Open Future Health Blog

Your habits when you are in your 40's and 50's are the foundation for your good health and fitness at 85. Improved diet is the low cost alternative to extensive medical intervention later in life. The body has the ability to heal itself, if we treat it with respect. ANYBODY who adopts a healthy diet, at ANY AGE, will benefit, and as the months go by, those benefits will multiply.

May 2017 - 4 items

The End of Illness

Thanks to a friend, Geoff Cardwell, I've been able to read Dr David B Agus, who wrote "The End of Illness." Dr Agus was a cancer specialist. Forty years ago he expected that his specialist field, cancer treatment, would make remarkable progress so that the medical profession would solve the problem of cancer. That's not the case. Cancers are still treated as foreign bodies that must be cut out, burnt out, or poisoned.

The death rate from cancer over 60 years has not changed. Cancers are still diagnosed by looking at the cell structure. Cancer cells look different. We classify cancer by the tissue in which cancering occurs. That makes no sense, because the cause of the cancer is not the tissue in which it occurs. Cancer is an event in your body, caused by a breakdown in the conversation between body cells, that normally keeps you healthy.

Cancer is NOT a genetic disease. Cancer is a cell, or a mass of cells that is no longer under control, in it's own environment. Cancer is caused by a breakdown of your metabolic system. The body is a complex system, with many tightly controlled sub-systems. We've discovered that you don't need to kill or remove a cancer to gain significant benefit. If you can stop it growing that's helpful. If the cancer shrinks that's a benefit.

Dr Agus argues that using doctors to diagnose problems and treat symptoms is a very poor use of a doctors knowledge and skills. But this is the major thing we ask doctors to do. Patients need to be much more active in preventing health breakdown in the first place. You need your own regular measurements (written down). You need to record how you feel, in writing at least once a week. These measurement and comments give you something strong as evidence that your health remains good. But it may also point to future problems, not yet serious.

Inflammation is a sign of general disorder in the system. Most of us suffer from low-level chronic inflammation. It's doing you damage but you don't know it. In a similar way, far too many of us are developing a fatty liver. There are no symptoms until it gets very serious, but that's perhaps 20 years after the problem began.

The End of Alzheimer's?

This reminds me of a book I was once very excited about. "The End of Alzheimer's" by Dr Dale Bredesen. The book doesn't provide the solution to Alzheimer's Disease, but Dr Bredesen makes the point that healthy people either don't get Alzheimer's Disease or get it several years later. That make an enormous difference, both the lives of the individuals and their families and to the cost of Alzheimer's to the health system and the community.

Dr Bredesen says that as we age, your declining health is like being in a tent with a leaking roof. If you can identify the leaks and fix them, you are much better off. This is about seeking the best possible health, not just an absence of pain or disease. That's something you might like to discuss with your doctor.

I have a friend who is trying to use the tests and recommendations discussed in "The End of Alzheimer's" to improve health. With some success. There is a reason for losing weight. There is a reason for adopting a ketogenic diet. There is a reason for doing some tests, that Dale Bredesen suggests, but are not common in NZ. We may then come up with a problem. We've done the test, we know the result isn't quite what we'd like, but we don't have a known effective way to change that. Are we any better off?

Testing for Calcium In the Arteries?

Inflammation in the arteries may lead to a calcium build up, and hence to a heart attack. We can measure that. But there is no certain way, medically proven to reduce that calcium deposit. So doctors are reluctant to do the test, of if the test is done, prefer not to disclose the result. "We have a number; if it's low, that's good, but if it's bad we don't know what to suggest." So the test has the potential to cause problems and solve nothing.

On the other hand, patients with high calcium scores claim to have lowered the score, and sometimes eliminated the calcium build up. Their doctors blame faulty tests, or using a different machine, or other factors to sustain the view that calcium builds up, and that can't be reversed. Open Future Health certainly doesn't know the answer here, but there are several online groups discussing the issue, and some people claiming success.

Beyond weight Loss - Inflammation

I thank Dr Stephen Phinney for the key information in this post.

Background on Inflammation

In the past GP's have been trained to think only of acute inflammation: redness, pain and heat; signs of distress in the body, and the effort the body is making to repair cellular damage. So they were taught to treat the symptoms of inflammation; for instance putting ice on a sprain, and football players taking to cold pools after the match. It turns out that both these practices delay healing, which is the purpose of inflammation. Even with something this basic, our understanding of how to treat traumatic injury, or fever has been wrong for a long time.

The presence of low-grade chronic inflammation in the body wasn't recognised in science before 1992. Dr W.D. Kannel of Harvard, reviewing data from the Framingham Heart Study, noted that high cholesterol only identified about 50% of those who had heart attacks. Looking for another risk factor he noted that an elevated white blood cell count, but still within the normal range, was apparently a good marker of heart disease risk. Why that might be so, was not understood.

