Marteletti and his colleagues have found evidence of altered immune activation
in pediatric and adult migraine. Following food challenge their subjects demonstrate
an increase in circulating immune complexes and in total and activated T-cells.

Egger et al have published the only double-flind placebo-controlled trials
of food intolerance in childhood migraine, confirming specific food sensitivities
in 52% of children with severe, frequent migraine. An average delay of two days
between exposure and symptom supports the thesis that provocation occurs in
stages. Egger, McEwen and Stolla subsequently demonstrated that children with
food-induced migraine could be desensitized to their food triggers by an immunologic
hyposensitization procedure. At the study’’ end, 80% of children receiving active
treatment and 25% of children receiving placebo were able to resume a full normal
diet without experiencing migraine attacks (p=0.001).

These studies support a role of immunologic hypersensitivity in the genesis
of migraine in food-intolerant children.

INTRODUCTION

Migraine headache and food intolerance are ancient phenomena, each mentioned
in the Hippocratic texts. Pediatric migraine as a distinct disorder received
relatively little attention until the middle of this century when Vahlquist
established strict criteria for its definition. These were paroxysmal headache
separated by pain-free intervals, associated with two fo the following four
features; nausea or vomiting, visual aura, positive family history of migraine,
unilateral distribution of throbbing pain.⁴ In studies conducted
twenty years apart in different countries, Bille⁵ and Silanpaa⁶
found the prevalence of migraine among schoolchildren to be approximately 4%,
using Valquist’s criteria.

A role for dietary components in provoking attacks of migraine was first clearly
described in Living’s classic monograph of 1873, which included four cases of
food-induced migraine⁷. During the first half of this century, numerous
reports of an association between migraine and food appeared, most attributing
headache to allergy^8-13. The weak association between food-induced
migraine and total IgE levels or the results of cutaneous prick tests, however,
led some authors to doubt the existence of allergic headache^14-17.

BIOCHEMICAL PROVOCATION OF MIGRAINE

Over the past three decades, competition between immunologic and pharmacologic
mechanisms for food-induced migraine has received considerable attention. The
pharmacologic concept was initiated by Hannington in 1967, when she proposed
that food-borne tyramine, not anti- genic protein, was the trigger¹⁸.
In subsequent reports, Hannington and her colleagues suggested that migraineurs
are sensitive to tyramine because of a deficiency of monoamine oxidase in plateletsl^19,20.
The defect in monoamine oxidase proved to be transitory, however, a result rather
than a cause of the migraine state²¹, and the group’s attention turned
to a persisting deficiency of platelet phenolsulphotransferase as the underlying
biochemical defect in migraine²². Phenolsulphatransferase not only
inactivates phenylethylamines²³ but also metabolizes other foodderived
phenols such as the flavonoids which may act as triggers for red wine headache²⁴.
Additional candidates for the chief biochemical trigger of migraine have been
advanced by researchers in Sweden, Canada and Germany, based upon response to
exclusion diets. These include tryptophan, the precursor of serotonin²⁵,
phenylalanine, the precursor of norepinephrine (which stimulates platelet serotonin
release)²⁶ and histamine (which allegedly accumulates because of
a deficiency of diamine oxidase)²⁷. The notion that food chemicals
provoke migraine because of enzymatic deficiency implies an inborn error of
metabolism, yet very few children with migraine have been studied biochemically.
During two double-blind placebo-controlled trials of tyramine feeding, Forsyth
and Redmond were unable to induce migraine headache in children²⁸.
A similar study in adults also yielded negative results²⁹. It seams
unlikely that monoamines alone are the principal. food triggers for pediatric
migraine, although Russell’s concept of a specifically metabolic and X-linked
genetically determined form of hyperamnionemic migraine has not been refuted.
Indeed, the vindication of its X-linked transmission supports its analogy as
one form of classical migraine¹.

IMMUNOLOGIC EVENTS IN THE GENESIS OF MIGRAINE

Marteletti and his colleagues have found evidence of immunologic disturbance
following food challenges in patients with ostensibly food-related migraine,
specifically an increase in circulating immune complexes and activated T-cells^30,31
and a decline in circulating levels of IL-4 and IL-6 accompanied by an increase
in gamma-IFN and GM-CSF³². They have also demonstrated protection
against precipitation of migraine attacks by oral administration of sodium cromoglycate,
a stabilizer of mast cell membranes³³. Prophylactic benefits of sodium
cromoglycate in adult migraine have been demonstrated by Mansfield et al in
a double-blind placebo-controlled trial³⁴ and by Monro et al^35,36.
Paganelli found that ingestion of allergenic foods by atopic individuals produces
an increase in circulating immune complexes containing food protein, which can
be attenuated by pretreatment with cromolyn sodium³⁷. Doering has
proposed that failure of migraineurs to clear food-containing circulating immune
complexes may precipitate an immunologically mediated headache and that susceptibility
to immunecomplex phenomena cannot be detected by prick tests or IgE measurements³⁸.

Egger has attempted to weld together immunologic and pharmacologic mechanisms
in migraine with his proposal that food allergic reactions cause an increase
in small intestinal mucosal permeability which allows excessive absorption of
vasoactive substances from the gut, derived either from food or from the endogenous
flora³⁹. His theory receives indirect support from the work of Andre
and of Dupont in Paris. Each has demonstrated that ingestion of food allergens
by atopic children causes an increase in para-cellular permeability of the small
intestine to biochemical substances such as the disaccharide lactulose, which
are ordinarily not absorbed from the intestinal tract. Dupont found a weak correlation
between prick test results and increased permeability in response to food challenge,
but a strong clinical correlation between provocation of allergic symptoms and
an increase in permeability on challenge^40,41. Andre was able to
show that pre-treatment with cromolyn attenuated the permeability increase⁴²
and concluded that the increase in permeability in response to food is more
sensitive and specific than prick tests or RAST and by itself constitutes an
accurate diagnostic test of food allergy⁴³. If food-induced eczema
is considered a model for immunologic food allergy, then the inconsistent relationship
between prick test or RAST results and clinical response to food challenge is
found in atopic eczema as well as migraine and does not constitute evidence
against an immunologic basis for migraine. In contrast the protective effect
of sodium cromoglycate in both conditions suggests a pathogenetic role for gut
mast cells.

OLIGOANTIGENIC DIETS FOR MIGRAINE

In 1970, McEwen and Constantinopoulos published the results of a prospective
trial of diet in so-called “intrinsic” asthma⁴⁴. Three years later,
Professor Soothill of the Hospital for Sick Children, Great Ormond Street, London,
began investigating the role of non-atopic dietary hypersensitivity in a number
of common diseases of childhood, including migraine. Soothill accepted six principles
for dietary trials of nonatopic food sensitivity which had been set down by
McEwen. These are:

(1) The essential baseline for further investigation is a symptom-free patient
on a formal diagnostic diet.

(2) Because food intolerances are often multiple, the diagnostic diet must
be limited to a small number of foods which are unlikely to provoke intolerance
(oligoantigenic).

(3) Because non-atopic sensitivity often provokes prolonged and fluctuating
symptoms, the diagnostic diet must be administered for sufficient time to allow
remission to occur and b_~ clearly recognized, usually two to three weeks.

(4) Because the symptoms of food intolerance are often delayed, testing by
dietary reintroduction of foods which have been avoided must be restricted to
one new food per week, which is eaten daily during the challenge period.

(5) As the dose-response curve of food intolerance is bell-shaped, challenge
with Virget foods should be done using normal quantities, not excessive quantities.

The death of a spouse or a child causes a profound drop in immune function which may explain why the death rate among men soars by almost fifty per cent during the six-month period after losing a wife. Research done at Harvard and at Ohio State University found that college examinations cause a measurable decline in immune function which may last for several weeks.

Although you may not be able to control all the stressors in your life, there are many steps you can take to build your immune resistance in the face of stress. Clear thinking, supportive social relationships, moderate exercise, adequate sleep, and immune-boosting nutrients can keep you from becoming a victim of stress. Let’s examine these in more detail:

Clear Thinking

The emotional impact of a stressful event is determined by the way you think about it. We humans have a tendency to “catastrophize” relatively small setbacks, giving them more weight than they deserve. “Cognitive restructuring” is the name given to a psychological strategy that allows us to re-evaluate our stressors and gain perspective. Cognitive restructuring forms the psychological basis for all the great religions and is central to the philosophy of Buddhism. Non-religious methods have been developed and popularized by psychologist Albert Ellis (Rational Emotive Therapy) and psychiatrist Aaron Beck (Cognitive Behavior Therapy).

