Friday, July 29, 2011

Saving Health Care by taxing junk food?

IHOP Bacon ‘N Beef Cheeseburger has 1,250 calories, plus 620 for onion rings. The Cheesecake Factory Farmhouse Cheeseburger has 1,530 calories, 1900 with fries. A PB&C milkshake at Cold Stone has 2010 calories; it contains peanut butter, chocolate ice cream and milk, with 68 grams of saturated fat and 153 grams of sugar. Since the new health-care law mandates calorie count information on menus, starting in 2011, will this make a difference? Most fast-food chains now offer lower calorie choices – whether this is helping people make wiser choices is not yet clear.

As readers know, the ‘standard American diet’ (SAD) of fast food laden with sugar, fat and salt, is causing an epidemic of obesity, with resultant high rates of diabetes and its many complications. Mark Bittman, a well known food writer and New York Times columnist, analyzes the impact of taxing junk food on our health and health care costs in the July 24th edition of the NYTimes. His premise is that the food industry is interested in profits, not the public health, and that the federal government should establish a bold, national fix. Much of this column is based on Bittman’s ideas. I should add that I agree with him.

The Rudd Center for Food Policy and Obesity at Yale says that taxes become a significant force in changing buying habits for soda at about a penny an ounce. The average American consumes 44.7 gallons of sweetened sodas a year, and another 17 gallons of non-carbonated sweetened drinks. With a 20% tax in the price of sugary drinks, there would be an estimated 20% decrease in consumption, resulting in the prevention of obesity of 1,500,000 Americans (over 10 years) and 400,000 fewer cases of diabetes, saving about $30 billion dollars in health care costs. The money gained in taxes could be used to subsidize the purchase of staple foods like vegetables, whole grains, dried legumes and fruit. This is an essential part of the plan: making healthy foods available and affordable, bringing grocery stores into ‘food deserts’, teaching children and adults how to shop and cook, and supporting farmers markets and community gardens.

Soda taxes have been proposed in Philadelphia, San Francisco, and New York. France and Hungary are also proposing a tax on junk food, while Brazil is subsidizing produce for the poor in its ‘Zero Hunger ‘ program. The idea is gaining ground.

Currently, instead of taxing junk food, we are paying – with tax dollars - to support corn farmers whose corn is made into high-fructose corn syrup – used to sweeten soda! So far, efforts to change what Americans eat through education and persuasion have failed, partly due to the 4 billion spent annually on advertising by the fast-food industry. Bittman says that 86% of food ads seen by children are for foods high in sugar, fat and sodium. The percentage of obese children has tripled in the last 30 years, and of obese adults has more than doubled.

Efforts to tax certain foods will be opposed by those decrying the ’nanny -state’. However, we are faced with a health crisis with serious budgetary implications. Public health regulations have been very successful in other areas.
We now tax cigarettes over $2 per pack – a combination of state and federal excise taxes – and the US smoking rate has fallen from 40% to 20%. Although over 400,000 people still die each year from tobacco, the toll was twice as high before taxation. We have government mandates for seat belts and children’s safety car seats in most states, which are estimated to save over 15,000 lives each year. Government regulation of drinking water and food safety, driving speeds, and building codes have saved countless lives and reduced health care costs.

Here in West Marin we are tremendously lucky to have organic farmers, farmers’ markets and healthy produce. We also have great tasting water. We should all thank our farmers, eat more produce and drink fewer calories, whether it’s soda, sweetened bottled tea, or beer. OK, beer drinkers, I said less, not none! And – support a tax on sweetened soda if it comes around, as it will reduce your health care costs.
Sadja Greenwood, MD, MPH back issues on this blog

Saturday, July 2, 2011

Turmeric - an ancient spice with exciting modern research

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.

At the University of Texas MD Anderson Cancer Center, Dr. Bharat Aggarwal is studying curcumin. Aggarwal, a biochemist and molecular biologist, considers turmeric to offer great promise for health. 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 turmeric (in 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, however some oncologists are interested in curcumin as a supplement. People under treatment for cancer should confer with their oncologist, as curcumin may alter the efficacy of chemotherapy drugs. A detailed discussion of curcumin used in cancer can be found at Dr. Aggarwal’s website www.curcuminresearch.org.

