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Healthy Living June Issue
BEYOND THE LEADING CAUSES OF DEATH


A System for Prevention and Treatment

Back in the late 1970s, a number of health professionals, spiritual leaders, and educators got together to establish a new preventive medicine center called Weimar Institute. The founders were not out so much to demonstrate something new as they were to confirm their confidence in a century-old approach to comprehensive wellness. They were convinced that the path to health for many people rested on eight relatively simple health concepts. These concepts were popularized by Ellen White in the 1905 health classic, The Ministry of Healing.

It may seem strange that health concepts outlined a century ago could be of value today, considering the advance in medical knowledge today compared with that era. Ellen White has been quoted on a variety of health topics in many chapters of this volume. How could a person have such advanced knowledge? Appendix X probes the answer to this question.

Weimar developed and trademarked an acronym to make it easier to remember these eight essential elements of health. The acronym consisted of a simple phrase that they made into a single word: "NEWSTART.?" Their choice of wording was fortuitous. Those two merged words not only pointed to those eight essential elements, but they also gave an accurate message that the adoption of these simple factors could help most people begin a whole new phase of their lives-to truly get a "new start" in life.

Let us look at what the letters of "NEWSTART" stand for. They are explained in Figure 1: NEWSTART.

Many already recognize all or almost all of these eight "natural remedies" as necessary conditions for a long and abundant life. In fact, these eight elements of health are no surprise to those of you that have been reading this book from cover to cover. The importance of each should have been apparent in the material that has been presented up to this point.

We will see in this chapter a number of important health issues that have not yet been explored. As we look at conditions that largely have a bearing on our quality of life, I believe we will sense anew the value of the comprehensive lifestyle that this book advocates. These eight elements provide the foundation for dealing with any health condition successfully.

For a specific person who has a specific health problem or wishes to avoid a certain problem, there may be one or only a few of the eight elements of NEWSTART that are more important than the others. In some situations, diet and exercise may appear to be the most important factors. For other people with other health problems, trust in divine power may seem to hold the missing key.



NEWSTART Element Number 1: Nutrition

The first element of NEWSTART is nutrition. I have devoted many pages in this book to the value of nutrition to our health. We have seen that it can help prevent heart disease and cancer. We have seen its value in helping to stave off kidney failure, kidney stones, and early skin wrinkling. We have looked at its role in avoiding serious infectious illnesses as well as in improving our mental health. But the total vegetarian diet can produce many other benefits that I have not yet mentioned. Nutrition is, of course, just one element of NEWSTART but its importance can not be overemphasized.



The Bottom Line on Diet and Health

In this era of medical cost consciousness, Dr. Synove Knutsen has published some fascinating data on the benefits of the vegetarian diet.1 Her results provide a fitting demonstration to the benefits of a vegetarian eating style regarding general health. Knutsen found that among both men and women, there were approximately 15 percent less chronic diseases among vegetarians when compared to non-vegetarians. Utilization of health care facilities also decreased; the non-vegetarians of both sexes reported more hospitalizations than the vegetarians. Medication use by non-vegetarians was dramatically more frequent. In general they used about twice as many medications as the vegetarians.



Vegetarian Diet and Endurance

What about the benefits of the vegetarian diet beyond its resistance to many diseases? Many people feel that once they go on a vegetarian diet they are going to be weaker. They worry that they will not feel as strong or robust. Many of us have grown up with the idea that meat and milk builds strong bodies. Those ideas have turned out to be myths. Competitive athletes have known for years that animal fat and protein is something to be kept at a minimum when trying to build endurance. In general, they engage in a practice known as "carbohydrate loading." Such approaches are based on years of research in the area of sports medicine.

One of the classic studies was performed in the late 1960s when the Scandinavian researcher, Doctor Per-Olaf Astrand, studied nine highly trained athletes. Dr. Astrand changed the diets of these athletes every three days. At the end of each three-day period, he had each athlete pedal a bicycle at high speed until exhaustion. His results are tabulated in Figure 2: Vegetarians have Greater Endurance.2 We see that with a high meat diet (high in both protein and fat), they became exhausted after about an hour. When on a mixed diet, lower in meat, fat, and protein, and higher in plant foods, they could peddle at high speed for almost twice as long-a total of 1.9 hours. However, when on a vegetarian diet, they went for 2.78 hours until exhaustion set in.

This dramatic improvement in endurance should not surprise keen observers of the animal kingdom. After all, the ox, the elephant, and the horse have no problems with strength or endurance on a vegetarian diet. Horses can run at high speeds for hours. Elephants are noted for running 10 or 12 hours straight at high speed. Can you imagine carrying all of that weight (over 6 tons) at 25 miles per hour for ten or twelve hours straight? On the other hand, meat-eating big cats such as cheetahs, tigers, and others have good speed at the start, but they fatigue within a short time, often within less than 5 minutes. Indeed, in the animal kingdom, endurance, the ability to provide top energy for long periods of time, is largely a characteristic of vegetarian animals.



Food Supplements

Typically, when I talk to people about the health benefits of nutrition, some are not content with my message of eating more fruits, whole grains, and vegetables. They want something more-and perhaps something less. It requires some effort, planning, and acquisition of new habits to dramatically increase your fruit and vegetable consumption. Many feel that an easier solution is to take supplements ("vitamin pills") in order to reap the benefits of improved nutrition. They attempt to improve their nutrition, not by eating substantially better, but by holding to the same foods and adding vitamin and mineral supplements to their regimen.

Unfortunately, taking extra doses of vitamins can cause problems. Take the B vitamin, niacin, for example. Niacin is actually an acid (nicotinic acid-not to be confused with "nicotine" of tobacco fame3) but acts like a vitamin in the amounts that it is found in nature. However, if you take large amounts of this acid, it acts as a drug.4 The reason for this is that there is only so much of this vitamin that the body can use. The excess, which cannot be used as a vitamin, begins to exert drug effects. Among those drug effects are the lowering of cholesterol and triglycerides.5 For this reason, many people take niacin in drug doses to bring their blood fats into line.

Like all drugs, niacin in drug doses can cause side effects. In the case of niacin, these side effects include peptic ulcers, diarrhea, altered heart rates, liver disease, gout, and worsening of diabetes.6, 7, 8 Like other drugs, niacin in large doses may have some desirable effects, but it also has some undesirable ones. The user of large amounts of niacin is really using a drug-not a mere vitamin. In fact, a recent scientific paper on niacin concluded with the following remarks: "Unfortunately, the side effect profile of this agent [niacin] warrants its use only in patients with marked dyslipidemia [extremely bad blood fats] in whom side effects and potential toxicity are closely monitored."9

The B group of vitamins, including niacin, is water-soluble and is thus easily eliminated. For this reason, many people who lack a deeper understanding of biochemistry think that their bodies would get rid of any excess niacin and it would cause no harm. However, they are sadly mistaken. Other B vitamins can cause problems in excess. Large amounts of folic acid can cause insomnia and other mental disorders. Vitamin B6 (pyridoxine) in large amounts can worsen Parkinson’s disease and cause other nerve problems.10

Vitamin C, another water-soluble vitamin, may increase the risk of kidney stones if taken in excess.11 It can also cause diarrhea and abdominal cramps.12 Those who abruptly stop taking doses of vitamin C greater than 500 mg daily risk developing vitamin C deficiency-apparently because the body becomes dependent on higher doses of the vitamin.13 Their gums can easily bleed when brushing their teeth. Figure 3: Dangers of Taking Excessive Water-Soluble Vitamins lists some of the problems caused by excessive amounts of water-soluble vitamins. The fat-soluble vitamins such as vitamins A, D, E, and K, are more difficult for the body to eliminate. Many people have taken modest amounts of vitamin A in supplements and have become ill as a result. A dose of 25,000 IU of vitamin A per day (about 5 times the amount needed to prevent nutritional deficiency) can cause problems as diverse as liver trouble, headaches, hair loss, dry skin, bone pain, and joint aches.14 Pregnant women who take over 10,000 IU of the vitamin put their unborn children at increased risk of birth defects.15

Excessive vitamin D can cause severe problems by interfering with calcium balance in the body, and can lead to calcium buildup in the blood (called hypercalcemia). This condition may produce anything from mild to life-threatening symptoms. The list of related problems includes nausea, vomiting, fatigue, confusion, high blood pressure, kidney failure, and coma.16

Vitamin E may be toxic in high amounts, causing problems with weakness and fatigue as well as nausea and diarrhea.17 Excess vitamin E also predisposes certain individuals to bleeding problems, particularly those who are on blood thinners (anticoagulants).18, 19 Dr. Sheldon Hendler is a widely quoted authority on vitamins and minerals. He holds a Ph.D. in biochemistry from Columbia University and an M.D. degree from the University of California. He expresses much more caution for vitamin E supplementation than many supplement advocates. Dr. Hendler sees "no reason for adults to take more than 400 IU daily" and lists concerns for some side effects beginning at doses of as little as 600 IU per day.20 There is a separate concern regarding the practice of routinely taking vitamin and mineral supplements. Surprisingly, you can cause a vitamin or mineral deficiency by taking large doses of supplements. How can such a thing happen? How can conscientious individuals who take extra vitamins and minerals put themselves at greater risk of deficiency? The answer lies with a true understanding of the interactions between vitamins and minerals. There are a number of ways in which vitamins and minerals are transported and utilized by the body. Taking excessive amounts of one vitamin or mineral results in an unbalancing of the uptake and utilization of other vitamins and minerals. Some of these interactions are illustrated in Figure 4: Vitamin - Mineral Interactions.21

In this figure, a line connecting any vitamin to a mineral indicates an interaction. For example, vitamin C has a line connecting it to iron. This indicates an interaction between these substances. In this specific interaction, if you take large doses of vitamin C day after day, your body will increase its absorption of iron, which could cause other problems. Interactions of other substances may cause a decrease in the absorption of a substance. Many people are unaware of these potentially harmful interactions. The message is that no one should take large doses of supplements without careful consideration. There are 11 separate interactions shown on this figure.

Not only do vitamins and minerals interact, vitamins can interact with other vitamins, and minerals can interact with other minerals as illustrated in Figure 5: Vitamin Interactions and Figure 6: Interactions Between Essential Minerals and Trace Elements.22

There are 12 vitamins shown, and 27 possible interactions. Note that three of the popular vitamins, A, C, and E, interact with each other. What about a simple multiple vitamin pill, or the supplements in a bowl of Product 19 or Total cereal? Unlike many supplements, these usually do not provide large amounts of nutrients. It is unlikely that serious repercussions will arise from taking such products (although they probably are not necessary if you are healthy and following the diet recommended in this book).

There are certain disease situations in which large doses of vitamins can be of benefit. However, such supplements are best taken under the direction of someone who is well aware of the risks as well as the benefits of such an approach. Indiscriminate use of vitamin supplements may well increase health risks rather than decreasing them.

In Chapter 2, "Good News About Cancer-It Can Be Prevented," I point out a better way to get many of the benefits of vitamins without taking supplements. There I share some of the exciting new research that is championing whole plant foods in the antioxidant domain where vitamins were formerly thought to reign. For example, current research indicates that you can get an antioxidant benefit equivalent to 1100 IU of vitamin E by eating a cup of the cooked green leafy vegetable, kale. Kale does this without exposing you to the risks of high vitamin E doses because it only contains 13 IU of the antioxidant vitamin E. But it also contains a host of other antioxidants, making it equivalent to 1100 IU of a vitamin E supplement.23

The message that I presented elsewhere in this book is that many fruits and vegetables have powerful antioxidant effects that exceed expectations based on their vitamin content. Similarly, other naturally occurring chemicals in plant foods may substitute for functions that we usually think of being associated with specific vitamins.

