Tag Archives: sugar

DIET- NUTRITIONAL – RISKS AND BENEFITS FOR INFECTION, CANCER, VASCULAR, SKELETAL, MOOD & ALL ELSE::

neil.burman@gmail.com

20 July 2014 HIGH CARBS OR LOW CARBS?  THE BIG FAT SURPRISE  – which is best for weight loss?  a collaborative literature metanalysis study  July 2014 by Naude ea the universities of Stellenbosch, Cape Town and Liverpool (UK)  claimed to compare the effects of low CHO and isoenergetic balanced weight loss diets in overweight and obese adults,  stratified by outcomes at 3-6 months and 1-2 years.  Of nineteen trials  (n = 3209), 3 had adequate allocation concealment. In non-diabetic participants, analysis showed little or no difference in mean weight loss in the two groups at 3-6 months (MD 0.74 kg) or  for blood pressure, LDL, HDL and total cholesterol, triglycerides and fasting blood glucose. In diabetic participants, findings showed a similar pattern.  CONCLUSIONS: Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.

‘But  Noakes points outLow-fat, high-carb, high-sugar diet a likely cause of obesity/diabetes  “I refer to the report in the Cape Times of July 10,  “Noakes’s popular low-carb diet is not healthier, better for weight loss – study “. Since the authors of that study (Naude ea) do not understand either what constitutes a low-carbohydrate diet or the unique biological effects of such diets, they were predisposed to produce a biased report that comes to exactly the wrong conclusion.

‘First, the conclusion of their study was predictable since the authors chose to review only studies in which subjects ate the same number of calories on both diets. It is not clear how the authors conceived that diets that provided exactly the same number of calories would produce different outcomes. Indeed, a core teaching of these nutritional scientists is that the degree of weight loss is determined by the reduction in calorie consumption. Thus the authors knew the outcome of their study even before they undertook it. This is not good science.

‘Second, the studies included in their meta-analysis are not of the low-carbohydrate diet described by either Dr Robert Atkins or ourselves in Real Meal Revolution. Dr Atkins realised in the 1970s that the majority of overweight/obese persons can only reduce their weights successfully, and keep that weight off in the long term, if they eat less than 60g carbohydrate/day for the rest of their lives. Higher intakes are increasingly less effective. In Real Meal Revolution we stress that those with insulin resistance/ type 2 diabetes need to keep their carbohydrate intakes even lower, ideally to about 25g/day. The  “low-carbohydrate ” diets included in the meta-analysis provided a minimum of 200g carbohydrate/day (or 4-8 times higher than the carbohydrate content that is known to be effective). As a result this is a meta-analysis of studies providing a high, not a low-carbohydrate load for those with obesity/insulin resistance/type 2 diabetes.

‘Third, the extent of weight loss in the studies included in he meta-analysis is small, the greatest values being about 10kg. For most people with significant weight problems, such small weight losses are probably relatively meaningless and should be classified a diet failure, not a success. But freeliving persons who follow individually prescribed carbohydrate diets providing about 25g carbohydrate/day report quite remarkable degrees of weight loss, not infrequently up to 40-80kg, usually achieved effortlessly if the low-carbohydrate rules are followed.

‘Fourth, the unique biological effects of the properly-defined low-carbohydrate is that (i) It reduces hunger, allowing subjects to eat fewer calories without experiencing continual hunger. The point, as stressed by Dr Atkins, is that the low-carbohydrate diet is a low-calorie, no-hunger diet. (ii) The diet lowers blood insulin concentrations. In those with obesity/insulin resistance/metabolic syndrome, it is continually elevated blood insulin concentrations that cause ill-health (as clearly established by the work of Dr Gerald Reaven of Stanford University over the past 50 years).

‘The authors  found that health benefits were no different on either diet.    A number of properly designed, peer-reviewed meta-analyses of the real low-carbohydrate diets show that weight loss and health benefits are superior compared with higher-carbohydrate diets. Unfortunately, the authors appear to be ignorant of those studies since neither they nor your reporter refers to them. This implies the presence of bias, questioning the true intent of the report.

‘The report also includes the statement of the Heart Foundation of South Africa (HFSA) to the effect that a diet high in saturated fat causes heart disease. Unfortunately, the HFSA spokesperson appears unaware of Nina Teicholz’s recentbook, The Big Fat Surprise: Why Butter, Meat, Cheese Belong in Healthy Diet, and the  June 23 Time Magazine  Ending the War on Fat, which show that this dogma is false and is not based on any credible science.     It is  time  the HFSA updated its understanding of what actually causes heart disease. They might also want to consider whether their promotion of their unproven low-fat, high-carbohydrate, high sugar diet for the past 37 years is the most likely direct cause of the obesity/diabetes epidemic that has since engulfed South Africans.

