What this study did was very detailed brain scans that looked at the size of brains and then asked people what they ate. They found a significant association between volume of brain and fish consumption, if it was baked or broiled, but not fried. Those folks with larger brains had a five-fold reduction in risk for cognitive impairment and Alzheimer’s, according to the lead author, Dr Cyrus Raji. This study came out of a 10 year project in which 3-D MRIs were done on 260 healthy adults who were then followed for changes in brain volume. 163 of them ate fish at least once a week, so they had a good sample size to follow.

How can you explain this benefit? Here’s my take. Our brains have omega fatty acids as their main membrane ingredient. As much as 40% of the dry weight of our brains come from DHA and EPA. Our diet in America is so deficient in omega -3 fatty acids that any source will boost us. Fish tend to have more omega-3 than feedlot raised animals. Eating fish will provide you with some omega-3 fatty acids and make the volume of your brain larger. It’s like pumping up a low tire with more air. And the reason frying won’t work? That’s easy. Frying is generally higher temperature than baking or broiling. Omega-3 fats have many “cis” bonds that are inherently delicate and unstable. The extra heat of frying will provide the energy for them to transform into “trans” bonds, changing their chemical nature and beneficial qualities. Just like olive oil can’t be used to fry food because it becomes a trans fat, so too does fish oil. The “cis” chemical bonds in fish oils are so delicate that we need to keep it in the fridge in a dark bottle when we buy it as a liquid because even light and room temperature will slowly degrade it.

This would suggest that cognitive impairment in the elderly is in part nutritional in origin. Considering that trans fats block several of the pathways that make our own omega-3 fats, and realizing that the American diet still has lots of trans fats in it, our epidemic of cognitive impairment may be partially attributed to the one-two punch of the dietary lack of omega-3 and the dietary excess of trans fats.

WWW: What Will Work for Me! Fish is great nutrition! Sounds like once a week is good and four times is better. Or maybe just focus on the fish oil! And while I focus on that, I’m making an extra effort to eat less trans fats. I’ve been raising my daily omega-3 fatty acid intake to 3 grams a day by taking a teaspoon of liquid lemon flavored fish oil. Tastes quite mild and goes down easily. So much for the Friday night fish fry. Time to go baked.

Reference: USA Today Nov 30, 2011

Atrial fibrillation is when the top part of your heart, the atrium, that is meant to prime the ventricle with a coordinated filling beat, gets spastic and effectively shivers like a little bowl of jello. In effect, it is beating 400 beats a minute which the ventricle below just can’t do. The net result is a chaotic beating of the heart with no pattern to the beat. Often it’s too fast, around 140-160 but the output of blood is actually lower because the ventricle isn’t being primed properly. You feel crummy. Younger folks will often revert back to a normal rhythm when the offending cause of their atrial fibrillation goes away – most commonly too much thyroid hormone.

Dr Bunch was the lead investigator in this study and found that folks with an excessive level of Vitamin D, greater than 100 ng, have a two and a half time increased risk of developing atrial fibrillation. The study has pretty good predictive power because they were following some 132,000 people. The comparison was to folks with “normal levels” that they defined as 40-80 ng.

Isn’t that interesting! See where we have come. A few years ago we called normal 9-50 ng because that is what we observed in the population. Now we are calling anything below 40 to be low. The Institute of Medicine is saying its safe to take up to 4000 IU a day, which is what a young 20 year old Caucasian will make in 4 minutes of good sunshine. But the IOM recommends only 600-800 IU a day for bone health. That’s way too low for heart protection. The average person taking 4000 IU a day will likely level off at around 40-50 ng. On just 2000 IU a day, the average person in Wisconsin will level off around 30-40 ng – too low.

Only 5% of the population develops atrial fibrillation in their lifetime, but it becomes much more common as we age and develop heart failure. This study becomes a bit of a caution to the Vit D enthusiasts who cheerfully take 10,000 IU a day without measuring a blood level. On 10K a day, the average person will level off at 80 ng, but some petit folks with little body fat will be much higher.

WWW. What will work for me?: I’m glad to hear the normal range being defined as 40-80 ng. That’s pretty good science. I got my level checked and I’m in the 60s. The reduction in cardiac risk with more D is pretty impressive when your level gets to 45 or so, so I like to think of that as my floor. A level of 100 is a long ways away.

