New England Health Advisory

Here’s a question I want you to answer. And be honest.  How often do you exercise? I don’t mean regularly getting off the couch to manually change the channel on the TV or hoisting a quarter pounder to your mouth. I mean, physical activity that makes you huff and puff and break out in a sweat.

Like most people, you probably don’t get enough exercise. And you—like everyone else—are paying for it big time. According to the Centers for Disease Control and Prevention, 68% of American adults—or 72% of men and 64% of women—are overweight or obese and 26 million have heart disease. The American Heart Association estimates that 74.5 million of Americans—or one in three—have high blood pressure, a risk factor for heart disease. And the National Institute of Health reports that 23.6 million of us have Type 2 diabetes.

What’s wrong with this picture? Many of these problems could be prevented—or our risk for them reduced—if we exercised regularly.

Exercise lowers blood pressure and our risk for heart disease and diabetes as well as colon, breast and other cancers. It helps us lose, and maintain, weight. It keeps our minds sharp and improves mood. It keeps joints and muscles flexible and strong. It may even add years to our lives.  And I mean quality years.

Skeptical?  Stanford University researchers started following runners and non-runners when they were in their 50s and older.  About two decades later, runners were less likely than non-runners to have problems doing everyday tasks like walking, dressing, getting out of a chair and grasping objects. Runners who did have difficulty developed problems about 16 years later than non-runners. Runners were also less likely to die. At the 19-year mark only 15% of runners had died compared to 34% of non-runners. The runners averaged about four hours of running each week at the start of the study; two decades later they were logging about 76 minutes per week, but they were still reaping benefits. That sounds pretty good to me.

Exercise has so much going for it that the government’s new Physical Activity Guidelines for Americans recommend being physically active most days of the week.  The guidelines recommend two-and-one-half hours of moderately intense exercise or one hour and 15 minutes of vigorous activity per week. To get major health benefits from exercise, we should do five hours of moderate activity or two-and-one-half hours of vigorous activity weekly.

Moderate activity includes brisk walking, gardening or water aerobics. Vigorous activity includes jogging, swimming laps, jumping rope or hiking up a hill while wearing a heavy backpack.  You can spread physical activity over the course of the day, but for best results, you should exercise at least 10 minutes at a time.

Everyone should also do strengthening exercises, such as strength training, toting heavy loads, push-ups and sit-ups, at least twice per week. Weight-bearing exercise keeps bones and muscles strong. Strong bones lower our risk for osteoporosis, the brittle bone disease. And strong muscles mean we are less likely to fall or become frail.

All of this exercise may seem like a big time commitment, but think of it this way: Heart disease, Type 2 diabetes, cancer and other health problems take time, too. I don’t know about you, but I’d rather work out than while away the hours visiting doctors; having diagnostic tests; monitoring my blood sugar; or recovering from a heart attack.  I would rather run or walk a few hours a week now than not be able to walk at all when I’m 80.

That’s why I make physical activity a priority. I have run three New York City Marathons. I have taken classes in step aerobics and spinning. I have worked with a personal trainer. These days I walk briskly for two or three miles nearly every weekday and cycle on weekends. (If it’s rainy or frigid, I walk instead.)  If we have a blizzard, I cross-country ski in the neighborhood. And because I live in New York City, I do lots of incidental walking every day—to the grocery store, the dry cleaner, the subway station (where I also climb stairs) or the post office.

Sure, there are times when I’ve skipped my workout. And I have been sidelined by a broken ankle, a torn meniscus, a herniated disc and lousy weather. But as soon as my injuries mended and the weather cleared, I got back on track. And I am better off for it.

Now it’s your turn.  It takes three to six months for something to become a habit. I promise you once exercise becomes just that, you’ll wonder how you managed without it. Ready to begin? These tips will get you started. The rest is up to you.

Get your doctor’s OK. If you are out of shape, are overweight or obese or have health issues, have your doctor sign off on your regimen and tell you what you can or can’t do.

Choose an activity you’ll enjoy. If you like it, you’re more likely to continue it.

Get the right gear. I’m not saying you should spend a fortune. But having the right shoes matters. If you don’t, your feet will hurt and you’re more likely to call it quits. Clothing that breathes and doesn’t irritate your skin will make your workout more enjoyable. If you cycle, buy bicycle shorts with cushioning. If Lycra isn’t your thing, get a cushioned liner to wear under shorts or sweats.

