Vitamin C

Vitamin C has crept into many a conversation I've had recently or article I've read. I feel like it's one of the things I should have paid more attention to at school, or listened to my mother about (you should eat more fruit!).

It was my wife that reminded me what the oncologists said when I started the last lot of chemo, they told me specifically to keep off vitamin C and fruits that were rich in it while I was being treated. I did think this was odd at the time but these minor things tend to get put to the back of your mind. Why no vitamin C, what does it do that interferes with the chemo?

http://umm.edu/health/medical/altmed/supplement/vitamin-c-ascorbic-acid

So vitamin C is basically vital to building and repairing stuff, generally keeping you healthy and a whole host of things. Boosting your immune system function seems a big one too. I wonder if this is why it's bad with chemo, which is trying to do the opposite - suppress it.

It's an antioxidant - combating free radicals (cue the mental image of a blueberry in combat gear suppressing the insurgents) which appear to be associated with a whole range of nasty things from cancer, to arthritis.

Strangely, for such a vital vitamin, the human body can not produce it. We have to get it all through diet.

When the Hodgkins returned, I also got a couple of other conditions that seem to have been sparked by it
- Uveitis
- Iritis
- Psoriatic Arthritis

Interestingly these "inflammatory" conditions (they campaign for UKIP?) seem to be the sort of thing vitamin C helps protect against.

I've been trying to find any literature that describes if taking vitamin C would help ward off or conversely increase the risk of relapsing again. I came across the following article, which is a "state of the nation" on Hodgkins

http://www.raschfoundation.org/reports/hodgkins/1/

It has an good section describing current research and treatments. There's a lot of articles about on high dose vitamin C (intravenous) as a treatment for non-Hodgkins , but not for Hodgkins.

Interestingly, vitamin D (there's a vitamin D council?!?) deficiency seems to be associated with Hodgkins and a lot of other cancers.

Back to vitamin C. It seems from what I can gather that it's all-round-good unless your on chemo, and even then there seem to be (surprise-surprise) conflicting data on whether it's good or not. How much should you take? Can you take too much? The NHS recommendation is 40mg per day, so the 500mg supplement I'm taking seems a bit overkill. The NHS recommends nothing over 1000mg or you may suffer nasty things like flatulence; or at least everyone else will. Suffer, that is.

Another interesting section in that first link was the interaction of vitamin C and NSAIDs (remembering I'm on long term aspirin)

• Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) -- Both aspirin and NSAIDs can lower the amount of vitamin C in the body because they cause more of the vitamin to be lost in urine. In addition, high doses of vitamin C can cause more of these drugs to stay in the body, raising the levels in your blood. Some very early research suggests that vitamin C might help protect against stomach upset that aspirin and NSAIDs can cause. If you regularly take aspirin or NSAIDs, talk to your doctor before taking more than the recommended daily allowance of vitamin C.

Dagnammit. Is nothing ever straightforward? Given the low dose of aspirin I'm on (75mg) I think I'll be ok, but definitely a question at my next check-up. Along with fasting, a subject for another time.

Cholesterol, part 2

Ok, this is going slightly off the topic I wanted to learn more about (i.e. how to cut down the risk of getting Hodgkins again), but I'm finding the topic very interesting, so here it is! Part 2.

I'm starting to think that cutting sugar / carbs out of my diet as much as possible is going to be a good thing. It looks like I already eat a high fat diet and have been getting worried about little things like cholesterol.

While I'm normally very cautious about reading articles from people called things like "Dr Bob" or (Dr Rath in this case) - as I generally get Dr Hibbert's voice from the Simpsons in my head while reading them, the article was interesting and well written and mainly echos a lot of stuff I've read before and a few things I didn't know.

  http://www.drrathresearch.org/cholesterol.html

Arteries are the thing that are at risk from build-ups of cholesterol build up. They are under the most stress (from the pumping of the heart and the pressure of the blood forced through them) they have the highest requirement of stuff to keep them healthy.

This article and the other papers from this organisation seem to say that vitamin C is largely responsible for the health and continued elasticity of the arteries and veins. If they are not healthy and lesions form, then LDL is the thing sent to fix or patch them. If the thing causing the damage to the arteries doesn't stop, then neither will the buildup of the thing trying to patch them.

Makes sense. At some point I'll need to see if I can find some peer reviewed stuff to back it up. I'll also need to add the "Vitamin C" to the list of things to research as it's come up a lot on other stuff I've read on inflammation and general health.

