SUDDEN INFANT DEATH SYNDROME

Sudden infant death syndrome (SIDS) is defined as the sudden, unexplained, usually nocturnal, death of an infant between the ages of about 2 months to roughly the end of the first year. The peak incidence is three to four months, unusual after six months and rare after one year. It is more common in male infants. Gross examination at autopsy is invariably negative, but there is plenty of evidence in the medical literature that there are microscopic changes in the brainstem. These changes have been explained as “agonal”, meaning that it is damage produced at the time of death rather than related to the cause. There is every reason to believe that these microscopic changes provide important clues that will be discussed later in this discussion. SIDS has been under investigation for many years and nobody has come up with a definite explanation for the tragedy. The latest information that has proved to be greatly beneficial is that the prone position in the crib is more dangerous than the supine. It has been suggested that the prone position is more likely to lead to suffocation or possibly that the infant might inhale chemicals in the mattress that are placed there commercially as a fire retardant. Anyway, this has led to a statistically significant reduction in this terrible event that has marred the lives of so many parents. There is still an incidence of SIDS that is unexplained and it seems to be more in the lower socioeconomic segment of the population where diet may be more inappropriate for good health. Many years ago I became deeply interested in the vitally important metabolic activity of vitamin B1 (thiamine). This came about because I was confronted with a 6-year old boy who had a neurological disease that occurred intermittently. It was invariably initiated by some form of stress such as a vaccination, a mild head injury, a sudden change in ambient temperature, or an infection. It took several years to solve the problem and required the help of a researcher at the National Institutes of Health. It proved to be thiamine dependency. This produces the same effects as thiamine dietary deficiency but there was a genetically determined defect in a crucially important thiamine requiring enzyme that enables glucose to be used as fuel for all body cells and particularly the brain. I have written repeatedly that the brain requires huge amounts of energy so it was not surprising that this boy’s illness affected the normal function of his brain. What was even more important was that this effect centered more on the lower, more primitive, part of the brain. This part of the brain contains all the vital mechanisms that enable us to compute an adaptive response to the constant changes that we meet daily in our environment. The intermittent nature of the disease indicated that the energy supply could cope with a smooth daily lifestyle but was inadequate to meet an adaptive response to some form of physical or mental stress. This boy could be protected from his brain illnesses by taking huge doses of thiamine daily. If he had a simple infection such as a cold, he would have to double this dose. It taught me how a stress event such as a relatively mild to moderate head injury, or even a simple infection such as a cold, can be converted to serious brain illness in a person with marginal energy metabolism. (Lonsdale D, Faulkner W R, Price J W, and Smeby R R. Intermittent cerebellar ataxia associated with hyperpyruvic acidemia, hyperalaninemia, and hyperalaninuria. Pediatrics 1969;43:1025-34). Because of this, I began an exhaustive library search for everything that I could find about thiamine metabolism. Not surprisingly, it led me to the complex symptoms caused by the ancient scourge known as beriberi, now known by all physicians to be due to a combination of thiamine deficiency and empty calories, most often in the form of white rice. It is clearly a disease that is related to the rate of metabolism, so infantile beriberi is more lethal than in childhood and the adult form is more chronic, representing the rate of metabolism as we become older. I found that infantile beriberi causes sudden death and in the early days of research of this disease one of the investigators had made an important statement. He said that “anywhere that public health statistics report sudden infant death, the unequivocal diagnosis is beriberi. There is no other disease known that affects infants like this”. I discovered a paper written in 1944 by a British