Reference: American Heart Association Meetings in Orlando, Nov 18, 2011 Report from Intermountain Medical Center, Dr Jared Bunch

Iceman, or Otzi, had a bad day. He had just gotten away from his chasers and stopped at the very top of the pass on the border of what is now Italy and Austria in 3200 BC. He had made it all the way to the top of the mountain and was now stopping for some lunch of ibex meat when a hidden assailant shot him in the back with an arrow. He likely died quickly, particularly after the blow to the back of his head dispatched him. His assailant pulled out the arrow shaft but left everything else behind, leaving us Europe’s oldest mummy, frozen in the snow to examine 5300 years later. When an autopsy was done this year and he was briefly thawed, samples showed that he had Lyme disease in addition to everything else. So, like tuberculosis, Lyme has been around awhile. It makes an illness that may not kill you, but sure slows you down until something else does.

Where do we get Lyme disease from? We thought it was just from ticks carried by deer. That’s the conventional thought. If you don’t have deer in your neighborhood, you are safe, right? Actually, wrong. In a paper presented at the International Lyme Conference in Toronto last month, John Scott presented a paper on the incidence of Lyme carrying ticks on birds in Canada. His paper caught my ear. 200 song birds that spend a fair amount of time on the ground were captured across Canada over the last three years with mist nets or from bird strikes against city buildings. The birds were then examined for the presence of ticks. The average bird carried two ticks, with one bird having 18. And when the 17 different kinds of ticks were examined, 29% of them were found to have B. burgdorferi in them. (That’s the Lyme bacteria) These birds migrate up into Canada from their winter homes. They cross virtually every state in the US. That means the average bird at your bird feeder may be pretty much the same, and have about a 30-50% chance of carrying the Lyme bacteria in a tick. Hmmm.

What are the symptoms of Lyme disease? How about something that feels like a cold that doesn’t go away, and then fatigue and malaise that doesn’t go away. Any new symptoms that wax and wane, you might think of Lyme. You don’t need to have a rash or a tick bite, as less than 50% of folks who have Lyme do. And the traditional Western Blot test may not be very accurate. The controversy about Lyme is unbelievable because there are those who believe you can cure Lyme with 30 days of antibiotic, and those who see patients who don’t get better until treated for Lyme for 1-2 years. I’ve heard too many stories from credible sources to believe the 30 day theory.

WWW. What Will Work for Me? I have a bird feeder and feed birds all winter. I will continue to do so. And I will look for ticks until we get a good hard frost when the risk of transmission seems to fall off. One thing winter is good for.

This idea is NOT out there so I am asking you to think of a conceptual idea that I believe is coming and explains a lot as to why vegetarian type diets differ from animal diets. I want to understand why Dr Esselstyn is having success with completely reversing heart disease, and why Bill Clinton is going to see Dr. Esselstyn to reverse his coronoary artery disease. My Uncle Paul did the same thing back in 1977-81. He completely reversed his coronary artery disease by being a vegan. Five vessel bypass surgery and he opened his native arteries back up. We had some interesting Thanksgiving dinners, but he lived and thrived.

Here is the idea. You are familiar with the glycemic index, right? We compare different foods and their ability to raise your blood sugar in comparison to pure glucose. Our body runs on glucose, so it’s a good comparison. Our body also runs on fats and proteins, but we haven’t counted them to date. What happens with high glycemic foods is that they set off the release of insulin. Above an index of 55 or so, you force your body to secrete insulin and that insulin then stores calories as fats. Curiously, our insulin and inflammation pathways are linked in the “common soil” hypothesis. High insulin equals high inflammation. Eating high glycemic foods forces you to get fat and to get inflamed, and then you get the long term diseases of inflammation.

So, here is the “Proteinomic Index” hypothesis. When we eat meat, we get complete protein with all 20 amino acids that our bodies use to build our own proteins. We have always claimed that meat is “high quality” because it provides all of the 8 “essential” amino acids that we cannot make ourselves in our cells. What we neglect to mention is that our bodies include a condo association in our guts that constitute a separate and distinct organ in an of themselves. The trillions of bacteria in our colon have 100 times the DNA of the human genome in them and the ability to make all the amino acids our bodies need. We get amino acids from those bacteria, included the essential ones. Just slower. When we eat a vegetarian diet, we feed ourselves and our colonic condo association.

The bacteria in our colons go to work and make their natural products, including the essential amino acids which we then absorb from them. Not to mention that we also get the amino acids we need from the variety of plant products we eat, but again at a slower pace.