Social Ties

Isolation kills people, increasing the death rate from infection, heart disease and cancer. Involvement with others builds immunity. A California research team studied people suffering from melanoma, a highly malignant form of skin cancer. They found that involvement in a cancer support group improved survival and increased the activity of a group of white blood cells called natural killer cells, which are an important component of the body’s defense against cancer. Harvard researchers found that students could improve immune function simply by watching a video about Mother Theresa’s compassionate work among the poor of Calcutta.

Rest and Exercise

Exercise of modest intensity, like brisk walking thirty minutes a day, improves immune function and mood, prevents migraines, lowers blood pressure and decreases the disability that affects inactive people as they age. Both your level of activity and your general level of fitness are important. The federal government’s Centers for Disease Control and Prevention estimates that a quarter million deaths per year in the United States can be prevented by regular physical activity at this level of intensity.

Your sleep is an active time during which your body restores itself. Sleep deprivation of experimental animals increases susceptibility to viral and bacterial infection, and, in humans, insomnia reduces natural killer cell activity. Healthy young men awakened from sleep between three and seven A.M. show a thirty per cent dip in natural killer activity the next morning.

The natural sleep requirement of adults varies from as little as six to as much as ten hours per day, with most people needing seven to nine hours, preferably without interruption. Daytime relaxation also has important health benefits. A period of quiet meditation each day may lower blood pressure, relieve anxiety, improve nighttime sleep, and decrease the discomfort of chronic headache and other painful conditions.

Nutrition and Herbs

The leading cause of immune deficiency, worldwide and within the United States, is poor nutrition. Study after study has found that vitamin and mineral supplements improve immune function among the elderly and among children with recurrent infections.

The specific nutrients with the most profound effects are the omega-three essential fatty acids (EFAs) which are found in flax seed and in fish, zinc, vitamin A, vitamin B6, folic acid, vitamin C, vitamin E, zinc, selenium and iron.

Restricting unhealthy dietary fat is also important for building resistance. The activity of natural killer cells is enhanced by low fat diets and diminished by high fat diets.

If you are highly stressed and prone to developing repeated infections, immune stimulating herbs may be a helpful addition to a nutritious diet. These include:

• Echinacea species – a native American herb
• Astragalus root – a component of traditional Chinese medicines
• Shiitake and reishi mushrooms – which are used in contemporary Chinese medicine as Fu Zheng remedies, which means they “support the normal”, stimulating health, rather than being used as medication to treat sickness.

A dose which stimulates immune responses is 900 mg per day of each. For people with severe allergies, it is advisable to use reishi alone, as reishi may inhibit allergic reactivity and shiitake may increase it.

This column will be devoted to information that enables you to
learn how to heal yourself, preventing or reversing chronic illness
with the techniques of Integrated Medicine. Some of the information
will be adapted from my new book, THE FOUR PILLARS OF HEALING,
published by Random House in June, 1997. Some of the information will
come from an analysis of recent developments in medical research. And
some of it will come as a response to your questions.

Conventional Medicine

Conventional Western medicine is organized around the Theory of
Diseases, which believes that a person becomes sick because he or she
contracts a disease. In this model, each disease is seen as an
independent entity which can be fully understood without regard to the
person it afflicts or the environment in which it occurs. Conventional
treatments are treatments of diseases, not of people. Most of the
drugs employed in conventional medicine are designed to act as
chemical strait jackets, preventing the cells of the body from
performing some function that has become hyperactive. The side effects
of these drugs are a direct extension of their actions and may be
fatal. A Harvard research team concluded that 180,000 Americans are
killed in hospitals by their doctors every year. Most of these deaths
occur because doctors prescribe drugs without paying attention to the
special characteristics of the person for whom the drugs are
prescribed.

Alternative Medical Systems, Ancient and Modern

Alternative systems of healing supply a perspective that can help to
reverse the “one size fits all” philosophy of conventional medical
practice. All alternative systems of healing, ancient or modern, share
one common characteristic which separates them from conventional
Western medicine. They all approach sickness as a dynamic event in the
life of an individual, a problem of balance and relationship, the
result of disharmony between the sick person and his or her
environment. This approach to understanding illness is called
biographical. In the biographical concept of illness, the “disease”
itself has no independent reality. The healer’s job is not to identify
and treat the disease entity, but to characterize the disharmony of
each particular case, so that they can be corrected. These
disharmonies are described differently in different cultures. The
language which describes them may be magical or naturalistic, but the
diagnostic and therapeutic focus is always on the person who is ill
and the context in which the illness occurs, rather than on the
disease itself.

Integrated Medicine perceives illness biographically and at the same
time uses the powerful database of modern biological and behavioral
science to help describe the varied disharmonies which undermine the
health of each individual. These disturbances originate, almost
entirely, with dietary, environmental or social conditions. Although
the media are full of stories about “cancer genes”, for example, the
scientific evidence is that greater than 90% of cancers are
environmentally induced. When identical twins are reared in separate
environments, the rate at which each twin develops cancer is
comparable to the cancer rate in the adoptive family, not the
biological family. The publicity accorded to “cancer genes” serves to
cripple individual initiatives at cancer prevention and to displace
scrutiny from cancer’s environmental and dietary triggers. Integrated
Medicine exists to empower you to improve your health by improving
your four pillars of healing: interpersonal relationships, diaita,
environment, and your innate system of detoxification and repair.

1. Leape LL. Error in medicine. Journal of the American medical Association. 1994; vol 272: pp 1851-1857.

The most reliable way to supplement your diet with Lactobacilli is to make your own yogurt or sauerkraut, or to buy nutritional supplements which have been tested by an independent outside laboratory and which list the concentration of viable bacteria found on culture. Lactobacilli are killed by heat, moisture and sunlight. The making of tablets generates heat which lowers the number of viable organisms. Lactobacilli should be freeze-dried, in powder or capsules, in opaque moisture-proof containers, stored in the refrigerator. They should be consumed with meals. The strains which have been most extensively tested for their viability in the human intestine are L.acidophilus strain NCFM-2 and L.plantarum. L. acidophilus is well-suited to growing in the small intestine, where it is normally one of the dominant bacterial species. L. plantarum has growth characteristics which lead it to grow especially well in the large intestine. The daily dose should be between one billion and ten billion viable bacteria. More may cause gastrointestinal irritation.

Lactobacilli not only colonize the intestinal tract but grow well in the vagina and the urethra, where they prevent growth of pathogenic bacteria. The application of vaginal spermicides like nonoxynol-9, found in many contraceptive creams, may kill Lactobacilli and give pathogens more ready access to the urinary tract. Taking Lactobacilli by mouth or inserting Lactobacillus capsules into the vagina, may restore genital tract symbiosis and prevent infection.

Bifidobacteria

The beneficial bacteria which normally predominate in the large intestine are called Bifidobacteria. Declining levels of Bifidobacteria in the elderly allow accumulation of toxin-producing Clostridium species, which have been implicated in the development of cancer in the large bowel. Taking Bifidobacteria in a dose of three billion organisms per day, lowers the level of Clostridia in the bowel and also reduces the concentration of chemicals which are thought to promote cancer.

The growth of Bifidobacteria in the large bowel is strongly affected by diet. Bifidobacteria thrive on vegetable fiber and on the complex sugars that occur in certain vegetables. These complex sugars, known as fructooligosaccharides (FOS), are especially concentrated in garlic, onion, artichoke, asparagus and chicory root. A synthetic form of FOS is available as a food supplement in the United States. Extensive research conducted in Japan, the U.S. and Europe demonstrates that supplementing the diet with FOS encourages the growth of Bifidobacteria and discourages the growth of most undesirable bacterial species in the intestine. One teaspoon a day of FOS lowers the concentration of toxic bacterial enzymes in the large intestine. These enzymes, called beta-glucuronidase and glycholate hydrolase, are able to convert normal constituents of the stool, derived either from food or from bile, into carcinogens (chemicals which cause cancer). Regular consumption of foods rich in FOS may decrease the risk of colon cancer. A complete guide to maintaining a healthy intestinal milieu and avoiding the problems associated with its disruption are the foci for Chapter Eight, “Poisons from Within.”

