Inflammation -- Cut It Off at the Pass

By James LaValle, R.Ph, ND, CCN

Internal inflammation is now known to be an underlying factor in almost all chronic disease, for example heart disease. Control it and you should be able to drastically reduce your risk for not just one but several diseases.

Oxidative stress (OS) is a term used to describe internal inflammation and the free radicals produced as a result. Free radicals are neutralized by antioxidants. Thousands of articles over the last few years have carried the message loud and clear to consumers, "Make sure you are taking in enough antioxidants to help counteract internal inflammation."

Yet some recent studies that have looked at the disease preventive effects of taking antioxidants have had dismal outcomes. So people are getting mixed messages and are wondering, "Does taking in additional antioxidants do any good?"

There are two issues playing out here. One is that in these recent studies, the types of antioxidants used were very dated, and the dosages were low. A study just reported in the November 2008 JAMA gave some participants 400 IU of synthetic alpha-tocopherol (vitamin E) and 500 mg of a synthetic ascorbic acid (vitamin C) to see if it lowered cancer or heart disease risk compared to those who didn't take the supplements. It didn't lower any risks.

Unfortunately, this study was started in 1997, just before a 1998 study found that natural vitamin E was much better absorbed than synthetic forms.¹ And further study has found that mixed tocopherols are even better at protecting us against free radical damage than just alpha-tocopherol alone.

Synthetic ascorbic acid is absorbed about the same as vitamin C contained in foods, so absorption may not be the reason no benefits were seen, but dosage may be. One study found that those who took in 700 mg or more of vitamin C per day had a 25% lower risk of developing coronary heart disease.²

So, the form of nutrients given and the dosages given MUST be considered to draw an accurate conclusion. From this study, we can conclude that when people were given low dosages of two synthetic vitamins, it was not enough to lower their disease risks.

That should not be surprising to anyone, because of the other big issue at play here, which is this -- the sheer quantity of free radicals we are dealing with is astronomical. If you don't do anything to reduce your oxidative stress or internal inflammation to begin with, it may not be realistic to expect a few antioxidant supplements to protect you.

The answer to inflammation and free radicals isn't simply to take in as many antioxidants as we can. A much wiser approach is to look at the causes of rampant free radical production and do all we can to address them. Here are some of the factors that raise inflammation, free radicals and oxidative stress:

1. Metabolic imbalances. For example, low thyroid function raises oxidative stress. A disease itself can cause oxidative stress -- for example, hypertension was found to be both a cause and effect of OS.³
2. Belly fat is a huge source of inflammation; it puts out inflammatory compounds like IL-6 and TNF-alpha.
3. Diet. Too many sugars and trans fats steer our prostaglandin pathways toward inflammation. In addition, sugars consumed in excess can "glycate" our tissues. Glycation occurs when a sugar molecule attaches to a protein molecule and causes biochemical damage. Glycated tissues cannot function properly and are a source of free radicals. Overheated oils contain free radicals that can increase oxidative stress in our body. If you combine these dietary factors with low antioxidant intake from fruits, vegetables and beans, you have a diet that promotes oxidative stress.
4. Chronic sleep deprivation. Research has shown that lack of sleep causes higher than normal blood glucose levels^4,5 which again takes us back to glycation. Then you get a double whammy since sleep deprivation lowers production of melatonin, a potent antioxidant.⁶
5. Chronic stress can affect all these areas because it increases belly fat⁷ and disrupts sleep.⁸ Increased stress hormones can also disrupt thyroid hormone conversion, causing even more inflammation.
6. Pollution is another cause of increased free radicals in our body. Heavy metals like mercury and lead cause very high free radical production, which is one of the reasons they cause disease. Lead is associated strongly with heart disease, for example.

How high would our antioxidant intake have to be to counter all this? From my experience, it is pretty high. While antioxidants in foods hold great promise for reducing disease risks (see Laura's article), it only makes sense that we should reduce the free radical production where possible, as well.

