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LMU 64 – Raw Beet Juice Reduces High Blood Pressure and Improves Athletic Performance (repeated bouts of sprinting) in Trained Soccer Players

LMU-64

LMU 64 – Raw Beet Juice Reduces High Blood Pressure and Improves Athletic Performance (repeated bouts of sprinting) in Trained Soccer Players

Source: Journal of Human Hypertension (2016) and the journal Nutrients (2017)

Lifestyle Medicine Update (August 25, 2017)

The research I am citing today is from the Journal Human Hypertension (2016) and The Journal Nutrients (2017), and it features the emerging evidence that raw beet juice provides benefits both to heart health and athletic performance. I am a big fan of pomegranate juice. If you follow my research updates, then you know that I believe everyone should consume at least 4 oz. per day of pomegranate juice to help prevent prostate and breast cancer.

Up until now, it is the only juice I have recommended but we have impressive data to show health benefits. But, I think we need to add to the list, raw beet juice, based on some impressive recent research. Raw beet juice is a rich source of nitrates. Once in the bloodstream, the body can convert nitrates into nitric oxide, which opens-up (dilates) blood vessels allowing more blood to circulate to the heart muscle.  And during exercises, such as endurance aerobic exercise or repeated bouts of sprinting, nitric oxide improves blood and oxygen flow to muscles -including the type II fast-twitch muscles required for quick acceleration, explosive strength and sprinting. So, in the past few years, researchers have designed human studies to investigate whether or not raw beet juice consumption can improve blood circulation to the heart, relax the artery wall and reduce high blood pressure to some degree and improve other cardiovascular risk factors.

The 2016 study in the Journal- Human Hypertension recruited 24 patients with high blood pressure, between the ages of 25-68. This well-designed, randomized crossover study showed that the ingestion of 250 ml (about 8.5 fluid oz.) of raw beet juice per day produced the following outcomes:

  1. A lowering of systolic and diastolic blood pressure
  2. Decreased markers of blood vessel inflammation (i.e. CRP)
  3. Improved blood flow to the heart and the general circulation
  4. Lowering of the bad cholesterol (LDL-cholesterol)
  5. And Improved antioxidant status

Other studies have shown similar effects. It appears that the high nitrate content of raw beet juice provides the building block for the body to increase its production of nitric oxide, which we believe accounts for many of these cardiovascular benefits. https://www.ncbi.nlm.nih.gov/pubmed/27278926 Beet juice also contains antioxidants, fiber, potassium, folic acid and vitamin C, some of which may account for the other benefits noted, such as lowering cholesterol, reduced inflammation and improved antioxidant status. http://www.webmd.com/food-recipes/features/truth-about-beetroot-juice. Eight ounces of beet juice contains about 100 calories – the equivalent of a little less than two fruit servings. http://www.webmd.com/food-recipes/features/truth-about-beetroot-juice

With respect to athletic performance, the improved blood flow to exercising muscles induced by higher nitric oxide levels has resulted in improved performance in various aerobic events, such as long-distance cycling, when athletes used raw beet juice prior to and during athletic competition. In 2017 a study in soccer players showed that raw beet juice can also improve the ability to perform repeated bouts of all-out sprinting, which helps them maintain more optimal speed endurance in the latter aspects of a soccer game, hockey game, basketball game, tennis, or any sport requiring repeated bouts or all-out sprint-like activity. http://www.mdpi.com/2072-6643/9/3/314/htm

So, if you are wanting to improve your blood pressure or cardiovascular risk profile, or wishing to improve your endurance performance, or your ability to sustain all-out repeated bouts of sprinting required in many sports, then you may want to add 8 oz. of raw beet juice to your daily wellness checklist or natural and approved ergogenic aids for athletic performance.

I have included the cited research papers in the text below.

 

References:

1. Asgary S et al. Improvement of hypertension, endothelial function and systemic inflammation following short-term supplementation with red beet juice: a randomized crossover pilot study. J Human Hypertenstion. 2016. Oct 30 (10):627-32. https://www.ncbi.nlm.nih.gov/pubmed/27278926

2. (WebMD Beet Juice) http://www.webmd.com/food-recipes/features/truth-about-beetroot-juice

3. Nyakayiru J et al. Beetroot juice supplementation improves high-intensity intermittent type exercise performance in trained soccer players. 2017. Nutrients 9(3),314 http://www.mdpi.com/2072-6643/9/3/314/htm

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 63 – Almonds Increase HDL (the Good Cholesterol)

LMU-63

LMU 63 – Almonds Increase HDL (the Good Cholesterol)

Source: Journal of Nutrition (August 1, 2017)

Lifestyle Medicine Update (August 19, 2017)

The research I am citing today was published in the Journal of Nutrition on August 1st, 2017. The study included 48 men and women with elevated LDL-cholesterol (the bad cholesterol that narrows arteries leading to heart attack and stroke). The intention was to compare the impact on blood cholesterol of consuming either a handful of almonds per day versus a banana muffin a day. The diets were identical except for the daily snack. On the almond diet, participants ingested about a handful of almonds a day. During the control period, they received a banana muffin instead. Subjects ingested a banana muffin each day for six weeks, then ingested a handful of almonds each day for six weeks.

The researchers found that while participants were on the almond diet, their HDL levels and functionality improved. There’s a lot of research showing that a diet that includes almonds lowers the bad cholesterol (LDL-cholesterol), but the effect on the good cholesterol (HDL-cholesterol) has not been studied to the same extent. In the normal weight subjects, the HDL-cholesterol increased quite substantially, as did HDL function.

