Dairy Products Are Not All The Same

In class and student clinic, some of the most common disagreements over what we should and should not be eating involve dairy. But is all dairy the same? Actually, a large study published in the British Medical Journal found that pasteurised, unfermented milk may increase the risk of fractures and death, especially in women, while yoghurt and cheese could have the opposite effects.

In this study, over 61,000 women aged 39-74 at the beginning of the study were followed for an average of 20 years, while over 45,000 men aged between 45 and 74 were followed for an average of 11 years. Dairy consumption, death rates, fracture rates, and the inflammation markers IL-6 and PGF-2 alpha were all compared and contrasted among the many thousands of participants.

For the women, drinking three or more glasses of milk a day was linked with a 93% increased risk of death, compared with those who drank one or less glasses of milk per day. The men showed only a 10% increased risk of dying, although they were followed for a much shorter length of time. Men also did not have an increased risk of bone or hip fractures. However, women drinking at least three glasses of milk daily had their risk of hip fracture increased by 60%, and their risk of general bone fractures was raised by 16%. The risk of cardiovascular disease in these women was up by over 90%, and their cancer incidence was up by 44%.

While many would stop there to panic about the harmful effects of milk and generalise it to all dairy, it was also found that cheese, yoghurt and fermented milk have protective effects. Women eating at least 60 grams of cheese every day reduced their risk of mortality by over 30%, and when the beneficial effects of the nutrients in cheese were not cancelled out, this shot up to 49%! Risk of death from cardiovascular disease dropped by 37-52%, and death from cancer dropped by 5-15% in these women. Additionally, bone fracture risk halved, and hip fracture risk decreased by 36%. As for men, mortality dropped by 14-18% overall, and cardiovascular mortality fell by 13-22%, but there was no significant protection against cancer. Men's fracture risk only fell by 23-25%. As for yoghurt and fermented milk, women who consumed at least 400 grams daily experienced a 14-38% reduced mortality risk, a 7-32% lower risk of cardiovascular death and a 19-25% reduced risk of dying from cancer. Hip fractures decreased by 30-51%. Among men, this decreased overall mortality by 10-17%, cardiovascular deaths by 10-16% and cancer deaths by 11-17%, with yoghurt-eating men having a 25% lower risk of hip fractures.

So why is there such a dramatic difference between milk and fermented dairy? Milk has higher amounts of galactose and lactose, which are broken down by the bacteria in foods such as yoghurt. Casein, a protein linked to food sensitivities and related problems, is also broken down during the fermentation process, while the probiotics may also balance out the effects of IGF-1, or break them down. The differences between men and women may indicate beneficial effects of fermented dairy, and harmful effects of milk, on certain hormonal pathways.

Individualised Treatment Able to Reverse Alzheimers?

One of the worst things about the aging process is how it affects the nervous system, as it stops being just about physical degeneration and mutates into something that can seemingly erase an individual's personality, memories, and everything else about them that is non-physical. But instead of "inspirational" (how?) movies etc. documenting these horrible diseases such as Alzheimer's disease, such as the awfully depressing Still Alice, we can get actually inspired by this: a recent study where 9 of the 10 patients involved experienced significant cognitive improvement after taking on individualised treatment protocols designed to correct metabolic defects.

The long history of failure in treating neurodegeneration suggests that these conditions are caused by failures in the body's systems or programs, not a need for a specific, targeted treatment. Treatments such as oestrogen replacement, exercise, melatonin, vitamin D, curcumin, ginkgo biloba and ashwagandha have so far shown minimal effects in research, often because they are prescribed alone. Research and treatment often only considers normalising metabolic parameters instead of optimising them; for example, a homocysteine level of 12umol/L is seen as "normal", but it is not optimal, and so many people with this reading will not be healthy. "Normal" is usually defined as "90%+ of people are in this range" or "you will live to see tomorrow, barring accidents". In systems such as naturopathy, optimal levels are the primary concern, as treatment is individualised to the patient. This is also why many of us have issues with health food store "consultations", where you have to generalise because you only have a few minutes with them and are often pressured to sell as much as possible by often unqualified owners (I was in one of these places for a while).

