Saturday, July 16, 2005

Essential Fatty Acids EFA's

Fats (triacylglycerols) and Essential Fatty Acids

Some basic terminology ...

fat or fatty acid ...

In the human most of the important fatty acids are
between 14 and 24 carbon atoms in length with the
most common being 16 or 18 carbon atoms. There is
a carboxy.. (acid) group at one end (COOH) and a methyl
group at the other end (CH3). Carbon number one is the
carbon atom in the carboxy.. group and the omega(w) carbon
is the carbon atom in the methyl(CH3) group at the other end.
(For purposes of this discussion we will use the w symbol
for the omega symbol).

saturated fat ...

A carbon atom can have four atoms attached(bonded)
to it. Methane gas for example is CH4. There is one carbon
atom with four attached hydrogen (H) atoms. When a fatty
acid is termed "saturated" this means that all the bonds
between the carbon atoms are "single" bonds. All the four
available spots for bonds are either taken up by an
adjacent carbon atom or a hydrogen (H) atom. For example
the omega end of linolenate would look like this ...

CH3-CH2-CH=CH-CH2...rest of the molecule

There is a single bond between the omega carbon (first from
the left) and the next carbon. The second carbon atom has
two hydrogen atoms and two carbon atoms bonded to it. But,
what about the third carbon from the left?

Unsaturated fats ...

If we look at the above example the third and the fourth
carbon atoms have a "double" bond between them and only
one hydrogen atom each. This is an example of an
unsaturated bonding, ie not as many hydrogen atoms are
bonded to the carbon atom as there could be. If we make
the rest of this molecule linolenate and name this
according to the location of the double bond what would
we call this fatty acid?

Polyunsaturated fatty acids ... These are fatty acids that
have more than one "double" bond. Lineolate is a good
example of one having double bonds at the 9th and 12th
carbon atoms (from the acid end) or the 9th, 12th and
15th carbon atoms.

Essential fatty acids ... "Mammals lack the enzymes to
introduce double bonds at carbon atoms beyond C-9 in the
fatty acid chain."

Stryer Biochemistry 4th Edition p623

This can be a source of confusion since the above statement
is counting from the acid end and the omega acids are
counting from the omega end. The two main "essential"
fatty acids are:

linolenate (w-3)also known as alpha linolenic acid(LNA)
linoleate (w-6)also known as linoleic acid (LA)

The w-3 tells you that the first double bond will be at
the third carbon atom from the w- end. The w-6 tells you
that the first double bond will be at the sixth carbon
atom from the w- end. These acids are termed "essential"
because human (mammalian) biochemistry cannot
synthesize them.

Insulin and Glucagon revisited ...

Just an aside here, but it is worth mentioning again in this
discussion of fat metabolism. In starvation the level of
free fatty acids rises because of the hormones glucagon
and epinephrine. Glucagon "mobilizes / utilizes" fat and
stimulates the breakdown of fat in the fat cells. Insulin
by contrast however, inhibits the breakdown of fat and
actually promotes the storage of fat / energy.

The good fats ...

Both of the above fats are "good" fats and necessary for
human biochemistry to proceed normally. The omega-6 linoleic
acid can be found in more foods than the omega-3 linolenic
acid. People are typically deficient in the omega-3 linolenic
acid. The good fatty acids "compete" with the bad fatty acids
(saturated animal fat, trans-fats etc) and diets that are
too heavy in the bad fats make it difficult for the good fats
to do their required biochemistry. Also, it is felt that there
should be a balance maintained between the omega-3 and the
omega-6 fatty acids. The ideal intake ratio of omega-6 to
omega-3 should be close to 1:1. However, most Americans get
a ratio closer to 25:1 (too much omega-6 relative to omega-3).

What do EFA's do ...

EFA's are integral to cell wall maintainance, the immune
system, nervous system, cardiovascular and reproductive
systems. They are precursors to the fatty acids necessary
for prostaglandin formation, which control vital functions
heart rate, blood pressure, immune function, fertility and
blood clotting.

Symptoms of omega3/6 imbalance and or deficiency ...

Omega 6/3 imbalance is associated with many symptoms
including depression, insulin resistance, diabetes,
cancer, heart disease, aging, obesity and schizophrenia.

Food sources ...

