Day: 09/02/2013

Calorie Restriction as a Means to Augment Cancer Therapies.

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Story at-a-glance

  • Mice with cancer survived longer when fed a calorie-restricted diet along with a standard cancer treatment, new research revealed
  • Experts at using nutrition to treat cancer now believe that the most important aspect of cancer prevention and treatment is intermittent fasting, or overall calorie restriction
  • A ketogenic diet, in which you replace carbs with low to moderate amounts of protein and high amounts of beneficial fat, along with calorie restriction appears to be especially beneficial for treating and preventing cancer
  • Carb restriction combined with calorie restriction and moderate protein restriction effectively “starves” cancer cells of their preferred fuel (glucose and glutamine)

Calorie restriction has been scientifically proven to slow down aging, extend lifespan, and even reduce the risk of age-related chronic diseases such as cancer.

Newer research is now showing, however, that strategically restricting your calories may also be an effective form of cancer prevention and treatment. As a leading cause of death worldwide, the incidence of cancer is on the rise, despite the decades long ‘war on cancer’ that conventional medicine has waged against this disease.

As simple, natural methods continue to prove their merit, it’s becoming clear that what are now viewed as alternative methods of cancer treatment may soon become regarded as the standard of care, and calorie restriction may be among the top go-to options.

Short-Term Calorie Restriction Improves Cancer Survival

A new animal study tested what would happen when mice with lymphoma were fed a regular diet or a calorie-restricted diet (75 percent of their normal intake) along with a targeted therapy to induce cancer cell death (known as ABT-737).1 The idea was that the lower caloric intake might limit the expression of certain proteins associated with cancer. As explained by the American Society of Hematology:2

“When humans and animals consume calories, the body metabolizes food to produce energy and assist in the building of proteins. When fewer calories are consumed, the amount of nutrients available to the body’s cells is reduced, slowing the metabolic process and limiting the function of some proteins.

These characteristics of calorie restriction have led researchers to hypothesize that reducing caloric intake could potentially help inhibit the overexpression of the protein Mcl-1, an alteration associated with several cancers.”

The study showed that calorie restriction did improve survival when done along with the treatment. Specifically, median survival was 30 days in the control group that received a regular diet and no treatment, compared with:

·         33 days in mice that received a regular diet and treatment with ABT-737

·         30 days in mice that received a reduced-calorie diet without treatment

·         41 days in mice that received a reduced-calorie diet and treatment with ABT-737

Furthermore, the number of circulating lymphoma cells was reduced in the calorie-restricted/ ABT-737 mice, which suggests that the cancer cells had been sensitized to the treatment.

Dr. Thomas Seyfried is one of the leading pioneer academic researchers in promoting how to treat cancer nutritionally, and in the video above you can hear my recent interview with him. Dr. Seyfried’s work is in line with the above-mentioned study and, in fact, he believes that the most important aspect of cancer prevention and treatment is intermittent fasting, or overall calorie restriction, which includes eating less of everything, period.

That said, Dr. Seyfried’s work confirms that sugar is the primary fuel for cancer, and that by restricting sugar and providing an alternate fuel, namely fat, you can dramatically reduce the rate of growth of cancer. This is because cancer cells lack the metabolic flexibility of your normal cells so when you deprive them of sugar they have no fuel, but your regular cells can thrive quite nicely on fat alone.

He explains:

“When we’re dealing with glucose and [cancer] management, we know from a large number of studies that if respiration of the tumor is ineffective, in order to survive, the cells must use an alternative source of energy, which is fermentation. We know that glucose is the primary fuel for fermentation. Fermentation becomes a primary energy-generating process in the tumor cell. By targeting the fuel for that process, we then have the capability of potentially managing the disease.”

The strategy Dr. Seyfried suggests is a low-carb, low- to moderate-protein, high-fat diet, which will effectively lower your blood sugar. This is an easily measurable parameter that you can check using a diabetic blood glucose meter. This type of diet, called a ketogenic diet, will also elevate ketone bodies, as fat is metabolized to ketones that your body can burn in the absence of food. When combined with calorie restriction, the end result will put your body in a metabolic state that is inhospitable to cancer cells.

“[Ketones] is a fat breakdown product that can replace glucose as a major fuel for many of the organs and especially our brain,” he says.

Carbohydrate Calorie Restriction May Be Most Important

While opinions are mixed about what ratios of protein, fats and carbs constitute the healthiest diet, most experts agree that calories from carbohydrates need to be restricted. One reason for this is a mounting body of evidence that suggests cancer is responsive to therapeutic ketosis—a natural physiologic state induced during prolonged states of decreased glucose.

Nutritional ketosis, as mentioned, involves restricting carbohydrates in order to decrease the availability of glucose. Restricting carbs also increases production of ketone bodies from your liver. Nearly all of your normal cells have the flexibility to readily adapt to using ketone bodies for fuel in lieu of glucose, but cancer cells do not have this metabolic flexibility. Hence, they effectively starve to death while all your normal cells actually operate more efficiently than before.

Additionally, when you restrict carbohydrates, you prevent spikes in blood sugar, insulin and IGF-1 from occurring. These spikes are actually very pro-inflammatory, and can activate oncogenes (genes that contribute to the conversion of a normal cell into a cancerous cell), and enhance both cancer cell proliferation and the metastatic process.

But here’s a key point: While carb restriction will reduce these spikes, it will not have a major impact on baseline levels of blood glucose, unless you also restrict your calorie and protein intake. So for cancer prevention and treatment, carb restriction must be combined with calorie restriction and moderate protein restriction in order to effectively “starve” cancer cells of their preferred fuel (glucose and glutamine).

In order to maintain and sustain nutritional ketosis, you need to decrease both carbohydrates and protein. But how much protein is enough or too much? Dr. Seyfried is more cautious in his evaluation of reducing protein for cancer prevention, but one of my mentors, Dr. Ron Rosedale, advocates restricting protein to one gram per kilogram of lean body mass. Typically, for someone like myself, that amounts to about 50-70 grams of protein per day.

The reason he promotes this so much is because of the stimulatory effect protein (branch-chained amino acids specifically) has on mammalian target of rapamycin (mTOR)—a pathway that seems to be largely responsible for the pathology seen in cancer growth. Dr. Dominic D’Agostino, PhD, an assistant professor at the University of South Florida College of Medicine, also believes protein must be restricted for cancer prevention.

He explained in our interview (see the video above):

“The ketogenic diet is, I think, a very good strategy to make calorie restriction tolerable. Because when your brain in particular is craving glucose, and, say, for example, you go on a calorie-restricted diet, but it’s a high-carbohydrate diet, you’re still getting fluctuations in blood glucose. Your brain goes through these intermittent periods of glucose deprivation and you get very hungry. It’s not a very comfortable feeling.

Nutritional ketosis, which occurs with carbohydrate restriction and is further enhanced with calorie restriction, forces the physiological shift from a glucose-based metabolism to a fatty acid and ketone metabolism. When your body is, shall we say, keto-adapted, your brain energy metabolism is more stable and your mood is more stable. It may take a few weeks to adapt physiologically to this. But nutritional ketosis can be maintained and sustained with carbohydrate restriction and is further enhanced with calorie restriction.

The total calories really need to be restricted, and also protein. Protein is gluconeogenic. There are gluconeogenic amino acids in protein. If protein is at, say, for example, two or three grams per kilogram per day that is probably going to feed in through the gluconeogenic pathway and contribute to glutaminolysis. It will be hard to deplete your glycogen stores, which is necessary to drive the ketogenesis in your liver.”