Change the diet, manage chronic stress, and by all means be proactive in preventing or reversing metabolic imbalances like low thyroid or insulin resistance using supplements as the needs indicate. For instance, alpha-lipoic-acid (ALA), a potent antioxidant, has been shown to decrease blood pressure and increase insulin sensitivity.⁹

Don't be discouraged by the headlines on these studies saying that antioxidants don't work. You can address oxidative stress, but the best approach is to find a health practitioner that can help you measure your level of oxidative stress, look at all the factors contributing it, and develop a comprehensive program to address it.

References

1. Burton G, et al. Am J Clin Nutr. 1998;67:669-84.
   
2. Knekt P, et al. Am J Clin Nutr. 2004;80(6):1508-1520.
   
3. Hypertension. 2006;48; 828-829.
   
4. Lancet. 1999;354:1435-39.
   
5. Journal of Clinical Endocrine Metabolism. 2004;89(11):5762-71.
   
6. http://www.ncbi.nlm.nih.gov/pubmed/12220332.
   
7. Epel E, et al. Psychosomatic Medicine. 2000(62):623-32.
   
8. Buckley TM and Schatzberg AF. J Clin Endocrin Metab. 2005.
   
9. Hypertension. 2002;39:303-307

[Ed. Note: James LaValle is the founding Director of the LaValle Metabolic Institute, one of the largest integrative medicine practices in the country. Dr. LaValle is the author of The Metabolic Code Diet: Unleashing the Power of Your Metabolism for Lasting Weight Loss and Vitality and the Executive Editor of THB's The Healing Prescription.]

Cutting Edge Fitness:
Turn Back the Hands of Time with Interval Training
By Missy Hawthorne BSN, CSCS

Exercising daily has become the mantra for good health. While studies show that any amount of physical activity you get will be of benefit to your health, the research is also clear that the more you exercise, the greater the health benefits (as long as you have no signs of overtraining). Exercise not only lowers your disease risks, it improves your quality of life as you age.

But did you know that exercise can add years to our life as well? In studying people who live longer, exercise has been the only lifestyle factor that is consistently associated with living longer. Recent studies have shown that interval training in particular can decrease your biological age by 10 years¹ -- in effect adding 10 years to your life!

With interval training, the intensity of the exercise becomes high enough to significantly increase the oxygen demands of the muscles, which in turn slows aging. Interval training is also a highly efficient workout, meaning you can great results in shorter periods of time. So for any of you who haven't yet tried interval training, I thought I would get you acquainted with what it is and how to do it.

Interval training consists of short bursts of intense exercise followed by brief periods of active recovery. To increase the heart rate during the intense phases, you must manipulate one or more variables such as speed, incline, resistance or impact. Running on a treadmill at a fast pace followed by brief periods of a much slower speed is one way to interval train. Another way to interval using the treadmill is to walk or run on an incline for a given amount of time followed by brief periods of walking or running on a flat surface. The incline changes the mechanics of movement increasing the intensity of the workout.²

You can also increase the intensity by adding weight; this makes the muscles work harder to move your skeleton. This variable can be easily manipulated on cardiovascular machines like the treadmill and elliptical or while executing a single exercise by incorporating added weight.

Plyometrics (or explosive movements) such as leaping, hopping or jumping are very effective in adding intensity as well. These movements get the heart rate up and can be alternated with any lower intensity movement such as slow walking or stepping in place.

Keep it simple by changing one variable at a time. It makes no difference to the body which variable changes, as long as the muscles work harder, oxygen demands increase and the heart rate goes up. And consider your current fitness level. To avoid injury, do not increase weight or speed for example, any higher than is needed to get the heart rate up. Slowly increase the variable as you become more fit.

If you think you are ready to incorporate interval training into your workouts, the final consideration is the actual time spent in the "high intensity" interval versus the recovery time. The goal is to sustain "high intensity" for 30 seconds to one minute allowing heart rates to climb to high levels.

