Diet and Supplements for Athletes

The general goal with diet and supplements for athletes should be to promote an anti-inflammatory state so body better responds to the wear and tear generated by heavy exercise 1-3. With this in mind, diet and supplement recommendations can be uncomplicated.

athletedietHumans have historically lived on health-promoting foods, including wild game (land animals, fish, and birds) and vegetation in the form of vegetables, fruits, nuts, tubers, and spices. Athletes and non-athletes should be consistent with our historical eating patterns. Grocery stores have a wide variety of natural animal proteins and vegetation, such that we can literally go to our favorite store and behave as modern hunter-gatherers. Athletes, versus non-athletes, will typically need additional calories, which means that athletes need to eat larger amounts of healthy foods 1-3.

There are no special supplements that will make an athlete perform better. Peak performance at any level is largely due to a proper mental state. There are certain key supplemental nutrients that we all need and this also applies to athletes. The most important appear to be vitamin D, omega-3 fatty acids, magnesium, and probiotics. Multivitamin use is also reasonable. Athletes should also consider the regular use of anti-inflammatory botanicals such as ginger and turmeric, as well as proteolytic enzymes 1-3.

There are certain calories sources that should be avoided by all of us, especially athletes. The most problematic calorie sources include sugar and gluten grains.

Avoiding Sugar
A recent CNN report by Dr. Sanja Gupta focused on the health problems associated with sugar consumption 4. The final third of the show included an interview with a cancer researcher who said that he absolutely avoids sugar because it helps to promote cancer; tumor cells essentially need sugar to grow and thrive. Unfortunately, the average American’s diet contains approximately 20% of calories from refined sugars and 20% from refined flours 5, which means that the average American is pursuing cancer expression. So the notion that endurance athletes should “carb load” with high glycemic refined carbohydrates is patently absurd.

One could try to argue that it is the chronic consumption of refined carbohydrates that is the problem and not when carb loading is related to athletic activities. Unfortunately, this argument falls flat. The consumption of 50 grams of available carbohydrate as glucose and white bread, but not pasta, led to a significant postprandial increase in monocyte nuclear factor-kappaB (NF-KB) activation in subjects in their twenties with and a body mass index (BMI) of 22 6. NF-KB is a marker of inflammation as it leads to the production of pro-inflammatory cytokines and other inflammatory mediators.
 
So, refined carbohydrates cause cancer in the long term and surges of inflammation immediately after eating. How can this be a good thing for athletes of any kind? One could argue that refined sugar is okay in moderation. This may be true, but no one knows what level of moderation is safe. Moreover, refined carbohydrate eaters generally eat too much as mentioned above; that is, 40% of American’s calories come from refined carbohydrates. The other glaring problem is the issue of sugar addiction. The same Sanja Gupta specially outline how refined sugar activates the same addiction pathways in the brain as cocaine 4.
 
The exception mentioned above was pasta, which, because of its low glycemic index, did not appreciably activate NF-KB 6. Does this mean that pasta in general and pasta parties before endurance events is a smart choice? The answer, again, is no.
 
Avoiding gluten
Wheat, rye and barley all contain gluten. While most individuals do not express overt celiac disease, the consumption of gluten causes a harmful pro-inflammatory IL-15 mediated immune reaction in all individuals 7. Why would any athlete want to regularly dine on foods that cause gut inflammation?
 
Not generally appreciated is that gluten consumption can cause a host of problems in individuals who do not have celiac disease. This is because gluten consumption causes a low grade leaky condition that may not produce any gut symptoms. Gluten causes gut enterocytes to produce a protein called zonulin that disassembles gut tight junctions, allowing for gluten and bacterial antigen penetration 8. The bad news is that multiple diseases have been linked to zonulin production including classic autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease, systemic lupus erythematosis, and ankylosing spondylitis 8. Several cancers are also associated to gluten/zonulin, including those of breast, brain, lung, ovaries and pancreas 8.
 
Zonulin/gluten has also been associated to the expression of schizophrenia 8.
 
Multiple mental disorders are caused by gluten sensitivity including depression, anxiety disorders, mental fog/lethargy, and attention deficit disorders 9-11. The reason for the mental disorders is thought to occur because gluten causes cerebral vascular hypoperfusion 11. Clearly, an athlete who wished to be in tip-top condition should avoid gluten, especially for the purpose of reducing the chance of brain hypoperfusion. 
 
The practice of sugar/gluten loading before an endurance event should be avoided. Potatoes are a non-gluten starchy carbohydrate that are a better choice, and they also contain an abundance of potassium that is needed for proper muscle function and vascular function. Grains, in fact, contain virtually no potassium.
 
References
  1. Seaman DR. A sports nutrition: a biochemical view of injury care and prevention. In Hyde TE, Gengenbach MS. Eds. Conservative management of sports injuries. 2nd ed. Boston: Jones and Bartlett; 2007: p.1067-1092. 
  2. Seaman DR. Nutritional considerations in the treatment of soft tissue injuries. In Hammer WI. Editor. Functional soft-tissue examination and treatment by manual methods. Boston: Jones & Bartlett; 2007: p.717-734. 
  3. Seaman DR. Nutritional considerations for pain and inflammation. In Liebenson CL. Ed. Rehabilitation of the spine: a practitioner’s manual. Baltimore: Williams & Wilkins; 2006: p.728-740.
  4. Dr. Sanjay Gupta. http://www.youtube.com/watch?v=sXhKQEdIDa0
  5. Cordain L et al. Cordain L et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005; 81(2):341-54.
  6. Dickinson S et al. High-glycemic index carbohydrate increases nuclear factor-kappaB activation in mononuclear cells of young, lean healthy subjects. Am J Clin Nutr. 2008;87(5):1188-93.
  7. Bernardo D et al. Is gliadin really safe for noncoeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides. Gut. 2007;56(6):889-90.
  8. Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011;91: 151-75.
  9. Volta U, De Giorgio R. New understanding of gluten sensitivity. Nat Rev Gastroenterol Hepatol. 2012;9:295-99. 
  10. Hopper AD, Hadjivassiliou M, Butt S, Sanders DS. Adult coeliac disease. BMJ  2007; 335:558-62.
  11. Addolorato G et al. Affective and psychiatric disorders in celiac disease. Dig Dis 2008;26:140-48.
 
Dr. Seaman is a Professor of Clinical Sciences at the NUHS branch campus at St. Petersburg College in Florida. He is also a Clinical Consultant for Anabolic Laboratories. He has written numerous articles on the treatment options for chronic pain patients, with a focus on nutritional management. He can be reached at defl[email protected]flame.com.

The Natural Approach to Treatment of High Cholesterol Profiles

It is in the news on a near-daily basis. Research studies address various aspects of it. Many people ask what their doctor can do about it.“It” is cholesterol.The evidence overwhelmingly demonstrates that elevated cholesterol levels greatly increase the risk of death due to cardiovascular diseases (CVD), such as heart attack and stroke. These diseases claimed 927,448 lives in the U.S. in 2002, making CVD the number one killer in the U.S. today.
 
cholesterolThere are two types of cholesterol: LDL and HDL. LDL cholesterol is the “bad” cholesterol because it carries cholesterol from the liver to the bloodstream, which can ultimately contribute to the formation of plaque that clogs the arteries, resulting in atherosclerosis. HDL cholesterol is the “good” cholesterol and has the exact opposite effect of LDL. Specifically, HDLs carry cholesterol away from the arteries and back to the liver, where it is then eliminated from the body.
 
Triglycerides transport and store fat in the body. It is clear that high triglyceride levels are not good for the body, and this can be particularly problematic when combined with excess levels of LDL cholesterol. People with high triglycerides often have high total cholesterol, high LDL cholesterol, and low HDL cholesterol.
 
The cholesterol-lowering drugs known as “statins” are among the most widely prescribed drugs used today (Lipitor ranked second). However, some adverse side effects of statins are possible elevation of liver enzymes and muscle discomfort. Literature shows that the nutritional supplements listed below have produced more advantageous changes in cholesterol profiles, with more tolerability and safety, than statins:
 
1. Policosanol: (a natural compound derived from sugarcane wax): 10-20 mg. Numerous studies show that policosanol reduces total cholesterol, LDL cholesterol, and lipoprotein (a), and it increases the good HDL cholesterol.
 
2. Fish Oil: 1-3 g. Fish oils help to reduce inflammation in the arteries and lower cholesterol and triglyceride levels.
 
3. Niacin (Inositol hexaniacinate): 1500 – 2500 mg. This is a non-flush form of niacin. It is known to reduce cholesterol levels and increase HDL. 
 
