The New Optimum Nutrition Bible

by Patrick Holford

  Beating PMS through diet

  Premenstrual problems, termed premenstrual syndrome (PMS), were until relatively recently accepted as a woman’s lot. Yet these symptoms—which include depression, tension, headaches, breast tenderness, water retention, bloating, low energy, and irritability—are in most cases avoidable. Classically, they occur in the week preceding menstruation, though a small percentage of women have the symptoms from the middle of the cycle, coinciding with ovulation. Since premenstrual problems are a result of hormonal changes, hormone treatment has been used to correct them. But the use of such drug treatment must be seriously questioned, as it disrupts the body’s chemistry and has been associated with increased risk of cancer.

  The effectiveness of vitamin B6 has been proved in some studies to help 70 percent of premenstrual sufferers.13 But researchers soon found that B6 with zinc, which is needed to convert B6 into its active form, was more effective. Dr. Guy Abrahams, a researcher in California, then discovered that magnesium was especially effective at reducing the symptom of breast tenderness and swelling.14

  More recently, research has focused on the role of gamma-linolenic acid, an essential fatty acid found in evening primrose and borage oils. GLA’s 60 percent success rate is almost certainly due to its role in making prostaglandins.15

  We now know that vitamin B6, zinc, and magnesium are also required to make prostaglandins and, perhaps for this reason, have been shown to help PMS sufferers. These nutrients alone can easily halve symptoms, as we found out in a trial at the Institute for Optimum Nutrition. In this trial of PMS sufferers, in which both patients and their doctors rated their improvement for each premenstrual health problem, there was a substantial improvement of 55 to 85 percent. On average, within three months a woman on a supplement program of this kind could expect a 66 percent improvement in each problem.

  In some kinds of PMS, hormonal changes disturb blood sugar control and bring on sugar and stimulant cravings, as well as symptoms of tiredness and irritation. Following a strict no-sugar, no-stimulant diet, while eating complex carbohydrates or fruit in small amounts and often, can make all the difference. Diet, coupled with supplements, can often relieve symptoms of PMS all together.

  In a small percentage of women, PMS indicates a more pronounced hormonal imbalance that cannot be corrected by diet and supplements alone. Such an imbalance is usually due to estrogen dominance (see this page) and a relative lack of progesterone. This condition can be brought on by a period of time on birth control pills and needs testing and correcting by a qualified nutrition consultant or doctor.

  The pros and cons of contraception

  As a source of contraception, birth control pills have too many health drawbacks. In my opinion, the best method of contraception for any couple is knowing when ovulation occurs through observing temperature and vaginal mucus changes (for more details, read the book A Manual of Natural Family Planning16). Once a woman is in tune with her cycle, she will very often have feelings and sensations that mark ovulation, and test kits can also now be bought. Once the time of ovulation is known, there is no chance of conception from three days after ovulation until seven days before the next ovulation. That is half the cycle dealt with. At other times, noninvasive barrier methods such as condoms or diaphragms can be used or even abstinence practiced.

  The Chinese say that too much sex depletes vital energy, particularly in a man. We know that a man can lose up to 3 mg of zinc per ejaculation. With an average daily intake of only 7.5 mg, a man having sex three times a day has certainly blown it as far as zinc is concerned! This is one reason why it is better for a man to abstain in the days leading up to conception.

  The only trouble with using ovulation times as a means of contraception is that suboptimum nutrition often leads to irregular periods. Also, if there is an underlying hormone imbalance such as estrogen dominance, it may take a while to establish a regular, healthy cycle. In such cases, it is especially important to avoid synthetic hormones, which are more often than not the cause of the imbalance in the first place.

  Menopausal symptoms—what works?

  For many women, it is not the fear of osteoporosis, breast cancer, or heart disease that is of greatest concern about menopause, but how to cope with the debilitating symptoms that affect their daily lives—most commonly hot flashes, fatigue, headaches, irritability, insomnia, and depression.

  The usual remedy prescribed by doctors is HRT, but that is now being actively discouraged owing to the proven increased risk of breast cancer (see this page). So, what works without the risk?