‘Indeed on a practical side, I wonder if the authors have ever considered studying the dietary intakes of the obese diabetic patients they treat at Tygerberg and Groote Schuur hospitals. Do patients with these diseases eat either high- or low-carbohydrate diets? Why is is that these twin diseases, which are crippling the health services of the Western Cape, began to increase exponentially only after the 1977 Dietary Guidelines that institutionalised the low-fat, high-carbohydrate diets? Surely these are the critical questions that should really be exercising the minds of the Western Cape’s nutritional scientists? The best conclusion that can be drawn from this study is that diets providing more than 10 percent of daily calories in the form of carbohydrate are equally ineffective in producing meaningful degrees of weight loss in those with obesity/insulin resistance/type 2 diabetes.”

15 June 2014    DIET RISKS FOR BREAST CANCER, INFECTION & ALL ELSE:   Sugar? Fats? Vitamins?

already 30 years ago Seely and Horrobin in ‘Diet and breast cancer: possible connection with sugar consumption’ hypothesized: younger and older  (possibly pre- and post-menopausal )women differ with respect to such correlations. In older women a strong correlation was found between breast cancer mortality and sugar consumption (correlation coefficient = 0.9).. In younger women the correlation with diet is weak. A possible connecting link between sugar consumption and breast cancer is insulin. This is an absolute requirement for the proliferation of normal mammary tissue and experimental mammary tumours may regress in its absence. Insulin secretion occurs in response to blood glucose level and could be excessive if the regulatory mechanism is overtaxed by large sugar intake. The same mechanism might account for the increased risk of mammary cancer in diabetics.
  A  major decades-long Nurses’ Health  Study  review from Harvard shows no relationship between fat intake and breast cancer.
By contrast, studies from  Mexican  2004,  Canada 2005, Italy 2006 , and New York  2009 confirm direct association between sugar intake and breast cancer. . Only a study from Denmark 2005  shows no relationship.
Hence the HighFat LowCarbs (William Banting 1863) diet is now established by the rigorous scientific references of the past 150 years  assembled by science writer Gary Taubes in The Diet Delusion ,  and advised to all  for prevention and management of obesity and all other common major diseases including breast and all cancers.
      As investigative journalists write recently, like Taubes and rational scientists the past 50years,  the major cause of all common chronic degenerative disease including cancer and immunoincompetence is not fat but refined carbs – the root cause of the SACCHARINE DISEASES  that Cleave, Campbell, Burkitt reported occurring in pastoral tribes converting to the western commercialized diet of sugar, refined cereals and rice .                   They note that in the Mouse Cancer Study in cancer-prone mice,

Gemma Llaverias ea, Jefferson University, Philadelphia   2011,  which claimed that high (fat)cholesterol intake promotes breast cancer, the control mice  (not major carnivores but omnivores) were fed a balanced natural chow with 4.5% fat, 23% protein, and 50% carbohydrate, whereas the test mice were fed a totally synthetic chow meant to represent a western human  cholesterolemic  diet: 20% fat, 17% protein, and 48% carbohydrate. So in fact the high risk factor for cancer and all disease was not the higher fat intake (20%  as dairy fat) vs 4.5%- from fish meal and soy/cereals) but the 48% carbs (2/3  sucrose, 15% (malto)dextrins -which absorb as rapidly as glucose) intake and 19% casein (a major health problem)   in the test chow. They failed to include a control group on what is natural mouse diet ie free of refined carbs and milk :  RSPCA 2014:   Wild mice – opportunistic omnivores- will eat a wide variety of seeds, grains, and other plant material as well as invertebrates, small vertebrates and carrion“. Thus plenty of natural seed/grain fats and mixed protein and plant carbs,  zero sugar or refined carbs- ie the Banting diet. ..
A new 18year observational  followup  study from Sweden last year in 62000 people assessed total energy intake – carbohydrate  from median 61 to 39% , protein 11 to 19% , and  fat 27 to 42% . LCHP scores were positively related to intake of animal protein, but negatively related to plant protein. For carbohydrate and fat, associations were consistent in sucrose and whole grain and saturated and unsaturated fat, respectively. Across the range of macronutrients, there was no clear significant trend for particular cancers. This is not surprising as the intake of carbs ranged from 40 to 60% and fat from 27 to 42%. Thus no cohort was on a highfat low carbs ketogenic diet as Banting, Noakes  et al find successful. . the lowest % carbs group at best had similar fat % intake ie there was no low-carbs cohort taking below 30% carbs..There is a vast difference in calorie intake  between their “optimal’  LCHP 42:40 fat:carbs ie 1:1  , versus the  true ketogenic HifatLowcarbs diet of eg 50:<30 fat:carbs ie >1.66:1.
       Allowing up to 20% protein in total energy intake, for real weight loss- especially with insulin resistance- diet  fat needs to  be  >50% energy and carbs <30%, thus ensuring ketogenesis to shed excess fat and avoid depositing more glycogen and adiposity ; so eg for a tall fat person, thats  up to 80gms protein 320kcal mostly from flesh; carbs below 50gms 200kcal (  rainbow vegs) , and fat ~1480 kcal ie ~160gms from cream (not milk),   eggs, butter, cheese, avo, and fatty flesh; and mixed nuts cautiously due to their ~20% carbs content. .

