The following lengthy and unedited article written by an unknown person was sent to me by Ir. CK Cheong via e-mail for my comment.
“Papaya was the only studied food found to halt breast cancer
Scientists studied 14 plant foods commonly consumed in Mexico to determine their ability to halt breast cancer cell growth. These included avocado, black sapote, fuava, mango, prickly pear cactus (nopal), pineapple, grapes, tomato, and papaya. They also evaluated beta-carotene, total plant phenolics, and gallic acid contents and antioxidant capacity. They found that only papaya had a significant effect on stopping breast cancer cell growth. (International Journal of Food Science and Nutrition, May)
Papaya is a store-house of cancer fighting lycopene
The intense orangey-pink color of papaya means it is chock full of cancer fighting carotenoids. Not only beta carotene, but lycopene is found in abundance. The construction of lycopene makes it highly reactive toward oxygen and free radicals. Scientists at the University of Illinois think this anti-oxidant activity contributes to its effectiveness as a cancer fighting agent. Epidemiological studies have indicated an inverse relationship between lycopene intake and prostate cancer risk. They showed that oral lycopene is highly bioavailable, accumulates in prostate tissue, and is localized in the nucleus of prostate epithelial cells.
In addition to antioxidant activity, other experiments have indicated that lycopene induces cancer cell death, anti-metastatic activity, and the up-regulation of protective enzymes. Phase I and II studies have established the safety of lycopene supplementation. (Cancer Letter, October 8, 2008)
Prostate cancer was the subject of a study in Australia that looked at 130 prostate cancer patients and 274 hospitalized controls. The scientists found that men who consumed the most lycopene-rich fruits and vegetables such as papaya were 82% less likely to have prostate cancer. In this study, green tea also exerted a powerf! ul anti-cancer effect. When lycopene-rich foods were consumed with green tea, the combination was even more effective, an outcome the researchers credited to their synergy. (Asia Pacific Journal of Clinical Nutrition, 2007)
Isothiocyanates found in papaya restore the cell cycle to eliminate cancer
Organo-sulfur compounds called isothiocyanates are found in papaya. In animal experiments, isothiocyanates protected against cancers of the breast, lung, colon pancreas, and prostate, as well as leukemia, and they have the potential to prevent cancer in humans. Isothiocyanates have shown themselves capable of inhibiting both the formation and development of cancer cells through multiple pathways and mechanisms. (International Journal of Oncology), October, 2008)
Researchers in Japan clarified the mechanisms of action in a type of isothiocyanate found in papaya known as BITC that underlies the relationship between cell cycle regulation and appropriate cell death. When cancerous cells die on schedule, they are no longer a problem. The researchers established that BITC exerted cancer cell killing effects that were greater in the proliferating cells than in the quiescent cells. Cancer cells that are proliferating are much more dangerous than cancer cells that are in a state of dormancy. (Forum of Nutrition, 2009)
Enzymes from papaya digest proteins including those that protect tumors
The fruit and other parts of the papaya tree, also known as the paw paw tree, contain papain and chymopapain, powerful proteolytic enzymes that facilitate chemical reactions in the body. They promote digestion by helping to break down proteins from food into amino acids that can be recombined to produce protein useable by humans. Proteolytic enzymes protect the body from inflammation and help heal burns. They do a good job of digesting unwanted scar tissue both on the skin and under its surface.
Research has shown that the physical an! d mental health of people is highly dependent on their ability to produce proteins they can use effectively. However, as people age, they produce less of the enzymes needed to effectively digest proteins from food and free needed amino acids. They are left with excessive amounts of undigested protein which can lead to overgrowth of unwanted bacteria in the intestinal tract, and a lack of available amino acids.
Eating papaya after a meal promotes digestion, and helps prevent bloating, gas production, and indigestion. It is quite helpful after antibiotic use to replenish friendly intestinal bacteria that were the casualties in the war against the unwanted bacteria. When the intestinal tract is well populated with friendly bacteria, the immune system is strengthened, and can better protect against flu and cancer.
Being a proteolytic enzyme, papain is able to destroy intestinal parasites, which are composed mostly of protein. To rid the body of intestinal parasites, half a cup of papaya juice can be alternated each hour for twelve consecutive hours with the same amount of cucumber or green bean juice.
Papaya contains fibrin, another useful compound not readily found in the plant kingdom. Fibrin reduces the risk of blood clots and improves the quality of blood cells, optimizing the ability of blood to flow through the circulatory system. Fibrin is also important in preventing stokes. Proteolytic enzymes containing fibrin are a good idea for long plane rides to minimize the potential of blood clots in the legs. People who sit at a desk all day might want to use proteolytic enzymes too.
Proteolytic enzymes are able to digest and destroy the defense shields of viruses, tumors, allergens, yeasts, and various forms of fungus. Once the shield is destroyed, tumors and invading organisms are extremely vulnerable and easily taken care of by the immune system.
Undigested proteins can penetrate the gut and wind up in the bloodstream where they are treated by the immune system as invaders. If too many undigested proteins are floating around, the immune system becomes overburdened and unable to attend to the other tasks it was meant to do. Proteolytic enzymes can digest these rogue proteins, freeing up the immune system.” (End of article)
Dear Dr Lim,
You are the only source of medical expert.
I heartily look up for professional advice other than my own brother-in-law who is a G P.
What is you expert opinion on this issue. Could this be a fake?
Warmest regards,
C K Cheong
Dear Ir. Cheong,
Thank you for your e-mail seeking my advice.
Correct! Most of the claims about papaya are reasonable, but a lot are still in the hypo-theoretical stage. Most of them seem scientifically reasonable based on our current knowledge on the nutritive, prophylactic values of papaya.
Nutraceutical and biological effects of some of the active ingredients such as lycopenes and the carotenoids need further study and evaluation. It is true for instance that lycopenes have been demonstrated in a number of studies as a prophylaxis (prevention) against prostate cancers. However, there are vegetables like tomatoes that are richer in lycopenes (a class of carotenoids) than in papaya. Of course I do understand that the subject in discussion was on papaya, and not on tomatoes or other fruits and vegetables.
However, I am unaware if papaya contains isothiocyanates as claimed in the article. This active principle is quite pungent as in mustard where isothiocyanates are present in abundance. If this is present in papaya, it would give papaya quite a pungent taste like mustard. But papaya does not have pungent mustard-like taste. So we need to study this carefully and analyze the phytochemicals present before we support this claim
Papain:
Papaya does contain a proteolytic enzyme called papain. This enzyme specifically cleaves the peptide covalent bonds between certain types of amino acids in a protein polymer (protein chain). In simple words, it helps to break down proteins and helps in the digestion of proteins.
Papaya contains fibrin?
However, I am not too happy by the statement that it also contains fibrin. This is actually a fibrous protein involved in the clotting mechanism of blood. In a slightly more technical language, this means it contains a fibrillar protein that is joined up (polymerized) to form a kind of mesh-work so that it forms a haemostatic plug or a blood clot in conjunction with thrombocytes or platelets (non-cellular fragments) over a wound site.
In very simple English, this simply means papaya contains a substance called ‘fibrin’ (as claimed in that article) which actually promotes blood clot. Our question is, how is it possible for papaya to contain an enzyme called papain that dissolves a protein clot, and at the same time contains fibrin that promotes a protein clot?
The article clearly says that ‘fibrin is also important in preventing strokes.’ This is just the opposite. A stroke or medically called cerebral vascular accident (CVA) is primarily caused by either a blood clot in one of the cerebral vessels in the brain, or its rapture – both compromising blood and oxygen perfusion to the brain.
Contradictory claims:
Thus you can clearly see that article contradict itself by saying that it contains a proteolytic enzyme (papain) that can dissolve a clot, but at the same time it claims to contain a fibrin that actually promotes a blood clot. To make the statement worse, it states there in red lettering ‘fibrin is also important in preventing stokes’. The author actually does not know what he was talking about. He was actually contradicting himself.
The clotting process essentially involves the conversion of a soluble plasma protein, fibrinogen, into strands of the insoluble protein fibrin, which forms a mesh that traps platelets
The situation would have been the reverse had the author the above claimed that papaya contains an anti-fibrin factor that prevents the clotting of blood that causes stroke or deep vein thrombosis (DVT). Such substances would be called fibrinolytic agents or anti-thrombotic substances that promote fibrinolysis, meaning it breaks down a clot or the fibrin. But the author did not. He clearly said in the above attached article that it contain a fibrin which is a protein clot itself. He even emphasized the word ‘fibrin’ in red lettering. Clearly he does not understand clinical biochemistry well and hence contradicted himself.
Normally in a normal physiologically induced thrombosis, this is counterbalanced by intrinsic antithrombotic properties and fibrinolysis. Fibrinolysis means, it is a process wherein a fibrin clot, the product of coagulation, is broken down. Its main fibrinolytic enzyme plasmin cuts the fibrin mesh at various places, leading to the production of circulating fragments that are cleared by other proteases or by the kidney and liver.
There are at least two questionable things we need to ask here.
Firstly:
Even if papaya contains an anti-coagulating (anti-thombocytic, anti-platelet aggregating, anti-fibrinogen or anti-fibrin substance(s) as he claimed, I suspect it will be at very low concentration to have any physiological effect against DVT or as a prophylaxis against stroke.
Secondly:
Even these substances are present in papaya; I doubt it would be effective if taken orally. Most of these anti-fibrinogens are protein in nature, and if taken orally as when we eat a papaya, the protein-digesting intestinal juices, the proteases from the pancreas will instantly destroy any proteins, including the soluble fibrinogen, insoluble fibrin or any fibrinolytic agent that is of protein in nature, rendering it biologically inactive. Even in the stomach, the proteins are already beginning to be broken down by the gastric juices the stomach is broken down by the action of the gastric juice containing hydrochloric acid and a protein-digesting enzyme called pepsin.
An example of a fibrinolytic factor which is a protein is obtained from certain giant leeches like Haementeria ghilianii. The anti-clotting proteins from this leech have molecular weights under about 100,000, and are isolated from the salivary glands of H. ghilianii. When a leech bites, the anti-coagulant goes directly into site of the bite. It will not be effective if it is taken orally like eating a papaya.
Such substances need to be injected directly into the blood stream to bypass the destructive actions of the digestive juices.
For instance, there are three major classes of fibrinolytic drugs: tissue plasminogen activator (tPA), streptokinase (SK), and urokinase (UK). While drugs in these three classes all have the ability to effectively dissolve blood clots, they differ in their detailed mechanisms in ways that alter their selectivity for fibrin clots. But none of these clot-buster drugs can be given orally. They need to administered via intra-venous route
Thirdly:
Even if papaya contains an fibrinolytic substance as claimed, it cannot exist inside the papaya in the original form per sec because the papaya itself has papain, a proteolytic enzyme that will destroy the anti-fibrin principles, unless it occurs in the form of a precursor trapped in the cells, and can only be released when the papaya is crushed by mastication.
In the first instance, I do not think such an anti-clotting substance exist in papaya. I have not come across any published literature on this.
If there are foods that have anti-coagulating and anti-platelet aggregating properties that may have health benefits against stroke, cardiovascular risk, and DVT, I would suggest foods that contain high levels of salicylates (Aspirin). Aspirin is the acetylated form of salicylic acid known as acetylsalicylic acid.
Cardio-protective, as well as cancer-protective foods:
Foods with medicinal values against cardiovascular risks would be capsicum, hot pepper, tomatoes, all curry powder, and spices, and curry leaves, guava, oranges, pineapples, grapes, plums, prunes, almonds, water chestnuts, teas, etc. Not only are these foods cardio-protective, but because of their high salicylate content, they were also shown to be preventive against colorectal cancer. So far I have not come across any published literature showing papaya can prevent heart, CVA and other vascular diseases. Neither have I come across research papers demonstrating anti-cancer properties in papaya.
Garlic, onions, leeks, mok yee (black fungus), oats, asparagus, whole grains and cereals, green leafy vegetables and plenty of fresh fruits can also do a very good job in preventing a lot of cardiovascular related diseases. It is not just papaya mentioned in the article.
This is the problem when we get things sent to us through chain e-mails, or from websites. Most people will believe them as gospel truth. They become blind to a lot of these hoaxes. Most of the claims have not undergone intensive well-designed scientific studies.
The authors’ names, qualifications and academic credentials, place of work and professional position are not given in all these claims.
Anyone can literally write and claim just about anything in the Internet and chain e-mails. They then send them out, and ask recipients of such mails to be forwarded to other people. So lies are spread like wild fires this way without editing and policing.
There are a lot more nutritional and medicinal claims mentioned in that article on papaya, but I do not think I should waste a lot of my time that needs a lot more evidence-based studies.
Lots of claims, little references:
Nevertheless, it will take me a lot of time and effort to discuss all those claims and details there. There were a few references there which as a medical research scientist and research nutritionist, I appreciate, but there were far more claims in the lengthy article than citations quoted. So those claims cannot be supported by scientific evidences, at least not at the moment.
However, the background hypotheses are attractive, and may be used as a basis for further studies, or as a thesis for a Masters degree in Nutrition, Medicine or Biomedical Sciences.
Regards
lim ju boo
Chief and Special Medical and Science Adviser
Head of Technical Advisory Board
Dynapharm In’tl Pharmaceutical Group
Malaysia
Dear Dr Lim,
Thank you so much for the expert advice and research information regarding the benefit of Papaya.
May you be well & happy always!
Metta
C K Cheong
Thursday, May 27, 2010
Sunday, May 23, 2010
Missing Teeth Linked to Heart Disease
Teeth linked to heart disease
AFP,The West Australian April 13, 2010, 6:45 am
People with dented smiles run a far greater risk of dying of heart disease than those who still have all their pearly whites, a Swedish researcher says.
Cardiovascular disease and, in particular, coronary heart disease was closely related to the number of teeth a person had, researcher Anders Holmlund said.
"A person with fewer than 10 of their own teeth has a seven times higher risk for death by coronary heart disease than a person of the same age and of the same sex with more than 25 teeth left," Professor Holmlund said.
Although many studies published in the past 15 years had shown a link between oral health and cardiovascular disease, Professor Holmlund's study showed a direct relationship between cardiovascular disease and the number of teeth in a person's mouth.
The study, conducted with colleagues Gunnar Holm and Lars Lind, surveyed 7674 women and men, most suffering from periodontal disease, for an average of 12 years, and examined the cause of death of the 629 people who died during the period. For 299 of the subjects, the cause of death was cardiovascular disease.
Professor Holmlund said the theory connecting teeth numbers and heart disease maintained that infections in the mouth and around the teeth could spill over to the systemic circulation system and cause a low-graded chronic inflammation, which was known to be a risk factor for heart attacks and other cardiovascular episodes.
The number of natural teeth a person had left "could reflect how much chronic inflammation one has been exposed to in a lifetime", he said.
The study had been limited by the fact that it had not been possible to adjust the results for socio-economic factors and to fully adjust them according to other cardiovascular risk factors.
Heart disease is the number one killer worldwide, claiming more than 17 million lives every year, according to the World Health Organization.
Brother CK,
I am a bit worried because I have lost a few teeth and undergone double cabg. Maybe our good friend and Dr JB Lim can give further insight into this article:
Thanks
Perry Tan
Dr JB Lim Comments:
I have never heard of this before. Show me the article and the reference or the journal where the study was published. I want to see the design of the study, the data and the statistical analysis of the data, and the conclusion he derived. I am extremely fussy about this as a medical researcher and a trained medical statistician.
The number of teeth left in a person is also related to his age – the older he is, the lesser teeth he would have left. This is natural. Wouldn’t the chances of death due to old age naturally becomes higher and higher the older the person is whatever the cause? The causes could be anything from accidents, cancers, infections, and degenerative diseases, and not necessary heart disease alone. Ultimately everybody dies of old age.
The only thing I can think to relate oral infection (Strep throat) to heart disease is Group A streptococcal infection (GAS), specifically the bacterium Streptococcus pyogenes that may give rise to acute rheumatic fever and rheumatic heart disease, and Streptococcal toxic shock syndrome. This is well-known and is not new to us as it is described in any standard text-book of medicine. This has nothing to do with the DMF (decayed, missing and filled) teeth in the mouth.
