Sally Fallon, president of the Weston A. Price Foundation, recently wrote a letter to members clarifying the issues raised by the Vitamin D council and exonerating cod liver oil.

If you’re having second thoughts about the health benefits of CLO, please read this and pass it on to anyone you know who currently takes or is considering taking cod liver oil.

————————–

Dear Members,

We are obliged to issue another official statement on cod liver oil after the November bulletin of the Vitamin D Council, which contains “an unprecedented warning about the ingestion of cod liver oil and resultant vitamin A toxicity.”

The warning accompanies a report on a review article co-authored by Dr. John Cannell, head of the Vitamin D Council, and fifteen other researchers, entitled “Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory Infections, and the Vitamin D Deficiency Epidemic” in the November issue of Annals of Otology, Rhinology and Laryngology.

NO PROOF THAT VITAMIN A IS TOXIC
Most of this paper is a review of studies showing the benefits of vitamin D in protecting against various illnesses, including respiratory infection. THIS PAPER DOES NOT PRESENT ANY INFORMATION WHATSOEVER INDICATING THAT COD LIVER OIL IS TOXIC, and, in fact, admits that vitamin A can significantly reduce the incidence of acute lower respiratory tract infections in Third World children.

A portion of the review article is an attempt to explain why a 2004 study providing 600 to 700 IU of vitamin D and 3,500 IU of vitamin A in the form of cod liver oil and a multivitamin failed to meaningfully reduce upper respiratory tract infections when studies from the 1930s found that cod liver oil could reduce the incidence of these infections by 30 to 50 percent. The authors of the recent commentary suggested that the older studies were more effective because cod liver oil in the 1930s contained much more vitamin D. They suggested that modern cod liver oil is low in vitamin D because the deodorization process removes the vitamin while manufacturers fortify the oil with only a fraction of the original amount. As an example, they cited cod liver oil made by Nordic Naturals, advertised as containing only “naturally occurring vitamins A and D,” which has only 3 to 60 IU of vitamin D per tablespoon but between 150 and 12,000 times as much vitamin A.

This conclusion is essentially the same as the conclusion reached by the Weston A. Price Foundation and the research of Chris Masterjohn; we have continually pointed out that vitamins A and D work together and that without vitamin D, vitamin A can be ineffective or even toxic. We do not recommend Nordic Naturals regular cod liver oil or any brand of cod liver oil that is low in vitamin D. But it is completely inappropriate to conclude from this 2004 study that cod liver oil is toxic because of its vitamin A content. Similar reviews could be put together showing the benefits of vitamin A and cod liver oil in numerous studies, including the studies from the 1930s. Obviously the solution is to use the type of cod liver oil that people took in the 1930s, which did not have most of the vitamin D removed by modern processing techniques.

Our recommendations for cod liver oil brands can be found here.

VITAMIN A DOES NOT ANTAGONIZE VITAMIN D
The Vitamin D Council report claims that the vitamin A in cod liver oil is excessive and antagonizes vitamin D by inhibiting the binding of its active form to DNA and thus preventing its ability to regulate the expression of vitamin D-responsive genes.

Vitamins A and D are both precursors to active hormones that regulate the expression of genes. The body possesses certain enzymes that convert each of these in a two-step process to their active forms: vitamin A is converted to retinal and then to active retinoic acid while vitamin D is converted to calcidiol and then to active calcitriol. While directly consuming either retinoic acid or calcitriol would be unnatural, consuming vitamins A and D, together, as in cod liver oil, is perfectly natural. The enzymes involved in these conversions are responsible for producing incredibly powerful hormones and are therefore highly regulated.

In order for vitamin D to activate the expression of its target genes, it must bind to the vitamin D receptor (VDR) and then combine with the retinoid X receptor (RXR), which is activated by a particular form of vitamin A called 9-cis retinoic acid. RESEARCHERS FROM SPAIN RECENTLY SHOWED THAT VITAMIN D CAN ONLY EFFECTIVELY ACTIVATE TARGET GENES WHEN ITS PARTNER RECEPTOR IS ACTIVATED BY VITAMIN A.

In the ABSENCE OF VITAMIN A, molecules called “corepressors” bind to the VDR/RXR complex and PREVENT vitamin D from functioning.

The molecular biology of 9-cis¬ retinoic acid, however, is extremely complex, and this has led to some confusion. The RXR and its activator 9-cis retinoic acid partner up not only with the vitamin D receptor, but also with the receptors for steroid hormones, thyroid hormone, and most other nuclear receptors. In fact, if enough 9-cis retinoic acid is present, RXRs will even partner up with themselves. Ordinarily, this versatile form of vitamin A is gradually derived in small amounts from the larger pool of all-trans retinoic acid as needed. When scientists add large amounts of 9-cis retinoic acid to isolated cells, then, it may cause effects that smaller amounts naturally produced in the cell would not cause.

Researchers have shown, for example, that 9-cis retinoic acid interferes with the ability of vitamin D to stimulate the production of osteocalcin, a vitamin K-dependent protein involved in organizing the mineralized matrix of bone. This may have been because the excessive amount of 9-cis retinoic acid caused RXRs to pair up with themselves and thereby made these receptors unavailable to vitamin D. When scientists incubate cells with activated vitamin D and all-trans retinoic acid, ordinarily the source of 9¬-cis retinoic acid in the cell, the two hormones stimulate the production of osteocalcin with remarkable synergy.

More information on the interactions between vitamins A and D can be found in these articles:

Vitamin K2

Does Vitamin A Cause Osteoporosis?

Vitamin D Safety

The Spanish research demonstrating the necessity of 9-cis¬ retinoic acid for the functioning of the vitamin D receptor can be found here, and here:

PLANT FOODS ARE NOT A GOOD SOURCE OF VITAMIN A
In the December Vitamin D Council newsletter, Dr. Cannell further claims that consuming preformed vitamin A is “unnatural” and that the body highly regulates the conversion of carotenoids found in vegetables to vitamin A as needed. However, the enzymes that convert carotenoids to vitamin A are less critically maintained because they are unneeded when preformed vitamin A is provided in the diet-as it usually is. They are therefore, like the enzymes that convert essential fatty acids in plant oils to their elongated and desaturated forms, subject to variations in genetics, circumstantial health, and dietary and environmental influences.