Furthermore, we know that eating an abundance of fruits, grains and vegetables can actually add years to your life. Studies suggest that a vegetarian diet may extend the average person’s life by more than a decade over that which they could expect on a heavy meat, plant-poor diet. It should be obvious to those who have read this book systematically that the way a vegetarian diet promotes longevity is by substantially decreasing the risk of the two most powerful killers, heart disease and cancer, as well as decreasing the risk of other degenerative diseases. Rather than thinking about the use of supplements when in quest of good nutrition, think about healthful food choices. The use of supplements begs another question: do vitamin and mineral supplements actually increase one’s lifespan? Fortunately, they have been around long enough for us to get a statistical answer to the question. Vitamin Supplements and Your Life Span

How much difference do food supplements make? This was the question addressed not long ago by researchers at the National Center for Chronic Disease Prevention and Health Promotion. The researchers used the extensive database from the First National Health and Nutrition Examination Survey (performed from 1971 to 1975), and then assessed the death rate of participants through 1987. They found that those who used supplements did not live any longer than the non-users.24 They concluded: "We found no evidence of increased longevity among vitamin and mineral supplement users in the United States." Clearly, supplements do not appear to be living up to their promise.

It is obvious that the foundation for nutritional health does not lie with vitamin and mineral supplementation. It rests with a diet based on an abundance of fruits, grains, and vegetables. Not only do these food choices provide the benefits of the vitamins and minerals that we know about, but they also provide a host of factors that have not yet been discovered. If you are on a supplement program, you will have to wait for scientists to discover more of the healthful compounds in plant foods, learn how to make or isolate them in the lab, and then finally put them into supplements for commercial sale. On the other hand, if you are eating fruits, vegetables, whole grains, nuts and seeds in moderation, then you will be getting all of the hottest protective phytochemicals (plant chemicals) before they are even discovered.

In spite of all of the scientific evidence of the nutritional completeness of the total vegetarian diet, there are still some members of "the old school" who believe that such a diet is nutritionally deficient in protein and calcium. As pointed out in Chapter 7, "The Great Meat and Protein Myth," Harvard researchers in the 1950s showed that a total vegetarian diet was fully adequate for protein. In the same chapter, it is pointed out that total vegetarians need a smaller intake of calcium than their meat and dairy-consuming neighbors. There is a variety of excellent sources of calcium in the vegetarian diet such as the green leafy vegetables.

Only one nutrient has been a perplexity for total vegetarians and that is vitamin B12. Interestingly, this vitamin is needed in only very tiny amounts. Less than one hundredth of an ounce is more than enough B12 to last a lifetime (provided you took it in small increments throughout your life). Despite our very meager need for this vitamin, a total lack of it can cause troubles such as anemia and nerve problems. Until recently, no one had found a reliable plant source for B12. As a result, many who are vegetarians have felt that because of the possibility of B12 deficiency, they should either get their Vitamin B12 level checked by a blood test every year (to be sure they are not becoming deficient) or supplement their diet with this vitamin for security’s sake.

Dr A. Mozafar, a Swiss researcher, has discovered that certain plants do contain vitamin B12.25, 26 Furthermore, he conducted a study to determine if plant foods grown organically would have greater concentrations of B12 in their tissues than those grown with chemical fertilizer.27 His results are shown in Figure 7: More B12 in Organically Grown Plant Foods.

Note that B12 was found in soybeans, barley, and spinach, and that when grown organically, the amount of B12 was significantly higher. This study immediately generated shock waves. Mozafar’s work flies in the face of a well-established nutritional position (held even by vegetarian scientists) that B12 is not found in plants as conventionally grown. Since he reported B12 levels even in the chemically fertilized plants, some nutritional experts have proclaimed his work as suspect.

The research has prompted many questions. Were there mistakes in the B12 measurements? Was there something different about the soil in the study? Is there really an increase in B12 content in certain organically grown plants? More studies are needed to confirm Mozafar’s results. Some are now asserting that a totally plant-based diet without B12 supplements is sufficient for all of our nutritional needs.

Until all the answers are in, however, I prefer to err on the side of caution. I still recommend that total vegetarians take a regular B12 supplement or eat foods in which B12 is added, such as many of the breakfast cereals or meat substitutes. There are at least 12 dry cereal varieties available at this writing that contain substantial amounts of B12. Some milk alternatives contain levels of B12 that are equal to or greater than the amount in cow’s milk. As little as 5 micrograms every other day is probably all that the average person needs. A listing of quantities of B12 and other nutrients in various brands of milk alternatives and cereals is found in the Appendix.



NEWSTART Element Number 2: Exercise

In this chapter thus far we have examined the first element of NEWSTART,which is nutrition. The second element, exercise, is also of critical importance in a total lifestyle approach to health. Throughout this book, exercise has been a recurring theme in disease prevention. As physical activity increases from less than 500 calories expended per week in exercise, mortality rates decrease.28 The greatest benefit is for those who expend greater than 3500 calories per week in exercise, but great benefit is obtained from exercising as little as 750 calories expended per week.29 To help you in planning an exercise program, activities that will expend 150 calories are listed in Figure 8: Examples of Moderate Exercise.30

In the 1990s, almost everyone has heard of the importance of exercise for decreasing the risk of both heart disease and cancer. Some of the cardiovascular benefits of endurance training are listed in Figure 9: Cardiovascular Benefits fo Endurance Training.31

Notice that the tendency for the blood to clot is a result of endurance exercise, which will protect against heart attacks and strokes. HDL also increases. We have known for years that exercise is important to boost levels of the good cholesterol, HDL. However, research now suggests that there is a dose response relationship between exercise and HDL levels. Simply put, the more you exercise the higher your HDL level. This has only been recently appreciated. The HDL was measured on nearly 3000 men who were categorized according to their reported exercise levels. The results are tabulated in Figure 10: HDL Levels Increase with more Exercise.32

The research documenting a dose response relationship between HDL and exercise provides another explanation for the heart-improving benefits of physical fitness. One special note is in order regarding this study. Because of the powerful HDL-depressing effects of smoking, all smokers were excluded from the research. In other words, we do not know from this research whether exercise boosts HDL in a similar manner for smokers. What we do know is that a smoker who is concerned about his heart disease risk would be best to stop smoking in addition to exercising and eating right. Actually, research suggests that exercise improves the chances of successfully stopping smoking. A recent Brown University study found that women who exercised were less likely to begin smoking again.33

Exercise provides a well-recognized benefit for those with diabetes or high blood pressure. It is also an essential ingredient of a program that boosts our immune systems and energy levels. There are many more benefits of endurance training, as listed in Figure 11: Other Benefits of Endurance Training.34, 35

One interesting study involved an attempt to improve the communication skills of two groups of Alzheimer’s patients. One group was put in a walking exercise program, and the other group was given lessons in conversation. Over 40 percent of the exercise group experienced significant improvement in communication skills, while the "conversation therapy" group experienced no significant improvement in their communication skills.36

In considering all of the thrilling evidence about the benefits of exercise, perhaps the most startling effect is the widespread prevention of disease that would occur if everyone merely exercised regularly. Current estimates are that the lack of exercise in America causes up to one-third of deaths from the following three major diseases: coronary heart disease, colon cancer, and diabetes.37

The first two elements of the NEW-START program (nutrition and exercise) beautifully complement each other. Nutrition works together with exercise to give more benefits than either one alone. This is true of diseases like heart disease, cancer, and diabetes. However, it is also true for quality-of-life concerns. Recall the classic research that demonstrated the superiority of the vegetarian diet regarding athletic endurance. Other quality-of-life benefits are in the area of mental performance. For example, middle-aged individuals-and even those up into their 80s who do not suffer from Alzheimer’s disease-have been demonstrated to have a measurable improvement in memory following aerobic exercise programs of nine or ten weeks in duration.38 In fact, older Americans have a progressive improvement in mental function as they increase their amount of exercise. As one research article put it: "There was a clear linear relationship between the level of activity and the level of cognitive [mental] ability."39 A consensus panel convened by the National Institute of Mental Health identified still other important quality-of-life benefits from exercise. They are listed in Figure 12: Exercise Improves the Quality of Life.40

Although health professionals have emphasized for years the importance of exercise in preventing life-threatening diseases in order to motivate their patients to exercise, this is probably not the most effective strategy to promote exercise. Improvements in the various facets of the quality of life appear to be the most important reasons that many become regular exercisers. RUNNER’S WORLD magazine published the results of an exercise survey of 700 of its subscribers in 1990. Notice the various reasons for adopting an exercise program:

These top reasons were all related to the quality of life. Further down the list were lifesaving reasons that professionals think are the most motivating. Only 42 percent identified heart disease prevention as a reason for exercising.

Medical research continues to uncover more and more benefits of exercise on quality of life. Harvard researchers recently documented that exercise decreases the risk of developing diabetes in adulthood.41 As little as one workout a week cut diabetes risk by 29 percent. The preventive effect was not merely the result of weight reduction. Other preliminary research suggests that regular exercise may help to forestall hearing loss.42 Dr. Helaine M. Alessio and colleagues from Miami University in Ohio exposed 28 people to relatively loud noise (100 decibels). The most fit subjects retained more hearing capacity than those who were not as fit. One explanation for the difference is that regular exercise may improve the flow of oxygen-rich blood through the tiny blood vessels in the ear.

As a testimony to the far-reaching benefits of exercise, when the Center for Disease Control and the American College of Sports Medicine published recommendations in 1995, they presented an ideal schedule of "daily exercise." Gone are the days of recommending three days a week as being sufficient. In the words of the report, "Every U.S. adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week."43

In Chapter 2 on cancer, attention is focused on the importance of exercise on the immune system. There we see some of the encouraging research that has demonstrated exercise’s ability to decrease cancer in general44 as well as providing special help for devastating cancers like those of the lung, colon, uterus, ovaries, vagina, and cervix.45, 46, 47 Some of the reasons that exercise has such far-reaching stimulating effects on the immune system are presented. A number of natural immune fighting cells and chemicals are enhanced by exercise. These same benefits to the immune system that help to prevent life-threatening cancers can also help to prevent the annoying everyday illnesses such as coughs, colds, and flues.48

It is not clear exactly how much exercise is needed to prevent cancer; however, consistency appears to be an important factor. The same likely holds true for other immune system benefits from exercise. The conclusion regarding the fighting of infections and cancer is that exercise should be a part of our daily lifestyle.

Many sedentary middle-aged or elderly people shy away from initiating an exercise program because of fear of experiencing a heart attack. However, if they start slowly and do not exercise to the point of exhaustion, chances are they will not need a medical consultation before initiating such a program.

Those with certain physical conditions should have an evaluation prior to initiating endurance training.49 They are listed in Figure 13: Who Needs to be Evaluated Before Beginning Endurance Training.

This figure quotes directly from a consensus conference put on by the National Institutes of Health in 1996 in which many exercise and heart disease experts convened to print consensus statements on physical exercise. According to the above consensus statements, if a 45 year-old man smokes and has high blood pressure, he would need a medical evaluation prior to training because he has "multiple risk factors" for heart disease. If he had only one risk factor he would not have needed an evaluation. More information regarding cardiovascular risk factors is found in Chapter 3, "Heart Disease-Conquering the Leading Killer."

