Readers Q&A:

Q: You guys are always saying this is bad for me or that is bed for me and I feel like there isn’t anything left for me to eat that isn’t bad. How the heck are we supposed to survive if everything is bad?

A: Eat whatever you want. All we are doing here is informing you of the things we have uncovered that are not generally known or, in some cases, are being deliberately concealed from public knowledge. But the choice of what you eat is, and always has been, totally up to you. For example, the above Quorn article: I wouldn’t touch the pure Quorn product (meat substitute) with a ten-foot pole, but the FDA has approved this as a food additive (I disagree with them, but that’s too bad, isn’t it?) and you can’t even be sure if that crap is in your otherwise-assumed-to-be-safe food, what then? How dangerous is the tiny amount in one can/box of food? Well, several issues ago, we talked about reading and deciphering food labels. What is the first ingredient? Whatever it is, that is also the largest quantity. Where in that list do you find “artificial flavors” or “citric acid” or “sugar and/or corn syrup”? That should help you make your decision as to whether or not you should consume that food product. Is it the last on the list? If so, there probably isn’t a large quantity in there (as a percentage of total volume). Does that mean this food is OK? No, but it means it isn’t likely to be the major cause of your fungal diseases. Can you eat the five mushroom slices that came on your steak when you went out to a restaurant? Yes. It won’t kill you. But think about these things the same way as someone who is trying to lose weight. One candy bar will kill a week of dieting. Is it worth throwing away all that hard work? Your choice. A few mushroom won’t kill you. Neither will a candy bar. But you stop forward progress every time you backslide. You decide.

Q: Be serious. How do you expect anyone to stay on a diet during the holidays?

A: Hey, it is your life. If you want to cheat, do it. Just keep it firmly planted in your own mind that the results of that cheating are totally your own responsibility. Don’t try to blame the holidays or any host/hostess who offered you a forbidden food. No one is responsible for your actions but you. Now that I have shown my drill sergeant attitude, let me also say that I fully understand that no time is harder than the period between Thanksgiving and New Year. Delicious, but fattening, foods are everywhere. They are present at every office party, family function and holiday get-together. Like you, I have always heard the same thing: “C’mon, it’s once a year! Live a little! Relax and enjoy yourself!” Who are they trying to convince – me or themselves? Here are some simple things you can do to keep your diet (diet being either low sugar, low fat, low carb, low mycotoxin, or whatever your normal style is) on track, without feeling as though you are missing out.

• Be first in line and eat before everyone else does. Always try to have a healthy meal about three hours before any holiday feasts. That should allow you to keep your eyeballs in your head and your portions within reason.
• Graze, but remember that before you give in to hors d’oeuvres like pigs-in-a-blanket and bite-sized quiches, attack your hunger with fiber, protein and healthy fat. For example, start at the vegetable tray, then hit the fruit plate, and finish up with a handful of nuts (not peanuts). By the time you are finished with that filling combination, the other appetizers won’t be so tempting.
• Have a cup or two of coffee before you attack the food. While everyone else goes for the cakes, pies and other sweets, try a cup of aromatic coffee (especially those flavored coffees). Not only does it satisfy that sweet craving, but the caffeine often acts as an appetite suppressant.

Q: Why is it that all the foods that taste good are the ones you say are bad for me? I feel like a child here because my mom always said things like this too.

