the-psoriasis-treatment

The figure below (click to enlarge) is from the outstanding book Physiology of sport and exercise , by Jack H. Wilmore, David L. Costill, and W. Larry Kenney. If you are serious about endurance or resistance exercise, or want to have a deeper understanding of exercise physiology beyond what one can get in popular exercise books, this book should be in your personal and/or institutional library. It is one of the most comprehensive textbooks on exercise physiology around. The full reference to the book is at the end of this post. The hormonal and free fatty acid responses shown on the two graphs are to relatively intense exercise combining aerobic and anaerobic components. Something like competitive cross-country running in an area with hills would lead to that type of response. As you can see, cortisol spikes at the beginning, combining forces with adrenaline and noradrenaline (a.k.a. epinephrine and norepinephrine) to quickly increase circulating free fatty acid levels. Then free fatty

One of the considerations with congestive heart failure is the need for fluid restriction and the patient will need to work her doctor to be able understand how much she should be getting daily. Sodium restriction is important for bringing down the blood pressure. In the case of this woman, I would employ a DASH diet to bring down her blood pressure with emphasis on plenty of fruits and vegetables as well as dairy products such as yogurt to obtain regular amounts of calcium. Since being overweight contributes to higher blood pressure, if she is overweight, then the DASH diet should be combined with a weight loss program by restriction of calories. Regular aerobic exercise can also support healthy blood pressure levels. I'd recommend about 30 minutes three times weekly. Because of her condition, I'd also recommend supplementation with CoQ10 to support the function of the heart. If she has a low vitamin D status, which is associated with higher blood pressure, then I'd also r

Postprandial glucose levels are the levels of blood glucose after meals. In Western urban environments, the main contributors to elevated postprandial glucose are foods rich in refined carbohydrates and sugars. While postprandial glucose levels may vary somewhat erratically , they are particularly elevated in the morning after breakfast. The main reason for this is that breakfast, in Western urban environments, is typically very high in refined carbohydrates and sugars. HbA1c, or glycated hemoglobin, is a measure of average blood glucose over a period of a few months. Blood glucose glycates (i.e., sticks to) hemoglobin, a protein found in red blood cells. Red blood cells are relatively long-lived, lasting approximately 3 months. Thus HbA1c (given in percentages) is a good indicator of average blood glucose levels, if you don’t suffer from anemia or a few other blood abnormalities. Based on HbA1c, one can then estimate his or her average blood glucose level for the previous 3 months or

This cut of pork is the equivalent in the pig of the filet mignon in cattle. It is just as soft, and lean too. A 100 g portion of roasted pork tenderloin will have about 22 g of protein, and 6 g of fat. Most of the fat will be monounsaturated and saturated, and some polyunsaturated. The latter will contain about 450 mg of omega-6 and 15 mg of omega-3 fats in it. The saturated fat is good for you. The omega-6-to-omega-3 ratio is not a great one, but a 100 g portion will have a small absolute amount of omega-6 fats, which can be easily offset with some omega-3 from seafood or a small amount of fish oil. Pork tenderloin is easy to find in supermarkets, and is much less expensive than filet mignon, even though it is a relatively expensive cut of meat. Below are the before and after photos of a roasted pork tenderloin we prepared and ate recently; a simple recipe follows the photos. This type of cooking leads to a Maillard reaction , which is clear from the browning of the meat and around

Engineered foods are designed by smart people, and the goal is not usually to make you healthy; the goal is to sell as many units as possible. Some engineered foods are “fortified” with the goal of making them as healthy as possible. The problem is that food engineers are competing with many millions of years of evolution, and evolution usually leads to very complex metabolic processes. Evolved mechanisms tend to be redundant, leading to the interaction of many particles, enzymes, hormones etc. Natural foods are not designed to make you eat them nonstop. Animals do not want to be eaten (even these odd-looking birds below). Most plants do not “want” their various nutritious parts to be eaten. Fruits are exceptions, but plants do not want one single individual to eat all their fruits. That compromises seed dispersion. Multiple individual fruit eaters enhance seed dispersion. Plants "want" one individual animal to eat some of their fruits and then move on, so that other individu

