Flaxseed can help lower blood pressure

Flax plants, used for food and to make textiles (linen) have been used for thousands of years.  Flax fibers spun into clothing have been found in a cave in the Republic of Georgia and dated as made 30,000 years ago.  Modern science has found that flax seeds contain a plant form of omega-3 fatty acid (alpha linolenic acid) as well as lignans - substances that act as plant estrogens. Lignans are also found in lower amounts in rye, wheat, oats, barley, soybeans, sesame seeds, cruciferous vegetables and in certain fruits such as strawberries and apricots.  Flax seeds, but not flax seed oil by itself, has been found to be associated with a lower risk for breast cancer.  A study from Duke University showed an association of flax seed with slower growth of prostate cancer.  

A recent study from St. Boniface Hospital Research Center in Manitoba showed that people with high blood pressure and resultant leg pain from constricted blood vessels were helped by supplementing their diets with ground flax seeds.  They took 30 grams a day, which is about 4 tablespoons, put into muffins and bars or eaten as plain ground flax.  The flax seed provided abundant fiber, and the subjects did not gain weight during the 6 month trial.  Subjects in the comparison group, also with high blood pressure, were given food enhanced with almonds and other  ground nuts.  Their blood pressures did not change during the 6 month study.  The blood pressure reductions seen in the flaxseed group were impressive - systolic blood pressure was 10 mm Hg lower and diastolic 7 mm Hg lower after 6 months.  In subjects with initial systolic blood pressure readings of  140 mmHg or higher, there was a reduction of 15 mm Hg systolic and 7 mm Hg diastolic.  These figures compare favorably with the reductions seen with many blood pressure medications.  It should be noted that subjects in this study continued their prescribed medications for blood pressure reduction.  The authors cautioned that people trying flaxseed meal should remain under their doctor’s care and not change their meds unless advised to do so.  

A study from the University of Saskatchewan in 2009 showed that men, but not women, had reduced scores of factors in the ‘metabolic syndrome’ when they took flax seed components and engaged in a walking program.  The metabolic syndrome is a cluster of conditions: increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.  These factors can lead to an increased risk of heart disease, stroke and diabetes.

This article has given the reader several good reasons to try adding flax seeds to your diet.  It’s easy to do so, and the taste is nutty and pleasant.  You can grind your own (with a spice or coffee grinder) from organic flax seed from many stores, or buy it already ground.  Be sure to refrigerate the ground flax.  Put it on oatmeal, salad, stir fries  or in shakes.  Incorporate it into baked goods.  There are lots of recipes for this on line. Ground flax adds fiber to your diet and can relieve constipation. Be sure to drink more fluids if you start using flax.  

Post-menopausal women may enjoy the slight increase in safe plant estrogens from the flaxseed lignans,  However, flax has not been shown to relieve hot flashes.

Sadja Greenwood, MD   back issues on this blog

Get Fitter Faster with Interval Training

Interval training is a fitness practice that anyone can use, no matter what their level of activity.  You alternate periods of light exercise, or even rest, with periods of relatively intense exercise - depending on your fitness level. You can do this when walking, running, biking, swimming, or using a stationary bike or other aerobic gym machine. If you don’t enjoy exercise ‘that much’, but know you should do it, of if you are short on time, the big advantage of interval training is that you can get results quite quickly.  According to Martin Gibala, professor of Kinesiology at McMaster University in Ontario, 20 minutes three times a week is the usual time commitment. In these 20 minutes, you alternate recovery periods with hard effort.  The protocol used by Gibala involves speeding up to 85-90% of your maximum heart rate for one minute, and then slowing down for one minute - you keep doing this 10 times during the 20 minutes.  

So far, trials of this method have shown that interval training makes the heart a better pump, makes blood vessels more elastic, and makes muscles better at using oxygen.  Average blood sugar levels were reduced after two weeks of interval training, in people with and without diabetes.  This happens because exercised muscles have greatly enhanced ability to take up blood glucose.  

People rode stationary bikes in the McMaster studies, because of the safety of this exercise, and the relative ease on joints.  It’s important to realize that people can start interval training at any level of fitness.  If your usual exercise is walking around the block, or around your neighborhood, try alternating faster walking for a minute with slower for the next minute, and keep this up for 20 minutes.  You don’t have to sprint if you are not used to doing so!  