Go slowly. Getting out of shape takes time; so does shaping up. Each day, go a little further; each week, push a little harder. The government recommends that once you can comfortably walk 30 minutes three times a week, bump up the time you spend walking to 50 minutes. If you cycle three days a week for 25 minutes, gradually work up to six days. And stick to a schedule. Write the day and time of your workout in a calendar. If something comes up, reschedule.

Hire a personal trainer for a while. He or she can devise a training schedule for you; show you proper form—say, for strength training; and keep you on track as you build fitness.

Set goals. They’ll keep you motivated and challenged.  If you walk or jog, sign up for a race. If you bicycle, take a weekend jaunt with a local cycling group. When I was a runner, I used to run in weekend races. As a cyclist, I have taken eight bicycle trips through the French countryside.

Rethink your views about exercise. I have always thought of my walk, jog, exercise class or bicycle ride as recess for grown-ups. It’s fun and the one time I can get away from work and family pressures. It clears my mind and helps me unwind. And knowing that it may lower my risk for lots of diseases and add years to my life are big pluses.

Yours in health,

Catherine Winters
Contributing Editor
New England Health Advisory

My husband’s family in Ireland is an adherent of the Irish temperance movement known as the Pioneers. So it was a surprise to find his Uncle Miah sipping an Irish whiskey after dinner at his house in County Cork. “Doctor’s orders,” he said with a sheepish shrug. Miah had suffered a heart attack a few months earlier, and his doctor suggested an after dinner dram of whiskey would be good medicine.

That’s not just Blarney. More than 60 separate studies find that drinking alcohol in moderation is good for your heart. And the good news doesn’t end there—moderate drinking is connected to lower risk of Alzheimer’s disease, diabetes and stroke, as well as weight loss. One Tuscan study even linked light to moderate red wine drinking to improved sexual function in women.

Scientists are still unraveling the reasons why drinking can be good for you—everything from the alcohol itself to its concentration of antioxidants may be the reason. Or it may even be some complex interaction of many different components. Some conflicting research says the same benefits can be had from grape juice, while other studies find that’s not the case. There is even some evidence to suggest that moderate drinking can slow declines in cognitive function brought on by old age. But on the other side of the coin, heavy drinking has been linked to a faster decline.

The Antioxidant Theory

A lot of research about alcohol’s benefits has focused on antioxidants, present in sizable amounts in certain kinds of alcohol, including whiskey, red wine and darker beers, and to a lesser amount in lagers and white wine. Antioxidants are thought to protect cells from free radicals—potentially harmful molecules your body produces when breaking down food or in reaction to environmental exposures like tobacco smoke and radiation. Scientists say free radicals can damage cells, and may play a role in heart disease and cancer, among other diseases.

Resveratrol, a particular type of antioxidant present in red wine, has been much discussed for its apparent ability to reduce inflammation in the arteries. It may have other important functions as well. New research on mice published in the July issue of the American Journal of Pathology links resveratrol to a shrinkage of abnormal blood vessels in the eye, yielding a promising breakthrough in dealing with leading causes of blindness. However, since the dose given to mice would be the equivalent of several bottles of wine, it would likely be given in pill form.

The Mediterranean Connection

While numerous studies, including a recent one done by French scientists at the Center for Cardiovascular Disease Prevention, point to better overall health among moderate drinkers, most researchers admit that the drinking may be a signifier of an overall healthier lifestyle, rather than a cause itself.

Much fuss was made, several years back, of the inclusion of wine in the so-called Mediterranean Diet, but it was important to note that the diet is low in saturated fat and high in whole grains and fruits and vegetables—all things that we know lead to better overall health.

The French study, published in the European Journal of Clinical Nutrition, questioned nearly 150,000 Parisians about their drinking habits, then subjected them to a battery of tests.

Moderate drinkers of both sexes were found to have low body mass index, heart rate, good blood sugar levels, lower “bad” cholesterol and higher “good” cholesterol. Men also showed lower stress and depression scores. Further, moderate and low drinkers displayed better health status than did the never-drinkers. Researchers concluded that “moderate alcohol consumption may represent a marker of higher social level, superior health status and lower cardiovascular risk.”

Moderation is Key

The key to realizing better health through drinking alcohol, as in so many things in life, is moderation. A study published in the New England Journal of Medicine linked drinking as little as the equivalent of a half glass of wine, three to four days a week, to a sizable reduction in risk for heart attack. Drinking more didn’t improve health further, and it didn’t matter what type of alcohol (wine, beer, whiskey, etc.) was consumed.

