LECTINS AND RESISTANT STARCH

I will give it to you straight: the concepts of lectins and resistant starches in our diets are new to me. I ran across them and their effects on our health at Bulletproof Coffee. I think overall, Dave Asprey's dietary recommendations are worthy but the diet itself is impossible to follow for any length of time. The following are my explanations of the two terms and my own recommendations.

1. Lectins

Lectins are proteins that are found in most edible plants and even some animal-based foods. Plants produce them as natural insecticides and fungicides. In fact, they are such powerful "antibiotics" that agricultural scientists have found ways to increase lectin levels in some GMO foods by inserting certain genes. Which is another reason to question genetically engineered foods since lectins are not good for human health.

Lectins bind to certain cells in the body such as the lining of our intestines and joint cartilage, effectively destroying them and/or their ability to communicate with other cells. In joints, they cause inflammation and many people find pain relief on a low-lectin diet. Yes, there is such a thing.

Most grains are high in lectins. Whole grains are the worst offenders. Which is one reason I try to follow the Wheat Belly Diet since I really don't have a problem with gluten. Dr. William Davis doesn't address lectins in his book which is why you will find differences between the Wheat Belly and Bulletproof diets. I have been sorting through these (and Tim Ferriss' 4-Hour Body) and trying to devise my own tasty, nutritious, grain-free, low-lectin eating guidelines. And low-cost too, since I empathize with those on limited budgets.

2. Resistant Starchess
All plants contain starches, whether "simple" like sugars, "complex" as in low glycemic index food, or "resistant." It is difficult to find fruits and veggies that have naturally occurring resistant starches but they can be produced at home and there is even a flour called "Hi-Maize" which you can buy at Amazon.

There are several advantages to consuming resistant starches. As the name implies, they are resistant to breakdown in the upper gastrointestinal tract and essentially arrive in the small intestine intact where they act as probiotics. The good bacteria in our guts use these starches as a source of fuel and metabolic products of this action include beneficial acids such as butyric acid.

They are also good for diabetics and pre-diabetics since they don't elevate blood sugar levels. And they act as a natural fiber, so much so that some scientists consider resistant starches as another type of fiber, besides soluble and insoluble.

Six "miracle drugs" with major side-effects

This is an interesting article on six medications that have major side-effects. Although the side-effects differ, all six have one thing in common: they were all heavily promoted by the pharmaceutical industry. The article headline calls them "miracle drugs" which is partly true. For example, I would die without my beta blocker. It is as simple as that. I have a heart arrhythmia which left uncontrolled by metoprolol would be fatal. Therefore, I have chosen to live with the side-effects in favor of life.

But some of the other medications may not be miraculous. Tylenol for example. The proton pump inhibitors (PPI's) like Nexium have reduced mortality from peptic ulcer disease but they were marketed for gastroesophogeal reflux disease, too. Simple heartburn. I did instruct my patients to take them only as needed, not chronically.

Always learn as much as you can about your medications and discuss any concerns with your physician. Research ways you can achieve the same results with non-medical interventions such as behavior modifications and supplements. Before stopping any medication you are currently taking, discuss it with your doc first.

SOCIETY'S PERSONALITY DISORDERS

I want to talk about politics. Yes, I know, this site is about health and well-being not politics but it is exactly the current political climate that got me thinking how health (in this case mental health) and our society are connected.

What prompts me to consider this connection was the ground-breaking book People of the Lie by M. Scott Peck, M.D. In a nutshell, he attempts to scientifically analyze evil by advocating for making it a psychiatric illness. He links evil with Narcissistic Personality Disorder but fails to make finer distinctions, such as listing the other personality disorders that contain elements of narcissism. The following

Cluster B (dramatic, emotional or erratic disorders)

• Antisocial personality disorder: a pervasive pattern of disregard for and violation of the rights of others, lack of empathy, bloated self-image, manipulative and impulsive behavior.
• Borderline personality disorder: pervasive pattern of instability in relationships, self-image, identity, behavior and affects often leading to self-harm and impulsivity.
• Histrionic personality disorder: pervasive pattern of attention-seeking behavior and excessive emotions.
• Narcissistic personality disorder: a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.

