July 12th, 2016

L-carnosine: A Underutilized Dietary Supplement

Carnosine is a naturally occurring molecule composed of two amino acids, histidine and alanine. As a dietary supplement, it has been available for years. However, it is not nearly as popular as it should be based on the existing science. Carnosine functions in “excitable” tissues, such as muscle and nerve tissue, and reaches high concentrations in skeletal muscle. In these tissues, it is critically important in maintaining the proper pH and electrical charge.

Carnosine is often confused with carnitine. Both contain the root word carn, meaning flesh, as they are both found in higher concentrations in meat (and fish). Since vegetarian sources of protein are do not contain carnosine, a vegetarian (especially vegan) diet may not provide adequate pre-formed carnosine, but like carnitine the human body is thought to be capable of manufacturing sufficient quantities. Nonetheless, like carnitine, supplementation with carnitine has its place in nutritional medicine. At this time, clinical studies in humans has shown carnosine supplementation to:

• Improve muscle function and recovery from muscle fatigue.
• Protect against degeneration of the brain as well as loss of cognitive function and memory associated with aging.
• Improve mental function and behavior in children with attention deficit disorder and autism.
• Heal peptic ulcers when it is combined with zinc.

A Closer Look at Carnosine Functions

In addition to being important in regulating the electrical charge in excitable tissue, research has shown carnosine to be important to cellular health for other reasons. In muscles, carnosine neutralizes the extensive formation of lactic acid during high intensity exercise, and promotes recovery from exercise. These effects accelerate the working capacity of muscle exhausted by preceding exercise, and explains carnosine’s popularity among bodybuilders and athletes for improving muscle function and recovery from muscle fatigue.

Carnosine is also an important intracellular antioxidant. Carnosine has been proven to scavenge reactive oxygen species (ROS) as well as protect against peroxidation of cell membrane fatty acids during oxidative stress. It has also demonstrated significant anti-aging effects related in part to its antioxidant effects, but it also prevents glycation (the attachment of sugar molecules to proteins) associated with premature aging.

Carnosine is especially critical in protecting the brain against neurodegeneration, as well as loss of cognitive function and memory. Carnosine has also been shown to rejuvenate connective tissue cells, which may explain its beneficial effects on wound healing as well as its use in trying to fight off the effects of aging in the skin, causing wrinkles and loss of elasticity. Carnosine levels in the body decline with age. By the time a person is 70 years old, carnosine levels have decreased in their body by 63 percent. Because of all of these effects and others, carnosine is becoming well known as a longevity and anti-aging nutrient.

Clinical Research with Carnosine

The primary focus of the clinical research on carnosine has focused on its anti-aging effects, as well as its effects on brain function.

In regard to general anti-aging effects, several clinical studies have highlighted the potential of carnosine in slowing down the aging process by preventing oxidative damage, as well as glycation. In addition, carnosine has also been shown to directly and indirectly inhibits release of inflammatory mediators such as cytokines. Reducing silent inflammation is becoming another key target, not only for an anti-aging strategy, but also to help prevent the development of chronic degenerative diseases like heart disease, diabetes and neurodegenerative disorders, such as Parkinson’s and Alzheimer’s disease. Given the unique actions of carnitine within the brain, it may be an ideal agent for preventing age-related declines in cognitive function and memory as well.

In regard to boosting brain power, several double-blind, placebo-controlled studies have looked at the use of carnosine in patients with neurodegenerative conditions. In one study compared a daily dose of either 0.75g or 2g of carnosine to a placebo, for 21 days, in 42 patients with chronic encephalopathy a brain disorder that is a progressive degenerative disease most often seen in individuals with a history of multiple concussions and other forms of head injury. Significant improvements in cognitive function and reductions in oxidative stress were found in the carnosine group.

Another study examined the effect of 1.5g of carnosine daily for 30 days in Parkinson’s patients treated with L-Dopa. The addition of carnosine to the treatment regimen significantly improved neurological symptoms, with a 36 percent improvement in symptoms compared to a 16 percent improvement in the control group. Clinical signs of Parkinson’s disease, including decreased bodily movements, and rigidity of extremities, were also significantly improved. This improvement in the “everyday activity” of Parkinson’s patients allows them more independence and better quality of life, leading the authors of the study to conclude that carnosine is a reasonable way of improving the treatment of Parkinson’s disease and decreasing the possible toxic effects of standard drug therapy.