You should talk to your doctor or nurse practitioner about any proposed new exercise program if you have been inactive.  Remember - it’s also risky to sit on the couch all day!

A recent study from the University of Copenhagen in Denmark showed that for people with diabetes- alternating levels of walking intensity could be much more effective than walking at constant speed to help manage blood sugar.  They measured insulin secretion after a glucose infusion, and did skeletal muscle biopsies, before and after a 4 month training period.  Only the people who had been given interval walking training showed improved blood sugar control and increased insulin sensitivity in in skeletal muscle.  People who walked a comparable amount of time without interval training were the comparison group.

I love to walk and daydream, sing to myself, or talk with friends as I stroll.  Whatever activity you like to do - carry on. Interval training can be effective if done only 3 times a week.   “If it’s physical, it’s therapy” were the words on a  t-shirt I  saw long ago in Golden Gate Park.  Here are some other great t-shirt slogans:

I got my shit together with a Clivus Multrum.

Fighting terrorism since 1492 (a group of Indians with long rifles)

Some Day my Prince will Come - and I wanna  come too. 

But I digress.  See you on the road, looking at your stopwatch.

Sadja Greenwood 

Update on Magnesium

Magnesium is an important mineral in the human body, involved in essential metabolic reactions such as energy production in mitochondria, synthesis of DNA and RNA, the conduction of nerve impulses, normal heart rhythm, wound healing et al. Along with calcium, it plays an important structural role in bone,. Magnesium is at the center of the chlorophyll molecule, so it is abundant in many plant foods, such as leafy greens, beans, nuts and unrefined grains.

Low serum levels of magnesium have been found in people with asthma, diabetes, osteoporosis, and alcoholism. However, treatment with supplemental magnesium has not been uniformly found to be as helpful as a healthy lifestyle and diet. Here are some recent studies on magnesium.

Diabetes – diets with higher amounts of magnesium are associated with a significantly lower risk of Diabetes. This is based on large cohort studies over 4-20 years in length. People with the highest intake of magnesium in food were found to have up to a 20% lower risk of diabetes compared to those with the lowest intake. This association achieved significance only in people who were overweight. Some studies, but not all, show that taking magnesium supplements may help with blood sugar control.

Blood Pressure: A study from the University of Hertfordshire in England found that magnesium supplements offer small but clinically significant reductions in blood pressure. The researchers looked 22 trials involving 1,173 people, and found systolic pressure reduced by 4mmHG and diastolic by 2-3mmHG.

Brain Function: Research at the Center for Learning and Memory at Tsinghua University in Beijing found that using a new form of magnesium as an oral supplement, magnesium-L-threonate (MgT), could increase many different forms of learning and memory in both young and aged rats. The authors concluded that since many people in industrialized countries have a magnesium deficit, increasing magnesium intake might prevent or reduce cognitive decline. Similar studies from MIT, Tel Aviv University and the University of Toronto confirmed these findings, and showed that animals given the new oral magnesium compound (MgT) had an increase of synapses in the brain – connective nerve endings that carry memories in the form of electrical impulses from one part of the brain to the other. The researchers also concluded that most of today’s over-the-counter supplements don’t get into the brain effectively.

MgT as a supplement is now commercially available, and can be found on-line from several sources (such as Amazon and supplement companies like iherb). However – there are so far no real studies on its safety in humans – remember that the studies have been done on rats! At least one human study is underway. It is probably prudent to wait for validation of its safety. Discuss this with your doctor.

Taking the usual forms of supplemental magnesium (magnesium oxide, citrate, chloride) in reasonable doses (up to 350 mg daily) is safe for most people, but not everyone. People with kidney problems should confer with their doctor before taking magnesium supplements, as magnesium is excreted through the kidneys – as well as in feces. Too high a serum level can be dangerous.
Many people are taking magnesium citrate or other forms of the mineral to help them relax and sleep. Unless you have kidney disease this is probably safe, but users should be aware of the guidelines as indicated below.

The recommended dietary allowance for magnesium for adults 19-30 years old is 400 milligrams/day for men and 310 milligrams/day for women. For adults 31 and older, it is 420 milligrams/day for men and 320 milligrams/day for women. Pregnant women should get slightly more – from food and prenatal vitamin-mineral supplements. When women take calcium supplements, it is advisable to take half as much magnesium as calcium – for example 500 mg of calcium with 250 mg of magnesium.

