In recent years, oregano has been surprisingly well studied. Harry Preuss of Georgetown University Medical Center, for instance, over the last decade has published five studies on oregano and other essential oils with results that are impressive. For uses as diverse as from antibiotics to weight loss, oregano and its constituent compounds are attracting new interest in an old remedy.

Snapshot of Oregano

Oregano (Origanum vulgare) is in the same family as rosemary, thyme and the mints. Also called "wild" or "winter" marjoram, it is not to be confused with the related "sweet" marjoram. A further distinction often is made in the health food industry between the oregano cultivated for culinary uses and the species that grow wild, particularly in the Eastern Mediterranean. The latter have a much stronger flavor and aroma reflecting their higher content of certain essential oils.

Constituents of oregano vary with the species, the growing area and the season. The chief active constituents of oregano are a volatile oil known as carvacrol along with the related compound thymol, which is more characteristic of the herb thyme. Also found are the precursor molecule p-cymene and smaller amounts of a variety of other phenolic compounds. Most of the volatile compounds found in oregano are terpenes. Although it might seem to be a foreign term from chemistry, almost everyone is familiar with one or more terpenes—probably the best known terpene is limonene, the highly aromatic compound found in the peel of oranges and the chief component of orange oil.

A number of the most ancient employments for oregano remain common. Uses attributed to Hippocrates and the Greek medical tradition include as an antiseptic, a cure for stomach complaints and as a solution to respiratory ailments. Other uses sometimes suggested include rheumatoid arthritis, urinary tract infections, headaches, convulsions and fatigue (the last being common in 19th Century materia medica manuals). A favored use both in the past and today is for parasites.¹ The essential oil exhibits diuretic, expectorant and antispasmodic properties as well as a stimulant effect on bile production.²

Modern Experimental Science Takes a Look at Oregano

Much of the focus of contemporary oregano research has been on its benefits against fungal and bacterial infections. Some eighty percent of all antibiotics produced in the US are fed to animals, a seriously bad practice that creates reservoirs of resistant bacteria that then are transmitted to humans via food and other vectors.

In the first of several studies, researchers at Georgetown University Medical Center examined a number of volatile aromatic oils for their benefits.³ Oregano oil, which today primarily is used as a food flavoring agent, was hypothesized to possess a broad spectrum of in vitro antimicrobial activities attributable to the high content of phenolic derivatives such as carvacrol and thymol. In a study published in 2001, the antifungal properties of oregano oil were examined both in vitro and in vivo using the yeast Candida albicans as the exemplar fungal model. In an animal model of systemic candidiasis using mice, consumption of oregano oil supplied in olive oil led to 80% survival at 30 days versus none in the animals fed only olive oil. Carvacrol, the major constituent of the oil, was similarly effective, yet visual observation found that the mice consuming the oregano oil presented a cosmetically superior clinical appearance. This trial showed that oregano oil warrants further examination for possible benefits in pathogenic fungal infections.

A second trial explored the benefits of oregano oil and the coconut oil fraction monolaurin against one of the more common bacterial infective agents, Staphylococcus aureus.⁴ As before, both in vitro and in vivo tests were carried out. In vitro, oregano oil was the most successful of the essential oils tested. In mice, systemic infection with S. aureus is routinely and rapidly fatal. This particular trial found that all 14 mice in the untreated arm of the study died within a one week period. Of the oregano oil treated mice, six of fourteen were still alive at 30 days. This compared favorably with the survival rates of those receiving daily vancomycin (7/14) and monolaurin (4/8). Over 60% of mice survived when receiving a daily combination of oregano oil and monolaurin (5/8). This trial therefore demonstrated that oregano oil, either alone or in combination with monolaurin, warrants further examination for possible use for prevention and therapy of Staphylococcus aureus infections. Numerous studies, in fact, have been undertaken since this one and have demonstrated, for instance, activity against methicillin-resistant staphylococci.⁵ In a world of increasing resistance to antibiotics, this is significant.

Needless to say, staphylococci are not the only bacterial pathogens against which new active agents are required. A third test conducted at Dr. Preuss' laboratory examined the efficacy in vitro of oregano and several other essential oils as well as monolaurin against a variety of gram-positive and gram-negative bacteria. Oregano oil proved active against all the tested pathogens except B. anthracis Sterne.⁶

The successful use of oregano oil against parasitic infections has been mentioned already.

New Research Directions for Oregano

Two interesting developments in modern research may break new ground for uses of oregano oil. The first involves insulin metabolism. Researchers in 2005 examined the ability of various combinations of essential oils such as fenugreek, cinnamon, cumin, oregano, etc. to enhance insulin sensitivity. As a first approximation, they examined the effects of these natural products on Zucker fatty rats, a model of obesity and insulin resistance, and spontaneously hypertensive rats, a model of genetic hypertension. The ability to alter systolic blood pressure (the upper figure) in rat models is the most sensitive early index of insulin sensitivity. In this particular trial, various combinations of essential oils lowered blood pressure in both rat species, suggesting improved insulin sensitivity.⁷

The story does not end with blood pressure data. Relatedly, a mouse study found that carvacrol appears to inhibit visceral adipogenesis (the creation of new fat cells in belly fat tissue) and it also attenuates the production of pro-inflammatory cytokines in these tissues.⁸ Work in another model, this one with induced edema in the paws, demonstrated anti-inflammatory and anti-ulcer protections, as well.⁹

Finally, there is information emerging regarding oregano's protection against prostate cancer. According to Dr. Supriya Bavadekar, PhD, RPh, Assistant Professor of Pharmacology at Long Island University's Arnold & Marie Schwartz College of Pharmacy and Health Sciences, the lead scientist for work presented at a conference in 2012, "Some researchers have previously shown that eating pizza may cut down cancer risk. This effect has been mostly attributed to lycopene, a substance found in tomato sauce, but we now feel that even the oregano seasoning may play a role."¹⁰

Safety and Usage of Oregano

Oregano and oregano oil are generally considered as safe (GRAS). However, caveats do apply. Large amounts of either may irritate the gastrointestinal tract. Concentrated amounts taken internally especially should be avoided in pregnancy and lactation. Also, the essential oil can be an irritant not just to the gastrointestinal tract, but to the skin, hence topically the essential oil usually is applied only as part of a prepared ointment.

For intestinal parasitic infection, an emulsified oil of oregano has been used in a dose of 200 mg three times daily for 6 weeks, but such treatments need to be overseen by an experienced physician. Traditionally for other purposes, a typical dose is one cup of tea made by steeping one heaping teaspoon of the dried leaf in 250 mL boiling water 10 minutes. Alternatively, 19th Century herbals and medical manuals suggested 2 - 5 drops / day of the essential oil taken on a sugar cube for gastrointestinal issues and as an aromatic stimulant.

References:

1. Force M, Sparks WS, Ronzio RA. Inhibition of enteric parasites by emulsified oil of oregano in vivo. Phytother Res 2000:14:213-4.
2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
3. Manohar V, Ingram C, Gray J, Talpur NA, Echard BW, Bagchi D, Preuss HG. Antifungal activities of origanum oil against Candida albicans. Mol Cell Biochem. 2001 Dec;228(1-2):111-7.
4. Preuss HG, Echard B, Dadgar A, Talpur N, Manohar V, Enig M, Bagchi D, Ingram C. Effects of Essential Oils and Monolaurin on Staphylococcus aureus: In Vitro and In Vivo Studies. Toxicol Mech Methods. 2005;15(4):279-85.
5. Nostro A, Blanco AR, Cannatelli MA, Enea V, Flamini G, Morelli I, Sudano Roccaro A, Alonzo V. Susceptibility of methicillin-resistant staphylococci to oregano essential oil, carvacrol and thymol. FEMS Microbiol Lett. 2004 Jan 30;230(2):191-5.
6. Preuss HG, Echard B, Enig M, Brook I, Elliott TB. Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria. Mol Cell Biochem. 2005 Apr;272(1-2):29-34.
7. Talpur N, Echard B, Ingram C, Bagchi D, Preuss H. Effects of a novel formulation of essential oils on glucose-insulin metabolism in diabetic and hypertensive rats: a pilot study. Diabetes Obes Metab. 2005 Mar;7(2):193-9.
8. Cho S, Choi Y, Park S, Park T. Carvacrol prevents diet-induced obesity by modulating gene expressions involved in adipogenesis and inflammation in mice fed with high-fat diet. J Nutr Biochem. 2012 Feb;23(2):192-201.
9. Silva FV, Guimarães AG, Silva ER, Sousa-Neto BP, Machado FD, Quintans-Júnior LJ, Arcanjo DD, Oliveira FA, Oliveira RC. Anti-inflammatory and anti-ulcer activities of carvacrol, a monoterpene present in the essential oil of oregano. J Med Food. 2012 Nov;15(11):984-91.
10. Federation of American Societies for Experimental Biology (FASEB). "Component of pizza seasoning herb oregano kills prostate cancer cells." ScienceDaily, 24 Apr. 2012. Web. 23 Jan. 2013.

Milk Thistle—A Liver Remedy with Many Names

Milk thistle is listed botanically as Silybum marianum (some older texts use the name Carduus marianus). It also is known as Holy thistle, Mary thistle, Marian thistle and wild artichoke. The seed and its extracts contain the active compounds silibinin, silydianin and silychristin. Silymarin is the collective name for these three compounds, which are termed flavonolignans. There remains a debate as to whether one or more of the minor constituents of milk thistle, in fact, are active and should be included in extracts rather than aiming for higher and higher extract ratios of silymarin.

Milk thistle has been known for its health benefits for more than two millennia. According to the American Botanical Council, in the year 2000 it was the eleventh most widely sold herb in the United States. This seems to be impressive until it is realized that sales in 1998 in Germany were twice those in the U.S. in 2000, to wit, $18 million versus $9 million.1 2 Even in 2011, sales in the U.S. channel known as Food, Drug and Mass were just over $15 million (SPINS data).³

Although one can sometimes buy the seed and brew a tea from it (the seed contains only 1.5 to 3 percent flavonolignans), almost all commercial products are extracts because it takes 12 to 15 grams of the seeds (used for infusions) to deliver an effective amount of silymarin. This is one reason that extracts are almost always used. Another is that assimilation is notoriously poor and elimination from the system rapid.

Milk thistle is available in capsules, tablets, tinctures and other liquid preparations, and as part of formulas containing various ingredients. Most dry extracts are either seventy or eighty percent silymarin, with the amount of silymarin typically being calculated using silibinin as the standard. Some special delivery extracts may start with only thirty to sixty percent silymarin, but bioavailability is key in such cases, not the concentration of the extract. The label should state the amount of silymarin present.