Because of carnosine’s beneficial effects in improving both muscle and brain function, researchers at Georgetown University recently assessed its effects in Gulf War illness (GWI) or chronic multisymptom illness (CMI); terms used to describe the disabling fatigue, widespread pain and cognitive dysfunction experienced by about 25 percent of 1990-1991 Persian Gulf War veterans.

A leading theory proposes that GWI/CMI is the result of wartime exposure to a variety of factors including vaccinations, various chemicals and stress. These factors initiate prolonged production of inflammation, free radicals, and the resulting injury to the brain, nervous system and muscle tissue. Since carnosine has been shown to protect the brain and muscle cells from the sort of damage underlying GWI/CMI, a double-blind, placebo-controlled study was designed to determine if nutritional supplementation with L-carnosine would significantly improve pain, cognition and fatigue in GWI. The 12-week study involved 25 GWI subjects who were given L-carnosine at 500, 1000 and 1500mg increasing at four-week intervals or a placebo. Primary outcomes included measures assessing cognitive function; feelings of fatigue and pain; and activity levels. The only measure that showed consistent benefit was the influence of carnosine supplementation on improving mental function.

While researchers had hoped to see improvement in all areas of GWI/CMI, the ability of carnosine supplementation to improve mental function in these patients was significant and adds additional clinical support for carnosine in this application.

Carnosine may also be helpful in improving brain function in autism. In one double-blind, placebo-controlled trial in 31 children with autism carnosine was shown to improve expressive and receptive vocabulary and subjective improvement on an autism rating scale over an eight-week trial at a dosage of 800mg/day.

Zinc Carnosine to Relieve Peptic Ulcers

Zinc increases mucin production in cell culture studies and has been shown to have a protective effect on peptic ulcers in animal studies. In human studies, zinc supplementation appears to be helpful for healing peptic ulcers with zinc bound to carnosine being the most beneficial. Clinical studies in humans using zinc carnosine demonstrate not only an ability to heal peptic ulcers, but also antagonize the bacteria (Helicobacter pylori or H. pylori) linked to indigestion (dyspepsia), peptic ulcer disease, and stomach cancer. When 60 patients suffering from dyspepsia with H. pylori infection were given either antibiotics alone (lansoprazole, amoxycillin and clarithromycin) or antibiotics plus zinc carnosine for seven days, better results were seen with the group getting zinc carnosine (94 percent success rate vs. 77 percent).

In one double-blind trial, 248 patients with confirmed gastric ulcers were randomly assigned to one of four groups receiving 150mg daily of zinc-carnosine extract or its respective placebo, or 800mg of cetraxate hydrochloride (a mucosal protective agent) or its respective placebo. Study medications were started within one week of endoscopy-diagnosed gastric ulcer and were continued for eight weeks. At eight weeks, 75 percent of the zinc-carnosine group experienced markedly improved symptoms compared to 72 percent for the cetraxate group. The endoscopic cure rate was 60.4 percent in the zinc-carnosine group and 46.2 percent in the cetraxate group at eight weeks.

Dosage Recommendations

The typical dosage recommendation for taking advantage of the anti-aging effects of carnosine is 1,500 to 2,000 mg per day. For children with autism, the dosage is 800 to 1,000mg per day. For peptic ulcers and indigestion, the dosage for zinc carnosine is usually 75mg twice daily.

There are no adverse effects or drug interactions at the recommended dosage levels.

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July 9th, 2016

The Rising Epidemic of Gout

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More than likely you are familiar with gout, an inflammatory arthritis triggered by crystallization of uric acid within the joints. It causes severe pain and swelling. Gout has reached epidemic proportions in the Unites States as it now affects about 10 million people—or about 5 percent of the adult population. In addition, elevations in blood uric acid levels are found in over 43.3 million (21 percent) adults in the U.S.
With gout affecting so many Americans, it is important to understand what it is and what natural approaches may be helpful in preventing gout attacks.

What Causes Gout?

Gout is the result of either increased synthesis of uric acid; reduced ability to excrete uric acid; or both over production and under excretion of uric acid.

Several dietary factors are known to be trigger gout, including consumption of alcohol, high-purine-content foods (organ meats, meat, yeast, poultry, etc.), fats, refined carbohydrates and excessive calories.

Here’s a closer look:

• Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production, which impairs kidney function. Elimination of alcohol is all that is needed to reduce uric acid levels and prevent gouty arthritis in many individuals.

