Type 2 Diabetes Information

One of the major risk factors for a stroke is carotid artery stenosis, which is the buildup of plaque in the arteries in the neck that supply blood to the brain. Treatment options include drugs and lifestyle changes.

Two invasive procedures are also used: Carotid endarterectomy, in which the artery is opened up and plaque is surgically removed, and angioplasty with insertion of a stent to keep the artery open. Unfortunately, there are well-known and horrific dangers associated with both of these procedures.

A new Lancet study looked at patients with symptomatic carotid artery stenosis (such as a “mini-stroke”) who had undergone carotid stenting. What they found is that for patients 70 or older, the risk of having a stroke or dying within four months of stenting was 12 percent (1 in 8!).

That’s over twice the rate for endarterectomy, which was 5.9 percent (1 in 17). Plus, most of the strokes and deaths in both groups occurred in the first 30 days following the procedure.

Even more shocking, these two procedures weren’t compared to conservative treatment—it wasn’t even a consideration. You can’t possibly determine whether these interventions are really helpful unless you know the stroke/death rates of patients who don’t undergo any type of invasive procedure.

If you or a loved one is recommended to have a one of these procedures, I suggest you do these three things:

* First, if you’re 70 or older say no to stenting.

* Second, ask your physician for scientifically documented information that indicates if you were to follow a conservative course, your risk of having a stroke or dying within four months would be greater than 1 in 17, as it is for endarterectomy, or 1 in 8, the stat for stenting.

* Finally, before succumbing to any procedure, get a second opinion.

It’s also important to adopt good preventive measures, including eating a low-fat, high-fiber diet, getting regular exercise, and taking the right nutritional supplements. For more, see Four Ways to Prevent a Stroke.

Now it’s your turn: Have you or someone you know had a doctor recommend these procedures?

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I’ve been extolling the benefits of supplemental vitamin D for nearly 10 years. This critical nutrient helps to protect against cancer, heart disease, type 2 diabetes, depression, dementia, falls and fractures, flu, and more.

Plus, having adequate vitamin D can lower your risk for 17 different kinds of cancer—and can lengthen your life. But to get these benefits you need to be sure you’re taking the right form of vitamin D.

There are two major types of vitamin D: D2 and D3. Vitamin D3 is the form your body makes in response to sun exposure. But unfortunately many doctors prescribe Drisdol, which contains vitamin D2 and is created by irradiating plant matter and fungus. So patients taking Drisdol are basically getting a “foreign” form of vitamin D.

Now, new research shows vitamin D3 is far more effective at reducing mortality rates than vitamin D2. Dr. Harvey Murff at Vanderbilt University analyzed 50 studies that included a total of more than 94,000 people. What his analysis found was that vitamin D3 reduced mortality by 6 percent, and D2 reduced it by only 2 percent.

The popular press never picked up on this study—perhaps because prescriptions for Drisdol make more money for Big Pharma than natural vitamin D3.

How much vitamin D should you be taking? That depends on your sun exposure, geographic location, skin color, age, weight, and other factors. There truly is no single dose that’s right for everyone. As a general rule, I’ve found that 5,000 IU daily works for most people. Your best bet is to have your blood level of vitamin D (25(OH)D) tested and take enough supplemental vitamin D3 (cholecalciferol) to keep it in the optimal range of 50–80 ng/mL.

Now it’s your turn: Has your doctor prescribed vitamin D2?

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An Important Osteoporosis Myth—Debunked!

When I use the term “anti-aging,” I’m not talking about living forever. The real goal is to function at peak capacity throughout life, feel great, and be able to do all the things that make life worth living. Regardless of your chronological age, you want to be biologically young.

You already know your chronological age—even if you'd rather not admit to it. But do you know your biological or functional age?

How Old Are You Really?

Although there is no universally accepted yardstick for biological or functional age, experts have identified several biomarkers of aging that can be measured by a physician. These include muscular strength, exercise tolerance, vision and hearing, blood pressure, vital capacity (lung function), heart size, and laboratory tests of DHEA, glucose, lipids, and creatinine clearance (kidney function).