Unfortunately, even that may not guarantee quality. As reported in 2010 in the Townsend Letter, “A recent review by ConsumerLab.com of ten milk thistle supplements showed that only one met ConsumerLab.com’s quality standards. Two products failed to properly list the part of the milk thistle plant used…while most products claimed their milk thistle extracts were standardized to 80 percent silymarin, ConsumerLab.com found actual amounts to range from 47 to 67 percent.”⁴

Common Uses and Dosages of Milk Thistle

Milk thistle is commonly suggested for digestive complaints, skin problems (such as psoriasis), gallstones, and especially liver complaints and disorders. A large body of research covers its use for liver cirrhosis and other alcohol related liver conditions, poisoning from Amanita mushrooms, hepatitis (infectious and drug-induced), and liver conditions related to diabetes. This research is generally supportive, but silymarin does not appear to reverse established cirrhosis.^5,6,7,8,9 Some countries, such as Taiwan, reimburse individuals for using hepatoprotectants (i.e., liver protectants), including silymarin.¹⁰ Considerable evidence indicates that silymarin is itself a potent antioxidant, but that it may be more significant for its role in raising cell levels of glutathione and superoxide dismutase (SOD).¹¹ A 2003 review of the uses and properties of milk thistle evaluated twenty-one clinical studies involving liver diseases and concluded that all but two showed efficacy.¹²

Most clinical studies on milk thistle have employed extracts concentrated and standardized to 70 percent silymarin with a daily intake equivalent to 200 to 420 mg silymarin. A normal regimen in clinical settings is 70 to 210 mg taken two or three times daily. As a simple antioxidant or as an addition to formulas, probably 50 to 100 mg is adequate.

Outside the clinical setting, milk thistle commonly is used in formulas. Liver/gallbladder cleansers often include silymarin at the rate of 50 to 200 milligrams daily, artichoke extract (often standardized at 5 percent caffeoylquinic acids) at the rate of 500 to 2,500 milligrams daily, or combinations of herbs that can include black radish, dandelion, fumitory herb, bupleurum and a range of other items.

Areas of Active Research Interest

Two areas of renewed investigation into the benefits of milk thistle, diabetes and non-alcoholic fatty liver disease (NAFLD), are closely related and are extensions of milk thistle’s known primary benefits. Some researchers consider NAFLD to be a primary contributory cause of diabetes. Indeed, already two decades ago, evidence suggested that perhaps sixty percent of all individuals who are overweight and obese suffer some degree of sub-optimal liver function. Animal tests attempting to uncover the mechanisms of action of milk thistle in NAFLD have suggested that antioxidant and anti-inflammatory benefits play the major roles.¹³ A clinical trial that tested silybin conjugated with vitamin E and phospholipids found that the combination could be used as a complementary approach to the treatment of patients with chronic liver damage.¹⁴

Through a variety of mechanisms, milk thistle extracts have proven to be useful in diabetes. A four month trial involving subjects who were type 2 diabetics taking 200 mg silymarin concluded that there significant benefits in glycosylated hemoglobin, i.e., HbA(1)c, and fasting blood glucose (FBS), but not a change in insulin.¹⁵ An analysis of several published clinical studies, similarly, found the aggregate of evidence supports benefits from milk thistle for these parameters.¹⁶

Perhaps the most active area of new research on milk thistle extract involves cancer, particularly prostate cancer.¹⁷

Benefits also have been shown against skin cancer.¹⁸ There has been a progression from employing milk thistle extracts for preventing hepatotoxicity during chemotherapy, treating hepatotoxicity after chemotherapy, and potentiating chemotherapy and radiation therapy to mitigating long term side effects of such therapies and, more recently still, to using milk thistle extracts for treating cancer directly.¹⁹

Buyer Beware Note
As indicated above, despite the fact that milk thistle extracts have been around for a long time and occupy an important spot in the market for herbal products, mislabeled and underpotent products are very common.

Moreover, silymarin is known to be difficult to absorb and to have a very short half-life in the body. Milk thistle extract deserves careful research into the quality of the brand and its method of delivery before purchase.

The greatest benefits in probiotic clinical and other trials usually are found in those cases in which probiotics are consumed in conjunction with foods and supplements that promote their growth, which is to say, with prebiotics. There even is a term for these beneficial combinations: synbiotics. Moreover, it is not at all certain that the probiotic bacteria always constitute the more important side of this equation.

What Are Prebiotics?
Probiotics are bacteria that potentially improve health by means of their actions in the alimentary canal. Among other effects, prebiotics selectively stimulate the growth of probiotics.¹ At the very least, this suggests that prebiotics are possible solutions to the factors in our diets and habits that harm probiotics.

Prebiotics for the most part fall into the following four types:

• Non-digestible fibers
• Resistant starches and sugars
• Bacterial metabolites
• Other prebiotics, e.g., glucosamine

Prebiotics might be thought of as being the opposite of factors that harm probiotics. Unfortunately, our modern lives are full of the latter—a great many everyday items harm beneficial bacteria in the gut and promote the growth of pathogens and yeasts. Antibiotics, sex hormones (birth control pills) and antacids all exhibit unfavorable effects upon probiotic organisms.

Of course, poor dietary habits generally are the primary hindrance to the health of probiotic species of bacteria. Sugar and other refined carbohydrates tend to promote the growth of yeasts while failing to provide food to probiotic flora. Long ago, it was established that sucrose and fructose, which are major components of the American diet, have an undesirable impact upon immune functioning. Part of this effect may be indirect via actions upon the gut flora. Moreover, caution must be exercised in unlikely places. Unless care is exercised in purchasing only organically-grown meats and poultry, and, likewise, in consuming deep-ocean fish instead of the farm-raised varieties, individuals will find that they are ingesting antibiotics at the dinner table.

The First Prebiotics in Humans
Our initial exposure to prebiotics literally is with our mother's milk. Researchers have found that the development of intestinal microflora in newborns is strictly related to their early feeding. Breastfed infants, unlike the bottle-fed ones, have an intestinal ecosystem characterized by a strong prevalence of bifidobacteria and lactobacilli. This is because among the numerous substances present in human milk, oligosaccharides have a clear prebiotic effect. Indeed, oligosaccharides are quantitatively one of the main components of human milk. These compounds are only partially digested in the small intestine and a significant fraction of the amount ingested reaches the colon and selectively stimulates the development of bifidobacterial flora.²

Mother's milk might be thought of as our earliest exposure to non-digestible fiber. Human milk oligosaccharides play an important role, as prebiotic soluble fibers, in the postnatal development of the intestinal flora. In contrast, infant formulas are virtually free of prebiotic oligosaccharides. As a consequence, formula-fed infants develop an intestinal flora significantly different to the flora of breastfed infants. However, it is possible to remedy some of the downside of formula feeding. A prebiotic mixture containing 90 percent short-chain galacto-oligosaccharides and 10 percent long-chain fructo-oligosacchrides simulates naturally present prebiotics. With this prebiotic mixture, the growth of bifidobacteria and lactobacilli can be stimulated, the faecal pH can be decreased, and the presence of pathogens can be reduced to levels similar to those of breastfed infants.³

Technically, mother's milk contains human-derived glycans that inhibit pathogen binding to the gut wall. In fact, oligosaccharides are the third largest component of human milk. Oligosaccharide protection against infectious agents may result in part from their prebiotic characteristics, but is thought to be primarily due to their inhibition of pathogen binding to host cell ligands. This suggests that human milk oligosaccharides are constituents of a human milk innate immune system passed from mother to child and able to inhibit binding and disease by specific pathogens.⁴

Human milk illustrates clearly that prebiotics can play many roles at once, for example, influencing the intestinal flora while at the same time inhibiting pathogenic bacteria directly. Both probiotics and prebiotics may be helpful in malnutrition, particularly in lactose intolerance and calcium absorption, and in constipation. As in the very young, probiotics and prebiotics have been shown clearly to boost immunity in the elderly, but the clinical significance of this remains to be clarified.⁵

Each of the various types of prebiotics brings with it its own set of strengths. Once again, the broad general categories of prebiotics are:

• Non-digestible fibers
• Resistant starches and sugars
• Bacterial metabolites
• Other prebiotics

Non-digestible Fiber Prebiotics
This group of prebiotics includes oligosaccharides, gums, etc., many of which the reader will recognize. These are the most common prebiotics added to supplements and foods.

• inulin (from chicory and other sources)
• oligofructose (a mixture of fermentable fructanes)
• fructooligosaccharides (FOS, from beets and other sources)
• konjac glucomannan, acid-hydrolyzed glucomannan, galactooligosaccharides and related compounds
• high-viscosity barley beta-glucan, probably via polymerized oligosaccharides
• arabinogalactans, sometimes derived from larch trees, are densely branched, high molecular weight, water soluble polysaccharides fermented by B. longum, mostly in the large intestine; may have immune effects

Mannan Oligosaccharides as Prebiotics
It already has been noted that some of the oligosaccharides found in mother's milk can exert direct immune-related effects that can be characterized also as prebiotic. More generally, inhibiting pathogen binding or attachment is important and can have prebiotic functions. Mannan oligosaccharides (MOS) contain cell wall fragments obtained from the yeast Saccharomyces cerevisiae. Yeast cells are fractured (lysed) and the resulting culture is centrifuged to concentrate mannan oligosaccharides (bound or unbound to proteins) along with beta-glucans (a type of fiber). The components then are washed and spray dried.

Mannans have specific structures that are recognized by immune cells. Many pathogenic (gram-negative) bacteria attach to the intestinal wall surface (epithelium) using mannose-specific attachments. MOS provides competitive binding sites for these intestinal pathogens, which is to say that the pathogens attach to the MOS rather than to the intestinal wall surface and pass through the gut and leave the intestine without attaching to the intestinal wall. Mannan oligosaccharides may also enhance health by stimulating antibody production or by affecting other intestinal functions.

Fructooligosaccharides: A Downside?
Oligosaccharides and resistant starches seem to improve the uptake of calcium and magnesium. Whether all members of these categories are protective remains an open issue. For instance, on the one hand, in the case of FOS and short-chain inulin, at least, intestinal vulnerability to salmonella may sometimes be increased. On the other hand, lactulose and also the symbiotic combination of bifidobacteria plus transgalactosylated oligosaccharides have been shown to improve resistance to salmonella.

Resistant Starches and Sugars
In Europe more than in the U.S., there is a movement towards using resistant starches (RS) in foods in some proportion in substitution for normal starches. Resistant starches, as the name suggests, resist or slow digestion, usually by resisting the actions of the starch digestant amylase found in the saliva and throughout the upper digestive tract. The component amylose resists being broken down by amylase to more simple sugars and then to glucose. High amylose starches can be derived from corn, rice, barley, soybean and other sources.

RS exerts its synbiotic action partly through the adhesion of bacteria to its surface. As one example, rice porridge high in RS appears to modify large-bowel microflora favorably by lowering Escherichia coli and coliform numbers, in this acting a bit like the MOS described above. Another mechanism of action is changing the pH of the gut to make it more acid. Many of the beneficial effects of RS on large-bowel function appear to be exerted through short-chain fatty acids (SCFAs) formed by bacterial fermentation. The presence of SCFAs indicates a lower pH and these acids themselves may support normal gut wall health.

In a nutshell, human colonic bacteria ferment RS and non-starch polysaccharides to short-chain fatty acids, mainly acetate, propionate, and butyrate. SCFAs stimulate colonic blood flow and fluid and electrolyte uptake. Butyrate is a preferred substrate for colonocytes (large intestine gut wall cells) and appears to promote a normal phenotype in these cells. The fermentation of some RS types especially favors butyrate production and bile turnover.

