From July/Aug '99
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RESEARCH
Echinacea Doesn't Work?
A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections by Wolfram Grimm in the February 1999 issue of the American Journal Medicine studied 109 patients and found only a small decrease in the percent of people suffering from colds (60% vs. 74%), number of colds (.78 vs .93), and duration of sickness (4.5 vs 6.5 days). However, none of the results were significant, so the authors declared the herb no better than placebo (106:138).
JM: At the turn of the century, Echinacea was the best selling medicinal plant in America; its use decreased after the introduction of antibiotics. This herb has been found to stimulate the immune system, thus it is believed to help prevent and treat common infections, including colds and other upper and lower respiratory infections. Two previous controlled studies have shown Echinacea reduced the severity and duration of colds, and respiratory infections of viral and bacterial origin. Side effects from this treatment are almost nonexistent. Even though the data did not reach statistical significance, the trend for improvement was definitely shown in this experiment. So next cold season I will be taking my Echinacea and increasing the dose at the first hint I'm coming down with something. How about you?
Grains for a Longer Life
Is whole grain associated with reduced total and cause-specific death rates in older women? The Iowa Women's Health Study, published in the March 1999 issue of the American Journal of Public Health by David Jacobs found a lower risk of dying for women who consumed whole grains and a higher risk for those who consumed refined grain products (89:322). Risk of dying from cancer, heart disease, and overall death risk was improved for those who ate whole grains.
JM: Whole grains are filled with nutrients in their natural condition. Stripping the outer coat of a grain to make white flour and white rice removes fiber, essential fats, vitamins and minerals -- all necessary for good health. Adding these back as vitamin and mineral supplements is not the same because they are then in unbalanced quantities and removed from the normal environment of the whole food -- the whole is much greater than the parts. Unfortunately, the largest change in terms of consumption of energy in the US diet since the 1900’s has been the reduction in grain intake from 36% in 1909 to 1919, declined to 18% in 1970, and increased to 23% in 1990. Reduction in whole grains consumed has been even greater, with the almost universal acceptance of white bread and rice by the American family. You, however, always knew it: whole grains can help you have a longer and healthier life.
Partial Hysterectomies Are Back
Supercervical hysterectomy: Back to the future? by D.E Darnell Jones in the March 1999 issue of the American Journal of Obstetrics and Gynecology supported the return of a partial hysterectomy which leaves the cervix in place, rather than a total hysterectomy (180:513). Because at the turn of the century, the risk of death was twice as great for a total hysterectomy, this operation was reserved for only those patients who absolutely needed to have their cervix removed. By the middle of this century, with reduced operative risks, total hysterectomy became fashionable with little scientific rational supporting its almost universal use.
The primary rational doctors give today for this extensive surgery is to prevent cervical cancer. However, screening with routine Pap smears effectively prevents cervical cancer. Consider this: Carcinoma of the cervix occurs in less than 1 in 1000 women who have had a partial hysterectomy. Vaginal cancer occurs more commonly than this, yet as the authors point out "no one recommends a routine vaginectomy with a hysterectomy."
There are many advantages to leaving the cervix: less operative risks, less chance of bladder, bowel, and sexual dysfunction, and less risk of infection.
JM: The Male-dominated medical business has a well-deserved reputation for being insensitive to women when it comes to their medical care. Preserving your cervix, if you do need a hysterectomy, is an important choice you should insist on, whenever possible. (See the McDougall Program for Women , chapter 10, for a detailed discussion of hysterectomies).
Prostate Cancer Detection is Just Luck
Early detection of prostate cancer --Serendipity strikes again by Mary McNaughton Collins in the November 1997 issue of the Journal of the American Medical Association found that serendipity may be responsible for finding one quarter of tumors detected by digital rectal exam and one quarter of PSA detected tumors (278:1516). The detection of a cancer by chance alone is referred to as serendipity. "If the prostate cancers likely to be detected by serendipity are eliminated from the calculations, the predictive value of DRE (digital rectal exam) decreases by 28% and the true predictive value of PSA screening would be reduced by 25% relative to recently published estimates."
JM: Autopsy studies reveal 30% of men over the age of 50 have prostate cancer. Therefore, biopsy of the prostate gland is likely to find a cancer regardless of whether or not the PSA or the DRE examination is positive or negative. Thus, more small tumors are being detected that otherwise would not have been found. If these small tumors do not threaten a man's life, then men are being too aggressively treated for these small tumors.
Tumors less than a cubic centimeter in volume are too small to cause an elevation of PSA levels. Over 25% of all tumors found are less than 1 cm3 and therefore undetectable by PSA. Small tumors are also usually missed by DRE. If small tumors are important then doctor's are missing too many.