Years ago, Ellen White recognized the benefits of physical exercise as shown in Figure 14: "More Rust out than Wear Out"50 and Figure 15: Morning Exercise.51

One word of caution: although moderate exercise has clearly emerged as healthful to the immune system, excessive exercise is not. Exercise to the point of complete exhaustion-typical in competitive athletes-can work in the opposite direction by decreasing immune responses.52



NEWSTART Element Number 3: Water

Thicker, more viscous blood increases stroke and heart disease risk. One measurement that, in part, determines blood thickness is called hematocrit. This reflects the number of red blood cells in the blood, and usually closely parallels the hemoglobin level. Hematocrit values greater than 50 percent double the risk of cardiovascular events in men and increase the risk fourfold in women.53 If a person is not drinking enough water, hematocrit rises, thus increasing risk of heart attacks and strokes. Also, a lack of water causes dehydration of red blood cells, making them less flexible, and they have a greater tendency to clot.54

All told, a wealth of information has been published on the subject of blood flow characteristics and its impact on a variety of disease states.55, 56, 57, 58 The research often is published under the title of "hemorheology." This term comes from "hemo" which refers to blood and "rheology" which refers to the study of the flow properties of complex materials. Among the implications of this research is that adequate water drinking combined with other aspects of a healthful lifestyle may help postpone or prevent a variety of diseases and their complications. A few of the benefits that may accrue from improvements in blood flow caused by a more liberal intake of water are shown in Figure 16: Physical Improvements Resulting from Increased Blood Flow.

Diabetes is associated with increased blood viscosity or thickness. As the blood sugar level is brought under better control, viscosity tends to improve. Uncontrolled blood sugar levels may predispose individuals to high viscosity in part because of dehydration. When blood sugars are running high, the kidneys lose sugar, and the sugar takes water with it. The issue of blood thickness in diabetes is of particular concern because high viscosity levels may play a role in diabetes-related kidney and nerve damage.59

Blood viscosity also appears to have a role in high blood pressure. In population studies, the higher a person’s blood pressure, the higher their blood viscosity tends to be. If a person can reduce hematocrit, the blood pressure will tend to decrease. This provides a double benefit: lower blood pressure and lower blood viscosity work together to further decrease stroke risk.60

Ironically, those on diuretics (water-losing pills) for their blood pressure may in some ways be perpetuating their problems. The reason is that these drugs tend to decrease blood volume, and thus can contribute to an increase in blood thickness. Diuretics may not only cause loss of water from the body, but may also contribute to loss of fluid from red blood cells-making them less flexible and deformable.61 Recall that such changes will, in turn, make the blood more likely to clot. The same changes may also perpetuate the high blood pressure.

Some have speculated that water may have another role in decreasing high blood pressure and in preventing strokes. Pure water actually acts as a mild diuretic. If you drink more water than you need, the excess water is eliminated through the kidneys. There is one subtle qualification: kidneys can only excrete water that is accompanied by sodium. As a result, excess water drinking results in the loss of some sodium. Thus, drinking plenty of pure water helps to decrease body sodium stores and thus may contribute to blood pressure lowering.

Other lifestyle habits can help to improve blood fluidity. These factors include stopping cigarette smoking, eliminating the use of alcohol, losing weight (if overweight), engaging in regular moderate exercise,62, 63 and adopting a high fiber, low fat, low protein diet.64, 65, 66

Regarding exercise, moderate exertion is beneficial to the circulation, but excessive exercise may be harmful to blood fluidity. For example, those who exercise in the heat and are perspiring heavily may be more likely to have problems with clotting due to "thickening of the blood" because of blood volume loss.67

Water drinking has still other benefits. Your mother no doubt told you that it was good for your kidneys and urinary bladder. However, she probably was not aware of its effect in helping to prevent gallbladder disease. A number of studies have indicated that drinking liberal amounts of water helps to dilute the bile in the gall bladder and thus decrease the risk of stone formation.68, 69, 70 Those who are overweight, or have a family history of gallstones, or who have known gallbladder disease would be wise to seriously consider the benefits of drinking more water. In my medical practice I have found that insufficient water intake can even mimic hypoglycemia. This problem seems to be more common in younger individuals with lower blood pressures. I will never forget the businesswoman who had extensive laboratory tests to determine why she had "hypoglycemic fainting spells." None of the tests provided an answer. After this extensive evaluation, I suspected the problem rested with something as simple as inadequate fluid intake. I promptly encouraged her to drink a minimum of 12 glasses of water every day. She followed my instructions and her problem was solved.

Drinking more water decreases the risk of kidney stones by diluting the mineral content in the urinary system. Consuming liberal amounts of water may also decrease the risk of urinary tract infections. Water drinking among smokers may also help to decrease the risk of cancer of the bladder for similar reasons. Smoking gives rise to powerful carcinogens (as explained in Chapter 16, "Dying for a Cigarette? Kick the Habit and Live"), some of which are stored in the bladder. The more water one drinks, the less concentrated are those toxins, and the greater the stimulus to void and expel them. In fact, water drinking has so many benefits, that a recent issue of the Journal of the American Medical Association called attention to the particular hazards facing older Americans from inadequate fluid intake.71 Harvard researchers estimated that by making sure older people drank enough fluids, over one million days of hospitalizations and over a billion dollars each year would be saved.

In this section, I have tried to provide in broad strokes just a glimpse of the exciting research that encourages us to drink plenty of water daily. The internal use of water can clearly reduce suffering and save dollars as well as lives. However, water can also be applied externally to deal with a host of physical problems. Those observations apply in general with equal force to other painful conditions such as muscle aches, strains, etc. A full discussion of the broad science of "hydrotherapy"-or water therapy-is beyond the scope of this chapter. However, suffice it to say that external applications of water have been used with clinical success in conditions as varied as headaches, asthma, muscle tension, and digestive complaints.



NEWSTART Element Number 4: Sunshine

Sunshine has gotten a bad rap. It is true that excessive ultraviolet light from sunshine can increase the risk of skin cancer and cataracts, but judicious amounts of sunshine can be extremely beneficial. For example, sunshine can play a critical role in helping to prevent osteoporosis. Sunlight, you will recall, is able to convert cholesterol into vitamin D, an essential factor in maintaining good bone health.72

In Chapter 7 that deals with protein, we saw that high intake of animal protein sources was also a significant factor in causing osteoporosis. In addition to sunshine and nutrition, however, other NEWSTART factors are important in dealing with osteoporosis. Exercise is vital to staving off age-related loss of bone mass. Recent research from Washington University School of Medicine in St. Louis has demonstrated that a woman can increase her bone mass by 2 to 3 percent per year by exercise alone.73

But what about skin cancer? Why not get our vitamin D from pills or supplemented foods, so we can avoid sunshine’s cancer risk? There’s no question about it: when many Americans think of sunshine, they think of an agent that increases the risk of cancer.



Sun Exposure in High Doses and Cancer

Sunlight in high doses increases skin cancer risk. About 95 percent of skin cancers are of two types: squamous cell and basal cell.74 Both of these types of cancer are increased by substantial cumulative lifetime exposure to the sun. Fortunately, however, they are slow growing and usually remain confined to the skin. Even though some 750,000 squamous and basal cell skin cancers are diagnosed each year in the United States, only about 2,100 fatalities (less than one percent) result.75 The fatalities occur mostly in those who fail to get prompt and complete removal of the cancer.

Melanoma, another type of skin cancer, provides a markedly different situation. This usually darkly pigmented cancer has a fearsome tendency to spread and kill the victim. Each year only about 34,000 cases of melanoma are diagnosed in our country; however, 7,200 (more than 20 percent) die annually from this dreaded skin cancer.76 Melanoma is currently on a rapid rise worldwide; in Europe, it increases by three to seven percent every year.77 Regarding this deadliest of skin cancers, it appears that the important factor is not so much the total amount of sunlight you are exposed to, but whether or not you get sunburned. Thus, overdoses of sunlight are to be avoided. More information on skin cancer is found in Chapter 2.

Sunlight in moderate amounts, however, is healthful, and may even be beneficial in cancer prevention. Research now suggests that judicious sun exposure and the production of vitamin D may also help to prevent certain types of cancer. Colon cancer is one of the malignancies that sunshine exposure may help to prevent. Researchers at the University of Washington studied cancer rates in nine different areas of the United States. They discovered that men from Southern states had much less colon cancer than Northerners.78 For example, when compared to men living in New Mexico, men in Michigan, Connecticut, and Washington had colon cancer rates 50 to 80 percent higher. The effect also seemed to hold true for women, although it was not as marked.

Another scientific article reviewed studies possibly linking cancer prevention with sunshine exposure. H.G. Ainsleigh, the author, pointed out that there is a long history of medical documentation suggesting that regular sun exposure substantially decreases the death rates from certain cancers.79 Like other researchers, Ainsleigh observed that the linkage between sun exposure and cancer prevention appears to be due to vitamin D. Vitamin D and related compounds appear able to suppress the abnormal growth of a variety of cancer cells. These include leukemia and lymphoma as well as cancers of the breast and colon.

Ainsleigh did not stop there. He went on to make some startling calculations; namely, that although frequent regular sun exposure statistically causes 2,000 U.S. cancer fatalities per year, it also acts to prevent another 138,000 U.S. annual cancer deaths-and could possibly prevent another 30,000 more if all Americans adopted the practice of regular, moderate sunning. He even raised the concern that blame for a 17 percent increase in breast cancer incidence during 1991 and 1992 may have been related to misplaced solar-phobia; with a "decade of pervasive anti-sun advisories from respected authorities, coinciding with effective sunscreen availability." Sunscreen may induce otherwise cautious sunbathers to get overdoses of sun exposure.

Regarding sunshine and cancer, two facts clearly stand out. First, excessive, injudicious amounts of sunshine can increase skin cancer risk. Second, avoiding sunshine is not a good alternative. It is likely that sunshine and the vitamin D it produces may actually play a role in cancer prevention as well as in bone health.



NEWSTART Element Number 5: Temperance

The concept of promoting personal health by a judicious exposure to sunshine provides a perfect backdrop for looking at the fifth NEWSTART element. The first "T" stands for "temperance." Temperance in the context of this book means "total abstinence from substances that are harmful and moderate use of substances that are helpful." Applying the "temperance" concept to sunshine would lead us to use this helpful factor in moderation. Often the challenge concerning temperance is to decide which substances to use in moderation and which to avoid totally. The concept of total abstinence has become very unpopular. Many health educators promote the mistaken idea that almost anything we do is appropriate so long as we do it in moderation. From a study of the research literature, coupled with personal experience from my own life and those of my patients, it is evident that we would be better off totally avoiding many things that are popular to use "in moderation." Elsewhere in this book (Chapter 17, "Want a Drink?"), the case for total avoidance of alcoholic beverages from a health perspective is presented. I am not a lone voice crying for total abstinence from alcohol. The World Health Organization has taken the same position, now advocating "no alcohol" as the standard.80 In several chapters of this book I have cited concerns with another popular addictive drug: caffeine. Caffeinated beverages present a subtle threat to our health which some are finally beginning to grasp.



