The Hopkins Health Watch - Vol 1, Issue 3
& Nutrition News,
Drug Watch and More...
Dark Chocolate is Good for Your Heart
Just in case you need an excuse to eat chocolate, new research shows that the flavonoids present in dark chocolate may help reduce heart disease. Scottish scientists measured platelet function in volunteers who ate 100 grams of either white chocolate, milk chocolate or dark chocolate. (The clumping of platelets can contribute to the narrowing of arteries.) White chocolate had no effect on platelets, milk chocolate had a mild effect, but dark chocolate reduced one type of platelet clumping by 92 percent. Dark chocolate contains 70 percent cocoa, compared to 25 percent in milk chocolate and 0% in white chocolate.
In another study done at the University of California in San Francisco and
published in the Journal of the American College of Nutrition, researchers
had volunteers eat 46 grams of high-flavonoid dark chocolate or low-flavonoid
dark chocolate for two weeks. In those who ate the high-flavonoid chocolate,
the arteries were better able to dilate, which would help increase blood flow.
If you're going to indulge your chocolate cravings to improve your heart health, be sure to eat dark chocolate, avoid chocolate that contains hydrogenated oils and be moderate! Too much sugar will outweigh any benefits you might get from the flavonoids.
And by the way, freshly ground and brewed coffee, and red wine are also rich in flavonoids.
Kennedy G, Innes AJ et al, "Dark chocolate inhibits platelet aggregation in healthy volunteers." Program and abstracts of the XIX Congress of the International Society on Thrombosis and Haemostasis; Birmingham, UK, July 12-18, 2003.
Engler MB, Engler MM, "Flavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations in healthy adults," J Am Coll Nutr. 2004 Jun;23(3):197-204.
New and exciting data has been released about a very promising nontoxic treatment for osteoporosis: the naturally occurring element strontium. Strontium lies directly below calcium on the periodic table of elements and that makes calcium, strontium and magnesium (which is just above calcium) all in the same chemical family. They are all naturally occurring metals with a 2+ valance that readily form into stable salts like calcium citrate, magnesium citrate and strontium citrate. They also form carbonates, sulfates, lactates and others. A recently published paper in the New England Journal of Medicine (NEJM) (1/29/04) suggests that it maybe at least as good a treatment for osteoporosis as currently available therapies including Fosamax (alendronate), Actonel, (risedronate), Evista (raloxifene ),and the newest treatment, the injectable parathyroid hormone Forteo (teriparatide).
Strontium was studied in both animals and humans from the early 1950s to the early1960s and was shown to have strong bone building properties. However, it promptly fell out of favor because atomic bomb testing converted a lot of the natural strontium into a completely unnatural radioactive isotope called strontium-90. This bad boy radioactive substance became widely disseminated throughout the world and because of its affinity for bones it got into our skeletons. Thanks to atmospheric nuclear testing, we probably all have minute amounts of strontium-90 incorporated into our bones and teeth today. Large exposures of strontium-90 are extremely toxic and linked to bone cancer, cancer of the soft tissue near the bone, and leukemia. It has a radioactive half life of 29 years, and some have speculated that the low level radiation emitted by trace amounts of strontium-90 may, in part, be responsible for the current epidemic of osteoporosis.
Strontium-90 is man made. Natural strontium on the other hand is stable, non-radioactive and appears to be completely nontoxic. The most recent NEJM article is a phase 3 trial that follows two other very positive multinational clinical trials. In this most recent one, 1,649 postmenopausal women with osteoporosis who had had at least one vertebral fracture were randomized to receive either 2 grams of oral strontium ( in the form of strontium ranelate) or placebo for three years. Both groups also took calcium and vitamin D. There were no negative side effects from the strontium except some transient diarrhea.
The positive effects on bone were dramatic. The lumbar spine, for instance, increased 8.1% in bone mineral density (it actually increased 14% but the authors corrected that number downwards for comparison because small amounts of strontium get deposited on the surface of the bone and strontium is more dense than calcium). This increase in bone density compares favorably with the alternative treatments such as Fosamax (6.2%), Actonel (5.9%)Evista (2.6%) and the parathyroid hormone (9% at 20 months).
More importantly, the authors note that strontium has both anabolic (bone building) effects and anti-resorption (anti-depleting) effects and therefore works differently than any of the other available agents. Unlike Fosamax and Actonel, which work strictly by decreasing bone resorption, strontium increases bone mass. Fosamax and Actonel merely thicken the old bone. Furthermore, fracture rates of the spine are reduced 41%, again favorably comparable to the pharmaceutical agents. In women over 70 years old, data shows that hip fractures are reduced by 36% and vertebral fractures are reduced by 59%. The conclusion by the author-experts assembled from France, Australia, Italy, Poland, England, Hungry, Germany, Denmark, Belgium and the USA was this: "Strontium ranelate given orally at 2 grams daily appears to reduce the risk of vertebral fractures rapidly, effectively and safely among postmenopausal women with osteoporosis."
