Learning human physiology over the many years of my academic career has taught me that when one process changes in the body, it always affects many other processes. Adept clinicians know this is especially true of the thyroid gland.
Apparently, a slight change in thyroid function might have a profound effect on our vascular system. While research has documented a clear correlation between subclinical hypothyroidism, hypercholesterolemia and atherosclerosis, research has yet to find a clear connection between subclinical hypothyroidism and coronary heart disease. Both hypercholesterolemia and atherosclerosis are risk factors for coronary heart disease so it makes sense that if a patient has subclinical hypothyroidism they should also be more likely to have coronary disease (CHD) since they are more likely to have the risk factors associated with CHD.
In order to explore the potential correlation, several doctors formed the Thyroid Studies Collaboration and recently published a study-level meta-analysis of prospective cohort studies that measured TSH and T4 levels in participants as well as total mortality and CHD outcomes. The definition of subclinical hypothyroidism itself is somewhat controversial and the collaborators decided to use the definition from the Cardiovascular Health Study. They defined subclinical hypothyroidism as a serum TSH level of 4.5mIU/L to 19.9mIU/L with a normal thyroxine (T4) concentration. The outcomes that were measured included CHD events, CHD mortality and total mortality. After statistical analysis, the Thyroid Studies Collaboration determined that subclinical hypothyroidism was associated with an increased risk of CHD events and CHD mortality but not of total mortality in those patients with higher TSH levels. There was an especially significant increase in CHD risk in patients with TSH levels of 10mlIU/L or more. The correlation remained significant even after the data was adjusted for traditional cardiovascular risk factors.
Based on the results of this meta-analysis, it is easy to conclude that everyone who has a TSH level of 10mlIU/L or more should be treated as though they have hypothyroidism. Unfortunately, the only way to be certain that treating subclinical hypothyroidism is beneficial is to conduct an appropriately powered, well designed double-blind placebo-controlled randomized clinical trial and measure outcome. Subclinical hypothyroidism is quite common; as a doctoral student of naturopathic medicine I hope such a study design is currently underway to assist future clinicians in arriving at a more definitive answer for their patients.
The authors do mention a couple of studies that hint that subclinical hypothyroidism should be taken more seriously. Apparently, ‘one randomized controlled trial has shown benefits with thyroxine treatment of subclinical hypothyroidism on intima-media thickness and another has shown benefits with thyroxine treatment of subclinical hypothyroidism on brachial artery endothelial dysfunction.’
Even if research has yet to definitively show that subclinical hypothyroidism should be treated, it is important that you and your patients get the whole food nutrition necessary for optimal thyroid function. There are also several botanicals that are known to gently support the thyroid gland without creating any physiological imbalances. By supporting your thyroid, you just might also be supporting your heart!!
JAMA. 2010;304(12):1365-1374.
In a recent study published in the Journal of Food Science, researchers sought to analyze the antioxidant activity and interactions of multiple phenolic compounds in navel oranges (Citrus sinensis). Freeman et al., cite other research findings in the literature noting that while individual phenolic compounds have a high antioxidant capacity, the antioxidant activity of whole fruit has been observed to be higher than any one individual compound at concentrations found in fruit. The difference, they note, may be due to the total influence of multiple compounds in fruit at low concentrations, unidentified compounds or “synergistic interactions between phenolic compounds.”
Freeman, et al., write that the potential additive or synergistic pharmacological influence of multiple compounds within a food is described in the literature as “endointeractions,” while “exointeractions” are interactions among unrelated plant components (i.e. food compounds from different foods) and/or drugs. In this study they hypothesized that “by starting with the individual phenolic antioxidants at the concentration found in a specific fruit, synergism could be demonstrated using only endointeractions.”
Freeman et al., prepared mixtures of 2, 3 and 4 phenolic compounds found in navel oranges; these included chlorogenic acid, hesperidin, luteolin,myricetin, naringenin, p-coumaric acid, and quercetin. They quantified the antioxidant capacities of each mixture using the Oxygen Radical Absorbance Capacity (ORAC) assay.
Overall, it was observed that several combinations of 2, 3 and 4 compounds yielded a significantly higher antioxidant capacity when compared to individual compounds. Notably, despite predictions, any combination past 3 did not progressively increase total antioxidant capacity. In all, the synergism of 5 combinations of 3 compounds increased the total ORAC, as did all but one combination of 2 compounds; one combination of 2 compounds actually diminished antioxidant capacity.
