Treating elevated homocysteine levels‏

When I encounter patients with elevated homocysteine levels above 10 or 12 micromols/L, I encourage them to start high quality, complete and balanced nutritional supplements that contain at least 1,000 mcg of folic acid, 100 to 200 mcg of vitamin B12, and at least 50 mg of vitamin B6. If my patients are already taking this level of these B vitamins and their homocysteine levels are still elevated, I will add Betaine or Trimethylglycine (TMG). I will gradually increase the dose from 1 gram to even 6 grams in order to get their homocysteine levels at least below 8 micromols/L and hopefully below 6.5 micromols/L.

Some physicians who understand the seriousness of elevated homocysteine levels will sometimes prescribe very high doses of B vitamins. I have not had that much success with this approach. However, I don’t mind increasing the B vitamins as long as they also are adding significant levels of Betaine (TMG). You should have your homocysteine rechecked after 2 to 3 months on either B vitamins or Betaine to be sure your homocysteine level has come down into that safe range. If not, you need to add more Betaine (TMG) up to 6 grams daily in order to reach that goal.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Decreased antioxidant levels increase risk of age-related macular degeneration with exposure to sunlight

The journal Archives of Ophthalmology recently reported that having reduced plasma antioxidant levels and increased exposure to sunlight increases the risk of neovascular, or advanced age-related macular degeneration (AMD).

In a recent study (titled the European Eye Study), over 4,400 participants over age 65 were analyzed for the presence of macular degeneration. Their blood plasma was evaluated for vitamins C and E, the carotenoids lutein and zeaxanthin, and the mineral zinc. Each individual also completed a questionnaire regarding their typical exposure to sunlight. This was used to estimate blue light exposure from visible light, which is known to contribute to the development of macular degeneration.

Early stage macular degeneration was detected in 2,182 participants, and 101 had the advanced form of the disease. The research found no association between blue light exposure and early macular degeneration. However, among participants in the lowest quartile (25 percent) of serum vitamin C, zeaxanthin, vitamin E and zinc, exposure to blue light significantly increased the risk of advanced macular degeneration.

Source: Sunlight exposure, antioxidants, and age-related macular degeneration; Fletcher et al; Arch Ophthalmol 2008 Oct;126(10):1396-403

What are normal homocysteine levels?‏

The medical literature has shown us that a homocysteine level below 6.5 micromols/L is a safe level. As the homocysteine level rises above this level the risk of cardiovascular disease will increase. The higher these levels the greater your risk of having a heart attack or stroke. Most labs report a normal homocysteine should be in the range of 5 to 12 or even 15 micromols/L. If your homocysteine level is above 12 micromols/L, you are in serious trouble. There are now even studies that show that individuals with elevated homocysteine levels are also at greater risk of developing several different kinds of cancers and even Alzheimer’s dementia.

The main point you must remember that the lower your homocysteine level the better. You certainly would want to see your homocysteine level below 6.5. The lower the better is the key when it comes to homocysteine levels. The next Health Nugget will tell you how you can lower your homocysteine level.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Homocysteine‏

Everyone seems to know their cholesterol level and maybe even their HDL (good) cholesterol and LDL (bad) cholesterol. However, very few are aware of their homocysteine level. Yet, elevated homocysteine levels alone have been shown to be the cause of nearly 15% of every heart attack and stoke in the US and around the world. Homocysteine is the by-product of protein metabolism (methionine) and normally is broken down into a benign and safe product. However, primarily because of a deficiency in B vitamins like vitamin B6, B12, and folic acid, homocysteine levels can rise to dangerous levels. Elevated homocysteine levels cause a tremendous amount of inflammation of our arteries. As you have learned, cardiovascular disease is the result of inflammation of our arteries and is not the result of too much cholesterol in our blood stream.