4. Red Yeast Rice Extract (Monascus purpureus): 1200 mg twice daily. This has been shown to reduce cholesterol levels and increase HDL.
 
5. Guggulipid: Up to 1500 mg. This herb helps to reduce cholesterol levels and increase HDL.
 
6. Garlic: 1000 mg. This helps reduce cholesterol levels and increase HDL cholesterol levels.
 
7. Multivitamin/Multimineral Complex: (with proper antioxidant formula): Antioxidants prevent cholesterol oxidation.
 
8.  Magnesium: 400-800 mg. This more reliably improves all aspects of dyslipidemia, including raising HDL-C and lowering triglycerides, and it has the same pleiotropic effects as statins without the adverse effects.
 
9. Green Tea: Daily consumption of green tea was found to decrease serum LDL.
 
10. L-Carnitine: 1000 mg. Decreases triglyceride levels by aiding in fatty acid oxidation.
 
11. Co-enzyme Q10: 100 mg. If a statin drug is presently being used: A vital nutrient that is required for proper heart function that is lowered by statin use.
 
12. Milk Thistle (Silybum marinum): 200 mg. Counteracts increased liver enzymes attributed to statin use.
Dr. Robert Silverman graduated magna cum laude from the University of Bridgeport College of Chiropractic and has a Masters of Science in human nutrition. He is a certified nutrition specialist, certified clinical nutritionist, certified strength and conditioning specialist, certified Kinesio Taping® practitioner, NASM-certified corrective exercise specialist, and a certified sports nutritionist from The International Society of Sports Nutrition. Dr. Silverman is a diplomat with the American Clinical Board of Nutrition and with the Chiropractic Board of Clinical Nutrition. He has a successful full-time private practice in White Plains, NY, where he specializes in the diagnosis of joint pain and soft-tissue management while incorporating proper nutrition protocols. Among his nutrition recommendations are products from Ajinomoto, including Capsiate Natura ®, which naturally increases metabolism; Natura Guard BP ™, which can help patients maintain healthy blood-pressure levels; and Glysom ™, which promotes sounder, more satisfying sleep for occasional sleeplessness.

Resolving Vitamin B12 Deficiency Using Oral Supplementation

New research validates high dose methylcobalamin lozenge regimen

Vitamin B12 (often referred to as cobalamin) is an essential nutrient that can only be  obtained from diet or supplements. Its main function in the body is to assist in the synthesis of DNA. As a result, quickly dividing cells such as red blood cells are among the most frequently affected by cobalamin deficiency. DNA synthesis supported by Vitamin B12 is achieved in concert with another B vitamin, folic acid. This is why a combination of these two vitamins is often found in supplements.
 
vitamindeficiencyAnother process requiring direct Vitamin B12 participation is production of ATP from lipids and amino acids. Thus, cobalamin is often promoted as an energy-boosting nutrient. The central and the peripheral nervous systems are critically affected by the scarcity of Vitamin B12, which can manifest itself in depression, premature memory loss, confusion, and unpleasant sensations in the tips of the toes and fingers.
 
The elderly are most susceptible to developing Vitamin B12 deficiency, with an estimated 15% of people over 65 having low levels of cobalamin in the blood.¹ Normal body stores of Vitamin B12 are quite significant (2,000 to 5,000 mcg, mostly in the liver), so it takes years to develop symptoms of Vitamin B12 deficiency. The signs are often non-specific. Deficiency might be hard to recognize unless Vitamin B12 levels are measured directly in the blood. For decades, levels below 200 pg/ml had been regarded as B12 deficiency, but recently a strong case has been made to view levels between 200 and 350 pg/ml as suboptimal for human health.² Other signs that might suggest Vitamin B12 deficiency in older people include chronic gastritis, anemia, and increased homocysteine level, especially when general malaise and depression are present.
 
One reason the elderly are predisposed to developing B12 deficiency is that cobalamin absorption requires robust digestion and intact production of Intrinsic Factor in the stomach. Gastric juices enable extraction of cobalamin from food and Intrinsic Factor binds with extracted cobalamin for further absorption in the small intestine. Dwindling digestive function combined with limited consumption of meat (the main dietary source of Vitamin B12) can reduce the amount of Vitamin B12 taken up by the body. Eventually, body reserves of cobalamin are depleted and symptoms of deficiency emerge. Because dietary Vitamin B12 is found almost  exclusively in food of animal origin, vegetarians also have a significant risk of becoming cobalamin-depleted.
 
Vitamin B12 Deficiency Is Diagnosed. What’s Next?
It is important to understand, however, that Intrinsic Factor allows for absorption of only up to 3 mcg of Vitamin B12 from a single meal or supplement administration.³ [/pullquote]
When Vitamin B12 deficiency is present, it’s always a good idea to identify the underlying cause. However, independent of the mechanism leading to B12 deficiency, correction of cobalamin shortage is required. Traditionally, physicians have administered Vitamin B12 injections to bypass the digestive tract, as cobalamin absorption is assumed to be compromised.

While this is true, with the exception of strict vegetarianism, current clinical research conducted with high-dose oral Vitamin B12 supplementation challenges the traditional practice of injections.
 
Since the discovery of its critical role in cobalamin absorption, the Intrinsic Factor-dependent  pathway has been understood to be the sole mechanism by which Vitamin B12  can cross the gastrointestinal (GI) cell membrane. It is important to understand, however, that Intrinsic Factor allows for absorption of only up to 3 mcg of Vitamin B12 from a single meal or supplement administration.³ Since the typical multi-vitamin contains only about 6 mcg, and absorption from this low dose has to rely on intact Intrinsic Factor production, oral supplementation with a typical multi-vitamin is not an effective way to address Vitamin B12 deficiency. In contrast, a single injection can deliver 1,000 mcg of Vitamin B12, which is administered once a week at first, followed by a once a month regimen for the rest of the patient’s life.
 
b12chartFortunately, another mechanism is operative for treating Vitamin B12 deficiency. Research has shown that Vitamin B12 can be absorbed by “passive diffusion” without Intrinsic Factor participation when administered in high doses.³ Although only about 1% of orally administered cobalamin crosses the GI cell membrane by this mechanism, the amount absorbed becomes significant as the dose of Vitamin B12 increases. Because Vitamin B12 has no known toxicity, and very high doses can be given orally without safety concerns. Research shows that after administration of 10,000 mcg of cobalamin, about 100 mcg of Vitamin B12 can be absorbed.

 
A series of recent human bioavailability studies with 10,000 mcg Vitamin B12 doses supports this conclusion (Unpublished, Protocol For Life Balance, Bloomingdale, IL; 2011-2012).
 
Injections or Supplementation?
The latest clinical confirmation of the effectiveness of oral Vitamin B12 in the form of methylcobalamin lozenges comes from a study conducted at ABC Wellness Clinic (Sterling Heights, MI) in collaboration with Protocol For Life Balance®.4 The study was presented at the 2012 Conference by the American Association of Naturopathic Physicians. In this clinical trial,ten patients with newly diagnosed cobalamin deficiency were randomly assigned to receive either once a week B12 injections or daily high-dose 10,000 mcg methylcobalamin lozenges for 8 weeks. 
 
The study demonstrated that Vitamin B12 lozenges were in fact as effective as injections (Figure 1). All patients’ cobalamin and homocysteine levels returned to normal and their symptoms improved independent of  the treatment group to which they belonged. The results strongly suggest that a high-dose daily lozenge regimen is a viable and convenient option to injections and should be used more often.
 
Additionally, lozenge supplementation offered a significant cost advantage as compared to injections. In this study, the cost of supplementation was approximately $35 for 8 weeks. The cost of just one office visit and a single injection was estimated to be $100, adding up to $800 for the duration of the study.
 
To summarize, confirmed efficacy, validated mechanism of absorption, an excellent safety record, ease of administration, and clear economic advantage makes oral high-dose Vitamin B12 a viable option in addressing cobalamin deficiency.
 
