March 2012

Spring Time is Approaching!

It seems that winter's grip is not as tight this year as in years past, but what do I know I live in the desert?

This month’s newsletter has some very interesting tidbits in it and I think you are going to enjoy reading it during this month of celebrations. In this newsletter you will learn more about the raging debate between High Fructose Corn Syrup and sugar, some extremely interesting new research into the medicinal benefits of Mangosteen juice, why your doctor lies to you, why people are shedding their shoes to run barefoot and finally how your diet soda is killing you! Don’t forget to take advantage of our winter special below. Happy reading and have a great month.

WINTER SPECIAL

What Is Worse: High Fructose Corn Syrup of Sugar?

We have been witnessing a battle between two Goliaths in the sweetening industry play out over the last several years. Several decades ago sugar was villanized as the culprit for a nascent national health dilemma: increase in adult onset diabetes and obesity. Around that same time high fructose corn syrup (HFCS) developed into the less expensive non-sugar alternative. From then we have seen an exponential growth in the use of HFCS as the ubiquitous sweetening agent in foods and beverages. In fact it is hard to find food products that do not contain this commercially cheap but calorically costly alternative to sugar. In spite of this switch we have not seen a decline in diabetes or obesity but the contrary; they are now the leading epidemic health issues in our country that is slowly infecting the world. But how could this be that HCFS although cheaper and sweeter did not fix things? The Corn Refiners Association insists that HFCS is no different than sugar and behaves no differently within our bodies than regular sugar. However, new research finds that high fructose corn syrup does act differently in the body than cane or beet sugar—and with potentially harmful effects. This new research was published in the journal Metabolism.

Authored by scientists from the University of Colorado and the University of Florida, the study is the first to find that the body metabolizes high fructose corn syrup differently than table sugar. In the study, 40 men and women consumed 24 ounces of either a HFCS-sweetened beverage or a sugar-sweetened beverage. Over a 6-hour period, blood and urine samples were taken, and blood pressure, heart rate, fructose, and a bevy of other metabolic markers were monitored. Individuals who drank the HFCS beverage had significantly higher fructose blood levels, as well as higher systolic blood pressure (the force of blood in the arteries as the heart beats, or the top number in blood pressure readings) than those who drank the table sugar beverage. Turns out your body can recognize the difference between the two sweeteners. Sucrose [table sugar] is 50 percent fructose and 50 percent glucose that is bonded together as a disaccharide (two sugars or a complex carbohydrate), while HFCS is a mixture consisting of 55% free fructose and 45% free glucose. It's the difference in fructose amount that appears to create the ill health effects on the body. Some earlier skeptics of HFCS claimed independently that HFCS does not tell your body that you are full as quickly or as efficiently as sugar.

According to Professor Marion Nestle, PhD she says that “Americans used to eat much more sucrose than HFCS. Now we consume about 60 pounds of each of them a year—way too much of either”. In her opinion the real solution in this battle is to “eat less sugar(s).” Unfortunately, ours is a society that through convenience is dangerously bent on indulging and immediately gratifying passions and appetites. This is a trend that is not lost to savvy marketers and food companies. The battle between HFCS and sugar is an important one and should be kept in context to the greater war on choice and accountability. We must never forget that convenience is the enemy to self-discipline and that we have the right and responsibility to choose between eating to live vs. living to eat.

PROMISING NEW RESEARCH IN MANGOSTEEN AND CANCER PREVENTION & TREATMENT

Xanthones from Mangosteen Extracts as Natural
Chemopreventive Agents: Potential Anticancer Drugs
T. Shan1, Q. Ma*,1, K. Guo1, J. Liu1, W. Li1, F. Wang2, and E. Wu2
1Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi’an Jiaotong
University, 277 West Yanta Road, Xi’an 710061, Shaanxi, China
2Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND 58105, USA


Carcinogenesis is literally the creation of cancer. Carcinogenesis prevention is considered to be a promising alternative strategy for the treatment of cancer. In recent years, many naturally occurring substances have demonstrated protection against experimental carcinogenesis. Based on this information compelling evidence exists for the use of mangosteen to not only prevent but also to treat cancer.

