Human fatty acid synthesis is reduced after substitution of dietary starch for sugar by Lisa Hudgins in the April 1998 issue of the American Journal of Clinical Nutrition found very-low fat diets that contain only simple carbohydrate markedly increase the synthesis of fatty acids to produce triglycerides in healthy people (67:631). The addition of starch (complex carbohydrate) reduced the production of fatty acids.

COMMENT: Many people fail to understand that a low-fat diet does not necessarily mean a diet that will prevent heart disease or cause you to lose weight. Simple sugars actually cause an increase in one risk factor for heart disease--triglycerides. Furthermore, triglycerides are the fats that go into the fatty tissues for storage.

Simple carbohydrates (sugars) are found naturally in fruits, whereas complex carbohydrates are found in starchy vegetables (like whole grains, legumes, and roots), and green and yellow vegetables. In processed foods, especially in drinks, desserts, and snacks, simple sugars are voluminous. I see too many patients eating low-fat; meaning fat-free ice creams, puddings, yogurts, cookies, and cakes made from sugar--and they never lose weight or become healthier.

This misunderstanding that anything low-fat means healthy is also used by advocates of high protein diets to convince you that carbohydrates are bad for you. They point out that carbohydrates raise triglyceride levels. This study is one of many that shows this happens with simple sugars, but not with complex carbohydrates.

BP PILLS AND DEPRESSION

Use of calcium channel blockers and risk of suicide: ecological findings confirmed in population based cohort study by Gunnar Lindberg in the March 7, 1998 issue of the British Medical Journal found the use of calcium channel blockers may increase the risk of suicide (316:741). They compared the use of this class of blood pressure pills with the rates of suicide in 152 municipalities in Sweden and found a correlation, which they did not find with the use of other classes of blood pressure pills. The relative risk, adjusted for differences in age and sex, among users versus nonusers was 5.4.

COMMENT: An association of depression with the use of calcium channel blockers has previously been reported in several studies. This study carried that research forward, looking at suicide which often follows depression. Patients who used calcium channel blockers had more than five times the risk of suicide compared to nonusers. These drugs easily pass from the blood into the nervous system where they can have effects on the nerves, neurochemicals, and receptors involved in mood. Most drugs used to treat heart disease and high blood pressure have effects on mood, however, calcium channel blockers seem to be the worst.

Calcium channel blockers (antagonists) are dangerous medications used to lower blood pressure and treat some forms of heart disease (angina and arrhythmias, for example). Previous McDougall Newsletters have dealt with the hazards of these medications: Doubling the Risk of Breast Cancer--Nov/Dec 1997; Causing an Increase in Cancer--Sept/Oct 1996; Gastrointestinal Bleeding--May/Jun 1996; and Heart Disease--Sept/Oct 1995. Yet calcium channel blockers are annually an 8 billion dollar business that can buy expert’s opinions--like other pharmaceutical manufacturers.

DRUG COMPANIES BUY DOCTORS

Conflict of interest in the debate over calcium channel antagonists by Henry Stelfox in the January 8, 1998 issue of the New England Journal of Medicine found, "Authors who supported the use of calcium channel antagonists were significantly more likely than neutral or critical authors to have a financial relationship with manufacturers of calcium channel antagonists (96 percent vs. 60 percent and 37 percent, respectively)." (338:101) Critical authors were also more likely to be associated with manufacturers of competing products. "We wonder how the public would interpret the debate over calcium channel antagonists if it knew that most of the authors participating in the debate had undisclosed financial ties with pharmaceutical manufacturers."

COMMENT: Pharmaceutical manufacturers provide money for doctors’ educations throughout their careers, and for research that guides doctors’ decisions. Noontime educational luncheons sponsored by pharmaceutical manufacturers occur weekly in almost every hospital countrywide, drug salespeople flood doctors’ offices daily, and most of our continuing education conferences have a pharmaceutical manufacturer’s sponsorship. Obviously, money influences the kind of care you get. And the pharmaceutical industry rules big money.

