Posts Tagged ‘Archives of Internal Medicine’

Boneing Up on Osteoporosis

Saturday, May 15th, 2010

I recently touched base with a colleague, Dr. Howard Schubiner who has helped me understand chronic pain as it relates to stress. We collaborated on a study looking at cognitive behavioral techniques to facilitate the ‘unlearning’ of pain pathways. He has a new book out titled, Unlearn Your Pain: A 28 day process to reprogram your brain, available through his website, www.unlearnyourpain.com . If you’re suffering from chronic pain and you do not feel better after normalizing your vitamin D, changing your diet, and exercising then you need to check this book out. It could be the answer to your prayers.

There will be an exciting conference in Los Angeles in the Summer of 2011, The Ancestral Health Symposium . Loren Cordain calls it the “Woodstock of Evolutionary Medicine”. Brent Pottenger is organizing the program and there should be a potpourri of presentations by many experts, advocates, and practioners. Brent’s wonderful blog will keep you posted as the event approaches.

There is a new book out, Principles of Evolutionary Medicine by Peter Gluckman, one of the world’s leading researchers in this area. I have my copy ordered. The table of contents looks terrific. It should be an intense read. Peter Gluckman and David Barker are members of a generation of evolutionary biologist who have connected the theory with animal and human disease models. There will be some Nobel prizes handed out to some of these scientists.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com .

This month’s recipe is Gourmet Mushrooms & Sausage over Wild Rice

Serves 4
-1 Tbsp. Olive Oil
-1 larger onion, chopped
-12 ounces Italian Sausage, casings removed (try venison or other wild game sausage)
-1 Tbsp. tomato paste
-1/2 cup parsley, chopped
-1/4 cup cilantro, chopped
-2 cups low sodium chicken or vegetable broth OR stock
-1 10-ounce package frozen spinach
- 2 cups of dried gourmet mushrooms rehydrated in water (Portobello, morels, porcini etc…)
-Salt and pepper
-1 cup wild rice
-1 cup cold water

Directions:
(For the stew)
-Heat oil in a large saucepan over medium heat; add onion and cook until soft (about 5 to 7 minutes.)
-Add sausage and cook, crumbling it until browned.
-Add the tomato paste and cook another 2 minutes. Stir in parsley & cilantro and cook 1 more minute.
-Add the broth and rehydrated mushrooms; bring to a boil. Add the frozen spinach and simmer, partially covered, for 10 minutes. Stir occasionally.
-Stir in salt and pepper to taste.
(For the rice)
-In a saucepan cover rice and water until it comes to a boil. Reduce to low and cook 20 minutes or until the rice is al-dente.

Place rice on the plate and spoon the mushroom and sausage mix over the rice and serve.

Vitamin D in the News

An article came out in JAMA (Journal of the American Medical Association) showing again that single annual high dose vitamin D replacement is not effective at preventing fractures of falls in elderly. This paper published 2007 also showed no benefit to annual dosing.

If you want to effect a change you have to change more than one variable as in the study that came out in Archives of Internal Medicine this month. In this study they replaced vitamin D and had patients participate in physical therapy.

Osteoporosis is NOT a disease of elderly it is a symptom of the elderly; it is a life long disease. Many young girls fail to attain peak bone mass due to poor nutrition (lack of protein and green veggies) and lack of exercise. They then enter late adult life and begin to gradually lose bone mass from a position of weakness. This accelerates after menopause and then they become symptomatic with fractures. It is NOT surprising to see a lack of benefit from relatively short term intervention (1-2 years) of a single variable in a disease influenced by many factors over many decades.

Research by Reinhold Vieth, PhD from University of Toronto showed that monthly dosing of vitamin D produces swings that tended to cause some calcium loss in the urine from high peak levels of D. Weekly and daily dosing did not cause this problem. Moreover, many of the reports of vitamin D toxicity come from Europe where they commonly use IM injections of high dose vitamin D in institutionalized elderly. The absorption of vitamin D from these injections is not consistent from patient to patient. Vitamin D ( 25(OH)D ) in too high of a blood level can induce some over production of the active hormone. High levels of the active hormone will pull calcium out of the bone and increase fracture risk.