Many factors can interfere with the conversion of carotenoids into vitamin A including thyroid problems, liver problems, diabetes and genetics. Babies and children convert carotenes very poorly if at all.

The statement that preformed vitamin A is unnatural is ludicrous in the light of what we know about traditional diets. The chief source of calories in the traditional Inuit diet, for example, is seal oil, which Weston Price found to be higher in vitamin A than cod liver oil. Fish heads, extremely rich in vitamin A, are a staple in the Japanese diet. Many cultures consume liver, often in high amounts-yet the authors of the review paper imply that liver is toxic. Tell that to the Frenchman enjoying his foie gras, the Englishman consuming liver and onions, or the South Sea Islander who submits to great danger to obtain shark liver for men and women, in order to ensure healthy children. The truth is that pre-formed vitamin A is more plentiful in traditional foods than vitamin D, yet politically correct nutrition insists that we must obtain vitamin A through the laborious process of converting carotenes.

More information on the conversion of carotenoids to vitamin A can be found in this article and this one: (see the section “Vitamin A Vagary”).

COD LIVER OIL IN PREGNANCY
The Annals paper does not cite any studies showing toxic effects from cod liver oil, but Dr. Cannell cites one study in his December newsletter associating intake of cod liver oil with hypertensive disorders during pregnancy. Users of cod liver oil in this study had about twice the intake of vitamins A and D as non-users and eight times the intake of long-chain omega-3 fatty acids. The study found the most robust association with long-chain omega-3 fatty acids, which were associated with lower risk between 0.1 and 0.9 grams per day and higher risk above 0.9 grams per day. The authors suggested that the association with high blood pressure might be related to oxidative stress caused by a high intake of polyunsaturated fatty acids.

The abstract of the study can be found here:

The new Annals article offers nothing new to incriminate cod liver oil. It provides a well-written argument that vitamin D intakes need to be higher and incriminates only highly processed modern cod liver oils that have inadequate amounts of this critical nutrient. We recommend only high-vitamin cod liver oils that provide abundant vitamins A and D without an excess of polyunsaturated fatty acids.

THE COD LIVER OIL PUBLIC HEALTH INITIATIVE
As we pointed out in our last update on cod liver oil, during the first half of the century, cod liver oil was the focus of a worldwide health initiative. Parents were urged to give cod liver oil to their children by doctors, by government officials, by teachers and principals in schools, and even by their ministers in churches. A large portion of adults in America born before the Second World War received cod liver oil as children and this practice contributed to a high level of health, intelligence and physical development in those lucky enough to receive it. In many European countries, children received a daily ration of cod liver oil, especially during the war years. In the UK, for example, the government issued cod liver oil to all growing children until the early 1950s.

What has led to the demise of this obviously beneficial practice? Cod liver oil is a food; it can’t be patented, it can’t be created in a laboratory; it can’t create millions for the drug companies. So interest in this wonderful superfood has naturally waned. But if you are basing your dietary habits on the principles of healthy nutritional diets, don’t hesitate to include cod liver oil-our recommended brands of cod liver oil–as a healthy and natural food source of critical vitamins so lacking in modern diets.

Sally Fallon, President
The Weston A. Price Foundation

recommended links

• Wolf River Naturals: a great place to purchase Blue Ice High Vitamin and Fermented Cod Liver oil.  Wolf River Naturals also sells Dr. Ron’s line of additive-free supplements, which is my favorite line and one of the few supplement companies I trust.

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Scientists at the Department of Physiology, Anatomy and Genetics, University of Oxford, have discovered that going veggie could be bad for your brain – with those on a meat-free diet six times more likely to suffer brain shrinkage.

The study involved tests and brain scans on community-dwelling volunteers aged 61 to 87 years without cognitive impairment at enrolment, over a period of five years. When the volunteers were retested five years later the medics found those with the lowest levels of vitamin B12 were also the most likely to have brain shrinkage. It confirms earlier research showing a link between brain atrophy and low levels of B12.

Vegans are the most likely to be deficient because the best sources of the vitamin are meat, particularly liver, milk and fish.

This study confirms other findings, covered in Trick and Treat, which shows that overall human brain sizes have reduced by an average 11% since we adopted an agricultural diet based on cereal grains rather than the meat-based diet of our Palaeolithic ancestors.

Vogiatzoglou A, et al. Vitamin B12 status and rate of brain volume loss in community-dwelling elderly. Neurology 2008; 71(11): 826-32.

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Dr. Daniel Steinberg, author of “The Cholesterol Wars”, has just issued new recommendations proposing that “proposing that aggressive intervention to lower cholesterol levels as early as childhood is the best approach available today to reducing the incidence of coronary heart disease.”

In a review article published in the August 5, 2008 issue of the American Heart Association journal Circulation, Steinberg and his colleagues stat that “with a large body of evidence proving that low cholesterol levels equate with low rates of heart disease, “…our long-term goal should be to alter our lifestyle accordingly, beginning in infancy or early childhood” and that “…instituting a low-saturated fat, low-cholesterol diet in infancy (7 months) is perfectly safe, without adverse effects…”

I don’t know whether to scream or cry when I read this stuff. Or both. Why? Because Dr. Steinberg’s dietary recommendations - if embraced by parents - are sure to increase the risk of heart disease and cause developmental problems in the children unfortunate enough to adopt them.

Let’s take a closer look at each part of the article on ScienceDaily.com describing the new recommendations and see if Steinberg’s claims make any sense.

Progress in treating heart disease? What progress? Heart disease is the #1 cause of death in the U.S. today. In the early part of the 20th Century, heart disease was relatively unknown. I would hardly call that progress.

As for statins, please refer to my previous article “The Truth About Statin Drugs” for a more accurate appraisal of the effectiveness (or lack thereof) of statins. In short, statins don’t reduce the risk of death in 95% of the population, including healthy men with no pre-existing heart disease, women of any age and the elderly. While statin drugs do reduce mortality for young and middle-aged males with pre-existing heart disease, the benefit is small and not without significant adverse effects, risks and costs.

For example, in the six largest studies done on statins and mortality to date, the absolute risk reduction ranged from -0.3% to 3.3%. In two of those studies, statins actually increased the risk of death. In an analysis of this data, the UK Medical Research Council determined that even if you were in the 5% of the population that statins benefit, you’d have to take a statin for 30 years at a cost of $42,000 just to add nine months (best case) to your life.