Study: Freeman, B.L., Journal of Food Science, Vol. 75, Nr. 6, (2010)
By Karen Brothers, ND student, NCNM
You’ve likely heard about whole food supplements and know that they contain 100 percent whole food. When you take them, you ingest the individual vitamins and minerals contained in the whole food as well as the food’s vital phytochemicals and cofactors that enhance the body’s ability to utilize those nutrients. If you’ve read the label of a whole food supplement, you’ve seen food names such as carrots, oranges, blueberries, brown rice, and broccoli. But it’s very likely that you’ve also seen a less familiar name in the list of ingredients: Saccharomyces cerevisiae.
Saccharomyces cerevisiae is a species of yeast whose various strains have been used in baking and brewing throughout history. It is one of the most thoroughly researched microorganisms in cell biology. Because a yeast cell’s structure and functions are very similar to those of a human cell, it is an extremely valuable model for understanding how human cells work.
Nutritionally, Saccharomyces cerevisiae has great value on its own. It provides protein and B-vitamins that our bodies can effectively absorb and utilize, and it as acts as a probiotic, maintaining good bacteria in our gut that help with overall digestive function and support our immune systems. In addition, it is non-pathogenic and non-allergenic. But there’s more.
Have you ever wondered how all of the goodness of whole foods can be packed into pill form? Some foods, such as carrots and berries, can be crushed, dried, and added to pills, and our bodies absorb and utilize their nutrients just as if we had eaten whole carrots or handfuls of berries. But what about minerals, which are not easily absorbed or utilized in their pure forms? Saccharomyces cerevisiae is the answer.
Saccharomyces cerevisiae cells are grown in a liquid growth medium in a large fermenter. The medium (think of a nutrient-rich broth) contains the desired minerals and other micronutrients at desired concentrations. As the cells grow and divide, they absorb the minerals and other nutrients in the medium, yielding a nutrient-rich biomass or food concentrate. This food concentrate can be crushed, dried, and added to pills just as carrots and berries are. And just like carrots and berries, the food concentrate is 100 percent whole food.
So the next time you read the label of a whole food supplement, the name Saccharomyces cerevisiae will be a bit more familiar to you and may remind you of just how beneficial saccharomyces cerevisiae can be.
References:
Passwater, RA. Nutritional Yeasts and Yeastophobia: An interview with Dr Seymour Pomper.
Whole Foods magazine. June 1999.
Passwater, RA. Nutritional Yeasts and Yeastophobia, Part 2: An Interview with Dr. Jack D. Sobel. Whole Foods magazine. July 1999.
Angier, NA, A stupid cell with all the answers., Discover, 1986, 7(11), 70-83.
Passwater, RA. Nutritional Yeasts and Yeastophobia: An interview with Dr Seymour Pomper.
Whole Foods magazine. June 1999.
Passwater, RA. Nutritional Yeasts and Yeastophobia, Part 2: An Interview with Dr. Jack D. Sobel. Whole Foods magazine. July 1999.
Angier, NA, A stupid cell with all the answers., Discover, 1986, 7(11), 70-83.
By Stacy Mobley, MPH, ND Student (SCNM)
Holistic practitioners understand a key factor underlying optimal nutrition absorption, decreasing inflammation, healthy skin, immune system function and abundant energy is balanced gut flora.
Aside from quality probiotic supplements used in clinical contexts where else might one turn for beneficial gut flora?The next time you decide to have a drink or grab lunch, think about adding one of these dishes/drinks below.
This is by no means a comprehensive list of probiotic containing foods/drinks, but definitely a great start, and an easy list to pass along to others:
Kombucha: A Russian fermented tea packed with antimicrobial and antioxidant properties. It is said to increase energy, decrease liver toxicity, and provide lots of vitamin B.
Wara: A milk-like fermented drink well known in Africa (Nigeria) for its ability to prevent diarrhea and constipation. It is packed with eight strains of Lactobacillus. It also inhibits Listeria monocytogenes, Listeria innocua, Clostridium butyricum, Clostridium perfringns, Bacillis cereus and S. aureus.
Miso: the result of fermenting soybean, brown rice, or another grain with koji. This tan to brown paste can be used to make soup or as a spread on crackers or other foods. It is naturally high in Zinc, Manganese, copper and Vitamin B. It is also a source of protein.
Kefir: This lactose free “milk-like” drink contains anti tumor and anti inflammatory properties via kefiran, a soluble polysaccharide. It has been known to reduce blood pressure, cholesterol and blood sugar levels. It is made by adding kefir grains to cow, goat, sheep, coconut, rice, or soy milk. There is even a way to make water kefir!
