I believe that the greatest threat to our health today is an ingredient in our diet, the consumption of which has risen dramatically in recent history. I’m talking about sugar. Let’s look at how much our sugar consumption has increased. Here are the figures for Great Britain and they are essentially the same for other developed countries.

Sugar Consumption

• In 1700, the average person consumed about 4.6 pounds of sugar per year.
• By 1770, it had increased nearly four times, to 16.2 pounds.
• By 1800, it was 18 pounds.
• By 1850, it had doubled to 36 pounds and by 1900 it was 90 pounds.

Here is a graph of sugar consumption in Great Britain from 1815 to 1955. Notice the dips that coincided with the two World Wars and the slow recoveries in sugar consumption thereafter, the first prolonged by the Great Depression and the second by continued rationing.

In the United States, it is now estimated that more than 50 percent of Americans consume a 1/2 pound of sugar per day, which amounts to 180 pounds of sugar per year. It is little wonder that we are in the midst of a chronic disease and obesity epidemic.

Forms of Sugar

Sugar comes in essentially two forms; naturally occurring and processed. The naturally occurring sugars give sweetness to certain fruits and vegetables for example, to apples, tomatoes and carrots. Processed sugars are the sugars that are extracted from natural sources, for example table sugar from sugar cane and sugar beet, and high fructose corn syrup manufactured from corn starch by an enzymatic process.

Some of the Simple Sugars and their Components

Glucose, also known as Dextrose
Fructose, also known as Fruit Sugar
Galactose
Maltose ( Glucose-Glucose ) Malt Sugar
Lactose ( Glucose-Galactose ) Milk Sugar
Sucrose ( Glucose-Fructose ) Table Sugar

We are designed to handle the simple sugar glucose very well. It is the major energy source for our brain, and every living cell in the body is capable of metabolizing glucose. Fructose on the other hand is not handled at all well and is metabolized largely in the liver. It is now considered by some to be toxic (1)

Today, we are taking in vastly more sugar than we need and the excess is overwhelming our normal metabolic processes. The result is a steady degradation in our health as exemplified by a greater susceptibility to infection and an increased incidence of serious chronic diseases. . Dr. Nancy Appleton has listed 146 ways in which sugar can adversely affect our health (2). Some of the most serious effects are listed below. Purified fructose is far more deleterious than glucose or natural fructose.

Serious Effects of Sugar on Our Health

1. Sugar weakens our immune system (3,4,5) . It has been shown that ingestion of 100 mg of sugar in the form of glucose, fructose, sucrose (table sugar), honey or orange juice resulted in an approximate 50% reduction in the ability of neutrophils to ingest bacteria. This inhibition lasted for at least five hours.

2. Sugar is the preferred food of cancer cells. They thrive on it and can use both glucose and fructose (6).

3. Excessive sugar consumption can lead to obesity. The increasing use of high fructose corn syrup in processed foods correlates with the obesity epidemic. Fructose is readily converted into fat (7) and it also inhibits the production of leptin (8), a hormone which tells us when we are full. So, as a result, we keep on eating and getting fatter.

Obesity itself is a major risk factor for Type 2 diabetes, cardio and cerebrovascular disease, cancer at at least 5 locations, dementia, osteoarthritis, and a host of other medical conditions (9)

4. Fructose consumption can lead to an elevation of serum uric acid levels which in turn results in elevated blood pressure, a major risk factor for heart disease and stroke. (10,11)

5. Fructose induces insulin resistance. There is growing evidence that fructose can induce the condition known as insulin resistance (12). This is where the tissues do not respond adequately to insulin and so do not absorb circulating glucose in the normal manner with the result that blood glucose levels rise above the normal range and produce adverse effects. The induction of insulin resistance by fructose occurs independently of weight gain and differences in caloric intake (13,14) and the effect may be mediated by increased uric acid levels. Insulin resistance precedes the development of type 2 diabetes and is characteristic of it.

6. Fructose and metabolic syndrome. It is now clear that high fructose consumption represents a serious threat to our health. Either directly or indirectly, it promotes fat synthesis, high blood pressure, and insulin resistance, all of which are characteristic of a condition known as metabolic syndrome, a collection of traits probably best described by Gerald Reaven (15) that greatly increase our risk of heart disease, stroke and type 2 diabetes. Metabolic syndrome now affects over 55 million people in the United States (16) and is indicative of chronic disease. It used to be found only in adults but now occurs in adolescents also.

Reducing Our Sugar Consumption

So, now that we know what a serious threat excessive sugar intake is to our health, what can we do about it? Obviously, we have to reduce our sugar consumption. How? Here are a few suggestions.

1. First, we need to be aware of our sugar intake. How quickly do we go through a bag of sugar at home? We should make a conscious effort to reduce our sugar intake and this can be done gradually so that we minimize the risk of relapse. Try reducing the amount of sugar you put in tea or coffee, and in recipes. If you do this in stages, it will be easier to adapt and you will see the benefit when you notice that it takes longer to go through a bag of sugar.

2. Avoid using artificial sweeteners because they will perpetuate your sweet tooth. The whole idea is to recalibrate our taste buds. Also, some artificially sweeteners may have side effects.

3. Avoid all sodas. They are rich in added sugars or artificial sweeteners.

4. Read all labels on processed foods and baked goods.. You may be surprised at the sugar content. If you cannot avoid such foods, then make a conscious effort to reduce your intake of them. Knowledge is power.

5. Wean yourself off dessert. Substitute fresh fruit and some cottage cheese for processed desserts such as pies, puddings and ice cream. You should reserve those for special occasions only and then in moderation.

6. Eat real fruit and avoid fruit juices which only serve to concentrate the sugars and remove the fiber. Aim for 2-3 servings of fruit per day and at least five servings of vegetables, half of which should be raw.

7. Don’t go shopping when you are hungry.

8. Eat a good breakfast, preferably high in protein and fiber and low in sugar and refined carbohydrates. The same applies to lunch. Eat a light dinner. If you need to snack, then have some fresh fruit and nuts on hand.