 
References
  1. Clarke R, Grimley Evans J, Schneede J, et al. Vitamin B12 and folate deficiency in later life. Age and ageing. Jan 2004;33(1):34-41.
  2. Spence JD, Stampfer MJ. Understanding the complexity of homocysteine lowering with vitamins: the potential role of subgroup analyses. JAMA. Dec 21 2011;306(23):2610-2611.
  3. Andres E, Dali-Youcef N, Vogel T, Serraj K, Zimmer J. Oral cobalamin (vitamin B12) treatment. An update. Int J Lab Hematol. Feb 2008;31(1):1-8.
  4. Culik DA BL, Sharpee RL, Pacholok SM. Effect of Daily High-Dose Methylcobalamin Lozenge Regimen or Weekly Injections in Patients with Cobalamin Deficiency. A Single-Center Prospective Randomized Open-Label Trial. AANP 2012 Conference: ABC Wellness; Protocol For Life Balance;2012.
Leonid Ber, MD specialized in hematology and endocrinology and has been intimately involved in the scientific advancement of the dietary supplement industry. He collaborated with companies such as Immudyne, Himalaya USA, Marlyn Nutraceuticals, Garden of Life, and most recently joined Protocol for Life Balance as Sr. Medical Scientist. Contact Dr. Leonid at: [email protected]  or 630-545-9098 x370

Have You Considered Using Nutrition to Help Patients With Neuropathy?

About seven years ago, I switched from an insurance-based practice treating solely musculoskeletal conditions to an all-cash practice treating some musculoskeletal conditions as well as a lot of additional conditions like obesity, diabetes, fibromyalgia and candida. During my first 20 years of practice, when a patient came in with serious neuropathy in their feet or hands, I was not able to give them complete relief. In fact, I felt like I needed to refer them out to another physician. However, in 2009 everything changed when Nan, a 58-year-old patient, entered my office.
 
neuropathyNan was a size 4X and needed to lose a lot of weight. Nan explained that she had noticed a weight-loss advertisement for my clinic, so she came to my office to lose weight. The reason Nan wanted to lose weight was because she was scheduled to have one of her legs amputated due to her terrible neuropathy. Nan feared that since she was so overweight, she would not be able to walk on the new prosthetic leg she would receive after her amputation. Her goal was simple: She wanted to lose enough weight to be able to easily adjust to her new prosthetic leg.
 
The way I handle weight loss in my office is to focus on healing the body. I tell patients that they will lose weight, but the real goal is to get their bodies healthy. I help them with a healthy diet plan, pure supplementation, some therapies to address cellulite and emotional eating, and a whole lot of one-on-one attention and support.
 
After a few months on the weight-loss program, not only had Nan lost about 55 pounds, but also her legs had healed to the point that her medical doctor cancelled the amputation surgery. Now, several years later, Nan has continued to feel the positive effects of her improved lifestyle changes. She has been able to stop taking 14 medications, keep both of her legs and no longer suffers from neuropathy. And, not surprisingly, Nan has referred many patients to our office.
 
After seeing Nan’s amazing results, I decided it was time to start treating more patients for neuropathy. The results have been amazing. Before treating Nan for weight loss, it had never occurred to me to treat neuropathy patients with a change of diet and pure nutritional supplementation. However, after seeing improvements in Nan and hundreds of other neuropathy patients, I am sold on the idea that the body really can heal itself given the proper environment.
 
Most chiropractors are well versed in neuropathy, but in case you have forgotten what you learned in school, let us review.
 
What is Neuropathy?
Neuropathy essentially means an abnormal and degenerative condition of the nervous system.
 
Neuropathy may be diffuse, affecting many parts of the body, or it can be focal, affecting a single, specific nerve and part of the body.
 
Diffuse Neuropathy:
The two categories of diffuse neuropathy are peripheral neuropathy, affecting the hands and feet, and autonomic neuropathy, affecting the internal organs.
 
Peripheral Neuropathy:
This is the most common type of neuropathy, damaging the nerves of the limbs—especially the feet—and affecting both sides of the body. Common symptoms of peripheral neuropathy are:
  • Numbness or insensitivity to pain or temperature
  • Tingling, burning or prickling sensations
  • Sharp pains or cramps (or like walking on sponges)
  • Extreme sensitivity to touch, even light touch
  • Loss of balance and coordination
Most of these symptoms are often worse at night.
 
Autonomic Neuropathy (also called visceral neuropathy): 
This is another form of diffuse neuropathy. It affects the nerves that serve the heart and internal organs. Neuropathy affecting the organs via nerve damage can lead to:
  • Urinary incontinence
  • Lack of sexual function
  • Digestion issues (the stomach emptying slowly, bloating, persistent nausea and vomiting) 
  • Lower bowel problems (constipation, diarrhea)
  • The cardiovascular system (which controls the circulation throughout the body)
Damage to the cardiovascular system affects the signal for the blood in regulating blood pressure and heart rate. As a result, one can feel dizzy upon standing (orthostatic hypotension). This type of neuropathy also affects the system in the perception of pain from heart disease. People may not experience angina as a warning sign of heart disease and may suffer painless heart attacks. Damage can also lead to hypoglycemia, or low blood sugar. This condition makes it difficult to recognize and treat an insulin reaction.
 
Uncontrolled diabetes (even on medication) results from a poor diet, lack of exercise and unstable sugar levels. This can lead to conditions such as neuropathy, affecting the whole body and potentially leading to amputations. Unstable glucose levels (e.g., high blood sugar due to poor diet) harm nerves and blood vessels. This affects circulation, especially in the peripheral area of the body such as the limbs. Poor circulation can lead to diabetic neuropathy where damaged nerve fibers cause numbness. When limbs are numb, there is a greater risk of injury and/or infection due to decreased sensations in the limb. When injury occurs, poor circulation means that blood cannot circulate fast enough to heal the wounded area. The result is often infection, gout and foot ulcers, which can then lead to foot and leg amputations.
 
Nutritional Deficiencies and Neuropathy 
Neuropathy can present after years of a poor diet. Patients who eat foods void of live enzymes will suffer consequences in later years. In our highly developed society, we have advanced to the point that people often eat foods that only come from a box, bag or can. The problem is that these foods are all dead foods where no live enzymes are present.
 
Malnutrition was the only common denominator in all the physical ailments these men experienced.[/pullquote]
Poor nutrition as a cause of neuropathy was first identified during WWII. The war provided an unprecedented opportunity for observation of the effects of nutritional deficiencies. Men of many ethnicities were subjected to years of defective nutrition as prisoners of war. It was discovered that malnutrition most affected the highly differentiated cells of the organism, causing the greatest suffering. In fact, it was found that the nervous system shows the most severe and common lesions. These findings were not dependent on external factors such as region or location. In fact, the findings were the same regardless of where each person was located. Malnutrition was the only common denominator in all the physical ailments these men experienced.
 
Proper Diet and Pure Supplementation
Prescribing a healthy diet and specific pure supplementation to a neuropathy patient will address the nutritional deficiency issues that are causing the neuropathy. This course will get the patient’s body to start digesting and assimilating food correctly. It also allows the body to start healing from the inside and decreases the degenerative process of the nervous system. Combining the following nutrients and vitamins in a neuropathy patient’s diet should greatly speed up their recovery process.
 
Vitamin E
Patients with neuropathy have a higher than usual need for vitamin E. This vitamin helps improve insulin activity and acts as an antioxidant as well as a blood oxygenator. Research has shown that people with low levels of vitamin E are also more likely to develop Type 2 diabetes.  Studies show that vitamin E improves glucose tolerance in older patients as well as diabetic patients. A vitamin E deficiency results in increased free radical-induced damage, particularly in the lining of the vascular system. Supplemental vitamin E may help prevent diabetic complications through its antioxidant activity. Neuropathy cases may require three months of vitamin E supplementation and diet change for benefits to become apparent. The trace mineral selenium functions synergistically with vitamin E.
 
Vitamin C
People with neuropathy typically have low vitamin C levels. Vitamin C lowers sorbitol levels in neuropathy patients. Sorbitol is a sugar that can accumulate and damage the eye, nerves and kidneys. The transport of vitamin C into cells is facilitated by insulin. Due to impaired transport or dietary insufficiency, a vitamin C deficiency exists in neuropathy patients and may be responsible for the increased capillary fluidity and other vascular disturbances often seen in neuropathy patients. 
 
Vitamin B6 (Pyridoxine) 
Diabetics with neuropathy have been shown to be deficient in vitamin B6 and benefit greatly from supplementation. Peripheral neuropathy is a known result of pyridoxine deficiency and cannot be distinguished from diabetic neuropathy. 

I now can reassure them that help does exist for their Neuropathy.

Vitamin B6 supplements also improve glucose tolerance in women with diabetes caused by pregnancy. Furthermore, pyridoxine helps prevent other diabetic complications because it is an important coenzyme in the cross-linking of collagen and inhibits platelet aggregation.
 