medical officer of health. She had been sent from Britain to Hong Kong, then a British protectorate, to study a form of sudden infancy death in Chinese women who were breast feeding these infants. (Fehily L . Human milk intoxication due to B1 avitaminosis. Brit Med J 1944;2:590-2). She had discovered that the cause of this death was infantile beriberi caused by thiamine deficiency in the mothers’ breast milk. Some readers may remember that the Japanese invaded China before World War II and the Chinese women were kept on a starvation diet of rice. There was severe malnutrition in both mothers and infants but, curiously enough, the sudden infancy deaths disappeared. When the Japanese invaders were driven out of Hong Kong, these mothers had restoration of ad lib rice in their diet. Just as curiously, the sudden infant deaths began to reappear. This may have been the first inkling in humans that the ratio of carbohydrate calories to thiamine was the important issue. We now know that the intake of “empty carbohydrate calories” overloads the capacity of thiamine to process it. Sir Rudolph Peters, in Cambridge, England, had clearly shown this to be true in his experiments with thiamine deficient pigeon brain cells in 1936. The production of carbon dioxide from thiamine deficient cells was no different than that exhibited by thiamine sufficient cells UNTIL GLUCOSE WAS ADDED. The thiamine sufficient cells immediately began respiration (CO2 production) while the thiamine deficient cells remained inert. Peters called this the "catatorulin effect". Fehily had noted in her paper that this infantile beriberi had the exact epidemiology as “cot deaths”, the term used for SIDS in Britain, and that it might be worth some research. It was initially thought that there was no way of predicting a SIDS incident but it was found that certain symptoms were potentially predictable, the most important one being short episodes of sleep apnea (cessation of breathing) occurring in sleep. My colleagues and I turned our attention to this and found that a study known as Brainstem Auditory Evoked Potential (BAEP) could actually predict SIDS potential risk in infants with any of the symptoms brought to our attention by parents. (Lonsdale D, Nodar R H, and Orlowski J P. The effects of thiamine on abnormal brainstem auditory evoked potentials. Cleve Clin Quart 1979;46:83-8). We also found that we could successfully treat affected infants with large doses of thiamine, given by injection. Another investigator, Joan Cardell, had found evidence that magnesium deficiency could be blamed and it is now well known that magnesium and thiamine are intimately related in their metabolic functions. I visited a researcher in Australia who had found that some abnormality in thiamine metabolism was indeed related to SIDS. Curiously, he had found that the level of thiamne in blood from SIDS victims was abnormally high. A pediatric colleague in New Zealand had found an unusual incidence of SIDS in his locality and sent me the results of blood thiamine values from 20 anonymous patients that had died. Among them were four SIDS. I was asked to let him know if I could spot the SIDS by the higher value of the blood thiamine. Three were obvious and the fourth was marginally higher and it was easy to spot the four. We concluded that it was a form of thiamine dependency similar to that in the child described above and with perhaps a different mechanism that still has not been explored. Thiamine deficiency (or dependency) in that part of the brain is equivalent to deprivation of oxygen, hence the so-called “agonal” defects in the brainstem of SIDS infants is evidence of cause rather than effect. All of this has largely been ignored by pediatricians and those investigators researching the problem of SIDS. The brilliant work of Peters is probably known by few, for medical journals consider that a scientific reference older than about 10 years is “out of date”. This is in spite of the fact that all scientific knowledge is built on the shoulders of those who have gone before and have often made fundamentally important observations that are major clues. I decided that I would place this information for public view, since it surely must have general interest, particularly to the would-be mothers who have read about SIDS and often nurse a secret dread of the possibility if and when they become pregnant. It should remind them that diet during that pregnancy is of fundamental importance in the healthy future of the baby.

