Sunday, June 1, 2008

Vitamin D & Breast Cancer; The Leptin Diet reviewed

Staying Healthy with …..
Natural Wellness Choices

June 1, 2008,

In this issue:

Vitamin D status dramatically effects breast cancer outcomes
The Leptin Diet

Inadequate Levels of Vitamin D Linked to Sharply Increased Odds of Cancer Spread and Death

Vitamin D deficiency is common among women diagnosed with breast cancer, and it may raise the risk of cancer spread and death, researchers report.

In a new study, women with vitamin D deficiency at the time of breast cancer diagnosis were:
94% more likely to experience cancer spread
73% more likely to die over the next 10 years compared to women with adequate vitamin D levels

More than 1 in 3 women studied had a vitamin D deficiency.

The findings are scheduled to be reported at the annual meeting of the American Society of Clinical Oncology in Chicago.

Vitamin D Puts Brakes on Breast Cancer
Vitamin D is found in some foods, especially milk and fortified cereals, and is made by the body after exposure to sunlight. It is necessary for bone health, and some studies suggest that it may protect women from developing breast cancer in the first place.
The author of the study, Goodwin, points out that from a biological point of view, it makes sense that vitamin D would put the brakes on breast cancer development and spread. "Breast cancer cells have vitamin D receptors, and when these receptors are activated by vitamin D, it triggers a series of molecular changes that can slow down cell growth, cause cells to die, and make the cancer less aggressive," she says.

For the new study, Goodwin and colleagues measured vitamin D levels in the blood of 512 women diagnosed with breast cancer in Toronto between 1989 and 1995. They were followed for a median of 12 years.

Vitamin D Deficiency Linked to Poor Breast Cancer Prognosis
After 10 years, 83% of women with adequate levels were alive without signs of cancer spread (metastasis) vs. only 69% of women with vitamin D deficiency. Most of the deaths were from breast cancer.

Vitamin D Testing & Optimal Dosing of Vitamin D
At the Hotze Health and Wellness Center we routinely monitor the vitamin D status with the 25 – Hydroxy Vitamin D level. Some physicians are not aware of which test to order – it should be the 25-OH Vitamin D also written as 25-hydroxy-vitamin D3 level.
If you have not had your vitamin D level checked, I would suggest you take 2000 IU of Vitamin D. Most need more than this dose to be in the optimal zone; however, You should not take more without knowing your blood level. Too much vitamin D can be harmful just like too little. We try to keep the blood level between 50 and 100.
Goodwin and colleagues are now trying to confirm the findings in a second, similar study; results are due by the end of the year. If confirmed, the next step will be a study to determine whether giving supplements actually lowers the risk of recurrence and death in women with breast cancer.

The Leptin Diet
Do you eat after dinner?
Do you snack between meals?
Do you eat a breakfast containing a lot of protein?
Do you tend to eat fast?
Do you regularly eat products with sugar or made from flour such as bread, pasta, pizza, cereal, cakes, cookies, crackers or tortillas?
Do you drink soft drinks? Regular or diet?
Is your waist size (at belly button level) >40 inches (>102cm) for men, and a waist size of >35 inches (>88 cm) for women? (see Appendix A)

If you answered yes to these questions you may a problem you have never heard of: leptin resistance

I recently read “The Leptin Diet” by Byron J. Richards. Before I read this book I had heard of leptin and knew it was involved in fat metabolism; however, I did not appreciate how central it role is. Byron Richards shows that the hormone made by our fat cells called leptin plays a crucial role in our overall health. Leptin also effects our ovaries, thyroid levels, pancreas and pituitary and the brain itself.

One major paradigm shift I have made is that I now think of fat as a major part of our endocrine system. We should start referring to our endocrine system as consisting of our thyroid, ovary, adrenals, pancreas and …fat. Leptin resistance explains a big part of what we address every day in our office. We are not just addressing the age related decline in the production of some hormones but the decreased utilization of all hormones including thyroid and testosterone due to the global hormone resistance produced by leptin resistance.
It is incorrect to assume that if an individual takes Armour thyroid that their weight issues will always resolve. Leptin resistance develops when we keep our triglyceride levels up with too much simple carbohydrates, eating too late in the day and by eating too frequently. I would recommend everyone read this book; especially those who wish to lose weight, lower triglycerides, reduce inflammation (i.e. the CRP) or slow the aging process.