Bacterial Metabolites as Prebiotics
There is an argument to be made that many of the benefits of yogurt, sauerkraut, kimchee and other fermented foods do not depend upon the fermentation bacteria ever going beyond the stomach. Instead, it is the many metabolites or fermentation products found in these foods that are important. Processing that sterilizes these products often will destroy the significant metabolites and, of course, the production of “faux” cheeses, yogurts, etc. usually means that the metabolites are never formed.

A good example of the effects of bacterial metabolites is Metabolin^TM a special blend of fermentation products prepared from selected strains of lactic acid bacteria, such as Propionibacterium shermani ssp. and Lactobacillus ssp. These bacteria produce natural organic acids and peptides that are instrumental in suppressing undesirable microorganisms. Inhibitory organic acids found in the product include propionic, acetic and lactic acids. The combination of natural acetic, propionic and lactic acid can effectively inhibit the growth of common gram-negative bacteria, yeast and molds. Peptides produced by lactic acid fermentation are known to be inhibitory substances to many types of bacteria. The same principles apply to Germinated Barley Foodstuff (GBF), a prebiotic that has shown promise in irritable bowel disease (IBD) and ulcerative colitis.

Other Prebiotics
As might be expected, there are a number of prebiotics that defy easy classification, yet nevertheless can yield significant benefits. For instance, most species of bifidobacterium (found mostly in the large intestine) can ferment D-galactosamine, D-glucosamine, amylose and amylopectin. Some of these are "amino sugars" better known for joint than gut health. Nevertheless, N-acetyl-glucosamine (NAG) has long been used in Europe for IBD and other similar conditions (1.5–3 grams per day in divided dose). Its prebiotic effect may be a part of its benefit.

Wild Bitter Melon—a Natural Prebiotic
Good prebiotics are continuing to be discovered, although it may not always be clear whether their effects reflect a combination of components already known or something new. A previous essay [in Total Health magazine Online October 2011], "Going WILD with Bitter Melon for Blood Sugar Support," examined a number of the benefits of bitter melon and the superiority of a specially stabilized wild variety (Glycostat®) exhibited in comparative animal trials conducted both in Indian and in the United States at Georgetown University Medical Center.⁶ Since that time, researchers at China Medical University (Taiwan) conducted a quite different set of trials with Glycostat to examine its usefulness as a prebiotic and potentially as an anti-obesity agent as part of a prebiotic/probiotic combination. As the researchers put it, "the active ingredients of . . . [a probiotic/prebiotic] compound formula will have the actions of coordination, competition and inhibition, leading to the augmentation, attenuation or even ineffectiveness." In other words, probiotics are commonly bundled together with many other ingredients, some of which are good choices and some of which are bad choices and only direct experimentation can clarify the issue.

In this case, two types of experiments were conducted. In the first test, which was in vitro, a special strain of bacteria, Lactobacillus plantarum CMU995, was shown to be resistant to acid and bile salts, and effective at adhering to a simulated gut wall, something important for establishing adequate residence time in the gut to exhibit benefits. As part of the in vitro testing, experimenters further determined that many extracts, such as green tea extract and aloe vera extract, inhibited the growth of lactic acid bacteria, whereas Glycostat did not. In fact, CMU995 could be mixed with Glycostat powder and was relatively stable at even 25°C conditions.⁷ Related tests showed that Glycostat exhibits a similar growth-promoting effect upon a wide number of lactic acid and other probiotic bacteria, a finding that suggests that this wild bitter melon ingredient may have broad symbiotic potential.

The second study was in vivo with mice on a high fat diet. There was an active arm, a control arm and an arm testing two percent cholestyramine (a cholesterol-lowering drug). Under test conditions, the drug lowered cholesterol 36.2 percent, the combination prebiotic/probiotic by 30.8 percent, and the probiotic alone by 26.6 percent. The combination increased the viable count of the lactic acid bacteria in the intestinal tract of the mice as well as reducing the concentration of triglyceride and leptin in the blood. There was a dramatic decrease in fat tissue weight and cell size at six weeks, the combination of prebiotic/probiotic being superior to all other arms.⁸

Conclusion
The exploration of the concept of synbiotics, meaning prebiotic/probiotic combinations with special benefits, is beginning to yield results not originally anticipated based solely on research with probiotics. The role of prebiotics remains much under appreciated by most Americans, who, if they desire to experience greater benefits from their probiotic supplements should experiment with the various prebiotic categories. Finally, as in the case of wild bitter melon, some items already recognized as having health benefits may exhibit more or other unexpected benefits if utilized as prebiotics in symbiotic combinations.

Examine Diet and Exercise Habits
Everyone is occasionally sad or discouraged, but this is not a normal state of affairs. The first area to consider when you find that your mood is often out of kilter is your diet. The second area to examine is your physical habits. Both are very important. For instance, most of us realize from our own experiences that getting some exercise and exposure to sunlight early in the day helps us to feel better.

Diets that are inadequate in terms of vitamins and minerals, and in some cases protein, often coincide with depression. Large amounts of sugars, refined carbohydrates and “junk foods” in general are just not sufficient to maintain good bodily health. If the overall quality of health is poor, it is unlikely that mental functioning and emotional wellbeing will fare any better. One of the virtues of the once highly popular “40- 30-30 diet” in which forty percent of the daily calories come from complex carbohydrates and the other sixty percent is derived evenly from protein and fats is that this diet forces us to consider closely the quality of the foods which we consume. Moreover, since some studies have shown that merely supplementing the diet with B vitamins and vitamin C can improve mood and mental functioning, a good balanced multi-vitamin and mineral supplement should be the backbone to any nutritional program.

The quality of the diet has to do not only with the nutrients included, but also with the “anti-nutrients” excluded. Two items in particular that are commonly found in the American diet can undermine one’s outlook on life. These are caffeine and alcohol. An intake of roughly 700 mg or more caffeine per day (about five cups of coffee) is often associated with depression and mood swings. Caffeine causes short-term increases in blood sugar levels that can be followed by dramatic downward fluctuations. Consuming caffeine, in other words, is yet another path to the sugar “rollercoaster” of energy ups and downs. Cutting out caffeine and refined sugars for as little as one week has been shown clinically to improve mood in many individuals complaining of depression.² Consumption of alcohol before bedtime can have similarly distorting effects upon mood. This is because alcohol consumption interferes with the body’s natural production of melatonin and thereby disturbs the nature and restfulness of the night’s sleep.³

Increasing Important Brain Chemicals
The quality of both mental and emotional functioning is highly dependent upon special messengers in the brain, the neurotransmitters. These chemicals carry the signals between nerve cells. The most important brain messengers are serotonin, norepinephrine and dopamine. Antidepressant drugs, such as Prozac, strongly manipulate the levels of one or more of these neurotransmitters, generally with a plethora of side effects. However, it is possible to naturally boost and/or to stabilize the brain’s levels of various neurotransmitters without getting caught up in the pharmaceutical drug culture.

One method of improving mood that works for many is to provide additional quantities of the “building blocks” of the major neurotransmitters. This can be accomplished through the skilled manipulation of the diet or, and this is more convenient for most of us, it can be accomplished with dietary supplements. Serotonin, for instance, is made in the body from the essential amino acid L-tryptophan that is found in various foods. The intermediate step in serotonin synthesis involves 5-hydroxytryptophan, usually abbreviated as 5-HTP. In various clinical trials, 5-HTP has been shown to be both safe and effective in cases of depression originating from a variety of causes. The primary side effect found with 5-HTP is gastrointestinal upset at higher intake levels.^4,5 Interestingly, 5-HTP has also been shown to be useful in cases of anxiety and not just in cases of depression.⁶ A natural or non-synthetic source of 5-HTP is the plant known as Griffonia simplicifolia. 5-HTP has been used for decades in Europe without any health issues being raised.

The best way to see if 5-HTP works for you is to start with 25 mg daily at one meal. Then, over the course of two weeks slowly increase the dosage to 75 mg taken with each meal if this amount is well tolerated. Finally, cut back the amount taken to whatever is adequate for maintenance for your particular needs. Typically, the trial period at the higher dosage range lasts for about two weeks, but it should be remembered that individuals vary greatly in their physiological requirements.⁷

Other useful nutrients for improving mood are the amino acids L-phenylalanine and L-tyrosine. Just as L-tryptophan is the precursor to serotonin, these amino acids are precursors for the production of the neurotransmitter norepinephrine. The conversion of L-phenylalanine and L-tyrosine to norepinephrine is enhanced by the actions of vitamin B-6, and therefore this vitamin is normally supplemented at the same time. Both of these amino acids have proven themselves useful in some forms of depression.^8,9

The usual recommendation is to start with 500 mg L-phenylalanine upon arising along with 25–50 mg of vitamin B-6. (Take amino acids separately from meals.) If this is well tolerated, a second dose of both the amino acid and the vitamin can be taken prior to lunch. The amount of the amino acid (not the vitamin) can be increased by 500 mg increments up to an intake of as much as 2,000 mg twice per day. Dosages for L-tyrosine would be about one half this level. Phenylketonurics obviously should avoid L-phenylalanine in any of its forms. Those with high blood pressure should also use these amino acids only with caution. The usual side effects with too high a dosage are mild headaches, insomnia and anxiety. Cutting back the dosage quickly relieves any unwanted effects. Many individuals find that after a period of time, they can reduce their intake of the amino acids substantially and retain the benefits. Due to individual differences, it is not uncommon to respond better to one or the other of these amino acids.

Another nutrient, which should be considered, is S-adenosylmethionine (abbreviated as either SAM or SAMe). SAMe only recently has become available commercially in the United States in a stable and economical form, but its outstanding benefits have been recognized for years. These include amelioration of depression and migraine headaches, but also range to improving osteoarthritis, fibromyalgia and liver disorders.¹⁰ SAMe supplementation increases brain levels of serotonin, dopamine and phosphatidylserine, plus it improves the binding of these neurotransmitters to their binding sites. Numerous studies have shown SAMe to be effective in elevating mood and brightening subjects’ outlook on life.¹¹ SAMe appears to be entirely safe under normal circumstances, although it can cause stomach upset in sensitive individuals when taken at higher dosage levels. (It is not recommended for those suffering from bipolar/manic depression.) The usual suggested intake is 200 to 400 mg taken one to three times per day before meals. Results are known to improve with sustained usage.

Herbal Solutions
Many herbs can exert significant influence upon our mood. Classic for their calming effects are chamomile, valerian and kava kava (do not combine kava kava with alcohol or acetominophen). Siberian ginseng extracts are energizers and mood elevators.¹² A relatively unknown anti-anxiety herbal extract is the flavonoid called chrysin, the socalled “Flavone X” sometimes used by athletes. Chrysin, which is an extract of a member of the passionflower family, turns out to be a successful anxiolytic (anti-anxiety) compound that is very useful for combatting stress.^13,14 The usual dosage is 500 mg to 1,000 mg taken with one to three meals each day for a total daily intake of between 500 and 3,000 mg.

