New Under the Sun:
Volume 5, Issue 1
Let us reflect on what AnthroHealth means: to live our lives in accord with our evolutionary adaptations. Humans are biological organisms, specifically, animals; and as with all animals, the environment plays a major role in our health. We are not machines whose separate parts can easily be fixed or replaced. Our systems interact. Modifying a parameter in one system can have unexpected effects downstream. Ignoring our evolutionary adaptations will have detrimental effects on our health. As we begin a new year, it is wise to keep this in mind.
Kidney Punch: Individuals with kidney disease are frequently given ACE inhibitors or beta blockers to lower blood pressure because these drugs have been marketed as preventing further harm to the kidneys. However, a recent meta-analysis of all research studies related to this issue (127) published prior to January 2005 did not find support for these prescription guidelines. What the analysis showed is that further kidney damaged appeared to be prevented by lowering blood pressure, that there was no evidence of additional kidney protection among patients with diabetes, and that any possible additional kidney protection among non-diabetic patients was uncertain. Juan P Casas, Weiliang Chua, Stavros Loukogeorgakis, Patrick Vallance, Liam Smeeth, Aroon D Hingorani, and Raymond J MacAllister a Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis. The Lancet 2005; 366:2026-2033.
on the above research, it appears that while further damage to kidneys
can be prevented by lowering blood pressure, ACE inhibitors or beta blockers
may not be the best solution. Diuretics, which are significantly cheaper,
appear to work just as well. However, one should not rely on drugs to
control blood pressure. Lifestyle changes must also be made. Three of
the most important are to quit smoking, reduce one’s weight, and get more
exercise. Dietary changes are also necessary, which will help with the
Fifteen years into a longitudinal study of 5304 individuals, researchers compared current blood pressure with that at study enrollment and correlated these to dietary information. They found that a high intake of fruits and vegetables was associated with a lower incidence of elevated blood pressure whereas a high intake of red meat and processed meat had an adverse affect on blood pressure. Lyn M Steffen, Candyce H Kroenke, Xinhua Yu, Mark A Pereira, Martha L Slattery, Linda Van Horn, Myron D Gross and David R Jacobs, Jr. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2005;82:1169-1177.
We can conclude from these studies that chronic drug therapy may not be the best option (also see the book review below), and is certainly not the only option for reducing blood pressure. The other options take more effort, but will provide multiple health benefits without potentially damaging side effects. Eat the AnthroHealth way. Take a walk in the sun. Enjoy life more.
Lung Fish: Previous research has shown that a diet rich in omega 3 fatty acids is good for your heart. New research indicates that it is also good for your lungs, based on results from a prospective study of 64 individuals with chronic obstructive pulmonary disease (COPD). Subjects were divided into two groups. One group received a daily supplement of omega 3 fatty acids resulting in a somewhat higher ratio of omega 3 to omega 6 fatty acids, while the other group ate a more typical diet high in omega 6 fatty acids, with very low levels of omega 3 fatty acids. Although both types of fatty acids are needed for good health, they must also be in balance if they are to function appropriately. Therefore, this research study was testing what effect balancing the two fatty acids might have on lung function.
After 24 months, it was found that those individuals supplemented with omega 3 fatty acids had improved lung function compared to those on the control diet. Part of this improvement appeared to be due to the beneficial effect that omega 3 fatty acids have on tissue inflammation. In this case, reduced inflammation would indicate more open airways. The researchers concluded that although there is no cure for COPD, treatment with a diet rich in omega 3 fatty acids would be of benefit. Matsuyama W, Mitsuyama H, Watanabe M, Oonakahara K, Higashimoto I, Osame M, Arimura K. Effects of omega-3 polyunsaturated fatty acids on inflammatory markers in COPD. Chest. 2005 Dec;128(6):3817-27.
Comment: Modern diets are generally quite out of balance between the two fatty acids because one of the best sources of omega 3 fatty acids is cold water fish such as salmon, mackerel, herring, and sardines. The wild meat our ancestors ate is also a good source, but domesticated meat definitely is not. And, as regular readers know, cold water fish is also an excellent source of vitamin D.
In the same issue of Chest where the COPD study was reported, another study found that vitamin D was associated with lung function. Those individuals with 25 hydroxyvitamin D levels above 32 ng/mL had better lung function than those with lower vitamin D levels. They further noted that the difference in lung function between the two vitamin D groups was greater than that between those who used to smoke and those who never smoked. Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin D and pulmonary function in the third national health and nutrition examination survey. Chest. 2005 Dec;128(6):3792-8.
