Nutrition

The future's so bright, I gotta wear shades.

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I feel a bit like Janus today. He was the Roman god of transitions; usually depicted with two faces, one looking forward and one looking back, Janus stands at the crossroads of our lives, guiding our passages from where we are to where we shall be. Today, I look back on what, in 2015, becomes two decades of private practice, and where I will be going in the future. So for a moment or two, Janus I shall be. 2014 was a year full of new beginnings for me, both personally and professionally. I’ve made a great many new friends, and enjoyed a renewal of both intellect and spirit. It was also the year I rediscovered my voice, as my writing -- once my career -- has again begun to flourish, not only publishing on my blog, but also at other sites such as the Good Men Project. My book has been resurrected, and is finally making steady progress.

The Center for Alternative Medicine, my practice in Litchfield, also saw an incredible amount of expansion in 2014. I introduced my private line of supplements for general health, assisting people with chronic diseases, and to support mental health issues such as anxiety and depression. This, along with my ability to create custom herbal formulas for patients, has fulfilled a life-long dream of mine; the ability to incorporate my knowledge, not only into the recommendation or use of herbs and nutrition, but in their creation. This is a wonderful capability that will benefit all of my patients, regardless of whether they are seeing me for physical injuries or internal disorders.

I am the only doctor in Connecticut, to my knowledge, that has ability to offer both of these services. It has taken years of education and experience to reach this point, and my heartfelt thanks goes to all of those people who have helped me get here.

Growth occurred internally, as well. Over the course of this past year, I went from having a single employee to three employees. Though most of my patients don’t see anyone except the person at the front desk, behind the scenes I now have people handling the medical billing as well as bookkeeping and accounts receivable. This rapid growth also had me working hard on administrative issues, developing the policies and procedures that never had to exist before.

The front desk is now in the capable hands of Giselle, whose laughter is infectious and whose efficiency is becoming legendary. The steely-eyed Joanne is facing off with the insurance companies, making sure that they live up to the promises they made to you, my patients. And Thanhien, who has managed million-dollar payrolls in her sleep, is making sure that our cash flow runs evenly. I could not ask for more capable hands to assist me.

As if those weren’t changes enough, I have an ambitious program outlined for the next year, with some entirely new services.

In December, I passed the examination to become a federally certified Medical Examiner, and am now one of only a handful of doctors in Connecticut who offer the medical examinations required every two years for everyone who carries a commercial drivers license. I really enjoy doing these exams, as I get to explore with drivers the wide range of health issues that effect them. I have already uncovered a few serious illnesses during the course of my exam, and helped drivers find appropriate care for them.

I also now have a CLIA-certified laboratory on site, and in partnership with a couple of other laboratories, we can now provide a comprehensive suite of employment and forensic testing services.

I now have the ability to provide breath, urine and hair analysis for drugs of abuse, for everything from alcohol to opiates. When these test results are required for evidence in court, I have the ability to provide what is called “chain of custody” handling, which means that the sample is overseen from collection to analysis, virtually eliminating the possibility of intentional or accidental tampering.

I can also provide a full range of relational DNA testing, including gestational paternal testing. This means that, with a couple of blood samples, I can determine the father of a child even before it has been born, with 99% accuracy. I can also perform non-invasive parental DNA tests, as well as testing for multiple siblings.

My DNA testing, like the drug testing, can be done with chain-of-custody handling for the court or other agencies, or even to support immigration and citizenship claims.

The best thing is that I am making all of these services as affordable as possible for the average person.

Anyone who has picked up a paper in the past few years knows that medical services and products are incredibly expensive and have a huge markup. This is, in part, due to the inefficiencies of the medical system, with huge amounts of overhead.

I, on the other hand, have been a sole practitioner for decades. I know how to keep my overhead low, and as a result, I can offer these services more conveniently and at less cost than anyone else.

Ok, so is that the crop? Let me think...private line nutrition, custom herbs, new staff, DOT exams, drug testing, DNA...yep, I think I covered all the bases.

Oh, yes, except for one thing:

I want to thank every single one of you who helped make 2014 the incredible year it was. My patients, my friends new and old, and my family have given me so much for which I am grateful. I can only hope that I have given back in equal measure. I wish for all of you the most wonderful year to come.

Are You Ready for a REAL Detox?

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With 20 years of providing nutritional therapy for patients, I am confident that my 28-day cleanse program is the best system out there in terms of improving your health. While most "detox diets" confuse simple weight loss and "feeling good" with measurable health improvements, I use individualized, objective, quantifiable yardsticks to determine how much we are improving your health, and how to best manage your health concerns over the long-term.

This cleanse is very often the first thing I do with my patients suffering from chronic disorders from allergies to depression.

Beginning Jan 2 through Jan. 9, I will be offering special package pricing for people wanting to begin the road back to health. This will include weekly individual nutritional counseling sessions as well as an educational seminar which you can enjoy at home on your schedule.

Please join me in beginning the new year with the best health you can imagine. Call now to reserve your place in my unique program.

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Avery L. Jenkins, DC, DCBCN, FIAMA Board-certified Clinical Nutrition Board-certified Medical Acupuncture

Of Reps, Wraps and Payola

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female drug rep I've never been one to hide my disdain for the tendency of mainstream medicine to allow financial incentives to color medical research and decision-making. In fact, what the record industry once called "payola" -- and which rocked that industry to its core in the 1950s -- is accepted practice in the medical industry.

As former Editor-in-Chief of the New England Journal of Medicine Marcia Angell has pointed out in her books and elsewhere, medical research has been virtually overrun by checkbook research -- with Big Pharma paying the Big Money to get the results they need.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine,” Angell said.

She's not the only one to have seen first-hand the corruption of medical research. Take, for example, this quote from an abstract of a paper on vaccinations. This article was published by a group called the Cochrane Collaboration, an international collection of scientists who have volunteered to review medical research in the effort to develop evidence-based practice guidelines. And this is what the scientists had to say about the research on the influenza vaccine:

"Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products."

But the real problem of Pharmaceutical Payola occurs much further down the food chain, at the offices of individual doctors. Multiple studies have found that pharmaceutical marketing has dramatic impact on doctor's prescribing habits.  One of the most effective ways of influencing doctors is through providing continuing medical education credits for free through company-sponsored seminars.

I've seen this influence more directly through the eyes of others. I once knew a woman who worked for a specialist group practice; her sole job was to review drug company studies, and advise the practice as to which ones in which they should participate. Her decision algorithm, however, had nothing to do with scientific advancement or patient wellbeing. Rather, her recommendations were entirely based on which studies would prove most lucrative to the practice. Because what the doctor doesn't tell you, dear patient, when he offers you a chance to be cured by this new breakthrough drug that they are testing, is that he is getting paid anywhere from $6,000 to $18,000 for each patient he enrolls -- plus another $20,000 when he hits the 20-patient mark.

Not surprisingly, all of this kind of bothers me. It bothers me mostly because detractors of alternative medicine routinely claim that mainstream medicine is "based on science" and alternative medicine is not. Nothing could be further from the truth.

