PCRM Going for Food Censorship

Posted on February 19, 2012 by Dr Carter

I just could not let this one go without commenting on the insanity that passes for “responsible” action.

On February 17, 2012, I was sitting in one of my favorite Bozeman café’s – the Stockyard Café – eating a delicious lunch of hamburger patty with onions, bacon and home fried potatoes with coffee. A copy of the Bozeman Daily Chronicle was on the counter so I started reading some of the interesting headlines (not) and soon arrived at page two where a short news-feed type article caught my attention. Apparently a patron at the “Heart Attack Grill” in Las Vegas, Nevada experienced a cardiac event while having a meal there.  Some of the patrons, thinking that it was all part of an act promoting the café, applauded the victim and paramedics who responded to the call; they did not know that the patron was experiencing a real heart attack. Oh well, it was Las Vegas where nothing is real.

Apparently the Physicians Committee for Responsible Medicine (PCRM, http://www.pcrm.org/ ) caught wind of this unfortunate event  and called the Grill “morally bankrupt” for offering both their menu and their names for menu items (http://www.heartattackgrill.com/ , menu download available on the Grill’s website). Apparently the PCRM does not understand either irony or black humor. The dietician who authored the PCRM response wrote the Grill’s owner, calling on him to close his business.   Dieticians are fine folks tasked with recommending diets to people in hospitals or with specific medical conditions such as diabetes.  Much of the time I don’t agree with dietician’s recommendations. Following is the definition of dietician from a source that should be reliable since it is a dot-gov site. (Although not true in a lot of cases, there are some OK dot-gov websites.)

Dietitians manage food service systems for institutions such as hospitals and schools, promote sound eating habits through education, and conduct research. Many dietitians specialize, becoming a clinical dietitian, community dietitian, management dietitian, or consultant. Reference http://www.bls.gov/oco/ocos077.htm

I have some issues with dieticians that I will provide examples for.

  1. They normally recommend the diet recommended by health.gov http://health.gov/dietaryguidelines/2010.asp These are the same folks that brought you the obesity epidemic.
  2. They subscribe wholeheartedly to the “saturated fats cause cardiovascular disease” hypothesis. This theory has never been proven and yet it is accepted as truth by the medical profession. Want proof – As a class, statin drugs (cholesterol lowering drugs) and their related combination products generated. $14.3 billion in U.S. sales in 2006 Reference http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/Statins-RxTrend-FINAL-Feb2007.pdf
  3. They support the American Diabetes Association (ADA) recommendations for diabetic diets. http://www.diabetes.org/ Dieticians routinely tell diabetic patients to eat 60 grams carbohydrates with three meals daily, and to have a 30 gram carbohydrate snack. In their defense – the American Dietetics Association is now recommending a more carbohydrate restricted diet more in the range of 100 grams total carbohydrate daily. In case you don’t know much about diabetes, this is way too much carbohydrate/sugar. Unfortunately, most diabetics will experience disease damage progression at this level of intake.

My practice is focused on clinical nutrition. If I had to characterize my practice I would describe my range of treatments as being 70% nutrition, 15% lifestyle and 15% other, such as hormone treatments. I do my best to base nutritional treatments on current research from reputable sources, meaning I don’t have a lot of use for the current dietary guidelines issued by the U.S. Department of Agriculture because, for example, they are still lipophobic and recommend whole grains as a major part of the diet.

So what does all of this have to do with the PCRM wanting to close down the Heart Attack Grill. From my point of view, the PCRM is frankly biased and perhaps FOS. But then, I am biased based on what I believe constitutes a good diet. Firstly the PCRM is a… I was going to say “front group,” but that is inflammatory… So the PCRM is an organization that promotes vegan diets as the be all and end all approach to be healthy and solve issues facing the world such as starvation in certain developing countries. Veganism, IMO, is a valid short term diet for the treatment of specific medical conditions, such as newly diagnosed type 1 diabetes. Veganism is not a sustainable long-term diet and is based more on philosophy than scientific principles. It is not sustainable because it results in nutritional deficiencies that cannot be corrected by diet alone. Also, vegans tend to be anywhere from mildly to extremely dogmatic, so I don’t generally see vegans in my practice as I use meats as a source of protein. The vegan movement, in fact, originated because of ethical concerns of some Brits (people from Britain) about the time the second world war ended. As the Vegan Society notes:

The Vegan Society, the world’s first, was born in November 1944 – after a lengthy gestation. As early as 1909 the ethics of consuming dairy products were hotly debated within the vegetarian movement. In August 1944, Elsie Shrigley and Donald Watson (a conscientious objector later to be acclaimed as the Vegan Society’s Founder) agreed the desirability of coordinating ‘non-dairy vegetarians’; despite opposition from prominent vegetarians unwilling to even consider adopting a diet free of all animal products. Reference http://www.vegansociety.com/about/history.aspx

That means that I disagree with two of the main arguments of the PCRM wanting to close the Grill: vegans may not be the ideal group to advise people on what to eat, and veganism is not a good diet for the majority of people.

I do have a personal issue with the Grill, however, and that is their menu items that are simply too heavy in calories, for example their triple and quadruple bypass burgers – here is what they look like : http://www.heartattackgrill.com/MenuInside.jpg . If a person eats that much food consistently over time they will become obese, and heart disease may be a consequence. It is a choice that Grill patrons have a right to make and that is OK. They just need to know the consequences of their eating habits, and most Americans do not know. As an example I would offer up the Travel Channel’s Adam Richman. He hosts a television show called “Man vs. Food.” The premise is that he is challenged to eat ridiculously large menu items at various restaurants around the United States – he is getting a bit pudgy. I may blog about some TV food shows in the future.

The bottom line is that PCRM has no right to tell a business to close because it conflicts with their dogma. Dogmatic people are generally very low in the humor department; an example would, perhaps, be a past leader of a totalitarian regime – he is not a smiley guy

This is that happy dogmatist from the past, Breshnev

 

 

 

PCRM, in their call to censor foods and restaurants they don’t like, are calling for food totalitarianism.

