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Health Bits and Pieces
By Michael Janson, M.D.
March 01, 2005
A high intake of folic acid is well known to reduce the risk of birth defects and cancer, and in addition to lower serum homocysteine levels to reduce the risk of heart disease. It now appears that supplements of folate also reduce the risk of high blood pressure. Daily consumption of 800 mcg of folate compared to 200 mcg was associated with a 29 percent lower risk of hypertension among younger women and a 13 percent reduction among older women. The study involved over 150,000 women, and it showed that total folic acid intake over 1000 mcg from food and supplements cuts the risk in half for younger women, and by 20 percent in older women. When supplements alone were considered, the reduction was 48 and 40 percent in the two groups respectively. High-dose supplements were necessary; food levels alone did not reduce risk. (Forman JP, et al., Folate intake and the risk of incident hypertension among US women. JAMA. 2005 Jan 19; 293(3):320-9.
One reason for the benefit from folate is that it appears to help protect the endothelium, the arterial lining cells that produce the relaxant, nitric oxide. This is apparent from a study of children with diabetes. Supplements of 5 mg of folate improved endothelial function and improved blood flow. (Pena AS, Folic acid improves endothelial function in children and adolescents with type 1 diabetes. J Pediatr. 2004 Apr; 144(4):500-4.). Folate is found in beans, leafy greens, whole grains, and supplements, but supplements are needed for the most benefits.
“Metabolic syndrome” includes elevated blood pressure, and high blood sugar, cholesterol, and insulin levels, low HDL, and abdominal obesity. It is also referred to as “insulin resistance” or sometimes as “syndrome X”, and is associated with an increased risk of type 2 diabetes and heart disease. A study of 6436 subjects evaluated from 1988 to 1994, and 1677 from 1999-2000 showed that the condition is rising in the United States. A small increase of 2.2 percent was observed in men, but in women the rise was 23.5 percent.(Ford ES, et al., Increasing prevalence of the metabolic syndrome among US Adults. Diabetes Care. 2004 Oct; 27(10):2444-9.) Weight control, exercise, and high fiber diets are essential to prevent the likely rise in diabetes.
Contrary to some fad diet recommendations to avoid all grains, whole grains actually decrease the incidence of insulin resistance. In a study of 978 adults with normal or impaired insulin sensitivity, researchers found that as whole grain intake increased, insulin sensitivity improved. (Liese AD, et al., Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Am J Clin Nutr. 2003 Nov; 78(5): 965-71). Increasing meat consumption, however, is associated with an increased risk of developing diabetes. In the Women’s Health Study of 37,309 participants, those with the highest levels of meat consumption had a 28 percent higher incidence of diabetes. (Song Y, et al., A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women's health study. Diabetes Care. 2004 Sept; 27(9):2108-15.) Dietary cholesterol, meat-related iron, and animal protein also increased diabetes incidence. This information, taken together, is in direct opposition to the claims of several widely popular fad diets.
Drug side effects are getting increasing press, with the increased risk of developing heart disease from the newer COX-2 inhibitor NSAIDs (non-steroidal anti-inflammatory drugs, such as Vioxx, Celebrex, and naproxen) and the revelation that Prozac is associated with increasing suicidal and violent behaviors. Even regular use of ibuprofen (such as Advil and Motrin, the older NSAIDs) for three months or more causes an increase in damage to the small intestinal lining. In a study of 41 arthritis patients, small bowel injury was seen in 71 percent of the NSAID users, compared to only 10 percent of the controls, who took acetaminophen (Tylenol) or nothing. (Graham DY, et al., Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol. 2005 Jan; 3(1):55-9.) Effective natural treatments for arthritis are also available, such as glucosamine sulfate, chondroitin sulfate, SAMe, niacinamide, gamma-linolenic acid, vitamin E, and fish oil supplements, among others. Natural anti-inflammatory supplements are also helpful, such as vitamin C, curcumin, ginger, bromelain, and nettle.
A study of lead levels and cataract in men shows that lifetime exposure to even low levels of lead from tap water, lead paint, and other sources increases the risk of cataract formation. In the 795 men, those with the highest bone lead levels, compared to those with the lowest, had 2.5-3 times the risk of developing a cataract. Bone lead is indicative of chronic exposure. (Schaumberg DA, et al., Accumulated lead exposure and risk of age-related cataract... JAMA 2004 Dec 8; 292(22):2750-4.) Lead is an insidious toxin, associated with high blood pressure and brain deterioration. Lead removal through chelation therapy (intravenous with EDTA or oral treatment with DMSA – dimercaptosuccinic acid) is a safe and effective way to reduce body lead burdens. It may also help to take N-acetyl cysteine, vitamin C, and zinc.
Michael Janson, MD, is Past President of the American College for Advancement in Medicine. He is the author of four books, including Dr. Janson’s New Vitamin Revolution and the User’s Guide to Heart Healthy Supplements. He has a free monthly newsletter, Dr. Janson’s Healthy Living, available at his website, www.drjanson.com. He practices in New England and Florida.