Problems with Moderate Caffeine Use

As pointed out in Chapter 2 on cancer, medical research has raised concerns that coffee and other caffeinated beverages may increase the risk of certain cancers. The list of those malignancies include cancers of the kidney, breast, pancreas, ovary, bladder, and colon.81, 82, 83, 84, 85 Theobromine is a caffeine relative found particularly in chocolate and tea. Research suggests that even small amounts of this compound taken regularly can double a man’s risk of prostate cancer.86 The concerns with caffeine and its relatives are not wholly theoretical: these drugs have potent cancer-causing effects. In laboratory studies they are capable of damaging the chromosomes of both plants and animals.87, 88, 89, 90, 91

Certain experts contest some of these findings. Are you willing to take the risk of continuing your caffeine habit? Many have become habituated-if not addicted-to moderate or large amounts of caffeine; the suggestion of total avoidance brings up great barriers. To illustrate your approach to this decision, assume that you are planning to build a new house. You find a place on a nice piece of property, but the land is over an old toxic waste dump. Some experts tell you that there is no proof of any risk from living above that dump. Others have grounds for concern that living there will increase your risk of cancers of the kidney, breast, pancreas, ovary, bladder, and colon. Do you roll the dice and move in, or do you say, "why take the risk?"

If you had never acquired the caffeine habit, you would probably stay totally clear of it. However, if it is a part of your life, is it worth giving up? I would say "yes." I have worked with many people who have overcome the caffeine addiction. At first it may be a struggle, but over time they not only get along fine without it but they also reap the health benefits of their decision.

Caffeine not only increases the theoretical risk of cancer, it also brings a host of other problems in its train. Coffee and/or caffeine are linked to an increased risk of such problems as miscarriages, low birth weight babies, worsening depression, anxiety and fatigue, elevated blood pressure, heart palpitations, heart disease, bone loss and osteoporosis, and other maladies. Further information is provided in Chapter 2 on cancer and Chapter 12, "The Frontal Lobe-The Crown of the Brain."



NEWSTART Element Number 6: Air

Throughout most of recorded history, it seems that people have taken fresh air for granted. However, with the advent of the industrial revolution, followed by current concerns for indoor and outdoor air pollution, fresh air has become a more valued commodity. An excellent article on fresh air was penned some years ago by Dr. Bernell Baldwin. Entitled "Why is Fresh Air Fresh?"92 Baldwin pointed out that fresh air is chemically different than the recirculated indoor air that most Americans breathe. High quality fresh air is actually electrified. The life-giving oxygen molecule is negatively charged or "negatively ionized." This negatively charged oxygen gives rise to a number of benefits as listed in Figure 17: Effects of Negetively Charged Fresh Air.93, 94, 95, 96, 97, 98, 99

An environment of negatively charged ions truly has remarkable effects. Some of the most impressive have to do with behavior. Some of the research has centered on animals that were raised in such a way as to develop the equivalent of human anxiety disorders. When these animals were allowed to breathe air with an abundance of negative ions they were protected against some of the physical changes linked to anxiety. Animals exposed to negative ions showed a normalization of pertinent brain chemistry measurements and did not show any tendency to high blood pressure or ulcers.100 (In fact, even in animals with no behavioral disorders predisposing them to ulcers, negative air ions helped to promote less significant ulcer disease including smaller ulcers, less bleeding and less acid secretion.101) In studies of children, negative ions have also demonstrated salutary effects. In one study, normal children and those with learning disabilities showed measurable improvements in brain function.102 The authors concluded: "Negative air ions are seen to be a tool with potential theoretical and remedial applications."103

Other research further underscores the fact that fresh-negatively ionized-air helps to keep our mood buoyant and positive. Baldwin and others cite the Middle Eastern "sharaw" (also transliterated "sharav") windstorms that bring an abundance of unwanted positive ions with them.104, 105, 106, 107 During these storms, as many as 30 percent of individuals develop problems with increased anxiety and suspicion, migraine headaches, nausea, vomiting, diarrhea, eye problems, irritability, respiratory congestion, etc. The positive ions seem to alter brain levels of serotonin, an important mood-elevating chemical. These hot desert winds rob the air of helpful negative ions.

Negatively charged air is also destroyed by recirculating air in buildings, tobacco smoke, city smog, and other pollutants. On the other hand, good quality negatively ionized air is found in abundance in natural outdoor environments, especially around evergreen trees, beach surf, or after a thunderstorm.

Researchers have been studying the harmful effects of polluted air on human beings. Their findings confirm that pollution depletes the air of negative ions. In addition, the common pollutant, ozone, has been demonstrated to cause eye irritation, shortness of breath, cough, worsened lung function, and decreased physical performance.108, 109 Worse yet, women living in one of the nation’s most highly polluted regions, the South Coast Air Basin of California, experience increased risk of cancer in proportion to their total exposure to particulate pollutants.110 Clearly, it behooves all of us to get as much fresh air as possible. When we are overcome by stress and worry, getting away from our urban dwellings and workplaces seems to promise more than a change of venue. The medical literature indicates that a drive to the seashore, a local state park, or other natural setting promises improved mental and physical health as we breathe in the refreshing fresh air with its abundance of negative ions. Better yet, if it can be arranged, living in a more rural setting would likely yield the blessing of better quality air as well as other amenities.



NEWSTART Element Number 7: Rest

I am convinced that if the benefits of rest could be put into a pill, it would be among the hottest selling supplements on the market. Unfortunately, in order to reap the benefits of rest, we must slow down and take the time to rest. Sadly, many of us do not believe that we can really pause long enough to take advantage of this vital remedial and preventative agency. Therefore, many are not even interested in learning about the far-reaching benefits of rest. They reason, why become convinced of the advantages of something that I do not have time for anyway? Because of these biases, I’d like to challenge you to think about rest as if it were a newly discovered vitamin, let’s call it vitamin R. In this hypothetical situation, we can now forget about whether or not we have time to rest. After all, every one of rest’s advantages can be obtained from taking a pill. Let us now look at this amazing "vitamin" and see if you want to include it as part of your daily program.

However, before we go too far with our illustration, I should clarify the fact that rest comes in a number of different forms. In fact, there are really four different types of vitamin R. Just as there are a number of B vitamins, so there are four siblings in the vitamin R family. They are listed in Figure 18: Vitamin R (Rest) Comes in four Kinds.

Vitamin R1 is sleep, or daily rest. Vitamin R2 is the weekly rest: in addition to sleeping each night, we need a weekly day of rest. Vitamin R3 is recreation: we need to take time to get away from work, physical tensions, and mental stresses of life. Vitamin R4 is also essential: this vitamin is meditation-and should be done at least on a daily basis. Let’s look more closely at each of these four types of vitamin R. R1, the sleep vitamin, is in short supply with many Americans. Research suggests that the average person does best on seven to eight hours of sleep per day. This figure was associated with the greatest longevity in the Alameda county health study that we examined in the first chapter ("Principles for Optimal Health").111 Statistics suggest that about two-thirds of American adults sleep between six and nine hours per night.112 Sleep needs vary with our genetics. Dr. James Perl, a Ph.D. psychologist and sleep expert, points out that about 20 percent of the population genetically needs less than six hours per night. He also observes that 10 percent of our populace genetically needs more than nine hours per night.113

Regardless of your specific need, anyone can come up short on vitamin R1. If you do not feel wide awake and energetic throughout your waking hours, you are likely sleeping too little. And if that is your problem, you are not alone. In the U.S., fatigue is one of the 10 most common reasons for visiting a physician.114 In fact, each year 3.3 million Americans visit their doctors for insomnia alone.115 Yes, problems with inadequate sleep are exceedingly common in our nation. The evidence suggests that as many as 60 percent of Americans have some problems relating to their sleep habits.116, 117

It may seem somewhat depressing to talk about how poorly the average American’s sleep needs are satisfied. There is some good news in this department, however. Those who handle stress better appear to require less daily sleep. In other words, if you are emotionally healthy and positive, your body is likely to sleep more efficiently.118 Exercise can also help you to have more energy on a given amount of sleep. Put another way, regular exercise helps to decrease our sleep requirements. In fact, exercise has been demonstrated to decrease fatigue and boost mental and physical vigor.119

Although positive moods and physical exercise can help us in the sleep department, there are things that work against our ability to get refreshing sleep. Television viewing is one reason why we do poorly in the sleep department. The more television you watch, the less time you have to sleep. This is particularly a problem for American youth. Many are not getting enough sleep because of their liberal diet of TV. There are, of course, many other reasons for our national sleep debt. I will not go into our tendency to squeeze too many activities into a finite number of hours per day. I would, however, like to stress one of the most fatal deceptions of the sleep-deprived. Most of those who are shortchanging themselves on vitamin R1 feel like they can get by without optimal amounts of this vitamin. Unfortunately, the medical literature is very clear on the effects of sleep deprivation and irregular sleeping habits (such as shift work).120, 121, 122, 123 Such practices slow reaction time and increase the risk of both fatal and nonfatal accidents. Sleep deprivation can clearly have life-threatening consequences. Probably one of the most notable is falling asleep while driving. One interesting aspect of the current research on falling asleep at the wheel is that accidents and fatalities seem to be the most common in those who have not learned their limits. In one U.S. study, 55 percent of such accidents occurred in individuals 25 years old or less, suggesting that inexperience in respecting fatigue’s cues can be costly.124 The toll of disability and death from fatigued drivers is not confined to the U.S., of course. A recent German study indicates that falling asleep at the wheel is the leading cause of German roadway fatalities, amounting to nearly 25 percent of the total.125

However, the risk of other types of accidents also increases dramatically in those who are sleep-deprived. Accidents at the work place also occur more commonly when we are short on sleep, working unusual hours, or otherwise fatigued. Large-scale disasters like the Chernobyl fiasco, the Exxon Valdez crash, and the Three Mile Island incident all occurred in early pre-dawn hours, when vigilance was at a low point. Dr. Fred Hardinge, an expert looked to by the Federal Aviation Administration on issues relating to fatigue and performance, has pointed out that most of the "friendly fire" problems in the Persian Gulf War were due to fatigue. Some of these short-term sleep deprivation problems-with long-term consequences, nonetheless-may result from what are called "micro sleeps." In these settings your eyes typically are wide open, yet your attention lapses and you do not realize what is happening.

Although short-term problems with sleep deprivation often grab the headlines, serious problems result from chronically not getting enough sleep. Remember that even six hours of sleep per night is insufficient for many people and sets the stage for problems. Frontal lobe brain damage can occur in sleep-deprived animals. PET scans demonstrate decreased blood flow to the frontal lobe of the brain in chronically sleep-deprived individuals.126 With such chronic sleep shortages, irritability and belligerence rise while attention span drops further. Rapid mood changes and trouble coping with stress can result. Withdrawal from group action and even depression are among the outcomes of chronic sleep deprivation. Delusions and hallucinations can also be consequences of this downward spiral.