HDL-cholesterol acts like a vacuum cleaner picking up some of the cholesterol that has already been deposited in the artery wall and transports it back to the liver. This function of HDL helps to reverse atherosclerosis, or artery narrowing, thereby reducing the risk of heart attack and stroke. So, the higher your HDL and the lower your LDL, the better is your risk profile for heart and cardiovascular disease. As HDL picks up cholesterol in the artery wall, it becomes larger, like a garbage bag slowly filling up with garbage. It then takes the garbage (cholesterol in this case) back to the liver where it can be metabolized and eliminated from the body. It’s important to note that only normal weight subjects saw a rise in HDL and improvement in HDL function.

Overweight subjects did not see this benefit even when consuming the almonds. We have known for a while the being over weight decreases the synthesis and release of HDL from the liver and that losing excess body fat tends to increase HDL levels. So, this study showed that almonds can’t overcome the depressed HDL levels seen in overweight subjects. The other way to increase HDL levels is to perform aerobic exercise regularly, which also helps to burn excess body fat and help achieve an ideal weight. So, aerobic exercise is a win-win with respect to increasing HDL levels. In the meantime, I often see individuals who are at their ideal weight, and who also exercise, and yet their HDL level is not high enough to be considered ideal. So, the addition of a handful of almonds to the daily diet may help to give HDL a boost in these cases. As well, eating a handful of almonds instead of a muffin will also help individuals lose extra body fat over time. And once they do, the almonds will likely help them further raise their HDL levels – a very desirable outcome.

What is the ideal HDL blood level?

Men: above 1.17 mmol/L (45 mg/dL)

Women: above 1.42 mmol/L (55 mg/dL) – women tend to have slightly higher HDL levels.

Remember that previous studies have shown the walnuts are also helpful in preventing heart disease. So, a combination of almonds and walnuts might the combination to consider in my view.

I’ve included a link to the research in the text below.

Reference:

  1. Berryman CE, Fleming JA, Kriss-Etherton PM. Inclusion of almonds in a cholesterol-lowering diet improves plasma HDL subspecies and cholesterol efflux to serum in normal-weight individuals with elevated LDL cholesterol. Journal of Nutrition. August 1, 2017. Vol 147, No 8:1517-1523?http://jn.nutrition.org/content/147/8/1517?
  2. https://www.sciencedaily.com/releases/2017/08/170811134918.htm

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 62 – Why Polyunsaturated Fats Lower Cholesterol and Saturated Fats Raise Cholesterol

LMU-62

LMU 62 – Why Polyunsaturated Fats Lower Cholesterol and Saturated Fats Raise Cholesterol

Source: The Journal of Nutrition. 2005

Lifestyle Medicine Update (August 12, 2017)

A looming question for many years has been, why do saturated fats and transfats raise bad cholesterol levels and polyunsaturated fats lower blood levels of the bad cholesterol? Well in a brilliant review of the research, published in The Journal of Nutrition in 2005, two researchers reviewed the data on this subject and provided the explanation the medical and health community has been seeking. So, let me try to hit the highlights for you:

Absorption

The first thing to know is that when you ingest foods with saturated fat, transfats or polyunsaturated fat (including omega-3 fats), they are absorbed from the gut in small transport vehicles called chylomicrons. Chylomicrons enter the lymphatic system and eventually enter the bloodstream. Once in the bloodstream some these fats get taken up by fat cells and get stored in fat tissue, and can re-enter the bloodstream bound to the protein carrier albumin, and act as a source of energy for our muscles and other tissues between meals, during exercise and during fasting. The fats in the chylomicrons not picked up by fat cells and muscle cells inevitably are picked up by liver cells.

What Happens in The Liver

The presence of saturated fat, transfats and polyunsaturated fats in the liver prompts liver cells to turn on cholesterol production. Cholesterol is required to transport each of these types of fats back out into the bloodstream, this time incorporated into another type of shuttle vehicle, known as the VLDL (very low-density lipoprotein). Once secreted into the bloodstream by liver cells, the fats in the VLDL are further removed from the circulation by fat cells and muscle cells, primarily.

 

Fat Cells and Muscles

Fat cells store fat and muscle cells like to burn fat as a source of fuel during rest and light activity. Once the fat has been removed the VLDL is now transformed into LDL (or the bad cholesterol). With the fat removed, most of the LDL shuttle bus is filled with the cholesterol that was originally synthesized back in the liver.

 

LDL-Receptors Clear Bad Cholesterol from the Circulation

Now here is where the big distinction occurs that changes everything from the standpoint of heart disease, stroke, and other vascular diseases. The ingestion of polyunsaturated fats, including omega-3 fats and monounsaturated fats (olive oil, canola oil, avocados, nuts) also increase the number of LDL-receptors on liver cells. This enables the liver to clear the extra LDL’s from the bloodstream so that the bad cholesterol does not rise. And the receptors work better because these polyunsaturated fats improve what’s known as the fluidity of the cell membrane (outer skin of the cell which houses the LDL-receptors). The ingestion of saturated fat does not increase the synthesis of LDL-receptors and so LDL-cholesterol circulates through the bloodstream for 3-5 days and very easily becomes taken up by cells in the artery wall (called macrophages), which promotes the narrowing of arteries (atherosclerosis) and related vascular problems (heart attack, stroke etc.).

Other Adaptations in the Liver Induced by Polyunsaturated Fats

Polyunsaturated fats also decrease the conversion of carbohydrates into fat within the liver. The liver often converts carbohydrates into a cholesterol-raising saturated fat known as palmitic acid. But polyunsaturated fats slow this process down. As a result, the liver makes less cholesterol. Polyunsaturated fats also increase the conversion of cholesterol into bile acids in the liver. With food ingestion, the liver and gallbladder secrete these bile acids into the intestinal tract to help digest the fats eaten a meal. As bile acids cannot be converted back into cholesterol, polyunsaturated fats help to reduce the total cholesterol pool in the liver, and thus, less is secreted into the bloodstream.