No discussion of herbal mood boosters can be presented without mention of St. John’s Wort. This plant has a long history of improving not just mood, but wound healing and recuperation. In terms of neurotransmitters, St. John’s Wort maintains norepinephrine levels and may act as a natural MAO (monoamine oxidase) inhibitor, but one without side effects. Scientists have determined that hypericin, a constituent of St. John’s Wort,₁₅ may be one active ingredient, but it now is known that other ingredients are perhaps even active. St. John’s Wort may improve brain levels of serotonin and dopamine along with those of norepinephrine by serving as a selective reuptake inhibitor for all of these.

As with other herbal compounds, the quality of the St. John’s Wort extract is extremely important. The clinical trials generally used extracts standardized to contain 0.125 percent hypericin, and subjects took 300 mg of this extract three times per day.₁₆ This means that the product chosen should be close to this standard. For instance, on the one hand, a product with 250 mg of extract per capsule standardized to 0.14 percent hypericin would still be in the proper range, but capsules of the bulk herb would offer no assurance of benefits. On the other hand, since there may be ingredients other than hypericin, which are active, it may not be wise to invest in extracts that are above 0.3 percent hypericin. Indeed, recent research has shown that most or even all of the mood elevating effects of St. John’s Wort are due to the presence of the compound hyperforin, not hypericin. _17,18 Also, do not expect instant results. Most authorities suggest that significant benefits become apparent with at least four weeks of consistent use.

As you can see, there are many options for improving your mood and emotional outlook. Do not accept that the “blues” are a normal and inescapable part of life. In an earlier article entitled “Brain Nutrition Support,” the benefits of omega-3 fatty acids and other special nutrients are discussed and those supplements should be considered along with the items described here. By making the appropriate changes in diet and exercise habits and by finding the herbal extracts and supplements that are right for you, you can improve your mood naturally.

For references click: http://totalhealthmagazine.com/references/November2012.pdf

However, antioxidants cannot protect against all forms of toxic assault. Although free radicals often initiate cancerous changes in cells, not all carcinogens are free radicals. In fact, most potentially cancer-causing compounds are not free radicals and only develop their full ability to wreak havoc upon cellular DNA after the body has acted them on. Our own detoxification system can be at fault. The liver uses a two-step enzymatic detoxification procedure to remove the bulk of toxins from the body, and both of these steps must be working freely and in a synchronized fashion to properly eliminate poisonous compounds. Important support for these actions by the liver comes from supplements such as calcium D-glucarate, sulforaphane precursors (generally broccoli seed extracts), diindolylmethane (DIM), methyl donors (including S-adenosyl methionine/SAMe and trimethylglycine/TMG) and enzyme building blocks, such as N-acetyl-cysteine (NAC).

Phase I and Phase II Enzyme Detoxifiers
In Phase I of the liver’s detoxification process, the cytochrome P450 enzymes make fat-soluble toxins more water-soluble. This helps to prevent toxic compounds from being stored in fatty tissues and makes it easier for them to be excreted from the body. The fifty to one hundred enzymes involved in the Phase I system prepare potential carcinogens for elimination by the Phase II system. In a process known as “conjugation” the Phase II system commonly uses enzymes to bind directly to compounds that have been changed in Phase I, thus inactivating them. These conjugated (bound) toxins are then excreted.

Unfortunately, Phase I enzymes, by making fat-soluble substances water-soluble, sometimes make poisonous compounds more active as carcinogens until these compounds are fully conjugated. Water-soluble toxins, for instance, are more effective at gaining access to the DNA genetic element of the cells. Therefore for protection against the initiation of cancers, the Phase II enzymes, the enzymes that are directly involved in the excretion of toxins from the system, must always be working just as actively as are the Phase I enzymes. Important Phase II enzymes include the glucuronic acid, glutathione and sulfation systems. Glutathione is widely known to be a major antioxidant and has further actions as part of the glutathione-S-transferases. Glucuronic acid, via the process of glucoronidation, is especially important for binding the toxic metabolites of the body’s steroid hormones (estradiol, progesterone, and testosterone). Sulfate is active as a component in the sulfotransferases.

Many of the benefits the Phase II enzymes were discovered first by studying the health benefits of eating certain vegetables. Remember broccoli? The anti-cancer benefits of broccoli and other cruciferous vegetables have been documented for many years. One study performed in Buffalo, New York in the mid-1970s showed that the regular consumption of these vegetables dramatically reduced the incidence of colon and rectal cancer. Protection against these malignancies was dose-dependent — the more of these vegetables eaten, the more protection. Reviews of the benefits of dark-green vegetables have concluded that broccoli is amongst the most common items in the diets of individuals and populations with very low rates of gastrointestinal tract cancers, that is, cancers ranging from those of the esophagus and stomach to those of the colon and rectum. Other studies have shown broccoli’s protective effects against lung and breast cancers as well.

Much of the work done on broccoli and its cousins has focused upon the impact of indoles, dithiolthiones and sulforaphane. These compounds appear to activate the cellular Phase II enzymes described above. Even highly potent toxins, for instance, aflatoxin, are prevented from doing damage to cellular DNA when these enzyme-activators are fed to test animals. Both glutathione and the enzymes that attach the glutathione to carcinogens are increased by the presence of indoles, dithiolthiones and sulforaphane.

Supplementing For Phase II Enzyme Activity
There are several ways in which the effectiveness of Phase II enzymes can be increased. The first is by supplying “building blocks” for these enzymes so the body can make more of them—in particular glutathione. Probably the easiest way to do this with supplements is to take approximately 750 milligrams of N-acetyl-cysteine (NAC) per day. (Most individuals poorly absorb Glutathione itself, albeit there are claims to the contrary.) Other compounds seem to directly stimulate the production of Phase II compounds. Among these are indole-3-carbinol, especially in its much more active form as diindolylmethane (DIM), and isothiocyanates, the best known of these being sulforaphane. The citrus oil extract D-limonene (250 to 500 milligrams taken once or twice per day with meals) is another potent stimulant to Phase II enzyme production. Perillyl alcohol, a D-limonene metabolite, is similarly active. It is derived from essential oils of various plants, including lavender, peppermint, tart cherries, sage and lemongrass.

Today, whey protein is the rage for bodybuilding and weight loss. Individuals who consume concentrated undenatured whey protein are taking advantage of yet another source of building blocks for Phase II enzymes.

A second approach is to supplement with compounds that indirectly increase the building blocks of Phase II enzymes while performing other important functions in the body. Methyl donors such as SAMe (starting at about 200 milligrams per day via enteric-coated tablets) and, especially, TMG (500 to 1,000 milligrams per day) indirectly produce much of the body’s cysteine for glutathione synthesis and also influence the availability of sulfate and the amino acid taurine. Methyl donors further protect the DNA through mechanisms that do not involve Phase II enzymes.

The supplement calcium D-glucarate improves the effectiveness of Phase II enzymes not through increasing their amounts or their degree of activity, but by preventing conjugated toxins from being freed by bacterial action in the intestines. Calcium D-glucarate serves to block the unwanted actions of the beta-glucuronidases, enzymes that reverse the conjugation of the Phase II enzymes and allow toxins to be reabsorbed into the body. Thus calcium D-glucarate, supplemented at the rate of 200 to 400 milligrams per day, might be viewed as the perfect complement to supplements that increase Phase II enzyme activity: it helps to insure the toxins, which the Phase II enzymes have conjugated and bound for excretion do not somehow find their way back into our systems.

Finally, it should be kept in mind that all of these approaches work better with a proper diet. This means drinking plenty of fluids, especially water, to keep the kidneys flushed. Likewise, detoxification works better when the diet includes adequate soluble and semisoluble fibers. Supplements supplement the benefits of food and not the other way around — this is a point that should not be forgotten.

Current estimates of asthma rates are almost twice as high as official estimates from only one to two decades ago. Asthma is most common in children below the age of ten and twice as common in boys as in girls. Although there are genetic components to the condition, the environment clearly is involved. For instance, roughly one half of children with asthma come from homes where there are smokers. Similarly, a report in the New York Times (April 19, 2003) indicated that 25.5 percent of the children in a 24-block area in the Harlem neighborhood of New York City have asthma, a rate that is 5 points higher than has been documented anywhere else in the United States.

What is asthma? In common with a number of other conditions, it involves spasms in the airway tubes of the lungs (the bronchial tubes or bronchi), swelling of the lung tissues and the production of thick mucus. Symptoms include shortness of breath (wheezing), chest tightness, chest pain, and even disturbed sleep at night due to breathing difficulties (many attacks occur between 2 AM and 4 AM). As is true of hay fever, allergies often are important in asthma, with typical triggers including pollen, mold, animal dander, dust and tobacco smoke. Non-allergy factors, which act as lung irritants, may also be involved. These can include environmental toxins, viruses, respiratory infections (such as the common cold), cold air, exercise and emotional factors. In certain individuals, even aspirin and other nonsteroidal anti-inflammatories can trigger attacks. A combination of allergenic and non-allergenic factors is the norm in asthma.

Quite a number of food additives are known to be linked to asthma. For instance, sulfites, which are often used to preserve perishable foods and are common in beer and wine, are known triggers. Similarly, tartrazine, which is yellow food dye #5 and is found in many processed foods, even in vitamins and prescription drugs, is another trigger. Food colors can serve as triggers especially in children.

Digestive issues are very often found in asthmatics. Particularly important may be the incomplete digestion of proteins. Evidence for this comes from several different considerations. First, food allergies are common in asthmatics and the usual offenders include eggs, milk, fish, wheat and certain nuts, principally peanuts. Second, at least one study has found lowered gastric acid secretion in about 80 percent of children with asthma. Third, rotation diets (to reduce allergic food reactions) and vegan diets appear to help in a large percentage of cases of asthma. These and other pieces of evidence suggest that poor digestion and the leaky gut syndrome may be important in the etiology of asthma. Inadequate digestion of proteins and the subsequent movement of incompletely digested large molecules across the gut membrane can cause a chronic low-level activation of the immune system and increased levels of inflammation in the body.

Yet another factor in asthma is obesity. Obesity, as is true of poor digestion, is associated with an increase in chronic inflammation throughout the body. Inasmuch as the rate of obesity is increasing in Americans of all ages, it is perhaps not particularly surprising to find that conditions such as asthma, which are linked to chronic inflammation, also are on the rise.

The drugs most prescribed for asthma are corticosteroids and leukotriene modifiers. Both of these classes of drugs are designed in part to reduce levels of inflammation, but may be viewed as treating symptoms rather than causes. Corticosteroids are direct anti-inflammatories. Blocking leukotrienes is an indirect method of achieving the same effect. Leukotrienes, which are components of the immune system and are released by cells in your lungs during an asthma attack, cause the bronchial tubes to become inflamed. It is this inflammation that leads to wheezing, shortness of breath and the production of excessive mucus.

Natural approaches to asthma should be directed toward resolving the body’s excessive response to triggers. Digestive health is a factor here. Other important factors include the health of the intestines and nutrition to calm chronic inflammation and hyper-immune response.

