Woman accused of illegally importing bear bile (AP)

Fri Mar 27, 7:57 pm ET LOS ANGELES – Federal prosecutors in California have charged a South Korean national with illegally importing almost a kilogram of bear bile to sell as an aphrodisiac. The U.S. attorney's office said Seongja Hyun (SONG-ja Hun) was charged Friday with the illegal importation of wildlife under the federal Endangered Species Act. If convicted, she faces up to 20 years in federal prison. Investigators discovered a package at a San Francisco postal facility sent to Hyun that contained four bags of a substance believed to be bear bile. Authorities say Hyun told them she had been selling bear bile harvested in China to treat ailments. They say a search of her apartment also turned up more bile, vials and packaging. It was not immediately clear if she had an attorney.
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Preventing Tooth Decay

Meet Sir Edward Mellanby, the discoverer of vitamin D. Along with his wife, Dr. May Mellanby, he identified dietary factors that control the formation and repair of teeth and bones. He also identified the cause of rickets (vitamin D deficiency) and the effect of phytic acid on mineral absorption. Truly a great man! This research began in the 1910s and continued through the 1940s.

What he discovered about tooth and bone formation is profound, disarmingly simple and largely forgotten. I remember going to the dentist as a child. He told me I had good teeth. I informed him that I tried to eat well and stay away from sweets. He explained to me that I had good teeth because of genetics, not my diet. I was skeptical at the time, but now I realize just how ignorant that man was.

Tooth structure is determined during growth. Well-formed teeth are highly resistant to decay while poorly-formed teeth are cavity-prone. Drs. Mellanby demonstrated this by showing a strong correlation between tooth enamel defects and cavities in British children. The following graph is drawn from several studies he compiled in the book Nutrition and Disease (1934). "Hypoplastic" refers to enamel that's poorly formed on a microscopic level.
The graph is confusing, so don't worry if you're having a hard time interpreting it. If you look at the blue bar representing children with well-formed teeth, you can see that 77% of them have no cavities, and only 7.5% have severe cavities (a "3" on the X axis). Looking at the green bar, only 6% of children with the worst enamel structure are without cavities, while 74% have severe cavities. Enamel structure is VERY strongly related to cavity prevalence.

What determines enamel structure during growth? Drs. Mellanby identified three dominant factors:

1. The mineral content of the diet
2. The fat-soluble vitamin content of the diet, chiefly vitamin D
   
3. The availability of minerals for absorption, determined largely by the diet's phytic acid content
   

Teeth and bones are a mineralized protein scaffold. Vitamin D influences the quality of the protein scaffold that's laid down. For the scaffold to mineralize, the diet has to contain enough minerals, primarily calcium and phosphorus. Vitamin D allows the digestive system to absorb the minerals, but it can only absorb them if they aren't bound by phytic acid. Phytic acid is an anti-nutrient found primarily in unfermented seeds such as grains. So the process depends on getting minerals (sufficient minerals in the diet and low phytic acid) and putting them in the right place (fat-soluble vitamins).

Optimal tooth and bone formation occurs only on a diet that is sufficient in minerals, fat-soluble vitamins, and low in phytic acid. Drs. Mellanby used dogs in their experiments, which it turns out are a good model for tooth formation in humans for a reason I'll explain later. From Nutrition and Disease:

Thus, if growing puppies are given a limited amount of separated [skim] milk together with cereals, lean meat, orange juice, and yeast (i.e., a diet containing sufficient energy value and also sufficient proteins, carbohydrates, vitamins B and C, and salts), defectively formed teeth will result. If some rich source of vitamin D be added, such as cod-liver oil or egg-yolk, the structure of the teeth will be greatly improved, while the addition of oils such as olive... leaves the teeth as badly formed as when the basal diet only is given... If, when the vitamin D intake is deficient, the cereal part of the diet is increased, or if wheat germ [high in phytic acid] replaces white flour, or, again, if oatmeal [high in phytic acid] is substituted for white flour, then the teeth tend to be worse in structure, but if, under these conditions, the calcium intake is increased, then calcification [the deposition of calcium in the teeth] is improved.

Other researchers initially disputed the Mellanbys' results because they weren't able to replicate the findings in rats. It turns out, rats produce the phytic acid-degrading enzyme phytase in their small intestine, so they can extract minerals from unfermented grains better than dogs. Humans also produce phytase, but at levels so low they don't significantly degrade phytic acid. The small intestine of rats has about 30 times the phytase activity of the human small intestine, again demonstrating that humans are not well adapted to eating grains. Our ability to extract minerals from seeds is comparable to that of dogs, which shows that the Mellanbys' results are applicable to humans.

Drs. Mellanby found that the same three factors determine bone quality in dogs as well, which I may discuss in another post.

Is there anything someone with fully formed enamel can do to prevent tooth decay? Drs. Mellanby showed (in humans this time) that not only can tooth decay be prevented by a good diet, it can be almost completely reversed even if it's already present. Dr. Weston Price used a similar method to reverse tooth decay as well. I'll discuss that in my next post.

Weight lossing factor of Green Tea

Today Green tea has become a daily favourite drink. I am well conscious about me fatty figure and always try to get rid of it. Recently i could learn the weight lossing power of Green tea. I became mad the moment i learnt its awesome health virtues. Funny how something tastes better the healthier you think it is for you! So, what are the remarkable benefits of this auspicious drink?Green tea has

Circumcision reduces risk of venereal disease (AFP)

Wed Mar 25, 5:11 pm ET WASHINGTON (AFP) – Men who have been circumcised have a significantly reduced risk of contracting genital herpes or papillomavirus infections, data published Wednesday show. The results confirm the benefits of medically supervised male circumcision that were previously observed in the case of the AIDS virus. Two clinical trials carried out in Uganda with 3,393 heterosexual men aged 15 to 49 both showed a 35 percent drop in the rate of papillomavirus infections, which are responsible for 70 percent of cases of uterine cancer. With herpes, the data showed a 28 percent drop in the rate of infection among men who had been circumcised, according to the report in the New England Journal of Medicine. But circumcision had no effect on the incidence of syphilis, the authors of the study said. "These new data should prompt a major reassessment of the role of male circumcision not only in HIV prevention but also in the prevention of other sexually transmitted infections," Matthew Golden and Judith Wasserheit wrote in an accompanying editorial. The study was conducted by scientists at the Rakai Health Sciences Program in Uganda in collaboration with researchers from Johns Hopkins, Makerere University in Uganda, and the US National Institute of Allergy and Infectious Disease (NIAID). "The cumulative scientific evidence supporting the public health value of medically supervised male circumcision is now overwhelming," said Thomas Quinn, a co-author of the study. "This new research confirms the substantial health benefits of male circumcision, including reduced acquisition of HIV, genital herpes, HPV and genital ulcer disease," he said. Previous clinical trials funded by NIAID found that adult male circumcision reduced the risk of HIV infection by more than 50 percent among heterosexuals.
[Via]

Skin Texture, Cancer and Dietary Fat

Richard and I exchanged a series of e-mails last week in which he remarked that Thai people generally have nice skin, which is something I've also noticed in Thai immigrants to the U.S. I believe you can often tell what kind of fat a person eats by looking at their face, especially as people age or bear children.

People who eat predominantly traditional fats like butter and coconut oil usually have nice skin. It's smoother, rosier and it ages more gracefully than the skin of a person who eats industrial fats like soy and corn oil. Coconut is the predominant fat in the traditional Thai diet. Coconut fat is about 87% saturated, far more than any animal fat*. Coconut oil and butter are very low in omega-6 linoleic acid, while industrial vegetable oils and margarine contain a lot of it.

