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Alternative Approaches to Medicine: Living Well Beyond 100 Years of Age ______________________ Coping With Change

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Title: Alternative Approaches to Medicine: Living Well Beyond 100 Years of Age ______________________ Coping With Change


1
Alternative Approaches to Medicine Living Well
Beyond 100 Years of Age______________________Cop
ing With Change Conference
The Ohio State University Retirees' Association
  • Glen Aukerman, MD
  • Medical Director
  • The Ohio State University
  • Center for Integrative Medicine

2
Objectives
  • Participants will have greater understanding of
  • Complementary and Alternative Medicine (CAM) Use
    Among Older Adults
  • Important to Communicate with your doctors about
    herbs, nutrition, nutritional supplements
  • Credible information about supplements and herbal
    products, their safety and effectiveness
  • Nutritional needs for increased functioning and
    reduced effects of aging
  • How other Systems of Health-Care, Ayurveda

3
Complementary and Alternative Medicine (CAM) Use
Among Older Adults
  • Older adults increasingly use complementary and
    alternative medicine
  • 2000 Health and Retirement Study showed
  • 88 of respondents 65 years and older used CAM
  • Dietary supplements 65
  • Chiropractic 46
  • Age correlated with use of dietary supplements
    and personal practices
  • inversely correlated with alternative
    practitioners
  • Men reported less CAM use than women
  • Men use more chiropractic and personal practices
  • Blacks and Hispanics used fewer dietary
    supplements, less chiropractic
  • more personal practices than Whites
  • Advanced education correlated with fewer
    chiropractic visits
  • more dietary and herbal supplement and personal
    practices use
  • More alternative practitioner use
  • Higher income, functional impairment, alcohol use
    and frequent physician visits correlated
  • No association between CAM use and number of
    chronic diseases
  • Ness J, Cirillo DJ, et al. Use of Complementary
    Medicine in Older Americans results from the
    Health and Retirement Study. The Gerontologist.
    45516-524 (2005)

4
CAM Use Among Rural Older Adults
  • CAM use, older rural white and black adults
  • 41-75 of older adults were using some form of
    CAM
  • Most common CAM used by this population were
  • prayer 85
  • vitamins 83
  • exercise 64
  • Other forms of CAM reported were meditation,
    herbs, chiropractic, glucosamine, and music
    therapy
  • Money was spent on CAM
  • 45 of respondents reported spending lt 100/year
    on CAM
  • Note may be due to limited income, lack of
    insurance coverage for CAM, and limited
    availability of CAM in rural areas
  • Cuellar N, Aycock T, Cahill B, Ford J.
    Complementary and Alternative Medicine Use by
    African American and Caucasian American Older
    Adults in a Rural Setting. BMC Complementary and
    Alternative Medicine 2003, 38

5
CAM Use Among Urban Older Adults
  • Cross-sectional analysis of medical charts 65
    years of age, urban academic hospital
    geriatrics practice
  • Elements measured included
  • a) CAM use Prevalence 64
  • b) proportion of CAM supplements and herbs
    (CAMsh) reported by patients and documented in
    patients charts 35
  • c) 46 of patients reporting taking CAMsh with
    anticoagulant activity (ginger, gingko, garlic,
    vitamin E) while concomitantly taking prescribed
    anticoagulant medications
  • 52 took a prescribed anticoagulant (per chart)
  • 48 took CAM but not prescribed anticoagulants
  • d) 46 of patients for whom the CAM
    anticoagulant was not documented in the chart
  • Cohen RJ, Ek K, Pan CX. Complementary and
    Alternative Medicine Use by Older Adults. The
    Journals of Gerontology Series A Biological
    Sciences and Medical Sciences 57M223-M227 (2002)
    Ther Gerontological Society of America

6
CAM Use Among Older Adults
  • Conclusions
  • CAM use is prevalent among older adults
  • Health care professionals should recognize that
    CAM may be used very differently among a variety
    of racial and ethnic backgrounds
  • Patients often do not report or under-report CAM
    use
  • CAM frequently not documented in the patients
    chart if reported
  • Health care professionals should encourage
    patients to discuss CAM activity, particularly
    vitamin/herb supplements, as these may cause
    potentially harmful drug-supplement interactions