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.

Since curcumin is anti-inflammatory, it is being tried in the treatment of rheumatoid arthritis, with trials at UCLA. Osteoarthritis may also be helped, according to a trial at Western Ontario and McMaster Universities, where researchers used a mixture of curcumin and soy phospholipids, called Meriva. 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 is safe, but should not be used in pregnancy or in people with gall bladder disease because it stimulates bile secretion and gallbladder contractions. Most people, however, can try curcumin supplements, which are better absorbed if combined with pepperine (black pepper). If you look at the recent book by Dr. Aggarwal, Healing Spices, you will find more information on turmeric as well as ways to make your own curries.
Sadja Greenwood MD, MPH –back issues on this blog

Sunday, June 5, 2011

HarvestPlus and the world food crisis

Rising temperatures, droughts and floods are causing agronomists and country leaders great concern. Food staples, such as wheat, corn, rice, and soybeans may not be reliably harvested in the amounts needed for a growing world population. Climate change is considered a significant reason for the problems with crops.

Micronutrients: Beyond rising prices for staple grains, poor people in developing countries are affected by a lack of essential micronutrients in the diet. The World Health Organization has identified iron, zinc and vitamin A as the most limiting elements. Lack of these in a diet of rice or cassava can lead to blindness, stunting and susceptibility to infectious disease. More than 2 billion people in developing countries may have ’hidden hunger’ for essential micronutrients, as they subsist on staple foods (maize, wheat and rice) but have little access to fruits, vegetables, and protein foods. Lack of vitamin A causes about half a million children to go blind every year. Zinc deficiency impairs brain and motor functions; shortage of iron causes anemia and weakness, and affects half the women of childbearing age in some poor countries. A supplement program to provide these nutrients is not affordable or feasible. Policymakers are now asking whether farming could do more to improve nutrition.

HarvestPlus, funded by the Bill and Melinda Gates Foundation and other donors, is working to reduce hidden hunger and provide micronutrients to people directly through the familiar, staple foods they eat. At this point they are using mainly conventional breeding techniques, rather than genetic engineering, to select plants high in iron, zinc and the carotenes that become vitamin A in the body. Their work on developing ’biofortified’ crops is done in collaboration with more than 200 agricultural and nutrition scientists around the world. Biofortification programs are active in China, India, Bangladesh, Latin America and Africa. They are working on cowpeas (a drought tolerant, warm-weather legume, well adapted to drier regions of the tropics), other beans, rice, corn, pearl millet, wheat, sweet potatoes, and cassava. Once biofortified crops are developed, they can be distributed and grown by farmers, year after year, by seed saving.

The traditional sweet potatoes used in Africa and Latin America are light in color and lacking in the needed carotenes that will become vitamin A in the body. Biofortified sweet potatoes, orange in color, have been bred and used in Uganda and Mozambique. Getting people to accept a different looking food item takes planning and education, and is becoming successful. Pearl millet high in zinc and iron will be introduced in India in 2012. Wheat high in zinc will be introduced in India and Pakistan in 2013. Beans high in iron will be tried in Ruanda, cassava high in provitamin A in Nigeria and maize high in provitamin A in Zambia.

World Population: There were 3 billion of us in 1960, and close to 7 billion at present. Food production rose during those years, so that people in developed countries had plenty to eat. In poor countries there could have been adequate calories if distribution had been improved. In many cases, however, crops for export to rich countries used land at the expense of food for the local poor.

In recent years the impact of climate change has raised fears of increasing food scarcity. Crops that can grow despite rising temperatures, drought, and flooding are needed. Arable land is potentially in short supply due to development. We are facing difficult times on this earth, and many are wondering what to do about the challenges. Here are some suggestions:

*Get involved in food politics in the US. See Marion Nestle’s blog, Food Politics, and Healthy Food Action, which will work to improve the 2012 farm bill.

