Phytochemicals

Phytochemicals 

These are chemicals from plants (phyto is Greek for plant)  Polyphenols, phytochemicals, flavanols, bioflavonoids etc are names which cause a lot of confusion.

Polyphenols:
The most studied class of phytochemicals are polyphenols because of their potential health benefits. There are numerous polyphenols (poly means many, phenols means benzene rings) which come from different plants and have different actions. 

• Phenolic acids – blueberries, tea, cereal grains.

• Stilbenes – the best known of these as resveratrol found in red wine, it is quite poorly absorbed.

• Lignans are found in flaxseed which may have some oestrogenic properties.

• Flavonoids (also called bioflavonoids) are named for the yellow colour and are found in flowering plants and fruit and vegetables. Flavonoids cause the colour and taste of foods, and have an antioxidant effect on fat, vitamins and enzymes.
  Flavonoids are divided into 6 subclasses many of which have confusingly similar names:
• Flavonols – found in onions, curly kale, leeks, broccoli blueberries, red wine and tea. Its production stimulated by sunlight and so its highest concentration is in the outer parts of the plants.
• Flavones - are found in parsley and celery
• Flavanones - are found in citrus fruits, tomatoes, and plants such as mint.
• Isoflavones - these have a structure similar to oestrogen, and are often called phytoestrogens. Most are made from soy and soy products.
• Flavanols - these are found in green tea, chocolate, red wine, apricots and other fruit. Also in fruits such as grapes, peaches and berries, and also cause the bitterness of chocolate.
• Anthocyanins - . These are pigments creating the blue purple red and pink colours of 4 hours fruits and vegetables.

Many variables affect the amount of polyphenols found in food, including the degree or ripeness at harvest, the rainfall, the sun exposure, how they are stored and how they are cooked.The polyphenols are designed to protect plants from oxidation, toxins and damage, and by consuming them, we can achieve some of these benefits.
The still is quite a lot of scepticism in conventional medicine on their value when taken the supplements, although there is no debate that we should all be eating plenty of fresh fruit and vegetables on a regular basis. The difficulty is to obtain polyphenols that have been growing correctly, picked at the right time, not over processed or over cooked and are available all year round. For this reason a quality supplement which is well absorbed containing these products should also be beneficial, but does not replace the need for fresh fruit and vegetables as well.

STATIN DRUGS

One of the most frequent questions I am asked as a Cardiologist and physician is – do I really need to take Statin drugs?  On one side doctors are suggesting they be incorporated in a polypill which everyone should take, to other more ‘naturally based’ experts saying they do not work and people should not take them (click here)

This article is my assessment from the current medical literature, and the advice I give to my patients.  Because the article is quite long, I will put my conclusion first as well as at the end, but I would recommend that you read the reasons for my conclusions as well.

My Conclusion – sifting through all of the data below, my recommendations are relatively simple:

1. If you have proven cardiovascular disease (heart attack, angina, stroke, angioplasty, high levels of calcium in cardiac CT scan) then you should take a statin drug preferably at a low dose. This would reduce your risk of a heart attack, stroke or death by about 20%.

2. If you get any side-effects – muscle pain, abnormal liver function tests, or you feel that your mental function has deteriorated, stop the drug for a couple of months, and then restart. Possibly consider restarting with a water-soluble statin such as pravastatin. If the symptoms recur then don't take the statins anymore.If you feel fine, then continue the statin. There is little evidence showing that any other cholesterol-lowering agent provides any benefit.

3. If you don't have cardiovascular disease (primary prevention) unless you have a very high cholesterol, diabetes or an extremely strong family history then I would not recommend that you take a statin drug. My advice would be to have a CT scan for calcium**  which will show early coronary artery disease, if this is strongly positive then maybe you should consider taking a statin drug. If it is negative or normal for age, then I would not take a statin.

4. For elderly people the benefits of statins do continue, but if there is any suggestion of impaired mental function, then stop taking the statin.

5. If you are taking a statin, you must be taking the supplement coenzyme Q 10, at least 100 mg daily.

Possible benefits of glutathione in the elderly

Glutathione is a very powerful antioxidant created within the body to prevent oxidative damage due to free radicals attacking and destroying cells. With age the amount of glutathione in the body particularly the brain decreases, and could set the stage for age-related health problems, particularly dementia, but also cardiovascular disease, diabetes and cancer.

