most of human history, the challenge was uncertain access to a food supply of any kind ( remember the Hunters Gatherers era ). Storing nutrients for times of food deprivation was essential to survival, and this is exactly what insulin does. Thus, insulin lowers blood sugar secondary to its major role in trying to store excess sugar mostly as fat.

Unfortunately, the fine-tuned processes that kept us alive during times of scarcity are undermined by our present diet that keeps blood levels of insulin constantly elevated.

One of the earliest effects of excess insulin is weight gain, as it stimulates the storage of fat and the burning of sugar. It lowers cellular level of magnesium, a mineral that relaxes the arteries and improves blood flow. Insulin also increases accumulations of sodium, causing fluid retention, resulting in high blood pressure. Elevated insulin also increases inflammatory compounds in the blood that damage the arteries and promote the formation of blood clots that may cause a heart attack. It stimulates spasms in the arteries and arrhythmia in the heart. Furthermore, it causes abnormalities in blood fats, including reductions in protective HDL cholesterol and elevations in triglycerides and small dense LDL cholesterol. All this translates into a significant increase in risk of heart disease.

There's more. Excess insulin upsets hormonal balance and increase the risk of polycystic ovary disease. It is even strongly linked to cancer because of its role in cell proliferation. Finally, high levels of insulin interfere with the normal activity of leptin with very few exception; if you are insulin resistant, you are also leptin resistant.

The best way to determine if you are IR is to have a fasting insulin test to measure total and/or free fasting insulin in serum. Free insulin is the active form of insulin, not bound to antibodies or other proteins, and levels will be slightly lower than total insulin. Ideal level are less than 10 IU/mL...Anything above this means you are IR---and the higher your level, the more severe the condition. If your insulin is creeping towards 10, you have a window of opportunity to take steps to improve your insulin sensitivity. If your level is above 10, it is imperative that you do what it takes to get IR under control.

Because IR and LR are so closely intertwined, insulin levels response beautifully to the R'Diet. As you adopt the diet, your cells become more sensitive to insulin and your insulin level will drop. At the same time you will be losing weight, reducing your risk of diabetes, heart disease, cancer, and other ills, and setting the stage for a long and healthy life.

 Fasting Insulin: 10 IU/mL and below optimal; over 10 high.

[ Some local labs doesn't have the facility. They may do it for you by sending your blood serum to Singapore for a fees if you do the others common tests with them. ]
 
03) HBGA1C ( GLYCATED HEMOGLOBIN )
 
Glucose interacts with proteins in a process called glycation or glycosylation. When that protein is hemoglobin, the iron-carrying pigment that gives red blood cells their color, the end result is glycated hemoglobin ( HbgA1c ). ( We could measure glycation in other blood proteins such as albumin, but this is the most economical and acceptable test. )

The HbgA1c test, which measures the percentage of hemoglobin that is glycosylated, is used by most doctors to estimate average blood sugar levels over the preceding 120 days ( the average life span of a red blood cell ). If your HbgA1c is 5.5 percent, this means your average fasting blood sugar for the past three months was approximately 100 mg/dL. An HbgA1c of 8 % translates into average blood sugars of approx. 200 mg/dL., and 11 % into approx. 300 mg/dL.

As opposed to measuring average blood sugars, this test really reveals the rate of glycation, and glycation can be modified especially by taking certain supplements. I have seen patients with similar blood sugars, yet one may have a HbgA1c of 6 % while the other's is 7 per cent. This is very important, for if diabetic patients can keep their glycation levels low they are that much less likely to be afflicted with complications of the arteries, nerves, eyes, and kidneys --- regardless of their glucose control. The non-diabetic HbgA1c range is from 4.5 percent to 6 percent, and the lower the level, the better.


There are several things you can do to curb glycation and lower HbgA1c. First, lower your blood sugar by changing your diet and improve your leptin and insulin sensitivity, Second, take targeted nutritional supple ments. Finally, reset your thermostat and lower your basal temperature ( by lowering leptin ), for higher temperatures accelerate glycation. All of these very important changes can be made by implementing the R'Diet.

  HbgA1c: 5.4 or less percent optimal; 5.6 - 5.8 acceptable; 5.9 - 6.9 high; 7.0 or higher at risk of diabetic complications.
[ You can have this test done at Malaysian Diabetes Association for RM 18/-. It's opposite the UH. ]
 
04) GLUCOSE *
 
A fasting glucose test measures the amount of glucose, or sugar, in your blood. Most of the carbohydrates you eat are broken down into glucose and released into the bloodstream. Some of that glucose is burned for energy. Excesses are either store in the liver and muscles in the form of glycogen for short-term energy needs or converted into fat for long-term storage.

Glucose testing is commonly used to screen for diabetes and to monitor blood sugars in people who have diabetes. Most physicians consider normal levels to be up to 110 mg/dL. A diagnosis of diabetes is made when fasting glucose is higher than 125 mg/dL. Levels between 110 and 125 are indicative of impaired glucose tolerance, often called prediabetes. I think we need to redefine normal; normal is not necessary healthy. If your glucose level is in the 70s or low to mid 80s, fine, but if it is in the 90s and above, you need to take steps to address the underlying hormonal imbalances that are driving your blood sugar up.

