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EDITORIALThe medical profession's attitude towards the use of vitamins and supplements is indeed a curious one. Just last week the American Heart Association issued its dietary guidelines for reducing the risk of cardiovascular disease. They did not recommend supplementing with vitamin E despite numerous studies having shown a clear protective effect. The landmark 1993 Harvard Medical School study involving over 100,000 health professionals found that supplementing with 100 IU/day or more of vitamin E reduced the risk of developing heart disease by 40 per cent. The AHA glossed over this study and focused on more recent studies that concluded that vitamin E did not reverse existing heart disease. However, treatment (reversal) and prevention are two very different things. The fact that vitamin E may not be effective in treating heart disease does in no way detract from its proven efficacy in preventing the disease. Anyone at all familiar with antioxidants knows that their primary effect is a lengthening of the lag time before disease develops not a reversal once the disease has taken hold. So once again the medical profession, at least the AHA, could not overcome their bias against supplements. This will no doubt affect many lives, but maybe not the lives of physicians themselves. A recent survey showed that about two-thirds of American female physicians regularly take supplements. Seventy-four per cent of those with high blood pressure and cholesterol levels take vitamin E. Even cardiologists do it. A 1997 survey of 181 American cardiologists found that 39 per cent of them took vitamin E supplements for the purpose of preventing heart disease. Is this a clear case of "Do as I say; not as I do"? Yours in health, Hans R. Larsen, Editor |
LETTERS TO THE EDITOR
What dosage of niacin, folic acid and magnesium is recommended in the treatment of lone atrial fibrillation?
Paul, Canada
Editor: Dr. Abram Hoffer, MD who first developed the adrenochrome theory of atrial fibrillation
recommends 1000 mg of niacin 3 times daily with 5 mg of folic acid 3 times daily. Also 250 mg of vitamin B6
daily. These large quantities of supplements should only be taken under medical supervision. He has no
recommendations for magnesium, but other sources recommend 100 mg of citrate/maleate 3 times daily.
I was recently diagnosed with a skin condition called "poikiloderma of Civatte". Can you tell me more about this? I have had no luck searching the Internet. Thomas, USA Editor: You can find quite a few articles on poikiloderma of Civatte (a benign skin condition of unknown origin, but cumulative sun exposure may be a factor) on MEDLINE. Go to our website www.yourhealthbase.com and click on "Resources". Then click on "Index Sites/Search Engines" and finally on MEDLINE. Then type in Poikiloderma of Civatte in the search box and click on "GO". You will find 14 articles about this condition. It appears that it can be effectively treated by the application of a broad spectrum, noncoherent, intensed pulse light (IPL) or by using a pulsed dye laser. I have been diagnosed as having calcific tendinitis in both my shoulders. I would appreciate any information you have on this condition and anything relevant to its management and cure. Tina, Australia
Editor: Calcific tendinitis is an inflammation of the tendons accompanied by deposits of
calciumhydroxyapatite crystals in the affected areas. It is usually caused by overuse of the affected joint,
but can be associated with arthritis or gout. The inflammation may be helped by ensuring an adequate
intake of antioxidants specifically vitamins C and E and selenium. Vitamin B complex may also be helpful as
may wearing a copper bracelet. Some natural medicine practitioners feel that avoiding potatoes, tomatoes,
peppers, eggplant, and tobacco is very important. Acupuncture may help relieve the pain and a recent study
found that ultrasound treatments can be quite effective in the short term.
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ABSTRACTS
Vitamin C fights lung cancer
BIRMINGHAM, ALABAMA. It is now almost 30 years since Drs. Pauling and Cameron published their
ground-breaking studies concerning the benefits of vitamin C supplementation in advanced cancer. Their
findings were originally dismissed by the medical community, but new evidence supporting their conclusion
continues to surface. For example, lung cancer patients have been found to have lower blood plasma
concentrations of vitamin C (ascorbic acid) and also consume less vitamin C in their diet than do healthy
individuals.
