Monday, July 15, 2013

Hysterical Journalism Rarely Provides Credible Information, or Understanding the Relationship Between Fish Oil and Prostate Health

As usual, we don't know as much as we think we do... 

There’s been a spate of articles recently about a new study about circulating omega 3 fatty acid levels in the blood and an increased risk of aggressive prostate cancer. Many of these articles, written in non-scientific and inflammatory ways, make claims that “fish oil supplements increase prostate cancer risk!”, despite the fact that the original study does not make this claim.

For many people, essential fatty acid supplementation can be an important addition to a healthy diet and lifestyle. Essential fatty acid supplementation, generally in the form of fish oils, have been shown in studies to be beneficial to heart and metabolic health, mood and attention, for healthy fetal development, and as an all-around anti-inflammatory (there are so many studies on the benefits of fish oil supplementation; I only included a small handful here).  Fish oils are so effective, that a pharmaceutical company created a synthetic version called Lovaza so that they could sell this as a prescription-only pharmaceutical, used for raising beneficial HDL cholesterol and improving overall heart health. 

The current study that has generated so much media attention was the latest data tabulation based on SELECT, the Selenium and Vitamin E Cancer Prevention Trial, a large clinical trial looking at the role of selenium and vitamin E on prostate cancer. The trial looked at men who were taking either supplemental selenium, supplemental vitamin E (dl-tocopherol acetate, the synthetic form of vitamin E), or both in combination. SELECT looked at over 35,000 men over a 7 year period. The original trial found a slight increase in prostate cancer for men who took synthetic vitamin E alone (not in combination with selenium) over a 7 year period. No increase in cancer rates were seen among men taking vitamin E in combination with selenium, and no explanation is given for this discrepancy.
Because so many blood samples were taken for this trial, the data collected for SELECT has been used for a number of other studies, including this most recent analysis on omega 3 levels and prostate cancer. However, because the original study did not control for omega 3 in either supplements or in the diet, there are many unanswered questions about the true impact of fish and fish oil supplements on prostate cancer risk.

This is the second study showing a possible correlation between omega 3 blood levels and aggressive prostate cancer. A study done in 2011 found that higher circulating blood levels of DHA (docosahexaenoic acid, one of several "omega 3 fatty acid" compounds) correlated with increased risk of developing a specific type of aggressive prostate cancer. That same study also found a decreased risk for that type of prostate cancer with higher circulating blood levels of trans-fatty acids (which are known carcinogens). Given the strong and consistent evidence of the profound harm caused by trans-fatty acids, we certainly will not begin to recommend the consumption of trans-fats in prostate cancer prevention, despite these findings! The original conclusion of the study was that the researchers had no idea why they were seeing the correlations they were seeing. In fact, the discussion section of that study states:

“A comprehensive understanding of the effects of nutrients on a broad range of diseases will be necessary before making recommendations for dietary changes or use of individual dietary supplements for disease prevention.” (Brasky “SerumPhospholipid Fatty Acids and Prostate Cancer Risk.” Am J Epidemiol. 2011;173(12):1429-1439. )

There are also quite a few studies of varying size and quality that show benefits of using fish oils in helping manage and prevent prostate cancer, including a study done on fish oil supplementation and prostate cell growth, another looking at a combination of fish oils and vitamin D in the inhibition of prostate cancer cell growth, and quite a few others. The truth is, the data available is inconclusive at best.

As to the most recent study, there are several weaknesses worth mentioning. These weaknesses include the following:

 -          The study never isolated the source of the circulating DHA - they never interviewed their test subjects to find out whether they were taking fish oils (and if so, what kind and how much) or eating fish.  While the assumption is that the higher DHA levels are due to either supplementation or excessive fish dinners, there may be some other biological mechanism at work here (might there be some unique biological process that occurs during more aggressive forms of prostate cancer whereby the body conserves O3s?). The truth is, we don't know. And neither do the researchers.

-          If the men in the study were taking supplemental fish oils, when did they start? Is it possible some of these men began taking fish oils after already receiving a diagnosis of enlarged prostate or prostate cancer? This information is not provided in the study, since the data collection was a study on the role of selenium and vitamin E, both of which were administered to the test subjects. What if some participants, in learning they had an enlarged prostate, began taking fish oil supplements on their own? This becomes the classic "chicken and egg" problem.

-          The study doesn’t look at the relationship between omega 3 fatty acids versus any of the other forms of essential fatty acids (omega 6, omega 9, etc). There have been some hypotheses stating that the body requires a balance of these three unique types of polyunsaturated essential fatty acids, and that the balance may be as important as the actual blood levels of any single fatty acid.  We know that a percentage of those with prostate cancer had higher DHA blood levels. We know nothing about the blood levels of other essential fatty acids in relation to the elevated DHA.