The recovery time is then proportional to the intensity and length of the "high intensity" phase. I have found 30 seconds of "all-out" intensity followed by 15 seconds recovery is not only very challenging but clients tend to work harder overall. Sticking to exact time increments is not as important as the alternating intensities.

So as that biological clock continues to tick, try to remember just how much a little extra effort and sweat can really do to slow that clock down and add years to your life!

References

1. Bellantyne, C. 2009. Does Exercise Really Make You Healthier? Scientific American, 1-4.
2. Ashmore, Amy. 2009. Slow Down Aging With Interval Training. Idea Fitness Journal, 30-32.

[Ed. Note: Melissa Hawthorne, RN, BSN, CSCS is the owner of Priority Fitness Personal Training and Wellness. She is a Master Trainer for the Resist-a-ball Company, ISCA Personal Training, Kick-boxing, and Beamfit. Melissa serves as a fitness consultant for the LaValle Metabolic Institute. To learn more, click here.]

Nutrients & Health:
Antioxidants - Can You Get Too Many?
By Laura LaValle, RD, LD

As a result of an increased awareness of the damaging effects of free radicals, everywhere you turn someone has a high antioxidant supplement they want you to buy. They range from supplements containing vitamins C and E and the trace mineral selenium (give or take a few nutrients) to supercharged juices made from exotic berries, like acai berries. The prices are anywhere from about $10.00 all the way up to $70.00 for a bottle of juice; or $2.00 for one small square of acai-added chocolate.

One of the features used to market these products is their high ORAC value, and the manufacturers are now trying to outdo one another by getting higher and higher on their ORAC values. So what is ORAC and are these products really worth the high prices?

ORAC stands for oxygen radical absorbance capacity.¹ Researchers at the National Institute of Aging developed ORAC testing as a way to measure the level of antioxidant protection capacity of a product or food. If a product has a high ORAC value, it has the ability to neutralize many free radicals.

Diets that are plentiful in high ORAC foods are associated with decreased disease risks,² and more recent studies are trying to clarify which compounds are responsible for those benefits. For example a study of several high antioxidant legumes (black bean, kidney beans, lentils and more) found that these foods have the potential for preventing the development of atherosclerosis (plaque formation) by inhibiting LDL cholesterol oxidation. The study found that the foods' phenolic compounds seemed to be most responsible for that effect, and that the foods' ORAC values correlated well with those effects.³

When most people think about antioxidant protection they tend to think about the well-marketed super fruits such as gogi berries (from China) and acai berries (from Brazil). Freeze-dried acai berry is indeed very high in antioxidants with an ORAC value of 161,400 units. Gogi berries have an ORAC score of 25,300, but there are many common foods that also have high ORAC scores that can be found at your supermarket right now.

Spices, for example. The ORAC value of ground cloves is very impressive at 314,416 units. Cinnamon and oregano are also right up there on the list of high ORAC foods. Unsweetened dry cocoa powder weighs in at 80,933 units. Pecans have a score of 17,940, and English walnuts which are known for their healthy omega-3 fats, have an ORAC value of 13,541. Kidney and black beans both have ORAC scores greater than 8,000.

A good website to visit for easy ORAC searches is http://oracvalues.com/sort/orac-value/. The values reported are for 100 grams of the food.

As Jim described, we find that the best way to lower oxidative stress is to address all the factors causing the increased oxidative stress to begin with, but for the dietary component we follow at LMI, we don't send patients out with acai drinks or pills. These products can be quite expensive and they only address one thing -- ORAC value. And believe it or not, we are still learning about all the effects of an excessively high intake of antioxidants, even those from substances like plant flavonoids. Some studies are showing they may have negative effects, like inhibiting key enzymes in the body.⁴

Researchers will continue to try to identify if there is a level of antioxidant intake that is too high. In the meantime, many people eat diets that are almost devoid of antioxidants, and in this polluted world, that is not good. So, I want to emphasize that the preponderance of the evidence does show dietary antioxidants are beneficial to our health, and even the researchers who are concerned, say that antioxidants are safe and beneficial even at amounts that would be consumed from a typical vegetarian diet, which is much higher than a typical low fruit and vegetable intake diet.

