August  2004

Vol. 3    No. 8

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Favorite Five

My Favorite Five Articles Found in Recent Medical Journals

Soy Supplements Fail to Benefit Bones, Brain or Heart 

Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial by Sanne Kreijkamp-Kaspers in the July 2004 issue of the Journal of the American Medical Association, found no significant difference in cognitive (mental) function, bone mineral density, or plasma lipids after a year of treatment with a concentrated soy supplement.  A group of 202 healthy postmenopausal women aged 60 to 75 years were randomly assigned to receive 25.6 g of soy protein containing 99 mg of isoflavones (52 mg genistein, 41 mg daidzein, and 6 mg glycetein) or total milk protein as a powder on a daily basis for 12 months.

Comment:  The support for the use of soy for improving health is primarily based on the observation that Asians (Japanese and Chinese, for example) who eat more soy, also have less heart disease and stronger bones.  However, soy is unlikely to be the critical issue that makes these people healthier. The real reason they are healthier is because Asians eat a starch-based diet (rice) with lots of fruits and vegetables and are much more active than most Westerners.  However, this simple answer may not be as appealing as one that allows people to eat their bacon and eggs and take a soy pill to counteract the ill effects – nor is it as profitable.

We use small amounts of soy at the McDougall Program in Santa Rosa, California and in our cookbooks to improve the interest and familiarity of recipes for our basic diet – to appease people used to Western foods – because soy products can look and taste like meat, cheese and milk.  However, because of the high-fat nature of soy foods, and possible adverse consequences of the hormone-like effects from their proteins, we encourage people to use these foods in small amounts. As condiments; like a little soy milk on cereal – not glassfuls drunk daily; or slivers of tofu in a rice dish, rather than a soy burger.  I never recommend soy supplements, as used in this study.  (For more information on the health issues surrounding soy, please read my August 2002 Newsletter article: Phytochemicals and Phytoestrogens.)

Kreijkamp-Kaspers S, Kok L, Grobbee DE, de Haan EH, Aleman A, Lampe JW, van der Schouw YT.  Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial.  JAMA. 2004 Jul 7;292(1):65-74.

Western Diet As the Cause of Schizophrenia and Depression

International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis by Malcolm Peet in the May 2004 issue of the British Journal of Psychiatry found the same kind of dietary intake known to predict the development of coronary heart disease and diabetes – the Western diet – also predicts the development of schizophrenia and depression. The authors recommend a dietary approach be tried to treat both of these mental health problems.

A higher national dietary intake of refined sugar and dairy products predicted a worse 2-year outcome of schizophrenia.  Dairy products and sugar were also associated with an increased prevalence of depression; whereas starchy vegetables (potatoes, pasta, etc.) were associated with a reduced prevalence. 

Comment:  The mechanisms that would explain these findings are far from explained. This is only one of many studies that implicate the foods consumed on the Western diet in depression, schizophrenia, and other mental illnesses.  (See my March 2004 newsletter article:  A Natural Cure for Depression.)  This is just one more reason for following a healthy plant-based diet – especially since there are no side effects and the results could change your whole mental outlook.

Peet M. International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis.  Br J Psychiatry. 2004 May;184:404-8.

Cinnamon Spice Benefits Blood Sugar and Cholesterol

Cinnamon improves glucose and lipids of people with type 2 diabetes by Alam Khan in the December 2003 issue of Diabetes Care, found “intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglycerides, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggests that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.”

The improvement in blood sugar (glucose) levels was in the range of 20 to 50 mg/dl after 20 to 60 days.  Cholesterol decreased 20 to 30 mg/dl and triglycerides about 20 mg/dl in the same period.  The effects seem to last for some days even after stopping the cinnamon. 

Comment:  Here is a safe addition to your diet to help improve your blood sugar, triglycerides, and cholesterol.  Of course, this action should be after a no-cholesterol, low fat diet, and exercise, with associated weight loss – this approach will usually cure type 2 diabetes.  (See my February 2004 newsletter article: Type-2 Diabetes – the Expected Adaptation to Overnutrition.)

Several “natural” vitamins, minerals and herbs have been reported to improve blood sugars and/or cholesterol – but do not expect these to alleviate your need for a serious change in diet and lifestyle – and they include: 

Food and spices:  bitter melon, Gymnema, Korean ginseng, onions, garlic, flaxseed meal, cinnamon, cloves, bay leaves, and turmeric.

Supplements: {alpha}-lipoic acid, biotin, carnitine, vanadium, chromium, magnesium, zinc, and vitamins B3, E, and K.

Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA.  Cinnamon improves glucose and lipids of people with type 2 diabetes.  Diabetes Care. 2003 Dec;26(12):3215-8.

Folic Acid Supplements Cause More Heart Disease

Folate therapy and in-stent restenosis after coronary stenting by Helmut Lange in the June 24, 2004 issue of the New England Journal of Medicine found, with the administration of folic acid supplements, an increase in risk of restenosis (artery closure) and the need for more heart surgery after an initial angioplasty with coronary stenting. After successful surgery, 636 patients were randomly assigned to receive 1 mg of folic acid, 5 mg of vitamin B6, and 1 mg of vitamin B12 intravenously, followed by daily oral doses of 1.2 mg of folic acid, 48 mg of vitamin B6, and 60 µg of vitamin B12 for six months, or to receive a placebo drug.  In the folic acid group, 34.5 percent had complete closure of their treated artery, compared to 26.5 percent in the placebo group.  Repeat heart surgeries were required in 15.8 percent of those taking folic acid, compared to 10.6 percent in the placebo group.

Comment:  The authors do not know why this vitamin combination, intended to lower a risk factor for heart disease, homocysteine, backfired, and increased the troubles for heart patients.  But they did recognize the adverse consequences, and cautioned doctors about recommending folic acid for patients with artery disease. 

My guess is this vitamin supplement caused imbalances in the body that resulted in more disease.  Vitamins are organic nutrients necessary for life and they are originally packaged in plant foods in proper amounts and proportions with other nutrients necessary for synchronized actions.  Isolation and concentration of a vitamin (or vitamins) into a pill is unnatural and can be considered as medicine at best – with a potential for positive and negative effects – and toxic at worst (as seen from this study).

High homocysteine levels are associated with heart disease because “high meat, low vegetable” diets raise homocystine in the blood.  Homocysteine is a marker indicating someone eats a poor diet, and therefore the best approach is to correct the original problem (the bad diet), rather than a sign of the problem (elevated homocysteine).   My recommendation is to get your vitamins (and other nutrients) from their original packages: plants.  (For more information read my August 2003 Newsletter article: Plants, not Pills, for Vitamins and Minerals.)

Lange H, Suryapranata H, De Luca G, Borner C, Dille J, Kallmayer K, Pasalary MN, Scherer E, Dambrink JH. Folate therapy and in-stent restenosis after coronary stenting.  N Engl J Med. 2004 Jun 24;350(26):2673-81.

Don’t Take Plavix and Aspirin Together

Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial1 by Hans-Christoph Diener in the July 24, 2004 issue of the Lancet found the risk of life-threatening or major bleeding is increased by the addition of aspirin to Plavix (clopidogrel).  The use of this combination is popular because studies show Plavix is slightly superior to aspirin in patients with previous heart disease, and especially in high-risk groups of patients – so many doctors have simply added Plavix to their usual prescription of aspirin for heart attack and stroke patients. 

Comment:  Most patients after a heart attack, angioplasty, or bypass surgery are prescribed aspirin and/or Plavix (usually both in my experience).  Serious bleeding, which offsets the benefits, is now found from this combination and patients need to be warned.2  Aspirin has been used for decades in high risk patients for prevention of future heart attacks and strokes because of a record of relative safety and effectiveness.  Aspirin is cheap and without profit for major drug companies – so it is not surprising that large amounts of money have been invested to show benefits of Plavix over aspirin and doctors have been easily convinced.  Regardless, both aspirin and Plavix should not be prescribed together because of the high risk of bleeding. 

My preference is still for aspirin because of effectiveness, safety and cost.  I do prescribe one baby aspirin (81 mg) daily for people with a history of heart disease (post- heart attack, angioplasty, or bypass surgery).3  I also often prescribe “statin,” cholesterol-lowering, medications in these cases.  Let’s not forget the foundation for becoming well and avoiding future troubles is a no-cholesterol, low fat diet (the McDougall diet), exercise and clean habits.

Talk to your doctor if you are taking Plavix and aspirin together.

1) Diener HC, Bogousslavsky J, Brass LM, Cimminiello C, Csiba L, Kaste M, Leys D, Matias-Guiu J, Rupprecht HJ; MATCH investigators.  Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial.  Lancet. 2004 Jul 24;364(9431):331-7.

2) Rothwell PM.  Lessons from MATCH for future randomised trials in secondary prevention of stroke.  Lancet. 2004 Jul 24;364(9431):305-7.

3) Klein L, Gheorghiade M.  Management of the patient with diabetes mellitus and myocardial infarction: clinical trials update.  Am J Med. 2004 Mar 8;116 Suppl 5A:47S-63S.

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