Calorie Restriction Is Essential for Cancer Patients, But Is an Important Cancer-Preventive Strategy, Too

From my perspective, it’s medically unethical to fail to integrate this safe and effective dietary strategy into a patient’s cancer treatment plan (along with optimizing vitamin D). A ketogenic diet along with intermittent fasting can be easily integrated into whatever cancer treatment plan you decide to follow. Personally, I believe it’s absolutely crucial, no matter what type of cancer you’re trying to address.

To get more specifics about using a ketogenic diet and calorie restriction for the treatment of cancer, I highly recommend picking up Dr. Seyfried’s book, Cancer as a Metabolic Disease. You can also review his papers,3, 4 which outline the guidelines and treatment strategies for cancer patients. If you’re a cancer patient, I’d recommend printing them out for your oncologist.

That said, remember that a ketogenic diet, in which you replace carbs with low to moderate amounts of protein and high amounts of beneficial fat, like avocado, coconut oil, butter, olive oil and macadamia nuts is recommended for everyone, whether you have cancer or not. It’s a diet that will help optimize your weight and health overall, as eating this way will help you convert from carb burning mode to fat burning.

Want to Try Calorie Restriction? Try Intermittent Fasting

While the research supporting calorie restriction is compelling, it’s not a very popular dietary strategy for most people, for obvious reasons. Many are simply not willing to deprive themselves of calories to the extent needed to prompt the beneficial effects. An alternative that is much more acceptable is intermittent fasting, which can be as simple as restricting your daily eating to a narrower window of time of say 6-8 hours (this equates to 16-18 hours worth of fasting each and every day).

Recent research suggests that sudden and intermittent calorie restriction appears to provide many of the same health benefits as constant calorie restriction, including extending lifespan and protecting against disease.

Unless you have a very serious disease, I believe it is best for most people to implement intermittent fasting slowly over six to eight weeks. You begin by not eating for three hours before you go to bed, and then gradually extend the time you eat breakfast until you have skipped breakfast entirely and your first meal of the day is at lunch time. Of course, you are only consuming non-starchy vegetables for carbs, low to moderate protein and high-quality fats. One of the things I’ve noticed is that once you’ve made the transition from burning carbs to burning fat as your primary fuel, the desire for junk foods and sugar just disappears like magic.

It typically takes a few weeks for most to shift from burning carbs to fat-burning mode. Once you succeed and switch to fat-burning mode, you’ll be easily able to fast for 18 hours and not feel hungry.

59% of the ‘Tuna’ Americans Eat Is Not Tuna.

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Story at-a-glance

  • DNA testing of US seafood samples revealed that 59 percent of tuna and 87 percent of snapper were mislabeled
  • At sushi restaurants, 74 percent of fish samples were not the fish they were labeled to be
  • 84 percent of “white tuna” sold in sushi venues was actually escolar, a fish associated with acute and serious digestive effects if you eat just a couple of ounces
  • You can help to avoid fraudulently labeled seafood by asking questions about its origin, avoiding cheaply priced seafood (if the price seems too good to be true, it probably is), and purchasing the whole fish whenever possible.

tuna

When you eat tuna, there’s a good chance you’re not actually eating tuna. Instead, the majority of fish labeled ‘white tuna’ may actually be escolar, a type of fish that can cause serious digestive effects, including oily anal leakage.

Oceana, the non-profit ocean protection group that revealed the findings, further found that nearly 60 percent of ‘tuna’ sold at restaurants and grocery stores is another type of fish entirely – and the results fared worst for sushi restaurants.1

Love Sushi? Skip the So-Called ‘Tuna’ (Ahi)

Oceana conducted DNA testing on more than 1,200 fish samples across the US and found that one-third were mislabeled. While red snapper had the highest mislabeling rates (87 percent of ‘red snapper’ samples were not actually red snapper), tuna was a close second, with 59 percent mislabeled.

At sushi restaurants, however, 74 percent of fish samples were mislabeled. This included every single sushi restaurant from which samples were tested, even in major metropolitan areas like Chicago, Austin, New York and Washington DC.

According to Oceana’s 69-page report,2 in many cases the mislabeled fish had been substituted for cheaper, less desirable and/or more readily available fish varieties. The results showed that:

·         Mislabeling was found in 27 of the 46 fish types tested (59 percent)

·         87 percent of fish sold as snapper was actually some other type of fish

·         59 percent of tuna was some other type of fish

·         84 percent of “white tuna” sold in sushi venues was actually escolar, a fish associated with acute and serious digestive effects if you eat just a couple of ounces

·         Grouper, halibut, and red snapper were sometimes substituted with king mackerel and tile fish, two types of fish the FDA advises pregnant women and other sensitive groups to avoid due to dangerously high mercury content

Only 1 Percent of Imported Seafood Is Tested for Fraud

How are so many seafood retailers getting away with selling mislabeled fish? To put is simply, no one is minding the store…

More than 90 percent of the seafood consumed in the US is imported, yet only 1 percent of imports are inspected for fraud, which may explain this clearly out-of-control situation. Oceana reported:3

“Our findings demonstrate that a comprehensive and transparent traceability system – one that tracks fish from boat to plate – must be established at the national level.

At the same time, increased inspection and testing of our seafood, specifically for mislabeling, and stronger federal and state enforcement of existing laws combatting fraud are needed to reverse these disturbing trends.

Our government has a responsibility to provide more information about the fish sold in the U.S., as seafood fraud harms not only consumers’ wallets, but also every honest vendor and fisherman cheated in the process – to say nothing of the health of our oceans.”

Another Reason to Avoid Tuna: It’s Typically Loaded With Mercury

Fish has always been the best source for the animal-based omega-3 fats EPA and DHA, but as levels of pollution have increased, this health treasure of a food has become less and less viable as a primary source of beneficial fats. This is particularly true for tuna, which tends to be a higher mercury fish.

One study from the U.S. Geological Survey found that ALL tuna tested contained fairly high amounts of mercury. The contamination may be even worse in restaurants, again confirming that eating restaurant tuna is a risky proposition.

Further, according to a separate study, toxicological testing revealed that tuna sold in restaurants actually contained HIGHER amounts of mercury than the store-bought variety.4 The reason for this is because restaurants tend to favor certain species of tuna, such as bluefin akami and bigeye tuna, which had significantly higher levels of mercury than bluefin toro and yellowfin tuna. 

Unfortunately, mercury tends to accumulate to a greater degree in muscle than in fat, rendering these highly prized, leaner species of tuna more susceptible to high contamination.

Another explanation is that restaurants tend to buy larger sized fish, which in turn contain larger concentrations of mercury due to their size. Remember, the larger the fish the longer it has lived, and the more time it has had to bioaccumulate toxins like mercury from the ocean.

Up to 80 Percent of Salmon May Also Be Mislabeled.

It’s not only tuna and red snapper that is commonly mislabeled. In the video above, I interview Randy Hartnell, founder-president of Vital Choice Wild Seafood and Organics. He explains that as much as 70 to 80 percent of the fish marked “wild” salmon were actually farmed. This includes restaurants, where 90-95 percent of salmon is farmed, yet may be mis-listed on the menu as “wild.” The following tips can help you determine whether the salmon is authentic:

1.    Canned salmon labeled “Alaskan Salmon” is a good bet, as Alaskan salmon is not allowed to be farmed.

2.    In restaurants, mislabeled salmon will typically be described as “wild” but not “wild Alaskan.” This is because authentic “wild Alaskan” is easier to trace. The term “wild” is more nebulous and therefore more often misused. In many ways, it is very similar to the highly abused “natural” designation.

3.    Whether you’re in a grocery store or a restaurant, ask the seafood clerk or waiter where the fish is from. If it’s wild, they will have paid more for it, so they’re likely to understand the value proposition. Since it’s a selling point, they will know where it came from. If they don’t have an answer for you, it’s a red flag that it’s farmed, or worse… The US Food and Drug Administration is moving forward with approving genetically engineered salmon to be sold, and as you know, GE foods still do not need to be labeled in the US.