Yeast against Yeast

“Nutritional yeast” has been used as a dietary supplement for generations, as a source of vitamins and minerals and for treatment of digestive complaints. After treating hundreds of yeast-allergic patients, I was very reluctant to prescribe yeast for anyone, until I discovered a preparation which the French call “Yeast Against Yeast”. The yeasts which invade human tissues, causing yeast infection, are mostly members of the genus Candida. The yeast used in baking bread or brewing beer belong to the genus Saccharomyces. Yeast Against Yeast is Saccharomyces boulardii, a microbe which inhabits the surface of many different plants and which was first isolated from lichee nuts in Southeast Asia by French scientists during the 1920’s. Saccharomyces boulardii has been used in Europe for decades to treat acute diarrhea and controlled trials have shown it effective in preventing or treating diarrhea brought on by antibiotics. S. boulardii appears to exert its beneficial affects by inactivating bacterial toxins and by stimulating intestinal immune responses. S. boulardii has been available in natural food stores in the United States since 1991. People who are allergic to baker’s yeast may also be allergic to S. boulardii, but for most people, including women with chronic Candida infection, Yeast Against Yeast lives up to its name.

]]> 6227 https://healthy.net/2000/12/06/five-steps-to-a-happier-and-healthier-holiday-season/?utm_source=rss&utm_medium=rss&utm_campaign=five-steps-to-a-happier-and-healthier-holiday-season Wed, 06 Dec 2000 13:28:52 +0000 https://healthy.net/2000/12/06/five-steps-to-a-happier-and-healthier-holiday-season/
Step One: Tame the Munch Monster
The holidays are coming! You know what that means: family gatherings, office parties, the sharing of gifts, joyful celebrations…and the most stressful time of the year. Shopping, feasting and visiting take their toll and the days between late October and early January can line up before us like the hurdles of an obstacle course. To make the last holiday season of this millenium your healthiest yet, prepare for Y2K and make your New Year’s resolutions now. Implement them now. Remember how you felt on January 2 of ’99? It doesn’t have to happen again. You don’t have to enter the Third Millenium worn out and over-stuffed. You can come through the next ten weeks feeling invigorated, in control and looking forward to the year ahead. The key ingredient is planning. Don’t let the holiday spirit catch you off-guard. Know your enemy and set your goals. It doesn’t take an iron will. It takes understanding.

What you eat has a major impact on how you feel, especially at this time of year, because food is such a major part of the holidays. It’s not usually the meals that do you in. It’s the snacks, sweets, appetizers, eggnogs and other alcoholic beverages. The U.S.A. is without a doubt the land of the Munch Monster. One-third of the food consumed in this country is nutrient-poor junk food, mostly eaten as snacks. The math is pretty simple. If one-third of your calories come from foods that are devoid of nutrients, either you’re going to become malnourished or you’re going to gain a lot of weigh, or both..

Taming the Munch Monster calls for some steps that may surprise you:

(1) Don’t go hungry–if you’re eating out, going shopping or going to a party. Hunger is a slippery slope on which it’s really hard to balance. The scene is pretty familiar: you’re famished and you’re waiting for a meal at a restaurant or a friend’s home or shopping for gifts or food. What happens? You eat a basket of rolls, gobble up the hors d’ouvres, grab whatever fast food is handy or buy more food at the market than you really need. Plan your day so you eat before you shop and stow a healthy snack in your bag. When eating out, have a light and healthy snack before you leave home.

(2) Stock your shelves with nutritious food. Deprivation does not work.. The key to healthy eating is an ample and ready supply of the right foods. The right foods supply working calories, calories that bring along with them vitamins, minerals, protein and nutrients like essential fatty acids (EFAs), carotenoids and bioflavinoids, which have gotten so much attention in the nutrition research literature lately. Don’t buy foods made with white flour, added sugars (this includes corn syrup), or added fats (especially bad are the hydrogenated vegetable oils-they increase the risk of heart attacks more than butter does). Beware of gourmet muffins no matter how “healthy” they look; they’re usually loaded with extra fat. Healthy convenience foods include seasonal fruits like apples and pears, vegetables like carrots or radishes or broccoli florets, a handful of almonds or walnuts or sunflower seeds, some plain low-fat yogurt with fruit or apple sauce mixed in for flavor, or stuffed grape leaves from a Greek or Middle Eastern deli.

(3) Keep water or seltzer handy at all times, especially when you’re shopping. It prevents dehydration, a problem made worse by coffee or tea. Drinking water before a meal won’t decrease what you eat, but a drink can stave off the munchies if they grab you at the wrong moment. A dash of fruit juice turns plain seltzer into a refreshing spritzer.

(4) If there’s one rule about eating that you never violate, make it: eat consciously. Don’t eat standing up-except at parties where there’s no choice. Don’t eat in your car, on the run, while reading, watching TV, talking on the phone or checking your e-mail. (It’s OK to eat while engaged in conversation.) Respect your food. Chew it slowly, savoring its flavor, texture and aroma. You’ll enjoy it more-and, astonishingly, you’ll wind up eating less.

Step Two: Find the Diet Style that Works for You!

Holidays are feast days and food is as much a part of the season’s celebrations as gifts and gatherings. You want to stay healthy through it all and enter the next millenium with lots of energy and few regrets. Finding a good diet to guide your palate into the next century seems sensible. It can also be confusing. Our government has established standards for healthy eating. Although they’re easy to follow, most of us fall short of them. The architects of the Federal diet built a food pyramid with starchy foods like bread, pasta and rice as the base, dairy products, fruits and vegetables, meat, fish and poultry in the middle, and foods that are mostly made from sugar or fat at the top, where they supply no more than ten per cent of our daily calories. These guidelines have the enthusiastic support of almost all university-based experts in nutrition.

During the past three years, half a dozen books have become huge bestsellers by telling us that the government got it wrong. We need more protein and less starch than we’re eating-or than the government wants us to eat. They also claim that fat in the diet is not so bad and may even be good for us. About ten million people have bought these books and many of them will swear that they lost weight without a struggle and, in addition, increased their mental and physical energy. Before the explosion of high protein, low carbohydrate diets, there were two other schools of thought that challenged the official standards. The first is associated with Nathan Pritikin and Dean Ornish. They advocated very low fat, vegetarian diets. Ornish demonstrated improved blood flow to the heart in people following his program and is now setting out to prove that his diet can prevent prostate cancer. In between high protein and high carbohydrate lies “the zone,” a carefully calculated balancing act based upon the magic formula, 40-30-30, which stands for 40% carbohydrate, 30 % protein and 30% fat. Despite its claims of uniqueness, 40-30-30 in practice creates a fairly ordinary formula for weight loss, but it does supply more protein and less starch than the official standards call for.

So, what’s right for you? The official standards, high protein/low carbohydrate, high carbohydrate/very low fat, or 40-30-30? The first thing to understand about all of these diets is: they all want us to eat less sugar. This is so important, because the amount of sugar eaten in this country has been increasing steadily for over two decades. Sugar is a major factor in the epidemic of obesity that is sweeping the US. When dietary fat was declared a bad thing back in the ’80’s, all sorts of low fat, high sugar snacks and desserts appeared on our shelves. The result is that people ate more calories, with sugar leading the way.

If you’re looking for a healthy diet plan, start by eliminating foods that contain added sugar, whether it’s white or brown. Sugar hides in foods under names like “corn sweetener,” “dextrose” and “fructose”(actually any ingredient ending in “-ose” is likely to be a type of sugar).

Fruit juice and honey contain sugar, of course, but unlike other sources of sugar, they also contain beneficial nutrients called carotenoids and bioflavinoids that appear to decrease your risk of heart attacks, cancer and stroke. If you need extra sweetness, get it from foods sweetened with pure fruit juice or juice concentrate, or use a small amount of honey. On average, we Americans consume about thirty teaspoons of sugar a day, which provides six hundred calories. We can do a whole lot better. The next step in healthy eating is to eliminate foods that contain “hydrogenated (or partially hydrogenated) vegetable oils.” These manufactured fats are now known to be the most dangerous fats that we eat, increasing the risk of heart disease and breast cancer far more than eating meat. You’ll be surprised at how many packaged foods contain these. If you concentrate on eating foods that do not contain these two ingredients, you will have taken a giant step toward improving your diet and your health. Then you can ask yourself, should I eat more meat or less meat, drink cow’s milk or soy milk or no milk, raise or lower my carbohydrates?

