By Bernie Noe, ND

Inflammation is a normal bodily process that occurs in response to injury and infection. It is a part of the normal healing process and includes the migration of white blood cells to the site of injury and the secretion of a variety of chemicals by the immune system. Inflammation becomes a problem when it becomes chronic, however. Inflammation is thought to play a role in many chronic diseases including anything that ends in "itis" (such as arthritis, colitis, bursitis, and tendinitis) as well as other diseases such as heart disease, asthma, diabetes, and possibly some cancers. Typical symptoms of inflammation include redness, swelling, and pain, although these often don't occur with chronic systemic inflammation.

There are a variety of ways to determine if inflammation is occurring in the body. The two most commonly used tests are sedimentation rate (or ESR) and C-reactive protein (CRP). Sedimentation rate is most commonly used to diagnose and monitor auto-immune diseases such as rheumatoid arthritis and lupus that typically cause severe inflammation. CRP, on the other hand, is a very useful test for the lower levels of chronic inflammation that can promote heart disease and diabetes.

In particular, the relationship between elevated CRP and heart disease (including heart attack) has been strongly established. While elevated cholesterol is more widely known as a risk factor for heart attack and stroke, only about half the people who experience heart attacks have high cholesterol. Elevated CRP may account for some of those with heart attacks who have normal cholesterol. In fact, in a large 10-year study of cardiac death, those with the highest levels of CRP (4.2 mg/dL) had 6 times the risk of cardiac death compared to those with the lowest CRP (1.2 mg/dL). An optimal level of CRP is anything less than 1.0 mg/dL, while 1.0-3.0 is considered borderline high and greater than 3.0 is considered high. CRP is also independent of cholesterol levels, so those with normal cholesterol can have high CRP and vice versa.

The primary causes of chronic inflammation (and hence elevated CRP) include eating too much sugar and white flour, inadequate intake of omega 3 oils, food allergy, overweight/obesity, physical inactivity, smoking, and excessive alcohol intake.

Sugar and white flour - High glycemic foods such as sugar and flour are one of the most common causes of inflammation and elevated CRP. They can also increase blood pressure, cholesterol, and weight and promote fatigue and depression. Those who have high blood sugar, high triglycerides, low HDL (good) cholesterol, high blood pressure, or are overweight may have metabolic syndrome and are especially likely to benefit from avoiding high glycemic foods. Added sugars such as dessert, soda, and maple syrup should be eliminated, and all grains should be whole grains and limited to once daily.

Omega 3 oils- found primarily in fish, omega 3 oils such as EPA and DHA are precursors to anti-inflammatory chemicals called prostaglandins that are produced by the body. In addition to reducing inflammation, they lower the risk of heart attack and stroke by about one third.

Food allergies- Food allergies are also a very common cause of chronic inflammation. Blood allergy testing, which is available through our office, is an easy way to determine if you are allergic.

Physical activity- In addition to causing inflammation, physical inactivity tends to cause weight gain, high blood pressure, high cholesterol, and high blood sugar - all of which are risk factors for heart attack and a host of other chronic diseases. The minimum guideline for physical activity is 30 minutes daily of moderate intensity exercise. Optimal is 45-60 minutes per day.

Alcohol - While alcohol in moderation may lower the risk of heart attack and stroke, alcohol in excess can cause inflammation and raise blood pressure. In general, men should limit alcohol to 2 drinks per day or less and women to 1 per day or less. Those with inflammation may benefit from further reductions.

Smoking - In addition to causing inflammation, tobacco raises the risk of heart attack and stroke in other ways, such as by increasing the risk of forming blood clots and by raising blood pressure. For help with tobacco cessation, call the Quitline at 1-877-YES-QUIT.

Overweight - Body fat, particularly abdominal fat, is an inflammatory tissue. Physical activity, avoiding sugar and flour, and eating lots of fruits and vegetables are great ways to promote weight loss.

Fruits and vegetables- Fruits and vegetables contain a variety of compounds that can reduce inflammation including flavonoids and anti-oxidants. They also promote detoxification, which may play a role in inflammation in some people. Countless studies have found that those with the highest intake of fruits and vegetables are at the lowest risk of high blood pressure, heart attack, stroke, diabetes, most cancer, and many other chronic diseases. The minimum intake is 5 servings per day, while optimum intake is 8-10 servings per day.

In my experience, about 1/3 of the people I test have elevated CRP levels and thus are at increased risk of heart attack and other diseases. If you haven't had your CRP levels checked, call the office to schedule an appointment to have this done.

