Plants over meats

Art of Healing

Published: Sunday February 3, 2013 MYT

BY DR AMIR FARID ISAHAK

Leafy veggies, grasses (eg wheat-grass) and sprouts are the basis of the nutrient-dense diet. They provide a whole range of important nutrients without much calories.

A nutrient-dense, wholefood, plant-based diet can save your life.

IF you are health-conscious, and you have not yet seen the documentary film Forks over Knives, then I highly recommend that you do so.

The film is being screened on the international screen of one of the cinema chains in Kuala Lumpur, and they have promoted it through frequent advertisements.

The title is meant to convey the message that a healthy diet can help you avoid chronic diseases, medical treatments and surgeries. Indeed, the film provides compelling evidence that a whole-food, plant-based diet is able to prevent, control or even reverse obesity, hypertension, hypercholesterolaemia, diabetes, heart disease and other chronic diseases.

In contrast, it is a well-established fact that much of the health problems afflicting affluent modern Western society is due to their diet, which is animal-based, replete with all sorts of processed foods.

The film follows the work of several US doctors, scientists and nutritional experts that prove the effectiveness of the whole-food, plant-based diet in preventing and reversing the chronic diseases.

It is a documentary film filled with facts and real-life testimonies of those who have benefited from following the recommendations, and will be enjoyed only by those who have interest in the subject.

Nutrient-dense, whole-food, plant-based diet

The diet promoted by the film is in line with what I recommend. It is based on whole or minimally processed plants, fruits, vegetables, whole grains, tubers, and legumes.

It excludes or minimises animal-based foods such as meat (including poultry and fish), dairy, and eggs, as well as refined foods like bleached flour, refined sugar, and oil.

However, I disagree with the exclusion of fish. There will always be controversy whether a vegetarian or even a vegan diet would even be better than a plant-based diet that allows some meat intake.

There are many promoters of vegetarianism for various reasons – religious, spiritual, health, eco-sustainability, etc – but I will restrict my discussion only to the health aspects.

It is a fact that vegetarians are generally healthier than meat eaters, as it is also a fact that meat consumption is linked to obesity, high cholesterol, heart disease, cancers and other diseases.

However, vegetarians are not totally free from the “meat-eaters diseases” mentioned above. So it is also important to look into what vegetarians actually eat.

Food provides us water (which we get mostly from our drinks), energy (calories) and nutrients. Most of us have too many calories in store, as evidenced form the high rate (and still increasing) of overweight/obesity in recent health surveys. Our sedentary lifestyle and the hormonal changes that occur as we age have made the majority of us fat and unhealthy. So we need to be conscious of eating excess calories when we eat.

We need lots of nutrients

It is the nutrients that we should concentrate on most when we eat. This is why I recommend the nutrient-dense, whole-food, plant-based (preferably organic) diet. Thousands of nutrients are required for our cells to function, to maintain health, to prevent disease, to fight invaders, and to recover from diseases and injuries.

It is my belief that current nutritional recommendations grossly underestimate the amount of many nutrients we need. Let us take vitamin C for example. Most official health institutions recommend that adults take 60-90mg of vitamin C per day, which is easily achieved in a diet which includes fruits and veggies.

A small orange contains about 50mg of vitamin, and many other fruits contain more vitamin C than oranges. But if you ask around, many health conscious people are taking 1,000mg of it daily. That is more than 10 times the official recommended intake!

Almost all vitamin C supplements for adults come in 1,000mg tablets/capsules, which means it is the “standard” dose for most who take vitamin C as a supplement. This also means that many people do not believe the official recommendation. The same may apply to other nutrients too.

However, it does not mean that you should just increase the doses of whatever supplements you are taking. You need to equip yourself with sufficient knowledge about these nutrients, and make an informed decision on your supplementation programme. Or you can get the advice of an expert you trust. Be aware that studies have shown that taking certain supplements actually increases cancers and death rates.

My aim here is not to promote supplementation, but to promote the nutrient-dense diet, ie getting more health-enhancing nutrients and less calories and “junk” from your diet. It is only when your diet cannot provide the desired amounts of certain nutrients that you should consider supplementation.

The nutrient-dense diet

Leafy veggies, grasses (eg wheat-grass) and sprouts are the basis of the nutrient-dense diet. They provide a whole range of important nutrients without much calories.

For example, you will lose weight when you eat spinach because you will spend more calories eating, digesting and absorbing the spinach than the amount of calories it provides.

I had mentioned previously that organic foods have much more life-force or qi than the non-organic variety, although studies on the nutrient content have so far shown no added advantage.

Unfortunately, when you cook these veggies, you destroy some of the nutrients (and the qi as well). And when you overcook them, you lose most of the nutrients.

The sad reality is this – if you go to most restaurants, you will find that the veggie dishes are mostly overcooked and soaked in unhealthy oils.

It is best to eat the veggies raw, or minimally stir-fried to preserve the nutrients. The only veggie that is better cooked is tomatoes (more lycopene is released if cooked).

Fruits and fleshy veggies are both nutrient-rich and calorie-rich, so while they provide plenty of nutrients, you have to be wary of the calories they contain.

You should go for a wide variety of fruits and veggies, but restrict the amount of each fruit and fleshy veggie.

This applies especially to those who are overweight and/or diabetic. In fact, one of the causes of childhood obesity is regular drinking of fruit juices (even those that are not sweetened) because of the high fruit-sugar content.

Apples, guava, pears and similar fruits that require a lot of munching can be put in a different category because it takes time to eat a lot of them; they are filling; and they contain lots of fibre and lots of nutrients (eg guava has more vitamin C than oranges).

Apples are part of many diet programmes because they can satisfy hunger without giving too many calories.

Avoid empty calories

Our problem lies in the rice, bread, mee, roti canai and other staple foods that bring in too much calories with scant nutrients.

The newly-harvested rice grain is full of nutrients, but the pure white rice that reaches our plate has been “polished” of much of its nutrients.

Likewise, sugar cane juice is full of nutrients and fibre, but the crystalline sugar that reaches our table has been “refined” off most of the nutrients.