There are also some do-it-yourself tests to determine your functional age.

Now it’s your turn: How did you score?

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We’ve long known that fish is a good source of low calorie protein, and that red meat can be bad news for your heart. But now a new study from the University of Valencia has quantified just how important your food choices are to your risk of developing diabetes.

What the researchers found is that a diet high in fish can help to lower the concentration of glucose in your bloodstream and lower your risk of developing type 2 diabetes. Plus, the inverse is also true. High red meat consumption increases your risk of developing diabetes and gaining weight.

The researchers also proved the same things I’ve often warned about when it comes to red meat. Specifically they found that a diet high in red meat puts you at increased risk of developing cardiovascular disease, high blood pressure, and dying younger. Fish eaters, meanwhile, live longer and stay healthier.

What’s the bottom line for you? These findings confirm the same dietary recommendations that I’ve long given to my readers and patients—in fact, they underscore them. Folks, you want to get the majority of your protein from fish (particularly coldwater fish like wild salmon), skinless poultry, egg whites with an occasional yolk, and low-fat or fat-free dairy products, legumes, and whole grains.

At the same time you want to keep the amount of red meat you eat to a minimum. If you want to occasionally eat red meat, I recommend choosing organic beef.

Now it’s your turn: How much fish do you eat?

Here are some easy, delicious fish recipes to try:

Easy Baked Salmon

Zesty Grilled Halibut

Tomorrow in households all across the country, people will be lounging in their armchairs watching football while turkeys roast in the oven. Yet Thanksgiving is more than just one meal—it’s the start of an entire holiday season filled with food, fellowship…and more food!

"Holiday feasting" is as human as wearing shoes. But so are heart attacks, strokes, obesity, and the terrible discomfort of engorgement. Here are seven tips for keeping your waistline and health intact, without sacrificing your holiday cheer:

1. Eat the turkey, but skip the skin. A 3-ounce serving of turkey contains 6 grams of fat. The same serving size without the skin has only 1 gram.

2. Remember, feasting is as much fellowship as food. We gather to enjoy each other's company, so focus on the conversation as much as you do the meal.

3. Keep your portions reasonable. You don't have to eat half the turkey; no one will be offended if you don't. Load your plate to where you can always see some plate between the items.

4. Embrace the salads, sweet potatoes, fruits, and vegetables. Crowd your plate with them, leaving little room for the higher-fat items.

5. Put down your fork between bites, slow down, and focus on how each food tastes. In other words, enjoy your meal.

6. Drink plenty of fluids. You'll be taking in a lot of nutrients, including protein, and washing these out takes lots of water. (Beer and wine don't count.)

7. Gather up your family and friends and organize a post meal walk. Exercise boosts your metabolism and helps clear glucose from your bloodstream, improving control for those with diabetes.

Now it’s your turn: How do you avoid overdoing it during the holiday season?

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If Big Pharma could find a way to patent magnesium, it could drive their already sky-high profits even higher. That’s because this single mineral is one of the most potent, versatile, and safe therapies available.

1. Saves lives after a heart attack. In a double-blind, placebo-controlled clinical trial, British researchers administered intravenous (IV) magnesium sulfate or a saline solution to 2,000 patients within 24 hours of heart attack onset. Incredibly, patients receiving magnesium had 24 percent fewer deaths. And  one to five years later, the cardiovascular death rate was 21 percent lower in those who had been treated with magnesium.

2. Lowers blood pressure. Magnesium relaxes the smooth muscle tissues that dilate the arteries and reduce blood pressure. In one study, participants with hypertension who took 300 mg of magnesium daily for three months had marked reductions in blood pressure compared to those who took a placebo pill.

3. Prevents diabetes. Swedish scientists reviewed several published trials that examined magnesium intake and found that for every 100 mg increase in daily magnesium, there was a 15 percent decrease in the risk of developing type 2 diabetes.

