What to do About Heartburn (Reflux)

You relax on your sofa after dinner and watch a movie.  Then you start tasting acid in your throat and you feel like your food is coming back up on you.  This is often referred to as Heartburn and it is often diagnosed as Gastroesophageal Reflux Disease (GERD).  More than 50 million Americans experience  this condition frequently.  But why does it happen?Conventional medicine thinks that the problem is caused by too much hydrochloric acid secretion and it is typically treated with drugs that block stomach acid.  Is this correct and what are the effects of these drugs?

The fact is that esophageal reflux is likely caused by too little rather than too much stomach acid, which then results in insufficiently digested food being pushed back up through the esophageal sphinctor towards the throat.  This bolus of undigested food carries the limited amount of acid from the stomach back up into the esophagus, thus irritating the lining of the throat.  We know that it takes a tremendous amount of the body’s energy to produce hydrochloric acid and that is why many of us are producing too little hydrochloric acid.  This is especially the case as we get older.  See the following graph from the book, Why Stomach Acid is Good For You, by Jonathan Wright:

 

Reflux (GERD) is typically treated with drugs that block acid production, including proton pump inhibitors like omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), and pantoprazole (Protonix).  In fact, such proton pump inhibitor drugs are among the most prescribed drugs and last year over 147 million prescriptions were filled for such drugs.  But these drugs have lots of side effects and they don’t get to the cause of the problem.

One reason these proton pump inhibitor drugs have such serious long term negative effects is that they block your ability to properly break down and digest your food.  This prevents you from absorbing many of the nutrients in the food.  Along with pancreatic enzymes, hydrochloric acid secreted in the stomach is part of the chemical process in our digestive tract that breaks down our food.  This can lead to deficiency of calcium, magnesium, zinc, iron, sodium, beta-carotene, folic acid, vitamin B1, and vitamin B12.  This, in turn, can lead to increased risk of osteoporosis, hip fracture, and anemia.

Another reason for problems with PPIs is that stomach acid helps control the growth of certain kinds of bacteria.  Therefore taking these drugs can result in bacterial overgrowth of the stomach and small intestine, increased risk of Costridium difficile infections, and of bacterial infections such as pneumonia, Cympylobacter, and Salmonella.

In addition, PPIs increase the risk of kidney and heart problems.  And while it is known that GERD increases the risk of Barrett’s esophagus and of esophageal cancer, despite widespread usage of PPIs in the United States, there has been an increase of these conditions.  Therefore these acid blocking drugs are not reducing the incidence of esophageal cancer.

 So if these acid blocking drugs are not the answer, what should we do?  For many of us the answer may be to take supplements of betaine hydrochloric acid to enhance the digestion and breakdown of our food.  Digestive enzymes may be needed as well. This strategy should be coupled with some dietary changes and nutrients that will help to rebuild the damaged lining of the digestive tract.  But don’t just stop taking your acid blocking medication without speaking to your doctor and slowly reducing the dosage and weaning yourself off.  Schedule a nutrition consultation and Dr. Weitz can guide you through a nutrition program to help your body to heal and overcome this reflux condition.

 

Part of this blog has been based on a chapter on Over-the-Counter Remedies for Digestive Health: Potion or Poison? by Jerry Hickey and Gerard Mullin in the book Comparative Gastroenterology, edited by Gerard Mullin and published in 2011 by Oxford University Press.

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Magnesium Prevents Stroke

 
A recent meta-analysis of studies on magnesium reveals that  the increased intake of magnesium is associated with decreased risk of stroke.  (Larsson SC, Orsini N, Wolk A. Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies. Am J Clin Nutr 2012;95:362-6.)
 
Magnesium supplementation has been shown in other research to reduce blood pressure, fasting insulin levels, have favorable effects on blood sugar and blood lipid concentrations and reduce the susceptibility of lipoproteins to peroxidation.  This current study found that an increased intake of 100 mg of magnesium is associated with an 8% decreased risk of stroke.  Rich food sources of magnesium include green leafy vegetables, beans and whole grains.  I recommend taking at least 200 mg of magnesium per day through either your multivitamin or by adding magnesium glycinate or citrate, in addition to eating a healthy diet.  Take 400-600 mg divided into 200 or 300 mg taken several times per day if you are dealing with high blood pressure or muscle spasms.
 
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Kidney Disease From Pain Killers

You’ve probably been told that over the counter pain killers, esp. NSAIDS, like ibuprofen, and Tylenol, are extremely safe.  Well, not exactly.  More and more evidence has been accumulating over the last few years about how dangerous these drugs are.  NSAIDs (non-steirodal anti-inflammatory drugs) increase the risk of high blood pressure and chronic heart failure, irritation and ulceration of the stomach, and can cause liver and kidney problems.   We’ve also known that aceteminophen (Tylenol) can put the liver under stress.  Now we are learning that aceteminophen can also lead to kidney problems.  