In fact, white sugar is pure calories and nothing else. So, if you are health-conscious, you should avoid (or reduce) white sugar, white rice, white bread, white flour and other similar “empty calorie” foods.

They are virtually empty of nutrients, unless the manufacturers fortify them (as many foods are nowadays). Go for the brown varieties, which still have some nutrients in them.

So, even if you are vegetarian, but your diet consists mostly of white rice (or other “white” stuff) and overcooked veggies, and you consumed lots of sugar, you will not be as healthy as you should be.

Healthy and unhealthy fats

The unhealthy fats in our diet are major contributors to our poor health. These are the animal fats that are unavoidable if you consume meat (less if you take lean meats).

Unfortunately, many people actually enjoy eating both meat and fat. Plant fats/oils are generally healthier, but saturated and processed plant fats (eg trans-fats like margarine) are not, as they influence the body’s fat production negatively (ie promotes increased levels of “bad” cholesterol and/or triglycerides).

You can get good fats from avocado, olive, oil palm, coconut and many other plants. If you consume commercial products, then the processing method is critical as heat will turn healthy oils unhealthy.

The best are the cold-pressed “virgin” or “extra-virgin” oils, which means that no heat is used and the oils are obtained during the first round of pressing/squeezing (the best quality is obtained this way).

One sad discovery from my research is that most commercially available “extra-virgin” olive oils are not what they claim to be.

Deep-sea fish and krill are the best known sources of health-enhancing omega-3 fatty acids, which are important nutrients if you wish to stay disease-free.

Although plants also provide omega-3 (eg flaxseed oil), there are some differences which make the marine source superior.

Our concern, however, is that even deep-sea fish can be contaminated by heavy-metals. That is why the omega-3 supplements made from them have to be “molecularly-distilled”.

For those who are not vegetarian, but who espouse the nutrient-dense, whole-food, plant-based diet, adding deep-sea fish like salmon can provide most of the protein intake instead of chicken or red meats. And whenever you consume meats, make sure you balance it with lots of veggies/salads.

With the craze over burger bakar, and “double” or even “triple” burgers sweeping the country, it looks like only a minority of us chooses plants over meats. But it is definitely the right choice.

http://www.thestar.com.my/Lifestyle/Viewpoints/Art-of-Healing/Profile/Articles/2013/02/03/Plants-over-meats/

The cholesterol controversy

Published: Sunday October 13, 2013 MYT 12:00:00 AM
Updated: Sunday October 13, 2013 MYT 10:05:40 AM

by dr amir farid isahak

Most doctors now prescribe statins to their patients because of the evidence presented to them over the last three decades. The standard model is that HDL-C is good for the heart, and LDL-C is bad. – Los Angeles Times

 

Is high cholesterol really bad?

AN estimated one in three people above 40 are on anti-cholesterol drugs or some other cholesterol-lowering treatment. This is because about 40% of those above 40 have high cholesterol (total or “bad” cholesterol).

The current medical advice is to keep your cholesterol (especially the “bad” low density lipoprotein, LDL-C) within normal range to avoid heart disease. For those already at high risk (e.g. diabetics) or who have heart disease, the medical management is to keep the total and LDL-C as low as possible.

The debate begins with whether high cholesterol is really an important risk factor for heart disease. The second question is whether reducing cholesterol reduces the risk of heart disease.

Doctors have been fed with results of studies that affirm the belief that cholesterol is bad and reducing it improves the health outcome, therefore convincing them that anti-cholesterol drugs are necessary.

Now that regulations have come out compelling drug companies to also release results of studies that are not in favour of their drugs, we are beginning to see a more balanced picture.


The cholesterol conundrum

About two years ago, I wrote in Controlling cholesterol (Fit4life, Nov 20, 2011): “While there is no doubt that many studies have shown the benefits of normalising lipid levels (to reduce the risk of heart attacks, stroke and peripheral arterial disease), my concern is that most patients are put on the statin drugs without recourse to basic and safer alternatives first.”

Since then, I have reviewed many reports and discussions on the subject, and have found that there are many doubts on the supposed benefits of lowering cholesterol levels, in particular, the use of statin drugs to achieve it.

Some cardiologists and cardiac surgeons (e.g. Dr Stephen Sinatra, author of The Cholesterol Myth) also query the fact that many patients with not-so-high cholesterol levels end up with serious blockage of their arteries, while others with high levels do not have serious disease.

While we all know that heart disease has many contributing risk factors, so much focus has been on cholesterol and the use of statin drugs to lower it. That is why so many people are now on statins.

Most doctors now prescribe statins to their patients because of the evidence presented to them over the last three decades. The standard model is that high density lipoprotein cholesterol (HDL-C) is good for the heart, and LDL-C is bad.

So, when we say high cholesterol is bad, we mean high LDL-C, or high total cholesterol (Total-C) with a disproportionately high LDL-C component. The risk value of the different cholesterol types is expressed in the ratio Total-C/HDL-C. A value of five or more is considered high risk, and four or below is desirable.

According to the World Health Organisation (WHO), one-third of ischaemic heart disease cases is attributable to high cholesterol, and a 10% reduction in serum cholesterol in men aged 40 reduces heart disease by 50% in five years.

Some doctors are so convinced of the benefits of statins that they prescribe them to almost all their adult patients. One such doctor is Dr Michael Miller, the director of the Center for Preventive Cardiology at the University of Maryland Medical Center. He tells his patients to regard statins like a daily vitamin boost because “it’s the only one that we know that works so well to improve cholesterol and lower cardiovascular risk” (reported in WedMD).

His view is echoed by Dr Patrick McBride, the director of the Cholesterol Clinic at the University of Wisconsin School of Medicine and Public Health. He said that “Statins are one of the great success stories of modern medicine” (reported in WebMD).

With such top experts endorsing the use of statins, how can it be wrong?

Well, nobody disputes the fact that statins are very good at reducing cholesterol levels. What is contentious is whether high cholesterol is really that bad; and whether reducing cholesterol levels lowers the cardiovascular risks and overall health outcomes as claimed.

