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Integrative Medicine and Wellness

with Joe Pizzorno, Jr., ND

The Integrative Medicine and Wellness blog has now been retired. We appreciate the wisdom and support Dr. Joseph Pizzorno has brought to the WebMD community throughout the years. If you would like to talk with others about wellness, please join or start a discussion on one of our Health Exchanges.

Monday, October 27, 2008

Vitamin K2, but Not Vitamin K1, is Helpful for Bone Density

The importance of vitamin K in the prevention and treatment of osteopenia/osteoporosis has just been discounted in a WebMD review (“Vitamin K: No Help for Bone Density“) of research published Oct. 14, 2008, in PLoS Medicine (Cheung A, et al.) In the study, Canadian researchers, not surprisingly, found that taking 5 mg per day of vitamin K1 does not protect postmenopausal women from age-related declines in bone density.

What is surprising is that the researchers, despite noting that vitamin K is a family of compounds, and that vitamin K2 is the form which is an approved treatment for osteoporosis in Japan, chose to use vitamin K1 in their clinical trial.

It is well known that vitamin K1 (phylloquinone) is involved in blood coagulation. It is also well documented that vitamin K2 (menaquinone) is the essential cofactor for the carboxylation (activation) of the (gamma-carboxyglutamic acid) Gla-containing proteins involved in calcium regulation.

Numerous peer-reviewed studies have shown that vitamin K2 – given either as the synthetic form MK-4 (a short-chain version called menatetrenone) at a dosage of 45 mg/day, or as the natural form, MK-7 (a long-chain menaquinone derived from natto) at a dosage of 45 mcg/day – is a highly effective activator of osteocalcin, the Gla-containing protein integral to calcium deposition in bone. This body of research conclusively demonstrates that vitamin K2 not only lessens fracture incidence and improves bone density but also, via the carboxylation of another Gla protein (matrix Gla protein), inhibits arterial calcification.

Finally, even though they did not use the right form of vitamin K, looking at the research more closely shows that in the treatment group fractures were down – only 9 women getting vitamin K1 vs. 20 getting placebo had fractures (which is why we want higher bone density!). In addition, surrogate markers of bone production were up and the trends were toward higher density at several points during the intervention.

Why Cheung et al. did not use the optimal form of vitamin K remains a mystery, as does the lack of critical analysis and incomplete conclusion provided by the review. Hopefully, the outcome of this misleading publication will not be an increased incidence of osteopenia/osteoporosis in women at risk of these conditions who are dissuaded from supplementing with vitamin K2.

References:

Cheung A, Tile L, Lee Y, et al. Vitamin K Supplementation in Postmenopausal Women with Osteopenia (ECKO Trial): A Randomized Controlled Trial, PLOS Medicine, Oct. 14, 2008; Vol 5: p. e196.

Pizzorno L, Pizzorno J. Vitamin K: Beyond Coagulation to uses in Bone, Vascular, and Anti-Cancer Metabolism. IMCJ, Apr/May 2008, Vol 7:No. 2, p.24-30.

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Posted by: Joe Pizzorno, Jr., ND at 5:10 pm

Thursday, October 16, 2008

Strong Bones for Life – Naturally (Part 2)

Your Bones, Your Choice

Of course, even old decrepit bone is better than no bone, the situation seen in osteoporosis, which results when osteoclasts’ demolition work greatly outpaces osteoblasts’ new construction. Fortunately, this unbalanced situation, which can develop if the body becomes chronically pro-inflammatory and/or lacks a good supply of all the materials needed to build new bone, can be prevented and treated without drugs.

Here’s what you need to build strong bones for life, naturally.

Calcium
Daily calcium needs:

  • Women 19-50: 1,000 mg
  • Women 51+: 1,200 mg
  • Postmenopausal women not taking HRT: 1,500 (if on HRT, 1,200 mg daily; if you are taking HRT, it should be bio-identical bi-est and progesterone compounded specifically for you after you have had your hormone levels – all three estrogen fractions and progesterone – checked, not Premarin and Provera! If your physician is not aware of this, switch physicians.)

Remember, you get calcium from both food and supplements, so keep a food diary for a week or two to estimate your typical calcium intake and then take enough supplemental calcium to reach the above amounts.

If you regularly eat dairy products (from cows, sheep, or goats), soyfoods with added calcium, sesame seeds, and greens such as spinach, collard greens, Swiss chard, or broccoli, you are likely getting about 600 mg calcium from food each day.

Choosing a Calcium Supplement
You will see different forms of calcium in supplements. Choose either chelated calcium or hydroxyapatite (#3 or #4 below). Here’s why:

  1. Naturally-derived calcium: may appear on labels as bone meal, oyster shell, limestone, or dolomite (clay). Avoid these supplements since naturally derived calcium may contain significant amounts of lead.
  2. Calcium carbonate: the most commonly used form and the least expensive, but not nearly as well absorbed as chelated calcium. If taking calcium carbonate, take with meals when your stomach will be secreting hydrochloric acid to digest the food as it will also help you break down and absorb calcium carbonate.
  3. Chelated calcium: will appear on the label as calcium-citrate, calcium-malate, calcium-gluconate or calcium-aspartate. In these chelated forms, the calcium is bound to an organic acid (citrate, malate, gluconate) or amino acid (aspartate), which improves its absorption. Chelated forms of calcium are more expensive than calcium carbonate, but build more bone for the buck, so are worth it.
  4. Hydroxyapatite: sometimes appears as MCHC (microcrystalline hydroxyapaptite). The most expensive form of calcium, hydroxyapatite, is a complex crystalline compound that contains calcium linked with phosphorus in a pre-formed building block of the bone mineral matrix. MCHC contains hyrdoxyapatite plus bone-derived growth factors and all the trace minerals that comprise healthy bone. If you are at high risk of osteoporosis or have osteopenia, you should be taking MCHC.

Vitamin D
Vitamin D is essential for calcium’s absorption both from the intestines and into bone.

You want vitamin D3, the natural form. The fully activated form of the vitamin in the body is titled 1,25-dihydroxycholecalciferol as know as “calcitriol”.

Some supplements (especially the less expensive ones) contain synthesized D2 (called ergocalciferol). Current research shows this is not as biologically effective as the natural D3. (Houghton L, Vieth R. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr. 2006 Oct;84(4):694-7).

Anyone living in northern latitudes (e.g., the Pacific Northwest or New England) is at high risk for vitamin D deficiency and should have her or his blood levels of 25(OH)D3 checked. 25(OH)D3 is the major circulating form of vitamin D in the blood and the best barometer of vitamin D status. Be sure this is the vitamin D test your doctor orders for you; many labs/doctors test D2.

Adequate blood levels of vitamin D to provide for bone health (as well as protecting against colon and breast cancer, multiple sclerosis, inflammatory bowel disease, depression – and a host of other ailments) begin at 75 nmol/L of 25OH-D3. Blood levels of vitamin D between 90 and 100 nmol/L are optimal.

The amount of vitamin D you need will depend on the results of your blood test. A daily intake for all adults of >/=1000 IU vitamin D is needed to bring vitamin D concentrations up to 75 nmol/L in at least 50% of the population. If you live in northern latitudes or live in the south but get little sun exposure or wear sunscreen, you can start taking 1,000 IU of D3 daily right away. However, you may need 2,000 or even 5,000 IU of D3 daily for 6-8 months to restore adequate levels of this critical nutrient.

We are currently involved in a corporate wellness program in Canada. We found that 82% of the employees have low levels of vitamin D in their blood.

Magnesium
If your blood test reveals that you are significantly vitamin D-deficient (we’ve seen vitamin D levels around 30 nmol in many patients and levels as low as 13 nmol in several), and your physician recommends you take more than 2,000 IU/day for an extended period of time, you will also need to supplement with magnesium citrate, 500 mg, twice daily.

Calcium and magnesium counterbalance one another in numerous cellular activities. If you are taking high levels of vitamin D, you will be absorbing significantly more calcium and will need to ensure your magnesium levels are sufficient to maintain this balance.

This is very important: symptoms of magnesium deficiency include migraines and tension headaches, muscle weakness, leg cramps, restless legs, elevated blood pressure, transient ischemic attacks, and heart arrhythmia.

Vitamin K
Vitamin K, specifically vitamin K2 or menaquinone, activates a group of proteins (the Gla-proteins), which are responsible for where calcium gets delivered in the body. Vitamin K2 ensures that the calcium you consume (and which will be getting into your circulation in higher amounts now that you are taking vitamin D) is deposited where you want it—in your bones, and not where you don’t—in your blood vessels and other soft tissues.

When your vitamin K2 levels are adequate, two of the Gla-proteins that are activated are: (1) osteocalcin, the protein responsible for anchoring calcium within bone, and (2) matrix Gla-protein, which prevents calcium from depositing in the heart, arteries, breast and kidneys.

Both vitamin K1 (phylloquinone) and vitamin K2 (menaquinone) are available as supplements. Vitamin K1 is primarily involved in helping your blood clot normally, although our bodies are able to convert a small amount of K1 into K2.

For bone health, K2 (menaquinone), particularly natural menaquinone derived from natto, which may be labeled MK-7 (menaquinone-7) is the most potent form. You may also see K2 as menatretrenone; this is MK-4, a synthetic version that must be taken in much higher doses bec
ause its half-life in the body is quite a bit shorter.

If you are taking MK-7, a daily dose of 45 mcg is sufficient. If taking MK-4, take 5 mg daily.

Best food sources of vitamin K (K1) include kale, spinach, Swiss chard, broccoli, Brussels sprouts, parsley and romaine lettuce. Natto, from soy, is an excellent source of K2, but is not easily available in the U.S., nor would the taste appeal to most Americans.

Boron
Boron protects against calcium loss by helping to maximize the activity of both estrogen and vitamin D in bone.

The drop in estrogen levels that occurs during menopause triggers an increase in the production of a pro-inflammatory mediator called interleukin-6, which stimulates the production and activity of osteoclasts. Boron is needed for the conversion of estrogen to its most potent form, 17-beta-estradiol, which allows the body to make the most use of its remaining estrogen.

Boron is also involved in the reaction in the kidneys in which vitamin D is converted to its most active bone-building form, (1,25-(OH)2D3)—a compound that is even 10 times more potent than D3.