Note to people who take blogs way too seriously – I am not suggesting in any way that PCRM is totalitarian in the way Breshnev was, nor that PCRM is going to put people in a Gulag for eating meat. I guess you could call this a legal disclaimer.

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Retaining and Improving Foot and Ankle Function – Minimalist Shoes

Posted on August 15, 2011 by Dr Carter

Our feet were designed to function with minimal interference, that is, they work better when they are bare. Protective coverings have been developed over the last several thousand years and range from sandals and leather moccasins to some of the ridiculous fashions (worn mainly by women) and heavy specialty protective boots used in different industries. I’m not going into the historical record of footwear, because frankly I don’t really care. I’m not discussing therapeutic orthopedic shoes either. The footwear I’m concerned about are the varieties that are currently in use by people who don’t need safety shoes, and especially minimalist shoes that allow normal foot and ankle function. What kind of “shoe” is actually good for your foot? Can wearing these shoes help you retain and regain foot functionality?

Perhaps the worst shoe design ever devised is the high heel favored by women of fashion. This style shoe causes many foot, ankle, calf and gait dysfunction issues – but then we really don’t care if think we look good do we. When I lived in Portland I treated a woman, a successful realtor, who held that the only appropriate shoe for her work was high heels. She had worn these shoes so extensively that she could not walk barefoot indoors, for example to take a shower. Her calf muscles were so shortened, standing without her heels raised was impossible for her.  After a two month treatment period where I had her graduate to progressively lower shoe heel height, she told me she would rather look good than have normal lower leg function.

Restrictive shoe types, especially those that crowd the toes together excessively, like pointy toe shoes and boots, result in foot deformities such as bunions; beautiful. Athletic shoes are not without problems either, as they often have thick padded soles that increase the risk of injuries such as ankle sprains. Runners using thick soled shoes tend to land heavily on the heel, called heel strike, causing foot, knee and hip overuse injuries and pain.  In the past few years there has been a growing movement promoting bare foot running, and some of the more vocal leaders of the movement claim that going without shoes prevents and cures injuries and improves walking and running form automatically. As with many exuberant proclamations there are elements of truth and myth.

During the summer of 2010, we decided to try out Vibram Five Fingers (VFF) on the recommendation of my wife’s very athletic daughter. When we first saw them their very appearance was, well, weird. They were very light weight thin soled shoes with individual slots for each toe. It was quite difficult trying to put them on the first time, but with experience one becomes much more adept. We took the advice of the store where we purchased them, and started out slowly, taking short walks at first and progressively building our distance. It is really wise to do this, as the foot that is accustomed to wearing heavy supportive shoes has a lot of muscle, ligament and tendon weakness. Minimalist shoes such as the VFF allow the foot to move with little restriction, and this requires the small muscles of the foot, and the calf muscles to work in a better but different manner than they are used to doing. We worked up to taking quite long hikes in the VFF and did not experience any problems as long as we watched foot placement to avoid sharp rocks and cactus. Running in these shoes is fine on smoother surfaces (not rocky) and they force either a midfoot  or forefoot strike; if you try to run with a heel strike you will quickly change due to heel pain, there is essentially no padding in the sole of these shoes. I also run intervals as part of my conditioning program and quickly adapted to a forefoot strike that was very comfortable.

This year, 2011, we wanted to try something different in the minimalist shoe world so we both purchased the Trail Glove made by Merrell shoe company. These shoes have a breathable mesh upper and a thin Vibram sole with a fairly non-slip tread pattern. The Merrells are the most comfortable shoe I have ever worn. They are light weight, fit snug in the heal and midfoot and have room in the forefoot area for the toes to spread and function without restriction; the sole is flexible. I have worn the Merrells for all of my walking, running and hiking this year and they have proven to be durable. The Merrell sole is more protective to the bottom of the foot than the VFF.  I recommend purchasing either the VFF or the Merrell at REI (http://www.rei.com/) because they will replace defective products without hassle – my wife’s Merrells developed a defect in the attachment of mesh to sole; they were replaced with a new pair.

There are some conditions I don’t really like minimalist shoes for, and that is really rocky terrain. There are places we hike that are rocky, and going uphill in minimalist shoes is not a problem. Descending is more difficult since there is a natural tendency to land more on the heel and when this happens on a sharp rock a heal bruise can be inflicted; I’ve have two heal bruises this summer because of this. The VFF does not have any tread on the sole, so it is even more slippery coming down than the Merrell. Would minimalist shoes be good for something like the Bridger Ridge Run? (http://bridgerridgerun.wordpress.com/). I would not personally want to use these shoes on a long rugged run/hike. In early July we went to a presentation on the Bridger Ridge Run by Mike Wolfe, an endurance athlete who has run this race a number of times. Someone asked him about using minimalist shoes for this event and he responded that a shoe with some sole padding/thickness would be a better choice due to the rough and rocky nature of the trail, but that really thick soles increased the risk of ankle sprains. For most walking and summer hiking I would definitely choose a minimalist shoe because of comfort and light weight. There a lot of anecdotal reports from people about joint pain being less, no shin splints, less ankle sprains, and even developing an arch in previously “flat” feet after they started wearing minimalist shoes. The VFF will also pick up samples of plants as you walk through them…

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Starting point for a healthier diet

Posted on June 3, 2011 by Dr Carter

I have watched Kurt Harris’ blog for some time now and he has not modified his dietary principles to any great extent over the last year, hence they can be considered a “stable version” in computer terminology. Here are his extraordinarily simple diet guidelines taken directly from his blog at http://www.archevore.com/get-started/. His content is in italics and my comments follow in non-italic font…

The basic diet guidelines I use for my patients and those on weight loss plans follow the same principles as Dr Harris, and I really like the clarity of his advice.

Kurt Harris’ Archevore Diet Approach

The 12 steps remove the neolithic agents of disease in an efficient and practical manner. Go as far down the list as you can in whatever time frame you can manage. The further along the list you stop, the healthier you are likely to be. There is no counting, measuring, or weighing.