*Support your local food bank.

*Support family planning nationally and internationally, by contributing to Planned Parenthood, the International Planned Parenthood Federation, or other family planning organizations

*Support HarvestPlus. The Gates Foundation can’t do it all!

Sadja Greenwood, MD, MPH back issues on this blog

Monday, May 30, 2011

Beets and Green Vegetables Relax Your Arteries

A recent conference on Nutrition and Health, sponsored by the University of Arizona, contained many useful ideas for everyday life. The problems with sugar, in last week’s column, were on the menu. Here is another topic.

Beets and Greens: These foods contain nitrates, which used to be considered harmful because of serious health problems when infants drank contaminated well water. However, it was found that the main problem was fecal bacteria in the wells, rather than excess nitrates. In the 1970’s, researchers found that dietary nitrates (NO3) are converted into nitric oxide (NO), in the presence of L-arginine (an amino acid) and oxygen. NO is an important ‘signaling molecule’ in the body, diffusing rapidly – as it is a gas – across cell membranes. It causes relaxation of the smooth muscles that line blood vessels, resulting in lower blood pressure and increased blood flow. Nitroglycerine works to lessen the pain of angina (chest pain resulting from lack of oxygen for the heart muscle) by its conversion to NO. Viagra works to simulate penile erection by the release of NO. The production of NO is elevated in people living in high altitudes, which helps them get more oxygen by dilation of the blood vessels in their lungs. NO transmits messages between nerve cells and is associated with memory, learning, sleeping, feeling pain, and depression.

Researchers at Wake Forest University studied volunteers over age 70 given a diet containing beet juice and high nitrate vegetables. The subjects were found to have increased blood flow to their brains, potentially helping to avoid dementia. Studies on beet juice, at the University of Exeter, found it enables people to exercise up to 16% longer. The amount of nitrate in studies on athletes was the equivalent of what is found in 2-3 red beets or a plate of spinach. Other vegetables high in nitrates are kale, lettuce, parsley, cabbage, celery, radishes and turnips.

People with high blood pressure may be interested to know that the DASH Diet (Dietary Approach to Stop Hypertension) may owe at least some of its effectiveness to an emphasis on green leafy vegetables. For those who want quick results without cooking, beet juice is available on line. Mix it with soda water or plain water, and start with a little at a time. A few people don’t feel well after drinking beet juice.

The Dash Diet This diet, which has been shown to be effective in lowering blood pressure, can work surprisingly well within two weeks. DASH is described on line at the WebMD site and also in the book – The DASH Diet Action Plan – based on the National Institutes of Health Research. This book has great reviews, and should be read by anyone who is serious about reducing blood pressure and possibly getting off of blood pressure medications. Of course, it is important to talk to your doctor about changing your medicines. For those who want to start the eating plan right away, here it is. Eat more vegetables, fruits and low or non-fat dairy foods. Eat less red meat, processed meat, sweets and foods high in fat. Eat more whole grains, fish, and poultry. Read labels carefully, and avoid foods high in salt. For snacks, try unsalted popcorn (avoid the buckets in movies!), unsalted nuts of all kinds, raisins, and low or non-fat yogurt. Don’t forget that the nitric oxide (NO) in green vegetables and beets will rapidly go to work for you, by relaxing your arteries, increasing blood flow, and lowering your blood pressure. And, of course, there’s moving the body, which is also good for you, your arteries and your blood pressure. See you on the trails!
Sadja Greenwood, MD, MPH

Tuesday, May 17, 2011

Go to Health: “Fructose is alcohol without the buzz”

So says Dr. Robert Lustig, Professor of Pediatric Endocrinology and director of the children’s obesity program at UCSF. His talk – Sugar: The Bitter Truth – has been watched over a million times on Youtube; I will try to summarize his points in this column.

