Men’s Body Click Diet part 3

What happened with my patient Brooks shows how this scenario plays out. It also reveals why I think that such mysterious and sometimes chronic inflammations of the prostate are usually not infections but instead have a lot to do with factors that are also related to abnormal growth or cancers of the prostate.

Brooks is a 50-year-old businessman whose previously dependable penis had become much less reliable with regard to its sexual responsibilities. At the same time he suffered from discomfort with urination, some hesitancy in starting his urinary stream and the need to get up at night to urinate more than once, which had been his previous custom. He was alarmed that whatever was going on represented some sort of permanent equipment failure. Told at first by both a general practitioner and a urologist that his prostate was 'pretty normal' and later that it was a 'little enlarged', he had undergone two courses of antibiotic treatment for nonspecific prostatitis. His symptoms improved while he was on the antibiotics but returned when he finished the medication.

I had a telephone consultation with him and after hearing him out and considering various possibilities, I suggested to him that he had 'some kind of mischief' with his prostate. This was a much softer diagnosis than that of nonspecific prostatitis. But it suggested a treatment that was aimed more at making his prostate happy than at trying to kill some unseen, unidentified and perhaps nonexistent germs.

The concept of trying to make some organ in your body happy seem, alien to a regular guy like Brooks. He shares with most people the medical notion that there is a specific treatment for every condition and that this treatment is not a strategy to make some part of your body happy. It did, however, make Brooks happy when I suggested that part of his therapy was at least daily efforts to encourage the emptying of his prostate and its tubing by provoking an ejaculation. This was contrary to the no-sex advice he had been given earlier, which seemed to me like the equivalent of telling someone with a bad cold not to blow his nose.

I offered Brooks a package of additional measures to make his prostate happy. These included daily doses of soy protein, flaxseed powder, flaxseed oil, zinc and an antifungal medicine. If you understand why I loaded my shotgun with such a diversity of remedies and how they all fit together, you will also see how I perceive that the whole range of prostate mischief from inflammation to cancer fits together.

I've already explained the soy protein and flaxseed powder. I also recommended an additional supplement of flaxseed oil. The prostate gland is one of the richest sources of the hormonelike substances that are made from omega-3 fatty acids, with which flaxseed oil is loaded. They are called prostaglandins, named for the very organ under discussion, because they were first isolated from fluids found in the prostate. (Soon after their discovery in prostatic fluids, they were found to be present in a wide variety of animal tissues of all kinds and not at all exclusive to the prostate, but the name stuck.) The use of fatty acids in flaxseed oil helps the prostate make prostaglandins. But the more important motive for a prescription of flaxseed oil was the strong likelihood that Brooks, like most people, was deficient in omega-3 oils. The flaxseed oil, then, was generally beneficial rather than a treatment aimed specifically at the prostate.

I recommended that Brooks take zinc because it helps the immune system fight off infections and control the body's inflammatory response to infection. Finally, I prescribed the antifungal medicine because of my consistent experience with other patients where I'd seen that an overgrowth of fungus germs, particularly yeasts, has a proclivity to bother people's reproductive systems. I have often found stubborn cases of prostate problems in men to be responsive to antifungal drugs.

But there's another, more important angle to the antifungal treatment Igave Brooks and the many other men I've treated in a similar way. In order for the isoflavones and lignans in soy protein and flaxseed powder to be transformed into the substances that beneficially modulate hormone chemistry, they must pass through the digestive tract, where they are changed by certain germs that live there. If the normal distribution of healthy flora has been disturbed so that there are too many bad germs and not enough good germs, the capacity of the intestinal flora to help hormone chemistry will be seriously impaired. Antibiotics are by far the most significant disrupter of intestinal germ populations. A single course of an antibiotic prescription can affect this balance for months or longer. My prescription of an antifungal medicine for Brooks was aimed at two overlapping targets. One was the possibility that a fungal infection was directly related to the prostate inflammation; the other was that his two courses of antibiotics had made him worse by causing a disturbance in his bowel germ population that would correct itself once the number of yeast germs living there was reduced.

Within ten days Brooks and his prostate were both happy. His equipment returned to reliable functioning and he has remained well since. He is as pleased as he is surprised. This is true for many men whose similar responses to simple changes in diet don't jibe with their expectation that I would have to treat them by calling out the big guns rather than coaxing their bodies back into balance. I'm confident that the remedies I suggested for Brooks worked because they were specifically connected to achieving a hormonal balance governed by a combination of factors related to his digestive flora and an intake of substances that made his prostate happy.