In one study of postmenopausal women, supplementation with 3 mg/day of boron reduced urinary calcium excretion by 44%!

Best food sources of boron are apples, pears and grapes. Leafy greens, legumes and nuts can also be good sources of this mineral; however, since the boron content of fruits and vegetables depends upon that provided by the soil in which they were grown, which can vary dramatically, boron supplementation with 3 mg/day is recommended.

Omega-3s
Inflammation-related activation of osteoclasts plays a key role in osteoporosis. Not only do the omega-3 fatty acids lessen the production of pro-inflammatory cytokines that activate osteoclasts acids, these fats also stimulate the activity of osteoblasts. In contrast, the pro-inflammatory omega-6 fats so abundant in the typical American diet stimulate osteoclasts. (Fernandes G, Lawrence R, Sun D. Protective role of n-3 lipids and soy protein in osteoporosis. Prostaglandins Leukot Essent Fatty Acids. 2003 Jun;68(6):361-72; Heaney RP, Carey R, Harkness L. Roles of vitamin D, n-3 polyunsaturated fatty acid, and soy isoflavones in bone health. J Am Diet Assoc. 2005 Nov;105(11):1700-2; Watkins BA, Li Y, Lippman HE, Feng S. Modulatory effect of omega-3 polyunsaturated fatty acids on osteoblast function and bone metabolism. Prostaglandins Leukot Essent Fatty Acids. 2003 Jun;68(6):387-98.)

Experts suggest the optimal ratio of omega 6:omega 3 fatty acids is 4:1 or even 2:1. The standard American diet delivers a ratio somewhere between 10 and 20:1.

In a recent study, subjects consumed each of three diets for a period of 6 weeks. The first, a typical American diet, delivered a 9.6:1 ratio of omega 6:omega 3 fats. The second and third diets provided ratios of 3.5:1 and 1.6:1 omega 6 to omega 3 fats, respectively. Walnuts, a rich source of both omega 6 and the omega 3 fats, were the primary sources of omega-3s in the second diet; a little more than one ounce (37 grams) of walnuts and ½ ounce (15 grams) of walnuts were included in each day’s meals in the form of walnut granola, walnut butter, walnut pesto or plain walnuts as a snack. The third diet contained about 20 grams (2/3 ounce) per day of flaxseed oil, a highly concentrated source of the omega 3 fat, alpha linolenic acid.

Indicators of bone loss called N-telopeptides (NTx, which are produced when osteoclasts break down bone collagen, were measured and found to be significantly lowered by the diets containing a lower ratio of omega 6 to omega 3 fats. The second diet, in which the ratio of omega 6: omega 3 was 3.5:1 reduced NTx 11.5%, while the third diet dropped NTx levels by 15.3%.

The researchers also measured levels of a pro-inflammatory cytokine called TNF-a (tumor necrosis factor alpha), which increases osteoclast production and activity. As the ratio of omega 6: omega 3 dropped, levels of TNF-a also dropped substantially. (Griel AE, Kris-Etherton PM, Hilpert KF, et al. An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J. 2007 Jan 16;6:2.)

In other research, a few weekly servings of salmon (14 ounces per week), has been shown to raise omega 3 levels more effectively than taking a daily fish oil supplement while also lowering blood levels of a number of pro-inflammatory chemicals including TNF-a. Researchers think omega-3s may be better absorbed from fish because fish contains these fats in the form of triglycerides, while the omega-3s in almost all refined fish oils are in the ethyl ester form. Once absorbed, omega-3s are converted by the body from their triglyceride to ester forms as needed. (Elvevoll EO, Barstad H, Breimo ES, Brox J, Eilertsen KE, Lund T, Olsen JO, Osterud B. Enhanced incorporation of n-3 fatty acids from fish compared with fish oils. Lipids. 2006 Dec;41(12):1109-14.)

Your Bones, Your Choice
You only have one body. Doesn’t supporting its inherent drive to maintain strong, healthy bones by supplying the natural compounds it uses in normal bone remodeling make better sense than giving it a drug that poisons your osteoclasts and puts you at risk for abnormal heart rhythms and jaw bone death? Your bones, your choice.

~Joseph Pizzorno, ND and Lara Pizzorno, MDiv, MA, LMT

Part 1: Bisphosphonate Drugs

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Posted by: Joe Pizzorno, Jr., ND at 7:00 am

Monday, October 13, 2008

Strong Bones for Life – Naturally (Part 1)

Bisphosphonate Drugs

It’s true, as Sally Fields emphasizes in her TV ads for Boniva, that you have only one body; it’s not true that Boniva and the other bisphosphonate drugs commonly prescribed to prevent osteoporosis offer the best way to take care of it!

Although prescribed to 30 million Americans each year, the bisphosphonates (e.g., Fosamax, Boniva, Actonel), have now been linked to serious potential complications.

A recent FDA alert warned physicians that all bisphosphonate drugs may cause “severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain…[that] may occur within days, months or years” after starting the medication, and in some patients, may not resolve even after discontinuing the drug.

Even more frightening are recent studies conclusively linking bisphosphonate use with jaw osteonecrosis or bone death. Osteonecrosis occurs when bone damaged as a result of poor blood flow or trauma is not removed and replaced with new bone. Initial symptoms include numbness, heaviness, swelling, pain and infection in the jaw, and progress to loosening of the teeth, decay and death of the jaw bone. Bisphosphonates accumulate in bones, particularly in the jawbone, and inhibit the bone’s natural ability to repair everyday damage.

A Cochrane Review noted that age = or > 60 years, female sex and previous invasive dental treatment were the most common characteristics of patients taking bisphosphonates who developed osteonocrosis. (Pazianas M, Miller P, Blumentals WA, et al. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther. 2007 Aug;29(8):1548-58.) Considering that the target population for bisphosphonate drug use is postmenopausal women, and many women now 60 or older have had some kind of invasive dental procedure in their lifetime, these risk traits for osteonecrosis with bisphosphonate use are far too common for comfort; so common that concerned dentists are highly reluctant to perform any type of dental surgery on women taking these drugs.

In one of the most recent studies, published in the Journal of Oral Maxillofacial Surgery in April 2008, researchers at the University of Southern California’s School of Dentistry found a direct correlation between the development of microbial biofilms (bacterial colonies that cause chronic infections) in affected bone and the use of bisphosphonates. (Sedghizadeh PP, Kumar SK, Gorur A, et al. Identification of microbial biofilms in osteonecrosis of the jaws secondary to bisphosphonate therapy. J Oral Maxillofac Surg. 2008 Apr;66(4):767-75.)

Just how many people now have osteonecrosis of the jaw caused by bisphosphonates? Incidence of osteonecrosis among cancer patients, who are given an intravenous and more potent variety of these drugs (e.g., Zometa and Aredia), is estimated at between 1% and 10%. Among those with osteopenia/osteoporosis taking the lower-dose pill forms (Fosamax, Actonel, Boniva), no one knows for sure. Studies to provide firm answers are just beginning, but it has been established that invasive dental procedures, such as tooth extractions or root canals, greatly increase risk of osteonecrosis in women taking bisphosphonates. As for treatments, cutting away the dead bone just worsens the situation, so antibiotic rinses are used, but frequently fail to remedy the condition. And since bisphosphonates remain in bones for years, no one knows how long the risk of osteonecrosis remains, even if the drug is no longer being taken. (Kolata G. Drug for Bones is Newly Linked to Jaw Disease, New York Times, June 2, 2006)

Recent studies have also reported bisphosphonate use as a risk factor for atrial fibrillation (abnormal heart rhythm) in women. One study estimates that 3% of atrial fibrillation cases might have been due to bisphosphonate (specifically, alendronate) use. (Heckbert SR et al.) Physicians are warned that bisphosphonate use needs to be closely monitored in certain populations at high risk of serious adverse effects from atrial fibrillation (such as patients with heart failure, coronary artery disease, or diabetes). In other words, those at risk for serious side effects from bisphosphonates also include anyone with heart disease or diabetes, a significant percentage of the U.S. population. (Heckbert SR, LiG, Cummings SR, et al. Arch Intern Med. 2008 Apr 28;168(8):826-31; Cummings SR, Schwartz AV, Black DM. N Engl J Med. 2007 May 3;356(18):1895-6.)

Not surprisingly, hundreds of lawsuits have now been filed against the manufacturers of biophosphonate drugs, and a class action suit appears likely.

Manufacturers of Bisphosphonates

  • Fosamax – Merck & Company
  • Boniva – Roche and GlaxoSmithKline, popularized by Sally Field commercials
  • Actonel – Proctor & Gamble Pharmaceuticals, Sanofi Pharmaceuticals
  • Skelid – Sanofi Pharmaceuticals
  • Didronel – Proctor & Gamble Pharmaceuticals
  • Reclast and Zometa – Novartis Pharmaceuticals

How Bisphosphonates Work

Even if the bisphosphonates did not put you at risk for severe musculoskeletal pain, the loss of your jaw, or abnormal heart rhythms, these drugs would still not be your best choice for strong healthy bones. Why? Because all they do is suppress bone turnover and remodeling.

Our bones, unless inhibited by bisphosphonates, are constantly rebuilding themselves throughout our lives. Cells called osteoclasts break down old or damaged bone, signaling other cells called osteoblasts to replace it with strong new bone. Bisphosphonates kill osteoclasts. Bone density goes up on these drugs, but the bone they leave in place is worn out tissue your body would normally clear out and replace with strong new bone.

This is why bisphosphonates put people at risk for osteonecrosis (jaw bone death). Because these drugs suppress osteoclastic activity, damaged bone is left in place rather than resorbed, so the amount of damaged old tissue accumulates until it reaches a level when any trauma or insult will result in extremely poor healing, the exposure of necrotic bone to the oral environment, development of pain, and increased risk of microbial infection, which is precisely what is seen in bisphosphonate-associated cases of osteonecrosis of the jaw.

Next: Part 2 – Your Bones, Your Choice

~Joseph Pizzorno, ND and Lara Pizzorno, MDiv, MA, LMT

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Posted by: Joe Pizzorno, Jr., ND at 2:24 pm

Wednesday, March 12, 2008

Pharmaceutical-Flavored Water?