  Exercise

  According to a study of Swedish women conducted by Lund University, the more vigorous physical exercise you do the less likely you are to suffer from hot flashes.

  Blood sugar control

  Recent research at the University of Texas at Austin has proven what nutritionists have known all along: if you have dysglycemia, which means that your blood sugar level goes up and down like a yo-yo, you are much more likely to experience fatigue, irritability, depression, and hot flashes than if you don’t. The best way to control this is to eat low-glycemic-load carbohydrates with protein. The system explained in my book The Holford Diet makes this way of eating highly practical.

  Vitamins C and E

  Vitamin C actually helps your hormones work, so when levels are low, 1 or 2 grams of vitamin C a day smooths the edges. Choose a supplement that contains berry extracts, rich in bioflavonoids, as there’s evidence that these help too. Vitamin E is another all-round hormonal helper. A daily intake of 900 IU helps vaginal dryness but takes at least a month to work.

  Essential fats

  Research isn’t great on the therapeutic effect of essential fats on menopausal symptoms, but they are so essential for balancing hormones and mood that I recommend eating seeds (flax, sesame, sunflower, pumpkin) daily and supplementing some EPA (300 mg), DHA (200 mg), and GLA (100 mg).

  Soy, isoflavones, and red clover

  Four trials have now shown that isoflavones, which are especially abundant in soy and red clover, approximately halve the incidence and severity of hot flashes. Two placebo-controlled studies did not find this effect, at least at a level of statistical significance, but did find that the higher the excretion of isoflavones, the lower the incidence of hot flashes, suggesting that a high intake of isoflavones, from diet or supplements, is effective. Soy, tofu, and isoflavones have been shown to protect against cancer, unlike estrogen HRT. My advice is to eat some tofu regularly, meaning at least every other day. You probably need 50 grams a day for an effect. Again, don’t expect immediate results. Supplements containing isoflavone extracts may help, but the research to date isn’t conclusive. They are worth trying if all else fails.

  Black cohosh

  Most promising are the results with the herb black cohosh, which helps hot flashes, sweating, insomnia, and anxiety. Also encouraging is new research that shows that black cohosh doesn’t have a downside—it doesn’t increase cancer risk and it isn’t antiestrogenic. The usual recommended daily amount is 50 mg, although much larger amounts, up to 500 mg, are more effective. It also helps raise serotonin, relieving depression.

  St John’s wort

  The combination of black cohosh and St. John wort (300 mg a day) is particularly effective for women who experience depression, irritability, and fatigue. St. John’s wort, renowned for its antidepressant effects, has been demonstrated to relieve other menopausal symptoms, including headaches, palpitations, lack of concentration, and decreased libido. A medical trial in Germany found that 80 percent of women felt that their symptoms had gone or substantially improved after taking St. John’s wort for twelve weeks.

  Dong quai

  The other “hot” herb for hot flashes is dong quai, botanically called Angelica sinensis. One placebo-controlled experiment giving dong quai plus chamomile to fifty-five postmenopausal women who complained of hot flashes and refused hormonal therapy found that they experienced a big reduction, of almost 80
percent, in hot flashes. These results became apparent after one month. Try 600 mg a day.

  Progesterone cream

  Menopausal symptoms are caused just as much by a fall-off in progesterone as by a drop in estrogen. Once a woman stops ovulating, progesterone levels plummet. While HRT preparations have all used man-made, progesterone-like chemicals called progestins, which have undesirable side effects including increased cancer risk, body-identical progesterone, often called “natural progesterone,” reduces cancer risk and works very well for menopausal symptoms.

  A recent trial in the United States, published in the Journal of Obstetrics and Gynecology found that progesterone cream significantly relieved or arrested symptoms in 83 percent of women, compared with 19 percent of women on placebo.

  Combined remedies

  Combinations of all these herbs, nutrients, and diet and lifestyle changes should yield the best results. One recent study gave a combination of panax ginseng, black cohosh, soy, and green tea extracts in the morning and black cohosh, soy, kava, hops, and valerian extracts in the evening. By the end of the second week, the number of hot flashes was reduced by 47 percent.17 By the way, acupuncture and yoga have also both been proven to help.