The truth is prostate cancers fall into two broad categories. Those that are destined to spread because of their aggressive nature. Unfortunately, these tumors have already spread by the time of diagnosis, so local treatment is too late. And those never destined to spread, so these never need treatment. Only in retrospect can you tell which kind a patient has. The bottom line is that no studies have shown aggressive treatment, like surgery and/or radiation, prolong lives over doing nothing at all.
Vitamin A Causes Weak Bones
Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture by Hakan Melhus in the November 1998 issue of the Annuals of Internal Medicine found the vitamin A form, known as retinol, increases the risk of osteoporotic related hip fractures (129:770). People in Northern Europe consume on the average 6 times more retinol than those in Southern Europe, and also have 7 times more hip fractures. Animal studies have shown high intakes of retinol accelerate bone loss, bone fragility, and spontaneous fractures. For every 1 mg daily increase in intake of vitamin A, the risk of hip fracture increased by 67%.
JM: So where do you get retinol from? This is the form of vitamin A found in many vitamin supplements, cod liver oil, fortified milk and other dairy products. Because animals make retinol from the plant precursor of vitamin A, known as beta carotene, unfortified dairy products and meat and fish (especially the livers) also contain significant amounts of this potentially toxic vitamin. Margarines are commonly fortified with vitamin A.
A previous study by these same authors found the more calcium consumed by people, the more hip fractures they suffered (Int J Epidemiol 24:771, 1994). The connection may be the retinol in dairy foods. This may account for the high rates of hip fractures in the United States, Norway, and Sweden.
The plant precursor of vitamin A, beta carotene is never toxic even when ingested in large amounts. However, retinol can cause birth defects, bone damage, and other serious changes.
Animal protein is the major factor in the cause of osteoporosis. Populations that consume large amounts of vitamin A also consume large quantities of animal protein. Worldwide, the more animal protein consumed the more hip fractures. In opposition to the dairy industry’s advertisements, the truth is the more calcium consumed by the people in a country, the more hip fractures. The least that can be said from this observation is calcium intake, and specifically dairy products, do not protect from the dietary factors that really do cause osteoporosis, like animal protein and retinol.
More Water, Less Bladder Cancer
Fluid intake and the risk of bladder cancer in men in the May 1999 issue of the New England Journal of Medicine by Dominique Michaud found the more the fluid intake, the less the risk of bladder cancer. The risk was decreased by 7% for each increment of 8 ounces of daily fluid intake (340:1390). Overall, high intake of fluids may reduce the risk by 50%. Water and all other fluids combined lowered the risk. The benefits are believed derived from the dilution of cancer-causing chemicals collected in the bladder, and reducing the contact time of these chemicals through increased frequency of urination.
JM: There are 310,000 new cases of bladder cancer diagnosed worldwide annually. In the US this is the fourth leading type of cancer in men. Several sources of cancer causing substances are suspected, for example, products of cigarette smoke combustion and chlorine in drinking water. Coffee and alcohol intake have also been associated with more bladder cancer, while fruit and vegetable consumption is associated with less bladder cancer. One more possible benefit from more fluid intake is less risk of kidney stones and there are no adverse effects from drinking more water (Am J Epidemiol 143:240, 1996). So, you will benefit from increasing your fluid intake above what your thirst drive seems to require.
Birth Defects From Organic Solvents
Pregnancy outcome following gestational exposure to organic solvents -- A prospective controlled study by Sohail Khattak in the March 24/31, 1999 issue of the Journal of the American Medical Association found an increased risk of major deformities in children born to women exposed to organic solvents at levels sufficiently high enough to cause symptoms(281:1106). Women who reported symptoms from exposure had 13 times greater risk of having a child with malformations. There also was found twice the risk of miscarriage, almost 3 times as much fetal distress and 3 times the likelihood having a low birth weight baby among woman working with these substances.
The malformations included: major heart deformities, deafness, clubfoot, neurotube defects (spina bifida), penis abnormalities, deformities of the larynx, and hernia.
The most common occupations for exposure were factory workers, laboratory technicians, professional artists, graphic designers, and printing industry workers.
The substances most commonly contacted were aliphatic and aromatic hydrocarbons, phenols, trichloroethylene, xylenes, vinyl chloride, acetone, and related compounds.
JM: The authors suggest "it is prudent to minimize women's exposure to organic solvents during pregnancy." This is too weak a stand against an identified cause of serious birth defects. All efforts must be taken by women of reproductive age to avoid contact with these substances (you may become pregnant when you least expect). If you work near such chemicals and become pregnant you should be immediately moved to a place where you will not be exposed. You also need to go through your household cleaning supplies to identify those containing organic solvents, and avoid these too. Considering the toxicity of these substances, everyone should use extreme caution to avoid contamination.
From July/Aug '99
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