It is no wonder the public is confused.

The truth of more than four decades worth of research is now very clear: the potential benefit of mammography screening is small and the harms are substantial at all ages, but especially so for women in their 40s.

The bottom line is that mammography screening, implemented to reduce breast cancer deaths due to earlier detection of breast cancer, has been eclipsed by therapy and increased awareness.

– See more at: http://umanitoba.ca/outreach/evidencenetwork/archives/4490#sthash.rf9YcMYp.dpuf

It is no wonder the public is confused.

The truth of more than four decades worth of research is now very clear: the potential benefit of mammography screening is small and the harms are substantial at all ages, but especially so for women in their 40s.

The bottom line is that mammography screening, implemented to reduce breast cancer deaths due to earlier detection of breast cancer, has been eclipsed by therapy and increased awareness.

– See more at: http://umanitoba.ca/outreach/evidencenetwork/archives/4490#sthash.rf9YcMYp.dp

VITAMIN INTAKE, INFECTION, BREAST CANCER:

VITAMIN C  each 100mg/day increment reduces allcause mortality by 27%, and breast cancer mortality by 22%:   a metaanalysis by the Karolinska- Harris ea   last month found 10 trials of vitamin C use and intake  in breast cancer, included 17,696 breast cancer cases, 2791 total deaths, and 1558 breast cancer-specific deaths. The summary RR (95% CI) for post-diagnosis vitamin C supplement use was 0.81 (95% CI 0.72-0.91) for total mortality and 0.85 (95% CI 0.74-0.99) for breast cancer-specific mortality. The summary RR for a 100mg per day increase in dietary vitamin C intake was 0.73 (95% CI 0.59-0.89) for total mortality and 0.78 (95% CI 0.64-0.94) for breast cancer-specific mortality- ie 25% lower mortality for every 100mg higher daily vit C intake..

Johnston CS1,ea., Arizona State University.            The early indications of vitamin C deficiency are unremarkable (fatigue, malaise, depression) and may manifest as a reduced desire to be physically active; moreover, hypovitaminosis C may be associated with increased cold duration and severity.. Healthy non-smoking adult men (18-35 years; BMI < 34 kg/m2; plasma vitamin C < 45 µmol/L) received either 1000 mg of vitamin C daily (n = 15) or placebo (n = 13) in a randomized, double-blind, eight-week trial. In the final two weeks of the trial, the physical activity score rose modestly for the vitamin C group vs. placebo after adjusting for baseline values: +39.6% p = 0.10). The number of participants reporting cold episodes was 7 and 11 for the vitamin C and placebo groups respectively during the eight-week trial (RR = 0.55;  p = 0.04) and cold duration was reduced 59% in the vitamin C versus placebo groups (-3.2 days; 95% CI [-7.0,0.6]; p = 0.06). These data suggest measurable health advantages associated with vitamin C supplementation in a population with adequate-to-low vitamin C status.

A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability.         

Br J Community Nurs. 2013 Suppl:S6, S8-11.Vitamin C: a wound healing perspective.   Moores JVitamin C, also known as ascorbic acid (AA), is involved in all phases of wound healing. In the inflammatory phase it is required for neutrophil apoptosis and clearance. During the proliferative phase, AA contributes towards synthesis, maturation, secretion and degradation of collagen. Deficiencies affect the maturation phase by altering collagen production and scar formation. The body strives to maintain homeostasis of AA, thereby ensuring availability for collagen synthesis. After wounding, plasma and tissue levels of AA diminish and, as a consequence, supplements may be useful for healing, although levels beyond saturation are excreted. Clinicians need to be aware of both the nutritional status of patients with either acute or chronic wounds and the possibility of any AA deficiency which may hinder healing.
Nat Commun. 2013;4:1881. Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reactionVilchèze C1,ea .Einstein College New York.  Drugs that kill tuberculosis more quickly could shorten chemotherapy significantly.  we show that vitamin C, a compound known to drive the Fenton reaction, sterilizes cultures of drug-susceptible and drug-resistant Mycobacterium tuberculosis, the causative agent of tuberculosis. While M. tuberculosis is highly susceptible to killing by vitamin C, other Gram-positive and Gram-negative pathogens are not. The bactericidal activity of vitamin C against M. tuberculosis is dependent on high ferrous ion levels and reactive oxygen species production, and causes a pleiotropic effect affecting several biological processes. This study enlightens the possible benefits of adding vitamin C to an anti-tuberculosis regimen and suggests that the development of drugs that generate high oxidative burst could be of great use in tuberculosis treatment.
VITAMIN D AND BREAST CANCER:
20 years  ago Newmark from Sloan Kettering NY wrote :  High dietary fat increases mammary epithelial cell proliferation, particularly the “hormonally driven” hyperproliferation during breast growth and development in young animals. Increased dietary calcium (and probably vitamin D) lessens the increase of proliferation induced by high fat. These data, although limited, suggest that the maximum effect of diet (high fat increase, as well as calcium and vitamin D modulation) on eventual breast cancer may be during puberty, and adolescence, when the mammary gland is actively growing and developing. (3) An inverse epidemiological correlation exists between sunlight availability as a source of vitamin D and the risk of breast cancer in the U.S. and Canada. (4) Current vitamin D and calcium dietary intake in the U.S. is far below the RDA in all female age groups, particularly for the elderly. (5) Reduction of breast cancer risk, and simultaneously osteoporosis, might be achieved by increasing dietary intake of calcium and vitamin D to RDA levels. This may be particularly applicable to females during puberty and adolescence.
                    20 years later we now still find:                 Vitamin D and Cancer: The promise not yet fulfilled(California) ; and is there a link (France)?

