Perlmutter Health Center

A Quarterly Health Update • Winter 1999 • Vol. 4 No. 1

David Perlmutter, MD, FACN

Quotations

"Everything great that we know has come to us from neurotics. They alone have founded our religions and created our masterpieces. Never will the world be aware of how much it owes to them, nor above all what they have suffered in order to bestow their gifts on it."
Marcel Proust, Remembrance of Things Past: Juermantes Way

"There are some remedies worse than the disease."
Publilius Syrus, Moral Sayings

"There never was yet philosopher that could endure the toothache patiently."
Shakespeare, Much Ado About Nothing, V, i.

"Look into the depths of your own soul and learn first to know yourself, then you will understand why this illness was bound to come upon you and perhaps you will thenceforth avoid falling ill."
Sigmund Freud, One of the Difficulties of Psychoanalysis

"The patient must combat the disease along with the physician."
Hippocrates, Aphorisms

"Natural forces within us are the true healers of disease."
Hippocrates, Aphorisms

"The time to repair the roof is when the sun is shining."
John F. Kennedy, State of the Union Address 1962

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Alarming Trends in Cigarette Smoking

Despite the fact that cigarette smoking is now recognized as the leading preventable cause of morbidity and mortality in the United States, we are now observing an alarming increase in the incidence of cigarette smoking among college students. A landmark study conducted at the Department of Health and Social Behavior, Harvard School of Public Health in conjunction with the Tobacco Research and Treatment Center, Division of General Medicine at Harvard Medical School, published in the November 18, 1998 issue of the Journal of the American Medical Association, revealed an astounding 27.8% rise in incidence of cigarette smoking among college students between the years 1993 and 1997. Further, the authors call to our attention the sobering fact that cigarette smoking among high school students increased about 32% between the years 1991 and 1997. These statistics indicate that we will likely see a reversal of a decline in smoking prevalence among adults that has been the trend since 1965.

Cigarette smoking accounts for more than 400,000 deaths in the United States per year. And, whereas some may argue about the relationship between certain lifestyle choices such as diet and exercise, and such disease entities as cardiovascular disease, the data supporting cigarette smoking as a direct cause of death are scientifically sound (despite the pathetic efforts of the tobacco lobbyists).

But should we be surprised that adolescents and college students now feel more compelled than ever to expose themselves to a drug which has an annual death rate 100 times greater than that of cocaine? Not hardly. Despite new sanctions placed upon the tobacco industry, advertisements continue to proliferate, glamorizing tobacco use – making it appear sexy and mature.

But the allure of tobacco may operate on an even deeper level than simply a behavioral response to advertising. It has long been known that adolescent cigarette smoking has increased among children whose mothers smoke. While it had been concluded that this behavior simply represented an example of a child modeling a parental figure, new research indicates that adolescent cigarette smoking may actually involve learning of specific flavors during infancy. A fascinating report entitled, "Smoking and the Flavor of Breast Milk," appearing in the November 19, 1998 issue of the New England Journal of Medicine, revealed that breast milk from cigarette smoking women could easily be identified when compared to breast milk from non-smoking women by its distinctive "cigarette smell." Further, the report demonstrated very high levels of nicotine in breast milk within thirty minutes of cigarette smoking which persisted for the next three hours.

As the authors stated, "These findings raise the possibility that in addition to the effects of nicotine on the developing brain, early experiences with the flavor of tobacco in breast milk (and perhaps even in amniotic fluid) pinpoints the likelihood that exposed children will find these flavors appealing later in life. We do not suggest that lactating women who smoke occasionally should stop nursing, however, the knowledge that the milk of mothers who smoke smelled and may taste like cigarettes, provides an additional reason to avoid smoking."

Over the past decade, a large number of research publications have appeared indicating a profound increased risk of respiratory diseases in children as a consequence of exposure to second hand smoke. Now it is clear that the various activities of adults including cigarette smoking while breast feeding and complacency regarding cigarette advertising can lead to the most deadly respiratory disease of all - tobacco addiction.

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Dogs and Drugs

The past decade has seen an explosive growth in the pharmaceutical industry not only in the drugs used to treat common diseases like hypertension and diabetes, but also highly specialized drugs designed for rarer clinical problems. Typically, when specialized drugs are developed for "niche markets," their prices are grossly inflated, thus ensuring profitability.

But now it looks as if the major pharmaceutical companies have expanded their "market potential" even further. On January 5, 1999, the Food and Drug Administration approved Clomicalm®, to treat separation anxiety in dogs. Pfizer's Anipryl® was approved for "canine cognitive dysfunction syndrome."

How wonderful and simple our lives will soon be now that we can medicate Fido who tends to cry when we leave him at home for the afternoon, or dumb old Muffy who never could figure out how to fetch and thus clearly satisfies the diagnostic criteria for canine cognitive dysfunction syndrome.

Where will it all end? In the past three years the number of children using drugs such as Prozac®, Paxil®, or Serzone® has doubled in the United States. In many elementary schools as many as 20 to 25% of the students are on Ritalin® or other psychoactive drug for Attention Deficit Disorder. Years ago we were told our plants would thrive if we talked to them. Perhaps the pharmaceutical industry is developing a drug to alleviate that burden as well.