In fact, the opposite is likely to be more consistent with reality. According to one study, fewer than 20% of mainstream medical procedures are supported by research. Only one-half of medical interventions are therapeutic. And very, very few surgical procedures are subjected to double-blind trials before widespread acceptance.

In contrast, chiropractic care for a variety of musculoskeletal ailments is well documented in the scientific literature. Acupuncture has an exceedingly long trail of research, and nutritional interventions are "alternative" only in the minds of troglodytes.

Whether I am adjusting someone for their headache, using acupuncture to treat a child with Tourette's, or using diet and nutritional supplementation to help a patient eliminate their arthritis pain or control their autoimmune disease, I can in every case point to research supporting my use of those procedures. And, unlike in mainstream medicine, nobody -- but nobody -- makes money from research into nutritional therapy or chiropractic. So it is unlikely to be tainted by money, even if the players in the industry had the finances to do so.

Which, at long last, brings me to the point of this post. (In journalism, this is called "hiding the lead." When I was a newspaper editor, I regularly chastised my reporters for doing this.)

Coupled with my scorn for mainstream medicine for allowing itself to be bought by the highest bidder has always been my admittedly sanctimonious opinion of my own ability to stand above the fray. I have even bragged that the largest gift I have received from any nutritional company was a case of apples (It was from Douglas Laboratories, back in the 90s) and a bottle of honey.

All of that changed yesterday, however, when a rep from one of the nutritional vendors whom I use for patient's supplements stopped by. My relationship with this company is less than a year old, but not for lack of interest. I first encountered them several years ago at a nutritional conference I was attending. Impressed by their products at the time, I have intermittently contacted them for more information, but never received any response. I'm not surprised; in the larger scheme of things, my little practice in Podunk, Connecticut is not going to bring out the big marketing guns.

Purely by serendipity, however, that changed last year. One of their reps stopped by, unannounced, saying that she had seen my sign in passing, and wanted to introduce herself. I'm pretty sure that she was on the way for Someone Else's Office and just got lost, but it was a serendipitous visit nonetheless. In a short introductory meeting, I let it drop, without qualification, that what would sell me was science. And quality. And if their products did not stand up to either, #thankyouverymuchbutbutnothanks.

A few weeks later, she showed up again, armed and ready. She dropped journal after journal in my hands, explaining how it fit into her company's products and the benefits provided. I was impressed. She left, and I did some homework; she wasn't just blowing me smoke.

So I ordered a few products, and began using them. Patient feedback was good, but more importantly, patient improvement, documented objectively, was impressive. I know, there's always the problem of confirmation bias when a clinician reviews his own work, so I can't conclude from a truly objective standpoint that the products worked. But you have to go with what you've got, sometimes.

This company offers a number of conferences, and at her last visit, I asked the rep why they don't include CEU credits for doctors attending them. Her answer was simple, blunt, and honest.

"We won't," she said. "We talk about our products."

Compare that answer to that of the pharmaceutical companies, which routinely spend millions of dollars sponsoring CEUs for medical doctors, and consider it a routine cost of doing business. I have attended some of those lectures, all of which have been extended infomercials for one or another miracle drug. The fact that this nutritional supplement company specifically delineated a difference between education and marketing was impressive.

At this visit, she also plopped another inch of independent research on my desk, and we talked about the scientific backing for some of their new products.  I was so engrossed by the information, that I completely forgot about the wrap she had brought from some deli.

I shouldn't have; this was unique. During her previous visits, she had never provided me with a free sample of anything, except as a quick taste test when I had mentioned that other, similar products had been met with unhappy looks from my patients.

So engrossed was I with the data that I forgot about the sandwich. Sandwiches, by the way, fall well within the guidelines for proper behavior for representatives visiting doctors, so I did not feel any gross or subtle moral violation for accepting the food.

After the rep left, I got around to opening it up, and discovered, perhaps, the Best Wrap I Have Ever Had In My Entire Life. I immediately emailed the rep to get her source; she demurred, however. So I still don't know where The Wrap came from.

So I have to confess. In addition to having been courted by a case of Red Delicious apples, I have now been waylaid by a chicken wrap of unknown provenance but undisputed tasteworthiness. That is the full extent that any company has sought to influence my prescribing behavior.

So the next time I recommend a supplement to you, I want you to have full and transparent knowledge. I'm doing it for the wrap.

 

5 Reasons You Can't Trust Nutrition Research, Part I

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All too often, the research cannot be trusted. If I had a nickel for every time a patient had told me that they  cannot have certain foods, because of an article they saw or their MD told them, I would be a rich man.

A case in point is salt. For years, I have been telling my patients with high blood pressure that salt is the least of their concerns, particularly when they have been scared off of it from their MD. I’ve had patients eating foods that were terrible for their hearts, because their cardiologist had put them on a salt-free diet, and as a result, worsening their condition instead of improving it.

Just last week, “new” research has been reported on which now shows that salt is not an important risk factor for high blood pressure.

The fact of the matter is that physicians such as myself who specialize in nutrition have known for years that only a very small part of the population with high blood pressure is sensitive to dietary salt. That research was done a long time ago.

But the news really never caught on with the popular press, and it clearly didn’t reach the ears of most medical doctors, who have been pressing the no-salt diet for years.

As I read the news online last week, I noted in the comments that several other readers were saying that the research on nutrition is so flighty that they no longer trust any of it, and will just eat whatever they want to.

I have noted before that much of the mainstream medical research cannot be trusted. The majority of it has been tainted by big money from the pharmaceutical industry which has the money to hire its own research organizations and produce “scientific research” that, unsurprisingly, perfectly supports drug marketing plans.

Nutritional research becomes similarly warped, although on a smaller scale and for slightly different reasons.

One of the key problems with nutritional research is funding. Unlike drugs, which have a phenomenal return on investment, herbs and nutrients cannot be patented. So nobody is likely to get rich from, say, a paper which demonstrates that Vitamin C effectively combats the common cold. The return on investment on non-patentable health solutions is pretty low, so research investors are few and far between.

Nonetheless, the research is influenced by greed in a different way. While it is hard to find the money to prove a nutritional intervention is positively therapeutic, there is a tremendous amount of money available for research which will demonstrate that certain nutritional interventions are useless and/or dangerous.

And there is also a tremendous amount of political pressure which can be brought to bear on nutritional therapies, if they are thought to be a threat to pharmaceuticals.

Not but not least in the financial parade are the people which can make money directly by distorting the research. This is the group I am the most familiar with, so they get to be number one in our list:

1. The media: Not getting it right on a daily basis.

It is a poorly-kept secret that, prior to becoming a physician, I was a journalist. In fact, I was a science and technical journalist. My background in the sciences gave me the ability to explain complex technical topics in easily-accessible ways to non-geeks. So I’m familiar with the ways in which reporters, editors and publishers will, both consciously and unconsciously, bend their coverage to suit their needs.

The major problem with the reporting of nutritional research is that the findings of any study are sensationalized to increase the page hits. A relatively minor study of salt and hypertension, for example, becomes the health section’s page 1 news -- and then, for the next 25 years, both diet and medical recommendations are misdirected.

