The Truth About the Recent Cholesterol Drug Study

Last week, the results of a new study on a cholesterol-lowering drug were released generating a ton of press attention. The study (the JUPITER study) made the front page of the NY Times, was featured on just about every television news show, and generally created a lot of buzz. Even if you weren't paying too much attention- and it was hard not to- you might have heard that the study showed that a cholesterol-lowering medication (Crestor) lowered the risk for heart disease by over 40% in people who did not have high cholesterol in the first place!

The Wall Street Journal was practically salivating in its predictions. "The findings could substantially broaden the market for statins, the world's best-selling class of medicines", they panted. "Morgan Stanley analysts predicted Crestor revenue could rise to as much as 8 billion and 18% of the global statin market in 2014".

OK let's take a look at what actually happened before we start putting statins in the water supply.

Approximately 17,000 participants were enrolled in the study, all at "prime heart attack age" (over 50 for men, over 60 for women). But none had either high cholesterol levels nor evidence of serious heart disease. By all traditional measures, they were a healthy men and women.

What they did have was elevated inflammation.

We know this because the researchers measured their blood levels for CRP (C-Reactive Protein) an excellent marker for inflammation in the body. For years and years I- and many other nutritionists and doctors- have been warning that inflammation is the real danger for heart disease and that cholesterol is a red herring. Inflammation is the silent killer. Inflammation is what we should be paying attention to. C-Reactive Protein is an important measure to know, even though most docs have scoffed at it and told us it's not that important. (Besides, they were too busy focusing on cholesterol.)

For years I've also been saying that any benefit that might be had by taking statin drugs has nothing to do with lowering cholesterol. But statin drugs have an interesting little "side effect": they happen to lower inflammation.

So here's this study when people with completely normal cholesterol (but elevated inflammation) benefit from a statin drug. Think they'd figure out that maybe cholesterol wasn't the issue in the first place?

Oh no. What you'll probably see is a movement to lower the "normal" cholesterol levels even further down so that even more people can be put on these drugs.

Which, by the way, are far from perfectly safe. Though the mainstream establishment downplays their side effects, most knowledgeable clinicians will tell you that side effects like muscle pain and fatigue are far more common than widely believed and that they see these side effects in about 15% of patients. And the drug costs $3.50 a day, if you care.

So what we have here is a study that showed a very very modest reduction in risk for heart disease, using a drug that accomplished that not by lowering cholesterol but by lowering inflammation. The benefit of the drug-- such as it was (and it was modest to say the least)--- clearly had nothing to do whatsoever with lowering cholesterol.

By the way, how can I say that the benefit was modest when it was reported as a whopping 44% reduction in risk?

Simple. Because the percentages don't tell the whole story.

The real numbers were as follows: In the non-treated group, about 14 in 1000 developed cardiovascular disease (in other words 1.4 percent of the group). In the treated group, only 8 in 1000 developed cardiovascular disease (.8 percent). Tiny numbers- but reducing 14 to 8 does produce a "44% reduction" (just as reducing 3-in-a-million to 2-in-a-million produces a 33% reduction!)

Inflammation truly is an important health issue, and anything that reduces inflammation should be paid attention to. The sad part of all this is that there are so many ways to reduce inflammation naturally without drugs. Fish oil is one of the most anti-inflammatory substances on the plant. So are the myriad of natural anti-inflammatories (like the quercetin found in apples and onions, and the hundreds of other flavonoids in the plant kingdom).

But of course none of those are 20 billion dollar-a-year businesses.

Recipe: Citrus-Stuffed Herbed Turkey

Here's a recipe I thought you might like, direct from the pages of "The Healthiest Meals on Earth" (which, by the way, has a lot of other ideas for holiday eating). See what you think!




Prep Time: Overnight to brine, overnight again for optional drying, and 30 minutes to prepare for cooking.

Cook Time: 3 hours and 45 minutes to 4 hours and 15 minutes, plus 20 minutes to rest before carving

Ingredients

Brining Solution
You will need 2 to 3 gallons (8 to 12 L) of brining solution for an 18- to 20-pound (8- to 9-kg) turkey.