Currently, the U.S. government defines moderate drinking as one 12-ounce beer, a five-ounce glass of wine or 1.5 ounces of liquor per day for a woman and up two drinks per day for a man. Each of these servings has about the same amount of alcohol and the same number of calories. The National Institutes of Alcohol Abuse and Alcoholism recently released new guidelines expected to be adopted by the U.S. government, defining low-risk drinking as no more than seven drinks a week for women and fourteen for men, with no more than three drinks in any one single day for women and four for men.

Dangers of Heavy Drinking

For all the beneficial effects scientists have determined can be gained through moderate alcohol consumption, this is one area where you can definitely have too much of a good thing.

Many studies link excessive alcohol consumption to cancer—particularly breast, liver and colon cancer—and stroke, among other health problems. And for those who cannot restrict their consumption to moderate drinking, the dangers of excessive drinking far outweigh the possible benefits. Excessive drinking is also implicated in unintentional injury from car accidents, falls and drowning.

Experts advise enjoying your drinks with food—never on an empty stomach—and drinking slowly to avoid intoxication. Of course, you should never drink alcohol if you’ll be driving, and double check that any medication you are taking is safe to be consumed with alcohol.

Odds are prescribing a drink a day won’t be the first thing your doctor thinks of to combat heart disease. But if you’re like Uncle Miah, it might be worth exploring with your physician. If you already enjoy a few drinks a week, relax. And as they say in Ireland when posing a toast, Slainte, which means good health!

Yours in health,

Jeanne O’Brien Coffey
Contributing Editor
New England Health Advisory

By Inger Pols

A friend of mine called me recently and said she’d read an article about a really important test to assess your wellness and she was concerned because she had gone through her records and found that her doctor had never given her that test. She was wondering whether she should demand the test or change doctors.

When she told me the article was about homocysteine, I knew she had read that high levels of homocysteine in the blood are reliable risk factors for heart attack, stroke, diabetes, cancer, neurological conditions such as Alzheimer’s and Parkinson’s, thyroid concerns, infertility, depression, digestive disorders and chronic pain.

And I also understood why she had not been tested; most doctors do not test for homocysteine levels for several reasons … and I’ll get to them.

But first a little info on what homocysteine is and why it matters.

What is Homocysteine?

Homocysteine is an intermediary amino acid. Amino acids are the building blocks of protein, which control virtually all cellular processes. There are 20 essential amino acids that the body needs to function: 10 of which the body can make, and 10 of which must come from our diets.

Homocysteine is not one of those essential 20. It is made from another amino acid called methionine, which is one of the essential amino acids we must get from food. We get it mainly through protein-rich foods like fish, eggs and sunflower seeds.

Now, the next five paragraphs are going to get a little science-heavy, so those not inclined to textbook reading can jump ahead to the next section.

During what’s called the methionine cycle, methionine is converted to a substance known as S-adenosylmethionine (SAMe). SAMe performs an important function in its ability to donate methyl groups as needed during chemical processes throughout the body. When SAMe donates its methyl group, homocysteine is synthesized. Scientists would say the SAMe has been methylated, which means it has lost a methyl group. This is important because the methylation process regulates gene expression, protein function and RNA metabolism.

All homocysteine in the body is created during this methionine cycle and most of it ends up bound to plasma and stored. But it can be released into the bloodstream when changes occur in the body’s biochemistry that are not ideal. So high levels of homocysteine are linked to a variety of specific health problems.

Once homocysteine is released into the bloodstream, one of two things can happen to metabolize it. First, it can be remethylated back into methionine. This process requires folic acid (folate), vitamin B12, vitamin B2, zinc, magnesium and TMG (or trimethylglycine) from choline. Most of the body’s homocysteine goes this route, known as the remethylation pathway, which creates more SAMe to support further healthy methylation.

The other possible option for the homocysteine is that it can be used to create cysteine, which is then converted into glutathione, a powerful antioxidant. When the body is under oxidative stress, this conversion process, known as the transsulfuration pathway because it produces sulfate byproducts, can be accelerated. The sulfate products are normally flushed from the body through urination. This pathway requires B6, B2 and zinc for proper function.

Both SAMe and glutathione benefit the body in important ways (glutathione is an anti-aging, antioxidant, detoxifying agent and SAMe has been shown to effectively treat depression, osteoarthritis and liver disease and it affects our cells’ ability to grow and function properly), so we want our bodies to be able to convert homocysteine efficiently. When the conversion process goes awry, homocysteine levels in the blood will increase.