Another problem with nutritional research reporting stems from the reporter’s inability to understand the science itself, or unfamiliarity with the field. It can be difficult to explain scientific-y stuff to a general audience, and to do so well, you must thoroughly understand the science yourself. Too few reporters have more than a basic grasp of the life sciences, much less a basic understanding of nutritional physiology, and fundamentally important data in a study gets flattened, misreported or simply ignored because of the reporter’s ignorance.

Finally, there are a few reporters who have been reported to consciously misconstrue the results of studies on alternative medicine in general.

New York Times health and medicine reporter Gina Kolata is a case in point. The author of hundreds of articles for the Times, Kolata has been uncovered by The Nation and others as using her articles to press her own agenda -- a profitable one, at that. On one occasion, Kolata published an article which strongly hyped a couple of cancer drugs (an article which turned out to be erroneous, to boot) and within hours was floating a book proposal based on buzz generated by her own hype. While this is an ingenious feedback loop for a reporter hungry for a book contract, it is hardly impartial reporting.

Imagine how nutritional research is reported by a writer with the reputation of Kolata, with one hand on the keyboard and the other reaching for the pocket of the pharmacuetical company. It won’t be the unbiased story that many would imagine it to be.

2. Oops, we used the wrong vitamin.

For some reason I've never been able to fathom, the world of mainstream medicine has always been very faddish about vitamins and minerals. One vitamin or another is always "hot" with MDs. When I started practice a couple of decades ago, Vitamin C was the one being recommended by every MD and his brother. I suspect this was based largely on the later work of Linus Pauling, who already had accredited status with the mainstream medical community for his groundbreaking work in molecular biology.

Vitamin C has since cooled considerably since its days as the go-to vitamin for almost everything. Today, that role is fulfilled by Vitamin D. which is currently being touted by the medical community as a second-class cure-all for everything from fatigue to fibromyalgia to heart disease to depression to joint pain (it remains a second-class cure because in mainstream medicine, nothing is better than a pharmaceutical, natch).

Interestingly enough, 10 years ago, before D got big, it was being maligned on many fronts as being a near-useless nutrient which was only being touted by quacks as a remedy for fatigue and fibromyalgia and depression...you get the idea.

Many of these studies suffered from one very significant, very undisclosed flaw: The researchers were using the wrong form of Vitamin D.

The legal definition of Vitamin D includes 2 forms: Vitamin D2 and Vitamin D3. Both are equally useful in preventing rickets in children, which is what all Vitamin D was once thought to be good for. However, when it comes to its effects on the cardiovascular, immune and other systems, the D3 form is much more potent than D2, which often has little to no effect at all in these systems.

However, researchers investigating Vitamin D often neglected to note the difference. Thus, studies would report that Vitamin D was ineffective at treating a certain disorder -- when actually, it was the ineffectual form of Vitamin D that was being used.

A variation on the "wrong vitamin" error is the "lousy vitamin" error. As most people know, there is a great deal of variability among vitamin products. Much of that variability results from how the vitamin is packaged in the tablet -- particularly how well that tablet survives the gastrointestinal tract to dissolve at the right time. Many vitamins just are not digested well, and I have seen on x-rays, vitamin tablets residing unmolested in the large intestine, waiting to be moved out of the body without having given up the slightest amount of the nutrient they were supposed to disseminate. "Pharmaceutical-grade" nutrients tend to be no better in this regard than what you may pick up over the counter at a chain pharmacy store.

So if you are testing the efficacy of a certain nutrient, and not monitoring whether that nutrient is actually getting into the patient's bloodstream, your results are going to reflect more the failure of the nutrient packaging than of the nutrient itself. It has happened more often than you would like to believe.

Coming up in Part II: Dodgy Dosages and Dietary Dilutions.

Heart Disease Myths

This month being national Heart Health month, I'll be doing a series of articles on heart disease and how to avoid it. I mean, how to really avoid it, as opposed to the have-this-scan take-this-pill approach to prevention. In fact, it is just that approach to health that has got most of the population walking straight toward the heart attack guillotine. In 20 paragraphs or less, I'm going to show you how to reverse that death march.

The problem is that mainstream medicine has failed miserably at reducing the rate heart disease. After billions of dollars and a half-century of research, heart disease remains this country's number one killer, causing 36% of all deaths.  The claim is often made, based off of a CDC report, that there are fewer people dying from heart disease, and that is true; but that's not because fewer people have heart disease, it's because we can keep people alive longer after heart attacks. They still have heart disease, and are usually very sick, but at least they're not dead. Which is wonderful for those people who are living with heart disease, but honestly, wouldn't it be far better to stop the disaster from happening in the first place?

A more honest method of measuring our ability to prevent heart disease is to measure it's prevalence, or what percentage of the population has heart disease.  In terms of the percentage of the population that has heart disease, "Among adults 18 years and older, the prevalence of heart disease and stroke between 1997 and 2009 has remained essentially the same," according to this report. So, in fact, we aren't really winning the war against heart disease. Instead, mainstream medicine is simply propping up the corpses and declaring victory.

While mainstream medicine pats itself on the back for its "success," the science-based skeptics among us can plainly see that they have been an utter failure at preventing heart disease. The heart of the problem, if you'll forgive the allusion, is that mainstream medicine has built its "prevention" approach on a shaky therapeutic foundation, one predicated more on profitability than on true prevention. These heart disease myths, while they are making lots of money for high-cost, high-tech clinics, surgeons, and pharmaceutical companies, are ignoring the scientific research which conflicts with the profit imperative. The sooner we recognize these myths for what they are, and discard them in favor of evidence-based prevention, the sooner we can reduce the number of Americans dying from heart disease. At the current rate, one American dies from heart disease every 40 seconds. I think we can do better than that.

Heart Disease Is Not A Disease

This may sound spectacularly absurd, but the fact of the matter is, most heart disease does not begin as a pathological process. Heart disease is not a disease in the same way that multiple sclerosis, thyroid disorders or many forms of cancer are diseases. What we call heart disease is actually an unholy conglomeration of lifestyle choices. Stop, for a second, and think about how evolution has molded our bodies. We are designed to live in physically-demanding environments where energy is obtained only with significant energy output. Our ancestors of only a few thousand years ago lived in places where the energy balance between alive and dead was as thin as the edge of a stone blade. Nutrition varied tremendously, from place to place and from season to season. Our bodies developed to adapt to them all. Our systems were honed to provide the best possible performance in those circumstances.

Simultaneously, historical evidence shows that heart disease was not prevalent in pre-industrial societies, from the medieval English to nomadic Ethiopians. What these unlettered, unhygenic people did that we do not is make use of one of the basic premises of medicine, Davis' Law. In non-technical terms, Davis' Law, and it's logical brother, Wolff's Law, boil down to this: Use it or lose it. The heart is a muscle, and the less you use it, the weaker it becomes. What happens to weak hearts? I don't think I really have to tell you.