Flaxseed oil is probably the easiest and best way to cover
your EFA requirement. One tablespoon of flaxseed oil per
day will give you the necessary omega-3 linolenic acid
you need. This is also an excellent source of omega-6
linoleic acid. Other sources of omega-3 linolenic acid
are:

walnuts, pumpkin seeds, Brazil nuts, sesame seeds,
avocados, some dark leafy green vegetables (kale,
spinach, purslane, mustard greens, collards, etc.),
canola oil (cold-pressed and unrefined), soybean oil,
wheat germ oil, salmon, mackerel, sardines, anchovies,
albacore tuna

Sources of linoleic acids (omega-6) are

Flaxseed oil, flaxseeds, flaxseed meal, grapeseed oil,
pumpkin seeds, pine nuts, pistachio nuts, sunflower seeds
(raw), olive oil, olives, borage oil, evening primrose
oil, black currant seed oil, chestnut oil, chicken,
corn, safflower, sunflower, soybean, cottonseed oils

(Thank PamRotilla.com for these sources)

Refined oils ...

It must be stressed here that any oil that has been refined
will have no EFA activity. The essential fatty acids
are very unstable and will not tolerate either light or
increased temperature. Your flaxseed (or any) oil should not
be refined. While refining may produce a pretty, clear oil,
it destroys most of the good things found in oils including
vitamin E. Make sure your source for EFA's is kept in
the refrigerator section of your grocery, in an opaque bottle.

Thank you for your time ...

Wednesday, July 13, 2005

Angina Doesn't Care If You Are Half-Right

Comment from one of our readers ...

I did find it interesting that your list of recommended
books did not include any by Ornish, McDougall and others.
But then I recognize that you stress the elimination of sugar
while the others stress the reduction of fats. It seems to
me to be different paths to the same place of greater health.

Mary Ann
Winnipeg, Manitoba

Discussion:

So much for genetics ...

My father had diabetes, my mother had diabetes and of course,
you would expect that at some point, I would have it . Some would
point to a "genetic" pre-disposition. I feel that it is much
more likely a "lifestyle" pre-disposition. I drank a lot of
cow's milk as a child and ate more than my share of "boxes of
24 Clark bars from the local Shell gas station."

The Eisenhower tunnel 1974

Driving through the Eisenhower tunnel in the fall of 1974 I
had this "unusual" pain in my chest. I thought to myself then
-could this be angina? January 1975 I would self-medicate
myself through a bad episode of bilateral pyelonephritis
(kidney infection). Fall 1990 on an attempted 20 mile run
around Lake Wawasee in Indiana, I would stop at twelve miles
due to severe chest pain into my left arm, relieved by rest.
That afternoon still feeling bad, I would sit and wonder
what they would do if I went to an emergency room. How
could this be angina? I was in year thirteen of a daily
running streak and had been vegan for all those years.
About three years later, circa spring 1993, I headed out for
a seven mile run from Broad Ripple in Indianapolis on the
beautiful canal path, only to have to stop in the first
half-mile. That is the first and last run I have ever had
to stop anytime in the first mile. I had severe chest
pain into my throat, left arm then right arm, then
the whole upper half of my body. This was accompanied by
some dizziness, disorientation and an extreme uneasiness.
I managed to run / walk another six miles. I would rest
for a while, let the pain subside, then run till it got
bad again, and then rest.

The answer ...

I would have to wait until July 5th, 1997, to get my answer.
On June 23 of that year I fell and broke the fifth metatarsal
in my right foot. I managed to run the next day, but it was
very painful. However, the fracture healed very rapidly.
While at work on Saturday July 5th, I had one of the
Radiology techs at St. Anthony's hospital take a film.
I was right about the fracture as I had suspected. Being
a Radiologist trained to look at the whole film, I as
usual, examined the whole film. I couldn't believe it when
I saw it. Atherosclerotic vascular calcification of the
Monckeberg variety (diabetes), in my right foot. I expected
to see that in films of other people, especially at VA
hospitals, but never in my own foot.

The last "six pack of Pepsi and late night box of Mike and Ikes" ...

That was the end of my "almost a six pack of Pepsi every day"
habit. That was my last late night box of Mike and Ikes. How
could this be happening to me, a running vegetarian. I had
been a great fan of Dr. Dean Ornish, the "black sheep"
Cardiologist who now is not quite such a black sheep, who
advocated a low fat vegetarian diet to reverse heart disease.
I pulled his book out of my library and reread it and I
quote, "There is no proven relationship between sugar and
coronary artery disease." Something here is not quite right.