Even that scenario is entirely hypothetical, because statins cause cancer in lab animals. Although this hasn’t been shown in humans to date, the window between exposure to a carcinogen and development of cancer can be as long as 25 years for humans. Since no one has been on statins for that long, there is still reason to believe that they might have the same effect in humans that they do on animals.

Progress? I don’t think so.

“Bad cholesterol”? That’s so 1975. It is well accepted even within the mainstream scientific community today that normal LDL cholesterol (so-called “bad cholesterol”) is not a risk factor for heart disease. Instead, it is the oxidation of the polyunsaturated fatty acid in the membrane of the LDL particle (when the level of antioxidants in the diet is insufficient to protect them) that contributes to heart disease.

Therefore, the only LDL cholesterol that could be called “bad” is oxidized LDL.
And what promotes oxidation of the LDL particle? Eating polyunsaturated fat (found in vegetable oils, nuts and seeds and in almost all processed food). Of course, these are exactly the fats the American Heart Association has promoted as “heart-healthy” for decades.

In addition to promoting oxidation of LDL particles, polyunsaturated fats contribute directly to atherosclerosis and heart attacks. 75% of arterial plaque is made up of unsaturated fat, of which 50% is polyunsaturated (only 25% is saturated). The greater the concentration of polyunsaturated fat in the plaque, the more likely it is to rupture. Such ruptures, and the ensuing blood clots that form, are a primary cause of heart attacks.

Another well-established cause of heart disease is inflammation. Omega-6 polyunsaturated fats, which constitute a large percentage of caloric intake for most Americans, are known to promote inflammation. Indeed, excess linoleic acid (LA) in the diet from vegetable oil has been shown to contribute directly to heart disease.

So, the notion that saturated fat “clogs arteries” and causes heart attacks is totally false. It is actually polyunsaturated fat - the so-called “heart-healthy fat - which has those effects.

If people’s lives weren’t at stake the irony of such a situation might be almost funny. As it stands it’s one of the great public health tragedies of modern times.

And what about the notion that eating cholesterol raises cholesterol levels in the blood? It turns out to be false - and Steinberg even admits as much in his own book. There are two parts of the hypothesis that cholesterol causes heart disease. The first part, called the “diet-heart hypothesis”, is that eating cholesterol in the diet raises cholesterol levels in the blood. The second part, called the “lipid hypothesis”, holds that high cholesterol levels in the blood cause heart disease.

We’ve already addressed the “lipid hypothesis” above. As for the “diet-heart hypothesis”, Steinberg clearly states in his book that there is little evidence to support it. Tightly controlled egg-feeding studies have shown that eating cholesterol only raises cholesterol levels in about 30% of the population (”hyper-responders”).

However, these same studies showed that egg consumption led to an increase in “light, fluffy LDL” that was actually protective against heart disease. Why? Because these large, buoyant LDL particles are protected against oxidation.

Finally, what about saturated fat? Does it cause heart disease as Steinberg suggests? Once again, the evidence squarely contradicts Dr. Steinberg’s claim. In 22 of 26 published studies there was no significant relationship between saturated fat intake and either coronary or all-cause mortality. Among the studies that Dr. Steinberg failed to mention in his book or in his recent recommendation:

• Rose, et al. (1965): Replacing animal fat with corn oil for two years lowered serum cholesterol by 23 mg/dL but quadrupled cardiac and total mortality.
• Sydney Diet-Heart Study (1978): Replacing animal fat with vegetable fat for five years lowered cholesterol by five percent but increased total mortality by 50 percent.

What’s more, in the few studies where saturated fat restriction did reduce deaths from heart disease, deaths from cancer, brain hemorrhage, suicide & violent death went up! In his book The Great Cholesterol Con, Anthony Colpo concludes:

There are two more claims made by Dr. Steinberg that I need to address.

As stated above, there is absolutely no evidence that lowering LDL protects against heart disease. More than 40 trials have been performed to see if cholesterol lowering can prevent heat attacks. When all the results were pooled together, just as many died in the treatment groups as the control groups.

But what is most disturbing to me about Steinberg’s statement is the idea that lowering LDL to such unnatural levels is a “safe and potentially life-saving standard”. Cholesterol is a vital substance in our bodies. 50% of all cell membranes are made up of cholesterol; it is a precursor to sex hormones which govern fertility, reproduction and sexual development; it is an antioxidant that helps prevent free radical damage; and it is needed particularly by infants and children to ensure proper development of the brain and nervous system.

In fact, evidence in adults shows that low cholesterol levels can be dangerous and even life-threatening:

• Low cholesterol is associated with increased total mortality in elderly people.
• Framingham (1987): “There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years.” In other words, as cholesterol fell death rates went up.
• Honolulu Heart Program (2001): “long-term persistence of low cholesterol concentration actually increases the risk of death. Thus, the earlier the patients start to have lower cholesterol concentrations, the greater the risk of death.”
• J-LIT (2002): The highest death rate was observed among those with lowest cholesterol (under 160mg/dl); the lowest death rate was observed with those whose cholesterol was between 200-259mg/dl.

Low cholesterol has also been associated with increased rates of cancer, depression, violent and aggressive behavior, and suicide.

With that in mind, how could anyone possibly claim that reducing cholesterol to extremely low levels in children is “safe”?

I’m not even sure where to start with this one, except to recommend that people like Dr. Steinberg be prosecuted for making such unfounded, irresponsible and dangerous recommendations.

According to the American Academy of Pediatrics:

Which is to say there is no evidence suggesting that cholesterol levels in kids are a risk factor for adult heart disease.

Furthermore, as we have already discussed, cholesterol is absolutely essential for brain development. Lowering brain levels of cholesterol in children, whose brains are still developing at a rapid rate, could have dire consequences.

Surely Dr. Steinberg must be aware of this? There is nothing controversial about the role of cholesterol in brain development. You can find this information in any physiology or biochemistry textbook. So why - especially in light of the lack of evidence linking cholesterol to heart disease in kids - is he suggesting that we give statins to children?

I really have no idea. In all likelihood Dr. Steinberg means well and believes he’s acting in the interest of our children. But I cannot understand how a respected medical doctor and researcher could overlook such an elementary and important fact and ignore the weight of scientific evidence.