4. Halts asthma attacks. Just as magnesium relaxes the smooth muscles of the arteries and improves blood flow, it also relaxes the airways and thus acts as a bronchodilator. Even after conventional treatments such as inhaled bronchodilators have failed, IV magnesium can be lifesaving.

5. Stops migraines. Research has shown that individuals who experience frequent migraine attacks are likely to have low levels of magnesium in the brain. Ensure adequate levels by supplementing your diet with 500 mg of magnesium daily.

How much magnesium should you take? The suggested dose of oral magnesium is 400–1,000 mg daily. It comes in several forms (citrate, aspartate, etc.) and all are acceptable. Build up gradually as magnesium has a laxative effect in many people.

Now it’s your turn: Do you take magnesium?

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I’ve been practicing medicine for nearly 30 years now, and I’ve seen lots of screening and diagnostic tests come and go. Many of the currently prescribed tests are overused and unreliable, and some are downright harmful. 

However, there are four tests I believe strongly in, and highly recommend you get:

1. Periodic Blood Workup: A simple blood test can reveal a tremendous amount about your heart attack and diabetes risk, immune and liver function, and more. I recommend getting a complete baseline blood work-up and periodic rechecks if you’re monitoring a specific condition.

2. Regular Blood Pressure Checks: According to the American Heart Association, as many as 72 million Americans have hypertension, 28 percent of them are unaware of it, and a large percentage of those who have been diagnosed have poor blood pressure control. This is why I recommend that everyone over 35 have their blood pressure checked regularly. For the most accurate reading, I recommend getting your own blood pressure monitor and checking it at home periodically.

3. Noninvasive Tests of Heart Function: Because heart disease is the leading cause of death in the United States, it is important to evaluate the health of your cardiovascular system. While blood tests can help, sometimes we need more direct information about the heart. The best, least invasive methods of getting this information are the exercise stress test and the echocardiogram.

4. Bone Density: Although I don’t recommend bone mineral density screening for everybody, I think it is important for postmenopausal women who are at greatest risk of osteoporosis. The best, most reliable test for this is dual energy x-ray absorptiometry (DEXA). This test is quick, painless, noninvasive, and quite safe—although it does expose you to a very small amount of radiation. 

Now it’s your turn: Do you get any of these screening tests?

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High blood pressure is a huge boon for pharmaceutical manufacturers. It affects roughly 75 million Americans, and, as with many medical conditions, most doctors are treating it by wearing out their prescription pads.

But most people aren’t getting the truth behind those blood pressure numbers:

1. Four in five blood pressure readings taken at the doctor’s office are inaccurate! Texas researchers enrolled patients with blood pressures higher than 120/80 and tested them according to the standard—but rarely followed—guidelines: sitting in a chair with a back support, feet planted on the floor and legs uncrossed for five minutes, no restrictive clothing or caffeine, and no exercise or tobacco for at least 30 minutes prior to testing. When these guidelines were followed, blood pressure readings went down significantly.

There’s a simple way to avoid this: Buy a blood pressure monitor, learn how to use it correctly, and periodically take your blood pressure at home. Do not, I repeat, do not simply accept a diagnosis of hypertension and allow your doctor to put you on the drug merry-go-round. Check and re-check your numbers, and try reducing your blood pressure through healthy lifestyle changes before you consider any pharmaceutical therapies.

2. Fixing your sodium-potassium ratio can lower your blood pressure. Human beings evolved as hunter-gatherers, on a diet virtually devoid of sodium and very high in potassium. Consequently, the kidneys tend to get rid of potassium but hang on to sodium. The solution? Eat less salt and more potassium-rich foods, including avocados, bananas, tomatoes, cantaloupe, and lima beans. In addition, try drinking Low Sodium V8 Juice each day.

3. Losing weight can reduce your blood pressure. Investigators at the Cooper Clinic in Dallas found that excess weight had a far greater impact on blood pressure than cardiorespiratory fitness. Normal-weight individuals had an average systolic blood pressure 12 mmHg lower than heavy people, even if they were only modestly fit.

