The Benefits of Brassicas
Edible plants in the Brassica family (also know as cruciferous vegetables), are grown all over the world – a partial list includes: broccoli, kale, collards, cauliflower, cabbage, napa cabbage, Brussels sprouts, mustards, bok choy, arugula, turnip, radish, daikon, cress, kohlrabi, horseradish, wasabi. These vegetables contain multiple nutrients with anti-cancer properties. In 1992, Drs. Paul Talalay and Jed Fahey of the Johns Hopkins University School of Medicine founded the Brassica Chemoprotection Laboratory, in order to test and cultivate plants that would have the highest levels of protective enzymes.
They isolated a phytochemical in broccoli called SGS, ‘sulforaphane glucosinolate’, an enzyme that helps neutralize cancer-causing chemicals, as well as free radicals, before they can damage DNA and initiate the development of cancer. They found that SGS blocked the formation of mammary tumors in rats treated with a potent carcinogen: The number of rats that developed tumors was reduced by as much as 60%, the number of tumors in each animal was reduced by 80%, and the size of the tumors that did develop was reduced by 75%. Scientists at the American Health Foundation discovered that SGS inhibited the formation of premalignant lesions in the colons of rats. Researchers in Toulouse, France found that SGS induced cell death in human colon carcinoma cells. This study suggests that in addition to the activation of detoxifying enzymes, induction of apoptosis [cell death] is also involved in the sulforaphane-associated prevention of cancer. These results have not yet been validated in humans.
Dr. Talalay and his team have examined a wide range of broccoli plants to determine which had the highest levels of sulforaphane. Varieties of broccoli were found to differ significantly in the amounts of SGS they contained and, as the plant grows older, the concentration of SGS decreased. Conversely, young plants (three-day-old sprouts) yielded much more concentrated enzyme-induced activity. Findings from this research demonstrated that certain varieties of three-day-old broccoli sprouts contain between 20 and 50 times the concentration of SGS as the mature, cooked vegetable. They are now producing and selling their own variety of broccoli sprouts (broccosprouts.com), and Brassica teas (BrassicaTea.com). You can often find broccoli sprouts in markets and you can buy organic broccoli seed for sprouting at home: http://www.healthyeating.com 800-695-2241. Here’s a good site for learning to sprout: http://www.themindfuleater.com/archives/2007/03/making_sprouts.html
Indole-3-carbinol - another compound in Brassica vegetables has also been found to decrease susceptibility to cancer in laboratory animals. It alters estrogen metabolism in a favorable way, and its metabolite 3'Diindolylmethane is a strong androgen receptor antagonist in human prostate cancer cells. Researchers at the University of California and elsewhere warn that it is too early to start using indole-3-carbinol as a supplement for cancer prevention.
However, it’s always a good time to eat more Brassica vegetables. Grow some of your own. Even if you don’t garden, you can grow radishes in deep pots, or make your own sprouts.
Sadja Greenwood, MD, MPH –back issues on this blog. Leave me a message!
no columns on 8/24/09 or 8/31/09.
Sunday, August 16, 2009
Sunday, August 9, 2009
Serotonin and Your Bones
Go to Health: Serotonin and your bones
Neurotransmitters are chemicals in our bodies which relay and regulate signals between a neuron (nerve cell) and another cell. The neurotransmitter serotonin is best known for its role in the brain, where it helps regulate mood, sexual desire & function, appetite, sleep, memory & learning, temperature regulation, and some social behaviors such as assertiveness and aggression. However, 90% of our body's total serotonin is made by the cells of the gut, where it is used to regulate intestinal movement. It is synthesized from tryptophan, an amino acid found in protein foods, including plant foods. When you have a ‘gut feeling’, it’s real - you are reacting to serotonin and other neurotransmitters in the intestinal tract! Blood platelets pick up serotonin from the gut and transport it to blood vessels, the heart, the liver and other organs, including bone cells. (Platelets are tiny cells, without a nucleus, that come from white blood cells in the bone marrow. One of their main functions is to prevent bleeding.)
Bones may seem dense, but inside they have honeycomb-like scaffolding that allow them to be strong without being too heavy. Throughout life they are constantly remodeling themselves, making new tissue where needed and clearing out old bone. In recent years, studies have shown that there are molecules that transport serotonin into bone cells. This was an unexpected finding, and research into its meaning is ongoing. What has emerged is that bones get weaker in the presence of more serotonin, and stronger with less.
SSRIs This finding is important for the 8-10% of adults who are taking SSRIs (selective serotonin reuptake inhibitors) to treat depression. These drugs increase the amount of serotonin in the body – thereby helping mood but potentially weakening bone. Studies in Canada and the US have shown greater rates of bone loss and fractures among people taking SSRIs. While these antidepressant drugs – such as Prozac, Paxil, Zoloft, Celexa, Luvox, Lexapro and others – have been very important for many depressed people, their possible side effects on bone should be more widely known.
Users of SSRIs and most midlife women should consider having a test for bone density (called a DEXA scan), and should also work on measures to help build strong bones. New bone growth is helped by exercise, especially strength training. Walk, jog, hike, play tennis or soccer – depending on your age and abilities. A good book for strength training is Growing Stronger – Strength Training for Older Adults. You can download it for free at
http://growingstronger.nutrition.tufts.edu/book.html.
*Most people need extra Vitamin D - get a blood level of 25 hydroxy vitamin D. A level above 30 ng/ml is desirable, and 50 ng/ml is considered optimum. You will probably need to take at least 1000 IU of supplemental D daily.
*Get 1000 mg of calcium and at least 500 mg of magnesium daily in food and supplements. Eat a healthy diet with lots of fruits and vegetables (red, orange and yellow pigments in plant food inhibit bone breakdown).
*Don’t smoke
* If you drink alcohol, stop at 1 drink daily for women and 2 for men.
*Taking sex hormones (estrogen, progesterone, testosterone) by pill or patch can help bone strength but also can increase cancer risk and is not advisable for most people over 50.
*Your doctor may advise a medication to increase bone strength; these can be helpful, but be aware of their side effects too..
Sadja Greenwood, MD, MPH –back issues on this blog. Leave a message!
Neurotransmitters are chemicals in our bodies which relay and regulate signals between a neuron (nerve cell) and another cell. The neurotransmitter serotonin is best known for its role in the brain, where it helps regulate mood, sexual desire & function, appetite, sleep, memory & learning, temperature regulation, and some social behaviors such as assertiveness and aggression. However, 90% of our body's total serotonin is made by the cells of the gut, where it is used to regulate intestinal movement. It is synthesized from tryptophan, an amino acid found in protein foods, including plant foods. When you have a ‘gut feeling’, it’s real - you are reacting to serotonin and other neurotransmitters in the intestinal tract! Blood platelets pick up serotonin from the gut and transport it to blood vessels, the heart, the liver and other organs, including bone cells. (Platelets are tiny cells, without a nucleus, that come from white blood cells in the bone marrow. One of their main functions is to prevent bleeding.)