Gallstones develop in the gallbladder, a small organ that stores and releases the bile made by the liver. Bile is a dark green fluid containing bile salts and cholesterol. The gallbladder releases bile into the small intestine to assist in digesting fats more efficiently. However, if the bile is contains high concentrations of cholesterol, then stones too difficult for the bile salts to dissolve may develop (1). Losing weight too quickly or fasting can cause development of gallstones. The quick weight loss and fasting is thought to disturb the balance of bile salts and cholesterol (2;3). The risk may increase if consuming a diet too low in fat. Avoiding fat reduces frequency of gallbladder emptying. This, in turn, may cause cholesterol to accumulate and lead to greater risk of forming stones (3;4). References 1. Dowling RH. Review: pathogenesis of gallstones. Aliment Pharmacol Ther 2000;14 Suppl 2:39-47. 2. Wudel LJ, Jr., Wright JK, Debelak JP, Allos TM, Shyr Y, Chapman WC. Prevention

Pernicious anemia, a megaloblastic anemia caused by B12 deficiency, is associated with hyperhomocysteinemia. Because B12 is needed for methionine synthase to methylate homocysteine to methionine, a deficiency causes an accumulation of both homocysteine and methylmalonic acid (1). When both are elevated, marking the pernicious anemia, it can lead to progressive demyelination and neurological deterioration. A folate deficiency may also result in megaloblastic anemia. If homocysteine is elevated but not methylmalonic acid, then the result is probably a folate deficiency. It is important for treatment to be correct. Large doses of folate can correct, or "mask," symptoms of pernicious anemia, which can result in irreversible neuropathy (2). References 1. Devlin TM. Textbook of Biochemistry with Clinical Correlations. Philadelphia: Wiley-Liss, 2002 2. Pagana, K.D., Pagana, T.J. Mostby's Manual of Diagnostic and Laboratory Tests, 3rd ed. Mosby Elsvier, 2006

I thought this was an interesting article from Businessweek a couple of years ago and was blown away by the numbers showing that few people actually receive any benefit from statins. If you don't read it, then here are a few tidbits from the article that I thought would give it to you in a nutshell: ...for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. ...an estimated 10% to 15% of statin users suffer side effects, including muscle pain, cognitive impairments, and sexual dysfunction "There's a tendency to assume drugs work really well, but people would be surprised by the actual magnitude of the benefits," For anyone worried about heart disease, the first step should always be a

Currently, the existing biomarkers for a cardiac event include B-type natriuretic peptide, tro-ponins and C-reactive protein. C-reactive protein is an acute-phase protein released in response to inflammation. Recently, the development of a high-sensitivity assay for CRP (hs-CRP) has been made available. The assay works because it can accurately reflect even low levels of CRP. There have been quite a few prospective studies that have shown that an assay of a baseline CRP can be used as a marker for cardiovascular events. When patients have a test that shows elevated levels, it is even a better marker than LDL cholesterol for predicting events such as myocardial infarction. An elevated test, however, can also mean hypertension, metabolic syndrome or diabetes, or a chronic infection. In addition, Lipoprotein (a), or Lp(a), when combined with C-reactive protein, can increase the predictive value of a cardiac event. This is especially true for those who have normal cholesterol levels. The r

When a patient is on a statin, nutritionists should advise that they don’t have to suffer from the side effects of statin-associated muscle pain (myalgia). Studies are showing that supplementation with two key compounds are useful for decreasing the pain. The first is ubiquinone (coenzyme Q10, coQ10) and the other is cholecalciferol (vitamin D3). Statins such as Lipitor, Zocor and Mevacor reduce cholesterol synthesis by directly inhibiting the enzyme HMG-CoA reductase and deplete production of its product, mevalonate (1). Mevalonite, however, is also the precursor to coQ10 and squalene. Both of these are vital nutrients with profound effects on the body. CoQ10 CoQ10 is a lipid-soluble antioxidant playing a protective effect in the membranes of every cell in the body. In that capacity, it serves to protect against oxidative damage to cells. Equally important, the compound is necessary for electron transfer in the mitochondrial electron transport chain for producing energy (2). Without

For the sake of simplicity, this post treats “atheism” as synonymous with “non-spiritualism”. Technically, one can be spiritual and not believe in any deity or supernatural being, although this is not very common. This post argues that atheism is a recent Neolithic invention; an invention that is poorly aligned with our Paleolithic ancestry. Our Paleolithic ancestors were likely very spiritual people; at least those belonging to the Homo sapiens species. Earlier ancestors, such as the Australopithecines, may have lacked enough intelligence to be spiritual. Interestingly, often atheism is associated with high intelligence and a deep understanding of science. Many well-known, and brilliant, evolution researchers are atheists (e.g., Richard Dawkins ). Well, when we look at our ancestors, spirituality seems to have emerged as a result of increased intelligence. Spirituality can be seen in cave paintings, such as the one below, from the Chauvet Cave in southern France. The Chauvet Cave is b