4.    Avoid Atlantic salmon, as all salmon labeled “Atlantic Salmon” currently comes from fish farms.

5.    Sockeye salmon cannot be farmed, so if you find sockeye salmon, it’s bound to be wild. You can tell sockeye salmon from other salmon by its color. It’s bright red as opposed to pink. The reason again for this bright red color is its superior astaxanthin content. Sockeye salmon has one of the highest concentrations of astaxanthin of any food.

Three Ways to Help Determine if Seafood Is Mislabeled

For the average diner, it can be difficult, if not nearly impossible, to determine if the tuna or red snapper in your sushi is actually what it’s claimed to be. That said, there are some ways to protect yourself against rampant seafood fraud:5

1.    Ask questions. Consumers should ask more questions, including what kind of fish it is, if it is wild or farm raised, and where, when and how it was caught

2.    Check the price. If the price is too good to be true, it probably is, and you are likely purchasing a completely different species than what is on the label.

3.    Purchase the whole fish. When possible, purchase the whole fish, which makes it more difficult to swap one species for another.

Are You a Seafood Lover? Use These Tips to Stay Healthy

Aside from the fraud issue, which is clearly prevalent, most major waterways in the world are contaminated with mercury, heavy metals, and chemicals like dioxins, PCBs, and other agricultural chemicals that wind up in the environment. This is why, as a general rule, I no longer recommend getting your omega-3 requirements from fish, but rather from a high-quality, animal-based omega-3 supplement like krill oil. However, I do make two exceptions.

One is authentic, wild-caught Alaskan sockeye salmon, the nutritional benefits of which I believe still outweigh any potential contamination. The risk of sockeye accumulating high amounts of mercury and other toxins is reduced because of its short life cycle, which is only about three years. Additionally, bioaccumulation of toxins is also reduced by the fact that it doesn’t feed on other, already contaminated, fish.

Whenever I consume fish, I make sure to also take chlorella tablets. The chlorella is a potent mercury binder and if taken with the fish will help bind the mercury before you are able to absorb it, so it can be safely excreted in your stool.

The second exception is smaller fish with short lifecycles, which also tend to be better alternatives in terms of fat content, so it’s a win-win situation — lower contamination risk and higher nutritional value. A general guideline is that the closer to the bottom of the food chain the fish is, the less contamination it will have accumulated. So if you’re a seafood lover, try to choose most of your fish from this group, which includes:

·         Sardines

·         Anchovies

·         Herring

If you insist on eating typical, store-bought fish and want to know more about the extent of your mercury exposure, I urge you to check out the online mercury calculator6 at GotMercury.org to get an idea of the risks. Additionally, as mentioned above, you may want to consider taking a natural mercury chelator with any fish dinner. In addition to chlorella, this also includes zeolite (green clay) and fermented vegetables. Since larger fish tend to live longer and have the highestcontamination levels, they should be avoided entirely. These include (please note this is not an exhaustive listing):

Tuna (tuna steaks, sushi, and canned)

Sea bass and largemouth bass

Marlin

Halibut

Pike

Walleye

Shark

Sword fish

White croaker

 

Metformin May Lower Risk of Prostate Cancer Death.

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Metformin, a widely used diabetes drug, may reduce the risk of dying from prostate cancer, according to new research.

A study of nearly 4,000 diabetic men found that those taking metformin when diagnosed with prostate cancer were less likely to die of the cancer or other causes compared to men using other diabetes drugs.

“We demonstrated that metformin is associated with improved survival among diabetic patients with prostate cancer,” said Dr. David Margel, a uro-oncologist at Rabin Medical Center in Petah Tikva, Israel, who conducted the research while at the University of Toronto.

“It’s associated in a dose-response manner,” he said. “The longer you were on metformin, the less likely you were to die of prostate cancer and of all causes.”

But whether metformin can prevent prostate cancer progression in people without diabetes remains to be seen, experts say.

Diabetes and prostate cancer are common in the United States. This year, about 239,000 new cases of prostate cancer will be diagnosed, and more than 29,000 men will die from it, according to the American Cancer Society.

Type 2 diabetes is rampant, and metformin is the drug most commonly prescribed to treat it. More than 61 million metformin prescriptions were filled in the United States last year. Brand names includeGlucophage and Glumetza. The drug, in its generic forms and certain brand names, is relatively inexpensive.

Previous research has focused on whether metformin might reduce the risk of getting prostate cancer, but most studies were negative. Some experts believe the drug instead works to improve survival once the cancer occurs.

In the new study, published online Aug. 5 in the Journal of Clinical Oncology, Margel looked at more than 3,800 diabetic men aged 67 or older who lived in Ontario. About one-third were taking metformin at the study’s start. Others were using different diabetes drugs.

The men took the metformin for a median of 19 months (half longer than that, half shorter) before the cancer was diagnosed and nearly nine months after.

During roughly four years of follow-up, Margel found those who took metformin had a 24 percent reduction in risk from prostate cancer death for every additional six months of use after their cancer diagnosis. The risk reduction of death from other causes was initially the same but declined over time.

In both instances, although an association was found between metformin and survival, a direct cause-and-effect relationship was not established.

No reduction in death risk was seen for patients taking any other diabetes drug.

Although other diabetes drugs work by increasing the body’s insulin production, metformin is an “insulin sensitizer” that works by making the body more sensitive to the insulin already produced. Insulin is needed to move glucose into cells for energy.

Some research suggests that high insulin levels can influence cancer growth. Metformin, by not increasing the body’s insulin production, may decrease cancer cells’ growth, some experts say.

Typical side effects of the drug are mild diarrhea and stomach problems, Margel said. “Usually they subside after one or two weeks,” he said.

In their next study, the researchers plan to test metformin in patients with prostate cancer but not diabetes. “Metformin is very safe to use among nondiabetic patients,” Margel said.

The findings point to a need for a large study in which men with early stage prostate cancer are assigned to a metformin group or placebo group, one expert said. Writing in an accompanying journal editorial, Kathryn Penney, an instructor in medicine at Brigham and Women’s Hospital in Boston, said at least nine ongoing trials are looking at metformin in men with recurrent or advanced prostate cancer.

But these current trials might be starting too late, she said. Instead, a trial should look at metformin’s effect at the time of diagnosis, when the disease is typically in early stages.

“If this trial showed a benefit, then yes, men without diabetes could be put on metformin at the time of prostate cancer diagnosis,” she said.

Source: Drugs.com

Calorie Restriction as a Means to Augment Cancer Therapies.

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Story at-a-glance

  • Mice with cancer survived longer when fed a calorie-restricted diet along with a standard cancer treatment, new research revealed
  • Experts at using nutrition to treat cancer now believe that the most important aspect of cancer prevention and treatment is intermittent fasting, or overall calorie restriction
  • A ketogenic diet, in which you replace carbs with low to moderate amounts of protein and high amounts of beneficial fat, along with calorie restriction appears to be especially beneficial for treating and preventing cancer
  • Carb restriction combined with calorie restriction and moderate protein restriction effectively “starves” cancer cells of their preferred fuel (glucose and glutamine)
  • calorie-counting

Calorie restriction has been scientifically proven to slow down aging, extend lifespan, and even reduce the risk of age-related chronic diseases such as cancer.

Newer research is now showing, however, that strategically restricting your calories may also be an effective form of cancer prevention and treatment. As a leading cause of death worldwide, the incidence of cancer is on the rise, despite the decades long ‘war on cancer’ that conventional medicine has waged against this disease.

As simple, natural methods continue to prove their merit, it’s becoming clear that what are now viewed as alternative methods of cancer treatment may soon become regarded as the standard of care, and calorie restriction may be among the top go-to options.