I saw a great movie last week called "The Betrayal", about a family of Lao refugees that immigrated to the U.S. in the late 1970s. The director followed the family for 23 years as they tried to carve out a life for themselves in Brooklyn. The main fats in the traditional Lao diet are lard and coconut milk. The mother of the family was a nice looking woman when she left Laos. She was thin and had great skin and teeth, despite having delivered half a dozen children at that point. After 23 years in the U.S., she was overweight and her skin was colorless and pasty. At the end of the movie, they return to Laos to visit their family there. The woman's mother was still alive. She was nearly 100 years old and looked younger than her daughter.

Well that's a pretty story, but let's hit the science. There's a mouse model of skin cancer called the Skh:HR-1 hairless mouse. When exposed to UV rays and/or topical carcinogens, these mice develop skin cancer just like humans (especially fair-skinned humans). Researchers have been studying the factors that determine their susceptibility to skin cancer, and fat is a dominant one. Specifically, their susceptibility to skin cancer is determined by the amount of linoleic acid in the diet.

In 1994, Drs. Cope and Reeve published a study using hairless mice in which they put groups of mice on two different diets (Cope, R. B. & Reeve, V. E. (1994) Photochem. Photobiol. 59: 24 S). The first diet contained 20% margarine; the second was identical but contained 20% butter. Mice eating margarine developed significantly more skin tumors when they were exposed to UV light or a combination of UV and a topical carcinogen. Researchers have known this for a long time. Here's a quote from a review published in 1987:

Nearly 50 years ago the first reports appeared that cast suspicion on lipids, or peroxidative products thereof, as being involved in the expression of actinically induced cancer. Whereas numerous studies have implicated lipids as potentiators of specific chemical-induced carcinogenesis, only recently has the involvement of these dietary constituents in photocarcinogenesis been substantiated. It has now been demonstrated that both level of dietary lipid intake and degree of lipid saturation have pronounced effects on photoinduced skin cancer, with increasing levels of unsaturated fat intake enhancing cancer expression. The level of intake of these lipids is also manifested in the level of epidermal lipid peroxidation.

Here's a quote from a study conducted in 1996:

A series of semi-purified diets containing 20% fat by weight, of increasing proportions (0, 5%, 10%, 15% or 20%) of polyunsaturated sunflower oil mixed with hydrogenated saturated cottonseed oil, was fed to groups of Skh:HR-1 hairless mice during induction and promotion of photocarcinogenesis. The photocarcinogenic response was of increasing severity as the polyunsaturated content of the mixed dietary fat was increased, whether measured as tumour incidence, tumour multiplicity, progression of benign tumours to squamous cell carcinoma, or reduced survival... These results suggest that the enhancement of photocarcinogenesis by the dietary polyunsaturated fat component is mediated by an induced predisposition to persistent immunosuppression caused by the chronic UV irradiation, and supports the evidence for an immunological role in dietary fat modulation of photocarcinogenesis in mice.

In other words, UV-induced cancer increased in proportion to the linoleic acid content of the diet, because linoleic acid suppresses the immune system's cancer-fighting ability!

It doesn't end at skin cancer. In animal models, a number of cancers are highly sensitive to the amount of linoleic acid in the diet, including breast cancer. Once again, butter beats margarine and vegetable oils. Spontaneous breast tumors develop only half as frequently in rats fed butter than in rats fed margarine or safflower oil (Yanagi, S. et al. (1989) Comparative effects of butter, margarine, safflower oil and dextrin on mammary tumorigenesis in mice and rats. In: The Pharmacological Effects of Lipids.). The development of breast tumors in rats fed carcinogens is highly dependent on the linoleic acid content of the diet. The effect plateaus around 4.4% of calories, after which additional linoleic acid has no further effect.

Conversely, omega-3 fish oil protects against skin cancer in the hairless mouse, even in large amounts. In another study, not only did fish oil protect against skin cancer, it doubled the amount of time researchers had to expose the mice to UV light to cause sunburn!

Thus, the amount of linoleic acid in the diet as well as the balance between omega-6 and omega-3 determine the susceptibility of the skin to damage from UV rays. This is a very straightforward explanation for the beautiful skin of people eating traditional fats like butter and coconut oil. It's also a straightforward explanation for the poor skin and sharply rising melanoma incidence of Western nations (source). Melanoma is the most deadly form of skin cancer. If you're dark-skinned, you're off the hook:

I believe the other factor contributing to rising melanoma incidence is sunscreen. Most sunscreens block sunburn-causing UVB rays but not melanoma-causing UVA rays. The fact that they allow you to remain in the sun for longer without burning means they increase your exposure to UVA. I've written about this before. Sunscreen also blocks vitamin D formation in the skin, a process that some researchers believe also promotes cancer. I'll end with a couple more graphs that are self-explanatory (source). "PUFA" stands for polyunsaturated faty acids, and primarily represents linoleic acid:





*Not only do Thais have clear skin, they also have clear arteries. Autopsies performed in the 1960s showed that residents of Bangkok had a low prevalence of atherosclerosis and a rate of heart attack (myocardial infarction) about 1/10 that of Americans living in Los Angeles.

More Thoughts on the Glycemic Index

In the last post, I reviewed the controlled trials on the effect of the glycemic index (GI) of carbohydrate foods on health. I concluded that there is no convincing evidence that a low GI diet is better for health than a high GI diet, and in fact the long-term trials suggest that a high GI diet may even be better for insulin sensitivity.

Despite the graphs I presented in the last post, for the "average" individual the GI of carbohydrate foods can affect the glucose and insulin response to carbohydrate foods somewhat, even in the context of an actual meal. If you compare two meals of very different GI, the low GI meal will cause less insulin secretion and cause less total blood glucose in the plasma over the course of the day (although the differences in blood glucose may not apply to all individuals).

But is that biologically significant? In other words, do those differences matter when it comes to health? I would argue probably not, and here's why: there's a difference between post-meal glucose and insulin surges and chronically elevated glucose and insulin. Chronically elevated insulin is a marker of metabolic dysfunction, while post-meal insulin surges are not (although glucose surges in excess of 140 mg/dL indicate glucose intolerance). Despite what you may hear from some sectors of the low-carbohydrate community, insulin surges do not necessarily lead to insulin resistance. Just ask a Kitavan. They get 69% of their 2,200 calories per day from high-glycemic starchy tubers and fruit (380 g carbohydrate), with not much fat to slow down digestion. Yet they have low fasting insulin, very little body fat and an undetectable incidence of diabetes, heart attack and stroke. That's despite a significant elderly population on the island.

Furthermore, in the 4-month GI intervention trial I mentioned last time, they measured something called glycated hemoglobin (HbA1c). HbA1c is a measure of the amount of blood glucose that has "stuck to" hemoglobin molecules in red blood cells. It's used to determine a person's average blood glucose concentration over the course of the past few weeks. The higher your HbA1c, the poorer your blood glucose control, the higher your likelihood of having diabetes, and the higher your cardiovascular risk. The low GI group had a statistically significant drop in their HbA1c value compared to the high GI group. But the difference was only 0.06%, a change that is biologically meaningless.

OK, let's take a step back. The goal of thinking about all this is to understand what's healthy, right? Let's take a look at how healthy cultures eat their carbohydrate foods. Cultures that rely heavily on carbohydrate generally fall into three categories: they eat cooked starchy tubers, they grind and cook their grains, or they rely on grains that become very soft when cooked. In the first category, we have Africans, South Americans, Polynesians and Melanesians (including the Kitavans). In the second, we have various Africans, Europeans (including the villagers of the Loetschental valley), Middle Easterners and South Americans. In the third category, we have Asians, Europeans (the oat-eating residents of the outer Hebrides) and South Americans (quinoa-eating Peruvians).