The R'Diet has a tremendous effect on glucose levels. By avoiding carbohydrates and excessive protein and adding more healthy fats to your diet, you can avoid dramatic spikes in glucose ( not to mention insulin and leptin ) --- the stresses that these unnatural spikes place on your energy-regulating system.
Glucose: 70 to 85 mg/dL optimal; 85 to 110 high; 110 to 126 very high; 126+ indicative of diabetes.

[
You can do this at home with your own meter.]



05) THYROID FUNCTION TESTS ( FREE T3, TSH )

 
Any discussion of metabolism must include the thyroid, a small gland located in the neck, straddling the windpipe. The thyroid produces two hormones, thyroxine (T4), and triiodothyronine (T3). Although the gland secretes much more T4 than T3, T3 is the more active of the two --- T4 is converted to T3 in tissues throughout the body, mostly in the liver. Thyroid hormone affects almost every cell in the body. It stimulates enzymes involved in the oxidation, or burning, of glucose in the cells and controls the body's metabolic rate and production of body heat.

When the thyroid produces excessive amount of hormones, the body runs hot, like a car idling too high. Body temperature is elevated, basal metabolism revs up, and fuel is rapidly burned up. It wears down the engine and wastes energy. Enormous appetite, insomnia, palpitations ( strong or irregular heartbeats ), trembling of the hands, irritability --- these are all symptoms of excessive thyroid hormone levels, or hyperthyroidism.

An under-active thyroid, or hypothyroidism, causes an excessive slowdown in metabolism accompanied by too low temperature, fatigue, slow heartbeat, high triglycerides, dry skin and hair, cold hand and feet, depression, menstrual problems, and memory disturbances. Our goal is to keep metabolism at the most efficient level so that the body can do its work without wasting too much energy as heat.

Where does leptin fit in ? It is the master hormone that helps to regulate the thyroid. In times of starvation, leptin level falls, signalling the thyroid and other hormones to switch into conservative mode. Metabolism slows down but becomes more efficient, body temperature lowers, and vital nutrients are conserved. Leptin resistance distorts the signals that this hormones sends to the thyroid and the rest of your body, and may direct well-fed, even obese individuals into energy accumulation and fat-storage mode.

There are several tests for thyroid function, but I only use two. One is free T3, which measures blood levels of the unbound form of the most active thyroid hormone. The other is TSH, thyroid stimulating hormone. TSH is the stimulus from the brain that tells the thyroid how much hormone to produce. The bulk of T3 is transported by thyroxine-binding globulin ( TBG ). Only 0.3 percent of the T3 in the blood is free, but that small percentage is responsible for the many biological actions of thyroid hormone. 
 
The ideal blood level of free T3 is 2.2 to 3.0 pg/mL and, within this range, the lower the level, the better, provided that TSH is within the healthy range of 1.5 to 3.50.





06) BASAL BODY TEMPERATURE

Another way to determine your metabolic rate is to measure your basal body temperature. This reflects your basal metabolism, the amount of energy your body is using when you're at complete rest. An elevated basal temperature is a clear sign that your metabolism is revved up and your thyroid is running on overdrive.

BBT is best measured upon awakening before you get out of bed and just before you fall asleep at night. It requires a basal thermometer, which is more sensitive than an ordinary thermometer. Digital basal thermometers are most convenient, but any basal thermometer will do. Have the thermometer at your bedside before going to bed. If it's a glass thermometer, shake it down below 96 degree the night before. When you awaken, before getting out of bed and while still lying down, take your temperature. Record it, and repeat for at least four to five consecutive days. Go through the same process at night, after lying in bed just before falling asleep. When you are done, remember to prepare the thermometer for your morning reading. A digital thermometer will beep when the temperature has been recorded.

The average BBT is about 97.8 degrees F. The 98.6 degrees you have always been told is normal reflects daytime temperatures, when we are more active. In any case, body temperature varies slightly from one person to the next. What you're looking for are trends and patterns. As the hormonal signals that govern your metabolism become more efficient, your basal temperature will likely go down. This decline will not be dramatic --- it may be as little as 0.2 degrees or as much as a full degree --- but it will be a very important sign that you're no longer wasting so much energy by generating excess heat. That fuel is instead being used to regenerate your body.
 
BBT: 96.8 - 97.5 degrees F or less optimal ( or decline of up to 1 degree F from baseline ).

[ You will have to own a digital thermometer. Do it yourself.....under the tongue. ]

07) INSULIN-LIKE GROWTH FACTOR-1 ( IGF-1 )
 

IGF-1 also called somatomedin-C, is the most reliable test for human growth hormone. Growth hormone is produced in the pituitary gland, released in spurts most abundantly during sleep and exercise. It's a very short-lived hormone and within minutes is broken down in the liver into IGF-1 ( so-named because its molecular structure and some of its actions mimic insulin ), and remains in the blood for a day or two. Human growth hormone, as its name implies, is partly responsible for growth. Levels build gradually throughout childhood, peak during adolescence, and begin an inexorable decline by the age of twenty. By the time you reach your sixties, you're producing less than 20 percent as much growth hormone as you did in your teens.

