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Mesa, AZ 85210
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fatty liver

PREVALENCE OF FATTY LIVER IN CHILDREN – (03-05-07)

Prevalence of Fatty Liver in Children and Adolescents

Well, if you’re in support of the concept that the health of our society is going to Hell in a handbasket, you’ll love this study. A staggering 13% of children aged 2-19 had fatty liver. Fatty liver. The pre-liver cirrhosis stuff. As if children did not already have the health card stacked against them from their parents’ poor health choices during pregnancy and as an infant.

Now we will have to add liver failure to the list of conditions that children are going to be getting earlier and earlier–right next to breast cancer, diabetes and heart disease.

Read entire article here

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TODAY’S TREATMENT FOR INSULIN RESISTANCE IN DIABETICS ACTS ONLY IN THE LIVER – (01-21-08)

Has natural selection in human populations produced two types of metabolic syndrome (with and without fatty liver)?

I have to admit, with as familiar as I am with metabolic syndrome, the concept that there may be three main clinical manifestations is new to me, but makes sense. We know that there are certain cells that make up the main contributors to insulin resistance and glucose metabolism: muscles, adipose tissue and liver. I’ve always viewed the effects as identical, but this author is suggesting that we may get 3 separate clinical pictures depending upon which tissue is most affected. Thinking about this and applying it to patients in my office, it makes much sense. I have very insulin resistant patients with very low body fat. I have patients that seem to have elevated liver enzymes long before anything else appears. And I have patients that look relatively lean but have a high body fat.

All these pictures would suggest different tissues being affected and may lead to different emphasis on treatments. Interestingly, the main drugs available today to treat insulin resistance in diabetics acts ONLY in the liver and would probably be minimally effective in the other two clinical scenarios presented here.

Read entire article here

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RISK INVOLVED IN OVERUSE OF ANTIBIOTICS – (01-15-07)

Metabolic profiling reveals a contribution of gut microbiota to fatty liver phenotype in insulin-resistant mice

Another mouse study…this one finds that a high fat diet was converted by the bacteria in the gut in such a way as to increase the risk of liver damage and increase insulin resistance.  So how does this impact our GI tract when we are bombarded with nonessential antibiotics and the bacterial types that we have spent several hundred thousand years gettting acquainted with are not replaced?

The buzzword around antibiotic overuse is always antibiotic resistance, and this is, in reality, only a very small measure of the damage antibiotic overuse does to our physiology and risk of chronic diseases.

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ASSOCIATION BETWEEN HYPOTHYROIDISM AND SMALL INTESTINAL BACTERIAL OVERGROWTH – (04-28-08)

Association between Hypothyroidism and Small Intestinal Bacterial Overgrowth

Talk about the complicated web that makes up our physiology!! In this small study, it was determined that 54% patients with hypothyroidism due to autoimmune thyroiditis had small bowel bacterial overgrowth (SMBO). So what are the connections? First, we know that anti-secretory therapy for ulcers leads to bacterial overgrowth as well.

Then, we know that SMBO has been linked to fatty liver (at first seems like a stretch, but SMBO will lead to leaky gut, allowing larger molecules to get absorbed and head straight to the liver, where the liver now has to deal with the burden). We also know that a large percentage of patients with autoimmune thyroiditis have celiac disease, which further disrupts the integrity of the GI tract.

So, we end up with an upregulation of the immune system as a result of the leaky gut, increasing our likelihood of an autoimmune condition. This can be a perfect example of a feed forward cycle, where an initial disruption in physiology leads to other problems, with these “other problems” feeding back into the cycle and making the initial disruption worse!!

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L-CARNITINE TREATMENT REDUCES SEVERITY OF PHYSICAL AND MENTAL FATIGUE – (05-26-08)

L-carnitine treatment reduces severity of physical and mental fatigue and increased cognitive functions in centenarians

L-carnitine is a substance that helps shuttle fatty acids across the mitochondrial membrane to allow them to be used for fuel. Anything that supports the function of the mitochondria is going to have positive benefits on a variety of conditions, most notably in those cell types that require high amounts of energy such as the neurons.

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DIABETICS SHOULD SNACK ON THESE

Despite massive amounts of evidence and research on how to avoid and / or eliminate diabetes, the public still isn’t receiving the message.  Sometimes small changes that are incredibly simple can make major improvements.

As an example, avoiding bottled water and switching to tea is a simple change moving from BPA loaded water to polyphenol rich tea.  Avoiding all artificial sweeteners.  Burst type aerobic exercise, even if it is just for 10 minutes a week.

