What’s New! – A Healthy Living Newsletter

May, 2002

My patients frequently ask my opinion about new health books on the market. And there's certainly no shortage of experts peddling their advice! While many of these books are excellent, others are written by people who don't have a clinical background in the subject. Simply put - they're inaccurate.

The people writing the books either don't regularly use the medicines they write about or they're presenting theories as if they are facts. Others can be valuable tools for improving the quality of your life.

If you find this newsletter useful, please forward it to a friend!

Hormone Replacement Therapy - Yes or No How to make an informed decision about Estrogen, Progesterone & other Strategies for Dealing with APMS, Menopause and Osteoporosis By Betty Kamen

Dr. Kamen set out to write an impartial comprehensive assessment of the medical research on HRT. But she couldn't. Much to her surprise, by the time she had finished researching, she had become a full-fledged opponent to any form of synthetic hormone therapy. She came to view the current barrage of synthetic hormones as part of the problem, rather than the solution to the symptoms of PMS, fibroids, endometriosis, menopause and osteoporosis. For example, hormone replacement therapy for menopause does reduce symptoms, but the medical research is no longer supporting its benefits to the heart or bones. In fact, a recently published report (April 2002) from the NIH (National Institute of Health) offered one of the strongest statements yet questioning the use of HRT - especially in terms of its alleged ability to protect the heart and bones.

Kamen starts off with a brief history lesson of the relatively new (last hundred years) symptom pictures of hormonal irregularities. Linking it to changes in our dietary habits, increased personal stress and environmental changes, Kamen explains in much-needed detail, how all these changes affect our hormones. For example, our body's response to the injected hormones into our meat (whether Big Macs or boneless chicken) and prodigious amounts of daily consumption of dairy, as well as the direct hormonal effect of insecticides and pesticides significantly imbalances females' hormones. This leads to fibroids, endometriosis, PMS, etc. She follows this with the body's response to synthetic hormones verses to natural hormones. "Estradiol, (one type of estrogen) enhances vulnerability to schizophrenia." Synthetic progesterone has adverse effects on those with diabetes and high triglycerides; the natural form doesn't. "The difference between natural and synthetic progesterone is not unlike the difference between leather and vinyl car seats. They may look the same, but just wait till you get into the car on a hot day!" Which leads me to my next point about this book. It's not an easy book to read, but Kamen writes well. Often, I wished she would have gone into more detail, but I was pleased that she covered so many important issues - for example, the stress/thyroid/female hormonal complaint connection.

"The healthier your adrenals (stress hormone) are, the less opt you are to suffer common menopause complaints of depression, sweating, vaginal dryness…hot flashes and wakeful nights." Many women seek help for the symptoms, but don't address the cause - and end up taking hormones that may be increasing their risk of stroke and cancer. Think of the thyroid as a barometer of our ability to deal with stress. No wonder there are so many cases of hyper and hypothyroidism in women.

Similarly, Kamen tackles osteoporosis in one of the best encapsulated forms of great information I have ever read. Dieting, skipping meals, drinking coffee, cigarettes and inactivity adversely effect bones. Antacids, tetracycline, laxatives, diuretics, long acting sedatives, and other drugs impede calcium absorption. Some forms of calcium, (citrates, hydroxyapetites, and aspartates) are significantly better absorbed than others. And don't take calcium alone; it needs other nutrients to protect our bones. Also, with a good diet - that Kamen describes in wonderful detail, the conventional 1500mg medical recommendation is excessive and may lead to additional problems. Further, Kamen suggests that you ask your dentist the results of your mandibular bone density portion of your dental x-rays. The mandibular bone density correlates to bone density elsewhere, particularly, in the hip.

Another feature of this book I really like is her pithy interjections of interesting, though generally extraneous facts. For example, the age of onset of menopause is significantly earlier in left-handed women verses right-handed. And "those with prematurely gray hair (norm is 50% gray by 40) are much more likely to develop osteoporosis." "Complete dentures are required by 44% osteoporotic patients before the age of 60."

Hormonal Replacement Therapy, Yes or No is a great book in most ways. Maybe that's why it has been reprinted so many times. It's important to read the research questioning the safety of decades of primarily synthetic estrogen medication. And that's exactly what Kamen does for the first 200 pages. However, in the last 50 pages, Kamen pushes long-term use of "natural progesterone" and in particular, a patented solution of topical natural progesterone in a compound of herbs and vitamins. While this is a major step forward for the conventional medical community, I'm concerned that in 20 years, there will be a new book stating the obvious that except in infrequent cases, "long-term hormonal therapy of any form can be dangerous and should be avoided".

Kamen is a proponent of diet, exercise, herbs and vitamins, but she doesn't have enough experience with natural medicine to stray too far from conventional medicine's need for a drug rather than let the body, prodded gently by natural medicine, do its own job.

And don't expect changes from the pharmaceutical companies as long as they can make money off of synthetic hormone patients. Because as we all know by now, natural hormones can't be patented - though if you mix them with herbs and vitamins in a proprietary blend similar to the product that Kamen recommends, they can.