Timing is everything. You want normal vitamin D levels during the phase of your life when you are building bone (third trimester of fetal gestation through 20 years of age). This is when it has its greatest benefit to bone. Treating older individuals who have lost bone is not likely to show much difference unless you focus on people with vitamin D levels below 20 and preferably with compensatory hyperparathyroidism; and throw in lots of exercise (stimulus to build bone). The solution is entire Vitamin D Cure program.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle. Check out the latests successes on Amazon.

Happy Valentine’s Day - Celebrate Your Heart and Soul

Friday, February 5th, 2010

This blog focuses on the heart and soul of health. The Vitamin D Cure emphasizes nutrition, targeted supplements, and exercise. Omega 3 fats and exercise were all over the science news in the last week. Remember in the book we recommend about 15 mg/lb of body weight daily of omega 3 fats from diet and supplement. We also recommend at least 30 minutes of exercise a day and aerobic exercise at least 3 times a week.

And this month for the palate, we have a vitamin D rich recipe of Salmon with asparagus and mushrooms. For Valentines Day you might chase this with some dark chocolate and a glass of port. Yuuuumy!

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com.

    Seared Salmon with Asparagus & Mushrooms

Ingredients:
• 4 Fresh skinless wild salmon fillets (about 1 pound)
• Salt & Pepper
• 2 Tbsp. olive oil
• 2 cups sliced assorted mushrooms (such as button, cremini, shittake)
• 1 cup onion, chopped
• 6 cloves garlic, minced
• 1 Tbsp. fresh thyme, chopped
• 1 cup dry white wine
• 1 cup clam juice, fish stock, chicken stock or broth (whatever you have)
• 2 cups asparagus, cut into 1 1/2 in. long pieces
• 1 cup cherry tomatoes, halved
• 1 Tbsp. fresh parsley, chopped
• 1 tsp. lemon juice

Directions:
• Pat fish dry and season with salt and pepper.
• Heat 1 Tbsp. of olive oil in a large skillet over medium heat. Add the mushrooms and cook until golden brown, about 5 minutes. Add onion, garlic and thyme; cook until mushrooms are tender. Add the wine and bring to a boil; reduce heat and simmer uncovered for 15 minutes or until liquid is reduced to 1/4 cup.
• Add clam juice (or stock) and return to a boil. Reduce heat and simmer for another 15 minutes or until the liquid is reduced to 3/4 cup.
• Add the asparagus and cover; cook for about 3 minutes or until al dente (crisp-tender.) Stir in the tomatoes, parsley and lemon juice. Season with salt and pepper and transfer to a serving platter; keep warm.
• In the same skillet, heat the remaining olive oil over medium-high heat. Add the salmon and cook for 4-6 minutes per 1/2 inch thickness, or until fish flakes easily with a fork, turning once.
• Serve salmon over vegetable mixture and garnish with lemon wedges and fresh thyme.
Makes: 4 Servings

Vitamin D, Diet, and Exercise in the News

Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease.
JAMA. 2010 Jan 20;303(3):250-7.
Division of Cardiology, Room 5G1, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110, USA.

CONTEXT: Increased dietary intake of marine omega-3 fatty acids is associated
with prolonged survival in patients with coronary heart disease. However, the
mechanisms underlying this protective effect are poorly understood. OBJECTIVE: To
investigate the association of omega-3 fatty acid blood levels with temporal changes in telomere length, an emerging marker of biological age. DESIGN, SETTING, AND PARTICIPANTS: 608 ambulatory outpatients in California with stable coronary artery disease recruited from the Heart and Soul Study RESULTS: Individuals in the lowest quartile of DHA+EPA experienced the fastest rate of telomere shortening, whereas those in the highest quartile experienced the slowest rate of telomere shortening (P < .001 for linear trend across quartiles). Levels of DHA+EPA were associated with less telomere shortening before and after sequential adjustment for established risk factors and potential confounders. Each 1-SD increase in DHA+EPA levels was associated with a 32% reduction in the odds of telomere shortening. CONCLUSION: Among this cohort of patients with coronary artery disease, there was an inverse relationship between baseline blood levels of marine omega-3 fatty acids and the rate of telomere shortening over 5 years.