The Dangers of High Homocysteine Levels

High homocysteine levels have been shown to increase free radical oxidation in the body, and the damage that goes along with them. This can accelerate aging. High homocysteine levels can also damage artery walls in one of several ways: They can contribute to atherosclerosis, or thickening of the artery walls; they can increase the likelihood of your blood clotting, potentially leading to a stroke; and they can lower the nitric oxide in your blood. Nitric oxide plays a critical role in healthy and flexible artery wall maintenance.

High homocysteine levels also affect your immune system, since weakened conversion processes to glutathione means less glutathione will be present and less antioxidant protection will be available to the body.  And high homocysteine levels promote higher levels of two chemicals the body uses to promote inflammation, arachidoic acid and prostaglandin E2 (PGE2). As we learned in the cholesterol article, inflammation is a necessary and healthy part of our normal body function. But chronic inflammation can cause permanent damage to systems and tissues such as nerves, joints, and arteries and can also result in chronic pain.

Because of the concern about inflammation and its effect on antioxidation, some argue homocysteine is a marker for a higher risk of most every chronic condition, including cancer. At a minimum, when homocysteine levels are high, we know that something is wrong inside the body and some important process is not functioning as it should. If homocysteine is such an important indicator, why aren’t we hearing more about it?

There are a number of reasons. First, the test is relatively expensive and is rarely covered by insurance. As a result, it’s not readily available. Another reason is that there are currently no patented drugs for lowering homocysteine levels, so pharmaceutical companies have no interest in contributing to the marketing, which is how most medical conditions gain attention today. Another reason not to test is that some doctors don’t know what to tell their patients if the test comes back high; without a drug to prescribe, the only answer is to change your diet and/or lifestyle, something not every physician is comfortable tackling in a brief office visit.

If your doctor does decide to test you, which typically only occurs with cardiologists working with high-risk heart patients, you’ll want to see a score of below 8.9 units. (lower is better). In between 9 and 19.9 units, your risk of dying a premature death from a chronic condition or degenerative disease will increase from significant to extremely high.  If the reading is over 20 units, you risk a heart attack or stroke at any moment.

The Prescription: Change Your Diet

So, as I told my friend, for most people who appear reasonably healthy, there’s no need for the test.  But whether you are tested or not, if you would like to improve your homocysteine levels, the prescription is clear: Change your diet. Eat mainly healthy fats and oils like omega 3s and avoid bad fats like trans fats. Increase your consumption of vegetables: Try to get half of your calories from vegetables, especially dark leafy green ones! Make sure your protein sources are high quality ones like organic eggs, wild fish, legumes and small amounts of nuts and seeds.

Look to ensure that your diet is rich in folate, vitamins B12, B6, B2, zinc and magnesium. (If you eat as above, it should be. If not, supplement with a whole food supplement.) A greens superfood powder or pill may also be helpful if you find your diet lacking. And work to reduce stress, a known pro-inflammatory.

A special note to vegetarians and vegans: while generally it is stated that high homocysteine levels result from a diet too heavy in meat and too light in vegetables, studies have shown that many vegans and vegetarians have high homocysteine levels. One study showed vegans to have 50% higher homocysteine levels and vegetarians to have 30% higher homocysteine levels than their omnivore counterparts. This is because their bodies lack the B12 required for the conversion processes. (B12 is typically found in animal protein.)

Vegetarians were found to have 37% less (and vegans 59% less) B12 than the omnivore group, enough to constitute clinical deficiency in 78% of the vegans and 26% of the vegetarians. The study also showed that people eating vegan and vegetarian diets lacked the essential amino acid methionine because the levels in plants are lower than those found in meat. Vegetarians—and especially vegans—need to consider adding B12 to their diets through injections, sublingual (under tongue) or spray B12 supplements.

Homocysteine may not yet be fully understood, but its importance is definitely being recognized. If you are a high risk for heart concerns, you may want to push for a homocysteine test. But because the prescription will be to change your diet, you may want to consider making some of those changes, whether you are tested or not.

To your health!

Inger Pols
Editor of New England Health Advisory

By Inger Pols

Today I’m going to continue the food swap series and look at making better meat choices. Unless you’re a vegetarian whose health is thriving, you most likely need to pay more attention to your animal protein selections. While it is possible to get everything you need to be healthy purely from plants, it’s difficult to do so. (I’ll talk more about how to create a healthy plant-based diet in a future newsletter.)

Almost every civilization has included some animal protein in its diet, even if it was only insects and bugs. While most of us do need to consume some animal protein to maintain optimal health, it’s likely that you are eating too much meat in general as well as too much unhealthy meat.