Per gallon (4 L) of water:

• 1 cup (300 g) sea salt or kosher (not table salt)
  
• 1/2 cup (170 g) raw honey
  
• 2 teaspoons (4 g) finely grated lemon peel, optional
  
• 2 teaspoons (4 g) orange peel, optional
  
• 1/2 tablespoon cardamom pods, optional
  
• 1 teaspoon dried thyme, optional

Turkey

• 1 18- to 20-pound (8- to 9-kg) free-range, not self-basting, turkey
  
• 8 sprigs each of fresh rosemary (young and tender, not woody), sage, and thyme (or other herbs of your choice), rinsed and lightly dried (should total 1 1/4 to 1 1/2 cups or 55 to 90 g when coarsely chopped)
  
• 2 shallots, peeled and halved
  
• 1 whole head garlic, peeled and crushed
  
• 1 lemon
  
• 1 orange
  
• 4 tablespoons (1/2 stick, or 55 g) butter, softened
  
• 2 tablespoons (28 ml) extra virgin olive oil
  
• Salt
  
• Ground black pepper
  
• 1/2 cup (120 ml) sherry

Starting with 2 gallons (8 L) of water, mix the brining solution in your roasting pan by combining all ingredients in correct proportions and stirring until the salt and honey are dissolved.

Rinse the turkey in plain water and pat it dry. Place the turkey in a lobster pot or large stockpot. (You can also use a plastic bucket if you line it with 2 or 3 clean garbage bags.) Pour in the brining solution to cover the turkey. If you need more brine to completely immerse the turkey, mix up another gallon. Place the turkey in the refrigerator for 12 to 24 hours. Remove the turkey from the brine, rinse very well under running water to remove all the brine, and dry thoroughly, including the cavity.

Preheat the oven to 400ºF (200ºC, gas mark 6).

Stem and coarsely chop the herbs, setting aside about three-quarters of them (1/2 to 1 cup or 40 to 60 g of herbs). Mince the remaining one-quarter (about
1/2 cup or 30 g) and put into a medium bowl. Add the shallots and garlic.

Quarter but do not peel the lemon and orange and squeeze them gently to make a little juice, tossing the fruit and juice together with the herb mixture.

In a small bowl, using your hands, mix the butter with the oil until creamy. Moving carefully so as not to puncture the skin, work your hand between the turkey skin and the breast as far as you can go to create a pocket over both breasts. Smear half of the butter-oil mixture over the breasts, covering as much meat as you can reach. Place half of the reserved, coarsely chopped herbs (or whole sprigs) in each pocket (on top of each breast). Do this carefully and when complete, gently reshape (from the outside) the herb "pouches" above each breast to look rounded and smooth. Salt and pepper the inside of both cavities and stuff them with the fruit and herb mixture. Tuck the wings behind the back, tuck the skin folds over the cavities to close, and truss the legs. Smear the entire bird with the remaining butter-olive oil mixture and sprinkle with salt and pepper. Slowly pour the sherry inside of the breast pockets, working it around to the leg joints.

Place a V rack inside of a roasting pan and cover it with foil. Poke about 15 holes into the foil. Place the turkey on the V rack, breast side down. Bake for 45 minutes, then reduce the oven temperature to 325ºF (170ºC, gas mark 3). Turn the turkey bird breast side up, baste (you can supplement the juices with a few tablespoons of sherry if you wish), cover with foil, and continue to cook for 2 1/2 to 3 hours more, depending on the size of the turkey.

Remove the foil to brown the breast and continue to cook for another 30 to 40 minutes, or until the thickest part of the breast and innermost parts of thighs and wings register 165ºF (74ºC) on a meat thermometer. (When the turkey is done, the legs should roll loosely on the joint, and the leg juices should run clear.)

Let the turkey rest on a cutting board for about 20 minutes before carving. Yield: For turkeys weighing more than 12 pounds, allow 1/2 to 3/4 pound (225 to 340 g) per person, so an 18-pound (8-kg) turkey can serve between 24 to 36 people.