How Leptin Problems Develop
Excessive Sugars à Triglycerides increase à Triglycerides block leptin entrance into the brain causing leptin Resistance à Body Acts like it is Starving: Hunger goes up; thyroid function is down regulated à Fat Cells swell as a result of leptin resistance and this produces low thyroid function à Swollen fat cells activate the inflammatory cascade via NF-kappa B activation which results in the production of adipokines à Inflammation results in global hormone resistance including insulin resistance and peripheral hypothyroidism due to the inhibition of the conversion of T4 to T3 à inflammation and hormone resistance produce the clinical pictures we see daily such as obesity, heart disease, depression, fatigue and premature aging
The pathway to health is to avoid simple sugars, eat protein with complex carbohydrates and work with the circadian rhythm of our body which likes nutrition to be robust in the morning and sparse in the evening. These concepts are summarized in the Five Rules.

5 Rules for Managing Leptin:

Rule 1: Never eat after dinner. Allow eleven to twelve hours between dinner and breakfast. Never go to bed on a full stomach. Finish eating dinner at least 3 hours before going to bed. Leptin follows a 24 hour pattern: it is highest in the evening hours and peaks late at night. It coordinates the function of melatonin, thyroid hormone, growth hormone, sex hormones and the immune system to carry out rejuvenating sleep.

Rule 2: Eat three meals a day. Allow 5-6 hours between meals and do not snack
Most advise eating 5-6 small meals a day or to snack between meals to maintain a steady blood sugar level and to keep the metabolism stoked with food. It is vital to create times during the day when triglycerides are cleared from the blood. If triglycerides build up during the day, they physically impede the entry of leptin into the brain causing leptin resistance.
When we snack we cause a rise in insulin which shuts off our fat burning mode.

Rule 3: Do not eat large meals. Eat slowly

Rule 4: Eat a breakfast containing protein. A high protein meal can increase metabolism by thirty percent for as long as twelve hours (the calorie burning equivalent of a two to three mile jog.) The two signs of a poor breakfast are 1) being unable to make it five hours to lunch without food cravings or a crash of energy and 2) being much more prone to leptin resistance later that afternoon or evening, a condition that sets in motion strong food cravings.

Rule 5: Reduce the amount of carbohydrates you eat
The whole purpose of the Leptin Diet is to create energy and metabolic efficiency to the body. Those with normal weight will get more energy from it and those who need to lose weight will find it will help normalize weight. Richards states that a person needs to be in a normal leptin mode for a good 6 months before the new set point is truly in place. There may be numerous temptations that divert one from the fat-burning mode but we need to stick to the five rules. Our fat cells are waiting to refill themselves at a moments notice. We must avoid breaking the Five Rules to prevent going into the Famine Recovery mode in which we try to put on extra fat to protect us from the next ‘famine’.

An abdominal pouch an important red flag that we are dealing with leptin resistance. Another way of saying this is: “If the waist is resisting staying in – we have leptin resistance.”

Richards points out that all long-lived healthy cultures have legumes in their diet. Legumes of Mediterranean people include lentils, chickpeas and white peas. Scandinavians eat more brown beans and peas. Japanese enjoy soy in the form of tofu, natto and miso. Research shows that for every 80 calories of legumes the risk of premature death is reduced by 8%.
We generally should avoid one legume – soybeans. Years ago soy protein was thrown away and considered useless. Then the soy industry got the idea to come up with trying to extrapolate from ethnic soy use and convince people to eat soy protein for health reasons. The idea worked and has made the soy industry millions and is causing digestive problems, poor thyroid function and poor hormone signaling. On top of all this 90% of all soy in the US is genetically modified. Peanuts are actually not a nut but a legume; however, peanuts can be contaminated with aflatoxin (a dangerous mycotoxin). Generally we should be limiting our peanut intake.

Got Isoprenoids?
Whole grains, fruits and vegetables contain nutrients known as isoprenoids. These nutrients often give vegetables and fruit their deep colors and can deactivate oncogenes (cancer causing genes). Cultures with a diet of fresh fruit, vegetables and whole grains have a lower rate of cancer. Ideally these foods should be organic since organophosphate pesticides are toxic to living cells and work in the opposite direction of the health benefits.
Most vegetables qualify as an unlimited food. We should eat a variety of colors. Juicing vegetables is okay as long as we get enough other fiber in our diet. However, vegetable juice primarily from carrots has too much sugar.

Corn, squash, carrots and potatoes are higher in sugar content and need to be considered as part of the carbohydrate total of a meal.

If you are not eating at least 5 servings a day, I highly recommend adding fruit/vegetable capsules to your daily regimen. You can order them at

Skewed taste buds
The taste of simple sugar is a major source of pleasure based addiction. The tongue has leptin receptors on it – we need to rebalance these receptors. Using no calorie sweetners should be avoided because they numb the receptors to leptin. By avoiding these sweet nothings we get rid of the cravings for sugar.

Glycemic Diet caveats
Potatoes get a bad rap in that if they are eaten with protein they have a much lower glycemic index than when eating separately or with excess calories.
We need more fiber in our diet. Fiber is found in whole grains, fruit, nuts, seeds, vegetables and legumes.