I think this professor or doctor here is talking nonsense. Some of them do. I have come across lots of them as my colleagues in my 25 years of professional career as a researcher.
Dr JB Lim BSc PG Dip Nutri MSc MD PhD FRSPH FRSM
Special Medical and Science Adviser
Head of the Technical Advisory Board
The Dynapharm Int’l Pharmaceutical Group
Dear Perry,
Thanks to Dr Lim, I am happy that you are okay after all do take care of your food and regular exercise.
Regards,
C K
Dear Dr. Lim Ju Boo
It is possible. Our health related to food and teeth or more the mouth section. Our mouth tends to have ulcer. Worse would be the diabetic patients
Dr. Chan Boon Lye
Dear Dr Chan,
Thank you for your comment.
Yes, of course. Our choice of food and our ability to chew and eat them is definitely determined by state of our teeth. In turn our overall health depends on the nourishment we get and our ability to choose and masticate the food. Hence nutrition is the direct function of our dental health. There is no doubt about this. This is a very old knowledge which I learnt even as an undergraduate student. I do not doubt this. But this was not what I was able to relate.
Missing teeth and heart disease?
What I was unable to find was a relationship was ‘missing tooth and heart disease specifically.’ This was news to me. I have already commented on the very old knowledge we already know how a sore Strep throat caused by a group A streptococcal infection in children may lead to rheumatic fever and rheumatic heart disease later in life in which the heart valves especially the mitral valve are incompetent or totally damaged. This is also not new to us.
Ever since I made that remarks people has been calling me if I could think of any other possibility where the heart can be affected by missing teeth since Professor Holmlund's study showed ‘a direct relationship between cardiovascular disease and the number of teeth in a person's mouth’.
Which specific heart disease?
Quite honestly I just do not know. First of all, I do not know what Prof Holmlund meant by cardiovascular disease (CVD). There are so many types of heart diseases involving the heart muscles – cardiomyopathies from congenital heart disease, nutritional diseases affecting the heart, ischemic and non-ischaemic cardiomyopathy, hypertensive cardiomyopathy, valvular cardiomyopathy, inflammatory cardiomyopathy, cardiomyopathy secondary to a systemic metabolic disease, alcoholic cardiomyopathy, diabetic cardiomyopathy, to restrictive cardiomyopathy. Which heart muscle disease did Professor meant? I presume he meant CHD or CAD (coronary heart / coronary arterial disease)?
What has missing teeth got to do with CAD?
Really I do not have the faintest idea how CAD caused by a blockage or a stenosis of the coronary arteries has anything to do with missing teeth?
Heart block?
Alternatively the only other thing I can think of is a ‘heart block’ which is an entirely different pathology of the heart from CAD. As far as I know, this also has no connection with the number of teeth in the mouth? Heart block here means (as all cardiologists know), is an anomaly of the conduction system within the heart. It is a medical condition in which the electrical impulse generated in the SA node in the atrium does not propagate to the ventricles. There are many types and degrees of heart block - first-degree AV block, second-degree AV block, bundle branch block, or bifascicular block. Type I second-degree heart block, or Mobitz Type I, or Wenckebach's AV block. A third-degree AV block is known as a complete heart block.
Causes:
Many conditions can cause third-degree heart block, but the most common cause is coronary ischemia or an acute myocardial infarction. This is the only condition where the two are related as far as my limited knowledge in cardiology allows me comment.
Progressive degeneration of the electrical conduction system of the heart can lead to third-degree heart block. Of course there are many other causes of heart block too, and not just a squeal of a heart attack. But all their aetiologies (causes) are intra-cardiac (within the heart muscles), and are not extra-cardiac in nature.
The vagus nerve to the heart:
The only nerve outside that affects the heart is the vagus nerve – the 10th and the longest nerve. The vagus nerve is actually two nerves, both of which run from the brain stem and branch out separately, down the body, across the abdomen and to the main organs such as the heart and stomach. This is the only nerve that directly controls a number of bodily functions, such as breathing, maintaining digestive function, keeping the brain up to date with what we have eaten or digested and cardiac rhythm.
Physiology of vagus innervations:
Parasympathetic innervation of the heart is mediated by the vagus nerve. Specifically, the vagus nerve acts to lower the heart rate. The right vagus innervates the sinoatrial node. Parasympathetic hyperstimulation predisposes those affected to bradyarrhythmias. The left vagus when hyperstimulated predisposes the heart to atrioventricular (AV) blocks. All these we know. The physiology of this innervation is nothing new to us.
Missing link:
But there is missing link here. The vagus nerve is not connected to the teeth, but it supplies to a few muscles in the mouth for mastication and for speech and keeping the larynx open for breathing. But it does not innervate the teeth.
The nerve to the teeth:
It is the trigeminal nerve (the fifth cranial nerve, also called the fifth nerve, or simply CNV) that is responsible supplying nerve to the teeth and also for sensation in the face. The fifth nerve is primarily a sensory nerve, but it also has certain motor functions (biting, chewing, and swallowing) like the vagus nerve to a few other muscles of the mouth.
One is the 5th cranial nerve (trigeminal nerve), the largest cranial nerve and is the great sensory nerve of the head and face, and the motor nerve of the muscles of mastication, and the other is the 10th cranial nerve (vagus nerve). But they are anatomically separate and have little to do with each other except they are all connected to the brain.
My simple ignorance:
So with this very simple anatomical explanation of mine you can see nether the trigeminal nerve has anything to do with the heart, nor the vagus which has something to do with the heart, has anything to do with the teeth.
Each went separate ways. In short I do not know the answer. Only Professor Holmlund who did all that funny finding has the answer. Maybe he can explain. Maybe not, but I doubt he can himself. You ask him, and don’t trouble me. I am not an expert on oral pathology and cardiology.
Regards
Lim Ju Boo
Dear Dr. Lim Ju boo,
Yes, I could not disagree with you.
A good analysis,
Boon Lye, Dr. Chan
AFP,The West Australian April 13, 2010, 6:45 am
People with dented smiles run a far greater risk of dying of heart disease than those who still have all their pearly whites, a Swedish researcher says.
Cardiovascular disease and, in particular, coronary heart disease was closely related to the number of teeth a person had, researcher Anders Holmlund said.
"A person with fewer than 10 of their own teeth has a seven times higher risk for death by coronary heart disease than a person of the same age and of the same sex with more than 25 teeth left," Professor Holmlund said.
Although many studies published in the past 15 years had shown a link between oral health and cardiovascular disease, Professor Holmlund's study showed a direct relationship between cardiovascular disease and the number of teeth in a person's mouth.
The study, conducted with colleagues Gunnar Holm and Lars Lind, surveyed 7674 women and men, most suffering from periodontal disease, for an average of 12 years, and examined the cause of death of the 629 people who died during the period. For 299 of the subjects, the cause of death was cardiovascular disease.
Professor Holmlund said the theory connecting teeth numbers and heart disease maintained that infections in the mouth and around the teeth could spill over to the systemic circulation system and cause a low-graded chronic inflammation, which was known to be a risk factor for heart attacks and other cardiovascular episodes.
The number of natural teeth a person had left "could reflect how much chronic inflammation one has been exposed to in a lifetime", he said.
The study had been limited by the fact that it had not been possible to adjust the results for socio-economic factors and to fully adjust them according to other cardiovascular risk factors.
Heart disease is the number one killer worldwide, claiming more than 17 million lives every year, according to the World Health Organization.
Brother CK,
I am a bit worried because I have lost a few teeth and undergone double cabg. Maybe our good friend and Dr JB Lim can give further insight into this article:
Thanks
Perry Tan
Dr JB Lim Comments:
I have never heard of this before. Show me the article and the reference or the journal where the study was published. I want to see the design of the study, the data and the statistical analysis of the data, and the conclusion he derived. I am extremely fussy about this as a medical researcher and a trained medical statistician.
The number of teeth left in a person is also related to his age – the older he is, the lesser teeth he would have left. This is natural. Wouldn’t the chances of death due to old age naturally becomes higher and higher the older the person is whatever the cause? The causes could be anything from accidents, cancers, infections, and degenerative diseases, and not necessary heart disease alone. Ultimately everybody dies of old age.
The only thing I can think to relate oral infection (Strep throat) to heart disease is Group A streptococcal infection (GAS), specifically the bacterium Streptococcus pyogenes that may give rise to acute rheumatic fever and rheumatic heart disease, and Streptococcal toxic shock syndrome. This is well-known and is not new to us as it is described in any standard text-book of medicine. This has nothing to do with the DMF (decayed, missing and filled) teeth in the mouth.
I think this professor or doctor here is talking nonsense. Some of them do. I have come across lots of them as my colleagues in my 25 years of professional career as a researcher.
Dr JB Lim BSc PG Dip Nutri MSc MD PhD FRSPH FRSM
Special Medical and Science Adviser
Head of the Technical Advisory Board
The Dynapharm Int’l Pharmaceutical Group
Dear Perry,
Thanks to Dr Lim, I am happy that you are okay after all do take care of your food and regular exercise.
Regards,
C K
Dear Dr. Lim Ju Boo
It is possible. Our health related to food and teeth or more the mouth section. Our mouth tends to have ulcer. Worse would be the diabetic patients
Dr. Chan Boon Lye
Dear Dr Chan,
Thank you for your comment.
Yes, of course. Our choice of food and our ability to chew and eat them is definitely determined by state of our teeth. In turn our overall health depends on the nourishment we get and our ability to choose and masticate the food. Hence nutrition is the direct function of our dental health. There is no doubt about this. This is a very old knowledge which I learnt even as an undergraduate student. I do not doubt this. But this was not what I was able to relate.
Missing teeth and heart disease?
What I was unable to find was a relationship was ‘missing tooth and heart disease specifically.’ This was news to me. I have already commented on the very old knowledge we already know how a sore Strep throat caused by a group A streptococcal infection in children may lead to rheumatic fever and rheumatic heart disease later in life in which the heart valves especially the mitral valve are incompetent or totally damaged. This is also not new to us.
Ever since I made that remarks people has been calling me if I could think of any other possibility where the heart can be affected by missing teeth since Professor Holmlund's study showed ‘a direct relationship between cardiovascular disease and the number of teeth in a person's mouth’.
Which specific heart disease?
Quite honestly I just do not know. First of all, I do not know what Prof Holmlund meant by cardiovascular disease (CVD). There are so many types of heart diseases involving the heart muscles – cardiomyopathies from congenital heart disease, nutritional diseases affecting the heart, ischemic and non-ischaemic cardiomyopathy, hypertensive cardiomyopathy, valvular cardiomyopathy, inflammatory cardiomyopathy, cardiomyopathy secondary to a systemic metabolic disease, alcoholic cardiomyopathy, diabetic cardiomyopathy, to restrictive cardiomyopathy. Which heart muscle disease did Professor meant? I presume he meant CHD or CAD (coronary heart / coronary arterial disease)?
What has missing teeth got to do with CAD?
Really I do not have the faintest idea how CAD caused by a blockage or a stenosis of the coronary arteries has anything to do with missing teeth?
Heart block?
Alternatively the only other thing I can think of is a ‘heart block’ which is an entirely different pathology of the heart from CAD. As far as I know, this also has no connection with the number of teeth in the mouth? Heart block here means (as all cardiologists know), is an anomaly of the conduction system within the heart. It is a medical condition in which the electrical impulse generated in the SA node in the atrium does not propagate to the ventricles. There are many types and degrees of heart block - first-degree AV block, second-degree AV block, bundle branch block, or bifascicular block. Type I second-degree heart block, or Mobitz Type I, or Wenckebach's AV block. A third-degree AV block is known as a complete heart block.
Causes:
Many conditions can cause third-degree heart block, but the most common cause is coronary ischemia or an acute myocardial infarction. This is the only condition where the two are related as far as my limited knowledge in cardiology allows me comment.
Progressive degeneration of the electrical conduction system of the heart can lead to third-degree heart block. Of course there are many other causes of heart block too, and not just a squeal of a heart attack. But all their aetiologies (causes) are intra-cardiac (within the heart muscles), and are not extra-cardiac in nature.
The vagus nerve to the heart:
The only nerve outside that affects the heart is the vagus nerve – the 10th and the longest nerve. The vagus nerve is actually two nerves, both of which run from the brain stem and branch out separately, down the body, across the abdomen and to the main organs such as the heart and stomach. This is the only nerve that directly controls a number of bodily functions, such as breathing, maintaining digestive function, keeping the brain up to date with what we have eaten or digested and cardiac rhythm.
Physiology of vagus innervations:
Parasympathetic innervation of the heart is mediated by the vagus nerve. Specifically, the vagus nerve acts to lower the heart rate. The right vagus innervates the sinoatrial node. Parasympathetic hyperstimulation predisposes those affected to bradyarrhythmias. The left vagus when hyperstimulated predisposes the heart to atrioventricular (AV) blocks. All these we know. The physiology of this innervation is nothing new to us.
Missing link:
But there is missing link here. The vagus nerve is not connected to the teeth, but it supplies to a few muscles in the mouth for mastication and for speech and keeping the larynx open for breathing. But it does not innervate the teeth.
The nerve to the teeth:
It is the trigeminal nerve (the fifth cranial nerve, also called the fifth nerve, or simply CNV) that is responsible supplying nerve to the teeth and also for sensation in the face. The fifth nerve is primarily a sensory nerve, but it also has certain motor functions (biting, chewing, and swallowing) like the vagus nerve to a few other muscles of the mouth.
One is the 5th cranial nerve (trigeminal nerve), the largest cranial nerve and is the great sensory nerve of the head and face, and the motor nerve of the muscles of mastication, and the other is the 10th cranial nerve (vagus nerve). But they are anatomically separate and have little to do with each other except they are all connected to the brain.
My simple ignorance:
So with this very simple anatomical explanation of mine you can see nether the trigeminal nerve has anything to do with the heart, nor the vagus which has something to do with the heart, has anything to do with the teeth.
Each went separate ways. In short I do not know the answer. Only Professor Holmlund who did all that funny finding has the answer. Maybe he can explain. Maybe not, but I doubt he can himself. You ask him, and don’t trouble me. I am not an expert on oral pathology and cardiology.
Regards
Lim Ju Boo
Dear Dr. Lim Ju boo,
Yes, I could not disagree with you.
A good analysis,
Boon Lye, Dr. Chan
Does cholesterol cause heart disease
Dear Dr Lim
Not sure if this article by Dr Dwight is true? It is going against normal things that have been taught in the medical school. If it is true, the medical texts have to be rewritten. These are some of age old questions & beliefs.
Dato Dr Vincent Ng,
Dear Dato Dr Vincent,
Many thanks for this interesting article by a heart surgeon-turned-nutritionist about the true aetiology of coronary heart disease.
Let me give you my professional opinion as briefly as possible as a chemist, physiologist, nutritionist and a physician with special interest in natural medicine.
Right but off tangent simultaneously:
Dr Dwight Lundell is right that it is the inflammation of the inner wall of the coronary artery that gives rise to coronary arterial disease (CAD) and not the increased buildup of fatty layers, known as atheroma due to cholesterol deposits.
But he was off tangent in blaming polyunsaturated oils like soybean, corn and sunflower oils, omega-6 fatty acids, and highly processed carbohydrates as the trigger factors for the inflammatory response. Neither in my opinion is CAD caused by high density or low density cholesterol.
Even the huge on-going Framingham longitudinal cohort study beginning in 1948 into three subsequent generations in Massachusetts has concluded that no levels of cholesterol per sec, be it high or low, be a single predictor of CAD.
There are so many other intertwining trigger factors such as genetic make-up, blood pressure, stress levels, smoking, lifestyle changes, etc that play a role in cardiovascular disease and its events. It is this massive long term Framingham cohort heart study that has caused all of us in the health-care professions to be so obsessed and so blind to levels of cholesterol in the blood and its correlation to cardiovascular events.