By Bernie Noe, ND

Breast cancer is the most common cancer in women, with 1 in 8 women developing it during their lifetime. Each year, approximately 230,000 women are diagnosed with invasive breast cancer, and about 40,000 of them will die from this disease. That's the bad news. The good news is that early detection of breast cancer allows more effective treatment of breast cancer and saves lives. The primary strategy to detect breast cancer early is the mammogram.

Mammograms are an x-ray of the breast, and are able to detect breast cancer tumors before they can be felt and before they produce any symptoms. Mammograms have been shown to reduce breast cancer death by 15-23% in clinical trials.

While there is some disagreement over when and how often women should get mammograms, there is no disagreement among major government and private cancer agencies as to the importance of getting mammograms. The two primary agencies that determine screening guidelines in the U.S. are the US Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). The USPSTF recommends mammograms every other year for women aged 50-69, while the ACS recommends mammograms every year for women aged 40 and older.

Screening women beginning at age 40 and performing annual mammograms, as recommended by the ACS, does further reduce breast cancer death as compared to the USPSTF guidelines. However, it also increases unnecessary procedures as a result of more false positives with the more frequent screening. Talk to your health care provider about what is right for you based on your family history and other risk factors.

Some women elect not to get mammograms out of fear that the radiation from a mammogram will cause breast cancer. While it is true that there is radiation from a mammogram, the amount is so small that the benefit far outweighs the risk. To put this in perspective, flying in an airplane from California to New York exposes a woman to the same amount of radiation she will get from a mammogram. Put another way, 4 women out of 1 million will get breast cancer from a lifetime of mammograms, while 165,000 out of 1 million lives will be saved by those same mammograms.

In addition to the early detection of breast cancer, another important strategy is to reduce your risk of developing breast cancer through diet and lifestyle. All of the following recommendations can help to reduce your risk of breast cancer:

Be physically active - Optimally, you should be physically active at least 45-60 minutes per day. As little as 2 ½ hours of brisk walking per week, however, was found to reduce risk by 18%.

Maintain normal weight - Fat cells produce estrogen, which increases the risk of breast cancer.

Avoid excessive alcohol - Women should limit alcohol to no more than 1 drink daily. Two to five drinks daily increases breast cancer risk by 150%.

Breast feeding - This may lower risk slightly.

Eat brassicas - Brassica family vegetables, such as broccoli, cauliflower, cabbage, and brussel sprouts, may lower the risk of breast cancer. These vegetables contain sulfurophanes, which have anti-cancer effects against many types of tumors, as well as indole-3-carbinol, which modifies estrogen metabolism and specifically reduces breast cancer risk.

Call the office for an appointment if you would like a detailed analysis of breast cancer risk and prevention strategies, including your personal 5 year and lifetime risk of developing breast cancer. 

Latitude and Vitamin D Intake Affect Crohns Disease

A study of women has found the risk of Crohns disease or ulcerative colitis ranges from highest to lowest in line with the northernmost to southernmost latitudes of Americans, and a separate study presented in the same day found that high doses of vitamin D for 26 weeks improve symptoms of Crohns disease patients. (Ulcerative colitis and Crohns disease are chronic diseases involving different inflammatory digestive system conditions.) Women who live at the latitudes furthest south, when compared to women who live in northernmost regions, experienced a 49 percent lower risk of Crohns and a 35 percent reduced risk of ulcerative colitis. Although reduced exposure to the vitamin-D-producing sunlight may be a factor, it is not known whether pollution or lifestyle factors are responsible. In a separate study, Crohns patients were given extremely high dosages of vitamin D and monitored closely. It was found that as much as 10,000 international units (IU) of vitamin D supplementation significantly improved symptoms. Both studies were presented October 31, 2011 in Washington DC at the annual scientific meeting of the American College of Gastroenterology. Neither study has yet been published, or is available online.

Probiotics Prove Effective Against Several Diseases

Taken together, four separate studies, all presented today, show probiotics (good bacteria) have an anti-inflammatory effect that makes them an effective treatment for psoriasis, chronic fatigue syndrome (CFS), ulcerative colitis, and some mild cases of abdominal discomfort; and that probiotics help prevent antibiotic-associated diarrhea (AAD). (Probiotics are live microorganisms, usually bacteria, believed to be beneficial to the host body; they are found in some foods such as yogurt, and in supplements. Ulcerative colitis, psoriasis, and CFS all have an inflammatory component. AAD can be triggered in some people by long-term use of antibiotics, which kill off beneficial bacteria along with the bad bacteria.) Cases of AAD decreased 60 percent among those on long-term antibiotic use, who also ingested probiotics. Also, ingesting Bifidobacterium Infantis 35624 triggered an increase in the blood levels of one inflammation-reducing factor among CFS and ulcerative colitis patients, and of two inflammation-reducing factors among psoriasis patients. This suggests probiotics can alter immune response and help prevent or treat these conditions. All four studies were presented November 1, 2011 in Washington DC at 76th annual scientific meeting of the American College of Gastroenterology. None has yet been published or posted online.

