Monthly Archives: October 2012

Brain Fog From Carbs

Brain Fog From Carbs

Roberts et al, Mayo Clinic Proceedings, Oct 16th  2012

This is a great study.  Dr Roberts followed 940 people, ages 70 to 89, who were healthy and had no signs of cognitive impairment.  They were tracked for four years of follow-up and then reevaluated.  200 of the 940 had developed “mild cognitive impairment” (MCI) meaning trouble with memory, language, thinking and judgment that were greater than their norms. Those who had the highest carb intake were 1.9 times as likely to develop MCI compared to the whole group. But those with the highest fat we 42% less likely to get MCI and those with the highest protein were 21% less likely.   When you combine the two effects, and compare the folks with the highest carbohydrate intake to the folks with the highest fat and protein, the high carb folks end up having 3.6 times the risk of developing MCI.

Did you get that?  Within four years, elderly folks who eat the most carbs will have a four fold risk of developing dementia if they eat more carbs than if they eat more protein and fat.  We can’t tell the exact details of what those carbs meant, but considering these were at the Mayo Clinic, were likely Midwestern type food.  Bread, boxed cereal, bagels, pancakes, donuts, potatoes, rice are what we eat in the Midwest.  We have sandwiches, toast and lots of sugar.  What this diet suggests is that the so-called “Paleolithic diet” is much better for you.  Our brains would rather that we get our carbs from whole vegetables, and not high glycemic sources like grains or potatoes.   Vegetables are, in fact, usually quite high in protein.  Our carbs should look like broccoli, spinach, squash, green beans and peas.   Your liver can make glucose from protein.  It just takes longer and uses a fair amount of energy to do so.  Our brains need glucose to function well too.

The researchers in this study were cautious not to criticize pure carb sources too stridently, suggesting that we should aim for balance.  Our first food pyramid had advocated for a low fat diet, which resulted in higher carbs.   It appears we are now getting back to the recognition of the damage caused by that strategy.  Fat is not our enemy per se.  Trans fats and saturated fats are problematic but our brains and our whole metabolisms yearn for more omega fats.

What goes unsaid in this study is that damage was found in just 4 years in elderly.  What happens to the rest of us?  Are carbs any better for us when we are younger?  Are our brains taking a hit when we are younger?   Is this why there are those who call Alzheimer’s Type III diabetes?   What happens over 5 years, or 20, or 40?  I believe this study sheds light on all those questions.  We need to avoid white carbs at all stages in life.  It’s your brains at risk.

WWW. What Will Work for me.  This is a very important study, as much by what goes unsaid.  I believe it should put a serious dent in our enthusiasm for eating high carbohydrate containing foods.  The glycemic index is a pretty good measure of what causes trouble.  A glycemic index over 55 typically starts inducing insulin production, and white carbs are all in the 60-90 range.  I’m trying to eat more and more vegetables.  We bought acorn, spaghetti and butternut squashes at the farmer’s market this Saturday.  And less bread.

Written by John E Whitcomb, MD   Brookfield Longevity and Healthy Living Clinic 17585 W North Ave, Suite 160,  Brookfield, WI 53045  262-784-5300

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Melatonin May Help Prevent Breast Cancer

Melatonin May Help Prevent Breast Cancer

Reference:  Breast Cancer Res Treat, Knower et al

Melatonin is your sleep hormone.  You make it in your pineal gland when it gets dark.  As you get older, you gradually make less.  It works as a sleeping pill, although not as well as we would like because it is so short acting.  But it carries another rap.  That it, it is our bodies strongest and most potent natural anti – cancer drug.   It penetrates all body compartments and protects us from cancer.  Part of why we get more cancer as we age is that we naturally make less melatonin as we edge past 50.   What’s the mechanism?

This study shows us.  Kevin Knower conducted the in vitro study and found melatonin treatment suppressed transcription of the gene that encodes the key enzyme aromatase.  Aromatase is the enzyme that converts testosterone into estrogen.  Estrogen is, by its nature, a proliferative hormone.  Reducing it’s presence reduces proliferation, the core issue with cancer.   That should slow down cancer.  Recent research has also showed that the metabolites of melatonin are also cancer blockers.

This study took breast fibroblast cells from women having breast reduction surgery as well as breast cancer associated fibroblasts from three women with estrogen positive receptor breast cancer.  And they found that those cells were suppressed in their production of aromatase by melatonin in doses that are easily achieved with a supplement, and in fact even naturally when you make it properly.