Bones may seem dense, but inside they have honeycomb-like scaffolding that allow them to be strong without being too heavy. Throughout life they are constantly remodeling themselves, making new tissue where needed and clearing out old bone. In recent years, studies have shown that there are molecules that transport serotonin into bone cells. This was an unexpected finding, and research into its meaning is ongoing. What has emerged is that bones get weaker in the presence of more serotonin, and stronger with less.
SSRIs This finding is important for the 8-10% of adults who are taking SSRIs (selective serotonin reuptake inhibitors) to treat depression. These drugs increase the amount of serotonin in the body – thereby helping mood but potentially weakening bone. Studies in Canada and the US have shown greater rates of bone loss and fractures among people taking SSRIs. While these antidepressant drugs – such as Prozac, Paxil, Zoloft, Celexa, Luvox, Lexapro and others – have been very important for many depressed people, their possible side effects on bone should be more widely known.
Users of SSRIs and most midlife women should consider having a test for bone density (called a DEXA scan), and should also work on measures to help build strong bones. New bone growth is helped by exercise, especially strength training. Walk, jog, hike, play tennis or soccer – depending on your age and abilities. A good book for strength training is Growing Stronger – Strength Training for Older Adults. You can download it for free at
http://growingstronger.nutrition.tufts.edu/book.html.
*Most people need extra Vitamin D - get a blood level of 25 hydroxy vitamin D. A level above 30 ng/ml is desirable, and 50 ng/ml is considered optimum. You will probably need to take at least 1000 IU of supplemental D daily.
*Get 1000 mg of calcium and at least 500 mg of magnesium daily in food and supplements. Eat a healthy diet with lots of fruits and vegetables (red, orange and yellow pigments in plant food inhibit bone breakdown).
*Don’t smoke
* If you drink alcohol, stop at 1 drink daily for women and 2 for men.
*Taking sex hormones (estrogen, progesterone, testosterone) by pill or patch can help bone strength but also can increase cancer risk and is not advisable for most people over 50.
*Your doctor may advise a medication to increase bone strength; these can be helpful, but be aware of their side effects too..
Sadja Greenwood, MD, MPH –back issues on this blog. Leave a message!
Sunday, August 2, 2009
Go to Health: Turmeric –Curcumin
Turmeric has been gathered and cultivated in India for over 2500 years, used as an orange dye, a medicinal plant and a spice in curry. Today there is renewed interest in turmeric and its main ingredient curcumin for their potential activity against cancer, Alzheimer’s disease, arthritis and many other health problems.
Cancer: At the University of Texas MD Anderson Cancer Center, Dr. Bharat Aggarwal is studying curcumin. He says that the combined rate of the four most common cancers in the United States—lung, prostate, breast, and colon—is much lower in India, where curry is a staple in the diet. Aggarwal is studying the ability of curcumin to shut down nuclear factor kappa B (NF-kB), which is involved in the regulation of inflammation and many other processes. By blocking the activity of this ‘master switch’, curcumin appears to interfere with the cancer process at an early point, impeding multiple routes of growth: reducing the inflammatory response, inhibiting the proliferation of tumor cells, inducing their self-destruction, and discouraging the growth of blood vessels feeding tumors. These effects can shrink tumors and inhibit metastasis. Also, shutting down NF-kB can enable chemotherapy drugs to destroy cancer cells more effectively. Research on curcumin and various cancer types is still preliminary, and laboratory based; there have been few human trials. It would be unwise to stop cancer chemotherapy to take curcumin; some oncologists are interested in using curcumin as a supplement. See the new book ‘Life over Cancer’ by oncologist Keith Block MD for a full discussion of this supplement and other complementary therapies..
Alzheimer’s Disease: Based on the finding that there is 4 times less Alzheimer’s disease in India than in the US (turmeric is used as a daily spice in Indian curries), researchers at UCLA are studying the ability of synthetic curcumin and Vitamin D to clear the amyloid plaques found in the brains of people with Alzheimer’s. Laboratory experiments have shown that blood cells called macrophages are able to destroy amyloid plaque when incubated with Vitamin D and a form of synthetic curcumin. Studies using Vitamin D and curcumin in human patients are underway at UCLA, USC and various universities in India.. At present, there is no recommended dose of curcumin for treatment or prevention. (see my blog on Vitamin D for dose ideas on Vitamin D)
Arthritis and Bone Loss
Since curcumin is anti-inflammatory, it is being tried in the treatment of rheumatoid arthritis, with active trials at UCLA. Osteoarthritis may also be helped. At the University of Arizona, there is a study on curcumin’s ability to prevent bone loss in mid-life women.
Inflammatory Bowel Disease: Both Crohn’s Disease and ulcerative colitis can result in abdominal pain, diarrhea, weight loss and fatigue, and often strike children or young adults. At the U. of Arizona there are studies showing that daily curcumin pills were able to decrease intestinal damage and cut the number of relapses by 50%. The researchers stressed that curcumin should not replace standard therapies.
Cautions: Curcumin as a supplement should not be used in pregnancy and lactation, or in people with gall bladder disease because it stimulates bile secretion and gallbladder contractions. Most people, however, can find a reputable supplement company (ask a pharmacist) and try 500 mg with food once or twice daily. Everyone can buy (or make) curry powder and cook curries at home!
Sadja Greenwoood MD, MPH –back issues on this blog
Cancer: At the University of Texas MD Anderson Cancer Center, Dr. Bharat Aggarwal is studying curcumin. He says that the combined rate of the four most common cancers in the United States—lung, prostate, breast, and colon—is much lower in India, where curry is a staple in the diet. Aggarwal is studying the ability of curcumin to shut down nuclear factor kappa B (NF-kB), which is involved in the regulation of inflammation and many other processes. By blocking the activity of this ‘master switch’, curcumin appears to interfere with the cancer process at an early point, impeding multiple routes of growth: reducing the inflammatory response, inhibiting the proliferation of tumor cells, inducing their self-destruction, and discouraging the growth of blood vessels feeding tumors. These effects can shrink tumors and inhibit metastasis. Also, shutting down NF-kB can enable chemotherapy drugs to destroy cancer cells more effectively. Research on curcumin and various cancer types is still preliminary, and laboratory based; there have been few human trials. It would be unwise to stop cancer chemotherapy to take curcumin; some oncologists are interested in using curcumin as a supplement. See the new book ‘Life over Cancer’ by oncologist Keith Block MD for a full discussion of this supplement and other complementary therapies..