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Alzheimer's Disease and Electromagnetic Fields

In these days of cellular phones and personal computers, the general public seems to be at least marginally concerned about the possible health risks of electromagnetic exposure as evidenced by articles appearing not only in alternative medical publications, but mainstream journals as well.

Research has described the possible link between usage of hand-held cellular telephones and brain malignancies, and certainly many unanswered questions abound concerning the possible risks of using this device. Several studies have pointed to an increased risk of childhood leukemia in children exposed to increased levels of electromagnetic energy as a consequence of living in close proximity to high voltage wires.

In 1995, out attention was drawn to the possible link between electromagnetic radiation and Alzheimer's disease in a study published in the American Journal of Epidemiology by researchers at the University of Southern California School of Medicine. In a more recent report, these researchers have confirmed a direct relationship between occupations exposing individuals to higher levels of electromagnetic radiation and the risk of developing Alzheimer's disease. Their report, published in the December, 1996 issue of Neurology, reveled a substantial increased risk of developing Alzheimer's disease in individuals whose occupations exposed them to higher than average levels of electromagnetic radiation. The occupations determined to be "high risk" with respect to exposure included electrician, machinist, machine operator, seamstress, sewing factory worker, sheet metal worker, typist, keypunch operator, welder, machine shop worker, and several others. The risk of developing Alzheimer's disease in these individuals was calculated to be as much as four times higher than the general population.

The specific mechanism by which individuals exposed to higher levels of electromagnetic radiation experience an increased risk of developing Alzheimer's disease is unclear. Several authors have described increasing amounts of beta amyloid, a brain chemical known to be prevalent in the brains of individuals suffering from Alzheimer's disease. How electromagnetic radiation leads to increased amyloid formation is unclear.

An important consideration with respect to reviewing this study is the fact that the individuals evaluated were at least 65 years of age at the time of their first examination. Thus, when reviewing their previous occupation, their vocations were activities they had engaged in beginning up to 40 years prior to their evaluation and diagnosis of Alzheimer's disease. The importance of this observation is simply that individuals operating computers, using hand-held cellular telephones, and in general exposed to the ever increasing amounts of electromagnetic radiation that characterizes modern society, will likely be at an equal or even increased risk for developing Alzheimer's disease, even without being involved in a so-called "high risk" occupation.

Frequently, perhaps because influences like electromagnetic radiation and toxic elements in the environment cannot be seen or perceived, there is reluctance by mainstream medicine to recognize potential health risks associated with these factors. Typically, when these topics are raised, a common response by defenders of the status quo seems to be, "There is no peer review literature supporting these outlandish claims." But in reality, that is simply not the case. The journal in which this research was published is perhaps the most well respected peer reviewed journal dealing with neurologic disease on the planet. Somehow it seems that articles dealing with environmental influences on disease, much like research dealing with the impact of nutrition on health, are generally overlooked in favor of concentrating on pharmaceutical approaches to treating our ever increasing variety of ailments.

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Book Review

Eat Right For Your Type by Dr. Peter J. D'Adamo with Catherine Whitney
ISBN 0-399-14255-X. Published by G. P. Putnam's Sons, New York, 1996.

These days, health food stores and book stores seem to be overwhelmed by an abundance of books attempting to popularize particular diet plans providing readers with the hope of restoring themselves to excellent health. Among the most popular diets are those which advocate a more vegetarian approach to eating. Still, there are others which advocate high protein with low carbohydrate consumption, and these have become in fact quite popular in that a certain segment of the population will notice an improvement in their sense of well-being while maintaining a diet which at first glance may seem unhealthful.

But rather than try to define a diet that is best for everyone, Dr. Peter D'Adamo in Eat Right For Your Type attempts to define very specific diets for individuals based on a very specific characteristic – blood type.

The first sections of the book review the evolution of blood types and correlates blood types O, A, B, and AB with the specific dietary habits of our ancestors when these blood types began to appear.

Next, Dr. D'Adamo explains that lectins, which are unique proteins found on specific foods, have the ability to agglutinate blood in individuals having specific sensitivities to them. These sensitivities, proposes Dr. D'Adamo, are determined by one's blood type, thus allowing identification of those specific foods to which one may be sensitive.

What follows are specific dietary recommendations based upon blood type. Hence, those individuals with blood type O should eat a high protein, low carbohydrate diet and in fact should consume generous amounts of animal protein. They are instructed to eliminate wheat and various other grains, virtually eliminate dairy products, and engage in vigorous aerobic exercise. Dr. D'Adamo points out that these individuals are also at increased risk for inflammatory diseases, especially if they stray from the appropriate diet. Blood type A individuals should be essentially vegetarian and emphasize a high carbohydrate, low fat diet. When type A's consume meat it is poorly digested and stored as fat. Dairy products should also be avoided by this group, but soy foods are emphasized. Vegetables make up an important part of their diet, and exercise should be gentle, such as yoga or golf. People with type B blood are best served by a varied diet including meat, low fat dairy products, eggs, and green vegetables. They should avoid corn, lentils, and wheat and engage in moderate exercise such as swimming or walking. Finally, those with AB blood are instructed to avoid red meat, seeds, corn, and wheat, while favoring tofu, seafood, dairy products, and green vegetables. These individuals are instructed to engage in calming exercises and relaxation techniques.