Medical vs. Chemistry Professions:
Unfortunately the medical profession has almost no understanding of chemistry and their colleagues in the chemistry profession likewise has little clue in medical research and its advances. Being also a qualified chemist myself I specifically believe it is the damaging free radicals – highly reactive molecules, molecular fragments or atomic fragments that has lost one of their paired electrons in their shared co-valent bond that is the culprit in causing so much damage to the DNA, cells, tissues, organs, systems and eventually to the entire body into degenerative disorders and rickety shape like CVA (stroke), CAD, autoimmune disorders, neoplastic diseases like malignancies, brain, kidney, liver, musculoskeletal, eye, hair, skin disorders. In fact death ultimately overwhelms all of us either due to any of the big classes of causes – accidents, cancers, infections, degenerations or genetic disorders.
No escape from free radicals:
There is no escape because highly damaging free radicals are everywhere – in the food, medicines, chemicals in the environment, pollutants, radiation from mobile phones, x-rays, CAT scans, PET scans, EMG scans, nucleotide and radioactive tagging and scans, metabolic wastes, ultra-violet rays, cosmic radiation from outer space, stress hormones like adrenalin, anger, ageing, etc, etc….down the endless lists.
If only cardiologists, neurologists, nephrologists, oncologists and other specialist clinicians can understand the highly, highly, destructive nature of these unquenched reactive molecules that they would not single out diet, nutrition and lifestyle has the sole causes to all these medical events.
Framingham benchmark:
A lot of scientists, nutritionists, cardiologists, physicians are very blind to refer to the Framingham Heart Study on their findings of blood cholesterol levels, hypertension, smoking etc as the benchmark as a predictor of cardiovascular events. But even they a few years ago came to the conclusion after such a massive and long haul study that cholesterol whether high or low has little bearing on morbidity and mortality from cardiovascular events. It came from the horse mouth. Unfortunately all our ideas about cholesterol and CAD came from this massive Framingham Study. Nowhere else we got this idea or theory.
My own experience:
In fact even my own experience having signed thousands of diagnostic forms for blood lipids analysis sent to us at IMR from Government hospitals throughout the country showed very little relationship between suspected AMI or angina pectoris (chest pains) and what we found on the blood cholesterol levels. Initially we thought we may have made analytical errors. We checked and checked again on the analytical procedure, and did quality control, but there was no mistake. There was very relation between what the clinician reported and what we found.
Cardiac enzymes not out yet:
Of course the release of cardiac enzymes (creatine phosphokinase (CPK, CK) and the protein troponin (TnI, TnT), etc at that time weren’t discovered yet and there was no means of using them as a diagnostic tool. Of course the clinician would also have done an ECG for ST elevation and other irregularities in the PQRST waves.
What I saw:
Let me put this straight away. In my 25 years in medical research in an analytical research laboratory at the Institute for Medical Research I have seen and handled what pure analytical grade cholesterol looks like, and how they feel on the fingers. Let me tell all these experts who believe that it is the high levels of blood cholesterol as the prime factor that cause the cholesterol to stick onto the tunica intima (inner coat of blood vessels).
Properties of cholesterol:
If these clinicians have ever worked in a chemistry laboratory to analyze cholesterol content in thee blood and foods, they would have seen what pure cholesterol looks like, how they feel on the fingers – their physical and chemical properties, etc. Let me tell them that cholesterol is just a very pale yellow powder, completely insoluble in an aqueous media like in water, blood or urine. It does not feel greasy, oily, nor does it stick on to the fingers. In fact it does not stick on to anything at all.
Cholesterol only dissolves in an organic solvent such as chloroform and petroleum ether and it is a little soluble in oil medium. That’s all. It completely does not stick to anything at all, not even to a piece of meat, beef, pork, fish, vegetables or fruits, and least of all water. It just drops off if you try to rub it on anything.
If you scatter pure cholesterol onto the surface of water, it will just float there like talcum powder. It will not dissolve like sugar or salt into water. If you rub it onto your finder tips, it is just like non-greasy powder which you can instantly wash off with just plain water. No soap or organic solvent needed.
In short, even in the blood most of them are dissolved in the small amount of blood lipids and carried around and round the body without sticking on to anything. But you need to be a analytical chemist, not a clinician to understand and experience this. This is surprising to a lot of people – especially the health freaks.
Properties altered during damage:
But when the chemical and physical properties of cholesterol is altered by heat and oxygen, and long exposure to light, and worse of all, by free radicals, that changes in their physical and chemical properties greatly. These were clearly seen by me. My personal experience using pure cholesterol as a standard reagent for analytical purposes showed that the cholesterol became sticky and gummy when subjected to light, heat and chemical attacks.
This is what makes cholesterol stick:
This is what make the cholesterol stick on to the tunica intima causing irritation and inflammation there, only after they are damaged by free radicals that attacks it into gummy substances. It is also the free radicals that at the same time irritates and damage the tunica intima and cause inflammation there. Got it? Thanks for understanding this chemo-pathophysiology. Hope you learn something new today from my night long till dawn effort in writing this comment.
Cholesterol is inert:
This is what the Cardiac Surgeon Dr Dwight the author of the attached letter circulated to me firmly believes. He was absolutely right about the inflammation and not the athermanous plaques (atheroma) which all the other medical experts – cardiologist, nutritionists, pathologists, and medical researchers erroneous are talking about.
A lot of people do not understand cholesterol is harmless per sec until its chemical properties are damaged by chemical agents to make them sticky and gummy as to stick on to the inner blood vessels like a leech. This damage is obviously more extensive and intensive the higher the content of cholesterol in the blood. The lesser the amount, the lesser the damage occur. This explains why higher blood cholesterol levels carry a higher risk of CAD, irrespective whether it is the high or low density lipoproteins.
Cholesterol is important for health:
Furthermore, a lot of people think that cholesterol is nothing but harmful to health. They just lack the knowledge of biochemistry and physiology. They don’t understand that cholesterol is absolutely essential for good health. It is used by the body to manufacture steroids, or cortisone-like hormones, including the sex hormones. These hormones include testosterone, estrogen and cortisone. Combined, these hormones control a myriad of bodily functions. They don’t realize that cholesterol helps the liver produce bile acids. These acids are essential for digestion of fats and ridding the body of waste besides acting as a cell to cell interconnects "lipid molecules". A lipid molecule is needed to stabilize our cell membranes. Without cholesterol the endocrine system malfunctions. Too low a cholesterol level may also cause mental disorders.
Furthermore, cholesterol is an important part of the myelin sheath in a neuron. It consists of fat-containing cells that insulate the axon from electrical activity. This ensures our brain functions properly by insulating the electrical impulses. The brain is the richest in cholesterol and without the cholesterol there, our brain would fail to focus with lost of memory. Cholesterol also has lots of beneficial effects on the human body immune system.
Cholesterol turn over:
In fact a developing brain in a foetus has the highest content of cholesterol. If cholesterol is so harmful to health, none of us would have emerged alive after intrauterine life. In the foetus itself the extremely high cholesterol content would have long clogged up all our blood vessels even before we could emerge from our mother’s womb. But did we all die inside the womb? Of course not, unless it was a pre-natal disorder. In foetal life the cholesterol is new and fresh and has not been chemically damage yet. In later life the cholesterol ages, and suffers chemical, oxidative, and free radical damage such as singlet-oxygen damage, and they then becomes sticky and gummy.
That is when they begin to stick on to the blood vessels more and more when we get older and older. Got this message? Thank you for being my obedient student.
Endogenous and exogenous feedback mechanisms:
So all these are chronic ideas people have about cholesterol. They don’t even realize that the liver can manufacture 10 times more cholesterol to meet body’s need, than all the cholesterol we can eat through food – brain, eggs, liver, etc we can eat in a day. There is a feedback mechanism in the body between endogenous (produced by the body) cholesterol and exogenous (outside the body through food) to keep that balance and stabilization of cholesterol in the blood. They also don’t realize that some 1500 -3000 mg of cholesterol is excreted by the bile daily to keep the balance in check. All these mechanisms become operative because the body needs the cholesterol and it has to stabilize its level.
The blind parrot imitates:
People are just ignorant about all these physiological homeostasis inside the body, and throw away all the food that has cholesterol in them such as egg yolk which together with the white of egg is the world’s most nutritious food because the entire chick has to depend entirely on it as its only and sole food and nourishment until the chick can come out from the empty shell.
The egg to the growing chick inside is like milk to a baby. So people who have no clue on nutrition, throw away the best part of the egg – the yolk, and eat only the albumin (white of egg) which is the ‘worse’ part with low biological value and chemical score.
Throwing away the yolk, and eating only the white of egg is like exchanging gold (yellow colour of yolk) for silver (white colour like the albumin). All their knowledge is skewed up including cholesterol which they thought is the cause of heart disease. Luckily we have Dr Dwight who wrote the attached article to come to our rescue – but unfortunately his thesis is also half-cooked that can only earn him far higher than a PhD degree - a D.Sc. degree but not yet a Nobel Prize in Medicine or Physiology. I hope I can complete the other half for him.
The heart surgeon who became a nutritionist…but one step short:
But Dr Dwight albeit right in one eye, but he was completely blind and ignorant in the other eye. He wrote a lengthy blame on unsaturated fats and oils including omega 6 vegetable oils, soybean oils, corn oils as the culprits which of course is against the understanding of mainstream orthodox medicine and nutrition. But not a single word did he mention about free radicals which is the mainstay aetiology of all degenerative diseases including cardiovascular diseases today.
Do you know why? He is a cardiothoracic and vascular surgeon one half but not a professional chemist the missing half. So I do not blame him if he only has mono-training in one area of medical science. He needs an eye implant and an extra pair of spectacles.
The emperor without clothes and the sharp-eye eagle:
This holistic vision can only be seen by a sharp-eyed eagle that can soar high up into the air to have a 3-D vision of the panorama below it. Else he will just concentrate on diet and nutrition and thinks that food is the only thing is the only answer in life about health.
The rest of the old-fashioned thinkers are even worse. They just follow one another blindly and repeat some ideology like parrots; else if they deviate even slightly from the standard thinking, the rest of the other fools will laugh at him and say he is mad without stopping to think critically. You may call me mad if you like.
Sorry…
Sorry Dr Dwight. You need to have a degree in chemistry also specializing on free radicals and understand their role in internal medicine and nutrition This will help you to change your thesis. You thesis currently is new and original, and running counter current with orthodox consensus, but you need to upgrade it from a PhD to a D.Sc. thesis, if possible a Nobel Prize winning Award in Medicine or Physiology. A holistic education will do this job.
But you need an extra degree:
I am a compulsive writer who likes to explain in fine details, but unfortunately that’s all the time I have for this very brief comment for the cardiothoracic surgeon-nutritionist. Maybe when Dr Dwight goes back to the university to read for another degree in chemistry, he will come out with his revised version of his theory just like mine here.
Thanks Professor Dato:
Thanks a lot Dato Dr Vincent Ng. I appreciate the tens of hundreds of e-mail articles you have been sending me over the last 2-3 years. When shall we have a hearty crab and prawn dinner together? Don’t worry about the cholesterol inside. I will be beside you as your nutritionist and emergency physician in the event you went into an eventful acute myocardial infraction.
I have to close now as it is already nearly 5:30 a.m.
Yours truly,
Lim Ju Boo
http://www.diamondinterest.com.my/technicalboard.htm
Dear All,
Bravo! I did not expect such a good and lengthy response from Dr. Lim JB on this topic. I must admit that it has given me better and deeper insight into the whole subject matter. Thanks.
- Dr. Chew BH
Yg Arief Prof Dr.Lim,
Thank you for your prompt response and the lengthy explaination you have given. I really appreciate your time spent in writing such a thesis in expounding the intricacy & truth of such theory. Indeed, your exposition is most enlightening and acceptable. I believe you are right on the dot and balanced in your view. All of us are always inspired by your wisdom, knowledge and great insights. I never forget how you can give your lecture none stop for hours on end and learning mandarin within hours at your age. Wah! great genius. You deserve to be the next Noble Price holder. Keep up the good work. God
Bless.
With kind regards,
Dato Dr Vincent Ng
Wow Dr J B Lim,
Incredible write-up that was a joy to read! I learned a lot of new things at the end of your so-called “brief” article.
I admire your holistic approach to subjects such as these, and it is true that only by holistic study via macro view and micro scrutiny that you get closer to the truth. But I must say, there is still one area that you lack. And that is the unscientific aspect of spirituality – the area of life where there are no logical explanations for unfathomable events that take place. This would certainly include the subject of visualization, actualization, materialization, mentalism, mind over matter, and such. But i do not know if your highly scientific and analytical acumen to look at things in such fine detail can stomach something as intangible as the spirit and the ether, from which there are no hard solid evidence but only empirical observations and data for consideration.
Dr Deepak Chopra wrote a very good book on heart disease from a spiritual standpoint that I have actually benefited from. However, science often will not tolerate opinions that do not have measurable data and facts to rely upon. I believe that ethereal energy is always there, whether we can see it or not. Sometimes the potential for it to be there requires human intervention, and at other times, it has always been there, just not so visible to the naked eye. Like Uranus before its discovery, and the invention of a telescope powerful enough to bring it closer to us in the 18th century. But it has always been there. Man just needed to make a machine to bring the un-see-able into reality. I believe the same is with energy. Man just needs to create a contraption to measure this. But i think Marcel Vogel who was originally with IBM came rather close with his Omega V machine, before he died almost 20 years ago. You can read him up by googling “the legacy of Marcel Vogel”.
In the meantime, do continue to write your thesis. You must be very patient to stay up so late (or early rather!) to finish it. At least you know, some 34-year-old who plays the violin, will be keen to read every word of it, and i hope that makes your effort all the more worthwhile.
To more ramblings!
- Hainanese Buy
Not sure if this article by Dr Dwight is true? It is going against normal things that have been taught in the medical school. If it is true, the medical texts have to be rewritten. These are some of age old questions & beliefs.
Dato Dr Vincent Ng,
Dear Dato Dr Vincent,
Many thanks for this interesting article by a heart surgeon-turned-nutritionist about the true aetiology of coronary heart disease.
Let me give you my professional opinion as briefly as possible as a chemist, physiologist, nutritionist and a physician with special interest in natural medicine.
Right but off tangent simultaneously:
Dr Dwight Lundell is right that it is the inflammation of the inner wall of the coronary artery that gives rise to coronary arterial disease (CAD) and not the increased buildup of fatty layers, known as atheroma due to cholesterol deposits.
But he was off tangent in blaming polyunsaturated oils like soybean, corn and sunflower oils, omega-6 fatty acids, and highly processed carbohydrates as the trigger factors for the inflammatory response. Neither in my opinion is CAD caused by high density or low density cholesterol.
Even the huge on-going Framingham longitudinal cohort study beginning in 1948 into three subsequent generations in Massachusetts has concluded that no levels of cholesterol per sec, be it high or low, be a single predictor of CAD.
There are so many other intertwining trigger factors such as genetic make-up, blood pressure, stress levels, smoking, lifestyle changes, etc that play a role in cardiovascular disease and its events. It is this massive long term Framingham cohort heart study that has caused all of us in the health-care professions to be so obsessed and so blind to levels of cholesterol in the blood and its correlation to cardiovascular events.
Medical vs. Chemistry Professions:
Unfortunately the medical profession has almost no understanding of chemistry and their colleagues in the chemistry profession likewise has little clue in medical research and its advances. Being also a qualified chemist myself I specifically believe it is the damaging free radicals – highly reactive molecules, molecular fragments or atomic fragments that has lost one of their paired electrons in their shared co-valent bond that is the culprit in causing so much damage to the DNA, cells, tissues, organs, systems and eventually to the entire body into degenerative disorders and rickety shape like CVA (stroke), CAD, autoimmune disorders, neoplastic diseases like malignancies, brain, kidney, liver, musculoskeletal, eye, hair, skin disorders. In fact death ultimately overwhelms all of us either due to any of the big classes of causes – accidents, cancers, infections, degenerations or genetic disorders.
No escape from free radicals:
There is no escape because highly damaging free radicals are everywhere – in the food, medicines, chemicals in the environment, pollutants, radiation from mobile phones, x-rays, CAT scans, PET scans, EMG scans, nucleotide and radioactive tagging and scans, metabolic wastes, ultra-violet rays, cosmic radiation from outer space, stress hormones like adrenalin, anger, ageing, etc, etc….down the endless lists.