For pennies a day, supplementation with vitamin B6, B12, and folic acid can significantly decrease our homocysteine levels into a safe range nearly 70% of the time. Since there is not a pharmaceutical drug that can accomplish this goal, physicians do not pay as much attention to this problem as they should. I certainly want my patients with elevated homocysteine levels to reduce those levels as best they can through supplementing their diet. I definitely want my patients to have low homocysteine levels—not high homocysteine levels.

Lutein and zeaxanthin may improve visual performance and reduce the effects of glare

The carotenoids lutein and zeaxanthin are most commonly linked to protection from age-related macular degeneration (AMD). In a new study conducted at the University of Georgia, lutein and zeaxanthin were found to reduce the harmful effects of glare on a test group of people with normal eyesight.

Healthy subjects with an average age of 23.9 were assigned to receive daily supplements of lutein (10 mg) and zeaxanthin (2 mg) for six months. The subjects' eyes were then tested for the effects of glare as experienced in everyday situations, including being outdoors on bright days, lengthy sessions of looking at a computer monitor, and nighttime exposure to oncoming headlights.

Following six months of supplementation, the participant's average macular pigment optical density (MPOD) increased significantly from the average value at the beginning of the study. MPOD is a measure of the eye's ability to filter short-wave light.

After testing the subjects for their performance in visual tasks following glare, researchers concluded that four to six months of supplementation with lutein and zeaxanthin significantly reduced the detrimental effects of the exposure and improved visual performance.

Source: Macular pigment and visual performance under glare conditions, Stringham and Hammond, Optom Vis Sci 2008 Feb;85(2):82-8

Dr. Kilmer McCully‏

In the early 1970”s, Dr. Kilmer McCully, who was a pathologist at Harvard, reviewed two autopsies of young boys who had died of a heart attack. This was very concerning since one of the boys was 7 and the other was only 3 years old. He observed that their arteries were as hardened as an 85 year old man’s arteries that had severe atherosclerosis (hardening of the arteries). These boys had a congenital disease known as homocystinuria. They did not have the ability to break down homocysteine into more benign products. Their homocysteine levels were extremely high. Most of these children never see their teenage years because they die prematurely from a heart attack or stroke.

This led Dr. Kilmer McCully to postulate that maybe normal individuals who may have slightly elevated homocysteine levels over a lifetime might be at greater risk themselves of having a premature heart attack or stroke. Several clinical trials over the years have shown that Dr. McCully was right. Elevated homocysteine levels, which can cause a tremendous amount of inflammation in our arteries, are an independent risk factor for developing a heart attack or stroke.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Type 2 Diabetes Mellitus is reversible‏

I have personally documented over 50 patients in my practice that had type 2 diabetes mellitus that were not only able to control their diabetes and get off their medications, but were also able to totally reverse their diabetes. Now not everyone who has diabetes is able to reverse their disease. However, after firmly establishing the healthy lifestyles promoted in the Healthy for Life Program (www.releasingfat.com), many of my diabetic patients were able to reverse their disease. This was documented by the fact that their fasting blood sugar, glucose tolerance test, and their hemoglobin A1C (a measure of the amount of sugar in a red blood cell) all returned to normal off of all diabetic medication.

Now it took my diabetic patients a minimum of 18 to 24 months on the Healthy for Life Program to accomplish this goal. This gives great hope to so many of my patients who are just becoming diabetic. It allows them to significantly slow down the aging process. Just think what you can do if you firmly establish these new, healthier lifestyles that improve insulin resistance before you become diabetic. I personally believe that the Healthy for Life Program is the answer to the diabetes and obesity epidemics.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

American Academy of Pediatrics increases vitamin D recommendations

On Monday, the American Academy of Pediatrics issued a press release regarding a new clinical report titled "Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents." In this new report, the AAP has updated the amount of vitamin D they formally recommend for children from 200 IU per day to 400 IU per day.

"We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits," said Frank Greer, MD, FAAP, chair of the AAP Committee on Nutrition and co-author of the report. "Supplementation is important because most children will not get enough vitamin D through diet alone."