Hopefully, if you follow this advice you will eventually be repulsed if you encounter anything intensely sweet and you will be doing your health a big favor.

© Christopher J. Jones, M.Sc., Ph.D.

References

1. Lustig, R. H. (2009) Sugar: The Bitter Truth. UC Television Video: http://www.youtube.com/watch?v=dBnniua6-oM

2. Appleton, N. 146 Reasons Why Sugar Is Ruining Your Health. http://rheumatic.org/sugar.htm

3. Sanchez, A., et al. “Role of Sugars in Human Neutrophilic Phagocytosis,” American Journal of Clinical Nutrition. Nov 1973;261:1180-1184.

4. Bernstein, J., et al. “Depression of Lymphocyte Transformation Following Oral Glucose Ingestion.” American Journal of Clinical Nutrition.1997;30:613.

5. Jones, C. J. (2010) How to Build and Maintain a Strong Immune System. http://www.health360.info/ensure-health.html

6. Liu, H. et al. ( 2010) Fructose Induces Transketolase Flux to Promote Pancreatic Cancer Growth. Cancer Res. 70:6368-6376. http://cancerres.aacrjournals.org/content/70/15/6368.full

7. Stanhope, K. L. & Havel, P. J. (2008) Fructose Consumption: Potential Mechanisms for Its Effects to Increase Visceral Adiposity and Induce Dyslipidemia and Insulin Resistance. Curr. Opin. Lipidol. 19:16–24.

8. Shapiro, A. et al. (2008) Fructose-Induced Leptin Resistance Exacerbates Weight Gain in Response to Subsequent High Fat Feeding. Am. J. Physiol. Regul. Integr. Comp. Physiol. 295: R1370–R1375.

9. Jones, C. J. (2010) Obesity and Its Serious Health Consequences. http://www.health360.info/obesity-health-consequences.html

10. Feig, D. I., Kang, D. H. & Johnson, R. J. (2008) Uric acid and Cardiovascular Risk. N. Engl. J. Med. 359:1811–1821.

11. Feig, D. I. & Johnson, R.J. (2003) Hyperuricemia in Childhood Primary Hypertension. Hypertension 42:247–252.

12. Johnson, R. J. et al. (2009) Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes? Endocrine Reviews 30 (1): 96-116.

13. Havel P. J. (2005) Dietary Fructose: Implications for Dysregulation of Energy Homeostasis and Lipid/Carbohydrate Metabolism. Nutr Rev 63:133–157.

14. Nakagawa, T. et al. (2006) A Causal Role for Uric Acid in Fructose-Induced Metabolic Syndrome. Am J Physiol 290:F625–F631.

15. Reaven, G. M. (1997) Banting Lecture 1988. Role of Insulin Resistance in Human Disease. Nutrition 13:65.

16. Ford, E. S., Giles, W. H. & Mokdad, A. H. (2004) Increasing Prevalence of the Metabolic Syndrome Among U.S. Adults. Diabetes Care 27:2444–2449.

A progressive form of senile dementia, Alzheimer’s disease damages areas of the brain involved in memory, intelligence, judgment, language and behavior. The disease is characterized by the presence of neurofibrillary tangles and beta-amyloid plaques in the nerve cells. Beta amyloid is a polypeptide consisting of 36-43 amino acids and is the main constituent of those plaques (deposits) found in the brains of people with Alzheimer’s disease. There are two types of Alzheimer’s disease; early onset and late onset. The early onset form, which strikes people between the ages of 30 and 60, is much rarer than the late onset form and affects only about 5% of all people who develop Alzheimer’s disease.

The appearance of Alzheimer’s disease is preceded by mild cognitive impairment (MCI), which affects about 16 % of people over the age of 70 and is characterized by increasing problems with memory, language and the performance of other mental functions. This condition goes beyond the normal forgetfulness usually associated with aging. Symptoms of MCI include forgetting important appointments, losing a train of thought midstream and exercising increasingly poor judgment. People are essentially losing their minds and about half of those with MCI will go on to develop Alzheimer’s disease within 5 years. So what could be causing this loss in mental capacity? Several factors have come under the spotlight.

1. Genetics

Some cases of early onset Alzheimer’s disease, also known as Familial Alzheimer’s disease (FAD) are linked to chromosomal DNA mutations which result in the formation of abnormal proteins. Affected are chromosomes 1, 14, and 21 and the proteins that result are abnormal forms of presenilin 2, presenilin 1, and amyloid precursor protein (APP) respectively. Each of these mutations will cause an increased amount of beta amyloid protein to be produced which is a major component of the plaques observed in Alzheimer’s disease (1).

These gene mutations are not involved in late-onset Alzheimer’s disease which develops after age 60. An increased risk of this form of the disease is related to the Apolipoprotein E (APOE) gene located on chromosome 19 (1). This gene codes for a protein that carries cholesterol in the blood. There are different versions of this gene and the one that may predispose to Alzheimer’s diseases is Apolipoprotein epsilon 4 (APOE e4). Carrying this form of the gene increases the risk of developing late-onset AD but does not guarantee it (1). The gene occurs in about 40% of all those who develop late onset Alzheimer’s disease. Other possible risk-factor genes are currently being investigated.

2. Prior Brain Injury

The possible involvement of brain injury as a precursor to Alzheimer’s disease has been extensively studied and there have been conflicting results. The current consensus is that the more severe the head injury, the greater the risk for Alzheimer’s disease. This would be the case if the injury was repeated or involved a loss of consciousness, and if the person already had other risk factors for the disease (2, 3). Precautions to take would include the use of a seatbelt while driving an enclosed vehicle and wearing a helmet for an exposed vehicle. Those engaged in contact sports where the head is at risk of injury should wear appropriate protection and homes should be fall-proofed as much as possible.