Strontium ranelate was developed by a large French pharmaceutical company (Institut de Recherches Internationales Servier; http://www.servier.com) and its sale is still restricted. I assume that they will patent the formulation and therefore will keep it off the market until all of the studies are finished. But I strongly suspect that we will find that strontium is the beneficial component and not the organic carrier (ranelic acid) since the earlier studies used strontium lactate and strontium carbonate with similar favorable results.
A Few Caveats in the Use of Strontium
Although strontium seems to be a remarkably benign supplement, there are a few guidelines to follow to maximize its benefit:
- Calcium should not be taken simultaneously with the strontium since the calcium dramatically decreases the absorption of the strontium.
- It should not be used as a treatment in children since it can alter the architecture of rapidly growing bones.
- Traditional bone mineral tests like the DEXA will give artificially high results since strontium is much denser than calcium and a correction will need to be factored in.
- As with all of the pharmaceutical agents, the long term safety of administration of strontium is unknown, but thousands of women have now taken it over the last decade.
- Strontium is not a "magic bullet" and a comprehensive approach to regaining bone strength is still optimum. Other modalities of bone support include calcium, vitamin D, magnesium, vitamin K, progesterone, estrogen (in small amounts), testosterone (if necessary) and weight bearing exercise.
Robert Gottesman, M.D. is a practicing clinician in Santa Ynez, California who has been using natural hormones in his practice for many years. He has contributed greatly to Dr. Lee's work over the years.
Editor's Note: Ask for strontium supplements at your local health food store or look for them on the web. One brand name by Advanced Orthomolecular Research out of Calgary, Canada is called Strontium Support, which contains 720 mg per capsule.
Male Breast Cancer is on the Rise
Although male breast cancer only accounts for less than one percent of all breast cancer, the fact that it increased in the U.S. by 26 percent between 1973 and 1998 is cause for concern. Breast cancer tumors in men tend to be detected later in life and at a later and more aggressive stage. The research, done at The University of Texas M. D. Anderson Cancer Center, will be published in the July 1 issue of the journal Cancer. Men are also more likely to have estrogen receptor positive tumors.
Although it's difficult to do good research on male breast cancer with such a small number of cases, there's every indication that excess estrogen is the primary culprit in men's breast cancer, as it is in women's breast cancer. Past studies have shown that men with gynecomastia, an enlargement of the male breast, have a higher than normal estrogen to androgen ratio, and others have hinted at an association between gynecomastia and breast cancer. The strongest risk factors for breast cancer in men are obesity and lack of exercise, which makes sense since fat cells in both men and women produce estrogen, and the more fat you have, the more estrogen you'll make.
More than 100 prescription and over-the-counter drugs can cause gynecomastia, including ulcer and heartburn drugs such as Tagamet (cimetidine), Zantac (ranitidine) and Prilosec (omeprazole); antidepressants, including Prozac and Wellbutrin; antibiotics including isoniazid, ketoconazole and metronidazole and ciprofloxacin (Cipro); anti-anxiety drugs including valium and ativan, and heart drugs such as captopril and digitalis.
Other causes of gynecomastia include excess alcohol, marijuana, and the anabolic steroids used by athletes.
Although the chances that gynecomastia will become breast cancer are small, it should be taken as a symptom of hormonal imbalance, most specifically excess estrogen, or a high ratio of estrogen to androgens (male hormones).
For more information, please read Dr. Lee's booklet, Hormone Balance for Men.
Published online in Cancer, the journal of the American Cancer Society, May 24, 2004,
Yet Another Good Reason to Eat Soy Products in Moderation
Soybean products, including soy oil, block iodine uptake. Your thyroid gland cannot function properly without iodine. Symptoms of low thyroid function include fatigue, dry skin and hair, cold hands and feet. Other iodine blockers include fluoride and chlorine. Other foods that block iodine uptake include raw kale, turnips, broccoli, cauliflower and cabbage, but once you cook them they're fine. For more details, please read Chapters 4 (about thyroid) and Chapter 16 (about soy) in What Your Doctor May Not Tell You About Breast Cancer.
Pap Smears Revert to Normal with the Right Treatment
A premenopausal woman (in her ´40s) named Nancy wrote me three months ago to tell me she was scheduled to have a hysterectomy because of abnormal (dysplasia) Pap smears. She had been treated with birth control pills (why is a mystery) but the Pap smear was still abnormal. I referred her to our "PREmenopause" book and suggested that she consider three months of cyclic progesterone cream (15 mg/day of progesterone from day 12 to day 26 of the cycle), folic acid (4 to 5 mg/day), and vitamin B6 (50 mg/day), and then get another Pap smear. I asked her to let me know the results.
Last week Nancy wrote to report that her repeat Pap smears were entirely normal. She said that her doctor did a cervical biopsy and it, too, was entirely normal. Her doctor called it a spontaneous remission and reluctantly cancelled their intended surgery. I suggested she get another repeat Pap smear in six months to mollify her doctor. I get mail like Nancy's every week: this approach is certainly preferable to a hysterectomy, by any measure.
In my experience, the great majority of abnormal Pap smears (that are not due to obvious inflammation) are due to deficiencies of folic acid and progesterone, and they all routinely revert to normal cells when the deficiencies are corrected.