If you haven’t read the books The Omnivore’s Dilemma by Michael Pollan and Eating Animals by Jonathan Safran Foer, or seen the movie Food, Inc., I strongly encourage you to check them out. I could easily (and probably will) write a newsletter on factory farming and the challenges it poses to our food supply. But I’ll save most of that for another day. However, I do want to tell you a little bit about hormones, pesticides and antibiotics in meat and why eating them can be bad for your health.

Hold the Hormones

For decades, the meat and dairy industries have been using hormones to help young livestock gain weight faster. More weight means more meat means more profit. A pellet is typically implanted in the animal’s ear that releases hormones, commonly synthetic estrogens and testosterone, throughout its life.

The hormones remain in the animal’s fatty tissue and are present in the meat we eat, albeit in smaller doses than the human body typically produces. But even small amounts of hormones have been shown to have big effects on some body processes. It’s long been known that excess exposure to estrogen increases breast cancer risk and now we know it increases prostate cancer risk too. Hormone-treated meat has been suspected of contributing to early puberty and male breast development.

The European Union has banned all hormones in meat. But there aren’t any studies underway in the U.S. to evaluate hormone safety in meat and milk, so this practice will likely continue. Perhaps if we were not so heavily exposed to estrogenic compounds in our daily environment, this might not be so problematic. But as we discussed in the prostate article, estrogenic compounds are hard to avoid and eating hormone-laden meat just adds to the burden on your body.

Rising Antibiotic Resistance

We know the benefits of taking antibiotics when we have a bacterial illness, but most livestock in the U.S. are fed antibiotics even when they aren’t sick! Antibiotics are primarily used to make animals gain weight. But now researchers are becoming concerned with this practice, as they fear it is giving rise to antibiotic-resistant bacteria, which could pose a serious health risk.

In fact, a number of studies have shown growing resistance to antibiotics, including one in the New England Journal of Medicine that revealed that 84% of the salmonella bacteria found in supermarket ground beef was resistant to some antibiotics. Another study showed that pork that came from animals that had been fed the antibiotic ciprofloxacin led to people catching resistant strains of salmonella. The FDA estimates that 11,000 people caught intestinal illnesses in 1999 from eating antibiotic-resistant bacteria in chicken.

Pesticides: Not Just a Concern with Produce

We hear a lot about pesticides with respect to produce, and they are a concern. But pesticides in our meat supply may pose an even greater danger. You can ingest far more pesticides on a meat-heavy diet than you would from consuming fruits and vegetables. Today’s livestock are not fed a traditional diet, but rather a feed that is loaded with pesticides. (The feed also often contains meat from diseased animals that die before slaughter.)

Pesticides accumulate in the flesh of animals and have been shown to cause cancer, nerve damage, birth defects, and to inhibit the proper absorption of food nutrients. According to the Environmental Protection Agency, 90% of fungicides, 60% of herbicides and 30% of insecticides are known carcinogens.

The EPA does set limits on how much pesticide can be used (according to what they deem as safe) and how much is allowed to remain on food. However, the only way to know for sure is to have the food tested, which does not occur today. So it’s really a guess as to how much is left behind and whether that amount of pesticides is “safe” or not. The EPA also states that in certain cases, such as economic loss to farmers, unauthorized pesticides (those known to be unsafe) are knowingly allowed to be used.

Making Better Meat Choices

Thankfully, in most supermarkets today you can find meat labeled as hormone free, antibiotic free and pesticide free, and that’s what I buy. (This does not alleviate all the problems associated with today’s farming practices, but it’s a step in the right direction.)

Because the food supply of the livestock is a big part of the problem, whenever possible, I look for grass-fed meat or chicken raised on something other than vegetarian feed. It can be hard to find, and it can be expensive, but I think it’s worth it. My kids also think it tastes much better; they can tell the difference!

Many people eat too much meat in one meal, so cutting back on portion size is another way to make eating meat more economical and healthy. Meat portions should never be larger than the palm of your hand. (Yes, that does mean those with bigger hands get a slight advantage!) But no one has a hand large enough to accommodate a 16 oz. porterhouse steak: A little meat protein goes a long way.

Another good food swap is to substitute bison for beef. Bison are fed grass instead of grain and are typically not given hormones, antibiotics or pesticides. Bison meat also has very little intramuscular fat, so it is low in fat, saturated fat and cholesterol versus beef, pork or chicken. Venison is also a good choice.

Lastly, a comment on luncheon meats. In addition to the concerns already mentioned about hormones, pesticides and antibiotics in the meats, most packaged meats (bacon, salami, ham, pepperoni, hot dogs, etc.) contain nitrates as a preservative. Sodium nitrate is converted into nitrosamines, which are chemicals that can cause cancer.