The real truth is that heart disease is, first of all, the beginning of the failure of a weak, underused muscle: Your heart. What the research actually shows, as opposed to the faux science you have been handed, is that the number one risk factor for heart disease is cardiopulmonary fitness, or in other words, how strong your heart and circulatory system is. The stronger your heart, the less chance you have of having a heart attack or stroke. This influence is so strong that it overrides genetic influence, smoking history, cholesterol levels and weight. For example, if you smoke and do regular, vigorous cardiac activity, you will have a lower risk of heart disease than an unfit non-smoker. If you've got an extra 25 pounds around the middle, but can pound out 50 miles on a bicycle, you are unlikely to die of a heart attack, even though your BMI would make a cardiologist gasp in fear. Our hearts are designed to be used, and used hard. We are made to chase our food with foot and spear, lift logs, roll stones and dig dirt. And the less we do that, the weaker our hearts become. Once a week on the stationary bike while reading the Sunday funnies doesn't turn the trick. You have to pant, sweat and push on an almost daily basis.

You can do this by going to the gym, or by engaging in a home bodyweight/cardio workout. But that takes a lot of self-discipline, more than most of us have. So my suggestion is to incorporate high levels of physical activity into your everyday activities.

Am I suggesting that this we turn our lives into a daily replay of some Scottish highland games? Well, not completely. But if you do want to actually prevent heart disease, it's time to make some changes. Keep the car in the driveway for any trip less than 1 mile. Chop wood to supplement your normal house heat. Ride a bike to work every day, shovel snow instead of blowing it, rake leaves instead of blowing them, and quit blowing away time in front of the television. In our society, we have made physical activity the special time, the consecrated time of the modern American. It's time to reverse that, by integrating high levels of physical activity in our lives and sitting down for our sacred space.

Diet is another lifestyle choice that contributes to heart disease. The confusion that the mainstream medical community faces is that it has no idea what a healthy diet really is, though it hasn't prevented them from promoting an ersatz "heart healthy diet" that fails to do much for anyone. The research shows that vegetarians have a much lower risk of heart attack; it also shows that people eating a meat-heavy Adkins diet also have a lower risk of heart disease.

So, if you want a healthy heart, what are you supposed to do? Become an omnivorous vegetarian?

The problem with the studies purporting to demonstrate the components of a heart-healthy diet is that they fail in two regards. First, they do not take into account what I call individual biochemical diversity, something that I have seen to be of tremendous importance in the nutritional treatment of disease. Second, they ignore the rather extraordinary fact that we do not absorb only energy and nutrients from our food; we also absorb information.

Individual biochemical diversity simply means that we all process our food differently. Some of those differences are genetic, making an eastern European's nutritive processes significantly different from those of a Maori. As a result, though both may suffer from the same malady, the nutritional therapeutic intervention will be different for both. So, yes, for some people, a heart-healthy diet is a vegetarian diet. For others, avoiding heart disease means lots of protein. The trick is finding out what kind of diet (and there are more than just two) will best prevent heart attacks for you.

Secondly, and perhaps more importantly, is the concept of xenohormesis. Living things produce certain molecules in response to certain stressors. When those organisms become food, we ingest those molecules, and our body recognizes the signal that the food is giving us. For example, an animal produces certain molecules when it is stressed because its food supply is low. When we eat that animal, we are informed that a famine may be on the way. So guess what? We start storing energy. And energy is stored as -- wait for it -- fat. And, just for giggles, guess how stressed out an animal that has spent the last month of its life in the execrable conditions of a feed lot is? Guess what its meat is full of? Yup. All those chemicals that tell us that a famine is coming.

The study of xenohormesis is in its infancy, but its a safe bet that the "food as information" paradigm plays a much larger role than we currently understand. The trick is, if you want to stay healthy, eat healthy foods.That means locally grown, locally raised, and if not FDA-approved organic (which is the worst kind of organic, mind you) at least raised with no help from Monsanto.

Cholesterol Doesn't Matter. At All.

This is the part where all of the pseudo-skeptics start getting the vapours and call up the quackwatch hotline. But the fact is, when it comes to heart disease, cholesterol doesn't matter. 

I have come to that conclusion, in part, after examining the epidemiological data over the past 30 years, which demonstrates that, although we've reduced cholesterol levels on a nationwide basis, the rate of heart disease, as I mentioned above, has not budged. My conclusion has come after reading multiple studies, often cited in the literature as a justification for the creation of a cholesterol panic, and finding that in many cases, the researchers' own data does not support their conclusions. And, in some cases, the data has been fabricated, or massaged, to produce the desired outcomes.

And I'm not the only physician to arrive at that determination. Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine, is among many prominent doctors who have looked behind the cholesterol curtain and found the same thing I have -- biased research, bad science, and a public health policy more interested in your wallet than your health.

I could write entire chapters on the damage that the cholesterol myth has done, and perhaps someday I will. Suffice it to say now that, whatever your medical doctor has told you about cholesterol, just ignore it. And, though I risk bringing the wrath of the FDA on my head for saying this (I would certainly never say this to a patient, as recommending pharmaceuticals is not part of my scope of practice), if you have no heart disease, and your MD has given you pills to bring down your cholesterol levels under the guise of prevention, just chuck them. They are likely to do you no good at all.

So I promised you an effective preventive strategy for heart disease in twenty paragraphs, and this is number 20. So here's the deal. Turn off the TV. Hide the car keys. Whatever it is, pick it up yourself and carry it with your own two feet. Sweat and gasp for breath at least once every day. Sprint to the mailbox like you're waiting for your lover's letter. Quit eating crap. Plant or mammal, if it died more than 60 miles from you, don't eat it. Eat anything that's fresh or unprocessed unless it disagrees with you. And one other thing: Ignore most of what you've been told about how to prevent heart disease.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Chiropractic Care and Anxiety

Anxiety is a problem which has afflicted us all at one time or another. Fortunately, our anxiety is usually the result of a specific context or situation, and it resolves as we move to meet the problem or it is otherwise solved. Not so for many, however, who have to deal with anxiety on a day-in, day-out basis. Many people experience panic attacks for no reason, where their heart starts pounding, they get short of breath, and they get a feeling of dread. Generalized anxiety, a free-floating sense of worry that is out of proportion to the cause, can last for weeks or months, and can result in insomnia, hyperactivity, headaches, irritability, abdominal distress and other symptoms.

Mainstream medicine, of course, relies primarily on drugs to treat anxiety disorders, but these drugs can create more problems than they solve. Benzodiazepines, for example, interfere so much with mental functioning that anyone who is taking that class of drug is not permitted to have a commercial drivers license, and they are also highly addictive. A common anxiolytic, Xanax, is one of the most frequently-used drugs to treat this condition, despite the fact that there are no long-term studies confirming either it's effectiveness or it's safety.  Overall, the use of anti-anxiety drugs increases your risk of death from a variety of causes, so with all of this in mind, drugs may not be the best answer for this particular problem.

Fortunately, there are several ways of managing anxiety that do not require drugs. EEG neurofeedback, a technique which uses real-time electrical signals in your brain to alter its patterns, has been used quite successfully to manage anxiety. Fortunately, Litchfield has an excellent clinical therapist who is also highly skilled in EEG neurofeedback. David Pavlick is a clinical social worker with an office at the Center for Alternative Medicine, and has helped many people overcome their anxiety.

