Michael Carlston, M.D. - Family Practice & Complementary Medicine

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

August 17, 2008

Dear Patients.

I hope you are enjoying your summer. Thankfully, after a very difficult June and July, the fires are not so much of a problem the last couple of weeks. We probably still have a long time before the rains return, however, so keep your fingers crossed.

The big news around my office is that the company I had been writing for, laid off most of their employees and everyone on their expert panel (including me). Their problems were foreseeable, but this is still disappointing, as I really enjoyed the writing. Simultaneously, I received requests to revise my chapter in the most popular medical school textbook on alternative medicine for the upcoming 4th edition and to review more research submissions to medical journals. Those requests immediately vaporized the new “free time”, and provided additional writing opportunities. I also started working on a general health book, which will cover material similar to this newsletter and the material I wrote for Veria. My plan is to move ahead on the book quickly, as my contract with Veria could resume early next year.

Best
Michael Carlston, MD
www.carlstonmd.com

Food You Can Trust
Osteoporosis Drug- New Adverse Effect

Food You Can Trust
Food safety and quality are becoming very big problems. Before I left on vacation in early June, the big news about food was the salmonella outbreak. After my return two weeks later, this was still a news item, because the cause was still mysterious. There were all kinds of theories as to where the contamination came from – tomatoes, peppers, cilantro, basil??? The FDA warnings about this outbreak managed to depress tomato sales by nearly 20%. No mean feat during tomato season. Tomato farmers (and eaters) weren’t real happy, because it was very quickly evident that tomatoes were not the cause. It turns out that the problem was jalapeño peppers.

Following the advice to increase fish consumption to be healthier, many Americans have turned to tilapia, because it is cheap and widely available. The only fish we eat more than tilapia is Atlantic Salmon. To get a better idea of just how much of the right types of oils various kinds of fish contained, researchers at Wake Forest University Medical Center decided it would be good to collect data from a world-wide sample. As tilapia has so suddenly jumped so far up the popularity list, they were disappointed to discover how badly it fared in their testing. The oils in tilapia are worse than your average mega-hamburger, bacon or even a couple of donuts. The American diet has way too much in the way of omega-6 oils. Salmon and most fish have very low levels of omega-6 oils, but very high levels of the omega-3 oils shown to treat and prevent many diseases. The problem with tilapia is that it is essentially all farm-raised and fed corn instead of the omega-3 laden plankton diet of wild tilapia.

You may be interested to learn that this same shift towards elevated levels of “bad” oils is also seen among land animals. Wild game usually has much higher levels of unsaturated fats than the same animals when domesticated. This is influenced by physical activity as well as diet.
Domesticated, corn-fed animals, whether they are aquatic or land animals, are full of omega-6 oils. The problem is not the animals; it is us, and the way we mess them up with our cost-cutting industrialization of the food supply.

I need to mention that the reason Atlantic salmon is #1 on the list of American fish consumption is because Atlantic salmon grow very fast, making these fish ideal for, you guessed it, fish farming. Several years ago while traveling in Alaska I was disturbed to learn that fishermen there are catching more and more Atlantic salmon. These fish are in the wrong ocean because they escaped from fish farms. As they grow so fast and spawn repeatedly, there is significant concern that they will eventually displace the local populations of Pacific Salmon.

What are the solutions for all these problems? The best idea is to eat locally. Industrializing food makes it less nutritionally healthy, leads to problems with bacterial contamination and fuels the rise of resistant bacteria. At the very least, if you eat locally and there is a problem with the food, you will learn about it before it becomes the latest summertime mystery story.

Osteoporosis Drug- New Adverse Effect
The medical tendency to prescribe medications while overlooking equally effective and more fundamentally important simple measures like diet and exercise may be most prevalent in osteopenia and osteoporosis. Far too often these patients, most often middle aged or elderly females, have been prescribed a drug like FOSAMAX, without looking into dietary or lifestyle factors contributing to poor bone health. We have another reminder why this is foolish.

A study of 1685 women (719 with atrial fibrillation and 966 without) found that women who had used FOSAMAX (alendronate sodium) were twice as likely to develop atrial fibrillation. We have no data on other osteoporosis drugs and so do not know if this risk is limited to FOSAMAX.

Another FOSAMAX problem has also come to light. This one seems to apply to all drugs in the same class (bisphosphonates). A small percentage of women who use these drugs long term have suffered abrupt and dramatic fractures, splitting their thigh bones in half, without the trauma (e.g., car accident) that typically causes fractures like this. Healthy bone is always being broken down and remade. Our healthy bones adapt to the stresses we place on them and are strong but just a bit flexible as well. This group of antiosteopenia drugs slow the breakdown part of the cycle, so the bones then become denser. As we saw years ago with fluoride supplementation for osteoporosis, although bones get thicker they can simultaneously become more brittle and MORE likely then to break. Ooops.

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