 -          If these men were taking fish oils, what was the form of the oil? Triglyceride form or Ethyl Ester form? There are different types of fish oil products out there and they do not necessarily all work the same. The ethyl ester form of fish oils specifically is a processed form of fish oils, and is not the form used by the body. Ethyl esters need to be metabolized into triglycerides in order for the body to make use of the essential fatty acids found in most fish oil supplements, and questions have been raised about how efficient the body truly is at making this conversion. Triglyceride forms of supplemental fish oil do exist, but are more expensive and more difficult to find than the ethyl ester forms. 

-          How do we know which study to believe? As mentioned earlier, there are multiple contradictory studies regarding fish oil and prostate cancer. The truth is, the data we have available on the relative benefits or harm of circulating omega 3 blood levels in a variety of types of cancer is contradictory and inconclusive.

-          Commercially available fish oil products may contain PCBs and other environmental pollutants. Many supplement companies do not utilize third party testing nor guarantee purity and potency standards in their product. While the study may indicate that these participants might have been taking fish oil products (or eating large amounts of fish), how do we know there wasn’t an additional correlation with circulating mercury levels, PCB or dioxin levels, or other carcinogenic environmental contaminants that we have been warned that we might be exposed to if eating contaminated fish or using contaminated fish products? Are we sure the correlation was purely between prostate cancer and circulating omega 3 levels, or might there be an additional one or several correlations that the study did not evaluate?

In summary, while this new study is certainly cause for further research and careful decision-making around the use of such supplements, I do not believe it is necessarily cause for stopping the use of fish oil supplementation all together. General recommendations for those who choose to continue to use fish oils as a supplement to an overall healthy lifestyle include:

-          Be sure your fish oil product is from a credible company, one that independently assays their products or uses third party quality testing. Do not “skimp” on quality of a fish oil supplement!

-          Do not exceed 3 grams of fish oil per day unless recommended to do so by a licensed health care provider.

-          Watch for the amounts of specific types of essential fatty acids in your fish oil supplement. The active constituents in most fish oils include EPA (ecosapentaenoic acid), DHA (docosapentaenoic acid), and occasionally other potent nutrients like vitamins A, D and E. Several commercial products claim "1000 mg of fish oil per capsule" but do not state on their label how much actual EPA, DHA, or other nutrients are present in their product.  Any “fish oil” product that does not provide the actual breakdown of specific nutrients is probably a poor quality supplement that does not provide for quality control. Furthermore, the actual study only shows a correlation between circulating DHA levels and prostate cancer, not with other types of omega 3 fatty acids (like EPA). DHA is an important nutrient for brain and nervous system health, and is essential for pregnant women and infants for proper fetal brain development. Its relative risks and benefits in aggressive prostate cancer is not understood at this time. If you are concerned about the role of fish oil in increased risk for prostate cancer but still want to get the benefits of a fish oil supplement, discuss your concerns with a licensed healthcare provider and consider a high quality fish oil with a somewhat lower level of DHA.

Tuesday, April 3, 2012

The hCG Diet and Other Bad Ideas

This morning I received an email from yet another company advertising classes to get health care providers trained to use their latest "weight loss innovations".  As a nutritionist, I receive a fair number of these. Most of the time I delete them, because I frequently find that I disagree with many aspects of the programs advertised.  So when I saw the program calling itself an "alternative to weight loss," I thought, “is someone finally seeing reason?” I do tend to believe there are far too many folks pushing dangerous weight loss schemes, and the language initially made it sound as though this program was focusing on “health gain”. Another point in its favor, the program was being advertised by a natural health advocate. So out of curiosity I clicked through the links to find out more information.

Once I managed to slog through the vague and misleading advertising language, I finally found a FAQ section and decided to start there.  I quickly found that the diet being promoted was a variant of the hCG diet, but instead of using injectable or homeopathic hCG (since the FDA has been cracking down on all non-prescription and off-label hCG supplies), the program uses some other homeopathic formula they've created to help suppress appetite and speed up weight loss.

Suffice to say that there was so much foolishness in the FAQ that I stopped reading it about half-way down (I couldn't handle extensive misspelling of words like "menstrual" and the absolute mangling of the spelling for several nutrients, nor could I handle the faulty science throughout ).  The final straw was the section on personal health care products, where a claim was made that apparently even topically applied fat is going to make you fat. The man whose diet this is actually claims that those on his program have to avoid the “fats” found in skin care products like oil-based foundations and moisturizers, because they might interfere with weight loss.  I suppose he believes that someone eating only 500 calories a day may become so overwhelmed with hunger that they resort to licking their makeup off their faces in an effort to get more calories in...