Aside from identifying offending foods, improving digestion can mean changing habits and adding supplements. For instance, eating too much and eating too rapidly or while under emotional stress are known to lead to poor digestion. Similarly, drinking large amounts of milk at meals may not be a good idea inasmuch as the calcium in the milk tends to reduce the stomach’s level of acid through a buffering action. In this regard, interesting tests performed in India showed that pasteurized and homogenized milk is harder to digest than is scalded milk—children consuming the latter grew better and had few allergies than those consuming the former.

Recognizing that our food habits may not change, it is a good idea to be aware of appropriate digestive supplements. Natural digestive aids include the fruits pineapple (for bromelain) and papaya (for papain). Protein digestion can also be supported with betaine hydrochloride taken with meals and pancreatic enzymes taken after meals. Leaky gut syndrome itself may respond over a period of two to three months to supplementation with N-acetyl-glucosamine. The daily use of a good probiotic is another way of improving digestive health.

Chronic inflammation is now almost a way of life in the United States. In part, this is the result of the gross imbalance in the types of essential fatty acids found in the American diet. Because certain grain and seed oils are cheap, food processors use almost entirely what are known as omega-6 fatty acid family oils in food manufacture. These cheap oils include corn and soybean oils. Unfortunately, on diets high in simple carbohydrates (the American diet gets 25 percent of its calories from added sugars!) and low in minerals, the omega-6 family of oils supports the production of substances that feed inflammation in the body. In contrast to the omega-6 fatty acids, the omega-3 fatty acids, such as are found in flax seed and fish, turn off inflammation. In pre-modern times, the ratio of omega-6 to omega-3 oils in the diet was approximately 3 to 1, whereas today it is between 10 to 1 and 20 to 1. In clinical trials, adding omega-3 fatty acids to the diet has been shown to relieve asthma.

Several other nutrients have been shown to help reduce the frequency and severity of asthma when added to the diet for a period of months. These include the mineral magnesium; the vitamins B6, B12 and C; and plant nutrients, including quercetin and grape seed extract. These are not magic bullets: changes in dietary habits that lead to a naturally rich supply of nutrients as components of food are more likely to promote benefits than is simple supplementation. A relatively balanced medical review of these points can be found in “Dietary supplements and asthma: another one bites the dust.” (Thorax. 2007 June; 62(6): 466–68.) The take-home message from that article is a better diet that includes lots of fresh whole fruit and vegetables, but much reduced amounts of refined foods, is the first place to start.

Greater rates of physical activity and sufficient sunlight to insure adequate vitamin D are some other simple measures linked to improved lung function. As is often the case in autoimmune conditions, the simple supplementation of vitamin D is not nearly as effective as engaging in those activities that naturally are linked to improved blood vitamin D levels. Moderate sun exposure activates molecules and pathways in the body beyond those of vitamin D and this complete package, as it were, has been shown to be important for health.¹

The most promising herbal supplements for asthma are extracts of Boswellia serrata ^{2 3 4}, Curcuma longa and licorice (Glycyrrhiza)⁵ as well as the sources of proanthocyanidins known as Pycnogenol6.

Finally, N-acetyl-cysteine (NAC) may offer some benefit. NAC helps to thin the mucosal secretions, which makes it potentially useful in asthma, bronchitis and other respiratory disorders.7 The daily intake of NAC probably should not exceed 1,200 mg even in adults except under special conditions, which is to say that more is not necessarily better. However, several trials have shown that much less than this amount is required for results. A study of chronic bronchitis giving NAC at the rate of only 200 mg twice per day found good results within three months, with benefits still improving at six months at the termination of the study. Therefore, supplementing with 200 –400 mg of NAC twice per day for a several month trial may be a good starting point for individuals suffering from asthma.

For references link to: http://totalhealthmagazine.com/references/september2012.pdf

The black currant is a small shrub standing up to six feet tall. It grows in Europe, European Asia, North America and, as a cultivated crop, is especially well represented in New Zealand. The berry comes in vivid shades of deep red, purple and black. It is quite small, being similar is size to the bilberry, and is similarly nutrient dense. It is particularly high in anthocyanins, which are the purple-black pigments that color the skin of the black currant, giving it its name. Anthocyanins are powerful plant or phyto-antioxidants. In addition to the anthocyanins found primarily in the skin, black currant by way of its seeds is a rich source of both the omega-3 fatty acid alpha-linolenic acid (ALA) and the omega-6 fatty acid gamma-linolenic acid (GLA). The origin of the fruit can have a strong bearing on its nutrient content. New Zealand’s pristine conditions and mineral-rich environment combined with its elevated exposure to ultraviolet light results in black currants that exceed the fruit grown in other areas in terms of anthocyanin content. The protective delphinidin-3-rutinoside constitutes 40 percent of the total anthocyanin content of the New Zealand fruit. Black currant also is a source of proanthocyanidins, compounds more commonly associated with grape seed and pine bark extracts.

Brain Health
Today, approximately a third of Americans are over the age of 50 and individuals over the age of eighty-five may make up the fastest growing segment of the population. The “Baby Boom” generation can expect to liver longer than its parents, but with this comes certain challenges. At least nine million Americans currently exhibit sub-clinical cognitive impairment and approximately 14–15 percent of all individuals over the age of sixty-five suffer from some form of age-related dementia.

Epidemiology studies, including both regional incidence and the analysis of specific risk factors for Alzheimer’s disease, indicate that substantial prevention of the disease in the 50 –70 percent range is a practical possibility for the United States. Brain aging, including conditions such as Alzheimer’s disease, should not be viewed as if it takes place separately from the deterioration of other bodily systems. It long has been established that elevated blood sugar levels, which is to say, diabetes and pre-diabetes, are linked to the rate of various forms of dementia. Glycation, a deleterious form of modification of protein and lipid macromolecules in which a sugar inappropriately binds to the molecules, has been linked to diseases such as diabetes, Alzheimer’s, and Parkinson’s as well as physiological aging more generally. Therefore, controlling weight and preventing blood sugar spikes are candidate courses of action for anyone seriously interested in preventing dementias.

Although we have grown accustomed to blaming cholesterol for almost any condition, cholesterol is linked to Alzheimer’s disease only when certain contributors to oxidative stress are present. Such findings corroborate the hardly novel observation that only twenty percent of Americans eat the recommended five-a-day fruits and vegetables: it is phytonutrients from the diet that typically control free radical-inducing conditions.

This is where black currant enters the picture. Certain areas of the brain, such as the areas that involves the neurotransmitter dopamine, are particularly vulnerable to oxidative damage, in part as a result of the neurotransmitter itself. This damage is significant in the manifestation of Alzheimer’s disease and is associated with reduced dopamine levels. Perhaps surprisingly, dopamine inhibits the formation of amyloidbeta peptide fibrils. Researchers have found anthocyanins are powerful protectors against oxidative stressors, with whole fruit extracts more powerful than single fractions. James Joseph of Tufts has been quoted to the effect that black currant is effective in increasing dopamine levels, which are low in Alzheimer’s patients. Dilip Gosh of HortResearch, New Zealand, has performed related research that suggests the ability of brain cells to control calcium concentrations is central to their ability to recover from dopamine cytotoxicity. Animal experiments suggest that anthocyanins taken orally can deliver their benefits centrally, which is to say, to the brain, to protect memory and motor coordination. The polyphenolics in fruits and vegetables, especially those of berries, have been shown to retard and even reverse age-related decrements in motor and cognitive performance.

Eye Health
For eye health, the black currant may be even more protective than the bilberry. The bilberry has many historical or traditional uses based upon both the dried berries and the leaves. Used as a medicinal herb since the 16th century, modern interest in the bilberry is partly based on the fruit’s use by British pilots during the Second World War. These pilots noticed that their night vision improved when they ate bilberry jam prior to night bombing raids. In the intervening years, scientists discovered that anthocyanosides, the bioflavonoid complex in bilberries, black currant and a number of other berries, are potent antioxidants.

Anthocyanosides, i.e., anthocyanins (the name changes based on whether a sugar molecule is attached), provide three primary benefits to the eyes. First, these highly colored plant pigments nourish the retina. Night vision depends on the retina’s ability to constantly regenerate visual purple (rhodopsin), and anthocyanins serve as “building blocks” for this important substance. Tests have confirmed these benefits. When subjects with normal vision supplemented with either black currant or bilberry extract, it was found the acuity of their nighttime vision improved, as did the speed at which they adjusted to darkness and the rate at which they recovered from blinding glare. However, it is important to bear in mind that positive results in trials required the ingestion of 50 mg or more per day of anthocyanins. A prudent level of intake would be on the order of 90 or 100 mg of the anthocyanins per day.

Another area of benefit involves the inducement of short distance vision and/or its aggravation or exacerbation if already present. Continual close range visual tasking, such as extended viewing of computer screens, leads to the development of tension of the ciliary smooth muscle, which impairs the eye’s refractory adjustment function. One result is axial length elongation, an aspect of myopia or “nearsightedness.” Bilberry extracts may help counter axial length elongation and at least one in vivo test provides evidence black currant is superior to bilberry in this regard. Related to ciliary smooth muscle tension is visual fatigue. As most computer users know well, the fatigue of the eyes can extend to the neck, head, arms, shoulders and lower back. Anthocyanin ingestion may be helpful.

Several types of deterioration that are typical of aging eyes, such as cataracts and macular degeneration, appear to be influenced by the rate of generation of free radicals. In laboratory trials, changing the diets from commercial laboratory chow to “well-defined” diets rich in flavonoids has shown to be beneficial. Interesting results have been found with human trials in which anthocyanins were supplemented, either alone or in combination with vitamin E.

Digestive Health
One of the more unexpected benefits of black currant extract is in the area of digestive health. When researchers at Massey University of New Zealand used an animal model to examine the impact of supplementation of the diet with inulin, 30 percent anthocyanin extract concentrate (BCE) or cassis infused dried fruit (IDF), they found significant results. Desirable bacteria, in this test meaning Bifidobacteria and Lactobacilli, were increased and unwanted gut inhabitants, meaning Bacteriodes and Clostridia, were reduced. Other research has shown black currant may support gastrointestinal health by reducing the activity of â-glucuronidase and increasing that of â-glucosidase.

Lung Function
As mentioned already, black currant contains proanthocyanidins as well as anthocyanins and other polyphenolic compounds. Work performed at The Plant and Food Research Institute of New Zealand examined the impact of black currant extract on immune function and aspects of normal inflammatory response when the lungs are challenged. The findings were that black currant supports normal inflammatory and immune responses under challenge conditions. Researchers have suggested black currant extracts may be supportive in conditions such as asthma.

Colds and Flu
Elderberry has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have antiviral activity against influenza and herpes simplex. Many people are familiar with these uses. However, relatively few individuals are aware of the fact many anthocyanins are active against viruses. Researchers at the Department of Microbiology, Asahikawa Medical College in Japan looked at the effects of black currant against influenza virus types A and B in vitro. According to the study results, both IVA and IVB were inactivated up to 99.9 percent by 10 ìg/ml of the black currant extract at pH 2.8, and 95 to 98 percent by this concentration at pH 7.2. The growth of IVA in cells treated with 10 and 100 ìg/ ml of the extract after infection was completely suppressed in six hours. The results indicated that the extract was effective under test conditions in inhibiting the release of the virus from infected cells.