3. Insufficient Exercise

There is growing evidence to suggest that regular exercise can ward off dementia. A new analysis from the Framingham study found that participants who spent at least one hour every day engaged in moderate to heavy physical activity had a 45% lower risk of developing dementia, including Alzheimer’s disease (4).

Increased physical activity has also been shown to counteract brain shrinkage in late adulthood. It was shown that walking at least 72 blocks each week resulted in greater volumes in the frontal, occipital, entorhinal, and hippocampal regions of the brain 9 years later and this in turn reduced the risk of cognitive impairment (5).

4. Obesity

As well as being a major risk factor for Type 2 diabetes, high blood pressure, coronary heart disease, stroke and certain cancers (6), obesity has now been shown to predispose to cognitive decline and dementia, including Alzheimer’s disease (7). Being overweight or obese has also been found to be associated with brain shrinkage in otherwise healthy, middle-aged adults. The higher the body mass index (BMI), waist circumference, waist-to-hip ratio and amount of abdominal fat, the smaller was the brain volume and the body weight indicator which correlated the most with reduced brain size was the amount of abdominal fat (8). MRI images of obese individuals who possess a certain variant of the fat mass and obesity-associated (FTO) gene displayed structural brain atrophy with an 8% reduction in the volume of the frontal lobes and a 12% deficit in occipital lobe volume (9).

5. Diabetes

In a study conducted at Uppsala University in Sweden, the health of 2,269 men aged 50 years in 1970 was followed for a median of 32 years. At the beginning of the study, the men were tested for their insulin responsiveness and glucose tolerance. At the end of the study, it was found that 102 (4.5%) of the men had developed Alzheimer’s disease, 57 (2.5%) had developed vascular dementia, and 235 (10.4%) had been diagnosed with other forms of dementia. Those men who had exhibited a poor response to insulin at the beginning of the study were much more likely to develop Alzheimer’s disease than those with a normal insulin response and this was after adjusting for other factors such as body mass index (BMI), serum cholesterol and systolic blood pressure . Men in the bottom 25% for insulin responsiveness were almost twice as likely to develop Alzheimer’s disease as those in the top 25%. Impaired glucose tolerance was not found to be associated with Alzheimer’s disease but instead with vascular dementia in which impaired blood flow to the brain causes the loss of mental capacity (10, 11)

A study performed in New York showed that elderly individuals with type 2 diabetes were also at greater risk of developing mild cognitive impairment (MCI) when compared with people who did not have diabetes. This difference was maintained even after adjusting for stroke and vascular disease, suggesting that the relationship between diabetes and MCI was independent of any cerebrovascular disease (12).

6. Diet

A) High Plasma Homocysteine Levels

In a rigorous prospective study of 1092 elderly subjects who were initially free of dementia, it was found after 8 years of follow-up that 111 of the subjects developed dementia, most cases being Alzheimer’s disease (13). It was discovered that an elevated level of plasma homocysteine could be a predictor of the disease with the risk nearly doubled for those with the highest concentrations. Homocysteine is formed in the liver from the amino acid methionine, a building block of protein, and this amino acid is present in 2-3 times higher concentrations in dietary animal protein compared to plant protein. The authors concluded that “an increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer’s disease.”

An association has also been reported between elevated levels of plasma homocysteine and cognitive impairment (reduced mental capacity) (14). The investigators found serum homocysteine to be “an early and sensitive marker for cognitive impairment”. Thirty-nine percent of their patients with mild cognitive impairment had pathological serum homocysteine levels. Homocysteine is formed in the liver from the amino acid methionine, a building block of protein, and this amino acid is present in 2-3 times higher concentrations in dietary animal protein compared to plant protein.

B) Folate, Vitamin B6 and B12 Deficiency

A deficiency in Vitamins B6, B12 and folate correlates with higher plasma homocysteine levels and when the deficiency is remedied, the levels of homocysteine fall. This is because these vitamins act as cofactors or substrates for enzymes involved in the metabolism of homocysteine. In view of the association between high plasma homocysteine levels and an increased risk of mild cognitive impairment and dementia, it was decided to study the effects of long-term administration of high concentrations of these vitamins on the rate of brain atrophy in elderly subjects with MCI.

It was found that administration of B vitamins over a 2-year period significantly reduced the rate of brain atrophy. When adjustments were made for age, the rate of brain atrophy per year as determined by MRI analysis was nearly 30% less in subjects receiving B vitamins compared to those receiving placebo (15) and this reduction in the rate of brain atrophy also correlated with a reduction in total homocysteine levels.

C) Plant-Based Diet

There is growing evidence to suggest that eating a predominantly plant-based diet reduces the risk of getting Alzheimer’s disease. As the animal and caloric content of the diet increase, so also does the risk of Alzheimer’s, except in the case of eating fish or taking supplements rich in the omega 3 fatty acid DHA, which may confer some protection (16). It has been shown that adherence to a Mediterranean-Type Diet is associated with a reduced risk of Alzheimer’s disease (17,18). This diet is characterized by a high intake of vegetables, legumes, fruits, and cereals; a high intake of unsaturated fatty acids (mostly olive oil), and a low intake of saturated fatty acids; a moderately high intake of fish; a low to moderate intake of dairy products (mostly cheese or yogurt); a low intake of meat and poultry; and a regular but moderate intake of alcohol, mainly wine and with meals. The study found that the greater the adherence to the diet, the lower the risk of Alzheimer’s disease. There was a significant dose – response relationship.

D) Turmeric, Curcumin and Curry

Turmeric is best known as the bright yellow powder that is available in the spice section of the grocery store. It is produced by boiling the underground stems of the turmeric plant and then drying them in ovens before grinding. Ground turmeric is an important constituent of curry powder, giving it its yellow color, and is commonly used in Indian, Southeast Asian and Middle Eastern cuisine. The bright orange-yellow stem can also be grated fresh and added to salads and to dishes as they are cooking. For some time now it has been apparent that turmeric, like its close relative ginger, conveys medicinal properties and health benefits. Most of the pharmacological effects of turmeric have been attributed to curcumin, a polyphenol responsible for the bright orange-yellow color.