This particular study focuses on the power of almonds to improve diabetes.  The authors took “well controlled” diabetics (I personally hate that phrase–no one is ever “well controlled” if they need medication to get there) and had them eat a single serving of almonds with breakfast 5 days / wk for 4 months.

They found a massive 30% reduction in blood sugar levels and a 4% reduction in HbA1c levels in these patients, which, in some patients, may be enough to reverse the diabetes diagnosis.  Few medications than can do this are without side effects.

These results are even more surprising when you take into account the standardized breakfast that the diabetics ate was bagels, butter and juice–ALL absolute no-nos for diabetics!  Despite the pro-diabetic breakfast, the almonds were still powerful enough to drop HbA1c levels.  How simple is that??

Two things to add..

First, raw or dry roasted almonds only.  Nothing that comes out of a can or has any added oils to them.  Big mistake that many make.  And while this study looked at almonds, I would not be surprised to find many other nuts having similar effects.

Second, chew more.  Several studies have found that by merely chewing food more we get a stronger anti-diabetic effect, especially in almonds.

If you’re diabetic, what are you waiting for?  If you’re not, you should make it a habit anyway..

Read more…

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PRESCRIPTION FISH OILS?

Everyone is aware of fish oils and the benefits to human physiology.  Did you know that they are available by a prescription?  I really shouldn’t got into this topic because it gets my blood boiling…

This is certainly not the first time that the drug companies have tried to ride the tide of popular natural approaches and monopolize on them, but this may be the most nausea-inspiring.  Why?

We can easily argue that the drug companies are about 30 years behind the research on the benefits of fish oils (the early studies came out in the 70′s).  GlaxoSmithKline has done very little research on the efficacy of fish oils and the conditions they can treat.

What is the excuse most drugs companies give for the exceedingly high cost of their drugs?  You guessed it– Research and Development.  So, we’ve established that GSK did very little of this and are merely riding the coattails of decades of research.  Sure–they’ve done some simple studies on their product Lovaza (formerly known as Omacor), but just enough to satisfy the FDA.

So what’s the problem?  At GSK’s prices for Lovaza, at recommended dosages (4 grams per day…more on that later), even budget conscious Costco is $182 / month.  yes–that is one hundred and eighty dollars for omega 3 fatty acids that for an arguably superior product that we sell in our office the cost is under $30.  Over 6 TIMES the cost.  And it’s certainly not about the R & D and it’s not about the quality.  That’s what’s so sickening.

And worse, some of your insurance is actually picking up the bill.  Yup.  Your insurance wouldn’t pay $30, but they’re willing to pay over $200.  And we wonder why there’s problems with healthcare costs…

Back to this particular study that looked at the cost effectiveness of the massively overpriced Lovaza being used at 4 grams / day and found that the cost per quality adjusted life year (QALY–a standard approach to determining if an intervention is worth the cost…anything under $50K is considered worth the cost) was $47K, or just under the margin.  A little funny when you back out of the data and look at how much the drug costs…..(I’d say it sounds “fishy,” but that would be too punnish..)

If we were looking at a reasonably priced OTC fish oil, this would be closer to $7800.  Ironically, when you take the most recent review of statin (in)effectiveness by the Cochrane Group, the cost of QALY was over $62K.  Not even in the same ballpark.

Of course, none of this addresses the massive benefits and cost savings with you couple healthy lifestyle changes like avoiding refined carbohydrates with a lower dose omega 3 use…

Read more… 

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WHAT TYPE OF EXERCISE FOR LIVER PROBLEMS?

We’ve addressed the different effects of aerobic vs resistance training for avoiding diabetes in the past.  While both are important, there is one that has a clearer benefit in the short run.

Aerobic exercise, more specifically geared towards intermittent burst type exercises, is an absolute when it comes to long term health.  This type of exercise is not used all that often as most follow the dogma of sustained aerobic activity.  For my non-hiking, non-martial arts aerobic training, I follow a regimen where each set is shorter, but more intense.  This means that each set asks more and more of my cardiovascular system, strengthening my heart and improving my blood vessels.

However, for short term benefit, resistance training, in most studies, has come out on top.  This is likely because it sets up a situation where the muscles need more glucose to perform, heal and strengthen.  To do this, our muscles have to become more sensitive to insulin (technically, the number of Glut4 receptors increase…) so we can get more glucose inside.