Women’s Health
Every part of the black currant berry can be used, not just the anthocyanidins and proanthocyanidins found chiefly in the skin. The seed oil is a source of both the omega-3 fatty acid alpha-linolenic acid (ALA) and the omega-6 fatty acid gammalinolenic acid (GLA). GLA is recognized as one of the “good” essential fatty acids used to enhance cell membrane fluidity and function. Although the body can manufacture GLA from dietary linoleic acid, it can be more efficiently utilized for body functions when supplied directly by dietary sources. GLA supports a balanced inflammatory response and has been shown to be important for lung, joint, and eye health. According to authorities such as Andrew Weil, MD, the combination of essential fatty acids found in black currant seeds may influence the production of prostaglandins and assist hormone production to support women during menopause.

Conclusions
Black currant has earned its place in the ranks of the “super” fruits. Its range of benefits is similar to that found with bilberry and far better documented than those often asserted rather than demonstrated for acai and other recently promoted fruits. For the health of the brain and eyes, black currant is a winner. It supports normal immune and inflammatory functions. Starting at an intake as low as 50 mg per day of the concentrated anthocyanins, it is compact health insurance against a world of health challenges.

In his book, Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control and Disease, Gary Taubes points out that under real life conditions, prior to the advent of refined carbohydrates, human beings appear to have suffered from no chronic diseases that can be linked directly to the consumption of fats. Apparently, eating fat does not make us fat. Among his ten “inescapable” conclusions (p. 454) is this. “Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization…“ (Taubes is a contributing correspondent for Science magazine and a contributing editor at Technology Review.)

In contrast, Taubes documents the thesis that with the advent of the age of refined carbohydrates, built-in mechanisms for regulating appetite, on the one hand, and regulating energy use, on the other hand, have become dysfunctional. Sucrose and high-fructose corn syrup are particularly harmful to metabolic regulation. Evidence from Taubes and others shows over the last 100 years, consumption of simple, refined and processed carbohydrates has increased between 50 – 60 percent. Some authorities estimate that perhaps 15 percent of the calories in the American diet now come from fructose alone!

To the fundamental question of what regulates fat accumulation, which is to say, weight gain, Taubes answers simply. “This was elucidated by 1965 and has never been controversial. Insulin is the principle regulator of fat metabolism...”

INSULIN AND THOSE EXTRA POUNDS

Let’s start with evidence from diet trials. Low carbohydrate versus low fat diets for the most part boils down to low insulin versus high insulin diets. Large comparative trials have demonstrated convincingly high protein and Atkins-style diets can be used quite successfully for weight loss and weight maintenance. Moreover, low carbohydrate diets are more successful than low fat diets in terms of delivering health benefits unless there is very careful attention in the carbohydrate-based diets to what is termed the “glycemic load.” After several decades of refusals in medical circles even to test the low carbohydrate diet hypothesis, the tide may be turning. Researchers conducting a recent trial concluded, “Reducing glycemic load may be especially important to achieve weight loss among individuals with high insulin secretion...”

Other researchers were more direct after a short-term trial of diabetics on a very low carbohydrate diet. “When we took away the carbohydrates, the patients spontaneously reduced their daily energy consumption by 1,000 calories a day. Although they could have, they did not compensate by eating more proteins and fats and they weren’t bored with the food choices.”

Put differently, even if it remains subject to debate as to which is more responsible for the current epidemic of obesity — fat or carbohydrates in the diet — it has become indisputable that insulin makes us fat and carbohydrate consumption powerfully influences insulin levels.

High blood insulin levels after meals decrease the ability to access fuels, especially fats, for energy for several hours, leading to hunger and overeating as well as reducing natural increases in caloric expenditure. For instance, the thermic response to food that should account for a full 10 percent of all calories metabolized during the day is blunted in the overweight. Low-glycemic load foods include non-starchy vegetables, legumes, and temperate fruits in contrast to high-glycemic load foods, such as refined grains, starchy vegetables, fruit juices and sweets. The former cause only small fluctuations in serum insulin levels whereas the latter can cause large swings. A low-glycemic diet by reducing insulin fluctuations not only reduces hunger, weight gain and belly fat storage, but also reduces triglyceride levels while improving the levels of “good” high-density lipoprotein cholesterol (HDL). This hypothesis has been borne out by a study lasting six years. The highest insulin secretors exhibited the largest change in weight and belly fat compared to the lowest insulin secretors. Those who were high insulin secretors and ate low-fat diets did even worse.

REDUCING INSULIN REDUCES HUNGER AND WEIGHT

Insulin controls blood sugar clearance—and a lot more. Testing blood sugar levels and even glucose tolerance is easy and inexpensive, whereas testing insulin levels, and especially testing insulin sensitivity, is time consuming and costly. Not surprisingly, the medical world largely has shunned insulin testing and often pretends other tests can be substituted. Such attitudes have limited some important research. One of those areas is the impact of directly reducing insulin levels—not blood glucose levels!—on weight loss.

Such an experiment was performed more than a dozen years ago with remarkable results. Researchers reasoned that hyperinsulinemia is a possible preceding event in the development of obesity. Rather than treating blood glucose levels, they reduced insulin levels with a pharmaceutical inhibitor of insulin secretion called diazoxide. In a double-blind placebo-controlled clinical trial with hyperinsulinemic obese adults lasting eight weeks and utilizing a low calorie diet, it was determined that reducing insulin output increased weight loss significantly without causing hyperglycemia.

This was not a fluke finding. A clinical trial conducted at a hospital in the Netherlands and published in 2008 reduced insulin levels through diazoxide treatment while prescribing moderate caloric restriction. Researchers expected a 15 percent drop in starting body weight after six months. (Even ten percent is considered a great success.) They were not disappointed. Body weight decreased by almost 21 pounds, total body fat mass decreased by 23.3 percent and yet there was no loss of lean body mass or bone mass. Fat loss was inversely related to fasting insulin levels achieved at six months—the lower the insulin, the greater the fat loss. Diastolic blood pressure (the bottom figure) decreased by 10.9 mmHg. Fasting and post-meal peak insulin levels were reduced by about 65 percent, which is to say, they decreased to the normal range for non-obese men. Haemoglobin A1c (glycosolated haemoglobin, an indicator of blood glucose control) increased slightly by 0.5 percent to 5.9 +/- 0.2 percent, which is still within the normal range. The weight loss was judged to be clinically significant.

Reducing insulin levels without any attempt to reduce blood sugar levels powerfully affects both appetite and weight regulation. Why. As mentioned earlier, elevated insulin levels seriously interfere with normal metabolism and reduce the ability to take fat out of storage and use it for energy. Something similar happens with appetite. In those who are overweight, the signal to the brain from the meal-induced release of insulin often is disrupted, making it more difficult for the brain to register that sufficient calories have been ingested for same-meal satiety. One result is over-eating. Insulin resistance actually causes a change in the microcirculation between the body and the brain. Other results are uneven energy levels, increased between-meal snacking and binge eating.

CAN INSULIN LEVELS BE REDUCED NATURALLY?

Has the reader ever seen a dietary supplement marketed for reducing insulin levels. Probably not. There are many natural products marketed for supporting blood glucose regulation, but insulin regulation is another story. Indeed, many products sold for blood glucose control work by increasing insulin levels in order to reduce blood glucose levels. However, elevated serum insulin is the fundamental driver for Syndrome X / the Metabolic Syndrome. Increasing natural insulin output in diabetics who have lost the ability to produce normal amounts of insulin may be beneficial, but doing so in non-diabetics and in those who already produce too much insulin is another matter.

An example of this is the popular herb Gymnema sylvestre. G. sylvestre does not reduce insulin resistance, but rather increases insulin output. It also reduces the absorption of ingested fats, an action that may appear to be beneficial until one considers the implications for nutrients such as vitamins A, D, E, K, CoQ10, tocotrienols, omega-3 fatty acids, etc. There is some evidence that extracts of G. sylvestre may improve the functioning of insulin-producing beta-cells in the pancreas, which can be a good thing in some diabetics. On a less positive note, there also is evidence G. sylvestre, most likely by elevating blood insulin levels, can raise blood pressure.

Fortunately, there is at least one natural item that has been shown to reduce insulin levels as well as reduce both hunger and weight gain. That item is known colloquially as Assam Gelugur.

ASSAM GELUGUR

“Assam” means “sour.” Assam Gelugur (variously spelled) is a Southeast Asian name for a family of very sour fruits used for flavoring, in cooking, preserving and as herbal medicine. One local use is for weight loss. In Thailand and throughout the Malay Peninsula, the primary species is Garcinia atroviridis. Related species used for much the same purposes are G. cambogia and G. indica. The active constituent in the fruit is its acid, which has the formidable chemical name 1,2-dihydroxypropane-1,2,3-tricarboxylic acid.

As is true of many herbal products, the benefits of Assam Gelugur extracts are highly dependent upon how they are prepared. The acid must be stabilized generally by the addition of high pH ions (basic or alkali), such as those of potassium, magnesium or calcium — using the wrong stabilizer results in little or no activity. Employing only potassium as the cation, if the material is properly reacted, results in a liquid, not a powder, hence leads to a product that is commercially unusable. In the case of the acid derived from Assam Gelugur, adding any calcium at all reduces some desired benefits and blocks other benefits entirely.

At the 2005 Annual Meeting of the American College of Nutrition, for the first time it was reported that a proprietary potassium-magnesium salt of the Assam Gelugur acid in an animal model gave the same blood glucose regulation as found in the control arm of the test while almost literally cutting insulin levels in half ! The same study demonstrated this salt dramatically improved glucose clearance from the blood, lowered systolic blood pressure and also lowered several key indicators of inflammation, including C-reactive protein and tumor necrosis factor-alpha (TNF-alpha). In contrast, the potassium-calcium salt exerted no effect upon insulin and blood sugar regulation and only very poorly influenced blood pressure. In the areas of insulin metabolism, glucose regulation and blood pressure, the proprietary potassium-magnesium salt was between five and ten times as active as the potassium-calcium salt of the fruit acid.

Extracts of Assam Gelugur in clinical trials repeatedly have shown to be safe and to improve weight loss and appetite control. The new wrinkle is the discovery of the proper technique for producing a stable extract that dramatically reduces insulin levels while at the same time improving blood glucose regulation. The validity of this material (a combination of proper extract plus unique delivery system), which is marketed under the name Leptisol®, soon will be explored decisively at a major university. This particular extract and delivery of Assam Gelugur has been chosen by the National Institutes of Health for a National Center for Complementary and Alternative Medicine clinical trial expected to begin at the end of the year.