It's not a big step from consideration of acute problems, such as what Brooks had, to the more chronic problems of prostate enlargement andprostate cancer.

Chronic Illnesses and Diet part 1

Chronic illnesses are frequently the result of a web of interrelated factors. Your body may be reacting to a germ, an allergen or a toxin or you may be deficient in a vital nutrient. And the whole situation may be complicated by insulin resistance. It's unrealistic to think that finding and treating just one piece of the puzzle will be sufficient to remedy the problem. Restoring balance is a more realistic approach.

Balance and Health

Balance is a key concept in most alternative medical approaches to health, such as traditional Chinese medicine, naturopathy, homeopathy and Ayurveda. One of the problems that mainstream medicine has with these alternative medical systems is that the practitioners appear to offer the same remedy for all sorts of illnesses. This doesn't seem right to doctors trained to think that there are a certain number of discrete diseases that exist in nature. Physicians have also been taught that for each disease there is a distinct treatment. We know, for example, that if you have a strep throat or pneumonia a particular antibiotic is the right treatment, while another antibiotic is appropriate for your urinary tract infection because a different germ is involved. If you burn your finger or you break your arm, the treatment is again going to be designed for the specific problem that you have.

There is certainly some truth to the idea that specific illnesses or conditions need precise, individualized treatments. But there is another valid argument to be made as we move away from acute ailments to focus on the increasing prevalence of chronic illnesses. Sometimes the symptoms of a chronic illness can be suppressed with drugs, but since the cause of the disease is unknown, an individualized remedy to cure the person is out of the question. When an alternative medical practitioner recommends a generalized strategy that is not necessarily aimed at the distinct disease but is more directed at correcting imbalance, these approaches are designed to get to the underlying causes rather than the individual symptoms.

If you are in pain, it's hard to believe in a treatment unless it works right away. Dietary changes and other generalized strategies, like the Body Clock Prescription, usually do not produce instant relief. These measures do sometimes take effect quickly, but it's frequently a slower process. I think you will be more motivated if you understand what lies behind much chronic illness.

Rhythmic Disturbances May Underlie Many Chronic Illness

As researchers continue to elucidate the mysteries of the scientific basis of disease, we realize more and more that similar fundamental mechanisms underlie much chronic illness. These include abnormalities of cell membranes and their capacity to send and receive messages, the backfiring of chemistry designed for cellular defense (autoimmunity and inflammation) and 'sparks' from your own metabolic fire, environmental radiation and chemical pollutants (oxidative damage). This is why a generalized strategy to treat chronic illness is beneficial.

To this list I would add dyschronism or the failure to keep the various cadences of the body's biochemical activities in harmony. Disharmony is the direct cause of jet lag, symptoms related to shift work and some sleep disturbances. But having your body in disharmony is also likely to bring out the worst in you more readily than if your body is well tuned. Poor tuning contributes indirectly to the expression of other illnesses, as indicated by the tendency for many ailments to have their own characteristic time peak of maximum intensity. There is evidence to support the idea that there is a rhythmic component in a number of diseases; among the most significant findings related to dyschronism are the following:

Seasonal affective disorder is a form of depression directly linked to the shorter daylight hours of winter.

Sudden cardiac death and nonfatal heart attacks occur most frequently between 7:00 and 11:00 a.m.

Strokes occur more frequently between 6:00 a.m. and noon.

Asthma sufferers experience their worst symptoms in the early morning hours.

The growth of breast cancer cells may be inhibited by melatonin. (When a 1995 study showed that Finnish flight attendants had an increased risk of breast cancer, the principal investigator hypothesized that frequently crossing time zones was part of the problem, since jet lag interferes with the normal production of melatonin. Although his theory has not yet been proven, other studies have shown that melatonin inhibits the growth of breast cancer cells.)

Circadian rhythms have been substantiated in the symptoms of rheumatoid arthritis (least pain and stiffness around 5 p.m.) and allergic rhinitis (peak of worst symptoms between 5:00 and 7:00 a.m.).

Underweight — the other side of the coin continue…

Causes and treatments

A full discussion of the causes and treatment of these serious eating disorders have filled books of their own.

A team consisting of a psychologist and/or a psychiatrist, a dietitian and a medical doctor should be involved in the treatment of a patient with an eating disorder. It is also important to bear in mind that treatment could stretch over many months before it has any significant effect and that even then the results are not always positive.