Since variations of this foolishness have been making their way around my world quite a lot lately (I have fielded more questions about the hCG diet in the past few months than I can count), I thought it would be useful to explain in a bit more detail exactly why these diets are a bad idea.

Let's start with a basic concept called "basal metabolic rate." This is the number of calories a body burns while at rest over the course of 24 hours. Calories are units of energy (heat, actually), and our body needs a certain number of calories just to run basic body functions like your heart beating and your blood circulating, the involuntary muscle movement involved with breathing, that sort of thing.  If you were to lie in a coma for 24 hours, there would still be a set number of calories your body needs just to stay alive.  That number is your basal metabolic rate. Any additional movement or activity requires additional calories to be burned. So the number of calories you *actually* burn over 24 hours varies quite a bit based on your overall activity level, but your basal metabolic rate is based on how much metabolically active tissue (muscles & organs) that you have.  We're talking a basic cellular head-count.

If your calorie intake is consistently below your required basic basal metabolic rate, your body doesn't have enough calories to keep normal body functions running. This is called "starvation".  Your body changes modes - there's a complex series of hormonal changes that will occur, including slowing down your production of thyroid hormones. Your body is going to do whatever it needs to do to try and not die, because your body considers starvation to be a life-threatening condition. So what happens? Your appetite levels increase, your blood sugar drops (which can cause crankiness, headache, irritability, hot flashes, chills, shakes and many other symptoms), all kinds of other short and long term body chemistry changes happen, all geared towards surviving a famine. Furthermore, your ability to burn FAT decreases, and you're actually more likely to start burning muscle instead of fat for fuel.

With very low calorie dieting, your actual fat stores may stay about the same (at least for awhile) while your body kills off healthy muscle tissue for fuel first.  This is a clever adaptation indeed. Muscle cells are metabolically active - meaning, they are cells that burn calories (ie: they "eat"). Fat cells, however, are metabolically inactive - they mostly just store stuff. Fat is a complex molecule, and you actually need enough regular fuel coming in for your body to have enough energy to actually burn it off.  It is far easier for the body to convert protein into blood sugar than to convert fat.  And you definitely need to be bringing in calories at least equal to your basal metabolic rate in order to burn fat.

Here's a grotesque metaphor to illustrate how this works.  Imagine you had 10 people at the table, all of whom need to eat a set amount of food. As long as you consistently serve 10 plates, everyone's happy.  Now imagine you start "dieting", and now only 6 plates are served. The contents of the plates cannot be redistributed to feed 10; the amount on one plate is required to feed one eater.  So what happens?  Well, only 6 plates get served. And over time if only 6 plates keep coming out, then 4 of the other eaters are killed and served to the remaining eaters.  So now there are only 6 eaters left.  That's your basic low-calorie diet.   Not enough calories to preserve health as-is, so some healthy metabolically active tissue is killed off and redistributed as fuel for the other cells. 

Now what happens when you start serving enough food for 10 eaters again?  Well, there are only 6 eaters left at the table, so you end up with 4 extra plates. So the 4 extra plates are now put into storage.  This is why if you do a very low calorie diet for long enough, then go back to your "normal" eating habits, even if you are not eating more than you were before, you will most likely gain all the weight back plus 5-10 more pounds.  The extra weight gain is precisely because you've now reduced your basal metabolic rate by destroying metabolically active tissue - you've reduced your ability to burn calories by inappropriately dieting.  This is why short term, low calorie diets DO NOT WORK for improving health or maintaining long term weight changes. This is really basic anatomy and physiology; these are not hard concepts to grasp.

All the credible research I've evaluated (and I've been doing this work for 11 years now) indicates to me that simply losing weight, without evaluating what kind of weight you're losing, is not always going to lead to health improvement, and will sometimes lead to a worsening of health.  Having a higher body fat to muscle mass percentage (regardless of the number on the scale) increases a person's risk for metabolic diseases like diabetes and heart disease. Which actually means that if you lose the wrong kind of weight, or lose it in the wrong way, not only have you not improved your metabolic risks, you may have actually just made your risks worse.  I'd rather see my clients stay at the same scale weight and convert fat into muscle (by exercising, better managing stress, increasing healthy protein intake, decreasing processed carbs, eating balanced meals at or above their basal metabolic rate calorie-wise, and getting enough sleep) than lose a bunch of muscle weight and mistakenly think they've helped their health. 

There are times when weight loss may be indicated for improving health, and if done with health as the number one goal, there are times when this may be useful. However, if the weight is truly "excess" weight and not just a person's normal healthy size, the excess weight is most likely a byproduct of poor diet or lifestyle, or some underlying health problem. If you are eating junky and not exercising or taking care of yourself, many things may start going wrong in your body. Your weight may increase, but also you may have other health concerns showing up. And the other health concerns are, quite frankly, the more important problem needing to be addressed.