From Wikipedia

Alzheimer's Dementia and Verbal Fluency

Just an update.
There is a new study out that reinforces my observations that dementia, Alzheimer's Dementia in particular, involves more than just memory loss. In this study, researchers found that speech problems are early markers of AD. These problems worsen with progression of the disease and are labeled as Primary Progressive Aphasia (PPA), "aphasia" being a medical term for the loss of verbal expression.

Word Finding or Word Searching means the inability to immediately speak the correct word. We say "it's on the tip of my tongue" and while it happens to all of us at times, it is more common in people with neurological disorders like AD. Other verbal signs of PPA include a decrease in fluency and gramaticality, repetition, and difficulty naming things.

If someone you love starts developing these symptoms, try to get professional help. It is difficult because the person with early Alzheimer's will be the last one to recognize and acknowledge the problem. In fact, you may find yourself in a defensive position which, believe me, is not fun. The rest of this post is from an earlier one on the same subject.

I am in the age group where many of my friends are now dealing with aging parents. Many of the latter have some form of dementia which complicates not only their health issues but also our ability to help and support them. “Dementia” does not only refer to memory loss. It also includes defects in reasoning, decision making, judgment, and language. Keep all of those factors in mind since there is an interplay between them and the affected person’s own personality.

One difficulty we face is that our parents often refuse to acknowledge that they have a problem. They can be very good at covering-up memory lapses such as joking about them (“if my head wasn't screwed on I swear I’d forget where I put it”) or even denying they have a problem. Sometimes the problem can be evident to us and sometimes they’re good at covering up. This is where I want to take you in this series of blogs: how can you identify dementia using the other symptoms? What does early, untreated dementia mean to you and your relationship with your parent? And what can we do about it?

Dementia is not a disease per se but rather a set of symptoms that cause difficulties in any or all of the following mental capabilities:                                  

1.       Memory

2.       Reasoning

3.       Judgment

4.       Decision Making

5.       Language (not only expressive but importantly, receptive)

Developing these five areas is what growing up is all about. Becoming proficient in them is what being an adult is all about. We gain better judgment because of what we remember that works and does not work. Because of that judgment, based on our experiences, we become better at reasoning and decision making, and “decision making” is the active result of reasoning whether it is in what we say or what we do. In this first part of the series, I want to focus on language or what we say (“expressive”) and what we understand others say to us (“receptive”).

Perhaps a better word than language is communication because only a percentage of what we communicate is auditory while a large part is body language, voice pitch and rate, and facial expression.  For a more detailed explanation, check into Neuro-Linguistic Programming (see “Recommended Reading” at the bottom of this page). In a nutshell, what a person hears is not necessarily what we believe we speak. Older people automatically have a disadvantage since the sense of hearing naturally worsens as we get older. Secondly, people with dementia have poorer memories so what they REMEMBER hearing is often not what was said. Thirdly, there becomes a disconnect between the communication received and that person’s reasoning, judgment, and decision making.  As a result, how they respond (say or do) can be totally unexpected based on what we spoke to them.

Some people naturally have difficulties with this processing and it becomes worse with dementia. We have to be careful: is the unexpected result because of that personality defect, the dementia, or the dementia making the defect worse? One true example: I have a friend whose mother is naturally stubborn about going to seek medical attention. As she gets older, she also needs more help but refuses to believe she has any problems that warrant going to her physician. She also has early dementia and has become lost several times. Still refuses help. When he phoned me last he was actually in town from California and the stress in his voice was undeniable. After helping arrange his mother’s affairs he suggested that he take her to get medical help the next day. She understood this to mean that he considered her weak and unable to take care of herself. She blew up at him and kicked him out of the house.