In 2011, the Food and Drug Administration issued a safety announcement that long-term use - longer than one year - of prescription proton pump inhibitor (PPI) drugs (such as Nexium and Prilosec) may cause low serum magnesium levels. Treatment usually involves magnesium supplements, but in about 25% of cases the PPI has to be discontinued. Over the counter doses of these same drugs are lower, and their use is advised for no more than 15 days up to 3 times a year.

Fortunately, magnesium is found in some wonderful foods easily available, such as leafy greens. beans, nuts and whole grains. Fresh green beans are in season!
Sadja Greenwood MD, MPH – past issues on this blog

Autism - Why the Increase?

Autism and autism spectrum disorder (ASD) are terms for a group of complex disorders of brain development, characterized by difficulties in social interaction, verbal and non-verbal communication and repetitive behaviors. There are multiple causes of ASD, although most are not yet known. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged - ASD begins before the age of 3 and last throughout a person's life, although symptoms may improve over time.

The rise in the diagnosis of autism among young children has been rapid and alarming.  Broadening the diagnosis of the disease and increased surveillance may be a factor, but do not explain what has happened.  Prior to 1990 the estimates of autism prevalence were about 3 per 10,000.  In 2000 and 2002 the autism estimate was about 1 in 150 children. Two years later, 1 in 125 8-year-olds was believed to have autism. In 2006, the number grew to 1 in 110, and then the number went up to 1 in 88 based on 2008 data. Currently, one in 68 U.S. children has an autism spectrum disorder (ASD), according the Centers for Disease Control and Prevention. This newest estimate is based on the CDC's evaluation of health and educational records of all 8-year-old children in 11 states: Alabama, Wisconsin, Colorado, Missouri, Georgia, Arkansas, Arizona, Maryland, North Carolina, Utah and New Jersey. The incidence of autism ranged from a low of 1 in 175 children in Alabama to a high of 1 in 45 in New Jersey, according to the CDC. Children with autism continue to be overwhelmingly male. According to the new report, the CDC estimates 1 in 42 boys has autism, 4.5 times as many as girls (1 in 189).

Clearly, we are experiencing a huge, unprecedented problem.  Here is an abbreviated version of current thinking on causation.  The theory that mercury (thiomersal) in vaccines causes autism has been investigated extensively and discredited. The clinical symptoms of mercury poisoning differ significantly from those of autism. In addition, multiple population studies have found no association between thiomersal and autism, and rates of autism have continued to increase despite removal of thiomersal from vaccines.  

Studies of twins suggest that heritability is 0.7 for autism and as high as 0.9 for ASD, and siblings of those with autism are about 25 times more likely to be autistic than the general population. However, most of the mutations that increase autism risk have not been identified. A recent study involving 13 institutions around the world showed that mutation in ‘an autism specific gene’ could lead to autism marked by gastrointestinal disorders, and sleep disturbances.  Mutations in this gene would account for a very small number of cases, but the finding was the harbinger of discoveries to come. 

A recent study from Denmark (a small country with excellent statistical records) showed that both maternal and paternal age are associated with a greater risk of ASD in the offspring, depending on combinations of parental age categories. For mothers younger than 35 years, the risk of ASD increased with increasing father's age. For fathers younger than 35 years, the risk of ASD increased with increasing maternal age.

A study just reported from UC Davis showed that pregnant women who lived in close proximity to fields and farms where chemical pesticides were applied experienced a two-thirds increased risk of having a child with ASD or other developmental delay. The study examined associations between specific classes of pesticides, including organophosphates, pyrethroids and carbamates, applied during the study participants' pregnancies, and later diagnoses of autism and developmental delay in their offspring. This study validates the results of earlier research that has reported associations between having a child with autism and prenatal exposure to agricultural chemicals in California," said lead study author Janie F. Shelton, a UC Davis graduate student who now consults with the United Nations. "While we still must investigate whether certain sub-groups are more vulnerable to exposures to these compounds than others, the message is very clear: Women who are pregnant should take special care to avoid contact with agricultural chemicals whenever possible. In the early developmental gestational period, the brain is developing synapses, the spaces between neurons, where electrical impulses are turned into neurotransmitting chemicals that leap from one neuron to another to pass messages along. The formation of these junctions is really important and may well be where these pesticides are operating and affecting neurotransmission.”