If only cardiologists, neurologists, nephrologists, oncologists and other specialist clinicians can understand the highly, highly, destructive nature of these unquenched reactive molecules that they would not single out diet, nutrition and lifestyle has the sole causes to all these medical events.
Framingham benchmark:
A lot of scientists, nutritionists, cardiologists, physicians are very blind to refer to the Framingham Heart Study on their findings of blood cholesterol levels, hypertension, smoking etc as the benchmark as a predictor of cardiovascular events. But even they a few years ago came to the conclusion after such a massive and long haul study that cholesterol whether high or low has little bearing on morbidity and mortality from cardiovascular events. It came from the horse mouth. Unfortunately all our ideas about cholesterol and CAD came from this massive Framingham Study. Nowhere else we got this idea or theory.
My own experience:
In fact even my own experience having signed thousands of diagnostic forms for blood lipids analysis sent to us at IMR from Government hospitals throughout the country showed very little relationship between suspected AMI or angina pectoris (chest pains) and what we found on the blood cholesterol levels. Initially we thought we may have made analytical errors. We checked and checked again on the analytical procedure, and did quality control, but there was no mistake. There was very relation between what the clinician reported and what we found.
Cardiac enzymes not out yet:
Of course the release of cardiac enzymes (creatine phosphokinase (CPK, CK) and the protein troponin (TnI, TnT), etc at that time weren’t discovered yet and there was no means of using them as a diagnostic tool. Of course the clinician would also have done an ECG for ST elevation and other irregularities in the PQRST waves.
What I saw:
Let me put this straight away. In my 25 years in medical research in an analytical research laboratory at the Institute for Medical Research I have seen and handled what pure analytical grade cholesterol looks like, and how they feel on the fingers. Let me tell all these experts who believe that it is the high levels of blood cholesterol as the prime factor that cause the cholesterol to stick onto the tunica intima (inner coat of blood vessels).
Properties of cholesterol:
If these clinicians have ever worked in a chemistry laboratory to analyze cholesterol content in thee blood and foods, they would have seen what pure cholesterol looks like, how they feel on the fingers – their physical and chemical properties, etc. Let me tell them that cholesterol is just a very pale yellow powder, completely insoluble in an aqueous media like in water, blood or urine. It does not feel greasy, oily, nor does it stick on to the fingers. In fact it does not stick on to anything at all.
Cholesterol only dissolves in an organic solvent such as chloroform and petroleum ether and it is a little soluble in oil medium. That’s all. It completely does not stick to anything at all, not even to a piece of meat, beef, pork, fish, vegetables or fruits, and least of all water. It just drops off if you try to rub it on anything.
If you scatter pure cholesterol onto the surface of water, it will just float there like talcum powder. It will not dissolve like sugar or salt into water. If you rub it onto your finder tips, it is just like non-greasy powder which you can instantly wash off with just plain water. No soap or organic solvent needed.
In short, even in the blood most of them are dissolved in the small amount of blood lipids and carried around and round the body without sticking on to anything. But you need to be a analytical chemist, not a clinician to understand and experience this. This is surprising to a lot of people – especially the health freaks.
Properties altered during damage:
But when the chemical and physical properties of cholesterol is altered by heat and oxygen, and long exposure to light, and worse of all, by free radicals, that changes in their physical and chemical properties greatly. These were clearly seen by me. My personal experience using pure cholesterol as a standard reagent for analytical purposes showed that the cholesterol became sticky and gummy when subjected to light, heat and chemical attacks.
This is what makes cholesterol stick:
This is what make the cholesterol stick on to the tunica intima causing irritation and inflammation there, only after they are damaged by free radicals that attacks it into gummy substances. It is also the free radicals that at the same time irritates and damage the tunica intima and cause inflammation there. Got it? Thanks for understanding this chemo-pathophysiology. Hope you learn something new today from my night long till dawn effort in writing this comment.
Cholesterol is inert:
This is what the Cardiac Surgeon Dr Dwight the author of the attached letter circulated to me firmly believes. He was absolutely right about the inflammation and not the athermanous plaques (atheroma) which all the other medical experts – cardiologist, nutritionists, pathologists, and medical researchers erroneous are talking about.
A lot of people do not understand cholesterol is harmless per sec until its chemical properties are damaged by chemical agents to make them sticky and gummy as to stick on to the inner blood vessels like a leech. This damage is obviously more extensive and intensive the higher the content of cholesterol in the blood. The lesser the amount, the lesser the damage occur. This explains why higher blood cholesterol levels carry a higher risk of CAD, irrespective whether it is the high or low density lipoproteins.
Cholesterol is important for health:
Furthermore, a lot of people think that cholesterol is nothing but harmful to health. They just lack the knowledge of biochemistry and physiology. They don’t understand that cholesterol is absolutely essential for good health. It is used by the body to manufacture steroids, or cortisone-like hormones, including the sex hormones. These hormones include testosterone, estrogen and cortisone. Combined, these hormones control a myriad of bodily functions. They don’t realize that cholesterol helps the liver produce bile acids. These acids are essential for digestion of fats and ridding the body of waste besides acting as a cell to cell interconnects "lipid molecules". A lipid molecule is needed to stabilize our cell membranes. Without cholesterol the endocrine system malfunctions. Too low a cholesterol level may also cause mental disorders.
Furthermore, cholesterol is an important part of the myelin sheath in a neuron. It consists of fat-containing cells that insulate the axon from electrical activity. This ensures our brain functions properly by insulating the electrical impulses. The brain is the richest in cholesterol and without the cholesterol there, our brain would fail to focus with lost of memory. Cholesterol also has lots of beneficial effects on the human body immune system.
Cholesterol turn over:
In fact a developing brain in a foetus has the highest content of cholesterol. If cholesterol is so harmful to health, none of us would have emerged alive after intrauterine life. In the foetus itself the extremely high cholesterol content would have long clogged up all our blood vessels even before we could emerge from our mother’s womb. But did we all die inside the womb? Of course not, unless it was a pre-natal disorder. In foetal life the cholesterol is new and fresh and has not been chemically damage yet. In later life the cholesterol ages, and suffers chemical, oxidative, and free radical damage such as singlet-oxygen damage, and they then becomes sticky and gummy.
That is when they begin to stick on to the blood vessels more and more when we get older and older. Got this message? Thank you for being my obedient student.
Endogenous and exogenous feedback mechanisms:
So all these are chronic ideas people have about cholesterol. They don’t even realize that the liver can manufacture 10 times more cholesterol to meet body’s need, than all the cholesterol we can eat through food – brain, eggs, liver, etc we can eat in a day. There is a feedback mechanism in the body between endogenous (produced by the body) cholesterol and exogenous (outside the body through food) to keep that balance and stabilization of cholesterol in the blood. They also don’t realize that some 1500 -3000 mg of cholesterol is excreted by the bile daily to keep the balance in check. All these mechanisms become operative because the body needs the cholesterol and it has to stabilize its level.
The blind parrot imitates:
People are just ignorant about all these physiological homeostasis inside the body, and throw away all the food that has cholesterol in them such as egg yolk which together with the white of egg is the world’s most nutritious food because the entire chick has to depend entirely on it as its only and sole food and nourishment until the chick can come out from the empty shell.
The egg to the growing chick inside is like milk to a baby. So people who have no clue on nutrition, throw away the best part of the egg – the yolk, and eat only the albumin (white of egg) which is the ‘worse’ part with low biological value and chemical score.
Throwing away the yolk, and eating only the white of egg is like exchanging gold (yellow colour of yolk) for silver (white colour like the albumin). All their knowledge is skewed up including cholesterol which they thought is the cause of heart disease. Luckily we have Dr Dwight who wrote the attached article to come to our rescue – but unfortunately his thesis is also half-cooked that can only earn him far higher than a PhD degree - a D.Sc. degree but not yet a Nobel Prize in Medicine or Physiology. I hope I can complete the other half for him.
The heart surgeon who became a nutritionist…but one step short:
But Dr Dwight albeit right in one eye, but he was completely blind and ignorant in the other eye. He wrote a lengthy blame on unsaturated fats and oils including omega 6 vegetable oils, soybean oils, corn oils as the culprits which of course is against the understanding of mainstream orthodox medicine and nutrition. But not a single word did he mention about free radicals which is the mainstay aetiology of all degenerative diseases including cardiovascular diseases today.
Do you know why? He is a cardiothoracic and vascular surgeon one half but not a professional chemist the missing half. So I do not blame him if he only has mono-training in one area of medical science. He needs an eye implant and an extra pair of spectacles.
The emperor without clothes and the sharp-eye eagle:
This holistic vision can only be seen by a sharp-eyed eagle that can soar high up into the air to have a 3-D vision of the panorama below it. Else he will just concentrate on diet and nutrition and thinks that food is the only thing is the only answer in life about health.
The rest of the old-fashioned thinkers are even worse. They just follow one another blindly and repeat some ideology like parrots; else if they deviate even slightly from the standard thinking, the rest of the other fools will laugh at him and say he is mad without stopping to think critically. You may call me mad if you like.
Sorry…
Sorry Dr Dwight. You need to have a degree in chemistry also specializing on free radicals and understand their role in internal medicine and nutrition This will help you to change your thesis. You thesis currently is new and original, and running counter current with orthodox consensus, but you need to upgrade it from a PhD to a D.Sc. thesis, if possible a Nobel Prize winning Award in Medicine or Physiology. A holistic education will do this job.
But you need an extra degree:
I am a compulsive writer who likes to explain in fine details, but unfortunately that’s all the time I have for this very brief comment for the cardiothoracic surgeon-nutritionist. Maybe when Dr Dwight goes back to the university to read for another degree in chemistry, he will come out with his revised version of his theory just like mine here.
Thanks Professor Dato:
Thanks a lot Dato Dr Vincent Ng. I appreciate the tens of hundreds of e-mail articles you have been sending me over the last 2-3 years. When shall we have a hearty crab and prawn dinner together? Don’t worry about the cholesterol inside. I will be beside you as your nutritionist and emergency physician in the event you went into an eventful acute myocardial infraction.
I have to close now as it is already nearly 5:30 a.m.
Yours truly,
Lim Ju Boo
http://www.diamondinterest.com.my/technicalboard.htm
Dear All,
Bravo! I did not expect such a good and lengthy response from Dr. Lim JB on this topic. I must admit that it has given me better and deeper insight into the whole subject matter. Thanks.
- Dr. Chew BH
Yg Arief Prof Dr.Lim,
Thank you for your prompt response and the lengthy explaination you have given. I really appreciate your time spent in writing such a thesis in expounding the intricacy & truth of such theory. Indeed, your exposition is most enlightening and acceptable. I believe you are right on the dot and balanced in your view. All of us are always inspired by your wisdom, knowledge and great insights. I never forget how you can give your lecture none stop for hours on end and learning mandarin within hours at your age. Wah! great genius. You deserve to be the next Noble Price holder. Keep up the good work. God
Bless.
With kind regards,
Dato Dr Vincent Ng
Wow Dr J B Lim,
Incredible write-up that was a joy to read! I learned a lot of new things at the end of your so-called “brief” article.
I admire your holistic approach to subjects such as these, and it is true that only by holistic study via macro view and micro scrutiny that you get closer to the truth. But I must say, there is still one area that you lack. And that is the unscientific aspect of spirituality – the area of life where there are no logical explanations for unfathomable events that take place. This would certainly include the subject of visualization, actualization, materialization, mentalism, mind over matter, and such. But i do not know if your highly scientific and analytical acumen to look at things in such fine detail can stomach something as intangible as the spirit and the ether, from which there are no hard solid evidence but only empirical observations and data for consideration.
Dr Deepak Chopra wrote a very good book on heart disease from a spiritual standpoint that I have actually benefited from. However, science often will not tolerate opinions that do not have measurable data and facts to rely upon. I believe that ethereal energy is always there, whether we can see it or not. Sometimes the potential for it to be there requires human intervention, and at other times, it has always been there, just not so visible to the naked eye. Like Uranus before its discovery, and the invention of a telescope powerful enough to bring it closer to us in the 18th century. But it has always been there. Man just needed to make a machine to bring the un-see-able into reality. I believe the same is with energy. Man just needs to create a contraption to measure this. But i think Marcel Vogel who was originally with IBM came rather close with his Omega V machine, before he died almost 20 years ago. You can read him up by googling “the legacy of Marcel Vogel”.
In the meantime, do continue to write your thesis. You must be very patient to stay up so late (or early rather!) to finish it. At least you know, some 34-year-old who plays the violin, will be keen to read every word of it, and i hope that makes your effort all the more worthwhile.
To more ramblings!
- Hainanese Buy
What are statins
JB Lim to Perry, Cheong
show details 6/28/09
Dear Mr Perry and CK Cheong,
Thank you for your e-mail enquiry on Atorvastatins, statins and other ways of lowering cholesterol.
Atorvastatins a class of drugs called statins, used for lowering blood cholesterol. It is commercially called Liptor, and is produced by a drug company called Pfizer. It also stabilizes plaque formation, and prevents strokes through its anti-inflammatory action.
However, as with all statins group, Atorvastatin can injure the liver, and if you have any active liver disease such as cholestasis, hepatic encephalopathy, hepatitis, and jaundice it is advisable to immediately stop the use of this drug.
What is important is you need to monitor your liver enzymes, initially every month, and if after about 3 months the liver enzymes remain normal, you need to do a liver function test (LFT) at least once every 3 months to ensure that your liver is not damaged by the continuous use of any of the statins group of cholesterol lowering drugs, including Atorvastin you are taking. There are many other statins now available if one group is not suitable for you.
One of the best statins is called Zocor or simvastatin. Your doctor may start you with 10 mg of Zocor once a day, to be taken at night when your liver starts to synthesize its own cholesterol when you are at sleep. If this is not effective, he may increase it to 20 mg to be taken once a day –before sleep.
If your liver enzymes Aspartate aminotransferase (AST) or Alanine transaminase (ALT) are elevated, it may indicate the beginning of liver damage because of the statins. In that case you should immediately stop the medications, and try to lower your cholesterol by more natural and harmless ways, such as stop taking trans-fatty acids found in margarine, shortening, hydrogenated oils. You should also not use coconut oil or use animal fats such as lard, ghee, tallow for cooking, but use polyunsaturated oils such as corn, safflower, soyabean or palm or vegetable oils (except coconut oil) for cooking. The use of olive oil (monosaturate) or Carotino (red palm oil) as a salad dressing can all bring down blood cholesterol levels.
Cut down on all animal fats, and take a lot of fatty fish containing omega 3 oils. The consumption of oats such as Quaker Oats as a porridge for breakfast on a daily basis will all bring down cholesterol levels dramatically.
Instead of using synthetic drugs like the statins - which causes the body to depend on them for life once taken, there is a very safe and very effective Indian herb called Gugulipid, or guggul. This is a natural substance derived from the mukul myrrh tree. The mukul myrrh gives off a sticky resin, from which gugulipid is derived. This extract has been used for thousands of years by the Indians in their Aryuvedic medicine.
Yet another natural medicine equivalent to synthetic simvastatin (Zocor) or Atorvastatin is called red yeast rice (Monascus purpureus) and this is used in Chinese medicine for lowering cholesterol. This yeast is also very effective, and much safer than all those synthetic statins your doctor gave you.
Also, there are many other ways of lowering your blood pressure instead of depending on angiotensin II receptor antagonist – irbesartan which you are also taking. Reducing salt intake, reducing body weight, and reducing stress through meditation, exercise, and qigong, and stop smoking, are among the methods. All these are much better, safer, and more permanent than taking all sorts of drugs.
In fact I give a lot of health talks to the public, the last one on “The Meaning of Health” which was my Keynote Address, and “The Physiological Basis of Weight Management, and Stabilization” were delivered just on Wednesday, the 24 June. It was organized by the Malaysian Senior Scientists Association, and was held at the National Science Centre at Bukit Kiara.
I have sent out notices on all these talks, but unfortunately hardly those to whom I e-mailed came, except strangers and a large crowd of about 390 academic staff from the universities, Ministry of Health and other Government departments plus ordinary people from the public attended.