The pattern here is one of maximizing GI, not minimizing it. That's not because high GI foods are inherently superior, but because traditional processing techniques that maximize the digestibility of carbohydrate foods also tend to increase their GI. I believe healthy cultures around the world didn't care about the glycemic index of foods, they cared about digestibility and nutritional value.

The reason we grind grains is simple. Ground grains are digested more easily and completely (hence the higher GI).  Furthermore, ground grains are more effective than intact grains at breaking down their own phytic acid when soaked, particularly if they're allowed to ferment. This further increases their nutritional value.

The human digestive system is delicate. Cows can eat whole grass seeds and digest them using their giant four-compartment stomach that acts as a fermentation tank. Humans that eat intact grains end up donating them to the waste treatment plant. We just don't have the hardware to efficiently extract the nutrients from cooked whole rye berries, unless you're willing to chew each bite 47 times. Oats, quinoa, rice, beans and certain other starchy seeds are exceptions because they're softened sufficiently by cooking.

Grain consumption and grinding implements appear simultaneously in the archaeological record. Grinding has always been used to increase the digestibility of tough grains, even before the invention of agriculture when hunter-gatherers were gathering wild grains in the fertile crescent. Some archaeologists consider grinding implements one of the diagnostic features of a grain-based culture. Carbohydrate-based cultures have always prioritized digestibility and nutritional value over GI.

Finally, I'd like to emphasize that some people don't have a good relationship with carbohydrate. Diabetics and others with glucose intolerance should be very cautious with carbohydrate foods. The best way to know how you deal with carbohydrate is to get a blood glucose meter and use it after meals. For $70 or less, you can get a cheap meter and 50 test strips that will give you a very good idea of your glucose response to typical meals (as opposed to a glucose bomb at the doctor's office). Jenny Ruhl has a tutorial that explains the process. It's also useful to pay attention to how you feel and look with different amounts of carbohydrate in your diet.

Integrated Nutrition, Lifestyle and Health Database

Ricardo from the website Canibais e Reis has just released a fantastic resource for anyone who's interested in the relationship between nutrition, lifestyle and health. It's an excel spreadsheet that integrates information from several international sources, including:

• UN Food and Agriculture Organization Statistical Yearbook
• FAOSTAT food consumption database
• British Heart Foundation Health Statistics database
• World Health Organization Global Health Atlas

This database provides a wealth of information on 86 different countries, and even includes a macro feature that automatically plots variables. This is an empowering resource for those of us who like to do our own research and come to our own conclusions, and I thank Ricardo for his hard work.

You can read more about the database and download it here.

Men's Sex Lives May Suffer as Waistlines Expand (HealthDay)

TUESDAY, March 3 (HealthDay News) -- The more obese a man, the greater his hormonal changes and the worse his sex life, a new study finds. On the up side, the study's authors found that gastric bypass surgery can help reverse those ills. "Previous studies have found that obesity is correlated to lower sperm count and can be associated with infertility, but we wanted to know if obesity was biologically associated with an unsatisfying sex life, and if so, could it be reversible," the study's lead author, Dr. Ahmad Hammoud, of the University of Utah, said in an Endocrine Society news release. "Our results show that the answer to both questions may be yes." The researchers checked the weight, body mass index (BMI) and reproductive hormone levels of 64 obese men at the start of the study and again two years later, after some of them had what's known as Roux-en-Y gastric bypass surgery. The participants also filled out questionnaires about the quality of their lives. "In our study population, we found that lower testosterone levels and diminished ratings for sexual quality of life were correlated with increased BMI," Hammoud said. "Subjects who lost weight through bariatric surgery experienced a reduction in estradiol [hormone] levels, an increase in testosterone levels and an increase in ratings of sexual quality of life." The study will appear in the Journal of Clinical Endocrinology & Metabolism. The findings highlight a link between sexual quality of life and hormonal measures independent from weight, Hammoud said. He added that further studies are needed to determine a cause-and-effect relationship. More information The U.S. National Institute of Diabetes and Digestive and Kidney Diseases outlines the health risks of being overweight.
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It's Time to Let Go of The Glycemic Index

The glycemic index (GI) is a measure of how much an individual food elevates blood sugar when it's eaten. To measure it, investigators feed a person a food that contains a fixed amount of carbohydrate, and measure their blood glucose response over time. Then they determine the area under the glucose curve and compare it to a standard quickly digesting food such as white bread or pure glucose.

Each food must contain the same total amount of carbohydrate, so you might have to eat a big plate of carrots to compare with a slice of bread. You end up with a number that reflects the food's ability to elevate glucose when eaten in isolation. It typically depends on how quickly the carbohydrate is absorbed, with higher numbers usually resulting from faster absorption.

The GI is a standby of modern nutritional advice. It's easy to believe in because processed foods tend to have a higher glycemic index than minimally processed foods, high blood sugar is bad, and chronically high insulin is bad. But many people have criticized the concept, and rightly so.

Blood sugar responses to a carbohydrate-containing foods vary greatly from person to person. For example, I can eat a medium potato and a big slice of white bread (roughly 60 g carbohydrate) with nothing else and only see a modest spike in my blood sugar. I barely break 100 mg/dL and I'm back at fasting glucose levels within an hour and a half. You can see a graph of this experiment here. That's what happens when you have a well-functioning pancreas and insulin-sensitive tissues. Your body shunts glucose into the tissues almost as rapidly as it enters the bloodstream. Someone with impaired glucose tolerance might have gone up to 170 mg/dL for two and a half hours on the same meal.

The other factor is that foods aren't eaten in isolation. Fat, protein, acidity and other factors slow carbohydrate absorption in the context of a normal meal, to the point where the GI of the individual foods become much less pronounced.

It's time to put my money where my mouth is. Researchers have conducted a number of controlled trials comparing low-GI diets to high-GI diets. I've done an informal literature review to see what the overall findings are. I'm only interested in long-term studies-- 10 weeks or longer-- and I've excluded studies using subjects with metabolic disorders such as diabetes.

The question I'm asking with this review is, what are the health effects of a low-glycemic index diet on a healthy normal-weight or overweight person? I found a total of seven studies on PubMed in which investigators varied GI while keeping total carbohydrate about the same, for 10 weeks or longer. I'll present them out of chronological order because they flow better that way.

Study #1. Investigators put overweight women on a 12-week diet of either high-GI or low-GI foods with an equal amount of total carbohydrate. Both were unrestricted in calories. Body composition and total food intake were the same on both diets. The reason became apparent when they measured the subjects' glucose and insulin response to the high- and low-GI meals, and found that they were the same!

Study #2. Investigators divided 129 overweight young adults into four different diet groups for 12 weeks. Diet #1: high GI, high carbohydrate (60%). Diet #2: low GI, high carbohydrate. Diet #3: high GI, high-protein (28%). Diet #4: low GI, high protein. The high-protein diets were also a bit higher in fat. Although the differences were small and mostly not statistically significant, participants on diet #3 improved the most overall in my opinion. They lost the most weight, and had the greatest decrease in fasting insulin and calculated insulin resistance. Diet #2 came out modestly ahead of diet #1 on fat loss and fasting insulin.

Study #3. At 18 months, this is by far the longest trial. Investigators assigned 203 healthy Brazilian women to either a low-GI or high-GI energy-restricted diet. The difference in GI between the two diets was very large; the high-GI diet was double the low-GI diet. Weight loss was a meager 1/3 pound greater in the low-GI group, a difference that was not statistically significant at 18 months. Insulin resistance and fasting insulin decreased in the high-GI group but increased in the low-GI group, also not statistically significant.

Study #4. The FUNGENUT study. In this 12-week intervention, investigators divided 47 subjects with the metabolic syndrome into two diet groups. One was a high-glycemic, high-wheat group; the other was a low-glycemic, high-rye group. After 12 weeks, there was an improvement in the insulinogenic index (a marker of early insulin secretion in response to carbohydrate) in the rye group but not the wheat group. Glucose tolerance was essentially the same in both groups.