 

Which Foods Contain Cholesterol-Raising Saturated Fats?

Finally, the saturated fats that raise blood cholesterol to the greatest degree are lauric, myristic and palmitic acid, found in beef, pork and high-fat dairy products to the greatest degree, although coconut and palm oil have a significant amount of lauric acid and other long-chain, cholesterol-raising saturated fats, as well. As for transfats, they not only raise blood cholesterol to the same extent as these saturated fats, but they also lower the good cholesterol (HDL), which makes them double trouble. HDL vacuums up some of the cholesterol in the artery wall, helping to reverse clogged arteries. So, higher HLD and lower LDL is the blood profile you are shooting for. In summary, to help lower bad cholesterol (LDL) and raise the good cholesterol (HDL) studies continue to support the following dietary and lifestyle strategies:

  • Reduce or eliminate beef, pork, and high-fat dairy products (butter, any milk or yogurt above 1%, ice cream, whipped cream, cream, and cheese – unless the cheese is under 4% milk fat)
  • Reduce or avoid coconut oil and palm oil
  • Reduce or eliminate transfats, often found in pastries, creamy salad dressings, shortenings, and certain processed foods.
  • Do your best to consume fish twice per week, olive oil, a handful of nuts each day, and maybe some avocado.
  • Substitute chicken breast, turkey breast, and soy products for other meats, and know that soy products also reduce cholesterol by blocking cholesterol absorption in the gut and blocking the absorption of cholesterol building blocks.
  • Beans and peas also help to lower cholesterol by dragging it out of the body via the fecal route. The same is true for 1 tablespoon per day of ground flaxseed, 1-3 teaspoons of psyllium husk fiber or the use of oat bran or an oat bran cereal. Apples and artichokes also help lower the bad cholesterol.
  • Over consumption of refined sugars and starchy foods also promote the conversion of carbohydrate into palmitic acid (a cholesterol-raising saturated fat) in the liver. So, keep your carbohydrate intake in check, as well as your body weight.
  • Endurance exercise helps to raise the good cholesterol (HDL), as does losing excess weight.

So, there you have it. Do your best to use diet and exercise to get your cholesterol into the ideal range: That means aiming for a:

Total cholesterol below 3.9 mmol/L (150 mg/dl)

And an LDL cholesterol below 2.0 mmol/L (76 mg/dl)

 

I’ve included the reference and link for the journal cited here in the text below

Reference:

Fernandez ML and West KL. Mechanisms by which dietary fatty acids modulate plasma lipids. The Journal of Nutrition. 2005. 135:2075-2078. (The American Society for Nutritional Sciences) http://jn.nutrition.org/content/135/9/2075.full

 

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 61 – Whey Protein and Other Nutrients Reverse Muscle Loss in Aging: And augmented further when combined with exercise training

LMU-61

LMU 61 – Whey Protein and Other Nutrients Reverse Muscle Loss in Aging: And augmented further when combined with exercise training

Source: PLOS One Open Access Journal (July 18, 2017)

Lifestyle Medicine Update (August 5, 2017)

The study I am citing today hails from the McMaster Institute for Research on Aging, at McMaster University in Hamilton Ontario. It was published on July 18, 2017, in The Public Library of Science One Open Access Journal. This human study of men 70 plus years old showed the value of using a whey protein shake mix, combined with a few other key nutrients, on reversing age-related muscle loss that accompanies the normal aging process.

As we get older the body secretes lower amounts of natural anabolic hormones, such as testosterone and growth hormone. For example, after age 40 the blood level of testosterone declines 1% each year in men, on average. So, from age 40 to 70 most men typically see their testosterone decline by 30%. That’s a lot. For growth hormone, the decline is even greater. These hormonal changes typically result in a breakdown of muscle mass, whereby the body breaks down muscle protein (structure) and burns it as a fuel.

As this process proceeds one month after the next and one year after the next, individuals become weaker, have less muscle tissue and often slowly lose the ability to perform normal daily living activities like rising from a chair or ascending a flight of stairs. They are also more prone to falls and related fractures and may eventually require assisted living.  So, can this process be prevented and/or reversed to a significant degree?  Studies continue to show us that the answer is yes and we don’t need hormone injections to accomplish it. Nutrition and lifestyle can do it.

The McMaster study showed that this type of age-related muscle wasting, known as sarcopenia, and related muscle weakness, could be reversed in older subjects who simply ingested a whey protein shake mix each day (30 gm, twice daily), along with several other key nutrients shown to support muscle and bone strength and structure. These nutrients included:

  • Creatine: 5 gm per day
  • Calcium: 800 mg
  • Vitamin D: 1,000 IU
  • Omega-3 Fats (Fish Oil): EPA–1400 mg/DHA- 890 mg

Compared to the group given the placebo, this group of men, aged 70 years old and older, showed an increased gain in muscle lean mass of 700 gms, in just the first 6 weeks.  That is the amount of muscle tissue most older people lose in one year. Then in the next 6-weeks, they combined the protein-nutrient supplement protocol with a simple fitness and strength training program that participants did twice per week, and with that, they saw a significant improvement in strength gains compared to the group not using the whey protein shake and additional supplements.

Researcher Kristen Bell, who worked on the study stated “Clearly, exercise is a key part of the greatly improved health profile of our subjects, but we are very excited by the enhancements the supplement alone and in combination with exercise was able to give to our participants.”