  1. Eliminate sugar (including fruit juices and sports drinks that contain HFCS) and all foods that contain flour. Sugars and refined flours, along with #4 below are the principle cause of the diseases of civilization (DOC): the main ones being cardiovascular disease, cancer, type 2 diabetes, metabolic syndrome and obesity. Other DOC that increase because of physiological disruptions caused by processed and industrial foods include Alzheimer’s disease, asthma, chronic liver diseases and lung diseases, Crohn’s disease, and chronic kidney disease.
  2. Start eating proper fats – Use healthy animal fats to substitute fat calories for calories that formerly came from sugar and flour. I recently blogged about healthy fats at http://blog.bznwtmgt.com/ American’s are lipophobic due to a concerted campaign of misinformation waged by mainstream medicine and the media; lipophobia is unjustified when the biochemistry of saturated fats (from animals and plants) is analyzed. Read Good Calories, Bad Calories by Gary Taubes.
  3. Eliminate gluten grains. Limit grains like corn and rice, which are nutritionally poor. The gluten containing grains and inflammatory to the gut when eaten (85% of population) and drive abnormal eating behavior leading to obesity.
  4. Eliminate grain and seed derived oils (cooking oils) Cook with Ghee, butter, animal fats, or coconut oil. Use no temperate plant oils like corn, soy, canola, flax, walnut, etc. These oils cause inflammation in the body, significantly contributing to higher rates of cardiovascular disease and cancer.
  5. Favor ruminants like beef, lamb and bison for your red meat. Eat eggs and fish. These foods are good protein sources and contain low levels of inflammatory omega-6 oils. Eating cold water fish is more beneficial than supplementing fish oil.
  6. Make sure you are Vitamin D replete. Get daily midday sun or consider supplementation. Vitamin D should be nominated for “vitamin of the decade” from 2000-2010 and research continues at an amazing pace. Low levels are associated with cancer, cardiovascular disease, and skeletal abnormalities such as osteoporosis.
  7. 2 or 3 meals a day is best. Don’t graze like a herbivore. You will not get hungry between meals if you eat sufficient protein and good fats with vegetables and a few fruits. Stored fat in the body only breaks down when insulin levels are low, so if you are always eating your fats stores will continue to build up and obesity is the result.
  8. Attend to your  6s and 3s. Pastured (grass fed) dairy and grass fed beef or bison has a more optimal 6:3 ratio, more vitamins and CLA. If you can’t eat enough pastured products, eat plenty of fish. The essential fatty acids, known as omega-6 and omega-3 oils often get unbalanced in the American diet (actually any processed food dominant diet regardless of country). The optimal 6:3 ratio is somewhere in the range of 4:1 to 1:1. The grain and seed derived oils are very high in omega-6, leading to a lot of extra oxidative damage to the body’s tissues, leading to higher rates of the DOC.
  9. Get proper exercise – emphasizing resistance and interval training over long aerobic sessions. Our bodies are much healthier and more functional when we move them on a regular basis using our muscles. Aerobics is not the best path to fitness; lifting weights and exercising at a high intensity has much greater benefits. Older and out of shape? You can scale – exercise at your limit – any program that you adopt. The main objective is to start moving.
  10. Most modern fruit is just a candy bar from a tree. Go easy on bags of sugar like apples. Stick with berries and avoid watermelon which is pure fructose. Eat in moderation. If you are not trying to lose fat, a few pieces of fruit a day are fine. I agree with Dr Harris’ last two sentences especially.
  11. Eliminate legumes Legumes contain a lot of anti-nutrients, similar to the grains, so it is best to avoid them. Don’t worry about eating them occasionally but pay attention to how you feel after consuming them. Don’t eat soy products.
  12. If you are allergic to milk protein or concerned about theoretical risks of casein, you can stick to butter and cream and avoid milk and soft cheeses. Note that this is last on the list. Many people sensitive to commercial dairy can tolerate raw dairy, this despite dire warnings from government agencies. Cows in an organic dairy are raised without the need for antibiotics, because they are fed grass; this eliminates many opportunistic infections like pathogenic E-coli, that often appear in factory farmed cattle. Aged cheeses can also be tolerated better, as much of the allergenic protein has been modified by the cheese culturing process.
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Coffee

Posted on February 6, 2011 by Dr Carter

I really enjoy good coffee. As a common beverage world-wide, is coffee good, bad, or indifferent when your goal is to make health supporting food choices? I’m not going into an exhaustive discourse here, rather I will make a few observations about healthier types of coffee and whether you should drink it or not. I’ll also make some recommendations on how to make coffee and where to get a good cup in the Bozeman area.

Coffee is prepared from the roasted seeds of coffee cherries that grow on trees in over 70 countries, primarily in Africa, Latin America and Southeast Asia. Due to its caffeine content, coffee normally has a stimulating effect on consumers. Coffee contains a complex mixture of chemical compounds. Some components, particularly those related to the aroma, are produced during roasting of the beans. The substances which dissolve in water during brewing to form the beverage are classified as nonvolatile taste components (including caffeine, trigonelline, chlorogenic acid, phenolic acids, amino acids, carbohydrates, and minerals) and volatile aroma components including organic acids, aldehydes, ketones, esters, amines, and mercaptans. Very interesting; meh…

The major physiologically active substance in coffee is the alkaloid caffeine, also called methyltheobromine, which acts as a mild stimulant. Caffeine is a naturally occurring substance found in the leaves, seeds or fruits of more than 60 plants, including coffee, cocoa beans, cola nuts and tea leaves. A cup of coffee, depending on the strength, may contain 20-100mg of caffeine.