What makes this study unique is they went on to look at changes in gene expression in subcutaneous fat tissue before and after the diets. They found a decrease in the expression of stress and inflammation-related genes in the rye group, and an increase in stress and inflammation genes in the wheat group. They interpreted this as being the result of the different GIs of the two diets.

I have a different interpretation. I believe wheat is a uniquely unhealthy food, that promotes inflammation and general metabolic havoc over a long period of time. This probably relates at least in part to its gluten content, which is double that of rye. Dr. William Davis has had great success with his cardiac patients by counseling them to eliminate wheat. He agrees based on his clinical experience that wheat has uniquely damaging effects on the metabolism that other sources of starch do not have.

Study #5. This is the only study I've seen that has found a tangible benefit for glycemic index modification. Investigators divided 18 subjects with elevated cardiovascular disease risk markers into two diets differing in their GI, for 12 weeks. The low-glycemic group lost 4 kg (statistically significant), while the high-glycemic group lost 1.5 kg (not statistically significant).  In addition, the low-GI group ended up with lower 24-hour blood glucose measurements.  This study was a bit strange because of the fact that the high-GI group started off 14 kg heavier than the low-GI group, and the way the data are reported is difficult to understand.  Perhaps these limitations, along with the study's incongruence with other controlled trails, are what inspired the authors to describe it as a pilot study.

Study #6. 45 overweight females were divided between high-GI and low-GI diets for 10 weeks. The low-GI group lost a small amount more fat than the high-GI group, but the difference wasn't significant. The low-GI group also had a 10% drop in LDL cholesterol.

Study #7. This was the second-longest trial, at 4 months. 34 subjects with impaired glucose tolerance were divided into three diet groups. Diet #1: high-carbohydrate (60%), high-GI. Diet #2: high-carbohydrate, low-GI. Diet #3: "low-carbohydrate" (49%), "high-fat" (monounsaturated from olive and canola oil). The diet #1 group lost the most weight, followed by diet #2, while diet #3 gained weight. The differences were small but statistically significant. The insulin and triglyceride response to a test meal improved in diet group #1 but not #2. The insulin response also improved in group #3. The high-GI group came out looking pretty good. 

[Update 10/2011-- please see this post for a recent example of a 6 month controlled trial including 720 participants that tested the effect of glycemic index modification on body fatness and health markers-- it is consistent with the conclusion below]

Overall, these studies do not support the idea that lowering the glycemic index of carbohydrate foods is useful for weight loss, insulin or glucose control, or anything else besides complicating your life. 

Further reading:

The Fructose Index is the New Glycemic Index

Better drugs encouraging AIDS complacency: Nobel doctor (AFP)

NEW DELHI (AFP) – People are forgetting to practise safe sex because they no longer fear dying from HIV/AIDS, says the doctor who won the Nobel prize for helping discover the virus. Treatment advances mean "some people in my country, France, and other Western countries have become complacent -- they see HIV/AIDS as a chronic disease -- not as one that can kill," virologist Francoise Barre-Sinoussi said. The doctor shared the Nobel Prize last year with fellow French virologist Dr Luc Montagnier for their discovery in 1981 of the human immunodeficiency virus (HIV) that causes AIDS. Barre-Sinoussi noted there has been a huge leap forward in treatments for HIV/AIDS with a cocktail of drugs that reduces the level of virus in the body and likewise lowers the risk of passing on the pathogen to others. But she told AFP she worried that people's confidence in retroviral drugs had created a false sense of security, leading to an increase in unprotected sex. Speaking on the sidelines of a medical conference last week organised by French charity Fondation Merieux in New Delhi, she noted a "frightening" rate of new male-to-male infection in some Western countries such as France. "We should tell the truth about HIV/AIDS -- that new treatments can be very effective, helping them live years longer," said Barre-Sinoussi. But she added that HIV/AIDS patients are prone to other illnesses, especially cancers. They can also be resistant to the life-saving drugs, creating "major complications." Between 2001 and 2006, male-to-male sex was the largest HIV transmission category in the United States and the only one associated with an increasing number of HIV/AIDS diagnoses, according to the US Centers for Disease Control and Prevention. About 56,300 people were infected with HIV in the United States in 2006, according to the organisation, with gay and bisexual men accounting for about half of all new infections. In the United States and all around the world, fears of being stigmatised discourage people from being tested, non-governmental bodies say. In the 1980s in the West gay leaders, dismayed by the deaths of so many from the virus, mounted an aggressive grassroots movement that triggered government action and prevention campaigns among the homosexual community. HIV infections among gay and bisexual men fell dramatically for a decade but rates have been rising again since the mid-1990s. The virus is also having a disproportionate effect on men who have sex with men in nations where the epidemic is just getting a foothold. Professor Mark Wainberg, head of Montreal's McGill University AIDS Centre, echoed Barre-Sinoussi's concerns. With the advances in treatment "the voices that spoke for safe sex are often silent," he told AFP at the same New Delhi conference. "People are saying 'look how well the drugs work -- they work for a long time.'" The public needs to understand the drugs themselves can be toxic and statistics are showing alarming rates of cancer in HIV-affected people, he added. "The data from our studies indicate the average age of people getting HIV/AIDS is 35 -- these are mature individuals, not kids," he said. "Some people are throwing caution to the wind." Around the world, about 33 million people are living with HIV/AIDS and two million die each year. It has killed at least 25 million. At the same time, Barre-Sinoussi said she was optimistic researchers would find an AIDS vaccine despite many major research setbacks. "We really have to go back to very basic science and think differently... think out of the box," she said.
[Via]

Mammograms Are No Joke - They Can Save Lives

By: Lynn Roodbol

There are so many jokes about mammograms! Have you heard the one about the fridge door ... or the bookends ... or the garage floor? Thanks to all the jokes, "Mammogram" has become a household word, and it's not that I don't have a sense of humor, but as a mammography technologist, I've heard the jokes many times. I think the jokes are embarrassing for women and demeaning with regard to their physical bodies. Many women say, "If men had to do this, there would be a better solution" - this may or may not be true. Most people agree that mammograms are not perfect, but until there is a better solution, I think it's time to look at mammograms in a different light.

In May of 1985 and 1986 I asked my doctor to order a mammogram for me and he refused both times saying I was too young. There were no screening mammography centers to which I could refer myself, so that was that. In December of 1986 at the age of 42 I felt a lump in my breast and had a mammogram the same day. It turned out to be Stage II breast cancer with 4 positive lymph nodes. I had a lumpectomy, a mastectomy and chemotherapy but chose not to have radiation. I obviously wasn't too young to have cancer.

In May 1985 a mammogram cost less than $60.00 and would have resulted in my having minor surgery to deal with a small lump. Delaying the diagnosis until December 1986 raised the cost of the medical care I received both in dollars and the amount of human suffering we faced. I say "we" because a diagnosis of cancer affects the family, friends and community of the person with the disease. A timely mammogram would have saved us all a lot of grief.

The common perception is that having a mammogram is a negative experience; I think this is a bad rap. Mammograms are quick and easy breast X-Rays; which usually means two views of each breast - one from the top and one from the side. They are performed by friendly, knowledgeable technologists who do their best to help women feel at ease. The technologists' goal is to get the best films possible and also to make the experience as quick and painless as possible.

When people go for a mammogram the most important thing to know is that relaxation of the upper body is the key to a positive experience. I know it's hard to relax when you're apprehensive, but this is why I believe we need to lessen the public apprehension of this test. It is easy to relax by taking some deep breaths before you have the test. By relaxing your muscles you will be much more comfortable through the test than if you are tense. An added bonus is that the films will be of higher quality, as it is easier to image the back of the breast close to the chest wall if the pectoralis muscles are relaxed. When it's done, you may hear yourself saying, "That wasn't bad at all!"