7
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8
Increased Life Expectancy Last Century
  • 30 years added to ave. US life expectancy
  • 100 years ave American life span expected this
    century
  • Decreases in early-life mortality
  • Decreases in mid-life mortality from medical
    advances
  • Curative medicine will play a lesser role
  • Nutrition and Supplements will play larger role
  • Aging population has increased health care costs
  • Costs will increase more as we have even longer
    lives
  • Unless we become more healthy through
    Nutrigenetics
  • Establishing and safeguarding optimal health from
    early life must become increasingly important
  • Concerns for governments and health care
    providers
  • Allocate resources wisely
  • Ensure and maintain a high quality of life in the
    population through better nutrition and
    fitness

9
The Future of Living Well to 100
  • Healthy aging presents an enormous challenge
  • Advances in biological sciences provide the
    knowledge and tools needed to
  • understand nutrition at genetic and molecular
    levels and
  • elevate the scientific basis underlying
    nutritional recommendations
  • Understanding roles requires interdisciplinary
    cooperation of
  • nutrition
  • genetics,
  • inflammation
  • Developing partnerships among specialties to
    promote the goal of healthy aging
  • come together as a science community
  • generate the evidence base to influence
    recommendations
  • Value of nutrition and genetics in achieving
    healthy aging
  • Am. J. Clinical Nutrition, Feb 2006 83 488s -
    490s. Gordon W Duff, Peter Libby, José M
    Ordovas, and Philip R Reilly

10
The Different Paths to 100
  • Most centenarians do not have significant
    disability
  • 90 of centenarians functionally independent _at_
    ave. age of 92 years
  • A more enabling point of view emerges to achieve
    extreme old age
  • The older an individual gets, the healthier he or
    she has been
  • Centenarians show
  • Relative resistance to age-related diseases
  • Slower aging
  • Where are we heading
  • 1 centenarian per 10,000 persons in the United
    States NOW
  • 1 centenarian per 5,000 persons for
    industrialized nations SOON
  • Ability to survive to extreme old age appears to
    be the result of
  • Complex combination of
  • Genetics,
  • Environment
  • Lifestyle (Diet, Exercise,Social Activities), and
    Luck
  • The Future Path lies in
  • Better Perinatal Nutrition Omega-3, Nutrients
  • Genetics of the Very Old
  • Identifying the molecular drivers of longevity or
    mortality omega 3/6 ratio

11
Starting Down the Right Path Nutrition
Connections With Chronic Diseases of Later Life
  • Prevention-oriented life cycle approach is
    critical to
  • Establishing and maintaining health throughout
    life
  • Delay and compress morbidity (sickness) and
  • Decrease the social toll associated with chronic
    disease and disability for as long as possible
    into old age
  • Good evidence that early nutrition affects key
    risk factors for
  • Chronic degenerative diseases of middle and later
    life, such as
  • Osteoporosis and
  • Cardiovascular disease
  • Influence of nutrition on health status and
    morbidity supports primary, secondary, and
    tertiary prevention of disease and intervention
    strategies at each point in the process
  • Enable people to live well, longer
  • Minimize chronic disability
  • Johanna Dwyer, Am. J. Clinical Nutrition, Feb
    2006 83 415S - 420S

12
Genetics of Aging Implications for Drug
Discovery
  • Aging is not a passive activity,
  • But an actively regulated metabolic process
  • Specific genes identified that regulate aging,
  • Aging and Longevity are only partially under
    genetic influence
  • Rest of Gain is from Nutrition
  • It is possible to increase life span by
    environmental modification
  • caloric restriction can increase life span
  • dysregulation of glucose homeostasis is a
    hallmark of aging in humans
  • type 2 diabetes, a disease of glucose
    homeostasis, is a form of accelerated aging
  • Aging and Diabetes are both common risk factors
    for a wide range of diseases
  • Aging and Diabetes are related at a molecular
    level
  • Andrew S Greenberg and Martin S ObinAm. J.
    Clinical Nutrition, Feb 2006 83 461s - 465s
  • Bard J Geesaman, Am. J. Clinical Nutrition, Feb
    2006 83 466S - 469S