Short-Term Calorie Restriction Improves Cancer Survival

A new animal study tested what would happen when mice with lymphoma were fed a regular diet or a calorie-restricted diet (75 percent of their normal intake) along with a targeted therapy to induce cancer cell death (known as ABT-737).1 The idea was that the lower caloric intake might limit the expression of certain proteins associated with cancer. As explained by the American Society of Hematology:2

“When humans and animals consume calories, the body metabolizes food to produce energy and assist in the building of proteins. When fewer calories are consumed, the amount of nutrients available to the body’s cells is reduced, slowing the metabolic process and limiting the function of some proteins.

These characteristics of calorie restriction have led researchers to hypothesize that reducing caloric intake could potentially help inhibit the overexpression of the protein Mcl-1, an alteration associated with several cancers.”

The study showed that calorie restriction did improve survival when done along with the treatment. Specifically, median survival was 30 days in the control group that received a regular diet and no treatment, compared with:

·         33 days in mice that received a regular diet and treatment with ABT-737

·         30 days in mice that received a reduced-calorie diet without treatment

·         41 days in mice that received a reduced-calorie diet and treatment with ABT-737

Furthermore, the number of circulating lymphoma cells was reduced in the calorie-restricted/ ABT-737 mice, which suggests that the cancer cells had been sensitized to the treatment.

Dr. Thomas Seyfried is one of the leading pioneer academic researchers in promoting how to treat cancer nutritionally, and in the video above you can hear my recent interview with him. Dr. Seyfried’s work is in line with the above-mentioned study and, in fact, he believes that the most important aspect of cancer prevention and treatment is intermittent fasting, or overall calorie restriction, which includes eating less of everything, period.

That said, Dr. Seyfried’s work confirms that sugar is the primary fuel for cancer, and that by restricting sugar and providing an alternate fuel, namely fat, you can dramatically reduce the rate of growth of cancer. This is because cancer cells lack the metabolic flexibility of your normal cells so when you deprive them of sugar they have no fuel, but your regular cells can thrive quite nicely on fat alone.

He explains:

“When we’re dealing with glucose and [cancer] management, we know from a large number of studies that if respiration of the tumor is ineffective, in order to survive, the cells must use an alternative source of energy, which is fermentation. We know that glucose is the primary fuel for fermentation. Fermentation becomes a primary energy-generating process in the tumor cell. By targeting the fuel for that process, we then have the capability of potentially managing the disease.”

The strategy Dr. Seyfried suggests is a low-carb, low- to moderate-protein, high-fat diet, which will effectively lower your blood sugar. This is an easily measurable parameter that you can check using a diabetic blood glucose meter. This type of diet, called a ketogenic diet, will also elevate ketone bodies, as fat is metabolized to ketones that your body can burn in the absence of food. When combined with calorie restriction, the end result will put your body in a metabolic state that is inhospitable to cancer cells.

“[Ketones] is a fat breakdown product that can replace glucose as a major fuel for many of the organs and especially our brain,” he says.

Carbohydrate Calorie Restriction May Be Most Important

While opinions are mixed about what ratios of protein, fats and carbs constitute the healthiest diet, most experts agree that calories from carbohydrates need to be restricted. One reason for this is a mounting body of evidence that suggests cancer is responsive to therapeutic ketosis—a natural physiologic state induced during prolonged states of decreased glucose.

Nutritional ketosis, as mentioned, involves restricting carbohydrates in order to decrease the availability of glucose. Restricting carbs also increases production of ketone bodies from your liver. Nearly all of your normal cells have the flexibility to readily adapt to using ketone bodies for fuel in lieu of glucose, but cancer cells do not have this metabolic flexibility. Hence, they effectively starve to death while all your normal cells actually operate more efficiently than before.

Additionally, when you restrict carbohydrates, you prevent spikes in blood sugar, insulin and IGF-1 from occurring. These spikes are actually very pro-inflammatory, and can activate oncogenes (genes that contribute to the conversion of a normal cell into a cancerous cell), and enhance both cancer cell proliferation and the metastatic process.

But here’s a key point: While carb restriction will reduce these spikes, it will not have a major impact on baseline levels of blood glucose, unless you also restrict your calorie and protein intake. So for cancer prevention and treatment, carb restriction must be combined with calorie restriction and moderate protein restriction in order to effectively “starve” cancer cells of their preferred fuel (glucose and glutamine).

In order to maintain and sustain nutritional ketosis, you need to decrease both carbohydrates and protein. But how much protein is enough or too much? Dr. Seyfried is more cautious in his evaluation of reducing protein for cancer prevention, but one of my mentors, Dr. Ron Rosedale, advocates restricting protein to one gram per kilogram of lean body mass. Typically, for someone like myself, that amounts to about 50-70 grams of protein per day.

The reason he promotes this so much is because of the stimulatory effect protein (branch-chained amino acids specifically) has on mammalian target of rapamycin (mTOR)—a pathway that seems to be largely responsible for the pathology seen in cancer growth. Dr. Dominic D’Agostino, PhD, an assistant professor at the University of South Florida College of Medicine, also believes protein must be restricted for cancer prevention.

He explained in our interview (see the video above):

“The ketogenic diet is, I think, a very good strategy to make calorie restriction tolerable. Because when your brain in particular is craving glucose, and, say, for example, you go on a calorie-restricted diet, but it’s a high-carbohydrate diet, you’re still getting fluctuations in blood glucose. Your brain goes through these intermittent periods of glucose deprivation and you get very hungry. It’s not a very comfortable feeling.

Nutritional ketosis, which occurs with carbohydrate restriction and is further enhanced with calorie restriction, forces the physiological shift from a glucose-based metabolism to a fatty acid and ketone metabolism. When your body is, shall we say, keto-adapted, your brain energy metabolism is more stable and your mood is more stable. It may take a few weeks to adapt physiologically to this. But nutritional ketosis can be maintained and sustained with carbohydrate restriction and is further enhanced with calorie restriction.

The total calories really need to be restricted, and also protein. Protein is gluconeogenic. There are gluconeogenic amino acids in protein. If protein is at, say, for example, two or three grams per kilogram per day that is probably going to feed in through the gluconeogenic pathway and contribute to glutaminolysis. It will be hard to deplete your glycogen stores, which is necessary to drive the ketogenesis in your liver.”

Calorie Restriction Is Essential for Cancer Patients, But Is an Important Cancer-Preventive Strategy, Too

From my perspective, it’s medically unethical to fail to integrate this safe and effective dietary strategy into a patient’s cancer treatment plan (along with optimizing vitamin D). A ketogenic diet along with intermittent fasting can be easily integrated into whatever cancer treatment plan you decide to follow. Personally, I believe it’s absolutely crucial, no matter what type of cancer you’re trying to address.

To get more specifics about using a ketogenic diet and calorie restriction for the treatment of cancer, I highly recommend picking up Dr. Seyfried’s book, Cancer as a Metabolic Disease. You can also review his papers,3, 4 which outline the guidelines and treatment strategies for cancer patients. If you’re a cancer patient, I’d recommend printing them out for your oncologist.

That said, remember that a ketogenic diet, in which you replace carbs with low to moderate amounts of protein and high amounts of beneficial fat, like avocado, coconut oil, butter, olive oil and macadamia nuts is recommended for everyone, whether you have cancer or not. It’s a diet that will help optimize your weight and health overall, as eating this way will help you convert from carb burning mode to fat burning.

Want to Try Calorie Restriction? Try Intermittent Fasting

While the research supporting calorie restriction is compelling, it’s not a very popular dietary strategy for most people, for obvious reasons. Many are simply not willing to deprive themselves of calories to the extent needed to prompt the beneficial effects. An alternative that is much more acceptable is intermittent fasting, which can be as simple as restricting your daily eating to a narrower window of time of say 6-8 hours (this equates to 16-18 hours worth of fasting each and every day).