4. Nutritional supplements can combat hypertension. I recommend the following daily: coenzyme Q10 200–300 mg, magnesium 400–800 mg, hawthorn 360–600 mg, fish oil 2–5 g, vitamin D 2,000–5,000 IU, and quercetin 500–750 mg.

Now it’s your turn: Have you been the victim of an erroneous blood pressure reading?

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We’ve long known that too much sitting, and not enough activity, can lead to obesity and diabetes—and now we can add cancer to the list. A new study presented at The American Institute for Cancer Research annual conference showed that nearly 50,000 new cases of breast cancer per year, and over 40,000 cases of colon cancer, are caused by inactivity.

What’s also important to note is that prolonged sitting, even by those people who do exercise regularly, also increases cancer risk. The researchers suggested that standing up and getting away from our desks and armchairs can reduce the risk of colon and breast cancer. That’s because moving gets your circulation in motion, and reduces the build-up of cancer markers, including inflammation.

So, how can you protect yourself?

* Clip on a pedometer. Most Americans average a little over 5,100 steps per day, and less than 5,000 is considered sedentary. Compare that to the average 9,000+ steps logged by the Australians and Swiss, and it’s no wonder that our obesity rate is so high. Pedometers are a great motivator to get moving. In one study, women who began wearing a pedometer added 2,000 steps to their daily average. Begin slowly, but aim for 10,000 steps a day.

* Stand up when you’re talking on the phone. Better yet, pace the room or walk around your house as you chat.

* Set a timer as a reminder to get moving. If you’re chained to a desk at work, or prone to sitting and watching television for long periods of a time, set a timer for every 30-minutes as a reminder to get up and move for five to ten minutes.

* Purposefully add extra steps to your day. Park at the far end of the mall parking lot, take the stairs instead of the elevator, and take the long way around when walking from one place to another. Every one of these steps adds up.

Now it’s your turn: How do you add more exercise to your day?

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If you love coffee, here’s another reason to go ahead and drink up. New research shows that drinking more than three cups of coffee per day can lower your risk of basal cell carcinoma (BCC), one of the most common forms of skin cancer.

The researchers analyzed data from the Nurses’ Health Study conducted from 1984-2008, and followed 72,921 participants. One of the lifestyle traits they measured was coffee consumption. What they found is that drinking three or more cups a day lowered skin cancer risk in women by 20% and lowered men’s risk by 9%—compared with those who drank less than one cup of coffee a month.

This adds to all of the other health benefits of drinking coffee. Drinking three to four cups of coffee slashes your diabetes risk by 33 percent. Coffee also reduces the risk of Parkinson’s disease by up to 80% and protects you from Alzheimer’s disease, improves concentration and alertness, and can even halt a full-blown asthma attack. 
 
While there are many reasons to enjoy coffee, there are some folks who need to be careful about how much coffee they drink. If you have high blood pressure or you’re pregnant or expecting to become pregnant, I’d recommend that you go easy on caffeine. And if you’re struggling with osteoporosis, limit your coffee intake to a cup every now and then—higher intake has been linked with a decrease in bone density.

Now it’s your turn: How much coffee do you drink? 

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Since the dawn of time, man has been indulging his sweet tooth with fruits and berries. Today, the aisles of our supermarkets are filled with sugar-laden treats. But tonight is perhaps the biggest sugar nightmare of all—as pint-sized ghosts and goblins go from house to house loading up on all of the makings of obesity, diabetes, and heart disease.

But Halloween—and the entire sugar-filled, high-fat holiday season—doesn’t have to expand your waistline or spike your blood sugar. In fact, here are five holiday indulgences you can enjoy, guilt-free…

1. Dark chocolate, eaten in moderation, reduces your stroke and heart disease risk, helps you lose weight, and improves cognitive function, mood, blood pressure, and insulin sensitivity. The biggest health benefits are found in chocolate bars that are 70% cocoa—so go ahead and enjoy it, in moderation.