AUTISM SPECTRUM DISORDER (ASD)

I am going to “stick my neck out” because I am so appalled by the widespread disease that is going to bankrupt us through medical costs. This presentation is to develop what I consider to be the direct cause of ASD. Some of this is from the hard won experience of a small group of physicians who have faced the challenges of sick chemistry affecting the growing brains of so many children. Before starting on that, however, I want to point out something that is well known already. The Japanese are the healthiest people in the world, but when they come to the U.S.A. they succumb to the same diseases as Americans. That must tell us that there is something wrong with the U.S. environment and that dietary mayhem that stalks vast numbers of people is an important part of this. I have seen hundreds of children within the autistic spectrum. The ones with ADD, ADHD and other similar diagnostic categories, like “variations on a symphonic theme”, are usually easy to treat with dietary correction and non caloric supplements. They are the high functioning group, whereas the children with autism are low functioning at the other end of the spectrum and are much harder to treat-- but they are treatable. First, let us look at the environment. We all know that our air, water and food are polluted with all kinds of chemicals and heavy metals. We invite our own collective disaster as we continue to damage our sensitive biological machinery. It is also obvious that we cannot change that, simply because industry creates our modern era of employment. The factor that is common to so many diseases, including ASD, is oxidative stress, so this demands a simple explanation. We, like the rest of the animal kingdom, consume oxygen in a process known as oxidation. This is complex chemistry and beyond the scope of an article like this, but it is governed by a simple fact: “not too little and not too much, the Yin and the Yang”. Too little oxidation is obvious, but many people have a little trouble with “too much”. The concept of free oxygen radicals has become fairly well known in health articles. The simplest explanation is that they might be compared with sparks that fly out from a fire that is burning briskly. Sparks are dangerous because they may spread the fire, so they have to be quenched. For example, a fireguard might be placed in front of an open hearth fire to prevent sparks setting fire to a carpet. The same principle applies to oxygen radicals; they have to be quenched also. The harder we work mentally or physically the more oxygen is consumed and the “metabolic fires have to burn more briskly”. This is where the “genius” of Mother Nature comes in. She invented chemical substances called antioxidants, many of which are derived from diet. It is important to note that antioxidants act as a team in the body for they might be compared with strands of wire that make up a fireguard. A single wire would not catch the sparks and a single antioxidant does not do the job of quenching oxygen radicals. It is simple to compare the oxidant chemicals with sparkplugs in a car: spark plugs ignite gasoline whereas oxidants in the body burn or “oxidize” protein, fat and carbohydrate, the equivalent of gasoline. Efficient oxidation is midway between “too little and too much”. This is essential to maintaining maximum efficiency of our cellular engines that are known as mitochondria. Thus, each of our body cells has its own energy budget, automatically adjusting or adapting to its required work load. I cannot imagine this wondrous process being coordinated without a computer and the limbic system and brainstem, that make up the lower more primitive parts of the brain, fulfill that function. Since this part of the brain is the most oxygen-demanding tissue in the body/brain combination, it is hardly surprising that it is the very first organ to “feel the oxidation pinch” if and when it occurs. But I have learned that a curious thing happens with mild oxidation deprivation. The computer becomes more irritable. Since this is the part of the brain that generates our emotional reflexes, an affected person becomes more emotional. The emotion itself (e.g. anger) is a normal reaction but becomes exaggerated and increased in volume. Children with ASD often have severe temper tantrums long after their normal incidence in infancy. They tend to be associated with some degree of violence such as kicking the wall. We know that mild to moderate oxidative inefficiency in brain occurs because giving air enriched with twenty percent carbon dioxide to patients who suffer panic attacks will initiate a panic attack. Such attacks are nothing more than fragmented fight-or-flight reflexes occurring without the threatened danger that normally initiates this survival reflex. The sympathetic arm of the autonomic (automatic) nervous system is activated too easily. If the oxidation mechanism becomes more severe and prolonged, the nervous control mechanisms begin to deteriorate and collapse. The prototype for this is the vitamin B1 deficiency disease beriberi. Now we must go back to ASD and the fundamental issue of oxidative stress. Published information in a medical journal has reported that neonatal jaundice and/or so called “colic” are in fact the first signs of oxidative stress. When I was speaking to an audience of parents of ASD children, I asked for a show of hands for the incidence of these two symptoms in their children. About two thirds of the parents responded for each of those observations. The next question that I asked was how many of these children had experienced ear infections and about the same number of parents raised their hands. Some of these children had received ear tubes and it is not as well known as it should be that they are not for drainage but to allow air (hence oxygen) into the middle ear cavity. Hence inefficienrt oxidative function enters into the underlying cause of ear infections. These symptoms are so common in the infancy of children that later become autistic that it would make sense to accept them as a potential warning of worse things to come later. To start nutrient supplements for infants with this kind of neonatal history would be, to my mind, absolutely mandatory. It is true that parents would never know if they have prevented ADD, ADHD or autism, because there is not an automatic incidence of brain dysfunction in every child with this clinical picture. It is, however, completely safe and can only do good, irrespective of the normal or potentially abnormal physiology. The only way that we would know whether such a preventive program would work would be by looking at public health statistics a few years later and see if the incidence of such problems has been shown to decrease. This would require a big change in the usual and customary pediatric approach. In our present state of knowledge, preventive nutrition is the only way that we can hope to reduce the incidence of ASD. If we wait until the dread diagnosis is made somewhere between the ages of eighteen months and four years, the treatment potential is much harder, much more expensive and prolonged. The old proverb that prevention is better than cure is, in this case, an imperative. The trouble is that mainstream medicine still has not caught up with the real meaning of the word “prevention”. Only a few pediatricians are aware of the vitally important ways in which Mother Nature exhibits her warnings. Even then, they must be able to recognize that oxidative stress can only be treated from a well rounded knowledge and experience of nutrient-based therapy. There are always plenty of calories in our diets. The tragedy is that the calorie-bearing foods are not being oxidized efficiently, particularly in brain. The ratio of calories to non-caloric nutrients is too high, producing an effect similar to a choked car engine. There is insufficient energy to power growth and function. Perhaps what really happens is that the “hard wiring” that must configure the adult brain becomes held back. Thus we see a child who has never completely broken through to adult status.