Our water supply has a drug problem.

Will your next refreshing glass of water actually be a drug cocktail? A just-released 5-month AP investigation indicates this is more than likely. Albeit in miniscule amounts, drugs– including antibiotics, anticonvulsants, mood stabilizers and sex hormones–were present in the drinking water supplies of 24 metropolitan areas, including southern California, northern New Jersey, Detroit, Washington D.C., Philadelphia, PA, and Louisville, KY.

Although you’re unlikely to notice any immediate effects (to reach a therapeutic dose of any of the drugs detected, you’d need to swallow 120 Olympic size pools of water), long term chronic exposure to this pharmaceutical cocktail may not be safe.

“These are chemicals that are designed to have very specific effects at very low concentrations. That’s what pharmaceuticals do,” notes John Sumpter, Distinguished Professor of Ecotoxicology at Brunel University, London.

Sumpter, who pioneered the field now known as endocrine disruption, was one of the first to show that effluents from sewage treatment contain estrogenic hormones, including estradiol, the main component of the contraceptive pill. His work lead to the surprising (at the time) conclusion that human drugs were getting into rivers and causing intersexuality in fish.

Fish may be more sensitive than humans (after all they breathe water), but do we want to just wait to see if humans are affected?

“We know we are being exposed to other people’s drugs through our drinking water, and that can’t be good,” says Dr. David Carpenter, a professor at the Environmental Health and Toxicology Division, School of Public Health at the University of Albany in New York.

And while prescription drugs are subjected to clinical trials to evaluate their safety in humans, it behooves us to realize that even those that are passed with a supposedly clean bill of health cheat, in real life terms, to get it.

Drugs are evaluated as single agents, typically over a period of months. In real life-and now in our water supply-drugs are not artificially constrained to one at a time, and the exposure is often not for a few months. In the case of our water, it’s for a lifetime.

Pharmaceuticals not only frequently produce significant undesirable side effects when given one at a time-properly prescribed and administered drugs are the 4th leading cause of death in the U.S.-they also interact with other drugs, and the results of these interactions have not been evaluated.

How do the drugs get in our water?

The drugs we take are not completely metabolized into harmless compounds, but pass out of our bodies in urine and feces. And even the drugs we don’t take end up in the water supply: more than half of us flush unused and expired meds down the toilet.

Plus, we’re not the only ones using drugs. Cattle are given steroids to bulk up, and pets are being medicated for everything from arthritis, cancer, and heart disease to diabetes, allergies, dementia and that Western lifestyle affliction, obesity, to the tune of $5.2 billion over the past five years. The most recent data shows Americans increased their spending on animal meds nearly 10% in 2006. (Animal Health Institute: http://www.ahi.org/index.asp)

What’s a consumer to do?

Lessen the load on the ecosystem:

  • Dispose of unused or unwanted medications at take-back sites or ask your doctor, nearby hospital or pharmacist to take back unused and expired drugs. Do NOT flush unused meds down the toilet or toss them in the trash. Check the www.earth911.org database or contact your local household and hazardous waste office to find out a drug-take-back program nearby.
  • Purchase drugs in small amounts; they’ll cost you less and you won’t end up with leftovers.
  • Work with a health care provider to develop health and wellness strategies you can commit to; you’ll feel better, enjoy life more, and reduce your need for medications.
  • When medication is necessary, ask your doctor or pharmacist for one with the least environmental impact.

Check out the Teleosis Institute, an organization that is working to provide programs to get pharmaceutical (and personal care product) waste out of the environment in California. If you don’t live in California, you’ll still find lots of good information and resources there, and you might also tell your elected officials to have a look.

Lessen the load on your body:

In addition to lessening your need for drugs by taking steps to become healthier, you can improve the quality of the water you drink by:

  • Filtering your water. For information on the various types of filters, check the National Resources Defense Council website: (http://www.nrdc.org/water/drinking/gfilters.asp)
  • Putting your filtered water in a reusable glass or stainless steel pitcher or bottle. Plastic bottles contain compounds, such as bisphenol A (BPA) and polyethylene terephthalate (PET), that have been shown to migrate into the beverages they contain. BPA A has been shown to be both estrogenic and neurotoxic. PET plastics used for water bottles leach antimony, a regulated contaminant with both acute and chronic health dangers. ( Le HH, Carlson EM, Chua JP, Belcher SM. Bisphenol A is released from polycarbonate drinking bottles and mimics the neurotoxic actions of estrogen in developing cerebellar neurons. Toxicol Lett. 2008 Jan 30;176(2):149-56. Westerhoff P, Prapaipong P, Shock E, Hillaireau A. Antimony leaching from polyethylene terephthalate (PET) plastic used for bottled drinking water.

    Water Res. 2008 Feb;42(3):551-6. Shotyk W, Krachler M.

    Contamination of bottled waters with antimony leaching from polyethylene terephthalate (PET) increases upon storage. Environ Sci Technol. 2007 Mar 1;41(5):1560-3. PMID: 17396641.

These 3 websites had the best summaries of the effects of the various filters we could find. Only reverse osmosis specifies that drugs are removed, and these filters remove needed minerals-which we need.

TYPES OF FILTERS

Carbon filters remove many organic chemicals and chlorine and radon. Carbon filters should be of good quality and maintained properly. Because bacteria can grow on some filters, it is imperative that carbon filters be changed frequently.

Reverse osmosis units remove most toxic minerals and organic chemicals but generally do not remove radon or chlorine. They should be used with carbon filters. Reverse osmosis units are slow and should only be used for drinking water at a spigot. The purified water becomes aggressive and can corrode the pipes of the delivery system. These pipes and faucets should not be made of lead or lead components.

Distillation removes pollutants by boiling water
and cooling the steam so it condenses back into water. Distillation is slow and expensive and distilled water is poorly buffered. Therefore, distilled water can be highly aggressive and should be stored in glass or other inert containers.

Water softeners remove calcium and magnesium from “hard” water and make it clean better. However, calcium and magnesium are considered human nutrients.

The healthiest water is free of pollutants but contains beneficial minerals like calcium and magnesium.

by Lara Pizzorno

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Posted by: Joe Pizzorno, Jr., ND at 3:00 pm

Wednesday, March 5, 2008

Are You Getting Enough Iodine?

Iodine intake has been decreasing in the U.S. since the early 70s as a result of changes in Americans’ food and dietary habits, and because, as recently published research shows, iodized salt may contain far less than the amount of iodine listed on the label.

Milk, and therefore dairy products, used to be a decent source of this important trace mineral, but their iodine content has greatly decreased due to changes in cattle feed and a phase out of iodine dairy sanitizers. The average iodine content of U.S. whole cow’s milk has plummeted from 184 mcg/L) in 1978 to 19 mcg/L in 1989-90.

Sea vegetables, such as kelp, dulse, hijiki, and nori, remain an excellent source of iodine (a mere 1/4 cup supplies 415mcg), but are not frequent American fare, and unless certified organic, may contain heavy metals.

This leaves iodized salt as the major source of dietary iodine for the U.S. population. Unfortunately, relying on salt for our iodine may not be effective for a number of reasons.

Americans have been told to limit salt intake and are taking the advice to heart. Because excessive sodium intake can increase hypertension risks, many agencies now recommend reducing salt intake. A 1995 report found 58% of men and 68% of women reported never using salt, using “lite” salt, or rarely using ordinary table salt. More recently, the American Medical Association has suggested that the FDA remove salt from the “Generally Recognized as Safe” list. (Interagency Board for Nutrition Monitoring and Related Research. Third Report on Nutrition Monitoring in the United States. Executive Summary; 1995; Page ES-10; http://www.cdc.gov/nchs/data/misc/tronm.pdf.)

Even those of us not actively limiting our salt intake may not be getting much iodine along with our sodium.

A study published in the January 2008 issue of Environmental Science and Technology, Dasgupta P, Liu Y, et al. indicates iodized salt is not likely to contain the amount of iodine it’s supposed to, and even if it did, virtually all of the salt actually used in prepared foods in the U.S. is not iodized.

According to product labels, all U.S. iodized salt contains 45 mcg of iodine per gram, but when the University of Texas researchers analyzed 88 samples of iodized table salt from 40 states, 53% of samples contained less. Iodine values in freshly opened, top-of-the can samples averaged 44.1 mcg/kg, but actual values ranged from as little as 12.7 to 129 mcg/kg. And the amount of iodine within each can was not homogenous but varied as much as 3.3 times among the 5 samples taken at different depths from the same container. Iodine was also found to decrease greatly during high humidity storage, although light or heat had little effect. (Dasgupta P, Liu Y, Dyke J. Iodine nutrition: iodine content of iodized salt in the United States. Environ. Sci. Technol., 42 (4), 1315-1323, 2008.)

In sum, if you’re using iodized salt, you have no idea how much iodine it is actually providing, and the longer you’ve had that container of salt, the more likely it’s iodine content has decreased.

In addition, in the U.S., the use of iodized salt is not mandatory either in restaurants or food processing. Americans are eating out a lot and even when eating at home, often rely on prepared processed foods. So, although the prepared food we’re buying may be highly salted, with very few exceptions, the salt used by restaurants and fast-food outlets is non-iodized salt, and so is the salt used by food processors, who say they fear the possibility that iodized salt might change the flavor of their products.

This concern turns out to be unsupported by fact. In 2006, UNICEF invited delegates from the Republic of Moldova to Switzerland, where all salt for both human and animal consumption must be iodized, to convince them to use iodized salt in food production. Iodine deficiency is common in Moldova where, every year, approximately 27,000 newborn babies suffer from brain damage as a result—a tragedy that using iodized salt in processed foods can eliminate. Delegates visited food factories where they found that the addition of iodine to Swiss bread, baked goods, and world-renowned cheeses causes no change in the taste or consistency of these foods. (Summary here.)

Switzerland used to have high levels of iodine deficiency. In 1806, when Napoleon ordered the Prefect of the Swiss Canton of Valais to conduct a survey for military service recruitment, out of 70,000 inhabitants, 4,000 were diagnosed with cretinism. Later, researchers discovered that cretinism, along with goiter (swelling of the thyroid gland in the neck) and, more importantly, mental retardation, were direct effects of iodine deficiency.