We’ve all heard the saying “when all you’ve got is a hammer, everything looks like a nail.” When someone like Dr. Steinberg has invested so much of their life and energy into the theory that cholesterol causes heart disease, I guess it’s hard to let it go.

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The study is especially significant because it is the largest study in humans to examine the relationship between semen quality and phytoestrogens (plant compounds that can mimic the physiological effects of the endogenous hormone, estrogen).

Dr. Jorge Chavarro of the Harvard School of Public Health and his colleagues found that men who ate the most soy food had 41 million sperm per milliliter less than men who did not consume soy products. The normal sperm concentrations for men ranges between 80 and 120 million/ml.

The association between soy food intake and sperm concentrations was even stronger in men who were overweight or obese, and 72% of study participants were. They also found the relationship between soy foods and sperm concentration was strongest in men with “normal or high” sperm counts.

Animal studies have linked the high consumption of isoflavones with infertility, but until now there has been little evidence of this effect in humans. Isoflavones are plant compounds with estrogen like effects and are found mainly in soybeans and soy-derived products.

What is particularly revealing is that the men in the highest intake group (who had the largest sperm count reduction) had a mean soy food intake of only half a serving per day. This is equivalent to having one cup of soy milk or one serving of tofu, tempeh or soy burgers every other day!

I don’t know about you, but I happen to know quite a few people who consume a lot more soy than than that on a regular basis. Sadly, many of them are children whose parents innocently believe that soy products are “healthy”. This is not their fault, of course; this erroneous and dangerous message has been aggressively promoted in the mainstream media for decades.

If the effect of such moderate servings of soy on adult males is so significant, what effect might soy foods have on developing boys who have not yet reached sexual maturity?

“Early puberty (caused by consuming soy products) may increase a boy’s chances of developing testicular cancer later in life, because it means longer exposure to sex hormones,” said University of North Carolina researcher Marcia Herman-Giddens. Congenital abnormalities of male genital tracts are also increasing. Recent studies found a higher incidence of birth defects in male offspring of vegetarian, soy-consuming mothers.

What about babies? Preliminary studies indicate that children given soy formula go through puberty much earlier than children who were not fed soy products. A 1994 study done in New Zealand revealed that, depending on age, potency of the product, and feeding methods, infants on soy formula might be consuming the equivalent of up to 10 contraceptive pills a day. By exposing your baby to such large amounts of hormonal-like substance, you are risking permanent endocrine system damage (pituitary gland, pineal gland, hypothalamus, thyroid, thymus gland, pancreas, ovary, testis, adrenal glands).

Dr Chavarro speculates that the increased estrogenic activity caused by consumption of soy foods may have an adverse effect on the production of sperm by interfering with other hormonal signals. This effect could be strengthened further in overweight and obese men because men with high levels of body fat produce more oestrogen than slimmer men, leading to high overall levels of oestrogen in the body and reproductive organs.

If you’re wondering how soy continues to be so widely accepted and aggressively promoted as a “health food” in spite of the overwhelming evidence to the contrary, I recommend reading The Whole Soy Story by Kaayla Daniel, PhD, CCN. You can read introduction to this eye-opening book here.

The history of soy products and their designation as a “health food” is particularly revealing, as Daniel points out:

Soy is one of the “Big Four” cash crops in the U.S. and the funds for its marketing are enormous:

And of course, these advertising dollars are largely responsible for creating the erroneous notion that highly processed soy foods are “healthy”:

However, in spite of advertising and popular belief, processed soy products are not health foods. Because of their estrogenic effects, they act more like drugs in the body than foods. And as we all know, drugs can be extremely dangerous when taken irresponsibly and without indication. Millions of men, women and children around the world are “drugging” themselves daily with soy products, and the tragic irony is that this is done in the name of “health”.

Keep in mind that tofu, tempeh and soy milk are not the only sources of soy. In fact, almost all processed food has soy in it, in the form of soy oil, soy lecithin, soy flour or soy protein. Everything from your favorite corn chips to hamburger buns to mayonnaise is likely to contain a substantial amount of soy.

The most sensible approach, then, is to eliminate processed soy products from your diet and dramatically reduce or eliminate your consumption of processed food (of course there are many other reasons to do this - soy is just one).

A small amount of miso or natto or other fermented soy product as a condiment every now and then is probably not harmful. But those are not the soy products Americans tend to eat.

For more information about the dangers of soy products, please see my recent article called The Soy Ploy.

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The rate of adherence to the study diet was 95% at year one and 85% at year two. Among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg for the low-fat group, 4.6 kg for the Mediterranean-diet group, and 5.5 kg for the low-carbohydrate group.

Perhaps more significantly, the relative reduction in the ratio of total cholesterol to HDL was 20% in the low carbohydrate group while only 12% in the low-fat group. Among the 35 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet.

Unfortunately, the bias against saturated fat and animal products that is still so prevalent in the mainstream (in spite of the lack of evidence to support it) prevailed in this study. The research team advised those following the low-carb diet to “choose vegetarian sources of fat and protein” and moderate their consumption of saturated fats and meat.

This suggests that the low-fat dieters may have consumed a substantial portion of their calories as fat in the form of omega-6 polyunsaturated fatty acids. Excess intake of omega-6 fatty acids contributes to a host of problems including heart disease, diabetes, and cancer; but even more relevant to this study and its results is the fact that omega-6 fatty acids can cause increased water retention. And as everyone knows, increased water retention equals increased weight.

This certainly causes me to wonder how much more dramatic the results of this study might have been if the low-carb subjects were encouraged to significantly restrict their consumption of omega-6 fats (which cause water retention, and thus weight gain) and replace them with saturated fats (which do not cause water retention). What is remarkable is that in spite of the consumption of omega-6 fats, the low-carb group still lost more weight than both the low-fat and Mediterranean groups. That’s a strong endorsement for the benefits of a low-carb diet for weight loss.

The low-carb and Mediterranean (to a lesser degree) diet also had other benefits beyond promoting weight loss and improving cholesterol measures. The level of high-sensitivity C-reactive protein decreased significantly only in the Mediterranean and ow-carb group, with the low-carb group again showing the greatest decrease (29% vs. 21%). C-reactive protein is a measure of inflammation that has been positively correlated with heart disease in recent studies. Once again, one must wonder if the reduction would have been even greater in the low-carb group had the subjects been told to restrict their intake of omega-6 fats, which are known to promote inflammation.