13
Influence of Human Genetic Variation on
Nutritional Requirements
  • Genetic variation is known to affect food
    tolerances among human subpopulations and may
    also influence dietary requirements, giving rise
    to the new field of nutritional genomics and
    raising the possibility of individualizing
    nutritional intake for optimal health and disease
    prevention on the basis of an individual's genome
  • Gene-diet interactions are complex and poorly
    understood, the use of genomic knowledge to
    adjust population-based dietary recommendations
    is not without risk
  • Current recommendations target most of the
    population to prevent nutritional deficiencies,
    inclusion of genomic criteria may indicate
    subpopulations that may incur differential
    benefit or risk from generalized recommendations
    and fortification policies
  • Current efforts to identify gene alleles that
    affect nutrient utilization have been enhanced by
    the identification of genetic variations that
    have expanded as a consequence of selection under
    extreme conditions
  • Patrick J Stover, Am. J. Clinical Nutrition,
    Feb 2006 83 436S - 442S

14
Evidence for Genetic Variation A Factor in
Maintaining Health
  • Influence of Genetics subtle, complex, not
    conforming to simple Mendelian patterns of
    inheritance as is seen with single-gene disorders
  • Genetic Variation can influence the propensity
    for the initiating event, the progression to a
    clinical disease state, and the trajectory of
    disease
  • Interleukin 1 example genetic variations
    affecting complex diseases is provided by the
    interleukin 1 family of cytokines
  • Key role in mediating inflammation central
    component of many chronic diseases
  • Coronary artery disease
  • Rheumatoid arthritis
  • Research has identified many sequence variations
    in regulatory DNA of the genes coding for
    important members of the interleukin 1 family,
    and these variations are associated with
    differential effects on the inflammatory response
  • These in turn alter the risk of some diseases in
    which inflammation plays a role and also affect
    physiologic responses, such as the inflammatory
    response to exercise. As this new genetic
    knowledge is developed and extended, it may be
    possible to make health care interventions at an
    earlier stage, before clinical disease is
    established, rather than after tissues have been
    permanently damaged
  • Gordon W Duff, Am. J. Clinical Nutrition, Feb
    2006 83 431S - 435S

15
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16
Chronic Illnesses Diet-Related Health Problems
Are the Most Serious Threat to Public Health
  • Sixty-five percent of US adults aged gt20 years
    overweight or obese
  • 280,184 deaths per year attributable to obesity
  • gt 64,000,000 Americans have cardiovascular
    disease (CVD) 38.5 deaths
  • Leading cause of mortality in the United States.
  • 50,000,000 Americans are hypertensive
  • 11,000,000 Americans have type 2 diabetes, and
  • 37,000,000 adults have high-risk total
    cholesterol (gt240 mg/dL)
  • Postmenopausal women aged gt50 years
  • 7.2 have osteoporosis and
  • 39.6 have Osteopenia
  • Osteoporotic hip fractures 20 excess mortality
    in the year after fracture
  • Cancer 25 of all deaths in the United States,
  • is the second leading cause of death
  • one-third of all cancer deaths are due to
    nutritional factors, including obesity

17
Nutrients Restore The Immune System
  • Changes in USDA Food Composition Data for 43
    Garden Crops, 1950 to 1999, Protein, Ca, P, Fe,
    Pyridoxine, and Vit C all decreased
  • The Fundamentally Altered 7 Crucial Nutritional
    Characteristics of Modern Diets and the Impact of
    Health in The 21st Century
  • Associations of Mortality With Ocular Disorders
    and an Intervention of High-Dose Antioxidants and
    Zinc, Age-Related Eye Disease Study
  • Relation Between Dietary N3 and N6 Fatty Acids
    and Clinically Diagnosed Dry Eye Syndrome in
    Women when om 6 om 3 gt 61
  • The Western Diet Frequently Contains Excessive
    Saturated and Trans Fatty Acids, Too Little N3
    PUFAs versus excess N6 PUFAs
  • Western Diet Yields a Net Acid Load Renal
    Failure
  • Latex Exposure comes from inhaled auto tires but
    Immune system is depressed when we eat foods
    laden with naturally occurring latex
  • Role of Thiamine and B Complex in High Calorie
    Malnutrition