Many doctors and researchers are now beginning to re-look the role of cholesterol in cardiovascular disease, the necessity of reducing cholesterol levels, and the role of statins as the preferred treatment (in addition to diet and lifestyle modification) to lower cholesterol significantly, because the “evidence” has now become shaky. Below are some examples of contrary evidence (with references).


Cholesterol levels and higher death rates?

A study across five European countries reported in 2005 (European Jnl Epidemiology 2005, Volume 20, Issue 7, pp 597-604) showed a strong correlation between cholesterol levels and deaths from heart disease, but no correlation between cholesterol and stroke or overall deaths (i.e. from all causes).

If deaths from heart disease increase with higher cholesterol, but deaths from all causes do not, I take it that means deaths from other causes decreases with higher cholesterol. What is most important is avoiding early death from all causes, not just from heart disease, as we have all this while been focused to.

The results imply that higher cholesterol may be protective against other causes of death (e.g. we now know that higher cholesterol means lower deaths from haemorrhagic stroke, but higher deaths from occlusive stroke, such that overall there is no correlation between cholesterol levels and stroke deaths).

The other top cause of death is cancer. Indeed some studies show that high cholesterol protects against cancer deaths. However, for studies which include both men and women, a different conclusion may be arrived at if the data for men and women are studied separately (see Norwegian study below).

Another study across 15 countries (14 countries in Europe, plus Australian Aboriginals) shows no correlation at all between cholesterol levels and heart disease. Lithuania, with average cholesterol level of about 6 (mmol/L) has the highest prevalence of heart disease, while Switzerland, with the highest average cholesterol of nearly 6.5, has the third-lowest heart disease prevalence.

France has the lowest heart disease rate, while the average cholesterol level was about 5.7 (the French paradox comes to mind).

The most puzzling is when all this is compared with the Australian Aboriginals, whose heart disease rate is almost double that of the Lithuanians. Their cholesterol level (4.9) is lower than that of all the Europeans! (European figures derived from WHO MONICA Project; Australian Aboriginal data is for same period of study, courtesy of Dr Malcolm Kendrick, author of The Great Cholesterol Con.)

Most other studies only compare the cholesterol-heart disease risk within a certain population, and when multiple populations were studied, the results are often lumped together. This cross-border comparison forces us to review the “direct” correlation previously taken for granted.


LDL-C not a reliable predictor

Risks factors are valuable if they are reliable predictors of future disease. LDL-C has long been accepted as a risk factor for cardiovascular disease. So it would seem logical that lowering LDL-C should lower the risk.

However, evidence-based medicine cannot be based just on expectations. Thus, it comes as a surprise that although doctors have asked their patients to lower their LDL-C, so far no study has actually been done to prove that lowering LDL-C to the target level reduces heart disease.

A study on 100 heart attack victims had in fact shown that their LDL-C levels were the same as in the control group, which means LDL-C is not a good predictor of heart attacks. The better predictor was hsCRP (high-sensitivity C-reactive protein), which is a marker for inflammation (see Datta S, et al. Comparison between serum hsCRP and LDL cholesterol for search of a better predictor for ischaemic heart disease. Ind J Clin Biochem Apr-June 2011 26(2):210-213).

A Harvard-led study had in fact shown that it is the triglycerides (TG, another type of fat routinely measured in the lipid profile blood test), and not LDL-C, which is the worse promoter of heart disease. They measured the various ratios involving cholesterol and triglyceride, and found that the most predictive of coronary artery disease is the TG/HDL-C ratio, and not the total-C/HDL-C ratio that is currently being used.

The TG/HDL-C ratio does not include LDL-C at all (whereas it is included in the total-C/HDL-C ratio, since LDL-C is part of the total-C), thus again implying that the role of LDL-C as a risk factor has been exaggerated (see Circulation 1997; 96:2520-2525).


Women benefit from higher cholesterol

The Norwegian HUNT 2 Study (J Eval Clin Prac 2012 Feb) followed 52,087 Norwegians aged 20-74 who were free of cardiovascular disease (CVD) at the start, for 10 years. The study assessed the relationship of total cholesterol with total mortality, CVD mortality, and heart disease mortality.

It concluded that the cholesterol-risk profiles for men and women were totally different. Women, in fact, benefited from having higher cholesterol levels!

Risk of death from all causes in women is lower with higher Total-C (starting from about 4.6 mmol/L onwards), but increases for men (starting from about 5.3 mmol/L onwards).

The chart may also explain why when women and men are considered together, there is no correlation between high cholesterol and deaths from all causes. The reason is that when we separate the data of the men and women, we find that the risk rises for men, but reduces for women, and the two combined will cancel out.

Yet, until now, millions of women continue to be prescribed statins as primary prevention to reduce their cholesterol, when in fact, studies show that lowering the cholesterol increases their risk.

I have presented evidence that go against the current teaching that high Total-C and LDL-C is such an important risk factor for heart disease, and that lowering it is imperative. This may confuse patients and doctors alike.

I hope that what I have presented proves that the current teaching about cholesterol and heart disease has not been totally truthful to evidence-based medicine, and doctors should re-examine their position.

In the next article, I will address the issue of whether using statins to lower cholesterol is justified by evidence-based medicine.

http://www.thestar.com.my/Lifestyle/Viewpoints/Art-of-Healing/Profile/Articles/2013/10/13/The-cholesterol-controversy.aspx

The longevity hormones

Art of Healing
        

Published: Sunday March 17, 2013 MYT 12:00:00 AM
Updated: Thursday August 22, 2013 MYT 4:59:01 PM

 

Art of Healing by Dr AMIR FARID ISHAK



Natural ways to increase cortisol include exercising in the
morning sunlight and consuming foods such as licorice.



In this third part in the series on hormones for health, we continue with other hormones that are not only ‘youth hormones’ in that they help maintain health and youthful biological age, but may also impact our lifespan.

ABOUT a year ago, I wrote about the Okinawans, who are famous for their longevity (Holistic ageing, Fit4Life, April 1, 2012). The secret of their longevity, according to Prof Emeritus Makoto Suzuki, who is the leading expert on the Okinawa longevity phenomenon, lies in their diet, culture and lifestyle.

While much has been written about their diet, culture and lifestyle, the only glaring difference in their blood tests is that they continue to have youthful levels of the hormone DHEA (dehydroepiandrosterone) as they age past 50.