My youngest brother Professor Dr Lim Yew Cheng was a Professor of Cardiothoracic and Vascular Surgery at the world famous Mayo Clinic in the United States, then at Singapore General Hospital, then a Professor of Cardiac Surgery at the University of Malaya Medical Centre, before going into private practice as a Consultant Cardiovascular Surgeon at Gleneagles Intan Medical Centre at Jalan Ampang, Kuala Lumpur.
If you need any help with your heart or any of your blood vessels you may seek his advice.
JB Lim
AE Consultant to me
Dear Dr Lim,
Thank you so much for the reply, it really help to clear our doubt.
I would like to forward this to all my relatives and friends.
Thank you once again, may you have a Good Weekend.
C K
show details 6/28/09
Dear Mr Perry and CK Cheong,
Thank you for your e-mail enquiry on Atorvastatins, statins and other ways of lowering cholesterol.
Atorvastatins a class of drugs called statins, used for lowering blood cholesterol. It is commercially called Liptor, and is produced by a drug company called Pfizer. It also stabilizes plaque formation, and prevents strokes through its anti-inflammatory action.
However, as with all statins group, Atorvastatin can injure the liver, and if you have any active liver disease such as cholestasis, hepatic encephalopathy, hepatitis, and jaundice it is advisable to immediately stop the use of this drug.
What is important is you need to monitor your liver enzymes, initially every month, and if after about 3 months the liver enzymes remain normal, you need to do a liver function test (LFT) at least once every 3 months to ensure that your liver is not damaged by the continuous use of any of the statins group of cholesterol lowering drugs, including Atorvastin you are taking. There are many other statins now available if one group is not suitable for you.
One of the best statins is called Zocor or simvastatin. Your doctor may start you with 10 mg of Zocor once a day, to be taken at night when your liver starts to synthesize its own cholesterol when you are at sleep. If this is not effective, he may increase it to 20 mg to be taken once a day –before sleep.
If your liver enzymes Aspartate aminotransferase (AST) or Alanine transaminase (ALT) are elevated, it may indicate the beginning of liver damage because of the statins. In that case you should immediately stop the medications, and try to lower your cholesterol by more natural and harmless ways, such as stop taking trans-fatty acids found in margarine, shortening, hydrogenated oils. You should also not use coconut oil or use animal fats such as lard, ghee, tallow for cooking, but use polyunsaturated oils such as corn, safflower, soyabean or palm or vegetable oils (except coconut oil) for cooking. The use of olive oil (monosaturate) or Carotino (red palm oil) as a salad dressing can all bring down blood cholesterol levels.
Cut down on all animal fats, and take a lot of fatty fish containing omega 3 oils. The consumption of oats such as Quaker Oats as a porridge for breakfast on a daily basis will all bring down cholesterol levels dramatically.
Instead of using synthetic drugs like the statins - which causes the body to depend on them for life once taken, there is a very safe and very effective Indian herb called Gugulipid, or guggul. This is a natural substance derived from the mukul myrrh tree. The mukul myrrh gives off a sticky resin, from which gugulipid is derived. This extract has been used for thousands of years by the Indians in their Aryuvedic medicine.
Yet another natural medicine equivalent to synthetic simvastatin (Zocor) or Atorvastatin is called red yeast rice (Monascus purpureus) and this is used in Chinese medicine for lowering cholesterol. This yeast is also very effective, and much safer than all those synthetic statins your doctor gave you.
Also, there are many other ways of lowering your blood pressure instead of depending on angiotensin II receptor antagonist – irbesartan which you are also taking. Reducing salt intake, reducing body weight, and reducing stress through meditation, exercise, and qigong, and stop smoking, are among the methods. All these are much better, safer, and more permanent than taking all sorts of drugs.
In fact I give a lot of health talks to the public, the last one on “The Meaning of Health” which was my Keynote Address, and “The Physiological Basis of Weight Management, and Stabilization” were delivered just on Wednesday, the 24 June. It was organized by the Malaysian Senior Scientists Association, and was held at the National Science Centre at Bukit Kiara.
I have sent out notices on all these talks, but unfortunately hardly those to whom I e-mailed came, except strangers and a large crowd of about 390 academic staff from the universities, Ministry of Health and other Government departments plus ordinary people from the public attended.
My youngest brother Professor Dr Lim Yew Cheng was a Professor of Cardiothoracic and Vascular Surgery at the world famous Mayo Clinic in the United States, then at Singapore General Hospital, then a Professor of Cardiac Surgery at the University of Malaya Medical Centre, before going into private practice as a Consultant Cardiovascular Surgeon at Gleneagles Intan Medical Centre at Jalan Ampang, Kuala Lumpur.
If you need any help with your heart or any of your blood vessels you may seek his advice.
JB Lim
AE Consultant to me
Dear Dr Lim,
Thank you so much for the reply, it really help to clear our doubt.
I would like to forward this to all my relatives and friends.
Thank you once again, may you have a Good Weekend.
C K
Subject: The Great Cholesterol Lie
Summary: Without inflammation, cholesterol would not accumulate in wall of blood vessel and cause heart disease
A Heart Surgeon Admits Huge Mistake!
By Dwight Lundell, MD
Part 1 of a 2-part article (see part 2 below)
We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong.. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.
I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.
The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.
It Is Not Working!
These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.
The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.
Despite the fact that 25% of the population takes expensive statins
medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.
Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.
Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.
Inflammation is not complicated -- it is quite simply your body's natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.
What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.
The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity. Let me repeat that. The injury and inflammation in our blood vessels is caused by the low fat diet that has been recommended for years by mainstream medicine.
What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.
In Part 2 of this two-part article, I'll discuss which foods cause inflammation, how those foods trigger the inflammatory process, and the foods to eat that will cure inflammation.
Part 2
By Dwight Lundell MD 02/06/2009
Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. Let’s say you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.
Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing
the body to respond continuously and appropriately with inflammation.
While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived to declare war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.
How does eating a simple sweet roll create a cascade of inflammation to make you sick?
Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works. When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.
What does all this have to do with inflammation? Blood sugar is controlled
in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.
While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.
Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential – they are part of every cell membrane controlling what
goes in and out of the cell — they must be in the correct balance with omega-3’s.
If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation. Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.
To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.
There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.
There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing omega-6 fats like corn and soybean oil and the processed foods that are made from them. One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.
Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.
The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.
What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.
[Ed. Note: Dr. Dwight Lundell is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital, Mesa, AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness. He is the author of The Cure for Heart Disease and The Great Cholesterol Lie]
Comments by visitors to Dr Lundell’s article ‘The Great Cholesterol Lie’
1. OH no!!!!! no!! This article added on to more confusion regarding the causes of coronary heart diseases!! What about taking the so called OMEGA eggs, soft boiled or sunny side over? What about prawns and crabs?? Scallops and throw in with sotong? Is there anyone out there care enough to provide a more rational and down- to -earth and more localized explanation / suggestions / comments or argument that may be of help?
A worried Perry
Date: Fri, 26 Jun 2009 13:38:42 +0800
Subject: The Great Cholesterol Lie help
2. Hi all,
After reading this it is still better to go easy on the LARD and 'chee yau char’ when you eat Char Kueh Teow though lard is NOT process oil! Hahaha! Carry on eating Bak Kut Teh with ease of mind!
CHM
3. Dear Dr Lim,
Sorry have to consult your expert opinion again. Could I get a copy of your Keynote Address and your presentation on the Definition of Health you presented at the Health and Wellness Seminar of the Malaysian Senior Scientists Association.
I would also like your paper on ‘The Physiological Basis for Weight Management & Stabilization’ you also presented at the seminar. Kindly also seek your expert view on Dr Lundell’s article ‘The Great Cholesterol Lie’
Thank You & Best Regards,
CK Cheong
4. Dear Dr Lim,
We would like you to comment on the above article ‘The Great Cholesterol Lie’ by Heart Surgeon Dr. Dwight Lundell e-mailed to you earlier. We would appreciate your qualified professional opinion on this health issue as all along nutritionists and cardiologists have put the blame on cholesterol as the cause of coronary arterial disease. Your expert comment please!
Thanks.
Dr KM Tan and colleagues
Dr JB Lim replies below:
Thank you to all of you for your questions and e-mails.
It is very difficult for me to explain why eating high cholesterol foods like brain, liver, eggs, prawns DO NOT cause your blood cholesterol to be elevated permanently. The explanation is very lengthy, and requires a technical understanding of liver biochemistry, and I don’t intend to start on this. This belief that high cholesterol foods cause high blood cholesterol and heart disease was very popular in the 1940’s – 1950’s but it is now out of fashion to talk about it. Advances in nutritional science have debunked this myth.
Nevertheless very briefly, high cholesterol foods may cause a mild and temporary rise in blood cholesterol lasting for only a few hours post digestion stage. This effect will go away a few hours later, only to rise again at night.
But this nocturnal rise in blood cholesterol has nothing to do with any high cholesterol foods you have taken earlier. It is due to your own liver producing them in high amounts at night when you are asleep. In fact the liver can produce its own cholesterol to meet your body’s need 10 times better than all the cholesterol you can eat through foods during the day.
Hence it is no longer a fashion to say that eating foods high in cholesterol causes high cholesterol in the blood or heart disease. It is the type or nature of the oil you consume or use them for cooking that is far more important. By this I mean saturated oils from animal fats such as lard or tallow, or trans-fatty acids from hydrogenated margarine, or saturated oil from coconut oil that you need to avoid, but not eggs, liver etc.
Furthermore, even if you manage to eat a lot of cholesterol, say 10 eggs a day which is about 3,500 mg of cholesterol, the liver is able to throw out at least half of it everyday through the bile. The liver will compensate by balancing its body output (endogenous) of cholesterol with the amount you have taken through food (exogenous), to stabilize the level in the blood. That is why unlike blood sugars, blood cholesterol do not rise up and down sharply after a meal. The liver keeps this in check.
Yes, fish oil containing omega 3 fatty acids do lower your blood cholesterol. Eating a lot of fatty fish, especially the belly part is healthy as it is cardio-protective. Again, the chemistry why this is so, is highly technical in any attempt to explain. But you may find the explanation given in advanced textbook of nutrition, biochemistry or nutrition biochemistry. Check them out.
This is my very brief answer to your question. Full explanation involves complex and lengthy biochemistry, and it is not necessary to go into that for education purposes for the housewives and lay public
Regards
JB Lim
Thank, CK Cheong, for consulting the expert advice of Doctor and Nutritionist JB Lim. I really valued reading that controversial coronary / food articles on the net can actually lead to tremendous stress!
And thanks Dr Lim, for taking the trouble and valuable time to explain in the simplest of terms and avoiding all the medical jargons...!!
For your info, I have undergone angioplasty with a 22mm stenting done but two years later, its was completely occluded. The cardiologists advised an immediate off-pump CABG with a double artery graft taken from my wrist - 4 yrs ago)
I am under regular medication of aspirin, irbesarstan SR & atorvastatin, plus many self -administered food supplements like omega fish oil, milk thistle, vit.E and even glucosamine and a few others!
After the CABG, my nutritionist put me on a strict diet and i missed all the high cholesterol food esp. sea food and my favorite soft boiled eggs for yrs.. The unbelievable thing is I immediately gave up smoking 100% after being a heavy chained smoker for 30 yrs!! -- haha, ck, now you know why i gave up smoking!!!
If according to that article, and yr invaluable explanation, I can occasionally deserve a sumptuous meal of crabs and what not!!
So, CK, the next time I visit you in KL, lets go for sea food instead of roti canai!! Invite Dr Lim along!
*Dr. Lim, one more worried question? Do the drugs I take, esp. atorvastatin, does it cause harmful side effect like affecting libido?
** by the way, any one in my situation is sure to be gullible to all sorts of 'professional advice' from the "street doctors" esp. direct sales people on their miracle health food/products.... and i am a regular victim!!
Thanks again,
Still worried, but lesser!
Perry
Summary: Without inflammation, cholesterol would not accumulate in wall of blood vessel and cause heart disease
A Heart Surgeon Admits Huge Mistake!
By Dwight Lundell, MD
Part 1 of a 2-part article (see part 2 below)
We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong.. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.
I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.
The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.
It Is Not Working!
These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.
The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.
Despite the fact that 25% of the population takes expensive statins
medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.
Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.
Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.
Inflammation is not complicated -- it is quite simply your body's natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.
What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.
The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity. Let me repeat that. The injury and inflammation in our blood vessels is caused by the low fat diet that has been recommended for years by mainstream medicine.
What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.
In Part 2 of this two-part article, I'll discuss which foods cause inflammation, how those foods trigger the inflammatory process, and the foods to eat that will cure inflammation.
Part 2
By Dwight Lundell MD 02/06/2009
Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. Let’s say you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.
Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing
the body to respond continuously and appropriately with inflammation.
While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived to declare war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.
How does eating a simple sweet roll create a cascade of inflammation to make you sick?
Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works. When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.
What does all this have to do with inflammation? Blood sugar is controlled
in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.
While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.
Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential – they are part of every cell membrane controlling what
goes in and out of the cell — they must be in the correct balance with omega-3’s.
If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation. Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.
To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.
There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.
There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing omega-6 fats like corn and soybean oil and the processed foods that are made from them. One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.
Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.
The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.
What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.
[Ed. Note: Dr. Dwight Lundell is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital, Mesa, AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness. He is the author of The Cure for Heart Disease and The Great Cholesterol Lie]
Comments by visitors to Dr Lundell’s article ‘The Great Cholesterol Lie’
1. OH no!!!!! no!! This article added on to more confusion regarding the causes of coronary heart diseases!! What about taking the so called OMEGA eggs, soft boiled or sunny side over? What about prawns and crabs?? Scallops and throw in with sotong? Is there anyone out there care enough to provide a more rational and down- to -earth and more localized explanation / suggestions / comments or argument that may be of help?
A worried Perry
Date: Fri, 26 Jun 2009 13:38:42 +0800
Subject: The Great Cholesterol Lie help
2. Hi all,
After reading this it is still better to go easy on the LARD and 'chee yau char’ when you eat Char Kueh Teow though lard is NOT process oil! Hahaha! Carry on eating Bak Kut Teh with ease of mind!
CHM
3. Dear Dr Lim,
Sorry have to consult your expert opinion again. Could I get a copy of your Keynote Address and your presentation on the Definition of Health you presented at the Health and Wellness Seminar of the Malaysian Senior Scientists Association.
I would also like your paper on ‘The Physiological Basis for Weight Management & Stabilization’ you also presented at the seminar. Kindly also seek your expert view on Dr Lundell’s article ‘The Great Cholesterol Lie’
Thank You & Best Regards,
CK Cheong
4. Dear Dr Lim,
We would like you to comment on the above article ‘The Great Cholesterol Lie’ by Heart Surgeon Dr. Dwight Lundell e-mailed to you earlier. We would appreciate your qualified professional opinion on this health issue as all along nutritionists and cardiologists have put the blame on cholesterol as the cause of coronary arterial disease. Your expert comment please!
Thanks.
Dr KM Tan and colleagues
Dr JB Lim replies below:
Thank you to all of you for your questions and e-mails.
It is very difficult for me to explain why eating high cholesterol foods like brain, liver, eggs, prawns DO NOT cause your blood cholesterol to be elevated permanently. The explanation is very lengthy, and requires a technical understanding of liver biochemistry, and I don’t intend to start on this. This belief that high cholesterol foods cause high blood cholesterol and heart disease was very popular in the 1940’s – 1950’s but it is now out of fashion to talk about it. Advances in nutritional science have debunked this myth.
Nevertheless very briefly, high cholesterol foods may cause a mild and temporary rise in blood cholesterol lasting for only a few hours post digestion stage. This effect will go away a few hours later, only to rise again at night.
But this nocturnal rise in blood cholesterol has nothing to do with any high cholesterol foods you have taken earlier. It is due to your own liver producing them in high amounts at night when you are asleep. In fact the liver can produce its own cholesterol to meet your body’s need 10 times better than all the cholesterol you can eat through foods during the day.