There is growing evidence to suggest that turmeric and curcumin may protect against neurodegenerative diseases such as Alzheimer’s disease. Their anti-oxidant and anti-inflammatory properties are believed to protect brain cells from oxidative damage (19). The prevalence of Alzheimer’s disease in a group of elderly people aged 70-79 in India was found to be 4.4 times less than in a similar group of people in the U.S. (20). When the cognitive level in 1010 Asians aged between 60 and 93 was compared to curry consumption, it was found that those who occasionally ate curry (less than once a month) and more often (more than once a month) performed better on a standard test of cognitive function than those who rarely or never ate curry (21).

Macrophages ( a type of white blood cell ), isolated from Alzheimer’s disease patients and pre-incubated with curcumin, were found to be more effective in ingesting beta amyloid than macrophages that has not been previously exposed to curcumin (22) and studies in a mouse model for Alzheimer’s disease have shown that curcumin can cross the blood brain barrier and bind to the beta amyloid plaques. It can also inhibit beta amyloid aggregation and destabilize the polymer (23). Further research and clinical trials are underway to determine if curcumin and related compounds can have therapeutic value in treating Alzheimer’s disease as well as contributing to prevention.

7. Vitamin D

A study of 1,766 individuals aged 65 and over in England found that cognitive function and serum levels of vitamin D3 were inversely related. Individuals with the lowest levels of vitamin D3 were more than twice as likely to be cognitively impaired as those with the highest levels and the effect was more marked in men than in women (24). This inverse relationship between serum vitamin D3 levels and cognitive function in the elderly was confirmed in a prospective study conducted on an Italian population over a 6 year period. Low levels of vitamin D3 were associated with substantial cognitive decline (25).

In an effort to understand how vitamin D might influence cognitive function, it has been recently shown that vitamin D3 interacts with curcuminoids to stimulate the clearance of beta amyloid by macrophages of patients with Alzheimer’s disease (26).

Conclusion

It is clear that the pursuit of a healthy lifestyle that includes keeping physically and mentally active, eating a diet that draws from the Mediterranean and East Indies, maintaining adequate vitamin D levels and taking precautions to avoid head injury are all key factors in avoiding dementia later in life.

References

1. http://www.nia.nih.gov/Alzheimers/Publications/geneticsfs.htm

2. http://www.mayoclinic.com/health/alzheimers-disease/AN01710

3. Van Den Heuvel1 C, et al. (2007) Traumatic Brain Injury and Alzheimer’s Disease: A Review. Progress in Brain Research. 161:303.

4. http://www.medpagetoday.com/MeetingCoverage/ICAD/21178

5. http://www.neurology.org/content/75/16/1415.abstract

6. http://www.health360.info/obesity-and-how-it-can-affect-our-health.html

7. Elias, M.F. et al. (2005) Obesity, Diabetes and
Cognitive Deficit: The Framingham Heart Study. Neurobiol Aging 26 (Suppl 1):11–16.

8. http://scienceblogs.com/neurophilosophy/2010/06/obesity_linked_to_brain_shrinkage_and_dementia.php

9. http://www.pnas.org/content/early/2010/04/02/0910878107.full.pdf+html

10. http://www.neurology.org/content/71/14/1065.abstract

11. http://alzheimers.about.com/od/whatisalzheimer1/a/diabetesandad.htm

12. http://archneur.ama-assn.org/cgi/content/abstract/64/4/570

13. Shadri, S et al. (2002) Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer’s Disease. N. Eng. J. Med. 14, 346 (7), 476-483.

14. Gottfries C. G. et al. (1998) Early Diagnosis of Cognitive Impairment in the Elderly with the Focus on Alzheimer’s Disease. J. Neural Transm. 105:8-9, 773-786.

15. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012244

16. http://www.health360.info/diet-and-alzheimer%e2%80%99s-disease.html

17. Scarmeas, N. et al. (2006) Mediterranean Diet and Risk for Alzheimer’s Disease. Ann. Neurol. 59 (6), 912-921.18.

18. Hitti, M. (2006) Mediterranean Diet may cut Alzheimer’s.

http://www.webmd.com/alzheimers/news/20060418/mediterranean-diet-cut-alzheimers

19. Mishra, S. and Palanivelu, K. (2008) The Effect of Curcumin (Turmeric) on Alzheimer’s Disease: An Overview. Ann. Indian Acad. Neurol. 11:13-19.

http://www.annalsofian.org/article.asp?issn=0972-2327;year=2008;volume=11;issue=1;spage=13;epage=19;aulast=Mishra

20. Pandav, R., Belle, S.H. and DeKosky, S.T. (2000) Apolipoprotein E Polymorphism and Alzheimer’s Disease: The Indo-US Cross-National Dementia Study. Arch. Neurol. 57:824-830.

21. Ng, T.P. et al. (2006) Curry Consumption and Cognitive Function in the Elderly. Am. J. Epidemiol. 164:898-906.

22. Zhang, L. et al. (2006) Curcuminoids enhance Amyloid-Beta Uptake by Macrophages of Alzheimer’s Disease Patients. J. Alzheimer’s Disease 10:1-7.

23. Yang, F. et al. (2005) Curcumin inhibits Formation of Amyloid Beta Oligomers and Fibrils, binds Plaques, and reduces Amyloid in vivo. J. Biol. Chem. 280:5892-5901.

24. Llewellyn, D. J., Langa, K. M. & Lang, I. A. (2009) Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment. J. Geriatric Psychiatry Neurol. 22 (3) 188-195. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730978

25. Llewellyn, D. J. et al. (2010) Vitamin D and Risk of Cognitive Decline in Elderly Persons. Arch Intern Med. 2010; 170 (13):1135-1141. http://archinte.ama-assn.org/cgi/content/abstract/170/13/1135

26. Masoumi A. et al. (2009) 1 Alpha,25-Dihydroxyvitamin D3 interacts with Curcuminoids to stimulate Amyloid-Beta Clearance by Macrophages of Alzheimer’s Disease Patients. J. Alzheimer’s Disease 17(3):703-717.

http://www.ncbi.nlm.nih.gov/pubmed/19433889

© Christopher J. Jones, M.Sc., Ph.D.