Despite individual variations, all patients' treatment plans followed a selection of the following rules:

-Reduce simple carbohydrates and inflammatory aspects of their diets, while increasing anti-inflammatory, whole foods (several low GI, low inflammatory, low grain diet options were given)
-Enhance the clearing of cellular garbage and temporarily induce ketogenesis (all patients were instructed to fast for 12 hours a day, which was sleeping + 3 hours before bed)
-Reduce stress (patients' own choices of methods)
-Optimise sleep to around 8 hours of unbroken sleep
-Exercise for 30-60 minutes a day for 4-6 days per week
-Brain stimulation if required
-Keep homocysteine under 7. Homocysteine is quite damaging to neurological health. Methylated folate and B12 were required for this, along with B5 and trimethyl-glycine if necessary.
-Keep serum B12 levels to over 500
-Keep CRP, an inflammatory marker, under 1, with an anti-inflammatory diet, curcumin, EPA/DHA and/or hygiene
-Keep insulin under 7 and HbA1c under 5.5
-Optimise thyroid, stress and "sex" hormones
-Repair GIT health with pre- and probiotics as needed
-Reduce A-beta protein with curcumin and/or ashwagandha
-Enhance cognition with Bacopa monniera and/or magnesium threonate
-Keep vitamin D3 between 50 and 100ng/mL with vitamins D3 and/or K2 supplementation
-Increase nerve growth factor with H. erinaceus and/or acetyl-l-carnitine
-Provide synaptic structural components with citicoline and/or DHA
-Optimise antioxidants with any of: mixed forms of vitamin E, selenium, blueberries, N-acetyl cysteine, vitamin C or alpha-lipoic acid
-Optimise zinc:copper ratios
-Treat sleep apnoea if necessary
-Optimise mitochondrial function with any of: CoQ10 forms, alpha-lipoic acid, N-acetyl cysteine, acetyl-l-carnitine, selenium, zinc, vitamin C or B1, or resveratrol
-Increase focus with vitamin B5
-Increase SirT1 function with resveratrol
-Treat any heavy metal toxicity
-Consume medium-chain fats, which are in coconut oil and are an alternative energy source for the brain besides sugar.

For example, the treatment plan of a 55 year old woman with cognitive impairment and early onset Alzheimer's disease consisted of:

-Fasting for a minimum of three hours between dinner and bedtime, and for a minimum of 12

hours between dinner and breakfast
-Eliminating simple carbohydrates and processed foods from her diet;
-Increasing consumption of vegetables and fruits, limiting consumption of fish to non-farmed, and no meat
-Exercising 4-5 times per week
-Taking melatonin 0.5mg orally at bedtime, and trying to sleep as close to 8 hours per night as her schedule would allow
-Trying to reduce stress in her life with meditation and relaxation

-Taking methylcobalamin (vitamin B12) at 1mg 4x/wk and pyridoxine-5-phosphate (vitamin B5) at 20mg each day;

-Taking citicoline at 200mg each day

 -2000IU vitamin D3 daily and CoQ10 at 200mg each day

-700mg of DHA and 500mg EPA twice daily-Bioidentical oestradiol with oestriol and progesterone
-Reducing her bupropion from 150mg daily to 150mg  3 times weekly.
bioidentical estradiol with estriol
 Regardless of the authors' positions on various systems of medicine, they are essentially stating that naturopathy as a system of medicine is superior in treating these issues, as opposed to pharmaceuticals or the "green allopathy" that characterises the research where only one substance such as ginkgo biloba is given. However, it is important to see a qualified naturopath for a full consultation.

Defending Paleo

This morning I noticed yet another attack on the Paleo diet and Pete Evans, which wrongfully assumed that no one actually does their own research or consults a qualified naturopath who has. There are reasons why this diet has become so popular, and no, they do not involve the words "gullible", "loony" or any other invalidating, condescending terms.