To quote the scientific language, “Melatonin at physiological doses could significantly attenuated stimulation of Stimulation of CYP19A1 PII-mRNA and aromatase activity by prostaglandin E2 (PGE2).”

This isn’t the first study that links melatonin to reduced risk of cancer or death from cancer.   A meta-analysis released in 2005 showed that melatonin supplementation in patients with solid tumors reduced death from all solid tumors by 34%.   That was all solid tumors.  Estrogen receptors aren’t in breast cancer.  Estrogen is a proliferative hormone.  All solid tumors use it to help them spread.

You make melatonin when it gets dark and you are young.  As we age, we make less.  It’s our sleepy hormone.  It’s naturally there.  Getting older means less melatonin, and by this study, less protection from cancer.

WWW. What will work for me.  As I get older, I make less melatonin.  Hmm.  Sounds like I need to take it at bedtime, whether I’m having trouble falling asleep or not.  I would suggest a trip to your local drug store and buy 3 mg.  You may feel groggy for a day or two but stick with it.  Some folks can’t stand 3 mg but do fine with 1 mg.  The only way to know for sure if to be tested for your level, which requires a spit test in the middle of the night.   But there is no downside from taking it.  Hence, take it.

Sleep and Weight Gain – Are you Getting Enough?

Sleep and Weight Gain – Are you Getting Enough?

Reference:  Annals of Internal Medicine, Monday, Oct 15 2012,  Broussard et al

Can’t lose weight and just don’t know why?  Consider your sleep and how much of it you are getting.  This important study builds on other similar studies in that journal.  The study found some very interesting things.  What they did was take seven 23 year old adults and have them sleep for four nights for either 4.5 or 8.5 hours with controlled exercise and calorie intake.   At the end of those four days, they nabbed a tiny sample of fat to study.  What they found was huge!    In just four days of sleep deprivation, they showed a 30% increases in insulin resistance.

Consider the epidemiology of sleep.  Twenty percent of Americans claim they only need 5 hours or less.  At least that is all they are getting.

And that’s the story.  Insulin resistance means you start doing goofy things with your metabolism.  Your insulin is meant to drive glucose into fat cells for storage.  But when you are insulin resistant, you have to have a higher insulin level, just to get the same response.  Fat cells can’t easily do two things at the same time. They can’t give up fat at the same time they are taking in sugar.  The switch is either on or off.  Sort of like a light switch.  If you are insulin resistant, you insulin is higher all the time, which means you are in storage mode.  The only way to get the calories you need to feel good is to eat them.  So, you eat a little more.   Voila, weight gain.  But note the details (where the devil always resides).  You ate more because your cells couldn’t get energy and were starving, even though you had calories for burning right there in the fat cells.  You just can’t release them because of your  abnormally high level of insulin.

This is another nail in the coffin of the simplistic “calories in, calories out” theory of weight gain and weight loss.   Of course the laws of thermodynamics are real.   And of course, at the end of the day, how much you eat matters.  But the nuance is the whole story of success or failure underneath.  We now know for certain that the type of food you eat has a dramatic effect on insulin levels.  High protein, low carb diets double your ability to lose weight over other diets.   We also know timing matters.   A low glycemic breakfast sets your tone for the whole day.  Boxed cereal is almost always high glycemic.   We also know you have to have hormones playing in harmonic symphony, with all your hormones in physiological balance.  And then there is sleep.  Who knew!  A good, healthy, 8 hours of sleep just plain sets your insulin receptors to act in a proper fashion.  Then, your fat cells open up and share some of those precious calories that you need to feel good, energetic and “top of the morning”.

WWW.  What will work for me.  When I’m on vacation and really relaxed, bored even with the slowdown of my hyper-frenetic pace, and I’m stuck in bed, unable to get up, I cheerfully sleep 8 hours and feel great.  But the excuse of saying, “I’m wide awake here at 530 am, might as well get up” may not be serving me well.

Is there Something Fishy about Fish Oil?

Is there Something Fishy about Fish Oil?

Reference:  Sang Me Kwak in Archives of Internal Medicine

Is fish oil really not that good for you?  From Korea, Dr Kwak and his team looked at 14 studies with over 20,000 total patients to come up with the suggestion that there may be no extra benefit to taking fish oil as a supplement for those who have had a heart attack.  This has been a bit of a bombshell with lots of folks calling about whether they should take their fish oil.  This question certainly made the news, as all news channels carried it and many have heard the question.

