Eat Your Chocolate!

As if you needed another excuse to eat chocolate right? Well new research has reported that a small daily intake of dark chocolate helps lower your blood pressure and reduce your risk for diabetes.

It’s already known among connoisseurs that eating chocolate seems to release the same set of pleasurable endorphins liberated during orgasm. Adding to that highly fortunate side effect, researchers at Tufts University have now said that dark chocolate may lower blood pressure by an average of ten percent and improve the body’s sensitivity to insulin.

These benefits, though, only apply to dark chocolate, which is rich in antioxidant flavonoids. The same antioxidants are found in fruit and red wine. Milk chocolate and white chocolate, which are absent in the antioxidant flavonoids, do not yield the same beneficial qualities.

Previous studies suggest flavonoid-rich foods, including fruits, vegetables, tea, red wine and chocolate, offer cardiovascular benefits, but this is one of the first clinical trials to look specifically at dark chocolate’s effect on lowering blood pressure among people with hypertension.

The study found that three ounces of dark chocolate per day for several weeks reduced blood pressure in patients with essential hypertension while also having a positive effect on insulin sensitivity. It suggests that cocoa flavonoids appear to have benefits on vascular function and glucose sensitivity. The caveat is that chocolate is still a high calorie food and the study authors do not advocate for over-consumption, merely that
dark chocolate could be added to an overall healthful diet without upping caloric intake.

In this trial, published in the July 2011 edition of the journal Hypertension, 3.5 ounces of dark chocolate or white chocolate were given every day to a group of men and women for 15 days. All subjects had high blood pressure and were not on blood pressure medication. Half of the subjects were given dark chocolate while the other half were given white chocolate. After 15 days, the patients had no chocolate for a week. Then each half switched to the other chocolate for the remaining time. White chocolate seemed to be the perfect control food because it contains all the other ingredients and calories found in dark chocolate, but without the beneficial flavonoids. During the time patients ate dark chocolate, their systolic blood pressure (top number) decreased by an average of 11.9 mm Hg. The diastolic (the bottom number) dropped by an average of 8.5 mm Hg. White chocolate showed no ability to lower blood pressure.

This is not only a statistically significant effect, but it’s also a clinically meaningful decline. This is the kind of reduction in blood pressure often found with other interventions.

Dark chocolate also seemed to improve how the body processed insulin and to reduce low-density lipoprotein (LDL), the protein that carries bad cholesterol by an average of 10 percent.
It’s important to note that the dark chocolate used in this study had a high level of flavonoids, giving it a slightly bittersweet taste. Much of the commercially produced chocolate on the market is milk chocolate, which has a low amount of these compounds.

To benefit from chocolate consumption, it must be 75% cocoa or higher.

Other Research Extolling the Benefits of Chocolate

http://www.ajcn.org/content/81/3/541.short?rss=1&ssource=mfr

http://www.bmj.com/content/343/bmj.d4488

http://www.unboundmedicine.com/medline/ebm/record/21696359/full_citation/Dark_Chocolate_and_Blood_Pressure:_A_Novel_Study_from_Jordan_

Sleep and Chronic Disease

Sleep and Chronic Disease

Chronic diseases of various types are the large majority of my clinical practice. As chronic diseases have assumed an increasingly common role in premature death and illness, interest in the role of sleep health in the development and management of chronic diseases has grown. Both insufficient and un-restorative sleep have been linked to the development and progression of a number of chronic diseases and conditions, particularly diabetes, cardiovascular disease, obesity, some types of cancer, and depression.

Diabetes
Research has found that insufficient sleep is linked to an increased risk for the development of  Type 2 diabetes. Specifically, sleep duration and quality have emerged as predictors of levels of Hemoglobin A1c, an important marker of blood sugar control. Recent research suggests that optimizing sleep duration and quality may be important means of improving blood sugar control in persons with Type 2 diabetes.

Cardiovascular Disease
People living with sleep apnea have been found to be at increased risk for a number of cardiovascular diseases. Notably, hypertension, stroke, coronary heart disease and irregular heartbeats (cardiac arrhythmias) have been found to be more common among those with disordered sleep than their peers without sleep abnormalities. Likewise, sleep apnea and hardening of the arteries (atherosclerosis) appear to share some common physiological characteristics, further suggesting that sleep apnea may be an important predictor of cardiovascular disease. In addition, large cohort epidemiologic studies have shown a positive correlation between sleep duration and increasing coronary artery disease and heart attacks (myocardial infarction).

Obesity
Laboratory research has found that short sleep duration results in metabolic changes that may be linked to obesity. Epidemiologic studies conducted in the community have also revealed an association between short sleep duration and excess body weight. This association has been reported in all age groups—but has been particularly pronounced in children. It is believed that sleep in childhood and adolescence is particularly important for brain development and that insufficient sleep in youngsters may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy. New research has shown that lack of sleep may ‘turn on’ some genetic drivers of weight gain.