Statistics released last year showed that Australian sales of bread and pasta have dropped by 30% in the last 3 years. Not surprisingly, this led to an earlier round of handwringing among conventional physicians and dietitians who were concerned about the food pyramid being abandoned for so-called “fad diets” such as the Paleo Diet, despite the fact that this and other gluten-free diets have benefited so many. One of their main concerns is a perceived lack of fibre in these diets, despite the fact that there are many other plant foods that are rich in fibre. For example, one orange or half a cup of sweet potato contains more fibre than a serving of bread. Another concern is a perceived lack of folate, as much of the bread sold in Australia is fortified with it. But again, many foods that are consumed in a Paleo diet are also high in this nutrient.

What the media also failed to acknowledge is that research, including that on individuals with a rare genetic disorder known as Laron Syndrome, has uncovered a potential mechanism behind some of the changes people have seen after beginning the Paleo diet. Individuals with Laron Syndrome have a severe congenital deficiency of insulin-like growth factor 1 (IGF-1), which results in a reduced prevalence of acne, cancer, and diabetes. Interestingly, a survey of 230 people with Laron Syndrome found that none of them had ever developed cancer. Unfortunately, the conventional Western diet overstimulates IGF-1, due to a high intake of insulinotropic dairy, grains, and sugar.
However, the infamous Paleo diet forbids the consumption of dairy and most grains, as well as processed foods, and is therefore far less insulinotropic. Another mechanism behind a less insulinotropic diet’s health benefits is that it does not impair the body’s antioxidant defences, which are essential in protecting against chronic diseases. They also do not suppress immunity or over-encourage angiogenesis and migrating cell’s adhesion abilities. As for diabetes, high consumption of dairy products may over-stimulate the insulin producing beta cells of the pancreas, further contributing to oxidative stress.

Alongside this study, many authors have argued that following a “Paleolithic-type” diet can reduce the risk of diseases such as cardiovascular disease, some cancers, diabetes, metabolic syndrome, and even osteoporosis and age-related muscle loss. In fact, some have stated that avoiding the foods forbidden by the Paleo diet is more important than calorie or carb-counting in improving glucose metabolism, based on their findings in diabetic patients.
A study on diabetic patients instructed to transition from a standard diet to a Paleo diet showed a decrease in LDL and VLDL cholesterol as well as triglycerides, blood pressure, and fasting insulin, which dropped by 68%! Interestingly, while the Paleo diet prescribed was higher in protein (30% as opposed to 18% of calories), it was only lower in carbohydrates by 6 percentage points of energy intake. This contradicts the common assumption that a Paleolithic diet is mostly meat and fat, which is incorrect anyway as there are many different interpretations. As for cancer, a study on men tested for their IGF-1 levels found that higher levels of IGF-1 were associated with a progressively higher risk of cancer death. The risk of fatal cancer in men with IGF-1 above 100ng/mL was 82% higher than it was for men with lower levels, and IGF-1 levels over 120ng/mL increased cancer risk by anywhere from 61% to 161%. These findings also contradict a study stating that people on higher protein diets have a higher cancer risk than those consuming a low protein diet. However, this study is a terrible weapon against the Paleo diet, as much of the aforementioned protein would be coming from dairy and hormone-treated, grain-fed meat (highly unpopular in Paleo circles), while sugar and processed carbohydrate intake was unspecified. The authors also admitted that a high protein diet was in fact beneficial for participants of an advanced age! It must be remembered that beef has a much lower insulinaemic index (51) than milk (140), and that not all “Paleo” diets are identical.

However, while restricting intake of added sugar, grains, and dairy can protect adults against chronic illnesses such as cancer, diabetes, and even Alzheimer’s disease, it may be unsuitable for healthy children. This is because sufficient IGF-1 levels are likely to be important for the development of the reproductive and nervous systems at young ages. I also would not recommend it if you are recovering from an injury such as a bone fracture or are intending to build considerable amounts of muscle, as higher IGF-1 levels are required for tissue growth. Overall, the Paleo diet in its many forms has been shown to have a multitude of health benefits, but as each person is different, there is no specific dietary advice that is right for all, especially not the food pyramid. 