For decades, IGF-1 concentrations were only measured in --- and growth hormone supplementation was only given to --- children of very short stature. Indeed, deficiencies of this hormone during critical stages of development severely retard growth. However, a small study published in 1990 by Daniel Rudman, M.D., in the New England Journal of Medicine turned growth hormone into an overnight celebrity. This study, which reported on the effects of six months of growth hormone supplementation in older men, concluded that their improvements in lean muscle mass, body fat, skin thickness, and bone density were " equivalent in magnitude to the changes incurred during ten to twenty years of aging. "

Many people, patients and physicians alike, have jumped on the growth hormone bandwagon, regarding it as the foundation of youth and a panacea for aging. I strongly disagree. I maintain that there is a reason why growth hormone and IGF-1 levels fall as we age --- and fall most significantly in those who live the longest. In caloric-restricted animals and those animals genetically modified whose longevity is dramatically increased, IGF-1 levels are almost always much lower than their shorter-lived peers.

IFG-1 is a growth factor. It promotes the growth of cells, and this includes cancer cells. There is a strong correlation between IGF1 levels and cancer rates. One study showed a fourfold increase risk of prostrate cancer in men with the highest IGF-1 levels compared to those with the lowest, and this was independent of baseline PSA levels. Other studies have shown that IGF-1 stimulates the growth of tumors of the breast, lung and colon and that lowering IGF-1 levels retards cancer growth. Reducing levels of this potent cancer stimulator can only bode well for health and longevity.

IGF-1 levels vary dramatically according to age, but for people who are forty and older, the typical range is 90 to 360 ng/mL. Your goal should be a downward trend, regardless of your baseline level. I have followed IGF-1 levels in several of my patients, and as they follow the R'Diet, IGF-1 levels decline. Similar to insulin, the goal is optimal sensitivity, not higher levels. At the same time, body fat drops, lean muscle mass increases, and bone density improves. In other words, they achieved the same, in fact higher, benefits that the purveyors of growth hormone offer --- without the risks. Improving leptin sensitivity converts energy from cellular replication/reproduction ( increased risk of cancer ) towards maintenance and repair ( increased health and life span ).

  IGF-1 : for ages forty and over, 90 to 360 ng/mL normal; optimal levels not yet determined, reduces " low normal " preferred.
 
08) NOREPINEPHRINE
 
Norepinephrine is a neurotransmitter that facilitates communication in the sympathetic nervous system, which engages during times of stress. This neurotransmitter along with epinephrine, prepares you to fight or flee from perceived dangers. Your heart rate speeds up and your blood pressure climbs. Glycogen stored in the liver is converted into glucose for anaerobic use, and fatty acids are mobilized for a burst of energy, among many other changes.

Without this crucial reflects it is unlikely that our ancestors could have outrun predators or chased down prey. The problem is that in modern life, most of our stressors do not require fight or flight. For the most part, stress leaves us all revved up with no place to go. When you are under a lot of stress, including the stress of leptin resistance, your sympathetic nervous system goes into overdrive. This takes a toll on the system and can lead to chronically high blood pressure and blood sugar, mental and emotional stress, and increased risk of disease.
 
The best marker of sympathetic nervous system activity is the blood or urine level of norephinephrine. Normal levels for a blood test [ not urine test ] are between 250 to 350 pg/mL. How can you keep norephinephrine levels on a low keel? Well, you can learn to relax, avoiding responding to stress, and you can lower your leptin levels by increasing leptin sensitivity. [ how about meditation, gigong, exercise, yoga, early nite nite before 10 pm, and the Metta, & B'Happy mode everyday? ] Leptin stimulates the sympathetic nervous system. LR is associated with high thyroid, high blood pressure, and elevated blood glucose and fatty acid levels; all are manifestations of sympathetic nervous system activity. The sympathetic nervous system also appears to be the mediator of leptin's effect on bone mass, and is yet another reason to keep tabs on your norepinephrine levels.
 
Norepinephrine: 250 to 350 pg/mL good, low normal is optimal.




09) HIGHLY SENSITIVE C-REACTIVE PROTEIN ( CRP )
 
Inflammation is part and parcel of your body's response to injury and disease. When cells or tissues are damaged, fibrinogen and other inflammatory compounds that encourage blood clotting are released to stem bleeding. There is a proliferation of immune cells to starve off infection and growth factors to replace damaged cells. After the crisis has passed, levels of these inflammation compounds should subside.

However, sometimes inflammatory chemicals are elevated in the blood of people who are not overtly sick or injured. This low-grade, chronic inflammation is associated with increased risk of heart disease, diabetes, cancer, autoimmune disorders, and other health problems.

One of the best markers for system inflammation is highly sensitive C-reactive protein ( CRP ), a protein that is produced during inflammation. Studies spearheaded bu Paul M. Ridker, M.d., a cardiologist and researcher at Brigham and Women's Hospital and Harvard Medical School, have found that a high level of CRP is a highly accurate predictor of future heart attack; people with the highest levels have up to 4.4 times the risk as those with the lowest levels. CRP is also a very reliable marker for IR and the risk of type 2 diabetes. In a recent study published in JAMA, researchers discovered that the women with the highest CRP levels were astounding 15.7 times more apt to develop type 2 diabetes than those with the lowest levels.