Some women are embarrassed to have a mammogram because they don't want anyone other than their partner to see and touch their breasts. The mammogram jokes add to their fear of pain and embarrassment making it harder for them to manage, and I know of some women who avoid having a mammogram for this reason. The test is done in privacy; no one but a female technologist will be present. Technologists, for the most part, are sensitive people who will do the test as quickly and professionally as they can. Many women who have resisted the test for a long time are amazed at how simple and painless it can be.

Mammograms include compression of the breast with a plastic plate to produce a high quality image with the least amount of radiation. Breast compression is meant to be tight, but it should not be painful and it only lasts for a few seconds. If you think about looking at a bunch of grapes - it's hard to see them all from one spot. If you spread the grapes out, you can see more grapes. Similarly with the use of compression, more breast tissue is visible when the breast is spread out. With a flatter, thinner layer of tissue the amount of radiation required is less than if the breast is not compressed. The amount of radiation you get is as low as can be achieved if adequate compression is used, and also if good quality control is maintained at the mammogram facility.

In the U.S.A. the cost of a mammogram runs between $50 and $150.00. There is financial help available from insurance companies, state and local programs, and from some employers. Please do not let the cost deter you from having a mammogram as the cost of not having a mammogram can be much higher both financially and emotionally. Check for information on the internet.

In most places in Canada, women can book their own appointment for a free screening mammogram; a doctor's referral is not required. In places without a screening program, mammography is available with a doctor's referral and is covered by health insurance. Approximately 7% of women will be asked to have further testing. Most of the time, follow up testing involves an additional mammogram with a different view to separate the breast tissue in a particular area to get a better image. In my analogy of the bunch of grapes, it's like having a few grapes on top of each other and separating them out in a different way in order to see them better.

There is controversy about the age bracket for women to have a mammogram. On a mammogram film, normal breast tissue in young women usually appears to be dense; normal breast tissue in older women usually turns to fat and appears less dense. Reading mammograms on young women is like looking through a tree which is full of leaves in summer. Reading mammograms on older women can be compared to looking through a tree in winter. You can see why reading mammograms on young women is more complex than reading films on older women and this is the main reason why screening mammography is more effective as women mature.

The fear of being diagnosed with breast cancer will often prevent a woman from having a mammogram. My personal experience is that it is much better to be diagnosed earlier rather than when the cancer has had chance to spread. The amount of fear, pain, embarrassment, and emotional anguish from having a mammogram does not even come close to that of being diagnosed with an advanced cancer. A mammogram takes about 10 minutes; an early cancer can be dealt with in a reasonable amount of time, while an advanced cancer is much more of a time commitment. The amount of fear that comes with a cancer diagnosis is astronomical compared to that of a screening mammogram.

It is often recommended that women have a screening mammogram every two years, but many people believe it is better to have mammograms on an annual basis. It is probably best if women can consult their doctors and make the decision on an individual basis. A number of factors affect the decision such as age, family history, general health, and previous breast problems. Between appointments, whether you choose to have a mammogram every year or every two years, it is important to be aware of any breast problems. If you notice anything unusual it is wise to contact your doctor. This applies even if your mammogram was negative because there are a certain percentage of cancers that do not show on a mammogram.

The Canadian Breast Cancer Foundation promotes a three-prong approach to breast health:

• annual clinical breast exam by a doctor or trained health professional
• screening mammogram
• monthly breast self exam

Breast self-exam can be a controversial issue. Many people do not recommend monthly self-exams, yet many women have found their own breast cancers this way. The important thing to remember is if you choose to do self exam, to do it right:

• learn the proper method from a doctor or trained health professional
• be disciplined and practice it regularly
• pick the same time of your menstrual cycle or the same date each month
• get to know your normal breast "architecture"
• make notes of your findings, draw pictures and record dates
• make detailed notes of unusual findings including dates
• check with your doctor if you find anything worrisome

Following these steps will give you confidence and put you in charge of your breast health. Some health professionals are concerned that women will be unnecessarily alarmed if they find a problem with their breasts. I believe that an educated approach to breast care will reduce the fear that many women live with, and they can consult their doctors in a more rational manner. Most breast lumps are benign, but early detection of breast cancer is worth the extra cost of investigating lumps and other unusual findings.

Mammography is a peculiar test in some ways. However, it is the gold standard at present and until there is a better method of screening which is also cost effective it makes good sense to have regular mammograms. Finding cancer in the early stages before it has a chance to spread makes the treatment much easier and the cure rate much higher. Having a mammogram is not meant to be funny, or even fun; but a few minutes of discomfort rewards us with knowing we are taking action to help protect our breast health.

Author Bio
www.cancersupportcoach.com Lynn was diagnosed with Stage II breast cancer in 1986 and colon and skin cancer in 1987. She has been involved in the cancer community since then as a peer counselor, support group facilitator, fundraiser and retreat organizer. She works as a mammography technologist in Guelph Ontario. Lynn is also a life coach for cancer patients to help them shorten the learning curve and navigate their journey with cancer.

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Weight loss enhances obese men's sexual well-being (Reuters)

NEW YORK (Reuters Health) – Obese men who undergo gastric bypass surgery will not only lose weight; their sex lives are likely to improve, too, new research shows. "We wanted to know if obesity was biologically associated with an unsatisfying sex life, and if so, could it be reversible," Dr. Ahmad Hammoud of the University of Utah in Salt Lake City, who led the study, said in a press release accompanying the new report. "Our results show that the answer to both questions may be yes." While obesity in men has been linked to low testosterone levels, high levels of estrogen, impaired fertility, and worse sexual quality of life, Hammoud and his colleagues note in the Journal of Clinical Endocrinology and Metabolism, there is little information on what happens to these men's sex hormones and sexual function if they lose weight. To investigate, Hammoud and his team looked at 22 men who had undergone gastric bypass surgery and 42 obese men who didn't have the operation. At the study's outset, participants weighed 330 pounds, on average, while the average BMI for the group was 46.2, what is considered to be . The heavier the men were, the lower their testosterone, and the more likely they were to report dissatisfaction with their sex lives-especially avoiding sexual encounters and having difficulty performing sexually. Two years later, the men who'd had weight loss surgery had dropped an average of nearly 17 points from their BMI. Their estrogen levels had fallen significantly, while their testosterone levels had gone up. And all showed improvements on each of the four measures of sexual quality of life the researchers looked at: they were less likely to avoid sexual encounters, have difficulty with sexual performance, have little sexual desire, or report not enjoying sex. There were no significant changes in measures of sexual quality of life or hormone levels in the group of men who didn't have the surgery. Because other both biological and psychological factors involved in obesity can affect both sexual health and hormone levels, Hammoud and his team conclude, more research is needed to determine whether there is a causal relationship between hormone changes and sexual quality of life. SOURCE: Journal of Clinical Endocrinology and Metabolism, April 2009.
[Via]

A Different Picture Of Heart Disease

By: Ng Peng Hock

In Feb 2006, researchers reported that many women suffer from a fundamentally different heart disease from men and is easily missed from standard tests. Moreover, women do not seek treatment as early as men, and women's hearts are smaller and their blood vessels are more easily damaged. Another possible reason is that the disease could manifest itself differently. As a result, women are less likely to survive heart attacks than men. Many women are still unaware that heart disease and stroke have emerged as the top killers of women worldwide.

The researchers found that for some women, instead of developing obvious blockages in the arteries supplying blood to the heart, plaque are accumulated more evenly inside the major arteries and in smaller blood vessels. In other cases, their arteries fail to expand properly or go into spasm, often at times of physical or emotional stress. These abnormalities are very common for younger women and these can be dangerous because they could trigger life-threatening heart attacks.