If you focus on health gain rather than weight loss, often your weight will reduce. Possibly not to fashion magazine thinness, but then whatever weight is lost becomes a side effect of an overall health improvement, as your body moves towards overall health.  The amount of healthy "weight loss" will vary depending on many health factors.  And as stated earlier, knowing your basal metabolic rate is your golden number.  Basal metabolic rate can be measured using machines like BioElectric Impedance Analyzers, or calculated by hand (there are many formulas available online for calculating basal metabolic rate).

 As a practitioner, I am not anti-weight loss, when the weight loss is done in healthy and appropriate (and respectful, and emotionally healthy) ways, and when the weight loss is secondary to healthy lifestyle changes (when the weight loss is one of hopefully several signs of overall health improvement).  But I am not blanket pro-weight loss either. And I am definitely against folks putting their health and sanity at risk simply for being "smaller", while justifying that body hatred with incorrect pseudo-medical language and techniques.

Back to the hCG diet... hCG, or human chorionic gonadotropin, is a hormone produced during pregnancy by the developing embryo.  hCG is also produced by certain cancerous tumors.  In the 1950s, an endocrinologist named Albert Simeons began experimenting with hCG as a weight loss enhancing drug.  His diet involved injected folks with low doses of hCG alongside very low calorie diets (under 500 calories).  He claimed that hCG would produce feelings of satiety and well-being, speed up weight loss, cause body fat to redistribute and increase lean muscle mass.  Modern day variants of the diet include medical centers who will administer the injections, or quite a few programs selling homeopathic or oral hCG supplements to be taken alongside a 21-40 day very low calorie diet.  Medical programs may cost up to $700 or more for a 40 day program.

Despite over 14 clinical trials researching the effectiveness of this diet, the diet has never been shown to work more than placebo.  Studies have shown that, just like any other fad crash diet, folks will lose a bunch of weight when sticking with a 500 calorie diet, and then generally gain it all back plus more. And worse, hCG itself has never been shown to help with weight loss (all the weight loss appears to be from the 500 cal diet; additional "benefits" have never been shown to be anything other than placebo effect), but side effects of hCG can include headaches, blood clots, leg cramps, temporary hair thinning, constipation, and breast tenderness. At least one person on record ended up with a pulmonary embolism after receiving hCG injections.  The Journal of the American Medical Association and the American Journal of Clinical Nutrition both warn that this diet is neither safe nor effective. And the United States Food and Drug Administration has stated that over the counter products containing hCG are fraudulent and ineffective for weight loss, cracking down on the sale of such products (including homeopathic formulations that contain trace amounts of hCG).

The hCG diet is a perfect example of why I consider fat-phobia to be a life-threatening societal issue. Because the fear of being "fat" / the hatred towards "fat" trumps common sense, and causes people to do stupid and dangerous things to their bodies (or pressure other people to do dangerous things). And certain so-called health care professionals and the diet industry make lots of money off of the fat-panic that causes people to turn off their common sense. And I think that's unconscionable.

Tuesday, May 10, 2011

Navigating Allergies: Environmental & Respiratory

It's that time of year. Sneezing, coughing, watery eyes, itchy throat. My own doctor tells me this is the worst allergy season she's seen in over 25 years in California: highest average pollen count combined with the longest length of allergy season. And my client load shows me the same thing - most folks seem to be miserable right now. Even folks who normally don't get seasonal allergies have been having trouble. It's not just CA either; I'm hearing folks complaining all over the country right now about how bad their allergies are this year.

It's not just the pollen. In many areas, spring means wildly varying temperatures and levels of moisture. This can increase spores from molds and mildews (both indoors and outdoors). Spring also sometimes means more wind, which can exacerbate dust allergies. Pets often begin shedding in earnest, and many of us begin spending more time outdoors as the weather begins to improve. All of this serves to increase the ambient levels of particulate matter in the air and also puts us out in the middle of it more than during winter.

So what can we do to help manage allergy symptoms this season? There's lots of easy things you can do to help better manage your seasonal allergies. Here's 6 suggestions for where to start. Trying even just a few of these suggestions will hopefully make some difference, especially if your allergies are primarily seasonal/environmental in nature.

1) When in doubt, wash it off.

One of the best ways to reduce your environmental allergen exposure is to wash your face when you come in from outside. Even just rinsing your face with plain water can help. For more severe allergy sufferers, things like neti pots and saline nasal washes can be a huge help. I've been pretty happy with NeilMed and Xlear's saline irrigation products, but I'm sure there's others too.