Hence it is no longer a fashion to say that eating foods high in cholesterol causes high cholesterol in the blood or heart disease. It is the type or nature of the oil you consume or use them for cooking that is far more important. By this I mean saturated oils from animal fats such as lard or tallow, or trans-fatty acids from hydrogenated margarine, or saturated oil from coconut oil that you need to avoid, but not eggs, liver etc.
Furthermore, even if you manage to eat a lot of cholesterol, say 10 eggs a day which is about 3,500 mg of cholesterol, the liver is able to throw out at least half of it everyday through the bile. The liver will compensate by balancing its body output (endogenous) of cholesterol with the amount you have taken through food (exogenous), to stabilize the level in the blood. That is why unlike blood sugars, blood cholesterol do not rise up and down sharply after a meal. The liver keeps this in check.
Yes, fish oil containing omega 3 fatty acids do lower your blood cholesterol. Eating a lot of fatty fish, especially the belly part is healthy as it is cardio-protective. Again, the chemistry why this is so, is highly technical in any attempt to explain. But you may find the explanation given in advanced textbook of nutrition, biochemistry or nutrition biochemistry. Check them out.
This is my very brief answer to your question. Full explanation involves complex and lengthy biochemistry, and it is not necessary to go into that for education purposes for the housewives and lay public
Regards
JB Lim
Thank, CK Cheong, for consulting the expert advice of Doctor and Nutritionist JB Lim. I really valued reading that controversial coronary / food articles on the net can actually lead to tremendous stress!
And thanks Dr Lim, for taking the trouble and valuable time to explain in the simplest of terms and avoiding all the medical jargons...!!
For your info, I have undergone angioplasty with a 22mm stenting done but two years later, its was completely occluded. The cardiologists advised an immediate off-pump CABG with a double artery graft taken from my wrist - 4 yrs ago)
I am under regular medication of aspirin, irbesarstan SR & atorvastatin, plus many self -administered food supplements like omega fish oil, milk thistle, vit.E and even glucosamine and a few others!
After the CABG, my nutritionist put me on a strict diet and i missed all the high cholesterol food esp. sea food and my favorite soft boiled eggs for yrs.. The unbelievable thing is I immediately gave up smoking 100% after being a heavy chained smoker for 30 yrs!! -- haha, ck, now you know why i gave up smoking!!!
If according to that article, and yr invaluable explanation, I can occasionally deserve a sumptuous meal of crabs and what not!!
So, CK, the next time I visit you in KL, lets go for sea food instead of roti canai!! Invite Dr Lim along!
*Dr. Lim, one more worried question? Do the drugs I take, esp. atorvastatin, does it cause harmful side effect like affecting libido?
** by the way, any one in my situation is sure to be gullible to all sorts of 'professional advice' from the "street doctors" esp. direct sales people on their miracle health food/products.... and i am a regular victim!!
Thanks again,
Still worried, but lesser!
Perry
Saturday, May 22, 2010
Coconut or Rice Water for Diarrhoea
This article was written by Dr JB Lim in response to an article sent by Dr Chan Boon Lye to Dr Lim for advice and comment about the use of ordinary rice water for children who frequently have diarrhoea.
Subsequently this subject was also brought up for discussion by a group of other doctors at a banquet Dr Lim and other medical doctors and scientists attended at the KLCC Convention Ballroom in Kuala Lumpur.
We thought this health issue will be of interest to people as diarrhoea is a very common problem affecting most people especially children. Dr Lim thought he should share his reply and comments to Dr Chan and to other doctors. Here’s what Dr JB Lim wrote to Dr BL Chan
Dear Dr Chan,
Thanks for your advice on the treatment of diarrhea. This is not something new to me. Even way back in the 1960’s as a postgraduate student in Nutrition at the University of London we were already taught the procedure on how to manage cases of infantile diarrhoea in developing countries like those in Africa where medical facilities were so basic and minimal.
We wanted to introduce this approach to all Government Clinics:
When I returned to Malaysia I worked at various Divisions of Rural Health, Community Medicine, Human Nutrition, etc at the Institute for Medical Research (IMR). We conducted health surveys among villages throughout the length and breadth of the country, and we found that diarrhoea was very prevalent in both urban and rural communities. So we thought we should recommend to the Ministry of Health to introduce this simple and extremely effective method of using rice water to treat all diarrhoea in all the villages and government rural clinics all over Malaysia where access to health facilities were at times difficult especially in the remote interiors of Sarawak and Sabah. Our objective was to educate doctors and nurses manning the clinics the use of rice water in managing cases of common diarrhoeas as part of our public health education to the villages.
Surprise response from the medical staff:
But before we did that, we need to conduct a survey to find out the status of how diarrhoeas were managed in government clinics. So we asked the doctors, health and medical team. We expected the doctors to tell us they use diarrhoeal agents - Loperamide (Beamodium), 400 mg of Berberine sulfate, Diphenoxylate HCl 2.5 mg + atropine sulfate 25 mcg (Dhamotil), plus various antibiotics etc, etc.
To our pleasant surprise, the doctors both in the Kuala Lumpur General Hospital (as it was called then) and the government clinics told us that they simply advised the rural folks to drink rice water or take light watery porridge with 2-3 teaspoonful of table salt added. We really didn’t expect them to give us this reply. We expected them to name us the list of anti-diarrhoeal drugs in use then. That was in the 1980’s. Later we found they already learnt of this method before they were posted to the rural clinics.
So this was not new to them nor was it to us. Even Medical Assistants and Rural Health Nurses working in some rural areas were taught this simple method on how to prevent dehydration and reduce infantile mortality in areas where diarrhoeas, malnutrition, and poor hygiene were common. The heath team has already done this even before we could even recommend to the Ministry of Health to introduce them.
Common pathogenic causes:
We know that most of these diarrhoeas in tropical countries like Malaysia are caused mainly by rotavirus, adenoviruses, parvoviruses, astroviruses, and gastroenteritis from bacterial E. coli O157:H7, Salmonella, Shigella, Campylobacter infections, as well as from protozoal infections such as from various types of pathogenic protozoa like amoebasis from amoebas such as Entamoeba histolytica, Gardia (giardiasis), etc, etc…down the list.
Infantile Diarrhoea:
We were aware that in infants persistent diarrhoeas from gastroenteritis can be fatal especially if the child is already suffering from malnutrition. We see children in some of these communities dying unnecessary due to diarrhoeas where dehydration can easily be corrected by merely what we now call it ‘rice water treatment’ There is no need even for so called ‘intravenous drips’ or oral rehydration salts (ORS) as done in a modern hospital. All that is required is to correct for fluid loss and establish electrolyte (potassium, sodium) balance. That is all that is needed.
In fact it is not just rice water or water from rice porridge which is just as good as the intravenous drip, but even any fruit or vegetable juice will do. Even coconut water is excellent.
Coconut water as IV drip:
Just to let you know that even the World Health Organization recommends the use of sterile coconut water to be used as an intravenous drip for fluid replacement and electrolyte imbalance in rural areas of poor countries where modern health facilities are hard to come by. Coconut water inside an unopened coconut is completely sterile, of the right biological electrolyte constituency with near equivalent osmotic tonicity as saline.
Imagine the entire baby coconut tree has to feed and thrive on this water which is exactly like mother’s natural milk for the baby coconut tree. So Mother Nature has prescribed the right fluid, nutrient and salts for the baby coconut inside the nut before it is washed away into the oceans to land ashore by harsh salty sea water to another place to start a new independent tree and life at another place.
So this fluid (coconut water) can never be wrong as it is given by God for a young plant to survive. Moreover, coconut water does not have foreign protein in it to trigger an anaphylactic shock even if infused many times (serial infusions) into any animal and human body. There is no built up of antibodies against any antigen (coconut water) if administered intravenously.
A Tribute to my Professors
We learnt of this from 3 of our professors even as students in England – 2 of them at London University and 1 at Cambridge. Later we found this has been in practice already for a number of years on the recommendation by the World Health Organization for poor tropical countries where young coconuts are readily available, and modern medical facilities are not readily available.
Clean, sterile and biologically just right composition:
Coconut water is absolutely clean and completely sterile, and do not have offensive proteins inside to trigger off increasing titres of antibodies against foreign protein antigen that could lead to anaphylactic events and shocks. Not only purer, cleaner and more sterile than pharmaceutical grade saline-dextrose infusion fluids for IV administration, but the electrolytes therein are of the right biological composition. We can’t beat Nature.
Simple, yet so safe and effective:
So this ‘rice water treatment’ may be used instead of using ORS. The use of coconut water as a direct IV infusion is also not something new to me. Even way back in the late 1960s we already knew about this. Both methods are simple, cheap, readily available, and extremely cost-effective.
We are light years ahead of the Internet:
I thought what you sent to me from the Internet would be something from the 21st Century which we are unaware of. I have always thought the Internet is a very powerful IT tool available only in this 21st Century where we can get lots of the latest information. But it looks like what you tell me only now in 2009 was what we already knew when we were students in the 1960’s.
As far as this piece of medical information is concerned, I think we are light years ahead of even the Internet. Thanks to my professors at London and Cambridge Universities who taught us this traditional and simple method half a century ago. No thanks to the Internet of the 21st Century. It is stale information for me.
Natural therapeutics with rice water is best:
My professional advice is, if you have diarrhoea, whether adult or children, just drink rice water, coconut water, or any fruit juice. There are a lot of water, salts, sugars, various vitamins from all these natural juices. Why go for synthetic ORS, or intravenous drips of crystalloids and colloids, dextrose, saline, Ringer’s lactate, etc as used in big hospitals?
Antibiotics therapeutic regime:
Worse still is for patients to take antibiotics for diarrhoeas which are mainly caused by rotavirus and protozoal infections in tropical countries. The problem is when we get rid of all the bacteria in the intestinal gut – beneficial as well as pathogenic forms and strains with antibiotics only make matter worse by giving opportunistic infections to antibiotic-resistant strains of pathogens to colonize there.
More medical problems than it solves:
This can cause another medical problem called dysbiosis (dysbacteriosis) which is the condition of having microbial imbalances on or within the body due to antibiotics. This is jumping from the frying pan into the fire. Instead of getting rid of all the bacteria (friendly and pathogenic) by random slaughter of all of them with antibiotics, it would be much better to flood the entire GI tract with friendly and beneficial Lactobacilli strains from yoghurt and allow them to colonize in the intestine.
The flood of friendly bacteria in the GIT naturally will outgrow and crowd out all the pathogenic strains. Many friendly strains are very useful in synthesizing many vitamins like vitamin K which are needed for normal blood clotting. Why destroy them with haphazard use of antibiotics? Unfortunately a lot of doctors prescribe unnecessary medication.
A lot of diseases are caused by doctors (iatrogenic diseases) by the unnecessary use of drugs, surgery and other invasive modalities. One example is nosocomial infections in hospitals, and the dangerous rise of MRSA (Methicillin-resistant Staphylococcus aureus) superbugs which are resistant to even the most powerful antibiotics. These are all induced by doctors using unnecessary drugs and over-prescription. Because of this random and wide-spread use of antibiotics, we just do not know how to deal with this MRSA problem anymore
What do I recommend to my patients?
Personally, I always prescribe to my patients who came to me with common diarrhoeas to take yoghurt (cultured milk) which they can easily buy in any supermarket or make their own in their kitchen. Not only yoghurt containing natural intestine-friendly bacteria like Lactobacillus acidophilus, L. bulgaricus, Bifidobacterium, etc, gets rid of all the invading harmful pathogens that caused the diarrhoeas, but they also ferment and breakdown the milk sugar (lactose) for patients who are intolerant to drinking milk (lactose-intolerant). The lack of lactase among Asian adults prevents the breakdown of lactose causing the lactose to ferment in the intestines, giving rise to gas, bloating, and causing them to have diarrhoea. This is yet another cause of having diarrhoea from lactose intolerance not just from all those viruses, bacteria, protozoa and pathogens I earlier listed above.
Even for Candidiasis:
I have also in the past suggested consumption of yoghurt and other probiotics as a prescription to my women patients suffering from vulvovaginal candidiasis (yeast candida infection of vagina) where antifungal agents and drugs like imidazole, miconazole and clotrimazole given previously by their gynecologists and doctors have failed to stopped recurrent infections.
A natural ‘drug’ like yoghurt solved all their recurrent problems. I should have complied all my cases and publish them in a medical journal, but unfortunately I have already retired from active medical research at the Institute for Medical Research.
Mechanism not understood:
Quite honestly I cannot understand the probiotic mechanism behind this therapy. The gastrointestinal tract is quite separate from the genito-urinary tracts system. How then does the Lactobacillus migrate from the anus after ingestion and travel up into the vagina and uterus? The anus and the vaginal orifices are anatomically close to each other and the bacteria could migrate from the anus up the vagina but this is not really a very good answer as it requires quite a bacterial load into the vagina to outgrow all those Candidia spp. It is not easy to get rid of these yeasts once they have established themselves. I am keen to know the probable therapeutic dynamics behind this line of management. As I said even powerful antifungals like imidazole, miconazole and clotrimazole failed to stop the growth.
If what I hypotheses is the probable answer, would it be better to insert yogurt as a cream directly into the vaginal canal instead of oral ingestion via the GI tract? Whatever the explanation is, yoghurt treatment always works for women with recurrent vaginal yeast infections where conventional antifungal preparations failed.
Not just yoghurt:
Not just yoghurt, but any probiotics supplements will do this job very well. But make sure the bacterial count from these probitics pills and dietary supplements are still there, and not destroyed due to prolonged storage, high storage temperatures, poor handling, and lack of GMP (Good Manufacturing Practice) during the production.
Other more serious aetiologies of diarrhoeas:
However, I always make sure my patient’s diarrhoea is due to a simple infections of the GI tract, and food poisoning, and not due to other causes such as osmotic diarrhea (e.g. maldigestion pancreatic disease or coeliac disease), inflammatory diarrhea caused by autoimmune disorders, tuberculosis, cancer of the colon, inflammatory bowel diseases (ulcerative colitis, Crohn's disease, etc), IBS (irritable bowel syndrome), celiac disease, food allergy, ischemic bowel disease, hormone-secreting tumors…etc, etc. A differential diagnosis is important if the diarrhoea is persistent and chronic.
Additionally, I always advise that the diarrhoea, especially if persistent, with mucous and with blood, tarry and black (melena), etc, be properly investigated and diagnosed first, albeit most of them are harmless as a normal physiological response to an irritant somewhere in the intestinal tract. Melena could be suggestive of gastric bleeding or ca (cancer) higher up the colonic tract. Medical history, description of the colour, texture, smell, frequency, signs and symptoms themselves will already give us diagnostic inference with 85 % accuracy without even invasive colonoscopy.
How do I treat myself?
If you were to ask me this question, how do I treat myself in an event of a diarrhoea? Well to tell you, I simple do nothing about it. I just let the diarrhoea run its natural course, and I am always much better after a few episodes of watery stools. If there is also vomiting, I too let the vomiting do its normal physiological job by allowing my body to let go all those causative agents I have ingested (food toxins from food poisoning, bacterial, viral invasion, etc) to throw out all of them.
I just leave it:
I don’t even take rice water, coconut water, fruit juice, ORS, and worse still take all those diarrhoeal drugs to block the food poisons and bacterial load from coming out. I take absolutely nothing, not even water to flash out the toxins. I just allow complete bowel rest by adding nothing more to my digestive system that could only add more load and problems to the digestive tract.
I have suffered from diarrhoea tens of hundreds of times in my life, but not a single time did I do anything to stop the. I knew this was a natural response of my body. If I have ingested any harmful thing in the food I just encourage my body to throw everything out – both by vomiting and stool discharge. In short, I take absolutely no medication, not even rice or coconut water. I just allow the body to do its job with bowel rest for 1-2 days.