My hypothesis, if you will, goes as follows. A slower absorption rate of amino acids is as valuable to us as a slower rate of absorption of glucose and carbohydrates. The rapid rate of rise of amino acids that follows a meat or animal meal, forces the secretion of insulin (and with meat, glucagon too) and that results in an insulin rise. The glucagon element is slightly confounding, as that seems to soften the metabolic consequences of meat, but the hypothesis remains. And the content of essential omega fats is another complementary concept that moves the formula a bit too. So, it likely needs to be refined further. But a vegan diet will provide you all the necessary amino acids at a slower pace than a meat diet. And that is better for you. That’s the hypothesis. It may not depend solely on the insulin effect. It may be a mix of other hormonal and nutritional effects. But it explains a lot. I’m putting it out there.

WWW: What will work for me. I just feel better the less animal I eat. I love the taste of animal in all its forms. But I sleep better, think better, feel better will less animal. And apparently, my arteries, by brain, my immune system, my gut all agree. I think the evidence is accumulating. I would plea for any comments, thoughts, agreements, passionate disagreements (always the best). But I think we have an idea here whose time has come. How I wish I had 20 years in an academic lab to chase this one down.

STRESS!!! We all have it. We are up to the eyebrows with stress and are assaulted on all sides, every day with anxiety, job stress, chemical stress, fighting politicians, anxious news reports, TV with murder and mayhem. Where do we find a quite moment and learn to unwind? And does stress have an impact on our health?

Heart rate variability is the cutting edge of current cardiology research. We are finding that the “tone” of your autonomic system is defined by your output of sympathetic nervous system impulses. When you are putting out heaps of adrenaline from stress, you make your heart more touchy and irritable. The result is sudden death because your heart then has the misfortune to go into a lethal rhythm which doesn’t pump blood. There you are, sitting in your living room and you just drop away. That’s a tragedy that steals hundreds of thousands of lives a year in America. Can it be averted?

You want the ability of your body to have a wide range of variability in your heart rate as you go through your daily life. A short and narrow range, reduced variability, has been associated with much high risk after a heart attack, and in many other medical conditions. A healthy autonomic nervous system has a balanced effect on your heart rate variability, giving you a wider range of variability. The narrowed range we see with disease states is also recorded in PTSD, in chronic fatigue syndrome and many other stress and fatigue related diseases. Wikipedia and Biocon websites explain much more detail if you are interested.

Now, this isn’t anything new. It turns out that meditative traditions, most notably from India from about 2,500-3,500 years ago have already mastered this. They have had a long emphasis on learning breathing techniques as a way of bringing calm back to their lives. A few minutes of patterned breathing, focusing on deeper, longer and slower breaths have an immediate and marked impact on the level of your autonomic tone. In effect, what you are doing is taming your lizard brain, the primitive part of your brain that runs the rate at which you breath, your temperature, your heart rate, your sex drive, your appetite and all the other functions your body naturally does over which you are not sure you have much more control than a “lizard”.

Now, CNN is reporting on the spreading use of this technique to help folks with asthma, chronic pain, fatigue, irritable bowel, heart disease and many other stressful illnesses. What we have done in America, in our typically mechanical way, is make a machine that measures our heart rate variability, and by giving us immediate feedback, allowing us to discover how to influence our heart rate by breathing. Meditative traditions focus on the mental exercise that does the same effect more directly because your brain isn’t being distracted by the process of observing the data, like the auditory tone you get in response to your heart rate changing. It may be a moot point because both get to the same training effect and lower your stress, control your autonomic system and increase your healthy variability.

WWW. What will work for me. Take five minutes and practice taking long deep breaths and slowly counting to five as you breathe in and then five as you breathe out. Do 10 breaths and see if you don’t feel different. I learned Transcendental Meditation 35 years ago and cured my muscle contraction headaches in about 3 months. I haven’t had a headache in 35 years. It’s worked for me.

Two reports this week about vitamins and extra risk for early mortality. This is sort of a surprise and takes some thinking what it might mean. First, in the very prestigious Archives of Internal Medicine is a report following 38,000 plus women in the Iowa Women’s Health Study asking them about what supplements and vitamins they took. Of the fifteen items that were surveyed, 14 were found to be associated with higher mortality. They women were 61 years old when the study started and upon ending 18 years later, more than half had died. This is a big study. Iron was found to be the strongest risk on the list. Now, I’m a bit suspicious that 14 of 15 were found to be problematic. That is a problem itself.