Instead of the classic crushing chest pain, sweating and shortness of breath, they often complain of vague symptoms such as fatigue, an upset in stomach, or pain in the jaw or shoulders. This certainly explain why some women suddenly have heart attacks even though their arteries look clear and in some cases, the doctors even send them home without treatment or refer them to psychiatrists. Even if they do get medical treatment, these women may not benefit from the standard drugs or therapies such as bypass surgery and angioplasty to reopen the clogged arteries. In many cases, these women whose arteries looked clear in normal tests have a significantly higher risk of having a heart attack or dying within four or five years. The abnormalities could be due to the fact that hormonal or genetic differences change how their arteries react. In America, there are as many as three million women may suffer from these conditions.

Despite the new findings, many women do have the same kind of heart disease as men, and they do benefit from the same preventative measures and treatments that help men: a healthy diet and weight; regular exercise; and a lower blood pressure and cholesterol level. It is still unclear how best doctors can tackle such conditions, but the new findings do provide important understanding of a major health problem, and it also alerts both women and their doctors about the alternative manifestations of the disease.

Author Bio
Feel free to use this article on your website or ezine as long as the following information about author/website is included.

Heart Disease Prevention - 8 Simple Ways You Can Do Immediately, Goto: http://www.howtopreventheartdisease.com

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Suriname starts free circumcision project (AFP)

PARAMARIBO (AFP) – Suriname has launched a three-month pilot project offering free circumcisions in a bid to cut sexually transmitted diseases, Health Minister Celsius Waterberg said Friday. Circumcision "could also minimize the risk of HIV infection", he said, adding the project would run in the capital city, Paramaribo. Some two percent of the Suriname population is HIV-infected, about 10,000 people, and the project aims to carry out the operations on 100 men aged between four and 21 years old over the next three months. If successful then the project will spread nationwide, Waterberg said.
[Via]

Natural Supplements for Womens Health: Blood Sugar

By: Alex Syrov

One of the problems that women face is a blood sugar. There are a number of factors that can cause high blood sugar levels. Pregnancy and menopause change estrogen levels which affect metabolism and how body processes fat. In turn, that affects blood sugar levels. Menstruation also affects blood sugar, at least indirectly. Everyone has heard about "those pesky hormones" and all about craving certain foods like salty items such as chips or everyone's favorite treat, chocolate. With some dietary changes and a little help from supplements you can achieve a healthy balance in your blood sugar levels.


Tackling the Diet

Carbohydrates are important for your body, but eating too many of them in your diet can cause your blood sugar to have more drastic highs and lows. In addition, you'll find that more fat collects along your midriff and hips. By being selective in the types of carbs you ingest, you will still get what you need in your diet but without those blood sugar swings.

Just say no to processed foods. Basically white foods - anything with white flour and sugars - are converted more quickly to glucose in your body. This causes a spike in your blood sugar levels that lasts just a short time. Before you know it, your energy plummets and you feel lethargic because that "sugar rush" is gone. Then, in order to get that energy level back up, you eat more carbs and the cycle starts all over again.

By choosing carbohydrates that are found in whole grain foods, your body has to work harder to process them. What this means for you is that extreme high-low factor goes away and you are left with a more balanced blood sugar level and your energy level is more consistent. And because your body works harder to process these types of carbohydrates, you are expending calories, meaning less fat gets deposited in your mid-section.

Vitamins and Supplements

While taking care with your diet helps greatly, sometimes you just need an additional boost. This is where women supplements and vitamins for women come in. Business is booming with herbal supplements and special vitamin formulas. But which ones help with your blood sugar?

When your blood sugar levels fluctuate, it can be draining on your body and leave you feeling a bit sluggish. Taking supplements for women that contain chromium might give you a boost and alleviate some of that fatigue. If you have diabetes or might be prone to developing it, ginseng can also be beneficial. It has been known to boost metabolism and help control blood sugar.

If you are looking for vitamins or supplements you have to make sure you only buy high quality products. Always look for products from companies that only specialize in vitamins and supplements products for women. One of the companies that makes nutrients for women and specializes in supplements for women health is nutraOrigin.

There are a number of other women vitamins and supplements that could also be beneficial. However, be sure the check with your doctor to determine which ones might be best for you. If you are taking other medications, certain vitamins or women supplements might counteract with them.

It all boils down to common sense. Do your research into the different vitamins and supplements. Make positive changes in your diet. Women are built differently than men. Therefore, you must be more diligent with your body and what goes into it for your health.

Author Bio
This article was provided by nutraOrigin - the makers of nature-based supplements for women. For more information about various women health issues, tips and nutraOrigin products, visit http://www.nutraorigin.com/.

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German researchers testing veggie Viagra: reports (AFP)

BERLIN (AFP) – German researchers are testing an impotency treatment for men made using only natural ingredients that in some cases works better than Viagra, newspapers reported Monday. "In clinical trials, 50 men had much better sex afterwards, more fun in bed and just generally felt better about themselves," the Sueddeutsche Zeitung daily cited Olaf Schroeder from Berlin's Charite hospital as saying. "Their libido was even higher than the control group taking Viagra," he said. The potent cocktail includes tribulus terrestris, a herb already used in alternative medicine, a root vegetable found in the Andes called maca and grape juice extract, newspapers said. The treatment, dubbed "Plantagrar", is due to be launched in early 2010, the Bild daily said. But some of those tested had unwelcome side effects. "Two of the subjects had bad diarrhoea," the Berliner Kurier quoted Schroeder as adding.
[Via]

Second-Generation Female Condom Approved (HealthDay)

WEDNESDAY, March 11 (HealthDay News) -- The Female Health Co.'s FC2 Female Condom has been approved by the U.S. Food and Drug Administration, the company said Wednesday. The product helps protect women against pregnancy and sexually transmitted diseases. The second-generation condom is similar in design and performance to the FC1, except that it is made of a synthetic rubber called nitrile and costs about 30 percent less, the company said. The FC1 was approved in 1993. The FDA approval of the FC2 will allow the U.S. Agency for International Development to distribute the condoms via global HIV/AIDS programs, the Associated Press reported. The first-generation FC1 has been distributed by United Nations agencies in 142 countries, the wire service said. More information To learn more about female condoms, visit the U.S. National Library of Medicine.
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Natural Alternative To Hormone Replacement Thereapy (HRT)

By: Tony Luck

Most women experience the onset of the menopause at an average age of about 50, but it can start anytime from the early forties to the late fifties. Symptoms can vary: some women sail through but others suffer the miseries of hot flushes, night sweats, irritability, depression, lack of energy and loss of libido.

Orthodox medical practitioners invariably prescribe hormone replacement therapy (HRT) and often anti-depressants and tranquillisers, which can become addictive. However, there is a natural alternative.

HRT is prescribed to counter balance the reduced production by your body of oestrogen which can lead to increased risk of osteoporosis and weakened bones leading to fractures. However, two large clinical trials have shown that HRT does not, in fact, significantly reduce the incidence of bone fractures, and there is an increased risk of heart disease, gallstones, and breast and endometrial cancer.

Rather than a shortage of hormones, it is said that most menopausal symptoms are more to do with an imbalance. By eating a healthy diet, taking regular exercise and natural supplements, you can boost the health of your bones, and balance sugar levels and your hormones.

It is well known that people in some parts of the world (for example Japan and the Mediterranean countries) rarely suffer from heart disease due to their different national diets. It is less well known that women in the Andes region of Peru do not suffer menopausal symptoms. Peruvian women take Maca, a tuberous plant related to the potato. As well as the beneficial effect on menopausal symptoms, Maca boosts energy and libido. Maca is also known as "Peruvian Ginseng" and "Peruvian Viagra".

