Protection from Alcohol-Induced Health Risks

By James LaValle, R.Ph, ND, CCN

You may remember my article from back in December [2008] discussing the good and bad effects of alcohol.  In it I warned women to stick to the one-glass-a-day rule to reduce risks from alcohol.  However, a recent study called the Million Women Study found that even one glass a day increased the risk of cancers in women. The study, which came out of the United Kingdom, found that in middle-aged women who drank anywhere from one to three drinks per day -- the risk of breast, liver, rectum, and in smokers, mouth and throat cancers, increased for each drink consumed.¹

One drink increased cancer rate by 15 cancers per 1000 women and this risk continued to double for each daily drink.  This study was significant because it involved a very big study population, most of whom drank wine, a form of alcohol that other studies have found has certain health benefits.

I know many women will look at that study and say, "Well, I am going to take my chances.  I am not giving up my one glass of wine!"    And that decision is probably OK because there may be a way to protect yourself.

You see the idea that even moderate alcohol consumption may increase cancer risks is not a new one.  Studies clear back into the early 1990s found the same thing.  However, other studies from back in the 1990s found that the increased cancer risk from alcohol may be largely because alcohol depletes folate.

Since folate plays a central role in the synthesis and replication of DNA, anything that disrupts it, like alcohol, could interfere with proper DNA replication and so could potentially initiate cancer.   More recent research indicates that folate also protects us because it is one of the important "methylating" nutrients that are the tags in our epigenetics. (See my recent article [February 2009] on epigenetics and how the powerful molecules called methyl groups seem to protect us against cancer and even obesity.) 

Alcohol blocks the absorption of folate and inactivates circulating folate in the body. But will making sure you get enough folate really protect you? Several studies have found that it does. 

For example, a 2007 study out of Sweden found that high folate intake can protect against breast cancer in women with moderate alcohol consumption.²  And data from the Nurses' Health Study has determined that high dietary intake of folate blunts the increased risk of breast cancer seen among women who drink more than one alcoholic drink per day; about 600 mcg was enough to cut the risk in half.³  

Another study that looked at a methyl-deficient diet as influenced by alcohol, folate and methionine intake found not only that a folate-deficient diet was indeed linked to damaged DNA, but that higher intakes of folate significantly protected against colorectal cancers in those who drank alcohol.⁴

Since this effect is more pronounced in women, I have to wonder if it is influenced not just by one's liquor cabinet, but by what's in the medicine cabinet.  Birth control pills can deplete folate, though this effect may be less pronounced on the newer lower estrogen dosage forms.  But if you are a female who moderately drinks alcohol and relies on oral contraceptives to prevent pregnancy, then boosting your folate intake is a double-must in my opinion.  

And there are other medications that can deplete folate like phenytoin (for seizures), sulfasalazine (for ulcerative colitis), triamterene (a blood pressure medication), some cholesterol lowering meds (cholestyramin and colestipol), aspirin, and anything that lowers stomach acid production like proton pump inhibitors.⁵

There is one other factor that could be influencing your risks from alcohol -- the genetic mutation called the C667T polymorphism, which prevents one from converting folic acid to its physiologically active form.  So, have your doctor test for MTHFR mutations, especially if you have any signs or symptoms of folate deficiency like depression or elevated homocysteine.  And if you test positive for the mutation, you may benefit as our patients do from taking the "methylated" form of folic acid, called 5-MTHF. 

So the message here if you are female and drink a daily glass of wine is to make sure you're taking in plenty of folate.  For further peace of mind, blood folate levels are easy to check, so ask your doctor to test you.  Folate is found in almost all fruits, vegetables, nuts, seeds, and beans as well as in fortified foods.  However, the intake of folic acid from fortified foods like cereals and food bars may increase health risks slightly. Laura explains more about that in her article.

References

1. http://www.medscape.com/viewarticle/588649.
2. Ericson U, et al. Am J Clin Nutr. 2007; 86:434-43.
3. Zhang S, et al. JAMA. 1999; 281:1632-1637.
4. Americans Still Refusing to Eat Their Vegetables. Found online at: http://www.msnbc.msn.com/id/17631389/.
5. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folic-acid/index.html.

[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:
Adiponectin Rising
By Missy Hawthorne, BSN, CSCS

As a fitness trainer who is also a registered nurse, I get very excited when I come across scientific information that tells us something new about how exercise improves our health.  I love sharing this information with my clients and now you, my Total Health Breakthroughs readers because it is very motivational and it re-affirms the time and effort we put into exercise. 

Recently, Dr. Jim LaValle with whom I work at the LaValle Metabolic Institute forwarded to me just such a piece of information -- a study that better explains how exercise helps us shed belly fat.  Since over 75% of my clientele are baby boomers, and many of them struggle to get rid of belly fat, I knew this would be interesting. 