I think about scenarios like this a lot. Does anyone have any suggestions on how to handle mom or dad in a situation like this? My own advice is if there is more than one sibling involved, that they all stick together and not encourage or enable the demented parent to act on irrational judgments, reasoning, and decision making. Gently correct, be supportive of reasonable actions and words, and try not to blame each other or the parent for bubbles in the road.

Early stage dementia is the best time for medicinal and nutritional intervention. Get the parent’s doc involved. Consider gingkobiloba, Omega-3’s, and Vitamin E, all of which have been shown to help dementia but not necessarily prevent it. Mind exercises are good, too as is exercise and sleep. Consider getting help with anxiety and depression which often accompany aging and dementia itself. 

Click here for more information about dementia: Dementia Pictures Slideshow.

MYTHOMANIA

How can we stay sane in a sociopathic society? How do we create a sane, empowering society when we ourselves have disordered personalities? I try to answer these questions in my newest book Mythomania: A Psychodrama. Think of it as a Prequel to My Worst Thanksgiving Ever since I describe the forces that conspired against me to destroy my clinic, finances, reputation, and eventually my marriage. Are you curious about how Angie ever got to the point where she thought that convincing the U.S. embassy in Nicaragua to abduct Ben away from me was a good idea? Worse yet, that she truly believed what she did was the only right thing to do?

I use Dr. M. Scott Peck's classic People of the Lie as a framework for my book. 30 years ago he tried to marry psychiatry with religion in an attempt to heal not only broken lives but also a broken society. In essence, what happened to me before the events of that Thanksgiving weekend was my own personal My Lai.

While there is precious little hope for People of the Lie, I do believe that we can take measures at all levels towards healing ourselves and our country. At the end of the book I offer a "Treatment Plan" with several suggestions that I feel are necessary for this process to be successful. Once again, enjoy and learn!

BAREFOOT DOCTORS

Coming off of the success of launching my newest book My Worst Thanksgiving Ever, I went back to my previous publications and decided to edit and republish my pamphlet Barefoot Doctors. I updated the links, wrote a new Introduction, and generally cleaned it up by getting rid of obsolete references. I also increased the font size a little in concession to my aging eyes.

Although it has been almost three years since I first published it, we have made very little headway getting the concepts and proposals into practice. That is largely due to the powers-that-be but I am partly to blame. Such grand schemes take effort and time and I have had precious little of both. The full text is available on Amazon for $2.99 but I would like to include snippets on this blog every now and then. Please feel free to leave constructive comments below.

THE PROBLEM

How to ensure that isolated populations receive NECESSARY medical assistance, with an adequate supply of dietary supplements that improve nutritional outcomes of these populations

I would like to address these issues directly but am convinced that eventually all answers need to be integrated together in order to produce a quality, self-sustaining health care model for underserved areas of the world (“USAW”). My current focus will be on Nicaragua for several reasons. Firstly, I live here and while I am not an expert on all aspects of their health care system, I do have an acquaintance with and an appreciation for it.

Secondly, Nicaragua is the second poorest country in the Western Hemisphere (behind Haiti). I do not present my ideas to “show them what is good for them” but rather as an attempt to have this country become a role-model for others; in other words, to be an inspiration.

Thirdly, Spanish is the third most frequent first-language in the world, behind English and Mandarin Chinese. Many of my ideas would not need to be translated to have their most profound effects although my goal is to make this model accessible to all USAW’s.

The question I am addressing is composed of two parts. The first is to ensure that isolated populations receive quality health care. This means adequate primary health care. This issue was addressed by Chairman Mao Zedong in 1965 and is the inspiration for my proposal:

“In the 1930s, the Rural Reconstruction Movement had pioneered village health workers trained in basic health as part of a coordinated system, and there had been provincial experiments after 1949, but after Mao Zedong's healthcare speech in 1965 the concept was developed and institutionalized. In his speech, Mao Zedong criticized the urban bias of the medical system of the time, and called for a system with greater focus on the well-being of the rural population. China's health policy changed quickly after this speech and in 1968, the barefoot doctors program became integrated into national policy. These programs were called "rural cooperative medical systems" (RCMS) and strove to include community participation with the rural provision of health services.”