The text below is all from commenter Jack C.’s notes on this post summarizing research on cheese. My additions are within “[ ]”. While the comments are there under the previous post for everyone to see, I thought that they should be in a separate post. Among other things, they provide an explanation for the findings summarized in the previous post. *** During [the] cheese fermentation process the vitamin K2 (menaquinone) content of cheese is increased more than ten-fold. Vitamin K2 is anti-carcinogenic, reduces calcification of soft tissue (like arteries) and reduces bone fracture risk. So vitamin K2 in aged cheese provides major health benefits that are not present in the control nutrients. [Jack is referring to the control nutrients used in the study summarized in the previous post .] Another apparent benefit of aged cheese is the breakdown of the peptide BCM7 (beta-casomorphin 7) which is present in the casein milk of most cows (a1 milk) in the U.S. BCM7 is a powerful oxidant and i

Several bacteria feed on lactose, the sugar found in milk, producing cheese for us as a byproduct of their feeding. This is why traditionally made cheese can be eaten by those who are lactose intolerant. Cheese consumption predates written history. This of course does not refer to processed cheese, frequently sold under the name “American cheese”. Technically speaking, processed cheese is not “real” cheese. One reasonably reliable way of differentiating between traditional and processed cheese varieties is to look for holes. Cheese-making bacteria produce a gas, carbon dioxide, which leaves holes in cheese. There are exceptions though, and sometimes the holes are very small, giving the impression of no holes. Another good way is to look at the label and the price; usually processed cheese is labeled as such, and is cheaper than traditionally made cheese. Cheese does not normally spoil; it ages. When vacuum-wrapped, cheese is essentially in “suspended animation”. After opening it, it is

Angioplasty is a procedure performed by inserting a catheter with a deflated balloon into an affected artery, then inflated to open the artery. Sometimes a stent, or mesh tube, is left to keep it open. The procedure does come with some risk, in fact, having the potential of inducing a heart attack. If a patient is uncomfortable with an angioplasty, there are now other alternatives that may be just as effective without the procedure. Medical researchers, for example, have been evaluating the combined approach using anti-coagulants, thrombolytic therapy (clot-dissolving drugs) and cholesterol-lowering drugs. According to Dr. Eric J. Topol of the Cleveland Clinic, the treatment has been deemed effective in at least a few small studies (1). Other cardiologists look to intensive-lipid therapy alongside dietary supplements such as fish oil and vitamin D. According to Dr. William Davis, the integrated therapy has been shown to help slow progression of atherosclerosis and even reverse it in a

I have been doing a lot of reading over the years on isolated hunter-gatherer populations; see three references at the end of this post, all superb sources (Chagnon’s book on the Yanomamo, in particular, is an absolute page turner). I also take every opportunity I have to talk with anthropologists and other researchers who have had field experience with hunter-gatherer groups. Even yesterday I was talking to a researcher who spent many years living among isolated native Brazilian groups in the Amazon. Maybe I have been reading too much into those descriptions, but it seems to me that one distinctive feature of many adults in hunter-gatherer populations, when compared with adults in urban populations, is that the hunter-gatherers are a lot less obsessed with food. Interestingly, this seems to be a common characteristic of physically active children. They want to play, and eating is often an afterthought, an interruption of play. Sedentary children, who play indoors, can and often want t

Atherosclerosis refers to accumulation of a thick sludge in patches that merge to form large plaques, called atheromas, in artery walls. The plaque is made up of cholesterol and other fats, macrophages, cell "junk", calcium, and tissues. LDL cholesterol is associated with atherogenesis because as it becomes oxidized it can induce endothelial cells to attract blood-borne monycytes, transforming them into macrophages and trapping them in endothelial spaces (1). The macrophages then engorge themselves with cholesterol and fat creating "foam cells. Then, once engorged, they release inflammatory cytokines that only lead to even more macrophages creating more foam cells (1). Along with damaged smooth muscle cells, the foam cells then form the sludge plaque, or fatty streak, that narrows lumen as it grows larger causing blood flow to to become restricted (1). Medications There are various drugs that can help to slow or reverse atherosclerosis, which include cholesterol-lowerin

The idea that heavy physical activity is a main trigger of heart attacks is widespread. Often endurance running and cardio-type activities are singled out. Some people refer to this as “death by running”. Good cardiology textbooks, such as the Mayo Clinic Cardiology , tend to give us a more complex and complete picture. So do medical research articles that report on studies of heart attacks based on comprehensive surveys. Reddy and colleagues (2009) studied sudden cardiac arrest events followed by death from 2002 to 2005 in Multnomah County in Oregon. This study was part of the ongoing Oregon Sudden Unexpected Death Study. Multnomah County has an area of 435 square miles, and had a population of over 677 thousand at the time of the study. The full reference to the article and a link to a full-text version are at the end of this post. The researchers grouped deaths by sudden cardiac arrests (SCAs) according to the main type of activity being performed before the event. Below is how the