You should probably avoid coffee if:

  • You don’t feel good after consumption.
  • It causes nausea, heartburn, aggravates stomach inflammation or ulcers, leads to diarrhea.
  • It causes insomnia – drinking only early in the day helps.
  • You drink too much. I have had patients come to me with multiple complaints, and on questioning them about coffee consumption they might reply “about six a day.” I’ll clarify with “six cups?” Whereupon they state, “No, six ten cup pots.” A lot of their health complaints resolve with reduction in their daily coffee intake.
  • You use coffee in order to have sufficient energy to function on a regular basis. This is often a symptom of adrenal insufficiency; caffeine stresses the adrenal glands. There are other important causes of fatigue that need to be assessed as well.
  • You have iron deficiency anemia – coffee interferes with iron absorption due to some of the polyphenols it contains. The polyphenols contained in coffee are associated with decreased risk of liver cancer
  • You have pre-existing cardiac symptoms aggravated by caffeine, e.g. arrhythmias, high blood pressure.
  • Coffee contributes to headaches; this is much more common in heavy coffee drinkers which means greater than 4 cups a day.

You could consider drinking moderate amounts of coffee (1-3 cups daily) if:

  • You have liver cholestasis (your liver does not secrete bile well). Most bitters (see below) are also cholagogues, a class of substances that improve bile secretion; the secretion of bile is of great help to the whole digestive process. Bile is required for the emulsification and digestion of fats and it (bile) stimulates peristalsis, encouraging bowel movements. The bitter taste is important, so it is better to avoid neutralizing it with sweeteners.
  • You engage in endurance sports. Caffeine acts as an ergogenic (energy generating) aid in endurance sports. Caffeine does not appear to benefit short term, high intensity exercise (e.g. sprinting), but can enhance performance in endurance sports – http://www.rice.edu/~jenky/sports/caffeine.html.
  • Several studies suggest that a daily caffeine habit may help protect against Alzheimer’s disease. But there’s a catch. The cup or two a day that most Americans drink doesn’t seem to be enough. Researchers say 500 mg of caffeine, or about five cups of regular coffee, is the dose that seems to protect the brain. If you can tolerate that much caffeine, especially if you are getting along in years and it doesn’t wire you, then it may help avoid this disease of severe memory loss – http://www.npr.org/templates/story/story.php?storyId=128110552.
  • The vast majority of studies have shown a benefit of coffee on the prevention of type 2 diabetes.
  • Less likely to develop Parkinson’s disease.
  • Coffee has been linked to lower risks for heart rhythm disturbances (a heart attack and stroke risk factor) in men and women, and lower risk for strokes in women.
  • All of the studies have shown that high coffee consumption is associated with decreased risk of liver cirrhosis and liver cancer – The four statements above are from http://www.webmd.com/food-recipes/features/coffee-new-health-food.

Sidebar: Bitter foods help improve digestion be improving bile secretion by the liver. Bitter taste receptors on the tongue probably evolved to evoke signals for avoiding ingestion of plant toxins. Many plant toxins are bitter tasting alkaloids. Some are still used as drugs in mainstream medicine, e.g atropine and scopolamine, whereas others such as strychnine which is extracted from nux vomica (Strychnine Tree) is a poison.  Atropine can temporarily reverse sinus bradycardia to normal sinus rhythm, which is most likely more than you wanted to know in a post about coffee. Scopolamine is much more commonly known, and is used to relieve nausea, vomiting, and dizziness associated with motion sickness, e.g. scopolamine patches applied prior to embarking on sea-going vessels. So the bitter taste receptors are useful for avoiding poisons, but the avoidance of all bitter tastes by most Americans contributes to digestive difficulties. Sweet is the preferred taste of most people and it contributes to the obesity epidemic in a big way. I will often prescribe bitters (safe ones) to people with digestive problems, especially those with fat intolerance. Coffee is a good bitter when it is not sweetened. I also recommend Angostora bitters which can be found at most liquor stores (a few dashes in a little water works best) and Swedish bitters available at health food stores. For those who tolerate small amounts of alcohol there are several aperatifs, usually served before a meal to stimulate the appetite, that are good. The two I prefer are Campari and Cinzano rosso; both of these are produced in Italy, where they are not as averse to bitter tastes. Whiskey is also a bitter, but there is a high tendency and risk of consuming it to excess, which interferes with digestion and leads to the social and health problems associated with higher intakes.

Where to get good coffee in the Gallatin Valley of Montana

When I lived in Portland, Oregon, prior to moving to Bozeman in 2003, I was in one of the coffee capitols of the world with respect to the availability of good coffee. Coffee People was good until they sold out to Starbucks. I don’t mind Starbucks because they serve consistently good coffee and a lot of their beans are fair trade; they are a bit expensive. Stumptown came on the scene sometime around the late 90′s (don’t hold me to that date) and they produced amazingly good coffee. They roast on-site and even though they serve up good coffee quickly they still have time for a little art.

Organic or not? Coffee is a crop that is treated with high concentrations of pesticides and other agricultural chemicals. How much pesticide actually makes it into the bean is a subject of conjecture. However, organic and sustainably grown coffee have fewer adverse effects on soils and surrounding ecosystems, so I recommend organic coffee for most of your consumption.

Bozeman area coffee houses – I’ll list these in my order of preference and only those businesses I have personally been to.

  1. Spotted Horse Coffee House, 86 N Broadway, Belgrade, MT. Spotted Horse is hands down my favorite. Their coffee Havana is pure essence of coffee and is a sipping coffee. I don’t think I have seen anyone slam a Havana, it is robust and flavorful, deserving of your full attention. I often follow up with a double breve to go. Their coffee is all organic.
  2. If I can’t get to Belgrade I prefer Wild Joe’s Coffee, 18 West Main Street, Bozeman. This is another organic coffee seller that fixes flavorful drinks.
  3. International Coffee Traders, 720 South 10th Avenue, Bozeman. This is a college coffee bar, being across the street from the north boundary of Montana State University. They do it right.
  4. Rocky Mountain Roasting, three locations in Bozeman and one in Belgrade. Their drinks are usually good, although the last time I had a double breve in Belgrade (January 1, 2011) the coffee was stale.
  5. Leaf and Bean, two locations in Bozeman. Can be OK, but I’ve had marginal quality a number of times.