BUT The Vitamin D Council    sums up the study evidence eg in a major Brit J Cancer metaanalysis last month of 30 prospective studies in 32000 BRCA  patients, and a Chinese study a year ago,   show  that  those with highest  vitamin D levels have 50-90% lower risk of  breast cancer risk, and mortality, and the chance of breast cancer spreading.  so far all they can recommend is that  vitamin D dose should for a robust adult not exceed  10 000 iu/day, or pro rata at longer intervals eg 150 000iu a fortnight.  Compared to those with the lowest quartile of plasma 25(OH)D level, women with highest quartile 25(OH)D level showed a significant decreased breast cancer risk (Q4 vs.Q1: OR = 0.10, 95% CI = 0.06–0.15) and every 1 ng/ml increment of plasma 25(OH)D level led to a 16% lower odds of breast cancer.

         It is likely that- given the limits on vitamin C intake due to diarrhoea, and cost, and bloating-  increments in vit D3 intake well above the current mediocre antirachitic 400iu/d norm- up to the generally well-tolerated 10 000iu/day, (after a loading dose of 200 000 to 600 000iu).  with supplement of vitamin K2-  will give even better benefit against breast cancer than vitamin C.     

 

IT IS COMMON CAUSE THAT ONE DOESNT, CANNOT   PREVENT OR TREAT INFECTION BY POOR NUTRITION OR LOWDOSE ANTI- MICROBIALS- such policy is futile if not dangerous for breeding resistance as well as disease extension.   The studies below confirm the obvious, (as Klenner, Pauling,  Cameron ea showed the past 50 years with highdose vit C injection), that  vitamin D3 orally also works as a multiantimicrobial agent if given as early as possible in safe very high dose and bloodlevel eg 600 000iu monthly (in the first month, – in Salhuddin’s  Pakistan PTB patients (presumably also Sunni muslim) initially mean wt 45kg, thats vit D3 ~440iu/kg/d) for two doses ie a mean of 300iu/kg/day over 90days;   not the current preventative recommendation of 80iu/kg /day to a safe blood level of around 50-60ng/ml. As Holick has said, with adequate water intake  even 50 000iu vit D3 a day ie 1.5million iu/month for months causes no toxicity. Given the 40% mortality rate in the frail Saudi MERS patients, and in acute severe influenza and other serious viral infections, it can be expected that such  highdose immediate vitamin D3 therapy orally with eg 600 000iu, combined with highdose vitamin C, zinc and some multivite,  (never mind appropriate antibiotics in acute bacterial infection) will similarly virtually eliminate mortality.

 

But no KSA Govt website mentions this- except the Saudi Gazette a year ago which strongly urged vitamin D supplement in the KSA as even daily sun exposure does not bring most Saudi women above the vitamin D deficiency threshold. It says Since Muslim women can only reveal the hands and face, they may need to be out in the sun for longer than 30 minutes. But the review conspicuously  fails to mention that in public outdoors in KSA, women must have even the head and face covered. It also  propagates surprising  dangerous  nonsense that “severe deficiency needs monthly vitamin D injectionMom, have you taken your vitamin D injection this month?, when all it requires is an oral daily, weekly  or fortnightly  dose vitamin D3  at trivial cost.” It does stress  “One of the main reasons why vitamin D deficiency is so common in the Kingdom is because there are very few food sources of vitamin D. Foods which have fairly good amounts of vitamin D are fish liver oil, sweet potatoes, egg yolks, vegetable oils, butter, and fatty fish such as salmon, sardines, and tuna,” said Dr. Rasha Jameel, a consultant in family medicine at a local hospitalIn the United States, all milk and dairy products are fortified with vitamins A and D, but no such measures are in place in the Kingdom“.