Iodine is necessary for the body’s production of thyroid hormones, which, in addition to regulating metabolic rate, direct brain development, so iodine is critical in the fetus (the brain is formed during the 1st trimester of pregnancy), infants and children (brain development continues through adolescence). Lack of sufficient iodine is the leading cause of preventable mental retardation in the world. Even a mild iodine deficit in pregnant women, infants, and children, can lower intelligence by 10-15 IQ points, lessening an individual’s mental abilities throughout life.

Switzerland introduced iodized salt in 1922, and since 1960, has eliminated iodine deficiency through universal salt iodization–providing iodine through all salt for human (including table salt and salt used for industrial food production) and animal consumption. Both the visible signs, like cretinism and goiter, as well as the more important hidden effects of iodine deficiency on brain development and IQ, have completely disappeared in Switzerland.

A vastly different situation currently exists in the US. Public-health studies over the past 30 years indicate that iodine levels in the U.S. population, particularly in women of childbearing age, are too low. Urinary iodine (the standard means of evaluating iodine levels in the body) has plummeted by almost 50% in adults, and the frequency of moderate iodine deficiency (urinary iodine excretion of less the 50 mcg per liter) in pregnant women has jumped from 1% to 7%. To underscore how low this is, the WHO defines iodine deficiency as a urinary iodine excretion of anything less than 100 mcg per liter, and estimates that, world-wide, approximately 2 billion people, including 285 million school-age children, are iodine-deficient.

In a recent editorial in the New England Journal of Medicine entitled “Iodine Nutrition – More is Better,” thyroidologist Robert Utiger of Harvard Medical School urges that the recommended daily intake of iodine be increased to 300 to 400 mcg, a dosage he feels can best be met through a universal salt iodization program similar to Switzerland’s. (Utiger RD, N Engl J Med. 2006 Jun 29;354(26):2819-21, PMID: 16807421)

Utiger’s suggested RDA is significantly higher than current U.S. recommendations (see Table: Recommended values of iodine intake in the U.S.), but he argues that the most recent data shows the small easily correctable risks of possible excess iodine consumption are far outweighed by the substantial irremediable risks of iodine deficiency, which is widespread. (Teng W, Shan Z, Teng X, et
al. Effect of iodine intake on thyroid diseases in China. N Engl J Med 2006;354:2783-93.)

“The best way to address this issue is to at least assure that iodized salt contains the amount of iodine it should, ideally to raise the iodine content of salt, and get the food processors to use iodized salt,” says Utiger.

What can you do now to ensure an adequate intake of iodine?

  • Check your multiple vitamin and mineral supplement to be certain it provides at least 150 mcg per day. If you are pregnant, trying to become pregnant or breast-feeding, your pre-natal supplements should deliver at least 290 mcg per day.
  • Use iodized salt when cooking at home and carry a small container in your purse or briefcase for use in restaurants.
  • Experiment with sea vegetables. Many can be found in the form of flakes or powder as well as strips or sheets.
  • Nori-used in sushi rolls is also available in seasoned snack-size strips, great for crumbling over soups or salads.
  • Kelp-light brown to dark green strips, can often be found in flake form.
  • Dulse-a reddish-brown seaweed that is soft and chewy in texture, can be found ground fine for use as a salt substitute.
  • Kombu-add a strip to beans while cooking; it will help prevent gas and add flavor.
  • Wakame-used to make Japanese miso soup.
  • Arame-a lacy sea vegetable with a sweeter, milder taste, adds salty flavor to soups or stews.
  • Hijiki-looks like strands of wiry, black pasta, a great addition, in small amounts (it’s quite flavorful), to carrot salad. Soak hijiki and mix with shredded carrots, chopped pickled ginger, sesame seeds and oil, a little finely sliced scallion, and a dash of tamari.

One important caveat: Purchase only certified organic sea vegetables to ensure they are free of contamination. Sea vegetables have a high affinity for heavy metals, and if grown in polluted waters, can soak up not only healthful minerals, but also contaminants such as arsenic, lead, cadmium or mercury.

(van Netten C, Hoption Cann SA, Morley DR, van Netten JP. Elemental and radioactive analysis of commercially available seaweed. Sci Total Environ. 2000 Jun 8;255(1-3):169-75. PMID: 10898404)

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Posted by: Joe Pizzorno, Jr., ND at 2:34 pm

Monday, February 11, 2008

Eat Red for Valentine’s Day

heart-pictureOur first-ever National “Eat Red Week,” (February 4-10) just ended, encouraging Americans to discover the heart-healthy power of red fruits and vegetables. Cherries (especially tart cherries), red grapes, tomatoes, red chili peppers-all these plant Valentines are loaded with phytonutrients our hearts, arteries and veins just love.

  • Tart cherries. Tart cherries get their deep red color from disease-fighting phenols called anthocyanins. Michigan State researchers found that tart cherries contain the highest concentrations of anthocyanins 1 and 2, which help block the cyclooxygenase enzymes (COX-1 and COX-2) that are also the target of common pain meds like aspirin, ibuprofen, and acetaminophen.(1)

    Tart cherries contain 30-40 milligrams of anthocyanins 1 and 2 in every 100 grams (3 ounces) of fruit. (Blueberries lack anthocyanins 1 and 2, but keep eating them; they’re packed with lots of other good things!) Tart cherries outstrip sweet cherries in the anthocyanin/phenol department, delivering more than twice as many per 100 grams (92-47 milligrams in sweet cherries vs. 312 milligrams in tart ones).

    Tart cherries also score way high on a lab test called the Oxygen Radical Absorbance Capacity (ORAC), which measures how many free radicals a food can neutralize. (Damage done to cells, tissues and organs by free radicals is a key factor not only in cardiovascular disease, but also in virtually every chronic, degenerative disease, not to mention, aging.)

    A person needs to consume 3,000 to 5,000 ORAC units each day for blood levels to maintain a good antioxidant defense system, nutrition researchers estimate. Just slightly more than 3 ounces (100 grams) of tart cherry juice concentrate delivers 12,800 ORAC units. A single ounce supplies 3,622 ORAC units. A quarter cup of dried tart cherries weighs in at 3,060 on the ORAC scale, and a half cup of frozen tart cherries supplies, on average, 1,362 ORAC units. (2)

    Other research recently published in the American Journal of Clinical Nutrition revealed that tart cherries rank 14 in the top 50 foods for highest antioxidant content per serving size – surpassing well-known antioxidant stars like red wine, dark chocolate and orange juice.(3)

  • Red grapes.“How do I love thee? Let me count a few of the ways I protect your heart…”

    Resveratrol, a flavonoid found in the skin of red and purple grapes (and therefore in red, but not white wine), improves blood flow by stimulating the production and/or release of nitric oxide (NO), a molecule made in the lining of blood vessels (the endothelium) that signals the surrounding muscle to relax, dilating the blood vessel and increasing blood flow.(4)

    Resveratrol also inhibits angiotensin II, a hormone secreted in response to high blood pressure and heart failure. Angiotensin II can damage the heart because it tells cardiac fibroblasts, the family of heart muscle cells responsible for secreting collagen, to proliferate. The resulting production of excessive amounts of collagen causes the heart muscle to stiffen, reducing its ability to pump blood efficiently. (5)

    Pterostilbene, another antioxidant in grapes, activates PPAR-alpha. The PPARs are a family of receptors on our cells that mediate their absorption of compounds for use in energy production. PPAR-alpha is crucial for the metabolism of lipids, including cholesterol. (6)

  • Tomatoes. A number of recent studies have found that women with the highest intake of lycopene-rich tomato-based foods have a significantly reduced risk of heart disease. In the most recent, a 4.8 year prospective case-control trial involving almost 40,000 middle-aged and elderly women in the Women’s Health Study, as the women’s blood levels of lycopene went up, risk for cardiovascular disease dropped– lots.

    The women were stratified into four groups, according to their dietary lycopene intake. After excluding those with angina, women whose plasma lycopene levels were in the three highest groups were found to have a 50% reduced risk of cardiovascular disease compared to those with the lowest blood levels of lycopene. (7)

  • Red chili peppers. Firing up your tastebuds with chili peppers can help protect the cholesterol in your blood from oxidation – a first step in the process that leads to atherosclerosis. In a randomized, crossover study involving 27 healthy subjects (14 women, 13 men), eating freshly chopped chili greatly increased cholesterol’s resistance to free radical injury.

    Subjects were randomly divided into 2 groups. For 4 weeks, half the subjects ate a freshly chopped chili blend (30 grams/day, about 1 ounce), consisting of 55% cayenne, while the other half consumed a bland diet (no chili and other spices were kept to a minimum). After 4 weeks, the groups switched diet for another 4 weeks. Blood samples were taken at the beginning of the study and after each diet.

    After the chili-diet, the amount of free radical damage to cholesterol was significantly lower in both men and women than after the bland diet. In addition, after eating the chili-spiced diet, women had a longer lag time before any damage to cholesterol was seen compared to the lag time seen after eating the bland diet. In men, the chili-diet also lowered resting heart rate and increased the amount of blood reaching the heart. 8

This year, send your heart a Valentine: eat red!

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Studies Cited:
(1) (Seeram NP, Momin RA, et al. Cyclooxygenase inhibitory and antioxidant cyanidin glycosides in cherries and berries. Phytomedicine. 2001 Sep;8(5):362-9.)
(2) (Wu X, Beecher GR, Holden JM, Haytowitz DB, Gebhardt SE, Prior RL. Lipophilic and hydrophilic antioxidant capacities of common foods in the United States. Journal of Agriculture and Food Chemistry. 2004;52:4026-4037.)
(3) ( Halvorsen BL, Carlsen MH, Phillips KM, Bohn SK, Holte K, Jacobs DR, Blomhoff R. Content of redox-active compounds in foods consumed in the United States. American Journal of Clinical Nutrition. 2006;84:95-135.)
(4) (Lu KT, Chiou RY, Chen LG, Chen MH, Tseng WT, Hsieh HT, Yang YL. Neuroprotective effects of resveratrol on cerebral ischemia-induced neuron loss mediated by free radical scavenging and cerebral blood flow elevation. J Agric Food Chem. 2006 Apr 19;54(8):3126-31.)
(5) (Olson ER, Naugle JE, Zhang X, Bomser JA, Meszaros JG. Inhibition of cardiac fibroblast proliferation and myofibroblast differentiation by resveratrol. Am J Physiol Heart Circ Physiol. 2005 Mar;288(3):H1131-8.)
(6) (Rimando AM, Nagmani R, et al. Pterostilbene, a new agonist for the peroxisome proliferator-activated receptor al
pha-isoform, lowers plasma lipoproteins and cholesterol in hypercholesterolemic hamsters. J Agric Food Chem. 2005 May 4;53(9):3403-7.)
(7) (Sesso HD, Buring JE, et al. Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in women. Am J Clin Nutr. 2004 Jan;79(1):47-53.)
(8) (Ahuja KD, Ball MJ, Effects of daily ingestion of chilli on serum lipoprotein oxidation in adult men and women. Br J Nutr. 2006 Aug;96(2):239-42.)