The obesity epidemic in the US has been growing steadily since the public was told in the 1980s to decrease fats in their diet. The introduction of low-fat processed foods, laden with sugars for palatability, and devoid of fiber, laid the groundwork for our weight gain. Roughly half of teenage boys drink more than two six-packs of soft drinks every week. Today, one in 50 adults is severely obese (with a BMI of 40 or higher) and 34% of us are obese (BMI 30 or higher). The share of obese children has tripled in that time, to 17%. This is more than double the percentages of 30 years ago. Someone whose height is 5’6” is obese at 186 pounds; a 6’ person is obese at 221 pounds.

Understanding sucrose, glucose, fructose and starch: Sucrose is derived from sugar cane and sugar beets. It is 50% glucose and 50% fructose. High fructose corn syrup is 55% fructose and 45% glucose. From the point of view of the liver, they are about the same – neither is good for us. The fructose in whole fruit is fine, because it is encased in fiber, which slows its absorption. Whole fruits also have many beneficial compounds for health. Starch is a complex carbohydrate, made up of joined glucose molecules, used by many plants for energy storage. Our digestion easily breaks down most starch to glucose.

Glucose digestion: When we eat plants, from cabbage to potatoes, we break down their starch to glucose; this travels in the bloodstream to all our body cells for energy use. About a quarter of the glucose goes to the liver, where it makes glycogen – a useful and necessary storage compound for energy. A small amount is translated into fat.

Fructose digestion: When we eat or drink sugar (sucrose) or high fructose corn syrup (HFCS), the 50% or 55% that is fructose goes to the liver, as only the liver can metabolize it. This is in contrast to glucose, used by all our body’s cells. Some fructose is broken down into uric acid and excreted by the kidneys. Uric acid increases the risk of gout, and also elevates blood pressure. Much of it is metabolized to fat, leading to a problem called non-alcoholic fatty liver – rarely if ever seen before the recent sugar craze. Some of it goes into the blood stream as triglycerides, which become fat. As triglycerides rise, and body fat increases, cells become resistant to insulin. Insulin, produced by the pancreas, causes cells in the liver, muscle and fat to take up glucose from the blood, for energy production and storage. When blood glucose rises, due to the cells’ insulin resistance, diabetes results. A diet high in fructose also is associated with ‘leptin resistance’ – the body does not respond to the hormone called leptin that cuts off appetite. The eater keeps on eating.

Alcohol digestion: Alcohol is fermented sugar. When it enters the liver, it is digested in a way that is similar to fructose, resulting in high blood pressure, fat deposition in the liver (ultimately cirrhosis) and increased triglycerides in the bloodstream. Alcohol also leads to obesity (beer belly), insulin resistance and possible addiction. A small amount of alcohol, especially as red wine, is heart-healthy (1 five ounce glass for women, 2 for men). However, even small amounts of alcohol raise women’s risk for breast cancer.

What to do!
Here is the formula that Dr. Lustig gives to the families with children in his obesity clinic: He says it works – they lose weight – if they can follow it and stay off of soda.
1.Only drink water or plain milk
2.Eat carbohydrates with their natural fiber.
3.Wait 20 minutes before seconds.
4.Buy screen time minute for minute with physical activity. Screen time includes TV, DVDs, computer games, et al.
Look at 2 in this table. This would mean avoiding all foods made with sugar – cakes, cookies, pies, candy, ice cream, jam, syrup, the works. These foods were occasional treats one hundred years ago, and now they are everywhere, and often cheaper than real food. It also means eating whole grain pasta, 100% whole grain bread, and brown rice. Even Dr Lustig admits to an occasional dessert, and lets his kids eat ice cream on Sunday (according to another Youtube video). However, he still labels sugar a ‘toxin’ and would like FDA regulation. Others are calling for a tax on high-sugar soft drinks, which would decrease use and help pay for health care reform. Stay tuned for a discussion of this proposal. In the meantime – opt for water, unsweetened coffee and tea, and an orange for dessert!
Sadja Greenwood, MD, MPH back issues on this blog

Sunday, May 8, 2011

Go to Health – Cinnamon

This common and amazing spice was first grown in Ceylon (Sri Lanka) and was imported to Egypt, the Mediterranean world and Europe as early as 2000 BCE. Spices like cinnamon, that we take for granted, were great luxuries in times past; they were used for flavoring, to prevent food spoilage, and for treating many ailments. Cinnamon was found to inhibit bacterial growth in stored food, which was very useful before the days of refrigeration.