 

This correlates with a new metaanalysis (in the  BMJ this month) of observational studies from Europe and USA, that all-mortality hazard ratio over a mean of 10 years  increases by 57% as vit D level falls from the highest to the lowest level. The KSA apparently chooses to ignore that, as this column reported recently from WHO data, despite  apparently being the wealthiest country per capita  of bigger populations  in the world,  KSA’s population life expectation is about 5 years lower than eg far less sunny Britain’s; ie KSA  all-cause mortality rate is avoidably materially higher. Despite KSA medical professors  having reported in studies  that most of the KSA population is deficient in vits D and C, the  KSA Govt website  chooses to ignore this on official websites;  unlike other even Middle-Eastern governments promoting vit D fortification or meaningful safe supplements costing trivial amounts.

 

Even a new study last year from KSA universities confirmed that ” Most commonly consumed food products by Saudi population which are supposed to be fortified by vitamin D are either not fortified or contain an amount less than  (apparently  from their table 2 ~ half of)  recommended by guidelines set for US marketplace”. Even a UAE authority recently stressed “Can fortified milk fight Vitamin D deficiency? Shockingly low levels of D3 among UAE population cannot be rectified by milk alone.” As Holick ea, including  a Turkish University 2010  trial report,  oral vitamin D3 is far more  effective , and safer than,   either vitamin D2, or vitamin D injection -never mind much cheaper. This current ostrich-head-in-the-sand denialism by the KSA government is like that of the RSA govt under Presidents Mbeki and Zuma 10-15 years ago about preventing and treating HIV-AIDS  – considering that the safe and beneficial daily intake of vitamin D3 is now universally recognized as 4000 if not 10 000iu/day (ie about 80iu/kg/day or pro rata up to perhaps fortnightly) , to a mean blood vit D  level of about 60 to 80ng/ml. .

As Prof Mike Holick pointed out a few years ago, “Even in Saudi Arabia, Qatar and South Africa, more than 50% of the population is deficient in vitamin D, all because of their avoidance of sun. Based on some of the literature, it seems that we could probably decrease health care costs across the board by 25% if everybody had optimal vitamin D status.” As Al Faraj ea reported in Riyadh in 2003,   Prof Zahid Naeem from a KSA university wrote in 2010,Vitamin D deficiency is an ignored epidemic in KSA  and globally“; confirmed by a KSA study by Ali ea in 2012: “Even in a sunny country like Saudi Arabia the prevalence of vitamin D deficiency in young female is high“..  One does not need to  speculate why the KSA and all governments globally choose to ignore this inconvenient truth,  downplay effective vigorous  vitamin C and D3 (sunshine) supplements-  such widespread vitamin D and C deficiencies, like cigarette smoking and alcohol abuse,   suit governments and Big Pharma-  the Disease Industry- in reducing populations growths and creating jobs for the highly profitable Disease Industry and it’s shareholders-   for whom Only Disease Pays. Cheap safe natural  Prevention Does not Pay since it at least halves sickness never mind disease industry jobs, taxes  and profiteering in the global $multitrillion Disease and Diet and Vaccine and Invasive Screening Industry scams.

 

And Karen Hansen ea at Univ Wisconsin 2014 have  just shown  that  giving vitamin D2  (not D3)  50 000iu fortnightly for a year is actually adverse – as Holick and others have  show – IT DEPRESSES – perhaps halves – THE BIOLOGICALLY ACTIVE blood 25OHVIT D3 while boosting perhaps 5 fold the far less active blood 25OHvit D2 levels , and actually worsens  rheumatoid arthritis clinically and serologically . One can speculate whether vit D2 actually blocks optimal function of VDRs vitamin D receptors. Trials published 2012 from Japan and Netherlands showed that vitamin D3 – blood 1,25(OH)2D3 (but not TNFalpha blockers) blocked  inflammation (ie TNF tumour necrosis factor alpha activation of vascular calcification).                                                 