Sudden death from "heart attack" in diabetics

I remember from my medical school days the old adage that
"approximately 50% of all people dying with their first
heart attack with no prior history of coronary disease,
would turn out to have adult onset diabetes mellitus." How
can you explain that the days after my anginal episodes
I would run normally with no angina as I still do "mostly"
in the 26th year of my running streak? Significant
obstruction of any of the major coronary vessels would
not go away the next day. Why do so many people with diabetes
die with unexpected and undiagnosed coronary disease?

Coronary arteries and arterioles

Coronary artery disease that we talk about is usually that
which we can diagnose. To make the diagnosis, contrast is
injected into the coronary arteries and then rapid sequence
images are obtained. However, modern imaging techniques
can only measure the larger vessels. To date, there is no
way to image the extremely small vessels (arterioles) where
the oxygen and nutrient transport takes place. There are
basically two types of atherosclerotic changes. Those that
occur around areas of normal turbulence, ie wherever an
artery bifurcates, there will be some turbulence from
boundary layer separation. I associate that type of change
with animal protein and fat ingestion. Then there is the sugar
induced calcification that involves the entire artery. It
is systemic and generally speaking if you have it anywhere
-you have it everywhere.

Stiff pipes ...

What does the calcification of the arteries and arterioles
do? It causes the artery or arteriole to become stiff,
rigid and "non-compliant." This becomes a rather significant
problem whenever one ingests a large fat load, especially
some of the bad fat loads that are out there today. The
normally compliant arteriole can expand to let the larger
fat molecules pass. The stiff, diabetic and non-compliant
arteriole cannot accommodate the larger fat molecule and
voila ... it becomes blocked. Does this cause angina?
You bet! It blocks oxygen and nutrient transport
as surely as a permanent lesion in one of the larger
arteries proximal to the arteriolar level. There is however,
one major difference -once the fat clears, if you survive,
the blockage can be gone.

Don't be "half-right" ...

Before my first severe episode of angina I had eaten some
fat (olive oil on toast) that I had never had before. About
twelve miles into that run I had severe angina. The day before
the worst episode in Broad Ripple, I had eaten a vegan scone
in Bloomington, that was loaded with all kinds of bad fats.
Most diabetics who die with their first heart attack usually
have eaten a big meal, just before the heart attack occurs.
Dr. Ornish is definitely right about eating low fat.
But, that is only half of the equation. The other and
very much the larger half, is NO SUGAR -PERIOD.

The MericleDiet and sugar ...

The MericleDiet is the only "Sugarfree" diet plan today. The
integrated system to cook once a week or so, maintain a
refrigerator stocked full of everything from complex
carbohydrates like rice and potatoes to lower glycemic
index foods like beans and salads, makes it easy to transition
away from all the ubiquitous "sugars and sugar substitutes"
that are in almost all processed and packaged foods. Also,
the MericleDiet is the only diet that is 100% Organic. I
had to make it sugar free for myself, vegan to reduce the
risk of cancer and organic to find any real nutrition.

Use Stevia, if you must have sweet ...

For those of you who have been on this list for some time you
already know about Stevia. Stevia is a naturally occurring
sweetener that has also been demonstrated to lower blood
pressure. For more information click on the link below.

For More Information on Stevia

To Visit Carol Bond Health Foods For Stevia(Stevita on her site)

Thanks for your time.

Wednesday, July 06, 2005

Medical Bankruptcy

Headlines From The Washington Post

"Sick and Broke"

By Elizabeth Warren
Wednesday, February 9, 2005; Page A23

Nobody's safe. That's the warning from the first large-scale
study of medical bankruptcy.

Health insurance? That didn't protect 1 million Americans who
were financially ruined by illness or medical bills last year.

A comfortable middle-class lifestyle? Good education?
Decent job? No safeguards there. Most of the medically
bankrupt were middle-class homeowners who had been to
college and had responsible jobs -- until illness struck.

As part of a research study at Harvard University, our
researchers interviewed 1,771 Americans in bankruptcy courts
across the country. To our surprise, half said that illness
or medical bills drove them to bankruptcy. So each year,
2 million Americans -- those who file and their dependents
-- face the double disaster of illness and bankruptcy.

But the bigger surprise was that three-quarters of the
medically bankrupt had health insurance.

How did illness bankrupt middle-class Americans with health
insurance? For some, high co-payments, deductibles, exclusions
from coverage and other loopholes left them holding the bag
for thousands of dollars in out-of-pocket costs when serious
illness struck. But even families with Cadillac coverage were
often bankrupted by medical problems.