Undersleeping Increases the Risk for Heart Disease

According to a new report in the Nov 10 issue of Archives of Internal Medicine, getting too little sleep may be associated with a future risk for heart disease. In the present study, the magic number was 7 1/2 hours a night.

A combination of little sleep and overnight elevated blood pressure increases the risk even more.

We already know from previous studies that sleeping too little increases the risk for obesity. Undersleeping also raises stress hormones, and plays overall havoc with your general health.

In the new study, researchers at the Jichi Medical University in Japan monitored sleep in over 1200 individuals with high blood pressure, and followed them for a little over 4 years. The researchers took note of how long the participants slept each night, monitored their daytime and nighttime blood pressure and, of course, kept track of cardiovascular disease events like stroke, heart attack and sudden death.

During the follow-up period, 99 cardiovascular disease events occurred. And it occurred at a significantly higher rate among the folks who were sleeping less than 7.5 hours a night.

Now granted, the actual number of people affected was small- but it's still worth mentioning because of the many other problems we know about that relate to not getting enough shut-eye. I don't know that it has to be 7.5 hours exactly, but I do know that the 4-5 hours some of us are getting just ain't cutting it.

In my soon-to-be-released DVD program "The Seven Pillars of Youngevity" I discuss sleep at length, largely because it's one of the pillars of good health and long life.

Consider this: A lot of what we know about healthy diet comes from looking at what our primitive, caveman ancestors ate before the advent of processed food and food products. Those Paleolithic ancestors of ours ate food from what I call the "Jonny Bowden Four Food Groups": food you could hunt, fish, gather or pluck. Maybe Paleolithic man has something to teach us about sleep as well. After all, the cavemen hit the sack at sundown, and woke up at sunrise. Their sleep habits were nicely in tune with the universe's rhythm.

The best diets mimic the Paleolithic diet. Maybe we should try to emulate our Paleolithic ancestors in the area of sleep as well!

The Silver Lining in the Economic Downturn

If you've ever listened to any inspirational speaker you've heard talk of finding opportunity when the universe presents a challenge. In fact the "opportunity in a challenge" theme runs through just about every inspirational talk I've ever heard. It's the meaning of popular comforting sayings ranging from "When Life Gives You Lemons, Make Lemonade" to "The Universe Never Closes One Door Without Opening Another", not to mention the classic phrase by Nietzsche, "That which does not kill us makes us stronger".

That stuff is all "easy to say" but hard to remember (let alone apply!) when times get really tough. Yet the truth is that the economic downturn really has presented itself with some opportunities, and we'd all do well to spend a few minutes thinking about them.

There'll be no shortage of commentators on how to learn from this mess on a personal and financial level, so let me concentrate on the opportunities in the areas of health and nutrition.

First- If you can't eat out as much, consider counting that as a blessing. We eat out way too much anyway. Use this period of belt tightening as an excuse to start eating home more. Every study over the last several decades has confirmed that the more meals you eat out the more likely you are to be overweight. Prepare some of your own food, and learn to put mindfulness into it.

Two- Since most folks have less dollars to spend frivolously, spend your food dollars wisely. Make coffee at home a few days (or more) a week and skip the $4 lattes. (You can buy an awful lot of fruits and vegetables on a Starbucks budget.)

Three- Since there's less money for gas, not to mention going out and "doing stuff", use that as an opportunity to rediscover the home (and the people who live there with you). I know it's a really "retro" concept, but what about meals together as a family? There are studies on that as well, and every one of them shows better performance in school, better well-being and better mental and physical health in kids who eat at least one meal a day with their family.

Four- If you're cutting back on expenses, cut back smartly. If you eat meat, for example, continue to eat the expensive grass-fed kind but eat much less of it. (As Michael Pollan put it, "spend more, eat less".) I'd rather have one grass-fed burger a week than 7 Happy Meals. Believe me your body will thank you for that choice.