A number of previous studies have shown that whey protein is the best protein source to help build muscle tissue. Many athletes and body builder use whey protein shakes to enhance the results of their workouts. The same is true for creatine supplements that help increase strength. But, increasingly we are seeing that the use of whey protein and creatine are also valuable nutritional ingredients to help prevent, slow or reverse age-related muscle loss and weakness.

With our aging population, I really feel that individuals over 50 years old and certainly over 60 years old, should consider using a whey protein shake, as well as creatine, to help preserve and reverse muscle loss. Reversing muscle loss speeds up metabolism helps to prevent fat gain, and helps preserve our ability to perform normal daily tasks as we get older enabling people to be stronger, more independent and functional with a higher quality of life. Of course, nutrients such as calcium, Vitamin D, and Omega-3 fats are also beneficial on many levels.

I’ve included a link to the research study in the text below

In the meantime, keep your workouts going and think about using whey protein and possibly other nutrients cited here to boost your strength, muscle tone, definition, lean mass, and metabolism.

References:

1. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181387

2. https://www.sciencedaily.com/releases/2017/07/170718142925.htm

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 60 – Nine Lifestyle Factors Shown to be Responsible for 35% of Dementia Cases: And other dietary, nutrient and lifestyle factors can reduce risk further and even reverse early memory loss problems (mild cognitive dysfunction)

Nine Lifestyle Factors Shown to be Responsible for 35% of Dementia Cases

LMU 60 – Nine Lifestyle Factors Shown to be Responsible for 35% of Dementia Cases: And other dietary, nutrient and lifestyle factors can reduce risk further and even reverse early memory loss problems (mild cognitive dysfunction)

Lifestyle Medicine Update (July 29, 2017)

A report presented at the Alzheimer’s Association International Conference on July 20, 2017, and simultaneously published in The Lancet (2017) showed that nine lifestyle factors are responsible for 35% of all case of dementia worldwide.

The nine factors that increase the risk of Dementia include:

  1. Not completing secondary education early in life
  2. High blood pressure
  3. Obesity in midlife
  4. Hearing loss in midlife
  5. Smoking
  6. Depression
  7. Physical Inactivity
  8. Social Isolation
  9. Diabetes in later life

This study was not able to include dietary factors, alcohol use, visual impairment, air pollution, or sleep practices. So, the contribution of lifestyle is probably quite a bit more than 35%, as indicated by one of the researchers. With respect to the influence of specific nutrients and cognitive function, quite coincidentally, a scientific review of the top ingredients for cognition, focus and mood were published on July 14, 2017, by NUTRA ingredients-usa.com The review highlights the research showing evidence that the following nutrients help to preserve memory and/or focus. Some nutrients can even improve mood. For instance, a 2015 meta-analysis showed clear benefits of omega-3 fat consumption to cognitive health and a clinical trial showing that daily DHA doses over 1 gram per day improved some aspects of cognitive function in older adults. As well, some studies have shown that omega-3 fat supplementation is also a good complement to drug therapy in the treatment of depression.

The supplement known as Phosphatidylserine is also of interest as some studies show that it benefits dementia or cognitive dysfunction in the elderly.  In the U.S. the FDA allows this statement for Phosphatidylserine supplements,“ very limited and preliminary scientific research suggests that phosphatidylserine may reduce the risk of dementia/cognitive dysfunction in the elderly”

CDP-choline supplements have also been shown to reverse early stage cognitive decline by increasing brain levels of choline. Choline is used to make the memory chemical acetylcholine, which typically declines with age.CDP-choline and phosphatidylserine show promise in helping to preserve choline and acetylcholine levels in the brain as we age.

B-vitamin Supplementation (especially folic acid, vitamin B12, vitamin B6 and vitamin B3-niacin) have been shown to benefit brain health in some studies and to slow the age-related shrinking or atrophy of the brain.  Some of the B-vitamins also lower homocysteine, which is a damaging chemical that is linked to Alzheimer’s disease development.

Some studies suggest that supplementation with the antioxidants, vitamin C, and vitamin E may help reduce the risk of cognitive impairment. More recently nutrients such as lutein and magnesium have shown promise in preventing age-related cognitive decline as well.

In India, a common treatment for early stage memory loss is the herb known as Bacopa Monnier, which has shown impressive results when tested against dementia medications. The adaptogen herb Ashwagandha has also shown promise in preliminary research as a supplement that can reverse mild cognitive impairment.The same is true for melatonin supplementation (3-9 mg one hour before bedtime).

The prevention of dementia also entails keeping your blood cholesterol in the ideal range to prevent cerebrovascular disease, whereby the blood vessels in your brain get clogged up with cholesterol. That’s never a good thing, of course. Of course, avoiding head injuries and head trauma is also important in preventing dementia-type problems over your lifetime.

So, the bottom line is that diet and lifestyle are key factors in the prevention of dementia and many cases of Alzheimer’s disease.  I encourage you to be proactive and protect your brain, use your brain and feed your brain the nutrients that help to keep it healthy and functional.

I’ve included a link to the cited research in the text below.