Restaurants serving OK coffee – You may notice a trend here, cafes for locals

  • Stockyard Cafe, 1018 East Griffin Drive. I really like small-town Montana cafes like the Stockyard. Open Fridays and weekends.
  • Cateye Cafe, 23 N. Tracy ~ Downtown Bozeman. A good dining spot for breakfast, lunch and dinner.
  • Soby’s Cafe, 321 East Main Street, inside the Historic Bozeman Hotel. If you don’t get full at this local cafe its your problem.

Creamers for coffee

  • Black coffee is the defacto default. Black coffee is good if it is quality and has been brewed or drawn (espresso) correctly. Stale or very acid coffee can be hard to drink black.
  • Skim milk, a standby “creamer” for the very popular skinny latte. A lot of women order either skinny or soy lattes in the belief that the lack of fat will help avoid weight gain. It is not the fat in foods that lead to weight gain, it is the pastries, refined carbohydrates and sweeteners that add pounds to the body.
  • Half-and-half is a standard creamer added to home-brewed, restaurant, or coffee house brews. Steamed half-and-half is used to make breve’s, my normal order at coffee houses other than the Spotted Horse.
  • Heavy whipping cream is what I add to coffee and tea at home (exception – see BulletProof below). I’ll be blogging about fats in future posts, so at this time readers will either think I’m off base or OK using concentrated fat sources.

Non-dairy creamers

  • I really don’t recommend commercial non-dairy coffee creamers as they are a mix of chemicals that humans were not designed to metabolize, Coffee Mate was the original…
  • Coffee Mate – corn syrup solids, partially hydrogenated vegetable oil, sodium caseinate, dipotassium phosphate, mono- and diglycerides, sodium aluminosilicate, artificial flavor, annatto color. Anything listing partially hydrogenated vegetable oil is not fit for human consumption.
  • Soy milk – I could easily go off on a diatribe about soy; soy is another toxin often promoted as a health food. Here are just a few of the adverse effects of soy – http://thehealthyskeptic.org/, post dated January 28, 2011, 9 Steps to Perfect Health – #1: Don’t Eat Toxins
  • Coconut oil mixed 50:50 with coconut cream concentrate – I obtained the recipe here – http://www.tropicaltraditions.com/ I buy all of my organic coconut oil from these folks, and they often have terrific sales. I found that in order to avoid grainy coffee I needed to blend the coffee and coconut creamer in a blender at high speed for about 30 seconds; comes out nice and creamy.

Flavored syrups
The popular syrups used for flavoring coffee drinks are essentially sugar. Adding sweeteners to coffee adds to your total carbohydrate load. Total carbohydrate load, high equals worse, correlates closely to obesity and its attendant diseases, e.g. diabetes.

My current favorite home coffee drink – BulletProof Coffee
The recipe is from Dave Asprey at http://www.bulletproofexecutive.com/

It’s really fast and easy to prepare. I brew up a cup of Dark Horse coffee from the Spotted Horse Coffee House, then add about 2 oz organic unsalted butter (because salted coffee is a crime) to the coffee and mix in a blender for a few seconds until there is a thick layer of foam like a latte. This drink is amazingly creamy and the butter does not cover up the taste of the coffee. Note: one ounce of butter is 2 tablespoons. Experiment with the amount of butter; I am using about 1-1/2 ounces or 3 tablespoons.

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Preventing & Treating Common Viral Respiratory Infections (URTI)

Posted on December 27, 2010 by Dr Carter

The fall and winter seasons have higher incidence of upper respiratory infections and it is useful to know how to decrease your risk of infection, as well as how to best treat infections you have contracted. I will also discuss complications that may occur with viral respiratory infections, some of them life threatening, and reasonable approaches to treatment.

Why do we have more colds and flu in the fall and winter seasons? In 2007, researchers reported that the flu virus is more stable and stays in the air longer when air is cold and dry. Dr. Jeffrey Shaman, an atmospheric scientist at Oregon State University, and his colleagues have found more evidence that high humidity may help to stave off the flu virus. Additionally, in temperate regions both outdoor and indoor absolute humidity are at a minimum during winter months, conditions that favor influenza survival and transmission. Another reason viral illnesses occur more frequently during the cold weather months is the decrease in ultraviolet (UV) light from the sun. UV light rapidly inactivates viruses but is impractical for continuous indoor use, whereas natural sunlight can inactivate the virus outdoors, the problem being that UV radiation is very low at latitudes greater than about 34 degrees during the winter season.

Whoa, stop the presses – I just (12/24/2010) found this post by by Chris Masterjohn, http://www.cholesterol-and-health.com/cholesterol-blog.html, about our long-held beliefs regarding latitude, vitamin D and UV light. We may have had it wrong all this time. However, cold weather normally causes people to spend less time outdoors, and when they are out on a sunny day, their skin is covered by clothing. The end result is the same – we get less UV exposure during the winter.

A study in the American Journal of Public Health showed that both UV light and the wearing of face masks similar to those used in health care facilities decreased the incidence of influenza (Am J Public Health. 2007 April; 97(Supplement_1): S32–S37.) Cultural acceptance may encourage the use of facemasks (Asia) or discourage their use (United States).

Prevention of Viral Infections

Public health authorities, such as the CDC (Centers for Disease Control and Prevention) list guidelines for preventing seasonal influenza, http://www.cdc.gov/flu/protect/preventing.htm. Here are their top recommendations, some of which I’ll discuss in more detail later.

1. CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.

2. To stop the spread of virus:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.

Avoid touching your eyes, nose and mouth. Germs spread this way.

Try to avoid close contact with sick people.

If you are sick with flu–like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)

While sick, limit contact with others as much as possible to keep from infecting them.

3. Take antiviral flu drugs if your doctor recommends them:

If you get the flu, antiviral drugs can treat your illness.

Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.

Antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications.