Cognitive Behavioral Therapy, or CBT, is the current darling of psychology, and it, too, appears to be  very effective in treating anxiety. In fact, a variety of talk therapy techniques have been shown to help people with anxiety.

But, as is the case for most chronic problems, a multidisciplinary approach usually results in better results. People with chronic problems, especially mental and emotional disturbances, should also be examined by a primary care chiropractor to eliminate underlying physical and nutritional causes for the anxiety.

Multiple studies have confirmed that balancing the essential fatty acids (EFAs) can reduce the symptoms of stress. Back when I started practicing, I used to hand a patient a bottle of EPA or DHA and have them take it for a month to see what kind of response we would get. These days, however, I can order a simple blood test, covered by insurance, which will show me the patients' levels of the various essential fatty acids, eliminating the guesswork. I can tell without trial and error whether or not such an approach is likely to work, and if so, exactly what kind of dosages of which EFAs I need to make my patients better.

The B vitamins, magnesium and calcium also play a role in anxiety states, and adjusting these levels may help as well. Imbalanced hormones will also often play a role, as an over- or underactive adrenal gland, or an imbalance in the hypothalamic-pituitary axis can be primary causes of anxiety symptoms.

Very often, I find, that in order to correct my patient's nutritional status, we have to begin by fixing impaired digestion, one of the most common -- and most overlooked -- causes of mental and emotional issues that I see.

With all of these conditions, once again, instead of guessing, I test, and use objective measures to tell me if these types of intervention will be useful.

Finally, Traditional Chinese Medicine can be successfully employed to help patients with anxiety. From a TCM point of view, there is no separation between mind and body, and the freedom from that false duality gives us the ability to view anxiety from an entirely different angle.

In TCM, anxiety stems primarily from an imbalance in the Spleen organ system. Because the Spleen, in TCM, is responsible for extracting qi from the food, Spleen imbalances result in qi stagnation or depression.

When qi becomes depressed in the middle jiao, then you start to experience the signs and symptoms of panic attacks, as well as other classical signs of anxiety. Thus, from a TCM point of view, restoring normal Spleen functioning is primary to the treatment of anxiety. (As a side note, I find it very interesting that in both TCM as well as Western alternative medicine, the digestive system is found at fault in mental disorders.)

So, fortunately, for people experiencing anxiety, there are a number of approaches that can be used to assist them. From nutrition to acupuncture to lifestyle and herbal interventions, a variety of forms of alternative medicine can be used as an adjunct to, or even primary means, of helping people deal with anxiety disorders.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

 

Time For Your Flu Vaccine? No.

I'm going to talk to you about the flu vaccine. Now, before you dismiss me with a hand-wave and think to yourself, "Oh my god, another anti-vaxxer idiot," let me make a few things clear.

I'm not anti-vaccine. I'm pro-science. I believe that public health policy should be firmly based on the best available research. And what the best available research says, according to the top researchers in the world, is that the flu shot is useless.

But I'm pretty sure that nobody involved in mainstream medicine wants anyone to actually think about whether you need the flu vaccine.

They just want you to line up and get the shot. You see, everybody in medicine makes money from the vaccine, from the Semi-Registered Nurse's Assistant's Aid's Best Friend (i.e., part-time CVS employee who just washed her hands) who actually injects you, to the stockholders and executives at Novartis and Glaxosmithkline, who make the vaccine, to the CDC, which gets lots of money indirectly by pimping the flu vaccination each fall.

The trouble is, it's bad medicine. And bad science.

Don't believe me? Then believe the Cochrane Collaboration. This is an independent organization which performs analyses of medical research, and one of the sources that evidence-based doctors, such as myself, use to guide their recommendations to their patients (of course, I'm absolutely *not* making any recommendations to any of my patients, and if any of my patients are still reading this, I want you to stop immediately).

According to the Cochrane review, the advantages of vaccinating healthy adults are virtually nonexistent. This recent study found that the flu vaccine:

  • Did not reduce the number of days lost from work;
  • Did not reduce the number of people hospitalized;
  • Did not reduce the number of complications due to secondary infection (pneumonia, etc);
  • Was effective in only 1 out of 100 people;
  • Paralyzed 1 out of every 1,000,000 people who were vaccinated.

Furthermore, the study's authors hedged their conclusions even more. The authors said "Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions" (Emphasis mine).

For those of you who are not familiar with reading scientific studies, this is a researcher's polite way of saying they think the data is trash.

This conclusion was reached by Cochrane researcher Tom Jefferson, in a 2006 analysis published in the British Medical Journal. Dr. Jefferson concluded that there is an "absence of evidence" that vaccinations have any effectiveness at all.  "In children under 2 years inactivated vaccines had the same field efficacy as placebo," Dr. Jefferson said, "and in healthy people under 65 vaccination did not affect hospital stay, time off work, or death from influenza and its complications."

But what about our aging American population? The elderly is a group heavily targeted by influenza vaccine marketing, but that is primarily the result of easy and profitable Medicare reimbursement more than any evidence that flu vaccines actually help this population.

In fact, the evidence is so bad that Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy has suggested that those who recommend the flu vaccine for older people are at best ignorant and at worst disingenuous.

"These 36,000 deaths that we keep talking about with the flu, that we want to get people vaccinated for so they don't happen, really is not going to occur. And we have to be honest about that," Osterholm told NPR last year. "I know that some people are going to find it very challenging to basically understand that much of what we've probably done has had little impact on deaths," he said.

Nor is the Cochrane Collaborative silent on this issue. This study, first published in 2006 and reviewed again in 2009, concluded that "the available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older." The study went on to note the "low quality" of the research, as well as "likely presence of biases, which make interpretation of these data difficult and any firm conclusions potentially misleading."

Some of the research backing Osterholm's claim includes research by Dr. Lisa Jackson and published in Lancet. Dr. Jackson's study -- which spanned 3 years and included over 3,500 people -- concluded that vaccines don't really help, particularly in the area of secondary infection prevention. Specifically, " influenza vaccination was not associated with a reduced risk of community-acquired pneumonia," her paper concluded.

What other studies seems to show is that, far from aiding those with weak immune systems, flu vaccines either fail to help or overtly damage people with already-compromised immune systems.

The Cochrane Collaborative's persistent claim that the data regarding flu vaccine research is compromised has been bolstered recently. A paper authored by researchers at the British Columbia Centre for Disease Control found that data from several Canadian hospitals reported peak vaccine effectiveness before the flu season had even started. They concluded that this created a "bias tending to over-estimate vaccine protection," which as other research has shown, is marginal at best.

However, there are research-proven ways of significantly reducing your risk of contracting the flu this winter, and the best ways of avoiding the flu involve no vaccines, no doctors, and don't cost you any money.

Those are probably the two most important ways to prevent the flu. And the research is unequivocal at this point that nutritional status has a profound effect on immune function, which determines how likely you are to get the flu. But then again, how many doctors actually test your nutritional status to make individual-specific recommendations for improving your immune function during the flu season?

Actually, I do know of one.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Food with a Pedigree

"Cauliflower," Mark Twain once wrote, "is nothing more than cabbage with a college education."