Vitamin B12
Vitamin B12 supplementation has been used with some success in treating diabetic neuropathy. This may be because it corrects, or normalizes, a deficient state of vitamin B12 metabolism. Vitamin B12 is needed for normal functioning of nerve cells. Taken orally, intravenously or by injection, it reduces nerve damage caused by diabetes in most people. Oral supplementation may be sufficient.
 
Start Helping Neuropathy Patients Nutritionally
Most patients who come into my office to get help with neuropathy are very skeptical. They have been told over and over again that there is no help available to them. I now can reassure them that help does exist for their neuropathy. I have been thrilled with the improvements that have occurred by giving my neuropathy patients a healthy diet to follow and the right pure supplementation. Patients who have suffered for years finally have been able to feel their feet again and be pain free.
 
Again, I  remember learning in school, “The body will heal itself given the proper environment.”  After 20 plus years of practicing, it is still exciting for me to see this happen daily right before my eyes with so many patients suffering with Neuropathy.

TODD SINGLETON, DC is an author, speaker, consultant, and a practicing doctor for over 20 years. He ran the largest MD/DC/PT clinics in Utah until he switched to an all-cash, nutrition model in 2006.  He has a nutrition practice in Utah specializing in Weight Loss, Neuropathy, Fibromyalgia, Diabetes and other nutritional deficiencies. He also teaches fellow chiropractors how to add these programs into their offices. He can be reached at (801) 916-9532. For additional information about Dr. Singleton’s work visit www.startneuro.com

Detoxification

We all know that detoxifying is good for us, but how do you choose a good protocol to follow?  When we remove toxins that have built up over years, it is just as important to consider things we DON’T do as well as the things we DO. A good detox program (there are thousands out there) should be written by a professional in the field of nutrition.  Many programs have been criticized for being too harsh, not supplying enough nutrition, or just plain causing more harm than good. Choose one that is effective, nutritionally sound and safe at the same time.
 
liver234It is critical to make sure your detox program: 
  • Does not ask you to fast. Toxins are released too quickly with no nutrition to bind and remove them, plus it is just too stressful on the system.
  • Does not ask you to refrain from solid food for too long. Easing into a detox makes for higher compliance for one thing. The closer a “program” is to the way you should be maintaining everyday healthy dietary protocols, the higher  the probability that you will stick with an energizing wellness plan for life!
  • Does not ask you to eat a lot of fruit while resting the gut. This gut-resting time period is usually 3 days to a week to ten days; however, it is possible to rest the gut and provide nutritional support for healing the gut without stressing the glycogen making capacity of the liver. Protein powders are good for resting the gut, and the resting period can vary, but including a lot of fruit is going to work adversely when it comes to blood sugar control (important!).
  • Provides the daily requirement of macronutrients (protein, fat and carbs). One hundred and thirty grams of carbohydrate a day are needed to make enough glucose for proper brain function. To give you an idea, a cup of wild, cooked rice has about 35 grams (135 calories) of carbohydrate, 10 grams per cup less than white rice.  A cup of cooked broccoli has a little over 5 grams (20 calories) of carbohydrate. Make sure you don’t go too low on your carbohydrate requirement.  Many programs unnecessarily limit carbs below what is needed for a healthy diet.
  • Provides lists of acceptable foods and non-acceptable foods, along with cooking tips and healthy, tasty recipes to increase compliance.  Also make sure that it takes into consideration the huge importance of regulating blood sugar throughout the cleanse.  
  • Provides a journal to help the practitioner assess the individual’s goals and progress.
Taking The Time To Detox:
 
When we set aside the time to cleanse our body, we give it the needed attention to get the desired results, although keeping the body cleansed of toxins should be a lifetime goal. The practitioner helps the individual adjust a program to their specific needs. While some detox programs expect you to drastically change your lifestyle and eating habits, the right cleansing system will set you on a lifelong, healthy course for eating the right foods moderately and sensibly, while supporting the body with essential nutrition. Post detox, you will feel revitalized, reenergized, and empowered to maintain optimal results.
 
Ridding The Body Of Toxins:
 
All of the toxins enter the body and overwhelm what is usually an already overburdened liver, increasing the need to optimize other detox pathways and support the removal process. In order to remove toxins from their place of storage (fat tissue) we must: Mobilize, Bind and Remove.
  
Mobilize: To release toxins from the fatty tissue, we usually reduce the caloric load, meaning simply that we eat less.  When total calories are reduced, the fat cells are mobilized, and the toxins stored in the fat cells are mobilized with the fat cells into the circulation.
 
Bind: Once toxins are mobilized, they must be bound so that the body can easily eliminate them.  The liver has a sophisticated process (two phases of detoxification) to facilitate the exit of toxins from the body. In Phase I, the liver utilizes nutrients, mostly antioxidants, to prepare the toxin for entry into Phase II.  It does this by changing the toxin from a fat-soluble substance to a water soluble one.  The important thing to remember is that if a person lacks either the antioxidant power for Phase I, or the nutrient binding power for Phase II, then that toxin cannot enter Phase II , and instead it becomes MORE toxic than when  it first entered the body.
 
In Phase II, the liver then utilizes nutritional elements, mostly glutathione (a nutrient consisting of three amino acids) and sulfur, to bind to the toxin and prepare for removal.  Supplements that raise glutathione levels or protect glutathione levels can be helpful (N-acetyl-cysteine, alpha lipoic acid, glutamine, milk thistle, turmeric, selenium, vitamin C, vitamin E).
 
Remove: Toxins are removed from the body by several different pathways. Although the colon is a major detox organ, other important detox organs include the liver, skin, lymph, blood, kidneys and  lungs. The body utilizes many nutrients to remove toxins. Vitamins, minerals, herbs, etc. can all help to mobilize, to bind, and to remove toxicity.
 
Outstanding detox nutrients: Fiber, fish oil, flaxseed oil, black currant seed oil, greens (spirulina, chlorophyll, kelp, parsley, etc.),  flax seed, cruciferous vegetables (especially sprouts!), garlic, apple pectin, chia seed, beet root, betaglucans, rice bran, vitamin C, N-acetyl cysteine, alpha lipoic acid, glutamine, milk thistle, silybin, Co-Q1O, quercetin ,silymarin, turmeric, minerals (calcium, magnesium, zinc, selenium, etc.), glucuronic acid, carrot, asparagus, papaya, caprylic acid, yellow dock, dandelion, mullein, eleuthero (Siberian ginseng), molybdenum, etc. Binding and removing toxins efficiently assures that they do not redeposit somewhere else in the body.
When fruit is balanced with protein and fat during a meal, there is less impact on blood sugar.[/pullquote] 
Many nutrients, like high fiber food and supplements, are good for both binding and removing toxins. High fiber nutrients include flax seed, chia seed, apple pectin, garlic, inulin, glucomannan, rice bran, and beta glucans. Many vegetables are high fiber, and also provide phytochemical power, such as asparagus and beets.  If you’re looking for a concentrated wallop of nutrient efficacy, SPROUTS from cruciferous vegetables (broccoli, cauliflower, cabbage, etc.) have up to 50-100 times the amounts of phytochemicals than even the actual plants themselves!
 
Even though it’s a good idea to limit the higher sugar fruits in the beginning of the program, many fruits like blueberries contain biologically active antioxidants and fiber, along with enzymes to help digestion, and blueberries are relatively low on the glycemic index. They contain fiber, and a minimum of 40 grams of fiber per day is required on any daily eating plan.
 
It is especially important post-detox to include fruits; however, your practitioner may still limit high glycemic fruits. Always check with your practitioner to assess your blood sugar handling status and modify intake accordingly. Your practitioner may determine that fruit spikes your blood sugar (sometimes a glucose reading is used to confirm individual responses) and may suggest alternatives. Remember that when you are not getting the beneficial phytochemicals from fruit (because of blood sugar concerns), it is even more crucial to substitute nutrient-packed cruciferous vegetables instead of filling that void with a food that does not offer as much nutritional power. When fruit is balanced with protein and fat during a meal, there is less impact on blood sugar. Recommendations are usually based on healthy individuals, not blood sugar challenged patients, so attending to this detail is important.
 
It is impossible to address all the details of detox here in the limited scope of this article; however, when choosing your detox program, make sure that the details and guidelines are provided to you and that the program meets the above requirements. Post-detox should be an easy transition to the way you want to eat for life.
 