It’s very important that antiviral drugs be used early (within the first 2 days of symptoms) to treat people who are very sick (such as those who are hospitalized) or people who are sick with flu symptoms and who are at increased risk of severe flu illness, such as pregnant women, young children, people 65 and older and people with certain chronic health conditions.

What I agree with and what I disagree with regarding CDC guidelines (If I disagree with a recommendation this does not mean I am suggesting you follow my opinion. This Blog does not recommend medical treatment, only your doctor can do that for you.)

1. I do not think influenza vaccinations are safe or effective. Pharmaceutical companies put their best guess forward as to which viruses will be active during the coming flu season; sometimes they are right and sometimes not. Flu vaccines have very little testing done for safety and effectiveness and the drug company has no liability if you are injured by their vaccine – thanks to the United States congress and rampant conflict of interest between drug companies and elected officials you have no legal rights after vaccine injury. How effective are flu vaccines? In an April 27, 2010 article on Minnesota Public Radio’s website they wrote: “If the main point of the nation’s influenza vaccination program is to reduce deaths from flu, then the program has failed, at least among people over 65. A growing body of research shows that because our immune systems age, flu vaccines don’t work as well in the elderly – the group of people most likely to die from flu-related causes.”

2. I agree with all of CDC’s suggestions to prevent the spread of viruses. The most important of these is hand washing or sanitizing.

3. Antiviral drugs are somewhat effective. The CDC states ” When used to prevent the flu, antiviral drugs are about 70% to 90% effective against susceptible viruses (i.e., viruses that are not resistant to the antiviral medication).” In order for a drug to be effective, according to FDA regulations, it only needs to show a significant difference from a placebo such as a sugar pill. There are also a number of side effects listed by CDC for the common antiviral drugs: http://www.cdc.gov/flu/protect/antiviral/sideeffects.htm

Prevention

So what have I found to work best and without side effects for cold and flu prevention? The three areas that are most important in protecting and bolstering the immune system are diet and nutrition, exercise, and stress reduction.

1. Optimize your vitamin D blood levels (the blood test is called 25-OH vitamin D) to 50-80 ng/mL. Safe upper limits for vitamin D3 (a fat-soluble nutrient) supplementation are in the range of 4,000-10,000 IU daily; I like to stay in the range of 4,000 IU daily to maintain good vitamin D levels. If you supplement only with vitamin D, and none of the other fat-soluble vitamins you risk causing a relative deficiency of vitamin A. My preferred supplement is Vitamin D3 Complete made by Allergy Research Group.

2. Wash your hands or sanitize them often after exposures.

3. Go for a walk or exercise outside unless the weather is too brutal. Viruses are much less concentrated where there are less people. Air out your house by opening the windows briefly during the winter; it helps dilute viruses much the same as going outside. Mild exercise does not really effect the duration of illness once an infection is acquired. However, exercise has the capacity to protect and even enhance the immune response. Experimental studies have shown that a regular exercise program of brisk walking can bolster many defenses of the immune system, including the antibody response and the natural killer (T cell) response.

Moderate exercise in sedentary subjects with naturally acquired URTI probably does not alter the overall severity and duration of the illness. Previously sedentary people who have acquired a URTI and have just initiated an exercise programme may continue to exercise. Br J Sports Med 2003;37:304-306

4. Decreasing sugar consumption to a minimum has been a long standing suggestion of nutritionaly minded doctors. The problem is, there is not a lot of evidence to directly support the concept that sugar supresses immunity. There are some old studies from 1977 showing that sugar consumption decreases neutrophil (a type of white blood cell) function. Excess sugar has a lot of negative impacts on health that are proven, so cutting back is always good.

5. Vitamin C is an important antioxidant. While many studies have shown that daily doses of vitamin C do little to protect you from the common cold, it can reduce the severity of colds. There are several controlled studies performed in populations of people working under heavy stress that have shown a significant protective effect of vitamin C in terms of common colds and pneumonia. Doses of 500-1000 mg daily are normally sufficient.

Treatments that work

My main treatment for viral URTI uses two products – at this time I’m not going into why the constituents of these two products work as antivirals.

1. Viracon, made by Vital Nutrients. Two capsules contain:

Sambucus nigra (Elderberry Fruit Extract 50:1) – 125mg

Scutellaria baicalensis 8:1 – 125mg

Propolis 70% – 100mg

Astragalus Root Extract 15:1 – 100mg

Isatis Root extract 15:1 – 100mg

Coptis chinensis Extract 10:1 – 50mg

Hypericum perf. Extract 0.3% – 50mg

Glycyrrhiza glabra (Licorice Root Extract) – 50mg

Zinc (citrate) – 5mg

2. Acute Immune, made by Mountain Peak Nutritionals: 2 capsules contain:
Vitamin A (as Palmitate) 10,000 IU
Vitamin C (as Poly C Ascorbate) 250 mg
Vitamin B6 (as Pyridoxyl-5-Phosphate) 25 mg
Magnesium (as Glycinate) 25 mg
Zinc (as Methionate) 10 mg
Echinacea Purpurea Extract (4% Phenolics) 350 mg
Olive Leaf Extract (18% Oleuropein) 350 mg
Mushroom Blend (Organic) 200 mg
Cordyceps Sinenis (Caterpillar)
Corilolus Versicolor (Turkey-Tail)
Grifola Frondosa (Maitake)
Letinula Edodes (Shiitake)
Schizophyllum Commune (Split Gill)
Tramella Fuciformis (White Wood-Ear)
DMG (as Dimethylglycine) 100 mg
Garlic Extract (10 % Allicin) 75 mg
Ginger Root Extract (5% Gingerol) 50 mg
Grapefruit Seed Extract (20:1) 50 mg
Beta 1,3 Glucan (60%) 50 mg
Oregano Extract (4:1) 50 mg
Quercetin 50 mg
Cayenne (as Capsicum) (90 HU/gm) 20 mg

I have people start these two products simultaneously at the onset of symptoms; if they feel any symptoms, even if they are not sure, they should start taking the two products in the doses I recommend. In the great majority of cases, over 90% in my experience, the URTI will be limited to about 24-48 hours duration and the symptoms will be mild. In cases where it does not prevent the development of the illness, the products will still improve the course and speed recovery.