Blood Sugar lowering: Currently, the interest in cinnamon centers on its role in lowering blood sugar. A study in normal subjects from the University of Lund in Sweden showed that adding cinnamon to a meal significantly lowered blood sugar an hour later, and also delayed stomach emptying. A study from the Beltsville Human Nutrition Research Center (US Department of Agriculture) on men and women with type 2 diabetes showed that cinnamon (given as 1, 3, or 6 grams daily in capsules) significantly reduced fasting blood sugar, LDL cholesterol, total cholesterol, and triglycerides. This is important, as people with type 2 diabetes have an increased risk of heart disease and stroke. The results from 1 gram of cinnamon were effective, and this amounts to about 1/5th teaspoon per day. Cinnamon had a sustained effect on levels of blood sugars and fats, even if not consumed every day. The authors of this study note that a number of other herbs have been reported to yield blood-sugar lowering effects in patients with diabetes: bitter melon, Gymnema (see below), Korean ginseng, onions, garlic, and flaxseed meal. The authors write that cinnamon may work by increasing glucose uptake by cells and activating the synthesis of glycogen ( a normal storage compound for glucose). Also, cinnamon is believed to stimulate cell receptors for insulin.

Gymnema sylvestris is an herb from India where it has been used to treat diabetes since before modern medicine. It curbs sugar cravings, and may also stimulate insulin secretion. It is available in the U.S. (online and in some natural food stores) as a supplement. Not enough is known about its side effects and dosage levels, so people who use it should work with their health-care practitioner. It should not be used in pregnancy or at the time of any surgery.

Polycystic Ovary Syndrome is a disorder associated with infertility in women, who also have multiple cysts on their ovaries, elevated glucose, weight problems, excess body hair and menstrual irregularities. A study was published in 2007 from Columbia University showing that oral cinnamon (1 gram daily) improved their glucose levels. More studies are underway using cinnamon for this condition.

Brain chemistry: A professor of psychology at Ohio Northern University found that students scored higher on attention, memory and visual-motor response speed when smelling cinnamon or chewing cinnamon-flavored gum.

How much is enough? There is concern that a substance called coumarin in cinnamon may be toxic to the liver in certain sensitive individuals. Liver damage is reversible if cinnamon is stopped. Since the genetics of this potential problem is not worked out, it is prudent to use cinnamon as a spice rather than in large doses. People with diabetes should talk to their doctors or nurse practitioners about using 1/5th teaspoon a day on oatmeal, baked apples or other foods, in case their need for medications decrease. Other people can continue to use cinnamon sensibly on favorite dishes and enjoy the wonderful flavor of this spice.

I have enjoyed reading Healing Spices by Bharat B. Aggarwal as a takeoff for this column on cinnamon. Aggarwal is a molecular biologist and cancer researcher at the M.D. Anderson Cancer Center of the University of Texas in Houston. Look for a wonderful collection of spices at the Bolinas People’s Store, or at most natural food stores. Leave me a comment, or a question!
Sadja Greenwood, MD, MPH back issues on this blog.

Monday, May 2, 2011

Phthalates – what are they & how to avoid them

Phthalates are a class of chemicals added to plastics to increase their flexibility and durability. About a billion pounds per year are produced worldwide. They are found in the enteric coating of pills and supplements, in adhesives and glues, personal care products, medical devices, detergents, paints, printing inks, shower curtains, vinyl upholstery, car interiors and many other plastic products. They easily diffuse into the environment as plastics age. We all have phthalates in our bodies – from our diet, skin exposure (from personal care products) general environmental contamination and inhalation. Cheese, butter and meats are a source of phthalates in food, in part from plastic packaging.