A: I think there really is no perfect answer to this one. I grew up hearing that phrase too, but the reality is that it is all a matter of acquired taste. When I moved to England (OK, Uncle Sam sent me there for three and a half years), I tried something the English called Black Sausage (AKA Blood Pudding). The first time I ate that stuff, I thought I was going to throw up. But it was on my plate one week out of every six (I did a lot of temporary duty at a small RAF base and they ate that stuff every morning with deep fat fried bread and eggs and bacon). It wasn’t too long until I came to like it (I also gained 90 pounds while living there). Today (ummm, 37 years later), I retain a fond memory of what it tasted like, but I’ll bet that if I actually put it in my mouth today, I’d experience that same feeling of wanting to spit it out (organic graffiti on the walls). You eat what is convenient. You eat what is available. And you develop a taste for those things over time. If you had been raised in a country that had no sugar, no corn, and they ate only fresh-caught fish, fresh root plants, fresh vegetables, and fresh fruits, you would have a taste for those things and would probably puke if someone forced you to eat a huge slice of Black Forest Cake (a truly decadent multi-layer chocolate delight). You can change your eating habits to the point where one day you will discover that not only do you not have a craving for those foods we have been calling “bad,” but when you see them, you might even experience revulsion at the thought of eating that stuff.

Q: Are you in favor of alternative medicine instead of traditional doctors?

A: Partially. We believe there is a time and place for both. No doubt you have noticed that alternative therapies seem to be everywhere. Advertisements for herbal remedies are nearly as prevalent in health magazines and on television as ads for FDA-approved medicines. Things that were once considered unconventional (e.g., yoga, massage, acupuncture) have become almost mainstream. Judging from the amount of marketing, you might even assume that most Americans are using some form of alternative medicine. So here’s my plug for CAM.

What exactly is “alternative” medicine? Complementary and Alternative Medicine (CAM – we mentioned this a few issues back), according to the National Institutes of Health, can be defined as any therapy or treatment that is not part of conventional medicine. This broad definition includes interventions as simple as taking an herb, like Echinacea or Ginseng, to fight off a cold, or as complicated as acupuncture or chiropractic.

A study published in the January/February 2005 issue of Alternative Therapies compared the results of two surveys to determine if the prevalence of alternative medicine use changed between 1997 and 2002.

This study analyzed the results from two national surveys of alternative medicine use by adults. The first survey took place in 1997, and the second in 2002. All of the respondents were age 18 or over, and were interviewed either in person or by phone. The surveys consisted of questions regarding the use of 15 different complementary and alternative therapies during the previous 12 months:

• Chiropractic
• Massage
• Acupuncture
• Energy healing
• Folk remedies/folk medicine
• Biofeedback
• Hypnosis
• Yoga
• High dose vitamins
• Homeopathy
• Herbal medicine
• Chelation (use of the amino acid EDTA for cardiovascular disease)
• Naturopathy
• Relaxation techniques
• Special diets (including vegetarian, Atkins®, the Zone®, and others)

The two surveys were not identical, but the researchers only compared results for the 15 therapies that were determined to be comparable. The respondents were also asked if any of the therapies they used were covered by insurance (most were not).

The results of the study revealed that although the prevalence of some treatments increased and others decreased, overall use of alternative medicine remained stable from 1997 to 2002. The greatest increase in use between 1997 and 2002 was seen for herbal medicine and yoga, and the greatest decrease was for chiropractic care. Nevertheless, chiropractic care remained one of the most common treatments used in 2002, along with herbal therapy and relaxation techniques. Approximately 72 million Americans use complementary and alternative medicines.

More than 10 years ago, when it was first discovered that a surprising number of Americans reported using alternative therapies, many critics predicted it was only a fad. This study strongly suggests otherwise. Many people feel comfortable using some form of alternative medicine. The results of this study reveal that nearly one in three U.S. adults are willing to seek out their own unconventional therapy for health problems. While most of these therapies are far safer than many conventional treatments, their lack of regulation raises some concern.

The use of herbal therapies increased by 50% between 1997 and 2002, the largest increase of all the therapies investigated. There is currently no system in place in the United States to determine the relative safety and effectiveness of herbal treatments. Currently the FDA places most herbal remedies in the category of dietary supplements, which is somewhere between drugs and foods (remember, Hippocrates said, “Let food be your medicine,” so I have a hard time separating the two like this study does). Classifying a product as a dietary supplement means that its manufacturer is not legally required to prove that it is safe and effective before being marketed. This means that the Echinacea you take for your cold might be helpful, might do nothing, or might even be harmful (depending on how you use it). Unfortunately, because many alternative therapies are marketed as “all natural,” they are usually perceived to be safe. There are many natural things that also have limits for quantity, so be careful.