Five- Rediscover your own ability to amuse yourself. Those of us who grew up a few decades ago know well that it's actually possible- amazing as it sounds- to survive without constant texting, iPods, messaging, social networking, YouTube and even Google. I'm not suggesting you turn everything off, but you might use this extra "stay-at-home" time to discover how interesting actual old fashioned conversation can be when you do it with people you like (or love). Not to mention really old-fashioned entertainments- like reading!


Finally, consider this post that I found on one of the financial message boards the other day that really inspired me. We had just had one of the worst days in the market, and people were discussing what to do with their diminishing portfolios. There was a clear mood of panic all over the place. Here's the post that caught my eye:

"What's the worst that could happen? That we'd lose all our money? This has just gotten me to focus on the important things we do have- our health, our family, our kids, our dog. If we lose it all, so be it. We can rebuild. As long as we have our health and our love, we'll survive this. It's only money."

What a great time to reassess your life and focus on what's really valuable and be thankful for what you do have.

Give the Gift of Jonny for the Holidays

OK I cringed when writing that headline- my only excuse is that my brilliant webmaster and marketing guru Christopher Loch thought of it, not me. But here's the deal: Amazon is offering a special bundle containing three of my books for just $49.45 (you save $25.48):

• The 150 Healthiest Foods on Earth
  
  
  
• The Most Effective Natural Cures on Earth
  
  
  
• The Healthiest Meals on Earth
  

A lot of people have told me that they were going to give one or more of my books for holiday presents, so maybe this is a good time! Granted the "together" price is about the same as you would get on Amazon if you bought them separately, but still, it's a great deal because Amazon discounts so deeply (34% on each book). I'd be honored if you'd consider giving people you love the whole collection. Or give them as separate gifts.

If you're familiar with the books, skip this next section, but just in case you're not:

The 150 Healthiest Foods on Earth tells you the surprising and unbiased truth about foods- which ones are great and why. It's also got some (I hope) interesting essays and information about grass-fed vs. organic meat, farm vs. wild salmon, and the "truth about soy". I'm thrilled to say it's going into its second year as a best-seller and into its fifth printing.

The Most Effective Natural Cures on Earth examines the way natural medicine and nutrition (and sometimes modalities like acupuncture or reflexology) can significantly impact a whole host of illnesses and conditions. I also give you "prescriptions" when appropriate, and tell you what the science says (and what it does not).

The Healthiest Meals on Earth is a great companion to "The 150 Healthiest Foods". It puts together over 40 superb meals based on the "Polymeal" concept of making each meal as dense in vitamins, minerals, phytochemicals, fiber, omegas and anti-inflammatories while tasting unbelievable. The recipes were developed by my associate, the amazing Jeanette Bessinger. The essays on food- and why these meals are so great for you- are by me.

(My really new book- The 150 Most Effective Ways to Boost Your Energy will be out Jan 1st so it's not included, although you can preorder it for $16.49)

Anyway, thanks to Chris for the "Give The Gift of Jonny" idea, and I hope those books give you some inspiration to give those you love the gift of health for this holiday season. After all, there's no greater gift- unless its love- and they kind of go together!

Nine Tips for Cooking Healthy over the Holidays

Here are a few things that might come in handy as we move into the holiday season. I'll give you more as I think of them!

1. Make your own butter. For spreading on food (including cooked vegetables), try 2/3 butter mixed with 1/3 flaxseed oil; mash together and then put back in the fridge so it will solidify. It's a great blend of healthy fats. If you're using it for cooking or stir frying, mix 1/2 butter with 1/2 coconut oil, or even 1/2 and 1/2 with olive oil. (My personal recommendations: Barlean's Flax Oil and Barlean's Organic Virgin Coconut Oil are the best in their categories!)


2. Replace potatoes with mashed cauliflower- add a little butter (see above) and season with fresh herbs. And speaking of herbs, if you use fresh, fragrant herbs in your turkey, you'll be able to get away with a lot less stuffing- or even none!


3. Go organic to avoid hormones, pesticides and antibiotic residues in meat.


4. Replace mayonnaise with low-fat yogurt for tasty dressings without the extra calories and artificial stuff. (Note: There's absolutely nothing wrong with mayonnaise, especially when you make it yourself from whole eggs, but you'll save some calories this way. During holidays, every little bit helps.)