--From Wikipedia “Barefoot Doctors” (1)

The success of the Barefoot Doctors program inspired the World Health Organization to hold a conference in Alma Ata, Kazakhstan in 1978 where the Alma Ata Declaration was signed unanimously. The declaration addressed several attitude changes that challenged the existing Western-based models (2). Specifically, it called for

1.      local communities participating in deciding health care priorities

2.      an emphasis on primary health care and preventive medicine, and

3.      sought to link medicine with trade, economics, industry, rural politics and other political and social areas.

The second part of the question is concerned with getting vitamins and minerals to these isolated communities. For clarity’s sake, I assume that this is an attempt to integrate preventive medicine measures into this health care model. This issue was not directly addressed by Chairman Mao nor by the WHO participants at Alma Alta but appears to be covered under their emphases on primary and preventive care. If this is a training issue for health care workers, we can integrate it into their education. If it is a matter of logistics, that would be covered under the “supply chain” question and will not be addressed here (although I have my own ideas about that, too).

The Barefoot Doctors died when China changed course and started emphasizing small, family-based businesses as its model for economic sustainability. Ironically, several thousand of the providers who were trained as Barefoot Doctors eventually went on to medical school and became licensed physicians. This is not a bad ending to the story: just one that was unexpected.

How to Think Like a Doctor

My flagship book How to Think Like a Doctor is available as a free Kindle eBook for the next five days. It really is amazing: there are more than 10,000 copies out there. Keep the ball rolling. If you don't have a Kindle, you can download the free Kindle Reader to any PC, tablet, iPod, or smartphone. I personally have over 1400 eBooks and about 1200 were free.

The following excerpt is from the Preface:

I came to Nicaragua originally to teach medical English to Nicaraguan medical students and intended to use this version as their textbook. My eventual goal is to revive Chairman Mao’s concept of Barefoot Doctors and make quality medical and health care available to underserved areas of the world. It is not only a dream of mine but is the logical follow-up to my first non-profit endeavor The Medicine Cabinet, with which we collected, repackaged, and sent medications and medical equipment to areas of need. Our first shipment was sent to the Rwandan refugee camps in Zaire in 1994 and was one of the first humanitarian projects to arrive there since the tragedy was not recognized as a humanitarian crisis by developed nations for several months.

The world desperately needs kind, compassionate, and capable health care workers. Ironically (and sadly), this is the polar opposite of what is happening in the United States now where a “good doctor” is now defined by how quickly he or she charts. I personally do not want to go to the grave with the epitaph “Here lies Michael Mangold, a good doctor because he charted on time.”

Lastly, a portion of the proceeds from the sales of this book will help fund the Barefoot Doctors Project, Nicaragua.

Mangold MD, Michael. How To Think Like a Doctor (A Quiet Revolution) (Kindle Locations 15-21).  Kindle Edition

GET OUTSIDE, PLAY WITH YOUR DOG, AND EAT DIRT

"Atopic dermatitis (AD)" is the medical term for what is more commonly called "childhood eczema." A new study out of Harvard shows that lower levels of prenatal maternal Vitamin D (25(OH)D) correlates with a higher risk of atopic dermatitis in early childhood. The researchers did not find a correlation between Vitamin D intake and early childhood eczema but did find a slight correlation between intake and mid-childhood atopic dermatitis.

In my own practice, we drew Vitamin D blood levels on approximately 1000 patients. ONLY ONE patient had a normal level. All of the rest were below normal. Granted, this was in a predominately White suburb of Milwaukee but the message is clear: get your Vitamin D on. If you can get outside, do it. Observe the normal precautions against sunburn, of course. If you cannot get outside every day, consider taking Vitamin D as a supplement. As always, discuss this with your health care provider first. Personally, I take a fish oil/Vitamin D combination capsule twice a day. Each capsule contains 2,0000 International Units (I.U.) of Vitamin D3 and 600 mg of Omega-3 Fatty Acids. Vitamin D supplementation is also an effective treatment for AD.