I think for the moment that I'm going to stop worrying about cholesterol, it seems that the bad health bit is linked not to cholesterol, but to a bad diet and bad lifestyle, which I don't have.

Well, A Calorie Is Just A Calorie Isn't It?

A very short entry this time, I promise!

A chap at work was talking about how he'd put on weight, being unable to exercise like he used to due to injury. We got talking about diet and while talking about fat-v-carbs he made a comment along the lines of "Well, a calorie is just a calorie isn't it?" and it got me thinking (mainly "I doubt it").

I'm pretty sure Newtons laws of thermodynamics would say it was, but I'm not so sure that our bodies are able to use protein, carbs and fat in the same way.

Another one of my workmates pointed me at this guys blog, who has had the same condition that I have had and seems to be very much into diet and health. He did an interesting experiment where he ate 5000+ calories a day on a high fat low carb diet for a three weeks ...

Why I Didn’t Get Fat From Eating 5,000 Calories A Day Of A High Fat Diet

... and a corresponding period on a high carb low fat diet.

Why I DID Get Fat From Eating 5,000 Calories A Day Of A High Carb Diet

A sample of one is not exactly scientific, but it made for interesting reading anyhow.

Since we are throwing none-academic URLs around, I found the following one very helpful in understanding the whole process of food-to-fat.

Simple Science: How Body Fat Gets Created

I guess I need to start reading all the carb / starch / sugars / fat breakdowns on food a bit more closely; or just stop eating anything in a packet that requires a nutritional breakdown in the first place I suppose!

Enough for a work night!

The Demonisation of Fat and Cholesterol

Post two ... The Demonisation of Fat and Cholesterol

Before I begin, I don't think this post will actually conclude anything, but is likely to be the start of a load of topics I need to explore further. As I said, these blogs are to help organise my thoughts.

Fat

Fat has had a bad press for as long as I can remember; it still seems to get bad press too, especially from respectable organisations like the British Heart Foundation (fats explained) and the British Diabetic Association (fat facts) who went on air recently (Lucy Jones - Eat Well For Less - BBC) and stated that saturated fats were a big cause of heart disease. But she also said eating plenty of cheap white bread is good for you and doesn't make you feel bloated. Now I know what the "ORLY" internet acronym is for.

I'm not sure how the "Low Fat = Good" thing got started and I can't find an reliable references to cite on this, but there seems to be a mounting body of evidence (excuse the pun!) that this is complete tosh at best and very harmful at worst. When it comes to fats, the only one thing everyone seems to agree on is that trans fats are bad bad bad.

Where possible I'm going to cite pucker peer reviewed studies and not just random internet quackery. Unfortunately, whoever thinks up the titles for the reports of these studies obviously has no flair for the dramatic.

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

No surprise that there is a Wiki page that follows the controversy of the whole Saturated Fat and CVD /CHD debate. If the researchers and experts can't agree, how are we supposed to make our own minds up?

The NHS isn't much help on this front either as the best it can manage is along the lines of "there seems to be some evidence saturated fat isn't bad but we'll stick with our original advice".

Ok, so I'm still none the wiser; time to look at this from a different angle as it seems every article one way or the other is debunked by another saying the exact opposite.

Cholesterol

So, the big reason not to eat saturated fat is because it causes high cholesterol which is apparently the thing that causes all the nasties.

On this point the NHS looks to have actually got off the fence and said that Saturated fat link with heart disease questioned. Good grief, I can't take the drama. Does HTML have <sarcasm> tags?

It's actually one of the better articles I've read on Dr Malhotra's research, as it's reasonably balanced, quoting ...

Dr Malhotra disputes the idea that this proves a direct cause and effect between cholesterol levels and heart disease: "correlation is not causation", he writes. 

The article points out that saturated fat is believed to raise levels of low density lipoprotein (LDL) cholesterol (so-called "bad" cholesterol), which in turn raises cardiovascular risk. 

Yet only one type of LDL cholesterol seems to be associated with saturated fat intake, the article says. This type of cholesterol is called large buoyant (type A) LDL particles. 

The second type of LDL cholesterol – the small, dense (type B) particles associated with carbohydrate intake – is linked to cardiovascular disease.

So, not all cholesterol is bad and in fact only the type of cholesterol associated with carbs is linked to CVD? Did any of the studies that looked at saturated fat intake also correlate carb intake too? No idea, I can't find any information on this at all. <more reading to do>

The paper says one reason for this rise in obesity is that food tastes worse without fat, so the food industry compensated by replacing saturated fat with added sugar. 