2. Nuts are one of the best snack foods around, and almonds top the list when it comes to health benefits. When hunger strikes, eat ¼ cup of these raw or dry roasted, unsalted nuts. You’ll fill up and get plenty of heart-healthy magnesium and vitamin E to boot!

3. Vegetables with hummus. Cut up some fresh broccoli, carrots, tomatoes, snap peas, bell pepper strips, or cauliflower flowerets and dip them in a little hummus. The calorie count of the veggies is low, plus they are full of stick-to-your-ribs fiber, while two tablespoons of hummus contains about 60 calories.

4. Red wine is not only enjoyable; it may actually help to extend your life. Studies have shown that moderate wine consumption reduces the risk of cardiovascular disease, improves insulin sensitivity, and lowers the risk of diabetes and some types of cancer, and fights depression and Alzheimer’s disease.

5. Beer. If beer is on tap at your holiday celebrations, go ahead and enjoy a mug. Not only is it okay, it’s a preventative for a multitude of health conditions including osteoporosis, heart attacks, and stroke. But don’t forget that the positive effects of alcohol end after one or two drinks.

Now it’s your turn: What is your favorite holiday indulgence?

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There’s no question America has a weight problem. More than half of the women, almost two-thirds of the men, and a quarter of the children in our country are overweight, giving us the dubious distinction of being the fattest country on the planet.

How did we get so out of control? Well, one of the biggest reasons is all of the bogus information floating around out there. I want to set the record straight—and debunk some of the most common weight loss myths, so you won’t fall victim to them.

Myth #1: Don’t weigh yourself every day. Most weight loss programs do not recommend weighing yourself every day—but daily weighing could actually be the key to success. Researchers enrolled more than 3,000 overweight people who were on weight loss or weight maintenance programs and followed them for two years. People who weighed in daily lost twice as much as those who weighed only once a week—and those who never stepped on a scale actually gained weight.

Myth #2: Avoid carbohydrates. Carbohydrates have certainly made headlines over the past few years and with all the information out there, unraveling the carb conundrum can be confusing. There’s no question that when you’re trying to lose weight, sugary and starchy carbohydrates have to go. That means no bread, pasta, potatoes, desserts, etc. You should also limit your intake of high-glycemic index (GI) fruits, which cause the same dramatic rise in blood sugar that refined carbohydrates produce. However, fiber-rich, low-GI vegetables, alone with lean protein, should be dietary mainstays.

Myth #3: We’re eating too much fat. The truth is we’re not eating enough of the right fats. While I encourage you to restrict your intake of saturated and unhealthy trans-fats, what most of us are lacking are the omega-3 and omega-6 fatty acids. These essential fatty acids (EFAs) can only be obtained through foods or supplements because the body is unable to produce them on its own. Fresh raw nuts and seeds are rich in omega-6 fatty acids, while cold water fish (salmon, mackerel, herring, sardines, tuna, and trout) and flaxseed are the richest sources of omega-3 fatty acids.

Myth #4: “Healthy” sugars like honey are okay to eat. Whether it’s white or brown sugar, honey, agave, or corn syrup—they all break down rapidly in the bloodstream and can wreak havoc on your metabolism. These high-GI sugars cause surges and plunges in blood sugar, food cravings, and constant hunger. Instead, try a natural, non-caloric alternative such as stevia—an herb that has been used as a sweetener in South America for hundreds of years.

Myth #5: Diet sodas are a good weight loss aid. Most artificial sweeteners like you get in diet soda feed your sweet tooth, but they make end up causing you to crave even more sugar. Plus, many of these chemicals have unwanted side effects. If you have a hankering for a soda every once in a while, I recommend Zevia, which is sweetened with stevia and erythritol (a sugar alcohol).

Now it’s your turn: Have you come across bad weight loss advice?