Yoga Improves Function in Chronic Back Pain Sufferers

A study has concluded that, although a 12-week yoga program has only a mild effect on back pain itself, it significantly improves back mobility and function, compared to conventional medical treatments, among patients who had reported chronic or recurrent pain in the lower back. (Back function is defined as the measured abilities to undertake activities without being limited by back pain. These activities include walking quickly, getting dressed and standing for long periods of time.) Back pain and general health were similar in the yoga and control groups when measured at 3, 6, and 12 months. However, the yoga group showed better mobility and back function at each of these intervals. Surprisingly, despite the improvements observed at the end of the 3-month yoga program, back function continued to improve even as long as 9 months after patients had switched over to at-home sessions. Strongly confirming previous research, this is the largest study on yoga and back pain ever conducted in the UK. This study was published in the November 1, 2011 issue of the Annals of Internal Medicine. Details are available online now at http://bit.ly/ufYGPF without any cost or requirement to subscribe.

First Human Trial: Resveratrol Improves Metabolic Health

The first-ever human trial of effects of resveratrol on obese volunteers has found that 150 mg of 99-percent-purified supplements of this polyphenolic chemical - found in red wine, peanuts, supplements, and other sources - improve energy metabolism, inflammation, and metabolic profile, which are risk factors for age-related diseases including metabolic syndrome, diabetes type 2, and cancer. (Previously, the only known non-drug intervention known to lower the risks of developing age-related and obesity-related diseases has been substantial calorie restriction, or CR. Resveratrol was shown in lab cells and in animals to provide metabolic effects similar to CR, but this is the first human clinical trial systematically studying the effects of resveratrol on human metabolism.) Resveratrol daily for 30 days produced numerous CR-mimicking metabolic benefits including improved mitochondrial function, energy metabolism, liver fat content, sleep metabolic rate, blood pressure, and blood glucose levels. The scientists concluded resveratrol works by altering gene expression within the mitochondria. This lowers mitochondrial energy generation, producing anti-aging benefits, and helps prevent cardiovascular disease, metabolic syndrome and diabetes. This study was published in the November, 2011 issue of Cell Metabolism; it is now available online at http://bit.ly/vlcWqL without subscription or cost.

Saffron Component Found Effective Against Multiple Sclerosis

Scientists have found that a substance known as crocin, found in the Persian spice saffron, prevents damage within the brain, to cells that make myelin, the material that protects brain cells from the deterioration that underlies inflammation of brain cells, the underlying cause of multiple sclerosis (MS) and other neuroinflammatory diseases. (Myelin is the insulation that normally surrounds neurons in the brain; without myelin, neurons become inflamed and this, combined with a particular type of cell stress that is more prominent in some people, results in MS.) Although this finding holds promise for a new future treatment for MS, the researchers are still a long way from the clinical trials required to refine a specific treatment. Will saffron help MS patients now? The study team did not speculate, but this spice has been found to have other health benefits, and may help prevent further progression of MS. This study was published in the November, 2011 issue of the Journal of Immunology. It is now accessible online at http://bit.ly/siL3Pa with a subscription or payment of an article access fee.

Diabetes Causes Memory Loss and Other Cognitive Problems

A study has found that diabetes can cause the atrophy of brain tissue, which then leads to memory loss, depression, and various cognitive problems. (Diabetes develops when glucose builds up in the blood instead of entering the body's cells to be used as energy. Many complications of diabetes are well-recognized, such as kidney disease, foot problems, and cardiovascular risks. But the effect of diabetes on the brain has been overlooked. Cognitive decline can affect the ability to successfully complete even the simplest of everyday tasks, such as walking, talking or writing.) In older patients with diabetes, the researchers found that two adhesion molecules (sVCAM and sICAM) cause inflammation in the brain, triggering a series of events that affect blood vessels and, eventually, cause brain tissue to atrophy. The gray matter in the frontal and temporal regions of the brain is the area most damaged by this diabetes-caused atrophy. This area is responsible for such critical functions as decision-making, language, verbal memory and complex tasks. This study was published in the November 2011 issue of the journal Diabetes Care. It is now available online at http://bit.ly/uwuteR with subscription or access fee.