A form of kidney disease known as analgesic nephropathy results from the regular use of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) and other anti-inflammatory medications, according to the  National Institute of Diabetes and Digestive and Kidney Diseases .   Analgesic nephropathy is a chronic disease that results from taking pain relievers over long periods of time and results in gradual damage to the kidneys that eventually leads to kidney failure and the need for dialysis or kidney transplant.   It is estimated that 4 out of every 100,000 people in the US will develop analgesic nephropathy.  Acetaminophen is also a leading cause of liver failure in the US.

I understand that there are times when NSAIDs and pain killers are necessary, but you should try alternatives whenever possible, including chiropractic care, ice, electrical muscle stimulation, cold laser, natural anti-inflammatory supplements  (such as turmeric, ginger, Bosellia serrata, capsicum from hot peppers, proteolytic enzymes, vitamin D, fish oil, and anti-inflammatory medical food), and Glucosamine sulfate (with or without chondroitin sulfate and/or MSM)for joint, ligament, and tendon healing.   Speak to Dr. Weitz or Amber about additional information on these supplements.

 

 

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Fish Oil Increases Effects of Weight Training

A new study documents the beneficial effects of fish oil supplements for elderly (average age 64) women who are also engaged in a strength training program.  This adds to the growing list of impressive benefits of fish oil supplements. (Rodachi C, et al. Fish-oil supplementation enhances the effects of strength training in elderly women. Am J Clin Nutr 2012;95:428-36.)

The nervous system is composed primarily of fats and fish oil supplements, which contain omega 3 fats, have been shown to improve nerve transmissions (improved nerve conduction velocity).  Fish oils (containing EPA and DHA) have also been shown to improve heart muscle contactility.  Therefore, it is reasonable to suspect that if fish oils become incorporated in the nervous system and the muscles that the muscle might be able to contract better or more forcefully. 

This study demonstrates that when older women engaged in a weight training program and also took 2 grams per day of fish oil supplements for 90 days, they had greater increases both in strength and in functional capacity (ability to stand up from a chair).  There was a significant increase in the strength of various muscles as measured by their peak torque output in those who both engage in weight training and took the fish oil over those who just did the weight training.  Likewise these muscles also contracted more quickly and these women had more functional strength as demonstrated by the ability to rise from a chair using their leg muscles.

Based on this and many other studies, I highly recommend that you not only eat fatty fish such as wild salmon twice per week, but that you also supplement with a high quality fish oil supplement on a daily basis.

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Eating multiple small meals

I advocate eating a small meal or snack every 3 hours or so throughout the day. This allows blood sugar levels (and insulin levels) to stay more consistent through the day and reduces the carbohydrate cravings that result from big dips in blood glucose.  This facilitates the process of achieving and maintaining optimal bodyfat levels.

A recent study published in the February 2012 issue of the American Journal of Clinical Nutrition, Less frequent eating predicts greater BMI and waist circumference in female adolescents, backs this view that eating small meals or snacks facilitates leanness.  This study examined the habits of female teenagers and discovered that those who ate less frequently had a higher body mass index (BMI) and a larger waist circumference.  This contrasts with other articles that have attributed frequent snacking as a risk factor for weight gain. 

 

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The Plastic Code

The Plastic Code

 
Plastic bottles and containers are categorized based on what they are made of and how they can be recycled. This is given a number contained in a triangle on the bottom. This code allows us to know which ones are unsafe and to avoid.  

1 (PET) Polyethylene terephthalate is used in many water and soft drink bottles and is considered safe for one time use and if not exposed to heat but will degrade over time and should not be reused.

2. (HDPE)  High-density polyethylene is used for opaque or cloudy containers of personal care products, vitamins, detergents, etc. It’s considered safe under normal conditions but will degrade over time.

3. (PVC)  Polyvinyl chloride is commonly found in some food wrap, plastic utensils, shower curtains, plumbing materials, computer keyboards, credit cards, and many other products. PVC should be avoided whenever possible.

4. (LDPE)  Low density polyethylene is found in most food wrap now, shopping bags, CD cases, and most product packaging, and is considered safe. 

5. (PP)  Polypropylene is found in bottle caps, diapers, kitchenware, yogurt containers, ropes, and carpets, and is considered the safest plastic for human use. 

6. (PS)  Polystyrene, aka styrofoam, is used in take-out food containers, drinking cups, egg cartons, and building materials. Polystyrene contains carcinogens and is known to degrade and leach toxins when exposed to heat or oil.  It should be avoided whenever possible.

7. (O) “O” stands for Other and this category includes plastics other than the first six categories. This group includes polycarbonate, acryllic, fiberglass, nylon and environmentally friendly hybrid plastics.  Many of these are safe, though this category also contains polycarbonate bottles with BPA, which is an endocrine disrupting substance and is to be avoided.

(This information is extracted from the wonderful book that I highly recommend, The Healthy Home, by Dr. Myron and Dave Wentz published by Vanguard Press this year (2011).