Despite this somewhat disparaging remark, the great American humorist was known to enjoy nibbling on this "intellectual vegetable" while writing his novels.

And while we may only see cauliflower as a minor addition to a tasty salad, as part of a  hors d'oeuvres plate, or hidden under a cheese sauce, this unassuming vegetable has medicinal properties. It has historically been used to treat headaches, which is one of the uses Twain found for it after the stress of losing his publishing company started giving him severe headaches.

As a cruciferous vegetable, cauliflower is known to have anti-cancer properties, and it is also rich in folate, vitamin C, vitamin E and beta-carotene. It also has an historical antecedent in treating heart disease. (If you are concerned about heart disease, please attend my lecture next week. We still have a few seats available.)  The indole-3-carbinol in cauliflower aids DNA repair in cells and acts as a mild anti-estrogen, thus reducing the growth of estrogen-sensitive tumors; intrestingly, cauliflower has been shown to slow the growth of aggressive prostate cancer.

But enough about cauliflower. Today's quiz is actually about another food with a surprisingly versatile medical pedigree. Commonly found in a couple of different subspecies, this food has been demonstrated to not only prevent cancer, but has been used in hospitals to treat cancer. In fact, patients have had this food therapy break down their cancers so rapidly that their livers were unable to keep up with processing the resulting toxins.

Not satisfied with just being useful to treat cancer, this food is also used to relieve coughing, glandular swelling and sore throat. Not a bad little trifecta there; but to make it even sweeter during this month of Cupid, this food has been used as an aphrodisiac since at at least Roman times.

Of course, your question this week is: What is this food?

The first person to email me with the correct answer will receive a 10% discount on their next purchase from our Dispensary. Your order can be of any size.

Good luck!

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

A Dentist with Majestic Ideas

Our Friday quiz revolved around a mystery man who was a pioneer in the field of clinical nutrition -- so far ahead of his time that, in fact, we are still catching up with him. But apparently, he was not quite the riddle that I thought he was, as I received many correct answers to the quiz.

That answer being, of course, Dr. Royal Lee, founder of Standard Process. Dr. Lee, who died in 1967, was the inventor of the endocardiograph, a tool which continues to be used to this day for heart health evaluation. In 1942, Dr. Lee was appointed a Fellow of the American Association for the Advancement of Science. He founded Standard Process in the depths of the Great Depression, with his first development, a whole foods extract he called Catalyn, which is still available today, and is one of the many Standard Process products in my Dispensary.

Standard Process products differ from most of the supplements available today in that they are completely whole-food extracts. While most supplements utilize vitamins and minerals produced synthetically, the whole foods used to create Standard Process supplements means that all of the nutrients are accompanied by the cofactors they are typically found with in food. For example, the carrot root used in Catalyn contains over 200 phytonutrients -- not something you can get from synthetic vitamins. In addition, Standard Process uses products from its own organic farm or other organic farms as their source.

This is one of the reasons that I frequently have my patients taking Standard Process supplements. While our increasingly modified and processed food sources become more denuded of basic nutrients, Standard Process ensures that my patients have their nutritional bases covered.

Dr. Lee also discovered the concept of protomorphogens. Protomorphogens are cell-specific templates that assist the cell in the production of nucleoproteins for repair, and thus are important to include in any supplement with which you are trying to aid cell metabolism and repair.

Although unknown by most, Dr. Lee has had a profound influence on the practice of clinical nutrition; I know that his products have assisted a great many of my patients.

Congratulations to H.S., the winner of this week's quiz. For her efforts, she will receive 10% off her next purchase from our Dispensary. I had many correct entries to this quiz, but Ms. H was the quickest to hit the send button. I will post the next quiz on Friday. Get your Google-fu ready.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

DocAltMed IQ Test: Mystery Man

Since its inception, the chiropractic profession has paid great attention to the nutritional needs of patients. After the AMA had annihilated the eclectic and homeopathic schools of medicine, both of which advocated replacing drug therapies with medicinal use of food and herbs,  chiropractic doctors were almost the only health professionals which kept alive the concept of  "food as medicine."

(It bears noting that, at the time the medical profession was attempting to hound chiropractic doctors out of practice for being unscientific, mercury was a common ingredient in many medicines routinely prescribed by MDs. Mercury is today recognized as a dangerous poison, to the degree that releases of small amounts of mercury have caused entire school evacuations. However, the same MDs who now understand the dangerous toxicity of mercury advocate for its continued use in vaccines administered to infants and children. Go figure.)

The medical profession's opinion of the importance of nutrition during the 20th century is well summarized by Dr. Elmer Nelson, who was the director of the Nutrition Division of the early FDA. Dr. Nelson, in court testimony, said “It is wholly unscientific to state that a well fed body is more able to resist disease than a less well-fed body. My overall opinion is that there hasn't been enough experimentation to prove dietary deficiencies make one more susceptible to disease.”

Interestingly, however, there was another profession that continued investigating the use of nutrition: Dentistry. In the interests of oral health, a few enterprising dentists continued research into nutrition's effect on disease.

One of these dentists was among the first to recognize the dangers of trans fats, excoriating the manufacturers of margarine as "food counterfeiters," who "have kept their eyes comfortably equipped with mercenary blinders."

Even more prophetically, this man recognized 60 years ago what is only now being acknowledged by mainstream medicine. This is the fact that isolated, synthetic nutrients do little to affect overall health. Nutrients work with one another synergetically. Vitamin B complex, by itself, is absorbed and utilized poorly. However, when accompanied by a number of cofactors which typically accompany Vitamin B in food, our ability to use this vitamin to fight disease is greatly enhanced.

This doctor, again writing in the 1950s, said: "The whole nutrient complex is greater than the sum of its parts. Just as no single component of a watch keeps the time, no single chemical accounts for the functional action of the entire nutrient complex. Vitamins are bundles of nutritional factors that create a vitamin effect. Only in whole, unprocessed food does the synergistic balance of nutritional components yield that vitamin effect to a living body."

In the course of developing means to healthily condense, extract, and process food, this dentist acquired almost 100 patents, developing processes that are used in supplement manufacturing to this day.

Your question this week is: Who was this doctor?

As always, the winner's of this week's quiz will receive a one-time 10% discount on an order of any size from our Dispensary. The answer will be released on this blog on Wednesday, Feb. 2. If you think you have the answer, email me. Good luck!

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Monday Fun Facts

Here's a grab-bag full of interesting nutritional tidbits. As always, chew thoroughly before swallowing.

Sun and Supplements

Synergy is a terribly overused word, one of those very appropriate terms nearly trampled into nonsense by marketing. But synergy is exactly the right term for how one fights the risk of cancers, as shown by a recent study. According to the study, a combination of some sun exposure and vitamin D supplementation may be the most effective means of reducing the risk of breast cancer, as opposed to either one alone. If you are in the mood for some light reading, here is the report:

Source Surf and turf

It appears that there is a functional relationship between flavonoids, beneficial plant chemicals found in fruits and vegetables and omega-3 fatty acids, the type found in fish oil. A recent study demonstrates that flavonoids can actually help increase blood levels of omega-3 fatty acids thereby making these important polyunsaturated fatty acids more available for the body to use.