You can also make your own nasal irrigation liquid - it's a basic saline solution. Boil 1 liter deionized, RO or distilled water to sterilize. Dissolve 9 grams sodium chloride into the water (pure sea salt, kosher, or pickling salts all will work fine for this purpose). Let cool and use. An additional 2-3 g food-grade baking soda can be added to buffer the solution, which will make it less harsh on your sinuses. *I would not advise using this solution for contact lenses: sinuses are far more forgiving than eyes*. Making your own saline is only useful/effective if you already own a neti pot, bulb syringe, or other apparatus for getting the saline into your nose safely and effectively... Follow some of the above links for instructions or to purchase nasal irritation equipment. It's a worthwhile investment, really.

2) Change your clothes!

If you have environmental allergies and you've been running around outside, you have to guess that you probably have some allergens clinging to your clothing. Change your clothes when you get inside. Again, this reduces the amount of particulate matter clinging to you and finding its way into your nasal passages. Another bit of advice - don't keep your dirty laundry in your bedroom. You don't need a pile of allergen-ridden dirty clothes near where you sleep.

3) Maintain a clean sleeping environment

Most of us spend 7-9 hours every day asleep. Is your bedroom a low-allergen zone? Sleep is the time when we heal, detoxify and rebalance. If we're not sleeping well, it's harder for our bodies to keep a handle on the amount of allergens and irritants coming our way while we're awake. If your bedroom is allergy-safe(r), it gives you a chance to get a break from the allergens for a few hours every day. This can help reduce the intensity of the allergy response, giving your immune system a chance to calm down.

Ways to improve the air quality in your bedroom include:
a) Run a HEPA air purifier 24/7 in your bedroom, keeping doors and windows closed
b) Consider hypo-allergenic bedding
c) Washing all bedding (especially pillow cases) once a week in hot water
d) Using unscented/hypoallergenic laundry products, especially to wash bedding
e) Wash your pillows! Or get new ones if your pillows are more than 5 years old. Remember, your face is going to be pressed up against that pillow for 7+ hours every day. Make sure the pillow and pillow case are clean enough that you would want to be in contact with them, for that amount of time, regularly.
f) Vacuum and dust your bedroom regularly
g) If possible, keep pets out of your bedroom (if you suspect pet hair is an issue, or if your pet
spends lots of time outside)

4) Get rid of unnecessary stinky products

Scented candles, air fresheners, potpourris, room sprays, scented oil burners and similar products all put additional particulate matter into the air. When allergy season is as severe as this year's has been so far, do yourself and everyone around you a favor and reduce or avoid using perfume. Even if you don't notice the smell of scented products, these fragrances contribute to the total load of what is ending up in your sinuses and lungs. The air is full of enough junk from the dust, molds and pollens. Consider reducing or eliminating these unnecessary (and in some cases, downright harmful) chemicals. Household cleaners and bodycare products may also contain chemicals that at best may exacerbate allergies and at worst may cause toxicity-related harm. For suggestions on safer alternatives, check out the Environmental Working Group's cosmetics database, or just look for unscented, hypoallergenic, and biodegradable products (if it's safe for a natural waterway, it should be safe for your body).

5) Reduce your exposure to things to which you already know you are allergic/reactive

Allergies are often described using the "bucket" model. Imagine a bucket. Now imagine you pour a little bit of water in. Then a bit of apple juice. Then some drain cleaner. Then some beer. At some point the total liquid level will cause the bucket to overflow. It doesn't matter which liquid you pour into the bucket, the bucket can only hold so much. Allergies are kinda like that. You may be a little allergic to pollen, a little allergic to milk, a little allergic to cats... and as long as your "bucket" isn't too full, you may either not have a reaction or just a mild one. But when the "bucket" is full, it doesn't matter how mild your allergy is - your system is already on allergy high-alert, so even small exposure to things that are normally only a small problem may exacerbate overall allergy response. In other words, now is not the time to be experimental. If you're already having allergies, try to limit your exposure to even minor allergens if you can. Even if normally those minor allergens are minor, your bucket is already probably pretty full due to the state of the overall air quality. So err on the side of caution right now around all suspected allergens. That includes food and topical allergens as well as respiratory/environmental - remember,the bucket is only so big, and may include all routes of exposure.

6) Reduce stress levels!

What does that have to do with allergies? Everything. Stress hormones change the way our immune system functions. Stress has been shown to exacerbate allergic response. Interestingly, stress may actually exacerbate what's known as "late-phase reactions", meaning stress may stretch out the duration of an allergy response, causing allergic responses to show up hours after an exposure and to last longer than what would be considered normal or usual. In theory this may cause a more mild allergy to manifest in a more severe (meaning possibly more dangerous) way.