Alzheimer’s Disease: Based on the finding that there is 4 times less Alzheimer’s disease in India than in the US (turmeric is used as a daily spice in Indian curries), researchers at UCLA are studying the ability of synthetic curcumin and Vitamin D to clear the amyloid plaques found in the brains of people with Alzheimer’s. Laboratory experiments have shown that blood cells called macrophages are able to destroy amyloid plaque when incubated with Vitamin D and a form of synthetic curcumin. Studies using Vitamin D and curcumin in human patients are underway at UCLA, USC and various universities in India.. At present, there is no recommended dose of curcumin for treatment or prevention. (see my blog on Vitamin D for dose ideas on Vitamin D)
Arthritis and Bone Loss
Since curcumin is anti-inflammatory, it is being tried in the treatment of rheumatoid arthritis, with active trials at UCLA. Osteoarthritis may also be helped. At the University of Arizona, there is a study on curcumin’s ability to prevent bone loss in mid-life women.
Inflammatory Bowel Disease: Both Crohn’s Disease and ulcerative colitis can result in abdominal pain, diarrhea, weight loss and fatigue, and often strike children or young adults. At the U. of Arizona there are studies showing that daily curcumin pills were able to decrease intestinal damage and cut the number of relapses by 50%. The researchers stressed that curcumin should not replace standard therapies.
Cautions: Curcumin as a supplement should not be used in pregnancy and lactation, or in people with gall bladder disease because it stimulates bile secretion and gallbladder contractions. Most people, however, can find a reputable supplement company (ask a pharmacist) and try 500 mg with food once or twice daily. Everyone can buy (or make) curry powder and cook curries at home!
Sadja Greenwoood MD, MPH –back issues on this blog
Sunday, July 26, 2009
The DASH Diet - Dietary Approach to Stop Hypertension
If your blood pressure is higher than you or your doctor would like, you may be pleased to know how you can help make things better. The DASH diet is a well-researched way to improve your health and your blood pressure. It emphasizes:
*fruits and vegetables
*fat free or low fat milk or yogurt
*whole grains – brown rice, whole wheat, oats, rye, barley, corn, quinoa
*lean meat, poultry or fish
*nuts, seeds and beans
*small amounts of oil or soft (non-hydrogenated) margarine.
*Sweets, soft drinks and added sugars should be very low in this diet.
*Salt and salty foods (read labels!) should be minimized to make the diet effective - try to lower your sodium intake to 1500 milligrams per day. 2/3 teaspoon of salt =1500 mg.
* alcohol can increase blood pressure: men should not drink more than 2 drinks a day, women not more than one.
The potassium found in fruits and vegetables and the calcium in dairy products or fortified soy milk are important in this diet. People have found that their blood pressure begins to decline within the first two weeks of adherence. Remember that celery is effective for lowering blood pressure, and pomegranate juice has also been found helpful. According to researchers at the U. of Maryland, if you already take medication to lower blood pressure, pomegranate juice or extract could make the effects of those drugs too strong, so check with your doctor. You may be able to reduce your dose of medications.
To make the DASH Diet work for you, details and plans for daily meals and snacks are needed. The National Heart, Lung and Blood Institute has a good explanatory website:
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
Alternatively, search your local library for the DASH diet; they will probably carry books on the subject. Amazon has several books: ‘The DASH Diet Action Plan: Based on the National Institutes of Health Research’ by Marla Heller, or ‘Your Guide to Lowering Your Blood Pressure With DASH’.
While you explore the DASH Diet, you should know about other approaches that have been shown to lower blood pressure:
*30 minutes of brisk walking daily may keep some people off of medication, and lower the dose for others. Two walks of 15 minutes are also good. Get a pal; make it fun; contact the trees and birds. Biking, swimming and other sustained aerobic exercise will also work.
*weight loss: the Dash Diet and exercise will help with this. Every 2 pounds lost can bring down blood pressure 1 point. After a year of gradual weight loss,, your blood pressure might be normal.
*transcendental meditation has been studied at the University of Kentucky and found to be the most effective relaxation method for lowering blood pressure: http://www.tm.org/national-institutes-of-health. This method of meditation is now non-religious and easy to learn.
*Resperate: this device has been studied at Rush University and the Mayo Clinic, and found helpful in guiding users into deep slow breathing that lowers blood pressure. It should be used 15 minutes 3-4 times a week, and will only be effective as long as it is used. The price is $300, but it can be tried for a month for $25. www.resperate.com or call 877-988-9388.
One in 3 adults in the US have high blood pressure. It is important to pay attention to this problem, in order to avoid having a stroke, heart attack or heart failure. Use a home blood pressure cuff, and work with your doctor and nurse-practitioner to get normal readings!
Sadja Greenwood, MD, MPH
*fruits and vegetables
*fat free or low fat milk or yogurt
*whole grains – brown rice, whole wheat, oats, rye, barley, corn, quinoa
*lean meat, poultry or fish
*nuts, seeds and beans
*small amounts of oil or soft (non-hydrogenated) margarine.
*Sweets, soft drinks and added sugars should be very low in this diet.
*Salt and salty foods (read labels!) should be minimized to make the diet effective - try to lower your sodium intake to 1500 milligrams per day. 2/3 teaspoon of salt =1500 mg.
* alcohol can increase blood pressure: men should not drink more than 2 drinks a day, women not more than one.
The potassium found in fruits and vegetables and the calcium in dairy products or fortified soy milk are important in this diet. People have found that their blood pressure begins to decline within the first two weeks of adherence. Remember that celery is effective for lowering blood pressure, and pomegranate juice has also been found helpful. According to researchers at the U. of Maryland, if you already take medication to lower blood pressure, pomegranate juice or extract could make the effects of those drugs too strong, so check with your doctor. You may be able to reduce your dose of medications.
To make the DASH Diet work for you, details and plans for daily meals and snacks are needed. The National Heart, Lung and Blood Institute has a good explanatory website:
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
Alternatively, search your local library for the DASH diet; they will probably carry books on the subject. Amazon has several books: ‘The DASH Diet Action Plan: Based on the National Institutes of Health Research’ by Marla Heller, or ‘Your Guide to Lowering Your Blood Pressure With DASH’.
While you explore the DASH Diet, you should know about other approaches that have been shown to lower blood pressure:
*30 minutes of brisk walking daily may keep some people off of medication, and lower the dose for others. Two walks of 15 minutes are also good. Get a pal; make it fun; contact the trees and birds. Biking, swimming and other sustained aerobic exercise will also work.
*weight loss: the Dash Diet and exercise will help with this. Every 2 pounds lost can bring down blood pressure 1 point. After a year of gradual weight loss,, your blood pressure might be normal.
*transcendental meditation has been studied at the University of Kentucky and found to be the most effective relaxation method for lowering blood pressure: http://www.tm.org/national-institutes-of-health. This method of meditation is now non-religious and easy to learn.
*Resperate: this device has been studied at Rush University and the Mayo Clinic, and found helpful in guiding users into deep slow breathing that lowers blood pressure. It should be used 15 minutes 3-4 times a week, and will only be effective as long as it is used. The price is $300, but it can be tried for a month for $25. www.resperate.com or call 877-988-9388.