Evidence is also accumulating that inflammation is closely tied to LR. As body fat increases, CRP levels rise, for the fat cells themselves are a major producer of inflammatory molecules called cytokines. In fact, leptin itself is from the cytokine family. The most significant increases are with central or abdominal obesity, and as you now know, this type of fat deposition is linked to LR.
Highly sensitive C-reactive protein: less than 1.0 optimal and the lower the better
 
( Note: Request the highly sensitive CRP test, rather than the standard, less sensitive CRP test. ) [ This test is available in Malaysia. ]



10) TRIGLYCERIDES (TGLs)*
 

TGL is the medical term for fat. Most of the fats we eat, from healthful olive oil to undesirable saturated fats, are in the form of TGLs. It's also the body's dominant form of stored fat --- those love handles and saddlebags are primary comprised of TGLs. TGLs are ferried around the body by water-soluble chylomicrons, which pick up TGLs that are absorbed into the blood-stream after a meal, and by very low density lipoproteins (VLDL) that are produced by the liver to mobilize stored fats.

Your TGLs can be easily measured on a fasting blood test. A level of 50 to 100 mg/dL indicated that you are capable of burning fat efficiently, that your body is not churning excessive amount of fat into your bloodstream or, more likely than not, a combination of the two. A TGL off 100 - 150 is moderate and over 150 is high, both red flags that you may not br burning fat efficiently. Although they could be an indicator of liver disease, pancreatitis, or low thyroid function, high TGLs are in most case a marker of LR and IR. They are a clear sign that you're making lots of fat out of your sugar, and that the fats in your blood are not being burned --- you're storing fat and burning sugar.

A high TGL level is an independent risk factor for heart disease ( perhaps because of its association with leptin and insulin ). In fact, recent research suggests it's much more predictive of a heart attack tha elevated cholesterol.

Although the normal TGLs range for most labs is up to 150 mg/dL, I think this is too high. While I consider levels up to 125 mg/dL to be acceptable and around 100 mg/dL even better, the level most reflective of optimal leptin sensitivity is under 100 mg/dL. If your TGLs are elevated, I've good news for you: TGLs are extremely responsive to the R'Diet. I've had patients whose initial THG levels os 2,000 to 3,000 mg/dL have dropped down into the 200s in a matter of weeks after starting on the program. Cutting back on non-fiber carbohydrates, eating more healthy fats, and in stubborn cases, taking additional fish oil and niacin supplements work far better than any drug on the market for lowering TGLs.

 TGLs: 100 mg/dL optimal; 100 - 135 acceptable; 135+ high.


11) HOMOCYSTEINE

Homocysteine is a byproduct of the metabolism of methionine, an amino acid found in protein. In a process called methylation, homocysteinie is rapidly converted into harmless amino acids. However, sometimes the methaylation process goes awry, and homocysteine builds up in the blood. This is bad news, for this amino acid is extremely irritating to the arteries. It dampens the production of nitric acid, which protects the endothelial cells lining the arteries and allows arteries to dilate, and sets the stage for atherosclerosis. Homocysteinie also accelerates the oxidation of LDL cholesterol and makes the platelets in the blood sticker, increasing the risk of blood clots that may cause heart attacks or stroke.

If your homocysteine level is elevated, you've more to worry about than heart disease. It also damages neurons in the hippocampus, an area of the brain involved in memory and learning, conferring a threefold elevation in risk of Alzheimer's disease, according to some studies. Methylation is also crucial for DNA repair, so elevations in homocysteine may illuminate underlying problems that may lead to cancer and premature aging.

Most labs consider the normal range to be 5 to 15 umol/L. I suggest you aim for the low end of that range -- an ideal level would be no more than 6 umol/L. Some studies have shown a progressive increase in risk of heart attack when homocysteine climbs above 6.3 umol/L. Up to 7 umol/L is acceptable, but when you get over 9 umol/L and especially up toward 13, you can get into trouble.

Early studies suggest that homocysteine and leptin are, if not inter-active, then at least coexisting: when homocysteine levels are elevated, so are leptin levels, including the presence of LR. Fortunately, lowering homocysteine levels is relatively easy. Cutting back on coffee and methionine-rich meat will help to some degree, but getting adequate amounts of folic acid, vitamin B12, and vitamin B6 is a sure ticket to lowering homocysteine. The nutrient rich R'Diet supplies a good portion of your daily vitamin needs, and the supplement program provides the rest. If your homocysteine level does not respond to the suggested levels of these B-complex vitamins, you likely have a genetic variation that requires more intense supplementation. Simply increase your B-vitamin intake, and your homocysteine will drop.

The recommended levels of the homocysteine-lowering vitamins are 800 mcg of folic acid, 150 mcg of vitamin B12, and 75 mg of vitamin B6. ( If you're older than age 55, consider increasing your vitamin B12 intake up to 1,000 mcg to compensate for age-associated declines in vitamin B12 absorption. ) If your homocysteine level is high, double your folic acid intake and increase your vitamin B12 to 1,000 mcg. If that doesn't do the trick, you can go as high as 5,000 mcg of folic acid and 2500 mcg of vitamin B12 and add 1,000 mg of trimethyglycine ( TMG, sometimes called betaine ), which also facilitates the methylation process. These vitamins are quite safe, but I wouldn't go too high on vitamin B6, for prolonged use of very high doses has been implicated in nerve damage.


 Homocysteine: less than 6 umol/L optimal; Up to 8 acceptable; over 9 high; over 13 umol/L very high.
 
12) BUN (BLOOD UREA NITROGEN)*

BUN is a common blood test that measures for urea nitrogen, a product of urea metabolism. When you eat protein, it's broken down into nitrogen-containing amino acids. The nitrogen is removed and combined with other molecules to produce urea, which eventually makes its way to the kidneys where it's eliminated in the urine. If kidney function is compromised, BUN levels rise above the normal range of 7 to 25 mg/dL.