Another interesting finding is that although caloric intake was only restricted in the low-fat and Mediterranean diet groups, the low-carb group also ended up eating fewer calories during the diet. Many people who follow a low-carb, high protein/high fat diet find that they spontaneously eat less because additional protein, and in particular fat, leads to greater levels of satiety (satisfaction).

One limitation of the study is that it relied on self-reported dietary intake (this is true of almost every dietary study except those performed in tightly controlled conditions, such as an inpatient facility). However, the study was somewhat unique in that it was conducted in a workplace at a research center with an on-site medical clinic. It also had several other strengths. The drop-out rate was exceptionally low for a study of this kind; all participants started simultaneously; the duration was relatively long (2 years); the study group was relatively large; and the monthly measurements of weight remitted a better understanding of the weight-loss trajectory than other studies.

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The first article, “Beware of New Media Brainwashing About High Fructose Corn Syrup“, appeared on Mercola.com, a health advocacy site run by Dr. Joseph Mercola which I recommend. I agree with Dr. Mercola on most things, and even when we don’t agree the differences are relatively minor.

In his article Mercola warns consumers that The Corn Refiners Association is spending $20 to $30 million dollars on an advertising campaign to “rehabilitate” the reputation of high fructose corn syrup (HFCS), claiming that the product is “no worse for you than sugar.”

HFCS is now the #1 source of calories for children in the U.S., a staggering fact when research has clearly linked HFCS to obesity, diabetes, metabolic syndrome, high triglycerides, liver disease and more. On top of that, HFCS is almost always made with genetically modified corn.

Head on over to Mercola.com to read the rest of the article and learn why you and your children should be avoiding HFCS as much as possible. HFCS is found primarily in processed foods (in everything from hamburger buns to soda), so if you follow my general recommendation of eating a whole-foods diet you should have no trouble avoiding it.

The second article, “8-Year-Olds on Statins? A New Plan Quickly Bites Back“, was published in the New York Times on July 8. It describes new guidelines issued by the American Academy of Pediatrics recommending that statin drugs be prescribed to kids as young as 8 years old!

While some doctors applauded the idea (which is incomprehensible to me), others were “incredulous”. Why are they incredulous? Because there is absolutely no evidence suggesting that treating children with statins will prevent heart attacks or reduce mortality from heart disease. Furthermore, there are no data on the possible side effects from taking statins for 40 or 50 years. Since statins have caused cancer in several animal studies, there is no reason to assume that this is not a risk in humans - especially with such long-term use of the drugs.

If you’re not familiar with the dangers of statin drugs, I suggest you read my recent article “The Truth About Statin Drugs“. Not only are statins nowhere near as effective as claimed, they have serious adverse effects and risks - including death.

What’s more, statins have been neither studied nor approved for use with children. In other words, the American Pediatric Association wants to perform an uncontrolled experiment with statin drugs and our children. This is completely unacceptable in light of what we already know about these drugs.

This is yet another obvious example of how the massive conflicts of interest in the medical field, which I described in a previous article, cloud the judgment of otherwise well-meaning physicians and health organizations.

Head over to the New York Times to read the rest of the article.

The third article, “Popular Fish, Tilapia, Contains Potentially Dangerous Fatty Acid Combination” which appeared on ScienceDaily.com, revealed that farm-raised tilapia has very low levels of beneficial omega-3 fatty acids and, even worse, very high levels of omega-6 fatty acids.

This is particularly troublesome because tilapia has become one of the most highly consumed fish in the U.S. (mostly due to its low price), and that trend is expected to continue through 2010.

Researchers have found that tilapia has higher levels of omega-6 fatty acids than doughnuts. That’s scary.

The health risks of excessive amounts of omega-6 fatty acids in the diet are well established. In short, they are significant contributors to both inflammation and oxidative damage in the body. Inflammation and oxidative damage are major risk factors for heart disease, diabetes, cancer and many other diseases.

Wild-caught oily fish, on the other hand, contain a favorable ratio of omega-3 to omega-6 fatty acids and may actually protect against inflammation and oxidative damage?

So what’s the problem with tilapia, you ask? The problem is that they are raised on a “fish farm” where they are fed inexpensive corn-based feeds which contain short chain omega-6 fatty acids that the fish convert and store in their tissues. While this practice has kept the price of tilapia low, it has also transformed it into a toxic food.

Repeat after me: fish don’t eat corn. Fish don’t eat corn. Fish don’t eat corn.

(Cows don’t normally eat chicken parts, gummi bears and garbage, either; but they do in commercial feedlots where most of the meat in the U.S. is produced. I’ll save that for another day, though.)

What all of these articles share in common is 1) further evidence of the rampant conflicts of interest in our medical care system, 2) the complete lack of an objective, independent regulatory body that can protect consumers from the malfeasance of Big Pharma and Big Agrobusiness, 3) the general departure from common sense and traditional wisdom when it comes to health care and nutrition.

It’s absolute madness.

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Back in April I wrote an article called “Throw Away Your Sunscreen” about the protective effects of exposure to sunlight against melanoma. Despite conventional wisdom that tells us to avoid sun exposure at all costs, it turns out that the vitamin D our bodies synthesize when exposed to UV light is a first line of defense against developing melanoma.

In an article published on June 9 in Archives of Internal Medicine, scientists reported that low levels of vitamin D are associated with a higher risk of myocardial infarction (heart attack) in men. The study showed that rates of cardiovascular disease-related deaths are increased at higher latitudes and during the winter months, and are lower at lower altitudes.

In an article published in the July issue of the Journal of Cardiovascular Pharmacology, on June 12, researchers found that vitamin D directly contributes to cardiovascular fitness. In fact, University of Michigan pharmacologist Robert U. Simpson, Ph.D. thinks it’s apt to call vitamin D “the heart tranquilizer”. Simpson and his team discovered that treatments with activated vitamin D prevented heart muscle cells from hypertrophy, a condition in which the heart becomes enlarged and overworked in people with heart failure.