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If you look around the waiting room at the Whitaker Wellness Institute, you’ll see people clutching paper or plastic bags. No, they’re not toting their lunches or recent purchases. These bags contain bottles of prescription drugs, which patients bring in for review with their doctor during their first visit. In many cases, these bags are bulging at the seams, with a dozen or more prescription medications!

This underscores what is surely the most egregious practice in modern medicine: polypharmacy, which is defined by Webster’s Revised Unabridged Dictionary as “the act or practice of prescribing too many medicines.” At greatest risk are older patients. Although people age 65 and over make up only 13 percent of the population, they receive one-third of all prescriptions. A quarter of individuals in this age group take three or four different drugs every day, and more than 20 percent take five or more.

No studies support the benefits or safety of such indiscriminate drug use—none at all!

Yet every week we see new patients who come to the clinic taking six, eight, 10, or more drugs. This is not just dangerous—it’s insane.

How can you protect yourself?

* Stop and ask questions the next time your physician whips out the prescription pad. Ask exactly why the medication is being prescribed, if there’s a non-drug alternative, and what the risk is of not taking it.

* Remind your doctor about all of the medications and vitamins you’re taking, each and very time a new prescription is written. You’d be aghast at how many doctors fail to look at what else their patients are taking before prescribing new medications. Plus, don’t forget to inform your doctor about any over-the-counter medsyou may be using.

* If your physician is too quick to prescribe pills, consider changing doctors or getting a second opinion.

* Read all of the paperwork you get from the pharmacy, and ask questions about the side effects. Many patients end up with a pyramid effect—taking new pills to treat the adverse effects of the medications they’re already taking.

Now it’s your turn: Have you been a victim of a doctor who is too quick to push pills?

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In the media coverage gearing up for November’s American Diabetes Month, here’s a breakthrough you won’t hear about—especially from the drug companies. New research has found that simply getting enough vitamin D can help to lower your risk of developing type 2 diabetes.

Scientists at Helmholtz Zentrum München in Germany found that people with good concentrations of vitamin D in their blood are at a lower risk of developing type 2 diabetes. Plus, the reverse is also true: A low level of vitamin D puts you at higher risk for diabetes. While there are many factors at work, the researchers primarily attributed the protective properties of vitamin D to its anti-inflammatory effects.

But diabetes prevention isn’t the only benefit of this vital nutrient. Vitamin D performs a host of crucial roles. It is necessary for calcium absorption and utilization. It regulates the activity of dozens of genes and promotes normal cell division and growth. It is also intimately involved in immune function, insulin secretion, blood clotting, and blood pressure control.

How much vitamin D do you need? The dose you require depends on your sun exposure, geographic location, skin color, age, weight, and other factors. There truly is no single dose that’s right for everyone. As a general rule, I’ve found that 2,000–5,000 IU daily works for most people. Your best bet is to have your blood level of vitamin D (25(OH)D) tested and take enough supplemental vitamin D3 (cholecalciferol) to keep it in the optimal range of 50–80 ng/mL.

Now it’s your turn: How much vitamin D do you take?

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News Alert: Cutting Calories Can Reverse Diabetes

In the midst of all of the frenzy over women and multivitamins and vitamin E and prostate cancer, an important news release got lost in the shuffle.

Researchers reported in the journal Cell that green cruciferous vegetables (such as bok choy and broccoli) contain a chemical signal that ensures that the immune cells in the skin and gut are functioning properly. In fact, the study found that when healthy mice were fed a “vegetable-poor” diet for several weeks, 70 to 80 percent of these protective immune cells disappeared.

That’s just one more reason, among many, to eat your greens…

In a study published in the journal Neurology, researchers from Rush University in Chicago discovered that eating an average of 2.8 or more servings of vegetables a day over a six-year period slowed cognitive decline by 38 to 40 percent. Those that provided the most powerful protection were leafy greens.

Plus, we’ve long known that greens are overflowing with phytonutrients, fiber, enzymes, and antioxidants such as vitamin E. Not only do they lower the risk of cognitive decline, these vegetables help give you more energy, promote healthy digestion, and improve overall health.