The diet proposed in Eat Right For Your Type is predicated on the contention that blood type directly relates to our ability to absorb nutrients and our reactions to various foods. While this contention has not received unanimous support in the scientific community, the author's attempt to draw this correlation is certainly compelling and worth reading.

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Weed Killers, Pesticides, and Cancer

It is likely that most people generally assume that the various products they purchase at their local garden store have been extensively tested to rule out any possibility that they may be related to cancer. Unfortunately, we are now learning that many of the most widely used pesticides and weed killers are actually fraught with danger as more evidence supports their relationship to amyotrophic lateral sclerosis, Parkinson's disease, and various forms of cancer.

A very distressing report appeared in the journal Cancer in 1999 (Volume 85, page 1353), from the Orebro Medical Center and Lund University Hospital in Sweden. This population-based case controlled study evaluated the risk of exposure to certain herbicides and fungicides with reference to various forms of cancer. Their very distressing discovery was that risk of non-Hodgkin lymphoma was 2.7 times greater in individuals exposed to a very commonly used weed killer, 4-chloro-2-methyl phenoxyacetic acid (MCPA). The authors reported significant concern since MCPA "is still much in use in agriculture as a weed killer."

In America, we vigorously use weed killers not just in agriculture, but around our homes, schools, and many other public areas. The media portrays killing weeds as almost a pleasant way to spend Saturday afternoon. We simply pay a short visit to the hardware store, buy a spray bottle of weed killer, and quickly go to work ridding our driveways and flower gardens of unsightly weeds.

This report, however, should make us question our laid back attitude towards exposure to such profoundly dangerous chemicals, and perhaps cause us to look less disfavorably upon the innocent weeds growing in the cracks of our sidewalks.

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Gallstone Prevention

It has been estimated that in the United States gallstones exist in about 20% of women and 8% of men over the age of 40 years. Typically, gallstones may remain unnoticed throughout an individual's lifetime. Occasionally, however, these stones may obstruct the outflow of bile from the gallbladder leading to severe abdominal pain.

The classic medical teaching with respect to those most likely to get gallstones has been described as the "3 F's," that is fat, female, and fertile. Thus, the highest risk group has been women who have been pregnant, overweight, and in addition, typically eating a diet high in animal products and over the age of 60 years. Thus, most of the medical research being published concerning gallstones has focused primarily on therapy rather than on modifiable risk factors. A recent article appearing in the American Journal of Clinical Nutrition in 1999 (Volume 69, page 120), drew some very significant conclusions concerning factors which could be modified to directly reduce risk of gallstones. The study, performed in Castellana, Italy, evaluated 100 patients who were recently diagnosed as having gallstones and compared their diets to 290 randomly selected patients who were proven by ultrasound evaluation to be free of gallstones. In addition, physical activity for the preceding 12 months prior to the ultrasound examination was also evaluated.

The results of the study demonstrated that the most significant factors related to the risk of developing gallstones were body-mass index (obesity) and intake of refined sugar. In addition, intake of saturated fats was also a direct risk factor and found to be more likely associated in men than in women. Those factors which were inversely related to the risk of developing gallstones included consumption of monounsaturated fats, fiber, and physical activity.

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More on Garlic and Cholesterol

The relationship between elevated serum cholesterol and atherosclerosis is now deeply entrenched in our society. No doubt, most Americans now have a more sophisticated understanding of cholesterol and recognize the importance not only of the level of total cholesterol but also have an understanding of the clinical relevance of LDL (the bad cholesterol), and HDL (the good cholesterol).

A closer inspection of current medical knowledge reveals that it is only when LDL is oxidized (a chemical change which may occur as part of normal metabolism) that it becomes much more important with respect to initiating atherosclerosis and allowing its progression. Thus, preventing oxidation of LDL supports the widespread consumption of various antioxidant vitamins.

At a recent symposium entitled "Garlic As A Supplement" held in Newport Beach, California in November, 1998, Dr. Benjamin Lau, Professor of Microbiology, Immunology, and Surgery at Loma Linda University School of Medicine, presented compelling evidence demonstrating that even short term supplementation of garlic in human subjects had a profound effect with respect to increasing the resistance of LDL cholesterol to oxidation. This finding, coupled with research previously described in The Perlmutter Letter indicating garlic's effectiveness in reducing total cholesterol, adds further support for the inclusion of garlic in an overall program for reducing cardiovascular risk and risk of atherosclerosis.

Aged Garlic Extract (Kyolic Garlic) is the most extensively studied commercially prepared garlic supplement and is the only garlic supplement prescribed at the Perlmutter Health Center.

To learn more about the extensive clinical research supporting the effectiveness of Kyolic Garlic, contact Wakunaga of America at (800) 421-2998.

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