Salahudfin ea’s new randomized controlled trial  from Pakistan Vitamin D3 injection accelerates clinical recovery from tuberculosis  shows “impressive clinical (weight gain, chest xray and sputum clearing)  improvement  over 3 months on outpatient TB therapy (Directly Observed Therapy (DOTS) with 2 months of 4 antituberculous drugs [Isoniazid, Rifampicin, Ethambutol and Pyrazinamide] followed by 6 months Isoniazid and Ethambutol)  with two doses 600 000iu vit D3 imi  (vs placebo inj)  a month apart-  ie equivalent to about 7 000iu/day over the 3 months treatment period . This dose  of vitamin D is as recommended for vitamin D supplement by the Pakistan Endocrine Society.  Trough  25OH vit D levels increased from about 20 to 90ng/ml.    After 12 weeks, the vitamin D supplemented pts (mean 28 yrs, BMI 17.2kg, 85% moderate to far advanced lung disease)  had  significantly greater mean weight gain (kg) + 3.75, (3.16 – 4.34) versus + 2.61, p 0.009; lesser residual disease by chest xxray-  30% fewer zones involved 1.35 v/s 1.82 p 0.004,   and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ vitamin D serum levels (p 0.021). Patients in the vitamin D arm and serum < 30 ng/mL (‘Insufficient’ and ‘Deficient’ groups) at enrollment had significantly greater improvements in TB severity scores compared to patients with normal baseline vitamin D levels; p 0.014. This corresponds with the earliest reports of the benefits of vitamin D in TB patients published in 1848 [21] that describes disease arrest, weight gain and reduction in mortality in patients with TB treated with cod liver oil compared to standard therapy alone. More recently, Martineau et al  [7]  demonstrated that a single oral dose of 2.5 mg (100,000 IU) of vit D2 significantly reduced growth of mycobacteria . A randomized, placebo controlled study on 67 Indonesian patients, by Nursyam et al , Jakarta  [22] reported that pulmonary TB patients given 420,000 IU of vitamin D over 6 weeks  ie 10 000iu/day had significantly higher sputum conversion rates as compared to placebo (p 0.002). Martineau et al. [8] showed that 100,000 IUs of 25-hydroxyvitamin D3 supplementation significantly improved sputum conversion rates in patients with the Taq1 25-hydroxyvitamin D receptor polymorphism of the tt genotype.                                                                     .        

            As Salahuddin ea note, the good results in Pakistan in only 3 months with vigorous  INITIAL dose vit D3  contrasts with Two recently published large randomised, controlled trials of conservative vitamin D3 over months  that achieved far lower blood vitamin D levels found no difference in clinical outcomes or mortality after 400,000 IU of 25-hydroxyvitamin D3 or placebo were given by   Martineau ea  in London, UK to 146 pulmonary TB patients – where mean (trough  or midpoint)  vit D level  (after 100 000iu vitamin D(3) or placebo at baseline and 14, 28, and 42 days after starting standard tuberculosis treatment) – was surprisingly only  40ng/ml at 56days – ie after a mean of 7000iu/d by  56 days,  vs 10ng/ml  on placebo)- less than half of the bloodlevel  achieved on vit D3  in the Pakistan trial ;      

 

        and  by Wejse et al  2009  in  Guinea-Bissau to 365 TB patients  – who received  300,000 IUs of vit D3   ie only 100,000 IU or placebo at inclusion and again 5 and 8 months after the start of treatment,  ie below 1000iu vit D3 per day over the 12 month trial period “. The Guinea-Bisseau pts thus might have achieved a mean blood vit D level boost of only  10ng/ml.. and now Havers ea (Baltimore)   show Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure; Low 25(OH)D was associated with high body mass index (BMI), winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of human immunodeficiency virus (HIV) progression and death (adjusted hazard ratio (aHR) 2.13; 95% confidence interval [CI], 1.09–4.18) and virologic failure (aHR 2.42; 95% CI, 1.33–4.41). and Shepherd ea (Eurocoord) Low Vitamin D predicts short term mortality in HIV-positive persons Odds of death decreased by 46.0%( P = .04) for a 2-fold increase in latest 25(OH)D level.. In patients with current 25(OH)D <10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P = .04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P = .76)

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URGENT UPDATE: AMERICAN/MEXICAN SWINE FLU IN SOUTHERN AFRICA

URGENT WARNING:

The first 2 pneumonia deaths associated with swine flu have now been reported from South Africa. Until details  of their  illness and  pathology tests and  autopsies and treatment   are revealed, as usual we will never know what other underlying risk factors there were.

What can we do to protect ourselves?

New Vitamin D data fits with what we know about fighting infection  – that in both the malnourished ( Dar-es Salaam) and nourished  eg (Canada) AIDS+TB patients, boosting vit D3 , let alone vitamin C,  b-carotene,  zinc,  aloe,  sutherlandia, and  deficient iron, drastically reduced mortality.  eg Grant 2009- Vitamin D also reduces the production of proinflammatory cytokines ie the cytokine storm for which antioxidants – free radical scavengers– are recommended .

Since we queried 3 months ago why only Mexicans were dying then, many deaths linked to the new H1N1 American-Mexican swine flu  have occurred outside Mexico (although at a far lower rate than in central- the poor- Americas), mostly in the frail but undoubtedly also in the healthy wellnourished very young- in whom the problem seems to include cytokinin storm overwhelming the lungs with  hyperimmune response to a new virus.

Us oldies have both less immune response, and also tolerance from previous exposure. Perhaps (just as us oldies may have inherited some resistance- tolerance from our parents/ grandparents who survived the 1918 & mid-19th Century Russian H1N1 epidemics), our adult children have also inherited tolerance thrrough  us.
Whereas  those who are malnourished AND have AIDs/TB  may have too weak immune systems to respond fatally to this ‘new’ virus.
Dr Barry Shoub head of the National Institute of Communicable Diseases NICD at his UCT  lecture July 2009  agrees – its a relief to hear confirmed that while this virus has spread like wildfire here, there is no increased mortality being reported from the townships where AIDs and  multiple resistant  MRTB are the most rampant and fatal in the world. .   On the other hand, unfortunately cortisone treatment has also not been reported to help those with the apparent hyperimmune response to this new flu.