Nuts Boost Serotonin in Those With Metabolic Syndrome

A study has found that, for people with metabolic syndrome, just one ounce of raw nuts per day results in higher levels of serotonin, a substance that helps transmit nerve signals and lowers negative outlook, and hunger feelings. (Nuts are high in unsaturated fatty acids and polyphenols. Metabolic syndrome is a set of risk factors that includes excess abdominal fat, high blood sugar and high blood pressure, all of which increase the risk of developing type 2 diabetes and heart disease.) Test volunteers included nuts in their diet for 12 weeks, while the placebo group avoided nuts. Only one ounce a day was consumed, and included raw unpeeled walnuts, hazel nuts, and almonds. Researchers were surprised nut consumption increased serotonin, a chemical that helps to offset depression. Serotonin is also linked to a lower risk of cardiovascular disease, a specific risk for those with metabolic syndrome. Nut consumption also reduced substances in the body associate with inflammation and cardiovascular risk. The study was published in the current issue of the Journal of Proteome Research, and is now available online at http://bit.ly/uBR8L9 with subscription or fee. 

Acetyl-L-Carnitine May Treat, Reverse Spinal Cord Injury

A study has found that the supplement acetyl-L-carnitine (ALC) can protect neuron cells and assist overwhelmed mitochondria, preventing them from shutting down, which in turn can halt the normal death of neuron cells following a spinal cord injury. (ALC is a derivative of essential amino acids that can generate metabolic energy. Mitochondria are the energy-generating components inside cells. During spinal cord injury, local mitochondria are overwhelmed by chemical stresses and lose their normal ability to produce energy, leading to cell death, which causes paralysis.) Administration of ALC shortly after spinal injury was found to supply alternative energy for cells, bypassing the reduced supply from mitochondria and protecting neuron cells from death. Protecting cells from death allowed treated subjects to fully recover from paralysis and walk normally within a month. This research was conducted on mice, but there could be huge implications for future treatment, and even reversal, of recent spinal cord paralysis in humans. (ALC can be given orally and high doses are well tolerated.) We reported this study September 30, 2011, but it was finally presented officially November 13, 2011 in Washington, DC, at the meeting of the Society for Neuroscience. It has yet to be published or posted.

Pomegranate Juice Lowers Hypertension in Kidney Disease Patients

A study conducted on kidney dialysis patients has found that drinking 100cc of pomegranate juice three times a week for one year reduced blood pressure readings, triglycerides, HDL (bad) cholesterol, total cholesterol, and the amount of dangerous plaque in arteries. (Pomegranate juice is rich in polyphenols, chemicals that are plant-based antioxidants. Arterial plaque is a factor in hardening of the arteries, and high HDL levels are a risk factor for cardiovascular disease.) The study included 101 kidney patients. In addition to a reduction in blood pressure readings for most patients, and other improvements, most patients in the pomegranate group (vs. the placebo group) decreased their blood pressure medications during the year of study. All improvements were classed as significant. The Israeli study received no support from the fruit or juice industry. This study was presented November 11, 2011 in Philadelphia at the Annual Kidney Week meeting of the American Society of Nephrology. It has not yet been published or posted online.

Sugary Drinks Raise Heart Disease Risk - Even Without Weight Gain

Researchers have found that, compared to women who drink one or fewer sugar-sweetened beverages a day, women consuming two or more sugar-sweetened beverages per day are significantly more likely to develop impaired fasting glucose levels (a risk factor for diabetes), as well as higher triglycerides and increased waist sizes (both risk factors for cardiovascular diseases, including stroke) - even if they did not gain weight. The association was found among women of various ethnicities, aged 45 to 84, but was not found among men. (It has been assumed generally that those who consume sugar-sweetened drinks have an increased cardiovascular and diabetes risk because they gain weight from the calories in the sugar; although this does occur, this study establishes that, at least among women, there is some direct link between sugar-sweetened beverages and these risk factors, as well as waist size, even in the absence of weight gain. The research included carbonated beverages and flavored water, and did not determine how this effect is caused. Presented November 13, 2011 in Orlando at the Scientific Sessions of the American Heart Association, this study is not yet available online or in the association journal, Circulation.