One in 3 adults in the US have high blood pressure. It is important to pay attention to this problem, in order to avoid having a stroke, heart attack or heart failure. Use a home blood pressure cuff, and work with your doctor and nurse-practitioner to get normal readings!
Sadja Greenwood, MD, MPH
Monday, July 20, 2009
Go to Health - Salt - Sodium Chloride
Our tongue and palate taste foods that are sweet, salty, sour, bitter and savory (umami). Salt is essential for us, as it is found in our blood, cells, bones, and the fluid between cells. Salt is necessary for the function of our nerves and muscles. The digestion of food in our stomachs by hydrogen chloride also comes from salt. When humans were hunter-gatherers, we got salt from eating animals; they got theirs from finding salt in rocks, brackish water and brine springs. (The city of Buffalo is named for the buffalo who made a wide path to a salt lick near Lake Erie!) When we became farmers, we needed to find sources of salt for our diets; the story of how humans have found, prepared and traded salt is a fascinating one of early commerce. You can find it in "Salt - A World History" by Mark Kurlansky.
How much salt to we need? The answer varies – depending on our body size, the amount we sweat, and problems such as serious diarrhea or kidney disease. The present consensus is that adults need 1000 - 1500 mg of sodium a day, and should not get more than 2400 mg. However, we are now averaging 3436 mg a day. Sodium is present in all animal food we eat, in small amounts in vegetables, but in large amounts in bread and prepared foods, which make up 70-80% of our daily salt intake.
Why does excess salt in our diet matter? You know the answer – it has to do with high blood pressure (hypertension). Increased salt causes more fluid to be retained in the blood vessels, so the heart must work harder to pump blood through the body. Salt may also act on arterioles - blood vessels that dilate and constrict to regulate blood pressure and blood flow. By contracting under the influence of sodium, arterioles increase resistance to the movement of blood and thereby increase blood pressure. Genetics play a role in our sensitivity to salt – some people are more susceptible to high blood pressure, and sodium sensitivity appears to increase with age. African Americans tend to be more salt sensitive than others and should be especially careful to eat less salt. A national study showed that 29% of US adults have hypertension (systolic pressure consistently over 140, diastolic over 90 on multiple readings), and another 28% have prehypertension. (systolic pressure of 120-139, diastolic of 80-89 on multiple readings). An increased risk for heart disease and stroke is the reason for concern about blood pressure.
Since most of the salt in our diets comes from prepared food – be prepared to find it! Carefully read the labels on canned and dried soups, sauces, vegetable juices, salad dressing, lunch meats, bacon, bread, popcorn, crackers and chips. Most of us don’t have the time or desire to make everything at home, but we can all be detectives. Making more foods from scratch saves money as well as health. Your taste for lots of salt is reversible; decrease your use gradually and your taste buds will adjust. As you eat more fruits and vegetables you will be increasing the potassium in your diet. A potassium-rich diet blunts the effects of salt on blood pressure, may reduce the risk of developing kidney stones, and possibly decrease bone loss with age.
When you are on the go, pack fresh and dried fruit in your bag, along with carrots, celery and unsalted nuts. Try low sodium V-8, or Knudsen’s plain or organic low sodium Very Veggie.
Next week I’ll describe the DASH diet, and other ways to lower blood pressure, including the right kind of exercise, and gradual weight loss.
Sadja Greenwood, MD, MPH
How much salt to we need? The answer varies – depending on our body size, the amount we sweat, and problems such as serious diarrhea or kidney disease. The present consensus is that adults need 1000 - 1500 mg of sodium a day, and should not get more than 2400 mg. However, we are now averaging 3436 mg a day. Sodium is present in all animal food we eat, in small amounts in vegetables, but in large amounts in bread and prepared foods, which make up 70-80% of our daily salt intake.
Why does excess salt in our diet matter? You know the answer – it has to do with high blood pressure (hypertension). Increased salt causes more fluid to be retained in the blood vessels, so the heart must work harder to pump blood through the body. Salt may also act on arterioles - blood vessels that dilate and constrict to regulate blood pressure and blood flow. By contracting under the influence of sodium, arterioles increase resistance to the movement of blood and thereby increase blood pressure. Genetics play a role in our sensitivity to salt – some people are more susceptible to high blood pressure, and sodium sensitivity appears to increase with age. African Americans tend to be more salt sensitive than others and should be especially careful to eat less salt. A national study showed that 29% of US adults have hypertension (systolic pressure consistently over 140, diastolic over 90 on multiple readings), and another 28% have prehypertension. (systolic pressure of 120-139, diastolic of 80-89 on multiple readings). An increased risk for heart disease and stroke is the reason for concern about blood pressure.
Since most of the salt in our diets comes from prepared food – be prepared to find it! Carefully read the labels on canned and dried soups, sauces, vegetable juices, salad dressing, lunch meats, bacon, bread, popcorn, crackers and chips. Most of us don’t have the time or desire to make everything at home, but we can all be detectives. Making more foods from scratch saves money as well as health. Your taste for lots of salt is reversible; decrease your use gradually and your taste buds will adjust. As you eat more fruits and vegetables you will be increasing the potassium in your diet. A potassium-rich diet blunts the effects of salt on blood pressure, may reduce the risk of developing kidney stones, and possibly decrease bone loss with age.
When you are on the go, pack fresh and dried fruit in your bag, along with carrots, celery and unsalted nuts. Try low sodium V-8, or Knudsen’s plain or organic low sodium Very Veggie.
Next week I’ll describe the DASH diet, and other ways to lower blood pressure, including the right kind of exercise, and gradual weight loss.
Sadja Greenwood, MD, MPH
Sunday, July 12, 2009
Go to Health: Celery and Purslane
Go to Health: Celery and Purslane
About 40% of medicines in the U.S. today come from plants—or are based on chemicals found in plants. Beyond that, nearly 70 percent of the Earth's 6.2 billion people rely on plant-based medicine. Here are two examples close to home that we may have ignored:
Celery – crunchy and familiar
Purslane - an amazing ‘weed’
Celery lowers blood pressure: Scientists at the University of Chicago and at the Hunan Hematological Research Center in China have determined the mechanisms by which celery lowers blood pressure. Celery contains a chemical called 3-n-butyl phthalide, which relaxes the smooth-muscle lining of blood vessels, making them wider and thereby lowering blood pressure. Phthalide works by lowering the concentration of stress hormones in the blood, which constrict blood vessels. In studies with normal rats, a dose of phthalide equivalent to four stalks of celery in humans lowered blood pressure by an average of 13 percent. The same dose also lowered the rats' cholesterol levels by 7 percent. Celery contains 341 milligrams potassium and 125 milligrams sodium per 100 gram serving. Any food with a ratio of three parts potassium to one part sodium is good for people with high blood pressure. Small studies indicate that celery may also be helpful in reducing uric acid levels in gout.