Other non-medical treatments (meaning that you don't need a physician's prescription) for AD include probiotics (the greater the variety of bacterial strains the better), moisturizers, and possibly a gluten-free diet. Exposure to ultraviolet light also helps flare-ups.

Prevention entails letting "kids be kids." Those who are raised in a "sanitized" environment develop eczema more often than children who habitually play outside. In the dirt. And children who are exposed to dogs while growing up also have a lower risk of developing AD.

So the moral of the story is this: get outside, play around, and pet your dog. Sounds like a prescription for a good life anyway.

My Worst Thanksgiving Ever

I am taking a break from writing about health issues here to promote my new book My Worst Thanksgiving Ever which is an account of the abduction of my son Benjamin by the U.S. embassy in Nicaragua over the Thanksgiving weekend of 2013. Even worse, I was subsequently blamed for "abandoning" him despite being mugged 5 times in two nights trying to find him. That just confirms one of my sayings: No Good Deed Goes Unpunished.

So please do me a favor and download the book. It will be available for free for the next three days. You can download a free Kindle Reader here. There are also free versions for your iPhone or Android device.

Download, read, relate, and pass on the news. I really appreciate it.

Wheat Belly

This is a re-post from 2014. The advice is timeless.

Anyone who has followed my dietary advice knows that my first recommendation is to ditch the wheat and all other products that contain gluten. When I talk about "diet" I don't mean losing weight necessarily (although that will follow) but rather your nutritional lifestyle. My revelation about going wheat-free came about with a talk one day at a Starbucks with the author of the book Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, William Davis, MD. In my own experience, I lost 30 pounds in six weeks when I first started the diet then another 10 after I incorporated a "cheat day" once a week. A cheat day is the one day a week (I chose Friday) when I would eat what I wanted and as much as I wanted. Despite the fact that I never got hungry following Dr. Davis' advice, my metabolism did eventually slow down and I revved it back up by pigging out one meal a week.


But the "diet" part is actually two-fold: avoid gluten AND avoid sugars and simple starches. While "Wheat Belly" measures the effects of carbohydrates on a person's insulin response, I found it easier to stick with the standard Glycemic Index, avoiding "fast carbs" and consuming only "slow carbs." Those phrases were popularized by Timothy Ferriss in his book The 4-Hour Body . Warning: not for the faint-hearted. He also gave me the idea of the cheat day. The thing I like best about Ferris is that he tries his ideas on himself first. This just supports Dr. Mangold's Rules for Good Living No. 2: Never Trust a Fat Dietitian.


Search for "Glycemic Index" and you will find no lack of sites that not only explain what the term means, but also give you lists of foods that are low and high GI. Sugars and simple starches are highest, while more complex veggies are low. Simply put, I did fine with cabbage, asparagus, kale, spinach, nuts, and legumes. Dr. Davis narrows the choices down even more but I still lost weight eating non-recommended foods. He also has a Wheat Belly Cookbook. As I said, I never went hungry nor should you.
Here's to your start of healthy eating!

A MESSAGE FROM THE HEART

I had a heart attack (acute myocardial infarction or AMI in doc-speak) in February 2015. The pain was atypical. Most AMI victims describe their pain as in the center of the chest (substernal), “crushing” or “tight,” and with radiation of the pain to the left shoulder and/or arm. My pain was sharp, very much like the pain I had when blood clots in my right leg broke off and went to my right lung (pulmonary emboli). It was right-sided, and did not radiate anywhere. Because it did not look like a regular heart attack, I took two aspirin and went to bed to “sleep through it.” The aspirin was a good idea; not seeking medical attention was stupid..

I finally went to a physician a month later. An EKG showed that I had heart damage to the lower lateral part of the left ventricle (inferolateral). A cardiac catheterization showed I have a 30% blockage of my left anterior descending artery (The “Widow Maker”) and an echocardiogram showed damage to a portion of my heart downstream (distal) to the block.