Low Vitamin C Levels Raise Risk for Heart Failure Patients

A study has concluded that, compared to heart failure patients with the highest levels of vitamin C, those patients with the lowest levels show a 2.4 times greater risk of having high levels of high-sensitivity C-reactive protein, or hsCRP, a marker for both inflammation and the risk of heart disease. This is the first study to specifically link low vitamin C levels with worse outcomes for heart failure patients. The study team suggested that low vitamin C may worsen heart failure outcomes for these patients by means of increased levels of inflammation, which is a factor in heart disease. Also, a substantial portion of the patients showed low vitamin C levels, and this may have been related to the regular use by these patients of diuretic drugs, which carry water (and water-soluble vitamin C) from the body. Presented November 13, 2011 in Orlando at the Scientific Sessions of the American Heart Association, this study is not yet available online or in print in the association journal, Circulation.

Milk Thistle Blocks Signal That Can Trigger Colorectal Cancer

Researchers have found that silibinin, a compound in milk thistle, has the ability to stop a long and complicated chain of cellular signals, which is usually triggered initially by the body following detection of wounded cells, and which may result ultimately in the development of colorectal cancer tumors. Molecular billboards often signal that tissue cells have been damaged and this sets in motion a chain of signals within the body cells that leads to the production of enzymes involved in an inflammatory response. The inflammatory mechanism can sometimes result in colorectal cells becoming cancerous. Drugs are marketed to block this series of cellular signaling, but when scientists tested these medications against silibinin, they found that the milk thistle compound, which was equally effective, also blocked the migration of existing cancer cells. This study, conducted in the lab using lung cells from mice, was released November 15, 2011 but will not be published until a future issue of Molecular Carcinogenesis. It is now available online at http://bit.ly/ty2BqY with journal subscription or payment of the access fee.

Mediterranean Diet Cuts Risk of Diabetes and Heart Disease

A study has confirmed previous research, by suggesting that swapping out some bread and pasta choices for unsaturated fat from olive, oils, and nuts, choices typical of the Mediterranean diet, improves insulin use in the body, cutting the risk of both diabetes and heart disease. (People whose bodies do not effectively utilize insulin often go on to develop diabetes type 2, which is a risk factor for cardiovascular disease.) The diet that was high in unsaturated fats was favorably compared to a diet high in protein, and another diet high in carbohydrates. Similar studies have included weight loss from similar dietary changes, but scientists conducting this study took steps to ensure that the weights of study participants remained at their starting levels, so that the health improvement could be pegged to diet choices alone. At the start of the study, all subjects had mildly elevated blood pressure, but they did not have diabetes. This study was presented November 16, 2011 in Orlando at the Scientific Sessions meeting of the American Heart Association. It has not yet been published, or posted online.

Bisphenol A Spikes After Eating Canned Soup

After just five days of eating a 12-ounce serving of canned soup per day, subjects were found to have urine levels of bisphenol A (BPA) that were 1200 percent higher than the BPA levels in the urine of subjects who ate fresh soup during the same period. (BPA is an endocrine disruptor shown to interfere with reproductive development in animal studies at sufficiently high levels, although it remains uncertain if the same effects cross over to humans. BPA leaches from some types of plastics, paper cash register receipts, dental fillings, and the plastic lining of cans.) Because urine is the usual route through which the body gets rid of BPA, the study of urine levels did not determine how long the BPA actually continued to remain in the body, or at what levels; it is possible that the body flushes all BPA out of the system. Although not conclusive, previous research linked BPA to cardiovascular disease, diabetes, and obesity. This study was published in the November 23, 2011 issue of the Journal of the American Medical Association. It is available online now at http://bit.ly/sM5cWb with subscription to the journal or fee payment.

Fish Consumption Lowers Risk of Alzheimer's Disease

A study has found that people eating baked or boiled fish at least once a week have better preservation of grey brain matter in areas related to Alzheimer's disease, which in turn causes a five-fold lower the risk of developing both mild cognitive impairment (MCI), and Alzheimer's disease. (Alzheimer's disease is an incurable, progressive brain disease that slowly destroys memory and cognitive skills, afflicting about 5.1 million Americans. In MCI, memory loss is present but to a lesser extent than in Alzheimer's disease. People with MCI often go on to develop Alzheimer's disease.) The scientists discovered that once-weekly consumption of boiled or baked fish resulted in healthier, stronger, and larger neurons (brain nerve cells) in the gray matter portion of the brain, which substantially reduces the risk of these memory-affecting diseases, and improves cognition. However, the researchers found no cognitive improvement or reduced risk of disease with consumption of fried fish. This study was presented in Chicago on November 30, 2011 at the annual meeting of the Radiological Society of North America. It has not yet published or posted online.

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