A 2013 report from Harvard School of Public Health was the first large national study to examine links between autism and air pollution across the U.S. Exposure to diesel particulates, lead, manganese, mercury, methylene chloride and other pollutants are known to affect brain function and to affect the developing baby. Women in the U.S. exposed to high levels of air pollution while pregnant were up to twice as likely to have a child with autism as women who lived in areas with low pollution.

Writing this column has made me ever more concerned that our crowded, industrialized world has created conditions dangerous for human life, as well as the lives of other animals and plants. Changing directions will take enormous commitment and political will. Awareness of the damage we are doing to children should give us a powerful incentive to find new ways to live. 

Sadja Greenwood, MD, MPH  leave me a message, and I’ll answer you!

Oxytocin - An Amazing Hormone

Oxytocin is produced in the hypothalamus (above the pituitary gland, behind the eyes) and stored in the pituitary gland.  It is also produced in other body parts, including the sex glands of men and women.

Oxytocin has been called the love hormone or the bonding hormone because its release contributes to the social bonding that occurs between lovers, friends and colleagues.  A study from Bar-llan University in Israel showed that fathers living with their partner and newborn had as much oxytocin in their blood as mothers, at one week postpartum and at 6 months.  Mothers with high oxytocin levels provided more affectionate parenting, and fathers with high levels encouraged more exploration and attention to objects.  The researchers were not sure whether these differences reflected cultural role expectations or were ‘indicative of distinct circuit effects of oxytocin in the male and female brain.’  The amounts of oxytocin found in each couple tended to be similar, although most people differ in the amount they produce. 

The oxytocin that is released during sex and orgasm, and also in handholding, hugging and eye-gazing plays a role in keeping couples together, and keeping men attracted to their partners, according to studies at the University of Bonn in Germany and also at Emory University in Atlanta.  There is an evolutionary benefit here for offspring survival.

(Another school of thought – not related to oxytocin - is that men are primed to have as many affairs as possible to spread their DNA.  Examples of both these theories may be found in the course of a man’s life.  Women have their own variation on these themes, but it’s exhausting to think of the numerous pregnancies that could occur with a variety of mates if evolution had its way.  Fortunately, there’s birth control.)

Oxytocin is released in large amounts during labor; it causes uterine contraction and thereby facilitates  delivery. A synthetic form of oxytocin, known as pitocin, is frequently given intravenously if labor is too slow. Oxytocin is produced during stimulation of the nipples by the infant’s mouth, and it produces milk release.  Intravenous pitocin has been considered an important drug in the treatment of hemorrhage after birth, although newer drugs are taking its place. 

Research into wound healing and oxytocin was carried out at Ohio State University.  This unusual study was done with 37 couples admitted to a hospital for 24 hours. Participants were given small blister wounds on the arm. Each couple was then given instructions on how to interact, and asked to avoid topics that could cause marital dissension.   Follow up of wound healing was done for 8 days.  They found that people with higher levels of oxytocin had more rapid wound healing than others.

A relationship between addiction and oxytocin has been found at the University of Adelaide.  Researchers looked at why there is a high level of variability in people’s oxytocin levels – they think that adversity early in life may be key.  Oxytocin exists in the newborn and helps to create bonding with the mother.  A difficult birth, disturbed bonding or abuse, deprivation or severe infection might act to prevent normal development of the oxytocin system by age 3.  Later in life, people with low oxytocin levels may be more attracted to drugs and alcohol when under stress.

Here’s one of the latest and most amazing studies on oxytocin.  Researchers at UC Berkeley have found that oxytocin helps to prevent muscle wasting with age and even osteoporosis. The study was done in mice, but is believed to be applicable to humans. The mice with osteoporosis had had their ovaries removed to mimic menopause.  The animals with muscle wasting were given oxytocin injections under the skin, and regeneration to about 80% of the muscle strength seen in young mice occurred fairly rapidly.  The title of the paper from Berkeley summarizes their findings: Oxytocin is an age-specific circulating hormone that is necessary for muscle maintenance and regerneration.

What are the take home messages of this discussion of oxytocin? Keep your relationships with significant others as happy as possible, with plenty of hugs, snuggles and massage.  Do things that make you happy, like listening to your favorite music, or playing an instrument, singing, making art, walking outside, or getting a massage. See you on the trail. 