Some people are allergic to celery. If that is not the case, try 4 stalks a day (not the leaves) for blood pressure problems, and check with your clinic and your home-based blood pressure cuff to see if it is useful.
Purslane has omega-3s and more: Purslane was used in ancient Greece, Africa and India as a medicine. Found throughout the world, it reached the Americas by the 1400s. Purslane contains more alpha linolenic acid (ALA) than any other leafy green vegatable. ALA, also found in walnuts, flax seed and greens, is slowly converted by our bodies into the omega-3 fatty acids found in fish. Purslane has a higher mineral content than most vegetables we eat and has various potent antioxidants. After millennia of widespread use as a folk medicine, it is now being tested on a surprising variety of health problems.
*Oral lichen planus –a chronic condition affecting the lining of the mouth with white patches, which can be painful. Studies done in the US and Iran show that purslane capsules were helpful.
*Diabetes – preliminary animal studies in China show that purslane can lower blood glucose levels and raise HDL cholesterol (the good kind).
*Anti-aging effects – animal studies in China showed that purslane increased memory, mental activity and various biochemical signs of aging.
*Heavy uterine bleeding – Studies at the medical university in Qom, Iran showed that 8 out of 10 women whose abnormal bleeding did not respond to standard treatment had normal periods after taking purslane seed powder for 3 days after the onset of bleeding.
*Phytoremediation: Japanese scientists at the University of Osaka have found purslane can remove bisphenol A - an endocrine disrupting compound with estrogenic properties – from ground water. Indian scientists at the Sardar Patel Centre for Science and Technology have found that purslane picks up heavy metals in industrial effluent, and can be used to clean contaminated areas.
Go purslane, the 21st century vegetable! You can find purslane at some farmer's markets. You can buy seed on line; just search for purslane seed.
Sadja Greenwood, MD –back issues on this blog. Leave me your comments.
About 40% of medicines in the U.S. today come from plants—or are based on chemicals found in plants. Beyond that, nearly 70 percent of the Earth's 6.2 billion people rely on plant-based medicine. Here are two examples close to home that we may have ignored:
Celery – crunchy and familiar
Purslane - an amazing ‘weed’
Celery lowers blood pressure: Scientists at the University of Chicago and at the Hunan Hematological Research Center in China have determined the mechanisms by which celery lowers blood pressure. Celery contains a chemical called 3-n-butyl phthalide, which relaxes the smooth-muscle lining of blood vessels, making them wider and thereby lowering blood pressure. Phthalide works by lowering the concentration of stress hormones in the blood, which constrict blood vessels. In studies with normal rats, a dose of phthalide equivalent to four stalks of celery in humans lowered blood pressure by an average of 13 percent. The same dose also lowered the rats' cholesterol levels by 7 percent. Celery contains 341 milligrams potassium and 125 milligrams sodium per 100 gram serving. Any food with a ratio of three parts potassium to one part sodium is good for people with high blood pressure. Small studies indicate that celery may also be helpful in reducing uric acid levels in gout.
Some people are allergic to celery. If that is not the case, try 4 stalks a day (not the leaves) for blood pressure problems, and check with your clinic and your home-based blood pressure cuff to see if it is useful.
Purslane has omega-3s and more: Purslane was used in ancient Greece, Africa and India as a medicine. Found throughout the world, it reached the Americas by the 1400s. Purslane contains more alpha linolenic acid (ALA) than any other leafy green vegatable. ALA, also found in walnuts, flax seed and greens, is slowly converted by our bodies into the omega-3 fatty acids found in fish. Purslane has a higher mineral content than most vegetables we eat and has various potent antioxidants. After millennia of widespread use as a folk medicine, it is now being tested on a surprising variety of health problems.
*Oral lichen planus –a chronic condition affecting the lining of the mouth with white patches, which can be painful. Studies done in the US and Iran show that purslane capsules were helpful.
*Diabetes – preliminary animal studies in China show that purslane can lower blood glucose levels and raise HDL cholesterol (the good kind).
*Anti-aging effects – animal studies in China showed that purslane increased memory, mental activity and various biochemical signs of aging.
*Heavy uterine bleeding – Studies at the medical university in Qom, Iran showed that 8 out of 10 women whose abnormal bleeding did not respond to standard treatment had normal periods after taking purslane seed powder for 3 days after the onset of bleeding.
*Phytoremediation: Japanese scientists at the University of Osaka have found purslane can remove bisphenol A - an endocrine disrupting compound with estrogenic properties – from ground water. Indian scientists at the Sardar Patel Centre for Science and Technology have found that purslane picks up heavy metals in industrial effluent, and can be used to clean contaminated areas.
Go purslane, the 21st century vegetable! You can find purslane at some farmer's markets. You can buy seed on line; just search for purslane seed.
Sadja Greenwood, MD –back issues on this blog. Leave me your comments.
Sunday, June 28, 2009
Go to Health - Moving Right Along
Go to Health: Moving right along
Our bodies have magnificently evolved to move, but life can get in the way: computers, sedentary work, commuting, television, child-care, fatigue. Here are two ways for busy people to vary the 30 minutes of dedicated daily exercise that has been shown to reduce cardiovascular risk and keep us fit.
The Treadmill Desk—aka iPLod
Dr James Levine at the Mayo clinic disliked visiting the gym after a long workday. In his lab he is studying ‘Non-exercise Activity Thermogenesis’. He has devised a way for office workers to walk slowly on a treadmill while working on their computers or talking on the phone. His lab also has a two lane walking track that serves as a meeting room. He puts the treadmill on a very slow speed (as slow as 1 mph), which is fast enough to burn an extra 100 calories per hour, and up to 1,000 extra per day on his average 10-hour workday. Levine placed 15 obese workers on treadmills in front of computers and found they burned an extra 119 calories an hour walking at their own pace. During the course of a year, those workers could lose close to 50 pounds if they practiced healthy eating, the researchers said.