THE PLACEBO EFFECT

Placebo, from the Latin, meaning “I shall be pleasing, acceptable” is defined in Webster as a substance having no pharmacological effect but given to placate a patient who supposes it to be a medicine”. It is also defined as “a pharmacologically inactive substance or a sham procedure administered as a control in testing the effect of a drug or course of action”. An unusual use of the word is “the vespers for the office of the dead”. The placebo effect is defined in Webster as “a reaction to a placebo manifested by a lessening of the symptoms, or the production of anticipated side effects.
The use of a placebo in medicine implies the use of doctor/patient fraud and it is not surprising that the ethics have been questioned. The point of this presentation is to discuss what, if anything, is known about its mechanism. It is clear that if we knew this and how to turn it on in the mind/body relationship of sick people, it would automatically disqualify a huge section of modern medicine. I have so often been told that an unusual observation of improved wellbeing in a patient is “only a placebo effect” as though the observation is itself fraudulent. Yes, we dismiss its potential importance out of hand without thinking about how it works.
A six million dollar study involved comparison of the effects of a pharmaceutical drug used for treatment of depression with that of St John’s Wort, also used for depression. The study was “controlled” by using a third arm with a placebo. The results must have been mystifying to the investigators. The drug and the herbal remedy were about even but the placebo did better than both of them.
This must indeed remind us that the personal approach of a physician to a patient may make a huge difference to the outcome of the illness. There is an opposite effect of a placebo (a nocebo) that can actually do harm, purely by suggestion, as in producing anticipated side effects, or perhaps even hasten death. Thus, when a physician says to his patient,” I am sorry to tell you that you have cancer” it may be by itself a deterrent to recovery, since many people believe that cancer is inevitably fatal. Although this has long been known as “bedside manner”, I am aware that modern scientific medicine too often neglects this vitally important function of a physician, or any person that works in the health field.
The mechanism is still unknown but it is to the credit of Professor Ingvar at the Karolinska Institute that it is being studied. It has long seemed to me to be related to how hypnosis works, since that can have far reaching physical and mental effects. There is an apocryphal story of a young native in Africa who crossed the witch doctor who cursed him while shaking a “magic” bone in front of him. The young man began to lose weight and move toward death. A Western clinic in the vicinity tried to cure him, but failed. The witch doctor was then asked if he would remove the curse. He agreed “for a consideration” and he shook the same bone in the face of his victim, announcing his removal of the curse. The young man promptly recovered.
Mary Baker Eddy was paralysed in her youth. Her father had to carry her everywhere. She sought treatment from Mesmer who was treating people with magnets and she recovered. Later on she relapsed and began reading the New Testament, whereupon she recovered again. She concluded that her recovery was in the hands of Jesus and founded the Church of Christian Science. The cathedral in Boston represents a remarkable success story.
All of this must make us think seriously about the action of the brain/body in maintaining health and the induction of disease. It has seemed to me that the only thing that really matters for the “placebo effect” is the complete and indelible faith of a sick patient in a process that promises cure. A “faith healer” only requires the faith of his patient and he must inject his infallibility through his own belief in his “special” power. It is of considerable interest that Christ said to his patients “Go, thy faith hath made thee whole”.
I was once a pediatric oncologist, a physician that treats cancer. I had a child with a Wilms tumor of the kidney, one of the highly malignant cancers in children. It had metastasized to the abdominal cavity and she was in the state of cachexia that was the herald of death. I told the mother that I had nothing that could possibly touch her severe state. Her answer was simply “If God will not work through you I will find someone who will”. She took the child to Oral Roberts who “laid on his hands”. The tumors vanished and she became healthy again. I had an annual letter from the family doctor for several years, telling me of her complete recovery.
A 6-year old child had a malignant tumor in his cheek that was completely resistant to all available treatment. His father asked if he could bring a faith healer into the hospital and I agreed. His family, unknown to me, were also seeking treatment in Detroit. One day when leaving Cleveland, the car hit a guard-rail and rolled down an incline killing everyone but my patient. He was adopted by an aunt who gave him a lot of TLC. A short time later the child walked into the room to show his aunt something in his hand. He told her that he had found it in his mouth. She had the presence of mind to take it to a pathologist who reported that it was indeed the tumor and that it was necrotic, meaning that the cells were all dead. A miracle is a remarkable event for which we have no explanation. As soon as a mechanism is found for the event, it ceases to be a miracle. We would all benefit from a discovery of the mechanism of this much scorned placebo effect!
The effect cannot be forced on anyone; it must come from the brain of the person in whom it operates. Religion, if used properly in inducing a faith in God, is the ideal method of acquiring a mechanism that transcends self. To me, it seems that any ritual that might be loosely called religiosity, is quite useless unless it has true meaning for an individual practicing it. As a physician, I am only too well aware that my “success” in helping a patient might be attributed to the patient. The only thing that I do is to apply nutrients to recruit cellular energy so that healing can begin within the brain/body. But the body is merely a chassis that carries the brain and the healing process must be guided by that complex organ. Perhaps “energy medicine” has discovered at least part of the mechanism that turns on the placebo effect. Its safety and relative cheapness will eventually make the public force it to become mainstream.