18
Inflammation and Neurodegenerative Diseases
  • Mental Fitness Decline in Alzheimer Disease
    accompanies
  • Physical changes in the brain, including the
    development of
  • characteristic plaques and
  • Neurofibrillary tangles
  • Pathogenesis of those changes is not clear
  • Activation of microglia in response to injury,
    illness, aging, or other causes begins a cascade
    of events characterized as an inflammatory
    process
  • Cascade is mediated at first by the
    proinflammatory cytokine interleukin 1, which is
    over expressed by the activated microglia
  • Interleukin 1 causes neuronal death, which
    activates more microglia, which in turn release
    more interleukin 1 in a self-sustaining and
    self-amplifying fashion
  • Over a period of years, this slow smoldering
    inflammation
  • in the brain destroys sufficient neurons
  • to cause clinical signs of Alzheimer disease
  • W Sue T Griffin,Am. J. Clinical Nutrition, Feb
    2006 83 470S - 474S

19
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20
The Fundamentally Altered 7 Crucial Nutritional
Characteristics of Modern Diets
Food staples and food-processing procedures
introduced during the Neolithic and Industrial
Periods have fundamentally altered 7 crucial
nutritional characteristics of ancestral hominin
diets 1) glycemic load 2) fatty acid composition
omega 63 ratio 3) macronutrient composition 4)
micronutrient density 5) acid-base balance 6)
sodium-potassium ratio, and 7)
fiber content
21
Changes in USDA Food Composition Data From1950
to 1999 for 43 Garden Crops
  • All 43 fruits and vegetables tested show
    statistically reliable declines (R lt 1) for 6
    nutrients
  • Protein, 6
  • Calcium,
  • Phosphorus,
  • Iron,
  • Riboflavin 38
  • Vitamin C
  • Conclusions
  • Declines are generally changes in cultivated
    varieties between 1950 and 1999, in which there
    may be trade-offs between yield and nutrient
    content
  • Observations
  • Need to replace those nutrients not available in
    current Western Food Supply
  • Donald R. Davis, PhD, FACN, Melvin D. s, PhD and
    Hugh D. Riordan, MD

22
Nutritional Needs As We Age
  • Nutritional Needs for Increased Functioning and
    Reduced Effects of Aging in the Elderly
  • Avoid Latex in Foods,
  • Decrease Gluten and Omega-6 as much as possible
  • Replace Nutrients no longer in our Food Supply

23
Western Diet Yields a Net Acid Load
  • Western net acid load estimated to be 50 mEq/d
  • Adults on the standard US diet sustain a chronic
    low-grade pathogenic metabolic acidosis that
    worsens with age as kidney function declines
  • Virtually all preagricultural diets were net base
    yielding because of the absence of cereals and
    energy-dense, nutrient-poor foods
  • introduced during the Neolithic and Industrial
    Eras
  • displaced base-yielding fruit and vegetables
  • base-producing diet, the norm throughout most of
    hominin evolution
  • Health benefits of a net base-yielding diet
    include preventing and treating
  • Osteoporosis
  • Age-related muscle wasting
  • Calcium kidney stones
  • Hypertension
  • Exercise-induced asthma
  • Slow progression of age / disease-related
    chronic renal insufficiency