Generally speaking, the outlook for both anorexia nervosa and bulimia is not encouraging. In the case of the former, the outcome may vary from sudden recovery with little or no treatment, to death. Someone may be a victim of it for a few months or for a lifetime and it appears that only 40-60% of significantly ill patients make a good physical and psychosocial recovery. The mortality rate is estimated at between 5% and 18%, with the most frequent causes of death being suicide and the effects of starvation. Although not much literature has been published on bulimia, it is estimated that only 40-50% of treated bulimics can eventually be regarded as cured. Some are cured with relatively little effort, while others seem to return to normal eating habits and discontinue their purging behaviour after intensive treatment, only to relapse during periods of stress.

Serious medical complications - including death - are more likely to occur in bulimics and prugers, due to excessive losses of essential body fluids and electrolytes (such as potassium and sodium).

The risk of suicide is also believed to be higher, possibly because bulimia is often associated with depression.

Preventing the preventable

Because these eating disorders so often have a negative outcome, it is vital to either prevent their development or at least take action as soon as warning signals appear. You can help to guard against the development of anorexia nervosa and bulimia in a young person by following these guidelines:

1. Make a practice of discouraging restrictive dieting, meal-skipping and fasting.
2. Avoid unnecessary emphasis on and talk about figures, being fat and food which is 'fattening'.
3. Carefully phrase any weight-related recommendations or comments.
4. Try to correct misconceptions about nutrition, normal body weight and encourage a healthy approach to weight loss.
5. Place the 'ideal' female portrayed by the media into perspective.
6. Provide information about the normal physical changes which occur during puberty.
7. Refer an adolescent who appears to have a problem - or is at risk of developing one - to a physician, a mental health professional (psychologist/psychiatrist) or a dietitian skilled in working with patients who have eating disorders.

Reading the signs

Clearly, it is very important to identify someone who is at risk of developing - or already suffering from - an eating disorder in good time, so that treatment can be effective. But how would you know if your daughter or an acquaintance was in clanger of becoming a victim? The possible warning signals for anorexia nervosa and bulimia are summarised in the table

In conclusion, it must be said that in man the control of food intake is a very complex and delicate process. Unfortunately, the primitive reflexes which control our need for food - and thus our hunger - have become buried under so many layers of conditioning and social factors that we are hardly aware of them anymore. Perhaps the time has come for modern man to realise once more that the primary reason for food intake is to support life and encourage good health. All the other reasons - whether to do with the emotions, society, taste or simply habit - are secondary. Or, in the well-known words of the famous French playwright, Jean Moliere, which are as apt today as they were in the 17th century: 'One should eat to live and not live to eat'.

Drugs and weight loss

Generally speaking, drugs are of limited value in the treatment of obesity and should be used with great care (preferably under medical supervision) because of the possibility of dependence and abuse. The most commonly used are the `anorexigenic' drugs which work by suppressing appetite. However, their effect is only temporary and they do nothing to encourage changes in the eating habits which caused the problem in the first place. Also, an ever-increasing dosage is needed for sustained weight loss.

Side effects of these drugs include insomnia, excitability, dryness of the mouth, gastro-intestinal disturbances and addiction. Anorectics increase short-term weight loss but interestingly, follow-up indicates that patients treated with drugs lose less weight in the long term.

There are many other drugs which have received attention in the treatment of obesity. For example:

• thyroid hormone, which increases energy use. Unfortunately, both fat and protein losses occur when this drug is used. Also, the results of thyroid medication seem to be no better than those achieved with a balanced diet alone - and negative side effects involving the heart have been reported.
• growth hormone, which decreases fat stores without causing protein losses. This hormone, however, is in short supply and is not generally used in the treatment of obesity.
• human chorionic gonadotrophin (HCG), which is injected and used along with a very low calorie (500 cal/2 100 kJ) diet. It is claimed that this hormone melts away fat and reduces hunger. However, no scientific proof for these claims has been found.
• drugs which interfere with the absorption of carbohydrates and fats. This implies that one can eat as much as you like without getting fat, because all the energy is not absorbed. More research is needed on these drugs to evaluate their long-term efficacy in humans.
• bulking agents, which are intended to fill the stomach with indigestible material in the hope that the resulting feeling of fullness will make the obese person eat less. (Research indicates that this method is not very effective and that it causes flatulence.)

Perhaps the most important point to remember regarding the use of drugs in combatting overweight is that, while they may aid the slimming process, they do not solve the underlying problem and will therefore never be effective as a sole treatment for obesity.