Taken together, these results support that mangosteen can modulate various molecular pathways involved in multiple processes of carcinogenesis including the inactivation of carcinogens, the induction of apoptosis ( the cells internal kill mechanism), the initiation of cell cycle arrest, and the suppression of metastasis or the uncontrolled spreading of the cancer cell growth . It may be used in combination with other chemotherapeutic agents as adjuvant therapies to achieve increased therapeutic efficacy and minimize chemotherapy-induced toxicity.

Extensive animal studies, long-term epidemiologic studies, and controlled clinical trials are still necessary to evaluate the safety and chemopreventive efficacy of mangosteen either alone or in combination with additional chemotherapeutic agents. α-mangostin, is the most widespread studied xanthone and exhibits the highest activity against breast cancer, human leukemia, lung cancer, pheochromocytoma, and colorectal carcinoma. However, more studies are needed to further explore the effectiveness of this xanthone clinically.

It is important to note that Dr. Tim’s Thai Mangosteen juice uses whole mangosteen fruit from Thailand and has one of the highest concentrations of mangosteen per serving. This means that we use the outer layer or pericarp of the mangosteen fruit. This is where the xanthones are found including α-mangostin.

MANY DOCS TELL WHITE LIES!

For all of you that have been reading my monthly newsletter over the years, you have probably figured out that one of my causes in this life is to see that patients are treated well. As a physician and a surgeon I came to appreciate and implement effective strategies that refocused my practice from being doctor centered to being patient centered. Once I did this it really improved my relationship with my patients and enabled us (doctor and patient) to work as a team to find effective and efficient solutions to my patients’ health care issues. I spent many years on the national speaking circuit for physicians teaching them about how to do what I accomplished in my practice. So, I like to share articles that I find that help to open the doors a little wider for patients to understand their doctors and for doctors to recognize some of the false assumptions under which they practice. The one that follows is a classic example of how good people like your doctors can be afraid to tell you the truth and unfortunately get caught fibbing.

Many docs tell white lies, study finds By MyHealthNewsDaily staff

Everybody lies — even doctors.

A new study finds 11 percent of doctors say that they have told a patient or a child's guardian something that was not true in the past year, and about 20 percent say they have not fully disclosed a mistake to a patient because they were afraid of being sued.

The results also show 34 percent of doctors surveyed did not "completely agree" that physicians should disclose all significant medical errors to affected patients. Instead, these doctors said they only somewhat agreed, or disagreed.

"Our findings raise concerns that some patients might not receive complete and accurate information from their physicians," the researchers write in the February issue of the journal Health Affairs. The findings also question whether patient-centered care — which is a philosophy of medicine that respects the preferences, needs and values of patients — is possible without more openness and honesty, the researchers from Harvard Medical School said.

While the ultimate effect of such untruths is not known, they could make patients "less able to make health care decisions that reflect their values and goals," the researchers said.

To be fair, the researchers acknowledged not knowing the circumstances under which physicians lied, and communication regarding health issues can be complex. Physicians must often wade through conflicting and confusing information as a case goes on. Telling a patient something that turns out to be wrong might not be helpful, the researchers said.

More research is needed to better understand when and why physicians feel justified in a lapse of honesty.Dr. Arthur Caplan, a medical ethicist at the University of Pennsylvania and msnbc.com contributor, told the Associated Press that to withhold a mistake is "inexcusable," adding that a physician's "care now has to be different because of what happened."

In a poll for msnbc.com, Truth On Call asked 100 physicians, including those in family practice, cardiologists and neurosurgeons if they've ever kept a serious medical mistake from a patient. Twenty one percent admitted they kept an error from the patient, 55 percent say they disclosed the mistake and 24 percent say they've never made a serious medical error. Responses differed greatly by specialty, Truth On Call found. Five percent of the 34 family practitioners polled said they made a mistake but kept mum, 47 percent said they disclosed it to the patient and 47 percent said they never made a serious mistake. Among the 33 neurosurgeons polled, 25 percent said they withheld a mistake, while 69 percent told and six percent said they never made a crucial error. And, among the 33 cardiologist polled, 33 percent said they didn't tell the patient about the mistake, while 50 percent told and 17 reported they've never made a mistake.