While nitrosamines can cause virtually any kind of cancer, the Journal of the American Medical Association shows that people eating more processed meat were 50% more likely to develop lower colon cancer. Nitrosamines have also been linked to a 68% higher risk of pancreatic cancer, and increasing consumption of processed meats by 30 grams resulted in a 15% to 38% increase in risk for developing stomach cancer.

Consumption of nitrates has been shown to cause an increase in brain tumors in children and to result in DNA mutations. The food industry calls nitrates a color fixer, as they turn meats bright red and can make old, gray, unattractive meat look healthy and delicious.

But the good news is that most major grocery store chains have some nitrate-free meat in their organic sections and you can find them at Trader Joe’s and Whole Foods. Again, they can cost a little more, but I’d rather see my meat as it really is and skip the cancer risk, especially for my kids, as their developing bodies can handle fewer toxins.

While these changes won’t fix the problems in our food supply, they will help you make healthier meat choices. Becoming an educated consumer and voting with your wallet is a step toward getting better meat options in our stores that are free of hormones, pesticides, antibiotics and nitrates.

To your health!

Inger Pols
Editor of New England Health Advisory

By Al Sears. M.D.

With a simple test I can tell you if you’re likely to have a heart attack or stroke.

I can also give you a remedy to help make sure you never do – no matter how high your risk is…

The test checks for levels of homocysteine. It’s your number one indicator of heart disease.

The big drug makers play down the importance of this critical factor. They haven’t figured out a way to make any money from it, so they try to convince you that it doesn’t matter.

Turns out knowing your homocysteine level is even more useful than we thought. Homocysteine can foretell a host of other diseases as well.

And here’s the good news: It’s easy to keep your level low.

Homocysteine is a naturally occurring amino acid. But too much of it irritates the lining of your blood vessels and prevents them from dilating. This increases your risk of heart attack and stroke.

One study found that levels of homocysteine were dramatically higher in men who died from heart attacks. They discovered that men with high levels were four times more likely to suffer a fatal heart attack than those with lower levels.1

In Norway, doctors studied men with heart disease for six years. Again, they found that those with high levels of homocysteine suffered the highest number of heart attacks. The higher their levels, the lower their chances of surviving.2

But their most startling discovery is that homocysteine levels are your strongest predictor of death. More so than any other measured factor, including cholesterol.

High levels of homocysteine can also alert you to other problems and potential diseases including:

• Kidney disease
• Acute Lymphoblastic leukemia
• Rheumatoid arthritis
• Depression
• HIV/AIDS
• Psoriasis
• Hypothroidism
• Gout
• Systemic Lupus Erythematosus, (SLE)
• Cancer

As you can see, many of these conditions don’t have a direct link to heart disease or stroke. Yet my own experience backs up the evidence.

The connection between high homocysteine and an underactive thyroid is also critical. Many times doctors fail to recognize thyroid problems. The result can leave patients with fatigue, migraines and depression.

The irony is that you can easily manage your homocysteine. A simple blood test will tell you if you have high homocysteine levels. I like to keep my patients’ levels at 7 or below.

I have not had a single case of elevated homocysteine that couldn’t be corrected with the right combination of natural supplements.

Here’s what I use with my patients. (Amounts are daily.) You can find these at your local health-food store:
•    Vitamin B12 – 500 mcg
•    Folic acid (B9) – 800 mcg
•    Vitamin B6 – 25 mg
•    Riboflavin (B2) – 25 mg
•    TMG (Trimethylglycine) – 500 mg

To your good health,

Al Sears, M.D.
Bibliography:

1.    Wald NJ, et al. Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med. 1998; 158:862-7.
2.    Nygard O, et al. Plasma homocysteine levels and mortality in patients with coronary artery disease. New England Journal of  Medicine, 1997, 337:230-6.

By Inger Pols

This is part five of a series on the supplements I think every adult should take. Previous issues focused on whole-food based multivitamins, ubiquinol, fiber and omega 3. You can read them by clicking here.

The final supplement on the list is vitamin D, which is made in our bodies through sun exposure. But today, we simply don’t get enough direct exposure to sunshine, without sunscreen, to make the vitamin D we need.

Vitamin D helps with bone health by facilitating calcium absorption. It also plays an important role in many other healthy body functions. Vitamin D has been shown to improve immune health and heart health, protect against cancer, autoimmune diseases, depression and a host of other conditions.

Vitamin D deficiency is a major cause for concern as it affects multiple systems in our bodies. Vitamin D deficiency is far more pervasive than previously believed, with research now indicating virtually all adults and children have lower than optimal vitamin D levels.