Sunday, March 20, 2011

Putting Radiation Risk into Perspective

There has been quite a lot of fear and speculation about the risk of radiation exposure for those of us living in California, Oregon, and Washington. That fear has led to such a rush of folks buying up IOSTAT potassium iodide supplies that there is fear that there will be insufficient potassium iodide for those folks in Japan who are at the highest risk of radiation exposure. The news reports vacillate between warning of imminent doom and telling us to not worry our pretty heads about it, and neither perspective seems to be terribly useful. But given what is happening in the world today, what do we actually have to be afraid of? And what steps can we take to protect ourselves and our loved ones?

What is Radiation? What’s the Risk?

To understand our risks, it helps to start with a basic understanding of radiation. All matter is made up of tiny particles called atoms. Some atoms are unstable. As unstable atoms shift to become more stable, they give off waves of energy, called radiation. There are different types of radiation, and varying levels of risk associated with different types. One type of radiation, called non-ionizing radiation, creates enough energy to move atoms but not enough to change them chemically. This type of radiation includes visible light, radio waves, and microwaves (cell phones, which work using microwaves, would be included in this type of radiation). The other type of radiation is ionizing radiation. This type is capable of pulling electrons off of other atoms, and can cause cellular damage including damage to our DNA. (information from the EPA website)

According to the National Council on Radiation Protection and Measurements, there is no measurable increase in risk for cancer or any other biological effects of radiation exposure up to 14 millisieverts (mSv). It isn’t until we reach exposures of 500 mSv or higher that we begin to see a decrease in blood cell counts and an increase in cancer rates at 1 person in 250. To put this into perspective, levels as high as 400 mSv per hour have been registered at the Fukushima plant itself, and a few hours of exposure to this dose-level can cause radiation sickness. For long periods since the crisis began, the BBC reports that levels have been at 10 mSv per hour or lower, and Monday morning the level was around .02 mSv per hour. These measurements are at the damaged plant itself. In Tokyo, radiation levels have been reported at as high as 12-13 mSv, which is higher than normal for that city but still far below what is considered to pose any health risk (according to Green Peace).

The danger associated with radiation exposure results from direct inhalation of a radiation plume. For us here in the US, it is possible that some radioactive material may end up in Hawaii, Alaska, or the West Coast. But as things stand as I am writing this article, by the time any plumes reach us they will most likely be so diffuse that they will not cause a significant health risk to anyone in the US, according to sources such as the BBC, the EPA, the Union of Concerned Scientists, and others. It is worth noting that ongoing low-level radiation exposure does have a cumulative effect on the body as well. The risk posed by a cumulative effect will be determined by factors such as the level of ongoing exposure, the duration of exposure, and your own body's ability to heal damage and clear radiation.

Many people are discussing the use of iodine as protection from nuclear fallout. The reason for this is because radioactive iodine (known as Iodine-131) is one of several possible radioactive contaminants released during a nuclear fallout. However, Iodine-131 is not the only radioactive material to be released in the event of a nuclear fallout. Other radioactive contaminants found in trace amounts from the power plant in Japan include Cesium-137 and Strontium-90.

Iodine: What is it? How does it help?

Iodine itself is an essential trace nutrient that the human body uses to manufacture thyroid hormones. The US recommended daily dietary reference intake (DRI - this has replaced the old RDA or recommended daily allowance) for iodine is between 110 and 130 mcg (micrograms) for infants up to 12 months, 90 mcg for children up to eight years, 130 mcg for children up to 13 years, 150 mcg for adults, 220 mcg for pregnant women and 290 mcg for breastfeeding women. The Tolerable Upper Intake Level (UL) for adults is 1,100 mcg/day (1.1 mg/day). The “DRI” recommendations are the smallest amount of a nutrient a person can take and still avoid developing a deficiency-related illness. The “UL” is the maximum amount that most people can safely take of a nutrient without developing toxicity symptoms.

The dosage for potassium iodide that is recommended in the case of a nuclear fallout is determined by age, weight, and level of radiation exposure. Dosage for exposures greater than 50 mSv, children up to 1 month: 16 mg; 1 mo.-3 yrs: 32 mg.; 3 yrs-18 yrs (or under 150 lbs.): 65 mg. For exposures greater than 100 mSv, adults age 18-40 yrs: 130 mg. And for exposures greater than 500 mSv, adults over 40 yrs: 130 mg. That high of a dose should last in the system for several weeks, and should only be repeated if there is explicit instructions by a health agency to repeat the dose.