In fact, the only one thought to be beneficial was calcium, and that has been shown in other studies to be problematic and not helpful. The study is apparently pretty well designed and regarded in its methodology except for one detail, and that is that they asked the women to remember what they had taken in the past. No one measured blood levels and reported on personalized details. If I have a family member with an iron deficiency anemia, I still think they should be on iron. (Once I know why they are low on iron.)

A second study was released in JAMA about prostate cancer and Vitamin E and selenium. Again, a pretty big study (SELECT Trial) and well designed with good placebo control. This one seems more rigorous in design because it was randomized. It only lasted 3 years but had 35,000 men. That’s big. What they found was that Vit E (400 IU) did NOT protect from prostate cancer, and in fact had about a 17% increased risk. That translates into 16 extra cases for every 10,000 men. 400 IU a day isn’t much. It’s the size of most E supplements in the grocery store. Most multivitamins only carry a fifth of that amount. But that’s a big jump and very disconcerting.

Both of these studies have the power of standardized large studies on their side, well executed and carefully thought out. Both suffer from a couple of fallacies that should be understood. We should more sophisticated than what they expect. We should all be past the era when we think any one supplement taken out of context and given in high dose would be beneficial. At no time in human evolution have we ever had isolated vitamins given to us in huge doses. Most of my functional medicine colleagues have long since given up on pure alpha-E and are instead focusing on gamma – delta E as that is where the action seems to be moving. We probably need the mix. And where do we get the very best balance of that mix? When we eat a diet rich in whole, organically raised foods. If your grandma recognized it as a food, it probably is. If was raised in your garden, it qualifies.

WWW. What Will Work for Me? I don’t take Vit E any more. I did for about 5 years back in the 90s. I’m pretty convinced that I do better with 9 servings a day of vegetables and a few fruits for fun. If I can find convincing evidence that our body naturally had high doses of a vitamin in it, like with D, I’ll change my mind. But then D isn’t a vitamin, it’s a hormone, and our bodies naturally make it when we have sunshine. Which we don’t for the next six months. So, trash the E. Start your D.

Reference: http://archinte.ama-assn.org/cgi/content/short/171/18/1625

http://jama.ama-assn.org/content/306/14/1549.abstract

And you thought bones were all just dry old support systems filled with boring calcium! Ha! Not nearly so. It’s back to the osteocalcin story. We’ve known for a couple of years that bones put out osteocalcin that is a critical player in keeping your sugar in control. That’s part of why exercise helps hold your blood glucose in control for a day or so. Nifty. This same team of researchers is on a tear and have figured out that osteocalcin does something a bit more interesting than just sugar control..

Sex! Well, not quite but close. It’s the headliner that gets you to read on. We’ve known for a long time that proper levels of estrogen and testosterone help keep healthy bones. So, that direction of metabolic interplay is well established. But what do bones have to do with sex?

What is the metabolic effect the other way? Lots. It’s osteocalcin and its effects on the testes. Dr. Karsenty found that osteocalcin has binding sites on the testes in mice. Male mice that had been genetically altered to lack osteocalcin had fewer and smaller offspring. Female mice had no affect on their ovaries from the osteocalcin.

Now, reported this week is that Dr. Karsenty has found that human testes also have osteocalcin receptors. So osteocalcin is another key component to men making healthy amounts of sperm and testosterone. We’ve known for decades that LH (leuteinizing hormone) is the critical hormone from our brains to set our production of testosterone. Maybe osteocalcin is the fine tuner.

What is the bigger picture here? Bones aren’t passive. In fact, the health of your bones is being intimately linked to your overall health. The nimble and delicate interplay of hormones between all of our organs continues to unfold. Keeping healthy bones becomes a key component of overall health.

So the question is begged. How do I keep healthy bones? Exercise! Walking, running, playing, weight bearing exercise. What ever you are doing, do a little more! Getting sweaty is probably a real boost. Hormone balance. Getting your estrogen, testosterone, and progesterone right helps. Lower acid eating (less meat and cheese, more vegetables). Proper sleep. More brightly colored foods. Less stress. Less inflammation. Whew, that’s the list.

WWW. What Will Work for Me. I’m continuing to learn to run. Each week, I’m adding five steps to my distance. Really, really, really, little increments. And every 125 steps, I walk for 20. It’s all mental. I keep telling my brain that my life and welfare depend on those twenty minutes of sweatiness. I keep saying “I love this” when deep down inside, my lizard brain is complaining. And running is making me spew out more osteocalcin. Think of that.

Reference: New York Times 8/23/2011 – Gerard Karsenty, Columbia University