The Body Buffering System:
A lot of doctors over treat simple diarrhoea with 5-6 different medications. This is really unnecessarily. The more they prescribe, the happier the drug companies. One of them is always an antibiotic which is always there in every prescription. Even the WHO doesn’t recommend antibiotics for diarrhoea anymore. WHO suggests correcting electrolyte imbalance with ORS and re-establish fluid replacement especially in a small child who is malnourished, and already suffering from protein-energy deficiencies (marasmus and kwashiorkor). Few realize that in an adult patient he would probably have to have 30 -40 episodes of severe diarrhoeas before the body’s homeostasis mechanisms and buffering systems give way.
Death due to diarrhoea:
According to WHO most of the infantile mortality from diarrhoea in poor malnourished communities is due not to the actual pathogens causing the gastroenteritis or food borne illness. Death is not from norovirus, rotovirus, adenovirus, astrovirus, or bacterial Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia, Cholera Vibrio cholera etc, but from dehydration and loss of electrolytes.
So WHO recommends just correcting the fluid and electrolytes imbalance? That is all that is needed in the management. WHO discourages the use of antibiotics to treat diarrhoea
I remember the late Dato Dr Sam Abraham, a Senior Paediatrician at the then General Hospital Kuala Lumpur with whom I was working in a research project in the late 1970-1980 told me that he has not seen even one case of a child dying because of diarrhoea and dehydration. Maybe he saw only well-nourished children from well-to-do families (he was the Consultant Paediatrician to Agong’s and Sultan’s children). Probably even in children they need to have very serve and frequent diarrhoea (maybe 20-30 episodes within 5-6 hours) before the effects of dehydration is apparent. It all depends on the nutritional status of the child at that time.
But in adults:
In adults where the body mass and normal buffering and homeostasis systems are very much better and stronger, it is not easy to suffer from potassium, sodium imbalance depletion from just 10-20 diarrhoeal events. Personally I have suffered 10-25 diarrhoeal episodes within a single night after getting food poisoning. This has happened few hundred times already in the past eating hawkers food outside. Nothing happened to me. I just did nothing about it, but just let the watery stools get out from the system.
I did not interfere with any medication to block this natural response of my body. The next day I was much, much better after all the discharge. I would be an absolute idiot if I were to interfere with the natural working of my body. I did not die of dehydration from sodium, calcium, potassium, chlorine, magnesium, and bicarbonate imbalance. I did not experience muscle twitching, tetany, cardiac arrhythmias, confusion, muscular weakness, shock, coma or any of those disturbances due to dehydration and salt imbalance.
I did not even want to take my own blood pressure, pulse rate, listen to the bowel noises of intestinal hurry through a stethoscope, or monitor my blood for blood urea nitrogen (BUN), creatinine, and glucose as normally done in a hospital. I just leave them without an iota of treatment, and yet I simply get better after having all those stools thrown out a few times.
Let Nature take her course:
The wrongs and pathogens inside the body need to be thrown out, and not silenced by drugs. I know I have done something wrong (eating contaminated foods) that have harmed my body, so my body was giving me warning by ringing the alarm bells (symptoms), and doing its part with a prescription, not prescribed by any doctor (using harsh drugs to silence the warning alarm bells within my body) but by God and Mother Nature that dictates the body to throw them all out naturally (through diarrhoea and vomiting).
As a nutritionist and doctor interested in non-invasive and non-pharmacological approaches in managing diseases, I respect God and Mother Nature with Her prescription. The body responds to rectify my wrong doings by having all the contaminated food I have taken hours previously, all thrown out from my body. Why interfere? Mother Nature and God is the Programmer and Designer of our body. He knows our body best, and He is the Best Physician in this entire Universe.
Treat the Root causes, NOT the symptoms:
The body is NOT designed and programmed to store poisons or made for the inhibition of warning signals (signs and symptoms) with harsh factory-made drugs and chemicals. Only the patients in their ignorance ask for treatment for their ‘undesirable’ symptoms silenced. They never ask the doctor to help them remove the root causes. Symptoms are NOT diseases, but just warning bells ringing. The root causes caused the problem, but drugs cannot remove root causes. Only lifestyle changes can remove root causes (like ingesting wrong foods).
The best remedy for food poisoning is to allow the body to throw them out naturally through vomiting and diarrhoea. Doctors make matter worse by giving so many medicines to block out this action to stop the vomiting and diarrhoea. But the patients ask for it.
Even when I have Spasms:
There were many times I had severe colicky pains with diarrhoea. I could have stopped the spasms by anti-spasmolytic drugs like Hyoscine butylbromide or Buscopan to get relieve from the pain of intestinal spasms, but I didn’t. I always allow time to let the intestinal spasms to relax naturally, and it always does this without fail – without any pharmacological intervention.
Interfering with Nature:
Can you imagine this scenario? We have taken something wrong for lunch or dinner, and our body is trying to get rid of them by triggering off the vomiting and bowel discharge mechanisms? Then we use powerful drugs to block off those natural physiological responses the body is trying to get rid of those offensive substances we have ingested a few hours ago. What happens next?
Both drugs and toxins now cannot get out:
Not only the food toxins cannot get out after the natural peristaltic movements of the colon is paralysed by the pharmacodynamic actions of some of the drugs the doctor gave us, but the drugs and their metabolites themselves cannot be expelled out through the normal pharmacokinetic pathways. When the food poison and the drug cannot get out through natural vomiting and diarrhoeal discharge, they will have no choice but to enter the bloodstream, into the liver (via portal vein), kidneys, and other organs to be lodged somewhere. The accumulation of these drugs if cannot be properly metabolized and excreted, will cause extensive damage to the DNA, cells, tissues, organs, and all systems – all because most patients in their absolute stupidity wants their symptoms to be abolished immediately (quick ‘cure’) using powerful pharmacological interventions the doctor gave because we ask for it. We complain of the symptoms, and not about the wrong food and the bacterial toxins we took during lunch.
Instant Relief:
In so doing, the doctor using powerful drugs do far more damage to the systems than help our discomfort. But just by the act of vomiting the offensive food out itself, would already make us feel much better within 15-20 seconds after throwing out. I think everybody has experienced this feeling of instant relief through vomiting and diarrhoea in their lives, and I need not have to describe more.
But patients are never interested in the root causes of their diarrhoeas (or any illnesses for that matter). They just only want the doctor to prescribe something (anything will do) to stop their symptoms and discomfort instead of asking the doctor how to identify the root causes, and how to treat the root causes, prevent or rid of them to enable the body to repair itself once again.
Treat the root cause first:
Patients normally just want to get rid of their symptoms such as pain and discomfort rather than going into the root causes of pain, itching, swelling discomfort etc. But signs and symptoms are not a disease per sec. Symptoms like diarrhoea is merely signals the body is trying to cry out to us that we have done something wrong to it, and want us to remove the root causes. Root causes may be anything from bad food and poor nutrition, to smoking, alcoholism, to noise pollution, drugs, chemical and environmental exposures, down to bad late nights and unnecessary stress, and negative thoughts. Any of these are extremely harmful to health, and the body reacts to them by the release of stress hormones like adrenalin, and corticosteroidal hormones, elevated blood pressure, sugars, cholesterol levels, etc. Smoking triggers off coughing, as much as certain viruses, bacteria and yeast infections may trigger off digestive upsets. They are all part of a natural response the body is trying to tell us. But unfortunately when we see a doctor about these symptoms, he uses powerful drugs to interfere and suppress these natural responses.
Let the Body heal itself, not suppress with drugs:
If we understand that something has entered the body, the body’s response is to try to get rid of them. This is the treatment prescribed by Nature. But patients only are interested in getting rid off the symptoms and warning systems using 5-6 unnecessary drugs to suppress them. They are not interested in getting rid of the causes to allow the body to heal itself naturally. But the body is specially designed to repair and heal itself naturally if any thing goes wrong, and if given time.
My advice to all doctors and patients is always to treat the root causes, never the symptoms or silence the body warning systems. But if a doctor explains, advises, and educate a patient, then he will not be able to earn a living out of the patients since consultation is the least and smallest part of his income.
Despite my years of rigorous training:
I don’t take any medicine whenever I am unwell. I just allow my body yo heal itself automatically after a few days of rest.
I realize that for every single capsule or tablet I put into my mouth, it will interfere with the body’s natural chemistry somewhere. This will do a lot of damage somewhere to the body. My training in Physiology, Pharmacology Nutrition and Medicine constantly reminds me of this inherent danger. So I am absolutely careful what I put into my mouth. The only tablets or capsules I take are all the natural health and nutritional supplements such as those produced by Diamond Interest because I know that all DI products are safe and health-protective. I take many of DI products daily after food.
But with other drugs for degenerative disorders, we will ultimately either die of the disease or chronic and accumulative drug toxicity if we depend entirely on drugs alone instead of changing the way we eat and live. I am constantly very mindful of this myself as a physician.
Neither my medical colleagues:
Most of my doctor colleagues told me they too do not dose themselves with unnecessary medication. They told me medications are meant for their patients only but they don’t take them for themselves or prescribe them for their families.
So just to make a quick summary – whenever I suffer from diarrhoea due to food poisoning, I don’t add anything more to my digestive system, whether drugs, coconut water or even rice water. I just allow my bowel to rest for a day or two. I respect Mother Nature to be my best doctor. The natural program in my body is to throw everything out, and once done with, the body heals itself naturally when the root causes are removed naturally.
If only patients know how wonderfully the body is made to protect us, they will never want to take chemicals (drugs) to interfere with the body’s chemistry since most drugs silence the body from crying out in pain or in swelling when something goes wrong.
The Power of the Body:
I only wish more doctors concentrate on physiology on how the body response to a stress, an injury, or a disease, and respect that the body can rectify and heal itself, than spending too much time on pharmacology and how to block symptoms.
Thanks for your article Dr BL Chan seeking my advice and comment. I may share your article and my comments to my medical colleagues and other doctor friends later if you don’t mind.
Regards,
Lim Ju Boo
Subsequently this subject was also brought up for discussion by a group of other doctors at a banquet Dr Lim and other medical doctors and scientists attended at the KLCC Convention Ballroom in Kuala Lumpur.
We thought this health issue will be of interest to people as diarrhoea is a very common problem affecting most people especially children. Dr Lim thought he should share his reply and comments to Dr Chan and to other doctors. Here’s what Dr JB Lim wrote to Dr BL Chan
Dear Dr Chan,
Thanks for your advice on the treatment of diarrhea. This is not something new to me. Even way back in the 1960’s as a postgraduate student in Nutrition at the University of London we were already taught the procedure on how to manage cases of infantile diarrhoea in developing countries like those in Africa where medical facilities were so basic and minimal.
We wanted to introduce this approach to all Government Clinics:
When I returned to Malaysia I worked at various Divisions of Rural Health, Community Medicine, Human Nutrition, etc at the Institute for Medical Research (IMR). We conducted health surveys among villages throughout the length and breadth of the country, and we found that diarrhoea was very prevalent in both urban and rural communities. So we thought we should recommend to the Ministry of Health to introduce this simple and extremely effective method of using rice water to treat all diarrhoea in all the villages and government rural clinics all over Malaysia where access to health facilities were at times difficult especially in the remote interiors of Sarawak and Sabah. Our objective was to educate doctors and nurses manning the clinics the use of rice water in managing cases of common diarrhoeas as part of our public health education to the villages.
Surprise response from the medical staff:
But before we did that, we need to conduct a survey to find out the status of how diarrhoeas were managed in government clinics. So we asked the doctors, health and medical team. We expected the doctors to tell us they use diarrhoeal agents - Loperamide (Beamodium), 400 mg of Berberine sulfate, Diphenoxylate HCl 2.5 mg + atropine sulfate 25 mcg (Dhamotil), plus various antibiotics etc, etc.
To our pleasant surprise, the doctors both in the Kuala Lumpur General Hospital (as it was called then) and the government clinics told us that they simply advised the rural folks to drink rice water or take light watery porridge with 2-3 teaspoonful of table salt added. We really didn’t expect them to give us this reply. We expected them to name us the list of anti-diarrhoeal drugs in use then. That was in the 1980’s. Later we found they already learnt of this method before they were posted to the rural clinics.
So this was not new to them nor was it to us. Even Medical Assistants and Rural Health Nurses working in some rural areas were taught this simple method on how to prevent dehydration and reduce infantile mortality in areas where diarrhoeas, malnutrition, and poor hygiene were common. The heath team has already done this even before we could even recommend to the Ministry of Health to introduce them.
Common pathogenic causes:
We know that most of these diarrhoeas in tropical countries like Malaysia are caused mainly by rotavirus, adenoviruses, parvoviruses, astroviruses, and gastroenteritis from bacterial E. coli O157:H7, Salmonella, Shigella, Campylobacter infections, as well as from protozoal infections such as from various types of pathogenic protozoa like amoebasis from amoebas such as Entamoeba histolytica, Gardia (giardiasis), etc, etc…down the list.
Infantile Diarrhoea:
We were aware that in infants persistent diarrhoeas from gastroenteritis can be fatal especially if the child is already suffering from malnutrition. We see children in some of these communities dying unnecessary due to diarrhoeas where dehydration can easily be corrected by merely what we now call it ‘rice water treatment’ There is no need even for so called ‘intravenous drips’ or oral rehydration salts (ORS) as done in a modern hospital. All that is required is to correct for fluid loss and establish electrolyte (potassium, sodium) balance. That is all that is needed.
In fact it is not just rice water or water from rice porridge which is just as good as the intravenous drip, but even any fruit or vegetable juice will do. Even coconut water is excellent.
Coconut water as IV drip:
Just to let you know that even the World Health Organization recommends the use of sterile coconut water to be used as an intravenous drip for fluid replacement and electrolyte imbalance in rural areas of poor countries where modern health facilities are hard to come by. Coconut water inside an unopened coconut is completely sterile, of the right biological electrolyte constituency with near equivalent osmotic tonicity as saline.
Imagine the entire baby coconut tree has to feed and thrive on this water which is exactly like mother’s natural milk for the baby coconut tree. So Mother Nature has prescribed the right fluid, nutrient and salts for the baby coconut inside the nut before it is washed away into the oceans to land ashore by harsh salty sea water to another place to start a new independent tree and life at another place.
So this fluid (coconut water) can never be wrong as it is given by God for a young plant to survive. Moreover, coconut water does not have foreign protein in it to trigger an anaphylactic shock even if infused many times (serial infusions) into any animal and human body. There is no built up of antibodies against any antigen (coconut water) if administered intravenously.
A Tribute to my Professors
We learnt of this from 3 of our professors even as students in England – 2 of them at London University and 1 at Cambridge. Later we found this has been in practice already for a number of years on the recommendation by the World Health Organization for poor tropical countries where young coconuts are readily available, and modern medical facilities are not readily available.
Clean, sterile and biologically just right composition:
Coconut water is absolutely clean and completely sterile, and do not have offensive proteins inside to trigger off increasing titres of antibodies against foreign protein antigen that could lead to anaphylactic events and shocks. Not only purer, cleaner and more sterile than pharmaceutical grade saline-dextrose infusion fluids for IV administration, but the electrolytes therein are of the right biological composition. We can’t beat Nature.
Simple, yet so safe and effective:
So this ‘rice water treatment’ may be used instead of using ORS. The use of coconut water as a direct IV infusion is also not something new to me. Even way back in the late 1960s we already knew about this. Both methods are simple, cheap, readily available, and extremely cost-effective.
We are light years ahead of the Internet:
I thought what you sent to me from the Internet would be something from the 21st Century which we are unaware of. I have always thought the Internet is a very powerful IT tool available only in this 21st Century where we can get lots of the latest information. But it looks like what you tell me only now in 2009 was what we already knew when we were students in the 1960’s.
As far as this piece of medical information is concerned, I think we are light years ahead of even the Internet. Thanks to my professors at London and Cambridge Universities who taught us this traditional and simple method half a century ago. No thanks to the Internet of the 21st Century. It is stale information for me.
Natural therapeutics with rice water is best:
My professional advice is, if you have diarrhoea, whether adult or children, just drink rice water, coconut water, or any fruit juice. There are a lot of water, salts, sugars, various vitamins from all these natural juices. Why go for synthetic ORS, or intravenous drips of crystalloids and colloids, dextrose, saline, Ringer’s lactate, etc as used in big hospitals?