I have spent the last twenty years helping my patients answer questions like that. Experience has taught me that no single diet plan is right for everyone. You might consider a high protein, low carbohydrate diet if your answer to any of the following statements is “yes”: (1) I have to eat frequently or I feel weak or shaky. (2) I often feel bloated or swollen. (3) I need a big breakfast to get me through the morning. (4) I feel strong and alert after eating a steak. (5) I just can’t lose weight, no matter how little I eat. Because these diets have been demonstrated to increase the loss of calcium from the body (increasing the risk of osteoporosis) and to put stress on the kidneys and the liver, you should discuss this type of diet with your doctor before starting it. High protein diets may be dangerous for people with kidney or liver disease. There is no evidence that a high protein, low carbohydrate diet either increases or decreases the risk of developing heart disease or cancer.

You might consider adopting a very low fat, vegetarian diet if you are attracted to it for philosophical reasons, if heart disease or colon cancer seems to run in your family, or if you answer “yes” to any of the following statements: (1) After eating a steak I feel sluggish or bloated. (2) I am usually constipated. (3) A piece of fruit can give me energy for hours.

If your daily diet shuns foods made with sugar and hydrogenated oils, and if you identify a special need for more (or less) protein and fat, you’ll sail through the holidays.

Step Three: Use Nutritional Supplements to Help You Stay Healthy This Winter
The 1990’s brought us three major advances in nutritional science. Understanding these advances can help you choose supplements that strengthen your immune system and support your ability to handle stress. Just remember that supplements are not substitutes. They work best when added to a healthy diet.

(1) Change Your Oil! There are bad fats and good fats. The good ones are known as essential fatty acids, or EFA’s, and they’re concentrated in certain special oils. Our bodies can’t make EFA’s but we need them for our cells to function properly. EFA’s are divided into two families called Omega-6 and Omega-3, because of subtle but important differences in their chemical structure. We need both families in our diets because we lack the ability to covert one type into the other. The past century has witnessed a significant decline in our consumption of Omega-3’s due to changes in agricultural practices, food processing and diet. Unless you eat fatty fish like sardines, herring or salmon twice a week or mix ground up flax seeds into your breakfast cereal every day, it can be hard to get from food the same level of Omega-3’s your great grandparents were eating. Although they knew nothing of EFA’s, your great grandparents knew enough to increase the family’s Omega 3’s in winter by passing around a bottle of cod liver oil. Recent scientific research has proved the value of Omega 3’s. Flax seed oil (which is sold in health food stores) decreases the frequency, severity and duration of respiratory infections in children and fish oil extracts have been shown to relieve menstrual cramps and arthritis pain and to help people suffering from conditions as varied as psoriasis, asthma and colitis. Fish oils may also improve concentration and memory, lower levels of triglycerides in the blood, reduce blood pressure and help people who have undergone coronary by-pass surgery prevent future heart attacks.

I have recommended Omega-3 supplements to my patients for over twenty years, especially during the winter months. Not only do they support a healthy immune system, they often help symptoms like dry or rough skin, dry hair and soft or brittle nails. The usual preventive dose is one-half teaspoon to one full tablespoon of flax seed oil per day, depending upon age. This equals two to ten capsules. Among fish oil extracts, the key ingredients are a pair of Omega-3’s called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The best preventive dose supplies about 500 milligrams of EPA and 300 milligrams of DHA per day (usually about 3000 milligrams of total fish oil extract). I don’t often recommend cod liver oil, because it may contain more vitamin A than is needed and vitamin A can be toxic. People taking prescription medications should consult their physicians before starting an Omega-3 supplement. Always let your doctor know if you’re taking nutritional supplements of any kind.

When you go shopping for Omega-3 supplements at the natural food market, you may encounter oils that supply a special ingredient called GLA (gamma-linolenic acid). GLA is a powerful Omega-6 EFA that is found in evening primrose, borage or black currant seed oils. It has been shown to help women with pre-menstrual breast pain or with menopausal symptoms. GLA sometimes helps children with eczema or attention deficit disorder. If taking an Omega-3 supplement has a paradoxical effect–if it makes your skin drier or your menstrual cramps worse–you will probably benefit from a supplement of GLA. The usual adult dose is about 275 milligrams per day, which is found in 3000 milligrams or evening primrose oil, 2000 milligrams of black currant seed oil, or 1500 mg of borage oil. Children may only need half as much.

Oils rich in EFA’s are highly perishable, especially when exposed to heat or air. To ensure freshness, store in the refrigerator after opening and discard the bottle six weeks later. Once they’re in your body, EFA’s are protected from damage by vitamin E and a group of related nutrients called anti-oxidants. Anti-oxidant research is the second major nutritional story of the ’90’s and will be discussed in Part 4 of this series.

(2) Join the Anti-Oxidant Revolution. The benefits of anti-oxidants for health have received a large amount of attention from scientists over the past ten years. Vitamin E has been shown to improve immune function in elderly Americans, and a broader group of anti-oxidants which include not only Vitamin E but Vitamin C, carotenoids, bioflavinoids and the mineral selenium have been shown to help prevent heart disease and cancer and to relieve symptoms associated with asthma and allergies.

The importance of anti-oxidants derives from our dependence on oxygen. We need oxygen to burn food as a fuel that produces energy and to burn away environmental toxins that enter our bodies. This process is called oxidation. It’s essential for human life, but like any fire it produces sparks that can fly off and start fires where they are not wanted. In your body, these sparks are called free radicals and they can damage the membranes and proteins of your cells. Free radical damage to the DNA in your genes can cause cancer. To quench these sparks, your body employs a fire department which is known as the anti-oxidant defense system. Its success depends upon teamwork. No component of this system is very effective by itself. Some anti-oxidants destroy free radicals by sacrificing themselves. They are oxidized in the process and must be repaired or restored. This is how vitamins E and C work and it is also the fate of carotenoids and bioflavinoids. You can usually recognize carotenoids and bioflavinoids in food by their rainbow of colors, which range in hue from pale yellow to deep purple. The appetizing appearance of ripe fruits and vegetables derives from the carotenoids and bioflavinoids they contain. It’s no surprise that tomatoes, blueberries, cherries and green tea have recently been touted as wonder foods for disease prevention. They’re all rich sources of these anti-oxidants.

Other anti-oxidants protect our bodies against free radicals by activating enzymes, which are proteins that catalyze (speed up) chemical reactions. Most of the B vitamins, including folic acid, activate enzymes that directly or indirectly help to repair free-radical damage. So do minerals like selenium and zinc.

For most of my adult patients, I prescribe a multivitamin and mineral supplement that supplies 400 units of Vitamin E, 800 micrograms of folic acid and 200 micrograms of selenium every day. This level of supplementation has been demonstrated to boost immune function and to help prevent cancer and heart disease. Children need one quarter to one half the adult doses. The amount and variety of carotenoids and bioflavinoids you need cannot be obtained from pills. Get these from eating six or more servings of colorful fruits and vegetables a day.

(3) Raise Your Magnesium Quotient. We’ve known for decades that calcium is needed for strong bones, that vitamin D is needed to absorb calcium from food and that the main natural source of vitamin D is the effect of sunlight on the skin. Recent research has shown that many adults living in the northeastern U.S. become deficient in vitamin D during the winter. If your multivitamin contains 400 micrograms of vitamin D, you will help yourself prevent this problem. Recent research has told us that magnesium is also important for healthy bones and the effect of calcium in the body is regulated in many ways by the level of magnesium.

Most Americans consume far less than the Recommended Daily Allowance (RDA) of magnesium. Emotional and physical stress, cold weather and alcohol can increase the amount you need well beyond the RDA. Many of the patients I treat are handicapped by a magnesium deficit, which can be corrected by increasing dietary magnesium and by supplementing their healthy diets with additional magnesium. The highest magnesium content occurs in beans, oats, nuts, buckwheat, and seafood, so it’s easy to understand why Americans may fall short of the RDA. Common symptoms of this shortfall include irritability, fatigue, muscle spasms, headaches (including migraines), palpitations, sensitivity to noise and trouble sleeping. If you have these symptoms, raising your magnesium quotient may really enhance your quality of life. Several types of magnesium supplements are sold in pharmacies and natural food stores. The usual daily dose for supplementation is two milligrams for each pound you weigh. Taken at bedtime, it may help sleep. Too much magnesium can cause diarrhea. If you’re over the age of 70, have kidney problems or take prescription medication, check with your doctor before taking a magnesium supplement.

The availability of nutritional supplements can be a real boon to your health and well being over the holiday season. Use this information to use them wisely.