Another good product is made by Barlow Herbal Specialties, LDM-100, an extract of Lomatium dissectum is a very effective antiviral. Use of extracts containing the resin (and possibly the coumarins) of Lomatium can, in some people, cause a whole-body rash. The safety of lomatium during pregnancy and lactation is unknown and is therefore not recommended.

I will often have people try 2-3 homeopathic remedies as well; if the remedy is going to work for a person they may experience the elimination of symptoms within 15 minutes of taking the correct one. The remedies are Eupatorium perfolitatum, Gelsemium or Oscillococcinum. These homeopathic medicines may be taken at first onset of symptoms and may be repeated up to 5 doses. The remedy that works for me personally is Eupatorium; I can awaken at night feverish and with aches and a sore throat, and a single dose can alleviate all my symptoms within about 15-30 minutes. Experiment with the common flu remedies and find the one that works for you, it is definitely worthwhile. You can check out the information for common flu/cold remedies here: http://www.holisticonline.com/remedies/flu/flu_homeopathy.htm

What if I have a URTI and need to shorten its course?

Many of us find that we have a business trip coming up in a few days and we are laid low with a miserable URTI. How can we shorten the course enough to feel better and undertake air travel safely?* Start taking Viracon and Acute Immune immediately. Then find a doctor who has expertise in intravenous (IV) nutrient therapy who can safely administer IV vitamin C such as myself. If you do not know doctors in your geographical area who offer IV nutrient treatments, your first best search tool is to go to http://www.acamnet.org/ and locate an ACAM physician by entering your Zip code. For the treatment of acute viral illness, IV vitamin C is one of the most effective nutrients/drugs available. After treating many patients with acute viral disease, I find that 2-6 treatments will resolve the illness. There are some genetic issues that need to be addressed before a person can receive IV vitamin C in doses greater than 10-15 grams; the most important of these is G6PD deficiency, but there is also risk in people with hemoglobin S disease. A blood test for G6PD levels needs to be completed prior to administering high dose vitamin C, since people with G6PD deficiency will most likely suffer red blood cell hemolysis, which can result in death. People who have normal G6PD levels, and those who do not have hemoglobin S disease, tolerate high dose (up to 100 grams) IV vitamin C well. To reiterate, make sure your doctor is experienced in high dose IV vitamin C treatments.

*It is not advised to travel by air when you have serious sinus and eustation tube blockage secondary to heavy mucus production caused by a URTI.

Cytokine storms

Not many people have heard about cytokine storms, but many have heard about the deaths caused by the bird flu (H5N1 virus) or swine flu (H1N1 virus). It is not uncommon for the elderly to develop pneumonia after a lingering flu-like illness, but it is much less common for younger people to die from the effects of influenza. A cytokine storm occurs when the body’s immune system overreacts to an intruder, such as a virus, by producing high levels of cytokines, which are signaling chemicals that help mobilize immune cells responsible for removing infectious agents from the body. When too many cytokines are produced, they may stimulate an inflammatory response in which the accumulation of immune cells and fluid at the site of infection may prevent affected tissues and organs such as the lungs from functioning properly (acute respiratory distress syndrome, ARDS) which can lead to death. Cytokine storms associated with ARDS have been treated by forcing progression of the inflammatory process into its recovery phase with anti-inflammatory treatments.

Perhaps the most effective treatment for cytokine storm is not a drug, it is IV vitamin C. There was a widely reported case from New Zealand in 2009, where a farmer contracted influenza and developed a cytokine storm. He was hospitalized, put on life support after his lungs stopped functioning, and was dying. His family obtained a court order that demanded the hospital administer IV vitamin C. He recovered, but only over the protest of the doctors who were forced to give the treatment. Sufficient doses need to be used for sufficient time in order for vitamin C to be effective.

Vitamin D also helps modulate the effects of cytokine storms, as do curcumin and fish oil; their effect is not near as strong as IV vitamin C.

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Making healthier food choices

Posted on November 10, 2010 by Dr Carter

There is one major action that people can take that will improve their health more than any other, but the majority either don’t know about it or choose to ignore it. I’m referring to people who have a choice, which most people in the more developed countries do. I am not referring to people living in impoverished areas or war zones, where food may be difficult to obtain and where even basic public health measures such as adequate housing, pure water and human waste disposal are absent.

This major action for better health is nothing other than food choices; it seems that most people, and that includes their physicians, do not know what constitutes a healthy diet. If you eat according to the dietary guidelines that have been espoused for the last 50 years by the USDA (United States Department of Agriculture) you will develop the diseases most common to American citizens, namely obesity, diabetes, heart disease, high blood pressure and you will be at higher risk for cancer and Alzheimer’s disease. Because of USDA guidelines and the well-known food pyramid, any mainstream source you access will give you the same basic dietary misinformation.  You can get all of the official viewpoints on what makes a healthy diet here: http://www.cnpp.usda.gov/dietaryguidelines.htm. If you read this over and get a feel for what they are saying, you can repeat your experience by going to any well known conventional health information site online: http://www.mayoclinic.com/health/nutrition-and-healthy-eating/MY00431 and http://www.webmd.com/diet/default.htm.

One of my main goals is educating people about healthy eating; there is a lot of well-meaning but misguided information promoted by both the U.S. government and the predominant medical system. Some of this is due to misinterpreted (or poor) nutritional studies and the remainder is due to conflicts of interest between industrial food producers and policy makers.

Here is the new USDA “MyPyramid.” I guess making it more personalized makes it better? It is really just the old pyramid tipped on its side with the hominid figure climbing the steps representing exercise.