Some companies, such as Mutual of Omaha and Humana, are trying out ‘walkstations’, and finding that some employees cannot get used to them, but others find it helps their ability to focus on work. While commercially produced walkstations are expensive, some people with home offices can build their own tray holding a laptop over a treadmill. Another message from this research is that staying on your feet as much as possible during the day – even with slow walking – is beneficial for weight loss or maintaining a healthy weight. Keep moving! Here are two good websites that illustrate these strategies.
http://www.mayoclinic.com/health/treadmill-desk/MM00706
http://www.nytimes.com/2008/09/18/health/nutrition/18fitness.html
Interval Training
Interval training is alternating bursts of intense activity with intervals of lighter activity. Researchers at McMaster University in Ontario are studying whether humans can increase endurance with only a few minutes of strenuous exercise, instead of hours. They had a group of healthy college students, not athletes, ride a stationary bike at a sustainable pace for between 90 and 120 minutes. Another set of students grunted through a series of short, strenuous intervals: 20 to 30 seconds of cycling at the highest intensity the riders could stand. After resting for four minutes, the students pedaled hard again for another 20 to 30 seconds, repeating the cycle four to six times. Each of the two groups exercised three times a week. After two weeks, both groups showed almost identical increases in their endurance, even though the one group had exercised for six to nine minutes per week, and the other about five hours. Additionally, molecular changes that signal increased fitness were evident equally in both groups. People who have a chronic health condition or who haven't been exercising regularly should consult a doctor before trying interval training, and overuse injury of muscles and tendons can also be a problem. Here’ a recent website on interval training:
http://well.blogs.nytimes.com/2009/06/24/can-you-get-fit-in-six-minutes-a-week/
Sadja Greenwood, MD –back issues on this blog, leave a message! no column on 7/6/09; celery & purslane on 7/13/09
Our bodies have magnificently evolved to move, but life can get in the way: computers, sedentary work, commuting, television, child-care, fatigue. Here are two ways for busy people to vary the 30 minutes of dedicated daily exercise that has been shown to reduce cardiovascular risk and keep us fit.
The Treadmill Desk—aka iPLod
Dr James Levine at the Mayo clinic disliked visiting the gym after a long workday. In his lab he is studying ‘Non-exercise Activity Thermogenesis’. He has devised a way for office workers to walk slowly on a treadmill while working on their computers or talking on the phone. His lab also has a two lane walking track that serves as a meeting room. He puts the treadmill on a very slow speed (as slow as 1 mph), which is fast enough to burn an extra 100 calories per hour, and up to 1,000 extra per day on his average 10-hour workday. Levine placed 15 obese workers on treadmills in front of computers and found they burned an extra 119 calories an hour walking at their own pace. During the course of a year, those workers could lose close to 50 pounds if they practiced healthy eating, the researchers said.
Some companies, such as Mutual of Omaha and Humana, are trying out ‘walkstations’, and finding that some employees cannot get used to them, but others find it helps their ability to focus on work. While commercially produced walkstations are expensive, some people with home offices can build their own tray holding a laptop over a treadmill. Another message from this research is that staying on your feet as much as possible during the day – even with slow walking – is beneficial for weight loss or maintaining a healthy weight. Keep moving! Here are two good websites that illustrate these strategies.
http://www.mayoclinic.com/health/treadmill-desk/MM00706
http://www.nytimes.com/2008/09/18/health/nutrition/18fitness.html
Interval Training
Interval training is alternating bursts of intense activity with intervals of lighter activity. Researchers at McMaster University in Ontario are studying whether humans can increase endurance with only a few minutes of strenuous exercise, instead of hours. They had a group of healthy college students, not athletes, ride a stationary bike at a sustainable pace for between 90 and 120 minutes. Another set of students grunted through a series of short, strenuous intervals: 20 to 30 seconds of cycling at the highest intensity the riders could stand. After resting for four minutes, the students pedaled hard again for another 20 to 30 seconds, repeating the cycle four to six times. Each of the two groups exercised three times a week. After two weeks, both groups showed almost identical increases in their endurance, even though the one group had exercised for six to nine minutes per week, and the other about five hours. Additionally, molecular changes that signal increased fitness were evident equally in both groups. People who have a chronic health condition or who haven't been exercising regularly should consult a doctor before trying interval training, and overuse injury of muscles and tendons can also be a problem. Here’ a recent website on interval training:
http://well.blogs.nytimes.com/2009/06/24/can-you-get-fit-in-six-minutes-a-week/
Sadja Greenwood, MD –back issues on this blog, leave a message! no column on 7/6/09; celery & purslane on 7/13/09
Sunday, June 21, 2009
Go to Health - Omega-3 fatty acids
Go to Health – Omega-3 fatty acids
Humans have been eating aquatic animals since the beginning of our evolution. We depended on the rivers, lakes, and marshes to survive in the African heat. Some anthropologists believe we were only able to become large-brained because we regularly included fish and other aquatic animals in our diet. The beneficial fats in fish and shellfish are known as EPA and DHA (also called omega-3 fatty acids); they are made by microalgae in seawater, consumed by fish and accumulated in their fat and organs.. When we eat fish, shellfish or fish oil capsules, we experience some of the following benefits:
*Heart - a current review of 15 large studies, published in the American Journal of Nutrition, states that EPA and DHA consumption markedly reduces the risk of cardiac death. The scientists recommended establishment of a Dietary Reference Intake for EPA and DHA (250-500 mg/day) to reduce the risk of heart disease – the leading cause of death of men and women in the US and other developed countries. The mechanisms by which omega-3 fatty acids work is thought to be by suppressing irregular heart beats, decreasing clotting and inflammation, and lowering triglycerides.
*Brain - the human brain is composed of about 60% fat; studies show that omega-3 fatty acids are essential for nervous tissue growth and function. In 1996, the Journal of the American Medical Association published a study comparing the prevalence of depression across ten nations. The survey showed how the lifetime and annual rates for depression vary widely from country to country. (1.5 in every 100 adults in Taiwan experience depression in their lifetimes while the figure is 19 for every 100 adults in Beirut). A 1998 study published in The Lancet compared this data with fish consumption, finding the higher consuming populations had less depression. A 2003 study published in the American Journal of Psychiatry compared similar cross-national data, involving bipolar disorder, again finding a strong correlation between this illness and seafood consumption. Dr.Andrew Stoll, a Harvard psychiatrist, uses fish oil capsules to treat depression, bipolar disease, and anxiety, in addition to standard treatment in serious cases. His book ‘The Omega-3 Connection’ explains the use of fish oil capsules for mood stabilization in many illnesses, including post-partum depression. Pediatricians are aware that improving maternal DHA/EPA nutrition decreases the risk of poor infant and child visual and neural development. Pregnant and breast feeding mothers are often advised to include (very low mercury) fish or fish oil in their diet, and some infant formulas are now available with added omega-3s.
*Vegetarians – Vegan omega-3 capsules made from microalgae are sold in natural food stores. Walnuts, flax, pumpkin seed and purslane contain a type of fat similar to fish oil, called alpha linolenic acid. This compound is converted to EPA in the body, but the conversion is not complete. Both EPA and DHA are found in fish oil, which makes it the most desirable nutrient for omega-3s. Concern about mercury in fish makes it important to eat wisely, avoiding large fish like swordfish and shark. Look for the words ‘molecularly distilled’ on fish oil caps. Here’s a good website for avoiding both mercury and endangered species of fish:
www.nrdc.org/health/effects/mercury/walletcard.PDF
Sadja Greenwood, MD
Humans have been eating aquatic animals since the beginning of our evolution. We depended on the rivers, lakes, and marshes to survive in the African heat. Some anthropologists believe we were only able to become large-brained because we regularly included fish and other aquatic animals in our diet. The beneficial fats in fish and shellfish are known as EPA and DHA (also called omega-3 fatty acids); they are made by microalgae in seawater, consumed by fish and accumulated in their fat and organs.. When we eat fish, shellfish or fish oil capsules, we experience some of the following benefits:
*Heart - a current review of 15 large studies, published in the American Journal of Nutrition, states that EPA and DHA consumption markedly reduces the risk of cardiac death. The scientists recommended establishment of a Dietary Reference Intake for EPA and DHA (250-500 mg/day) to reduce the risk of heart disease – the leading cause of death of men and women in the US and other developed countries. The mechanisms by which omega-3 fatty acids work is thought to be by suppressing irregular heart beats, decreasing clotting and inflammation, and lowering triglycerides.