Antibiotics therapeutic regime:
Worse still is for patients to take antibiotics for diarrhoeas which are mainly caused by rotavirus and protozoal infections in tropical countries. The problem is when we get rid of all the bacteria in the intestinal gut – beneficial as well as pathogenic forms and strains with antibiotics only make matter worse by giving opportunistic infections to antibiotic-resistant strains of pathogens to colonize there.
More medical problems than it solves:
This can cause another medical problem called dysbiosis (dysbacteriosis) which is the condition of having microbial imbalances on or within the body due to antibiotics. This is jumping from the frying pan into the fire. Instead of getting rid of all the bacteria (friendly and pathogenic) by random slaughter of all of them with antibiotics, it would be much better to flood the entire GI tract with friendly and beneficial Lactobacilli strains from yoghurt and allow them to colonize in the intestine.
The flood of friendly bacteria in the GIT naturally will outgrow and crowd out all the pathogenic strains. Many friendly strains are very useful in synthesizing many vitamins like vitamin K which are needed for normal blood clotting. Why destroy them with haphazard use of antibiotics? Unfortunately a lot of doctors prescribe unnecessary medication.
A lot of diseases are caused by doctors (iatrogenic diseases) by the unnecessary use of drugs, surgery and other invasive modalities. One example is nosocomial infections in hospitals, and the dangerous rise of MRSA (Methicillin-resistant Staphylococcus aureus) superbugs which are resistant to even the most powerful antibiotics. These are all induced by doctors using unnecessary drugs and over-prescription. Because of this random and wide-spread use of antibiotics, we just do not know how to deal with this MRSA problem anymore
What do I recommend to my patients?
Personally, I always prescribe to my patients who came to me with common diarrhoeas to take yoghurt (cultured milk) which they can easily buy in any supermarket or make their own in their kitchen. Not only yoghurt containing natural intestine-friendly bacteria like Lactobacillus acidophilus, L. bulgaricus, Bifidobacterium, etc, gets rid of all the invading harmful pathogens that caused the diarrhoeas, but they also ferment and breakdown the milk sugar (lactose) for patients who are intolerant to drinking milk (lactose-intolerant). The lack of lactase among Asian adults prevents the breakdown of lactose causing the lactose to ferment in the intestines, giving rise to gas, bloating, and causing them to have diarrhoea. This is yet another cause of having diarrhoea from lactose intolerance not just from all those viruses, bacteria, protozoa and pathogens I earlier listed above.
Even for Candidiasis:
I have also in the past suggested consumption of yoghurt and other probiotics as a prescription to my women patients suffering from vulvovaginal candidiasis (yeast candida infection of vagina) where antifungal agents and drugs like imidazole, miconazole and clotrimazole given previously by their gynecologists and doctors have failed to stopped recurrent infections.
A natural ‘drug’ like yoghurt solved all their recurrent problems. I should have complied all my cases and publish them in a medical journal, but unfortunately I have already retired from active medical research at the Institute for Medical Research.
Mechanism not understood:
Quite honestly I cannot understand the probiotic mechanism behind this therapy. The gastrointestinal tract is quite separate from the genito-urinary tracts system. How then does the Lactobacillus migrate from the anus after ingestion and travel up into the vagina and uterus? The anus and the vaginal orifices are anatomically close to each other and the bacteria could migrate from the anus up the vagina but this is not really a very good answer as it requires quite a bacterial load into the vagina to outgrow all those Candidia spp. It is not easy to get rid of these yeasts once they have established themselves. I am keen to know the probable therapeutic dynamics behind this line of management. As I said even powerful antifungals like imidazole, miconazole and clotrimazole failed to stop the growth.
If what I hypotheses is the probable answer, would it be better to insert yogurt as a cream directly into the vaginal canal instead of oral ingestion via the GI tract? Whatever the explanation is, yoghurt treatment always works for women with recurrent vaginal yeast infections where conventional antifungal preparations failed.
Not just yoghurt:
Not just yoghurt, but any probiotics supplements will do this job very well. But make sure the bacterial count from these probitics pills and dietary supplements are still there, and not destroyed due to prolonged storage, high storage temperatures, poor handling, and lack of GMP (Good Manufacturing Practice) during the production.
Other more serious aetiologies of diarrhoeas:
However, I always make sure my patient’s diarrhoea is due to a simple infections of the GI tract, and food poisoning, and not due to other causes such as osmotic diarrhea (e.g. maldigestion pancreatic disease or coeliac disease), inflammatory diarrhea caused by autoimmune disorders, tuberculosis, cancer of the colon, inflammatory bowel diseases (ulcerative colitis, Crohn's disease, etc), IBS (irritable bowel syndrome), celiac disease, food allergy, ischemic bowel disease, hormone-secreting tumors…etc, etc. A differential diagnosis is important if the diarrhoea is persistent and chronic.
Additionally, I always advise that the diarrhoea, especially if persistent, with mucous and with blood, tarry and black (melena), etc, be properly investigated and diagnosed first, albeit most of them are harmless as a normal physiological response to an irritant somewhere in the intestinal tract. Melena could be suggestive of gastric bleeding or ca (cancer) higher up the colonic tract. Medical history, description of the colour, texture, smell, frequency, signs and symptoms themselves will already give us diagnostic inference with 85 % accuracy without even invasive colonoscopy.
How do I treat myself?
If you were to ask me this question, how do I treat myself in an event of a diarrhoea? Well to tell you, I simple do nothing about it. I just let the diarrhoea run its natural course, and I am always much better after a few episodes of watery stools. If there is also vomiting, I too let the vomiting do its normal physiological job by allowing my body to let go all those causative agents I have ingested (food toxins from food poisoning, bacterial, viral invasion, etc) to throw out all of them.
I just leave it:
I don’t even take rice water, coconut water, fruit juice, ORS, and worse still take all those diarrhoeal drugs to block the food poisons and bacterial load from coming out. I take absolutely nothing, not even water to flash out the toxins. I just allow complete bowel rest by adding nothing more to my digestive system that could only add more load and problems to the digestive tract.
I have suffered from diarrhoea tens of hundreds of times in my life, but not a single time did I do anything to stop the. I knew this was a natural response of my body. If I have ingested any harmful thing in the food I just encourage my body to throw everything out – both by vomiting and stool discharge. In short, I take absolutely no medication, not even rice or coconut water. I just allow the body to do its job with bowel rest for 1-2 days.
The Body Buffering System:
A lot of doctors over treat simple diarrhoea with 5-6 different medications. This is really unnecessarily. The more they prescribe, the happier the drug companies. One of them is always an antibiotic which is always there in every prescription. Even the WHO doesn’t recommend antibiotics for diarrhoea anymore. WHO suggests correcting electrolyte imbalance with ORS and re-establish fluid replacement especially in a small child who is malnourished, and already suffering from protein-energy deficiencies (marasmus and kwashiorkor). Few realize that in an adult patient he would probably have to have 30 -40 episodes of severe diarrhoeas before the body’s homeostasis mechanisms and buffering systems give way.
Death due to diarrhoea:
According to WHO most of the infantile mortality from diarrhoea in poor malnourished communities is due not to the actual pathogens causing the gastroenteritis or food borne illness. Death is not from norovirus, rotovirus, adenovirus, astrovirus, or bacterial Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia, Cholera Vibrio cholera etc, but from dehydration and loss of electrolytes.
So WHO recommends just correcting the fluid and electrolytes imbalance? That is all that is needed in the management. WHO discourages the use of antibiotics to treat diarrhoea
I remember the late Dato Dr Sam Abraham, a Senior Paediatrician at the then General Hospital Kuala Lumpur with whom I was working in a research project in the late 1970-1980 told me that he has not seen even one case of a child dying because of diarrhoea and dehydration. Maybe he saw only well-nourished children from well-to-do families (he was the Consultant Paediatrician to Agong’s and Sultan’s children). Probably even in children they need to have very serve and frequent diarrhoea (maybe 20-30 episodes within 5-6 hours) before the effects of dehydration is apparent. It all depends on the nutritional status of the child at that time.
But in adults:
In adults where the body mass and normal buffering and homeostasis systems are very much better and stronger, it is not easy to suffer from potassium, sodium imbalance depletion from just 10-20 diarrhoeal events. Personally I have suffered 10-25 diarrhoeal episodes within a single night after getting food poisoning. This has happened few hundred times already in the past eating hawkers food outside. Nothing happened to me. I just did nothing about it, but just let the watery stools get out from the system.
I did not interfere with any medication to block this natural response of my body. The next day I was much, much better after all the discharge. I would be an absolute idiot if I were to interfere with the natural working of my body. I did not die of dehydration from sodium, calcium, potassium, chlorine, magnesium, and bicarbonate imbalance. I did not experience muscle twitching, tetany, cardiac arrhythmias, confusion, muscular weakness, shock, coma or any of those disturbances due to dehydration and salt imbalance.
I did not even want to take my own blood pressure, pulse rate, listen to the bowel noises of intestinal hurry through a stethoscope, or monitor my blood for blood urea nitrogen (BUN), creatinine, and glucose as normally done in a hospital. I just leave them without an iota of treatment, and yet I simply get better after having all those stools thrown out a few times.
Let Nature take her course:
The wrongs and pathogens inside the body need to be thrown out, and not silenced by drugs. I know I have done something wrong (eating contaminated foods) that have harmed my body, so my body was giving me warning by ringing the alarm bells (symptoms), and doing its part with a prescription, not prescribed by any doctor (using harsh drugs to silence the warning alarm bells within my body) but by God and Mother Nature that dictates the body to throw them all out naturally (through diarrhoea and vomiting).
As a nutritionist and doctor interested in non-invasive and non-pharmacological approaches in managing diseases, I respect God and Mother Nature with Her prescription. The body responds to rectify my wrong doings by having all the contaminated food I have taken hours previously, all thrown out from my body. Why interfere? Mother Nature and God is the Programmer and Designer of our body. He knows our body best, and He is the Best Physician in this entire Universe.
Treat the Root causes, NOT the symptoms:
The body is NOT designed and programmed to store poisons or made for the inhibition of warning signals (signs and symptoms) with harsh factory-made drugs and chemicals. Only the patients in their ignorance ask for treatment for their ‘undesirable’ symptoms silenced. They never ask the doctor to help them remove the root causes. Symptoms are NOT diseases, but just warning bells ringing. The root causes caused the problem, but drugs cannot remove root causes. Only lifestyle changes can remove root causes (like ingesting wrong foods).
The best remedy for food poisoning is to allow the body to throw them out naturally through vomiting and diarrhoea. Doctors make matter worse by giving so many medicines to block out this action to stop the vomiting and diarrhoea. But the patients ask for it.
Even when I have Spasms:
There were many times I had severe colicky pains with diarrhoea. I could have stopped the spasms by anti-spasmolytic drugs like Hyoscine butylbromide or Buscopan to get relieve from the pain of intestinal spasms, but I didn’t. I always allow time to let the intestinal spasms to relax naturally, and it always does this without fail – without any pharmacological intervention.
Interfering with Nature:
Can you imagine this scenario? We have taken something wrong for lunch or dinner, and our body is trying to get rid of them by triggering off the vomiting and bowel discharge mechanisms? Then we use powerful drugs to block off those natural physiological responses the body is trying to get rid of those offensive substances we have ingested a few hours ago. What happens next?
Both drugs and toxins now cannot get out:
Not only the food toxins cannot get out after the natural peristaltic movements of the colon is paralysed by the pharmacodynamic actions of some of the drugs the doctor gave us, but the drugs and their metabolites themselves cannot be expelled out through the normal pharmacokinetic pathways. When the food poison and the drug cannot get out through natural vomiting and diarrhoeal discharge, they will have no choice but to enter the bloodstream, into the liver (via portal vein), kidneys, and other organs to be lodged somewhere. The accumulation of these drugs if cannot be properly metabolized and excreted, will cause extensive damage to the DNA, cells, tissues, organs, and all systems – all because most patients in their absolute stupidity wants their symptoms to be abolished immediately (quick ‘cure’) using powerful pharmacological interventions the doctor gave because we ask for it. We complain of the symptoms, and not about the wrong food and the bacterial toxins we took during lunch.
Instant Relief:
In so doing, the doctor using powerful drugs do far more damage to the systems than help our discomfort. But just by the act of vomiting the offensive food out itself, would already make us feel much better within 15-20 seconds after throwing out. I think everybody has experienced this feeling of instant relief through vomiting and diarrhoea in their lives, and I need not have to describe more.
But patients are never interested in the root causes of their diarrhoeas (or any illnesses for that matter). They just only want the doctor to prescribe something (anything will do) to stop their symptoms and discomfort instead of asking the doctor how to identify the root causes, and how to treat the root causes, prevent or rid of them to enable the body to repair itself once again.
Treat the root cause first:
Patients normally just want to get rid of their symptoms such as pain and discomfort rather than going into the root causes of pain, itching, swelling discomfort etc. But signs and symptoms are not a disease per sec. Symptoms like diarrhoea is merely signals the body is trying to cry out to us that we have done something wrong to it, and want us to remove the root causes. Root causes may be anything from bad food and poor nutrition, to smoking, alcoholism, to noise pollution, drugs, chemical and environmental exposures, down to bad late nights and unnecessary stress, and negative thoughts. Any of these are extremely harmful to health, and the body reacts to them by the release of stress hormones like adrenalin, and corticosteroidal hormones, elevated blood pressure, sugars, cholesterol levels, etc. Smoking triggers off coughing, as much as certain viruses, bacteria and yeast infections may trigger off digestive upsets. They are all part of a natural response the body is trying to tell us. But unfortunately when we see a doctor about these symptoms, he uses powerful drugs to interfere and suppress these natural responses.
Let the Body heal itself, not suppress with drugs:
If we understand that something has entered the body, the body’s response is to try to get rid of them. This is the treatment prescribed by Nature. But patients only are interested in getting rid off the symptoms and warning systems using 5-6 unnecessary drugs to suppress them. They are not interested in getting rid of the causes to allow the body to heal itself naturally. But the body is specially designed to repair and heal itself naturally if any thing goes wrong, and if given time.
My advice to all doctors and patients is always to treat the root causes, never the symptoms or silence the body warning systems. But if a doctor explains, advises, and educate a patient, then he will not be able to earn a living out of the patients since consultation is the least and smallest part of his income.
Despite my years of rigorous training:
I don’t take any medicine whenever I am unwell. I just allow my body yo heal itself automatically after a few days of rest.
I realize that for every single capsule or tablet I put into my mouth, it will interfere with the body’s natural chemistry somewhere. This will do a lot of damage somewhere to the body. My training in Physiology, Pharmacology Nutrition and Medicine constantly reminds me of this inherent danger. So I am absolutely careful what I put into my mouth. The only tablets or capsules I take are all the natural health and nutritional supplements such as those produced by Diamond Interest because I know that all DI products are safe and health-protective. I take many of DI products daily after food.
But with other drugs for degenerative disorders, we will ultimately either die of the disease or chronic and accumulative drug toxicity if we depend entirely on drugs alone instead of changing the way we eat and live. I am constantly very mindful of this myself as a physician.
Neither my medical colleagues:
Most of my doctor colleagues told me they too do not dose themselves with unnecessary medication. They told me medications are meant for their patients only but they don’t take them for themselves or prescribe them for their families.
So just to make a quick summary – whenever I suffer from diarrhoea due to food poisoning, I don’t add anything more to my digestive system, whether drugs, coconut water or even rice water. I just allow my bowel to rest for a day or two. I respect Mother Nature to be my best doctor. The natural program in my body is to throw everything out, and once done with, the body heals itself naturally when the root causes are removed naturally.
If only patients know how wonderfully the body is made to protect us, they will never want to take chemicals (drugs) to interfere with the body’s chemistry since most drugs silence the body from crying out in pain or in swelling when something goes wrong.
The Power of the Body:
I only wish more doctors concentrate on physiology on how the body response to a stress, an injury, or a disease, and respect that the body can rectify and heal itself, than spending too much time on pharmacology and how to block symptoms.
Thanks for your article Dr BL Chan seeking my advice and comment. I may share your article and my comments to my medical colleagues and other doctor friends later if you don’t mind.
Regards,
Lim Ju Boo
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