What is interesting is that no one has reported on the editorial that accompanied the article.  Frank Hu, from Harvard and one of America’s leading omega – fat and diet experts noted in the editorial that two large studies were excluded from the meta-analysis that would have tilted the data to show support and a positive effect.  It doesn’t make headlines to show that someone did sloppy research.  It sure makes headlines to publish the controversy.  You sell advertising copy.  Hu also noted that 97% of the people in the studies involved were also taking a statin, with their known anti-inflammatory effect.  That means this report is a mashing of data that doesn’t apply to most of us who aren’t taking a statin and haven’t had a heart attack.  Give me 1007 studies and I can find 14 in that group that will say almost anything.

But this report lays out a bigger problem with nutritional research.  To apply the concept of a randomized, placebo controlled trial to lifestyle issues requires large studies that go for very long times.  That’s hugely expensive.  And then you have hundreds of confounding variables.  Heart disease does not start at 45.  It starts with the first trip to fast food and sugar at age one.  To reverse it, once it is mature, is a very demanding threshold.  The goal of prevention and modulation of risk factors with lifestyle changes requires a very long time horizon.  The Harvard Nurses Study, run by Frank Hu, shows omega fats to be hugely helpful.  And lifestyle changes beat any pharmaceutical intervention cold – including fish oil.

WWW.  What will work for me.  I’m annoyed this study was even published.  It’s such a badly done piece of work.  That the editors let it through, even with Frank Hu’s clear editorial critique suggests they are looking for controversy instead of truth.  Anyone can write anything.  I’m sticking with my fish oil, thank you for much.  And you should too.  (Actually, we should all be sticking with our grass raised meat for those of us who eat meat.  Then you wouldn’t need the fish oil as much.)

Written by John E Whitcomb, MD  Brookfield Longevity and Healthy Living Clinic, 17585 W North Ave, Suite 160   Brookfield, WI 53045   262-784-5300


Arsenic in Your Rice

Arsenic in Your Rice

Reference: Consumer Reports Nov 2012

Arsenic has become the number one heavy metal poisoning in America.  We have curious just where that arsenic is coming from.  How could our mouths be full of mercury in our fillings, and arsenic still edge out mercury as the most common heavy metal poisoning?  Arsenic is a nasty poison.  It is associated with a bunch of cancers like lung, skin and bladder.  But it is also can cause tingling and burning in the arms and legs, trouble with hearing, heart disease thickening of the skin, liver trouble and on and on.   In Bangladesh, shallow wells drilled to get clean water have led to a horrific arsenic poisoning epidemic that has contributed to 20% of the deaths in that country.   WHO says its safe if you get below 10 micrograms per liter, and Bangladesh had many places with much higher levels.

But just what did Consumer Reports find in America?  Rice for our rice region (Arkansas, Texas) has arsenic in it.  Arsenic is feed to hogs and chickens as one method of speeding up growth.  Their manure is full of arsenic.  The manure gets spread on fields.  And there you have it!  That arsenic finds its way into our food supply with even the most iconic of rice products having arsenic in it.  The table Consumer Reports presents is pretty sobering.   If you consider 10 being the upper limit you should have, (New Jersey puts it at 5) the table shows that many of our rice products in our food supply have 3-8 ppb.   If you eat those products regularly, you get more arsenic.   It appears that whole grains brown rice is the worst as the arsenic concentrates in the brown fiber coating of the grain.   With no regulations on government standards on arsenic in animals feeds, fertilizer, or rice, you end up getting the short end of it.  This is a touchy time to raise the idea of regulations.

Of course, you won’t die from a single serving.   The argument that “our food is safe” is based on the premise that you can easily eat one serving and have no visible or detectable limits today.  But that argument falls pretty short when you think about how long you had planned to hang around.  I’m interested in not getting cancer 20 years from now.  And when I buy a box of rice cereal, I usually finish it.  When I buy a bag of brown rice, I usually eat it all.   Each of us have a set of favorite foods, and we buy that food regularly.  If that food is laced with arsenic, and you eat it regularly, it stands to reason that you might not be well served.

WWW.  What will work for me?  I’m not eating any rice products for the foreseeable future.  I measured my heavy metal burden on myself a few months ago and found myself to have more lead than arsenic, but my arsenic level was in the slightly “yellow” zone of cautious exposure.   I had gotten rid of all the treated lumber on our property, including our picnic table as one step of cleaning my home, but I never thought my rice supply would be dirty.  If I want rice, I’ll go the Indian store and buy Basmati.  Tests have shown that to be much cleaner.  And I’ll pay attention to this story.