DHEA

DHEA is the most abundant hormone in the body. It is produced by the adrenal glands. It is required by both sexes and levels decline with age. At age 60, the level is only about 40% of its peak.

It improves sexual function, increases muscle mass, reduces fat, stimulates bone growth, improves sleep, mobility, memory, immunity and reduces pain. It may help improve arterial disease, multiple sclerosis, Alzheimer’s, lupus, and possibly cancer.

It is also the precursor for the sex-hormones (oestrogens and androgens).

While the direct effect of DHEA is relatively weak compared to the sex hormones, a healthy level of DHEA is crucial because it is needed to manufacture the sex hormones.

Strenuous physical exercise and stress increase DHEA secretion, as do high protein and high fat diets. Conversely, a sedentary lifestyle and diets high in carbohydrates, cereals and sugar reduce secretion.

In anti-ageing hormone management, DHEA is among the most important hormones monitored and corrected/optimised (if necessary).

Pregnenolone

While DHEA is the mother of the sex hormones, pregnenolone is the grandmother of all the steroid hormones, which include DHEA, the sex hormones, glucocorticoid adrenal hormones (eg cortisol and other steroids responsible for stress and glucose management), and mineralocorticoid adrenal hormones (eg aldosterone, responsible for salt and water regulation).

Pregnenolone is manufactured from cholesterol. This is one example of the vital role that cholesterol plays in the body. So cholesterol itself is not bad. It is the excess and the “bad” cholesterol that is harmful.

Even that concept (that high cholesterol is bad) is controversial and I hope to write about this in the future.

Pregnenolone level declines with age, and is indirectly responsible for the decline of the steroidal hormones. A serious deficiency in pregnenolone affects many organ systems because it is the precursor of so many hormones which influence so many organs.

While the main function of pregnenolone is as a precursor or pro-hormone, it is also a neurotransmitter. It has been used with some success to improve memory and to reduce stress/depression.

Since memory decline is a constant and worrying feature of ageing, anti-ageing doctors often use pregnenolone to alleviate the problem, and about half of the patients report some improvement.

Pregnenolone testing and supplementation are not readily available here. Therefore most of the anti-ageing doctors test for, and correct/optimise the other hormones instead as an indirect way of addressing suspected pregnenolone deficiency.

Melatonin

Most of you may be aware that melatonin is used to counter the effects of “jet-lag” after long-distance travel, but you may not be aware that it is also a youth/longevity hormone.

Its level also declines with age like the other hormones previously mentioned, and its impact on health goes beyond normalising the sleep rhythm.

Melatonin is a neuro-hormone produced in the pineal gland, which is a small gland almost diagonally opposite the pituitary, in the mid-brain. In the esoteric world of mysticism, metaphysics and occultism, the pineal gland is variously believed to be the “seat of the soul”; the centre of the “sixth sense”; or even the “third eye” (connected to the Ajna chakra, which is important in spiritual awakening, clairvoyance and higher states of consciousness).

Circulating levels of melatonin vary in a daily cycle, and influences the circadian rhythm of several biological systems. In animals, it even influences sexual development, hibernation and seasonal breeding.

Melatonin production decreases with age. The reduced and delayed melatonin production/release (at night) as we grow older partly explains the later sleeping and waking times.

While the sleep-inducing effects of melatonin is well known (it also improves quality of sleep by relaxing the muscles and calming the nerves), our interest here is its health and anti-ageing effects.
Melatonin improves HGH (the youth hormone) secretion and also improves thyroid function. It calms down excessive stress, and lowers the stress hormone cortisol.

Melatonin is a powerful broad-spectrum antioxidant that does not itself become a free radical once it has been oxidised, unlike other antioxidants. Each melatonin molecule, through its metabolites, can neutralise up to 10 free radicals (reactive oxygen/nitrogen species).

The other powerful antioxidant that mops up many free radicals without itself becoming a free radical is silica hydride.

Melatonin is especially useful in protecting DNA from free-radical damage. It has been shown in animal experiments to protect against brain injury and Parkinson’s disease. As a longevity hormone, it has been shown to increase lifespan by 20% in mice. Let us hope human studies will be done too.

Melatonin is readily available over-the-counter in many countries and even in some aeroplanes for the convenience of travellers. Unfortunately, it is not available here, so we have to get it from overseas to prescribe to our patients who need them.

Cortisol – the stress resistance hormone

Cortisol is the most important glucocorticoid hormone produced by the adrenal glands. It also has a circadian rhythm (highest in the morning) and decreases with age.

Cortisol is a catabolic hormone (breaks down tissues to provide energy) in contrast to HGH, DHEA and the sex hormones, which are anabolic (build and preserve tissues/body).

Cortisol allows us to respond adequately to stress by making energy available (increased blood glucose), maintaining or raising blood pressure, and fighting inflammation.

Cortisol and its derivatives are therefore widely used as anti-inflammatory drugs (for all forms of inflammation and pain), and are widely abused in sports to enhance performance and manage the stress of competitions.

The overuse and abuse can give rise to dangerous side-effects.

The abuse has given a bad name to cortisol and steroid hormones because the public only know the bad side of the story. In reality, those with low levels of cortisol can easily be helped with their health and behavioural problems such as poor memory, emotional lability, anxiety, depression, attention deficit, irritability, poor reaction to stressful situations, negativism, being quarrelsome, paranoia, excessive emotions, hair loss, being underweight, inflammatory skin conditions, muscle and joint pains, fatigue, dark eye circles, and a host of other problems.

There are many people who can benefit from cortisol therapy (if their problems correlate with low cortisol levels), but many are reluctant and aghast because the doctor prescribes a steroid (hormone) drug!

Correcting and optimising cortisol levels can result in mood enhancement, more energy, better work performance, better stress management, and improved immune system.

The natural ways to increase cortisol are by exercising in the morning sunlight and by consuming certain foods (eg licorice).

Since cortisol level decreases with age, and the aged are the ones most likely to have problems of inflamed and damaged joints and other tissues, their ability to cope with the damage is compromised. Thus many end up with chronic injuries and have to consume all sorts of anti-inflammatory and analgesic drugs.