Notice the extreme contrast between what is considered a safe upper intake limit for iodine for an adult (1.1 mg) compared to the dose recommended for nuclear fallout protection (130 mg). This is a tremendous difference, and there are some health and safety risks involved with taking such a high dose. The 130 mg dose is what's called a "loading dose", meaning you take this dosage once, and it should protect you for up to 2 weeks in the event of a nuclear crisis. This is not a dose you repeat, unless the radiation levels continue to stay high two weeks later or unless a health agency informs the public that additional doses are necessary. Iodine-131 is a radioactive form of iodine, and is one of several radioactive materials that may be released during a nuclear fallout. The reason you take such a high loading dose of (non-radioactive) iodine is because the thyroid is constantly using iodine, and the huge loading dose enables your body to be so oversaturated with non-radioactive iodine that it basically outcompetes - the radioactive iodine doesn't have anywhere to bind because the thyroid is already saturated with iodine.

Health Risks Associated with High Doses of Iodine

There are some health risks to watch for if taking such a high dose of iodine. For one thing, some percentage of the population is actually allergic to iodine, and may even go into anaphylactic shock from ingestion at this level. If you have a known iodine allergy, this is going to be a problem for you, and you may want to consider alternative protective measures. Those with shellfish allergies should proceed with caution as well, since some percentage of those with shellfish allergies are actually allergic to the iodine in the shellfish.

Another thing to know is that excess iodine may exacerbate both hyperthyroid and hypothyroid conditions - if your thyroid is already sensitive, taking such a high dose of iodine may cause serious problems for you. For some people even without preexisting known thyroid problems, excess iodine can cause hyperthyroid symptoms as the thyroid begins making too much thyroid hormone. The thyroid controls metabolic rate for every system in the body, and if the thyroid overproduces, it causes every body system to speed up, so symptoms may include racing pulse, heart palpitations or arrhythmias (even atrial fibrillation), nervousness, irritability, tremors, sweating, trouble sleeping, high appetite, rapid weight loss, hair loss, hypoglycemia, diarrhea, vomiting, muscle weakness, and other symptoms. In some cases the high dose of iodine can actually knock the thyroid out completely, resulting in a hypothyroid condition. Hypothyroid symptoms include fatigue, muscle weakness, sudden and unexplainable weight gain or water retention, sore joints or muscles, difficulty controlling body temperature, hair loss, constipation, anxiety or depression, and dry itchy skin.

What else can I do to protect myself?

Your personal level of risk for radiation exposure of any sort is somewhat dependent on your current health and overall nutrient level. If you eat a good diet, take decent quality vitamins, exercise, and generally are in good health, even in the event of a radiation exposure, your risk levels will be lower than someone who doesn't take care of their health. If you are looking for natural ways to protect yourself in the (hopefully unlikely) event of a radiation exposure, now would be a great time to up your intake of fresh fruits & veggies, whole grains, legumes, and healthy animal foods, start a decent quality multivitamin (centrum and costco generic multivitamins don't actually count - most of the cheaper multivitamins aren't very well absorbed), and get enough sleep. Avoid foods and lifestyle habits that can weaken the body or exacerbate poor health, such as processed and refined starches, added sugars, hydrogenated fats, smoking, excess alcohol, and poor sleep. Most of us do have a sense of what constitutes health-supporting diet and lifestyle habits. If you have been considering reducing your soda intake, increasing your veggies, or cutting out the fried foods, now would be a great time to start.

There are some specific foods that may be cell-protective in terms of radiation exposure. These foods include seaweeds, spirulina, chlorella, natto (Japanese fermented soybean product), and miso soup. In 1945, there were several compelling anecdotal stories in Japan on the use of macrobiotic diets to protect patients in Japanese hospitals after the atom bomb was dropped on Hiroshima and Nagasaki. Dr. Tatsuichiro Akizuki, M.D., was director of the Department of Internal Medicine at St. Francis’s Hospital in Nagasaki. He fed his patients and his staff a strict and simple macrobiotic diet consisting of seaweed, miso soup, Hokkaido pumpkin, brown rice and sea salt with strict prohibitions against sugar. In his hospital, there were no severe radiation symptoms seen among the patients or the staff while folks in hospitals further from the bomb site had far more symptoms and higher mortality rates (Tatsuichiro Akizuki, M.D., Nagasaki 1945 (London: Quartet Books, 1981); Tatsuichiro Akizuki, “How We Survived Nagasaki,” East West Journal, December 1980). This story and others like it prompted studies to be performed in Canada, Japan, and Russia, all showing beneficial results when using seaweeds and miso paste to reduce radiation levels from tissue.

Another factor one cannot underestimate in terms of overall health impact is the health impact of stress and fear. These are scary times, and many people are very nervous about what a possible nuclear fallout may mean for themselves, their loved ones, and our world at large. While fear is an understandable reaction to the situation in Japan, the fear itself may cause more health damage than the actual radiation exposure, particularly for those of us in the US who are at significantly less risk than people living in Japan. So while it is not useful to say, “hey you! Stop being afraid!,” I will strongly recommend that folks do what they feel they must to control their anxiety. Staying abreast of current events sometimes helps and sometimes does not help, since so many news articles are written to be eye-catching, and few things catch the eye faster than exaggerated claims and sensationalism. I would recommend finding one or two news sources that you trust and only monitor those. Do be sure to avoid any news sources with overly sensationalizing headlines or flashy pictures of trauma and devastation. Some of the news sources from outside the US may actually be more accurate and less sensationalizing than many mainstream news sources here in the US.