Dr. Lynn Toohey received her Ph.D. in nutrition (summa cum laude) from CO State University in Ft. Collins, CO. She has lectured to chiropractors, chiropractic associations, and other health professionals across the country and overseas on nutrition-related topics, including the Colorado Chiropractic Association (CCA), United Chiropractors of New Mexico (UCNM), the Ohio State Chiropractic Association (OSCA) the Florida Chiropractic Association (FCA), the Georgia Chiropractic Association (GCA) and the International College of Applied Kinesiology (ICAK). Dr. Toohey has been published in a number of peer-reviewed journals, including The Journal of Nutrition, The American Journal of Clinical Nutrition, and the British Journal of Nutrition. She has been a Keynote speaker for the MS Society (Vancouver Branch), and for the British Society for Allergy, Environmental and Nutritional Medicine.

Five Reasons Why Incorporating Nutrition Will Launch Your Success, Plus One Tip on Getting Started

Tommy Thompson, former United States Secretary of Health and Human Services, and current United States Senate candidate is enthusiastic about wellness and prevention.
 
nutritionsuccess“Seven out of 10 deaths are caused by chronic diseases, and more than 75 percent of health care costs are spent treating conditions that are preventable,” Thompson said during an event held at Standard Process Inc. last year. “There’s so much more we could be doing, especially in the area of nutrition, to prevent these diseases from ever occurring versus treating them after the fact. It’s encouraging to see that we’re finally ready to invest in keeping people well in the first place.”
 
According to the Nutrition Business Journal’s recently released 2011 Integrative Medicine Report, “The power brokers in Washington have clearly warmed to integrative approaches to healthcare, and the industry stands posed to dramatically benefit from its mounting contribution to public health in the United States.”
 
How are you contributing towards keeping your patients well? Are you doing enough, or all that you can?
 

Here are five reasons that you should seriously consider adding nutrition to your practice, plus a piece of advice on how to get started today.
 
1. As a chiropractor, you are different than many other health care professionals. Your education and training have taught you to be committed to the health and wellness of the people you treat, not just to the treatment and management of disease.
 
It makes sense then that close to 70 percent, of chiropractors use nutrition in their practices – they see it as a valuable tool in treating the whole person and keeping their patients free of chronic diseases, including heart disease, diabetes, cancer, arthritis, and obesity. It is in your patients’ best interest to see that nutrition and chiropractic go hand in hand toward prevention, just as the majority of chiropractors have already seen.
 
2. If you want to thrive as a chiropractor, you need to build your reputation. Using nutrition in your practice will give you an advantage because patients will view you as more well-rounded. By using a more complete approach to wellness, you will be able to give higher quality patient care.
 
This in turn, will build your credibility faster and enhance your reputation within the community you serve. When people see benefits from your holistic approach, they’ll refer more friends and family to you. That’s a win-win for all involved!
 
3. Chiropractors are finding that problems treated solely by chiropractic manipulation do not respond as well without nutrition, especially today, as they do when nutrition is incorporated.
 
“More and more, I’m seeing that I can be more effective as a chiropractor by using nutrition with patients,” says Dr. Jeffrey Fedorko, who has been growing his Canton, Ohio practice for 30 years, and served as the past president of the Congress of Chiropractic State Associations (COCSA). 
 
Dr. Fedorko adds, “Patients just aren’t as healthy as they were when I first started, and many are not responding without the addition of good nutrition. When I do add nutrition, the results are amazing and my patients take notice!”
 
4. Consumers’ attitudes are changing as health care costs and frustration with the conventional “sick care” system continue to rise. More and more people see natural, holistic care as analternative to high prescription and surgery costs.
 
Nutritional supplement companies are ready, willing, and able to help chiropractors learn more about nutrition and how to take this worthy wellness and prevention path to elevate their practices.[/pullquote]
“People today are more aware of the importance of being proactive about their health, and they’re realizing they can do this by making better choices in their lifestyles,” says Dr. Fabrizio Mancini, president of Parker University. By incorporating nutrition into your practice, you can help your patients understand which choices will have the biggest impact on their health. And, when you have a positive impact on their health, you’ll have a positive impact on your business.
 
5. It makes good business sense. Here’s why. As a chiropractor, you make a living using your own two hands. While that’s very commendable, it’s also risky. When you go on vacation, you take your hands with you, and the business stops, but the bills don’t stop.
 
On the other hand, if you have developed a solid nutrition practice in addition to the musculoskeletal work you do, then you still have an income stream, even when you are out of the office for an extended period of time. Many chiropractors have been able to increase their income by 25-30 percent by incorporating nutrition into their practices. In addition, it adds value to your practice when you decide to retire, because the business is more than you and your two hands.
 
Tip to get started: “Just begin; don’t be afraid,” Dr. Fedorko advises chiropractors who are interested in incorporating nutrition into their practices. “Start with one condition and allow your practice to dictate where you go next,” he says. “As your patients ask ‘What about this?’ learn about the next issue and the next. Or, pick an area of nutrition that is of particular interest to you, or that you really enjoy, and learn more about it. The most important thing to realize is that to be more effective, you need to begin using nutrition.”
 
Nutritional supplement companies are ready, willing, and able to help chiropractors learn more about nutrition and how to take this worthy wellness and prevention path to elevate their practices. 
 
Many offer webinars, training modules, and best practices information that will help you get started and grow. They also offer patient brochures, PowerPoint presentations, and training on how to communicate with your patients about nutrition. Use these valuable tools to add nutrition to your health care toolbox. You’ll be helping your patients achieve a higher level of health and creating a healthy bottom line for your practice.
Charles C. DuBois is president of Standard Process Inc. He is honored to be the leader of a company that is committed to carrying on the philosophy of Dr. Royal Lee founding father of Standard Process, so that health care professionals and their patients will continue to receive the best in whole food nutrition. For more information about Standard Process, please visit the company’s new website at standardprocess.com or call 800-848-5061. 

Nutrient Intake and Plasma Beta-Amyloid Neurology

alzheimersColumnist Review by Dr. Dan Murphy, D.C. 

 
Y. Gu, PhD, N. Schupf, PhD, S.A. Cosentino, PhD, J.A. Luchsinger,MD, N. Scarmeas, MD: From the Department of Neurology and Department of Medicine, Columbia University, New York

Key Points From This Study:

  1. An important pathological hallmark of Alzheimer’s disease (AD) is B-amyloid (AB) peptide (mainly AB40 and AB42) deposition in the brain, resulting in formation of plaques.
  2. It is not easy or practical to measure brain AB levels, but plasma AB is easy to obtain and minimally invasive.
  3. These authors examined whether dietary intake of nutrients was associated with plasma AB levels in a cross-sectional analysis of 1,219 persons 65 years or older. Participants were in a community-based multiethnic cohort.
  4. Plasma levels of AB were measured and analyzed against stringent and comprehensive nutrient and supplement data collection.
  5. The associations of plasma AB40 and AB42 levels and dietary intake of 10 nutrients were examined using linear regression models, adjusted for age, gender, ethnicity, education, caloric intake, apolipoprotein E genotype, and recruitment wave.
  6. Nutrients examined included saturated fatty acid, monounsaturated fatty acid, omega-3 polyunsaturated fatty acid (PUFA), omega-6 PUFA, vitamin E, vitamin C, beta-carotene, vitamin B12, folate, and vitamin D.
  7. Higher intake of omega-3 PUFA was associated with lower levels of AB40 (24.7% reduced risk) and lower levels of AB42 (12.3% reduced risk). [Total AB reduced risk of 37%]
  8. Other nutrients were not associated with plasma AB levels.
  9. “Our data suggest that higher dietary intake of omega-3 PUFA is associated with lower plasma levels of AB42, a profile linked with reduced risk of incident AD and slower cognitive decline in our cohort.”
  10. “There is increasing evidence to suggest that diet may play an important role in preventing or delaying the onset of Alzheimer’s disease.”
  11. “The nutrient intakes from foods and from supplements were separately estimated, and only the nutrient intake from foods was used in the current analysis.”
  12.  “Participants with higher omega-3 PUFA also had lower levels of AB40.”
  13. Higher intake of omega-3 PUFA was significantly associated with reduced plasma levels of both AB40 and AB42.
  14. “In this cross-sectional study of a group of elderly participants without dementia, we found that higher dietary intake of omega-3 PUFA was associated with decreased plasma AB42 levels, independent of age, gender, ethnicity, education, and APOE genotype.” [This indicates that even in those with genetic markers of increased Alzheimer’s risk, increasing levels of omega-3 fatty acids reduces the associated risk]
  15. A dietary pattern characterized by high omega-3 PUFA was associated with a nearly 40% reduced risk of AD.
  16. “Higher dietary intake of omega-3 PUFA might lead to lower plasma levels of AB42 (and possibly AB40) and a subsequent lower risk of AD.”
  17. There was no persistent association for other nutrients, suggesting that the nutrients might have little or no association with AB-related mechanisms.
  18. “In the current study, we found that higher dietary omega-3 PUFA intake was associated with lower plasma AB42 level, suggesting that the potential beneficial effects of omega-3 PUFA intake on AD and cognitive function in the literature might be at least partly explained by an AB-related mechanism.”
Comments From Dr. Dan Murphy:
 
This is yet another article indicating that low levels of omega-3 fatty acids increase the risk of Alzheimer’s disease. It is projected that as the Baby Boomer generation (1946-1964) continues to retire, about 14 million of them will suffer from Alzheimer’s, a burden to our society that threatens to bankrupt our country. I believe that all Americans should have their omega-6/omega-3 ratio checked and we should all strive to keep our ratio below 4/1.

