05/30/06 NEWSLETTER carlstonmd.com
Dear Patients HOME

I am in the midst of a very busy run of medical meetings so the office will be closed the next few days. This one is the American College of Sports Medicine�s Annual Meeting. We�ll be back in the office Monday.

Best, Michael Carlston, M.D.
www.carlstonmd.com 
707-545-1554
In This Issue: INDEX
  • FLAME RETARDANTS AND OBESITY
  • VITAMIN D AND ASTHMA
  • NIH MULTIPLE VITAMIN/MINERAL CONSENSUS CONFERENCE
  • TICK TIME
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    FLAME RETARDANTS AND OBESITY TOP

    Flame retardants do their job well, but like every chemical, they don’t do just one thing, especially when absorbed into complex biological organisms (like us). Nerve damage, carcinogenic effects and possibly genetic damage are on the list. We can now add the possibility that they are another factor in the obesity epidemic.

    Scientists studying rats have learned that PBDE flam retardants make rat fat cells resistant to insulin. In rats, as in humans, insulin resistance keeps the body from absorbing glucose and is part of a vicious cycle of weight gain. There should be a witticism in here about burning fat but it escapes me.
    VITAMIN D AND ASTHMA TOP

    Extending investigations of this amazing vitamin, researchers learned that it seems to prevent asthma. Mothers who ate more vitamin D containing foods during pregnancy bore children less likely to wheeze or develop asthma. For every 100 i.u. consumed by a pregnant woman, her child’s risk of later developing asthma dropped 20%. Once again, recommendations that we all consume more vitamin D look wise. Hopefully the groups that set official standards will make revisions ASAP.
    NIH MULTIPLE VITAMIN/MINERAL CONSENSUS CONFERENCE TOP
    Two weeks ago the NIH hosted a meeting to develop an official position and recommendations on MVM use. I attended the meeting because I wanted to hear the evidence myself. It was very interesting for many reasons.

    First, many of the “generally accepted” concerns about vitamins and minerals - E and bleeding, and beta carotene and cancer risk (except lung cancer in smokers) for example, were convincingly refuted by the weight of quality evidence.

    Second, there was a great deal of very positive evidence presented, including much that has not been published yet. Included in this category were data about the cost reducing impact of taking MVM. One most compelling finding was the calculation that if the Americans who presently take MVM sporadically converted to daily use, they each save nearly $900/year annually in health care costs over and above the expense of the MVM. This would save the US economy $60 billion annually in health care costs.

    Thirdly was the interesting basic science discoveries and theories about the impacts of various vitamins. Dr Bruce Ames of UC Berkeley proposed a very interesting theory of carcinogenesis resulting from transient nutrient deficiencies - the more times it happens, the more likely that a cancer might be created that the body can not destroy.

    Then, after returning home, I was very surprised to read the panel’s official statement. It seemed that they attended a different meeting than I, finding relatively little positive evidence and voicing concern over toxic effects of excessive vitamin consumption. As one speaker told us that between 65 and 100% of Americans are deficient in vitamin D, the emphasis seemed wrong.

    One of the presenters who is chairman of the department of epidemiology at Harvard pointed out that adverse effect surveillance programs are not relevant to MVM because acute toxicity is rare, but well defined and long term ill effects would be too subtle to identify in this way. So, I had another surprise when I saw that the panel had made this recommendation.

    I think part of the problem is the usual academic disconnect. One presenter told us that in his institutions’ effort to summarize the research on vitamin and mineral supplementation prevention of chronic disease, they reviewed 10,400 articles ----- but only felt 63 (yes 63) were usable. I was extremely unimpressed with conclusions so derived.

    My conclusions from the meeting were:
      There is a great deal of evidence of MVM supplementation efficacy
      The likely adverse effects are rare
      More research is needed
      It is foolish not to take some modest MVM
      It is wise to consider more substantive, individualized MVM supplementation

    TICK TIME

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    I also acquired a highly practical reminder of seasonal health risks on the way to the airport. My car broke down. I pulled off the highway to wait safely at Olompali State Park. I walked 10 yards through some tall grass to get the correct spelling of the name of the park for the tow truck. Then, while I waited in the car, I found five or six ticks on my legs. Remember that this is a good season to practice your tick inspection technique on family and friends. They are nasty, disease-laden, parasites, so get them off before they can harm you.
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