Recently, two dear friends of mine were diagnosed with breast cancer and now they are dealing with the consequences. It’s hard to imagine the thoughts and fears going through their minds and how their lives and those of their family members have been turned upside down. How can we fight back against this scourge and its debilitating consequences? Knowledge is power and nowhere is this more important than in dealing with cancer, and protecting ourselves and our loved ones from it and from any recurrence as much as possible.

It seems to me that we must do everything in our power to maximize our body’s immune system, keep our weight in the normal range, exercise regularly, get fresh air and minimize our exposure to toxic chemicals, alcohol, smoking and bad food. So how can we do this? I will consider protection in three categories; a) after puberty, b) between birth and puberty, and c) before birth.

After Puberty

Both men and women can get breast cancer so men should pay attention also, even though their risk is 100 times less. There are also women in their lives who are special. Obviously, after puberty we cannot control the events that occurred beforehand and so we have to act now. Here’s what we should do to protect ourselves and our adolescent children.

1) Keep Your Weight in the Normal Range. Aim for a BMI ( Body Mass Index ) between 18.5 and 24.9 (see reference 1). In 2007, the World Cancer Research Fund and the American Institute for Cancer Research reported (2) that obesity is a convincing risk factor for cancer at several sites in the body, including the breast in post-menopausal women. It is not, however, a risk factor for breast cancer in pre-menopausal women although this may change as more women are becoming obese earlier and in childhood, and will thus be exposed for longer periods to estrogens and inflammatory agents released by fatty tissue.

2) Eat a Predominantly Plant-Based Diet with as much fresh, locally grown fruits and vegetables as possible. Choose organic or pesticide-free produce such as is available in farmers’ markets. Do not compromise; otherwise you will be exposing yourself and your family to chemicals whose effects have not been properly tested. The benefits of eating fruits and vegetables is that they provide phyto (plant) chemicals many of which are anti-oxidants and counter the deleterious effects of free-radicals which are the by-products of our oxidative metabolism. Vegetables should take priority over fruits. It is tempting to each too much fruit because of the sweetness but an excessive intake of sugars should be avoided as they can weaken our immune response and compromise our body’s defenses.

Include mushrooms in your diet. Regular consumption of mushrooms is associated with a decreased risk of breast cancer in both pre- and post-menopausal women (3,4,5). Certain polysaccharides in mushrooms are thought to exert anti-cancer and anti-viral effects by stimulating our immune system (6). Studies with breast cancer cell lines in culture have suggested that mushrooms can also exert anticancer effects via a different mechanism. When an extract of shiitake mushrooms was applied, it was found to inhibit both the growth of the cancer cells and hasten their demise (7). The mechanism of this action is currently being investigated.

3) Exercise. Regular exercise has been shown to reduce the risk of developing breast cancer and prostate cancer, both directly by lowering the circulating levels of estrogen and testosterone and the tissues’ responses to them, and indirectly by promoting weight loss (8).

With respect to breast cancer, several studies involving pre-and post-menopausal women have suggested that regular exercise may reduce the incidence of the disease by 20-40%. (8, p.233). For those who are diagnosed with early stage breast cancer, a recently reported study of 1,500 women found that if they walked at least 30 minutes each day for 6 days each week and ate at least five servings of fruits and vegetables every day, their risk of mortality was reduced by half and this reduction was seen in both obese and non-obese women (8, p.231).

4) Avoid Meat and Dairy Products Containing Added Hormones and Antibiotics. If you eat meat and dairy products, avoid those containing hormones and antibiotics. These are added for convenience and profit and put our health and wellbeing at risk. Choose organic or naturally-raised produce, free from added hormones and antibiotics.

5) Avoid Alcohol Consumption. Based on extensive case-controlled and prospective studies, the World Cancer Research Fund has reported that consumption of alcoholic drinks is a convincing cause of breast cancer in both pre- and postmenopausal women. There is no threshold in the amount of alcohol consumed but the risk of getting breast cancer increases with increasing alcohol consumption (2). There is a dose-response relationship.

6) Don’t Smoke or Breathe in Second-Hand Cigarette Smoke. Smoking increases the risk of breast cancer in both pre- and post-menopausal women (9). Women who start smoking at an early age have a 20% greater chance of getting breast cancer than women who never smoke. Also, exposure to second-hand smoke has been shown to increase the risk of breast cancer in premenopausal women. Women who have slow-acting forms of the NAT2 gene which codes for the breakdown of aromatic amines such as those occurring in cigarette smoke (10) are at greater risk of getting breast cancer (9). Breast cancer risk has been shown to be 27-50% higher in long-term smokers who have the slow-acting form of the NAT2 gene.

7) Have Your First Child Early. The younger a woman is when she has her first child; the lower will be her risk of developing breast cancer. If she does not have her first child until after age 35, her risk of developing breast cancer is approximately twice that of a woman who has her first child before age 20 (11) .

Breastfeed. There is convincing evidence that breastfeeding protects the mother against both pre- and postmenopausal breast cancer (2). The longer the breastfeeding continues, the greater is the protection conferred.

9) Minimize Exposure to Environmental Toxins. We are being increasingly exposed to chemicals in our environment; in the foods we eat, the fluids we drink, the personal care and household products we use, the materials we touch and the air we breathe (12). It is estimated that there are now over 80,000 chemicals used in commerce and the Environmental Protection Agency (EPA) has only required testing of approximately 200. We have virtually no knowledge of the long-term effects of exposure to these chemicals, either separately or in the combinations employed. Just as with alcohol and with the aromatic amines in cigarette smoke, people may differ considerably in their ability to break down and dispose of these chemicals and so in some individuals they may remain in their tissues for longer and cause chronic damage.

