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Real Alternatives

September 2, 2010 Written by JP       [Font too small?]

On any given day, countless patients make the decision to visit a health care professional who practices alternative medicine. Sometimes they do so as an adjunct to the care they’re already receiving from a conventionally trained physician. In other instances, they simply want something different. Hence the term “alternative medicine”. But not every alternative is created equally nor does it need to be administered or monitored exclusively by a holistic physician.

This past week I read hundreds of health related tweets. Three of them stood out. The first is by an old favorite of mine, Dr. Michael Eades, who posted a message about the correlation between insulin resistance and brain plaques associated with Alzheimer’s disease. The second comes courtesy of The Wall Street Journal. It’s a sobering note about the increasing use of mastectomies to prevent breast cancer. The final item is from the Los Angeles Times health section. It describes a new blood thinning drug that may be more effective than aspirin in preventing strokes. What do all of these stories have in common? They afford us an opportunity to consider alternative therapies.

The August 2010 issue of the journal Neurology describes a fascinating study that examined blood sugar control and cognitive functioning of 135 seniors over a 15 year period. The brains of the seniors who died were examined for indications of Alzheimer’s disease – brain plaque and tangles. These observations were then compared to prior blood work that established blood sugar and fasting insulin levels. In all, a total of 16% of the study group exhibited signs of Alzheimer’s disease and 65% were found to have significant brain plaque during subsequent autopsies. Neuritic plaque was found in 72% of those with insulin resistance and 62% of those without. That is considered a statistically relevant difference. (1,2,3)

Alternative for Insulin Resistance: Insulin resistance is a precursor to type 2 diabetes in which insulin is rendered less effective in managing blood sugar. One way to address it may be to eat a handful of mixed nuts daily. A recent 12 week trial found that eating 15 grams of walnuts, 7.5 grams of almonds and 7.5 grams of hazelnuts successfully lowered fasting insulin and HOMA-insulin resistance in patients with metabolic syndrome – a combination of cardiovascular and diabetic risk factors. (4)

According to new research appearing in this month’s Journal of the American Medical Association, women who possess certain mutated genes can lower the risk of breast and ovarian cancer by having preventative mastectomies and/or their ovaries removed. It’s estimated that 1 out of every 1000 women carry the BRCA1 or BRCA2 gene mutations. These genetic mutations put them at a dramatically elevated risk of developing breast cancer at some point in their lives – 50% to 80% risk. The study in question examined 2,482 women over a 25 year period. The results indicate that there were no cases of breast cancer in those who chose to have a mastectomy. Conversely, breast cancer was diagnosed in 7% of the women who did not opt for the surgery. The removal of ovaries resulted in significant protection as well: 1.1% ovarian cancer incidence with surgery; 5.8% without. Lower all-cause mortality, breast cancer-specific mortality and ovarian cancer-specific mortality were also noted in the volunteers who underwent surgical procedures. (5,6,7)

Alternative for Breast and Ovarian Cancer: I can’t make any promises that dietary changes will offer comparable chemoprotective effects. But some evidence suggests that nutrition during various stages of life may reduce the risk of developing breast and ovarian cancer. According to several recent studies:

  • Eating more fiber during adolescence may confer a 25% lower risk of proliferative benign breast disease, “a marker of increased breast cancer risk”. (8)
  • Close adherence to a Mediterranean-style diet demonstrates an inverse association with breast cancer in postmenopausal women. This finding was reported in the September 2010 issue of the American Journal of Clinical Nutrition. (9)
  • Limiting dietary acrylamide, “a probable carcinogen” found primarily in “heat treated, carbohydrate-rich food”, may reduce the likelihood of ovarian cancer. A good place to start is to avoid the foods listed in the image below. (10,11)


Source: Environ Health Perspect. 2010 April; 118(4): A160–A167. (link)

An experimental blood thinning medication known as Apixaban is the current toast of the town in cardiology circles. The cause for celebration is a new clinical trial that found that this new, improved blood thinner could reduce embolisms and strokes by 54% compared with aspririn. According to the unpublished data, 1.4% of patients using the medication and 1.2% of those taking aspirin exhibited major bleeding events. This is considered an “acceptable risk”. The hope is that Apixaban, manufactured by Pfizer, and two other rival medications, Praxada (Boehringer Ingelheim) and Xarelto (Bayer AG), will soon offer a more effective and manageable way to reduce blood clots in at-risk patients.(12,13,14)

Alternative “Blood Thinner”: The latest edition of the journal Hypertension singles out Pycnogenol or pine bark extract as a potentially viable “antiatherogenic antithrombotic” supplement. Several scientific inquiries of late support this notion. It appears that Pycnogenol exerts its blood thinning/circulation enhancing effects by: a) reducing thromboxane generation; b) ameliorating endothelial dysfunction; c) inhibiting platelet aggregation without increasing bleeding time. The authors of the latter study concluded that, “These observations suggest an advantageous risk-benefit ratio for Pycnogenol”. (15,16,17,18)