References:

1. http://www.medscape.com/viewarticle/883211?nlid=116875_1842&src=WNL_mdplsfeat_170725_mscpedit_wir&uac=62515BJ&spon=17&impID=1396748&faf=1#vp_1

2. http://www.aljazeera.com/news/2017/07/lifestyle-cut-dementia-risk-lancet-170720072645780.html

3. http://www.nutraingredients-usa.com/Ingredients/Probiotics-prebiotics/The-top-ingredients-for-cognition-focus-mood?utm_source=newsletter_product&utm_medium=email&utm_campaign=25-Jul-2017&c=LwVSym2olBn%2B3sEAtgq7rzCtF2G6qEVs&p2=

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 59 – Stem Cell and PLP Joint Injections for Arthritis, Tendon Damage, Joint and Sports Injuries: Do the help? A Research Update on Efficacy

Stem Cell and PLP Joint Injections for Arthritis

LMU 59 – Stem Cell and PLP Joint Injections for Arthritis, Tendon Damage, Joint and Sports Injuries: Do the help? A Research Update on Efficacy

Source: Medscape Review Paper (July 12, 2017): Stem Cells in Sports Medicine: Ready for Prime Time?

Lifestyle Medicine Update (July 21, 2017)

Based on the prevailing research I encourage most patients over the age of 40 to take a supplement each day that contains 500 mg of glucosamine sulfate combined with several natural-anti-inflammatory agents such as quercetin, bromelain, and MSM. After age 40 the body makes less glucosamine, which is required for cartilage synthesis, and thus, without glucosamine supplementation, the rate of joint cartilage breakdown starts to exceed its rate of synthesis leading to osteo or degenerative arthritis.

As well, white blood cells in the inner lining of our joints begin to secrete more inflammatory chemicals (cytokines) that increase the risk of pain and further destroy joint cartilage and bone. So I like the use of natural anti-inflammatory agents combined with glucosamine to preserve joint cartilage and help prevent age-related joint inflammation, stiffness, and pain.

Some studies have shown that glucosamine sulfate supplementation can actually halt further destruction in patients with mild to moderate stages of osteoarthritis and reduce associated joint inflammation when taken at a daily dosage of 1500 mg per day. So, for patients who already have osteoarthritis, I usually recommend a daily dosage of glucosamine sulfate at 1500 mg per day. It also helps if you follow an anti-inflammatory diet by reducing high-fat meat and dairy products, foods high in trans-fats, deep-fried foods and watching your refined sugar intake.

But what about people with more advanced stages of osteoarthritis, or severe cartilage damage, or severe tendon problems and acute sports injuries? Well, more and more doctors are experimenting with stem cell injections into the joints and/or Platelet-rich Plasma injections (or PLP injections) An update on the efficacy of these procedures was published in Medscape on July 12, 2017. Many patients now ask me about stem cell and PLP injections, often with respect to joint, tendon and cartilage injuries. So, I thought I would share what we have learned to date.

Stem cell injections into the affected joint have shown disappointing results thus far, largely because cartilage lacks a blood supply which is required for stem cells to get access to the areas required for repair and regeneration. However, for certain types of joint problems stem cell injections have shown some impressive results, especially with a condition known as osteonecrosis of the hip (femoral head and condyle), whereby bone degeneration and pain occurs due to loss of blood supply to the bone itself. However, new approaches using stem cell injections are being developed to help improve the ability of stem cells to repair cartilage damage in arthritis and other joint lesions and injuries. But they are not yet refined. What seems to be more effective, at this time, is the use of PLP injections. Platelet-rich plasma implies that a doctor extracts your whole blood then centrifuges it to remove red blood cells. The centrifuged blood has a higher concentration of growth factors than whole blood that appears to encourage the healing response in cartilage damage, tendon damage, and sports injuries.  In orthopedic applications, human studies have shown some impressive results in osteoarthritis of the knee and in speeding up the healing bone fractures. All this research is still early stage, but I think it has potential to be helpful in select cases, especially if combined with other evidence-based rehabilitation therapies performed by chiropractors, physiotherapists, athletic therapists and exercise rehab specialists.

PLP injections are also being used in dentistry and in dermatology and anti-aging medicine to promote the regrowth of hair in androgen or male-pattern hair loss. In fact, a placebo-controlled study published in 2015 showed impressive results in reversing male pattern hair loss in a well-designed trial, in case that may also be of interest to you.

As always, I have provided the scientific references in the text below

References:

1.Mandelbaum B. R. Stem Cells in Sports Medicine: Ready for Prime Time? Medscape July 12, 2017, http://www.medscape.com/viewarticle/882226?nlid=116577_1842&src=WNL_mdplsfeat_170718_mscpedit_wir&uac=62515BJ&spon=17&impID=1391837&faf=1#vp_1

 

2. Gentile P et al. The effect of platelet-rich plasma in hair growth: A randomized placebo-controlled trial. Stem Cells Translational Medicine 2015; 4:1-7.  http://pietrogentile.it/rel_04_2016/wp-content/uploads/2016/04/05-PRP-hair-sctm20150107_rp3.pdf

 

3. Rovati L. C. et al. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties. Therapeutic Advances in Musculoskeletal Disease 2012.

 

4. Reginster J. Y. et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet 2001. 357(9252):251-6.

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 58 – Calcium Continues to be Linked to Colon Cancer Prevention: Large Meta-analysis Study

Calcium Continues to be Linked to Colon Cancer Prevention

LMU 58 – Calcium Continues to be Linked to Colon Cancer Prevention: Large Meta-analysis Study

Source: International Journal of Cancer (2014)

Lifestyle Medicine Update (July 14, 2017)

Colon cancer is the second leading cause of cancer death when you combine the statistics for men and women. Studies in the Journal of the National Cancer Institute suggest that 70-90% of colon cancer cases can be prevented through prudent dietary and lifestyle practices. One of the factors that appear to be linked to colon cancer prevention is the optimal intake of calcium from day to day. In fact, over the past 25 to 30 years, studies have suggested that calcium may confer protection against colorectal cancer. Animal studies have shown this effect, and many population studies (epidemiological studies) have shown a strong correlation between higher calcium intake and lower incidence of colorectal cancer.

