December 2008

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headacheA study published in the December issue of Anesthesia & Analgesia indicated that acupuncture is superior to placebo and medication in treating chronic headaches.

The study reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine.

Fourteen of the studies (with a total of 961 patients) compared acupuncture directly to placebo, or sham acupuncture. 53 percent of people treated with real acupuncture improved, compared to 45 percent of those receiving the placebo treatment.

Acupuncture has far fewer side effects and risks than medication used to treat headaches, and can also produce feelings of relaxation and well-being.

Unfortunately, acupuncture has only been affordable for a relatively small percentage of the population. But a new movement called “community acupuncture” is changing that. In community acupuncture (CA) clinics, several patients are treated simultaneously, often in comfortable reclining chairs arranged in a circle. Points below the elbows and knees and on the head are emphasized, so there is no need for the patient to disrobe.

Because of the higher volume of patients that can be treated in this manner, treatments are offered at a much lower rate – often on a sliding scale between $15-40, or about the same cost as an insurance co-pay.

The community acupuncture model, which was developed by acupuncturist Lisa Rohleder and pioneered in her clinic Working Class Acupuncture in Portland, OR is rapidly expanding across the country. Try Googling “community acupuncture” along with the name of your town to see if there’s a clinic where you live.

codI’ve received several questions about the safety of cod liver oil (CLO) since the Vitamin D Council warned consumers about the ingestion of CLO due to concerns about potential vitamin A toxicity in their November bulletin.

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.

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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.

Healthy Skeptic note: I recommend either high-vitamin cod liver oil or fermented cod liver oil from Green Pasture and Wolf River Naturals.

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.

wrenchAh, the joys of technology.

I broke something in the process of upgrading to the latest version of WordPress early this morning, and the blog was down the entire day.

Just got it up and running again, and with a shiny new coat of paint to boot! If you weren’t able to access the site earlier, you shouldn’t have any trouble now.

Make sure to eat plenty of good fat over the holidays!

pregnant womanBack in July I posted an article called Statins For Pregnant Women and Kids? criticizing a research study that actually recommended statins for pregnant women.

Well, it appears that even mainstream scientists are beginning to acknowledge the very real risks that statins present for pregnant mothers and fetuses.

Current clinical guidelines already recommend that women who are pregnant should stop taking statins but the advice is based on the knowledge that cholesterol is essential for normal fetal development.

But new research from The University of Manchester has shown that even water-soluble or ‘hydrophilic’ statins, such as pravastatin, can affect placental development leading to worse pregnancy outcomes.

According to Dr. Melissa Westwood, a Senior Lecturer in Endocrinology based at the Maternal and Fetal Health Research Centre at St. Mary’s Hospital, Manchester:

“Our study examined the effects that both lipophilic and hydrophilic statins had on a key biological system that is crucial for maintaining the normal function of the placenta, which acts as the nutrient-waste exchange barrier between mother and fetus.”

Fat-soluble statins like cerivastatin were already known to adversely affect the placenta, resulting in reducing growth. But the researchers also found that pravastatin – the water-soluble statin thought to be potentially compatible for use in pregnancy – had the same detrimental effect.

“These results clearly show that the effect of statins on the placenta is not dependent on their lipophilicity as had previously been suggested,” said Dr Westwood, whose findings are published in the Journal of Cellular and Molecular Medicine.

“While hydrophilic statins have not been reported to increase the incidence of fetal malformations, our research suggests that they will have a detrimental effect on placental growth, which is likely to result in poor pregnancy outcome.

“Healthcare professionals should continue to advise women to avoid the use of any type of statin once they plan to start a family or when a pregnancy is suspected or confirmed.

brainFrom a brief article at Barry Groves’ Trick and Treat blog:

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.

tibetan bowlEach week, it seems, more and more evidence pours in demonstrating the effectiveness of non-drug treatments for depression.

In a study, published December 1, 2008 in the Journal of Consulting and Clinical Psychology, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples’ quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term.

Over the 15 months after the trial, 47% of the group following the MBCT course experienced a relapse compared with 60% of those continuing their normal treatment, including anti-depressant drugs. In addition, the group on the MBCT programme reported a higher quality of life, in terms of their overall enjoyment of daily living and physical well-being.

MBCT was developed by a team of psychologists from Toronto (Zindel Segal), Oxford (Mark Williams) and Cambridge (John Teasdale) in 2002 to help people who suffer repeated bouts of depression. It focuses on targeting negative thinking and aims to help people who are very vulnerable to recurring depression stop depressed moods from spiralling out of control into a full episode of depression.

Click here to read the full article.

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