That’s why I recommend that all my patients and readers center their meals around vegetables—especially greens. Eat salads with dark green lettuce. Sauté spinach with garlic for a gourmet side dish. Serve cooked collards, kale, and mustard greens with barbecued chicken for a down-home treat. The possibilities are endless.

Now it’s your turn: What’s your favorite way to eat green vegetables?

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I could easily rattle off a dozen steps you can take to lower cholesterol. However, if you’re truly interested in using alternatives to statin drugs, let me give you two that are extremely effective and, unlike statins, cannot hurt you.

* First, grind up one-quarter cup of flaxseed and add it to cereal, salads, or other food, or to a protein drink. The fiber in flaxseed soaks up cholesterol in the intestinal tract, and the omega-3s have multiple benefits, particularly for your heart.

* Then, take niacin, 500 mg twice a day. This form of vitamin B3 works so well it has been adopted by conventional medicine. Its primary downside is the flushing it can cause when taken in therapeutic doses. Niacin dilates the blood vessels and promotes the release of histamine in the capillaries, resulting in an uncomfortable warm, tingly, itchy feeling.

You can minimize flushing by taking divided doses with meals and/or at bedtime. I do not recommend niacinamide or inositol hexaniacinate (“no-flush” niacin) for lipid lowering because they don’t work as well.

A baby aspirin (81 mg) or 15–25 mg of Benadryl half an hour before taking niacin at bedtime can also help reduce flushing. Although larger doses of niacin (up to 3,000 mg) are often used, 1,000 mg a day will help lower LDL cholesterol and triglycerides. Niacin is also the most effective known agent for raising protective HDL cholesterol.

As always, you should work with your personal physician to find the solution that’s right for you. Follow this regimen and check back with me in four to six weeks and let me know about any changes that have occurred in your cholesterol levels.

Now it’s your turn: Have you used natural techniques to lower your cholesterol?

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It’s been a rough week for nutritional supplement users. A couple of days ago it was reported that older women who took nutritional supplements, particularly iron, had a slightly increased risk of death. Yesterday, everyone was talking about a clinical trial published in JAMA that linked vitamin E use to increased risk of prostate cancer.

As a physician who uses nutritional supplements as primary therapies in my medical practice, a writer and formulator who vigorously promotes them—and a man who takes a wide variety of supplements himself—I make a point to take a hard and critical look at studies such as these. My #1 responsibility is to be certain that the therapies I recommend are safe and efficacious. If careful evaluation of the research reveals risks or dangers, I would be the first to let you know.

All too often, however, reporters pick up on the juiciest, most sensational minutia and run with it, and this most recent study is no exception. After reviewing it in detail, I have several comments:

1.      The absolute increase in risk of prostate cancer in the men taking vitamin E alone was 1.6 per 1,000 man-years. This means that for every 1,000 men taking the form of vitamin E used in this study (see #3 below) for one year, 1.6 more cases of prostate cancer were diagnosed than in men in the placebo group.

2.      There were no statistically significant differences in aggressiveness of prostate cancer or in death rates among the various groups. Keep in mind that most prostate cancers never cause problems. In fact, they usually go undetected—unless men are regularly screened, as those in the study were. Just last week, the US Preventive Services Task Force recommended against routine PSA screening for prostate cancer, stating that it led to unnecessary interventions and did more harm than good. As I’ve said time and again, the vast majority of older men have prostate cancer, but most of them die with it, not from it.

3.      Unlike drugs, vitamins and minerals are not magic bullets targeting one single symptom or physiological process. They are meant to be used as they are found naturally in food—in combination. Most vitamin E supplements contain only alpha-tocopherol (the form used in this study). For years, alpha was thought to be the most essential tocopherol, but research has shown that other forms also help fend off free radicals. Alpha-tocopherol does not occur alone in nature: it is accompanied by three other tocopherols and four tocotrienols. One of them, gamma-tocopherol, is actually more abundant in the diet than alpha-tocopherol. It is a potent antioxidant that also boosts the power of its more prominent cousin. Furthermore, in this and other studies, the combination of vitamin E plus selenium did not increase risk, which reinforces the importance of taking vitamin E along with other vitamins and minerals.   