Both short-term and long-term sleep deprivation can affect your resistance to disease. Losing even three hours of sleep on a given night can cut in half the effectiveness of your immune system.127 A number of immune alterations occur with sleep deprivation: antibody levels are decreased128 while interleukins-1 and -2 fail to experience the rise that occurs with deeper stages of sleep.129 Growth hormone (GH) requires sleep for optimal release. Absence of GH further impairs immunity as important immune defenders, the cytotoxic T cells (a type of white blood cell), are dependent on this hormone.130 Chronic fatigue also increases the risk of problems that may not be so obvious: heart disease, heart related deaths, and stomach and intestinal problems.131

Even if you are spending nine hours each day in bed, you may not be getting the quality of sleep that you need. Sixty years ago, sleep was regarded as a static process of rest, but sleep quality can radically differ even if it looks like two people spend the same amount of time in bed. How can you increase sleep quality? Figure 19: Ways to Improve Sleep Quality lays out some of the basics.132

Sleep quality is actually related to the entire NEWSTART program. Although daily rest is an important aspect of health, we tend not to rest as well if we are not following other aspects of a healthy lifestyle. Perhaps nowhere is this seen more clearly than in research relating sleep and aging. Most have not questioned the "fact" that sleep quality deteriorates as a person gets older.133 However, new research from Stanford University Medical School and other centers is calling this assumption into question. What the newer data suggests is that people who stay healthy and follow a good lifestyle are unlikely to develop changes in sleep quality as they age.134, 135



Vitamin R2: The Weekly Rest

In America, it is not uncommon for people to put in a seven-day workweek. Many do this repetitively and do not seem to suffer for it. However, the medial evidence suggests that there may be both long-term and short-term consequences to such a practice. Just as the body has a natural daily clock (circadian rhythm), it also has a weekly clock (circaseptan rhythm). Circa-septan rhythms are just that: body rhythms that run about seven days in length.

Medical research has demonstrated such rhythms in connection with a variety of physiological functions. Some that have been identified included heart rate, suicides, natural hormones in human breast milk, swelling after surgery, and rejection of transplanted organs. To understand the significance of these rhythms, consider the latter two items in the list. A person will tend to have an increase in swelling on the seventh and then the fourteenth day after surgery.136, 137 Similarly, a person with a kidney transplant is more likely to reject the organ seven days and then fourteen days after the surgery.138, 139 Research on circaseptan rhythms continues and new relationships are continually being discovered. There are seven day rhythms that have been observed in both human and animal cancers and their response to treatment.140, 141, 142 Fibrinogen, a blood clotting compound that has been demonstrated to increase the risk of heart attack, has now also been observed to have a seven day rhythm.143 Further work has shown that in addition to inflammatory responses operating on a circaseptan rhythm, so do the drugs that we often use to treat them.144

An understanding of circaseptan rhythms has lead me to more fully appreciate the fact that I need to pay attention to weekly rhythms to protect my own health and the health of my patients.

Dr. Baldwin asserted some years ago that the current research indicated that "this seven-day rhythm is a normal built-in feature of our physiology."145 Recent researchers have been even more adamant than Baldwin. "From the medical point of view so-called circaseptan (about 7 days) reactive periods are of predominant interest. This periodicity can be observed in numerous adaptive and compensating processes. It does not depend on the external week cycle and was already known to the antiquity."146 What both of these authors are saying is that the importance of the seven-day rhythms should not be underestimated. Furthermore, these rhythms are a part of who we are; they are not a function of the fact that we happen to keep a seven-day week in our culture. Thus, this seven day rhythm "does not depend on the external week cycle."

From a historical perspective the weekly cycle is also of great interest. We keep a 24-hour day based on the earth revolving on its axis. We keep a monthly cycle based on the periodicity of the moon. The year is based on the earth’s circling the sun. But what is the week based on? Some have conjectured that mankind over the years came to the conclusion that no other weekly cycle harmonized well with our internal rhythms. It is interesting to note that although cultures have experimented with different weekly cycles, all those that Baldwin is aware of have reverted to the seven-day program. He points in particular to France during the time of the French revolution. They then experimented with a ten-day (metric) week, with disastrous results. The mental institutions filled rather quickly to capacity and then some. Baldwin attributes the abolition of that program in part to the logical thinking of the renowned mathematician, Laplace.

However, others have pointed to an even more compelling reason for the existence of the weekly cycle: it is the way that God created us. Indeed, in the first of the scriptural books of Moses, the seven-day weekly cycle is described as part of God’s design in creation. That cycle is described as consisting of six days of work followed by a Sabbath day of rest. Baldwin sees significance in the Sabbath concept in relation to circaseptan rhythms.147 He recognizes this as a "zeitgeber" ("time-giver" in German). Zeitgebers keep our weekly rhythms synchronized by pausing one day in seven for a time of rest. In order for these time-givers to work, however, it must come at the same time each week. In other words, it is not sufficient to get one day in seven off; it is optimal to get a specific day in seven off on a regular basis.

My own experience agrees with this body of medical research. I personally need one day in seven where I set things aside and experience a true rest. That does not mean I sleep the whole day. Instead, I use it as a day for recreation, for reflection, for meditation, and for focusing in on spiritual values. Whether you keep the seventh day of the week as I do (from sundown on Friday evening to sundown on Saturday evening in harmony with the biblical injunction) or a different 24 hour period, there is a benefit to observing one specific day in seven as a day of rest. One other observation is in order. In scheduling our daily rest of sleep, we often have to prioritize sleep even though we have not finished all of our work for the day. Many have learned by experience that in most circumstances it is best to go to bed on time. In the same way, even if your work for the week is not completed, I would still encourage you to take that specific day in seven off and rest as if your work was completed. In fact, a physician friend of mine once said that such a priority is one of the beauties of God’s Sabbath commandment. Even though he is aware of the importance of the weekly rest, if God did not specify a specific day, he feels he would not be regular in keeping one specific day per week as a "zeitgeber." I have found the same true in my experience.



Vitamin R3: True Recreation

If you look at how most Americans spend their time, you would think that television is our nation’s number one form of recreation. However, in the sense of the term as I use it, TV programing does not meet my criteria for true recreation. When discussed in the context of rest, I see recreation as living up to its name, specifically: "re-creation." I believe that after engaging in true recreation, I should be more able to meet life’s challenges, not less able. True recreation is revitalizing and helps me better accomplish the work and responsibilities that I have. What kind of activities then fit the bill as "true recreation?" From my experience and study, outdoor recreation tops the list. Options include a host of activities such as gardening, hiking, doing pleasant yard work, cross country skiing, walking, and dozens of other options. These activities provide a mental break from the routine, as well as offer the advantages of many of the other NEWSTART elements such as exercise, sunshine, and fresh air.



Vitamin R4: Meditation and Prayer

Meditation and prayer provide a form of rest that has been practiced for centuries. Even secular Westerners are becoming more interested in learning about this potent form of release from stress, tension, and anxiety. In my own experience, I have found meditation and prayer to be a vital part of a balanced lifestyle program.

Prayer is the breath of the soul, figuratively speaking. As moral beings and spiritual beings, we need to spend sufficient time in contemplating our trust in divine power. There is a connection between the "R" and "T," specifically vitamin R4 and "T," trust in God. It can help us in so many ways, such as in controlling stress, strengthening the immune system, providing protection against heart disease, cancer, etc. The list goes on and on. Yes, trusting in our Maker, Defender, Redeemer, and Friend. But how can we trust Him if we do not really talk to Him through prayer? In Chapter 12 on the frontal lobe, I point to the example of Dr. Larry Dossey as an illustration of how even honest skeptics are now concluding that prayer has unique benefits.148 Dr. Dossey has collected a host of scientific studies that demonstrate that when people pray to God on behalf of others, health benefits result. These results even include the spontaneous regression-or cure-of cancer. Dossey’s experience illustrates that from the perspective of thinking scientists, the benefits of prayer extend beyond those of mere meditation. It is remarkable that the attitude of prayer makes a difference in whether or not healing ensues. It is the trustful prayer of faith in committing one’s life to God that most likely results in healing-not the aggressive prayer that prays for white blood cells to destroy cancer, or attempts to raise self to levels of unrestrained optimism.149

One of the themes with vitamins R1 and R2 is that these substances must be "ingested" regularly to provide optimal benefits. Just as we need daily rest in each 24 hour period, and weekly rest once in every seven days, so do we need regular periods for recreation on the one hand, and prayer and meditation on the other. Actually, each of the other types of rest affects vitamin R4 as well. As we have seen, lack of sleep or irregular and/or excessively long work hours contribute to some obvious problems: poorer quality and quantity of sleep, increased fatigue, poorer work performance and increased accidents. 150 However, inadequate sleep also affects us spiritually. The frontal lobe appears to be particularly prone to sleep deprivation. Surprisingly, our values even tend to suffer when we are short on sleep.151 This last element of rest-meditation and prayer-also addresses the most potent robbers of rest and relaxation, namely stressors and our maladaptive ways of handling them. As pointed out in Chapter 14, "Stress Without Distress," the use of meditation and prayer offers powerful help on these levels. There I emphasize that we have a critical need for meditation and prayer on a daily basis. I go on record as defining these elements as forms of "rest and rejuvenation that few appreciate" to their fullest extent. The interested reader is referred to that chapter on stress for a further discussion-and practical application-of this vital vitamin R4.



NEWSTART Element Number 8: Trust in Divine Help

After presenting the all-important spiritual element of rest ("vitamin R4"), this section may seem redundant. However, this final element of the NEWSTART eight bears repeating. Throughout this book, I have demonstrated how research is showing that spirituality and trust in divine power have a role in dealing with many common diseases. We looked at the role of faith in heart disease, the relationships of spirituality to the AIDS epidemic, and the link between religion and cancer. Later in the chapter the stress-religion-arthritis connection will be covered. One fascinating study looked at the religious experience of those Americans who reached the golden age of 100. Among the centenarians, the researchers found that religiosity significantly enhanced physical health. Although there are still many unanswered questions, the benefits of trust in God are due to more than simply attending religious services.152 Furthermore, the far-reaching benefits of faith seem to transcend age and racial boundaries. A recent study of black Americans found that those who engaged in organized religious activities had improved health and life satisfaction.153 Even those who engaged in religious pursuits outside of an organizational structure experienced this boost in satisfaction. Indeed, one of the most consistent findings-across racial groups-is that spirituality profoundly improves quality of life. The profound benefits in the quality of life brought about by exercising faith are described by a Duke University researcher in Figure 20: Faith in God Favors Good Health.154

Another amazing aspect of spirituality is that it not only helps believers but it also benefits non-believers in their community. Research has demonstrated that communities gain health benefits when they have higher numbers of adherents to faiths that emphasize implicit obedience to God and his standards of conduct.155 One theory for why non-believers benefit is that social norms favor conformity to the healthier lifestyle embraced by their more religious neighbors.

Another compelling explanation as to why trust in divine power is so important in a comprehensive health program is borrowed from an illustration by Zeno Charles-Marcel, M.D., Medical Director of the Lifestyle Center of America in Sulphur, Oklahoma. The basis for an individual’s particular health status is depicted in Figure 21: The Basis for your Personal Health Status.

After a patient undergoes a complete "history and physical" evaluation, including appropriate laboratory and/or other pertinent tests, I have a clear picture of the patient’s health status. That health status, which is often felt by the patient in daily living as his or her "quality of life," is just the visible tip of the iceberg. Underneath are reasons that increase in importance as we go deeper in the illustration. Health status is directly dependent on that particular individual’s health habits, as I have demonstrated distinctly and frequently in this book, beginning in the first chapter. For instance, consider the dietary habit of eating red meat. The more red meat an individual consumes, the higher the cholesterol, blood pressure, heart disease risk, cancer risk, renal failure risk, etc. tends to be. But why is a certain individual a heavy meat eater? We have to go deeper to find the answer. If a person grew up eating meat and potatoes, guess what he tends to eat now? If he grew up consuming caffeine beverages, guess what beverages he prefers now? The particular culture that individual grew up in largely determines the habits he has now. Fortunately, the illustration does not end there. There is always that "one person" who grew up eating meat and potatoes and had parents that smoke and drank who does not smoke, does not drink, and is a vegetarian. Why did that person become "counter-culture" and choose different habits? That individual let his own personal choices and values take precedence over his culture. Ultimately, every person’s own personal choices become a deeper reason than culture for his set of habits. The kinds of choices a person makes and values he possesses are directly related to his sense of overall meaning and purpose in life; this is where the spiritual life and trust in divine power have a direct bearing. Thus, trusting in a higher power bestows certain health benefits. That same trust has a direct connection to the overall meaning and purpose of one’s life, which then affects the personal values and choices, which then affects the culture one chooses to adopt, which directly influences the particular set of health habits, which at last directly affects the health. The original health benefits come full circle and are reinforced and multiplied.