5. If you're going to have desserts, consider building them around nutrient dense foods like sweet potatoes, pecans and pumpkin. Even without a boatload of sugar these make great basics for a terrific desert, and they're way more loaded with nutrients than the usual cream pies. You might even feel a little better about overindulging if your choices are healthier.


6. Check the ingredients label on canned foods! High-fructose corn syrup is lurking everywhere and is certain to be in a lot of canned cranberries. Avoid sugar as much as possible. For small amounts of sweetening consider Xylitol or cold pressed raw honey.


7. When choosing honey try to find the raw, unfiltered, cold-pressed kind. It's still sugar, but at least it's actually a food and has some good stuff in it like enzymes and nutrients.


8. Don't go overboard on the number of courses. Studies show that the more options we have at the table, the more we eat. Stick with a few basics. You'll create a satisfying meal that doesn't overstuff your guests.


9. Consider serving a salad as the last course. You can make a really good (and small) dessert salad out of some crumbled blue cheese, candied walnuts or pecans, dried cranberries and a whole bunch of greens. Add a little raspberry or pomegranate dressing and you're in business!


Adapted from my book, "The Healthiest Meals on Earth"

The Science of "Youngevity"

I recently finished recording a new course called "The Seven Pillars of Youngevity" which will be available later this year on DVD. I'm also scheduled to write a book on the subject of healthy aging for 2010. And I'm turning 62 this month, so I have more than a little interest in how to stay vital, healthy, sharp and happy no matter what the calendar says!

There's a ton of stuff to say about the subject of "youngevity" but here are two simple things that seem to work consistently to extend life, at least in every species studied so far:

1. Calorie restriction
2. Resveratrol

Scientists aren't 100 percent sure what the life-extending mechanism involved in calorie restriction is, but several are suspected. One has to do with insulin- when you eat less, you produce less insulin (low fasting insulin has been a feature of the blood tests of healthy centurians). A second theory has to do with oxidative stress (the damage to cells and DNA by rogue molecules known as free radicals).

The last theory got some backing recently when researchers tested two types of calorie-restricted diets on mice. Two groups of mice got a calorie-restricted diet, but one group's diet was high in compounds known as "AGEs" (advanced glycolated end products) which are known to be associated with oxidative stress, organ dysfunction and decreased life span.

If it was just the calorie restriction that works to extends life, both groups of mice should have done equally well, but that's not what happened. The mice fed the diet laced with AGEs developed insulin resistance, heart and kidney damage and died earlier. So the benefit of a calorie-restricted diet may be partly contingent on what's in those calories- you want them to come from good stuff, not junk! (You'd still probably be better off eating 1200-1800 calories of junk than 7,000 calories of junk, but better still if you ate 1200-1800 calories of actual real whole food!)

Resveratrol- found in red wine, the skins of dark grapes and to some extent peanuts- has also been found to extend life in the lab. It appears to give many of the same benefits of calorie restricted diets.

A recent study treated mice with three kinds of diets: high calorie, standard or calorie restricted. Each group of mice got their diet with or without resveratrol supplementation (creating six subgroups). Regardless of the diet, the mice given resveratrol supplementation for one year had significantly less symptoms of cardiovascular disease, osteoporosis, cataracts, and decline in motor coordination. The resveratrol-treated mice also had liver and muscle tissues resembling much younger animals.

Researchers are still sorting out the mechanisms by which resveratrol works, but one theory has to do with its significant antioxidant and anti-inflammatory effects.

While they're figuring it all out, I'm taking resveratrol every day and also eating less calories than the average American. (Some research shows that just reducing calories by 1/3 can be really beneficial. How hard can that be? Divide everything you eat into thirds, and put one of those thirds away for later).

As my grandmother used to say, "Couldn't hurt!"

Oh No! Not Vitamin D Again!

I know you may be sick of me talking about this vitamin, but I just can't stop myself. Virtually every week new information becomes available that points to the fact that we just are not even beginning to get enough of this incredible vitamin.