Long-Chain Omega-3 Fatty Acids for Indicated Prevention of Psychotic Disorders:A Randomized, Placebo-Controlled Trial.
Arch Gen Psychiatry. 2010 Feb;67(2):146-54.
Orygen Youth Health Research Centre, 35 Poplar Rd. Vienna, Austria

CONTEXT: The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that omega-3 PUFAs are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis merits investigation. OBJECTIVE: To determine whether omega-3 PUFAs reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis. DESIGN: Randomized, double-blind, placebo-controlled trial conducted between 2004 and 2007. PARTICIPANTS: Eighty-one individuals at ultra-high risk of psychotic disorder. INTERVENTIONS: A 12-week intervention period of 1.2-g/d omega-3 PUFA or placebo was followed by a 40-week monitoring period; the total study period was 12 months. RESULTS: 93.8% completed the intervention. By 12 months, 2 of 41 individuals (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4). Omega-3 Polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo. The incidence of adverse effects did not differ between the treatment groups. CONCLUSIONS: Long-chain omega-3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with sub-threshold psychotic states.

COMMENT: Higher omega 3 blood levels in heart patients appear to be associated with slower shortening of telomeres in white blood cells. Remember, the lengths of telomeres are associated with longevity or survival. In data edited from the book, the use of cod-liver oil to prevent rickets in Finland appeared to reduce the risk for schizophrenia in men 30 years later by as much as 78 percent. But, was this benefit from the vitamin D, the vitamin A or the omega 3 fats found in cod liver oil? This second study shows us that the omega-3 fats are playing an important role in this protection, and perhaps at any age preceding the onset of psychosis. It would break my heart if you didn’t take your omega 3 supplements.

Resistance training and executive functions: a 12-month randomized controlled trial.
Arch Intern Med. 2010 Jan 25;170(2):170-8.
Brain Research Centre, Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Department of Physical Therapy, University of British Columbia. 357-2647 Willow St, Vancouver, BC V5Z 3P1, Canada.

According the authors, among community-dwelling women aged 65 to 75 years, 12 months of progressive resistance training once or twice weekly improved selective attention and conflict resolution relative to twice-weekly balance and toning exercises. They also found that resistance training twice weekly improved peak quadriceps muscle power. This is the first study to demonstrate that engaging in progressive resistance training as infrequently as once a week can significantly benefit executive cognitive function in community-dwelling senior women.

In the same issue were two additional corroborating studies…

Physical activity and incident cognitive impairment in elderly persons: the INVADE study.
Arch Intern Med. 2010 Jan 25;170(2):186-93. Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany. Conclusion: Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 years in a large population-based cohort of elderly subjects.

Physical activity at midlife in relation to successful survival in women at age 70 years or older. Arch Intern Med. 2010 Jan 25;170(2):194-201. Department of Nutrition, Harvard School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA. Conclusion: These data provide evidence that higher levels of midlife physical activity are associated with exceptional health status among women who survive to older ages and corroborate the potential role of physical activity in improving overall health.

These data validate the Jack Lalanne phenomenon and the message in the Vitamin D Cure. Eat healthy, exercise hard, take some targeted supplements like vitamin D, omega 3 and magnesium, and you will live a long, healthy and vigorous life.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Hi Dr Dowd,

… I have been suffering with joint pain, muscle weakness, bone pain for 3 years. I am a 52 year old female. It was hard moving, getting up from a chair, holding heavy objects in my hands and so on. I have gone to physical therapist, with not much change. I have seen rheumatologists and also an endocrinologist…with no relief. I was given Lortab and steroids. They help for a little while. Last May my vitamin D was measured and was 20 or insufficient. My then rheumatologist told me to just supplement with D 3. Recently I bought a chewable D 3 1000 from GNC for my son and took one myself. The next day when I woke up, it was like I had gotten a huge steroid shot. It was unbelievable. I felt relieved. My pain was very minimal. My low back pain was gone. My back has been a problem for more than 3 years. … I bought your book last night and read it from beginning to end. …

Thank you,
Judy, from MI