Sodium’s association with high blood pressure is well known. However, sodium also plays a large role in keeping you healthy. It’s important to know how to strike the right balance. Along with potassium, sodium is essential for fluid balance, facilitating the flow of water in and out of cells to bring nutrients in and take wastes away. Sodium also has a role in the regulation of blood pressure and helping muscles and the heart relax. Each sodium ion contains an electrical charge, acting as an electrolyte, which allows transmission of nerve impulses to the brain and throughout the body. Sodium levels in the body are controlled by the kidneys. If the body doesn’t receive enough sodium daily—a chronic problem for our early ancestors—then the kidneys retain sodium. When the body has a high enough amount, then the excess sodium is excreted in the urine. At times, sodium levels may fluctuate. If a person has a dysfunctional kidney, then the body may retain too much sodium, which can result in

I use one particular olive oil for cooking and another extra-virgin olive oil to mix with some balsamic vinegar for my salads. Olive oil, as the staple source of fatty acids in the Mediterranean diet, has also been heavily researched for its health benefits especially in comparison to other sources of fat such as butter, corn or soy oil. On April 20, a study in BMC Genomics was published that found that olive oil eaten at breakfast modified gene expression in patients with metabolic syndrome (1). The breakfast caused the changes in mononuclear cells after intake of the olive oil and repressed pro-inflammatory genes (1). The study was performed on 20 patients in a double-blind randomized trial (1). The researchers noted that many of the genes were also implicated in type 2 diabetes, dyslipidemia and obesity (1). The study adds to evidence that olive oil helps reduce inflammation unlike other oils such as butter (2) and, thereby, adds to the reasons why the Mediterranean diet is associa

Regardless of type of exercise, disease markers are generally associated with intensity of exertion over time. This association follows a J-curve pattern. Do too little of it, and you have more disease; do too much, and incidence of disease goes up. There is always an optimal point, for each type of exercise and marker. A J curve is actually a U curve, with a shortened left end. The reason for the shortened left end is that, when measurements are taken, usually more measures fall on the right side of the curve than on the left. The figure below (click to enlarge) shows a schematic representation that illustrates this type of relationship. (I am not very good at drawing.) Different individuals have different curves. If the vertical axis was a measure of health, as opposed to disease, then the curve would have the shape of an inverted J. The idea that long distance running causes heart disease has been around for a while. Is it correct? If it is, then one would expect to see certain thin

Fibromyalgia, or chronic fatigue syndrome, has increased by 200 to 400 percent in the last decade and now affects approximately 6-12 million Americans. It's a syndrome with symptoms of hormonal, sleep and autonomic control dysfunctions. Those with fibromyalgia often suffer from widespread pain in muscles, poor sleep, and low energy levels. Co-existing conditions are food reactivities and irritable bowel syndrome, migraine headaches, chronic sinusitis, restless leg syndrome and sleep apnea. Medical treatment may include analgesics for pain relief such as with acetaminophen or NSAIDS. Most will require treatment for hypothyroidism with Armour Thyroid. A Cortef prescription or supplementation with adrenal glandulars or licorice is also helpful for adrenal support. Lastly, sex hormone therapy may be needed. Nutritional support may include supplements of iron to guard against iron-deficiency anemia,which may contribute to lacking energy, as well as coQ10, which is fat-soluble antioxidan

Niacin is a very interesting vitamin. It is also known as vitamin B 3 , or nicotinic acid. It is an essential vitamin whose deficiency leads to a dreadful disease known as pellagra . In large doses of 1 to 3 g per day it has several effects on blood lipids, including these: it increases HDL cholesterol, decreases triglycerides, and decreases Lp(a) . Given that this is essentially a reversal of the metabolic syndrome, for those who are on their way to developing it, niacin must really do something good for our body. Niacin is also a powerful antioxidant. The lipid modification effects of niacin are so consistent across a broad spectrum of the population that some companies that commercialize niacin-based products guarantee some measure of those effects. The graphs below (click to enlarge) are from Arizona Pharmaceuticals, a company that commercializes an instant-release niacin formulation called Nialor (see: arizonapharmaceuticals.com). The graphs show the peak effects on HDL cholestero