Even low-dose aspirin may cause bleeding
AARHUS, DENMARK. The use of low-dose aspirin (75 to 150 mg) on a daily basis to prevent heart attacks
and strokes is becoming increasingly popular. It is well established that standard doses (325 to 500 mg) of
aspirin are associated with a substantially increased risk of upper gastrointestinal bleeding (stomach ulcers),
but little research has been done on the effect of low-dose regimens.
DHEA replacement therapy is safe
LE KREMLIN-BICETRE, FRANCE. DHEA (dehydroepiandrosterone) and its sulfate ester DHEAS are the
most abundant steroid hormones in the human blood plasma. DHEA and DHEAS are secreted by the
adrenal cortex and levels peak between the ages of 20 to 30 years. Levels decline steadily thereafter and at
70 years of age are less than 20 per cent of the peak. Several studies have shown that supplementation
with DHEA strengthens the immune system, heightens brain activity, and improves overall well-being.
Niacin reduces risk of blood clots
MEMPHIS, TENNESSEE. Peripheral arterial disease (blocking of the peripheral arteries) mostly affects
elderly people and commonly involves the arteries in the thigh and the back of the knee joint (femoral and
popliteal arteries). Hypertension, high cholesterol levels, diabetes, and smoking are important risk factors
for peripheral arterial disease (PAD). Patients with PAD exhibit variations in blood coagulation factors that
increase their risk of blood clots (thrombosis) and stroke. Research has shown that PAD patients have
higher levels of von Willebrand factor (vWf), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen and
that high levels of these factors are associated with an increased risk of thrombosis. Prothrombin fragment
1.2 (F1.2) level is also an indicator of increased thrombosis risk.
Carrots and tomatoes protect against lung cancer
BOSTON, MASSACHUSETTS. Lung cancer is the most deadly of all cancers in the United States and kills
more men and women every year than any other cancer. Smoking is the major risk factor with more than 90
per cent of all lung cancer victims being current or former smokers. Numerous epidemiological studies have
found a highly significant protective effect associated with an increased intake of fruits and vegetables. It
was originally thought that the protective component was beta-carotene, but several trials involving
supplementation with synthetic beta-carotene did not confirm that it would help lower the incidence of lung
cancer. It now turns out that the main reason why beta-carotene was selected as being the likely protective
component was that it was the only carotenoid for which the concentration in various foodstuffs was actually
known!
Breast cancer surgery revisited
AMSTERDAM, THE NETHERLANDS. Breast conserving therapy (lumpectomy followed by radiation) has
been shown to be as effective as mastectomy (removal of entire breast) in the treatment of breast tumors
with a diameter of 2 cm or less. A team of medical researchers from Belgium, the Netherlands, South
Africa, and the UK now report that breast conserving therapy (BCT) results in similar survival rates as
mastectomy when dealing with larger tumors (2.1-5 cm) as well. Their study involved 868 women with stage
II breast cancer who were randomly assigned to receive either BCT or radical mastectomy. After 10 years
of follow-up there was no significant difference in the rate of survival among the BCT patients (65 per cent)
and the mastectomy patients (66 per cent). The incidence of distant metastasis was also similar in the two
groups over the 10-year follow-up period; 39 per cent for the BCT patients and 34 per cent of the
mastectomy patients. There was, however, a significant difference in the recurrence of local tumors among
the two groups. Among the BCT patients six per cent had a recurrence as compared to only 3.3 per cent in
the mastectomy group. The 13-year survival rates were 60 per cent in the mastectomy group and 55 per
cent in the BCT group. The researchers conclude that BCT and radical mastectomy result in similar survival
rates among patients with stage II breast cancer.
Homocysteine: cause or effect?