I’m a strong believer in tapping into the best of what both allopathic and holistic medicine have to offer. The point of today’s blog is simply to remind myself and you that there are often natural alternatives that should be considered. That’s not to say that select medications and surgical interventions aren’t appropriate at times. Such decisions need to be individually evaluated in conjunction with your health care team. But if you’re unaware that viable alternatives exist in the first place, then, in effect, they don’t exist for you. My advice is not to count on your doctor to inform you about all the available options. Instead, you should be prepared. Go in to your medical appointments with reliable information to share. This will not only improve the quality of your care, but it may also contribute to your doctor becoming a better healer.

Be well!

JP

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9 Comments & Updates to “Real Alternatives”

  1. Nina K. Says:

    Good morning, JP ☺

    great article, but with one downside: black olives contain acrylamid?! i googled it and almonds follow directly black olives :-( , thats bad! But one thing i don’t understand: is the acrylamid only reactive when those foods where heated /roasted /grilled? I love salads with black olives and almonds are one of my greatests love of all nuts, aaaawww!

    Greetings from the european front ;-)
    Nina K.

  2. JP Says:

    Thank you, Nina. :)

    It seems as though high-heat roasted almonds and canned black olives are the biggest culprits. Some details:

    http://www.springerlink.com/content/2nfp8q4bd8ywayk9/

    http://onlinelibrary.wiley.com/doi/10.1111/j.1750-3841.2006.00206.x/abstract

    http://pubs.acs.org/doi/abs/10.1021/jf072960b

    My best advice: Opt for raw almonds and non-sterilized black olives.

    Be well!

    JP

  3. Greg Says:

    Hi JP,

    Thanks to a change in insurance coverage, I am taking the opportunity to seek out a naturopath or holistic doctor. Actually, it is due to a couple of changes – the other being that my regular doctor retired. I was diagnosed with MS 3 years ago, but I refuse to accept that diagnosis. I have been using alternative therapies to combat the symptoms (you can read about it in my blog @ http://gregorypjohnson.blogspot.com. I appreciate your viewpoint on the matter of ‘tapping into the best of what both allopathic and holistic medicine have to offer.’ In my case, the ‘best’ medication for MS – Rebif – was doing more harm than good and I am doing much better with the holistic approach.

    Thanks for the insight!

  4. JP Says:

    Greg,

    I wish you all the best in your continuing quest for true wellness. I hope your experience with the naturopath turns to out to be a blessing.

    Be well!

    JP

  5. liverock Says:

    JP

    It turns out that people at risk of dementia/Alzheimer’s Disease and have taken up exercising the brain with crossword puzzles and other brain stimulating activities to help stave off dementia are more likely to ACCELERATE the onset of dementia,according to a new study.

    Ah well,I think its time put down the crossword and to start watching the Jerry Springer Show again.!!

    http://www.sciencedaily.com/releases/2010/09/100901161549.htm

  6. JP Says:

    Liverock,

    It’s an interesting observational study. But, it’s the first of it’s kind. Let’s make sure it’s corroborated by others before we do anything drastic like watching Jerry Springer! ;)

    Be well!

    JP

  7. JP Says:

    06/01/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411995/

    Front Public Health. 2015 Apr 28;3:69.

    Effect of mediterranean diet in diabetes control and cardiovascular risk modification: a systematic review.

    BACKGROUND: Over the past few years, there has been a worldwide significant increase in the incidence of type II diabetes mellitus with both increase in morbidity and mortality. Controlling diabetes through life style modifications, including diet and exercise has always been the cornerstone in diabetes management. Increasing evidence suggests that the Mediterranean diet could be of benefit in diseases associated with chronic inflammation, including metabolic syndrome, diabetes, obesity as well as atherosclerosis, cancer, pulmonary diseases, and cognition disorders As a matter of fact, a number of studies addressed the relationship between Mediterranean diet and diabetes control. The result of these studies was conflicting. Some were able to elicit a protective role, while others showed no added benefit. As a result; we decided to conduct a systematic review to have a better understanding of the relationship between adherence to Mediterranean diet and diabetes control.

    METHODS: A systematic review was conducted on the effect of Mediterranean diet in diabetes control and cardiovascular risk modification as well as the possible mechanism through which this diet might exhibit its beneficial role. We did a comprehensive search of multiple electronic databases such as Medline, Google Scholars, PubMed, and the Cochrane central register data until May 2014. We included cross-sectional, prospective, and controlled clinical trials that looked at the associations between Mediterranean diet and indices of diabetes control such HbA1c, fasting glucose, and homeostasis model assessment, in addition to cardiovascular and peripheral vascular outcomes.