In summary, I recommend that we all put our panic into perspective, increase our intake of fresh fruits, vegetables and seaweed, and continue to monitor reliable media sources for further information. If you do have potassium iodide on hand, DO NOT TAKE IT unless you have seen a reliable source of information telling you that levels of radioactive Iodine-131 in your area have become high enough to pose a health risk (over 100 mSv for adults). I would recommend waiting until a public health agency declares such a thing, but I understand not everyone believes that our government is monitoring carefully enough. If you are of that mindset, please at least wait until the sources you trust show a significant elevation in Iodine-131 in your environment before taking high doses of potassium iodide. 130 mg of potassium iodide is not a prophylactic dose, and is not a safe dose of iodine to take on an ongoing basis.

Some links:
What is radiation? from the EPA
FAQ from the Union of Concerned Scientists
FDA FAQ for bioterrorism and emergency preparedness
Explanation (with visuals) of relative radiation risks in Tokyo
Explanation of risk from radiation exposure
Links to studies of specific foods for protecting against radiation damage

Monday, June 7, 2010

Sex and Fiber!

To my fiber arts aficionados, no, I'm not talking about wool roving.

Did you know that a simple way you can improve your overall libido is by adding fiber to your diet? It may sound like a stretch, but it's true. Fiber is the non-digestible part of all plants, and we can find dietary fiber in all of our whole plant-based foods: whole grains, fruits, vegetables, nuts, seeds, and beans.

Fiber and Digestion
Fiber is best known for its role in improving digestion. We have better bowel movements when we have more fiber. When we go to the bathroom, we eliminate toxins such as spent hormones, common chemicals found in our food, air and water, and other substances, which can make us feel tired, sluggish, and headachy. Not a winning combination for a romantic night in. And constipation is counter-productive to feeling sexy.

Fiber and Circulation
Fiber helps lower cholesterol and improve circulation. Cholesterol can block arteries, reducing overall circulation. Compromised circulation means less blood flow to ALL our parts. Keep in mind, the human penis becomes erect entirely because of blood flow. Better circulation means better circulation everywhere.

Fiber and Blood Sugar
Fiber slows the absorption of sugar into our blood stream, which can help keep our blood sugar levels more even. There's nothing less sexy than getting cranky and light-headed from low blood sugar!

Fiber and Hormone Balance
Certain types of fiber, such as the lignans found in flax seeds, can actually help balance our hormones too. Lignans cause the liver to create a chemical called Sex Hormone Binding Globulin, which helps our bodies keep our hormones optimally balanced.

A healthy body is a sexy body. Try and get at least 4-6 servings (that's equal to about two to three cups) of veggies, plus fruits, beans, nuts and seeds, and whole grains every day. Your sex life will thank you for it...

Sunday, May 2, 2010

Love the Life You Live!

Welcome to my blog! In this blog, I'll be discussing how you can love the life you're living, by maximizing your physical health, enhancing your sense of overall well-being, and helping you figure out how to make the most out of your life. I am a board certified holistic nutritionist, herbalist, and somatics coach with a passion for getting people healthy, happy and inspired.

There are a million diets, self help fads, supplements, techniques and ideas for how to improve your health and wellness. Most of us know that we should be eating our vegetables, getting enough sleep, exercising, managing our stress levels... you know that already. For many of us, the problem is not knowledge, it's implementation. It can get overwhelming to try and figure out how to eat well and exercise and do all those great sounding self care things while also having family and friends and a job and a busy life. But if we don't find a way to do at least some of those things, we won't connect as deeply with our loved ones; we won't do as well at our jobs; we won't love the life we're living.

So where do we start? Start by creating an image of what you want your awesome life to look like. How would you answer the question, "what does my ideal life look like? What do I wish were possible for me? Who would I be? What would I do? How would I move in the world? What kind of person would I be? How would I feel?" Start by creating an ideal you. Write it out in bullet points. Discuss your ideal life with an encouraging friend. Write poetry about it. Do interpretive dance exploring it. Whatever method makes sense to you, go for it. But figure it out, and dream it in exquisite detail. Dream big. Once you have your vision, you can start figuring out the steps you need to take to get there, but you have to start by dreaming it.

I would love it if you left a comment with one thing you are excited about becoming, or one vision of what the ideal you would be like!