Finally, in a study published on June 23 in the Archives of Internal Medicine, a team of Austrian scientists revealed that low blood levels of vitamin D appear to have an increased risk of death overall and from cardiovascular causes. Harald Donbig, M.D. and his colleagues studied 25-hydroxyvitamin D and 1,25 dihydroxyvitamin D levels in 3,258 consecutive patients (average age 62 years) who were scheduled for coronary angiography testing at a single medical center between 1997 and 2000.

During 7.7 years of follow-up, death rates from any cause and from cardiovascular causes were higher among individuals in the lower one-half of 25-hydroxyvitamin D levels and the lowest one-fourth of 1,25-dihydroxyvitamin D levels. These associations remained when researchers controlled for other factors such as coronary artery disease, physical activity and co-occurring diseases.

So what does all this mean to you? A recent consensus panel estimated that about 50 - 60 percent of older individuals in North America and the rest of the world do not have satisfactory vitamin D status, and the situation is similar for younger individuals. Blood levels of vitamin D lower than 20 to 30 nanograms per milliliter have been associated with falls, fractures, cancer, autoimmune dysfunction, cardiovascular disease and hypertension.

To put it blankly, that means half of all people around the world are deficient in vitamin D and therefore at increased risk for serious and potentially fatal conditions.

Low 25-hydroxyvitamin D levels are also correlated with markers of inflammation such as C-reactive protein, as well as signs of oxidative damage to cells, Donbig’s study revealed. In a previous article, I explained that inflammation and oxidative damage (not cholesterol) are the primary causes of the worldwide heart disease epidemic. Inflammation and oxidative damage are also contributing factors to diabetes, metabolic syndrome, cancer and many other diseases.

So how does vitamin D work its magic? It acts as a potent hormone in more than a dozen types of tissues and cells in the body, regulating expression of essential genes and rapidly activating already expressed enzymes and proteins. In the heart, vitamin D binds to specific vitamin D receptors and produces its “calming”, protective effects.

There are essentially three ways to obtain vitamin D: exposure to UV light, food and supplements. The most effective of all of these methods is exposure to sunlight. Full-body exposure of pale skin to summer sunshine for 30 minutes without clothing or sunscreen can result in the synthesis of between 10,000 and 20,000 IU of vitamin D. At most latitudes outside of the tropics, however, there are substantial portions of the year during which vitamin D cannot be obtained from sunlight; additionally, environmental factors including pollution and the presence of buildings can reduce the availability of UVB light.

In northern latitudes or during winter months when the sun isn’t shining, I recommend taking 1 tsp./day of high-vitamin cod liver oil (Green Pasture or Radiant Life are two brands I recommend) to ensure adequate vitamin D (and vitamin A) intake. You can also eat vitamin D-rich foods such as herring, duck eggs, bluefin tuna, trout, eel, mackerel, sardines, chicken eggs, beef liver and pork. If you follow this approach further supplementation should not be necessary.

Before closing, I must mention (briefly) the issue of vitamin D toxicity. Vitamin D is widely considered to be the most toxic of all vitamins, and dire warnings are often issued to avoid excess sun exposure and vitamin D in the diet on that basis. The discussion of vitamin D toxicity has failed to take into account the interaction between vitamins A, D and K. Several lines of evidence suggest that vitamin D toxicity actually results from a relative deficiency of vitamins A and K.
So, the solution is not to avoid sun exposure or sources of vitamin D in the diet. Rather, it ensure adequate vitamin D intake (through sunlight and food) and to increase the intake (through diet and/or supplements) of vitamins A & K. Stay tuned for a future post on the interaction between vitamins A, D & K and their relevance to human health.

Suggested Links

• The Vitamin D Miracle: Is it For Real?
• From Seafood to Sunshine: A New Understanding of Vitamin D Safety
• Vitamin D Toxicity Redefined

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Last week I mentioned the INTERHEART study, which looked at the relationship between heart disease and lifestyle in 52 countries around the world. What this study revealed is that approximately 90% of heart disease could be prevented by simple changes to diet and lifestyle.

Let’s just make this crystal clear: 9 out of 10 cases of heart disease are completely preventable without drugs. With sales of statin drugs reaching close to $30 billion this year with Lipitor alone bringing in close to $14 billion, this might come as some surprise. But the pharmaceutical companies are, quite literally, invested in people taking their cholesterol-lowering drugs in spite of the complete lack of evidence that lowering cholesterol prevents heart disease.

In order to understand the changes we need to make to prevent heart disease, we have to briefly examine what causes it. By now you know that the answer is not “cholesterol”. In fact, as I mentioned briefly in last week’s article, the two primary contributing mechanisms to heart disease are inflammation and oxidative damage.

Inflammation is the body’s response to noxious substances. Those substances can be foreign, like bacteria, or found within our body, as in autoimmune diseases like rheumatoid arthritis. In the case of heart disease, inflammatory reactions within atherosclerotic plaques can induce clot formation.

When the lining of the artery is damaged, white blood cells flock to the site, resulting in inflammation. Inflammation not only further damages the artery walls, leaving them stiffer and more prone to plaque buildup, but it also makes any plaque that’s already there more fragile and more likely to burst.

Oxidative damage is a natural process of energy production and storage in the body. Oxidation produces free radicals, which are molecules missing an electron in their outer shell. Highly unstable and reactive, these molecules “attack” other molecules attempting to “steal” electrons from their outer shells in order to gain stability. Free radicals damage other cells and DNA, creating more free radicals in the process and a chain reaction of oxidative damage.

Normally oxidation is kept in check, but when oxidative stress is high or the body’s level of antioxidants is low, oxidative damage occurs. Oxidative damage is strongly correlated to heart disease. Studies have shown that oxidated LDL cholesterol is 8x greater stronger a risk factor for heart disease than normal LDL.

Since there may be some confusion on this point, I want to make it clear: normal LDL cholesterol is not a risk factor for heart disease in most populations, but oxidated LDL cholesterol is. This points to oxidation as the primary risk factor, not cholesterol. Why? Because when an LDL particle oxidizes, it is the polyunsaturated fat that oxidizes first. The saturated fat and the cholesterol, hidden deep within the core of the lipoprotein, are the least likely to oxidize.

It follows, then, that if we want to prevent heart disease we need to do everything we can to minimize inflammation and oxidative damage.