Recent research suggests that sudden and intermittent calorie restriction appears to provide many of the same health benefits as constant calorie restriction, including extending lifespan and protecting against disease.

Unless you have a very serious disease, I believe it is best for most people to implement intermittent fasting slowly over six to eight weeks. You begin by not eating for three hours before you go to bed, and then gradually extend the time you eat breakfast until you have skipped breakfast entirely and your first meal of the day is at lunch time. Of course, you are only consuming non-starchy vegetables for carbs, low to moderate protein and high-quality fats. One of the things I’ve noticed is that once you’ve made the transition from burning carbs to burning fat as your primary fuel, the desire for junk foods and sugar just disappears like magic.

It typically takes a few weeks for most to shift from burning carbs to fat-burning mode. Once you succeed and switch to fat-burning mode, you’ll be easily able to fast for 18 hours and not feel hungry.

Probiotics Linked to Reduced Risk of Allergies, Psoriasis, Colitis, Periodontal Disease and More.

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Story at-a-glance

  • The root of many health problems is related to an imbalance of intestinal bacteria, and this foundation of good health is laid even while in utero
  • A recent analysis of available clinical trials found that women who take probiotics—i.e. healthy bacteria—during pregnancy reduce their child’s risk of developing allergies
  • Providing abundant probiotics in the form of fermented foods is one of the most powerful ways to restore your baby’s beneficial gut flora; raw, organic grass-fed yogurt is well tolerated by most infants and children
  • Recent research shows probiotics can put those suffering with psoriasis, ulcerative colitis and/or chronic fatigue syndrome into remission, and reduce chances of relapse
  • Another study showed a certain probiotic strain improved the efficacy of standard treatment for chronic periodontitis, which includes scaling and root planing, by 53 percent

Most people, including many physicians, do not realize that 80 percent of your immune system is located in your digestive tract, making a healthy gut a major focal point if you want to achieve optimal health.

The root of many health problems is related to an imbalance of intestinal bacteria, and this foundation of good health is laid even while in utero.

Without a well-functioning gastrointestinal (GI) tract, a newborn baby will be more vulnerable to pathogens, allergens, and a number of immune-related diseases, so getting an infant’s gut up and running efficiently is crucial. Women who are pregnant or planning to become pregnant would be wise to address their own gut health as early as possible to give their child the best start possible in this regard.

That said, it’s never too late to address your or your child’s gut, and most people would likely benefit from doing so.

The bacteria located in your GI tract play a crucial role in the development and operation of the mucosal immune system in your digestive tract. They also aid in the production of antibodies to pathogens.

Friendly bacteria even train your immune system to distinguish between pathogens and non-harmful antigens, and to respond appropriately. This important function prevents your immune system from overreacting to non-harmful antigens, which is the genesis of allergies.

But probiotics perform such a wide variety of functions, they’re really critical regardless of what ails you. And because adding probiotics to your diet is so easy, by way of cultured foods and/or supplements, it’s a step I highly encourage you to take.

How To Reduce Your Child’s Risk of Allergies

Babies gets their first “inoculation” of gut flora from mother’s birth canal during childbirth. If the flora is abnormal, the baby’s flora will also be abnormal; whatever organisms live in the mother’s vagina end up coating the baby’s body and lining his or her intestinal tract.

According to a recent analysis of previous clinical trials1, women who take probiotics—i.e. healthy bacteria—during pregnancy reduce their child’s risk of developing allergies. Unfriendly flora can also predispose babies to Gut and Psychology Syndrome (GAPS), of which allergies are just one potential outcome.

Other health problems associated with GAPS include autism, learning disabilities, and a number of other psychological, neurological, digestive, and immunological, problems. As reported in the featured Reuters article2:

“Since allergies and asthma both spring from hypersensitive immune responses, several trials have set out to assess the effect of probiotic supplements on those conditions…

[The] team analyzed the results of 25 trials of supplements given during pregnancy or within the first year of a child’s life. All of the studies compared mothers and babies randomly assigned to take probiotics with those given placebo supplements.

Participants were given probiotic doses daily, and in some cases more than daily, for a few months to a year. The trials tracked whether kids went on to test positive for common allergies – such as peanut or pollen allergies…

Babies who were exposed to probiotics in the womb and received supplements after birth had a 12 percent lower risk of allergies in the following months and years than kids in the comparison groups. But allergy risk was not reduced when babies were started on probiotics after birth only.”

How Allergies Are Related to Poor Gut Health

A condition known as “leaky gut” occurs when gaps develop between the cells (enterocytes) that make up the membrane lining your intestinal wall. These tiny gaps allow substances, such as undigested food, bacteria and metabolic wastes, that should be confined to your digestive tract to escape into your bloodstream — hence the term leaky gut syndrome.

Leaky gut syndrome can be a contributing factor to allergies, which can help explain why children with healthier gut flora have a reduced risk of developing allergies. Even more significantly, pathogenic microbes in the baby’s digestive tract can damage the integrity of his or her gut wall. This can allow all sorts of toxins and microbes to flood his or her bloodstream, which can then enter his or her brain and disrupt its development.

Breastfeeding helps protect your baby from this abnormal gut flora, which is why breastfeeding is so crucial to your child’s health. No infant formulas can do this. 

Leaky gut is also associated with inflammatory bowel diseases like Crohn’s and ulcerative colitis, as well as celiac disease. The condition Once the integrity of your intestinal lining is compromised, and there is a flow of toxic substances “leaking out” into your bloodstream, your body experiences significant increases in inflammation.

“Healing and sealing” your gut has been shown to help alleviate allergy symptoms. The key lies in altering your diet to eliminate offending foods, such as grains and processed foods, and introduce healthier ones that will support a proper balance of bacteria in your gut. To restore gut health, and prevent leaky gut from occurring, eating traditionally fermented foods is essential.

Fermented Foods Can Help a Baby Avoid MAJOR Health Problems

Providing abundant probiotics in the form of fermented foods is one of the most powerful ways to restore a baby’s beneficial gut flora. Oftentimes, a commercial probiotic supplement won’t even be needed.

Raw organic grass-fed yogurt is well tolerated by most infants and children. It’s best to make your own yogurt at home from raw organic milk, and start with a very tiny amount. Once yogurt is well tolerated, then start introducing kefir. If you have any problems with dairy, you can substitute vegetables fermented with yogurt culture or kefir culture. Avoid commercial yogurt from the grocery store, as these are laden with sugars that feed pathogenic bacteria—the exact opposite of what you’re looking for.

To learn more about introducing fermented foods to your newborn, I recommend picking up a copy of Dr. Natasha Campbell-McBride’s book, Gut and Psychology Syndrome3, which has a large recipe section for fermenting your own foods at home and using them to benefit all members of your family. If you have a baby with a severe condition, then the addition of a high-quality probiotic supplement might be needed.

There have been more probiotic studies involving adults than those with children, and even fewer with infants. Unfortunately, precious little research has been devoted to the study of probiotics for neonates, especially extremely low birth weight neonates (ELBW), but scientific studies thus far are very promising. One study in particular, published in BMCMedicine4 in 2011 by the Department of Neonatal Pediatrics in Nepean Hospital along with several other Australian hospitals, brings us closer to important evidence-based guidelines for the use of probiotics with preterm neonates. For more details on this, please see my previous article on the use of probiotics for neonates.

That said, probiotics have been shown to provide a number of benefits to infants and children. For example, daily supplements of probiotic foods may reduce a child’s risk of eczema by 58 percent, according to one study. Another study found that a daily dose of Lactobacillus reuteri can help improve colic.