Depression
The relationship between sleep and depression is complex. While sleep disturbance has long been held to be an important symptom of depression, recent research has indicated that depressive symptoms may decrease once disordered sleep has been effectively treated and sufficient sleep restored. The interrelatedness of sleep and depression suggests it is important that the sleep sufficiency of persons with depression be assessed and that symptoms of depression be monitored among persons with a sleep disorder.

I’ve discussed the importance of sleep in prior articles but I felt that it should be stressed again due to it’s paramount importance in optimal health. There are many factors that influence sleep and addressing the underlying causes of sleep disturbance can go a long way to improving overall health. As naturopathic physicians, we are particularly equipped with the knowledge and tools to address the complex physiologic, metabolic, and psychologic mechanisms that may be influencing and impairing sleep.

References

Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Knutson KL, Ryden AM, Mander VA, Van Cauter E. Arch Intern Med 2006;166:1768–1764.

Sleep and Diabetes. Swetha Bopparaju and Salim Surani. International Journal of Endocrinology Volume 2010 (2010)

A Prospective Study of Sleep Duration and Coronary Heart Disease in Women. Najib T. Ayas, MD; David P. White, MD; JoAnn E. Manson, MD, DrPH; Meir J. Stampfer, MD, DrPH; Frank E. Speizer, MD; Atul Malhotra, MD; Frank B. Hu, MD, PhD Arch Intern Med. 2003;163:205-209.

 Inflammatory aspects of sleep apnea and their cardiovascular consequences. Kasasbeh E, Chi DS, Krishnaswamy G. South Med J 2006;99:58–67.
 
The link between short sleep duration and obesity: We should recommend more sleep to prevent obesity. Arch Dis Child 2006;91:881–884.

Sleep and obesity. Stephen R. Daniels, MD, PhD. The Journal of Pediatrics Volume 154, Issue 6 , Page A3, June 2009

The association between sleep duration and obesity in older adults
S R Patel et al. International Journal of Obesity (2008) 32, 1825–1834
 
Diagnosing major depressive disorder I: A psychometric evaluation of the DSM-IV symptom criteria. Zimmerman M, McGlinchey JB, Young D, Chelminski I. J Nerv Ment Dis 2006;194:158–163.
 
Symptoms of depression in individuals with obstructive sleep apnea may be amenable to treatment with continuous positive airway pressure. Schwartz DJ, Kohler WC, Karatinos G. Chest  2005;128:1304–1306.

Sleep Duration and Breast Cancer: A Prospective Cohort Study. Pia Verkasalo et al. Cancer Res October 15, 2005 65; 9595

A Prospective Study of Sleep Duration and Mortality Risk in Women. Sanjay R. Patel, MD. SLEEP 2004;27(3):440-4.

Sleep duration and the risk of breast cancer: the Ohsaki Cohort Study. M Kakizaki. British Journal of Cancer (2008) 99, 1502–1505.

Colorectal Cancer-Prevention and Early Detection is Best!

The incidence of colorectal cancer appears to be rising across the globe. Despite this unfortunate statistic, it is imperative to recognize that early detection dramatically improves survival rates and that there are preventive measures that can substantially reduce incidence.

Preventive measures include a diet rich in fiber, green vegetables, and supplementation with calcium, magnesium and vitamin D3. While there are certainly other factors influencing the development of colorectal cancer, these can be some of the simplest and most impactful.

Early detection includes yearly fecal immunochemical test (FIT), yearly fecal ocult blood test (FOBT) and a colonoscopy every 10 years minimum after age 50. In addition, regular health check-ups with your naturopathic physician can improve early detection by assessing your health from a more comprehensive and holistic perspective.

References:

1) Optimal Vitamin D Status for Colorectal Cancer Prevention:
A Quantitative Meta Analysis. American Journal of Preventive Medicine
Volume 32, Issue 3 , Pages 210-216, March 2007

2) Calcium plus Vitamin D Supplementation and the Risk of Colorectal Cancer. N Engl J Med 2006; 354:684-696February 16, 2006

3) Calcium, Magnesium, and Colorectal Cancer Qi Dai, Robert Sandler, Elizabeth Barry, Robert Summers, Maria Grau, John Baron. (2012) . Epidemiology 23:3, 504-505

Probiotics Prevent Childhood Atopy and Eczema

Numerous recent studies have confirmed that maternal supplementation with probiotics significantly reduces the risk of atopic diseases like eczema and asthma in children. Probiotics, which are the healthy bacteria that live within our bodies, modulate mothers’ immune systems by regulating immunoglobulins and cytokines which are then passed on to infants through breast milk. This effect has been observed in children with parents who have atopy, as well as those who don’t.
Choosing a probiotic can be difficult due to the large number of varieties on the market, as well as the significant variation in quality and quantities. Any probiotic that you do choose should be hypo-allergenic, third-party tested for impurities as well as assured strengths for each of the strains contained in the product. A good quality probiotic should deliver at least 10billion cell forming units per dose. The strains of probiotic are also important as they can each have specific effects on immune system function. Ask one of the physicians at the West Vancouver Wellness Centre which probiotic will be right for you.