The only way to know how much vitamin D you need on a daily basis is to get your levels tested a couple of months after you begin to supplement. You want to see levels of 125-200 nmol/L, or nanomoles per liter. (Sometimes test results are reported in nanograms per milliliter or ng/ml. It’s the same test, just a different measurement: Like miles per hour versus feet per second. If your test results are in ng/ml, you will want to see at least 50 ng/ml for optimal vitamin D function.)

Estimates now suggest that 5,000 International Units, or IU, of vitamin D a day or 35 IU per pound for kids or heavier people is appropriate. But some of us need more: I was recently listening to a renowned brain expert say that as a physician, he was shocked when he found out after vitamin D testing that his body required 10,000 IU a day to function at its optimal level since he lives in southern California and is exposed to sunshine all year.

My whole food multivitamin contains 5,000 IU of vitamin D3 and I get plenty of daily summer sunshine, so I don’t take a supplement in summer. But most multivitamins have shockingly low levels of vitamin D3. So even if you are taking a good whole-food multivitamin, you’ll most likely need to add some D3, unless you get time outside without sunscreen every day. And even though my multivitamin provides a good baseline, I still find that I need to supplement with an additional 1,000-2,000 IUs of vitamin D3 during the long New England winters. Unless you are in a warm weather climate, you probably will too.

If you haven’t read my full article on vitamin D, you should check it out. Before we leave the topic of supplements, I want briefly mention three other supplements that did not make my top five list that you may want to consider: collagen, probiotics and DIM.

Collagen

If you read my article on bone health, you know how important collagen is to avoiding bone fractures. You can and should get your collagen from eating good collagen-rich foods like dark green leafy vegetables. But if you find—like many—that you may not be eating enough collagen and you are not taking a good whole-food multivitamin, you may want to consider collagen supplementation.

As I shared in an earlier article, in order to maintain my weight and to prevent blood sugar issues, I try to eat small amounts of protein, healthy fats (omegas 3s) and fiber at every meal or snack. If I am ever in a situation where I am not consuming protein, I will take a collagen supplement (and a fiber or omega 3 supplement if needed) for balance. While not nearly as good as eating the right foods, in a pinch, it’s better than taking in carbohydrates (sugar) without any having protein to balance it out since carbs ingested without a protein counterbalance are stored as fat in the body.

Probiotics/Digestive Enzymes

We’ve all heard of antibiotics: They kill off or inhibit the growth of bacteria. But antibiotics also kill off the healthy bacteria in our digestive tract and inhibit our ability to digest food and to absorb nutrients. Probiotics contain the beneficial flora that your digestive system needs and digestive enzymes that work in your stomach to help break down foods. Both can be damaged by illness, poor diet and antibiotics, so if you have experienced any of those and have not taken a course of probiotics and enzymes afterward, your digestive system is likely not operating at top capacity.

Probiotics and digestive enzymes are also a must if you have digestive concerns such as cramps, constipation, diarrhea, gas or bloating or Irritable Bowel Syndrome. If you struggle with allergies or asthma, food sensitivities such as sugar or gluten, yeast infections or urinary tract infections, rosacea, acne or skin conditions, headaches or migraines, chronic bad breath (halitosis), PMS or hormonal imbalance, or achy joints, you should consider probiotic supplementation.

Depending on how long and how strong your course of antibiotics was, or how severe your digestive concerns are and what your diet is like (if it is very acidic), you may want to stay on probiotics for a while to ensure balance is restored and maintained. At a minimum, you’ll want to take probiotics and digestive enzymes while taking antibiotics and for several weeks afterward. A two to three month supplementation cycle is great for restoring balance and digestive health after any significant stress to your digestive system. Eating yogurt can help, but your body most likely needs more help than yogurt alone can provide.

Even if you haven’t had antibiotics lately or faced a digestive health concern, your system could still be imbalanced from a concern long ago. Probiotics can help restore balance if you have a heavily acidic diet that promotes yeast and causes other imbalances in your digestive pathway. I recommend a month (or two) of probiotic and digestive enzyme supplementation every year to help ensure your digestive system has everything it needs to maximize the nutrient absorption of the food you are eating.

There are many different probiotic strains and each works differently in the body, so you may need to experiment with more than one brand to find the right one. If you are facing a specific issue, research your condition to find the best strains. The right probiotic should make a difference within the first week or two. If you don’t see improvement after two weeks, try another brand with different strains of bacteria. If you are just looking to restore balance annually with no specific concerns, choose a highly rated probiotic that has bifidobacteria and lactobacillus acidophilus in the billions.