Sadja Greenwood, MD, MPH  past issues at on this blog

Leave me a message, and I'll reply

Can Aspirin Help to Prevent Cancer? - the pros and cons

Can Aspirin Help Prevent Cancer? - the pros and cons

Two physicians at Harvard Medical School, Drs. Michelle Holmes and Wendy Chen, recently wrote in the New York Times about the apparent ability of regular aspirin use to prevent death in women with breast cancer.  They called for a randomized trial of aspirin, enrolling 3000 women with stage 2 and 3 breast cancer for five years, which they estimate would cost $10 million.  They have repeatedly tried to raise these funds through federal grants, and have been rejected.  It is possible that the publicity from their article will result in funding from the government, private foundations or private individuals.  The first randomized clinical trial of aspirin is now going on in Britain, funded by a nonprofit group.  They are looking at 4 cancers - colorectal, breast, gastro-esophageal, & prostate - with results expected by 2025.  

Evidence so far:  Many studies in the past 20 years have shown that taking aspirin is associated with the prevention of colon cancer.  A recent study helped to refine the findings - people with high amounts of an enzyme known as 15-PDGH in their gut lining had a 50% lower risk of colon cancer than those with a low level, if they took the equivalent of 2 regular strength aspirins a week.  A regular strength aspirin is 325 mg, and a ‘baby’ aspirin is usually 81 mg.  (2 x 325=650, and 7 X 81=567 - close enough). The test for 15-PDGH is not yet available.  People at high risk for colon cancer - a diet low in vegetables and whole grains, high in red meat and processed meat, inactivity, obesity, smoking, family history of colon cancer - should talk to their doctor about the pros and cons of low dose aspirin.  (People with these habits might also want to make some life-style changes.)

Breast cancer: a Columbia University study published in 2004 showed that women who took aspirin regularly (the 325 mg or 81 mg dose was not distinguished) were 20–30% less likely to develop hormone positive breast cancer.  Aspirin did not decrease the risk of hormone negative breast cancer. The proposed mechanism is that by a series of physiologic steps, aspirin decreases hormone biosynthesis in the body.  The researchers also discussed the anti-inflammatory properties of aspirin, which may reduce cancer risk overall.  NSAIDS such as ibuprofen were also associated with slightly decreased cancer risk, but not as great as aspirin.  Acetaminophen (Tylenol) did not show a protective effect.  Another study, published in 2010 by the authors of the recent NYTimes article, looked at data from The Nurses Health Study in the US.  It found that in women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death.

A recent study from the National Cancer Institute showed that daily aspirin use may reduce the risk of ovarian cancer by 20%.  About 20,000 women in the US will be diagnosed with ovarian cancer in 2014, and more than 14,000 will die of this disease, which is hard to diagnose early enough for a cure.  Early symptoms are non-specific, such as abdominal bloating, pelvic or abdominal pain, feeling full quickly, and urinary frequency.    

Many people take aspirin to prevent heart disease, especially if they have already had a heart attack - to prevent another.  Paramedics regularly give aspirin to a heart attack patient on the way to the hospital. Heart attacks and strokes occur when the blood supply to a part of the heart muscle or brain is blocked by ‘plaque’, a buildup of cholesterol, fatty substances, cellular waste products and calcium.  Aspirin helps to prevent blood clotting in the presence of plaque. The dose to take should always be discussed with your health care provider. 

There are side effects of aspirin use, which is why it cannot be recommended to everyone to reduce the risk of cancer or heart disease.  Aspirin can be irritating to the stomach and can cause serious bleeding in the gastrointestinal tract.  It can also cause bleeding in the brain, known as a hemorrhagic stroke. 

Here’s the real message of this column: it looks as though a simple medicine - aspirin - could be very important in the prevention of many common cancers.  However, because of the possible side effects and dangers of aspirin, randomized studies are greatly needed to show its efficacy and safety.  Funding is needed for this, and it will not come from pharmaceutical companies, as aspirin is such a common and inexpensive drug.  The recent publicity about this subject has stirred great interest.  Hopefully there will soon be such studies -with answers coming more quickly than the British study due to be finished in 2025!  

Sadja Greenwood, MD,MPH   back issues on this blog

What's the Connection between Sleep, Exercise and the Immune System?