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Reduce Toxins in Your Home

We should reduce or eliminate toxic chemicals in our homes, since these chemicals may cause birth defects and increase our risk of chronic diseases such as autoimmune diseases, allergies, asthma, diabetes and cancer.  In addition, many of these toxic chemicals are endocrine disruptors.  Endocrine disruptors interfere with hormones and have many potentially negative effects. In fact, reducing our exposure to chemicals in our environment was one of the strongest recommendations to prevent cancer in the American Cancer Society’s report to the President on Cancer that was published in May 2010.

http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf

There are many sources of toxic chemicals in your home, from the paint and building materials used to make your home, to carpets, to furniture (contain flame retardant chemicals), to cleaning supplies, to chemicals used on your yard, to personal care products like shampoos, shower gels, makeup, antiperspirants, and skin care products.  While I cannot address all of the toxic chemicals that may be found in each of these substances in this blog, I wanted to list several substances to avoid if found on labels of  personal care products such as soaps, shampoos, skin care products, etc. that contain any of the following:                        

  1. Parabens (methyl, propyl, butyl, and ethylparaben)  
  2. Pthalates*                                                                                                                                                           
  3. Mercury
  4. Diethanolamine (DEA), (also MEA and TEA)
  5. FD&C Synthetic colors, (such as red dye #4, etc.)
  6. Propylene Glycol (PG)
  7. Polyethylene Glycol (PEG)
  8. Sodium laurel sulfate
  9. 1,4-dioxane
  10. Coal tar
  11. Toluene
  12. Phenylenediamine
  13. Petrolatum
  14. Talc
  15. Benzenes
  16. Formaldehyde
  17. Quaternium-7, 15, etc.

* Unfortunately, pthalates are often not listed on the ingredients, since the federal regulators consider them inert substances.  

(This list was modified from the wonderful new book on home toxins,  Wentz and Wentz, The Healthy Home, 2011)

In addition, you should avoid any product that contains perfume, as these contain pthalates.  Instead, choose fragrance free products whenever possible.  In order to avoid all of the above chemicals, you will need to go to stores that carry non-toxic products like Whole Foods, Trader Joes, and the Santa Monica CO-OP, though you should not assume that all the products contained in these stores are non-toxic either, though generally they will have less.  For example, a deodorant that brags about being paraben and aluminum free lists propylene glycol as the first ingredient, though arguably this is a somewhat less toxic substance.

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Prescription Drugs Kill

For the first time in history in the United States, drugs exceeded car accidents as a cause of death in 2009.  ( see http://www.latimes.com/health/la-me-drugs-epidemic-20110918,0,3886090.story)  This increase in drug deaths is fueled mainly by an increase in deaths cause by prescription narcotics.  Some of the prescription drugs being abused the most are pain killers and drugs for anxiety.  Some of the drugs involved in the most overdose deaths are Vicodin, Oxycontin, Xanax, Soma, and Fentanyl.  According to this article in the September 17 Los Angeles Times is that “such drugs now cause more deaths than heroin and cocaine combined.”

When are we going to stop treating so many problems with drugs instead of trying to find the root cause of these problems?  Isn’t it obvious that we are overmedicating people?  Is the reason for your anxiety that you have a Xanax deficiency?  Prevention, adopting a healthy lifestyle, fitness,  stretching,  good posture, and chiropractic care are ways to reduce the need for many of these drugs, such as Vicodin and Oxycontin.  This report should be a wake-up call to change our health care system from a diagnosis and prescription model to an emphasis on prevention.

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Portfolio Diet Reduces Cholesterol

A new paper in JAMA demonstrates that placing individuals who have high cholesterol on a  diet that includes .94 grams of plant sterols/1000 calories, 22.5 grams of soy protein/1000 calories, 9.8 grams of viscous fibers/1000 calories from oats, barley, and psyllium, 22.5 grams/1000 calories of nuts and seeds per day.  (http://jama.ama-assn.org/content/306/8/831.short)  They were also encouraged to eat legumes (peas, beans, and lentils).  Participants only lost about 2-3 lbs of bodyweight but saw significant reductions in LDL (the “bad” cholesterol) and blood pressure without a lowering of HDL (the “good” cholesterol).  This study shows the power of lifestyle changes to reduce the risk of chronic diseases, like heart disease.

Our FirstLine therapy modified Mediterranean diet also includes soy protein, 2 grams of plant sterols, targeted neutraceuticals, and an emphasis on fiber, nuts, and legumes and there have been published studies showing even more significant reductions in LDL cholesterol, bodyfat percentage, triglycerides, CRP, and increases in HDL cholesterol. (http://www.lipidjournal.com/article/S1933-2874(09)00422-X/abstract)

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Fiber Reduces Breast Cancer

A new study published in the American Journal of Clinical Nutrition found that eating more fiber reduced the risk of breast cancer.  This is because women who eat more fiber have lower circulating levels of estrogen, which reduces the risk of breast cancer.  This also adds to other research on the benefits of fiber, including reduced risk of obesity, lower cholesterol levels, and reduced risk of colon cancer.

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