Dr. Dan Murphy graduated magna cum laude from Western States Chiropractic College in 1978. He received Diplomat status in Chiropractic Orthopedics in 1986. Since 1982, Dr. Murphy has served part-time as undergraduate faculty at Life Chiropractic College West, currently teaching classes to seniors in the management of spinal disorders. He has taught more than 2000 postgraduate continuing education seminars.  Dr. Murphy is a contributing author to both editions of the book Motor Vehicle Collision Injuries and to the book Pediatric Chiropractic. Hundreds of detailed Article Reviews, pertinent to chiropractors and their patients, are available at Dr. Murphy’s web page:  www.danmurphydc.com

An Easy Way to Add Nutrition to Treat Your Patients in Pain

Low back pain is one of the most common reasons patients visit all physicians in the United States and it represents a substantial financial burden on society (1). The most common treatments are pharmaceuticals, which are either prescribed or self administered, and manual care, which is delivered largely by chiropractors. Nutrition is not generally considered in the treatment of low back pain and, in fact, there are few trials that have specifically studied the effect of diet and/or supplements. This leads some to incorrectly view that nutrition may not be useful. The problem with this view is that no matter where the pain may be, the same peripheral and central nervous mechanisms are involved, which includes the release of chemical mediators, such as prostaglandins and cytokines (2), which are known to be modulated by diet and supplementation (3). In this article, three different types of common pain patients will be discussed. Those whose back pain begins without obvious injury; those who suffered an obvious strain that led to pain; and individuals with chronic aches and pains that vary in intensity and generally make life miserable.

Reduced caloric intake

nutritiontotreatpainIn human and animal studies, caloric restriction has been associated with the reduction of pain and inflammation (4-6). The precise mechanisms are not known for sure; however, it is clear that overeating nutrient-free and calorie dense foods will lead to postprandial elevations in glucose and triglycerides, which is associated with inflammation and is referred to as postprandial dysmetabolism (7). Americans spend most of their waking hours in the postprandial dysmetabolic state (7). While postprandial dysmetabolism is largely studied in the context of heart disease and diabetes, it can be applied to all conditions associated with inflammation. In other words, it makes no sense for patients with pain to live their lives in the postprandial inflammatory state. Identifying these patients in advance is helpful; they are overweight and sedentary, which is the majority of patients. These patients overeat sugar, flour, and excessively fatty foods at the expense of vegetables and fruit.Perhaps a chronic postprandial dysmetabolic inflammatory state is why patients are less responsive to spinal adjustments today, compared to yesteryear. This has been suggested to me as a possible reason by numerous DCs in the past twenty years who had been in practice for at least 40 years.  Modest caloric restriction immediately reduces postprandial inflammation (7), a practice that should be adopted by all patients in pain. Simply cut out the high calorie dessert foods and snacks and increase the consumption of whole foods, particularly vegetables and fruit.

Back pain that develops without obvious injury

Many patients present with back pain that slowly develops without an obvious inciting injury. Many of these patients have tried anti-inflammatory medications without success and so decide to give chiropractic a try. It is important to remember that many of these patients enter your office in the postprandial dysmetabolic inflammatory state. They likely need mechanical and chemical care as outlined in Table 1.


Table 1. Back pain that develops without obvious injury
Spinal manipulation
Reduced caloric intake
White willow bark extract (1000 mg)

White willow bark is a good choice for this category of back pain patient and should be taken as needed to help modulate the pain. Back pain guidelines and review articles have identified that white willow is no less effective than medications and is associated with less side effects (1,8). Important to note is that white willow bark should not be viewed as a “natural aspirin.” The beneficial effects of white willow are thought to be due to its unique flavonoid profile that offers a novel analgesic effect (9).

Back pain that develops due to an obvious injury

When patients state that a specific mechanism of trauma was responsible for their back or other pain, the key term to be thinking about is “acute inflammation.” Clearly, these patients need to avoid the postprandial dysmetabolic inflammatory state. Care should be given to delivery of manual care as the tissues are acutely inflamed and can be further injured. Table 2 also includes the use of proteolytic enzymes as a component of the treatment approach.


Table 2. Back pain that develops due to an obvious strain
Spinal manipulation
Reduced caloric intake
Proteolytic enzymes

Proteolytic enzymes include bromelain, trypsin, chymotrypsin and papain. Research has identified multiple mechanisms of action. The most notable in the context of acute inflammation is that proteolytic enzymes help to activate plasmin, which degrades fibrin and can help control tissue fibrosis after acute injury (10). Proteolytic enzymes should be taken on an empty stomach at least three times per day. A very safe dose ranges from 600-2000 mg per day (10) for about a week. In a study on ankle sprains, subjects that took enzymes were back to work in less than 2 days compared to over 4 days for those taking the placebo. And those taking enzymes were back to exercising again in under 10 days versus almost 16 days for the placebo group (11).

Chronic aches and pain

As people age, they become accepting of aches and pains as if they are normal. This view is not accurate. In most cases, their musculoskeletal pains can be effectively modulated with manual treatments and nutritional interventions. The majority of these patients do not realize that they have lived in a postprandial dysmetabolic inflammatory state for perhaps decades. Reducing caloric intake is as important as lifestyle. I would suggest making their college or high school body weight the goal to be achieved.

Table 3. Chronic back pain
Spinal manipulation
Reduced caloric intake
Ginger, turmeric, boswellia, etc.

Table 3 includes various botanicals in addition to manipulation and caloric reduction. Ginger and turmeric are two of the most studied botanicals (12,13). Typically about 1-2 grams per day are recommended and should be taken on a continuous basis. Substantial pain reduction has occurred for patients with rheumatoid arthritis, osteoarthritis, and general musculoskeletal pain (12).

 

Dr. Seaman is a Professor of Clinical Sciences at the NUHS branch campus at St. Petersburg College in Florida. He is also a Clinical Consultant for Anabolic Laboratories. He has written numerous articles on the treatment options for chronic pain patients, with a focus on nutritional management. He can be reached at defl[email protected]flame.com.

 

References

  1. Chou R et al. Diagnosis and treatment of low back pain: a joint guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007; 147:478-91.
  2. Marchand S. The physiology of pain mechanisms: from the periphery to the brain. Rheum Dis Clin N Am. 2008; 34:285-309.
  3. Seaman DR. Nutritional considerations in the treatment of soft tissue injuries. In Hammer WI. Editor. Functional soft-tissue examination and treatment by manual methods. Boston: Jones & Bartlett; 2007:717-734.
  4. Kjeldsen-Kragh J et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991; 338:899-902.
  5. Hargraves WA, Hentall ID. Analgesic effects of dietary caloric restriction in adult mice. Pain. 2005; 114:455-61.
  6. Fontan-Lozano A et al. Molecular bases of caloric restriction regulation of neuronal synaptic plasticity. Mol Neurobiol. 2008; 38:167-77.
  7. O’Keefe JH, Bell DS. Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a cardiovascular risk factor. Am J Cardiol. 2007; 100:899-904.
  8. Bogduk N. Pharmacological alternatives for the alleviation of back pain. Expert Opin Pharmacother. 2004; 5(10):2091-98.
  9. Nahrstedt A, Schmidt M, Jäggi R, Metz J, Khayyal MT. Willow bark extract: the contribution of polyphenols to the overall effect. Wien Med Wochenschr. 2007; 157(13-14):348-51.
  10. Maurer HR. Bromelain: biochemistry, pharmacology, and medical use. Cell Mol Life Sci. 2001; 58:1234-45.
  11. Bucci LR. Nutrition applied to injury rehabilitation and sports medicine. Boca Raton, FL: CRC Press; 1995: p.
  12. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses. 1992; 39:342-8.
  13. Goel A, Kunnumakkara AB, Aggarwal BB. Curcumin as “curecumin”: from kitchen to clinic. Biochem Pharmacol. 2008; 75:787-809.