Kimchi: a Korean dish made from Chinese cabbage, carrots, peppers, and other ingredients contain not only lactobacillus kimchii but a high dose of beta carotene, calcium, iron and vitamins A, B, and C.
Natto: fermented soybean, a Japanese breakfast dish that contains a healthy dose of plant protein! It also contains lots of Vitamin K and an enzyme, nattokinase that is known to break down blood clots.
Sauerkraut: A high source of Vitamin C and digestive enzymes. It is made by fermenting cabbage and salt. This dish, like the others listed, can be used in a variety of ways. It is best known in the West as a hot dog condiment.
Tempeh: This protein packed Indonesian delight is made from fermented soybean using a fungus called rhizopus oligosporus. These nutty patties can be used in stir fry, as meatless burgers, or simply eaten as a side dish to a yummy soup. It contains a natural antibiotic (heat resistant, may I add) that can fight certain bacteria like S. aureus, which can cause pneumonia and sepsis!
Vitamin D intake from food may prevent or improve cognitive function
In this large population-based study recently published in Neurology, researchers highlight a growing interest in the literature exploring the role of vitamin D as a neurosteroid hormone in the nervous system, and its influence in cognitive function and/or neurodysfunction. Investigators note current research suggests that vitamin D supplementation may be especially helpful to deficient elderly patients, possibly maintaining or improving global cognitive function. Because no randomized controlled trials have tested this possibility, the authors of this study suggested that before conducting a supplement drug trial it is important to first assess whether vitamin D from food – and not supplements - could be associated with cognitive performance in the elderly.
Annweiler C. et al “hypothesized that high dietary intake of vitamin D could protect against cognitive decline.” They tested their hypothesis among two groups of older women participating in the Epide´miologie de l’Oste´oporose (EPIDOS) cohort. A total of 5,596 women participated, divided into two groups based on their baseline weekly vitamin D intake from food (inadequate < 35 ug/wk & recommended ≥ 35 ug/wk). Intake was estimated based on a food frequency questionnaire, and cognitive impairment was scored via a validated mental state questionnaire. Sun exposure, season, depression, education, age and many other potential confounders were considered in the statistical analysis. Notably, women were excluded from the study if they consumed vitamin D supplements in the previous 18 months.
Ruling out potential confounders, the central finding of this study was that weekly vitamin D intake from food sources was significantly associated with overall cognitive performance; women with inadequate dietary intakes of vitamin D had a greater prevalence of cognitive impairment. Among several explanations the authors discuss, one explanation of the observed associations between vitamin D intake and cognitive decline may have to do with the nature of food. Citing two other studies, they write, “Nutrition indeed integrates complex interactive effects of many dietary constituents. Nutrients are not consumed in isolation but rather as components of an overall diet, which is precisely considered as a modifiable risk factor for cognitive decline.”
In order to establish causality and accurately determine mechanisms of action Annweiler C. et al encourage prospective nutrition studies and clinical trials “to assess a direct effect of vitamin D intake on cognitive decline.”
Study: Annweiler, C. et al Neurology, 75; 1810-16 (2010)
Inspiration Follows Action: A Traditional Portuguese recipe to jump start your New Year’s commitment to whole foods!
Wednesday, January 5, 2011
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One thing I am learning as a Naturopathic Medical student is that patients are less likely to follow through on important life style changes if they’re too complex. Most of us wait around in hopes that a bolt of inspiration will inspire us to revolutionize our diet, top to bottom. Yet, as the old saying goes, inspiration follows action, not the other way around.
Rather than attempting to change your entire dietary routine overnight this year, resolve, instead, to make just one traditional whole foods recipe! By the way, a great way to incorporate whole foods into your diet is to seek out traditional recipes; you’ll find that most traditional cultures stick to whole food nutrients.
There are an infinite number of rewards from making just one delicious whole-food meal from scratch. It gives you a sense of great accomplishment and empowerment for taking responsibility for the nourishment and health of yourself and your loved ones. And you'll likely be inspired to make a second recipe soon after! Another perk; as you introduce yourself to just one traditional dish at a time you end up getting more familiar with a host of whole foods and herbs – naturally.
How about starting the New Year with a fulfilling Portuguese “Bacalhau” or salted cod fish dish?!? This dish has been very much enjoyed in my family for many generations, a holiday favorite of my Father. My dear parents are the source for this recipe. Copy the instruction below and give it a whirl!