Step Four: Prepare Healthy Party Foods
Long nights and short days seem to be perfect for parties. They don’t have to derail your plans to make this the healthiest holiday season ever. All the food you serve, including delicious party food, can be healthy, if you understand the answer to the following question: What creates appetizing snacks, desserts or hors d’oevres? It’s not the calories. It’s rich color; a distinctive texture–either crunchy or creamy–and a taste that quickens the senses by being sweet, salty or spicy. There’s a cornucopia of nutritious foods that together create a dazzling buffet that feasts the eyes and the palate. The beauty of these foods is that they don’t require added sugar, butter, or cream to please. Some require a bit of preparation, others don’t. Some may need salt, but you can usually decrease the need for salt by using spices. These natural treats add nourishment to your parties and actually supplement the nutrients you receive from the food you eat every day. They are powerhouses of vitamins, minerals and phytochemicals like carotenoids and bioflavinoids, those anti-oxidants found in plants that make vegetables and fruits the healthiest foods you can add to your diet.

A tour through this gourmet garden of Eden might include shrimp with salsa; smoked salmon or pickled herring with seven-grain toast topped with fresh dill; a white bean salad with navy or Tuscan beans, chopped escarole or spinach, red onion, chopped walnuts, and a light dressing of tarragon vinegar and walnut oil; or a pasta salad with olive oil, chopped tomatoes and basil. Flavor these with spices like parsley, sage, rosemary, thyme and garlic. Spreads made from tofu, beans or chick peas without added fat are now available through gourmet and natural food stores. If their taste is bland, add a touch of curry, cayenne, garlic or soy sauce. Serve these with crudites, baked tortilla chips or triangles of fresh pita bread. Attractive little bowls of almonds, walnuts, and pumpkin seeds adorn your table and, whether roasted or raw, add minerals like zinc and magnesium to your feast. Raisins and dates add sweetness. Most commercial trail mixes or dried fruit mixtures are loaded with added sugar, so it’s better to create your own.

For a healthy dessert, make ambrosia, the food of the gods, by tossing orange sections, shredded coconut, chopped walnuts, sliced almonds, and seasame seeds in a dressing of pineapple juice and orange juice concentrate. The aroma of apples sprinkled with cinnamon and honey baking in your oven will also delight your guests. If you want to devote more time to preparing dessert, there are many books with all natural recipes for spice cakes, fruit breads, pies and cookies, which use fruit juice for sweetness. I tested many of these for my first book, “Superimmunity for Kids” (Dell, 1989, still in print). Big hits in our home were a tofu custard pudding and oatmeal spice cookies.

If you’re entertaining kids, you can also try air-popped popcorn sprinkled with parmesan cheese, carrot sticks with peanut or almond butter, frozen banana pops, homemade fruit juice ice pops, or granola chews made with rolled oats, nut butter, raisins, and apple juice concentrate.

Healthy beverages can complement your healthy buffet. Warm apple cider brewed with cinnamon sticks is a cold-weather favorite. Have lots of sparkling mineral water on hand for those friends who want a low-calorie, no-fault libation. A dash of wine, red or white, a splash of fruit juice, or a slice of lime make a refreshing spritzer. Alcohol and automobiles are a dangerous combination. Every responsible adult must openly confront the choice of drinking or driving. You don’t dampen the holiday spirit when you serve alternatives to alcohol or pay attention to what your guests are drinking. You nurture that spirit by showing your concern for the health and well-being of your friends and the strangers they’ll pass on the road.

Step Five: “The Y2K Detox Plan”
Life is full of pitfalls and you may experience days when you regret the excesses of the day before. These are Detox Days. A brisk walk, a gentle massage, a hot bath or sauna can all aid in recovery, but the most important think to remember about detoxification is that Detox is not something you do, like starting an exercise program. It’s something your body does, spontaneously and continuously, 24-7. Detoxification occurs in every cell of the body, but is most concentrated in the liver, intestines, kidneys and lungs. In these organs, enzymes-proteins that catalyze chemical reactions-destroy or excrete thousands of toxic substances, whether they are absorbed from food, water or air or produced within the body.

The main support for Detox is a nutritious diet. Red, yellow and green vegetables, uncooked nuts and seeds, whole grains, and spices supply the nutrients that are most important for efficient detoxification. Because fiber is also important, I don’t recommend fasting or juicing. Eat for Detox. Have a hearty vegetable soup or stew that includes at least half of the following: chunks of sweet potato or winter squash, tomatoes, carrots, asparagus tips, collards or dandelion greens, spinach or Swiss chard, and sea vegetables like dulse, hijiki, kelp, nori or wakame,. Make sure you include some members of the cabbage family (which includes not only cabbage but broccoli, cauliflower, bok choy, Brussel sprouts, green onions and kale). Not only are these nutritional powerhouses, they stimulate the liver to make more enzymes for safe detoxification. People who eat from the cabbage family several times a week have a lower incidence of cancer, in large part because of the improved detoxification these vegetables support. Season this dish with ginger, garlic, turmeric, parsley or purple onions, spices that are rich in anti-oxidants and minerals. I enjoy a bowl of Detox soup every day during the winter.

The best nutritional supplement to aid in detoxification is a “pro-biotic”, a supplement of acidophilus or other beneficial bacteria for helping intestinal function. As a nation, we are deficient in beneficial intestinal bacteria. This results from our generally low fiber diets and our excessive exposure to antibiotics, either as medications or as contaminants in meat and poultry, which are routinely given antibiotics to promote growth. Most pro-biotic supplements contain species of Lactobacillus bacteria, either acidophilus or casei, (normally found in cultured milk), or plantarum (this plant-based bacterial species is what makes sauerkraut sour). Commercial yogurt and fermented foods may have no living bacteria by the time they reach your table. If you don’t want to make fresh yogurt or sauerkraut, take a supplement that supplies about ten billion living organisms a day, either as a powder or capsule. The heat generated in the manufacture of tablets may kill the bacteria, so these are unreliable.

Your body will detoxify well if you feed it properly. Unfortunately, there are many actions that people take to relieve symptoms that actually interfere with detoxification. Acid-lowering drugs are being aggressively marketed for the treatment of heartburn, a common holiday complaint. Heartburn, however, is not caused by an excess of acid. It results from a normal amount of acid getting into the wrong place. People who are prone to heartburn have a weakness of the valve that separates the stomach from the esophagus (the LES valve). Fatty foods, coffee, alcohol, chocolate or lying down after a large meal can stress or weaken the LES, allowing stomach acid to enter the sensitive esophagus. The key to treatment and prevention is not to turn off stomach acid, but to support the LES by eating sensibly and-if necessary-taking a chewable calcium pill after eating and before bedtime. Calcium naturally stimulates the LES to function properly. Acid-lowering drugs, on the other hand, deprive the gastrointestinal tract of stomach acid, its first defense against infection. Two of these drugs, Tagamet and Zantac, actually block enzymes in the liver which are required for detoxification.

Pain relievers are another class of drugs commonly used for relieving holiday symptoms. When you take acetaminophen (found in Tylenol and other products), your liver uses a precious anti-oxidant called glutathione to remove the drug from your body. The more acetaminophen you take, the more glutathione is lost. Because alcohol and eating poorly also deplete the liver of glutathione, additive effects can occur and have occasionally produced serious consequences.

Aspirin and ibuprofen (Advil, Motrin, Alleve) are often used for the relief of pain and/or inflammation. Their most common side effect is damage to the lining of the stomach and intestines. They may also interfere with proper kidney function. Aspirin kills about a thousand people a year in the United States, mostly because of internal bleeding. A study conducted at Boston University found that the use of only one adult-strength aspirin a day triples your risk of being hospitalized for serious internal hemorrhage. Although occasional use of pain relievers is not likely to be a problem, their frequent use signifies the need for another strategy for feeling well, one which uncovers the reason for your pain. If seasonal stress is the reason, don’t reach for the pills. Follow the Y2K Detox Plan, along with a brisk walk and relaxing bath or massage. Maybe your body will heal itself without the drugs.

Iron is unique among essential minerals, because there is no mechanism for its excretion once absorbed into the body. Whatever iron is absorbed must either be used or stored and excessive storage of iron in the body promotes the generation of free radicals. Excess dietary iron has been implicated by some scientists as a cause of cancer and heart disease. It also increases the risk of bacterial infection.