Clearly, throughout my personal life and my work as a physician, I have seen the importance of integrating the spiritual element into a total approach to healing. The medical research shared throughout this book, and again mentioned in this section, underscores this important agency of trust in divine power as both a remedy and a basic tenet of prevention.

Now that we have seen an overview of each element in NEWSTART, let us illustrate how these elements can be applied to some specific diseases that have not been dealt with elsewhere in this book. I begin with the example of rheumatoid arthritis, a common disease. Rheumatoid Arthritis

Arthritis and other bone and joint disorders are among the leading causes of disabilities in America. Current estimates from the U. S. Centers for Disease Control are that these diseases afflict some 40 million Americans.156 One particularly destructive form of arthritis is called "rheumatoid arthritis." It is a disease caused when the body actually attacks its own joints and other tissues. For reasons not yet completely understood, an affected person’s immune system goes awry and starts attacking the joints, causing what often becomes a permanently crippling disease.

Scandinavian researchers placed individuals with severe rheumatoid arthritis on a total vegetarian diet for an entire year.157 After a single month on this dietary program, they analyzed the patients and found a decreased number of tender and swollen joints. Their grip strength was better. Furthermore, their problems with severe joint stiffness in the mornings had improved. Even actual laboratory measurements that reflected the degree of inflammation in the body were better. Two such improved blood tests were the sedimentation rate, and the C-reactive protein level. These results are demonstrated in Figure 22: Total Vegetarian Diet Helps Rheumatoid Arthritis.

Perhaps most importantly, the patients on the vegetarian diet felt better-by actual measurement on a health assessment questionnaire. The control group on their regular diet had a mild decrease in pain, but there were no other measurable improvements. Of course, we cannot conclude from this that all individuals with rheumatoid arthritis will be cured by a total vegetarian diet alone. However, the research suggests that it can significantly improve the condition. For the rheumatoid arthritic, nutrition alone may improve quality of life, blood tests, and may even help to decrease medication needs. A decrease in drugs also translates into good news. These agents always carry some risk of side effects. Diet is also important in the prevention of rheumatoid arthritis. There is a growing awareness that some forms of rheumatoid arthritis are apparently triggered by infectious illnesses. One well-described linkage is between salmonella food infection and rheumatoid arthritis.158, 159 We have already seen in Chapter 10, "Animal Diseases and Human Health Risks," that much of the risk of exposure to salmonella can be avoided by moving to a vegetarian diet.

Besides rheumatoid arthritis, there are other forms of arthritis caused by the body attacking itself. These forms of arthritis include lupus arthritis and a group of arthritis conditions called the spondyloarthropathies. The latter include ankylosing spondylitis and Reiter’s syndrome. Because they seem to be caused by a similar process, we would expect these diseases to respond to a similar nutritional approach. Indeed, a recent report indicated as much regarding spondyloarthritis and diet.160 There, 25 patients were placed on a milk-free diet for six weeks. More than half of them made dramatic improvement on the regimen, registering decreases in joint swelling, stiffness, and pain. They were also able to decrease medication usage. Of particular interest, some patients had a return of symptoms when they resumed the use of dairy products. The Effect of Other Elements of NEWSTART on Rheumatoid Arthritis.

Exercise is also extremely important for dealing with rheumatoid arthritis. Not long ago, physicians would put arthritics on orders for bed rest. Now, however, recent evidence suggests that the more we can help a person exercise the better off they will be. Although inappropriate exercise can worsen joint problems, the experts are coming to the conclusion that an exercise program tailored to meet the needs of the patient can often help them with their arthritis.161, 162, 163

For example, a recent small study showed that rheumatoid arthritis patients could benefit from a program of high-intensity exercise (technically, a high intensity progressive resistance training program).164 They demonstrated decreases in self-reported pain and fatigue. They could walk measurably better with improved coordination and faster walking times. There was no worsening of disease activity or joint pain. Part of the benefit may relate to growth hormone (GH). This vital hormone is not only important for children. Research suggests that GH stimulates the rebuilding of cartilage and bone even in adults,165 and thus may play a key role in repairing the joints after the wear and tear of the day. Of critical importance to the exercise-arthritis link is the following fact: growth hormone levels surge following vigorous exercise.166 Exercise is also extremely important for anyone who is overweight and has arthritis. This is true whether we are dealing with rheumatoid arthritis, osteoarthritis, or any of the other forms of arthritis. The more weight a person carries, the more stress there is on weight-bearing joints like the hips, knees and ankles. Exercise and proper diet are the two cornerstones for attaining and maintaining optimal weight. Dr. David Felson, a professor of medicine at Boston University has studied knee osteoarthritis. He has found that losing weight can make arthritis of the knee significantly better.167

Overweight individuals also run a higher risk of developing arthritis. Dr. Chad Helmick, a Centers for Disease Control expert has discovered that adults of either sex who carry extra weight-even if they are not so heavy as to be classified medically as "obese"-were 30 percent more likely than normal-weight adults to have arthritis. The risk for those carrying excessive weight was even greater: obese men increased their risk of arthritis by 70 percent while obese women had a 50 percent higher risk.168

But there appears to be more to the exercise-weight control relationship than wear and tear on joints. Recent research suggests that overweight women have a higher risk of even developing rheumatoid arthritis.169 Women in the upper 25 percent of weight for height had a 40 percent increased risk of coming down with rheumatoid arthritis. Some researchers speculate that this linkage has to do with sex hormone levels. Water can be used externally to benefit those with arthritis; it is effective for the rheumatoid variety and other forms of joint inflammation. The application of hydrotherapy (water therapy) can serve many purposes in individuals with these conditions. Heat can be applied to affected joints using hot water packs, whirlpools, steam, etc. Such treatments can be particularly effective. For example, recent published work showed that the use of hot mineral baths and mudpacks could help both rheumatoid arthritis and the related condition of ankylosing spondylitis.170, 171 Heating of the tissues can have very desirable benefits. Although the brain has difficulty tolerating temperatures above 104 degrees Fahrenheit (40 degrees Celsius), desirable effects occur on tissues other than the brain at temperatures between 104 and 114 degrees Fahrenheit (40-45 degrees Celsius) for 5 to 30 minutes.172 Krusen’s prestigious textbook of Physical Medicine and Rehabilitation173 lists some of the benefits of heating tissues-such as joints-into this range: 1. Decreased stiffness due to increased flexibility of tissues (particularly tendons and other structures made largely of the fibrous tissue called collagen). 2. Relief of muscle spasm. 3. Increased tissue blood flow and increased speed of body reactions. 4. Relief of some types of pain. This can be due to decreased stiffness, improvement in tissue oxygenation or by "counterirritation" where the stimulation of temperature receptors in the skin decreases pain sensation. Heat is also known to increase the pain threshold, thus making pain easier to tolerate. 5. Mild heating can provide assistance in removing fluid buildup and inflammation in areas with more chronic congestion. Application of high temperature heat can, however, worsen acute inflammation.

Cold, on the other hand, can help decrease acute inflammation. For this reason, ice is the first-line natural treatment for a recent strain or sprain. Ice can also sometimes assist with pain control. This may have to do with the "counterirritation" phenomenon. It may also be a result of numbing of the pain sensors or decreasing inflammation. Because heat and cold each have unique benefits, we will sometimes use a combination of both hot and cold in alteration. This is called a contrast treatment. A common pattern for such a treatment is to apply three minutes of heat to an affected joint and then follow this with 30 seconds of cold. This constitutes "one cycle." Four to five cycles are usually applied at each treatment. Two or three treatments are given each day.

One type of arthritis that was previously confused with rheumatoid arthritis is now called Lyme arthritis. This form of arthritis results from an infection with a bacterium called Borrelia burdorferi.174 This germ is typically transmitted from the bite of an infected deer tick. The problem is greatest in the American Northeast, but also occurs widely throughout the U.S. There is evidence that this form of arthritis may be able to be improved by the use of extreme heat referred to as hyperthermia. Although the results are still preliminary, this illustrates another linkage between a rheumatoid arthritis-like condition and infection, and suggests that there may be an important role for more natural means of therapy. One of the remaining questions is: may what works for Lyme work for other cases of rheumatoid arthritis? The question demands an answer: theoretically, some of what we call rheumatoid arthritis may be undiagnosed chronic infection, as was the case with Lyme.175, 176 Already other infectious agents are being linked to rheumatoid arthritis-like diseases.177, 178 We have already noted the link between arthritis and salmonella. Other bacteria that cause intestinal infections have also been implicated. These include Shigella and Yersinia.179 The Chlamydia family of germs, known for their ability to cause sexually transmitted diseases as well as upper respiratory infections like bronchitis, have now also been linked with a rheumatoid arthritis-like condition.180 A number of viruses are also currently listed as candidates to cause rheumatoid arthritis. These include Epstein-Barr virus and the parvoviruses.181 Mycobacteria, the type of germs that cause tuberculosis and other infections, may also be arthritis culprits.182 The reason for highlighting the linkage between some types of arthritis and infection is that preliminary results suggest that generalized heating treatments may help such forms of arthritis.

The internal use of water also seems to be of value in many illnesses that affect the bones, muscles, and joints. Drinking water improves the flow properties of blood-this is technically referred to as enhanced hemorheology. Such improvements in blood flow may have a role in a number of conditions, such as dealing with back pain (whether or not it is related to arthritis) and helping to improve healing of joints and other tissues. Marjorie Baldwin, MD, and Bernell Baldwin, a Ph.D. physiologist, both of Wildwood Lifestyle Center in Georgia, included information on the importance of water and blood fluidity in their review of arthritis therapies.183 They site the research of Knisely who found that blood with poor flow properties was common in rheumatoid arthritis, and was unable to supply the optimal blood flow needed by the joints.184 We would expect that more liberal water intake would have had significant benefits in these circumstances.

Sunshine has been demonstrated to affect the immune system. Under the influence of sunlight there is some level of immune suppression which may actually be desirable in diseases of an autoimmune nature like rheumatoid arthritis. Specifically, the Langerhans cells in the skin have been studied in relation to the immune-suppressing effects of sunlight.

Sunlight also boosts vitamin D levels. This vitamin is important for calcium balance in the body. Vitamin D may also help to prevent bone loss that often accompanies rheumatoid arthritis. At least this seems to be the case in the other major type of arthritis, osteoarthritis. Researchers at Boston University School of Medicine found that individuals with lower blood levels of vitamin D were twice as likely to have their disease worsen during the four-year study.185 The researchers speculated that higher levels of vitamin D might slow cartilage destruction. If this is indeed the case, then vitamin D may also offer help for the person with rheumatoid arthritis.