Here's a book that sets out to do one thing and ends up doing another. Aimed at the young adult age group, Eating Disorders presents a series of articles about anorexia, binge eating, and bulimia from multiple points-of-view. The reader hears from the professionals in the field as well as the people affected by the eating disorders. Of course, all the experts disagree with each other. Some argue force-feeding should be allowed. Others question the right of people with anorexia being allowed to starve themselves to death. One group maintains that the unrealistic body sizes of actresses and models are the cause of these disorders. While still another suggests that poor relationships among women with their fathers is the cause. It goes on and on. However, reading the accounts of the young women and men with the eating disorders, gives a whole different vantage point to this topic.

Like the motto of alcoholics, once an anorexic, always an anorexic. And the comparison with alcohol doesn't stop there. When a person stops eating, there is more affected than just loss of body weight. One of these changes is a mental state similar to being intoxicated. The writers refer to it as a euphoria. Imagine walking around intoxicated without ever having to worry about a hangover. Couple that with people praising you for the weight loss. Unlike former alcoholics, cured anorexics seem to remember the anorexic period as a strong time in their lives of having personal control. Despite the fact that I have treated and heard about many cases of eating disorders, I found the accounts in the book fascinating. These weren't the well-rehearsed reports that one often hears.

Here are the basic statistics on eating disorders in general. One-third are cured, one-third improve and the last third battle the eating disorder the rest of their lives. Eight to ten percent are men. Most with eating disorders are from a middle-to-upper socioeconomic background. For 86% of those with eating disorders, the onset came by age 20; for 33% it starts between 11 and 15 years of age.

If you know someone who you think has a eating disorder, there's more bad news. Insurance companies classify eating disorders, and anorexia in particular, as a mental disorder. If person's employer didn't contract to cover mental disorders, then until the person has organ failure or is close to death and must be hospitalized, there is no coverage. According to the some of the experts in the book, only once weight is restored to within 95% of a normal weight range can counseling and medication like Prozac be effective.

Is this a great book? No. I found it annoying that the editors asked the reader questions on each chapter. However, it's extremely easy to read and would help anyone who suspects a friend or family member of having an eating disorder, understand the thought process of that person. I wouldn't suggest sharing the book with impressionable and perhaps slightly overweight young people. That's how at least one person in the book started. "Gee, I could do that. The woman in the story just let it get out of hand." Instead, it's a good starting point for adults who are concerned - and who don't want to be bogged down with a more technical text. Hopefully, it will tell that adult that eating disorders are more an outward manifestation of depression and need for acceptance and confidence building than a desire to lose weight.

The DASH Diet for Hypertension Lower Your Blood Pressure in 14 Days - Without Drugs Thomas Moore, MD, Laura Svetkey, MD, Pao-Hwa Lin, PhD, Njeri Karanja, PhD with Mark Jenkins

The NIH (National Institute of Health), funded by the US government, collected a group of prestigious medical researchers and scientists to find out if eating a healthier diet would decrease high blood pressure. And guess what they found out? It does. At first glance, the whole study seems superfluous and obvious. However, the study tackles some really important questions. Why does food work consistently better than simply taking the individual nutrients in pill form? How much can diet alone help with hypertension? And can a diet be flexible and good-tasting enough to have compliance among hypertension patients?

The DASH (Dietary Approaches to Stop Hypertension) Diet centers on a 2 year study. A group of participants were separated into 3 groups. The first ate a typical American diet, the second ate the same as the first group with additional fruit and vegetables; while the third group consumed only the DASH diet. "The DASH diet is rich in fruits, vegetables, and low-fat dairy products; moderate in fish, poultry, and nuts; and reduced in red meat, sweets and sugar-sweetened drinks."

At the end of the two years, the results were tallied. Typically, blood pressure is measured in 2 parts. The systolic blood pressure, or first number, reflects the blood pressure in the arteries as the heart is working the hardest pumping out blood; while the diastolic blood pressure, the second number, indicates blood pressure when the heart is at rest. As expected, the first group with the typical American diet didn't see a change in blood pressure. The second group had a significant change in the systolic portion of their blood pressure. While the DASH diet participants significantly decreased both their diastolic and systolic blood pressures. These changes occurred within two weeks of starting the diet and were maintained as long as the diet was maintained. In those with hypertension, the DASH diet decreased systolic blood pressure an average of 11.4 points, and the diastolic blood pressure 5.5 points. This decrease is comparable to conventional medications.

This is great news for those with moderately high-normal blood pressure, i.e. those with blood pressure in the 140/90 range. It will bring them back into a healthier state. But for those with blood pressures around 160/95 or higher, this diet may help them decrease their medications but it will not completely resolve the high blood pressure. Exercise should be added to their regime.

The DASH diet is a nice compromise diet. It has too much dairy and too few beans to be extremely healthy, but it is a do-able diet for most Americans. Also, there is no emphasis on the quality of the food. But the recipes are good. Even the names of the dishes sound great: "Vermont Roast with Brown Mustard", "New Orleans Red Beans and Rice" and Dave's Cajun Catfish". The decreased salt will be hard for most, but they do try very hard to increase the flavor of the foods. Even better, the book tells you how to eat out and maintain the diet.

The DASH Diet for Hypertension is an easy-to-read and very practical book. It's not earth-shattering news for natural medicine practitioners, but it's nice to see it in print with a formidable host of well-credentialed scientists supporting it. And while this study may seem like US tax dollars being wasted, as the results were so predictable, if it helps physicians encourage their patients to change their diet to a healthier one, it's worth every penny.

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