A meta-analysis published in 2014 in the International Journal of Cancer has provided additional evidence that higher calcium intake, including calcium supplements, is associated with a significant reduction in risk of colorectal cancer. The meta-analysis combined the data from 15 various human studies. The data showed that for every 300 mg increase in calcium from supplements there was an associated 9% reduction in risk of colorectal cancer and that for every 300 mg increase in total calcium (combination of food and supplements) there was an associated reduction in risk of 8%. This means that a calcium intake of 1200 mg per day, which what you should be shooting for to optimize bone density and prevent osteoporosis), is also associated with reducing the risk of colon cancer by 32-36%. That is a significant reduction in risk. Unfortunately, most people have a calcium intake that is much lower than that (500-800 mg per day).

How does calcium reduce colon cancer risk? Studies suggest that calcium slows down the rate of cell division of cells that line the colon. When you slow down cell division, cells tend to make fewer genetic mistakes that lead to cancer development. Also, calcium binds to bile acids in the gut, which prevents their conversion into cancer-causing secondary sterols (lithocholic and deoxycholic acids).So, the take-home message appears to be to ensure that you are getting sufficient calcium-rich foods each day. And if necessary, use a supplement containing additional calcium and vitamin D. Vitamin D works with calcium for support but is also linked to lower colon cancer risk.

I’ve included a list of healthy, calcium containing foods below, showing that number of milligrams of calcium available in a standard serving size. I think you’ll find it to be a good reference.

I also included the scientific reference below for the meta-analysis study.

 

Sources of Calcium From Common Healthy Foods

FoodPortion SizeAmount of Calcium (mg)
Low Fat Yogurt1 cup415
Low Fat Milk (nonfat,1%)I cup300
Low Fat Cottage Cheese½ cup75
Sardines with bones3 oz370
Salmon with bones (canned)3 oz165
Processed Tofu with calcium sulfate4 oz145
Canned Shrimp3 oz100
Cooked Lentils1 cup75
Chicken Breast3 oz10
Tuna3 oz5
Collard Greens½ cup180
Spinach½ cup85
Stalk of Broccoli1 medium70
OrangeI medium55
Green Beans½ cup30
Lettuce½ head15
Orange Juice½ cup10
Apple1 medium10
Whole Wheat Bread1 slice20
Cooked Spaghetti1 cup15
Cooked Rice½ cup10
Apricots, raw, dried4-6 halves24
Dates3-422
Figs Canned335
Figs Dried256
GrapefruitI medium40
Prunes, dried raw527
Raisins¼ cup31
Raspberries2/3 cup40
Strawberries1 cup42
Roasted Almonds1 oz80
Kale½ cup47
Baked Beans½ cup78
White Beans½ cup96
Dry-roasted soybean nuts½ cup232

 

Reference:

  1. Keum N, Aune D, Greenwood D.C., Ju W, Giovannucci E.L. Calcium intake and colorectal cancer risk: Dose-response meta-analysis of prospective observational studies. International J Cancer (2014) 135 (8): 1940-1948)

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 57 – Apple Cider Vinegar: It May Actually Reduce Blood Sugar and Help Diabetics and Pre-diabetics

Apple Cider Vinegar

LMU 57 – Apple Cider Vinegar: It May Actually Reduce Blood Sugar and Help Diabetics and Pre-diabetics

Source: Medscape General Medicine Journal (2006) and Longevity Magazine Journal (2017)

Lifestyle Medicine Update (July 7, 2017)

The June 29th, 2017 Longevity Magazine Journal had an article that caught my eye regarding the medicinal value of Apple Cider Vinegar. Over the years many patients have asked me about the health benefits of apple cider vinegar, but in truth, I knew very little about it and had not seen many published clinical trials to supports any proven therapeutic effects. However, in recent years several well-designed studies have shown a positive effect on diabetes management, regarding the ability of vinegar products to reduce blood sugar (glucose) and possibly improve insulin sensitivity.

To understand it better, white distilled vinegars are generally 4% to 7% acetic acid whereas cider and wine vinegars are 5% to 6% acetic acid. Studies suggest that it is the acetic acid in vinegar that has the blood sugar lowering effect. Experimental studies show that acetic acid slows down the absorption of carbohydrates from the gut into the bloodstream by inhibiting certain carbohydrate digesting enzymes in the intestinal tract. How acetic acid may improve insulin sensitivity, which lowers the body’s demand for insulin, is still a bit of a mystery.  But if that’s the case, it’s a marvelous thing for diabetics and prediabetics, as lowering circulating insulin also helps to reduce the conversion of carbohydrates into fat. And there is some preliminary evidence that Apple cider vinegar may also aid in weight loss (via reduction of body fat).

With respect to lowering post-meal blood sugar one study in non-diabetic subjects demonstrated that 20 mL of white vinegar (5% acetic acid) as a salad dressing ingredient reduced blood sugar rise by 30% following a mixed meal.  (The meal was comprised of a lettuce salad and white bread containing 50 g carbohydrate).While compiling a glycemic index (GI) table for 32 common Japanese foods, other researchers showed that the addition of vinegar or pickled foods to rice (e.g., sushi) decreased the blood sugar elevation (glycemic response) of rice consumption by 20 to 35%. A researcher named Ostman and colleagues reported that substitution of a pickled cucumber (1.6 g acetic acid) for a fresh cucumber (0 g acetic acid) in a test meal (bread, butter, and yogurt) reduced post-meal blood sugar elevation by over 30% in healthy subjects.