TAMOXIFEN FOR BREAST CANCER

Tamoxifen for early breast cancer: an overview of the randomised trials by the Early Breast Cancer Trialists’ Collaborative Group in the May 16, 1998 issue of the Lancet found benefits from Tamoxifen for women with breast cancer regardless of their age, menopausal status, daily tamoxifen dose, and whether chemotherapy had been given (351:1451). Proportion of mortality reductions were similar for women with node-positive and node-negative disease. Cancer of the uterus was doubled with 1 to 2 years of tamoxifen use and quadrupled after 5 years (Tamoxifen has estrogen stimulating effects that can cause endometrial cancer, in addition to its blocking effects that benefit breast cancer).

COMMENT: I can only imagine that sometime in the recent past, cancer doctors working hand in hand with pharmaceutical companies must have gotten together and divided up the breast cancer business. The side of the business profiting from toxic chemotherapy got the premenopausal women, which are mostly those with estrogen receptor negative tumors. The tamoxifen side got the postmenopausal women with mostly estrogen positive tumors. I could never understand any sound scientific reason to treat these women so differently because the studies as far back as the early 1980s showed all women, regardless of menopausal or estrogen receptor status benefited from the less toxic tamoxifen therapy (Lancet 1:257, 1983). Likewise, those with positive and negative lymph nodes under their arm benefited from Tamoxifen.

Estrogen stimulation should be reduced after initial breast cancer surgery (I recommend a lumpectomy with clear margins). Tamoxifen works by blocking the growth-stimulating effects of estrogen on the tumor. Chemotherapy is believed to work by destroying a woman’s ovaries and in that way reducing the stimulating effects of estrogen on her tumors. However, I think a year of sickness with vomiting and hair loss is an inhumane way to reduce a woman’s estrogens. The simplest, safest, and most economical means of removing ovary function is by laparoscopy surgery (Surg Laparosc Endosc 7:223, 1997).

MAMMOGRAMS AND FALSE POSITIVES

Ten-year risk of false positive screening mammograms and clinical breast examinations by Joann Elmore in the April 16, 1998 issue of the New England Journal of Medicine found over a period of 10 years of screening one-third of women had abnormal test results requiring additional evaluation, even though no breast cancer was present (338:1089). The estimated accumulative risk of a false positive mammogram was nearly 50 percent with 18.6 percent of women undergoing a biopsy after 10 mammograms.

COMMENT: That’s a lot of testing and surgery following an x-ray examination that has questionable benefits, even for women over 50 (Lancet 346:29, 1995). False positive mammograms and clinical breast examinations by doctors result in anxiety, complications, scars, and costs. After a false positive mammogram, 26 percent of women report worry and anxiety 3 months after they have been told they don’t really have breast cancer (Ann Intern Med 114:657, 1991). My recommendations are that women under 50 and over 69 should avoid routine screening. Those between these ages should understand that the benefits are far oversold. Two studies show statically significant benefits for women over 50, the other six don’t! (J Natl Cancer Inst 85:1644, 1993). Late next fall The McDougall Program for Women will be out with an exposing chapter on mammography.

ASTHMA FROM RICH FOODS

Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC by the International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee in the April 25, 1998 issue of the Lancet found asthma most common in UK, Australia, New Zealand, and Republic of Ireland; and least common in several European Eastern Countries, Indonesia, Greece, China, Taiwan, India, and Ethiopia (351:1225). The places of lowest prevalence for allergic rhinoconjunctivitis and eczema were similar to those of asthma.

COMMENT: You might think respiratory diseases, like asthma and rhinitis (runny nose), and conjunctivitis (inflamed eyes), would be most common where pollution was worse. However, that’s not what the worldwide pattern shows. These allergic diseases are common in affluent nations where pollution levels are generally low.

Based on what I know about their cause and the experiences I have had with treating these allergic problems, I would have predicted these findings, because, again, it’s the food. Dairy products have been linked to all of these allergic conditions, and removal of dairy from the diet has profound benefits for the patients. Other highly allergic foods, like eggs, probably play a role too. Rich foods also lead to acid indigestion and acid reflux. The refluxed acid travels to the back of the throat where it is inhaled, burning the bronchial tubes and causing the bronchospasm and mucus production, characteristics of asthma. That same stomach acid is breathed into the sinus passages causing rhinitis, and sinusitis.