A Few References:
Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study
A. Huurre1, K. Laitinen1,2, S. Rautava1, M. Korkeamäki3, E. Isolauri1
Clinical & Experimental Allergy
Volume 38, Issue 8, pages 1342–1348, August 2008

   
Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood – a meta-analysis
Doege K, Grajecki D, et al.
British Journal of Nutrition, 2011 July 26
Address: Department of Gynecology, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany).

Green Tea Lowers Cholesterol Too!

The benefits of green tea, and its extracts such as EGCG, have been well researched and documented for the prevention and treatment of a variety of conditions including breast, prostate, and ovarian cancers, arthritis pain, heart disease prevention, and migraine prevention. Recently, however, studies have highlighted new benefits for the reduction of LDL cholesterol.

The findings, published in the American Journal of Clinical Nutrition, may help further understand why green tea and its extracts have been linked to a lower risk of heart disease in previous studies.

To investigate, researchers pooled data from 14 previous trials and combined them into a single meta-analysis. In each of those studies, researchers randomly divided participants into two groups: one that drank green tea or took a green tea extract for periods ranging from three weeks to three months, and one that got an inactive preparation.

Researchers found that green tea consumption – both from drinking green tea and taking a green tea supplement could lower both total and LDL cholesterol levels.

On average, study participants who received green tea ended up with total cholesterol levels that were 7.2 milligrams per deciliter (mg/dL) lower than in the comparison group.

Their LDL, or “bad,” cholesterol dropped 2.2 mg/dL, a decrease of slightly less than two percent.

There was no difference in HDL, or “good,” cholesterol between the two groups.

The cholesterol-lowering effects of green tea may be due to chemicals known as catechins, which decrease the absorption of cholesterol in the gut, according to the researchers.

While it is believed that there are other substantial mechanisms at play for green tea’s prevention of heart disease, it would appear that lipid reduction is a contributing factor as well.

This is great news! Heart disease is the number one cause of morbidity and mortality in Canada and the more tools we have for prevention and treatment, the better.

Green tea intake lowers fasting serum total and LDL cholesterol in adults: a meta-analysis of 14 randomized controlled trials.
American Journal of Clinical Nutrition, August 2011.

Pomegranate for your Heart!

Here’s some interesting research on the value of pomegranate fruit for the treatment and prevention of cardiovascular disease. It looks like there are a number of benefits, including blood pressure reduction, lipid reduction, and preventing oxidative damage to vascular endothelium. Plus it tastes good!

Antioxidant and antiatherogenic effects of pomegranate
Stacy L. Haber, Jamie K. Joy, and Roxanne Largent
Am J Health Syst Pharm July 15, 2011 68:1302-1305; doi:10.2146/ajhp100610

Protect Your Eyes With Antioxidants.

In this June’s issue of Archives of Opthalmology they released a study indicating that high dietary antioxidant intake lowered the risk of age-related macular degeneration. They looked specifically at omega-3 fats EPA and DHA, zeaxanthine, lutein, zinc, and beta-carotene. While this is not new information, it certainly fortifies the previous evidence. Especially in the summer months, when uv light exposure is high, there is greater need for antioxidant protection for your eyes. Wear sunscreen, hats, sunglasses and take your antioxidants!

‘Human Breast Milk’ From Genetically Modified Cows?

The latest news from the Telegraph.

“It’s better for you because it’s genetically modified.” Call me a skeptic but somehow I just don’t think so…

Prescription Drug Regulation Changes In BC

Here is a short news clip of a colleague of ours being interviewed regarding the new provincial regulation changes regarding prescriptive authority for naturopathic doctors. This is something that the naturopathic medical profession has been working towards for years and that we finally achieved last year. Adding prescriptive authority to our scope of practice allows us to be truly holistic and comprehensive primary care physicians.

Osteoporosis And The Evidence For Bisphosphonates.

A recent review of all the significant short and long-term randomized controlled trials and cohort studies since 1965 with respect to the use of bisphosphonate medication in the treatment of osteoporosis has revealed some very interesting insights. In the short-term, bisphosphonates show some effectiveness in preventing vertebral fractures demonstrated by x-ray. The efficacy with regard to preventing hip fractures is uncertain; for primary prevention hip fractures are not reduced and for secondary prevention the effect is of small magnitude and of questionable clinical relevance. In the long-term, there is an increased risk of atypical fractures affecting the subtrochanter and diaphysis of the femur. In addition, one cohort study suggests the incidence of hip fractures could be increased instead of reduced. Clarification of the long-term effects of bisphosphonates is therefore necessary and suspension of the use of these drugs for osteoporosis should be considered.

Given these results, it would seem very prudent to re-evaluate whether treating osteoporosis with bisphosphonates such as Didronel, Actonel, and Fosamax is providing the individual with any clinical (read: personal) benefit. That said, I’m not suggesting substantial osteoporosis be left unchecked and un-treated. Quite the contrary, we just need to be sure that the treatments provided are effective, safe and evidence-based.