24
Thiamine Deficiency
  • Modern Western diet is loaded with simple
    carbohydrates
  • B-Vitamin deficiency is extremely widespread
  • Thiamine is very high in this deficiency because
    of its biochemical association with glucose
    metabolism
  • Because of vitamin fortification of many foods
    and the relative affluence of our present culture
    we have no considered that obscure symptoms,
    particularly those that are generally termed
    functional, are of dietary origin
  • Deficiency is direct result of years of high
    calorie diet and treatment with large doses of
    the appropriate vitamin/mineral supplementation
    is mandatory
  • Physiological doses have no effect since the
    enzyme/cofactor bonding appears to be damaged or
    partially atrophied. (Need High Dose, not Mega
    Dose)
  • Physicians become disenchanted when they treat a
    patient with low-dose supplementation and see no
    benefit
  • The RDA of thiamine is 11.5 mg per day, but only
    in a biochemically healthy individual, and many
    physicians are under the impression that this
    kind of vitamin deficiency, if it occurs at all,
    is easily and quickly treated
  • In the treatment of beriberi, it took very large
    doses of thiamine for months and there was often
    only partial recovery and sometimes none at all

25
Clinical Features Now Emerge
  • Clinical features of beriberi have been forgotten
    in modern medicine since it has been assumed
    that the classic deficiency diseases do not occur
    in developed societies
  • Dysfunction in the autonomic system was a
    prominent part of the clinical expression of
    beriberi (21) and reversible autonomic
    dysfunction, associated with evidence of high
    calorie malnutrition, has been reported in recent
    times in the United States (22,23)
  • Sweating, tachycardia, dermographia, wide
    unstable pulse pressure, attention deficit and
    other symptoms of autonomic dysfunction in
    children have been reported as functional
    dysautonomia (24)
  • Relation between thiamine requirements and the
    intake of carbohydrates
  • The influence of stepwise increases of
    carbohydrate intake on the status of thiamine in
    healthy volunteers under isocaloric conditions
    (25) An increase of dietary carbohydrate intake
    caused a decrease of plasma and urine levels of
    thiamine without affecting enzyme activities
  • Thiamine Deficiency has been reported in
    refractory heart failure (36) and has occurred in
    epidemic form in Cuba involving 50,862 (461.4 per
    100 000) people
  • Lesions included peripheral neuropathy,
    retrobulbar optic neuropathy, sensory and
    dysautonomic peripheral neuropathy, sensorineural
    deafness, dysphonia, dysphagia and spastic
    paraparesis (37,38). TD ataxia (39),
    post-gastrectomy polyneuropathy (40) and
    reversible autonomic neuropathy involving bladder
    dysfunction (41) have been described
  • Natural Sources and Modern Antagonists to
    Thiamine
  • Thiamine is present in lean pork and other meats,
    wheat germ, liver and other organ meats, poultry,
    eggs, fish, beans and peas, nuts, and whole
    grains
  • Dairy products, fruit and vegetables are not good
    sources
  • The RDA is 0.5 mg per 1000 kcal, adequate for a
    healthy individual consuming a healthy diet
  • Considerable losses occur during cooking or other
    heat-processing of food
  • Polyphenolic compounds in coffee and tea can
    inactivate thiamine so that heavy use of these
    beverages could compromise thiamine nutrition

26
B-complex Vitamins Biochemical
Roles,Physiologic Roles of Co-enzyme Forms, and
Brief Description of Clinical Deficiency Symptoms
27
Various Eye Disorders Predict Survival
  • Various ocular disorders (eg, visual impairment
    and cataract and those in persons with diabetes
    mellitus, severe retinopathy, or visual
    impairment)reported to be significant predictors
    of a decreased life span, after extensive
    adjustment for potential confounders
  • Cataract surgery has been associated with
    decreased survival in many studies
  • Nuclear opacities associated with decreased
    survival
  • Age-related macular degeneration (AMD) has not
    been found to be related to decreased survival in
    the few studies that have examined the
    relationship
  • Ability to find an association is limited because
    few participants in these studies had advanced
    disease (neovascular AMD or geographic atrophy)
  • Age or underlying disease related to the ocular
    conditions and mortality could explain the
    findings why ocular factors could be associated
    with decreased survival
  • Loss of vision could have a direct effect on
    mortality if it results in a susceptibility to
    accidents such as fatal falls or in depression
    reported to increase mortality
  • Cataracts may be markers of systemic processes
    that are associated with accelerated physiologic
    aging and earlier death
  • Generalized oxidative damage play a role in
    cataract development, aging process
  • Nutrients found helpful
  • Centrum Silver
  • Reverses Cataracts
  • Omega-3 Fish Oil
  • Reverses Dry Eyes Syndrome
  • Zinc oxide 80 mg
  • had lower mortality