Omega-3 fatty acids are crucial for brain and heart health and are anti-inflammatory.

Examples of flavonoids, which possess antioxidant, anti-inflammatory and anti-cancer properties, include EGCg from green tea, quercetin from apples, citrus and onions and curcumin from the spice turmeric.

Source The Cardiac Surgeon's Savior

A recent medical study discovered that vitamin C can reduce the risk of experiencing a serious heart arrhythmia after heart surgery.

Atrial fibrillation is a common complication of heart surgery and increases the risk for longer hospitalizations and death. Vitamin C use, post-surgery, may significantly reduce the incidence of atrial fibrillation, according to the study.

Source

Bad Breath, Strong Bones

Diets high in garlic and other related vegetables such as onions and leeks have been shown to reduce the risk of developing the bone weakening disease osteoporosis.

Diallyl disulphide, a compound found in garlic and other related vegetables, was shown to repress the expression of certain destructive enzymes that are linked with osteoarthritis, providing a potential mechanism of action for garlic’s effect.

Source

Don't forget: Alternative medicine = scientific medicine.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Beyond Avandia: Diabetes Treatment Without Drugs

Dr. Avery Jenkins recommends drug-free treatments for diabetesEven if you don't follow health news closely, it would have been hard to miss the recent headlines as the diabetes drug Avandia went "on trial" before the FDA.

The problem was simple: Avandia tends to kill the people who take it by giving them strokes and heart attacks. So some intelligent people thought it should be taken off the market.

Before all was said and done, it was revealed Avandia's maker GSK had manipulated  risk analysis data, one of the panel's scientists was on the payroll of a GSK competitor, and in the end the FDA figured that killing off some people with diabetes wasn't so bad after all and let Avandia stay on the market.

Missing from the whole discussion was the idea that you don't need Avandia or any other drug to treat type II diabetes!

Type II diabetes is a nutritional and lifestyle disease. The best way of combating any disease, whether it is cancer or the common cold is by addressing it at the source, not by tossing drugs at the symptoms. And the best way of addressing diabetes is by the selective use of foods that help your body naturally regulate your blood sugar, and through exercise routines specifically designed to keep blood sugar levels within a target zone.

Which is how my patients with diabetes improve their health. Of course, I can't say that anything but a drug can cure diabetes, even though the research clearly demonstrates effective diabetic management through exercise and nutrition. I'll leave the quack claims of "cure" to the makers of drugs like Avandia, who are quite willing to sacrifice your health for their profits.

But here's the key fact: It can be more effective, safer, and less expensive to use non-drug therapies to improve the health of people with type II diabetes. And even if you are already taking drugs for diabetes, alternative therapies can still assist your health.

Thus, if you are one of the many thousands of Americans with no health insurance, you have a choice: You can pay a considerable percent of your monthly income on Avandia and its brethren (a one-month supply of Avandia typically costs $170), or you can see me (New patient examination and in-house labs: $150) and I'll help you develop a plan that will allow you to manage your diabetes. You will be in control of the treatment and its costs.

Even if you have insurance that would cover the costs, would you prefer to run the substantially increased risk of death by treating the disorder with drugs? Or would you prefer to take a safer path to better health?

Everybody deserves a choice. The problem is, there aren't many doctors offering one.

I am offering you a choice. A safer, more cost-effective choice. If you want to talk to me about diabetes, click here.

Kids, Don't Try This At Home

As many of my readers and patients know, I am trying to qualify for Paris-Brest-Paris, a 1,200-kilometer endurance ride held every 4 years. Although not a race, it is a timed event, and you have to reach all of the checkpoints by a specified time to avoid being disqualified. Qualifications start this year, as I have to do a full series of endurance rides (called "brevets"): 200k, 300k, 400k and 600k. If I complete all of them successfully, I get to repeat the process next year; and if I complete all of those successfully, I will be able to ride in Paris-Brest-Paris.

So I'm thinking to myself that in a few weeks, I start the brevet series with a nice 200k, and maybe, just maybe, I ought to see if I can do a major chunk of that, like 100 miles. I have been training, though not as diligently as I should.

On Sunday, with no other obligations pending, I took off for a 101-mile loop leaving from Granby CT, going north to Northampton, then looping around through Amherst and Granby MA and eventually back to Granby, CT.

And a beautiful day it was. I passed more cows than you can count, went through beautiful, quaint, New Englandy towns, enjoyed the features of one of my all-time favorite college towns, Amherst, and in general just took pleasure in a fine ride on a beautiful day. The temperature was 72F by 11 a.m. and the few cirrus clouds called it quits by lunchtime.

One of the key tricks to any endurance exercise, whether it is a marathon, a triathlon, or brevet, is managing your fuel and water. You have to constantly plan ahead, because if you wait to drink until you are thirsty, or wait to eat until you are hungry, it is already too late. In addition, the gastrointestinal tract tends to shut down under the stress of endurance exercise, and you may never get hungry. The only way you'll know that you are out of fuel is when your legs turn to lead and your mood plummets.

There are a lot of complex rules governing your body's management of glucose, the basic energy molecule, and there are a lot of nuances to controlling blood sugar levels during exercise. But the general rule of thumb is to have some water every 15 minutes and something to eat every 45.

That's a rule that I generally follow. On Sunday's trip, I also took a longer stop at mile 63 where I had a "deli delight" lunch -- a submarine sandwich, a bag of chips, and some Oreo cookies.

After that, I hopped back on the bike for the final leg of the trip. This was a fun part, because I had finally hit a few hills -- more than rollers, but not what I call a hill around my house. I was gratified to see that, although the legs were paining me a bit, I still had the juice to attack the hills, albeit somewhat anemically.

I was taking the perimeter road around Bradley Airport when I realized, at mile 93, that I had the barest shot of breaking 7 hours for a century. For many cyclists, there's nothing special about a 7-hour century. It's a good pace, that's all. But I'm a slow guy, always have been a slow guy and always will be a slow guy. And among the Berkshires and their foothills, I've never come close to breaking 7 hours.

So...I take a deep breath and put the hammer down. For the next 7 miles, I sprint absolutely as fast as I can. At parts, I know I'm running at my maximum heart rate, because I was getting the tunnel vision and the eyes-rolling-to-the-back-of your head symptoms that have always happened when I'm doing a maximum heart rate measurement.

As I hit the last half mile, I come to a bend. And I look at the clock, and think to myself, "If this is downhill, I've got it made. Uphill, I'm toast."

I round the bend, and there it is: Uphill. So I let out a yell that would tell God Himself to get out of the way, and put absolutely everything I've ever owned into that last half mile. I mean, I ride like Cerebrus' meaner brother was chasing me.

And through my ever-narrowing vision and feeling like I'm about to pass out, I see the clock tick over to 7 hours at the exact same time the odometer clicks to 100.00

It's over. I didn't break 7 hours, but if I realized my opportunity only one hundredth of a mile beforehand, I would have. Still, hitting 7 on the nose is good enough for me. It's still a personal best, and I'm looking at setting a lot of records for myself this summer.