This updated recommendation is largely based on data from clinical trials performed since 2003 (when the original recommendation of 200 IU per day was given). This new data has demonstrated not only a wide safety margin for vitamin D supplementation, but also a surprising occurrence of vitamin D deficiency, particularly in exclusively breastfed infants who are not supplemented with vitamin D.

"Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother's milk, it is important that breastfed infants receive supplements of vitamin D," said Carol Wagner, MD, FAAP, member of the AAP Section on Breastfeeding Executive Committee and co-author of the report. "Until it is determined what the vitamin D requirements of the lactating mother-infant dyad are, we must ensure that the breastfeeding infant receives an adequate supply of vitamin D through a supplement of 400 IU per day."

Quotations taken from the formal AAP press release available at http://www.aap.org/pressroom/nce/nce08vitamind.htm

To review the new clinical report in its entirety, please visit http://www.aap.org/new/VitaminDreport.pdf

Diabetes is a choice‏

I personally believe that over 90% of the cases of type 2 diabetes mellitus can and should be prevented. Even if you have a strong family history of diabetes, it still can be avoided. There is no doubt that many people are more susceptible to developing diabetes. However, it is not inevitable that you will develop diabetes if you have a strong family history, are Black or Hispanic, or even have early signs or prediabetes. You have a choice. The choice is yours. Does it take motivation? Certainly it does; however, you are still in control.

The clinical trials we have just completed have taken patients who had prediabetes and allowed them to "tip back" into a normal metabolic state. If these individuals continue to incorporate these new, healthier lifestyles, they will continue to do well and significantly decrease their risk of becoming diabetic. It is truly a choice.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Clinical trials prove Healthy for Life Program is effective‏

I have just completed a clinical trial using my 12-Week Healthy for Life Program at the University of Colorado Medical School. This clinical trial was done by Holly Wyatt, an endocrinologist, and it was done under the guidelines and direction of the FDA (IRB). 53 participants with insulin resistance completed the study. They enrolled in the 12-Week Online Healthy for Life Program, received high-quality nutritional supplements, began a modest exercise program, and learned to eat a healthy diet. Meal and snack replacements were also used as a behavioral modification tool and they did not spike their blood sugars and contained those good fats. Here are the results:

• They had an average weight loss of 13 pounds and their BMI or Body Mass Index decreased over 2 points and their waist size went down an average of 2 ½ inches.
• Both their systolic and diastolic blood pressure dropped 10 points.
• Total cholesterol dropped 7% (previous study they dropped 17%) and LDL and triglyceride levels also dropped between 10 and 27%.
• Insulin sensitivity improved over 15%
• Blood insulin levels dropped an amazing 47% over the 12 weeks of the study.

All the participants who completed the 12-Week Healthy for Life Program were able to “tip back” into a normal metabolic state and reverse the health consequences of insulin resistance.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Oily fish intake and dietary omega-3s may improve eye health

According to new research, eating one portion per week of fish rich in omega-3 fatty acids may reduce the risk of age-related macular degeneration (AMD) by over 50 percent.

Fish intake, the major source of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may reduce the risk of age-related macular degeneration (AMD). There are two types of AMD: wet and dry. Of these two types, wet AMD is the primary cause of vision loss.

In a study recently published in the American Journal of Clinical Nutrition, researchers recruited 105 people (age 65 and over) with wet AMD and 2170 healthy people to act as controls, then compared their dietary habits using questionnaires. The scientists then investigated the association of oily fish and dietary DHA and EPA with wet AMD.

Compared to people who consumed less than one portion of fish per week, participants who consumed at least one serving of oily fish per week had a 50 percent reduction in risk of developing wet AMD. In addition, people who got at least 300 mg per day of DHA and EPA were 68 and 71 percent less likely to have wet AMD than those with lower consumptions.

The results of this study support previous research indicating a protective benefit of omega-3s against the onset of AMD. The benefit may be due in part to their important role in the layer of nerve cells in the retina.