When we get sick – with an infection, other illness or traumatic event – we want to sleep more.  It’s a natural reaction seen in other animals as well.  Recent research at the University of Pennsylvania showed that sleep helps to facilitate the immune response by increasing resistance to infection and survival after infection.  This research was done on fruit flies – but don’t discount it too quickly.  The genetic pathways found in these insects are preserved in mammals.  The take-home message from this work is that when you get sick – sleep as much as your body tells you to.

Research at the Finnish Institute of Occupational Health showed that healthy young adults restricted to 4 hours of sleep per night for 5 days  showed marked changes in their immune systems, with pro-inflammatory changes and an increase in allergic reactions and asthma.  Sleep deprivation also affects metabolism, leading to obesity, heart disease and diabetes. 

What are some natural ways to get enough sleep?  If you work at home and can’t sleep well at night, try a nap during the day – any time from 10 to 30 minutes may revive your day.  Regulate your 24 hour (circadian) rhythms by exposing yourself to bright light n the morning – sunlight or a ‘happylight’ during foggy days or the winter.  Before bedtime, wear blue-blocking glasses for an hour, while you read, compute, play music or watch television.  When you block the short blue wavelengths of the light spectrum with these orange colored glasses, you prevent the suppression of your natural melatonin. Melatonin is a hormone produced by the brain’s  pineal gland, located behind your eyes.  Melatonin outflow promotes good sleep. As an anti-oxidant, it has many salutary effects on the body, which we have suppressed with the artificial light of light bulbs, televisions, tablets et al.  Go to the website LowBlueLight.com to read about the benefits of normal melatonin release - by wearing the glasses for an hour or more before bedtime.  You can get a pair that will fit over your regular glasses and allow you to read, compute, or watch TV.  You can also take 1-3 mg of melatonin as a sleeping pill - start with the lowest dose.  This is safer than prescription sleeping pills such as Ambien or Valium.

Exercising  is another way to induce melatonin release and help sleep.   Morning exercise may be the most effective in increasing melatonin secretion in the evening, but exercise at any time of day can work for many people.  Here’s another benefit of exercise – a recent study from UCLA showed that maintaining muscle mass through resistance exercise (or plain hard work such as lifting, or farming) is more important than BMI (body mass index) in determining the risk of death from any cause.  So – turn your compost, get out those weights, take a Pilates class or do pushups to increase your muscle mass.

I will be away for a few weeks; my column will resume on Monday, May 26^th. Keep eating those colorful vegetables and fruits, a brassica vegetable every day, herbs, olive oil, pre and probiotic foods, and nosh on nuts.  Get some blueblocking glasses for evening use, and thereby improve your sleep. They are widely available on the Internet; I think the ones at LowBlueLight are the best – but more expensive. If you are sleep deprived at night, remember that taking a daytime nap does not mean you are lazy  - just look at your dog or cat..  Write me a comment and I’ll reply. 

Sadja  Greenwood, MD – back issues on this blog

Regulate your Blood Sugar with the Right Plant Foods

Dietary compounds known as flavones and anthocyanins, found in many herbs and vegetables, can help to regulate blood sugar and lower inflammation.  Recent research from the University of East Anglia and King’s College London looked at nearly 2000 women who were twins, and compared their dietary histories with their blood levels of glucose, insulin and inflammatory markers.  The research focused on flavones, found in herbs and vegetables such as parsley, thyme and celery, and anthocyanins, found in berries, red and purple grapes, wine, and other red or blue-colored fruits and vegetables.

Findings were that those who ate the most foods with flavones and anthocyanins had lower insulin resistance.  This means that their cells were able to respond to insulin and take in blood glucose in a normal way.  People with high insulin resistance have elevated levels of insulin in their blood, and may experience weight gain, increased blood pressure, high triglycerides, low HDL (good cholesterol), and other health problems. Diabetes is a frequent result. 