    OUTCOME/CONCLUSION: Most of the studies showed favorable effects of Mediterranean diet on glycemic control and CVD, although a certain degree of controversy remains regarding some issues, such as obesity. Important methodological differences and limitations in the studies make it difficult to compare results, thus further longer term studies are needed to evaluate the long-term efficacy of the Mediterranean diet along with the possibility of explaining its mechanism.

    Be well!

    JP

  8. JP Says:

    06/01/15:

    http://ajcn.nutrition.org/content/100/5/1344.long

    Am J Clin Nutr. 2014 Nov;100(5):1344-51.

    Intake of dietary flavonoids and risk of epithelial ovarian cancer.

    BACKGROUND: The impact of different dietary flavonoid subclasses on risk of epithelial ovarian cancer is unclear, with limited previous studies that have focused on only a few compounds.

    OBJECTIVE: We prospectively examined associations between habitual flavonoid subclass intake and risk of ovarian cancer.

    DESIGN: We followed 171,940 Nurses’ Health Study and Nurses’ Health Study II participants to examine associations between intakes of total flavonoids and their subclasses (flavanones, flavonols, anthocyanins, flavan-3-ols, flavones, and polymeric flavonoids) and risk of ovarian cancer by using Cox proportional hazards models. Intake was calculated from validated food-frequency questionnaires collected every 4 y.

    RESULTS: During 16-22 y of follow-up, 723 cases of ovarian cancer were confirmed through medical records. In pooled multivariate-adjusted analyses, total flavonoids were not statistically significantly associated with ovarian cancer risk (HR for the top compared with the bottom quintile: 0.85; 95% CI: 0.66, 1.09; P-trend = 0.17). However, participants in the highest quintiles of flavonol and flavanone intakes had modestly lower risk of ovarian cancer than did participants in the lowest quintile, although the P-trend was not significant [HRs: 0.76 (95% CI: 0.59, 0.98; P-trend = 0.11) and 0.79 (95% CI: 0.63,1.00; P-trend = 0.26), respectively]. The association for flavanone intake was stronger for serous invasive and poorly differentiated tumors (comparable HR: 0.68; 95% CI: 0.50, 0.92; P-heterogeneity = 0.10, P-trend = 0.07) compared with nonserous and less-aggressive tumors. Intakes of other subclasses were not significantly associated with risk. In food-based analyses used to compare subjects who consumed >1 and ≤ 1 cup black tea/d, the HR was 0.68 (95% CI: 0.51, 0.90; P < 0.01).

    CONCLUSIONS: Higher intakes of flavonols and flavanones as well as black tea consumption may be associated with lower risk of ovarian cancer. Additional prospective studies are required to confirm these findings.

    Be well!

    JP

  9. JP Says:

    06/01/15:

    http://www.minervamedica.it/en/journals/panminerva-medica/article.php?cod=R41Y2015N03A0121

    Panminerva Med. 2015 Sep;57(3):121-5.

    Recurrence of retinal vein thrombosis with Pycnogenol® or Aspirin® supplementation: a registry study.

    AIM: The aim of this study was to use Pycnogenol® to reduce the recurrence of retinal vein thrombosis (RVT) after a first episode. Pycnogenol® is an anti-inflammatory, anti-edema and an antiplatelet agent with a “mild” antithrombotic activity. The registry, using Pycnogenol® was aimed at reducing the number of repeated episodes of RVT.

    METHODS: Possible management options – chosen by patients – were: standard management; standard management + oral Aspirin® 100 mg once/day (if there were no tolerability problems before admission); standard management + Pycnogenol® two 50 mg capsules per day (for a total of 100 mg/day). Number of subjects, age, sex, distribution, percentage of smokers, and vision were comparable.

    RESULTS: Recurrent RVT was seen in 17.39% of controls and in 3.56% of subjects supplemented with Pycnogenol® (P<0.05 vs. controls). There was RVT in 15.38% of the subjects using Aspirin®. The incidence of RVT was 4.88 times higher with standard management in comparison with the supplement group and 4.32 lower with Pycnogenol® supplementation in comparison with Aspirin®. Vision level was better with Pycnogenol® (20/25 at nine months; P<0.05). With Pycnogenol®, edema at the retinal level was also significantly reduced compared to the other groups. Pycnogenol® has a very good safety profile. In the Aspirin® group 26 completed 9 months and 6 subjects dropped out for tolerability problems. In the Aspirin® group, 2 minor, subclinical, retinal, hemorrhagic episodes during the follow-up were observed (2 subjects out of 26, equivalent to 7.69%). This pilot registry indicates that Pycnogenol® seems to reduce the recurrence of RVT without side effects. It does not induce new hemorrhagic episodes that may be theoretically linked to the use of Aspirin® (or other antiplatelets).

    CONCLUSION: Larger studies should be planned involving a wider range of conditions, diseases and risk factors associated to RVT and to its recurrence.

    Be well!

    JP

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