  Synthetic or natural HRT?

  The conventional view is that menopausal symptoms are brought about by a lack of estrogen. There is little doubt that the cessation of menstruation is due to declining levels of estrogen, which are needed to trigger ovulation. For this reason, estrogen HRT is given. However, as soon as a woman starts having cycles without ovulation, often many years before her periods stop, no progesterone is produced (this is because the progesterone is produced in the sac that is left after the ovum is released). While estrogen levels decline—they do not stop—progesterone production drops to zero. The continued relative excess of estrogen compared to progesterone, coupled with progesterone deficiency, may prove to be the major cause of menopausal symptoms.

  Both estrogen HRT and natural progesterone augmentation (given as a small amount of skin cream twice a day) can stop symptoms. However, conventional HRT suits few women and 70 percent stop within a year of starting it, usually because of unpleasant symptoms or a lack of results. While estrogen and synthetic progestin HRT is strongly linked to increased risk of breast cancer and is no longer being recommended to women for osteoporosis prevention, natural progesterone is anticancer (see this page) and four times more effective at reversing osteoporosis (see this page). It is best to get professional advice, including tests, to correct hormone imbalances. However, the combination of diet, supplements, and, when needed, small amounts of natural progesterone, can transform a woman’s experience of menopause.

  Andropause—the male menopause

  Men too can suffer from menopausal symptoms later in life. The symptoms of male menopause, known as andropause, are very similar to those of female menopause—fatigue, depression, irritability, rapid aging, aches and pains, sweating, flushing, and decreased sexual performance.

  Having successfully treated thousands of ailing men, Dr. Malcolm Carruthers, world authority on testosterone and author of The Testosterone Revolution, is convinced that andropause is real and connected to decreasing levels of free testosterone, the male sex hormone.

  Exactly why free testosterone levels decline is a bit of a mystery; however, a number of contributors may be involved. These include stress, too much alcohol, and overheating of the testes. More insidious, however, are the effects of increasing xenoestrogens, chemicals in the environment with actions similar to those of the female hormone estrogen, which have recently been found to be antiandrogenic, blocking the action of testosterone.

  Xenoestrogens are found in everything from pesticides to plastic. “Perhaps future generations of archaeologists,” says Carruthers, “will come across a thick stratum of plastic bags, marking the demise of Homo plasticus or ‘plastic bag man’ who was neutered by the by-products of the consumer society.” According to recent research, the pesticide DDT breaks down into a substance (DDE) that has little estrogenic activity, but fifteen times the antiandrogen effect of DDT. Residues of these chemicals, long since banned, are still found in the food chain. To what extent the average intake of pesticide residues is contributing to decreasing levels of testosterone is unknown.

  Testosterone is made in the body from cholesterol. Very low-cholesterol diets can lower testosterone levels, but antioxidant nutrients such as vitamin E help protect valuable cholesterol from being damaged. Testosterone can also be made from DHEA, a natural hormone produced by the adrenal glands, which is available over the counter in the United States. For those suspected of suffering from andropause, I recommend following the general optimum nutrition principles in this book, testing for testosterone deficiency, and only then, if necessary, correcting with testosterone implants or creams.

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  Preventing the Problems of Old Age

  The best way to stay healthy in old age is to prevent disease before it starts. Many animals, after all, stay healthy throughout their lives. In the Western world, it is barely even legal to die of old age: most death certificates require a cause, a disease. I firmly believe that it is possible to lead an active life without years of poor health and unnecessary suffering. Certainly three of the “grandfathers” of optimum nutrition, Linus Pauling, Roger Williams, and Carl Pfeiffer, all lived to a ripe old age.