In the past, we thought exercise helped us get rid of belly fat simply as a result of the increased calories burned.  Since then, several studies have shown that exercise actually helps improve insulin resistance.  We thought this may be because of the increase in muscle mass.  Muscle needs glucose as a source of fuel, and by increasing our muscle mass, we are helping to lower the blood glucose level, thus reducing the constant output of insulin.

However, this new study shows that there is something else involved -- exercise helps us shed belly fat because it increases the production of adiponectin.¹ 

Adiponectin is a hormone produced in fat cells that increases the effectiveness of insulin. Studies show when we have plenty of adiponectin, not only is our insulin production lower, our blood sugar is better controlled, and that decreases our risk of diabetes and heart disease.   Furthermore, people who have plenty of adiponectin generally have better controlled weight.  So, you would think that since adiponectin is produced in fat cells, as you gain weight, more adiponectin would be made, and we would have no problems.

However, when we gain weight, adiponectin production goes down. Weight that is gained in the belly, as opposed to weight gained more in the hips and thighs, is the weight that dramatically reduces adiponectin production.  So, as you gain weight and adiponectin production drops, your weight just gets worse.

But now we know that a way to get that adiponectin back up is through exercise!  In the study, brisk walking mixed with light jogging 4-5 days per week for 40 minutes per session increased adiponectin in adult overweight males. Adiponectin levels rose 260% after two to three bouts of exercise despite unchanged body weight, and even remained elevated after 10 weeks. 

This study used brisk walking alternated with light jogging, but any moderate aerobic exercise should have similar effects.  After the initial increase in adiponectin, no further increases in insulin sensitivity or fat oxidation were correlated with adiponectin, but the authors of the study think that the adiponectin may be jump-starting another as yet unknown mechanism by which exercise improves insulin sensitivity and weight loss.

If you need to lose belly fat or even if you don't, but want to prevent it, you now know an interesting hormone by the name of adiponectin that can help via exercise.  One more reason to keep moving!   

References

1. Kriketos, A. et al.  Diabetes Care, 2004, 27:629-630.

[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.]

Nutrition & Health:
Confused About Folate?
By Laura LaValle, RD, LD

At the risk of sounding redundant, I am making folic acid the topic of yet another article.  Why?  Because making sure you are getting enough folate is one of the most important things you can do for your health.  Yet if you read the headlines lately, you may be running scared from folate.  Should you take folate or shouldn't you, and if so, how much should you take?  Let's clear up some of the confusion.

First, the nomenclature.  Folate is the natural form of the nutrient that is found in foods.  Folic acid is the synthetic form that is used in many vitamins and for fortification of foods.

Remember, folate is the main nutrient involved in the repair and maintenance of our DNA, and that's why it is involved in everything from cancer, to birth defects, to cervical dysplasia.  Studies show that getting enough folate may help protect against several types of cancer, especially colon cancer.

And as Jim's article discussed, taking in adequate folate protects women who consume low to moderate amounts of alcohol from breast cancer.  Folate also helps ensure that we have adequate levels of SAMe, which plays a role in mood, protecting against devastating depression.   And while many families are debating whether their young daughters should take an HPV vaccine to protect against cervical cancer, it goes completely un-heralded that folate reduces cervical cancer risk significantly.¹

Because of a high rate of neural tube defects, the United States decided in 1998 to start fortifying foods with folic acid, and it has been very successful.² But some studies have found that getting too much folic acid may increase cancer risks slightly in adults, and these are the headlines that have people running scared.  Moreover, recent studies which found that folic acid didn't lower risk of heart disease have led to headlines that are implying, "Hey, don't bother with folate."

Some important clarifications about this topic were made in the newsletter from the Harvard School of Public Health, called The Nutrition Source.  First and foremost, they point out that the increased cancer risks are slight, and that they are linked primarily to the over consumption of folic acid from fortified foods like cereals and pasta.

The newsletter explained that the reason for the increased health risks may be that at very high intakes of folic acid, the body can't process it all into the active form, and the presence of the unconverted folate prevents uptake of converted folate  into the brain and other tissues.

The risks of too much folate from fortified foods though small, deserve further study, but the experts at Harvard aptly point out that the vast majority of the evidence shows that "humans show a lower risk of colon and breast cancer with greater intakes of folate or folic acid," -- not an increased risk.³

Folate from foods poses no health risks, possibly because its absorption and efficacy are enhanced by the presence of other nutrients in the foods.  The folks at Harvard recommend taking a multivitamin with 400 mcg of folate, and also making sure to eat plenty of natural food sources of folate.

The multivitamin is especially important if you know you are not eating enough fruits, vegetables, beans, nuts and seeds each day.  For people who consume alcohol regularly, they recommend getting at least 600 mcg of folate per day.⁴ This is especially important for women.