Centuries ago, the Incas inhabited this area and, in order to boost their energy, their warriors used to take Maca before going into battle. When the Spanish conquered the area they found that their horses suffered from the high altitude. The locals advised them to feed Maca to the horses and the animals immediately experienced an increase in energy levels. The Spanish found that what was good for their horses would also benefit humans, so payment for the taxes levied on the locals was taken in Maca.

There are three phases of menopause: the peri-menopause or the year or so prior to the onset of the menopause when the your body misses the occasional menstrual period. During this time a low dose of 1500mg is recommended to counteract the slow down in the production by your body of hormones. During the actual menopause, increase the dose to around 4000mg each day for a period of 2-3 months, and then reduce the dose to 2000mg. In the post menopause phase, reduce your daily intake of Maca to 1500mg. The risk of osteoporosis is apparent from the onset of the menopause and thereafter. In addition to your daily intake of maca, you are advised to also take a daily dose of Forever Freedom, a natural health drink that contains aloe vera with added Glucosamine, Chondroitin, MSM, and vitamin C. This will ease stiffness and pain in the joints and promote mobility and good bone health.

Author Bio
Tony Luck runs a website with advice about maca, a natural alternative to hormone replacement therapy (HRT) and other natural remedies.

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Paleopathology at the Origins of Agriculture

In April of 1982, archaeologists from around the globe converged on Plattsburgh, New York for a research symposium. Their goal:

...[to use] data from human skeletal analysis and paleopathology [the study of ancient diseases] to measure the impact on human health of the Neolithic Revolution and antecedent changes in prehistoric hunter-gatherer food economies. The symposium developed out of our perception that many widely debated theories about the origins of agriculture had testable but untested implications concerning human health and nutrition and our belief that recent advances in techniques of skeletal analysis, and the recent explosive increase in data available in this field, permitted valid tests of many of these propositions.

In other words, they got together to see what happened to human health as populations adopted agriculture. They were kind enough to publish the data presented at the symposium in the book Paleopathology at the Origins of Agriculture, edited by the erudite Drs. Mark Nathan Cohen and George J. Armelagos. It appears to be out of print, but luckily I have access to an excellent university library.

There are some major limitations to studying human health by looking at bones. The most obvious is that any soft tissue pathology will have been erased by time. Nevertheless, you can learn a lot from a skeleton. Here are the main health indicators discussed in the book:

• Mortality. Archaeologists are able to judge a person's approximate age at death, and if the number of skeletons is large enough, they can paint a rough picture of the life expectancy and infant mortality of a population.
• General growth. Total height, bone thickness, dental crowding, and pelvic and skull shape are all indicators of relative nutrition and health. This is particularly true in a genetically stable population. Pelvic depth is sensitive to nutrition and determines the size of the birth canal in women.
  
• Episodic stress. Bones and teeth carry markers of temporary "stress", most often due to starvation or malnutrition. Enamel hypoplasia, horizontal bands of thinned enamel on the teeth, is probably the most reliable marker. Harris lines, bands of increased density in long bones that may be caused by temporary growth arrest, are another type.
  
• Porotic hyperostosis and cribra orbitalia. These are both skull deformities that are caused by iron deficiency anemia, and are rather creepy to look at. They're typically caused by malnutrition, but can also result from parasites.
  
• Periosteal reactions. These are bone lesions resulting from infections.
• Physical trauma, such as fractures.
• Degenerative bone conditions, such as arthritis.
• Isotopes and trace elements. These can sometimes yield information about the nutritional status, diet composition and diet quality of populations.
  
• Dental pathology. My favorite! This category includes cavities, periodontal disease, missing teeth, abscesses, tooth wear, and excessive dental plaque.

The book presents data from 19 regions of the globe, representing Africa, Asia, the Middle East, Europe, South America, with a particular focus on North America. I'll kick things off with a fairly representative description of health in the upper Paleolithic in the Eastern Mediterranean. The term "Paleolithic" refers to the period from the invention of stone tools by hominids 2.5 million years ago, to the invention of agriculture roughly 10,000 years ago. The upper Paleolithic lasted from about 40,000 to 10,000 years ago. From page 59:

In Upper Paleolithic times nutritional health was excellent. The evidence consists of extremely tall stature from plentiful calories and protein (and some microevolutionary selection?); maximum skull base height from plentiful protein, vitamin D, and sunlight in early childhood; and very good teeth and large pelvic depth from adequate protein and vitamins in later childhood and adolescence...
Adult longevity, at 35 years for males and 30 years for females, implies fair to good general health...
There is no clear evidence for any endemic disease.

The level of skeletal (including cranial and pelvic) development Paleolithic groups exhibited has remained unmatched throughout the history of agriculture. There may be exceptions but the trend is clear. Cranial capacity was 11% higher in the upper Paleolithic. You can see the pelvic data in this table taken from Paleopathology at the Origins of Agriculture.

There's so much information in this book, the best I can do is quote pieces of the editor's summary and add a few remarks of my own. One of the most interesting things I learned from the book is that the diet of many hunter-gatherer groups changed at the end of the upper Paleolithic, foreshadowing the shift to agriculture. From pages 566-568:

During the upper Paleolithic stage, subsistence seems focused on relatively easily available foods of high nutritional value, such as large herd animals and migratory fish. Some plant foods seem to have been eaten, but they appear not to have been quantitatively important in the diet. Storage of foods appears early in many sequences, even during the Paleolithic, apparently to save seasonal surpluses for consumption during seasons of low productivity.

As hunting and gathering economies evolve during the Mesolithic [period of transition between hunting/gathering and agriculture], subsistence is expanded by exploitation of increasing numbers of species and by increasingly heavy exploitation of the more abundant and productive plant species. The inclusion of significant amounts of plant food in prehistoric diets seems to correlate with increased use of food processing tools, apparently to improve their taste and digestibility. As [Dr. Mark Nathan] Cohen suggests, there is an increasing focus through time on a few starchy plants of high productivity and storability. This process of subsistence intensification occurs even in regions where native agriculture never developed. In California, for example, as hunting-gathering populations grew, subsistence changed from an early pattern of reliance on game and varied plant resources to to one with increasing emphasis on collection of a few species of starchy seeds and nuts.

...As [Dr. Cohen] predicts, evolutionary change in prehistoric subsistence has moved in the direction of higher carrying capacity foods, not toward foods of higher-quality nutrition or greater reliability. Early nonagricultural diets appear to have been high in minerals, protein, vitamins, and trace nutrients, but relatively low in starch. In the development toward agriculture there is a growing emphasis on starchy, highly caloric food of high productivity and storability, changes that are not favorable to nutritional quality but that would have acted to increase carrying capacity, as Cohen's theory suggests.

Why am I getting the feeling that these archaeologists have a better grasp of human nutrition than the average medical doctor or nutritionist? They have the Price-esque understanding that comes from comparing the diets and multi-generational health of diverse human populations.

One of the interesting things I learned from the book is that Mesolithic populations, groups that were halfway between farming and hunting-gathering, were generally as healthy as hunter-gatherers:

...it seems clear that seasonal and periodic physiological stress regularly affected most prehistoric hunting-gathering populations, as evidenced by the presence of enamel hypoplasias and Harris lines. What also seems clear is that severe and chronic stress, with high frequency of hypoplasias, infectious disease lesions, pathologies related to iron-deficiency anemia, and high mortality rates, is not characteristic of these early populations. There is no evidence of frequent, severe malnutrition, so the diet must have been adequate in calories and other nutrients most of the time. During the Mesolithic, the proportion of starch in the diet rose, to judge from the increased occurrence of certain dental diseases [with exceptions to be noted later], but not enough to create an impoverished diet... There is a possible slight tendency for Paleolithic people to be healthier and taller than Mesolithic people, but there is no apparent trend toward increasing physiological stress during the mesolithic.