The way I use the concept of temperance is unfamiliar to most people. By this word, I include a very popular notion, that of moderation. I am a firm believer in moderation-regarding healthy lifestyle factors. For example, I believe we should be moderate in the amount and intensity of the exercise we do (too much can be harmful). Similarly, I believe we should be moderate in the amount of food we eat on the vegetarian diet (you can overeat and suffer the health consequences of overeating even on the best of foods). However, I am against the concept of moderation when it applies to health-robbing factors. To cite two common examples: cocaine or tobacco, even in moderation, is harmful. In short, I use the term temperance to refer to moderation in those things that are good, but total avoidance of those things that are harmful.

How does this concept of temperance apply to rheumatoid arthritis? To optimally heal from this illness, we need to avoid anything that will impair our body’s natural healing mechanisms. Some patients have noted that when they do not get to bed early, their arthritis is worse the next day-even if they obtained the same number of hours of sleep. This goes along with what we know about melatonin and growth hormone, two compounds that are involved in building up the body after the wear and tear of the day. Both of these hormones may be made in smaller amounts if a person stays up late. A review of Chapter 9, "Melatonin-the Natural Way," will remind you of how many factors can interfere with quality sleep. These factors include tobacco, nicotine, and caffeine, to mention only a few. The bottom line is that temperance teaches us to avoid all of these agents as well as any other factor that would sap our body’s reserves.

Fresh air is also important. Polluted air, such as that tainted by active or passive tobacco smoking theoretically may worsen rheumatoid arthritis.186 There are suggestions that active smoking increases the risk of ever developing rheumatoid arthritis. In a study of over 1500 women from Washington State, researchers found that those who smoked had a 50 percent increased risk of coming down with rheumatoid arthritis.187 And these women were not necessarily heavy smokers. One pack per day for 20 years was enough. Interestingly, a Scandinavian study demonstrated an even stronger linkage between smoking in men and rheumatoid arthritis.188 In their prospective study of over 50,000 individuals, they found that men who were smokers had 3.8 times the risk of developing rheumatoid arthritis. Those who were ex-smokers still had well over double the risk of the never smokers. The results could not be explained by age, place of residence, marital status, social class, perception of general health, or weight.

One of the strategies in treating any type of arthritis is to strengthen the surrounding muscles, other soft tissues, and bones so that less stress is borne on the joint. This is one of the reasons why exercise is so important. A very little known fact about exercise is that outdoor exercise is much more beneficial than that done indoors. Years ago researchers discovered that athletes could develop greater strengthening on an outdoor exercise program than one done indoors. They attributed this difference to the amount of oxygen in outdoor air compared to indoors, and the ultraviolet light from the sun.189

Rest is necessary for optimal recovery from rheumatoid arthritis. During the hours of sleep, important hormones are secreted that build the body up from wear and tear sustained during the day. I have already identified two of the most important hormones; namely, melatonin and growth hormone. One of the keys to optimal melatonin production is adequate rest early in the night. For more information on this see Chapter 9 on Melatonin. The same sleeping habits seem to favor adequate growth hormone production. However, another compound appears to have a role in rheumatoid arthritis that is also helped by adequate sleep. It is a hormone-like compound called interleukin 1 (IL-1) that is made by white blood cells. The evidence suggests that a deficiency in interleukin 1 activity may play a role in causing or aggravating rheumatoid arthritis.190, 191, 192 IL-1 is made best when a person is getting adequate sleep.193

In reality, rest provides a special example of temperance. It speaks to moderation in work not only on a daily level, but on a weekly level and beyond. We will explore some of the additional aspects of rest later in the chapter. At this point, I would like to mention that there is a relationship between rest and fresh air. Few realize that fresh air has stress relieving, mildly tranquilizing, and sleep inducing effects. Do not hesitate to keep your windows open and a fresh current of air circulating throughout your sleeping room.

Regarding rheumatoid arthritis per se, there is no question that stress can have a role in the development or perpetuation of the problem. One of the most powerful buffering agents is the final NEWSTART element, Trust in Divine Power. In my personal experience, the greatest power for spiritual strength and a positive outlook on life comes from God.

In Anatomy of an Illness, Norman Cousins describes how he emerged victorious from his bout with rheumatoid arthritis largely by a change in his spiritual outlook from cultivating negativism to cultivating joy. Cousins’ improvement illustrates the importance of mental outlook and the spiritual dimension. Rheumatoid arthritis is our first example of showing how the NEWSTART elements highlighted by Ellen White have power today to improve quality of life as well as longevity. We could demonstrate the same thing with dozens if not hundreds of other maladies. The main message is that these remedies work in combination to promote health. This book, however, is not intended to provide medical explanations for every disease state, but it rather lays down principles to help individuals gain or maintain health. Next, we will see how the principles of NEWSTART can be applied to another set of common diseases.



Urinary Infections

The same Norwegian researchers who demonstrated a link between the vegetarian diet and rheumatoid arthritis made a startling observation about the total vegetarian diet and urinary tract infections.194 In a study of 22 individuals, these researchers found that their program of 7 to 10 days of fasting followed by a total vegetarian (no animal product) diet tended to decrease the ability of urine to support some of the common germs that can cause urinary infection. Their findings relate not only to the common scourge of bladder infections, but also to rheumatoid arthritis. As we noted earlier in this chapter, there is evidence that infectious agents may have a role in this crippling type of arthritis. The Norwegian group had previously found that on their program, rheumatoid arthritics decreased their blood antibodies to a common urine infectious agent, called Proteus mirabilis. This suggested that the germ might have been involved in the arthritis process. Of note, Proteus mirabilis was one of the germs that measurably decreased in ability to infect the urinary tract of those on the total vegetarian diet.

Other NEWSTART factors also play a role in urinary infections. It comes as no surprise that drinking significant amounts of water helps to prevent such infections. However, the drinking of other beverages may increase the risk of urinary difficulties. Cola drinking has been found to increase urine minerals like oxalate and citrate that set the stage for kidney stones.195 This is important not only because of the severe problems that stones can cause in themselves, but also because these rock-hard particles can provide an ideal environment for certain types of urinary infections.

Interestingly, a beverage other than water may provide special help to those with frequent urinary infections. Recent research has vindicated mom’s wisdom in advocating cranberry juice. In a Harvard study of older women (average age of 78 1/2), researchers found that the use of a cranberry beverage can decrease the tendency to urinary infection.196



Asthma

Asthma is another disease that has a special relationship to diet. In this section I will look at how a vegetarian diet can help asthmatics. Before I do that, however, I want to point out one of the most interesting recent findings on asthma that also brings into focus two of the other NEWSTART elements: water and trust in divine power. In reading the Scriptural books of Moses and looking at the plan that God outlined for the Israelites, I am struck by how much His guidance dealt with issues of a clean environment. There were scrupulous laws that dealt with washing and cleanliness after contact with death. There were specific instructions that dealt with the disposal of human wastes. There were laws that gave explicit instructions on what to do with contagious diseases like leprosy. This emphasis on cleanliness, of course, only had value as God’s people trusted Him enough to follow His counsel. Furthermore, attention to scrupulous cleanliness can be seen as an extension of the third element of the NEWSTART program. Water is often the agent we use to produce cleanliness.

Now what does all this have to do with asthma? Quite a lot. The National Cooperative Inner City Asthma Study is probably one of the largest studies on asthma to date. It carried a price tag of some $17 million, and the results are just now being published. This monumental study found a powerful linkage between asthma and exposure to the proteins of the common cockroach.197 Asthma sufferers are more likely to demonstrate abnormal immune reactivity to this pesky bug and its droppings. In fact, of all the foreign proteins that can trigger an allergic asthma attack, cockroach proteins-called "antigens"-appear to be the most powerful. In the Inner City Asthma Study, 38 percent of the asthmatic youngsters were allergic to roaches. This relationship helps to explain why urban Americans are more likely to suffer from asthma. In addition to being exposed to known triggers of asthma in city air such as ozone, sulfur dioxide, nitrogen dioxide, and other air pollutants,198 city dwellers are likely at increased risk of exposure to cockroach proteins due to the abundance of these pests in urban areas.

This linkage provides at least one insight into why asthma, the most common chronic childhood illness, is steadily on the rise. The number of asthmatics in America has risen 45 percent in the past decade. There are now some 15 million asthma sufferers; about a third of them are under 18.199 Since 1980, the annual death rate from asthma in young people under 24 has risen precipitously with a 118 percent upsurge over that time period.200 Some racial groups are hit harder than others. Black children and youth were 4 to 6 times more likely than whites of similar age to die from asthma.201

Unfortunately, in living arrangements which often include apartments in crowded cities, we are often affected by our neighbors’ lack of cleanliness as well as our own practices. However, the evidence still makes a powerful case for a scrupulously clean environment. How can people reduce their exposure to roach proteins-particularly if they live in an apartment surrounded by neighbors’ roach-infested dwellings? Experts suggest that four strategies can go a long way to keeping your premises free of roach-proteins: First, kill the roaches that are in your home or apartment with fogs, sprays, and/or poison baits. Next, thoroughly wash all floors and surfaces to get rid of roach proteins. Vacuum carpeted surfaces for the same reason. You may want to consider even a thorough carpet cleaning throughout your entire dwelling. (These procedures will also help to decrease the amount of poison residues in the environment from the first step.)

Then, act preventively. Do not leave any food out that would attract roaches. This includes everything from the obvious food on the table, crumbs on the floor, and food scraps in an accessible garbage can. It is a good idea to remove all accessible food immediately after eating. Refrigerate that which you wish to save. The rest can be eliminated through either a sink disposal, or by taking the trash outside of your dwelling. Last, set roach traps. This will help to catch any of the bugs that just happen to wander in.

Proliferation of allergies and other causes have a role in the asthma picture; however, other lifestyle factors are also important. We need to look carefully at the diet issue. Research suggests that it may have a profound role in dealing with this major disease. A total vegetarian diet, which is completely free of animal products, has been demonstrated to reduce medication needs in asthmatics.

Thirty-five patients who had suffered from bronchial asthma for an average of twelve years were the subjects of a Scan-dinavian study.202 All of the participants were receiving long-term medications; 20 were on some of the most potent asthma medications that we use, the cortisone-type drugs such as Prednisone. These compounds can help people manage their asthma better, but they can also have significant long-term damaging side effects. In the research study, these 35 chronic asthmatics were asked to go on a total vegetarian diet for a year. Over two-thirds of them remained on this diet for the full year. Almost all of those who followed the nutritional program made significant improvement as outlined in Figure 23: Total Vegetarian Diet Helps Bronchial Asthma.

In general, asthma symptoms decreased, while physical functions improved. Blood tests also improved-including the IgE level-suggesting that allergies were improving. Furthermore, almost all were able to decrease their asthma medications significantly. The researchers concluded: "Selected patients with a fear of side effects of medication, who are interested in alternative health care, might get well and replace conventional medication with this regimen."203

This is exciting news. It suggests that many asthmatics may be able to significantly improve their health and decrease or eliminate their medications. Of course, a word of caution is in order at this point. If you or a loved one has asthma, continue to work with your doctor. Make sure you do not change your medication intake until you get approval from your physician.

At least part of the reason for the success of the vegetarian diet regarding asthma likely has to do with a decrease in food allergies. Johns Hopkins researchers recently discovered that food allergies play a major role in aggravating childhood asthma.204 Lung function measurements demonstrated that susceptible children develop more irritable airways as a response to the allergy-producing foods. This irritability sets the stage for spasm of the air passages and asthma attacks. In those susceptible children, their asthma will generally not improve unless the offending foods are removed from the diet. Some of the foods they were allergic to are common foods that would be avoided on a vegetarian diet, such as eggs, cow’s milk, and fish.