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Posted by: Joe Pizzorno, Jr., ND at 3:19 pm

Thursday, December 6, 2007

Natural Medicine is Based on Science, Too!

Newsweek Gratuitously Targets CAM

I strongly agree with Jerry Adler in his editorial in this week’s Newsweek Magazine that we should make health care decisions based on evidence. In fact, my whole career in the past 35 years has been to advance science-based natural medicine. Science does not belong to any one profession; it is a way of looking at the world to achieve reproducible results and maximize efficacy and safety. Unfortunately, Mr. Alder appears to have an anti-CAM rather than a pro-science agenda.

While he gleefully (and appropriately) gives examples of CAM (complementary and alternative medicine) therapy failures and unsubstantiated and outlandish claims, he ignores equally egregious examples of prescription drug failures, adverse drug reactions and intentional fraud found in conventional medicine. Why does he conveniently ignore the several articles the past year in the medical journals he so trusts that have documented numerous examples of research faked to make drug intervention trials look better and conscious efforts by pharmaceutical companies to avoid reporting adverse events?

Only a single example, the Vioxx tragedy, is estimated to have caused as many as 100,000 excess deaths. This single, properly prescribed and supposedly well-researched drug has, in my opinion, caused far more serious harm by several orders of magnitude than all CAM errors, contaminated or misadvertised products, and adverse events combined. As Mr. Alder so conveniently ignores, several state attorney generals have now sued Merck for intentional consumer fraud. And they are winning.

I don’t want to appear to justify CAM failures by pointing out conventional medicine failures – neither is acceptable. As I tell my students and include in my many lectures; “We do research not to prove what we do works, but rather to get better.” I am a “true believer” in the natural medicine approach to health. However, that does not mean that everything we believe is correct or that every therapy is safe and effective. The only way to know is to do objective research.

Happily, there are now hundreds of thousands of good quality studies published in peer reviewed journals evaluating CAM therapies. While most show efficacy and safety, some do not. Knowing the difference is how we get better. I could give so many examples. Let’s look at just a few recent studies:

  • A study of 42 healthy volunteers found that green tea phytonutrients increase activity of the enzymes that detoxify carcinogens.
  • A placebo-controlled study of 297 children found that giving them drinks containing FDA-approved food colors resulted in hyperactive behavior.
  • A study of 29 postmenopausal women who had suffered from at least 14 hot flushes each week experienced a 50% reduction in symptoms after consuming 1.4 ounces of crushed flax seeds per day.
  • A study of 29,361 men found that those who ate more than a serving of either broccoli or cauliflower each week almost halved their risk of developing advanced-stage prostate cancer.
  • A study of 889 patients found that drinking cranberry juice significantly boosts eradication of Helicobacter pylori (the bacterium responsible for ulcers and many digestive complaints) in women receiving triple therapy with the antibiotics omeprazole, amoxicillin and clarithromycin (OAC).
  • A prospective study of 5,611 adults 60 years or older found that those who most closely followed a Mediterranean style diet decreased their overall mortality rate by 50% after 6 years.

The list is endless.

Mr. Adler’s diatribe does a disservice to the over one hundred thousand CAM researchers and clinicians conscientiously studying this medicine and providing health care and the approximately half the population of the US who seek health care from state-licensed CAM professionals and use CAM products.

In this blog, we will continue our commitment to providing our understanding of the best research available. This means considering both negative and positive results.

References
Chow HH, Hakim IA, Vining DR, et al. Modulation of human glutathione s-transferases by polyphenon e intervention. Cancer Epidemiol Biomarkers Prev. 2007 Aug;16(8):1662-6.

McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, Kitchin E, Lok K, Porteous L, Prince E, Sonuga-Barke E, Warner JO, Stevenson J. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007 Sep 5; [Epub ahead of print]

Pruthi S, Thompson SL, Novotny PJ, Barton DL, Kottschade LA, Tan AD, Sloan JA, Loprinzi CL. Pilot evaluation of flaxseed for the management of hot flashes. J Soc Integr Oncol. 2007 Summer;5(3):106-12

Kirsh VA, Peters U, Mayne ST, Subar AF, Chatterjee N, Johnson CC, Hayes RB; Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Prospective study of fruit and vegetable intake and risk of prostate cancer: J Natl Cancer Inst. 2007 Aug 1;99(15):1200-9. Epub 2007 Jul 24.

Masala G, Ceroti M, Pala V, et al. A dietary pattern rich in olive oil and raw vegetables is associated with lower mortality in Italian elderly subjects. Br J Nutr. 2007 Aug;98(2):406-15. Epub 2007 Apr 3.

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Posted by: Joe Pizzorno, Jr., ND at 1:27 pm

Wednesday, December 5, 2007

Functional Medicine Day: Autism Spectrum Disorder

Welcome to the Functional Medicine day. Today we are welcoming functional medicine doctors and interested health care consumers to discuss this cutting-edge approach to medicine. I am posting this interesting case to get the conversation started. [Note to visitors: To learn more about functional medicine, you can download this PDF file: What is functional medicine?]

Autism is a growing concern, with increasing numbers of children being diagnosed, especially boys. Incidence of autism is now about 1/166, which represents about a tenfold increase in the past 2 decades, although the numbers vary according to researcher. The causes are not yet fully determined, but we do know that, as typical of most diseases, autism is multifactorial.

The main causes appear to be mitochondrial dysfunction, detoxification dysfunction and intestinal fungal overgrowth. This latter cause, according to autism expert Sid Baker, MD, occurs in about 1/3 of cases with aggressive antifungal therapy resulting in complete remission in many.1 Nutrients reported to help autistic children include magnesium, vitamins B2 and A, and medium chain fatty acids. There have been reports that many autistic children have problems eliminating heavy metals, especially mercury.

Case Study

This child, now seven, was first brought to see me at age two. His mother reported that she had seen some symptoms at age 1 (repetitive behaviors), but they disappeared when they removed nuts from his diet. He was growing normally and apparently meeting milestones until age two when he started to get physically weak. This was first noticed when he became unable to climb the gym set at the park which he had climbed with no problems many times before.

Relevant family history is that his parents (mother 49, father 55) were supposedly infertile ( >12 known miscarriages). Unexpectedly, his mother maintained her pregnancy and successfully vaginally delivered him and his fraternal twin. His problems are not surprising considering the history of unsuccessful pregnancies and parents’ age well beyond optimal. His fraternal brother is relatively normal, although he does suffer from migraine headaches and food allergies.

Screening blood tests (which showed elevated serum lactic acid) and evaluation of developmental landmarks by a pediatrician resulted in a presumptive diagnosis of autistic spectrum disorder. Conventional care offered little hope, so his parents sought help elsewhere. An elevated lactic acid can be an indication of mitochondrial deficit, so I initially put him on high levels of vitamin B2 and modest levels vitamin B1, Mg, creatine, acetyl-L-carnitine, NAC, glutathione, lipoic acid, and CoQ10 — a combination of nutrients that would promote energy metabolism while bolstering mitochondrial antioxidant defenses. Later, after doing a urinary organic acids profile, we refined his supplement program and had his mother start giving him medium chain fatty acids (two grams per day). These fatty acids from coconut oil are more easily metabolized by the mitochondria for energy production. The results were remarkable: he became much stronger, and his autistic symptoms all resolved.

Although he is not cured, his metabolic function has been much improved; however, if he stops taking the supplements, he quickly starts to deteriorate. Activation of his mitochondria requires 100 mg/d of B2 (about 50 times the RDI).

His health is not perfect; he is still somewhat physically fragile, and I know we haven’t found or fixed all his problems. But if you met and talked with him, you would only see a bright, engaging boy, a bit small for his age.

Interestingly, in reviewing this with his mother before posting his story on the blog, she now feels that his apparent developmental deficiencies were all due to muscle weakness rather than mental issues. Her comment:

Brent (not his name) was having problems learning to read, and he would ask me, “Mom is that an “i” or an “l”, or is that an “h” or an “n”, and I was very concerned thinking he was slipping mentally, as he should have known this without any problem at this stage. But I would notice at other times he could read words easily, especially if they were listed rather than in sentence form. I also noticed the longer he tried to read a book, the worse his word recognition or decoding became. I was talking with a counselor at his school, and she explained it is much harder for the eyes to track horizontally between each small word and that the eye muscles have to develop the coordination and strength. When she said muscle strength, I knew immediately Brent’s problem was eye muscle weakness, not loss of mental function. I explained the problem to him; we changed how he reads, and he got his self confidence back and is now decoding and reading quite well. So, he obviously has muscle weakness throughout his body. The other very obvious place being his swallowing difficulties.

I can understand how a mother would not want her child to be diagnosed as autistic. And autism syndrome covers a wide range of dysfunction, ranging from mild to severe. She may be right that most, if not all, of Brent’s developmental problems could be explained by muscle weakness secondary to mitochondrial dysfunction. As we progressively restored his mitochondrial function, his muscles began developing again, and his physical and mental deficiencies eventually resolved.

The problem with an autism spectrum disorder diagnosis is that there is no specific confirmatory lab test–it is more a diagnosis by exclusion. If we had not caught this early and normalized his mitochondrial function, it is highly likely it would have resulted in (further?) neurological damage and converted his presumptive diagnosis into full manifestation.