THERAPEUTIC USE OF VITAMINS AND MINERALS

Everyone knows that vitamins are necessary to life and that they are normally obtained from the consumption of naturally occurring foods. There are also a number of minerals that are just as vital but general knowledge of them is not as well known. Over the years I have often had the thought that the entire periodic table is required for maintaining optimum health. This may sound strange but it is known, for example, that lead is actually a nutrient. A completely lead free diet is extremely hard to create but this was achieved and given to animals. They failed to grow until the minute dose of lead was restored. We all know that lead is a poison but in these minute concentrations it is a nutrient, perhaps as some kind of modifier of metabolism. Compare this with selenium, now known to be a vital antioxidant. Until 1957 this was classified as a poison and when someone announced that it was an essential nutrient he was thought to be crazy. How many more elements do we actually require? This concept has the advantage of causing the burial ceremony “dust to dust and earth to earth” to make sense.
The point of all this is that everything we eat has a “dose window”, even water! Lead, as a nutrient, obviously has a minute dose and its “window” is extremely small. Selenium taken in a dose of micrograms is a nutrient but it also has a very narrow “window” and can easily reach toxicity. By contrast, vitamins have large dose “windows” and it is very much harder to reach a toxic dose. Water soluble vitamins have no storage in the body and Mother Nature obviously required us to receive a daily dose, supplied by the “God-made” food that surrounded our primitive ancestors. Fat soluble vitamins like vitamin E are stored in the body and it is less easy for them to become deficient although that still does occur.
So why are we talking about treatment (therapy) of disease with these naturally occurring chemical substances? It obviously requires some explanation of what they do in the body and why we can no longer rely on “God-made” food to supply them. In a purely natural setting, vitamins and essential minerals are recycled, but as civilization has developed, we now have a sewage system that empties into a processing plant. Farming practices have changed too. Phosphate fertilizers, rather than the old fashioned manure, result in healthy looking plants but they are woefully deficient in these vital “non-caloric” nutrients.
The body functions through the use of enzymes, each of which is under genetic control. They can be roughly compared to cog wheels in a man-made machine, a mechanism that enables energy to be used in producing action. They are synthesized in the cells that require them and are used to perform all the needed operations of their specific cell. They are complex proteins built up from chains of amino acids that create a code for the desired function. Each enzyme requires one or more chemical substances that are known as cofactors to the enzyme. Without cofactor(s) the enzyme becomes very inefficient. Vitamins and certain essential minerals are these cofactors and that is why they are so vitally important. One example of this is the disease known as beriberi that I have discussed in previous posts. Vitamin B1 (thiamin) is one of the cofactors to an enzyme that enables glucose to be used as fuel for cells, so it is easy to see how important this vitamin is for it stands astride the complex mechanisms that create energy. That is why I have compared thiamin to a spark plug in a car cylinder. We know that the Required Daily Allowance (RDA) for thiamin is about 1.5 mgs a day, so why does it take about 100 mgs three times a day for several months to reverse the symptoms of beriberi? We have to assume that the lack of this important vitamin for a long enough time results in structural deterioration of either the enzyme itself or its capacity to bind with its cofactor(s).
A cofactor has to bind to its particular enzyme to create the right chemical combination. There can also be a rare genetically determined error in the binding mechanism, resulting in the need for a huge increase in concentration of the cofactor. This is known as vitamin dependency rather than simple dietary deficiency but the clinical results of dietary deficiency and dependency are the same. The first case of vitamin B1 dependency to be discovered was a 6-year old boy who had recurrent episodes of a neurological illness that imitated childhood, dietary caused beriberi.
It is also necessary to consider why a prolonged dietary deficiency of a vitamin cofactor requires mega doses of the vitamin to revive the action of the enzyme/cofactor combination. The exact reason is unknown but it is relatively easy to assume that the enzyme itself undergoes constructional changes from disuse or perhaps the binding of the cofactor(s) becomes gradually more difficult. I can certainly confirm that Recommended Daily Requirement (RDA) doses of a given vitamin do nothing for a patient if deficiency has been prolonged.
There is also another twist to this. Calories, as I have indicated in a number of posts, are produced by oxidation (combustion) of fuel represented by protein, fat and carbohydrate. If the calories are increased without the necessary corresponding vitamins they are known as “empty” or “naked” calories. My analogy bears repeating. The effect can be compared with the loss of energy in a car engine when there is either an inefficient spark plug to ignite the gasoline or too high a ratio of gasoline to oxygen. With an excess of gasoline in the cylinder we call the engine choked and the result is poor engine performance and black smoke (unburned hydrocarbons) issuing from the exhaust. This principle applies to the human body and although the details are widely different, the resulting lack of energy is noticed by an affected patient as unusual fatigue. The equivalent of exhaust smoke is the finding of organic acids, derived from inadequate oxidation, that can be extracted from the patient’s urine.
I refer to this as high calorie malnutrition and it is incredibly common in America. Its effect is quite different from that of starvation, the word that is usually associated with malnutrition. In the former category the stomach is well filled but “the cellular engines are choked”. It results in obesity, inflammatory diseases, fatigue and the common conditions that are so frequent in this era. In the latter category, all forms of nutrients are missing and the patient gradually sinks into attrition. Proper nutrition is based on the correct ratio of non-caloric substances to the calorie-providing protein, fat and carbohydrate. As I have pointed out in many posts, sugar is the most abused calorie bearing carbohydrate and in the last post I reported the findings of Dr. Yudkin 38 years ago. The overall health of millions is compromised by this largely ignored error in the vital importance of appropriate nutrition. It is truly amazing that nutrition has for long been almost completely ignored in medical schools although that is at least beginning to change. Self responsibility is gained through knowledge and we have been delinquent for too long in expecting doctors to heal us when we are sick. Doctors do not heal. The body performs this amazing activity and all it requires is energy to run the "mind/body" combination. The most important aspect of prevention is in knowing what to eat and drink. It far outweighs the present preventive approach that depends on a variety of medical examinations and tests.