DIM or Diindolylmethane

Diindolylmethane, or DIM, promotes healthy hormonal balance through beneficial estrogen metabolism. DIM is a naturally occurring phytonutrient found in cruciferous vegetables (like broccoli, cabbage or collards), which we know are good for us, but do not eat nearly enough of. DIM can balance estrogen by blocking “bad” estrogen and promoting good or beneficial estrogen in our bodies.

For women, healthy estrogen metabolism prevents breast, cervical and uterine cancers; for men, it is required for prostate health. (Men, you have estrogen in your bodies and are exposed to it in foods and the environment as well, so it’s just as important for you!) We are going to be talking more about DIM and prostrate health in Friday’s issue.

Not everyone needs DIM, so it didn’t make my top five list. But if you’re concerned about hormonal balance, fibers, tumors or reproductive cancers or prostate health, DIM is a supplement you should consider taking daily. (I found it quiets my hot flashes.) Generally speaking, unless cancer runs in your family, you are perimenopausal and/or you are already struggling with reproductive issues like fibroids or hysterectomy, it’s something you can wait to take until you’re in your 50s.

Research has shown that most DIM supplements cannot be absorbed; they require microencapsulation. Only one company, BioResponse, has a patented microencapsulation with extended release naoparticles, ensuring predictable absorption. This company is the only brand being used in all the published clinical trials, including those sponsored by the National Cancer Institute, so it’s the one I take and recommend.

To your health!

Inger Pols
Editor of New England Health Advisory

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By Al Sears, M.D.

If you enjoy breakfast or lunch on-the-go, I understand. Our lives are so busy; we don’t always have time to cook.

But beware: Some “convenience foods” aren’t worth it. You’ll pay for it with added inches to your waistline. And those excess pounds lead to chronic diseases like obesity, cancer, and heart disease.

Here are three foods that will put you on the fast track to fat:

Breakfast Cereal: This one is a little deceptive. No one thinks of cereal as being a threat to their health.

But no matter which one you choose, breakfast cereals are high on the glycemic index (GI). For many people, a dose of high-glycemic carbs in the morning is the prescription for building excess body fat.

You’d almost be better off eating a candy bar or a piece of cake.

The GI of an average piece of chocolate cake is between 31 and 38… a Snickers bar is about 43. Not bad.

Compare that to the GI of Kellogg’s Corn Flakes… which registers a whopping 132. That means corn flakes break down into sugar in your bloodstream faster than pure glucose!

And if you add fuel to the fire by putting sugar on your cereal, you’re sending an overwhelming surge of sugar into your system.
Remember, high blood sugar triggers a wave of insulin. And insulin is the hormone that sends the message to build and store fat.

Even “healthy” cereals like Grape-Nuts have a GI of 80. That’s also very high.

It might be a fast fix when you’re rushing in the morning, but cereal in the morning will make you fat. Avoid it at all costs.

French Fries: Possibly the worst foods you can eat. First off, potatoes are high-glycemic and not good for you in any form. But when you take potatoes and deep-fry them in trans fatty oil, you have a recipe for sickness and disease.

While white potatoes aren’t the best choice, the oil they’re cooked in adds much more danger than the potatoes do. If you need a potato fix now and then, opt for a baked potato or, better yet, sweet potatoes. They’re loaded with carotenoids, vitamin C, potassium, and fiber.

Bagels and Breads: Don’t fall for the “whole-grain goodness” trap. When it comes to the glycemic index, it matters very little whether breads are made from whole grain or not. Grains spike your blood sugar, and you know what that means.

Forget about the commercials you see on TV. Unless you are very poor and can’t get enough calories without them, you should avoid grains at least until you get as lean as you want to be. You’ll be better off without them.

In the morning, take a few extra moments and scramble some eggs. Before you throw the eggs in, sauté some sliced tomatoes and spinach. Maybe some onion, too. In less than 10 minutes, you can have a breakfast that will make you feel pumped and energetic for the whole morning.

And if you need a fast lunch, try a wrap instead of a sandwich. More and more restaurants offer wraps these days. They come in all styles – spinach is my favorite. (Try and avoid the heavy flour tortillas.)

To your good health,

Al Sears, M.D.

Bibliography

1.    Whitehouse MW, Macrides TA, Kalafatis N. “Anti-inflammatory activity of a lipid fraction (Lyprinol®) from the N. Z. green-lipped mussel.” Inflammopharmacology. 1997;5:237-46.