This is the perfect scenario for avoiding or improving prediabetes / diabetes.  This is likely why this study found improvements in liver and diabetic function with a mere 8 weeks of training.  Not surprisingly given the time frame, there was no change in body weight.

This is why some people give up after only a few months of not losing weight.  They forget that the goal is NOT to lose weight, but rather to improve the way their physiology is orchestrating. 

So, if you are exercising and using resistance training, stay off the scale and instill some faith in the idea that you ARE doing the right thing for your body.  Just give it time.

Read more…

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January 21, 2008 Research Update

James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Soy Product and Isoflavone Consumption in Relation to Prostate Cancer in Japanese Men.

There seems to be a never ending parade of people noting that soy is detrimental to our health. Unfortunately, many of the references they use do not hold up to scrutiny. Add to this that there are volumes of research on the beneficial aspects of soy and the isoflavones they contain. Keep in mind, however, that our bacterial flora in our gut plays a large role in how beneficial these isoflavones are. Over time, the bacteria in our gut “learn” to convert the isoflavones to their aglycones, and these aglycones are the compounds that are very protective for hormonal cancers. This was a large study looking at whether soy protected against prostate cancer. For localized prostate cancer, soy consumption lowered risk almost 50%. However, it did increase the risk for advanced prostate cancer. Rather than deterring from soy consumption, I would suggest that soy should be part of a lifestyle of healthy changes, coupled with other lifestyles to lower risk of prostate cancer (sunlight exposure, no dairy, plant based diet, exercise, etc..). Read More.

Comparison of Characteristics of Future Myocardial Infarctions in Women With Baseline High Versus Baseline Low Levels of High-Sensitivity C-Reactive Protein.

While the research is plentiful, the concept that inflammation is a major player in CVD has been slow to catch on. This study is just another that adds to the research, with some additional tidbits added in. The higher the hsCRP levels, the sooner healthy women had heart attacks and the more likely these women were to experience a fatal heart attack. The real kick in the glut region is that the use of statin drugs to lower cholesterol probably is not having its impact on CVD risk via cholesterol, but rather by acting as an anti-inflammatory. However, there are many other, much more potent, means of lowering inflammation that don’t involve medications that lower levels of CoQ10, an absolutely essential nutrient for healthy cell function. Read More.

Has natural selection in human populations produced two types of metabolic syndrome (with and without fatty liver)?

I have to admit, with as familiar as I am with metabolic syndrome, the concept that there may be three main clinical manifestations is new to me, but makes sense. We know that there are certain cells that make up the main contributors to insulin resistance and glucose metabolism: muscles, adipose tissue and liver. I’ve always viewed the effects as identical, but this author is suggesting that we may get 3 separate clinical pictures depending upon which tissue is most affected. Thinking about this and applying it to patients in my office, it makes much sense. I have very insulin resistant patients with very low body fat. I have patients that seem to have elevated liver enzymes long before anything else appears. And I have patients that look relatively lean but have a high body fat. All these pictures would suggest different tissues being affected and may lead to different emphasis on treatments. Interestingly, the main drugs available today to treat insulin resistance in diabetics acts ONLY in the liver and would probably be minimally effective in the other two clinical scenarios presented here. Read More.

Heightened Risk of Breast Cancer Following Pregnancy: Could Lasting Systemic Immune Alterations Contribute?

This one gets a little deep. Many realize that pregnancy lowers your risk of developing breast cancer. What many do not know is that this is long term risk–in the short term the risk is actually elevated. So why the discrepancy? I have heard the theory proposed that the high levels of progesterone in pregnancy actually increase the risk of terminal duct lobular carcinoma of the breast, but lower the risk of interlobular ductal breast cancer. This article is suggesting a different (or complimentary) theory. We know that pregnancy induces a change in immune status towards a Th2 dominated state. With a Th2 immune profile, the body is less likely to look inside for something to attack (like the developing fetus). However, we use this system for cancer surveillance. This may indicate that a Th2 state during pregnancy would leave cancer cells to divide unchecked by the immune system, leading to increased rates of cancer. Read More.

Supplemental and Dietary Vitamin E Intakes and Risk of Prostate Cancer.

This study again points out that there is definitely a difference in what we call “Vitamin E.” In most lower quality Vit E supplements, only the alpha form is used. However, Mother Nature uses primarily the gamma form, and, from many studies the gamma form has the more powerful effect on our risk of chronic disease. Interestingly, many studies have pointed to the fact that higher levels of the alpha form will lower the level of gamma forms in the blood. The history as to why the alpha form is the principle form marketed has been covered in past issues of Updates. In this study, higher dietary intakes of gamma tocopherol, but NOT alpha, resulted in a 38% reduction in risk of prostate cancer. Read More.