4.      This is one negative study among many positive studies that show benefits of vitamin E for the prevention and/or treatment of heart disease, Alzheimer's and other neurodegenerative disorders, macular degeneration, and other common diseases.

5.      Finally, it is nonsense to jump to the conclusion, based on this study, that vitamin E causes prostate cancer and that all men should stop taking it.

Bottom line: This has in no way changed my recommendations. I continue to prescribe vitamin E as part of a comprehensive nutritional supplement program. The multivitamin I use at my clinic and have been recommending for years includes 300 IU of vitamin E (alpha-tocopherol) along with gamma and other tocopherols and tocotrienols, 200 mcg of selenium, and a broad range of other vitamins and minerals.

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These days, you can hardly walk past a pharmacy, or grocery store for that matter, without seeing an advertisement for shingles vaccines. If the Centers for Disease Control and Prevention and Big Pharma had their way, every person over the age of 60 would receive it. Plus, because the FDA approved Zostavax for people in their 50s, their target audience has grown by tens of millions.

Folks, this is a bad idea. First of all, this vaccine is still fairly new and its long-term side effects and effectiveness have yet to be determined. Second, no one knows if it helps ward off repeat outbreaks. And third, like most vaccines its benefits are exaggerated.

The primary clinical trial prior to Zostavax’s approval showed that it reduced risk of developing shingles by about 50 percent, but this isn’t as impressive as it sounds. In the placebo group, 3.3 percent of the study participants developed shingles, compared to 1.6 percent in the vaccine group. Yes, that’s a 50 percent difference, but the real, absolute risk reduction is just 1.7 percent.

Another way of looking at it is 175 people would have to be vaccinated to prevent one case of shingles, and 1,087 would need to be treated to prevent one case of postherpetic neuralgia (lingering nerve pain after an initial attack)—at a cost of $150–$300 per vaccination.

Of course, you should make up your own mind, but I can tell you that I would never recommend the shingles vaccine for my patients.

Now it’s your turn: What are your thoughts about the shingles vaccine?

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Some of you may have seen on the news last night or read in the paper this morning about a new study published in the Archives of Internal Medicine on multivitamins and other nutritional supplements. One typical headline screamed, “Vitamins Tied to Higher Death Rates in Older Women…”

Folks, this stuff may increase nightly news ratings and sell newspapers, but in the end it’s doing more harm than good.

In case you aren’t familiar with the study and its findings, researchers followed approximately 40,000 women whose ages were 55-69 at the start of the study for an average of 19 years. Based on questionnaires these women filled out in 1986, 1997, and 2004 and comparing them with death rates, they determined that the women who took certain nutritional supplements had a slightly increased risk of death.

Let’s look at some other critical findings:

1. The most significant risk was with supplemental iron, which was associated with a 3.9 percent increased risk of death. This isn’t news. It is well known that excess iron is linked with increased risk of cardiovascular disease and other conditions and should be taken only by individuals diagnosed with anemia.

2. The calculated overall risk of death was only slightly higher among the women who took multivitamins: 40.8% vs 39.8%.

3. The study design was observational, meaning it did not allow the researchers to determine any specific causes for the slightly increased mortality among those reporting to take certain nutrients.

Nothing in this study compels me to change my recommendations regarding nutritional supplements. An editorial piece published along with the study suggests we should get be able to get adequate vitamins and minerals from diet alone—yet large government studies reveal tremendous gaps in the average American diet and widespread nutritional deficiencies.

Here’s the bottom line: Don’t stop taking your supplements. Other more credible research clearly demonstrates the value of targeted nutritional supplementation. You can find my complete daily nutrient recommendations on my website at www.drwhitaker.com.

Now it’s your turn: Which nutrients do you take?

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