Guess What Beat Steroids in Treating Cough?

One of the most famous, or infamous, depending on your experiences, classes of prescription pharmaceuticals is the corticosteroids. Aiming to relieve inflammation, these also unfortunately carry many severe side-effects, including those stemming from the fact that they inhibit protein synthesis. Fortunately, one study looking at natural alternatives to medications found a superior alternative in the treatment of post-infectious cough (PPC), a combination of honey......and......coffee! PPC is the name given to a cough that persists for at least three weeks after a cold or other upper respiratory tract infection, and these sometimes stay around for as long as several months. Besides corticosteroids, conventional treatment may also involve codeine, antihistamines, narcotic and bronchodilator drugs, which all carry their own negative side effects.

This study, conducted in Iran, involved 97 participants who had suffered from PPC for more than three weeks. They were divided into three groups: one receiving a jam-like paste consisting of 20.8 grams of honey and 2.9 grams of instant coffee; one receiving 13.3mg of prednisolone, a corticosteroid, and the last group receiving 25mg of guaifenesin (the control). The participants were instructed to dissolve a specific amount of the product they received in warm water, and to drink this every eight hours for one week. Both before and after the week of treatment, the severity of each person's cough was evaluated by a validated visual questionnaire score. While the honey-coffee group saw their cough frequency scores drop from 2.9 to 0.2, the steroid group showed a drop from 3.0 to 2.4, and the control group only showed a drop from 2.8 to 2.7. These differences were deemed to be clinically significant. The authors also stated that even though billions of dollars are spent every year on attempts to control and resolve coughs, the effect of cough medicines are not reliable, and that despite PPC not being responsible for any mortality, it does cause significant disruption to quality of life.

PPC is often caused by persistent inflammation of the upper airways. So, how exactly do coffee and honey work against this? Well, multiple studies have shown anti-inflammatory effects of coffee, such as one where caffeine was found to block caspase-1 and therefore production of interleukin-1beta, which is a common inflammatory cytokine. Caffeine may also relieve asthma by acting as a bronchodilator, as even small amounts have been shown to improve lung function, measured by forced expiratory volume and mid-expiratory flow rates. There seems to be no significant effect of caffeine on nitric oxide levels, which is a chemical that dilates airways and blood vessels. Honey has been found to possess anti-bacterial and anti-inflammatory properties, with the former being relevant to post-infectious coughs where there may be a subclinical infection. It has direct anti-bacterial properties from hydrogen peroxide and constituents derived from the flowers that the bees had taken the nectar from, as well as simply being able to dehydrate bacterial cells due to its high sugar content and acidic pH. Unlike caffeine, honey can increase nitric oxide, which is also anti-inflammatory. The other anti-inflammatory effects of honey come from its prostaglandin-inhibiting abilities, antioxidant effects and its ability to speed up healing, which reduces the "need" for inflammation. So in conclusion, even though it may not make sense that a mixture of coffee and honey is able to stop a cough that often calls for prescription drugs, it has shown efficacy and has plenty of other research to back it up.

*One of these side effects is tendon damage, which is actually a vomiting trigger for me if I think about it or see it.

Some Protective Effects of Miso

Although soy has a mixed reputation in the natural health world, fermented soy foods can have a wide variety of health benefits. One of these, miso soup, is particularly beneficial, as research shows that it may prevent radiation poisoning, some cancers and osteoporosis.

When the second atomic bomb fell on Nagasaki in 1945, Dr Akizuki and 20 others were caring for 70 tuberculosis patients in a hospital only 1.4 kilometres away from the epicentre of impact. Despite usual expectations, Dr Akizuki and the others did not have their health destroyed by acute radiation poisoning. He then considered that their consumption of miso soup, with wakame seaweed, every day was the cause of this. Subsequent research on mice found that miso eaten before, but not during or after, irradiation protected against tissue damage and improved survival. The length of fermentation time, from 3 days to 180 days, also had an association with the efficacy of miso against radiation damage, with longer fermentation increasing the effects.