Based on these two studies we can conclude that if want healthy lung functioning, we better eat our sardines! (You probably saw that one coming.)
Book Review: Last month I reviewed Selling Sickness. The theme of the impact of Big Pharma on our health continues with this month’s book review of Greg Critser’s Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies. Critser covers much of the same territory that Moynihan and Cassels did. Because of this, I must make a disclaimer. It may be that I read this book too soon after reading Selling Sickness, but I found the first two (long) chapters to be rather slow. In part, this is probably because the authors’ takes on Big Pharma were quite similar. However, it may also be because Critser spent many pages delving into the backgrounds and personalities of the key pharma players and how they drove Big Pharma to its current position. I found this a bit tedious. But if I had read Critser’s book prior to reading Selling Sickness, I might have had a very different, more positive, view of these chapters.
Ambivalence fades with Chapter 3: “The Full Price: What Living in Pharma’s World Means for Our Bodies.” This is a chapter that everyone should read as a reminder that human bodies are organisms not machines and that drugs do not just “fix” one problem, but that they have systemic effects that can cause more problems than they “cure,” especially if the drugs are for chronic illnesses. Most of us are aware that chronic drinking will damage the liver, but are perhaps unaware that chronic medication with drugs may also have liver-damaging effects. Organisms strive to maintain homeostasis. The liver plays a major role in this process. While capable of tissue-regeneration, the liver can become overstressed, even to the point of death, in its efforts to produce needed substances while eliminating others.
Critser does an excellent job of describing the price of chronic drug use paid not only by the liver, but also by the heart, lungs, and digestive system. He further discusses the fact that males and females, and the young and the elderly metabolize drugs differently. A dosage that could be safe for a 200-pound man in his 40s may cause permanent harm to a petite, elderly woman. This is an issue in part due to the limited patient samples used in drug trials. As Critser notes, the “…chief irony of the new pharma age [is that] to be the nation at the edge of new discoveries, we must be willing to be part of the experiment.” (p. 194)
We are not only experimenting on our own bodies, but on those of the developing fetus. Critser mentions research indicating that statins taken to lower cholesterol may be implicated in limb and nervous system birth defects. As the book was in publication, so too late to be included in the text, the FDA sent out an alert that Paxil use by pregnant women in their first trimester is associated with a doubled incidence of heart defects in the fetus. Now, this increase is only from 1% to 2% compared to the general population, but for the woman taking Paxil, that is bound to be a frightening increase when there are already so many unknowns to pregnancy.
Critser follows the full price chapter with a brief one on the failures of the FDA to adequately monitor drugs both pre- and post-approval. Most of the chapter is devoted to explaining Big Pharma’s efforts to get their man appointed to head the agency. At the time his book went to press in 2005, Critser noted that they finally got their choice, Les Crawford, appointed. Unfortunately for them, he abruptly resigned this past September (as Generation Rx was shipped to bookstores) possibly due to financial conflicts of interest with Big Pharma. It would be interesting to read Critser’s take on this new development.
Generation Rx concludes with Critser’s plea for us to reassert our independence. Physicians should distance themselves from Big Pharma, and perhaps even be required to fully disclose to their patients their educational background, continuing medical education courses taken, and any financial ties to Big Pharma and/or other outside sources. The FDA needs to be a fully independent watchdog, not Big Pharma’s enabler. And we all need to become realistic about our health. Good health requires effort; we should not rely on drugs. Critser hammers this home by stating: “When you think about drugs, recite these mantras: Drugs are poisons—useful poisons but poisons nonetheless. Every time you use one you also ‘use’ one or more vital organs to process it. If it is a new drug, you are a test subject. If it is a clinical trial, you are part of a human experiment. Say it. Say it again.” (p. 252) [His emphasis.]
As became clear in the final three chapters of his book, Critser has a poor opinion of Big Pharma and their pals in government. But it is also obvious that he is very worried by current healthcare trends and their possible long-term effects. This is an uneven book, but Critser does make a number of valuable points, two of which (drug-related birth defects; Big Pharma and the FDA) I found current support for with little effort. On balance, I suggest reading Generation Rx to discover if you are a card-carrying member.
FDA Paxil MedWatch: http://www.fda.gov/medwatch/safety/2005/safety05.htm#Paxil2
Report on Les Crawford’s resignation: http://www.washingtonpost.com/wp-dyn/content/article/2005/10/25/AR2005102501544.html.
AnthroHealth Tip of the Month: Check your medicine cabinet. Think about your lifestyle. Would it be possible to reduce or eliminate some of your medications or supplements if you modified your lifestyle to take into account our biological adaptations?
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.