The study also found that those who ate the most anthocyanins were least likely to suffer from chronic inflammation.  Inflammation – as seen by redness, swelling, and pain, is a normal and necessary part of the body’s reaction to injury.    As healing occurs, the inflammatory response goes away.  However, chronic inflammation is a risk factor for many illnesses and should be identified and reduced.  It can be caused by chronic infections, gum disease, and obesity, especially abdominal obesity.  The usual antidote has been to eat less, follow a Mediterranean type of diet, and move more.  This new study indicates which foods may be especially helpful.  Anthocyanins are concentrated in foods that are red, purple or blue, but are found in most plants, in leaves, stems, roots, flowers and fruits.  The highest amounts are found in blueberries, cranberries, blackberries, black currants, cherries, eggplant peels, black rice, dark colored grapes, red cabbage, red-fleshed peaches, beets, and blood oranges. 

The researchers also cited dark chocolate and red wine as compounds with anthocyanins, and cautioned that moderation is the key, because of the potential for too much sugar (chocolate) and addiction/inebriation (wine).  Here’s a no sugar chocolate recipe:  mash a ripe banana, add unsweetened cocoa powder and some peanut butter to taste. Stir it up with a fork, and share it with a pal for dessert.  Put it on a whole grain cracker for crunch, or add chopped nuts. 

This is an exciting study because it is one of the first large-scale human studies to look at how flavones and anthocyanins can reduce chronic inflammation and also affect insulin resistance, blood glucose regulation and the risk of diabetes.  A study of twins is especially valuable, as it eliminates or modifies the role of genetics.

The take home message of this article is – go for dark colors in your food choices.  Also go for the flavones in celery, parsley, thyme and other herbs.  You can find these foods year-round at natural food stores and many markets.  Try growing purple potatoes – I can’t stop them in my garden.   Thyme and parsley are also easy to grow in our climate.

Sadja Greenwood, MD, MPH   back issues on this blog

Birth Imbalance – Where are the Girls?

Jimmy Carter has a chapter titled ‘The Genocide of Girls’ in his new book A Call to Action: Women, Religion, Violence and Power. Under ordinary circumstances, about 105 boys are born for every 100 girls.   In most populations, adult males tend to have higher death rates than adult females, both due to natural causes such as heart attacks and strokes, and also to violent causes, such as homicide and war.  In early adulthood there are roughly equal numbers of men and women, and later on women predominate. 

However, the sex ratio has changed drastically in several Asian countries, including India and China, due to a strong cultural preference for boys.  Boys carry on the family name, are considered stronger workers, and are expected to provide for their parents in old age. Girls traditionally leave to go their husband’s home. In India, girls have been considered a burden because of the need to provide a dowry for their wedding.  The dowry system was banned by law in 1961, but is still pervasive.  The strong cultural preference for boys resulted in infanticide and starvation of girls in earlier times.  At present, ultrasound has enabled women to know the sex of their fetus at about 12 weeks of pregnancy, and sex-selective abortion is easy to obtain in India, China, and other countries. Studies of sex ratios indicate that gender-based abortion or female infanticide may also be occurring in Afghanistan, Bangladesh, Pakistan, countries in the Caucasus and elsewhere.  Sex ratios over 110 (male) to 100 (female) are common in these areas, reaching as high as 120 to 100 in parts of India and China.

Carter goes on to discuss some of the results of the altered sex ratio, such as a shortage of brides, increased demand for prostitutes and abduction or trafficking of young women to become brides - for a price, mainly pocketed by the traffickers. Carter cites the 2011 book Unnatural Selection: Choosing Boys over Girls, and the Consequences of a World Full of Men, by Mara Hvistendahl, a contributing editor for Science magazine.  In another 2004 book, Bare Branches - The Security Implications of Asia’s 

Surplus Male Population, authors Valerie Hudson and Andrea M. den Boer argue that historically, high male-to-female ratios often trigger domestic and international violence. Most violent crime is committed by young unmarried males who lack stable social bonds. Although there is not always a direct cause-and-effect relationship, these surplus men often play a crucial role in making violence prevalent within society. Governments sometimes respond to this problem by enlisting young surplus males in military campaigns. Countries with high male-to-female ratios also tend to develop authoritarian political systems.  The name ‘Bare Branches’ is a Chinese saying for unattached males.  The authors say that the surplus male population in Asia’s largest countries will have serious global implications.