This is worsened by the decline in the anabolic hormones that are needed to preserve and build
tissues.

The right balance and synergy of hormones are required to maintain optimum health. Even during the day, there is a programmed symphony among them. The “active” hormones like cortisol and testosterone peak in the morning, while the hormones like melatonin and HGH work quietly at night while we sleep.

In the next article, I will discuss hormone therapy in more detail.

http://www.thestar.com.my/Lifestyle/Viewpoints/Art-of-Healing/Profile/Articles/2013/03/17/The-longevity-hormones.aspx

The youth hormone

Sunday March 3, 2013

 

ART OF HEALING
BY DR AMIR FARID ISHAK
starhealth@thestar.com.my

Human growth hormone maintains the health of many organ systems, and also acts as a biomarker of ageing.

THIS is the second article on hormones that are important for good health. In the first installment (Hormones for health, Fit4life, Feb 17), I wrote about insulin, testosterone, oestrogen and progesterone. I also explained about bio-identical hormones.

Today, I will share about the most important hormone in anti-ageing (maintaining our health and youthfulness) – human growth hormone (HGH).

HGH, DHEA (dihydroepiandrosterone) and pregnenolone are hormones and pro-hormones (ie hormone precursors) which maintain the health of many organ systems, and also act as biomarkers of ageing.

Their levels in the blood peak in early adulthood (around age 20-25 years) and then decline steadily as we age. The current level and rate of decline influences our overall health, as they influence many organs.

The level and rate of decline may be determined by genetic factors, lifestyle, diet, exercise and weight. They can further be modified by supplementation and medical therapy. I call them the “youth hormones”.

Of these, HGH is the most important.

The sex hormones are also youth hormones. Testosterone is a reliable bio-marker for men (if the blood sample is taken in the morning), but estradiol is not a reliable bio-marker due to its marked (menstrual) cyclical variation, although the trend (if tests are done on the same day of the cycle, usually at the end of the third week, in a woman with regular cycles) may be useful. After menopause, when there is no menstrual cycle, the level becomes a reliable indicator.

For post-menopausal women out there: most of you probably do not know that your estradiol (the main oestrogen) level is probably even lower than that of the average man of the same age who is not fit and healthy (and most men above 50 are in this category).

These men tend to have higher estradiol levels than they should (which is not good for them), in contrast to menopausal women who have lower levels required for good health.

If your estradiol level is even lower than a man’s, how can you expect to be healthy, feminine and sexy?

Human growth hormone

HGH is the “master” hormone of the body. As the name implies, it is crucial for growth in children. Children who are HGH-deficient will become stunted, while those who have excess HGH (usually due to a pituitary gland tumour) will become “giants”.

All the world’s tallest men and women recorded in the Guinness Book of World Records were likely to have suffered from this problem (acromegaly). They have a myriad of health problems and do not live long.

What we are concerned here is the role of HGH in healthy ageing. After age 25, HGH levels decline by about 13% every decade in the average person (more in the unhealthy, and less in the fit and healthy).

This means that you will have about 50% left by the age of 60.

Since HGH, as the master hormone, directly or indirectly (through increasing the production of many growth factors) influences all the organ systems, its decline is responsible for most of the signs and symptoms of ageing.

The decline in the level of oestrogen after menopause only accelerates the ageing process, which has been going on for at least three decades previously (mainly due to the HGH decline).

The different tissues and organs age at different rates. For example, while most women are wary of their bones becoming brittle (osteopenia/osteoporosis) after menopause, the bone density (and strength) actually starts to decline from about age 35 onwards, about 15 years before menopause, while their hearts usually become unhealthy only after 50 (because oestrogens are excellent protectors of the heart).

Since many men enter andropause even earlier than age 50 (if low testosterone levels are used as the criteria), their accelerated ageing also starts earlier.

In 1990, the New England Journal of Medicine published a landmark study by Rudman and colleagues on the effects of HGH (injection therapy) on men above 60 years old (NEJM July 5, 1990). They reported improvements in body composition (less fat, more muscle), strength, exercise tolerance and wellbeing in the subjects tested.

Although it was a small study, this in fact started the anti-ageing revolution. Since then, there have been over 20,000 studies on HGH. Some of the benefits of having healthy levels of HGH shown in these studies include slower senescence (ageing), reduced adiposity (body fat composition), improved blood lipids, reduced blood homocysteine (a marker of inflammation and heart disease risk), reduced atherosclerosis, improved heart function, improved diabetes, increased lean body mass, improved exercise tolerance, improved immune system, better quality of life, better sleep, less fatigue, better sexual function, improvement from depression and anxiety, improved memory, improvement from memory loss in Alzheimer’s, improved rheumatism and fibromyalgia, improved osteoporosis, and many other benefits (references available on request).

Controversies

However, there are some controversies. Naturally high IGF1 (insulin-like growth factor 1, which is the marker for HGH in the blood) has been associated with some cancers (eg breast and prostate), but a causal relationship has not been established.

The higher IGF1 levels have not been shown to be the cause of the cancers, and instead, could be due to the cancer, as cancer cells are known to produce many growth factors to sustain their growth and spread.

In people with acromegaly, HGH production is 10-100 times more than normal. Yet, overall they do not have more cancers (although they have slightly more colon cancers than others). So it is more likely that in cancer patients, the high IGF1 levels is due to the cancer itself.

Another controversy is that HGH can worsen diabetes. IGF1 levels increase with HGH. Insulin-like growth factors have glucose-lowering effects like insulin, and improve insulin-sensitivity. Thus, more studies show improvement in diabetes rather than worsening.

The controversy arises because diabetes occurs more in HGH-treated children, and in those with acromegaly. There are other explanations for these.

There is no doubt that having healthy levels of HGH means better health, and those with severely low levels need treatment. What is controversial is whether those with lower levels within the “normal” range when tested (and have any of the parameters mentioned above which can be improved by HGH) should be interfered at all; and whether high HGH levels predispose to cancer (see above).

The answer is simple – if you want better health and you have low HGH, you can try to improve its level and feel the benefits yourself. Make sure your doctor explains to you all the pros and cons, including possible side-effects (eg edema, which only happens if you take excess doses in the injection form).