Now the Canadian Pediatric Society is proposing to boost the recommended intake by women who are pregnant or breast-feeding to 2,000 IUs per day. (This new guideline appears in a consensus statement published in September by the society in its journal Pediatrics and Child Health).

What does this have to do with you if you're not pregnant? Actually, a lot.

What researchers are learning is how much more vitamin D we need for optimal health than anyone suspected. Researchers writing in a recent issue of the International Journal of Cancer exposed prostate cells to the most biologically active form of vitamin D and found that it significantly increased the activity of a protective anti-oxidant enzyme (called glucose-6-phosphate dehydrogenase, just in case you wanted to know!). The enzyme literally mopped up damaging free radicals in the prostate cells, protecting them against injury and death.

Studies have shown absolutely no ill effects or dangers in taking 2000 IUs a day which the prestigious Institute of Medicine considers the "safe upper limit" for daily consumption. But off the record- most experts don't consider that a "true" ceiling for safe use, especially since the body can easily generate 10,000-20,000 IUs a day sunbathing without a whit of harm. But for political and legal reasons most organizations won't recommend anything higher than what the conservative IOM recommends.

OK that's fine. I think if taking even 1000 IUs of vitamin D a day puts you ahead of the game and 2000 IUs is even better. I personally take 2000 IUs every day as part of my own regimen. Best thing of all it's the perfect vitamin for people who hate to take vitamins. It's a tiny little easy to swallow gel the size of a tic tac and it's one of the cheapest vitamins on the planet.

Treating Cravings and Addictions with Food and Supplements

You may never have been addicted to drugs, but you might know something about the addiction to food. Or sugar. Or alcohol. Or gambling. Turns out that all these addictions- and the associated cravings- have more in common with one another than you might think. And interestingly enough, the key to managing them might be in your diet.

This week's issue of The Economist, a London based newspaper, reports on interesting ongoing research using dietary approaches to addictions.

Here's how they explain the problem:

"People are programmed for addiction. Their brains are designed so that actions vital for propagating their genes- such as eating and having sex- are highly rewarding. Those reward pathways can, however be subverted by external chemicals (in other words, drugs) and by certain sorts of behavior such as gambling."

We also know from animal experiments that reward pathways in the brain can be hijacked by sugar. Rats who became addicted to sugar actually showed all the signs of cocaine withdrawal when sugar was removed from their diet.

The key to the whole thing- no big surprise- is in your brain chemistry, that complicated computer system where messages can frequently get corrupted and things can easily go astray. Addictive substances literally "hijack" the pleasure centers of the brain so that it's harder to obtain regular plain old garden-variety pleasure from regular activities. Instead, you need bigger and bigger doses of the substances or behaviors that give you the biggest jolt- sugar, cocaine, drugs, alcohol, gambling and the rest of the usual suspects.

One supplement that's getting a lot of research attention for addictions and that has remained under the radar for now is NAC- N-Acetyl-Cysteine. A study published in the American Journal of Psychiatry found that giving NAC to cocaine addicts reduced their desire to use the drug so much that the researchers recommended NAC as a potential treatment. An entirely different study found that NAC reduced the desire to gamble in 80% of gambling addicts (as compared to 28% of those given a placebo). And animal studies have shown that NAC reduces relapse with cocaine and heroin.

OK, so probably not many of you are cocaine or heroin addicts. But cravings are cravings, and if NAC works with some addictions (or cravings) it should work with others. I've recommended NAC for years as part of a liver health program since it boosts the body's level of the important antioxidant glutathione (which is not well absorbed in supplement form).

Now it looks like it may have another use!

Other nutritional factors that can support a healthy brain function are tyrosine (a precursor of the neurotransmitter dopamine), 5-HTP (a precursor of serotonin) and GABA (a relaxing neurotransmitter). My friend Dr. Daniel Amen put these together in an elegantly designed formula called NeuroLink, which also contains a nice dose of vitamin B6, needed to convert 5-HTP into the feel good neurotransmitter serotonin.