Ingredients:
• approximately 1 to 1 ½ pounds of salted cod fish “bacalhau”
• approximately 1 ½ to 2 pounds of potatoes “batata” washed and unpeeled
• 2 onions “cebola” peeled and sliced into rings
• 3 to 6 hard boiled eggs “ovos” peeled and sliced into ovals
• anywhere from ½ cup to ¾ cup of olive oil “azeite”
• approximately a dozen (quantity may be more or less if desired) pitted olives “azeitonas” (may slice if desired but not necessary)
• desired amount of fresh parsley “salsa” chopped
• desired amount of fresh ground black pepper “pimenta”
• few banana peppers sliced in half with seeds removed (this is optional, but something my father loves to add)
• paprika is also optional(this was not used for my father’s holiday dish, but you may wish to try it!)
• approximately 1 to 1 ½ pounds of salted cod fish “bacalhau”
• approximately 1 ½ to 2 pounds of potatoes “batata” washed and unpeeled
• 2 onions “cebola” peeled and sliced into rings
• 3 to 6 hard boiled eggs “ovos” peeled and sliced into ovals
• anywhere from ½ cup to ¾ cup of olive oil “azeite”
• approximately a dozen (quantity may be more or less if desired) pitted olives “azeitonas” (may slice if desired but not necessary)
• desired amount of fresh parsley “salsa” chopped
• desired amount of fresh ground black pepper “pimenta”
• few banana peppers sliced in half with seeds removed (this is optional, but something my father loves to add)
• paprika is also optional(this was not used for my father’s holiday dish, but you may wish to try it!)
Instructions:
• First, the salted cod fish must be soaked in water for 3 days to take the salt out. My father recommends changing the water at least every day. And make sure that the water covers the fish. The more often the water is changed, the more salt will be removed. If the fish break, it is not a problem! This is your opportunity to flake the cod fish into smaller pieces. Be careful to remove the bones if and as they are seen. Remember to drain the water and do not save it.
• After the cod fish has been soaked for 3 days, it is now time to prepare the potatoes, and caramelize the onions. In a large pan, cook the whole potatoes halfway through. Then remove the potatoes from the pan, and allow to cool. Once the potatoes have cooled enough to handle, you may peel them and slice them. My father mentioned that slicing the potatoes is the best for the dish. Cutting the potatoes into quarters or eighths will work but will not be as appealing as sliced potatoes. Don’t forget to discard the water.
• In a large sauté pan, drizzle a little bit of olive oil and the sliced onions. Under medium heat, allow onion rings to lightly “caramelize”.
• In a large suitable size glass casserole dish, first drizzle a little bit of olive oil. Next to be added will be layers and garnishings. My father first adds a layer of potatoes, then codfish, then hardboiled sliced eggs, and the final layer is caramelized onions. You can also add the onions in between other layers if you choose to. The olives are usually added to the top but may also be added in between layers too. The parsley may be added in between the layers as well as garnished on top. Sprinkle some black pepper. Sprinkling of some paprika is optional. The optional but delicious banana peppers may be added on top. Drizzle the rest of the olive oil on top of the top layer.
• Bake in a 350ºF oven for approximately 45 minutes or until brown.
• Enjoy with a fresh salad. My favorite dressing for a salad is cilantro, fresh squeezed lime juice and onions. This dressing is so simple! Just add all 3 ingredients into a chopper and whoo-laa! Hmmm, I am hungry just as I am writing this recipe.
• First, the salted cod fish must be soaked in water for 3 days to take the salt out. My father recommends changing the water at least every day. And make sure that the water covers the fish. The more often the water is changed, the more salt will be removed. If the fish break, it is not a problem! This is your opportunity to flake the cod fish into smaller pieces. Be careful to remove the bones if and as they are seen. Remember to drain the water and do not save it.
• After the cod fish has been soaked for 3 days, it is now time to prepare the potatoes, and caramelize the onions. In a large pan, cook the whole potatoes halfway through. Then remove the potatoes from the pan, and allow to cool. Once the potatoes have cooled enough to handle, you may peel them and slice them. My father mentioned that slicing the potatoes is the best for the dish. Cutting the potatoes into quarters or eighths will work but will not be as appealing as sliced potatoes. Don’t forget to discard the water.
• In a large sauté pan, drizzle a little bit of olive oil and the sliced onions. Under medium heat, allow onion rings to lightly “caramelize”.