BERGEN, NORWAY. Numerous studies have found a clear correlation between high blood levels of
homocysteine and an increased risk of cardiovascular disease. High homocysteine levels are particularly
strong predictors of cardiovascular events or death in patients who also suffer from renal failure, coronary
heart disease, peripheral artery disease, diabetes, systemic lupus erythematosus or venous
thromboembolism. Case-control studies have found that homocysteine levels as little as five micromol/L
above normal can increase cardiovascular disease risk by 20 to 30 per cent. Researchers at the University
of Bergen strongly support the conclusion that a high homocysteine level is a potent risk factor for
cardiovascular disease, notably atherosclerosis. They point to the fact that folic acid and vitamin B6 lower
homocysteine levels and that several recent trials have shown that supplementation with folic acid and B6
can halt the progression of atherosclerosis and reduce the incidence of heart attacks.
Lycopene and cancer
TORONTO, CANADA. Lycopene is a carotenoid found in tomatoes, tomato products, and in other fruits. It
is a powerful antioxidant with a singlet-oxygen quenching capacity 10 times greater than that of vitamin E. It
is the most abundant carotenoid in human plasma and is highly concentrated in the adrenal glands, testes,
prostate, and breast tissue. Several studies have found an inverse correlation between serum and tissue
levels of lycopene and the risk of breast and prostate cancers. Other studies have linked a high intake of
tomatoes to a 50 per cent reduction in cancer mortality among elderly Americans. One study found that
men who consumed 10 or more servings of tomato products per week reduced their risk of prostate cancer
by 35 per cent. A more recent study found that supplementation with a tomato extract significantly lowered
the level of prostate-specific antigen (PSA) in patients with prostate cancer. High tissue (adipose) levels of
lycopene have also been found to be protective against heart attacks. No published studies have shown
any adverse effects of high lycopene levels or a high intake of tomato products. It has been hypothesized
that lycopene prevents cancer and heart disease by protecting lipids, lipoproteins (especially low-density
lipoprotein), proteins, and DNA. There is also evidence that lycopene counteracts the proliferation of cancer
cells induced by insulin-like growth factors.
Tamoxifen and endometrial cancer
AMSTERDAM, THE NETHERLANDS. Tamoxifen therapy has long been used in the treatment of metastatic
breast cancer and in the prevention of recurrence of breast cancer. It is known that tamoxifen increases the
risk of developing endometrial cancer, but so far it has been assumed that this "side effect" was of relatively
little importance. Now researchers at the Netherlands Cancer Institute question this assumption. Their
study involved 299 women who had developed endometrial cancer subsequent to being diagnosed with
breast cancer and 860 matched controls who had been diagnosed with breast cancer, but had not
developed endometrial cancer.
New recommended intakes for antioxidants
WASHINGTON, DC. An expert panel of the US National Academy of Sciences' Institute of Medicine has
advised modest increases to the recommended daily intakes of vitamin C, vitamin E, and selenium. The
new levels for vitamin C are 90 mg/day for men and 75 mg/day for women. Smokers are advised to get an
additional 35 mg/day. The level for vitamin E is now set at 15 mg/day and for selenium at 55
micrograms/day. The panel also, for the first time, set "tolerable upper intake levels" for the three
antioxidants. These levels represent the maximum intake that is likely to pose no health risks for most
people. The upper limits are 2000 mg/day of vitamin C for both men and women, 1000 mg/day of vitamin E,
and 400 micrograms/day of selenium. The panel did not recommend limits for beta-carotene and other
carotenoids and cautioned that beta-carotene supplementation should only be used to prevent or correct a
vitamin A deficiency. They also cautioned against extrapolating beneficial effects observed with certain
foods (eg. tomatoes) to a specific component in the food (eg. lycopene) and certainly stopped a long way
short of recommending megadoses of vitamins or antioxidants for the prevention or treatment of diseases
like cancer and heart disease.