Regardless of the diagnosis, Brent clearly has a significant mitochondrial defect that resulted in serious problems, most all of which we were able to resolve with a sophisticated nutritional intervention.

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1 Editor’s Note: The successes reported by Dr. Baker as a result of alternative treatments have not yet been supported by scientific studies.


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Posted by: Joe Pizzorno, Jr., ND at 12:27 am

Thursday, November 29, 2007

Vitamin K – Keeping Calcium in Your Bones and Out of Your Blood Vessels

You may have thought vitamin K was all about blood clotting – the necessary kind that prevents you from bleeding to death when you get cut or injured – but this nutrient plays other roles just as essential to your health. New research reveals that vitamin K controls calcium, keeping it in your bones and out of your blood vessels.

In nature, vitamin K is found in primarily in two forms – K1 (phylloquinone) and K2 (menaquinone).

K1 is the form in which vitamin K produces clotting factors. Produced by plants and algae, K1 is found in green leafy vegetables such as broccoli, kale and Swiss chard, and in plant oils, such as canola and soybean oil.

K2 is more potent and has the widest range of activity. Far more active than K1 in both bone formation and reduction of bone loss, K2 is also the form in which vitamin K has been found to protect against arterial calcification and the oxidation (free radical damage) of LDL cholesterol. (Schurgers LJ, Dissel PE, et al. Z Kardiol 2001; Jono S, Ikari Y, et al. Thromb Haemost 2004)

Produced by bacteria and also via the conversion of K1 to K2 by beneficial bacteria in the intestines of animals, including humans, K2 is better absorbed than K1 and remains active far longer; K1 is cleared by the liver within 8 hours, but measurable levels of K2 have been detected 72 hours after ingestion. (Schurgers LJ, Teunissen KJ Blood 2007)

Natto (fermented soybeans) is the richest dietary source of vitamin K2. Dairy products (milk, butter, cottage cheese, cheese) and egg yolk also provide small amounts.

How Does Vitamin K Work in the Body?

Vitamin K carboxylates Gla-proteins. Carboxylation activates these proteins, which have widespread effects throughout the body, including regulating blood clotting and calcium. Fifteen Gla-proteins have been identified, but researchers think up to 100 may yet be discovered. (Uotila L, Scand J Clin Lab Invest Suppl 1990)

K1 is the preferred form used in the liver to carboxylate clotting factors, while K2 is preferentially used in the rest of the body to carboxylate the other vitamin K-dependent Gla-proteins, including osteocalcin, which is essential for bone health, and matrix-Gla protein, which prevents calcification of soft tissue, i.e., blood vessels and organs.

Vitamin K aids bone health in a number of ways:

  • After it’s carboxylated by vitamin K2, osteocalcin can latch on to calcium and bind it to hydroxyapatite crystals forming the bone matrix. (Think of carboxylation as adding a trailer hitch to calcium, allowing it to be towed into and attached to bone.) (Bügel S, Proc Nutr Soc 2003)
  • Vitamin K2 also teams up with vitamin D3 to increase the production of Gla-proteins, including osteocalcin in osteoblasts (the cells that build bone), while also inhibiting the production of osteoclasts (the cells that break down bone). (Plaza S, Lamson D. Alt Med Rev 2005, Masterjohn C. Med Hypotheses 2007; Yamaguchi M, Sugimoto E, et al. Mol Cell Biochem 2001; Yamaguchi M, Uchiyama S, et al. Mol Cell Biochem 2003)
  • K2 works synergistically with bisphosphonate drugs, such as Fosamax, which lessen bone loss by poisoning osteoclasts (the cells that break down old bone). In a study of postmenopausal women with osteoporosis, fractures were experienced by 2 out of 25 women taking a bisphosphonate, 6 of 24 women taking calcium lactate, and only 1 of 26 women taking vitamin K and a bisphosphonate. (Iwamoto J, Takeda T, et al. Yonsei Med J 2003)

Research has linked osteoporotic fracture with vitamin K insufficiency for more than 20 years. A study published in 1984 found that patients who suffered fractures caused by osteoporosis had vitamin K levels 70% lower than age-matched controls. This association has been repeatedly confirmed with one recent trial involving almost 900 men and women finding those with the lowest blood levels of vitamin K had a 65% greater risk of hip fracture compared to those with the highest levels of the nutrient. (Hart JP, Lancet 1984; Bitensky L, Hart JP et al, J Bone Surg Br 1988; Hodges SJ, Pilkington MJ, et al. Bone 1991; Booth SL, Tucker KL, et al. AJCN 2000 )

Supplementation with vitamin K2 has been shown to be an effective treatment against osteoporosis. A review study of randomized controlled human trials of at least 6 months duration that assessed the use of vitamin K1 or K2 to lower fracture risk identified 13 trials. In all but one, vitamin K reduced bone loss with K2 being most effective, reducing risk of vertebral fracture by 60%, hip fracture by 77%, and all non-vertebral fractures by 81%. (Cockayne S, Adamson J, et al. Arch Intern Med 2006)

Vitamin K Combats Cardiovascular Disease

When levels of vitamin K are insufficient, high levels of uncarboxylated (inactive) osteocalcin float around in the bloodstream. Not only is calcium not delivered to the bones, which become porous, but it’s deposited in the arteries, which become calcified. (Bitensky L, Hart JP, et al. J Bone Joint Surg Br 1988; Schurgers LJ, Dissel PE, et al, Z Cardiol 2001; Demer LL, Tintut Y, et al. Curr Opin Nephrol Hypertens 2002; Berkner KL, Rune KW, J Thromb Haemost 2004; Braam LA, Hoeks, AP, et al. Thromb Haemost 2004; Adams J, Pepping J. Am J Health Syst Pharm 2005; Purwosunu Y, Muharran, et al. J Obstet Gynaecol Res 2006; Cranenburg EC, Schurgers LJ, et al. Thromb Haemost 2007)

Cardiovascular disease is not just about cholesterol, which, if oxidized, can cause atherosclerosis, the formation of plaques on the innermost wall of the arteries. Just as lethal is arteriosclerosis, hardening of the arteries due to calcium deposits in their muscular midsection. Arteriosclerosis is the major culprit behind those surprising sudden deaths that occur in young men whose cholesterol levels are just fine.

Sudden death from heart attack is much more highly correlated with calcification of the aorta than cholesterol. In Framingham study research, aortic calcification was associated with double the risk of death from cardiovascular disease in men and women younger than 65, even after other risk factors (e.g., cholesterol) were taken into account. In men younger than 35, calcification of the aorta increased risk of sudden coronary death 7-fold. (Witteman JC, Kannel WB et al. Am J Cardiol 1990; Pohle K, Ropers D, et al. Heart 2003; Iribarren C, Sidney
S et al. JAMA 2000)

In other research involving more than 100,000 men and women in California, aortic calcification increased risk of coronary heart disease 127% in men and 122% in women. Among women, it also increased risk of stroke 146%. (Iribarren C, Sidney S. JAMA 2000)

Fortunately, one of the vitamin K2-dependent proteins, matrix Gla-protein (MGP) is the strongest inhibitor of tissue calcification presently known. MGP is produced by small muscle cells in the vasculature where – once carboxylated by vitamin K2 – it binds to and inhibits a protein called bone morphological protein-2 (BMP-2). BMP-2 causes calcium deposition in blood vessels. (Kaneki M, Takayuki H, et al., Nutrition 2006; Demer LL, Tintut Y et al, Curr Opin Nephrol Hypertens 2002)

K2 also helps promote blood vessel elasticity by safeguarding elastin, the core protein in the muscle fibers primarily responsible for the elasticity of the arterial wall. Existing elastin is damaged and new production is inhibited by calcium deposition. (Seyama Y, Wachi H. J Athero Thromb)

In the Rotterdam study, a major European clinical trial following 4,807 subjects aged at least 55 over a 7-10 year period, researchers found that K2, but not K1, significantly reduced risk of cardiovascular disease by 57%, death from all causes by 26%, and severe aortic calcification by 52%. K1 had no beneficial effects. (Geleijnse JM, Vermeer C, et al. J Nutr 2004)

Special K Benefits for Postmenopausal Women: Combating the Calcification Paradox

As women enter menopause, they simultaneously lose calcium from bone and increase its deposition in arteries – a negative double whammy called the “calcification paradox,” which greatly increases risk of both osteoporosis and cardiovascular disease. (Adams J, Pepping J, Am J Health Syst Pharm 2005) The drop in estrogen causes both problems, but vitamin K can help rectify them.

A 3-year study of 325 postmenopausal women receiving either K2 or placebo found that supplementation with K2 can prevent bone loss associated with estrogen decline. In the women given K2, bone mineral content increased, and hip and bone strength remained unchanged, whereas in the placebo group, bone mineral content and bone strength decreased significantly. (Booth SL, Broe KE, J Clin Endocrinol Metab; Knapen MH, Schurgers LJ, Osteoporos Int. 2007)

Plus, the vitamin K-dependent matrix-Gla protein that inhibits vascular calcification helps maintain the elasticity of postmenopausal women’s blood vessels. In a 3-year study of 181 postmenopausal women, one-third were given a supplement containing vitamin D, one-third got a supplement providing both vitamin K1 and D, and one-third were given a placebo. In both the vitamin D and the placebo group, the elasticity of the common carotid artery decreased, while in those given K along with D, elasticity was maintained. (Braam LA, Hoeks AP, Thromb Haemost 2004)

Should You Supplement with Vitamin K?

While it is unlikely that your vitamin K levels are insufficient to meet clotting needs, levels of vitamin K necessary for clotting are much lower than those needed for bone and arterial protection. Studies of healthy adults have found high levels of uncarboxylated osteocalcin and matrix Gla-protein (MGP) in all subjects tested. (Cranenburg EC, Schurgers LJ et al. Thromb Haemost 2007)

Deficiency is more likely in people with digestive problems such as celiac disease, irritable bowel disease, or who have had intestinal bypass surgery, since vitamin K is a fat-soluble nutrient, and these conditions increase the likelihood of fat malabsorption.