This review also discussed a protective effect against certain cancers such as breast cancer. In a human cohort study involving 21, 852 women, it was found that consumption of miso soup and isoflavones was associated with a reduced risk of breast cancer, but not other soy foods. These findings did not change after adjusting for reproductive or family history, smoking or other dietary factors. Compared with the lowest quartile of soy isoflavone intake, women in the highest quartile had a 54% reduced risk of breast cancer, with a stronger association in post-menopausal women.

The review also mentioned an epidemiologic study where the risk of colon cancer was reduced by soybean consumption. A study on mice was then discussed, where mice fed miso had a decreased number of abberant crypt foci (ACFs) after carcinogen exposure. In another that followed, mice administered 180 day fermented miso and the same carcinogen also saw a significantly lowered number of ACFs, from an average of 87 to an average of 65 ACFs. Mice in the 3-4 and 120 day fermented miso groups had averages of 85 and 83 ACFs respectively, only a few less than the controls.

Additionally, in light of studies showing an inhibition of lung cancer by soy isoflavones, research on rats once again found a reduced number of tumours in rats given miso. Another epidemiological study on humans found that miso soup consumption in women without a history of liver disease is associated with a reduced risk of dying from liver cancer. Despite a high salt content, miso may even lower the risk of stomach cancer too! This may be because of other minerals and compounds present, or salt on its own being harmless in terms of cancer as opposed to the foods that first come to mind upon hearing the words “high salt”.

On top of these health benefits, compounds found in miso soup may be an effective alternative to conventional treatments for osteoporosis. In an animal study, 96 rats with their ovaries removed received either oestrogen replacement therapy, anti-osteoporosis pharmaceuticals of genistein, a phytochemical found in fermented soy products such as miso, for 12 weeks. The genistein turned out to be the most effective, beating all other treatments in improving bone mineral density, bone mineral content and breaking strength, but does this hold up in human studies? A 2007 study on 389 postmenopausal women with osteopenia compared the use of 54mg of genistein daily to a placebo, alongside calcium and vitamin D supplementation. After two years, there was no change in endometrial thickness in comparison to the placebo group. However, bone mineral density increased in the femoral neck and lumbar spine, by 0.035g/cm2 and 0.049g/cm2 respectively, while in the control groups, bone mineral density declined by 0.037g/cm2 and 0.053g/cm2 respectively. These findings show that women do not have to choose between reproductive cancers and osteoporosis, as natural treatments including genistein often have targeted effects.

In conclusion, miso and other fermented soy products can have many health benefits unlike their unfermented or processed cousins. Miso can be taken as a drink, as a base in a light soup or a condiment in other recipes.

Vitamin D, Part 2

Recently I wrote a blog post about some of the reasons why vitamin D is not useless. I mostly covered cardiovascular health and some reduced mortality-related research, here I am getting more into the neurological side of things.

But first, mortality reduction! Some of the most interesting research on vitamin D reducing mortality rates come from ICU patients. The New England Journal of Medicine reported a terribly high 45% mortality rate in vitamin D-deficient patients, but a considerably less horrible 16% death rate in patients with sufficient vitamin D. That is, even sufficient vitamin D slashes risk of death in the ICU by two thirds. Six years later, a study on 135 ICU patients revealed a 32.2% risk of death when vitamin D was below 12ng/mL, but a 13.2% risk when levels were higher. This is about a 2.4 higher risk (Clinics (Sao Paulo)). However, studies attempting to rescue already-deficient ICU patients have not always been successful, underscoring the importance of prevention.