Probiotic Proves Beneficial for Non-Gut Inflammatory Disorders as Well

Other recent studies confirm the importance of your gut health for health problems such as psoriasis and chronic fatigue syndrome. One such study, published in the journal Gut Microbes, is interesting in that it’s the first study showing how a single probiotic strain can influence your systemic immune system. As reported by Medical News Today5:

“The mucosal immune system protects the internal mucosal surfaces of the body such as the gastrointestinal, urogenital and respiratory tracts. These internal surfaces act as a barrier to the outside world for the internal tissues of the body, which are then further protected by the systemic immune system. There is some convincing evidence that probiotics, or gut-friendly bacteria, influence the development and maintenance not only of the microbial balance inside the gut and the mucosal immune system but also the systemic immune response.”

The probiotic used in the study is called Bifidobacterium infantis 35624. Three separate randomized, double-blind placebo-controlled trials were included in the study, which assessed the effects of the probiotic on one gastrointestinal and two non-gastrointestinal inflammatory disorders. Twenty-two of the patients enrolled in the study were diagnosed with ulcerative colitis, 26 were diagnosed with psoriasis, an inflammatory skin condition, and 48 patients had chronic fatigue syndrome.

The levels of inflammation markers in 35 healthy volunteers were used as baseline references. The three biomarkers assessed were C-reactive protein (CRP) and pro-inflammatory cytokines, tumor necrosis factor alpha (TNF-a), and interleukin-6 (IL-6). At the outset of the trials, all patients, whether their disorder was related to gastrointestinal inflammation or not, had significantly elevated levels of all three of these biomarkers. During the trial period, which lasted between six and eight weeks, each patient received either the probiotic or a placebo. At the end of each of the three separate trials, the researchers found that:

·         All three patient groups who received Bifidobacterium infantis 35624 had significantly lower levels of CRP compared to those who received a placebo

·         Patients with ulcerative colitis psoriasis patients had lower TNF-a

·         Those with ulcerative colitis and chronic fatigue syndrome had reductions in IL-6

According to the researchers, these reductions in inflammatory biomarkers typically count as remission, and are indicative of a reduced risk of relapse. A similar study published in 20096 found that Bifidobacterium infantis was the only probiotic strain out of 13 tested capable of improving symptoms of irritable bowel syndrome (IBS).

Probiotics Helps Improve Periodontal Disease, and More

In related news, another double-blind, placebo-controlled study7 found that the probiotic Lactobacillus reuteri Prodentisimproved the efficacy of standard treatment for chronic periodontitis (scaling and root planing) by 53 percent. According to the featured article8:

“By the end of the 12 week long study 53 per cent fewer sites (surfaces on a teeth) in patients with deep dental pockets and supplemented by Lactobacillus reuteri Prodentis was in need for surgery, compared to the placebo group… After the intervention period it was also concluded that 67 percent of the patients in the placebo group fell into the high-risk category for disease progression, while the corresponding figure for patients supplemented by Lactobacillus reuteri Prodentis was only 27 percent.”

Probiotics have also been found to influence the activity of hundreds of genes, helping them to express in a positive, disease-fighting manner. Researchers have documented beneficial probiotic effects in a wide variety of disorders, including9, 10:

Inflammatory bowel disease (IBD)

Irritable bowel syndrome (IBS)

Constipation and diarrhea

Colon cancer

Eradication of H. pyloriinfection, which is associated with ulcers

Vaginal infections

Strengthened immune response

Eczema

Rheumatoid arthritis

Cirrhosis of the liver

Hepatic encephalopathy

Depression, anxiety, and other mental health problems

Fermented Vegetables—An Ideal Source of Probiotics

The advent of processed foods dramatically altered the human diet, and we’re now reaping the results in the form of rapidly rising chronic health problems. I believe the shunning of traditionally fermented foods has a lot to do with this. The culturing process actually produces the beneficial microbes that we now realize are so crucial for health, and when eaten daily, they help maintain a healthy balance of intestinal microbes. Fermented foods are also some of the best chelators and detox agents available, meaning they can help rid your body of a wide variety of toxins, including heavy metals. The best way to ensure optimal gut flora is to regularly consume traditionally fermented foods. Healthy options include:

Lassi (an Indian yogurt drink, traditionally enjoyed before dinner)

Various pickled fermentations of cabbage sauerkraut,, turnips, eggplant, cucumbers, onions, squash, and carrots

Tempeh

Traditionally fermented raw milk such as kefir or yogurt, but NOT commercial versions, which typically do not have live cultures and are loaded with sugars that feed pathogenic bacteria

Natto (fermented soy)

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When choosing fermented foods, steer clear of pasteurized versions, as pasteurization will destroy many of the naturally occurring probiotics. This includes most of the “probiotic” yogurts you find in every grocery store these days; since they’re pasteurized, they will be associated with all of the problems of pasteurized milk products. They also typically contain added sugars, high fructose corn syrup, artificial coloring, or artificial sweeteners, all of which will only worsen your health.

When you first start out, you’ll want to start small, adding as little as half a tablespoon of fermented vegetables to each meal, and gradually working your way up to about a quarter to half a cup (2 to 4 oz) of fermented vegetables or other cultured food with one to three meals per day. Since cultured foods are efficient detoxifiers, you may experience detox symptoms, or a “healing crisis,” if you introduce too many at once. If you do not regularly consume the traditionally fermented foods above, a high-quality probiotic supplement may provide similar benefits.

Learn to Make Your Own Fermented Vegetables

Fermented vegetables are easy to make on your own. It’s also the most cost-effective way to get high amounts of healthful probiotics in your diet. To learn how, review the following interview with Caroline Barringer, a Nutritional Therapy Practitioner (NTP) and an expert in the preparation of the foods prescribed in Dr. Natasha Campbell-McBride’s Gut and Psychology Syndrome (GAPS) Nutritional Program.

Although you can use the native bacteria on cabbage and other vegetables, it is typically easier to get consistent results by using a starter culture. Caroline prepares hundreds of quarts of fermented vegetables a week and has found that she gets great results by using three to four high quality probiotic capsules to jump start the fermentation process.

Remember: Your Gut, Brain and Primary Immune Defense Are All Connected…

You’d be wise to remember that the vast majority of your immune system is located in your digestive system, making a healthy gut a major focal point if you want to maintain optimal health. Furthermore, as discussed in a number of other recent articles, your gut is quite literally your second brain, as it originates from the same type of tissue. Your gut and your brain actually work in tandem, each influencing the other. This is why your intestinal health can have such a profound influence on your mental health, and vice versa.

This also helps explain the link between neurological disorders (including ADHD and autism) and gastrointestinal dysfunction. For example, gluten intolerance is frequently a feature of autism, and many autistic children will improve when following a strict gluten-free diet. However, even more importantly, establishing normal gut flora within the first 20 days or so of life plays a crucial role in appropriate maturation of your baby’s immune system.

Babies who develop abnormal gut flora are left with compromised immune systems, and besides raising your child’s risk of allergies and other disorders discussed above, it may even be a crucial factor when it comes to vaccine-induced damage. As explained by Dr. Campbell-McBride, vaccinations were originally developed for children with healthy immune systems, and children with abnormal gut flora and therefore compromised immunity are not suitable candidates for our current vaccine schedule as they’re more prone to being harmed. To learn more about this, please see this previous article.

To sum it all up, regardless of your age, three very positive changes occur when your good-to-bad intestinal bacteria ratio is brought into balance:

1.    Digestive problems diminish or disappear

2.    Your body begins to use all the good food and nutritional supplements you feed it

3.    Your immune system de-stresses and is better equipped to fight off disease of all kinds, contributing to a longer and healthier life

Source: mercola.com

Anti-Fungal Drug Not Tied to Most Birth Defects.