Although this test is routinely used to evaluate kidney function, I used it to monitor my patients' protein intake. The average BUN hovers around 18 - 22 mg/dL. If a person is eating too much protein, his/her BUN will be in the upper range of normal. A common mistake people make as they adjust to the R'Diet is eating too much protein. This is easy to do since fat and protein are often found in the same foods, and many assume that if they're following other low carb/high fat diets, they're okay. ( In reality, many "high-fat diets" such as the Atkins diet are really high protein diets. ) A key principle of the R'Diet is moderate, not high, intake of protein. Regular monitoring of BUN can help ensure dietary compliance. 

BUN: 17 mg/dL optimal; up to 21 acceptable; mothan 21 mg/dL high.


13) CREATININE*

Creatinine is a marker of kidney function. It's a breakdown of creatinine, a constituent of muscle tissue. When the kidneys are functioning properly, creatinine is excreted at a constant rate. If the kidneys are diseased or damaged, however, excretion becomes less efficient, and creatinine builds up in the blood.

A primary contribution to kidney damage is diabetes, and as the cells become more sensitive to insulin and blood glucose levels normalize on the R'Diet, creatinine levels often go down. The ideal range for creatinine is 0.7 to 1.0 mg/dL. (Levels vary among individuals depending on muscle mass; creatinine is generally higher in men than in women.) Although up to 1.4 mg/dL is considered within normal limits, levels of 1.3 to 1.4 mg/dL are indicative of borderline kidney function. When levels are over 1.4 mg/dL, you are looking at partial kidney failure. 
 

 Creatinine: 0.7 to 1.o mg/dL optimal; 1.1 to 1.2 mg/dl acceptable; 1.3 to 1.4 borderline; 1.4 and above high.
 

14) URIC ACID*

Uric acid is a breakdown of the metabolism of purines, which are produced in the body (they are the building blocks of DNA and RNA) and are found in the diet most abundantly in fish, shellfish, turkey, and some type of meat. When there is an overproduction of uric acid or an inability of the kidneys to excrete it, uric acid levels build up in the blood.

Until recently, elevated levels of uric acid were associated only with gout. Chronically high concentrations of uric acid can collect in the tissues and form sharp crystals in the joints, causing the intense pain and swelling characteristic of gout. However, research over the past years has determined that high levels of uric acid are also found in individuals with high blood pressure, elevated cholesterol, diabetes, and weight problems --- all signs and symptoms of leptin and insulin resistance. In one large study, increased uric acid levels were found to be highly predictive of increased risk of death from heart attack or stroke.

You would do well to keep your uric acid level within the normal range of 3 to 7 mg/dL. And no, you don't have to curtail your intake of purine-rich foods, which has been recommended to patients with gout for years. The R'Diet is a much surer path to lowering uric acid levels than the hopelessly outdated low-purine diet.

 Uric Acis: 3 - 7 mg/dL normal; more than 7 mg/dL high.
 

15) LIVER ENZYMES (ALKALINE PHOSPHATASE, ALT, and AST)*

In addition to its role in detoxification and digestion, the liver plays multiple roles in metabolism. It store glucose as glycogen, packages fats for storage and transportation, synthesizes proteins, and helps regulate blood sugar. Therefore, we like to keep an eye on how the liver is doing in the R'Diet.

A number of blood tests monitor liver function. These include tests of certain enzymes, which are produced by all tissues in the body but are most concentrated in liver and muscle cells. Enzymes are released into the bloodstream when this issues are damaged or diseased. Minor elevations in the liver enzymes are no cause for concern unless they remain elevated on repeated tests. Commonly tested liver enzymes include alkaline phosphatase, or ALP; ALT, also called SGPT; and AST, sometimes referred to as SGOT.

 Liver enzymes: alkaline phosphatase (ALP) 44 to 147 IU/l normal; ALT (SGPT) 5 to 30 IU/l normal; AST (SGOT) 10 to 34 IU/l normal.


16) CHOLESTEROL (TOTAL, HDL, LDL, and SMALL DENSE LDL)
 
The quest to lower cholesterol has reached epidemic proportions in this country. More than 15 million Americans take drugs to lower their cholesterol, and public health officials are urging another 25 million to jump on the bandwagon. I think they're misguided, and I did like to tell you why. Cholesterol is an essential compound that is required in the production of steroid hormones such as testosterone and estrogen. It's also a key structural component of every cellular membrane and is involved in the synthesis of vitamin D and bile, which is required for the digestion of fats. You've probably heard about "good" cholesterol and "bad" cholesterol. The truth is, there's no such thing. Cholesterol is just cholesterol. It's a cholesterol molecule's transport vehicle that makes it more or less problematic.

These transport vehicles are water-soluble protein called lipoproteins. High density lipoprotein (HDL) is the so-called good cholesterol. This large carrier shuttles excess cholesterol to the liver where it's recycled ( because it's so important ) or excreted in the bile. Low density lipoprotein is the "bad' one by virtue of its smaller size. Although many doctors are unaware of it, LDL comes in more than one form. The most harmful of all is small, dense LDL, fir its small size enables it to slip into and damage the endothelium, or lining of the arteries --- an important step in atherosclerosis.