Sources:

What’s in the bottle? An introduction to dietary supplements. NCCAM. Available at:  http://nccam.nih.gov/health/bottle/#q6

Overview of Dietary Supplements. US Drug and Food Administration. Available at:  http://vm.cfsan.fda.gov/~dms/ds-oview.html.

Tindle HA, Davis RB, Phillips RS & Eisenberg DM. Trends in the use of complementary and alternative medicine by US adults: 1997-2002. Alternatives Therapies. 2005. 11 (1): 42-49.

How to Talk to Your Doctor about Complementary and Alternative Medicine

by Richard Glickman-Simon, MD

In some respects, the gap between complementary and alternative medicine (CAM) and allopathic medicine is narrowing. Nevertheless, significant differences remain, and they surely always will. On one hand, this tension is not a bad thing, since it often creates opportunities for medical innovation. In the clinical setting, however, the division can be destructive, particularly if it leads to a breakdown of communication between patients and their physicians.

Americans continue to be attracted to CAM in considerable numbers; over 40% report regularly using CAM products and services, up from about a third over the past decade. The vast majority of these CAM users also see their allopathic physicians for the same medical condition. Contrary to popular opinion, most people who pursue an interest in CAM do not fundamentally reject biomedicine or the conventional physician. Rather, many patients are attracted to CAM because they find it to be consistent with their lifestyle, beliefs, and values.

Patients are far more likely to discuss both their allopathic and CAM treatments with their CAM practitioners than with their physicians. In a survey of 86 breast cancer patients, women cited the following reasons for not discussing their CAM interests and practices with their doctors:

• The impression of physician disinterest
• The anticipation of a negative response
• The belief that the physician is unwilling or unable to contribute useful information
• The perception that the CAM therapies they are using are irrelevant to the biomedical treatment
• Their views regarding the appropriate coordination of different healing strategies

Women in this study also said they were not looking for physicians to endorse particular CAM therapies. Rather, they appreciated those who were respectful, open-minded, willing to listen, and honest about their limited knowledge of CAM.

Physicians show considerable variation in their enthusiasm for CAM. An analysis of several international surveys found that a significant number of physicians selectively practice CAM, refer their patients to its practitioners, and/or believe in its effectiveness. Nineteen percent of physicians practiced massage or chiropractic, about 17% practiced acupuncture or herbal medicine, and 9% practiced homeopathy.

The researchers also found that physicians commonly referred their patients to acupuncturists and chiropractors (43% and 40%, respectively) but rarely to herbalists (4%). Finally, roughly 50% believed in the effectiveness of acupuncture, chiropractic, and massage but only 13% had faith in herbal medicine.

Physicians cited four main reasons for their acceptance of CAM:

• Patient’s lack of response to conventional treatment
• Patient’s request or preference
• Belief in the effectiveness of CAM therapy
• Fewer adverse effects

Many of the surveys were conducted in countries more accommodating towards CAM than the United States. A survey of U.S. primary care physicians (family practitioners, pediatricians, and internists), however, reaffirms the same findings: a sizable but widely variable percentage of physicians use or accept the legitimacy of selected CAM interventions, and their opinions vary according to the nature of the intervention. American physicians, for example, tended to be more enthusiastic about mind-body interventions (meditation and biofeedback) and less keen on those therapies that require the administration of medicinal substances, such as megavitamins or homeopathic remedies. (I do not believe in homeopathy, instead favoring dietary solutions)

While it appears that roughly half of physicians take at least some CAM modalities seriously, a considerable number remain skeptical. When asked why they oppose the use of CAM by their patients, physicians most often cite one or more of the following:

• Alternative practitioners do not possess sufficient knowledge to properly diagnose an illness
• There is insufficient scientific evidence of effectiveness for CAM
• CAM is potentially harmful, either directly through its adverse effects or indirectly by delaying appropriate medical care.