Note that the biggest (orange) slice is still grains (carbohydrates). The large (green) vegetable slice is fine, fruits (red) are OK, recommended oils (yellow) are unhealthy for the most part, lots of dairy (blue) which may not be advisable for many people due to allergy issues, and finally a little protein (purple) under the heading of Meat & Beans. You can go http://www.mypyramid.gov/ and get more information. Just looking at the image gives you no usable guidelines.

Faculty members at the Harvard School of Public Health built what they call the Healthy Eating Pyramid.

Their quote: “It resembles the USDA’s in shape only. The Healthy Eating Pyramid takes into consideration, and puts into perspective, the wealth of research conducted during the last 15 years that has reshaped the definition of healthy eating. The Healthy Eating Pyramid sits on a foundation of daily exercise and weight control.” http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html.  Follow this link to see why they feel this pyramid is healthy; I’m not going to copy their information here.  It still has major problems, just not as blaring as the USDA version

The base of their pyramid is good, because exercise, weight control and not eating to excess are major contributions to better health. The second layer has fruits and vegetables; vegetables should be emphasized over fruits. Vegetables are plants that grow above ground such as broccoli, cauliflower, cabbage, leafy greens like chard and spinach. Tubers grow below ground and contain more starch; we’ll discuss them a little later.

Next are oils and despite this being Harvard, they don’t get it right. They recommend most of the oils that should be on your avoid whenever possible list, including Canola, soy, corn, sunflower, peanut, and other seed or legume oils. These oils are recommended because they are not associated with increases of blood cholesterol, but they contribute to poor health in other ways because of their high omega-6 fatty acid content and because they oxidize (become rancid) very easily, especially when heated. Chemically they are known as polyunsaturated fats, because they contain multiple highly reactive double bonds between carbon atoms. Omega-6 oils when consumed in excess, lead to more inflammation in the body and increased oxidative damage of blood vessels.  They do mention nuts, seeds, avocadoes, and fatty fish such as salmon that do contain healthy fats.

Whole grains, or refined grain products, are a mainstay of the American diet. Harvard suggests that “the best sources of carbohydrates are whole grains such as oatmeal, whole wheat bread, and brown rice. They deliver the outer (bran) and inner (germ) layers along with energy-rich starch.” The common belief that whole grains are a healthy food source is widely accepted, unfortunately it is not correct. Whole grains, especially the gluten containing grains of which wheat is king, contain anti-nutrients, proteins that cause bowel inflammation and immune reactions, and lectins that contribute to adverse immune responses. The safest grain is white rice. Other sources of carbohydrate that have much lower amounts of plant toxins include sweet potatoes, yams, cassava root (from which tapioca is made) and the common potato (potato toxins known as glycoalkaloids are reduced by cooking at temperatures at or above 170 degrees C is effective at lowering levels.) Potato glycoalkaloids appear to be concentrated in a small 1.5-mm layer immediately under the skin, so pealing potatoes or baking them and not consuming the skin eliminates most toxin exposure.

Nuts, seeds, beans and tofu are on the next higher level of the Harvard pyramid. Good quality nuts and seeds eaten as snacks, not as a food staple, are an acceptable source of protein, carbohydrate and fat. Some of the nuts and seeds are high in omega-6 oils, but keeping the intake low helps. Beans are in the legume family, and they contain similar anti-nutrients and lectins to the grains, although in lesser amounts. Tofu is made from soy beans, a legume that is the most genetically modified plant in America. Soy contains anti-nutrients that interfere with mineral absorption, it interferes with thyroid hormone function, it is a major food allergen, and impairs brain function in older men.

Fish, poultry and eggs are on the same level as the nuts, and I agree with most of their recommendations. Their limit of 3 eggs weekly is based on the cholesterol content of egg yolks, but the contribution of dietary cholesterol to blood levels of cholesterol is minor. Egg yolks also contain lecithin, a major component of healthy cell membranes in the body. I don’t place a limit on eggs unless a person is eating them as their predominant source of food (please note: this is a tongue-in-cheek comment, I have not met anyone yet who eats this way).

Dairy (1-2 servings per day) or vitamin D/calcium supplements; I would tend to go with the vitamin D plus supplemental calcium. A lot of commercial dairy contains antibiotics and hormones at levels high enough to effect human health and the vitamin D level is insufficient for optimal health. Most fortified dairy will contain vitamin D2, a cheap plant derived form of vitamin D. The preferred form is vitamin D3 and a dose sufficient to meet all the vitamin D needs of the body is in the range of 4000 IU daily for adults. Calcium needs are better met by foods rather than supplements. Here is a list of calcium rich foods; for dairy just make sure it is organic

Turnip greens, mustard greens, collard greens, Swiss chard, full fat yogurt, kale, mozzarella cheese, aged raw milk cheddar cheese, milk (goat’s milk and cow’s milk, if you are not sensitive or allergic). Basil, thyme, dill seed, cinnamon, and peppermint leaves. Romaine lettuce rhubarb, broccoli, sesame seeds, fennel, cabbage, summer squash, green beans, garlic, brussel spouts, oranges, asparagus.

Red meat and butter are at the top of the pyramid because they contain cholesterol. The cholesterol hypothesis has never proven to be a reliable indicator of who is going to have a heart attack or stroke, but it is still accepted as gospel truth by medical authorities.  If you want a clear story of how the cholesterol hypothesis came to be accepted as fact, read Good Calories, Bad Calories by Gary Taubes; highly recommended. Red meat is only a problem for those with genetic hemochromatosis, an inherited disorder of iron metabolism. Red meat, sourced from ruminant animals, is a healthy protein and is low in omega-6 fats when the animals are grass-fed. Butter contains healthy fats and is useful as a flavoring agent in cooked foods.

I’ll be talking more about healthy sources of macronutrients (protein, fat, carbohydrate) both here and at http://blog.bznwtmgt.com/.

Here is an example of what I consider a healthy meal.

The protein is chicken that has been cooked in a crock pot, and the leftovers were used as a quick meal by sautéing them in coconut oil. The steamed broccoli and carrots were flavored with butter and lemon juice. Moderate protein, high fat, restricted carbohydrate.

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