But how are we to get enough folate without getting too much from over-fortified cereals and pastas?  It really isn't that hard.  As you can see from the list below, 5-6 servings of fruits and vegetables per day should cover it!

Natural Sources of folate:^5,6
Beef liver, 3 oz (I recommend organic only) -- 185 mcg
Black-eyed peas, 1/2 cup cooked -- 105 mcg
Spinach, 1/2 cup cooked --100 mcg
Great Northern beans, 1/2 c. cooked -- 90 mcg
Asparagus, 5 spears -- 100 mcg
Turnip greens, 1/2 cup -- 80 mcg
Strawberries, 8 medium-sized -- 80 mcg
Brussels sprouts, 1/2 cup cooked -- 80 mcg
Broccoli, 1 cup cooked --100 mcg

References

1. http://cancerres.aacrjournals.org/cgi/content/full/64/23/8788.
2. Lumley, J, et al. (2001) Cochrane Database Syst. Rev. 3CD001056.
   
3. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folic-acid/index.html#1.
   
4. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-b/index.html.
   
5. http://ods.od.nih.gov/factsheets/folate.asp.
   
6. http://www.folicacidnow.net/foodSources.html#four.

[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:
Cincinnati-Style Chili Over Spaghetti Squash
By Laura LaValle, RD, LD

Here in Cincinnati, where I currently live, people love their chili.  When I first tried Cincinnati chili, I was surprised at the difference in taste from Southwest versions.  Cincinnati chilis are actually derived from Greek origins, and you'll see the list of ingredients is quite unique.  Spiced with cinnamon, cumin, cloves and even a little cocoa, it is loaded with antioxidants.

While it is traditionally served over spaghetti and topped with raw onions, hot sauce, and mounds of cheese, the dietitians at LMI modified the recipe for a wheat and cow's milk dairy free version that I like just as much.

Time to table: 1 hour
Serves: 8

Healing Nutrient Spotlight
Excellent source of vitamin C, iron, niacin, vitamin B-6, vitamin B-12, zinc, selenium, manganese
Good source of vitamin A, thiamin, riboflavin, magnesium, copper

Ingredients*
1 T. olive oil
1/2 cup chopped onion
2 lbs. organic grass-fed ground beef
¼ cup chili powder
1 tsp. ground cinnamon
1 tsp. ground cumin
¼ tsp. ground allspice
¼ tsp. ground cloves
1 bay leaf
1/2 of a 1-ounce square unsweetened chocolate
2 10.5-ounce cans beef broth
1 15-ounce can tomato sauce
2 T. cider vinegar
¼ tsp. ground cayenne pepper
2 medium spaghetti squash
1 cup goat's cheese feta crumbles
finely chopped sweet onions
hot sauce

*Use organic ingredients for optimal nutrition.

Preparation
Heat oil in a large saucepan over medium heat. Add onion and cook, stirring frequently, until tender, about 6 minutes. Add ground beef and cook, breaking it up with a wooden spoon, until browned.  Add chili powder, cinnamon, cumin, allspice, cloves, bay leaf, chocolate, beef broth, tomato sauce, cider vinegar, and cayenne pepper. Stir to mix well. Bring to a boil. Reduce heat to low; cover and simmer 1 1/2 hours, stirring occasionally. Remove the bay leaf prior to serving.

Meanwhile, prepare spaghetti squash.  Cut squash in half lengthwise. Scrape out only the seeds as you would with any squash or pumpkin. Bake cut side down in shallow pan along with a few tablespoons of water for about 30 to 40 minutes at 375°F.  You can also microwave the squash for 6 to 8 minutes or until tender.  Separate "spaghetti" strands by running a fork through lengthwise from stem to stem.  Serve sauce over squash and top with finely chopped sweet onions, hot sauce, and goat's milk feta if desired.

Nutrition
410 calories, 38 g protein, 18 g carbohydrates, 21 g fat, 9 g saturated fat, 2 g monounsaturated fat, 1 g polyunsaturated fat, 110 mg cholesterol, 2 g sugars, 4 g fiber, 709 IU vitamin A, .2 mg thiamin, .3 mg riboflavin, 7 mg niacin, .9 mg pantothenic acid, .5 mg vitamin B-6, 28 mcg folate, 2 mcg vitamin B-12, 17 mg vitamin C, 72 mg calcium, .4 mg copper, 4 mg iron, 55 mg magnesium, 733 mg potassium, 27 mcg selenium, 860 mg sodium, 7 mg zinc

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These articles appear courtesy of Early to Rise’s Total Health Breakthroughs [Issue 03-24-09] which offers alternative solutions for mind, body and soul. For a complimentary subscription, visit http://www.totalhealthbreakthroughs.com/