Vitamin C a must for smokers
LONDON, UNITED KINGDOM. It is well established that smoking is an important risk factor for heart
disease and, of course, lung cancer. There is evidence that smoking interferes with blood circulation in both
coronary and peripheral arteries. A team of British and Swiss researchers now report that smoking also
affects blood circulation (microcirculation) within the heart itself. Their study involved eight healthy male
non-smokers (controls) and eleven long-term smokers with no signs of heart disease. The researchers used
positron emission tomography (PET scanning) to measure the coronary flow reserve of the smokers and
non-smokers before and after the infusion of three grams of vitamin C (ascorbic acid). Coronary flow
reserve (CFR) is the ratio between maximal blood flow within the heart and blood flow at rest. A high
coronary flow reserve is beneficial. The researchers found that the smokers had an average 21 per cent
lower CFR than the controls, but that the vitamin C infusion corrected the deficiency and brought the CFR in
the smokers back to the level of the non-smokers. The vitamin C infusion had no effect on the CFR of the
non-smokers. The researchers conclude that their results support the hypothesis that the damaging effects
of smoking is at least partially caused by excessive oxidative stress. They suggest that it may be worthwhile
to undertake a large-scale trial to see if daily oral supplementation with vitamin C can prevent the
development of coronary artery disease in smokers.
Recommendations for prevention of heart diseaseDALLAS, TEXAS. The American Heart Association has just released its most recent guidelines for reducing the risk of cardiovascular disease by dietary and other lifestyle practices. The major guidelines are:
The guidelines point out the protective effects of folic acid, vitamin B6, soy protein (25 grams/day) and
isoflavones, but cite insufficient evidence in the case of vitamin E and other antioxidants. Supplementation
with beta-carotene is discouraged. Consumption of at least two fish servings a week is recommended. For
people already suffering from coronary heart disease the guidelines suggest that consumption of one fatty
fish meal per day (or alternatively a fish oil supplement) would be highly beneficial.
St. John's wort found effective
GIESSEN, GERMANY. Extracts of St. John's wort (Hypericum perforatum) was first used in ancient
Greece to treat "demonic possession". It is now a prescription drug in most of continental Europe and is the
most popular antidepressant in Germany. Perhaps as many as 23 trials of St. John's wort have been
published, but many of them have been criticized for poor design and execution. German medical doctors
now weigh in with a major, double-blind, randomized, controlled trial that compares St. John's wort to the
commonly used tricyclic antidepressant imipramine (Tofranil). The study took place in 40 psychiatric,
internal medicine, and general medicine practices in Germany between June 1997 and April 1998 and
involved 324 outpatients with mild to moderate depression. One hundred and fifty-seven of the patients
were given hypericum extract (standardized to 0.2 per cent hypericin) in the form of 250 mg film-coated
tablets taken twice daily. The remaining 167 patients received two 75 mg imipramine tablets daily. The
participants were evaluated weekly for six weeks using the Hamilton depression scale. In the St. John's
wort group the depression score decreased from 22.4 at baseline to 12.0 after six weeks. In the imipramine
group the score went from 22.1 to 12.75. St. John's wort was found to be significantly better than
imipramine in the treatment of anxiety-related parameters and was much better tolerated than imipramine
(39 per cent adverse events in the St. John's wort group compared to 63 per cent in the imipramine group).
The researchers conclude that Hypericum perforatum extract is therapeutically equivalent to
imipramine in treating mild to moderate depression, is better than imipramine in relieving anxiety associated
with depression, and is significantly better tolerated by patients.
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NEWSBRIEFS
Don't have that first cigarette.
Doctors do take vitamins.
Joggers live longer.
"Terminator" seed approved.
Safety of sunscreens questioned.
Honey outperforms antibiotics.
Unsafe injections kill millions.
"Mouse arm" common in Europe.
Mobile phones affect sleep patterns.
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Victoria, BC, Canada V8S 1A5 Phone: (250) 384-2524 E-mail: health@pinc.com URL: http://www.pinc.com/healthnews/ ISSN 1203-1933.....Copyright © 2000 by Hans R. Larsen International Health News does not provide medical advice. Do not attempt self- diagnosis or self-medication based on our reports. Please consult your health-care provider if you wish to follow up on the information presented. |