Conclusion
Modern diets typically contain refined carbohydrates, especially sugars. These diets increase the storage of consumed fats and other calories while at the same time preventing the utilization of stored and consumed fats for energy. The mechanism involved is an elevated release of insulin, which leads to lessened meal satiety, poor regulation of appetite and weight gain. The solution. Low-glycemic load foods (remember, vegetables can be your primary sources of carbohydrates in place of bread, rice, etc.), higher protein consumption (not necessarily all from animal sources) and, perhaps, an extract from an Asian fruit called Assam Gelugur.

Let’s start with the basics. Osteoporosis can be a silent disease that may not be revealed until a fracture is experienced. Only perhaps one half of individuals suffering from osteoporosis are aware of their condition. On the National Health and Nutrition Examination Survey (NHANES) only one percent of men and 11 percent of women over 65 reported they had osteoporosis. However, bone mineral density (BMD) testing revealed that four percent of male and 26 percent of female survey takers actually had the disease. The mismatch between perception and reality with regard to bone health gains importance from the fact that the number of individuals involved is huge.

Over 10 million Americans suffer from osteoporosis, a number that is expected to grow to 14 million in the next decade. About 20 percent of these cases are men. Another 34 million have thinning bones and low BMD that puts them at risk for osteoporosis. It is estimated that 50 percent of women (and 25 percent of men) will suffer an osteoporotic fracture in their lifetimes; amounting to approximately two million fractures per year in the U.S. Although women are significantly more likely to experience an osteoporotic fracture (up to 90 percent of all hip and spine fractures in women 65 – 84 years can be attributed to the disease), men account for about 29 percent of fractures annually. Studies have also indicated that 30 percent to 50 percent of patients on glucocorticoid therapy sustain fractures due to secondary osteoporosis.

The common wisdom regarding osteoporosis risk is rather wide of the mark. To make matters worse, our usual supplement choices may not reflect any better aim. To improve bone health and reduce fracture risk, Americans have been taught to focus on calcium supplements and bone mineral density. Many experts, however, look elsewhere. They draw a distinction between bone quality (which concerns reduced risks of fracture) and bone quantity (which is concerned exclusively with bone mineral density). One reason for this distinction is that for the vast majority of women, BMD is not statistically significantly related to fracture risk. Bone quality, not merely quantity, is important. Moreover, calcium, the major component of BMD measurements, does not add greatly to bone’s resistance against the most dangerous types of mechanical stresses. Calcium alone does not greatly improve bone quality. It is the other 28 percent of the bone, the collagen and other components found in the bone matrix, that are active in bone formation, and give a degree of flexibility to bone — hence primarily help to reduce fracture risk. Likewise, it is factors other than calcium in the diet and supplements that primarily determine what the body does with calcium and whether supplemental calcium actually improves bone health.

Calcium Absorption

Calcium and vitamin D are familiar to most people; indeed, usually they are considered to be synonymous with bone health supplements. The uptake, transport, and incorporation of calcium into the skeleton is a complex process that is critically dependent on the endogenous hormone calcitriol (activated vitamin D), which in turn is reliant on a set of regulatory reactions that carefully maintain the overall calcium balance. Calcium bioavailability involves a highly regulated intestinal absorption system as well as the regulated incorporation of calcium into the bones themselves.

Calcium is absorbed primarily in the small intestine both actively (by a transport system) and passively (by diffusion). “Passive” absorption accounts only for a small amount of total calcium assimilation. “Active” transport is a regulated transport that responds to levels of calcium in the body and only allows absorption if more calcium is needed. Thus, if calcium levels are sufficient in the body, the active transport system becomes inactive. Similarly, the faster and the greater the amount of calcium presented to the body at any one time, the greater the likelihood that calcium absorption will be regulated downward.

Does the form of calcium matter? If all that is involved is absorption from the gut, apparently not very much. For example, mean apparent calcium absorptions have been calculated based on three to eight studies (for each of four calcium salts) and 12 to 14 studies (for carbonate and milk calcium). Here are the results based on either fasting (between meal) or meal-based ingestion:

• carbonate, from 26.4 percent (fasting) to 29 percent (meal)
• citrate/malate from 32 percent (fasting) to 37 percent (meal)
• citrate 23.5 percent (fasting)
• lactate/gluconate 24.5 percent (fasting)
• chloride 30.6 percent (fasting)
• milk 32.4 percent, cheese 32.8 percent
• mineral waters 32.3 percent

Although these numbers must be interpreted cautiously inasmuch as the studies were performed using different test groups and study parameters, it is clear that when averaged over several studies, calcium absorption is limited to about one quarter to one third of ingested dose with the greatest documented differences between calcium forms amounting to only a few percent. One should be aware of the fact that carbonate is the calcium storage form for several of the “food-matrix” commercial calcium supplements: eggshell, algal and shellfish calcium are all calcium carbonate. The absorption of calcium generally declines with age and the use of certain medications. Likewise, taking large amounts at any one time diminishes uptake. Contrarily, dividing calcium doses significantly increases fractional absorption by preventing the saturation and shutdown of the active transport system. In one particularly illustrative (and extreme) example, dividing a 1000 mg dose into 17 evenly-spaced doses over an eight-hour period increased its fractional absorption by almost 100 percent!

Are Some Forms of Calcium More Beneficial? Yes, but It’s Not the Calcium!

Active absorption is the major source of calcium uptake, yet if the primary influence on active absorption — the amount of acid released in the stomach — is reduced, then passive absorption takes on greater importance as a fallback. Calcium chelates are complexes of calcium and other organic molecules, such as organic acids (citrate, malate, threonate, ascorbate) or amino acids (aspartate). Like salts, they can dissociate into ionized calcium for the active transport mechanism, but they are more resistant to this process. Unlike salts, however, they are soluble in their unionized, intact form; this may allow them to be directly absorbed by passive diffusion. The advantages to chelates appears to be that in situations in which calcium digestion is sub-optimal, they exhibit less of an absorption penalty. Hence, if calcium is taken between meals or individuals exhibit achlorhydria or are taking proton-pump inhibitors or histamine blockers, chelated calcium, such calcium citrate or calcium malate, may be preferable forms.

Matrix-bound calciums are complexes of calcium or calcium salts with an organic matrix. In most cases, matrix-bound calciums are inorganic salts of calcium, with a protein and polysaccharide component extracted from a natural source. Matrix-bound calciums are often marketed as “food-based” or “recognized by the body as food,” but these statements should be interpreted with caution. For the most part, the calcium in these matrices is a calcium salt, usually calcium carbonate. Algal, eggshell, and shellfish calciums all predominately consist of crystals of calcium carbonate. In contrast, calciums from milk and bone are different — they are tricalcium phosphate and hydroxyapatite (different types of calcium phosphates).

Often it is claimed that matrix-bound calcium products — algal, eggshell, milk, bone, etc. — provide superior benefits. Perhaps they do, but it is not because of the nature of the calcium present. The benefits of matrix-bound calcium over other forms has more to do with the nature of the matrix than with the calcium:

• Algal and eggshell calciums contain additional trace elements
• Bone-specific growth factors are found in eggshell and ossein (bone) matrices
• Milk calcium (if it uses the milk matrix and is not simply purified tricalcium phosphate) has a significant portion of colloidal phosphocaseinate that may prevent calcium precipitation and may prolong calcium residence time in the gut. Providing a sustained calcium dose has a stimulatory effect on passive diffusion.

To clarify the impact of matrix components other than calcium on bone health benefits, let’s take a closer look at the effects of bone-derived calcium on bone growth. Bone-derived calcium is ossein-hydroxyapatite complex (OHC) also sometimes referred to as microcrystalline hydroxyapatite. This complex of hydroxyapatite calcium and protein (ossein) is isolated from bovine bone. Ossein is rich in proteins that stimulate bone growth: collagens, osteocalcin, and growth factors (IGF-I,II, TGF-B, bone morphogenic protein). This calcium source has been the subject of numerous studies (for a summary of 18 comparative OHC studies. When compared to calcium alone in the form of calcium carbonate, the ossein matrix provided an additional increase in BMD of at least one percent for total BMD and increases of up to five percent in vertebrae.

Clinical studies thus have uncovered an important clue about the relation between calcium absorption and BMD, especially with regard to certain sites, such as the spine. If taken with meals, most forms of calcium yield similar absorption data and the differences between the best and the poorest performing sources can generally be overcome by taking just a bit more calcium. The 5 percent additional calcium found in the spinal vertebrae of women taking bone-derived calcium rather than calcium carbonate represents the actions of the other components found in the calcium source and not the impact of the calcium itself.

Non-calcium Nutrients Benefits for Both Bone Quantity and Quality

Non-calcium nutrients play many roles in bone health. The trace mineral boron, for instance, has a part in estrogen metabolism. Potassium has been shown to reduce calcium loss from the body. Magnesium helps to keep calcium in the bones, where it belongs, rather than in the lining of the arteries, where it does not. Zinc stimulates bone formation and reduces bone resorption.

There are other factors, as well. Vitamin K maintains lumbar bone and reduces new fractures. Folic Acid reduces homocysteine levels because high levels have been linked to osteoporosis. Vitamin D, of course, is required for the regulation of absorption of calcium from the gut and then its use for maintaining bone calcium levels. Vitamin C, copper, manganese and glucosamine are all important for supporting the activities of the bone matrix, the most active site of bone repair.

Remember, the bone is approximately 28 percent collagen and other components found in the bone matrix and that are active in bone formation, give a degree of flexibility to bone, and primarily help to reduce fracture risk. Despite the media focus on BMD, preserving or even increasing BMD does not reduce fracture risks in the vast majority of women. This means that supplementing calcium alone does not reduce fracture risks in the vast majority of women. Bone is living tissue that must constantly be repaired. It is the quality of the repair, not just the amount, that matters.

Vitamin K’s role offers an illustration of the point. Vitamin K is a family of fat-soluble vitamins that are needed for the modification of certain proteins that are involved in blood coagulation as well as proteins that are involved in calcium chelation in bone and other tissues. Vitamin K1 (phylloquinone) can be found in leafy green and cruciferous vegetables and, to a lesser extent, in fruit. Vitamin K2 (menaquinone) is found in a number of fully fermented foods, including cheeses and soy products. Most of the activity of vitamin K in bone growth involves its function as a cofactor. For example, it is involved in the activation of Matrix Gla protein, which is thought to control the calcification process. Matrix Gla protein also has been shown to inhibit calcification in soft tissues (e.g., the cardiovascular system). Osteocalcin (sometimes called bone Gla protein) is the most abundant non-collagenous protein in bone. It is thought to directly bind to hydroxyapatite and possibly regulate calcium flux.

Low vitamin K status has been associated with reduced BMD and increased fracture risk in several reports. Short-term studies of vitamin K2 have shown it to be effective for maintaining BMD. Longer-term studies, typically requiring two years for benefits to manifest, have shown decreases in fracture incidence by up to 66 percent as well as increases in BMD, especially when combined with vitamin D3. Even in osteoporotic patients and without any significant impact on BMD, K1 supplementation for a period of four years reduced fracture risks. In short, Vitamin K supplementation for sustained periods of time, generally two years or more, benefits both BMD and fracture risk. The primary benefit likely is in the latter area and involves bone quality because fracture risks are reduced even in the absence of benefit to BMD.