Scientific evidence is now mounting that sugar is a possible independent risk factor for a condition called metabolic syndrome, a combination of diabetes, high blood pressure, obesity and high levels of "bad" fats, such as triglycerides and LDL cholesterol. Metabolic syndrome puts people at greater risk of heart disease, stroke and other conditions affecting the blood vessels. 

Two-thirds of people admitted to hospital with a diagnosis of heart attack have metabolic syndrome, but 75% of these patients have completely normal total cholesterol concentrations, says the paper. "Maybe this is because total cholesterol isn't really the problem," the article suggests.

To depart completely but briefly from the scientific to the anecdotal, I've recently cut out wheat from my diet. At the same time as the Hodgkin's kicked off last time, it had also sparked psoriatic arthritis. After doing a bit of reading I thought I'd try cutting out wheat and since then my joints have been a whole load better. I've not done any dieting other than cut out wheat and still eat like a horse but still I've lost 10kg of body fat ... or ... triglycerides (it was slow, steady loss, so I'm not worried).

I'm not sure if the weight loss is the carbs associated with the wheat, or the sugar that normally goes with the wheat, or something else that I've not thought of. I've also stopped feeling tired during the day, especially after lunch when I used to get an attack of the sleepies; an all round result then.

So, back to the story ...

Cholesterol is bad. What exactly does cholesterol do? (yes, this isn't exactly an academic body link, but it's nice and simple. like me!)

The True Function of Cholesterol in the Body

Here are just some of the many tasks cholesterol accomplishes in your body each day:

- Cholesterol is a crucial building material in the body. It helps maintain the structure of cells and vessels, improving overall health and function in the body.

- Cholesterol is a precursor to important sex hormones like testosterone, estrogen, androgen and progesterone. It is also a precursor to corticosteroids, hormones whose primary function is to protect the body against stress and disease. This includes the crucial hormones, cortisol and DHEA.

- Used as an insulator around nerves, cholesterol promotes healthy nervous system function and helps to prevent diseases associated with the nervous system. It is absolutely essential for brain function.

- Since bile salts are made from cholesterol, adequate cholesterol is needed for proper digestion. In addition, cholesterol aids the digestive system by strengthening the intestinal walls.

- Cholesterol is a precursor to vitamin D, an important nutrient which supports a healthy immune and nervous system, reproduction, insulin production and the metabolism of minerals. Recently the suggested daily allowance for vitamin D has been significantly raised in light of how important it is for good health.

- Serotonin receptors in the brain require cholesterol in order to function properly. Serotonin is an important neurotransmitter that promotes a natural feeling of well-being. Low levels of serotonin are linked to depression, violence and suicide.

I knew they'd get sex in there somewhere.

So, basically cholesterol is good and important; very important. Note to self: another load of reading to do on Statins - another day.

I seem to be going around in circles. Saturated fat is bad, but it's not, in fact it's beneficial. Cholesterol is evil, but it's not, in fact it's essential. Sugar appears to be the new evil and phrases like "type 3 diabetes" has me very intrigued.

Time to do a lot more reading and start a part 2 for the post.

Aspirin

Post one ... Aspirin

In a futile attempt to organise my thoughts, I've started this blog to list out things I've found of interest. Initially it's going to be for health a diet related information, but if it works out there's likely to be "other stuff I find interesting" leaking onto here too.

Aspirin.

My GP has recommended that I go on a low dose of aspirin to help reduce the risk of me getting an old arch enemy back. She'd been reading some research around aspirin and Hodgkin's, which I've managed to track down ...

Aspirin and the Risk of Hodgkin's Lymphoma in a Population-Based Case–Control Study

http://jnci.oxfordjournals.org/content/96/4/305.full

Quite a result.

In this population-based case–control study, regular aspirin use was associated with a 40% reduced risk of Hodgkin's lymphoma, compared with non-regular aspirin use. This association was consistent across subgroups of age, sex, race, religion, smoking history, and analgesic use. 

It's not just Hodgkin's which it seems to help protect against, but a lot of forms of cancer (the more readable form of the papers) ...

http://www.ox.ac.uk/news/2012-03-21-daily-aspirin-could-help-prevent-and-treat-cancer

Not only does it reduce the risk of cancer occurring in the first place, but increase the chances of survival if it does.

While not being a big fan of taking any drug if I can help it, I'll be definitely taking my 75mg daily. I know they can have other side effects (ulcers for example), but I think the much lesser side effects are outweighed very heavily by the benefits.