The Harvard researchers surveyed close to 1,900 physicians from a broad range of specialties about their agreement with the principles outlined in the Charter on Medical Professionalism, a charter endorsed by more than 100 professional medical groups worldwide.

While the majority of doctors agreed that physicians should "never tell a patient something that is not true," about 17 percent did not completely agree.

In fact, 55 percent said that they had "described a patient’s prognosis in a more positive manner than warranted," in the last year, and about 28 percent said they had "intentionally or unintentionally revealed to an unauthorized person health information about one of [their] patients."

In addition, about 35 percent of doctors did not agree with the statement that physicians should " disclose financial relationships with drug and device companies to heir patients." Women and minority physicians were more likely than white, male doctors to say they agreed with the principles of honesty and openness, according to the study. This may be because, as underrepresented groups in medicine, women and minorities feel more compelled to comply with such professional codes, the researchers wrote. Some physicians might not tell their patients the whole truth because they don’t want to upset them, worry them or cause them to lose hope, the researchers said.

"Especially in the context of life-threatening illness, physicians might not tell patients the complete truth because of lack of training, time limitations, uncertainty about prognostic accuracy, family requests and feelings of inadequacy about their medical interventions," the researchers said.

Some physicians may also wonder about revealing errors when no harm came of them. However, studies show that "informing patients fully about medical errors can reduce anger and lessen patients’ interest in bringing malpractice lawsuits," the researchers said.

BAREFOOT RUNNING: CRAZY OR COURAGEOUS?

I have been noticing a growing trend in running: running barefoot. Now, I am not sure yet where I am on this topic nonetheless I find it fascinating that what we once did as children is now being championed as a favored form of running. There is a fellow who has written a book about his conversion to barefoot running in which he extolls its virtues and uses the example of an indigenous tribe in Mexico as validation for his argument. This surge of interest in "natural" training has scientists discussing its pros and cons. In a recent article in Reuters written by Stefan Warmuth out of London he quote several authorities on running both shod and barefoot as well as quoting excerpts from the book "Born to Run," by Christopher McDougall.

Stefan Warmuth writes “Despite the cold and many other potential hazards, naked from the ankle down is the way Anna Toombs likes it, and she gets plenty of catcalls in the street as a result.

The 35-year-old co-founder of the personal training company Barefoot Running UK says she's lost count of the times people yell "where are your shoes?" as she and partner David Robinson negotiate London's parks and pavements to indulge their passion and train their clients. "People give you a lot of weird looks," says Robinson. They are also getting a lot of inquiries. A surge of interest in "natural," or barefoot, training has seen runners around the world kick off their arch-supporting, motion-controlling, heel-cushioning shoes and try to feel the ground beneath their feet.

Top scientists -- from sports physicians to podiatrists to evolutionary biologists -- are jumping in too. At a recent sports science conference in London, hundreds of participants, many of them shod but a few daringly barefooted, flocked to a two-hour long discussion about the merits or otherwise of running without shoes. "It's a really polarized debate -- there are what you might call the barefoot evangelicals on one side and the aggressive anti-barefoots on the other," says Ross Tucker, an expert in exercise physiology at South Africa's University of Cape Town and a middle- and long-distance running coach.

Born to run?

The current barefoot trend has its roots in the book "Born to Run," by Christopher McDougall. In it, he tells of time spent with Mexico's Tarahumara tribe who can run huge distances barefoot, often very fast, apparently without suffering the injuries that plague many keen runners in the developed world.

The debate centers on whether running in shoes with cushioned heels and supportive structures changes the way people move so dramatically that it's more likely to cause injuries.

Proponents of barefoot running say the natural way is more likely to prompt a runner to land on the padded and springy part of the foot, toward the front, rather than strike the ground with the heel as many shod runners do. Lieberman and colleagues from Britain and Kenya studied runners who had always run barefoot, those who had always worn shoes and runners who had abandoned shoes.