We mustn’t depend on, wait for rescue with  Tamiflu, Relenza ( resistance spreads rapidly, and adverse effects are serious),  or on a hasty  untested American Swine Flu vaccine – especially if it is laced with squalene let alone mercury or aluminium?.

We urgently need to boost both the frail, and the very young, with what we have: oral antioxidants: vitamin D between 5000-10000 iu/day or 50 000 iu/week; b-carotene about 10 000 iu/day;  zinc 30-60mg/day;    vitamin C+bioflavinoid 50/50(Enhanced Vitamin C) 1/2gm  to 5gm (a heaped teaspoon)  twice a day- increasing gradually over a week to tolerance ie  the dose that doesnt cause diarrhoea; vits E, lipoic acid;  and extra calcium carb 1/2gm twice a day also to minimize vit C diarrhoea;  Probiotics; Aloe; fish oil (eg cod liver oil) a tsp or 4gm a day); sutherlandia; and colloidal silver ACS nasal spray and orally; with a good nonspecific multinutrient. . .

And since this flu virus seems to kill the lungs if it does serious  harm, we need to boost lung defense specifically  with For-Lungspan- N-acetyl cysteine (an antioxidant) and guaifenesin each  a few hundred mg/day.

These all- natural nutritional supplements are  available over the counter – and the more malnourished the person, the less will already make a big difference to nutrition and resistance.

And obviously in the malnourished, or  frail, it is crucial to check hemoglobin and iron levels and reverse iron deficiency if present- deficiency can be assumed  in poor girls/women who are still menstruating, in those with chronic heartburn  let alone previous bowel bleeding or absorption problems, the pregnant, and in poor township kids who are likely riddled with parasites – if their hemoglobin is below ~12g, add iron for sure. .

And obviously general nutrition is crucial: with mass unemployment, and rampant endemic price fixing abuse of basic foodstuffs which business and politicians choose to ignore if not conspire in,  the poor may not be able to afford nourishing balanced diet. But many  do spend money on buying essential supplements – for which they need guidance as above..

And for solace the poor spend more on smoking and alcoholism –  the greatest killers of both users and those they encounter: it is incomprehensible that businesses  employ staff who destroy themselves and others by smoking or  alcohol  abuse, since these are choices. This despite the fact that in most countries suicide – especially assisted suicide- is illegal.

So is the use of sugar, which is one of the deadliest addictions (for promoting  decay, infection, glycation) – especially when it is so easily substituted by a safe alternative sweetener  like stevia or  saccharine-cyclamate, and when the food chain is now stuffed with high-calorie cornstarch.

All commercial sweetened  “cooldrinks” should be banned if they contain the adverse additive  problems of  caffeine  sugar   aspartamate  benzene and/or phosphoric acid.  Like its fermentation product  alcohol C2H5OH,  sugar C6H12O6  is a deadly intoxicant and corrosive oxidant, and should like alcohol be red-labeled  in cooldrinks for sale  solely to consenting adults, since these destabilize the brain (le alone immunity) just like alcohol does, by sending the blood sugar and then insulin soaring and plummeting wildly.  Compare the chemical effects of  about 12-24gm alcohol – 72-150kcalories (an average sugary  a”glass” or two  of beer  or  wine, a generous “tot” of spirits)  with  that of one or two Red Bulls or even Cokes or Fantas.

And undiluted or adulterated commercial “fruit juice” is bad by the glass since it is high in sugar (fructose), it should be used if at all in small volumes diluted in water- and one has to drink perhaps 6 litres a day (or 6kg of fruit)  to obtain 3 gm vitamin C .

If tap water (the best) is not enough, there are  rooibos or  other  teas, chicory, modest coffee, skim milk, and soda water to satisfy all desires- and  for those with a sweet tooth, a relatively safe concentrate to dilute well like Eleven to One in a wide range of fruit flavours. Fresh fruit in moderation, and coloured veggies are always the best, for their roughage, polyphenols, vitamins, antioxidants etc- but they do not provide enough of these for our polluted stressed depressing  and contagious world, especially for the longerlived. .

And with rampant overweight-obesity-(pre)diabetes, fatfree cooking must be enforced, to minimize intake of both carcinogens and worse, glycates , AGES— sugar fused with fat or protein.

OBESITY AND DIABETES ARE NOT GENETICALLY INEVITABLE.

Health headlines from BBC the past week are ironically contradictory,  profits  or  prophets of gloom.