*Brain - the human brain is composed of about 60% fat; studies show that omega-3 fatty acids are essential for nervous tissue growth and function. In 1996, the Journal of the American Medical Association published a study comparing the prevalence of depression across ten nations. The survey showed how the lifetime and annual rates for depression vary widely from country to country. (1.5 in every 100 adults in Taiwan experience depression in their lifetimes while the figure is 19 for every 100 adults in Beirut). A 1998 study published in The Lancet compared this data with fish consumption, finding the higher consuming populations had less depression. A 2003 study published in the American Journal of Psychiatry compared similar cross-national data, involving bipolar disorder, again finding a strong correlation between this illness and seafood consumption. Dr.Andrew Stoll, a Harvard psychiatrist, uses fish oil capsules to treat depression, bipolar disease, and anxiety, in addition to standard treatment in serious cases. His book ‘The Omega-3 Connection’ explains the use of fish oil capsules for mood stabilization in many illnesses, including post-partum depression. Pediatricians are aware that improving maternal DHA/EPA nutrition decreases the risk of poor infant and child visual and neural development. Pregnant and breast feeding mothers are often advised to include (very low mercury) fish or fish oil in their diet, and some infant formulas are now available with added omega-3s.
*Vegetarians – Vegan omega-3 capsules made from microalgae are sold in natural food stores. Walnuts, flax, pumpkin seed and purslane contain a type of fat similar to fish oil, called alpha linolenic acid. This compound is converted to EPA in the body, but the conversion is not complete. Both EPA and DHA are found in fish oil, which makes it the most desirable nutrient for omega-3s. Concern about mercury in fish makes it important to eat wisely, avoiding large fish like swordfish and shark. Look for the words ‘molecularly distilled’ on fish oil caps. Here’s a good website for avoiding both mercury and endangered species of fish:
www.nrdc.org/health/effects/mercury/walletcard.PDF
Sadja Greenwood, MD
Monday, June 15, 2009
Go to Health - Chewing Gum – some surprising benefits
Chewing gum is prohibited in many schools because it can be noisy, distracting and tends to be stuck under chairs and tables. Chewing gum has been considered impolite and ugly, especially bubble gum. Most commercial gum is made with sugar or questionable substitutes such as saccharin and aspartame. Gum chewers can develop pain in their temporomandibular joints (TMJ), especially if they chew on one side of their mouth for too long. That’s the down side. Here are some interesting benefits.
*Aid in weight loss: chewing gum vigorously (100 chews a minute) has been shown to slightly increase metabolic rate. Gum can also be an appetite suppressant. A study found that chewing gum before an afternoon snack caused people to consume 25 less snack calories. While that is not a high number, even a slight reduction in caloric intake can have significant effects in the long term. Gum can be an alternative to mindless munching. Dieters who crave sweets can chew xylitol sweetened gum after a meal to signal the end of eating. Xylitol is a form of sugar found in plants, trees, fruits and vegetables It has 40% less calories than sugar, and tastes as sweet, with no aftertaste. It may be safe for some with diabetes - check with your doctor.
*Abdominal surgery
A new study has shown that chewing gum after abdominal surgery may help in recovery. Chewing gum reduces the time for the gut to become active, lowering the incidence of obstruction of the bowel and stimulating the release of gut hormones. Furthermore, gum chewers have better chances of avoiding nausea and vomiting after the operation.
*Dental benefits: ingredients such as Xylitol and Peelu in gum may help cleaning your teeth, decreasing tooth decay and dental plaque.. The US Army puts xylitol gum in its MRE (meals ready to eat) because it blocks bacteria from producing the acids that cause tooth decay,. Xylitol also increases saliva flow, which helps neutralize any acids and provides calcium to repair any weakened areas of the teeth. Soldiers returning from combat had been showing serious amounts of dental decay. Now they are advised to chew xylitol gum for 5 minutes 3x daily.
*Memory Aid!: An English study of gum chewing showed that chewers scores were 24% -36% higher than controls on immediate and delayed word recall, and also more accurate on tests of spatial memory. Explanations for the link between recall and chewing gum are varied: Chewing gum raises the heart beat by around 3 beats per minute, increasing blood flow in the cerebral area, which could explain the improvement in such brain activity. Chewing gum while taking in information, and chewing again at the time it needs to be recalled, such as in an exam, may aid in a memory association between the action or taste of chewing gum and the information being remembered. Based on these suppositions, a Stanford student has developed a product called Think Gum, popular on campus at exam time. It contains peppermint, rosemary, ginkgo biloba, vinpocetine from periwinkle plants, the Indian herb bacopa, and guarana, a source of caffeine (10 mg per piece). Since simpler may be safer,
My advice is– try xylitol gum – found in natural food and vitamin stores..
Sadja Greenwood, MD – back issues on my blog http://sadjascolumns.blogspot.com
Chewing gum is prohibited in many schools because it can be noisy, distracting and tends to be stuck under chairs and tables. Chewing gum has been considered impolite and ugly, especially bubble gum. Most commercial gum is made with sugar or questionable substitutes such as saccharin and aspartame. Gum chewers can develop pain in their temporomandibular joints (TMJ), especially if they chew on one side of their mouth for too long. That’s the down side. Here are some interesting benefits.
*Aid in weight loss: chewing gum vigorously (100 chews a minute) has been shown to slightly increase metabolic rate. Gum can also be an appetite suppressant. A study found that chewing gum before an afternoon snack caused people to consume 25 less snack calories. While that is not a high number, even a slight reduction in caloric intake can have significant effects in the long term. Gum can be an alternative to mindless munching. Dieters who crave sweets can chew xylitol sweetened gum after a meal to signal the end of eating. Xylitol is a form of sugar found in plants, trees, fruits and vegetables It has 40% less calories than sugar, and tastes as sweet, with no aftertaste. It may be safe for some with diabetes - check with your doctor.
*Abdominal surgery
A new study has shown that chewing gum after abdominal surgery may help in recovery. Chewing gum reduces the time for the gut to become active, lowering the incidence of obstruction of the bowel and stimulating the release of gut hormones. Furthermore, gum chewers have better chances of avoiding nausea and vomiting after the operation.