The surgeon's knife

Surgical treatment of obesity is usually the last resort and is generally only used on the excessively obese person when all other method have failed. Surgical procedures used include small bowel bypass and/ or stapling of the stomach, biliopancreatic bypass and jaw wiring. The chances of success are small unless the patient is highly motivated and prepared to follow a very strict diet. Also, these techniques involve considerable risk and could result in the development of other health problems as side effects.

How fibre affects the body continue...

Appendicitis

Appendicitis is inflammation of the appendix, the small blind-ended tube at the beginning of the large bowel. Although the underlying causes of appendicitis are not clearly understood, there is evidence that regular intake of fibre may prevent the development of the disease.

Hiatus hernia, varicose veins and piles

Many doctors believe that abdominal straining due to constipation encourages the development of conditions such as hiatus hernia (where the top of the stomach is pushed upwards, out of the abdomen and into the thoracic cavity), varicose veins and haemorrhoids (piles). It is often necessary to have surgical treatment for these conditions. Treating constipation with high fibre diets and, as a result, avoiding straining, may prevent these problems and may even reduce the need for more drastic treatment in some cases.

Coronary heart disease (CHD)

Coronary heart disease is the most common cause of death in affluent Western countries (see page 151). A large number of factors influence the development of the disease, of which raised blood cholesterol levels, high blood pressure and hypercoagulability (the tendency of the blood to clot too easily) are probably the most important.

Researchers believe that high-fibre, low fat diets protect against CHD by lowering blood cholesterol and probably also by decreasing blood pressure and the clotting ability of blood. It is especially the water soluble or gel-forming dietary fibres - found in oats, legumes and some fruit and vegetables - which help to lower cholesterol levels. While it should be borne in mind that diet is but one of the many factors which influence the development of CHD, it is also one of the controllable ones.

Diabetes mellitus

There are two forms of diabetes mellitus, a disease characterised by the excretion of glucose (sugar) in the urine (see What is diabetes? on page 175). Both forms are today treated with a high carbohydrate, high fibre, low fat diet. Fibre in the diet normalizes the body's response to dietary carbohydrate (glucose tolerance). A regular high intake of dietary fibre also improves insulin function by increasing the sensitivity of muscle and fat cells to the hormone.

Gallstones

The body manufactures these crystalline substances when the amount of cholesterol in the bile is so high that the bile salts cannot keep it in solution. The stones may block bile ducts between the liver and gall bladder or between the gall bladder and small intestine, resulting in severe pain and even jaundice. As in the case of other diseases of affluence, a number of factors may contribute to the development of gallstones. It has however been shown that high fibre intakes stimulate the production of those bile salts which keep cholesterol in solution, thus decreasing the risk of gallstone formation. Populations who follow high fibre diets have a significantly lower risk of the disease than those on the average refined Western diet.

To what degree is fibre involved?

Although research has proved that dietary fibre has a positive effect on body functions in general, the degree to which it is involved in the risk and development of the above diseases is still unclear. Studies are hampered by the fact that a variety of causes play some role and also because high-fibre diets differ in more than one respect from low-fibre ones. For example, they usually have a lower fat content - especially saturated fatty acids from food of animal origin - and are higher in vitamins and minerals. These factors could add to the beneficial effects seen in people who eat a high-fibre diet.

What is diabetes?

Diabetes is a disorder in which the pancreas cannot produce enough insulin, a hormone which prevents blood sugar levels from rising too high, or in which the insulin that has been produced does not function properly. It does this by helping body cells to take up glucose - either to metabolise to energy or to store as glycogen or fat.

If an individual manufactures too little insulin, there are two possible forms of treatment: The young, more severely affected diabetic can only survive if given daily injections of insulin for the rest of his or her life. However, if diabetes develops at a later age, treatment with pills is usually effective. These pills are not insulin; they are essentially compounds which give the pancreas the necessary stimulus to produce more insulin to cope with the carbohydrate (sugars and starches) which the individual eats. Because sugar causes a dramatic rise in blood sugar levels, diabetics should obviously avoid it in their diets; indeed, they should avoid all unnecessary food in general if they are overweight, as not only is the insulin requirement related to food intake, but excess weight has an aggravating effect on the condition. Obese diabetics who develop the disease in later life can often be treated by diet alone.

A low fat, high fibre intake - which 'dilutes' the contents of the digestive tract - slows down the passage of glucose into the blood stream and hence the elevation of the blood sugar is less dramatic.