If you don’t get any benefit after three to six months, then you can stop. If you are convinced of the benefits (especially if there are measurable improvements in your weight, body composition, and obvious improvements in your skin texture), then you can continue.

How to improve HGH levels

There are natural ways to improve your HGH level. The best ways are:

● Make sure you have sufficient deep sleep (six to seven hours of good sleep), and go to sleep not later than midnight because the HGH is released in spurts at about 2-3am (peak spurt) and again at about 5am, provided you are in deep sleep. Those who are chronically sleep-deprived, and those who work shifts, therefore miss on these spurts.

● Have a healthy nutrient-dense, high-protein, low-calorie diet. HGH is a peptide hormone and requires amino-acids for its production. Avoid caffeinated and milk products, alcohol and the empty calories in cakes and cookies.

● Intense exercise, which must include muscle-building (weights and/or resistance) training.

● Maintain a lean body (body fat below 20% for men and below 25% for women).

There are also supplements that can improve natural HGH secretion. These are called “secretagogues” and contain the component amino-acids which also act as HGH secretion-boosters. They are available in powder form (most effective) or tablet/capsules.

There are also sublingual sprays which contain homeopathic formulas or even HGH encapsulated in patented “delivery systems” to allow for its absorption (HGH is a large peptide which cannot be absorbed when taken orally). However, the effectiveness of these formulations has not been scientifically validated.

Then there are also supplements which provide the growth factors (including IGF1) directly instead of inducing HGH secretion, which then increase the growth factors production in the body.

Medical therapy by HGH injection is given only to children and older people with proven deficiencies after appropriate tests are done. These patients must be strictly monitored by their doctors.

The older patients may first try supplementation, and switch to injections only if these fail. For the majority, injections are not necessary.

The dangers and side-effects of overdosing only apply to those getting HGH injections. You need not worry about getting any side-effects if you are taking supplements to improve your HGH levels, which is why you can continue these for as long as you like if you get the benefits, while your doctor monitors your IGF1 level at suitable intervals

Source:   http://thestar.com.my/health/story.asp?file=/2013/3/3/health/12780967&sec=health

Fighting diabetes

ART OF HEALING

By DR AMIR FARID ISHAK

Sunday December 9, 2012

Reducing the incidence of diabetes, the scourge of modern living, needs to be one of healthcare’s top priorities.

NOVEMBER was diabetes awareness month, with Nov 14 designated as World Diabetes Day. Many programmes were organised throughout the month to increase public awareness and education about this scourge of modern living.

The last National Health & Morbidity Survey (NHMS 2011) reported that about 21% of Malaysian adults above 30 years old are diabetic. This is a 6% absolute increase over the 2006 figures (15% in NHMS 2006), which also means a whopping 40% relative increase.

This is typically what happens when a society gets affluent, with the increase in obesity rates coupled with sedentary lifestyles. A higher standard of living means people consume more food (especially unhealthy fatty meals with processed meats), and they shy away from menial jobs in favour of cushy desk jobs.

And the chase for more money, plus the incessant traffic jams (now that almost everyone can buy a car or two), also mean that there is no time left for daily exercise.
The impact of diabetes is tremendous. Recently, an old friend of mine died of diabetic complications, another had his legs amputated, while another almost had his big toe amputated too.

In a span of three months, three people I know had to start dialysis due to diabetic kidney failure.

Diabetes is also linked to heart disease, stroke and many other problems. And the men also have erection problems.

The situation is getting worse as people take a lackadaisical attitude towards this major health problem, despite our Health Ministry’s efforts to educate the public.

Once, I was having breakfast at a hotel with an obese man who happily gobbled a sugar-frosted donut, mee goreng, bread with butter and jam, and several other items.

After he finished his food, he then took out his pill box and started to swallow the many pills like an obedient patient.

I asked him what they were for, and was told that they were for hypertension, diabetes, cholesterol, “blood thinner”, etc.

I was speechless.

In such a case, I wonder whether his doctor counselled him enough on the need for discipline in his diet, or that he is recalcitrant beyond reproach.

Judging from the many diabetic patients that have very high and uncontrolled glucose levels in their blood, I believe the problem of dietary indiscipline is a major issue with Malaysians. The many choices of delectable and delicious dishes on offer here make it hard to control the appetite too.

Much research and many articles have been written about the prevention and treatment/management of diabetes, but very little can be found on curing diabetes. The official medical position is that there is no cure for diabetes – a stand I totally disagree with.

Sometime back, I wrote about a study that showed it is possible to reverse (cure) diabetes with a nutrient-dense, fibre-rich, low-fat diet, combined with weight reduction and exercise. The Journal of Applied Physiology (Dec 15, 2005) published by the American Physiological Society reported that 50% of patients with type 2 diabetes and metabolic syndrome were cured after three weeks of a diet and exercise programme.

The team studied 31 overweight and obese men (ages 46-76 years) with diabetes or metabolic syndrome (a precursor to diabetes and a host of other diseases).

However, even with that study’s conclusion, the push for cure does not generate much interest in research, as opposed to the push to find newer drugs that can “control” diabetes better, with less side-effects.

That is the sad reality of the medical industry now. Every year, there will be new drugs launched with “superior” control and safety profiles. The prices, of course, keep increasing, just like new car models.

So, I was pleasantly surprised that the theme for this year’s Global Diabetes Walk is “Walk for Cure”. The event (Nov 25) was organised by the Columbia Asia Hospital group, along with Lions International, in support of the World Diabetes Foundation and Persatuan Diabetes Malaysia.

I hope that the theme signals an acknowledgement that diabetes can be cured. Diabetes does not mean sufferers are condemned to a life of pills and injections, provided they can discipline themselves to do whatever is necessary to achieve the cure.

Curing obese diabetics

For obese diabetics, the first thing they need to do is drastically lose weight. Drastic does not mean unhealthy crash diets, but a drastic reduction in weight, even though that takes time.

While obesity is a known risk factor for diabetes and a host of other diseases (including cancer), evidence-based medicine demands that we cannot just assume that the reverse is true – that reducing weight will reverse the disease. It must be proven.