*Dental benefits: ingredients such as Xylitol and Peelu in gum may help cleaning your teeth, decreasing tooth decay and dental plaque.. The US Army puts xylitol gum in its MRE (meals ready to eat) because it blocks bacteria from producing the acids that cause tooth decay,. Xylitol also increases saliva flow, which helps neutralize any acids and provides calcium to repair any weakened areas of the teeth. Soldiers returning from combat had been showing serious amounts of dental decay. Now they are advised to chew xylitol gum for 5 minutes 3x daily.
*Memory Aid!: An English study of gum chewing showed that chewers scores were 24% -36% higher than controls on immediate and delayed word recall, and also more accurate on tests of spatial memory. Explanations for the link between recall and chewing gum are varied: Chewing gum raises the heart beat by around 3 beats per minute, increasing blood flow in the cerebral area, which could explain the improvement in such brain activity. Chewing gum while taking in information, and chewing again at the time it needs to be recalled, such as in an exam, may aid in a memory association between the action or taste of chewing gum and the information being remembered. Based on these suppositions, a Stanford student has developed a product called Think Gum, popular on campus at exam time. It contains peppermint, rosemary, ginkgo biloba, vinpocetine from periwinkle plants, the Indian herb bacopa, and guarana, a source of caffeine (10 mg per piece). Since simpler may be safer,
My advice is– try xylitol gum – found in natural food and vitamin stores..
Sadja Greenwood, MD – back issues on my blog http://sadjascolumns.blogspot.com
Sunday, June 7, 2009
Mifepristone (RU486), the medical abortion pill
Go to Health – Mifepristone – the Medical Abortion pill – RU486
Women have been using herbs, poisons, soap solutions, sticks and pointed roots for millennia to try to get rid of an unwanted pregnancy. Illegal, unsafe abortion is a nightmare for women and their health-care providers. Surgical abortion, legal in the US since 1973 (since 1969 in California) has made the process safe, effective and much less traumatic.
In the 1980’s, French doctors began to work on a pill that would induce abortion – it was licensed there in 1988 and called RU486, or mifepristone (Mfp). In the US, it underwent clinical trials in the 1990’s and was approved in 2000. It is legal and available in all 50 states, Washington D.C., Guam and Puerto Rico.
Medical abortion with Mfp can be used as soon as a woman confirms that she is pregnant, and up to 8-9 weeks from the beginning of her last menstrual period. It is most effective if done early. The pills are effective about 95% of the time. In 3% to 5% of cases women will need a suction abortion due to continued pregnancy, prolonged or excessive bleeding.
Mfp works by blocking the action of progesterone, a hormone needed for the continuation of pregnancy. After taking the Mfp pills, in a clinic or doctor’s office, the woman is given a medicine called misoprostol (MSP) to use in a few days. MSP is taken by mouth or inserted into the vagina – clinics differ in their instructions on this. It causes the uterus to contract and expel the pregnancy, often with bleeding that resembles a heavy, crampy period. Infection is a rare side effect of medical and surgical abortions. Women should always be under the care of their clinic or doctor while undergoing an abortion and should follow instructions carefully.
The University of California San Francisco has a helpful website explaining the procedure and comparing medical and surgical abortions: http://www.ucsfhealth.org/adult/edu/abortion.html
Medical Abortion with Mfp is legal throughout Europe (not in Ireland and Poland), and in many Asian countries including India, China, Vietnam and Japan. In Africa, only South Africa and Tunisia allow abortions. In Latin America abortion is legal only in Cuba and Mexico City. The World Health Organization estimates that 21% of all pregnancies in Latin America end in unsafe abortions. MSP, which causes strong uterine contractions, is available over the counter in many areas, sold as Cytotec, a drug designed for preventing stomach ulcers. It is widely used – without Mfp - by women seeking abortion, with very little information on how to use it or handle problems of heavy bleeding, cramping or infection.
The recent murder of Dr George Tiller, a doctor who performed late abortions in Kansas, is a terrible reminder of the passions on both sides of the abortion debate. I had an abortion when it was illegal in this country; I took care of women after illegal abortions, and I performed many thousands of legal procedures. My conclusions – keep it safe and legal; remember contraception.
Sadja Greenwood, MD
Women have been using herbs, poisons, soap solutions, sticks and pointed roots for millennia to try to get rid of an unwanted pregnancy. Illegal, unsafe abortion is a nightmare for women and their health-care providers. Surgical abortion, legal in the US since 1973 (since 1969 in California) has made the process safe, effective and much less traumatic.
In the 1980’s, French doctors began to work on a pill that would induce abortion – it was licensed there in 1988 and called RU486, or mifepristone (Mfp). In the US, it underwent clinical trials in the 1990’s and was approved in 2000. It is legal and available in all 50 states, Washington D.C., Guam and Puerto Rico.
Medical abortion with Mfp can be used as soon as a woman confirms that she is pregnant, and up to 8-9 weeks from the beginning of her last menstrual period. It is most effective if done early. The pills are effective about 95% of the time. In 3% to 5% of cases women will need a suction abortion due to continued pregnancy, prolonged or excessive bleeding.
Mfp works by blocking the action of progesterone, a hormone needed for the continuation of pregnancy. After taking the Mfp pills, in a clinic or doctor’s office, the woman is given a medicine called misoprostol (MSP) to use in a few days. MSP is taken by mouth or inserted into the vagina – clinics differ in their instructions on this. It causes the uterus to contract and expel the pregnancy, often with bleeding that resembles a heavy, crampy period. Infection is a rare side effect of medical and surgical abortions. Women should always be under the care of their clinic or doctor while undergoing an abortion and should follow instructions carefully.
The University of California San Francisco has a helpful website explaining the procedure and comparing medical and surgical abortions: http://www.ucsfhealth.org/adult/edu/abortion.html
Medical Abortion with Mfp is legal throughout Europe (not in Ireland and Poland), and in many Asian countries including India, China, Vietnam and Japan. In Africa, only South Africa and Tunisia allow abortions. In Latin America abortion is legal only in Cuba and Mexico City. The World Health Organization estimates that 21% of all pregnancies in Latin America end in unsafe abortions. MSP, which causes strong uterine contractions, is available over the counter in many areas, sold as Cytotec, a drug designed for preventing stomach ulcers. It is widely used – without Mfp - by women seeking abortion, with very little information on how to use it or handle problems of heavy bleeding, cramping or infection.
The recent murder of Dr George Tiller, a doctor who performed late abortions in Kansas, is a terrible reminder of the passions on both sides of the abortion debate. I had an abortion when it was illegal in this country; I took care of women after illegal abortions, and I performed many thousands of legal procedures. My conclusions – keep it safe and legal; remember contraception.
Sadja Greenwood, MD
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