And then there is silicon. Silicon (Si) is a semi-metallic element with important roles in plant and animal metabolism. It is distinct from, and often confused with silicone, a synthetic polymer. Silicon is found in nature as orthosilicic acid (OSA), Si(OH)4, a common component of mineral waters. OSA is taken up by plant roots. In animals and humans, silicon is involved in the synthesis of collagens, increasing the production of collagen mRNA, stimulating the production of the amino acid proline (the most abundant amino acid in the collagen), and serving as a cofactor for the collagen synthetic enzyme prolyl hydroxylase. Silicon may also have functions in the formation of glycosaminoglycans and in bone mineralization.

Silicon is required for proper bone formation in animals and has a positive correlation with BMD in humans. Analysis of data from the Framingham and Framingham Offspring studies for 1251 men and 1596 pre- and postmenopausal women (aged 30 – 87 years) revealed up to a 10 percent difference in BMD between individuals with the highest (>40 mg Si/day) and lowest (<14 mg Si/day) intakes of silicon. Combined therapy of silicon (as OSA) with calcium and vitamin D had profound effects on the preservation of BMD in humans. The addition six mg/day to a calcium/cholecalciferol regimen (1000 mg calcium carbonate and 800 IU vitamin D3) maintained baseline BMD levels in women with osteopenia over a period of 12 months, and displayed a significant increase (19 percent) in bone collagen formation, i.e., activation of the bone matrix. Women taking calcium and vitamin D alone experienced significant mineral loss. These data further implicate silicon as an effective, although often overlooked, addition to any strategy for maintaining skeletal health.

Conclusion
Bone health is a serious matter and it involves more than maintaining BMD or supplementing with calcium. The primary issue with calcium is not absorption, getting it into the body, but rather getting it to go where it is supposed to go and do what it is supposed to do. Most forms of calcium are similarly absorbed. Calcium forms are separated from one another in terms of benefits to a large extent by associated nutrients, including trace elements and activating factors. It is these factors that separate bone-derived or eggshell calcium from mere calcium carbonate. Similarly, nutrients such as silicon and vitamin K support calcium and vitamin D in part by influencing the factors associated with bone quality, not just bone quantity. Yes, calcium and BMD are important, but greater bone matrix health and reduced fracture risks are the true hallmarks of improved bone quality.

On the one hand, there are those who still maintain that coconut oil, a source of more saturated fat than butter, lard or beef tallow, is the devil incarnate for brain and heart health. On the other hand, current science is in the process of validating the high regard that the coconut oil enjoys in the Ayurvedic and Chinese traditions of healing.

Indeed, coconut oil bears a striking overlap in its metabolic implications, in this case for Alzheimer’s disease, with medical foods designed to provide the brain alternate fuel sources. A nice introduction to this topic is Alzheimer’s Disease: What If There Was a Cure? by Mary Newport, MD.

The scientific backtracking regarding coconut oil recently was put in a nutshell in a New York Times interview of Thomas Brenna, a professor of nutritional sciences at Cornell University.¹ Dr. Brenna observed that coconut oil’s bad reputation for cardiovascular health rested mostly on partially hydrogenated coconut oil, oil designed specifically to raise cholesterol levels in the rabbits being used in experiments. Virgin coconut oil differs dramatically in a large number of ways from the trans-fat laden partially hydrogenated item. Even the health dangers of the saturated aspect of coconut oil currently are being debated. As Dr. Brenna remarks in the interview, “I think we in the nutrition field are beginning to say that saturated fats are not so bad, and the evidence that said they were is not so strong.”

Coconut Oil—A “Good” Saturated Fat
Coconut oil is saturated (it is solid up to 76° F), consisting of 86.5 percent saturated fatty acids and 5.8 percent monounsaturated fatty acids.² Lauric acid makes up approximately 46 percent of coconut oil and generally is considered to be the villain in terms of serum cholesterol. However, in clinical trials, the effects of dietary supplementation with coconut oil usually have been found to be either no effect or a small increase in LDL cholesterol and a significant increase in HDL cholesterol, meaning that the ratio—and cardiovascular risk—improves with supplementation.^3,4

Moreover, extra virgin coconut oil consists mostly of medium-chain fatty acids (MCFA), with 50 percent being lauric acid. Medium-chain fatty acids have been used for many years for special health purposes. They have attracted attention as part of a healthful diet because they are absorbed and transported directly into the liver via the portal vein and thereafter metabolized rapidly by beta-oxidation, thus increasing diet-induced thermogenesis.⁵

One derivative of coconut MCFA is medium-chain triglyceride (MCT) oil, which is 75 percent caprylic and 25 percent capric acids, fatty acids very similar to lauric acid and present in virgin coconut oil in smaller amounts. MCT oil often is found in the hospital nutrient mixtures for bedridden patients who are dependent upon intravenous nutrition. These fats were developed in part because they do not require the action of bile for digestion, but rather are absorbed directly through the walls of the small intestine and transported to the liver to be used immediately as fuel.

The special characteristics of coconut MCFA mean that the body prefers to burn it for fuel rather than to store it. You might say that the body treats coconut fatty acids more like it does carbohydrates, but without getting involved with insulin. Scientists know this because of experience with MCT oils. In my book Anti-Fat Nutrients (revised 4th edition, Basic Media), I discuss MCT oil at length. In seriously catabolic patients, MCT oil was found to help prevent the body from depleting lean and muscle tissues. Again, MCT fatty acids are not readily stored as body fat, but rather they are preferentially burned in the mitochondria of the cells to provide energy.⁶ For some athletes and bodybuilders, this quality has proved useful since excess training depletes the glycogen stores of the muscles, and continued training after that point can only take place partially through the break down of muscle protein for fuel.⁷ Coconut oil medium-chain fatty acids have properties similar to those of MCT oil, but not as pronounced.

Does this mean that coconut oil can help dieters? Yes, as long as there are not too many expectations. Indeed, the nutrition author Ray Peat, PhD, has remarked that in the 1940s farmers attempted to use coconut oil for fattening their animals, but they found that it made them lean, active and hungry instead! The fatty acids found in coconut seem to promote the burning of fat for fuel and, as already noted, have a pronounced thermogenic effect. However, the thermogenic and fat-burning qualities of medium-chain fatty acids seem to be more significant for healthy subjects of normal weight and for those moderately overweight than for those who are clinically obese (fortunately, a category that excludes most of us). Moreover, medium-chain fatty acids serve to protect the body’s protein in the lean tissues during the use of low calorie and low carbohydrate diets.⁸

Immune and Digestive Benefits
Coconut oil has many other benefits. Two names are closely associated with the research in this area. These are Jon J. Kabara, PhD, one of the primary researchers into the benefits of lauric acid, and Mary G. Enig, PhD, the great researcher in the area of fats and one of the first (literally decades before the mainstream medical researchers) to point out the health dangers of trans-fatty acids.

Dr. Enig was the keynote speaker in 2001 at the 36th Annual Conference of the Asian Pacific Coconut Community. There she gave her talk on the benefits of the coconut as a functional food. She noted that approximately 50 percent of the fatty acids in coconut fat are lauric acid, which has the additional beneficial function of being formed into monolaurin in the human body. Monolaurin is a monoglyceride used by the human metabolism to destroy lipid-coated (that is, fatcoated) viruses and a number of other undesirable organisms.

Approximately 6–7 percent of the fatty acids in coconut fat are capric acid. Dr. Enig points out that capric acid is another medium-chain fatty acid that has a similar beneficial function when it is formed into monocaprin in the human or animal body. Monocaprin has beneficial effects similar to those found with monolaurin.

The work of Dr. Jon Kabara and others shows that coconut oil components exert their health benefits in a way that is very safe to humans. In general, it is reported that the fatty acids and monoglycerides produce their inactivating effects by destabilizing the membrane that surrounds pathogens, for instance, by causing the disintegration of the virus envelope. Despite such sometimes quite potent actions against unwanted microbes, there is no evidence of any negative effect on probiotic organisms in the gastrointestinal tract.

In his accessible, yet thoroughly researched book, The Healing Miracles of Coconut Oil (HealthWise), author Bruce Fife, ND, ranges across a number of health topics for which coconut oils has proven to be effective. He notes that coconut oil is so stable that it helps to preserve other oils, thereby reducing antioxidant requirements. Populations that eat large amounts of coconut and coconut products, such as the oil, are characterized by low rates of heart disease. Lauric acid and other medium-chain fatty acids are found in mother’s milk, where among other things, they improve the uptake by the baby of nutrients such as amino acids, calcium and magnesium. Similar effects upon nutrient assimilation have been found in the very ill and in the elderly. Moreover, these health benefits do not even take into account the long accepted uses of coconut oil to nourish the skin and the hair.

Benefits for Brain Health?
Let’s return to Nestlé Health Science acquired a stake in Accera, the U.S. maker of Axona, a medical food targeted at people with mild to moderate Alzheimer’s. The basic argument for this medicinal food is that in Alzheimer’s disease, the brain is starved for energy because it has a reduced ability to metabolize glucose. Reduced energy means reduced levels of cognition and memory. Fortunately, there is an alternative to glucose known as ketone bodies. Axona is a proprietary formulation of caprylic triglyceride that is converted by the liver into ketone bodies.

Recall that coconut oil is a good source of medium-chain triglycerides (MCTs), the fatty acids that are converted in the liver to ketones. Ketones can provide energy to cells without the need for insulin. This is important for several reasons, not the least being that Alzheimer’s is related to insulin resistance and the attempt to get glucose to the brain with a high carbohydrate diet is counterproductive.⁹ Moreover, access to ketones may more generally promote neurologic health—several neurologic conditions have shown promising results with ketogenic diets. Ketogenic diets may help treat difficult cases of epilepsy and Parkinson’s disease as well as other neurological disorders, indeed perhaps improve cognition and health in general.

The use of coconut oil with the conditions above at this point is promising, but hardly proven. Moreover, there are not yet much in the way of set rules or recommendations. Dr. Newport was giving her husband as much as 11 tablespoonsful per day, with four to eight tablespoonsful seeming to be a regular recommendation. At 115 calories per tablespoon, a coconut oil supplemented diet should not otherwise continue to be the standard American diet built upon a foundation of refined carbohydrates. Those wanting to add serious amounts of coconut oil to their everyday diets, as opposed to merely switching to it as a cooking oil, might find it useful to explore high protein/low carbohydrate options more generally. The chief warning to those who would try such diets is that Paleolithic-type diets need to include plenty of vegetables and reasonable amounts of whole fruit (avoiding fruit juice).

Summing Up
In his book, Bruce Fife asks the rhetorical questions, “If there was [sic] an oil you could use for your daily cooking needs that helped protect you from heart disease...other degenerative conditions, improved your digestion, strengthened your immune system, protected you from infectious diseases, and helped you lose excess weight, would you be interested?” Surely this is a good question. Aside from the record of traditional use, numerous research papers and United States Patents argue for the health-promoting benefits of coconut oil. Now that organic coconut oil/extra virgin coconut oil is readily available in health food stores, perhaps it is time for health-conscious shoppers to give it a try.