Except for the lactic acid bacteria like Lactobacilli, all microbes require iron for growth. Many of them produce special binding proteins to secure iron from their environments. Humans also produce iron-binding proteins which have as their role the capture of free iron so that microbes can’t use it. An excess of iron overcomes this protective mechanism and in-creases susceptibility to bacterial infection. The amount of iron needed for optimal health reflects a delicate balance between deficiency and excess.

The best known effect of iron deficiency is anemia, which is the name given to a state in which the number of red blood cells is lower than normal. Anemia is not the same as iron deficiency, however. There are many different causes of anemia, which include folic acid deficiency, vitamin B12 deficiency, disorders of the bone marrow and conditions which increase the rate at which red blood cells are broken down in the spleen. Iron deficiency, when mild, may not produce anemia but may still cause fatigue, im-mune de-fects or fungal infections of skin. There are probably twenty million people in the U.S. who are iron deficient and half of them are not anemic. Wom-en with chronic fatigue and mild iron deficiency who are not anemic improve their energy after taking low doses of iron. Twenty milligrams per day is all that’s needed, no more. Low-dose iron supplements can cure people with recurrent boils on the skin, but only if those people have mild iron deficiency. Presumably, correcting iron deficiency improves metabolism and immunity.

It is unfortunate that most commercial iron pills contain sixty to three hundred milligrams of iron, far more than are needed or than can even be absorbed from a single pill. High dose iron supplements, taken orally or by injection, increase susceptibility to bacterial infec-tion. Studies in southeast Asia and in Africa demonstrate that even low-dose iron can be harmful. When Indonesian school children who are not iron deficient take iron pills, they fail to grow normally. When iron supplements are given to Somali nomads or Masai tribes-man, their rate of infection increases, even though their iron deficiency is corrected. The high frequency of negative responses to iron supplements in Africa and Asia may reflect the interaction between iron and zinc.

Iron in food or pills interferes with zinc absorption and supplemental iron can aggravate zinc deficiency. The recommended daily allowance for zinc (RDA) is based on the assumption that forty per cent of the zinc that is swallowed is absorbed into the body. Actually, zinc absorption is only seventeen to thirty-five per cent and depends upon what is eaten along with zinc. Starch and fiber interfere with zinc absorption, as do calcium and iron. Lack of stomach acid, which may be caused by infection or acid-lowering drugs, also interferes with zinc absorption. Zinc deficiency is common in Africa and Asia, where people consume large quantities of milk, which is high in calcium and low in zinc, and of starches and fibres which inter-fere with zinc absorption. Zinc deficiency profoundly depresses immunity and administering iron to a zinc-deficient person is extremely risky. Not only does iron stimulate bacterial growth, but, by aggravat-ing zinc deficiency, it weakens the immune system of the person being supplemented.

No one should ever take iron supplements unless iron deficiency is present, with the possible exception of pregnant women. The best test for iron deficiency is a blood test called the serum ferritin level. Ferritin is a protein that carries iron, and low ferritin levels are a common sign of iron deficiency. Like all laboratory tests, the interpretation of ferritin levels is subject to interpretation. Because the body has a limited capaci-ty for iron absorption, it does not make any sense to administer more than twenty milligrams of elemental iron at a time. Iron should not be taken as part of a multivitamin or multimineral preparation. Iron interferes with the absorption of the essen-tial minerals zinc, manganese and molybdenum; it destroys vitamin E; its own absorption is blocked by calcium and magnesium. Iron is best absorbed after a meal, with a small quantity of vitamin C (between one hundred and five hundred milligrams).

Following these guidelines will significantly reduce your exposure to disease provoking microbes in food and drink.

(a) Always wash your hands carefully with soap and water when returning home from outside and before handling food. Hand washing is a very effective way to remove pathogens. Regular hand washing also protects against catching colds or flu from other people.

(b) Do not drink tap water that has not been properly filtered or kept at a rolling boil for at least five minutes. Chlorination does not kill the cyst forms of parasites like Giardia or Cryptosporidium. Use water filters that are certified by the National Sanitation Foundation (NSF), an independent non profit organization, under their Standard 53 for “cyst removal”. No water filter practical for home use will remove bacteria. Have the bacterial concentration in your drinking water tested by an independent laboratory. Call the Water Quality Association at (708) 505-0160 or the American Council of Independent Laboratories at (202) 887-5872 for the name of a certified laboratory near your home.

The quality of bottled water is completely unregulated. Some bottled water comes from municipal water supplies. To discover the source of any bottled water, call the bottler and request documentation about the nature and purity of the source. Bottled water that comes from municipal water supplies or lakes should be treated by reverse osmosis before being bottled, if it is to be considered safe.

Avoid using ice unless you feel secure about the purity of the water from which it was made. Remember that automatic ice makers use unfiltered tapwater. Freezing kills most parasites but does not kill bacteria.

Use pure water for brushing your teeth and rinsing your toothbrush.

(c) Peel all fruits and vegetables, unless they are to be thoroughly cooked. Wash your hands afterwards. If you cannot peel
them, soak them for fifteen minutes in a solution made by adding one teaspoon of three per cent hydrogen peroxide to two quarts of water and then rinsing thoroughly with filtered water.

(d) When eating out, only eat food that has been cooked just before it is served to you. In many restaurants and delicatessens, soups, sauces and stews are frequently stored in large containers, often left uncovered on the floor and reheated in a microwave oven. Microwave cooking does not kill Salmonella and other strains of pathogenic bacteria. It is safest to eat food that is fairly plain and to avoid soup, unless you know how food is handled in the restaurant where you are eating.

(e) Avoid salad bars. At first glance, salad bars seem like a good place to get healthy food in a hurry. Look again. Some years ago the Wall Street Journal sent a reporter to investigate the cleanliness of salad bars in different parts of the country. Problems were rampant and they lay not only with the restaurant but with the clientele. People are unsanitary in their use of salad bars. They sometimes sample food and put it back. The handles of the serving utensils frequently fall into the food trays, providing an opportunity for contamination.

(f) Do not eat food that has been prepared by a street vendor.

(g) Avoid restaurants where there are flies. Flies can spread parasitic cysts and pathogenic bacteria.

(h) Remember that uncooked meat, fish or poultry are often contaminated with pathogenic bacteria. When preparing your own meals, always keep raw flesh foods away from other food that will be eaten raw, like salad. Cook meat, fish and poultry well and wash your hands after handling them. Also wash the utensils you use to cut them. People have become ill by handling chicken contaminated with Salmonella (as most American chicken is), and then using a contaminated knife or contaminated fingers to prepare other food that was not to be cooked. To kill Salmonella on utensils, soak them in a solution of chlorox for fifteen minutes, then make sure you rinse the chlorox thoroughly away. Do not use dishrags to wipe off kitchen counters, stoves, sinks and tables. Dishrags actually spread germs around. Use recycled paper towels to mop up the bacteria-laden juices from meat, poultry and fish and either use paper towels or sponges to wipe surfaces. Run the sponges through the dishwasher every day to thoroughly remove bacteria.

Fish is one of the most perishable foods, readily spoiled by bacteria and by natural enzymes contained in the fish’s flesh. An investigation by Consumer Reports in 1992 found that almost half the fish they tested were contaminated with fecal bacteria, a sign of improper food handling. When you buy fish, make sure they smell fresh. Cook them well, within a day of their purchase.

Tofu is increasingly popular as a substitute for meat. Tofu that is bought floating in water has high levels of bacterial contamination. Wrapped and sealed tofu is safer. To kill bacteria, tofu should be cooked to an internal temperature of one hundred and sixty degrees.

(i) Watch out for toxic molds. Mold toxins (mycotoxins) may suppress the immune system and cause cancer. Mold toxins frequently contaminate U.S. breakfast cereals, especially bulk delivered organic cereals sold in health food stores and food coops. It is best to buy cereals in vacuum packed, sealed containers. All peanuts and peanut butters are contaminated with mycotoxins called aflatoxins, which are among the most potent promoters of cancer ever studied. Aflatoxin levels are highest in the fresh ground peanut butters found in health food stores and supermarkets. In southern Georgia, heavy consumption of peanuts and grains likely to contain high levels of aflatoxins was associated with an increased rate of mental retardation among local children. Aflatoxin production is inhibited by treating food with sorbic acid, a naturally occurring antifungal, first isolated from unripe berries of mountain ash trees in 1859. Peanut butter preserved with sorbic acid is safer than “fresh” peanut butter.