Sun Exposure and Prostate Cancer Risk: Evidence for Protective Effect of Early-Life Exposure.

While we’re on the subject of protecting the prostate, we have to throw in sunlight exposure / Vitamin D. I cannot stress how important Vit D is to our long term health and the research supporting its role in most chronic diseases. Despite this research, the general public still has the idea ingrained into them that sun exposure is a bad thing, and we need to drink SPF 50 daily to protect our skin from melting away in cancer as we walk to the car. However, in this study, sun exposure at a higher latitude as a child as well help cut prostate cancer risk by over 50%. In adults with high levels of recreational sun exposure there was a lowering the risk for more aggressive prostate cancers. We have yet to fully see the ramifications on cancer rates that will occur as a result of our avoidance of sun exposure. Read More.

Prevalence of Cardiovascular Risk Factors and the Serum Levels of 25-Hydroxyvitamin D in the United States.

Are you starting to get the idea that I’m not making this stuff up. The breadth of human physiology that Vit D cuts across makes it one of the most important nutrients (although it is actually a hormone, NOT a vitamin) on the radar screen today. Read More.

Efficacy of daily and monthly high-dose calciferol in vitamin D–deficient nulliparous and lactating women.

I very frequently get questioned on the doses of Vit D that I recommend to patients. While these dosages vary from patient to patient, a dosage of 2,000 IU / day is becoming a pretty standard recommendation. Many patients think that this is a very high dose. However, we are seeing more and more patients where 2,000 / day is not enough. This study backs up these observations, finding that 2,000 IU / day for 3 months was safe, but researchers found that very few women were able to get their serum levels above 50 nmol /L, suggesting that we are going to need to rethink our recommendations again. However, keep in mind that these researchers used Vit D2, which is proven to be an inferior source of D. Read More.

Vitamin D Status Predicts Physical Performance and Its Decline in Older Persons.

First, before I go on, these are 4 articles from 4 entirely separate journals published in the same month. If the average doctor is NOT concerned about vit D status in his or her patients, they have to be going out of their way to avoid current medical literature. That being said, we again see that, in this population of patients 65 years of age and older, that serum levels < 20 ng / ml were present in more than half the patients in this study (ideally, we want to be above 100 nmol / L or 40 ng / ml). The bottom line is that the higher the serum levels, the better the patients performed on physical performance tests. Read More.

Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety.

While this article came out in 1999, it is a wonderful review for anyone wanting to find out more about dosages and safety of Vit D supplementation. By the way, this author is suggesting that 10,000 IU / day may be a more appropriate dosage if you base supplementation levels on serum levels of Vit D. Read More.

 

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March 5, 2007 Research Update

James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Preventing Sudden Death with n-3 (Omega-3) Fatty Acids and Defibrillators.

Remember all the hoopla about adding automated external defib units in public places because it would save lives? Well, increasing blood levels of omega-3 fatty acids is 8 times more effective. But you already knew this because it was all over the news… Just kidding!! Also to consider is that placment of AEDs really won’t do a whole heck of alot to reduce risk of other diseases like diabetes and certain cancers. Read more.

Consumption of One Egg Per Day Increases Serum Lutein and Zeaxanthin Concentrations in Older Adults without Altering Serum Lipid and Lipoprotein Cholesterol Concentrations.

Eggs really have gotten a bad rap over the past decade or so because we were so caught up in the mistaken notion that dietary cholesterol = serum cholesterol. This just isn’t true. In addition to being a good protein source, the veg-a-fed eggs will be high is omega-3 fatty acids. As if this wasn’t exciting enough, the coloring of the yolk is provided by carotenoids. This study finds that the consumption of one egg per day is able to raise the serum levels of the carotenoids lutein and zeaxanthin; both of which are known to protect the retina. Read more.

Immunity and Antioxidant Capacity in Humans Is Enhanced by Consumption of a Dried, Encapsulated Fruit and Vegetable Juice Concentrate.

Given that I am not in support of replacing your 8-10 servings of fruits and veggies a day with some type of pill, let’s just keep the results of this one secret. Basically, for 77 days, participants took a drink mix with fruit and vegetable concentrate. Markers of healthy immune function and protection of DNA were all increased within the time frame. I have actually come to support the concept of a “greens” drink given how much broad-spectrum antioxidant power these drinks possess. Read more.