One major reason for this skepticism is a lack of training and experience in CAM. Approximately two-thirds of the 125 American medical schools offer some instruction in alternative medicine, but all of it is elective, no school requires courses in CAM. This means that the vast majority of practicing physicians, particularly those with long established practices, have had little if any formal exposure to CAM. Any significant education with CAM, therefore, must be obtained independently, which helps to explain the tremendous variability of CAM in physicians’ practices.

Moreover, since the biomedical model of disease dominates medical education in this country, most American physicians graduate with an attitude towards health and healing inconsistent with many CAM philosophies.

The perceived lack of scientific evidence to support CAM is a source of controversy. While it is true that there is limited evidence for the efficacy of most CAM therapies, it is also true that many biomedical interventions also lack scientific evidence supporting their efficacy. It is interesting to note that, despite their concern for scientific proof, physicians’ acceptance of any medical intervention, allopathic or alternative, often has more to do with such factors as patient beliefs, the availability of referrals in the community, and cultural norms.

There is also the “plausibility factor”. Many physicians will not accept the legitimacy of a therapy without a plausible scientific explanation for its effects. Interestingly, the plausibility factor often determines the constantly shifting boundary between CAM and conventional medicine. As scientific theories are developed to explain their effects, CAM interventions tend to cross over into the mainstream of acceptability.

Even if a physician knows very little about CAM in general, he or she is often more comfortable advising patients on therapies that conform to familiar biomedical principles. For example, the growing body of research that helps to explain the clinical effects of mind-body techniques, such as meditation and biofeedback, makes physicians more likely to engage their patients in these specific interventions. Physicians are far more reluctant to discuss interventions for which a scientific explanation is less plausible, such as homeopathy or energy healing.

Other News You Might Want to Know

The bipolar medication lithium is so toxic that it often causes major kidney damage, yet most patients must use it for lifetime maintenance of manic-depressive disorder. Similarly, schizophrenics often spend lifetimes on neuroleptics with long-term side effects such as tardive dyskinesias (uncontrollable movement of the face, tongue, lips and extremities).

The point here? Side effects almost always go hand-in-hand with taking a medication for a long duration in order to treat a chronic condition. With that in mind, it seems outrageous that on October 25, 2005, a panel voted to defeat the FDA’s proposal to extend pre-approval testing of psychiatric drugs from two short-term studies to six-month trials. In layman’s terms, psychiatric drugs will not be tested for a long enough time to determine their safety for long-term use before they are approved. Now, they can be tested for as little as two weeks, then given the stamp of safety approval by the U.S. Food and Drug Administration, after which they will be used for years, if not decades, on unsuspecting patients.

Full story at: http://www.newstarget.com/015406.html

Advertisements for SSRI Antidepressants are Misleading

Consumer ads for a class of antidepressants called SSRIs often claim that depression is due to a chemical imbalance in the brain, and that SSRIs correct this imbalance, but these claims are not supported by scientific evidence, say researchers in PLoS Medicine.

Although scientists in the 1960s suggested that depression may be linked to low brain levels of the chemical serotonin (the so-called “serotonin hypothesis”), contemporary research has failed to confirm the hypothesis, they say.

The researchers – Jeffrey Lacasse, a doctoral candidate at Florida State University and Dr. Jonathan Leo, a neuron-anatomy professor at Lake Erie College of Osteopathic Medicine--studied U.S. consumer advertisements for SSRIs from print, television, and the Internet. They found widespread claims that SSRIs restore the serotonin balance of the brain. “Yet there is no such thing as a scientifically established correct ‘balance’ of serotonin,” the authors say.

According to Lacasse and Leo, in the scientific literature it is openly admitted that the serotonin hypothesis remains unconfirmed and that there is “a growing body of medical literature casting doubt on the serotonin hypothesis,” which is not reflected in the consumer ads.