I slow from a gallop to a walk for the remaining 4 miles to the parking lot, and as I make the final turn the wrong way, I realize something might be wrong. I get back to the truck, park the bike, and take stock. My hands are shaking; I feel very dizzy; and I'm slurring my words like Sean O'Malley on St. Patrick's Day.

The problem? My blood sugar had plummeted. I react as fast as I am able, by downing a sugary soda and a concentrated sugar paste. It took a good 15 minutes before I was in control of my faculties again.

In any endurance sport, after the first 60-90 minutes, you have used up all of the energy reserves stored as glycogen in your body. From that point on, as I mentioned earlier, you must constantly add fuel, otherwise you will get into trouble -- as what nearly happened to me.

While I was balancing energy outflow with intake, my nutrition plan did not take into account that impromptu sprint for the last 7 miles. The massive increase in energy use forced my blood sugar levels to dangerously low levels. And, since the body's most energy-consumptive organ is the brain, the symptoms are often neurological -- thus the befuddled direction-finding, the shaking hands, the slurred speech, even while I was able to maintain muscle activity on the bike.

More and more, I am finding that I can help endurance athletes prepare their bodies for the onslaught of their competitive events by working with their diets beforehand so they can achieve their personal best. Just as any athlete needs a coach for their physical training, a nutrition coach is also a necessity.

March Podcast — Brittle Bones and Bad Drugs

Did drugs cause this broken bone?The March edition of the Alternative Healthpod is now available. If you are not a subscriber, you can listen to it here, or as always subscribe to it by clicking on this feed. You can also subscribe via iTunes. Show Notes:

Two new studies published last week show that long-term use of oral drugs prescribed to prevent osteoporosis may be associated with unusual fractures of the thigh bone -- in other words, they are weakening the bone they are supposed to strengthen.

The research is not the first to link the drugs, known as bisphosphonates, with fractures. Other research has found that these drugs also increasing the risk bone death in the jaw.

Dr. Melvin Rosenwasser, a professor of orthopedic surgery at Columbia University College of Physicians and Surgeons in New York City, and co-author of the study, said that when bisphosponates are "used beyond a certain point...they may actually be bad."

A second study looked at bone biopsies taken from the thigh bones of 21 women, all past menopause, who had suffered fractures at the site. Nine had not taken the drugs, while 12 had, for an average of 8.5 years.

The women on the bisphosphonates, researchers found, had 90% "old" bone, meaning that new bone was not being created in the women taking the osteoporosis drugs.

Source: American Academy of Orthopedic Surgeons Annual Meeting, 2010.

If you are taking osteoporosis drugs, or are concerned about your risk of fracture, please contact me immediately at 860-567-5727, or email me at alj@docaltmed.com.

It’s Not The Winter Blues, It’s Your Winter Diet!

That's the name of this year's first podcast, and it is up and available now. The feed for all my podcasts is here. And, as promised, here are the show notes:

Br J Community Nurs. 2009 Oct;14(10):422, 424-6. Dietary factors and depression in older people.

Williamson C. British Nutrition Foundation, London. c.williamson@nutrition.org.uk

Depression is one of the most prevalent mental health conditions and can affect people of all ages, but it is becoming more common among the older population with increasing life expectancy. Observational studies have found poor micronutrient status (particularly folate and vitamin B12) to be associated with an increased risk of depression in older people. Supplementation with folic acid has been shown to enhance anti-depressant drug treatment and there is preliminary evidence that supplementation with certain micronutrients may help improve depressive symptoms in older patients. There has also been a lot of interest in the role of long-chain omega-3 fatty acids in depression.

Dietary pattern and depressive symptoms in middle age.

Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A. Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. tasnime.akbaraly@inserm.fr

 BACKGROUND: Studies of diet and depression have focused primarily on individual nutrients. AIMS: To examine the association between dietary patterns and depression using an overall diet approach. METHOD: Analyses were carried on data from 3486 participants (26.2% women, mean age 55.6 years) from the Whitehall II prospective cohort, in which two dietary patterns were identified: 'whole food' (heavily loaded by vegetables, fruits and fish) and 'processed food' (heavily loaded by sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products). CONCLUSIONS: In middle-aged participants, a processed food dietary pattern is a risk factor for CES-D depression 5 years later, whereas a whole food pattern is protective. 

If you are interested in more information about diet and depression, contact me by clicking here.

Thanks for listening, and as always, your feedback and comments are very much appreciated!

Cosmo Unveils The Secret Behind Good Health. Maybe.

That fount of modern female wisdom, Cosmopolitan magazine, inadvertently highlighted the fundamental problem with modern healthcare in its recent online article, Hairstyles Men Love. Next to this picture of an undeniably-photogenic Anna Faris:

Anna Faris is evolutionarily advanced

The article notes that "From an evolutionary perspective, guys subconsciously like hair that looks clean and healthy, like Anna Faris's blond locks. "Hair that's in top condition shows that you have a balanced diet and good health — signs of an ideal mate," says biological anthropologist Helen Fisher PhD."

So far, so good. Sociobiology, or the description of human behavior from a evolutionary perspective, has come a long way since its introduction 40-odd years ago, and is now a widely accepted (if oft-misused) theory. It is quite probable that in matters as fundamental as procreation, we are hard-wired to respond in certain ways just as much as the female Western Tanager will always go for the guy with the big red top.

But then Cosmo blows the lid off of the secret behind looking healthy:

"Work a silicone-based straightening serum through damp hair before blow-drying," Cosmo advises. "Clip locks in 4-6 sections depending on how thick your hair is. Then tackle one at a time with a paddle brush and a blow-dryer equipped with a nozzle pointed straight down. Finish with a light shine spray."

Ok, let me see if I've got this right. The secret to attracting guys, Cosmo says, is to develop that healthy glow, which presumably indicates a fecund future of healthy, bouncing babies to carry the genetic line forward. And the secret to attaining that health is a silicon-based straightening serum?!?

Not a word about the things that I associate with good health, like, maybe, good nutrition, exercise, sanitation -- all that stuff that actually does give a person that healthy glow, instead of simply imitating it.

In the same way, mainstream medicine mistakes appearing healthy for looking healthy. Instead of looking at the person, they look at the numbers:

Cholesterol low?                   Check.

Thyroid hormone normal?     Check.

BMI "normal"?                      Check

All well and good. But the fact of matter is, manipulation of the numbers does very little to change a person's health. You can have a normal body mass index and still be highly prone to cancer and heart disease. You can have normal thyroid hormone levels, yet still have a thyroid that is dysfunctional. And don't even get me going on cholesterol. Cholesterol levels are no indicator of any kind of health whatsoever.

So, by manipulating the numbers, the modern MD thinks they are creating health in their patients. But, like the two ounces of straightening serum, they are only creating the appearance of health.

Reducing your cholesterol level has no effect on your overall lifespan. None. Zero. Zip.

Normalizing your thyroid hormones does not mean your "thyroid" symptoms will go away.

A normal BMI does not mean you are fit.

Just like two ounces of straightening serum will give the appearance of health without the reality, the statin drug or the synthetic hormones will make pretty pictures -- but, in the long run, won't change your health for the better.