A fasting blood test will measure levels of total cholesterol, HDL, LDL, and, if specifically required, small, dense LDL and other subfractions. LDL particle size including small, dense LDL is done by certain specialty labs. Optimal levels for colesterol are considered to be less than 200 mg/dL for total cholesterol, less than 100 mg/dL for LDL, more than 40 mg/dL for HDL, and less than 90 mg/dL for apo B. But frankly, I pay little attention to my patients' cholesterol levels. Only when a patient presents with a level in the 300s or 400s mg/dL. (almost always caused by an underlying genetic defect predisposition ) will I be very concerned. I do not believe that a high cholesterol levels is nearly as important as the medical profession has brainwashed us into believing. It is merely a symptom of a larger underlying problem. It is the metabolic hormones that regulate its amount and particle size that are much more important.

Cholesterol levels are really a reflection of how much your body needs to manufacture to repair damage and make steroid hormones. If you have leptin and insulin resistanc, you're going to need more cholesterol, and you're going to have lower HDL cholesterol, and higher LDL, particularly small, dense LDL. when you correct the underlying hormonal problems and fat burning processes by following the R'Diet, abnormalities in cholesterol will also be corrected. Total cholesterol will go down and, more important, protective HDL will rise while levels of the most dangerous small, dense LDL cholesterol will go down.

 Cholesterol: As far as I'm concerned, yhis test is highly over-rated, and that only with extremely high cholesterol (over 300 ) should worry about total cholesterol. I believe that what type of cholesterol you have is more important: HDL cholesterol higher than 40 mg/dL; a high proportion of large LDL to small, dense LDL.

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Getting Healthy with the Rosedale Diet


* HEART DISEASE

Heart disease is the # 1 killer of both men and women in the U'States. Although the incidence of HD had been on the decline since the '60s, it's beginning to creep up again. Since HD is so closely linked to obesity and diabetes, this is not surprising.

I consider the high incidence of HD to be " man-made " problem that is caused by metabolic malfunction, not an inevitable disease of aging. It ought to be a rare disease. Due to its close connection to obesity, leptin is also an obvious culprit in HD. LR is also an independent risk factor for cardiovascular disease, meaning that in and of itself, it can directly and negatively affect your heart and arteries. Restoring leptin sensitivity will go a long way in greatly reducing the risk of HD and extending your life.

* Carrying excess fat around your waist and abdomen ( having an apple-shaped body ), a result of and a telltale sign of LR, can put a severe strain on your heart, and increases your risk of heart attack..

* LR increase the risk ( and can be a primary cause ) of IR, which also increase the risk of HD.

* LR can activate the fight-or flight response, causing blood vessels to constrict, increasing blood pressure and putting extra strain on the heart, and increasing the risk of stroke.

* LR can cause blood vessels to go into spasm, a lesser known cause of heart attack.

* Elevated leptin levels can promote the formation of blood clots, which increases the risk of heart attack ( when a clot interferes with the blood flow to the heart ) and stroke ( when a clot interferes with the blood flow to the brain ).

* Elevated leptin increases the production of chemicals that trigger inflammation, which can promote the formation of plague, the cellular debris that forms in the lining of the arteries, impairing the flow of blood.

* LR confuses your body about where to put calcium. Instead of putting calcium in your bones, you will end up putting it in your arteries. You will simultaneously get both HD and osteoporosis.

* Elevated leptin can cause a thickening in the endothelium, the very thin inner lining of the artery. This cause the artery to be less flexible with each heartbeat, raising blood pressure and promoting clots. The endothelium is a very important part of your circulatory system. It produces its own array of hormones to regulate its own blood flow. Injury to the endothelium is the main trigger of inflammation that results in plague. LR also impair the ability of the endothelium to burn fat, thereby increasing fatty deposits in the artery.


The Standard Treatment

The standard medical treatment for HD is a high carbohydrate--low fat diet usually combined with prescription medicine to lower cholesterol. To me, this approach is backward. The medical fixation on lowering cholesterol reflects the typical " treat the symptom, not the underlying cause " approach that is not only ineffective, but in the long run, can be harmful. In recent years, statin drugs ( Lipitor, Mevacor, Pravacol, and Zocor, and others ) used to lower cholesterol have become among the most widely prescribed drugs in the world. Statin drugs, however, are not without significant side effects. Foe example, statin drugs can deplete the body of CoQ10, which is essential for providing energy to the cells of the body, especially heart cells that need lots of energy. CoQ10 depletion can result in muscle damage often associated with aches and pains ( a common side effect of " statin " drugs ).

Since your heart is basically a muscle, it is probably getting damaged also, impairing its ability to pump blood and increasing the risk of congestive heart failure. In other words, over time, these drugs can weaken the heart and impair its major function. Sure, in the short run, they may lower your cholesterol, but in the long run, they can kill you.



For all the " cholesterol causes HD " hype, it might surprise you to learn that cholesterol has never even been proven to cause HD. Even if high cholesterol were slightly correlated with HD, correlation and cause should never be confused ---- something else could be causing both. Statin drugs inhibit cholesterol production, but they don't get to the root cause of overproduction of cholesterol. Something is signalling the liver to produce more cholesterol.