  The trick, of course, is to prevent heart disease and cancer by following the advice in chapters 23 and 32. Both Pauling and Pfeiffer were convinced that, through optimum nutrition, you could add at least ten years of healthy living. Williams said, “Well-rounded nutrition, including generous amounts of vitamins C and E, can contribute materially to extending life span of those who are already middle-aged. The greatest hope of increasing life span can be offered if nutrition—from the time of prenatal development to old age—is continuously of the highest quality.” Pfeiffer took 10 grams of vitamin C a day toward the end of his life, while Pauling took 16 grams. There is certainly a good case for taking a gram of vitamin C (1,000 mg) and 112 IU of vitamin E for every decade of life. So an eighty-year-old may benefit most from 8 grams of vitamin C and 900 IU of vitamin E.

  Improving digestion and absorption

  The production of stomach acid and enzymes often declines with age. Stomach acid production depends on zinc, so it is important to ensure that your zinc intake is adequate. A lack of zinc also reduces people’s sense of taste and smell, leading to a liking for salt, sauces, and strong-tasting food like cheese and meat. Zinc-deficient people often go off fruit and vegetables. Improving zinc nutrition, rather than overcooking vegetables and adding lots of strongly flavored sauces, can improve your health considerably, including relieving constipation.

  The lack of stomach acid and enzymes also leads to poor absorption of nutrients from food into the body. If you have digestive problems or are sixty-plus, to assist nutrient absorption it is worth trying a digestive enzyme supplement containing a small amount of betaine hydrochloride (stomach acid). Betaine is another name for trimethylglycine (TMG), which lowers homocysteine (see chapter 16). This can improve the absorption of both vitamin and minerals.

  Studies on the elderly clearly demonstrate that key nutrients such as vitamins B12 and folic acid are poorly absorbed. For example, while the recommended daily allowance (RDA) for vitamin B12 is a measly 6 mcg and the average dietary intake is more like 6 mcg, a recent study found that 10 mcg of B12 is ineffective in restoring B12 status in those with low or borderline serum B12, a hallmark of the elderly, while 50 mcg per day is effective in both restoring B12 status and lowering homocysteine levels.18 It is also worth paying a little extra for the most easily absorbed mineral formulas (see chapter 48).

  Combating arthritis, aches, and pains

  One of the greatest causes of suffering in old age is aching joints and arthritis. One is often led to believe there is nothing that can be done except to take painkillers (which more often than not speed up the progression of the
disease). This is completely untrue. There are many proven ways to reduce pain and inflammation without drugs, outlined in chapter 26 and discussed fully in my book Say No to Arthritis, even when degeneration is severe.

  Fred is a case in point. He had seen many specialists and tried all the conventional treatments. Then he tried the optimum nutrition approach. “I used to have constant pain in my knees and joints, could not play golf or walk more than ten minutes without resting my legs. Since following Patrick’s advice, my discomfort has decreased 95 to 100 percent. It is a different life when you can travel and play golf every day. I never would have believed my pain could be reduced by such a large degree, and not return no matter how much activity in a day or week.” Key strategies for reducing pain and inflammation are:

  Identify and avoid allergens.

  Supplement niacin (up to 500 mg a day) and pantothenic acid (500 mg a day).

  Supplement antioxidants.

  Supplement anti-inflammatory herbs and nutrients such as omega-3 fats and boswellia.

  Supplement bone-building nutrients, including minerals and glucosamine.

  Good, all-round optimum nutrition.

  Sometimes aches and pains occur in the muscles and not the joints. This is not arthritis and may be due to one of two conditions. The first is fibromyalgia, which is characterized by a number of tender points in specific muscles. This is now thought to be due to a problem in the energy metabolism of the muscle cells and not to inflammation. Anti-inflammatory agents may therefore not help, although painkillers can suppress the symptoms. A particular form of magnesium, magnesium malate, is proving very effective at relieving fibromyalgia, together with a supportive diet plus supplements. Stress, which uses up magnesium, makes this condition worse. Polymyalgia, characterized by early morning stiffness, often in the shoulders and hips, is more often brought on when the body’s detoxification systems are overloaded. This means that the liver, kidneys, brain, and all the cells, including muscle cells, cannot deal with the garbage produced by digestion and daily living. Different systems of the body can be affected.