Also on the high-risk food list were items like wheat and soy. These foods are good in themselves but most Americans eat these foods daily. And that may be a problem. Some allergists believe that repeated exposures to a given food tend to promote allergies in susceptible individuals. The inclusion of wheat and soy on the common allergen list tends to lend support to that argument. If you read labels, it will come as no surprise that most Americans are exposed to wheat and soy repeatedly every single day. If you assent to the daily wheat intake, but think we as a nation do not use much soy, think again. Soy is used as filler in ground beef, as a source of lecithin in many baked products, and a common source of oil (as well as mono- and di-glycerides used in processed foods). There are literally dozens of other uses.

If you think about it, eggs and cow’s milk, two of the other major foods associated with childhood allergy, are also common dietary constituents. Fish probably does not find its way onto American plates nearly as often as these other items. But there is more to the allergy issue than frequency of ingestion. In my experience with patients, dairy foods seem to be one of the most aggravating foods for allergy suffers. The medical literature seems to be consistent with my experience. Dairy foods have been linked with everything from skin conditions205 to immediate allergic reactions.206 The bottom line on the allergy-asthma linkage seems to be that sufferers with this airway disease should seriously consider a switch to a vegetarian diet. They should also be careful to avoid repeated exposure to certain common foods.

Besides removing allergens, other dietary factors likely had a role in the asthma improvement registered by the Scandinavians. There is evidence that the vegetarian diet is associated with less inflammation than a meat-based diet. This appears to be related to less inflammatory leukotrienes and prostaglandins production on the vegetarian diet. Furthermore, those individuals on a less refined diet are likely to be consuming less salt. A body of literature suggests that asthma is worsened by a diet high in table salt.207, 208



Food Allergies and Migraine Headaches

There is growing evidence that migraine headaches are also related to food allergies. The worst culprits in a recent study were dairy products.209 Other reports suggest that cheese in particular is one of the worst offenders. At a convention of British and U.S. neurologists (brain, nerve, and headache specialists), the participating physicians were asked to list which foods triggered migraine in their patients. Their responses are listed in Figure 24: Foods that Trigger Migraine Headaches.

You will note that most of the dietary factors implicated by these physicians are not part of a healthful vegetarian diet. There are, however, a few foods on the list that are healthful for most people, but may be unhealthful for certain sensitive individuals. Examples include certain nuts and citrus fruits. There are other connections in the medical literature between migraine headache and diet. These connections also suggest that a healthful vegetarian diet would prove beneficial. For example, the fats in a plant-based diet tend to be monounsaturated and polyunsaturated ones rather than the saturated variety. The research suggests that this may help prevent migraines.

One of the reasons appears to be related to platelets. These clotting cells of the body can apparently clump and release compounds that trigger a migraine headache. Platelets that have more polyunsaturated fats in their outer layer (called the "platelet membrane") tend to be associated with fewer migraines than if the platelet membrane is rich in saturated fat.210 This research suggests that increasing the plant products in the diet may help to decrease migraine attacks.

Further evidence of this linkage comes from research on children who were prone to migraine. Dr Glueck and his colleagues at the University of Cincinnati have found that children with worse cholesterol levels had more migraine headaches.211 In fact, the deleterious cholesterol profile was the same one that predisposes individuals to heart disease (i.e., low HDL and high LDL). The question, of course, is whether the cholesterol values are the result of a common process (such as higher polyunsaturated fat helping platelet membranes at the same time it is lowering cholesterol) or whether cholesterol in and of itself has a relationship to migraine headaches. There is probably some truth in both possibilities.

We have already seen that dietary polyunsaturated fats may be beneficial in migraine patients if those fats become incorporated into the platelet membrane. However, research also indicates that increased amounts of cholesterol in the blood tend to make platelets more sticky.212



Stroke and Vegetarian Diet

Current research indicates that a diet rich in whole fruits and vegetables decreases still other diseases. For example, the Nurses’ Health Study has demonstrated a 68 percent lower risk of stroke in women eating five or more servings of carrots per week. Those that ate a serving of spinach per day dropped their stroke risk 43 percent. The famous Harvard study of residents of Framingham, Massachusetts has shown that men, too, benefit from eating more fruits and vegetables in preventing strokes.213 Specifically, they found that all strokes and "mini-strokes" (transient ischemic attacks) dropped over 20 percent for each additional three servings of fruits and vegetables per day. The devastating bleeding strokes were prevented even more. Three more daily servings of fruits and vegetables decreased the risk of those strokes by over 50 percent.

Neither of the two studies that I have commented on reported specifically on meat intake. They were focusing simply on fruits and vegetables. But what typically happens when you increase your fruit and vegetable consumption? You decrease meat intake. This link with meat eating, however, was made explicit in some recent Australian research.214 Researchers there found that eating meat more than four times per week increased the risk of stroke.

What is it about fruits and vegetables that help to decrease stroke risk? There are several likely explanations. As we have seen in the migraine headache research, a vegetarian-type diet appears to make platelets less sticky. When these clotting cells are thus rendered less prone to initiate a clot, we would expect a decrease in the tendency of narrowed brain vessels to block off totally and cause a stroke. It is likely that stroke risk is also lowered as a result of the blood pressure-lowering effect of fruits and vegetables. One classic study was published in the British journal Lancet over a decade ago.215 For more information on the diet-high blood pressure linkage, refer to the chapter on blood pressure (Chapter 6One Nation Under Pressure").

In preventing stroke, the vegetarian diet has been documented to help reverse blockages in arteries. The study that has received probably the greatest publicity is that performed by Dr. Dean Ornish and his colleagues.216 I include more information on the reversal of blockages in heart arteries in Chapter 4, "Blocked Arteries-Clean Them Out Naturally." It seems reasonable to think that similar reversal will occur in blood vessels supplying the brain.



Cataracts

Cataracts are among the most common problems facing older Americans. They are major causes of visual impairment and blindness in these individuals.217 The evidence suggests that diet and lifestyle can affect the risk of this condition. Cataracts apparently occur more readily when a person is exposed to a greater intensity and duration of ultraviolet light as is found in normal sunshine.218 The eye lens seems to be damaged when ultraviolet light converts oxygen into reactive compounds called free radicals or "oxyradicals."219 Thus, we have seen a popular emphasis on the use of sunglasses that have total UV blocking capabilities. However, even this sun-induced damage can be prevented-at least in part-by a group of compounds called antioxidants. These compounds such as vitamins A, C, and E are found in abundance in plant foods. Evidence of this connection was provided by the Harvard’s Nurses’ Health Study. Researchers there discovered that a diet higher in foods containing Vitamin A compounds decreased the risk of cataracts.220 Regular use of Vitamin C supplements also lowered cataract risk in the Harvard research. In other scientific studies, subjects who consumed fewer daily servings of fruit and/or vegetables had an increased risk of cataracts, as shown in Figure 25: Low Fruit and Vegetable Intake Promotes Cataracts.221

Notice that those who ate less than three and a half servings of fruits and vegetables per day had nearly thirteen times the risk of developing cataracts as those with more liberal intake of these foods.



Peptic Ulcers

As many as 500,000 cases of stomach and intestinal (duodenal) ulcers are diagnosed every year in America.222 The direct costs of these conditions (called collectively "peptic ulcer disease") amounts to nearly 2 billion dollars annually.223 The evidence suggests that lifestyle plays a major role in the development of ulcers.

One known relationship between stomach and intestinal (duodenal) ulcers is with cigarettes. Tobacco has several effects that increase the risk of ulcers. First, tobacco stimulates acid secretion; next, it decreases blood flow to the lining of the stomach and intestines; and last, it decreases the amount of a protective substance called prosta-glandin that is made by the stomach lining.224 The result is that smokers have double to triple the risk of ulcer problems.225

If you currently have problems with ulcers-or believe you are at risk for problems-there are at least three further areas that relate to temperance that warrant concern. The first is the avoidance of coffee and other caffeine-containing beverages. It is well established that these beverages stimulate acid secretion.226 For this reason, caffeine beverages are on the hit list. Secondly, decaffeinated beverages contain tannins that also increase acid production and thus can interfere with the healing of an ulcer.227 The third factor is an unbalanced lifestyle with impaired stress management. Many still question the link between psychological stress and ulcers.228 It is certain that stress does not help these digestive problems, and because stress is linked with other adverse outcomes, ulcer sufferers should attempt to manage stress through changes in lifestyle.

Other aspects of the healthy lifestyle that I advocate throughout this book may also play a role in preventing ulcers. A vegetarian diet with its abundance of fiber and vitamin A-related compounds may also be a winner in the fight against ulcers. Recent research suggests that a diet rich in fiber and vitamin A may reduce the likelihood of developing duodenal ulcers.229

Cleanliness and hygiene may also be major factors in preventing ulcers. Such concerns involve the third element of NEWSTART, which is "W" for water. Simple hand washing would go a long way in decreasing our risk of a host of diseases as we have already learned. Although not all of the information is in, this simple technique may also decrease ulcer rates.

One of the hottest recent discoveries in the area of peptic ulcer disease is the linkage with bacteria called Helicobacter pylori. Although the relationship between this germ and ulcer disease was postulated in 1982 by the Australian physicians, Barry Marshall and Robin Warren, it has only recently been widely accepted as a key factor in ulcer disease.230 Simply put, those with a chronic infection with H. pylori run a significantly increased risk of developing ulcers. One intriguing factor that has not received much attention is the transmissibility of H. Pylori. Infection is clearly related to lower socioeconomic status, and may be related to standards of hygiene.231 Thus, careful attention to cleanliness and such simple practices as hand washing may play a role in decreasing the risk of developing ulcers. Flies have even been found to transmit the infection from one person to another.232

Another interesting sidelight to the infection-ulcer connection relates to foods containing allium, such as garlic, onions, and scallions. These foods, specifically garlic, are known to have antimicrobial effects and therefore may help to decrease the risk of H. pylori infection. So far, this connection has not been confirmed. Yet, consider the following facts. H. Pylori not only increases the risk of ulcers, but it also increases the risk of stomach cancer. Allium foods, on the other hand, decrease the risk of stomach cancer.233 The results suggest protection in both animal tests and human research. Although these foods may work by blocking cancer development or growth, they may also exert a role in eradicating or decreasing H. pylori infection. In short, a balanced temperate lifestyle that pays attention to the NEWSTART principles can help to prevent or treat ulcers as well as the other conditions that are presented in this chapter.



Conclusion

I began this chapter with a problem: how could I possibly provide information that would help to meet the needs of readers who had problems not specifically addressed in my book? My solution was to provide a framework for approaching any health-related concern. By championing a centuries-old approach to wellness, I have attempted to do just that. Although Weimar Institute has recently popularized the NEWSTART acronym, the remedial agents that they advocate are as old as the Mosaic Health Codes in the scriptures. The NEWSTART program is not a panacea, however. It is a complete, balanced program that addresses the vital areas of healthful living in our lives. It is more than a low-fat vegetarian diet or a regular exercise program. It is a comprehensive approach to living designed to foster optimal health-physically, mentally, socially, and spiritually. The eight elements of the NEWSTART program offer each of us an opportunity to maximize health by focusing on the changes that are calculated to promote health and happiness. Why not begin this new start today?





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