• In a large suitable size glass casserole dish, first drizzle a little bit of olive oil. Next to be added will be layers and garnishings. My father first adds a layer of potatoes, then codfish, then hardboiled sliced eggs, and the final layer is caramelized onions. You can also add the onions in between other layers if you choose to. The olives are usually added to the top but may also be added in between layers too. The parsley may be added in between the layers as well as garnished on top. Sprinkle some black pepper. Sprinkling of some paprika is optional. The optional but delicious banana peppers may be added on top. Drizzle the rest of the olive oil on top of the top layer.
• Bake in a 350ºF oven for approximately 45 minutes or until brown.
• Enjoy with a fresh salad. My favorite dressing for a salad is cilantro, fresh squeezed lime juice and onions. This dressing is so simple! Just add all 3 ingredients into a chopper and whoo-laa! Hmmm, I am hungry just as I am writing this recipe.
Bom Apetite and Feliz Ano Novo!... to ALL Innate Friends and Family!
A Webinar with Artemis Morris, ND, L.Ac
January 13, 2011, Thursday, 12:00 - 1:00 PM EST
Have you or your patients ever thought? I know the Mediterranean diet is healthy, but...
2. Eating a lot of fat in my diet will raise my cholesterol levels and increase my risk of heart disease.
3. Any kind of olive oil will do in the Mediterranean Diet.
4. I can’t cook, bake, or fry will olive oil- it will spoil it’s benefits and taste horrible.
5. There’s no meat in the Mediterranean Diet- and I can’t follow a vegetarian diet.
6. Diabetics shouldn’t drink any alcohol because it will always raise their blood sugar.
In my Jan 13th webinar we will bust through these and other myths that may plague your ability to implement the positive benefits to health that are enjoyed when following the Mediterranean Diet.
The health benefits of the Mediterranean Diet include reducing you risk of cardiovascular disease by 50%, preventing 90% of Type 2 Diabetes, preventing cancer and depression by 30%, improved asthma and allergy symptoms, and extension of life by 25-50% (1, 2, 3, 4, 5). These health benefits require compliance to the main traditional tenets of the Mediterranean Diet. In this webinar, these central tenets will be reviewed in the context of the common myths held by us and our patients; we will clear up confusion due to the discordant messages in the public and scientific community.
We will also review the Mediterranean Diet pyramid by Trichopoulos and Willett (6) and demystify it’s meaning, as well as, evolve it to include individualized recommendations for our patients based on Naturopathic Medical principles and ethnographic research applied to the healthy Mediterranean Diet.
The Mediterranean Diet Pyramid (6) based on the diet of Crete and Greece around the 1950s is low in saturated fat (less than 7-8% of total calories) and has a fat content between 25%- 35% depending on what part of the Mediterranean you lived in during those times. However, It is the types of fats and how they are utilized and prepared that makes a difference in health as numerous studies have shown. The other basic points of the most popular Mediterranean Diet pyramid, as presented in this webinar, includes, eating meat monthly; weekly sweets, eggs, poultry and fish; daily olive oil, dairy products, legumes, and whole grains. Wine is allowed to be consumed in moderation and physical activity is recommended daily. As you can see, trying to follow the pyramid alone can be confusing and lead patients astray from the traditional healthy diet of the Mediterranean which we will review and revise in this webinar.
This is a powerful webinar for clinicians seeking to integrate the traditional tenets of the Mediterranean diet with individualized approaches to patient care rooted in Naturopathic Medical principles.
About The Presenter
Dr. Artemis Morris is a Naturopathic Physician and Licensed Acupuncturist. She has been researching the Mediterranean Diet through ethnobotanical and clinical studies for the past three years. She completed her Naturopathic Doctorate and Masters in Acupuncture at Bastyr University. Dr. Artemis is the medical director and founder of Revive Wellness Center, a multidisciplinary collaborative practice in New Haven, CT and has a private practice in Milford, CT . She teaches clinical nutrition at the University of Bridgeport College of Naturopathic Medicine and is a consultant for books on natural health topics. Dr. Artemis lectures on Traditional Chinese Medicine, botanical medicine, and various natural health topics for a variety of audiences. Dr. Artemis specializes in nutritional medicine, herbal medicine, Diabetes, and women’s healthcare. Dr. Artemis is devoted to research in natural medicine, ethnobotany, education in the safe and effective use of nutritional supplements, and is working on her book on The Mediterranean Diet based on her research.
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