• A low-purine diet has long been the mainstay of dietary therapy for gout. Foods with high purine levels should be entirely omitted. These include: organ meats, meats, shellfish, yeast (brewer’s and baker’s), herring, sardines, mackerel and anchovies. Intake of foods with moderate levels of protein should be reduced as well. These include: dried legumes, spinach, asparagus, fish, poultry and mushrooms.

• Refined carbohydrates, fructose, and saturated fat intake should be kept to a minimum. Simple sugars (refined sugar, honey, maple syrup, corn syrup, fructose, etc.) increase uric acid production, while saturated fats decrease uric acid excretion. The diet should focus on complex carbohydrates, such as legumes, whole grains and vegetables, rather than on simple sugars.

• Liberal fluid intake keeps the urine diluted and promotes the excretion of uric acid. Furthermore, dilution of the urine reduces the risk of kidney stones. Drink at least 48 ounces of water each day.

Cherries to the Rescue

One of the old folk remedies for preventing gout attacks is the consumption of cherries. There is a growing body of science to support this recommendation. For example, consuming one-half pound of fresh or canned cherries daily has been shown to be very effective in lowering uric acid levels, preventing attacks of gout, and reducing blood markers of inflammation. In the most recent study, researchers found that cherry intake (defined as one-half cup or 10 to 12 cherries or the equivalent in extract form) over a two day period was associated with a 35 percent lower risk for gout attacks and that cherry extract intake was associated with a 45 percent lower risk.

Cherries, hawthorn berries, blueberries, and other dark red-blue berries are rich sources of flavonoids (plant pigments) known as anthocyanidins and proanthocyanidins. In addition to consuming these fruit as food, extracts of cherry, bilberry, grape seed, or pine bark can be used as dietary supplements to ensure sufficient intake of the beneficial compounds that help fight gout. The typical dosage recommendation for these flavonoid rich extracts is 150 to 300 mg daily.

Celery Seed Extract

The compound 3-n-butylphthalide, or 3nB for short, is unique to celery and is responsible for the characteristic flavor and odor of celery. A celery seed extract standardized to contain 85 percent 3nB and other celery phthalides has shown benefit in the treatment of “rheumatism”—the general term used for arthritic and muscular aches and pain. In these studies that included gout sufferers, the pain had been present for approximately 10 years in a remittent or continual form and it led to a lack of joint mobility and pain that prevented the carrying out of household duties, hobbies and activities involved in employment of these subjects.

The results of the studies were extremely positive and quite statistically significant. The chance that such a positive effect in reducing pain in these subjects was a placebo effect was less than one in 1,000. Subjects experienced significant pain relief after three weeks of use with the average reduction in pain scores of 68 percent and some subjects experiencing complete 100 percent relief from pain. Most subjects achieved maximum benefit after six weeks of use although some did notice improvements the longer the extract was used. It appears to be particularly helpful for sufferers of gout as 3nB lowers the production of uric acid by inhibiting the enzyme xanthine oxidase.

These benefits persisted even after taking into account factors that can affect gout risk, such as gender, obesity, purine intake (in foods that can increase gout risk), plus use of alcohol, diuretics and anti-gout medications.

The recommended dosage for celery seed extract (85 percent 3nB and related phthalides) is 75 to 150 mg twice daily.

Final Comment

Obesity and its related insulin resistance are associated with a significant increased risk for gout as well as an earlier age of onset. Weight loss in overweight individuals is associated with significant improvement in blood uric acid levels and gout symptoms. Therefore, safe and effective weight loss is a primary treatment goal in overweight individuals.

July 6th, 2016

Promoting Breast Health

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Dealing with fibrocystic breast disease reduces the risk for breast cancer.

Breast cancer is a major fear for many women these days. The fear comes from the fact that many have watched someone close to them succumb to this disease and/or its treatment. Fortunately, there is much that can be done through diet and lifestyle to dramatically reduce the risk of breast cancer.

One of the risk factors for breast cancer is fibrocystic breast disease (FBD). Though it is not as significant a factor as the major breast cancer risk factors, family history, early onset of menstruation (menarche), and late or no first pregnancy. It does carry with it increased risk and is a major reason why many women are subjected to mammograms as the lumps of FBD often cannot be easily distinguished from breast cancer. FBD does provide some additional insight on how a woman can reduce her risk of breast cancer.