Source: Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration; Augood et al; American Journal of Clinical Nutrition, Vol. 88, No. 2, 398-406, August 2008

Treating insulin resistance‏

One develops insulin resistance as the result of their poor lifestyles. When you combine the All-American diet with inactivity, you slowly become less and less sensitive to your own insulin. Over time you develop insulin resistance. Since it is our poor lifestyles that get us into this problem, it makes common sense that firmly establishing healthy lifestyles could get us out of this situation. I spent three years researching the medical literature in regards to insulin resistance. The result of that research was my book Healthy for Life [Real Life Press 2005]. My research showed that there was a triad of healthy lifestyles that all improved insulin sensitivity from a different mechanism. When you firmly establish these healthy lifestyles, you give yourself the absolute best chance of reversing insulin resistance and “tipping back” into a normal metabolic state.

I have established an online 12-Week Healthy for Life Program located at www.releasingfat.com to help my patients and any one who wants to become more proactive in protecting or regaining their health. It is really a behavioral modification program designed to take my patients by the hand and guide them into these new, healthier lifestyles that improve insulin sensitivity. My patients are excited when they learn that they never have to go hungry, they feel great, have more energy, their health parameters improve, and they begin losing weight and are not even trying. Even if you have a strong family history of diabetes, I personally feel that you can prevent becoming diabetic over 90% of the time by just living a healthy life.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)

Low vitamin D levels lead to poor physical performance in the elderly‏

In a recent study, researchers examined the association between vitamin D status and physical performance. Among subjects with low vitamin D levels, physical performance and grip strength were significantly lower than that of participants who did not have reduced levels.

In addition to its role in bone health, vitamin D is thought to play a role in musculoskeletal function. In a recent study, researchers examined the association between vitamin D status and physical performance in a sample of 976 persons over the age of 65. The physical performance of the subjects was analyzed using a short physical performance battery (SPPB) and handgrip strength. The SPPB tests included walking speed, ability to stand from a seated position, and ability to maintain balance in progressively more challenging positions.

Over 28% of the women and 13% of the men had vitamin D levels low enough to be considered a deficiency. Nearly three-fourths of the women and over half of the men had vitamin D levels that were considered insufficient. Among subjects with low vitamin D levels, physical performance and grip strength were significantly lower than that of participants who did not have reduced levels. The finding remained valid after taking into consideration other factors (such as season of the year and physical activity levels).

Given the high prevalence of vitamin D deficiency in older populations, additional studies examining the association between vitamin D status and physical function are needed. Current vitamin D recommendations are based on its role in bone health, although emerging research indicates vitamin D may also play important roles in preservation of muscle strength and physical function, as well as potential preventative roles in conditions such as cancer.

Source: Association Between Vitamin D Status and Physical Performance: The InCHIANTI Study, Houston et al, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 62:440-446 (2007)

Early signs of insulin resistance‏

When I began to appreciate the serious consequences of insulin resistance, I had a tremendous advantage over the clinical researchers who were located in the major medical centers of our country. I had been doing annual physicals in the police department, fire department, and sheriff department and all of their employees for over 20 years. When I would see one of these individuals who had develop prediabetes or diabetes, I could look back at years and years of physicals and labwork that I had done. There was a very typical pattern that was evident and I became very familiar with the early signs of insulin resistance. I then began to look for these earlier signs of insulin resistance in all my patients.

* Elevated Blood Pressure—I became concerned when there blood pressure was greater than 130/85.

* Low HDL or good cholesterol—I became concerned when women had an HDL less than 50 or men less than 40.

* High Triglyceride Level—I became concerned when this level began to rise even if it was still in the normal range. I would do a ratio and divide their triglyceride level by their HDL cholesterol, which was an indirect measure of insulin levels. I became concerned when this ratio was greater than 2.

* Expanding Waist Size—I became concerned when women had a waist size greater than 32 to 33 inches and men had a waist size greater than 36 to 37 inches.

Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)