Now for something that will land you in hospital...stroke! After a stroke, around 40% of victims are moderately or severely debilitated, while 15% die soon after (NIH). Vitamin D deficiency is common among stroke victims, with poorer functional outcomes associated with lower levels. For example, each 10ng/mL decrement in vitamin D levels were linked in one study with a doubling in the risk of a poor functional outcome after 90 days (J Stroke Cerebrovasc Dis). In another, vitamin D levels of 30ng/mL or above was associated with a 90% better functional improvement compared to levels under 10ng/mL (Cerebrovasc Dis). While many recommend levels of 50-80ng/mL in order to prevent many age-related diseases, you can see that even sufficient levels are enough to save and improve many lives.

It is well known these days that multiple sclerosis, an autoimmune disease where the immune system attacks the myelin sheaths of neurons (these enable efficient communication), has a higher incidence in colder climates. It is estimated that while the Southern states of the USA have a 57-78/100,000 incidence rate, the northern states have 110-140 cases per 100,000 residents, but in Canada the incidence is 291/100,000 (Healthline)! Genetically low levels of vitamin D are linked with a higher risk of multiple sclerosis too, which most likely calls for supplementation instead of relying on sun exposure (PLoS Med). In fact, more than 90% of people with MS have deficient vitamin D, defined as less than 20ng/mL (clinicaltrials.gov). Interestingly when the immune cells of patients with MS were exposed to vitamin D, their division slowed, which may be one of multiple (sorry) mechanisms behind its effects (Brain).

As for age-related cognitive decline, vitamin D has been linked to a higher risk and faster rate of memory loss and loss of executive function (JAMA). In a study of 76 participants, those with dementia had an average vitamin D level of 16.2ng/mL, while those with mild or no cognitive impairment had an average level of 20ng/mL. For all participants, lower levels of vitamin D sped up cognitive decline, not only those who were already impaired.

So, why is vitamin D levels overlooked in standard blood tests, unlike iron? And if they aren't already doing it, why are people suffering from dementia not given time in the sunshine or supplements? Lack of concern or bias against "mere" vitamins? The "not enough evidence" line looks increasingly like an excuse, especially if someone you love has dementia or any of these issues.

Zika, And Essential Oils That May Repel Mosquitoes

As many of us know already, since October 2015 Brazil has seen an unexpected spike in cases of microcephaly, a condition where babies are born with smaller head sizes and negatively affected brain development. The country has reported over 3,000 cases of microcephaly in newborns in 2015 and over 1,000 so far this year, up from 150 in the whole of 2014. These have since been linked to infections with the mosquito-borne Zika virus. Women in Brazil, Jamaica and other countries have been advised to delay pregnancy until more is known about the risks to newborns, while the CDC has issued a travel warning for over 20 affected countries. The importance of heeding these warnings for US travellers has sadly been underscored by the birth of a microcephalic baby in Hawaii, whose mother was infected during time in Brazil, and two more pregnant women in Illinois confirmed to be infected. While the Zika virus usually causes only mild symptoms of fever, joint pain, rash and eye redness, many never know they were ever infected, and there is no (recognised) treatment.

Avoiding areas with epidemics of mosquito-borne infections is always advisable, however, there are natural alternatives to the conventional DEET repellents which can be used in everyday situations, especially if you react to it. One such natural substance is the essential oil of Apium graveolens seeds, or celery seeds. This was tested in one study for its repellent effects against adult Aedes aegypti mosquitoes, as well as for any larvicidal effects. A. aegypti is the species of mosquito that carries the Zika virus. In the larvicidal test, the lethal concentration for half of the mosquito larvae after 24 hours was 16.1 parts per million (ppm), and 29.08ppm for 90% of the larval population. Longer exposure increased the toxicity potential of the oil, with another 24 hours of exposure reducing the lethal concentration for half of the larvae to 13.22ppm. As for the repellency test, the celery essential oil resulted in 100% protection against mosquito bites in the first 150 minutes, which is two and a half hours. Protection was reduced to 88.8% (one bite recorded) in the next 15 minutes, and then to 77% (two bites) in the last 15 minutes. Direct application of the essential oil did not cause any skin irritation, unlike conventional chemical repellents. However, it did irritate the mosquitoes. No adult mosquitoes were able to tolerate exposure to 10% seed oil, whereas exposure to only 1% seed oil on paper was enough for them to begin flying away from the paper after four seconds. During the 15 minute contact irritancy test, only 2-3 flights from the alcohol-impregnated paper were recorded, while there was an average of 63.66 takeoffs from the essential oil paper.