Unfortunately glutathione cannot effectively be given as a supplement because it is poorly absorbed, but N-acetylcysteine (NAC) is converted into glutathione, and also helps the body to make more glutathione.
It is difficult in humans to trial this, but in a rather nice study (click here) the authors gave NAC to isolated liver cells in both young and old rats exposed to high levels of oxidants.  N-acetylcysteine was very protective and reduce the amount of damage greater than twofold.

Oxidative stress does appear to be a major cause of disease in today's world; antioxidants taken orally are relatively weak compared to the antioxidants created within the body (glutathione, catalase, superoxide dismutase etc.). The production of the latter tends to be less as we get older, and are frequently overwhelmed by our toxic world. It thus does seem reasonable to suggest that people should take products which could help the creation of these internal antioxidants, such as N-acetylcysteine.

Calcium supplements are safe! 

This is the conclusion from a new joint clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology (click here) . Over the years there have been many reports on the benefits and adverse effects of calcium both taken in the diet, and as supplements. Occasional studies have suggested that calcium in the diet has no effect on cardiovascular disease, but supplements might have. (The word might is in italics because in some trials there is only a suggestion but it is not clinically significant). There are also some studies which show benefit, including one which showed women taking more than 1000 mg of supplemental calcium per day had less cardiovascular disease than those who did not.  Because there are obvious benefits in bone and other health from taking calcium both in the diet and as supplements, these 2 bodies looked at all the evidence that was available, and concluded "dietary and supplemental calcium are safe for cardiovascular health when consumed in the recommended amounts. The recommendation applies to calcium consumed either alone or with vitamin D that does not exceed the National Academy of medicine is tolerable upper intake limit of 2000 to 2500 mg per day""  There will always be studies which so some benefit or lack of benefit, particularly the smaller studies, many of the studies are impure because patients report the amount of calcium they either consumer as supplements or diet during the day, and follow-up is incomplete. There is also a strong lobby against the use of supplemental calcium (in fact the use of supplements), but even if there is an indication rather than a statistically significant result, this will be reported out of proportion to its scientific evidence. When 2 major societies in the United States come to the conclusion that calcium supplementation is safe, there seems little point in individu
als debating the results of further studies.

The dangers of long-term PPI (Proton Pump Inhibitor)treatment.

Proton pump inhibitors (PPIs) like omeprazole, lantoprazole, are being used very frequently, and in many cases long-term, to treat peptic ulcers and gastro-oesophageal reflux, and "indigestion". They act by reducing the production of gastric acid. While they are incredibly effective in treating these conditions, they do have other less desirable and sometimes fatal effects:
By raising the gastric pH they can affect pepsin and other enzymes used to dissolve proteins.
The elevated pH also enables bacteria and viruses to survive where otherwise they would be killed, sometimes leading to infection in the lower GI tract.
Diseases resulting from prolonged use of PPIs include:

• Gastric and gut infections, especially traveller's diarrhoea.
• Pneumonia – the bacteria surviving in the stomach can migrate up the oesophagus and down into the lungs.
• Increasing fractures, presumably due to a direct effect of these drugs on bone architecture.
• Vitamin B12 deficiency – these drugs greatly affect the absorption of vitamin B12, particularly in the elderly. This can result in peripheral nerve problems, but also dementia.
• Heart disease and strokes, there is an increased incidence of heart disease and almost doubled increase in heart deaths according to a recent study from Stanford University. (http://www.ncbi.nlm.nih.gov/pubmed/26061035)

While there are many cases where these drugs are extremely useful, the need for long-term treatment needs to be carefully studied, and they should only be used if necessary. Like all drugs, they have significant side-effects.

Fish oils are crucial in today's diet

Fish oils – a crucial part of today's diet

The omega-3 fatty acids found in fish oils (DHA and EPA) are crucial to balance the high levels of omega 6 fatty acids we get in today's diet. The ideal ratio should be 2-to-1, omega 6 to omega 3, but the average modern diet provides a 20 to 1 ratio. This leads to inflammation and many other effects, and asthma, autoimmune disease, heart disease, diabetes, cancer, obesity, irritable bowel, macular degeneration have all been shown to be worsened by this 3/6 imbalance. The omega-3 oils are also important components of many tissues especially brain.