Fat & Milk
A 2004 study from the British Journal of Nutrition found that milk fat intake is inversely correlated with heart disease and the risk for a heart attack. Surprisingly the insulin and leptin levels were lower in relationship to the higher percentage of milk fat in the diet. 2% milk is fine as long as the total calories in a meal does not get too high.

Leptin problems and Addictions
There is a fine line between healthy pleasure seeking, eating and addictions. Individuals who develop leptin problems are at significantly increased risk for developing addictions to substances (alcohol or drugs) as well as addictive behavioral patterns (sexual compulsions, gambling, shopping). The widespread use of brain medications in children, medications which produce dopamine surges or alter appetite signals, it setting the stage for late life problems with addictions. The apparent need for brain meds in children is likely due to poor brain development in the womb and early childhood.

Things to avoid
MSG is a neurotoxin. It damages the structure in the brain that is supposed to be registering the leptin signal of fullness. MSG makes us act like the mouse that makes no leptin and no normal appetite regulation.

HFCS: High Fructose Corn Syrup is devastating to metabolism. The standard way to induce diabetes in rats is to give them high fructose corn syrup and excess saturated fat.

Perchlorates – Lettuce woes and tap water blues
The water supply in many regions of the United States is contaminated with perchlorate, a rocket fuel ignition catalyst. Perchlorates bind to the thyroid gland more tightly than iodine and disrupt metabolism. Almost all lettuce contains high amounts of perchlorates. The only way to avoid it is to buy produce grown in regions which do not have a perchlorate contaminated water supply. Unfortunately, California, Arizona, Texas and Florida all have serious perchlorate contamination issues.

To your health!

Donald P Ellsworth, M.D.
Feel free to pass this information on to others

Appendix A How to measure waist circumference
Fat in your belly is linked with greater health risks than fat from other parts of your body. Measuring the circumference of your waist, or how wide your torso is all the way around, is an easy way to determine whether you have excess fat in your abdominal area. Here’s how to do it:

Use a soft tape measure to assess your waist size. Pull up or remove your shirt and lower the waistline of your skirt, shorts or pants, if needed, so that your middle is exposed. Stand in front of a mirror, if possible, to make sure you’re positioning the tape measure correctly.

Press your fingers into your torso near the right side of your waist. Push your fingers into your skin to find the bony pelvis. Keep pushing and moving your fingers along the edge of the hip bone until you find the top curve of the bone. This spot is known as the iliac crest. The highest point will be located on the side of your torso, just underneath the lower portion of your ribcage. Generally, this spot will be at around the same level as your bellybutton, and near, or at, the narrowest part of your torso.

Position the tape measure horizontally at this spot at the top of your hip bone. Then circle it around your abdomen and entire torso. Make sure that the tape lies horizontal on all sides of your torso. Place the end of the tape measure which reads “0” at the spot on the tape where the loop circles your waist completely.

Avoid sucking in your gut. Stand up straight and exhale gently as you pull the tape so that it stays taut against your body, but make sure it is not squeezing into your skin. Look at the number at the point where the “0” end of the tape intersects around your waist. This is your waist measurement.
A waist size of >40 inches (>102cm) for men, and a waist size of >35 inches (>88 cm) for women is considered high-risk. A high number may indicate that you have excess fat in your abdominal area. If your BMI is 25 or higher, this can increase your risk of certain diseases such as type 2 diabetes, dyslipidemia (uncontrolled cholesterol), high blood pressure and cardiovascular disease.

Appendix B How To Read Labels On Fruits And Veggies - Yes They Have Labels
We hear daily to read labels on packages of food, pet food cleaning products, vitamins and more, but did you know fruits and vegetables have important labels also? Today the banana might not be just an average banana. If you care about how your food is grown the label tells all.As much as we may dislike them, the stickers or labels attached to fruit do more than speed up the scanning process at the checkout stand.

The PLU code, or price lookup number printed on the sticker, tells you how the fruit was grown.As reported by Maria Gallagher, in the June 26, 2002 issue of the Philadelphia Inquirer, by reading the PLU code, you can tell if the fruit was genetically modified, organically grown or produced with chemical fertilizers, fungicides, or herbicides.Here's how it works:For conventionally grown fruit, (grown with chemicals inputs), the PLU code on the sticker consists of four numbers.

Organically grown fruit has a five-numeral PLU prefaced by the number 9.
Genetically engineered* (GM) fruit has a five-numeral PLU prefaced by the number 8.

For example,A conventionally grown banana would be: 4011

Note: All combinations of the four-digit code beginning with the numeral "4" have been used up, so new labels beginning with the numeral "3" will also be used to designate conventionally raised produce.An organic banana would be: 94011A genetically engineered (GE or GMO) banana would be: 84011