Cultures that adopted intensive agriculture typically showed a marked decline in health indicators. This is particularly true of dental health, which usually became quite poor.

Stress, however, does not seem to have become common and widespread until after the development of high degrees of sedentism, population density, and reliance on intensive agriculture. At this stage in all regions the incidence of physiological stress increases greatly, and average mortality rates increase appreciably. Most of these agricultural populations have high frequencies of porotic hyperostosis and cribra orbitalia, and there is a substantial increase in the number and severity of enamel hypoplasias and pathologies associated with infectious disease. Stature in many populations appears to have been considerably lower than would be expected if genetically-determined maxima had been reached, which suggests that the growth arrests documented by pathologies were causing stunting... Incidence of carbohydrate-related tooth disease increases, apparently because subsistence by this time is characterized by a heavy emphasis on a few starchy food crops.

Infectious disease increased upon agricultural intensification:

Most [studies] conclude that infection was a more common and more serious problem for farmers than for their hunting and gathering forebears; and most suggest that this resulted from some combination of increasing sedentism, larger population aggregates, and the well-established synergism between infection and malnutrition.

There are some apparent exceptions to the trend of declining health with the adoption of intensive agriculture. In my observation, they fall into two general categories. In the first, health improves upon the transition to agriculture because the hunter-gatherer population was unhealthy to begin with. This is due to living in a marginal environment or eating a diet with a high proportion of wild plant seeds. In the second category, the culture adopted rice. Rice is associated with less of a decline in health, and in some cases an increase in overall health, than other grains such as wheat and corn. In chapter 21 of the book Ancient Health: Bioarchaeological Interpretations of the Human Past, Drs. Michelle T Douglas and Michael Pietrusewsky state that "rice appears to be less cariogenic [cavity-promoting] than other grains such as maize [corn]."

One pathology that seems to have decreased with the adoption of agriculture is arthritis. The authors speculate that it may have more to do with strenuous activity than other aspects of the lifestyle such as diet. Another interpretation is that the hunter-gatherers appeared to have a higher arthritis rate because of their longer lifespans:

The arthritis data are also complicated by the fact that the hunter-gatherers discussed commonly displayed higher average ages at death than did the farming populations from the same region. The hunter-gatherers would therefore be expected to display more arthritis as a function of age even if their workloads were comparable [to farmers].

In any case, it appears arthritis is normal for human beings and not a modern degenerative disease.

And the final word:

Taken as a whole, these indicators fairly clearly suggest an overall decline in the quality-- and probably in the length-- of human life associated with the adoption of agriculture.

Are the MK-4 and MK-7 Forms of Vitamin K2 Equivalent?

The vitamin K found in food can be divided into two categories: phylloquinone
(K1) and menaquinone (K2). K1 is concentrated in leafy greens and other green vegetables. K2 can be further subdivided into menaquinone-4 through -14. The number represents the length of the side chain attached to the napthoquinone ring. Menaquinone-"X" can be abbreviated MK-"X". MK-4 is the type synthesized by animals for their own use from K1 (and from MK-7 in rats). MK-5 through MK-14 are synthesized by bacteria. MK-7 in particular is made in large amounts by the bacterium Bacillus subtilis that ferments the infamous Japanese condiment natto. It's also sold as a supplement. Animals concentrate MK-4 in a number of organs, with smaller amounts of K1. Certain organs such as the brain, pancreas and salivary gland show an overwhelming preference for MK-4 over K1 in rodents and humans. The liver is a notable exception; in some animals, including humans, it concentrates longer menaquinones to a greater extent than MK-4 if they're present in the diet.

As far as I can tell, MK-4 is capable of performing all the functions of vitamin K. MK-4 can even activate blood clotting factors, which is a role traditionally ascribed to vitamin K1. Babies are often born clotting deficient, which is why we give newborns vitamin K1 injections in the U.S. to prevent hemorrhaging. In Japan, they give children MK-4 to prevent hemorrhage, an intervention that is very effective. Could that have to do with the fact that Japan has half the infant mortality rate of the U.S.?

Certain cultures would have had a predominance of MK-4 over other forms of vitamin K in the diet, which supports the idea that MK-4 can stand nearly alone. These cultures include heavy consumers of dairy like the Masai. Humans go through one of their most critical growth phases-- infancy-- with most of their vitamin K coming from MK-4. Colostrum, the first milk to come out, is particularly rich in MK-4.

Vitamin K is required to activate certain types of proteins, called Gla proteins. Gla stands for gamma-carboxyglutamic acid, a modified amino acid that's synthesized using vitamin K (by a reaction called gamma-carboxylation). Gla proteins are important: the class includes MGP, osteocalcin and blood clotting factors, important for keeping arteries clear, bones strong and blood clotting correctly.

I've said before that vitamin K's function is to carboxylate Gla proteins. In fact, that's a gross oversimplification. Research on vitamin K2 is turning up new functions all the time. One of the more exciting things that's been discovered is that it acts like hormone, activating a nuclear receptor called the steroid and xenobiotic receptor (SXR) and thereby influencing the expression of a number of genes. This puts it in the same category as vitamin A and D. It also acts as an antioxidant, a cofactor for sphingolipid synthesis in the brain, and an activator of protein kinase A signaling. These are all functions that have been studied in the context of MK-4, and for most of them, no one knows whether MK-7 has equivalent effects.

I'm always on the lookout for studies that can shed light on the question of whether MK-4 and MK-7 are equivalent. MK-7 is able to activate clotting factors and osteocalcin, so it can clearly function as a cofactor for gamma-carboxylation in some contexts. Osteocalcin is a Gla protein that's important for bone health. MK-7 supposedly hangs out in the blood for longer than MK-4 in humans, which is one of the things MK-7 supplement manufacturers like to mention, but these findings were conducted by MK-7 supplement vendors and the results have not been published. Interestingly, MK-4 and MK-7 have the exact same plasma half-life in rats, so I think the human experiment should be repeated. In any case, a longer plasma half-life is not evidence for superiority of one form over another in my opinion.

Today, I found another difference between MK-4 and MK-7. I was reading a paper about SXR-independent effects of vitamin K2 on gene expression. The investigators found that MK-4 strongly activates transcription of two specific genes in osteoblast cells. Osteoblasts are cells that create bone tissue. The genes are GDF15 and STC2 and they're involved in bone and cartilage formation. They tested K1 and MK-7, and in contrast to MK-4, they did not activate transcription of the genes in the slightest. This shows that MK-4 has effects on gene expression in bone tissue that MK-7 doesn't have.

I tend to think there's a reason why animals synthesize MK-4 rather than other forms of vitamin K2. Vitamin K2 MK-4 seems to be able to perform all the functions of vitamin K, including activating Gla proteins, participating in sphingomyelin synthesis, binding SXR, and activating transcription through protein kinase A. That's what you would expect for an animal that had evolved to use its own form of K2. Investigators haven't tested whether MK-7 is capable of performing all these functions, but apparently there's at least one it cannot perform.

I'd bet my bottom dollar there are other important functions of MK-4 that have not yet been identified, and functions whose full importance has not yet been appreciated. There's no way to know whether MK-7 can fully stand in for MK-4 as long as we don't know all of MK-4's functions. I also think it's worth mentioning that MK-4 is the only form of vitamin K2 that's been shown to reduce fracture risk in clinical trials.

That being said, MK-7 may still have a place in a healthy diet. Just because it can't do everything MK-4 can, doesn't mean it has no role. It may be able to fill in for MK-4 in some functions, or reduce the dietary need for MK-4. But no one really knows at this point. Hunter-gatherers would have had a source of longer menaquinones, including MK-7, from livers. So it's possible that we're adapted to a modest MK-7 intake on top of MK-4.