Because the blockage was only 30%, I didn’t need a stent or bypass surgery. My cardiologist started me on the “ASA protocol" for heart attack victims: a baby aspirin a day, a statin drug, and an ACE inhibitor. ASA is also the medical abbreviation for aspirin which is acetylsalicylic acid. Statin drugs like atorvastatin are cholesterol medications that have been found to decrease the likelihood of subsequent heart attacks. Angiotensin Converting Enzyme inhibitors lower blood pressure, relax arterial smooth muscle tone, and treat congestive heart failure, a common complication of AMI’s. Most patients are also started on a beta-blocker. I was already taking metoprolol for high blood pressure and a heart arrhythmia so the cardiologist doubled my dose. I feel like a walking pharmacy but when you consider the alternative…

A similar event recently happened to a friend of mine who was smart enough to get medical attention immediately. According to his facebook reports, he was actually undergoing angioplasty when a big thrombus broke off and occluded a distal artery completely. The cardiac team was able to minimize damage immediately though. His take home message: don’t take chest pain lightly. Better to look silly if it is nothing than to be dead. I heartily agree.

I’ve reconsidered my supplements since the heart attack. If you follow my regimen, please note that these are what I take, and that even supplements have side-effects. For example, I now take 1,000 International Units of fish oil daily. You can substitute with krill oil if you think that squeezing oil out of a fish’s body is disgusting. Fish oil has amazing benefits, including positive effects on cholesterol, skin, neurons, and arterial smooth muscle. But it can “thin” your blood so there is a slightly increased risk of bleeding events. As for me, I will take that risk.

Antioxidants are important for cardiac health, too. I now take 500mg of Vitamin C twice a day as well as 400 IU’s of Vitamin E twice a day. More than 800 IU of E provides no added benefits so don’t waste your money. Take all vitamins with meals. Fat soluble supplements like fish oil and E are better absorbed with meals that contain the greatest amount of fat of the day.

Other supplements I take include Vitamin D (a blood test showed I was low), probiotics, B-complex, and enzymes. I am taking a look at another enzyme, serrapeptase, to see if it will help resolve my clot. Briefly, serrapeptase (Serratio Peptidase) is a proteolytic enzyme, which means that it digests protein. It is produced by bacteria in the gut of silkworms and is used to digest their cocoons. Preliminary research indicates that Serrapeptase may even help inhibit plaque buildup in arteries, thereby preventing atherosclerosis (hardening of the arteries) and a resulting heart attack or stroke. So far, the research does seem to be preliminary but I am going to be my own guinea pig. You can order serrapeptase from Amazon.com. I haven’t found it in a health food store yet. I don’t plan on taking more than one capsule a day since more than 40,000 IU daily is not indicated.

No matter what the cardiac cath shows next year, I also plan on continuing the ASA/beta-blocker protocol. It is a life saver.

MY WORST THANKSGIVING EVER

   It has been a rough time for me since my last post. I have been through a lot and will eventually tell all in a screenplay I am now writing called "Elkton Rules: The Little Prison That Thought it Could." I found a director who is interested in it. More later.

   In the meantime, I am finally getting my book My Worst Thanksgiving Ever published as installments. The first three chapters are available for only $2.99 which is the lowest price I could negotiate with Amazon. Please buy it if you can, and spread the word.

   I know this isn't a health-related post but in a way, publishing the book is doing wonders for my mental health. So far, the only version of what happened to me in Nicaragua has been Angie's and this is my chance to set the record straight. It isn't just a matter of telling one version of the story. It is the ONLY version since she was not there when it happened. It is amazing how powerful hearsay can be when it is made up.

   I have to learn the hard way, but discovered that there are easier ways to increase the traffic to your blogs. In my opinion, there are great ways to spread my messages about health and nutrition. For example, check out Grow Traffic and see what they have to offer you.

  Enjoy the book and if you have any constructive criticisms about for me, let me know.
Thanks.