Thursday, November 29, 2012

Health and the Holidays


Thanksgiving, my favorite Holiday, has passed, again threatened by consumerism, anxious to get started sooner and earlier in the “spirit of Christmas.” But, the true spirit of Christmas, charity, is best expressed by a thankful heart, a sure sign of strength and understanding of our relationships with our fellowman. Understanding how each of us fits in our society also brings forgetting and forgiveness, or what Christians call repentance. Charity, gratitude, forgiveness will help us endure and mitigate the harshness of illusionary independence; these attributes contribute mightily to spiritual and, hence, physical health.

One of the most striking aspects of my practice is helping patients change the lifestyles that have caused their health problems. But, more important, and difficult, is to help them forgive themselves when they falter and return to those toxic habits. I remind them of Atlas, the weakling wrestler, son of Gaia, Mother Earth. Defeated often, he whined to his mother who promised him he would henceforth get up stronger each time he fell and hit the ground--herself. Sure enough, with each defeat Atlas got stronger and grew into the mighty Atlas we know today.

I also bring up the Parable of the Prodigal Son. After spending his inheritance in riotous living, he returns to his father, who, grateful to have regained his lost son, sacrifices the fatted calf to the chagrin of his eldest who has faithfully remained at his side. Among the obvious lessons is the oft-misunderstood principle that there is more strength in one who stray and returns, than in one who never falters through sheer discipline. The latter may follow the letter of the law only, as evidenced by his lack of rejoicing that his lost brother has returned. The faithful brother may even secretly envy the “pleasures” his lost brother enjoyed while idly spending his inheritance. He may even lack kindness, compassion, and the ability to forgive, central tenants of a true and faithful son and brother.

The prodigal son, upon being forgiven, will he not be more humble? Will he not be more capable of understanding, giving and forgiving himself? By having known failure we are exposed to the key to happiness, or a courageous life: an understanding of letting go and being guided by divinity, accepting whatever comes our way: “thy will be done.” Then, we will no longer wish for anything, but an understanding of life’s Middle Way, suffering willingly and patiently, both good and evil. Then, we will endure and thank all those in our lives who help us learn these lessons.

Merry Christmas to you all.

Thursday, November 1, 2012

The best medicine is ready for prime time

The cover issue of the Journal Science (arguably one of the best scientific journals) was on “Disease Prevention.” It features vegetables and fruits.
 
In my opinion, when the journal Science speaks, it is time to listen.
 
Hard to believe, but I have had intelligent, successful doctors tell me that there is no evidence that nutrition plays a role in health. Perhaps a few years ago that mind-boggling statement could have been argued, just because the data, and history thereof, have been dismissed, and at times suppressed, by those who stand to gain the most from keeping people ignorant about food being the best medicine. Today, the weight of evidence is so overwhelming that any opposition reveals profound ignorance, and perhaps protection of gains and turf.
 
Let me borrow from Dr. Jeffrey Bland’s excellent FMU notes:
 
“Industrialized food has not helped: Cultural and other biases have distorted the historical record, leading to conclusions which test many current health policy assumptions about a steady improvement in British nutrition since the nineteenth century.
 
As these papers show, the urban mid-Victorians, including the working classes, ate a notably good diet, including significant amounts of vegetables and fruit, which enabled a life expectancy matching that of today. We follow the example of George Rosen (a public health practitioner, and in his time editor of the American Journal of Public Health and Journal of the History of Medicine, among others), in believing that a historical dimension is essential to a sound perspective in public health today.” He continues in part three of the series: “Where our previous two papers documented the volume and variety of the mid-Victorian diet, this final paper reveals that the mid-Victorian diet conferred extremely significant protection against the major degenerative diseases, even amongst those who, because of their extremely limited incomes, might be considered to be significantly undernourished and so vulnerable to such afflictions.”
 
“The Incidence of cardiovascular disease and cancer were relatively rare observations. Rather the trend in Victorian England was to carry on almost fully functional until the end of life, with the majority of people succumbing to overwhelming infection or—in many cases—fire. Dr. Clayton attributes the reduced incidence of degenerative disease in Victorian England to a combination of several factors:
 
1. Consumption of traditional foods, including heirloom varieties of fruits and vegetables with many bitter and aromatic notes. Also, they were not consuming any processed foods apart from the very basics: bread, butter, cheese. Fish was a common source of protein. All together, the intake of phytonutrients (flavonoids, phenolic compounds, carotenoids,xanothophylls, methyl group donors, cyanogens, etc.) is estimated to be two to three times higher than today.
 
2. With a very small upper and middle class, most everybody else in that era is blue collar, and working manually with their hands. No portable fuels were available other that coal and wood, and the internal combustion engine was yet to be invented. With no laborsaving technology available, there was a huge difference in the level of physical activity then. Dr. Clayton suggests individuals were better muscled than they are today, and as a result their muscles were far more effective, resulting in the slim to thin Victorian phenotype commonly seen in photographs of the era.
 
3. Incidence of cancer in the Victorian era was lower than today and peak age of onset for those who did present with cancer was noted to be in early middle age. Dr. Clayton suggests this demonstrated that cancer was not age-related in such a nutritionally protected population, but rather became manifest only in individuals who were truly genetically vulnerable.
 
References:
 
1. Clayton P, Rowbotham J. An unsuitable and degraded diet? Part one: public health lessons from the mid-Victorian working class diet. J R Soc Med. 2008;101:282-289.
 
2. Clayton P, Rowbotham J. An unsuitable and degraded diet? Part two: realities of the mid-Victorian diet. J R Soc Med. 2008;101:350-357.
 
3. Rowbotham J, Clayton P. An unsuitable and degraded diet? Part three: Victorian consumption patterns and their health benefits. J R Soc Med. 2008;101:454-462.
 
More references from recent literature search:
 
“Back to the future: rethinking the way we eat,” Am J. of Medicine 2012;125:947
 
“Total Antioxidant Capacity from Diet and (lower) Risk of MI,” Am J. of Medicine 2012;125;974
 
“Mediterranean Diet Tied to Sustainable Weight Loss,” Epub NEJM Oct 12 2012
 
“Serum lycopene decreases the risk of stroke in men,” J. Neurology 2012;79:1540
 
“Multivitamins lower the risk of cancer by 8%, Epub JAMA Oct 17 2012
 
“Moringa tree leaves, J. Nat Geo November 2012
  • 25X more iron than spinach
  • 17X more calcium than milk
  • >15X more potassium than banana
  • >10x more vitamin A than carrots
  • >9X more protein than yogurt