 According to a 2011 Gallup poll, American parents favor boys by a 40% to 28% margin. The results were similar to a survey in 1941, when Americans preferred a boy to a girl by a 38% to 24% margin. The overall preference was driven by men, of whom 49% preferred a son compared to 22% who preferred a daughter. Men's preference for sons was most pronounced among men aged 18 to 29. Women, on the other hand, showed no preference for either sex, with 33% stating that they preferred a girl and 31% responding that they favored a boy. In the United States, there are numerous centers where prospective parents can go to choose the sex of their offspring, before or after pregnancy has occurred. Methods used before pregnancy involve in-vitro fertilization; these methods, similar to IVF, are quite expensive and involve discomfort and some risk to the woman  Methods after pregnancy involve sex-selective abortion, and can be done by about 10 weeks with a blood test.  Sex selective abortions in the US are done mainly to prevent inherited diseases that affect a male child -such as hemophilia and Duchenne's muscular dystrophy. There is some evidence that immigrant groups in the US from countries with a strong male preference are using sex-selective abortion.   However, there has not been an imbalance in sex ratios in this country at the present. 

This has been a discouraging column so far, and I would like to end in a more upbeat way, with suggestions for change.  Be aware of the problem - in virtually every religion and known human society there has been gender inequality (with the possible exception of Paganism).   This awareness is leading to slow but positive social change.  Teach your sons, daughters and friends to see the problem and correct it, as they can.  Support one of many organizations working to give women access to education, tools and family planning, such as Oxfam America.  Consider Kiva; with a $25 loan you can support a person of your choice who is starting a small business                    , and get paid back if and when her project is successful.   

Sadja Greenwood, MD   prior columns on this blog

Jimmy Carter's new book on Violence Against Women

"Yet although economic disparity is a great and growing problem, I have become convinced that the most serious and unaddressed worldwide challenge is the deprivation and abuse of women and girls, largely caused by a false interpretation of carefully selected religious texts and a growing tolerance of violence and warfare, unfortunately following the example set during my lifetime by the United States.“  These are the words of Jimmy Carter in the introduction to his new book A Call to Action: Women, Religion, Violence and Power. Carter states that the Bible, the Koran and other cherished texts proclaim a commitment to justice and mercy, and equality of treatment between men and women.  However, “some selected scriptures are interpreted, almost exclusively by powerful male leaders within the Christian, Jewish, Muslim, Hindu, Buddhist and other faiths, to proclaim the lower status of women and girls.   He goes on to say that these claims are used to justify gross and sustained acts of discrimination and violence against women, including unpunished rape and other sexual abuse, infanticide of newborn girls and gender selective abortion of female fetuses, a worldwide trafficking of women and girls, honor killings, genital mutilation, lower pay and fewer promotions for women and greater political advantages for men.

Because the Carter Center has worked to combat neglected tropical diseases throughout the world, its people have interacted with remote communities in some 70 developing countries.  They have seen how religious beliefs and violence have impacted the lives of women in patriarchal societies.  “Almost everywhere, we find that women are relegated to secondary positions of influence and authority within a community but almost always do most of the work and prove to be the key participants in any successful project.  When there is a shortage of food or limited access to education, the men and boys have the first priority……when a civil conflict erupts, women are the primary victims of bombs and missiles, the displaced adults in charge of children, and the victims of rape. Beyond all this are the special biases that come from the distortion of religious beliefs and the imposition of discriminatory tribal customs that lead to honor killings, genital cutting, or child marriage.”

You have probably read enough to make you decide that you must read this book, or you can’t stand any more.  I found the book disturbing and hopeful, because President Carter and The Carter Center have not only discussed an array of terrible problems but have suggested helpful, local approaches.  In subsequent columns I will write about their approach to genital cutting, child marriage and dowry deaths, and sexual slavery and prostitution (including what goes on in the Bay Area).  For now, think about your religion or spiritual path followlng an egalitarian mother-father God, or moving beyond humans to embrace all living things.  Whatever is best for you.

For a complete change of pace - here’s what the Point Reyes Light (3/27/14) reported about alcohol use in Marin from ‘available data’.  Nearly one-quarter of the county’s adults reported binge drinking in the past month. The county has averaged 32 deaths annually from drug overdoses in recent years - mostly from prescription drugs.  Nearly half the county’s 11th graders drink alcohol and one-third binge drink.  A new program to deal with teen drug and alcohol problems is being developed at the San Geronimo Valley Community Center.  A meeting in Bolinas will take place on May 13th, 9:30-11:30 am.   Watch the Hearsay for more information.

Sadja Greenwood   past columns on this blog    Leave me a message, and I will answer you.