Below is a very impressive list of just some of the benefits of fish oil, which is why almost everybody from conception should be taking fish oils, continuing right through life. Unfortunately it is difficult to consume enough fish to achieve the major benefits, and there is always the worry of pollutants such as mercury, PCB and insecticides which could undo much of the benefit. For this reason a high quality pure fish oil supplement is by far the safest and most likely to give benefit.

The benefits of fish oil are almost to numerous to list, but some of the important ones include:

1. ADHD and IQ in babies and children – pregnant women taking fish oil supplements have babies with better mental function. After birth a study from the University of South Australia showed that children treated with fish oil had reduced symptoms of ADHD, inattention, hyperactivity, restlessness and impossible behaviour.
2. Reduced anxiety. A study in Neuroscience sure that fish oils reversed all anxiety like and depression like behaviour changes induced in rats. While this is also been seen in humans, the purity of a rat study confirms the benefit to the brain of fish oils.
3. Arthritis – the anti-inflammatory action has been shown in many studies to improve arthritis, particularly rheumatoid.
4. Alzheimer's disease – the DHA in fish oil is crucial for the brain tissue, and fish oils have been shown to help  function in patients whose minds are failing.
5. Cancer – fish oils have been found to help kill a variety of cancer cell lines, including colon, breast and prostate. While it's impossible to do a study excluding all other treatments, most cancer patients should be taking fish oils.
6. Depression – a recent fascinating study reviewed 26 papers where fish oil and depression were discussed. Over 150,000 participants were reviewed and those who had a high intake of fish oils had an almost 20% reduction in the incidence of depression.
7. Diabetes – studies in Brain Research have shown that fish oils reduce the risks of diabetic patients developing neurological problems, but the anti-inflammatory action might also reduce the development and worsening of type II diabetes.
8. Eye diseases – fish oils have been shown to reverse dry eye, cataracts and macular degeneration.
9. Cardiovascular disease – it has been known for a long time that fish oils are beneficial to patients with coronary artery disease, not just the development of the disease, but also reducing the risk of sudden death.

It is hard to understand why all doctors are not advising their patients to take fish oil supplements, probably because of the pollution (especially mercury) found in many of the supplements, or natural fish. However good quality fish oils which are pure are available, and my advice is for everybody to take them throughout life.

Why coconut oil is so good

Why coconut oil is so good

Slowly the conventional medical attitude to fats is changing. For many years we have been telling our patients not to eat saturated fats, eat a few polyunsaturated fats and mostly monounsaturated (olive oil canola oil). In reducing the fats we have encouraged people to eat sugars and this is one of the major reasons for the obesity epidemic worldwide. All of this was on very flawed data starting from the 7 country studies of Ancel Keys who claimed to show the incidence of heart disease related to the Unfortunately there were 22 countries studied by Dr Keys but only 7 were used, when all 22 were included there was still a very slight association but much less clear (see graphs). Following this the really has been virtually no information confirming that the intake of saturated fats leads to coronary artery disease. However for many years dairy fats and any other saturated fats have been excluded from the diet of people with heart disease. We are now realising we got this totally wrong!

Coconut oil is a saturated fat, and the evidence is that eating,drinking and cooking with it does nothing but good. It contains medium chain triglycerides in addition to the saturated fats. Studies have shown that consuming coconut oil has a number of beneficial effects including:

1 It has an antioxidant effect, oxidative stress is one of the major causes of many of today's health conditions.
2. It reduces inflammation and thus can be used for inflammatory conditions such as aches, pains, fevers and even stomach ulcers.
3. It seems to have an antiseptic affect, and has been used topically to treat viral bacterial and even fungal conditions.   Many people use it instead of toothpaste.
4. Probably the most exciting but sadly so far least researched is its potential effect on the brain. The brain can only use sugar or medium chain triglycerides as its source of energy (it cannot use fat). In Alzheimer's disease the brain cannot use sugar properly, and there are many anecdotal reports that coconut oil may well improve the mental function of patients with this terrible disease.
5. There have been some reports that it helps in thyroid function, and can help in weight loss and even reduction in cholesterol (click here.)

Coconut oil can be drunk as a very refreshing cool drink, it can be added to salads and other dishes, it can be used as a cooking oil, and can also be eaten straight from the spoon.

I'm quite certain that in the coming years this very safe and natural product will become part of our staple diet.