Well, this has been proven many times. There are many clinical records of obese patients curing themselves of diabetes (also hypertension, arthritis and other problems too) after losing much weight.

If you have been watching The Biggest Loser on TV, then you know that it takes a lot of hard work and discipline to lose weight the healthy way. However, the participants subject themselves to the punishing regime because they compete to win a prize. It need not be that torturous, but much discipline is still required to lose weight healthily.

For tips on how to do so, please read Managing your weight (Fit4life, April 19, 2009).

Those with morbid obesity (very severe obesity, and therefore having a higher risk of developing many diseases) can opt for bariatric surgery, which makes the stomach smaller, or by-passes the stomach altogether. Studies have shown that many of those with diabetes cured themselves of it after they regained their normal weights following the surgery.

I personally know of someone who is a totally different person (literally) now that he is half his former size, minus the diabetes and hypertension.

The results achieved after bariatric surgery can be fast because the weight reduction starts immediately after the surgery, and the effect is permanent.

The patients only need to learn how to eat smaller healthier meals. As there are risks associated with the surgery, anyone contemplating going through it should get sufficient advice from the experts first.

The good results achieved after bariatric surgery proves conclusively that diabetes can be cured in obese patients. What can we learn from this?

Fats first

Insulin is an important metabolic hormone. It is anabolic (makes the body grow). It instructs cells to assimilate (take in) glucose and fatty acids.

Type 1 diabetes sufferers do not make enough insulin. Their only recourse is insulin injections (or sprays in the future). They can still keep their insulin doses low if they lead healthy lifestyles, with a healthy diet, optimum weight and plenty of exercise.

Transplants of pancreatic tissue or stem cells may be innovations we can look forward to that may free them of daily injections.

Type 2 diabetes sufferers make more insulin than healthy people, but their cells have become “resistant” to the hormone’s instructions. There are many possible explanations for this.

First, the insulin receptors on the cells may be deficient or defective. So, even the higher level of insulin does not result in adequate instructions for the cells to assimilate the glucose. Diabetics have high sugar (glucose) levels in their blood, but their cells are starving and cannot function well. The high circulating glucose also causes more problems.

The most effective drugs are those that improve insulin sensitivity. Exercise, building muscles, weight reduction, and a whole list of nutrients also improve insulin sensitivity.

The effect on fats is similar, but not as drastic as the hyperglycaemia. Diabetics also have problems with their lipid profiles. Most diabetics are fat before they become diabetic. Many years of consuming excess calories (usually carbohydrates and fats, and even excess proteins) will cause the body to increase its “fixed deposit” store – that is the fat or adipose tissue.

When the mass of fat tissue gets too much, insulin resistance sets in (by whatever mechanism). Thus, some diabetics actually experience rapid weight loss (mainly fat loss, which gives a haggard look) as a symptom (apart from persistent thirst and frequent urination), prior to being diagnosed as having diabetes.

In such cases, the effect of insulin on both glucose and fats is strong, and they actually regain the fat to look healthier once they are treated.

My theory is that the body utilises the insulin to store the fats first, in preference to sending the glucose into the cells. This is because a high level of fats floating in the blood is more dangerous than a high level of glucose.

We all know that the risk of getting a heart attack and stroke increases for several hours after a fatty meal. So the body has to prioritise the removal of fats from the blood. Many untreated or poorly-treated diabetics are walking around with glucose levels that are many times the normal levels. Although they are at high risk of getting into trouble, the risk is even higher if it were the fats that are that much higher.

This may explain why a consistent low-fat, low-calorie diet (better still, with plenty of exercise) or bariatric surgery that drastically reduces fat and calorie intake, will cause the fats to be utilised for energy production, and fat storage to be significantly reduced.

This spares the need to utilise insulin to store fat. That means whatever insulin available can now be fully utilised to manage glucose.

While this theory explains the situation in obese diabetics, we have to look for other explanations for the non-obese diabetics. Genetics (family history) is, of course, one major contributor. But while we are still at a loss as to how to explain those who do not have a family history of diabetes and are not overweight or obese, but are still afflicted with the disease, we do know that everyone can reduce his risk by having a healthy diet as described above, maintaining a healthy weight, and doing sufficient exercise.

I have a relative who was overweight, but not obese. He was hooked on carbonated drinks. After many years of consuming several cans/bottles of those drinks daily, he developed the classic symptoms of diabetes and lost weight rapidly, causing him to look gaunt.

After starting treatment for diabetes, he is now better disciplined with his diet and drinks. His diabetes is “well controlled” on anti-diabetic drugs, and he looks much healthier.

However, I am not able to convince him that he can try to reverse the disease (maintain normal glucose levels without drugs, ie cure). He is a doctor.

Source: Fighting diabetes

Turmeric - Curry goodness

ART OF HEALING
By DR AMIR FARID ISAHAK

 Sunday June 24, 2012


Scientific studies show that turmeric provides more benefits than just making our food tasty.

I AM an ardent believer and promoter of natural and nutritional therapies over drug-based therapies for most of the health problems that we may face.

However, most natural and nutritional therapies have not been scientifically proven to be effective as claimed, even though there are enough experience and testimonials for us to believe and continue using these therapies.

In this scientific age, it becomes incumbent upon us to validate these claims with scientific studies. So I am happy to share with you today, some of the studies that prove the effectiveness of natural and nutritional therapies.

Although most of these studies are small, and therefore, do not have the same level of validity or confidence as the large-scale drug studies — often done concurrently in many research centres worldwide, they are still important because we now have some objective proof of the validity of the observations and experience of our forefathers who have passed on their knowledge to us.

Unfortunately, it is unlikely that large-scale studies will be done on these natural and nutritional therapies, because such studies will cost millions of dollars; and no company is willing to spend on something they cannot patent and reap profits from thereafter.

Our only hope is if government institutions and universities come forward and take up the challenge.

Some of the studies have only been done on animals, but the positive results tell us that human studies should be done, and hopefully, give equally positive results too.

Spicing up RA treatment

Today, I shall start with the goodness of curcumin, the supernutrient found in the common spice turmeric.