28
Associations of Mortality With Ocular Disorders
and an Intervention of High-dose Antioxidants
and Zinc
  • Objective  To assess the association of ocular
    disorders and high doses of antioxidantsor zinc
    with mortality in the Age-Related Eye Disease
    Study (AREDS)
  • Methods  AREDS is an ongoing, multicenter study
    of the clinical course of cataract and AMD. The
    study included a randomized clinical trial that
    evaluated the effect of high daily doses of
    selected oral supplements (vitamin C, 500 mg
    vitamin E, 400 IU beta carotene, 15 mg and
    zinc, 80 mg as zinc oxide with 2 mg of cupric
    oxide) on the incidence and progression of the 2
    conditions. A total of 4757 persons aged 55 to 81
    years at enrollment were entered into the study
    at 11 clinical centers between November 13, 1992,
    and January 15, 1998
  • Results  During median follow-up of 6.5
    years, 534 (11) of 4753 AREDS participants died
  • Advanced age-related macular degeneration (AMD)
    compared with participants with few, drusen had
    increased mortality (relative risk RR, 1.41
    95 confidence interval CI, 1.08-1.86)
  • Advanced AMD was associated with cardiovascular
    deaths
  • Visual acuity worse than 20/40 in one eye had
    increased mortality (RR, 1.36 95 CI,
    1.12-1.65)
  • Nuclear opacity (RR, 1.40 95 CI, 1.12-1.75) and
    cataract surgery (RR, 1.55 95 CI, 1.18-2.05)
    were associated with increased all-cause
    mortality and with cancer deaths
  • Zinc participants had lower mortality than those
    not taking zinc (RR, 0.73 95 CI, 0.61-0.89)
  • Conclusions 
  • The decreased survival of AREDS participants with
    AMD and cataract suggests that these conditions
    may reflect systemic rather than only local
    processes
  • Improved survival in individuals randomly
    assigned to receive zinc requires further study

29
Relation Between Dietary Omega3 and Omega6
Fatty Acids and Clinically Diagnosed Dry Eye
Syndrome in Women
  • 32,470 women aged 4584 y were assessed Fatty
    Acid intakes using a validated food-frequency
    questionnaire and assessed Dry Eye Syndrome by
    using self-reports of diagnosed cases
  • Results A
  • gt 61 ratio of omega6 to omega3 Fatty Acid
    (Fish Oil) consumption was associated with a
    significantly increased risk of DES
  • ConclusionsThese results suggest that a higher
    dietary intake of Omega3 Fatty Acids is
    associated with a decreased incidence of Dry Eye
    Syndrome in women
  • Observations
  • Added Omega 3 fish oil reduces and prevents dry
    eyes resulting from excess Omega-6 Plant oils in
    the diet
  • Biljana Miljanovi , Komal A Trivedi, M Reza Dana,
    Jeffery P Gilbard, Julie E Buring and Debra A
    Schaumberg Brigham and Womens Hospital,
    Massachusetts Eye and Ear Infirmary Harvard
    Medical School, Boston, MA