The Women's Health Initiative, the study terminated in 1998, produced the data that confirmed Kannel's observation. Type two diabetes, is characterised by system-wide inflammation. The population of the study was divided into quartile's on the basis if type two diabetes risk. Then the inflammation data for each group was evaluated. There were two measurements of inflammation, C-Reactive Protein, and Interleukin-6.

Comparing the mean inflammation of the lowest risk quartile with the highest risk quartile, they found this result. C-Reactive Protein was 15.7 times higher, and Interleukin-6 was 7.5 times higher in the high risk quartile.

In 2005 Karen Margolis reported from the WHI data, that "The white blood cell count, is a stable, well-standardized, widely available and inexpensive measure of systemic inflammation, and is an independent predictor of CVD events and all-cause mortality in postmenopausal women."

In 2007 Margolis reported that "Postmenopausal women with higher WBC counts have a higher risk of incident invasive breast, colorectal, endometrial, and lung cancer, as well as a higher risk of breast, lung, and overall cancer mortality."

Measuring Inflammation in the Body

There are many possible measures of low grade inflammation, at least 20.

The most commonly used are the following six
Total white blood cell count
Absolute granulocyte count
C-reactive protein
Interleukin-6
Fibrinogen
Serum amyloid A

Dr Phinney says; "The only tool in my list of medications for reducing inflammation, is one of the newer statins. The best solution for this problem is to find ways to reduce or avoid the creation of inflammation in the first place."

Fighting Inflammation with Nutrition

The following foods reduce inflammation: Fruits and vegetables, especially the colourful ones with flavanoids. Omega 3 oils, like fish oil. Moderate use of alcohol. If you want an anti-inflammatory supplement use gamma-topopherol

The following foods are inflammatory. Omega-6 fats are essential, but our diet is flooded with them, and in excess they are highly inflammatory. Iron in excess too, and Dr Phinney thinks Iron is over prescribed, when the real problem is carbohydrate intollerance. Trans-fats, are highly inflammatory, but in NZ there is no requirement to label products containing trans-fats, and no ban on their use (The argument is made that they are rarely used in NZ food products). Sugar, but particularly fructose is inflammatory. Alpha-topopherol is sold as an anti-inflammatory, but in the body it blocks gamma-topopherol, the bodies natural inflammatory defence, defeating our objective.

So Phinney recommends eating fish three times a week, using gamma-topopherol (Sometimes sold as Gamma-E), drinking wine in moderation, eating lots of fat or olive oil, and eating a very low carbohydrate diet.

Evidence Supporting LCHF Diets to Reduce Inflammation

Cassandra Forsythe, in research for her PhD, looked at low-fat v low-carbohydrate diets, and the inflammation they produced. Cassandra was working with Dr Jeff Volek in the Department of Kinesiology at the University of Connecticut. Both Stephen Phinney and Richard Feinman were part of her advisory team.

Inflammation is clearly recognised as a prominent feature of many chronic common medical problems. Heavy intake of carbohydrate at any meal, induces an increase in reactive oxygen species, and activates pro-inflammatory pathways.

Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation:
Forty overweight men and women were enrolled. Qualifications; aged 18 to 55; BMI >25; total triglyceride's elevated; and low HDL-C. People using glucose lowering, blood pressure lowering, or lipid lowering medications were excluded. Two groups were formed balanced for gender, age and BMI. One group was assigned a low-fat diet. The other group a very-low-carbohydrate ketogenic diet.

The study was for 12 weeks. No advice to reduce calories was offered to either group. All participants were given individual counseling and a personalised diet, by a registered dietitian. This was reinforced each week when each participant came to a weigh-in. Further education and advice was offered as required. Detailed 7 day food diaries were maintained for weeks one, six and twelve.

Reducing the amount of carbohydrate in the diet led to "considerably greater reductions in a number of pro-inflammatory cytokines, chemokines (both signalling protein molecules indicating cell damage) and adhesion molecules.

While weight loss may help reduce inflammation, the greatest reductions of inflammation were achieved by those who best restricted carbohydrate intake regardless of weight loss. The very-low-carbohydrate diet had strong advantage in blood lipid normalisation, blood glucose control and in reducing the demand for insulin.

A striking result of the VLC Ketogenic Diet was an increase in arachidonic acid, which appears to be beneficial. Several pro-inflammatory markers were reduced including; TNF-α, IL-6, IL-8, MCP-1, E-selectin, I-CAM, and PAI-1 that were related to the increase in arachidonic acid.

The abstract to the paper, Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation, is available (PDF). Today, she works as a nutrition educator and weight loss coach and is the author of two popular books for women: The New Rules of Lifting for Women, co-authored with Lou Schuler and Alwyn Cosgrove, and Women's Health Perfect Body Diet.

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