Another essential oil that may protect against A. aegypti mosquitoes is peppermint oil.  This study was also performed using the adult repellent and larvicidal tests, and like celery seed oil, peppermint oil was found to completely protect against bites for the first 150 minutes. In the next 30 minutes, only 1-2 bites were recorded for the treated participants as opposed to 8-9 for the control group. Peppermint oil was less effective than celery seed oil in killing off mosquito larvae, as the lethal concentration for 50% of the larvae was 111.9ppm; this was 295.18ppm for 90% of the larvae. The authors also stated that cinnamon, ginger and rosemary oils may be effective in repelling mosquitoes. Overall, evidence does recommend the use of essential oils to protect against mosquito bites, especially if there is hypersensitivity to conventional repellent, but standard precautions must still be taken and never ignored when there is the threat of irreversible harm such as birth defects. As new updates have stated that Zika may be transmissible through sexual intercourse, saliva and urine, avoiding infection is highly important.

Why We Should Eat Garlic

Whether you love the taste of garlic or can't stand it, or just see it as over-hyped, there's no denying the multitude of health benefits demonstrated in the scientific literature.

So what can garlic do, besides smelling terrible/fantastic? Well, research shows that garlic reduces many of the risk factors that can lead to heart attack and stroke. In fact, Penn State researchers note studies connecting garlic use with a 38% reduce risk of heart problems. In a four-year clinical trial in Germany, garlic resulted in a reduction of the risk of heart attack and stroke by over 50%! On average, the volume of arteriosclerotic plaque was reduced by 18%.

Garlic may also protect against arterial calcification. A study from UCLA randomised 60 subjects to receive either a placebo or a supplement containing 250mg of aged garlic extract (AGE), 100ug of vitamin-B12, 300ug of folic acid (B9), 12.5mg of vitamin B6, and 100mg of L-arginine. After one year, the risks of coronary artery calcium progression were significantly lower in the supplement group compared to the placebo group.  Researchers also found an increase in beneficial brown fat around the heart muscle, which produces energy and is not associated with a higher risk of calcification, unlike white fat. Another randomised, placebo-controlled study from UCLA looked at the effects of AGE in patients on statin drugs.  For one year, patients took either a placebo or 4 ml of AGE.  At the end of the year, the rate of coronary calcification was 3 times slower for those taking the AGE, though you may be able to do more than just slowing it down if AGE is not the sole component of the treatment plan. As for the common complaint of high blood pressure, in a study on stroke patients researchers were able to accurately predict blood flow based on the amount of garlic the patients were eating - less garlic meant poorer circulation.

Garlic is also widely known for its ability to fight infections. In one study comparing garlic to metronidazole in treating vaginal infections, women received either two 500mg garlic tablets or two 250mg doses of metronidazole every day.  After seven days the garlic tablets reduced the active infection by 70%, compared to 48% for metronidazole. While garlic had no negative side effects, metronidazole is a "probable carcinogen" with a wide range of side effects including nausea, diarrhoea, vomiting, headache, dizziness, and abdominal pain. As for the common cold,
the Cochrane Collaboration in Australia documented a study in which garlic reduced the incidence of colds by more than 50%. Researchers gave 146 people either a placebo or a garlic supplement that was standardised to 180mg of allicin, the compound that gives garlic its pungent smell. After 12 weeks, the placebo group had 65 total colds, while the garlic group had only 24. In addition, the placebo group had a total of 366 sick days, compared to 111 in the garlic group. Garlic may also reduce the severity of cold symptoms. In a randomised, double-blind, placebo-controlled study published in the journal Clinical Nutrition, researchers gave 120 people either a placebo or 2.5g per day of an AGE supplement. Over six months, the garlic group had 58% fewer colds and suffered from 61% fewer days with colds. The garlic group also had 21% fewer symptoms when they did catch a cold. 