The Importance of Dietary Fiber and Probiotics in Breast Health

Breast disease, both breast cancer and FBD, has been linked to low fiber diet and constipation. In one interesting study published over 40 years ago in the medical journal The Lancet, researchers noted an association between abnormal cell structure from breast cells in nipple aspirates of breast fluid and the frequency of bowel movements; women that had fewer than three bowel movements per week had a risk of FBD that was 4.5 times greater than women having at least one a day. This association is probably due to the absorption of gut-derived toxins and a less than ideal bacterial flora in the large intestine transforming various toxic metabolites including carcinogens and mutagens. The take a way message is to promote effective elimination and detoxification by keeping things moving. A high fiber diet is critical in this goal.

One of the key ways in which the body gets rid of toxic chemicals as well as hormones like estrogen is by attaching glucuronic acid to them in the liver and then excreting this complex in the bile. Beta-glucuronidase is a bacterial enzyme that uncouples (breaks) the bond between the excreted estrogen and glucuronic acid. When beta-glucoronidase breaks the bond, the freed estrogen is available to be reabsorbed back into the body instead of being excreted. An elevated beta-glucuronidase activity is associated with an increased risk for various cancers, particularly hormone-dependent cancers like breast and prostate cancer as well as in colon cancer.

There are some very easy ways to reduce the activity of this bacterial enzyme and increase the excretion of estrogen. A very simple, yet effective way is to increase the intake of high fiber foods, especially vegetables and legumes. Women on a vegetarian diet excrete two to three times more estrogens than women on an omnivorous diet who also reabsorb more estrogens. Furthermore, omnivorous women have 50 percent higher average level of free estrogen reabsorbed from the intestinal tract. This difference is most likely due to the higher fiber intake of the vegetarian diet.

A higher intake of dietary fiber is associated with a more favorable gut flora. In women with FBD or concerned about breast cancer, recommending a high quality probiotic is very much indicated. Probiotic supplementation has been shown to lower the activity of beta-glucuronidase and may also help improve bowel function as well. Two very important goals in promoting breast health. The recommended dosage is 5 to 12 billion colony-forming units (CFU) of Lactobacillus and/or Bifidobacteria sp. daily.

Increase Phytoestrogens Vegetarian diets are also high in “phytoestrogens” that are able to bind to the same cell receptors as the estrogen your body produces. That’s a good thing, because when phytoestrogens occupy the “parking places,” estrogen can’t produce effects on cells. By competing with estrogen, phytoestrogen causes a drop in estrogen effects, and are thus sometimes called antiestrogens. Great sources of phytoestrogens include soy and soy foods, ground flaxseeds, and nuts and seeds. In fact, taking 1 tablespoon of ground flaxseeds daily is a very good recommendation for breast cancer prevention and breast health.

Fish Oils

Fish oils provide the long chain omega-3 fatty acids EPA and DHA. Women with the highest ratio of the long-chain omega-3 fatty acids EPA and DHA to omega-6 fatty acids (the omega-3:omege-6 ratio) had a 67 percent reduced risk of breast cancer making it one of the most powerful nutritional factors in preventing breast cancer. Take 1,000 to 3,000 mg of EPA+DHA from a high quality fish oils.

Cabbage Family Vegetables

Cabbage family vegetables such as broccoli, cauliflower, cabbage and kale contain anticancer phytochemicals known as glucosinolates that are potent stimulators of natural detoxifying enzymes in the body. Studies have shown that increasing the intake of cabbage family vegetables or taking the chief glucosinolates indole-3-carbinol (I3C) or DIM as a dietary supplement significantly increased the conversion of estrogen from cancer-producing forms to non-toxic breakdown products. Adding one or two servings daily of cooked cruciferous vegetables to the diet or taking supplements containing IC3 (400 mg daily) or DIM (2 mg/kg/day) shifts the ratio from bad to good estrogen breakdown products.

Vitex Agnus-Castus (chasteberry)

One of the most useful herbal remedies for breast health is vitex. The evidence in the treatment of FBD has been reported in both randomized and non-randomized studies. In one study, 1,634 women with FBD after three months of treatment with vitex, 81 percent of patients rated vitex as a good or very good treatment for FBD. The use of vitex for women is often reserved for those who are also showing other signs of PMS (mood swings, depression, irritability, etc.). The usual dosage of chaste berry extract (often standardized to contain 0.5 percent agnuside) in tablet or capsule form is 175 to 225 mg daily.

Final Comment

Another key recommendation for breast health is to drink more green tea or take a green tea extract. Population-based studies have shown green tea consumption reduces breast cancer risk. For example, studies have suggested that breast cancer rates are lower in Japan in part because people there typically drink about three cups of green tea daily. To achieve the same degree of protection from supplements containing green tea extract would mean taking a daily dose of 300 to 400 milligrams.