How Well Do You Know Your Ginseng? Maybe Not So Well… Here’s Why

What is Ginseng? There is good reason why you may not know your ginseng so well.  Although ginseng is one of the most well known herbs or supplements it is also the most misunderstood.  Most people have heard of “ginseng”, for example it ranks #1 in the Ebay search word for “herbs and botanicals”.  
 
ginsengrootGinseng has a remarkable history going back over 2,000 years in written medical documentation, and many estimates place its use as a natural healing herb going back over 5,000 years!  Ginseng has been used to prevent and cure an extraordinary catalog of human ailments, from diabetes to mental/neural dysfunction, to sexual function and waning libido, fatigue, cardio vascular health, adrenal stress, and even cancer. Ginseng is considered by many herbalists as the world’s most complete adaptogen.  Wait!!! Before you compare ginseng to your favorite adaptogen, one point needs to be clarified: not all ginseng is the same!
 
Over 5,000 Clinical and Research Studies
In the 20th Century, Japanese and Russian scientists discovered and cataloged the active ingredients unique to ginseng: plant saponins called Ginsenosides.  This began an explosion of research, resulting in over 5,000 published clinical and research studies to date and growing.  There is a substantial body of scientific literature published primarily in Korea, Japan, China and Russia.  In the last 15 years there has been a growing number of German and American studies. 
 
What is Ginseng? Is All Ginseng the Same?  What Does It Do?  
First let’s look at ginseng’s official classification, which is revealing: “Panax Ginseng”.   Panax comes from the Greek word Panacea, which, according to Webster’s, is “a remedy for all ills or difficulties, a cure-all.”  Wow, that is quite a name.  Why this name?  For over 2,000 years ginseng was used as the leading medical treatment for both physical and mental illness.   In the last 30 years much of ginseng’s efficacy has been verified by scientific research. 
 
The Ginseng Challenge
Here is the ginseng challenge: Not all ginseng has the same efficacy.  In fact, its efficaciousness varies widely depending on classification and how it is processed.  So let’s take a look at what makes the difference.
 
Classification
Classes of ginseng vary primarily according to where it grows.  What are the different types?  Korean Ginseng: “Panax CA Meyer”, Japanese Ginseng: “Panax Japonicus”, American Ginseng: “Panax Quinquefolius”, Chinese Ginseng (AKA Pseudo-Ginseng or Tianqi in Chinese): “Panax Notoginseng”.  Are we missing Indian Ginseng? No, that’s not ginseng it is “Ashwaganda”.   Surely we are missing Siberian Ginseng? No, that’s also not ginseng, that is “Eleuthrococcus senticosus”.  
 
How do classifications compare?  Classifications are determined mainly by where the Ginseng is grown which affects the shape and the ingredients.  The key difference is the number of different types of main Ginsenosides. Korean Ginseng has 38, American has 13, Chinese has 14 and Japanese has 6.   Why is this important?  At its core ginseng is an adaptogen which brings your body into homeostasis, where healing is optimized.  The more types of Ginsenosides, the broader range of adaptogenic effect. In this limited article we will focus on Korean Ginseng, “Panax Ca Meyer” which has the most types of ginsenosides. We also will focus on cultivated ginseng since wild-grown ginseng is very rare and not generally available.
 
Processing of Korean Ginseng
Here is one of the main ginseng misconceptions: Most people think that Red Panax Ginseng from 6 year roots that are peeled is the best ginseng.  However, science tells a completely different story.  Red ginseng is processed with high temperature steam that creates the red color.  White ginseng is only sundried with no extraneous heat, creating the white color.  The optimal harvest time is 4-5 years for maximum Ginsenoside density and balance, by 6 years the root has less density and balance.  Whole roots are far superior to peeled roots, as the fine rootlets carry some of the most important ingredients.   The hot steam used to make red ginseng does help to liberate Ginsenosides, but it destroys all of the vitamins, removes all of the organic Germanium, and degrades the amino acid profile. 
 
There is a very important final process used to create high-efficacy white ginseng extract.  This is a slow, low-heat vacuum extraction process which results in the extract providing more Ginsenosides than red ginseng extract. (Analysis of Ginsenosides of White and Red Ginseng Concentrates, Chung Ang Department of Food Science and Technology, Chung-Ang University, 4/14/03) 
 
Beyond Ginsenosides
One point is very important regarding why Ginseng works.  It is not just the Ginsenosides, it is all the ingredients in combination which provide such a remarkable effect:  the phenols, lipids, 18 essential fatty acids, 6 vitamins, 7 amino acids, 8 essential amino acids, fatty acids, and 18 minerals, including organic gemanium and polyacetylene. Many of these ingredients are reduced and lost with the high heat steaming used to make red ginseng. 
 
Balance
A key word in considering the efficacy of ginseng extracts is “balancing”.  The most efficacious ginseng extract comes from whole unpeeled 4- or 5-year-old roots extracted using slow low-heat vacuum extraction. This kind of extract has the broadest range of Ginsenosides and retains all the other ingredients and the broadest adaptogenic affect.
 
This combination of 4-year roots, not peeling, sun drying, slow low-heat vacuum extraction is a very expensive and time-consuming process.  The result is a ginseng extract that provides the most powerful, uniform and reliable homeostatic results.
 
A Common Misconception about Korean Panax Ginseng
ginsengroot2When we study the history of Korean Panax Ginseng we find that it is a completely balancing herb and considered a sweet herb with both Yin and Yang characteristics, depending on how it is processed.  “Sheng Nung Pen Ts’ao Ching” (book of herb)
 
However, in today’s red-ginseng-dominated market, there is a broad consensus among herbalists, chiropractors, and TCM physicians that Korean Panax Ginseng is a very Yang and heating herb and therefore it should be used for a toning purpose for a short time, mainly for those who are “Yang deficient”.   The concept is that American Ginseng, “Panax Quinquefolius”, is a less Yang affecting and more Yin herb and should be used for ongoing daily use.   However, the concept applies to the predominant red ginseng and red ginseng extract.  It does not apply to the white ginseng extract process described above.
 
Confusion in Ginseng Research
In reviewing the clinical research on ginseng you will find that many studies offer mixed results.  As you have learned above, there is a broad difference in efficacy between the different types and processes for ginseng.   Another significant factor surfaces when you study the clinical research.  The amount of ginseng used in Western studies is normally only 1/3 or less than the amount used in Eastern studies.  This also creates lack of consistency in the findings.
 
A final area of concern is the predominance of in vitro in animal studies, a common problem with natural products vs. pharmaceuticals due to the well-known financial structure of our healthcare system.  However, ginseng results are so universal that more human trials are underway.   
 
Research Opportunities
In 2001 the Herbal Botanical Council completed a study testing various types of ginseng for strength and ingredi­ent profile.  herbalgram.org/site/DocServer/Ginseng_Evalua­tion_Program.pdf?docID=241 
 
Today, Doctors can participate in a longitudinal case study being performed by the Bio Energy Medicine Research Institute “BEMRI”. Each participating physician receives over $1,200 worth of an enzyme fermented high-absorption ginseng (patent pending) for testing with 3 patients.  

To learn more Contact BEMRI at (440) 463-1083 or go to www.BEMRI.com
 
Ronald K. Gilbert, D.C., CCSP, NMD
B.S. 1984, Va Commonwealth Univ.
1985, Diplomate, National Board of Chiropractic Examiners
D.C 1986, Northwestern College
CCSP 1988, Parker College, Sports Medicine
1992 , American Board of Chiropractic Orthopedics
NMD 2002, St Luke School of Naturopathic Medicine,,
ND 2002, Commission on Certification of Naturopathic Physicians
2002 ,100 hr. Post-Grad Internal Medicine, National University of Health Sciences.

David C Konn
Double Major Psychology and Kinesiology
Macalester College, St Paul MN
CEO Neuro Energies Inc.
Regional President of Empowered Doctor
Managing Director, Ilhwa North America

 

Obesity: Why Exercise Doesn’t Work!

Are you guilty of recommending exercise to help your overweight patients lose unwanted fat? The answer could have a major impact on your clinical outcomes. Do you really believe that juggling balls for a few minutes daily—as seen on NBC recently—will burn enough calories to get the job done?
 
exercisedoesnotworkDo you not find the advice to buy a pedometer to track how many steps you can add to your walk every day an endless, boring journey? The fact is focusing on calories burned to lose weight is a bunch of pseudo-science BS that is guaranteed to short circuit any chance of your patients  reaching their goals. Scientific literature shows little evidence of exercise being very effective in promoting weight loss.
 