Refrigerators are a haven for mold, which loves to grow on bruised fruits and vegetables. If a hard food that is uncooked becomes moldy, cut and discard the moldy part and at least one inch of the food in each direction from the site of mold. (“Hard” foods include apples, broccoli, carrots, cauliflower, hard cheese in chunks, garlic cloves, onions, pears, potatoes, squash and turnips.) If a soft food, juice or cooked leftover becomes moldy, throw it all away; do not attempt to salvage any of it. Refrigerated leftovers not consumed within forty eight hours should be discarded even if they are not visibly moldy.

The larger family, called “omega-six” EFAs, are abundant in many vegetable seed oils, including corn, sunflower and safflower. Deficiency of omega-six EFAs causes impairment of growth and fertility, hormonal disturbances and immunologic abnormalities. An excess of omega-six EFAs may promote the development of cancer. People living in North America and Europe have relatively high levels of omega-six EFAs in their diets, because of the increasing consumption of vegetable oil during the twentieth century.

The smaller family, called “omega-three” EFAs, is most concentrated in fish oils and in flax seed (linseed) oil. It is also found in green leafy vegetables and in the flesh of animals that feed on grass and leaves. The human brain is rich in omega-three EFAs; their deficiency causes abnormalities in the development and function of the nervous system as well as immune defects. Omega-three EFAs formed an important part of the diet of Stone Age humans, who relied heavily on wild game and leafy plants for nourishment. Consumption of fish, flax seed meal and soy beans supplied omega-three’s for our more recent ancestors. The past century has witnessed a systematic depletion of omega-three EFAs from the Western diet because of changes in food choice and in techniques of animal husbandry and food processing. Some theorists have traced the origins of numerous different diseases to a lifetime depletion of omega-three EFAs.

Extensive research published since 1985 has demonstrated that flax oil can prevent cancer and birth defects in animals. Fish oils, the other concentrated source of omega-three’s, have made front page news because of their ability to prevent disorders as apparently unrelated to one another as cancer, heart attacks, migraine headaches, and premature births, and to reverse the effects of conditions as different as psoriasis, ulcerative colitis, rheumatoid arthritis and cystic fibrosis.

Some indications that an EFA deficiency or imbalance are present are: dry skin; the need to use moisturizing creams and lotions; “chicken skin”, the presence of tiny rough bumps, usually on the back of the arms; dry or unruly hair; dandruff; soft, fraying or brittle nails; menstrual cramps; premenstrual breast tenderness. A person who has these symptoms will often find that they improve by supplementing an otherwise healthy diet with the appropriate oil. Discovering the appropriate oil requires a bit of personal experimentation. Most people in the United States and Europe are short on omega-three EFAs and will benefit from supplementing their meals with flax oil (one tablespoon a day). Flax oil should be stored in the dark and in the refrigerator; it should not be used for cooking.

Virtues of the GLA


Although most Americans consume more than enough of the omega-six EFAs, there is a small but significant proportion of the population (about fifteen per cent, if my patients are in any way representative), who are unable to properly metabolize omega-six EFAs and will benefit from supplementation with oils that are rich in omega-six’s. The three most useful omega-six rich oils are evening primrose oil, borage oil and black currant seed oil, all of which are sold in capsule form. These oils contain a special EFA called gamma-linolenic acid (GLA), which allows the body to overcome the most common impediment to proper utilization of omega-six EFAs. Although experimental data indicate that feeding large doses of omega-six rich oils, such as corn oil or safflower oil, can promote the growth of cancer, there is no evidence that feeding GLA in the form of primrose oil contributes to cancer. Quite the contrary, primrose oil behaves like the omega-three rich oils (flaxseed and fish) in actually preventing tumor growth in experimental animals. The usual requirement for GLA among those who need it is supplied by taking four to six capsules of evening primrose oil, two to three capsules of borage oil, or three to four capsules of black currant seed oil every day (assuming each capsule contains five hundred milligrams of oil). I generally reserve GLA supplements for people whose dryness does not respond to omega-three supplementation. Because the omega-three and omega-six EFAs compete with one another in the body, feeding fish oil to a person who needs GLA may actually increase that person’s omega-six deficit, making the skin dryer or the breasts more tender. An increase in these symptoms with omega-three supplements is almost surely a sign to switch to GLA. Lack of response is usually a reason to add GLA. Controlled studies have demonstrated therapenefits for GLA in people suffering from arthritis, eczema and premenstrual syndrome. What is important in making therapeutic decisions, however, is not the disease but the patient. EFA therapy does not treat disease, it improves cellular function.

To protect EFAs from harmful oxidation, it is essential to consume adequate levels of dietary anti-oxidants, especially vitamin E. Consumption of a nutrient-dense diet will assure a higher-than-average intake of all anti-oxidants. Depend-ing upon the specific foods chosen, however, where those foods have been grown, the efficiency of digestion and absorption, the need for EFA supplementation, and the pres-ence of inflammation within the body, supplementation of the diet with additional anti-oxidants may be necessary. For people who supplement their diets with fish oils or flax oil, a minimum anti-oxidant supple-ment should include vitamin E (four hundred units per day), selenium (one hundred micrograms per day), and vitamin C (one thousand milli-grams per day), in addition to–not instead of–a nutrient-dense diet.

TRANS FATTY ACIDS AND HYDROGENATED OILS


The dangers of trans-fatty acids in the diet have recently received scientific attention that is long overdue. To understand the toxic potential of trans-fatty acids, you have to know how they effect the body’s use of EFAs.

EFAs have a chemical structure which is polyunsaturated. Technically, this means that each molecule of an EFA has two or more double chemical bonds. The double bonding twists the mole-cule, giving it a serpentine shape. When incorporated into a cell’s membranes, the snake-like EFA molecules add fluidity and flexibility to the membrane. EFAs, unfortunately, are rather unstable when exposed to air. The double bonds break down rapid-ly, producing a toxic form of fat that can be detected in food by its rancidity. Preservatives may be added to food to prevent this breakdown from occurring, thereby increasing the shelf-life of the food. A natural preservative for fatty acids is vitamin E (alpha-tocopherol), but the most commonly used preservatives are the synthetic anti-oxidants, BHT and BHA.

A more efficient way to prolong shelf-life, however, is to hydrogenate the fatty acids, destroying the EFAs. In hydrogena-tion, the double bonds are broken by hydrogen gas and the unsatu-rated fatty acids become saturated with hydrogen. This means that all sites for chemical bonding are filled. Natually saturated fatty acids are commonly consumed in meat and dairy products. They are also manufactured in your liver and stored in your body’s fat cells. Saturated fatty acids are straight, not twist-ing, in shape, and impart stiffness and solidity to mem-branes. Human cell membranes usually have one saturated fatty acid lined up along-side one unsaturated fatty acid, producing just the right blend of stiff-ness and flexibility for responding properly to signals sent from other cells.

In present-day food processing, the hydrogenation of vegeta-ble oils is usually not complete. It is partial. Par-tially hydrogenated oils are easier to work with and produce a softer foodstuff than fully hydrogenated oils. Chemically, partial hydrogenation converts EFAs into trans-fatty acids, which are unsaturated fatty acids that twist abnormally. Trans-fatty acids do not have the serpentine shape and fluidity of naturally unsaturated fatty acids (which are called cis-fatty acids). Trans-fatty acids are stiff and straight, like saturated fatty acids, but, because they are unsaturated, they replace natural cis-fatty acids in the cell membranes. The result of trans-fatty acid consumption is stiff cell membranes, abnormal response to signals from other cells, and an increase in dietary requirements for EFAs. Partially hydrogenated vegetable oils, which are unbiquitous in manufactured foods, are loaded with these anti-nutrients.

In the first edition of Superimmunity for Kids, written ten years ago, I warned parents about the dangers of raising their children on margerine and other foods built from partially hydrogenated oils. My arguments derived from research on the chemical effects of trans-fatty acids and knowledge of how this chemistry could distort cell function. Clinical studies have vindicated the warning. High consumption of trans-fatty acids raises cholesterol levels and increases the risk of heart attack, especially among women. Dr. Walter Willett, chairman of the Department of Nutrition at Harvard University’s School of Public Health, estimates that consumption of trans-fatty acids in the United States accounts for thirty thousand premature deaths per year. Hydrogenated vegetable oils containing trans-fatty acids have no place in a healthy diet and should be avoided by everyone.