A COMMENT ON MODERN MEDICINE

Dr. Oz writes regularly in Time magazine and I became interested in his essay in the January issue of 2012. It is entitled “Pressure Relief” and the added comment is “This year brings a breakthrough procedure to fight hypertension”. He begins by saying that it is “hardly a surprise that hypertension can kill you” and goes on to say “medication and lifestyle modification have been the baseline treatment for the 25% of Americans who are hypertensive’. He goes on to admit that benefit is unpredictable and sometimes useless. Although he mentions lifestyle, instruction in this is rarely approached in the average medical consultation. He then describes a new method of treatment that is undergoing a trial in the U.S. “using radio frequency energy to zap and disable a few select nerves in the kidney”. He describes it as a “breakthrough”, perhaps the most overused word in announcements of the results of medical research. It always strikes me as a “fat cat” use of a word, since it provides a “promise” that evokes a kind of hero worship attached to a “brilliant” idea. Furthermore, the promise that evokes great hope in potential patients is sometimes never fulfilled.
Now, it is true that we have known that high blood pressure is sometimes, and relatively rarely, due to arterial interference of kidney function. This was discovered by Goldblatt and is known as Goldblatt kidney. It is a complicated issue that does not require detailed discussion here. The problem I see is that which affects modern medicine in general. The word “zap” got my attention because it carries with it a concept of destruction. It obviously involves a technical procedure, so you can bet that it will be expensive and we have all been warned that the cost of medicine is taking us toward national bankruptcy. When, in fact, do we ever see something in medicine that is relatively cheap? The word ”prevention” rarely crops up and is never used in a true sense of forestalling serious disease. Preventive medicine is still regarded at most medical institutions as periodic chest X-rays, mammograms colonoscopy and etc. I am not denying their potential benefit but it only means that if anything is found by any one of these techniques, it represents early disease. It is not strictly prevention. The question that sticks out is why the arterial supply of the kidney has been compromised in the first place. If the function of the kidney and its connections with other organs depends on its nervous system, to “zap and disable a few selected nerves” must truly be an example of “closing the stable door after the horse has gone”. When we “fry” complex natural systems in the marvelous construction of the human body, we are bound to be wrong in the long run. Our overall health is appalling when Dr. Oz has to tell us that “twenty five percent of Americans are affected with hypertension”. Is this inevitable in the gradual aging of the human body or is it something that we are doing to ourselves? It must be a reflection of medical failure to have to “zap” something that is a vital part of the detailed construction of the body. Indeed, we must conclude that removal of an important organ by surgery, because it is beyond repair, is also evidence of medical failure.
So, what can we say about prevention? This blog has focused on oxygen as the primary nutrient in every post and the emphasis is always placed on how the oxygen is used in providing cellular energy. We recognize that Mother Nature is an able, if not always perfect, designer of the body. The approach that we have offered is based on the Three Circles of Health (Post, Monday Oct 25,2010,”A Proposed Revision of the Medical Model). Genetics/stress/energy circles make the assumption that the only one that we can control is the energy required for all our cells to function properly and derived from appropriate nutrition. Even that is changing since the newest branch of genetics is epigenetics, the science of how we can influence our genes by nutrition and lifestyle. The last post on this blog (Thursday, Dec 15, “Sweet and Dangerous”) provides research information supplied by the late Professor John Yudkin as long ago as 1973. It is very difficult for many people to believe that sugar affects our health in so many ways as Yudkin claims. He stated that the epidemic of cardiovascular disease was related to sugar. That implies that the overall problem of atherosclerosis is involved and that is the cause of the disease that affects the arterial (hence oxygen delivery) supply to the kidney.
Perhaps the best evidence of the effect of diet is in a book by Dr. Caldwell B. Esselstyn,Jr. (Prevent and Reverse Heart Disease. Avery:2008) who has been able to provide strong evidence that cardiovascular disease can not only be prevented, but can even be reversed by a plant based diet. Dr. Esselstyn has said that we should not eat “anything with a mother”. When I pointed out to him that humans are equipped with incisor (cutting), canine (tearing at meat) and molar (vegetable grinders) teeth, his response was that “meat eating would only have been used in a dietary emergency by our primitive ancestors”. This might be contested by anthropologists since there is plenty of evidence that they did eat meat. However, to many people a plant based diet spells out the removal of so much of the contemporary pleasure derived from what we eat and drink. Those that do begin to obey the natural rules of nutrition find a new pleasure in their ability to appreciate the nuances of flavor that comes from the consumption of “God made” food. Unfortunately, “God made” food is the most expensive, but ”junk” foods absorb far too much of the family budget and are remarkably expensive if an accounting is used. Generally speaking, it is not breakfast, lunch and dinner that is slowly killing us. It is what we do in our social activities. I am not a “kill-joy”: I am a realist! Our national consumption of ”junk” has nothing to do with nutrition. As Yudkin said, “palatability must not be confused with good nutrition”. The food industry panders to palatability, because it sells. That is why so many products in the Super Market are “laced” with sugar. I repeat the wise words of Hippocrates ----“Let your medicine be your food and food be your medicine”.