We try to put our patients' dollars to better use by choosing supplements for them that address their specific health needs. We find that a low carbohydrate, organic foods diet that includes plenty of high antioxidant foods like spices, beans, nuts, plentiful vegetables and 1-2 servings of fruit or berries each day can go a long way to reducing oxidative stress -- without the expensive super-high ORAC supplements that still need more research.

References

1. What Is ORAC? Found online at: http://www.oracwatch.org/what_orac.php.
   
2. Leighton F, et al. Drugs Exp Clin Res. 25:133-141
   
3. Xu BJ, et al. Journal of Food Science. Found online at:
   http://www3.interscience.wiley.com/journal/118510071/abstract.
   
4. Skibola CF, et al. Free Radic Biol Med. 200 Aug; 29(3-4):375-83.

[Ed. Note: Laura B. LaValle, RD, LD is presently the director of dietetics nutrition at LaValle Metabolic Institute. Laura and her husband, Jim LaValle, R.Ph, CCN, ND have developed the powerful and life-changing Metabolic Code Diet - containing step-by-step, easy to follow recommendations for harnessing optimal metabolic energy and turning your body's chemical make up into a fat-burning furnace.]

Healthy Recipes:
Mushroom Pâté Almondine
By Laura LaValle, RD, LD

Mushrooms are a good source of B-vitamins and are a wonderful base to this savory pâté. With only 7 net carbs per serving, this is yet another great way to enjoy a flavorful snack while keeping your blood sugar in check. Enjoy it as a dip with assorted vegetables or with low-carb crackers.

Serves: 6

Time to Table: 40 minutes

Healing Nutrient Spotlight
Good source of vitamin C, riboflavin, niacin, selenium, copper, manganese

Ingredients*
2 cups chopped onion
1 T. olive oil
4 garlic cloves, minced or pressed
1 ½ cups chopped green beans
4 cups sliced mushrooms (about 14 ounces)
2 T. dry white wine or sherry
1 T. soy or tamari sauce
½ tsp. dried thyme
2 T. slivered raw almonds, toasted
1 hard-boiled egg, chopped

*Use organic ingredients for optimal nutrition

Preparation
Place almonds on a cookie sheet and bake at 350°F for about 5 minutes or until lightly browned. Set aside.

In a medium skillet, sauté onions over medium heat in olive oil for about 10 minutes or until translucent. Add garlic, green beans, mushrooms, wine or sherry, soy or tamari sauce, and thyme. Reduce heat to medium low. Cover and cook for 10 minutes, then uncover and cook for another 10 to 15 minutes or until the vegetables are very soft and most of the liquid has evaporated.

Combine toasted almonds, cooked vegetables and egg in a blender or food processor and puree until well blended. Serve with assorted raw vegetables.

Nutrition
104 calories, 4 g protein, 10 g carbohydrates, 5 g fat, 1 g saturated fat, 3 g monounsaturated fat, 1 g polyunsaturated fat, 35 mg cholesterol, 5 g sugar, 3 g fiber, .3 mg riboflavin, 2 g niacin, .2 mg vitamin B-6, .9 mg pantothenic acid, 7 mg vitamin C, 35 IU vitamin D, .3 mg copper, .2 mg manganese, 292 mg potassium, 8 mcg selenium, 170 mg sodium

(This recipe is adapted from the Moosewood Cookbook.)

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These articles appear courtesy of Early to Rise’s Total Health Breakthroughs [Issue 03-10-09] which offers alternative solutions for mind, body and soul. For a complimentary subscription, visit http://www.totalhealthbreakthroughs.com/