I can confirm this fact, having over the years watched tens of thousands of exercisers struggling to lose weight with the typical exercise recommendations made by the healthcare system. The fact is many people don’t like exercise anyway, and certainly not our overweight patients. 
 
What if you could design an exercise program for your patients that would help them lose weight, that didn’t require jogging, sit ups, aerobics or stretching, one that would increase your patients’ strength, balance, coordination, and flexibility, would increase their “heart reserve,” protecting them from a heart attack, a program that required little will power, commitment, or  perseverance to stick with, could be accomplished with two short workouts weekly, and would have your patients singing your praises to all they know.
 
It is possible!
But before recommending this hypothetical exercise program, your patients need to understand why the archaic exercise and eating plans of the past few decades are not working. They need to know why they are getting fat in the first place and why their bodies are holding on for dear life to this fat, even “trapping” it in fat cells.

Impress on your patients that the reason for this is that their bodies are being overwhelmed by sugars, hidden sugars and carbohydrates at every meal and with every snack. Explain to them that the body will use some of this sugar immediately for energy, but the excessive sugar presents a problem and must be dealt with right away, as it is toxic to the cells, arteries and tissues. Explain that the response by the body to sugar in our blood is to excrete “insulin” from the pancreas.
 
The overall action of insulin is to take this excess sugar and store it in the muscle and liver. But there is only so much room there and the excess gets stored in the fat cells.
 
But here is the real damaging part to their weight loss goals: Insulin also serves to keep the fat stored in the fat cell, “locked up” so to speak until the blood sugars are low again. If most of what we are eating is being locked away in the fat cells due to the high sugar diets we are consuming, this leaves us with very little energy available for our muscles and organs.
 
The result is we are going to be constantly hungry.  If we continue eating the same foods that promoted the high sugar problem in the first place, well, this fat storage process will continue on indefinitely. Our body does have another option when faced with a dwindling energy supply: It can slow down all functions, conserving energy at the cellular level and making us lazy.
 
Or our body can respond by becoming both hungry and lazy…sound familiar?

Now, if our goal is to lose fat, not just weight, and we don’t want to lose muscle, we must find a way to get at the fat that is locked away in the fat cells and use it for energy. 
 
Here is where it gets interesting: The weight loss industry’s focus on reducing calories to lose weight may not hold water.
 
Why?
When our muscles and organs are not receiving enough energy from the foods we are eating, due to this energy being locked up in the fat cells, our body will compensate by conserving energy, and our metabolism, which is every cell in our body, will slow down. This conservation of energy may offset any reduction in calories (dieting) resulting in no weight loss.
 
We also know that the body can and will use sources other than fat for energy.

The lean tissues of the body, such as the muscles and organs, will be recruited as raw material for energy production, therefore resulting in no reduction in fat!

The final nail in the coffin for the obese patient is the addition of exercise into the mix. 
 
If there is little fat available because it is locked up in the fat cells, and we begin eating less food, thinking this will help us lose weight but only results in the body just slowing down, and now we add exercise, where do we get the energy for the exercise? Again, muscle and organs such as the heart will now be used as a source of energy. The patient may now begin losing weight, but it will be lean tissue weight as a result of starving it. This also leaves these tissues susceptible to deficiencies.
 
Although this may sound simplistic, the answer to most of  our weight loss problems (outside of the bio-chemical glitches of the body such as thyroid) is simply a matter of  being able to access our fat reserves by eliminating the foods that are stimulating excessive insulin. Why?  Because, again, insulin serves to keep fat locked up in the cells.
 
So why exercise? 
If the greater influence to losing weight is the diet, one could say that the overemphasis on exercise may be having a negative effect on weight loss, as exercising while the fat stores are locked up may only serve to make us hungry, lazy and fatter.
 
If we can create an environment in which the fat stores are now available for use for energy, it would seem that adding exercise into the weight loss protocol would be a good way to reduce fat stores and therefore weight. Although “effective exercise” can aid in weight loss and benefit quality of life, all exercise beyond the ability of the body to adapt is counterproductive! 
 
So what is “Effective Exercise”?
In other words, workouts should be designed to be invigorating, not overwhelming, long and fatiguing.[/pullquote]A practical, effective exercise approach to health and fitness is to SIMPLY focus on muscle retention, and even adding a few pounds of muscle, as it is the most critical element of human fitness. 
 
Skeletal muscle plays key biological roles in keeping you strong, functional and healthy.  Muscle is obviously needed for physical movements, participates in the regulation of blood sugars, uses fat for energy and keeps us from becoming insulin sensitive or diabetic.
 
For the population that does not particularly like exercise and has limited time, resistance exercise can be safely performed and results in more parameters of fitness being influenced than any other exercise protocol.
 
This results in improvements in strength, endurance, flexibility, conditioning, muscle tone, stress relief, limited repetitive activity on joints, minimized oxidation, tapping into the fat stores effectively through “protein synthesis” and improved cardiovascular parameters.
 
What is interesting is that science and my practical experience with thousands of clients has demonstrated that these benefits can be had with as few as two workouts a week. 
 
By being realistic with our patients about exercise limitations in supporting weight loss, we can now recommend a program that will give them all the benefits of exercise with only two effective workouts a week.
 
This implication could dramatically improve compliance for a population that does not necessarily like exercise or would shy away from the types of exercises that are not appropriate or prudent for them, such as jogging, aerobics, boot camp type classes, etc. 
 
By not overemphasizing the volume of exercise as most programs do, which only sets our patients up for failure from the get-go, we can finally put the emphasis on the real problem and address the foods that are contributing to fat deposition.
 
With the emphasis on the foods that will keep insulin levels low and an exercise program that challenges the largest muscles of the body twice a week, large amounts of fat will be recruited to provide the energy to recover from this type of workout, even on the days you are not exercising. The typical game plan of walking or riding an exercise bike for 30-60 minutes daily, along with a few “toning” exercises, will probably not do the job. If you do get some results they will be the result of a tremendous cost in time and energy which eventually leads to giving it up and weight gain.
 
It is important to note that high-intensity, short-duration exercise has a stimulating effect on the metabolism, whereas the body perceives long-duration workouts as an unrelenting stressor, a cue to shut down metabolic activity and hormonal output to conserve energy (the same shut down caused by fasting or even low calorie diets).
 
In other words, workouts should be designed to be invigorating, not overwhelming, long and fatiguing.
 
By using reverse psychology and prescribing only two exercise sessions a week for your patient, by eliminating their hunger by not dieting, and by recommending effective exercises that are prudent and appropriate for their fitness level, the chances for long-term compliance is greatly improved, which inevitably will lead to better clinical outcomes.
 
The Cochrane Collaboration review: Pirazzo et al. 2002. The USDA analysis:

Kennedy et al. 2001:419 (table 11) Only one study tracked participants for more than a year: Jeffery et al. 1995 The WHI report on weight: Howard, Manson, et al. 2006
 
Haskell, W.L., I. M. Lee, R.R. Pate, et al. 2007 “Physical Activity and Public Health: Updated Recommendations for Adults from the American College of Sports Medicine and the American Heart Association.” Circulation. Aug 28: 116(9):1081-93
 
Wilder, R.M. 1993. “The Treatment of Obesity”. International Clinics. 4:1-21
 
Nussey, S.S., and S.A Whitehead. 2001. Endocrinology: An Integrated Approach. London: Taylor & Francis.
 
Berson, S.A., and R.S. Yalow. 1970. “Insulin ‘Antagonist’ and Insulin Resistance.” In Diabetes Mellitus: Theory and Practice. ed. M. Ellenberg and H. Rifkin, pp. 388-423. New York: McGraw-Hill
 
Yakovlev, 144, Breitbart et al., 163, Booth et al., 159
 
Brooks, 1997; Westcott, 1996

Ronald Grisanti D.C., D.A.B.C.O., M.S., is medical director of Functional Medicine University. If interested in improving your diagnostic skills and increasing your community reputation and recognition, we strongly recommend subscribing to our Free Clinical Rounds Series. These challenging case studies will give you the unique opportunity to test your clinical skills and, at the same time, improve your ability to handle many of the most difficult cases. Go to the following link to get your free access: www.Clinical-Rounds.com.

 
Rick Bramos, U.S.  Army Coach (’73), Personal Trainer and Fitness Instructor  certifications from the American Council on Exercise (A.C.E.).  One of  the first men Certified to teach Step, Body Pump and Spinning (’92). FREE BOOK CHAPTERS www.2daystofitness.com