SWEET AND DANGEROUS

Readers of this blog must have noticed repetition of certain features surrounding the role of sugar in the American diet. It is well known that repetition ensures that “something sticks” in a reader’s mind. So here is some more information on this subject. I had been aware of the writings of Dr. John Yudkin for many years and I was able to obtain a copy of the 4th printing by Bantam Books of his book entitled “Sweet and Dangerous” from the local library. This amazing book, nearly forgotten, was published originally by Peter H. Wyden, Inc. The first edition appeared in April 1972 and a second printing in July of 1972. A Rodale Press Book Club edition was also published in 1972 and Bantam Books produced 4 printings. It was published simultaneously in the United States and Canada. It obviously made news at that time and it is indeed sad that his work is so little known in the sick world of today. On the back of the Bantam Book there is a short passage as follows:

”In this controversial headline-making book, Dr. John Yudkin, the renowned physician, biochemist and researcher whose pioneering studies of sugar have been acclaimed throughout the world, offers his never-before-published findings about sugar and explains clearly and concisely why ordinary table sugar is a health hazard for all ages”.

The text of the book would be startling to the uninitiated and would be ridiculed by many readers. How on earth could sugar, the very fuel that drives our cells and enables us to function, be dangerous? It begins with

”Why this book is necessary for your health” and continues by saying:

“[First], my research on coronary disease has convinced me beyond doubt that sugar plays a considerable part in this terrifying modern epidemic”.

His experimental work was performed at Queen Elizabeth College of London. Yudkin, together with the professors of botany and chemistry of the College, organized a symposium:

“that brought home to the three of us the enormous versatility and unique properties of the substance that is such a commonplace in all our lives”.

He goes on to say that:

“these properties tie in all too neatly with the increasing evidence pointing to the involvement of sugar in many diseases, not just the coronary epidemic”.

It is impossible to provide all the data that are supplied in this book but on page 5 Yudkin makes two “key statements that nobody can refute”.

”First,there is no physiological requirement for sugar. Second,“if only a small fraction of what is already known about the effects of sugar were to be revealed in relation to any other material used as a food additive, that material would promptly be banned”.

There is no greater difficulty than giving people advice about food, drinks and so-called recreation drugs. How many people in today’s world do not know the danger of tobacco? In spite of this fully accepted danger, thousands still smoke, knowing full well that they might be committing slow suicide. It is extraordinarily difficult to get people to understand that their recurrent illnesses and many common symptoms are sugar related. We encourage our children from infancy to become “sugarholics” and very few physicians believe it is dangerous or plays any part at all in disease.
I have repeatedly stated that sugar is being used as a “drug” that, like salt for many people, gives a jolt of pleasure that is perceived by the brain as the result of a signal from the tongue. Thus, it should be clear that artificial sweeteners like aspartame(Nutrasweet) have the same effect as sugar. The Nutrasweet Company published a study years ago that refuted medical claims that this sweetener was responsible for migraine headaches. The Nutrasweet was given to the experimental subjects in capsules that they swallowed, thus bypassing the taste mechanism. Perhaps they showed that it was not poisonous in the usual and customary sense of poison, but they missed the point completely. All “God made” food provides permutations and combinations of sweet, sour, bitter, salt, astringent and metal. This is how the brain is programmed, in much the same way that we are adapted to full spectrum white light made up by a mixture of red, orange, yellow, green, blue, indigo and violet. We are designed to consume natural food under the sun. Picking out a solitary signal of “sweet” or “salt”, (or living in partial spectrum, e.g. blue light), without the other signals that make up flavor, deviates the interpretation and processing by the brain, hence the potentially addictive quality of both sweet and salt, a phenomenon that I have witnessed in hundreds of my patients. Sugar is extracted from sugar cane or beet and is processed quite differently without the fiber that would be consumed if the whole plant source is eaten. That is our biological inheritance and the further we stray from it, the greater the risk of causing functional deviation in the way that our brains signal our adaptive responses to the constant changes in our environment. Hans Selye, the great (but controversial) Canadian investigator concluded from his extensive studies in animals on the effects of “stress” that human diseases were “the diseases of adaptation”. His conclusions, published under the title of “The General Adaptation Syndrome” took up an entire issue of the prestigious Journal of Endocrinology as long ago as 1946. I have read it and reread it over the years and believe that it provides clues to disease that are being constantly neglected in this era of “high tech” analysis. Sugar, in its "astronomical" concentration in so many "man-made" foods is a very important cause of "diseases of maladaptation".