The first step is to become aware of the products we use by reading labels and checking for safety by consulting with non-profit organizations such as the Environmental Working Group (13). Pay special attention to any products applied to the breast and the under arm region. We have to unprocess our lives and purify our environment as much as possible, for the benefit of our health and wellbeing and for our loved ones.

10) Be Aware of Family History. If there is a family history of breast cancer, it is important to be aware of it. Be vigilant in performing regular breast examinations (14) and consulting your doctor. Avoid all of the known risk factors discussed here and pursue those lifestyle factors known to promote breast and bodily health.

From Birth to Puberty

1) Babies Should Be Breastfed. The World Cancer Research Fund and the American Institute for Cancer Research have recommended that babies should be breastfed (2). Breastfeeding provides the perfect food formulated for the baby and confers significant health benefits, including enhanced immunity and resistance to infections and allergies (10). It also reduces the likelihood of obesity later (15), which in turn will reduce the risk of certain cancers, including breast cancer.

2) Baby Food. Ideally, baby food like other foods should be prepared at home from fresh and preferably organic ingredients. If the baby’s food is purchased ready made then it should be minimally processed and free from environmental chemicals and preservatives.

3) Minimize Exposure to Environmental Chemicals. As young children begin to explore their surroundings they come into contact with carpets, furnishings and draperies that may have been chemically treated. When they touch these and then place their hands in their mouths, the chemicals are ingested.

4) Avoid Hormone-Treated Foods. There is a clear difference in the development of children raised on a predominantly vegan or vegetarian diet compared to those raised on meat. Girls raised as vegans will not have their first period until they are 17 and will have an earlier menopause, thus their exposure to estrogens and their breast cancer risk will be greatly reduced. Girls raised on meat in their diet can enter puberty at 12 or earlier and the earlier age at which adult height and features are obtained is a risk factor for cancer of the breast, colon, ovary and pancreas (2). It has been shown that for every year that a girl’s first period (menarche) is delayed, there is a 7-9% reduction in the risk of getting premenopausal breast cancer (2).

5) Keep Your Children’s Weight within the Normal BMI Range. Encourage exercise and avoid processed, high carbohydrate foods low in nutrients such as white bread, white rice, cake, sugary drinks and sweets. It is essential to protect our children from becoming overweight and obese. Prolonged sedentary behavior such as watching television or playing video games should be actively discouraged. It is a tragedy that so many children are overweight today and at future risk of serious chronic diseases, including cancer.

Before Birth

1) Protect from the Earliest Stage. Protection against cancer should begin in the womb. It is clear that most cancers are triggered by environmental causes and the developing fetus is especially at risk from environmental chemicals that can cross the placenta. There is now clear evidence that babies are being born already polluted (13). In many cases, the pollutants are present in higher concentrations in the baby than in the mother. The mother should therefore follow the recommendations above for optimal health and minimize her exposure to environmental toxins.

(i) In the womb, toxins may be secreted by the fetus but then they are reabsorbed again when the fetus swallows the amniotic fluid. Because of this they can be concentrated in the fetus.
(ii) Fetuses, infants and young children do not have fully developed detoxification systems and so are more at risk from the chemical effects of toxins.
(iii) Their cells are rapidly growing and dividing as tissues and organs develop and these processes are vulnerable to the action of toxic chemicals.

In order to maximize our health, we need to unprocess our lives as much as possible and return to a much more natural way of living; engaging in regular low intensity exercise, spending more time out of doors, eating fresh, locally grown and preferably organic produce, using personal care and household products that are as natural as possible and avoiding cigarette smoking and alcoholic drinks.

© Christopher J. Jones, M.Sc., Ph.D

References

1) Jones, C. J. (2009) Obesity and How It Can Affect Our Health. http://www.health360.info/?p=143

2) World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. AICR, Washington DC, pp. 516. http://www.dietandcancerreport.org

3) Zhang, M. et al. (2009) Dietary Intakes of Mushrooms and Green Tea combine to reduce the Risk of Breast Cancer in Chinese Women. Int. J. Cancer 124: 1404-1408.

4) Shin, A. et al. (2010) Dietary Mushroom Intake and the Risk of Breast Cancer based on Hormone Receptor Status. Nutr. Cancer 62(4): 476-483.

5) Hong, S.A. et al. (2008) A Case-Control Study on the Dietary Intake of Mushrooms and Breast Cancer Risk among Korean Women. Int. J Cancer 122(4): 919-923.

6) Borchers, A.T. et al. (2008) The Immunobiology of Mushrooms. Exp. Biol. Med. 233(3): 259-276.

7) Fang, N. et al. (2006) Inhibition of Growth and Induction of Apoptosis in Human Cancer Cell Lines by an Ethyl Acetate Fraction from Shiitake Mushrooms. J. Altern. Complement. Med. 12(2): 125-132.

Ornish, D. (2007) The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health. Ballantine Books, New York, 386 pp.

9) Fiore, K. (2009) Smoking Causes Breast Cancer, Analysis Shows.
http://www.breastcancer.org/risk/new_research/20090424b.jsp

10) NAT2 (2010) http://www.snpedia.com/index.php/NAT2

11) National Cancer Institute. Pregnancy and Breast Cancer Risk.
http://www.cancer.gov/cancertopics/factsheet/Risk/pregnancy

12) Jones, C. J. (2009) So Just How Toxic Are We? http://www.health360.info/so-just-how-toxic-are-we.html

13) Environmental Working Group http://www.ewg.org

14) Breast Self-Examination (2009)
http://healthline-update.blogspot.com/2009/03/how-to-perform-breast-self-examination.html

15) WebMD. What are the Benefits of Breastfeeding for Baby? http://www.webmd.com/parenting/baby/breastfeeding-9/nursing-basics

Health care costs in the USA are spiraling out of control, and in an attempt to rein them in, Congress recently passed legislation to reform health care provision in the country. However, there is growing concern that the new legislation will not save money but instead place an even greater financial burden upon the nation.