By focusing on reducing or completely eliminating, when possible, the factors in our life that contribute to oxidative stress and inflammation, we can drastically lower our risk for heart disease. Let’s take a brief look at each risk factor.

Stress

In the INTERHEART study, stress tripled the risk of heart disease. This was true across all countries and cultured that were studies. The primary mechanism by which stress causes heart disease is by dysregulating the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is directly intertwined with the autonomic nervous system, and it governs the “fight-or-flight” response we experience in reaction to a stressor.

Continued activation of this “fight-or-flight” response leads to hyper-arousal of the sympathetic nervous system, which in turn leads to chronically elevated levels of cortisol. And elevated levels of cortisol can cause both inflammation and oxidative damage.

Stress management, then, should be a vital part of any heart disease prevention program. In fact, some researchers today believe that stress may be the single most significant factor in the cause and prevention of heart disease. There are several proven methods of stress reduction, including mindfulness-based stress reduction (MBSR), acupuncture and biofeedback. It doesn’t matter which method you choose. It just matters that you do it, and do it regularly.

Smoking

I assume that you are already well aware of the dangers of smoking, so I won’t spend much time on this one. For the purposes of this discussion, I will point out that smoking as few as 1-4 cigarettes a day has been shown to increase the risk of heart disease by 40%. But smoking 40 cigarettes a day increases that risk by 900%.

So if you smoke and you’re concerned about heart disease - quit.

Nutrition

Over the past century we’ve seen a consistent decline in the consumption of traditional, nutrient-dense foods in favor of highly processed, nutrient-depleted products. The flawed hypothesis that cholesterol causes heart disease has wrongly identified health-promoting foods like meat, organ meats, eggs and dairy products as harmful, and replaced them with toxic, processed alternatives such as chips, white breads, pastries, crackers, cookies, frozen foods, candy and soda.

There are two ways that nutrition contributes to heart disease: too much of the wrong foods, and not enough of the right ones.

The average American gets 57% of his/her calories from highly refined cereal grains and polyunsaturated (PUFA) oils. The #3 source of calories, behind grains and PUFA, is sugar and high-fructose corn syrup. Refined grains, polyunsaturated oils and sugar are all major contributors to both inflammation and oxidative damage.

Not only do refined carbohydrates, vegetable oils and sugar contribute to inflammation and oxidative damage, they are also completely devoid of micronutrients that would protect us from these processes. Meats, fruits and vegetables are all high in antioxidants that prevent oxidative damage, and rich in other micronutrients that play important roles in preventing heart disease.

More than 85% of Americans are not getting the federally recommended five servings of fresh fruit and vegetables each day. The intake of dark leafy green or yellow/orange veggies for the average American is equivalent to 18g - one-half of one small carrot. Iceberg lettuce, tomatoes, french fries, orange juice and bananas constitute 30% of fruit and vegetable intake for most Americans.

Many people know that the “Standard American Diet” is extremely unhealthy. But what most do not know is that the so-called “heart-healthy” diet that has been vigorously promoted for decades actually contributes to heart disease! The “heart-healthy” diet is high in refined carbohydrates and polyunsaturated oils, which, as we have seen, cause inflammation and oxidative damage.

On the other hand, saturated fats (which have been demonized by the medical mainstream) such as butter, coconut oil, lard, tallow and ghee are protected against oxidation and possess many other important health benefits. These fats are the ones we need to be eating to protect ourselves from heart disease.

It is extremely important to buy organic meat, eggs and dairy products that come from animals that have been raised on fresh pasture rather than in commercial, factory feedlots. See this article and this one for more information on why this is so essential.

Finally, it must be pointed out that not all “organic” products are healthy. Most packaged food (including organic cereals, crackers, chips and so-called “nutrition bars”) are full of highly refined carbohydrates, sugar, and vegetable oils. And by now, I don’t need to tell you what that means!

So what would a truly heart healthy diet look like, then? Download my Guidelines for Natural Prevention of Heart Disease to find out.

Physical Inactivity

Physical inactivity is likely a major causative factor in the explosive rise of coronary heart disease in the 20th century. During the vast majority of evolutionary history, humans have had to exert themselves to obtain food and water. Even at the turn of the 20th century in the U.S., a majority of people had jobs that required physical activity (farmers, laborers, etc.) Now the majority of the workforce has sedentary occupations with little to no physical activity at all.

Currently more than 60% of American adults are not regularly active, and 25% of the adult population is completely sedentary. People that are physically inactive have between 1.5x and 2.4x the risk of developing heart disease.

On the other hand, regular exercise reduces both inflammation and oxidative damage. Even relatively low levels of activity are protective - as long as they are consistent. A public review at Harvard University showed that 30-minutes of moderate physical activity on most days of the week decreases deaths from heart disease by 20-30%.

The best strategy for people struggling to find time to exercise is to make it part of their daily life (i.e. riding a bike or walking to work, choosing the stairs over the escalator or elevator, etc.)

When combined, the four strategies listed above will significantly reduce your chances of getting heart disease - without taking a single pill of any kind.

If you already have heart disease, or you are at high risk for heart disease (overweight, high blood pressure, diabetic, etc.), then you may need additional support. See my

• Natural Prevention of Heart Disease Guidelines
• The Truth About Cholesterol Brochure
• Resources for further learning
• Recommended tests for heart disease
• Recent New York Times article questioning efficacy of cholesterol-lowering drugs

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Today’s article about the dangers of soy products is from Nourishing Our Children, an organization dedicated to supported learning, behavior and health in children through optimal nutrition. I encourage all parents to visit their website and read the “What Parents Need to Know” section. There is also a downloads section with free guides and briefing books available for download.

Although widely promoted as a health food, hundreds of studies link modern processed soy to malnutrition, digestive problems, thyroid dysfunction, cognitive decline, reproductive disorders, immune system breakdown, and even heart disease and cancer. How could soy be linked to all this disease? Because the soybean contains many naturally occurring toxins. All legumes contain toxins but the problem with soy is that the toxins are found in very high levels and are resistant to the traditional ways of getting rid of them.

Long, slow fermentation (as in the traditional production of miso, tempeh and soy sauce) gets rid of the phytic acid and other digestive inhibitors but not the phytoestrogens in soy.