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Although some reports have shown that high doses of the anti-fungal drugfluconazole (Diflucan) may raise the risk of birth defects, a new Danish review finds that more commonly prescribed lower doses of the medicine do not carry the same dangers.

Yet, in spite of this reassurance, experts may remain reluctant to prescribe the drug for expectant mothers who have yeast infections, since it is still linked to an increased risk of a rare congenital heart problem called tetralogy of Fallot.

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“Many pregnant women suffer from a yeast infection called vaginal candidiasis, or vaginal thrush, which is the most common clinical indication for use of oral fluconazole,” explained lead researcher Ditte Molgaard-Nielsen, an epidemiologist at the Statens Serum Institute in Copenhagen.

First-line treatment for vaginal candidiasis during pregnancy is vaginal preparations of topical anti-fungal drugs, she noted.

“However, in cases when topical treatment is ineffective this study provides comprehensive safety information, and may help inform clinical decisions when treatment with oral fluconazole is considered in pregnancy,” Molgaard-Nielsen said.

Specifically, the researchers looked at 15 birth defects linked to fluconazole and found it was not associated with an increased risk for 14 of them, she said.

“However, we did see an increase in the risk of tetralogy of Fallot, an uncommon congenital heart defect, but the number of exposed cases were few and this association should be confirmed in other studies before anything can be concluded with any certainty,” Molgaard-Nielsen added.

The report was published Aug. 29 in the New England Journal of Medicine.

Dr. Scott Berns, senior vice president and deputy medical officer for the March of Dimes, said that “when pregnant it is important to avoid taking any medicines unnecessarily.”

“I would chose the topical drug to treat a yeast infection. That is my first line,” he said. “If I had to use oral fluconazole, this study is reassuring that most of the time the baby is going to be fine. But, there is that small chance of tetralogy of Fallot. So, why take that chance?”

Another expert doesn’t think these findings will change clinical practice.

“Ob/Gyns are still going to be reluctant to prescribe this drug,” said Dr. Kecia Gaither, director of maternal fetal medicine at Brookdale University Hospital and Medical Center in Brooklyn, N.Y.

Gaither prefers to use natural methods for treating yeast infections. “One of them is increasing the use of yogurt intake,” she said. “There is certain bacteria in yogurt that prevents yeast infections. I have not run into a person who continues to have recurrent yeast infections after that is done.”

For the study, Molgaard-Nielsen’s team collected data on more than 7,300 women who took fluconazole during their pregnancy, among whom 210 infants were born with birth defects, and compared them to a control group of more than 968,000 unexposed women, among whom more than 25,000 babies were born with birth defects.

In both groups, the risk for having an infant with a birth defect was 0.6 percent, the researchers found.

Moreover, fluconazole wasn’t linked to a significantly increased risk for 14 of 15 birth defects to which the drug had been previously linked, they added.

These include craniosynostosis (a defect in the baby’s skull), middle ear defects, cleft palate, cleft lip, limb defects, an abnormal number of finger or toes, fused fingers or toes, diaphragmatic hernia, heart defects and shifting of a lung.

There was, however, a significantly increased risk of tetralogy of Fallot, with seven cases (0.10 percent) among women who took fluconazole, compared with 287 cases (0.03 percent) in unexposed women, the researchers found.

According to the U.S. National Institutes of Health, tetralogy of Fallot is a rare, complex birth defect where four different areas of the heart are malformed and the heart cannot pump enough blood or oxygen to the rest of the body. Surgery is usually required shortly after birth, although the long-term outlook for these patients has improved greatly in recent years.

Source: Drugs.com

Certain Antibiotics Tied to Blood Sugar Swings in Diabetics.

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Diabetes patients who take a certain class of antibiotics are more likely to have severe blood sugar fluctuations than those who take other types of the drugs, a new study finds.

The increased risk was low but doctors should consider it when prescribing the class of antibiotics, known as fluoroquinolones, to people with diabetes, the researchers said. This class of antibiotics, which includes drugs such as Cipro(ciprofloxacin), Levaquin (levofloxacin) and Avelox(moxifloxacin), is commonly used to treat conditions such as urinary tract infections and community-acquired pneumonia.

One expert said the study should serve as a wake-up call for doctors.

“Given a number of alternatives, physicians may consider prescribing alternate antibiotics … in the place of fluoroquinolones (particularly moxifloxacin) to patients with diabetes,” said Dr. Christopher Ochner, assistant professor of pediatrics and adolescent medicine at the Icahn School of Medicine at Mount Sinai, in New York City. “In general, this study demonstrates that closer attention needs to be paid to particular drug-condition interactions.”

The study included about 78,000 people with diabetes in Taiwan. The researchers looked at the patients’ use of three classes of antibiotics: fluoroquinolones; second-generation cephalosporins (cefuroxime, cefaclor, or cefprozil); or macrolides (clarithromycin or azithromycin).

The investigators also looked for any emergency-room visits or hospitalizations for severe blood sugar swings among the patients in the 30 days after they started taking the antibiotics.

The results showed that patients who took fluoroquinolones were more likely to have severe blood sugar swings than those who took antibiotics in the other classes. The level of risk varied according to the specific fluoroquinolone, according to the study, which was published in the journal Clinical Infectious Diseases.

The incidence of hyperglycemia (high blood sugar) per 1,000 people was 6.9 for people taking moxifloxacin, 3.9 for levofloxacin and 4.0 for ciprofloxacin. The incidence of hypoglycemia (low blood sugar) was 10 per 1,000 for moxifloxacin, 9.3 for levofloxacin and 7.9 for ciprofloxacin.

The incidence of hyperglycemia per 1,000 people was 1.6 for those taking the macrolide class of antibiotics and 2.1 for those on cephalosporins. The incidence of hypoglycemia per 1,000 people was 3.7 for macrolides and 3.2 for cephalosporins.

“Our results identified moxifloxacin as the drug associated with the highest risk of hypoglycemia, followed by levofloxacin and ciprofloxacin,” wrote Dr. Mei-Shu Lai, at National Taiwan University, and colleagues.

They said doctors should consider other antibiotics if they have concerns that patients might experience severe blood sugar swings.

“The study … does not prove a causal connection between particular fluoroquinolones and blood sugar dysregulation,” Ochner said. But he believes that it provides evidence that people with diabetes may be at special risk from moxifloxacin in particular.

“If moxifloxacin is to be prescribed to diabetic patients, there should be some additional expected benefit that justifies the increase in incurred risk,” Ochner said.

But another expert said there could be other explanations for why people on fluoroquinolones had more blood sugar fluctuations.

“It is hard to draw conclusions that fluoroquinolones themselves are the culprit, as all of these patients had infections, and infection can lead to hypo- or hyperglycemia in persons with diabetes,” said Dr. Alyson Myers, an endocrinologist at North Shore University Hospital in Manhasset, N.Y.

“In addition, those in the fluoroquinolone group were more likely to have chronic kidney disease or steroid use – the former can increase rates of hypoglycemia and the latter can increase rates of hyperglycemia,” Myers said. “Another confounding factor would be the type of diabetes treatments that patients were receiving, as sulfonylureas and insulin are both associated with greater risks of hypoglycemia than other diabetes medications.”

Source: Drugs.com

18-Year Study Finds Drug Cut Prostate Cancer Risk.

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A drug used to treat enlarged prostateand male pattern baldness also reduces a man’s risk of prostate cancer by nearly a third, according to a large new study.

The findings on nearly 19,000 men also overturn earlier concerns that treatment withfinasteride – the agent in the prostate drugProscar and the hair-loss drug Propecia – might promote the development of more virulent prostate cancers in men who contract the disease, researchers said.

Finasteride did not affect overall survival rates or survival rates after diagnosis with prostate cancer for men who did and did not receive the drug, said study lead author Dr. Ian Thompson, a urologist and professor at the University of Texas Health Science Center.