So how much does chronic disease cost in the USA?

It is difficult to obtain an accurate figure because we are dealing with an upwardly moving target. The data for 2003 which were reported in 2007 by the Milken Institute (1) revealed that more than 109 million Americans, over one third of the population, had at least one of the following seven chronic diseases; cancer, diabetes, heart disease, high blood pressure, lung disease, mental disorders, or stroke (1). Some individuals suffered from more than one of these conditions, and the total number of cases reported was 162.2 million. This is a staggering figure and so also is the cost; $277 billion for treatment and $1,046.7 billion estimated for lost productivity adding up to $1,323.7 billion, nearly 10% of the annual gross domestic product (GDP) and a severe recurrent drain upon the nation. These figures are certain to be higher now because healthcare costs have continued to rise. And this is just for chronic diseases. Treatment of other ailments would be in addition and the total expense is now estimated to be over $2,000 billion ($2 trillion) annually.

According to the Centers for Disease Control and Prevention (CDC), a division of the U.S. Department of Health and Human Services, 133 million Americans had a least one chronic condition in 2005 and the medical costs for treating all chronic diseases at that time were over 75% of the nation’s annual $2 trillion healthcare costs (2).

Here are some examples from the CDC report.

1) Treating heart disease and stroke: Projected to be $448 billion for 2008.

2) Direct and indirect costs of diabetes: $174 billion a year.

3) Direct medical costs of treating cancer: Estimated to be $89 billion per year.

4) Cost of treating arthritis: Estimated at nearly $81 billion per year and the total cost, including lost productivity, $128 billion. (Note: The Milken Institute allowed a much higher percentage for lost productivity for the diseases they reported.)

5) Total cost of treating obesity in 2000: Estimated at $117 billion. Some of this cost involved treating the conditions above. If obesity rates and treatment expenses continue to rise, they are projected to cost $344 billion by 2018 (3).

These figures give some idea of the burgeoning costs of healthcare in the USA, and are partly explained by increases in the prevalence of certain conditions and partly by the increasing costs of healthcare provision. The best way to bring these costs under control is by improving the nation’s overall health through the adoption of a better diet and regular exercise habits. As Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”

References

1) DeVol, R., Bedroussian, A. et al. (2007) An Unhealthy America: The Economic Burden of Chronic Disease. The Milken Institute, Santa Monica, pp 238. http://www.chronicdiseaseimpact.com/

2) Centers for Disease Control and Prevention (2008) Chronic Disease Overview. http://www.cdc.gov/NCCdphp/overview.htm

3) America’s Health Rankings (2009) Obesity in America http://www.americashealthrankings.org/Obesity.aspx
The full report, based on research by Kenneth E. Thorpe, is at http://www.americashealthrankings.org/2009/report/Cost%20Obesity%20Report-final.pdf

© Christopher J. Jones. M.Sc., Ph.D.

The facts are telling us loud and clear that the United States of America has some serious health problems. And what’s more, most of them are preventable. Let’s consider the following.

Heart disease and stroke are the number 1 and number 3 causes of mortality respectively in the U.S. These, and other cardiovascular diseases, claimed 864,480 lives in 2005 and it was estimated that approx. 80 million people in the U.S. in 2006 had one or more forms of cardiovascular disease (1). The good news is that the mortality rate is presently falling but it’s expected to rise again because the incidence of diabetes is increasing and diabetes is a major risk factor for cardiovascular disease.

The prevalence of diabetes increased 6-fold from 1950 to 1993 and it’s still going up. It’s estimated to double between 2005 and 2050 unless there is a significant transition to a healthier diet and more energetic lifestyle. According to the American Diabetes Association (2), currently 23.6 million adults and children in the United States have diabetes. Of these, approx. 17.9 million have already been diagnosed and an estimated 5.7 million are unaware that they have the disease. In addition, there are 57 million more Americans who are pre-diabetic with elevated blood glucose levels that are under the threshold for full-blown diabetes. Kidney disease is also on the rise and it’s estimated that kidney failure rates will increase by 60% between 2001 and 2010.

Another major risk factor for cardiovascular disease and stroke is high blood pressure, also known as hypertension, which affects over 72 million people in the U.S. It is thought to be associated with high salt consumption. Genetic factors may also play a role because the incidence of hypertension is greater among African Americans than among Caucasians or Asians.

Cancer is the number 2 cause of mortality in the U.S. after cardiovascular disease, claiming an estimated 565,650 lives in 2008 (3). Based on data from 2001 through 2003, a study by the National Cancer Institute has estimated that cancer will affect 1 in 2 men and 1 in 3 women during their lifetime and that the number of new cases will nearly double from 1.36 million in 2000 to almost 3 million by 2050 because of aging and population growth (4).

The National Health and Nutrition Examination Survey (NHANES) conducted in 2003-2004 and repeated in 2005-2006 revealed that over 66% of adults in the U.S. aged 20 and over are overweight and nearly half of these are clinically obese (33.3% of men and 35.5% of women). These include 4.7% of American adults who are morbidly obese (5).

Alzheimer’s disease, a progressive and fatal form of senile dementia, is attracting growing public attention. It is now estimated that there as many as 5.3 million people in the United States living with Alzheimer’s disease and it’s tripling healthcare costs for Americans aged 65 and older (6). Alzheimer’s disease is now the seventh leading cause of death in the United States.

These are collectively appalling statistics and there is growing evidence to suggest that a great many of these health problems and their expensive consequences can be prevented. How then could such a sorry state of affairs be permitted to occur in arguably the most advanced nation on the planet? It is a national tragedy and one shared by many developed countries. So how can it be turned around?