Shana Swan at the University of Rochester School of Medicine has studied the exposure of pregnant women to phthalates. She has written that most findings concern male children, where she found a correlation between a shortened distance between the anus and penis, and a smaller penis size with higher concentration of phthalates in the mother’s urine during pregnancy. These measurements may indicate an anti-androgen effect of phthalates, which was also found in some experimental animals. Swan writes that sensitive biomarkers to assay human phthalate exposure have been available for a short time (10-11years), so that the long term effects may not yet be known. The necessary epidemiological studies are expensive and slow, so that animal studies and small human studies will be necessary. Results from these are controversial. Some recent studies have found correlations between low sperm counts and phthalate levels in men. . Studies on early puberty in girls have not reliably shown a correlation with phthalates at this point.

Studies on phthalate levels in pregnant women and their babies/children have been done in several universities. Women exposed to phthalates and pesticides in the workplace are more likely to take six or more months to conceive and to have lower birth-weight babies, according to a recent study at Erasmus Medical College in Rotterdam. Researchers at Mt Sinai (NYC), Cornell and the US Centers for Disease Control found that higher prenatal exposure to phthalates was connected to disruptive and problem behaviors in children ages 4-9. Behaviors included aggressiveness, and ADHD.

What you can do
Lowering exposure to phthalates is prudent, and especially important if you are pregnant or care for children. Body-care products containing phthalates are a source of exposure for infants. Read the ingredients whenever you buy a product: avoid personal care products (hair products, nail polish, deodorants, perfumes, lotions, etc) with DBP, DEP, BzBP. Be aware that the term ‘fragrance’ can mean that phthalates are present. This may mean a serious change in your use of body-care products and cosmetics. You can find safer cosmetics of all kinds at the website of the Environmental Working Group: www.ewg.org/skindeep/.

DEHP is used in PVC plastics. DMP is in insect repellents. Choose plastics with the recycling code 1,2 or 5. Codes 3, 6 and 7 may contain bisphenol A or phthalates. Parents should not buy soft plastic PVC toys for children. California has a law – signed by Governor Schwarzenegger – that bans products containing more than 0.1% phthalates from toys as well as baby bottles and other items that children can put in their mouths.

Something positive!
After reading about the widespread nature of phthalates in our environment, as well as bisphenol A, you are probably ready for some better news. Dr. B.B. Aggarwal, a cancer researcher at the University of Texas MD Anderson Cancer Center, has written a new book called Healing Spices in which he brings together ancient traditional medicine and modern medical research to show how herbs and spices can promote healing and health. I will report on his findings in subsequent columns. In the meantime, know that he has a chapter on cocoa and chocolate, and is also a strong proponent of turmeric. See his website – Curcumin – The Indian Solid Gold, and prepare to be surprised at the science on the actions of curcumin against cancer and other diseases. Curcumin is the active agent in turmeric. Make some curry for dinner!
Sadja Greenwood, MD, MPH – back issues on this blog

Friday, April 22, 2011

Go to Health: More on Brassica Vegetables aka Cruciferous

This genus of plants contains more plants for human consumption than any other. You can think of them as roots: radishes, rutabaga, turnips, daikon, as stems: kohlrabi, as leaves: cabbage, kale, collards, bok choy, Brussels sprouts, arugula, cress, as flowers: cauliflower, broccoli, and as seeds: mustard seed and oil producing rapeseed (canola). Wasabi is also a brassica.

There are numerous beneficial compounds in these plants. Besides vitamins, carotenes and fiber, they contain nutrients with anti-cancer properties – the most promising one being sulforaphane.

Plants in the genus brassica produce sulforaphane (SGS) to defend against insect predators. Researchers at Johns Hopkins found that SGS is especially high in broccoli sprouts. SGS is an ‘indirect antioxidant’ that eliminates many types of free radicals before they can harm cells, and cycles over and over again, triggering a long lasting process. It stimulates other natural antioxidants, such as glutathione, the body’s most abundant antioxidant. Studies from the University of Michigan found that SGS, from broccoli, inhibits breast cancer stem cells in mice and cell cultures, and prevents new tumors from growing. Studies are also ongoing on protection against ovarian and prostate cancer. There is preliminary work on the ability of SGS to protect against skin cancer, ulcer-producing bacteria in the stomach (helicobacter pylori) and inflammation of blood vessels in the heart.
The researchers at Johns Hopkins have established a company that sells regular or decaf green or black tea with SGS – it is available from the Baltimore Coffee and Tea Company at 800-823-1408. You can also make home-grown broccoli sprouts – organic broccoli seed for sprouting is available by calling 800-695-2241. If you want some help in making broccoli sprouts at home, watch “how to grow broccoli sprouts with your homemade sprouter” on You Tube. The best way to prepare regular broccoli to maximize SGS is to steam it lightly for 3-4 minutes- until it is tough-tender.