MORE ABOUT THE BRAIN/BODY ACTION

Many of my previous posts have dealt with the problems surrounding the efficient use of oxygen in brain/body function. I am going to tell the story of a highly intelligent lawyer to illustrate that medicine is simply on the wrong track in much of its therapy.
The lawyer in question was a 56-year old woman who had an onerous job as a law professor. She had the main complaint of “digestive problems”. She was taking a host of digestive agents that were gradually becoming less effective. The focus of treatment elsewhere had been on the problems associated with bowel dysfunction only.
Of extreme importance, she said that she had “always had some symptoms that might be classified as Attention Deficit Disorder (ADD) and they were becoming more noticeable”. Conventionally this would be regarded as two different conditions, one under the care of a gastgroenterologist and the other under the care of a psychiatrist or neurologist. In my view they are actually symptoms arising from a cause that is common to both.
The fact that the bowel has an automatically governed nervous system has been known for a long time. We now have information that for every signal that goes from the brain control mechanisms to the bowel, there are nine signals that go from the bowel to the brain. This nervous system is so complex that it has been termed “the second brain”. It is therefore easy to see how our emotions, generated in the same part of the brain from which the signals to the bowel are sent, can affect the digestive system. Previous posts have discussed the lower part of the brain as a computer that oversees and controls all automatic organ functions in the body. Emotions are not thought processes; they are “computerized” brain reactions to appropriate stimuli. I have indicated previously that emotions represent the result of incoming messages from physical and mental stress.
The whole point of all this is that function depends on cellular energy and the ADD in this patient was evidence that the requireed energy was inadequate to meet the challenges of an active brain. The digestive or absorption problems could have been related to energy deficit in the cells that carry out this function or they could be a result of inadequate brain/bowel communication. Either way, the solution depended on solving where the biochemistry of energy metabolism had lost its efficiency. Cellular energy is generated by the consumption of oxygen in the process of oxidation, as discussed in a number of previous posts. Anyone reading this should review some of them or the explanation given here will not make sense.
I began this post by describing the patient as very intelligent and working in a stressful profession. That does not mean that she disliked her situation. On the contrary, she loved what she was doing and was very good at it. Just as a high powered car requires the appropriate fuel, oxygen for combustion and an efficient spark for ignition, so do our brain/body systems function on the same principles. It is the details that differ and the synthesis of cellular energy is extremely complex. The highly intelligent brain consumes oxygen at a greater rate than one of lesser functional capacity. The oxygen consumption is proportional to its activity, so an intelligent, brain using person is at greater risk for energy deficiency than a person of lesser intelligence who does not require as much mental work. The early death of Mozart has been argued and discussed over the years. We know that his music publication in the last years of his life was prodigious. I have hypothesized that his brain energy consumption exceeded his ability to generate it. It can never be proved but it is something to be kept in mind, particularly if abnormal fatigue is a leading symptom. Symptoms are really “alarm bells ringing” in a complex system and they have to be interpreted. What we need is the symptom equivalent of the Rosetta stone that enabled us to read the writings of ancient Egypt.
Perhaps we can begin to see that so much modern disease is induced by an inadequate diet that represents the consumption of excess fuel (food) containing an inadequate vitamin/mineral concentration (spark plugs), causing loss of efficiency in oxidative metabolism. I have referred to this as high calorie malnutrition. For those readers that need a little more information, look back at an older post that discusses the “choked engine”.
As I have repeatedly tried to emphasize, it is the brain that suffers most, since it is the organ that is most highly dependent on oxygen consumption. The lower brain, referred to as” the computer”, works 24/7 and it is hardly surprising that it is most at risk. The functional confusion in brain control mechanisms that results from this gives rise commonly to the symptoms that are usually designated as “psychosomatic”, a diagnostic category that is totally inadequate and insulting to the patient.
When vitamin B1 (thiamine) was first synthesized in 1936, nobody knew how it worked in the body. As I have previously discussed, we know now that its deficiency causes beriberi and in 1936 Sir Rudolph Peters did the research that led to our understanding of its vital actions. At the time, the animal model for studying beriberi was the pigeon. Without providing the details, Peters found something that is of great importance in our understanding of this vitamin. The study involved the biochemical activity of thiamine deficient pigeon brain cells compared with cells that had adequate thiamine. There was no difference in the activity of the thiamine adequate versus thiamine deficient cells until glucose was added in the experiment. It was immediately apparent that the thiamine deficient cells remained inactive whereas the thiamine sufficient cells became active. Modern research has shown very clearly that the processing of sugar in the body, and particularly in the brain is tied to the presence of an adequate thiamine ingestion.
I am not suggesting that thiamine is the only component that matters in our approach to a problem of this nature. It can, however, stand as a model for what happens to us when oxidative metabolism is compromised. It must be more than obvious that our food is the equivalent of gasoline in a car, but it also requires chemical components that are the equivalent of the spark plugs and other components of adequate “engine” function.This is the kind of approach required for thousands,if not millions,of people and it particularly applies to those who have been labeled "psychosomatic".