Conventional Western medicine is organized around the treatment or prevention of specific diseases, with each disease seen as a separate and independent entity. This approach no longer serves a useful purpose. Experts of the World Health Organization, meeting in the Dominican Republic in September, 1997, expressed the view that trying to deal with each of the various diseases that kill young children is futile. The factors responsible for disease must be dealth with. Most fatal illness results from a combination of poor nutrition and poor environmental hygiene. They expressed the view that reduction of childhood mortality can only be achieved by an integrated management approach, improving nutrition and environment so that many diseases are dimished or eliminated at the same time.

Experts in the problems of aging have expressed a similar view. The longer a person lives, the more diseases she develops and the more drugs she takes. Adverse reactions to prescription drugs have become the fourth leading cause of death in the United States, killing over 100,000 people a year, more people than are killed by accidents of all types. The immense number of medi-cal prob-lems associated with un-healthy aging cannot be addressed by attempts to prevent and treat the specific diseases that appear with increas-ing frequency as people age. Prevention and treatment must strengthen the resistance of the person in ways that allow a multitude of different disease entities to diminish.

This is an old wisdom, shared by all ancient systems of healing. Traditional healing systems approach sickness as a problem of balance and relation-ship, the result of dishar-mony between the sick person and his or her environ-ment. For the traditional healer, the “dis-ease” itself has no independent reality. The healer’s job is not to identify and treat the disease entity, but to characterize the disharmonies of each particular case, so that they can be cor-rected.

Integrated Medicine couples the ancient perspective that health is balance with the powerful tools of modern biological science. It embraces the best of conventional and alternative therapies, but is more than just a mixture of therapeutic techniques. It is a process of medical practice that acts to heal the person rather than just treat the disease. A person has social relationships, beliefs and feelings, memories and expectations, a sense of identity, a daily pattern of eating and drinking, exercise and rest, hygienic habits, an occupation, an environ-ment, and innate systems for detoxi-fica-tion and repair. It is these aspects of the person–the common components of his or her life–that Integrated Medicine attempts to support, applying strategies that are scientifically validated. Learning how to recog-nize, understand and respond to the impact of the common components of life on health and illness is a challenge of such magnitude for conventional medicine that it has been called a paradigm shift. Unfortunately, medical doc-tors are large-ly unprepared for this paradigm shift, frequently failing to recog-nize the psychological or social needs of pa-tients or to meet “essential core compe-tence” in clinical nutrition. It is the goal of the Foundation for Integrated Medicine to help the public and health professionals acquire the knowledge necessary to move from a disease-centered to a person-centered model of health care.

Science has demonstrated several factors that profoundly influence health, longevity and the ability to recover from illness. In educating health professionals and the public, The Foundation for Integrated Medicine will concentrate its efforts by disseminating information concerning four of these factors. They are:

(1) Strong interpersonal relation-ships, including both the network of family, friends and community involvement that is referred to as “social support” and the relationship between the person who is sick and the caregiver. Helping people to nurture the bonds of closeness with others is the first goal of Integrated Medicine. Helping health professionals improve their skillfulness in the science of caring for patients is the second. Doctors demonstrate skill in the science of caring when they listen to their patients’ concerns, elicit and acknowledge their patients’ viewpoints, meet their patients’ needs for information and encourage their patients to become active in their own care. Study after study shows that doctors who follow these principles get better results, independently of the diagnosis or the specific treatment that is given.

(2) Sound nutrition. Poor nutrition is the leading cause of immune deficiency, worldwide and within the United States. North Americans, unfortu-nately, obtain about one-third of their total calories from nutrient poor junk food. Even well-educated, presumably well-nourished adults taking nutritional supplements frequently do not consume nutritionally adequate diets and, despite their supple-ments, fall short in their con-sumption of important minerals like magnesium, iron, zinc and calcium. The vitamin E levels of U.S. children are markedly lower than those of Japanese, German, Austrian or Canadian children, suggesting that children in the U.S. may as a group suffer from Vitamin E deficiency. Healthy chil-dren with lower vitamin E levels have impaired immunity on laboratory testing. When apparently healthy adults are followed for ten years, those people who have impairment on those same laboratory tests of immune function have twice the mortality rate of those with normal immuni-ty. Study after study has found that vitamin and miner-al supplements improve the immune function of elderly Americans. The specific nutrients with the most profound effects on immune function are essential fatty acids, selenium, zinc, vitamin A, vitamin E, vitamin B6, folic acid and iron. Helping people build optimum immunity through nutrition is a third goal of Integrated Medicine.

(3) A hygienic environment. Numerous studies conducted in U.S. cities demonstrate a close correlation between daily death rates and exposure to small particles of dust, even at levels of pollution that are considered safe by the World Health Organization. Community-wide pollution has been well established as a cause of respiratory ailments, but its effects extend beyond the respiratory tract. The rate of cancer among suburban women increases with outdoor exposure to airborne dust parti-cles. In the industrialized nations of the world, people spend ninety per cent of their time indoors and the greatest airborne health risks may be posed by indoor air pollutants. The rising incidence of childhood cancer in industrialized countries is probably related to environmental toxins encountered in the home. A child born in the U.S. today faces a risk of 1 in 600 of developing cancer before the age of 10. The Environmental Protection Agency has proposed a new direction, “moving beyond the chemical-by-chemical approaches of the past, and instead looking at a child’s total cumulative risk from all exposures to toxic chemicals.”(New York Times, September 29, 1997, page 1.) Children are routinely exposed to low levels of toxins from many different, unrelated sources. A goal of Integrated medicine is the education of the public and of health professionals in the dangers of environmental toxicity and the steps that can be taken to decrease the overall toxic burden of children and adults.

(4) Intestinal health. “Toxicity” is a concept readily grasped by all ancient healing systems, but often ignored by conventional medicine. The idea that the intestines constitute a source of endogenous toxins is as old as the practice of medicine. The human intestinal tract is thirty feet long, contains over a hundred billion bacteria and has the surface area of a doubles tennis court. Although this immense surface area is necessary for efficient absorption of nutrients from food, it must be closely guarded to prevent bacterial toxins and allergens from entering the body. Almost three-quarters of the human immune system is located in the walls of the small intestine, signifying how important the guarding of this intestinal frontier is to health. When the integrity of the intestinal lining is damaged by infection or by drugs like aspirin or alcohol, tiny breaks occur that allow allergens and bacterial toxins to enter the body, taxing the liver’s detoxification capabilities and over-stimulating the immune system, sometimes making it turn aggressively against the body itself.

Improving knowledge of the rela-tionship between intestinal toxicity and chronic disease is a major goal of the Foundation for Integrated Medicine. For this reason, we have embarked on the Parasite Project, an educational endeavor focused on the high prevalence of intestinal parasites in all countries of the world, the impact of these parasites on nutrition, immune function and the development of disease, and the most effective means of diagnosis and treatment.

A weakness of all traditional healing systems is their ignorance of microbes and the role that microbes play in causing disease. The development of the microscope and of methods for isolating and studying microbes was an essential step in the evolution of health care, aiding control of the major epidemic diseases and of the sterile techniques that make modern surgery possible. Contemporary medicine’s initial cooncept was that microbes are the primary causes of infectious diseases like pneumonia, TB or polio. More recent research demonstrates that microbes alone do not cause disease. It is the reaction of the person’s immune system to the microbe that causes disease. The most recent research indicates that harmful immune reactions to microbes may be important for the development of many diseases that were not initially thought of as infectious. Today microbes are the proven or suspected triggers for coronary heart disease, ulcers, some forms of cancer, multiple sclerosis, rheumatoid arthritis and other inflammatory diseases, asthma, psoriasis, Crohn’s disease, ulcerative colitis, some types of irritable bowel syndrome, and the fibromyalgia syndrome. Infectious diseas-es can no longer be thought of as discrete disease entities with clearly defined causes. They must be understood wholistically: microbes are the triggers that initiate a series of reactions in the body that contribute to the development of a wide range of different, apparently unrelated disorders. The way in which the person reacts to the presence of the microbe, which is influenced by nutrition, environmental toxicity and emotional health, is as important for determining the pattern of illness and recovery as are the microbes themselves. It is within this context of under-standing that the Parasite Project is taking place.

The Foundation for Integrated Medicine can be contacted through this column at HealthWorld on Line (healthy.net), by mail c/o Dr. Leo Galland, 133 East 73 Street, New York N.Y. 10021, or by fax at (212) 242-1057 or (212) 794-0170.