On top of all this, garlic naturally reduces blood and tissue concentrations of lead - just as effectively as a common chelation drug. In a study published in the journal Basic & Clinical Pharmacology & Toxicology, garlic (as 1.2mg of allicin) was compared to the chelation drug known as d-penicillamine in 117 workers at a car battery plant. After four weeks, both the drug and the garlic significantly reduced lead concentrations in the blood by about the same amount.  But the garlic also improved clinical symptoms, significantly reducing irritability, headaches, deep tendon reflex, and systolic blood pressure, while the drug had serious side effects. Overall, garlic isn't overrated, but it is how you cook with it that counts, as usual.

(References on GMI article)

Vitamin D Is Not Useless

Recently I have heard of a few mainstream news articles about studies that "prove" vitamin D is useless at preventing and treating disease, one of them being a JAMA "review" stating that vitamin D is ineffective in treating hypertension. Fortunately, Life Extension has already written a rebuttal, which saves me a lot of time in coming up with one myself.

Of the 46 studies used in the review, only 16 included participants that gave an average systolic blood pressure of over 140mmHg, so most of the 4,541 participants did not even have hypertension. If it proved anything, it is that vitamin D does not lower blood pressure in those within healthy ranges. One of the studies on normotensive participants actually used doses often considered too low to be therapeutic (200, 400 or 600 IU), while another excluded people with clinical vitamin D deficiency, and yet another excluded people with hypertension but was still included to prove a lack of effect on hypertension! Another tested the effect of one oral dose of 100,000 IU on patients with peripheral arterial disease, hoping for positive changes after just one month. PAD doesn't appear overnight, so why would it instantly disappear? And besides, often you simply do not absorb too much more of a vitamin than what you need, but 100,000 IU is probably overdosing anyway so I wouldn't even recommending injecting that amount. Another failed study showed no effect of 50,000 IU per week for six months in patients with heart failure. If you wanted an effect, you should probably have started earlier instead of telling people that fat is unhealthy, the sun is evil and supplementation is a waste of time.

However, some of the studies used in this review actually reported a positive effect of vitamin D on hypertension. In one of these, 34 type II diabetic patients with serum vitamin D under 20ng/mL were given 100,000 IU of vitamin D2 or placebo, and monitored for eight weeks. The vitamin D2 decreased systolic blood pressure by 14mmHg, and this was deemed "significant". In another, 148 women with serum vitamin D under 20ng/mL were prescribed 1,200mg of calcium with or without 800IU of vitamin D3 for eight weeks. 81% of the women taking vitamin D showed a decrease in systolic blood pressure of 5mmHg or more, compared with 47% in the calcium-only group. Then, in a double-blind study of 283 African-Americans using doses as high as 4,000IU per day, blood pressure was once again significantly lowered. But is vitamin D really useless for heart failure? Another on 23 patients with chronic heart failure involved 13 of the patients being given 4,000 IU daily over six months, and resulted in a lower systolic blood pressure and higher ejection fraction among the treated patients.

As for mortality rates, vitamin D may also have a benefit there. A year-long study of 510 patients with serious, life-threatening illnesses compared "quintiles" of vitamin D levels with mortality rates (most likely yearly), and found that while the probability of survival in the lowest quintile was 66.7%, those in the highest quintile had a 96.1% chance of survival! (Clin Chem) No one with vitamin D levels of over 58.5ng/mL died during the follow-up. A much larger study, this time with 10,170 people, investigated risk ratios for mortality for each 10-unit increase in serum vitamin D (Am J Med). The most significant decreases in mortality risk were from 0 to 10ng/mL and 10 to 20ng/mL, with smaller improvements up to 60ng/mL. So if vitamin D levels mattered more, life expectancy would probably increase, but it is hard to tell by how much because it isn't really known how many people are vitamin D deficient because of how undervalued this vitamin is. It is not tested like serum iron or even B12 are, but should be.