More recently, in a crossover trial, individuals with insulin resistance or with type 2 diabetes consumed a vinegar test drink or placebo immediately before the consumption of a mixed meal containing 87 g total carbohydrate. In the insulin-resistant subjects, vinegar ingestion reduced post-meal blood sugar by 64% compared to subjects ingesting the placebo and improved post-meal insulin sensitivity by 34%. The vinegar drink they consumed before the meal consisted of 20 g vinegar dissolved in 40 g water and 1 tsp of saccharine. A 64% reduction in blood sugar compared to the placebo is quite amazing. In the individuals with type 2 diabetes, the vinegar drink produced a 17% reduction in post-meal blood sugar and a 19% improvement in post-meal insulin sensitivity – still very impressive values.

Other studies on “healthy subjects” by Ostman and fellow researchers also showed a reduction in post-meal blood sugar and improved insulin sensitivity.  And those ingesting the vinegar with meals also reported greater meal satiety (they felt more full).  So, the suggestion is that the ingestion of vinegar at meals may help people lose weight by making them feel more content and less inclined to overeat.

With respect to other health conditions, there is insufficient evidence at this time, from human studies, to declare that apple cider vinegar or other forms of vinegar can reduce blood pressure, prevent cancer, reduce cholesterol or improve arthritic conditions. The jury is still out on these conditions.

However, if you’re blood sugar is a bit too high, or you are already in the diabetic range, it may prudent to consume more vinegar and vinegar-containing products with your meals (i.e. oil and vinegar salad dressings), or include more pickled foods containing vinegar (but be careful with ones that are high in salt which can raise blood pressure).  You may even want to consider ingesting 2 teaspoons or more of apple cider vinegar mixed in a cup of water or juice at one or two meals each day. Apparently, you can also buy supplements containing 285 milligrams of dehydrated apple cider vinegar in some health food stores.  Once again, it would be best to take these supplements or any other form of vinegar with a meal in order to slow carbohydrate absorption into the blood stream and improve insulin sensitivity.

I’ve included the scientific references and related summary reports below.

References:

1.Johnstone CS, Gass CA. Vinegar: Medicinal uses and antiglycemic effect. Medscape General Medicine Journal. 2006. Published online 2006 May 30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1785201/

2. Longevity Magazine Journal:  https://www.worldhealth.net/forum/topic/943/

3. WebMD: http://www.webmd.com/diet/supplement-guide-apple-cider-vinegar

 

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 56 – AMA Recommends More Choline in Prenatal Vitamins: And Adults Need More TooVitamins: And Adults Need More Too

AMA Recommends More Choline in Prenatal Vitamins

LMU 56 – AMA Recommends More Choline in Prenatal Vitamins: And Adults Need More Too

Source: American Medical Association Annual Meeting (2017) – Chicago

Lifestyle Medicine Update (July 1, 2017)

The breaking news I am citing today comes from the 2017 American Medical Association Annual Meeting in Chicago, whereby the AMA announced that it now supports an increase in the nutrient known as “choline” in all prenatal vitamins to 450 mg per day. Choline is under appreciated, and not widely discussed nutrient that, like folic acid, is proven to help prevent spina bifida defects (i.e. spina bifida) in the developing fetus and other neural tube deformities that can affect spine and brain development.

As of 2016, none of the top 25 prenatal multivitamins contain the scientifically-backed choline dose for pregnant women (450 mg per day), according to a study published in 2015 by researchers at the University of Chicago. This recommended dosage was first established 1998 by the Institute of Medicine, which recognized choline as an essential nutrient.

But choline isn’t just important to the developing fetus. The growing and adult human body also have a need for adequate choline.Choline is required to help protect against liver and kidney damage and degeneration, including fatty liver problems commonly seen in overweight subjects, diabetic and with moderate to excess alcohol consumption. Research suggests that choline deficiency greatly increases the risk for primary liver cancer or hepatocarcinomas, as they are known in medical circles. Choline is also required to build all the cell membranes (outer skin) of all body cells and plays a key role in cell signaling mechanisms. Choline is also transported across the blood-brain barrier to enter the brain. Brain cells use choline to make the memory chemical acetylcholine. The more acetylcholine you have, the better your memory as a rule.

So, it may be surprising to learn that 90% of adults don’t get the recommended amount of choline each day, according to the latest findings from the National Health and Nutrition Examination Survey data or the NHANES data as it is known in the United States. Adults are advised to consume 400-550 mg of choline per day in their diet. Many healthy foods contain choline: Here are some examples of the amount of choline found in 3.5 ounces or 100 gm of the following foods:

  • soybeans contain 116 mg
  • salmon contains – 91 mg
  • chicken contains about 80 mg
  • soy protein contains 86 mg
  • peanut butter contains 66 mg
  • almonds contain 52 mg
  • broccoli contains 40 mg
  • Brussels sprouts contains 41 mg
  • cauliflower contains 39 mg
  • wheat germ contains 152 mg
  • wheat bran contains 75 mg
  • oat bran contains 59 mg
  • whole wheat bread contains 27 mg
  • I cup or 8 ounces of skim milk contains 38 mg
  • And one tablespoon of lecithin granules contains 250 mg of choline

It’s important to know that as we age the transporter that pumps choline into the brain becomes more sluggish. This is one of the reasons that a decline in memory occurs later in life. And the brain of Alzheimer’s patients shows a dramatic reduction in choline and choline-based molecules upon autopsy. There are some supplement forms of choline that can enter the brain in subjects over the age of 55 and help to maintain more optimal levels of the memory chemical acetylcholine and other choline-dependent molecules required for healthy brain cell structure and function. These supplement ingredients include things like CDP-choline and phosphatidylserine, both which are commonly found in memory support supplement formulations.