Too sick to work, they suddenly lost their jobs. With the
jobs went most of their income and their health insurance
-- a quarter of all employers cancel coverage the day you
leave work because of a disabling illness; another quarter
do so in less than a year. Many of the medically bankrupt
qualified for some disability payments (eventually), and had
the right under the COBRA law to continue their health coverage
-- if they paid for it themselves. But how many families can
afford a $1,000 monthly premium for coverage under COBRA,
especially after the breadwinner has lost his or her job?

Often, the medical bills arrived just as the insurance and
the paycheck disappeared.

Bankrupt families lost more than just assets. One out of
five went without food. A third had their utilities shut off,
and nearly two-thirds skipped needed doctor or dentist visits.
These families struggled to stay out of bankruptcy. They
arrived at the bankruptcy courthouse exhausted and emotionally
spent, brought low by a health care system that could offer
physical cures but that left them financially devastated.

Many in Congress have a response to the problem of the
growing number of medical bankruptcies: make it harder for
families to file bankruptcy regardless of the reason for
their financial troubles. Bankruptcy legislation -- widely
known as the credit industry wish list -- has been introduced
yet again to increase costs and decrease protection for every
family that turns to the bankruptcy system for help. With the
dramatic rise in medical bankruptcies now documented, this
tired approach would be no different than a congressional
demand to close hospitals in response to a flu epidemic. Making
bankruptcy harder puts the fallout from a broken health care
system back on families, leaving them with no escape.

The problem is not in the bankruptcy laws. The problem is in
the health care finance system and in chronic debates about
reforming it. The Harvard study shows:

• Health insurance isn't an on-off switch, giving full
protection to everyone who has it. There is real coverage
and there is faux coverage. Policies that can be canceled
when you need them most are often useless. So is bare-bones
coverage like the Utah Medicaid program pioneered by new
Health and Human Services Secretary Mike Leavitt; it pays
for primary care visits but not specialists or hospital care.
We need to talk about quality, durable coverage, not just
about how to get more names listed on nearly-useless
insurance policies.

• The link between jobs and health insurance is strained
beyond the breaking point. A harsh fact of life in America
is that illness leads to job loss, and that can mean a double
kick when people lose their insurance. Promising them
high-priced coverage through COBRA is meaningless if they
can't afford to pay. Comprehensive health insurance is the
only real solution, not just for the poor but for middle-class
Americans as well.

Without better coverage, millions more Americans will be hit
by medical bankruptcy over the next decade. It will not be
limited to the poorly educated, the barely employed or the
uninsured. The people financially devastated by a serious
illness are at the heart of the middle class.

Every 30 seconds in the United States, someone files for
bankruptcy in the aftermath of a serious health problem.
Time is running out. A broken health care system is
bankrupting families across this country.

The writer is a law professor at Harvard University.

Discussion:

Elizabeth is to be commended for the fine article above which
deals with so many of the problems associated with our health
delivery system today. During my last days in the Radiology
Department I had become increasingly concerned that we weren't
doing something right for the vast majority of so many sick
people. I was seeing more advanced disease earlier and earlier
in life. You could never convince me that we have extended
the "useful" lifespan of anyone. In fact I don't think now
that the lifespan is extended anyway. I saw way too many
young women in their forties die of breast cancer and many
men of similar age with advanced heart and carotid vascular
disease.

Becoming proactive ...

You could just wait until you get ill, lose your mortgage and
house, file bankruptcy and try to pay your medical bills with
your credit cards or ... you can adopt your own life and health
insurance plan. By taking an active part in your own health
and learning what you can, you can seriously reduce your risk
for "wallet" threatening disease. Getting sick is bad
enough without having to be broke, out of your job and your
house. Get good insurance, health insurance and also while you
are at it -some proactive quality of life insurance. The
MericleDiet will reduce your risk for disease about as much
as it can be reduced.

The MericleDiet "Quality of Life Insurance Policy"

While health insurance costs in the hundred of dollars
per month and catastrophic health care costs in the thousands
per month -The MericleDiet and the information associated
with it is a real bargain at $49 one time fee for life.
Even if you utilize just a tenth of the available
information, it is easily worth much more than that.

For more information please click on the link below.

Visit the MericleDiet

Thanks for your time.

Copyright © John Mericle M.D. All Rights Reserved