There is a downside to brassica vegetables – eaten in high amounts they can interfere with the formation of thyroid hormone, and induce goiter formation. So – include them in your diet, especially if you are a cancer survivor, but eat a lot of other vegetables and fruits as well.

Dietary spices – These include onions, garlic, ginger, cloves, cinnamon, cardamom, mint, all Indian curry ingredients, all Italian herbs etc. These and other spices/herbs have been studied at MD Anderson Cancer Center at the University of Texas for their many roles in preventing cancer. There is interesting science here. Include them in your diet every day. I will be writing more details about these ‘nutraceuticals’.

Sadja Greenwood, MD, MPH see back issues on this blog

Friday, April 1, 2011

Bisphenol A (BPA): What you should know

BPA is one of the most commonly manufactured chemicals in the world. It is a component of polycarbonate plastic and is found in a wide range of common materials and food packaging. It has been known for many years that BPA has estrogenic properties; its effects on the reproductive systems of animals -fish, amphibians and mammals - have raised concern for humans. The chemical has been called an endocrine disrupter, which can mimic the body’s own hormones and lead to negative health effects. Animal studies (those unfortunate mice and rats) have suggested effects of BPA on the brain, breast, prostate, thyroid, obesity, sexual behavior et al. Some studies suggest an increased risk for breast and prostate cancer. Newborns and children may be specially affected by environmental BPA levels, due to their reduced capacity to eliminate the substance and their higher daily exposure, adjusted for weight. A study from Rockefeller University on primates in 2008 showed that even at relatively low exposure levels, BPA abolishes the ability of spinal synapses to respond to estrogen, which may play a critical role in cognition and mood. An English study published in the JAMA (University of Exeter - 2008) showed that higher levels of BPA in the urine of US adults correlated with cardiovascular disease, diabetes and abnormal liver enzyme levels. A study carried out by the Division of Research at Kaiser in Oakland showed that male workers in China with high occupational exposure to BPA had a significantly higher risk of lowered sexual desire, erectile dysfunction and difficulty ejaculating. This study is obviously important to men, and a motivator for youth to avoid exposure as much as possible. I have cited only a few examples of research on BPA that suggest negative health effects on humans and animals. While studies abound, our response in the US has been painfully slow.

Canada announced its intent to ban the import and sale of polycarbonate baby bottles containing BPA in 2008. Walmart announced soon thereafter that it would stop selling food containers, water and baby bottles, sippy cups and pacifiers containing BPA at its Canadian stores. In 2010, Canada declared BPA to be a toxic substance and is proceeding to decrease its use overall. European countries have been slower to act. But the European Union executive commission plans to stop the manufacturing of polycarbonate baby bottles containing BPA by June, 2011. Minnesota, Chicago, Connecticut, Massachusetts and Maine have taken steps to ban products containing BPA from baby food containers and other products. However, in 2009, California’s EPA unanimously voted against placing BPA on the state’s list of chemicals that are believed to cause reproductive harm.