They found that barefoot endurance runners often land on the fore-foot before bringing down the heel, while shod runners mostly rear-foot strike, prompted by the raised and cushioned heels of modern running shoes.

Difference of impact

In a series of analyses, they found that even on hard surfaces, barefoot runners who fore-foot strike generate smaller "collision forces" -- less impact -- than rear-foot strikers in shoes. Barefoot runners also had a springier step and used their calf and foot muscles more efficiently.

Lieberman, who spoke at the conference after an early-morning barefoot run along the banks of London's Thames, is keen to stress that the scientific evidence on whether barefoot running is better in terms of injuries is still very unclear.

Back in 1960 Ethiopia's Abebe Bikila, one of the world's greatest Olympic marathon runners, won the first of his consecutive gold medals without shoes, covering the 26.2 miles in 2 hours, 15 minutes and 17 seconds. And in 1984, South African barefoot runner Zola Budd set a track world record when she ran 5,000 meters in 15 minutes and 1.83 seconds.

Simon Bartold, a sports podiatrist and international research consultant for the sports brand Asics, says most athletes, amateur or otherwise, should stick to wearing shoes.

"I'd come down pretty heavily in favor of footwear," he said. "It does offer some real protection and some real performance advantages over barefoot."

I spent the better part of my career as a physician and a surgeon treating deformities and surgically reconstructing feet, ankles, and lower legs. I have seen the problems of both sides of this issue. I can’t help but recollect a time many years ago as a young boy running in the streets of southern California shoeless and believing that the more I went barefoot the tougher my feet would be. In fact me and my buddies would purposely run and walk on gravel and other sharp uncomfortable surfaces to accomplish this goal. Turns out that none of us ever suffered an injury worse that stepping on a nail or a piece of glass. (nails go through tennis shoes with remarkable ease also). So it doesn’t surprise me to see that a resurgence of this type of running is occurring. It is hard to say anything too contrary to barefoot running when you read the stories of the Olympic runners winning marathons barefooted. I think that wisdom would dictate that given one’s experience, level of athleticism, running surfaces and insurance plan the choice to run barefoot or with shoes is up to each individual. As for me, now I prefer shoes, unless of course I am on the beach.

OH NO, MY DIET SODA IS KILLING ME!

Drinking a single can of diet soda each day can increase your risk of having a heart attack or stroke, reports a recent study published in the Journal of General Internal Medicine.

The researchers monitored the soda-drinking habits of more than 2,500 individuals and compared them with the number of vascular events, heart attacks and strokes that occurred over a 10-year period. After factoring in pre-existing conditions diabetes, high blood pressure, BMI, and others, they found that those who were downing diet drinks on a daily basis were 43 percent more likely to experience a vascular event than those who drank none. But people who drank anywhere between 6 diet sodas per week and 1 diet soda per month had the same risk as people who never drank soda.

What's even more surprising: In contrast to previous research, the report found no association between regular soft drink consumption and risk of vascular events.

Keep in mind that the research only found an association between drinking diet and having a heart attack or stroke, that doesn't mean diet soda causes heart attack or strokes. Since no other studies have found a link between diet soft drink consumption and heart attacks, more research is needed, explains lead researcher Hannah Gardner, PhD, from the Miller School of Medicine at the University of Miami.

The researchers have several theories for the connection. Even though they adjusted for weight at the beginning of the study, they didn't collect weight measurements at the end of the 10 years or throughout the study. Since diet soda has also been linked to weight gain, it's possible that the diet drinkers gained more weight, which increased their heart risks. As reported in “The Truth About Diet Soda”, diet soda drinkers may have worse dietary patterns overall. (Although the researchers conducted dietary surveys to adjust for this, food surveys are notoriously unreliable.) Basically, no one knows for sure what's going on.

So what do you do while scientists search for a solution? Simple: Make coconut water (COCO-5) or just plain H2O your main beverage. (Squeeze in lemon or lime if you need some extra flavor.) Even though no one is sure how good or bad diet soda is for you, coconut water and water are a sure bet.