Our vitamin K needs also increase with age. Older individuals (over age 70) require higher levels of vitamin K. (Tsugawa N, Shiraki M, et al. Am J Clin Nutr 2006)

Bile acid sequestrants (e.g., Cholestyramine, Colestipol), a class of drugs used to lower cholesterol levels, also bind and carry out fat-soluble vitamins, including vitamin K.

Anticoagulant medications, such as Coumadin, decrease clotting by interfering with vitamin K and may actually cause arterial calcification by preventing vitamin K from activating matrix Gla-protein. (Uotila L, Scand J Clin Lab Invest Suppl 1990; Schurgers LJ, Aebert H, et al. Blood 2004) Two recent studies involving more than 100 subjects have shown that patients treated with oral anticoagulants have double the calcification of patients not on these vitamin K-blocking drugs. (Schurgers LJ, Aebert H, Blood 2004; Koos R, Mahnken AH, Am J Cardiol 2005).

People taking these medications should discuss their vitamin K needs with their physician and NOT experiment with vitamin K foods or supplements on their own.

Want to Check Your Vitamin K Status?

A normal prothrombin time (the test for clotting activity that has been the standard used to check vitamin K sufficiency) is not sufficient indication that enough vitamin K is present to maintain vascular matrix-Gla protein activity or bone osteocalcin activity. Request an osteocalcin test; it measures how much uncarboxylated osteocalcin is present in the blood. High levels of uncarboxylated osteocalin indicate insufficient vitamin K is present to promote optimal bone health. Similarly, high levels of undercarboxylated matrix-Gla protein (MGP) indicate that insufficient vitamin K is present to protect against vascular calcification. (Berkner KL, Rune KW, J Thromb Haemost 2004; Cranenburg EC, Schurgers LJ et al. Thromb Haemost 2007; Bugel S. Proc Nutr Soc 2003)

~Lara Pizzorno, MDiv, MA, LMT

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Posted by: Joe Pizzorno, Jr., ND at 11:32 am

Tuesday, November 20, 2007

Genetically Modified Foods: Just Say No!

Just Say “No” to GMO
This is perhaps the most controversial article we have written so are far for this blog. While we only cite one data source, Smith’s Genetic Roulette, we spot checked several research articles and did a PubMed search that appears to confirm the seriousness of this issue.

Are GMO foods the next best hope for feeding our planet or should we follow the example set by consumers in the European Union, whose outcry reached such proportions that, in April 1999, virtually all major manufacturers publicly committed to stop using GM ingredients in their European brands?

The Case for GMOs

According to the GMO industry, there are many good reasons to use GMOs:

  • Reduced need for herbicides
  • Reduced need of pesticides
  • Reduced greenhouse emissions as GMOs require less tillage or plowing, thus less use of fossil fuels
  • Ability to manipulate foods to increase desirable components such as nutrients
  • Increased production of food for starving third world countries.

These are certainly worthwhile goals, and humans have been successfully modifying the genetics of their food supply for centuries.

The supporters assert that over a trillion GMO meals have been eaten, thus proving their safety. The problem, of course, is that the new technology is far different from the hybridization and selection methods used in the past.

The big question: “Are GMOs safe?”

The EU Consumer-Led Revolt
The EU consumer-led revolt against GMOs was triggered in February 1999 when media coverage exploded after top GMO safety researcher, Dr. Arpad Pusztai was called to speak before Parliament and went public with some very alarming research results.

Dr. Pusztai, a highly respected leader in the field with 35 years employment at the Rowett Institute in Scotland, had been given a UK government grant to design the long-term testing protocols that were supposed to be part of the European GM food safety assessment process. When Pusztai fed rats GM potatoes genetically engineered to produce a supposedly safe insecticide called the GNA lectin, all the animals showed potentially pre-cancerous cell growths, smaller brains, livers and testicles, partially atrophied livers, and damaged to the immune system–with most changes appearing after just 10 days.

Since other rats fed normal potatoes spiked with GNA lectin–even 700 times more GNA lectin than was present in the GM potatoes–did not develop these problems, Pusztai’s results indicated that the problem lay with genetic engineering process itself. And that meant that all GM foods created from the same process, including those already on the market, might produce unintended ill effects.

According to Pusztai, when he expressed his concerns, he was fired and threatened with a lawsuit if he discussed his research. His 20-member research team was disbanded; the testing protocols were dropped, and a campaign was begun by pro-GM forces to discredit the study. Then an invitation to testify before Parliament allowed Pusztai to tell his story, and all hell broke loose. By April 1999, the protests of informed consumers had convinced manufacturers that GMOs would not sell in the EU, and all agreed to keep GMOs out of their European products, in spite of official approvals by a pro-GM European Commission.

Americans Ill-Informed about GMOs
In the U.S., the Pusztai story got virtually no press, and the U.S. mainstream media has failed to discuss other data suggesting GM foods may pose enormous health risks, including:

  • A preliminary study from the Russian National Academy of Sciences finding that more than half the offspring of mother rats fed GM soy died within three weeks (compared to 9% from mothers fed natural soy).
  • The estimated 10,000 sheep that died in India within 5-7 days of grazing on GM cotton plants engineered to produce their own Bt-toxin pesticide.
  • The only human GM feeding study ever published, which shows that the foreign genes inserted into GM food crops can transfer into the DNA of our gut bacteria. This study gives new meaning to the adage, “You are what you eat.” Long after those GM corn chips you munched are history, your intestinal flora may still be churning out the “Bt” pesticide GM corn plants have been engineered to produce.

U.S. consumers mistakenly believe that, unless the FDA had approved each and every GM food through rigorous, well designed, long-term studies, GM food ingredients would not be allowed in our food supply and certainly could not be omnipresent in prepared foods in the form of corn, soy, cottonseed and canola derivatives.

Reality is that the FDA has absolutely no GMO safety testing requirements, and GM ingredients are ubiquitous in prepared foods. Unless a processed food contains only organic ingredients, it is highly likely to contain GM ingredients. The “research” that supports GMO safety is voluntarily provided by companies on their own GM crops and has been described by critics as “meticulously designed to avoid finding problems”.

But 44,000 FDA internal documents later made public as a result of a lawsuit revealed problems. The overwhelming consensus among the FDA’s scientists was that GM foods were substantively different, so different that their consumption might result in unpredictable and hard-to-detect allergens, toxins, new diseases and nutritional problems. Agency scientists urged superiors to require long-term studies, but were not only ignored, their statements about possible negative effects of GMOs were progressively deleted from FDA policy statement drafts. Evidence of this FDA activity was presented at a Washington, D.C., press conference in 1999, another story major media didn’t publicize.

The result: The same companies that carefully avoid including GM ingredients in their European products are feeding GMOs to ill-informed consumers in the U.S. Americans know so little about GMOs that, although virtually all of us have now, albeit unwittingly, consumed GM foods (the vast majority of processed foods contain derivatives from the four major GM crops: soy, corn, cottonseed and canola), only about 1 in 4 realize it.

What’s the Problem with GMOs?
The way they are created disrupts the plant’s DNA in unintended, potentially harmful ways.

In genetic engineering, a single gene is removed from one organism and forcibly inserted into another. First, scientists identify the gene they want and analyze its sequence. (If the source gene is to be taken from bacteria, some of its sequence has to be rearranged
because bacteria produce certain amino acids using a code different from the one used by plants).

After figuring out a working gene sequence, engineers add a promoter sequence at one end of the gene to turn it on (the most popular one in GM crops being CaMV 35S, which forces the gene to constantly churn out the protein), and a terminator sequence at the other end (which tells the DNA to stop). Lastly, scientists add a marker gene, usually one that confers antibiotic resistance, so they can later douse the plant cells with antibiotics, killing off normal cells and revealing those that have been genetically modified. This combination of gene sequences – called a “gene cassette” – is then multiplied into millions and inserted into target plant cells via one of two primary methods, both of which trigger a wound response the cell.

One method employs a bacterium (Agrobacterium tumefaciens), which normally infects a plant by inserting a portion of its own DNA into the plant’s DNA and then causing the plant to produce tumors. Genetic engineers remove the tumor-creating section of this bacterium’s DNA and replace it with the desired gene cassette, so the bacterium “infects” the plants with the foreign genes instead.

The second method uses a gene gun. Scientists coat millions of particles of tungsten or gold with gene cassettes and blast them into millions of plant cells, only a few of which incorporate the foreign gene cassette.

In either of the two delivery forms, the next step is the application of the antibiotic to which the gene cassette confers resistance. Most of the plant cells die, but a few – the ones in which the transgene has inserted – survive. These are developed into plants that researchers can duplicate by making clones through tissue culture or harvesting the seeds.

Each plant grown from a gene insertion is unique because where the transgene ends up integrating itself into the host DNA is uncontrolled and cannot be reproduced. For this reason, the possible consequences to the plant’s DNA are different with each insertion, so all plants developed from a specific insertion are collectively referred to as an “event.”

In sum, genetic engineering artificially combines genes from different species and forcibly inserts them into unknown and random locations on the host genome. The procedure, which disrupts the precise orchestration of thousands of genes that has evolved over millennia in the normal plant’s genome, is highly mutagenic. (We now know that genes, like nutrients, do not work singly, but as part of highly integrated networks.) Plus it introduces bacterial genes for drug resistance along with strong promoters to express the foreign proteins at high levels in all parts of the plant.