What you can do
1) Shop wisely: BPA is found in the internal coating of food and beverage metal cans to protect the food from the metal. Choose fresh or frozen foods over canned whenever possible. Eden Organic has eliminated the use of BPA in their canned and packaged food, and Muir Glen organic tomato products will be BPA free this year. These products are available at natural food markets.
2) In your kitchen: If you feed your baby from a bottle, use glass, and avoid plastic pacifiers and cups. Don’t microwave food in plastic containers, and store leftovers in glass or ceramic containers. Carry extra water in a stainless steel or glass bottle. Nalgene is now selling plastic water bottles made of copolyester , with non-BPA materials. Hikers will want to have a light-weight water bottle, but more research may be needed on the long term safety of these new materials.
3) Go to the website of healthyfoodaction.org and sign their petition asking President Obama to eliminate the use of potentially cancer-causing chemicals in our environment, including BPA
4) Ask our assemblymember, Jared Huffman, to work on banning BPA containing products in California. Mention the 2009 California EPA vote when you call or write. Huffman is an environmentalist – 479-4920. Contact Governor Jerry Brown while you are at it: 916-445-2841. Go citizens!
Sadja Greenwood MD, MPH back issues on this blog

Thursday, March 17, 2011

Go to Health: The 2012 Farm Bill: What you can do

Every five years, Congress writes a Farm Bill that establishes our nation’s food and agricultural policies. The 2012 Farm Bill will cost approximately 300 billion. It’s largest slice, the Nutrition Title, governs foods bought by those on food stamp assistance. Currently, farm policy has driven down the price of commodities such as corn and soybeans, resulting in lower prices for high fructose corn syrup and soybean oils. Our consumption of unhealthy foods made with these substances has increased. At the same time we have grown and eaten fewer vegetables and fruits; their production has not been subsidized, and their prices have increased over the years.

Many organizations interested in local food production, water and soil quality, and the health of our population are working on changing the way we support farmers. A prestigious group of nutrition experts, including Walter Willett of the Harvard School of Public Health, Marion Nestle at New York University and Andrew Weil, have written a charter for a healthy farm bill, which concerned citizens are urged to sign. The charter calls for a new food system that is:
*healthy – accounting for health impacts on farmers, workers in food industries, and eaters
*sustainable – protecting natural resources and biodiversity
*resilient – overcoming challenges of climate change, pest resistance, and problems with expensive water and energy
*fair – providing fair access to affordable and healthy food, and fair conditions for farmers, workers, and eaters
*economically balanced – providing economic opportunity across the nation’s states, for a diverse range of farmers and workers , from local to global in scale
*transparent – farmers, workers and eaters should be able to participate in decision making on food production distribution, marketing, and disposal.

You can sign the Charter for a Healthy Farm Bill by going to the website of www.healthyfoodaction.org. There will undoubtedly be more discussion and controversy than ever before as the new farm bill is debated and written. Energized and informed people (you are probably one of these!) confront a system that has given rise to overproduction of foods for animal feed and underproduction of healthy vegetables and fruits, and a national health crisis. This column will continue to discuss the new Farm Bill in coming months.

While you are at the website for healthyfoodaction.org, you can also sign a petition asking President Obama to set the course for a new cancer prevention strategy, by eliminating the use of potentially cancer-causing chemicals in our food and environment, such as Bisphenol-A (BPA) and Dioxin.

BPA is a compound used to make polycarbonate plastics and epoxy resins.. BPA is known as an ‘endocrine disrupter’ because of its estrogenic properties and possible effects on fetuses and young children. It has been found in the internal coating of food and beverage metal cans to protect the food from direct contact with metal. It is also found in polycarbonate bottles. Eden Foods has eliminated the use of BPA in their canned and packaged foods, and Muir Glen organic tomato products will be BPA free this year. You can find foods from Eden and Muir Glen at many natural food stores.

Dioxins are chemicals that enter the atmosphere as by-products of the bleaching of paper pulp, chemical and pesticide manufacture, and burning of trash. The defoliant Agent Orange, used by the US in the Vietnam war, contained dioxin. Stay tuned for a more complete discussion of BPA, Dioxin and other chemicals in my forthcoming columns. You will be pleased to know that Bolinas citizen Sharyle Patton, working at the Biomonitoring Resource Center and the Collaborative on Health and the Environment at Commonweal, is a world expert on the chemicals in our environment and their effects on our bodies. Her research is having an important impact on policy in many countries.
Sadja Greenwood, MD back issues on this blog