Symptoms are the way your body has learned over the eons to deal with a disease. Extra cholesterol is being manufactured by the liver because it's getting instructions to do so, but why? The importance of elevated cholesterol is not that you have extra cholesterol, it's the fact that your liver is getting a message to make it. You have to know why, and you have to fix the why. The why could be that the liver is being smothered by too much fat because of LR and cannot then get the proper instructions from insulin. It could also be that your body, inflamed due to damage, is trying to repair the damage. New cells have to be manufactured to replace the damaged ones, and no cells can be made without cholesterol. What needs to be done is to reduce the damage and correct the instructions being given to the liver, not impair the body's capacity to repair it.

Cholesterol is also the precursor to manufacture any of the important steroid hormones such as testosterone, progesterone, estrogen, and cortisone. Far from being a villain, cholesterol is required for life. Even though oxygen can " oxidize " you and form dangerous free radicals, no one would ever suggest that you stop breathing! Oxygen is required to keep you alive. So, too, is cholesterol. No life on earth can be made without it.

Interestingly, it has recently been shown that " statin " drugs might offer benefits not by lowering cholesterol, but by reducing inflammation, and perhaps in spite of lowering cholesterol. Once again, it is important to get the root cause of the inflammation, not the body's response to it. There are a number of factors that can inflame your blood vessels and your heart, such as having elevated glucose, leptin, or insulin levels. Following the R'Diet will help solve this problems permanently and go a long way in reversing and preventing HD. Within a matter of weeks, you will increase blood flow to your heart and brain ( and the rest of the body! ) and you will start burning fat in your arteries as well as everywhere else. You don't need to take drugs for the rest of your live to keep your heart healthy.


The Rosedale Rx

If you have been diagnosed with heart or blood vessel disease, you should follow the R'Diet Supplement Plan Plus ( RDSPP ). I recommend that patients with HD add the following supplements to what they are already taking on the RDSPP.

Extra CoQ10: CoQ10 is included in the RDSPP. My patients with congestive heart failure take 200 mg three times daily for a total of 600 mg. CoQ10 improves your heart's ability to pump blood, which is fundamental to your survival.

Vinpocetine: Vinpocetine is not included in the RDSP. Vinpocetine is an extract of the periwinkle plant, Vinca minor, the same plant that has given us potent cancer treatments for childhood leukemia. For more than two decades, vinpocetine has been used in Europe and Japan to treat stroke victims and people suffering from dementia due to impaired blood circulation to the brain. It is also a potent antioxidant.

Take one 10 mg capsule twice daily.

If you have elevated homocysteine, I recommend the following additional supplements.

Vitamin B12: For best absorption, use the sublingual form ( a tablet that melts under the tongue ). Take one 1-mg tablet daily.

Trimethyglycine ( TMG ): This supplement can help convert harmful homocysteine into harmless by-products. Take one 250-mg tablet twice daily. ( Some people may need to go up to 1,000 mg daily to achieve the desired result. )

Folic Acid: This B-vitamin helps reduce homocysteine levels. Take one 400-mg tablet daily.

[ Do not ever take any drugs. It will degenerate your metabolism. You will looks very old besides the long-termed side effects. More sickness crops up and you will spent more to see more specialists. I've gone through these paths. Don't do it. Yes, you can treat inflammations which is the root cause with foods. I did it. So can you.]


* DIABETES

The increased incidence in diabetes is as shocking as it is alarming. This is a disease that should be very rare, yet it is commonplace, even among children, and rapidly escalating. At one time, type 2 diabetes was called senile diabetes, a reflection of the fact that it usually did not affect people until they were well into their late decades. As more and more middle-age people began to develop this disease, the name was changed to adult-onset diabetes (no one middle-aged wants to be called senile!). Given the fact that so many children are now getting adult-onset diabetes, medicine has once again stuck a name onto a so-called new disease --- MODY, Maturity-Onset Diabetes of the Young. This is a prime example of how the so-called disease of aing are not related solely to chronological age, but to overall health.

Type 1 diabetes (also called juvenile diabetes) is a result of too little insulin, the hormone that is produced to rising glucose or sugar levels. Without enough insulin, blood sugar levels can climb dangerously high leading to organ damage and death. Type 2 diabetes (discussed in the paragraph above) is an entirely different story and accounts for 95 percent of all cases of adult diabetes. Type 2 diabetes is characterized by a condition called insulin resistance (IR), which occurs when the cells of the body are constantly exposed to high levels of insulin. Plenty of insulin is being made, but cells have become desensitized. In the case of type 2 diabetes, the cause is more closely linked to a failure in cellular communication, that is, how well your cells can "listen" to insulin and leptin, than your age.

When your cells become resisitant to insulin, the receptors on cell membranes no longer "hear" the signals from insulin. This can cause catastrophic problems down the road, including blood lipid abnormalities, high blood pressure, heart disease, and even cancer.

IR often goes hand in hand with elevated leptin levels and leptin resistance (LR), and both conditions are linked to eating too much of the wrong food. Lower your leptin levels and your insulin problems will greatly improve.

* LR results in deep pockets of fat in the waist and abdomen which "smother" the liver from receiving proper hormonal signals, a very important one being from insulin. When your liver become insulin resistant, it will make too much sugar, contributing to IR, and diabetes.

* Elevated leptin also increases fight-or-flight mode, which boosts blood glucose levels and production of cortisol (stress hormone) by the adrenal glands, which causes blood glucose levels to soar even higher.