Studies have shown that curcumin has strong anti-inflammatory activity. Since inflammation is also known to be the underlying cause for many chronic degenerative diseases (Alzheimer’s, arthritis, heart disease, stroke, diabetes and cancers), scientists began to look into the effect of curcumin on these diseases.

In a study involving 45 patients with active rheumatoid arthritis (RA), patients given curcumin (500mg) showed significantly better improvement compared to patients given a common anti-inflammatory, anti-arthritic drug, diclofenac sodium (50mg).

More importantly, curcumin treatment was found to be safe and did not cause any adverse effect, whereas the drug, like all drugs, has a long-list of known side effects.

This paper, published as A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis in the journal Phytotherapy Research on Mac 9, provides evidence for the safety and superiority of curcumin over drug treatment in patients with active RA.

The researchers recommend that more studies be done to assess the effectiveness of curcumin in the treatment of RA and other arthritic conditions.

Prior to this study, there were many other studies that showed the effectiveness of curcumin used with drugs in mitigating the pain and other symptoms (eg swelling, stiffness, immobility) associated with RA and other forms of arthritis; but none directly compared curcumin with a drug head-on.

In fact, in this study, curcumin alone was better than the drug with curcumin.

Some doctors may argue that the drug dose used here was low (50mg), and that they usually prescribe the 100mg (long-acting) dose.

Well, the curcumin dose used here was also low, because other studies have used doses up to 2,000mg per day.

It has been determined that even 8,000mg per day is safe! The average curry-lover gets about 100mg per day in his diet.

Healing our cells

The level of homocysteine in the blood is an independent risk indicator of heart disease.

Patients with high homocysteine levels have been found to have endothelial cells that do not function properly.

Endothelial cells line the inside of our blood vessels. They release nitric oxide, which dilate the vessels, and other chemicals, which prevent blood from clotting and plaques from forming.

Curcumin has been found to prevent this dysfunction, and therefore, is useful in the treatment of patients with high homocysteine levels.

Another independent marker of the risk for heart disease is the level of C-reactive protein (CRP).

CRP is a protein that the body produces in response to inflammation, and has been shown to damage endothelial cells. This results in increased vascular disease and blood clotting.

Curcumin treatment has been shown to completely inhibit the effect of CRP on these endothelial cells.

Studies on rabbits have also shown that curcumin treatment resulted in a significant decrease in oxidized LDL-cholesterol (bad cholesterol) and early atherosclerotic lesions in rabbits fed high fat and high cholesterol diets.

Although the studies quoted above are on animals, the results are encouraging, especially when the current drug therapies for cancer are so damaging by themselves.

Thus far, curcumin has been found to kill or inhibit the growth and spread of many types of cancer cells, including human head and neck squamous cancer cells, oral cancer cells, liver cancer cells, lung cancer cells, melanoma cells, breast cancer cells and colon cancer cells.

Curcumin also inhibits pre-cancerous polyps in the colon, and improved the sensitivity of chemotherapy in some cases.

Other health effects

Research at the Medical Univer-sity Graz in Austria showed that curcumin delays liver damage that can eventually lead to cirrhosis.

Kansas State University research found that adding turmeric, and some other spices too, can reduce the levels of heterocyclic amines — carcinogenic compounds that are formed when meats are barbecued, boiled or fried — by up to 40%.

The high consumption of turmeric by Indians is suspected to be the reason why the rate of Alzheimer’s disease in India is less than a quarter that of the US. A study showed that curcumin destroys the amyloid plaques.

An overview published in the reputable publication Advanced Experimental Medical Biology (2007) stated that: “Curcumin has been shown to exhibit antioxidant, anti-inflammatory, antiviral, antibacterial, antifungal, and anticancer activities, and thus, has potential against various malignant diseases, diabetes, allergies, arthritis, Alzheimer’s disease, and other chronic illnesses.”

Five years later, more evidence has accumulated attesting to the goodness of this nutrient commonly available in our diet.

In the meantime, we can continue to benefit from its goodness as told to us by our forefathers. Some of the “home” uses of turmeric/curcumin are as:

·A natural antiseptic, useful for disinfecting wounds and burns.

·A natural painkiller.

·An aid in weight loss.

·A remedy for depression.

·A natural remedy for arthritis and rheumatism.

·An aid for wound healing.

·A natural treatment for psoriasis and other inflammatory skin diseases.

How to take it

If you are healthy, and would like to benefit from the goodness of turmeric/curcumin, then you should make sure turmeric is part of your daily diet.

If you are a curry lover, that is not a problem. You can also sprinkle turmeric on many other dishes to add to the flavour.

If you have any of the health problems listed above that have been shown to benefit from curcumin, then you will need turmeric or curcumin supplements.

Turmeric supplements contain less than 10% of curcumin, but being a whole food, it contains other nutrients that may work in synergy with curcumin.

Turmeric also contains vitamins B6 and B3, folic acid, potassium, iron, manganese, fibre, and essential omega-3 fatty acids.

In our diet, spices are rarely taken just by themselves. They are usually taken with other foods, which may contain other spices as well.

For example, Indian cuisine commonly uses turmeric and pepper together.

A recent study found that the absorption of turmeric and curcumin is enhanced by piperine, a constituent of black pepper.

So, while chefs combine the two spices for better taste, we also get better health benefits.

Without piperine, the absorption of turmeric/curcumin is poor. So, even if you take the supplement form, you should look for supplements that also contain piperine or black pepper.

If this combination is not available, then you should take the supplement together with a little bit of black pepper.

From the research available, you will need at least 500mg of curcumin supplement per day to reduce any of the existing problems (arthritis, high homocysteine, high CRP, etc) as listed above.

If the results are not satisfactory after about three months of consumption, you can increase the dose without any worry of side effects.

I hope this article gives encouragement to those who have faith in natural remedies that it is just a matter of time before scientific research will unveil the goodness of the remedies already available in nature all this while, which were ignored because we were too busy looking for drugs to solve our health problems.

I hope to share the proven health benefits of other natural and nutritional therapies in future.

http://thestar.com.my/health/story.asp?file=/2012/6/24/health/11533925&sec=health