A pecan-enriched diet increases gamma-tocopherol/cholesterol and decreases thiobarbituric acid reactive substances in plasma of adults.

While the addition of any type of nuts to the diet improving health is not surprising, the blood levels of the tocopherols WERE interesting. Recall that most supplement forms of Vit E are in the alpha tocopherol form. While the alpha form was initially thought to be the most potent of the tocopherols, research has since shown that the gamma tocopherol is much more protective for heart disease. This study found a very nice 10% increase in serum gamma tocopherol when pecans were added to the diet and well as lowered markers of oxidative stress. Interestingly, levels of alpha tocopherol dropped. This illustrates why some of the higher quality Vit E supplements will have mixed tocopherols–because supplementation of one form may lower the levels of another form (it is known that supplementation of the alpha form will lower levels of gamma in the blood). Read more.

Infertility, infertility treatment, and congenital malformations.

This is really a very bad omen. I’ve said it before and I will say it again. We are messing with Darwin and there will be a serious price to be paid for our intervention. Forget Maslow’s Heirarchy of Needs–the ONLY reason a species exists is to propagate its own. So, if a couple is infertle, there is a definate reason why Mother Nature does not want this couple to reproduce. Many times there is a physiological problem that needs to be fixed and before the couple cl become pregnant. If we don’t fix that problem and we force anpregnancy onto this couple, we have dramatically shifted the balance of Nature. There is a point at which medicine needs to decide that the best intervention is NO intervention. Read more.

Sunscreen enhancement of UV-induced reactive oxygen species in the skin.

Doesn’t this just run contrary to public health recommendations? Basically, the addition of sunscreen, after one hour, ends up creating MORE damage to the skin than not using sunscreen. This is compounded by the fact that sunscreen blocks Vit D production by up to 98%. So, not only does our public health measures promote the use of SPF 900 when walking from the house to the care to block all potential sunlight formation of Vit D, but using that sunscreen will ultimately result is greater damage and risk of cancer to the skin. Quite a kick in the gluts, huh? Read more.

Prevalence of Fatty Liver in Children and Adolescents.

Well, if you’re in support of the concept that the health of our society is going to Hell in a handbasket, you’ll love this study. A staggering 13% of children aged 2-19 had fatty liver. Fatty liver. The pre-liver cirrhosis stuff. As if children did not already have the health card stacked against them from their parents’ poor health choices during pregnancy and as an infant. Now we will have to add liver failure to the list of conditions that children are going to be getting earlier and earlier–right next to breast cancer, diabetes and heart disease. Read more.

Follicle-stimulating hormone stimulates TNF production from immune cells to enhance osteoblast and osteoclast formation.

While this was a mouse study, it does have some potentially important implications. First, it further confirms the role that inflammation plays in bone loss. Basically, the more inflammation present, the more cells that are produced to break down bone (osteoclasts) and thus greater bone loss. The marker of inflammation, TNF-alpha, was increased by FSH, a hormone that will increase around peri-menopause as the body tries to jump-start the ovaries to release an egg. Next implications, ascorbic acid was found to prevent this increase in osteoclasts in the presence of elevated TNF alpha. Read more.

A Population-Based, Cross-Sectional Comparison of Lipid-Related Indexes for Symptoms of Atherosclerotic Disease.

“In conclusion, these observations add to the published data suggesting that LDL cholesterol may not be the best target of lipid-lowering treatment strategies.” Wow. What’s the average primary care doc going to do? We’ve become so blinded to checking LDL and total cholesterol that we haven’t seemed to notice that other markers do a much better job of predicting heart disease then cholesterol. I can honestly tell you that I’ve had patients come in being aggressively put on statins for a cholesterol level under 230 that would’ve responded to something as simple as a handul of almonds. Read more.

Risk of Colorectal Cancer Is Linked to Erythrocyte Compositions of Fatty Acids as Biomarkers for Dietary Intakes of Fish, Fat, and Fatty Acids.

Another wow. Look at these odds ratios…as high as an 9.45 times increase in risk of colon cancer with higher levels of saturated fat / lower levels of healthier fats in red blood cells. This is one of those reasons I have such a beef with our national organizations. Information like this needs to be disseminated to everyone within earshot. Just by increasing our intake of healthier fats and reducing intake of unhealthy fats we could make a serious dent in the rates of one of the greater cancer killers. But our national organizations remain silent, instead pushing to collect ever more money to find a “cure” for a very preventable disease. Read more.

 

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