The point is that pregnant women need more choline to help guard against neural tube defects in their developing babies, and we as adults should also be more cognitive of our need for more choline to protect our liver, kidney, memory and brain function. Choline supplements in the form of lecithin have also helped to lower blood cholesterol in a few preliminary studies. Dr. Taylor Wallace at the George Madison University is one of the key researchers currently examining choline. His lab at the University is one first to show widespread insufficient intakes of choline across the U.S. population, published in the Journal of the American College of Nutrition in 2016.

Okay, for pregnant women make sure there is 450 mg of choline in your prenatal multivitamin. For the rest of the adult population, you may want to up your intake of choline foods and/or add some lecithin or wheat germ or soy products to your daily fare and/or consider a brain-supporting choline supplement formulation containing CDP-choline and phosphatidylserine if you’re over 55 years of age

As always, I’ve included the references in the text below

References

  1. http://www.nutraingredients-usa.com/Research/AMA-calls-for-more-choline-in-prenatal-vitamins?utm_source=newsletter_daily&utm_medium=email&utm_campaign=26-Jun-2017&c=LwVSym2olBlTT94uoetl63MteNCASAKV&p2=
  2. http://www.nutraingredients-usa.com/Research/Time-for-the-DGAC-to-look-again-at-choline
  3. https://www.nutritionexpress.com/article+index/vitamins+supplements+a-z/lecithin/showarticle.aspx?id=1968
  4. Textbook: Modern Nutrition in Health and Disease -10th edition. Editors: Shils M, Shike M, Ross A.C, Coballero B, Cousins R. Lippincott Williams & Wilkins: pages 525-536.

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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LMU 55 – The Prescription Opioid Drug Epidemic and Consequences

The Prescription Opioid Drug Epidemic and Consequences

LMU 55 – The Prescription Opioid Drug Epidemic and Consequences

Source: ON Chiropractic: Spring 2017

Lifestyle Medicine Update (June 14, 2017)

The research I’m citing today was published by Dr. Jane Ballantyne in 2017. Dr. Ballantyne is a physician and professor of Anesthesiology and Pain Medicine at the University of Washington.  Her review paper addresses the prescription opioid drug epidemic that has crept into society since the late 1990’s. To paint the picture, there are now 2,000 deaths per year in Canada, alone, from the misuse of prescription opioid drugs such as oxycodone (Oxycontin), fentanyl, hydrocodone, hydromorphone, Demerol, and others.

This problem stems from the decision dating back to the 1990’s whereby medical doctors were given the green light to start prescribing opioid drugs in a broader way in the management of pain control. Until that time these drugs were prescribed primarily to treat cancer pain, but in the late 1990’s doctors were given permission to use these drugs to treat all kinds of chronic muscle and joint pains, low back pain, post-surgical pain and other painful conditions. Since 1999, prescriptions for opioids have quadrupled, and drug-related deaths have risen alongside them.

Most of the deaths from opioid ingestion are accidental, not suicide, stemming from the fact the body builds up a tolerance to the drug and thus, patients use higher and higher doses to try to get the pain control or euphoric effect they are seeking. At high doses, opioids shut down the breathing centers in the nervous system, the patient becomes unconscious and they die. A 2014 study showed that nearly 1 in 8 deaths among individuals 25-34 yrs. of age was opioid-related in Canada. Studies also show that 100% of patients engaged in long-term opioid therapy will develop a physical dependency, which means it will be very hard for them to stop or reduce their dose of opioids.  Studies show that presently half of all opioid prescriptions in the U.S. are for mechanical low back pain and other musculoskeletal conditions. Similar findings in Canada show that arthritis and back pain were the most prevalent chronic physical health conditions among opioid users.

A disturbing aspect is the fact that a 2016 systemic review of all studies showed that opioids provide only modest short-term relief of chronic low back pain. So, they don’t even work that well to block pain. Yet, opioid addiction occurs in about 10% of patients for whom they are prescribed and misuse of these drugs occurs in over 24% of patients who are prescribed opioids. So, it’s a very slippery slope once you start putting these drugs into your body. Due to the mounting evidence showing that opioid addiction, dependency, misuse and opioid-related deaths are occurring at unacceptable levels, and that they don’t provide highly effective pain relief for many of the conditions for which they have been prescribed, the 2016 Center for Disease Control Guidelines now encourages the use of non-pharmacologic, conservative care for non-cancer musculoskeletal pain, along with consideration of alternatives including behavioural changes, and non-addictive painkillers.

This means that for low back pain, arthritis and various other muscle and joint conditions doctors and patients should be seeking help from talented physiotherapist, chiropractors, massage therapists and/or acupuncturists, many of whom also use leading-edge technologies, such as spinal decompression therapy, shock wave therapy, lasers that reduce inflammation and enhance tissue repair, and so on. As well, some natural anti-inflammatories and an herbal-based supplement containing the extract from the California poppy have shown proven benefit in many human clinical trials, in reducing inflammation and blocking pain, without any major untoward side effects. These, too, may be included as part of the conservative management of chronic pain.

As Dr. Ballantyne concludes in her article, “Canada has not handled pain management well, with millions of dollars and thousands of lives negatively impacted by an overreliance on opioids. But the tide is changing”.

I’ve included the main reference in the text below, as well as links to other supportive studies on this subject.

References:

1. Ballantyne J. Opioids: Patients deserve better. ON Chiropractic (publication of the Ontario Chiropractic Association) Features Story: Spring 2017:18-27

2. http://evidencenetwork.ca/archives/19635

3. https://www.verywell.com/how-does-an-opioid-overdose-kill-1298843

4. http://www.naturopathydigest.com/archives/2008/may/meschino.php

5. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56410

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.