Sugar- including cane sugar and excess fruit sugar- and cooked/processed fat – are perhaps the greatest slow “foodstuff” poisons commercialised and concentrated by “civilization”.
The industrial society and it’s omnipresent (TV- cellphone) media deliberately ruin children’s health by introducing them early to profitable sweeteners, cooked fats, fast food, TV and computer addictions, instead of natural fresh foods, exercise, playing and books. The inevitable tidal wave of obesity and chronic degenerative disease then becomes further wealth- The Disease Industry for whom Only Disease Pays. .

Obesity may thus be partly genetic, but is not inevitable with sensible habits:
A new twin study from UK found that “Becoming overweight as a child is more likely to be the result of genes than lifestyle”. http://news.bbc.co.uk/2/hi/health/7230065.stm.

But as the Child Growth Foundation says: “Even if someone has a gene which predisposes them to obesity, it doesn’t mean they will become obese if they work hard to eat healthily” . The National Centre for Eating Disorders carefully analyses how much can be done by the individual to reduce genetic risk http://www.eating-disorders.org.uk/docs/obesity.doc .

The only safe intense sweeteners are those which are both plant-sourced and which reduce insulin resistance – eg stevia. The artificial sweeteners that have been proven 100% safe are cyclamate-saccharine – but they do not reduce insulin resistance.

The only OBESITY “drug” that has been proven in major trials and long term follow up to reduce all major chronic diseases and premature deaths – by 1/3- and HALVE new diabetes (and thus cholesterol-lipid- problems) when started well before overweight and hypertension are established, is the 80year old plant extract METFORMIN. This is THE ONLY widely available low cost prescription drug that safely produces an average of 8% weight loss sustained for as long as it is taken consistently at tolerated dose.
In Canadian experience, metformin halves all deaths in type 2 diabetics followed up for a decade; and in preventative trials, it approximately halves the incidence of new type 2 diabetes. Metformin is 100% safe provided it is started at low dose eg ~125mg/day- and increased gradually over 2 weeks to the maximum dose that is well tolerated without excessive diarrhoea, nausea, abdominal bloating or pain. This dose averages about 2.5gms a day in westerners, but (due to genetic variation) may be as low as 250mg/day. It should always be stopped briefly with any acute symptoms or acute illness, and resumed at a tolerated lower dose. It must thus always be taken in consultation with a health professional.
It is understandably rarely promoted by the Disease Industry because it is out of patent, too cheap- and it work too well. For this profitable Industry, Only Disease Pays! So only expensive new drugs are heavily promoted.

Due to the destructive combination of stressful indolence- hours spent every day watching TV instead of playing outside/ sport- and stress (cortisol) and fast food stuffed with sugar and fat, even preteen children (never mind adults at all ages) suffer increasingly from overweight and teenage type 2 diabetes, and girls from polycystic ovary- infertility-hairiness problems.

Synthetic patent weight-reducing and anti-diabetic drugs eg sbutramine, orlistat, the glitazones, have major adverse effects, and have none of the global long term advantages of metformin. The only reason for their prescription is the intensive drug industry marketing imperative.

Apart from correcting the causes outlined above, preventing and treating overweight and diabetes can be easily achieved with a permanent safe low cost natural multicombination of supplements like appetite- and insulin-resistance reducing agents eg vitamins, minerals and biologicals eg metformin/galega, 5HTP, and fish oil tailored to individual tolerance. http://www.ajcn.org/cgi/content/full/83/6/S1499?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&title=n-3+fatty+acids+and+the+metabolic+syndrome.&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Health advisors who argue against this are rarely un-informed, they have usually chosen ( for profit) to promote drug industry new drugs rather than healthy truth. The Disease Industry will never invest in trials to prove the obvious, since the supplements are not patentable ie not profitable. So they pay cynical lobbyists to argue loudly that such evidence-based natural safe supplements must first be proven in vast longterm trials – although such trial proof is not required for new designer drugs by the Regulators eg the FDA, Medicines Control Councils who are funded by the drug industry! And politicians, governments don’t argue because the drug industry is a huge creator of jobs and revenue.

Modern drugs for chronic disease allowed by the FDA to be freely prescribed are withdrawn only when enough people die: The Americans have just had to stop the glitazone arm of the massive ACCORD trial in diabetics after 25% more deaths occurred on Avandia than in controls. http://www.msnbc.msn.com/id/23029191/. But- lo and behold- there is still no announcement yet about the withdrawal of the unnecessary glitazones that have no overall longterm health benefit except for the investors!.

http://news.bbc.co.uk/1/hi/health/7219315.stmLast
Thursday, 31 January 2008, 10:27 GMT
Obesity drug use rises eight-fold
Obesity levels are increasing
More than 1m prescriptions are made for obesity drugs a year – eight times the number dispensed seven years ago. The majority of these were for two treatments – sibutramine and orlistat.

http://news.bbc.co.uk/1/hi/health/7219473.stm
Friday, 1 February 2008, 00:14 GMT
Gout surge blamed on sweet drinks