“If indeed the more high-grade cancers in the men taking finasteride were real, we would expect to find a higher death rate,” Thompson said. “The survival of these men was exactly the same.”

Published in the Aug. 15 issue of the New England Journal of Medicine, the study is an 18-year follow-up on the Prostate Cancer Prevention Trial, which took place in the late 1990s. Back then, the trial found that finasteride could reduce overall risk of prostate cancer by 25 percent – but that it increased by 27 percent the risk of high-grade prostate cancer in those men who did wind up with the disease.

The concern over the high-grade cancer findings led officials back then to decline recommending finasteride as a prostate cancer prevention tool. “Basically, this potential home-run prostate cancer intervention never happened,” Thompson said.

When checking back with the men involved in the earlier trial, researchers behind the new study found that the drug actually worked better than earlier reported in reducing prostate cancer risk.

They also found that detection of high-grade cancers occurred in 3.5 percent of prostate cancer patients who took finasteride and 3 percent of patients given a placebo. There was no difference between the finasteride and placebo groups regarding overall long-term survival or survival following a prostate cancer diagnosis.

“It shows that the higher proportion of high-grade disease doesn’t really matter, because it doesn’t affect the risk of death,” said Dr. Otis Brawley, chief medical officer for the American Cancer Society.

Brawley said the increased diagnosis of high-grade prostate cancer likely occurs due to finasteride’s effectiveness in shrinking enlarged prostates.

“You take Proscar for six months to a year and it halves the size of your prostate, but the cancer inside your prostate does not shrink,” Brawley said. “If I’m performing a biopsy on a smaller prostate, I’m more likely to hit that cancer than if I am sticking into a larger prostate. This drug wasn’t causing more prostate cancer. It’s causing more prostate cancer to be diagnosed.”

Since finasteride does not affect survival rates, its true value may lie in reducing the diagnosis of minor prostate cancers that should not be treated, Thompson and Brawley said.

Prostate cancer is the most commonly detected form of cancer in men, found in one in six men during their lifetimes, Thompson said. Prostate cancer kills only 3 percent to 5 percent of men, however.

Most men “will get away with it, dying of causes other than prostate cancer,” Thompson said.

Because of this, prostate cancer has become an overtreated disease, with men suffering side effects such as impotence and incontinence because they received treatment for a cancer that wasn’t likely to lead to their deaths, Brawley said.

“It does not affect a man’s risk of death at all to take finasteride, but if he takes finasteride it will lower his risk of being diagnosed with prostate cancer,” Brawley said. “Half to 60 percent of men who were diagnosed with localized prostate cancer, if it was never diagnosed, it would never have bothered them in their lifetimes. We cure some people who never need to be cured.”

Source: Drugs.com

Epilepsy Drug Warnings May Slip Through Cracks.

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One-fifth of American neurologists are unaware of serious safety risks associated with epilepsydrugs and are potentially risking the health of patients who could be treated with safer medications, a new study reveals.

The 505 neurologists who took part in the survey between March and July 2012 were asked if they knew about several epilepsy drugs’ safety risks recently identified by the U.S. Food and Drug Administration.

These risks included increased danger of suicidal thoughts or behaviors linked with some newer drugs, a high risk for birth defects and mental impairment in children of mothers taking divalproex (brand nameDepakote), and the likelihood of serious hypersensitivity reactions in some Asian patients treated with carbamazepine (Tegretol).

One in five of the neurologists said they did not know about any of these risks. Neurologists who treat 200 or more epilepsy patients per year were most likely to know all the risks, according to the study, which was published online recently in the journal Epilepsy.

Although this study focused on epilepsy drugs, the findings suggest that the FDA needs to find better ways to inform doctors about newly discovered drug safety risks, said the researchers from Johns Hopkins University School of Medicine. Their results show that warnings about these risks are not getting through to doctors making important prescribing decisions.

There is no single place for neurologists to find updated drug risk information, said study leader Dr. Gregory Krauss, a professor of neurology. A few get emails from the FDA, while others get the information from neurology societies, continuing medical education courses or journal articles.

“There is poor communication from the FDA to specialists, and there’s some risk to patients because of this,” Krauss said in a Johns Hopkins news release.

“Unless it’s a major change requiring the FDA to issue a black box warning on a product, important information appears to be slipping through the cracks,” he said. “We need a more systematic and comprehensive method so that doctors receive updated safety warnings in a format that guarantees they will see and digest what they need to protect patients.”

Source: Drugs.com

Experimental Drug Shows Promise for Rare Genetic Disorder.

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A new medication appears to be highly effective in combating a heredity-based form of the organ-damaging genetic disorder known as amyloidosis, according to researchers.

Amyloidosis refers to a family of more than a dozen diseases in which different types of abnormal proteins called amyloids lodge in major organs and nerves. These amyloids build up to the point that they cause damage and, ultimately, organ failure.

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The new therapy caused a marked decline in blood-borne levels of an amyloid protein called transthyretin, or TTR, in 32 patients suffering from amyloidosis during one of the two Phase I drug trials, said the study’s co-author, Dr. Akshay Vaishnaw, chief medical officer for Alnylam Pharmaceuticals, which developed the medication and funded the trials.

“We can dramatically reduce the levels of TTR protein,” Vaishnaw said. “In fact, we can reduce them by 94 percent. One shot a month will produce this reduction.”

The study findings are published in the Aug. 29 issue of the New England Journal of Medicine.

Amyloidosis is a very rare disease. Between 1,500 and 2,500 Americans a year are diagnosed with AL amyloidosis, the disorder’s most common form, according to Harvard Medical School. Heredity-based forms of amyloidosis, most of which are related to transthyretin, are even rarer.

People suffering from TTR amyloidosis eventually become wheelchair-bound as the buildup of abnormal proteins along the nerves causes painful neuropathy in their arms and legs, Vaishnaw said. Transthyretin amyloids also lodge in the heart, causing heart disease that can lead to irregular heartbeat and heart failure.

Nearly all transthyretin amyloids are produced by the liver and, up to now, liver transplant has been the only effective treatment for TTR amyloidosis, Vaishnaw said.

The new medication – tested in the trials in two versions, called ALN-TTR01 and ALN-TTR02 – is delivered via an intravenous infusion and works by inhibiting the genetic process that prompts the creation of transthyretin. Blocking transthyretin production in the liver causes blood levels of the amyloid to drop.

The drug produced no major side effects in the patients tested, Vaishnaw said, noting that one patient did suffer an infusion reaction unrelated to the drug.

“This is a very exciting report, but it’s also a very early report,” said Dr. Raymond Comenzo, director of the Blood Bank and Stem Cell Processing Laboratory at Tufts Medical Center in Boston. “There was clear-cut evidence of safety and of effectiveness in reducing circulating levels of transthyretin.”

However, more research will need to be done to show that the drug not only reduces TTR amyloid levels but also helps improve amyloidosis symptoms in patients, Comenzo added.

“One has to wonder what the road ahead is, how will the clinical development process work its way out,” Comenzo said. “The [U.S. Food and Drug Administration] is going to want to see a benefit that’s measured in terms more than just levels of circulating TTR.”

For example, he added, regulators will want to see a reduction in organ damage or an overall improvement in survival rates.

Vaishnaw said he expects to be able to show those kinds of results, given that previous studies have shown that amyloid deposits will begin flushing from a person’s organs if the levels of amyloid in the bloodstream decrease dramatically.

“It’s allowing the organs to clear the deposits that are already there,” Vaishnaw said. “We’re hoping that over time we’ll allow clearing of the existing deposits, which has been seen in other amyloidosis disorders.”

However, it will likely be years before the medication passes through drug trials and receives FDA approval, he added.

Source: Drugs.com