Myths About Isoflavones

One of the most common myths is that soy estrogens (isoflavones) are beneficial for your health. Isoflavones are the estrogen-like compounds occurring naturally in soy foods. They act as the plant’s natural pesticides, causing insects to become sterile. Research has shown that isoflavones can prevent ovulation and stimulate the growth of cancer cells. As little as 38 mg isoflavones per day (less than the amount found in 1 cup of soy milk) can result in hypothyroidism with symptoms of lethargy, constipation, weight gain and fatigue. The isoflavones in soy have been shown to cause reproductive problems, infertility, thyroid disease and liver disease in mice, rats, cheetahs, sturgeon, quail, sheep, pigs and marmoset monkeys.

Traditional Versus Modern Soy Foods

It is important to distinguish between traditional and modern soy foods. In Asia, traditional soy foods were consumed in small amounts, usually as a fermented condiment. Traditional fermented soy foods include miso, soy sauce, tempeh and natto. Tofu was prepared by a precipitation process that gets rid of some of the anti-nutrients, and tofu was often then fermented. Tofu was usually consumed in small amounts in fish broth, which provided lots of compensating minerals and compounds that support thyroid function.

Soymilk underwent a very long preparation process to get rid of anti-nutrients and it was consumed with shrimp or egg yolk, ingredients that helped compensate for the many anti-nutrients that remained. Mostly a food for the elderly, it was sometimes given to nursing mothers but never to growing children.

Problems with Soy Protein Isolate

Modern soy foods are very different. Most are made with soy protein isolate (SPI), which is a protein-rich powder extracted by an industrial process from the waste product of soy oil manufacturing. It is the industry’s way of making a profit on a waste product. The industry spent over 30 years and billions of dollars developing SPI.

Soy Protein Isolate is produced at very high temperatures and pressures. This processing does get rid of some of the anti-nutrients in soybeans, but unfortunately many of the proteins are denatured in the process, including lysine. That is why growing animals fed soy must be given a lysine supplement. In feeding studies, SPI caused many deficiencies in rats. That soy causes deficiencies in B12 and zinc is widely recognized; but the range of deficiencies was surprising.

Although SPI is added to many foods, it was never granted GRAS status, meaning “Generally Recognized as Safe”. The FDA only granted GRAS status to SPI for use as a binder in cardboard boxes. During the processing of soy, many additional toxins are formed, including nitrates (which are carcinogens) and a toxin called lysinoalanine. It was concerns about lysinoalanine in SPI that led the FDA to deny GRAS status for SPI as a food additive.

In spite of all these problems, SPI is the basic ingredient of soy infant formula and the FDA even allows a health claim for foods containing 6.25 grams SPI per serving.

The Dangers of Soy Infant Formula

Infants on soy formula can take in dangerously high levels of soy isoflavones. On a body weight basis, this can mean ten times the level that can cause thyroid suppression in adults after three months, and eight times the level that can cause hormonal changes in adults after just one month.

According to a Swiss report adult women consuming 100 mg isoflavones (about 2 cups of soy milk, or 1 cup of cooked mature soybeans) provide the estrogenic equivalent of a contraceptive pill.

This means for a baby that weighs 6 kg (or just over 13 pounds), 10 mg provides the estrogenic equivalent of a contraceptive pill. Thus, the average amount of soy-based formula taken in by a child provides the estrogenic equivalent of at least four birth control pills. Because babies are more vulnerable than adults to the effects of dietary estrogens, the effects could actually be much greater than that of four birth control pills.

Hence the statement, “Babies on soy formula receive the estrogenic equivalent of at least five birth control pills per day.”

Homemade Baby Formula

For adopted infants, or as a solution for mothers who aren’t physically able to breastfeed or who aren’t able to produce enough milk, we’d like parents to know that there are nutrient dense, homemade Baby Formula Recipes in the book Nourishing Traditions which have been used with great success by parents all over the world since 1995!

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A recent review of the scientific literature published in Current Opinion in Clinical Nutrition and Metabolic Care clearly indicates that egg consumption has no discernible impact on blood cholesterol levels in 70% of the population. In the other 30% of the population (termed “hyperresponders”), eggs do increase both circulating LDL and HDL cholesterol.

You’ve probably been conditioned to believe that anything that raises LDL cholesterol (so-called “bad” cholesterol) should be avoided like the plague. But even the medical mainstream has come to recognize that all LDL cholesterol is not the same. It’s true that small, dense LDL particles have been linked to heart disease. This is primarily due to the fact that they are much more susceptible to oxidative damage than normal LDL cholesterol particles.

However, egg consumption increases the proportion of large, buoyant LDL particles that have been shown to be protective against heart disease. Egg consumption also shifts individuals from the LDL pattern B to pattern A. Pattern B indicates a preponderance of small, dense LDL particles (risk factors for heart disease), while pattern A indicates a preponderance of large, buoyant LDL particles (which protect us from heart disease). This is a good thing.

Eggs one of the most nutrient-dense foods available. One egg provides 13 essential nutrients, all in the yolk (contrary to popular belief, the yolk is far higher in nutrients than the white).

Eggs are an excellent source of B vitamins, which are needed for vital functions in the body, and also provide good quantities of vitamin A, essential for normal growth and development.

The vitamin E in eggs protects against heart disease and some cancers; eggs also contain vitamin D, which promotes mineral absorption and good bone health.

Eggs are rich in iodine, for making thyroid hormones, and phosphorus, essential for healthy bones and teeth.

Eggs are also good sources of antioxidants known to protect the eye. Therefore, increased plasma concentrations of lutein and zeaxanthin in individuals consuming eggs are also of interest, especially in those populations susceptible to developing macular degeneration and eye cataracts.

There’s absolutely no reason to limit your consumption of eggs to three to four per week, as recommended by “heart-healthy” nutritional guidelines. In fact, consuming two to three eggs per day would provide a better boost to your health and protection against disease than a multivitamin supplement. Eggs truly are one of nature’s superfoods.

It’s important, however, to make sure that you buy organic, pasture-raised eggs. Studies show that commercially-raised eggs are up to 19 times higher in pro-inflammatory omega-6 fatty acids. Unfortunately, almost all eggs sold in supermarkets - even the organic eggs sold at chains such as Whole Foods and Wild Oats - are not truly pasture-raised. To find these eggs, check your local farmer’s market or visit the Eat Wild website to locate a source in your area.

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