Drs. Dean Ornish (7), Caldwell Esselstyn (8), and Joel Fuhrman (9), and others have shown that it is possible to lower blood pressure and significantly reverse coronary artery disease through dietary change. Symptoms of angina progressively disappear during the first few months of adopting a low-salt, low-fat, vegan diet and the incidence of future cardiac events is greatly reduced by this intervention. It is therefore reasonable to suggest that if such a diet had been followed in the first place, the symptoms of disease would never have appeared.

Drs. Neal Barnard, Joel Fuhrman, and others have demonstrated that the majority of their Type II diabetic patients can discontinue their insulin medication within the first month of adopting the new diet. Dr. Barnard has written a book on reversing Type II diabetes (10). Again, it is reasonable to suggest that if the therapeutic diet had been followed in the first place, then Type II diabetes would never have occurred.

More than 80 percent of Dr. Fuhrman’s chronic headache and migraine sufferers have recovered without medication when they have changed to the new diet. He also reports that many of his patients with autoimmune diseases such as asthma, hyperthyroidism, systemic lupus erythematosus, and rheumatoid arthritis were able to recover and renounce their medications once they changed to the new diet (9).

These findings are very important because they indicate that dietary change is not only clinically effective if it is maintained, but it is also very cost-effective by eliminating medication, surgical intervention and the emotional and economic costs associated with disease and disability. Most important of all, it saves lives.

Dr. Alan Goldhamer (10,11) has demonstrated that over 90% of his patients with high blood pressure achieved completely normal readings by means of a physician-supervised, water-only fast. Blood pressure levels remained low after the fast, once the new diet was adopted.

Adherence to a diet of fresh fruits and vegetables, legumes and whole grains coupled with exercise has been shown to be effective in promoting weight loss. It is known that obesity is a major risk factor for Type II diabetes, high blood pressure, certain cancers, osteoarthritis and other medical conditions including abdominal hernias, gall bladder disease, gout, liver malfunction, respiratory problems, sleep apnea and varicose veins.

The evidence with respect to reversing cancer is much less clear because of legal constraints on pursuing alternative solutions when there is a possibility that the patient’s life can be saved with conventional therapies. However, one exception is prostate cancer, where the benefits of early conventional treatment are questionable. Many men decide to adopt a wait-and-see approach because the treatment often makes them incontinent and impotent. This was a perfect model for Dr. Dean Ornish and his colleagues to examine (13 – 15). His research team studied 93 men with biopsy-confirmed prostate cancer who had elected not to undergo conventional treatment. The participants were randomly divided into two groups; one of which was asked to make comprehensive changes in diet and lifestyle and another group, which was not.

After one year, the researchers found that prostate-specific antigen (PSA), a protein marker for prostate cancer, had decreased in men in the group who made the comprehensive lifestyle changes, but had increased in the comparison group. If PSA levels increase, the disease is probably getting worse. There was a direct correlation between the degree of lifestyle change and the changes observed in PSA. Also, it was found that serum from participants in the lifestyle-change group inhibited in vitro prostate tumor growth by 70 percent, whereas serum from the control group only had a 9% inhibitory effect. Again, there was a direct correlation between the degree of lifestyle change and the inhibition of prostate tumor growth. Patients who made comprehensive changes in their lifestyle also reported significant improvements in their quality of life, including better functioning and reduced feelings of anxiety and stress.

With respect to breast cancer, several studies involving pre-and post-menopausal women have suggested that regular exercise may reduce the incidence of the disease by 20-40%. (Spectrum, p.233). For those who are diagnosed with early stage breast cancer, a recently reported study of 1,500 women found that if they walked at least 30 minutes each day for 6 days each week and ate at least five servings of fruits and vegetables every day, their risk of mortality was reduced by half and this reduction was seen in both obese and non-obese women (Spectrum, p.231).

The writing is clearly on the wall. If we don’t take effective action to eat a healthy, essentially vegan diet, low in fat and salt, to exercise regularly and get enough sleep, we run the risk of serious disease and premature mortality with all the emotional and economic costs that they entail.

References

1) http://www.americanheart.org/presenter.jhtml?identifier=4478
2) http://www.diabetes.org/about-diabetes.jsp
3) http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf. American Cancer Society. Cancer Facts & Figures 2008. Atlanta: 80 pp.
4) Hayat, M. J. et al. (2007) Cancer Statistics, Trends, and Multiple Primary Cancer Analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. The Oncologist 12, 20-37.
5) Centers for Disease Control and Prevention , National Health and Nutrition Examination Survey Information Sheet, August 2008 http://www.cdc.gov/nchs/data/infosheets/infosheet_nhanes.htm
6) http://www.alz.org/alzheimers_disease_facts_figures.asp
7) Ornish, D. (1991) Dr. Dean Ornish’s Program for Reversing Heart Disease. Ballantine Books, New York, 672 pp.
Esselstyn, C. B. (2007) Prevent and Reverse Heart Disease. Avery, New York, 308 pp.
9) Fuhrman, J. (2003) Eat to Live: The Revolutionary Formula for Fast and Sustained Weight Loss. Little, Brown and Co., New York, 292 pp.
10) Barnard, N. (2007) Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs. Random House, New York, 466 pp.
11) Fuhrman, J. (1995) Fasting and Eating for Health: A Medical Doctor’s Program for Conquering Disease. St. Martin’s Griffin, New York, 255 pp.
12) Goldhamer, A. (2001) Medically supervised water-only fasting in the treatment of hypertension. J. Manipulative Physiol. Ther. 24, 335 – 339.
13) Ornish, D. (2007) The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health. Ballantine Books, New York, 386 pp.
14) Ornish, D. et al. (2005) Intensive Lifestyle Changes may affect the Progression of Prostate Cancer. J. Urol. 174, 1065-1069.
15) Daubenmier, J.J. et al. (2006) Lifestyle and Health-Related Quality of Life of Men with Prostate Cancer managed with Active Surveillance. Urology 67, 125-130.

© Christopher J. Jones, M.Sc., Ph.D.
Adventist Health Ministry,
Laguna Niguel, CA 92677, U.S.A.