In his book, Genetic Roulette, Jeffrey M. Smith, provides a detailed discussion of the documented health risks of GMOs, including evidence of reactions seen in animals and humans. Following are just a few of the indications he provides that GMOs are significantly changed by the process and may produce undesirable effects:

  • Evaluation of gene insertion sites have shown relocations of up to 40,000 DNA base pairs, mixing together of foreign and host DNA, large scale deletions of more than a dozen genes and multiple random insertions of foreign DNA fragments.
  • During insertion, the foreign gene may become truncated, rearranged or interspersed with extraneous pieces of DNA. The proteins produced by the distorted foreign gene may be misfolded or have added molecules, so they may operate differently and be harmful in unpredictable ways.
  • One study using a micro-array gene chip found that 5% of the host’s genes changed their levels of expression after a single gene was inserted.
  • The promoter used in nearly all GM crops permanently turns on the foreign gene at high output. Scientists had thought the promoter would only turn on the foreign gene, but, in fact, it can accidentally turn on other natural plant genes–permanently–genes that may overproduce an allergen, toxin, carcinogen or anti-nutrient, or regulators that block other genes.
  • When certain viruses infect an organism, they splice themselves into the host’s DNA. If the GM promoter is inserted in the vicinity of a dormant virus, it might switch it on, resulting in virus activation.
  • In GMO Roundup Ready soybeans, the “stop signal” placed at the end of the gene cassette is dysfunctional, so longer than intended RNA proteins are produced, which are further rearranged into four non-intended variants, any one of which might be harmful.
  • DNA changes in GM plants can alter the amounts of the chemicals the plant naturally produces, increasing its output of toxins or decreasing the amount of protective phytonutrients produced. For example, GM soybeans produce less cancer-fighting isoflavones.
  • GM proteins in soybeans, corn and papaya are similar to known allergens and may cause allergies.
  • Transgenes survive digestion and can transfer to gut bacteria or move into the blood and organs, including passing through the placenta into the fetus and through the blood-brain barrier. The only human feeding trial ever published confirmed that genetic material from Roundup Ready soybeans transferred into the gut bacteria in three of seven human volunteers. Once in the human gut bacteria, the transferred portion of the transgene produced herbicide-resistant protein. If the antibiotic-resistant genes that have been inserted into most GM foods on the market were to transfer to pathogenic bacteria in the gut, antibiotic-resistant diseases could develop. If the transgene for the Bt pesticide were to transfer to our gut bacteria, we could become living pesticide factories.

Sound scary? The limited amount of research and case reports regarding what actually happens when animals and people consume GM foods is not reassuring. Here are just a few highlights from Smith’s coverage of GMO’s effects:

  • Rats fed Monsanto’s Mon 863 Bt corn for 90 days showed significant changes in their blood cells, livers and kidneys.
  • Rats were fed the GM FlavrSavr tomato for 28 days. Seven of 20 rats developed stomach lesions (bleeding stomachs); another 7 of 40 died within two weeks.
  • About 25% of the sheep in herds grazing continuously on Bt cotton plants in India after the cotton harvest died within a week, according to reports from 4 villages. Post mortem studies suggested a toxic reaction.
  • Twelve dairy cows died on a farm in Hesse Germany, after being fed a diet with significant amounts of the GM corn variety, Bt 176. Other cows in the herd developed a mysterious illness and had to be killed. Syngenta, the producers of Bt 176, compensated the farmer for part of his losses, but despite the farmer’s demands and public protests, no detailed autopsy reports were made available.
  • More than 20 farmers in North America have reported that pigs fed GM corn had low conception rates, false pregnancies or gave birth to bags of water. Both male and female pigs became sterile.
  • In mice fed GM soy, production of alpha-amylase, an enzyme responsible for digesting starch, dropped by as much as 77%.
  • In male mice fed Roundup Ready soybeans, the structure and gene expression pattern of testicular cells changed significantly.
  • Female rats were fed Roundup Ready soy starting before conception and continuing through weaning. 55.6% of the offspring died within three weeks compared to 9% of non-GM soy controls. In another study, after a lab began feeding rats a commercial diet containing GM soy, offspring mortality reached 55.3%. When offspring from the GM-fed r
    ats were mated together, they were unable to conceive.
  • In 2003, approximately 100 people living next to a Bt cornfield in the Philippines developed skin, respiratory, intestinal reactions and other symptoms while the corn was shedding pollen. Blood tests of 39 people showed an antibody response to Bt-toxin. Symptoms reappeared in 2004 in at least four other villages that planted the same GM corn variety.
  • GM soy was imported into the UK shortly before 1999. Within a year, soy allergies in the UK had risen from 10% to 15% of the sampled population. Antibody tests show that some individuals react differently to GM and normal soy varieties. GM soy has higher levels of a known allergen.
  • One brand of the supplement L-tryptophan created a deadly epidemic in the U.S. in the 1980s. The company responsible had genetically engineered bacteria to produce the supplement more economically. The resulting product contained many contaminants, five or six of which were suspected as the cause of the disease. Not only the GM L-tryptophan supplement, but all L-tryptophan was removed, and still remains off the market.

Bottom Line
A PubMed search on “GMO” and “Safety” yielded 41 articles. Restricting the search to human studies dropped that to 20 articles. Restricting further to clinical trials yielded only one study, and it was of ability to track the presence of GMOs in the food supply!

Here is a list of the titles of the first 20 articles returned by this PubMed search:

  • Reappraisal of biosafety risks posed by PERVs in xenotransplantation.
  • Session VII: Risk management and monitoring.
  • The politics and science behind GMO acceptance.
  • Model for tuning GMO detection in seed and grain.
  • Approaches in the risk assessment of genetically modified foods by the Hellenic Food Safety Authority.
  • Biological safety concepts of genetically modified live bacterial vaccines.
  • Molecular farming on the rise–GMO regulators still walking a tightrope.
  • New measures of insecticidal efficacy and safety obtained with the 39K promoter of a recombinant baculovirus.
  • Need for an “integrated safety assessment” of GMOs, linking food safety and environmental considerations.
  • European GMO labeling thresholds impractical and unscientific.
  • [Application of near-infrared diffuse reflectance spectroscopy to the detection and identification of transgenic corn]
  • Role of the “National Reference Centre for Genetically Modified Organisms (GMO) detection” in the official control of food and feed.
  • GMO: human health risk assessment.
  • Regulations governing veterinary medicinal products containing genetically modified organisms in the European community.
  • Assessment of novel foods in animal nutrition.
  • The human side of GMO biosafety research.
  • GMO biosafety research in China.
  • Allergy assessment of foods or ingredients derived from biotechnology, gene-modified organisms, or novel foods.
  • Public health issues related with the consumption of food obtained from genetically modified organisms.[Genetically modified plants and food safety. State of the art and discussion in the European Union]

The rest of the article titles were similar. Notice something missing? No actual human research published! These are all opinion articles and recommendations on how to determine safety. But virtually no actual research. Now, we realize that such studies may have been published in food technology journals that are not in Medline. However, the medical research world is where we live and where we trust the results of the peer-review process.

The answer to our question, “Are GMOs safe?” is very clear: we don’t know.

The surprising lack of studies published in the scientific medical literature is, to us, a huge red flag. If these are so safe, where are the actual human studies? The assertion that a trillion meals have been eaten is not compelling. If there is no actual system in place for monitoring the impacts of these foods and virtually everyone in the US is eating them every day then how is their safety to be assessed?

How to Go Non-GMO
If the risks documented in Genetic Roulette raise enough questions about GMOs’ potential for harm that you wish to avoid consuming GMOs until more research has been done – research not controlled by the biotech companies – here are a few tips.

If you are traveling to Europe, no worries. GMOs are banned in EU foods. In the United States and Canada, however, GM foods are not only legal, but are unlabeled, so avoiding them can be challenging.

Eat Organic:
Organic foods are not allowed to contain GM ingredients. Even the small percentage of non-organic ingredients allowed in foods labeled organic is not allowed to contain GMOs.

Prepared or Processed Foods:

  • Most generic vegetable oils and margarines used in restaurants and in processed foods in North America are made from soy, corn, canola, or cottonseed—the four major genetically engineered crops. Avoid these oils, unless they are organic or labeled non-GMO. Choose any other oil, e.g., olive, sunflower, or safflower.
  • Check the list of ingredients for GM enzymes, additives, sweeteners, soy and/or corn derivatives. Genetically modified bacteria and fungi are used in the production of enzymes, vitamins, food additives, flavorings and processing agents in thousands of foods on the grocery shelves as well as health supplements.
  • Flavorings such as vanillin and hydrolyzed vegetable protein, which is derived from corn and soy, can also come from GM sources. Xanthan gum is another product that may be derived from a GM process.
  • Aspartame, the diet sweetener, is a product of genetic engineering.
  • Honey can be produced from GM crops. For example, some Canadian honey comes from bees collecting nectar from canola. This has shut down exports of Canadian honey to Europe.
  • Most packaged foods contain soy and/or corn derivatives, e.g., soy or corn oil, soy flour, soy protein, soy lecithin, textured vegetable protein, corn meal, corn syrup, dextrose, maltodextrin, fructose, citric acid, lactic acid. Non-GMO alternatives can be found not only in health food stores, but in supermarkets. Mayonnaise, for example, which is traditionally made with soy oil, can be found in both non-GM soy and safflower varieties.

Vitamin Supplements: Among vitamins, vitamin C (ascorbic acid) is often made from corn; vitamin E is usually made from soy. Vitamins A, B2, B6, and B12 may be derived from GMOs as well. In addition, vitamin D and vitamin K may have “carriers” derived from GM corn sources, such as starch, glucose, and maltodextrin. In addition to finding these vitamins in supplements, they are sometimes used to fortify foods. Organic foods, even if fortified with vitamins, are not allowed to use ingredients derived from GMOs.

Eating Out:

  • Ask what oil is used for cooking. If the answer is “vegetable oil,” margarine, soy, cottonseed, canola or corn oils, ask if olive or some other oil can be used instead or for something cooked without oil. Check to ma
    ke sure the olive oil is pure and not a blend of canola and olive.
  • Avoid menu items with dairy, unless organic, and items made with non-organic meat. Very few restaurants buy organic milk or milk certified to be from cows that are not treated with genetically modified rbGH, and both non-organic meat and dairy products usually come from animals that have eaten GM feed. Also, a common enzyme, chymosin (called rennet), used in the production of hard cheeses, was formerly derived from the stomach linings of calves. In 1990, a GM cbymosin was introduced and is now found in more than 70% of non-organic U.S. cheeses.
  • Ask what foods are freshly prepared. Avoid menu items made with packaged sauces or processed foods since most contain GM derivatives (e.g., corn and soy derivatives).
  • Avoid desserts made with aspartame.

For an extensive list of foods by brand and category, indicating if they have GM ingredients, see http://www.truefoodnow.org/shoppersguide/guide_printable.html

References:
www.responsibletechnology.org
Smith, JM. Genetic Roulette, Yes! Books, Fairfield, Iowa, 2007.

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Posted by: Joe Pizzorno, Jr., ND at 1:51 pm