The Standard Treatment


The current strategy for treating either form of diabetes is to use drugs to control blood sugar levels. I think this approach is backward. Contrary to what everyone is taught, including your doctor, diabetes is NOT a disease of blood sugar, it's a disease of insulin signaling. As the warden famously said to Paul Newman in the movie Cool Hand Luke, "What we have here is a failure to communicate." Diabetes is perhaps the quintessential disease of cellular miscommunication. Type 2 diabetes should more appropriately be called insulin resistant diabetes, the body is not effectively using insulin it produces. Once again, the real solution is to treat the underlying causes of the problem, not the symptom.

The conventional treatment of diabetes is typical of what happens when you treat symptoms instead of the underlying disease. Drugs used to treat diabetes most often cause more problems down the road than they help. There's only one standard drug that helps to improve insulin sensitivity somewhat: metformin, sold under the brand name Glucophage.


For decades, most drugs used to treat diabetes lowered blood sugar by "whipping" your pancreas to produce even more insulin, causing insulin resistant to worsen and further damaging the already stressed cells that manufacture insulin (islet cells of the pancreas).

Other drugs (such as pioglitazone, sold under the brand name Actos, and rosiglitazone maleate, sold under the brand name of Avandia) purported to restore insulin sensitivity work by lowering blood sugar levels in one of the worst possible ways --- they create new fat cells to store the excess sugar. If you weren't obese to begin with, once you've been taking these drugs for a while, you will be. Sure, you lower blood sugar temporary, but at a steep price. Being fatter will only increase your risk of many disease down the road, including diabetes.

Diabetes is mostly a nutritional disease and must be treated as such. The real "cure' for diabetes is to eat a diet that promotes insulin and leptin sensitivity.


Friends,
Make sure you test yourself.

Your HbgA1c MUST be 5.4 or less % is optimal; 5.6 - 5.8 acceptable BUT watch what you put into your mouth. DON'T accept Malaysian Diabetes Association report. Trust the above. I was tested for 6.1%. It said good. I told them no. They were dumbfounded! Next test, 5.8, I told them I'm still diabetes and must improve my diet. Again, they were dumbfounded. My metta to them.

Your glucose MUST be 70 to 85 mg/dL optimal; 85 and above is NOT acceptable by my standard because it's very, very easy to creep up to become DIABETES. I have being on this torturous path. Here is another sure sign. Belly fats, big buttock, chipmunk cheek is a SURE sign of LR and IR. I also have being on this torturous path. How? Remember PPMM ! I was "honored" with heart attack; high blood pressure, angina, neuropathy, erectile dysfunction, not sleeping well, and a "walking time-bomb" that is a very high risk of getting a stroke.

Don't trust the local reports. Trust Rosedale's guidelines and my adapted local food "NF4L" from the westernized R'Diet.

Please, I beg you folks to love your health for the sake of those you loves. Metta.


The Rosedale Rx

The good news is that type 2 (insulin resistant diabetes) can not only be improved, but can be completely reversed. Even type 1 diabetes can be greatly helped by following my program. With proper insulin sensitivity, a relatively small amount of insulin is necessary to communicate its vital messages of what to do with energy. As long as the diabetes --- or the dugs used to treat diabetes --- have not completely destroyed the ability of the pancreas to produce insulin, following the R'Diet will in most case 
reverse the disease. You will likely need to lower your dose of many medications, including high blood pressure medications and insulin, and many of you will be able to go off them altogether. This should be done only under your doctor's supervision. Even if your pancreas is not producing any insulin and you must always take insulin, you can still benefit from my program. The diet and supplement regimen will gratly improve your insulin sensitivity so that you can manage on less insulin. In addition, your blood sugar will ne much less of a roller coaster, with fewer low sugar episodes.

Moderate exercise is also a wonderful way to burn off sugar, as long as you don't overdo it and overstress your body (which can raise blood sugar levels).


[Friends, insulin is the only hormone in the body with this function, that is, getting into cells. Two exceptions. Firstly, glucose can enter without insulin into the brain. The second exception is most important in the control of diabetes. When you exercising, the muscle cells can remove glucose from the blood without insulin. This is one of the key concept for a diabetic. Exercise.]

If you've been diagnosed with diabetes, you should follow the RDSPP. I recommend that patients with diabetes take additional amounts of the following supplements.

Vanadyl Sulfate. Take 20 mg three times daily for a total of 60 milligrams until blood sugar is under control. Discontinue if sugar goes low after stopping your diabetic medications.

Extra Thiamine. Take one 50 mg capsule twice daily.

Extra Alpha Lipoic Acid. Take one 200 mg capsule three times daily for a total of 600 mg. ( Always take lipoic acid with food; it's easier on the stomach.
.
* OSTEOPOROSIS

* ARTHRITIS


Parting messages...Dr. Ron Rosedale:

(01) A disease is NEVER a disease of the individual part. Diabetes is NOT a disease of blood sugar, osteoporosis is NOT a disease of calcium and heart disease is NOT a disease of cholesterol. A disease is caused NOT by the breakdown of the part itself, but corruption in the instruction of that part, a disruption in the unity of the whole.

(02) We are all metabolically damaged to some extend. None of us has perfect insulin and leptin sensitivity...it is for that reason that I say we all have diabetes some more than others, and should be treated as such.
 
 
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