30
Western Diet Contains Excessive Saturated and
Trans Fatty Acids and Fewer Omega3 PUFAs than
Omega6 PUFAs
  • High dietary intakes of Saturated Fatty Acids and
    trans fatty acids increase the risk of Heart
    Disease by elevating blood total and LDL
    cholesterol
  • Omega-3 fish oil PUFAs reduce the risk of CVD via
    many mechanisms, including reductions in
    ventricular arrhythmias, blood clotting, serum
    triacylglycerol concentrations, growth of
    atherosclerotic plaques, and blood pressure
  • After 3.5 years of takings 850 mg omega3 fatty
    acids, /- vitamin E subjects with preexisting
    CVD reported
  • 20 reduction in mortality
  • 45 reduction in sudden death
  • Preventing or ameliorating many inflammatory and
    autoimmune diseases
  • No difference total or LDL cholesterol after a
    50-d trial on Low and High fat diets that had
    identical ratios of PUFAs to SFAs, n6 PUFAs to
    n3 PUFAs, and MUFAs to total fat
  • Low- (22 energy)
  • High- (39 energy)
  • Fat quality is more important than fat quantity
    in regard to CVD risk

31
Latex Chemical Sensitivity
  • Exposure comes from inhaled auto tires
  • Immune system becomes depressed when we eat
    foods laden with naturally occurring latex
  • Fruits and Vegetables make latex bittering agent
    to prevent animal damage
  • Latex is converted protein and carbohydrate when
    fruits and vegetable ripens on the plant
    naturally
  • Latex is trapped in the plant when picked green
    to ship
  • Latex becomes injury protein when treated with
    ethylene gas in ALL grocery warehouses, such as
    Whole Foods, Wild Oats, Kroger, Giant Eagle, etc
  • Symptoms are stiffness, fatigue, aches, redness
    on chin, cheeks, ears, and forehead, burning
    eyes
  • Dried, frozen or canned foods have less latex

32
Nutrient Replacement List
  • Omega 3 Fish Oil (1000 mg cap), 1-2 caps before
    meals and at bedtime
  • Good Start 1000-2000 mg of combine EPA and DHA
    daily
  •  
  • High Potency B Complex (B-50 or B100), 1 tablet
    before meals
  • Multivitamin (for age and gender), 1/2 tablet
    twice daily
  •  
  • Magnesium Oxide 250 mg tabs, 1 tab before meals
    and at bedtime
  •  
  • Calcium 500 mg with Vit D, 1 tablet up to three
    time daily
  • Do not take calcium at same time as thyroid
    dose
  •  
  • Vitamin C 1000 mg, 1 tablet before meals
  • Vitamin E 400 IU, 1 cap twice a day
  • Cinnamon caps 500mg, 2 caps before meals and at
    bedtime for
  • Cholesterol, metabolic syndrome, diabetes,
    weight control, fatigue

33
Credible Resources and Information About
Supplements, Herbal Products, Their Safety and
Effectiveness
  • http//efaeducation.nih.gov for immune omega
    balance in diet
  • www.nih.gov for basic answers to supplements
  • www.ajcn.org for nutritional frontiers
  • www.nutritiondata.com/facts for individual food
    omega-36 facts
  • www.jacn.com for nutrition policies
  • www.nci.gov for cancer supplements
  • http//lpi.oregonstate.edu/ for new science in
    Nutrients
  • www.consumerlab.com Products / Nutrients reports
    (subscription)
  • http//medicalcenter.osu.edu/patientcare/hospitals
    andservices/primarycare/im/?CFID228520CFTOKEN20
    456422 for updates and Classes on Integrative
    Medicine
  • www.naturalstandard.com for evidence-base CAM
    (subscription)
  • Free Trial Logon for NaturalStandard for October
    is October
  • Password for October is tomorrow

34
Chicken Breast Roasted
  • Nutritional Facts for Chicken, 1 unit breast
  • broilers / fryers, breast, meat and skin, cooked,
    roasted
  • Total omega-3 fats (est) 63.8 mg
  •   Total omega-6 fats (est) 818 mg
  • Omega 63 ratio 131
  • Total Fat 4.5 grams
  • Saturated Fat 1.3 grams
  • Fat Calories 607
  • Carbohydrate Calories 127
  • Protein Calories 120
  • Carb 0.0, Fats 40.7, Protein 73.5
  • Healthy Foods approach 63 ration of 21
  • http//www.nutritiondata.com

35
Peanuts
  • Nutritional Facts for Peanuts,
  • all types, dry-roasted, without salt, 1 cup
  • Total omega-3 fats (est) 44 mg
  •   Total omega-6 fats (est) 22,910 mg
  • Omega 63 ratio 5201
  • Total Fat 218 grams
  • Saturated Fat 25.2 grams
  • Fat Calories 607
  • Carbohydrate Calories 127
  • Protein Calories 120
  • Carb 15, Fats 71, Protein 14
  • Healthy Foods approach 63 ration of 21
  • http//www.nutritiondata.com

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Potato Chips With Olestra
  • Nutritional Facts for Potato Chips
  • With without Olestra
  • Total omega-3 fats (est) mg
  •   Total omega-6 fats (est) 818 mg
  • Omega 63 ratio 131
  • Total Fat 4.5 grams
  • Saturated Fat 1.3 grams
  • Fat Calories 607
  • Carbohydrate Calories 127
  • Protein Calories 120
  • Carb 0.0, Fats 40.7, Protein 73.5
  • Healthy Foods approach 63 ration of 21
  • http//www.nutritiondata.com

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Avocado, Pureed
  • Nutritional Facts, 1 cup avocado pureed
  •  Total omega-3 fats (est) 221 mg
  •   Total omega-6 fats (est) 3,396 mg
  • Omega 63 ratio 151
  • Total Fat 29.5 grams
  • Saturated Fat 4.3 grams
  • Fat Calories 247
  • Carbohydrate Calories 61.5
  • Protein Calories 13.5
  • Carb 6, Fats 45, Protein 8
  • Healthy Foods approach 63 ration of 21
  • http//www.nutritiondata.com

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Food Choices to Balance Omega 36
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Just the Beginning of Opportunities
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Ayurveda Roles of InflammationNuclear
Factor-kappa B CURCUMIN (Turmeric Curcuma
longa) Ashwagandha (Withania somnifera)
  • Slides From Hari Sharma, MD
  • Ayurveda Practitioner
  • The Ohio State University
  • Center for Integrative Medicine

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CURCUMIN (Turmeric Curcuma longa)
  • Prevents breast cancer spread in mice xenograft
    model.
  • Interferes with proliferation of skin melanoma
    cells.
  • Sensitizes cells to radiation and chemotherapy.
  • Suppresses proliferation of wide variety of tumor
    cells Down regulates
  • Transcription factor.
  • Expression of COX-2, LOX, cell surface adhesion
    molecules, protein kinase, etc.
  • Anti-mutagenic effect.
  • Suppresses nuclear factor kappa beta (regulates
    inflamm. immune response).
  • Blocks estrogen-mimicking chemical.
  • Anti-inflammatory Inhibits cyclooxygenase-2
    (COX-2), lipoxygenase (LOX), thromboxane,
    leukotrienes, interleukin-12, hyaluronidase.
  • Potent antioxidant (prevents damage to DNA and
    genes).
  • Promotes normal cell cycle.
  • Inhibits angiogenesis.
  • Anti-thrombotic.
  • Hepatoprotective.

References
Clin Cancer Res 200511(20)7490-7498 Anticancer
Res 200323363-398 J Ethnopharmacol
199338(2-3)113-119 Indian J Med Res
197159(8)1289-1295 Blood 20031011053-1062 J
Cell Biochem 2003891-5 Mol Cancer Ther
2003295-103 Pharmacol Res 200347113-140 Antica
ncer Res 200121873-878 Oncogene
2004261599-1607
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ASHWAGANDHA (Withania somnifera)
  • Anti-tumor and radiosensitizing properties
  • Adaptogenic
  • Rasayana General and Medhya
  • Increases quality and quantity of Ojas
  • Clears Ama from channels
  • Immune-enhancer
  • Anti-cancer
  • Prevents angiogenesis

References
  • Food and Chem Toxicol 2004422015-2020
  • Indian J Expt Biol 199230169-172,
    199634927-932, 199331607-611
  • Med Sci Res 198715515-516
  • Cancer Lett 199595189-193
  • Acta Oncol 19963595-100
  • Angiogenesis 20047115-122
  • J Ethnopharmacol 200175165-168

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