Recently, I was contacted by a 60 year old woman who wanted me to go over her blood work. Her fasting blood sugar was nice and low at 75. That's actually lower than mine, so I was a little envious. However, at the same time, she had marginally elevated HA1C.

HA1C measures the percentage of hemologbin that shows glycation damage. Glacation is a reaction between sugar moleculres and proteins in which the proteins get damaged. An example would be the proteins in the lens of the eye, which in their healthy state are completely translucent, but when they undergo glycation, they become opaque. Think of it like the change from raw egg white to cooked egg white, a process which is called "denaturing." Obviously, you can't see through cooked egg white, and it's the same for the ocular lens.

This woman's HA1C was 5.9% where normal is considered 5.7% or less. And, the fact is that some labs designate 5.9 as the top of the normal range, so really it was marginal. Nevertheless, it concerned her a lot, which is why she contacted me. I will point out that this woman is not the least bit overweight- if anything she is on the slim side. And she's feeling fine- there are no symptomatic issues.

The reason why HA1C is becoming recognized as a valuable tool is because it reflects the status of long-term glucose control. A simple glucose test only tells you what the blood sugar was at a single moment in time. But, blood glucose can fluctuate wildly. So, by looking at HA1C, you get an idea of how well glucose is being controlled over a period of several months.

It is probably true that HA1C is at least as predictive of future problems as any of the cholesterol tests and probably more predictive. And if I had to choose between being stuck with a high cholesterol or a high HA1C, I think I'd rather be stuck with high cholesterol. It would worry me more to have an elevated HA1C.

Now, what can you do about it? Well obviously, all of the factors that go into diabetes prevention apply, which means: eating a whole natural foods diet and emphasizing plant foods over animal foods, exercising regularly including aerobic and resistance exercise, maintaining a healthy lean to fat ratio (meaning retaining quite a lot of bodily muscle and not much bodily fat), and that's about it for the frontline defense. However, if you want to do more, you can consider taking anti-glycation supplements. Two of the best are Carnosine and Benfotiamine. Carnosine is a dipeptide, which means two amino acids holding hands, in this case alanine and histidine. It sounds simple, but Carnosine is as powerful an antiglycation agent as they come. Even the FDA realizes it because they have made Carnosine eyedrops a prescription treatment for cataracts. And Benfotiamine is the fat-soluble form of Vitamin B1 which has been used for decades in Europe to treat and prevent diabetes. It's commonly prescribed by doctors over there, and it's as safe to take as regular thiamine.

Those are the two anti-glycation supplements that I take. Another good one is P5P, which is an advanced form of Vitamin B6. I don't take it separately, but there is some P5P in the Extend Core multi that I take every day.

I am going to include the HA1C test in my annual blood work next April, and frankly, it will be for the first time. I never thought about doing it before because my blood sugar was always nice and low, so I figured, why bother? But now that I know that it's possible to have enviably low blood sugar while still having marginally high HA1C, I will start tracking it.

Would you believe that pomegranate protects the kidneys of patients undergoing dialysis? I think that's amazing. In a small study out of Israel involving 101 dialysis patients, some got pomegranate juice 3X a week while the rest got a placebo drink. The patients receiving pomegranate juice showed marked reduction in inflammation and damage caused by free radicals. The doctors also observed significant improvement in cardiovascular risk factors among the patients getting pomegranate, which was important because many kidney patients die from cardiovascular events. Their conclusion was:

"Considering the expected epidemic of chronic kidney disease in the next decade, further clinical trials using pomegranate juice aimed at reducing the high cardiovascular morbidity of chronic kidney disease patients and their deterioration to end-stage renal disease should be conducted."

The study was presented during the American Society of Nephrology's Renal Week 2010 in New York City, the largest nephrology meeting in the world.

My first thought was that if pomegranate could do that much good for those who are in kidney failure, how much good could it do for a relatively healthy person?

I don't know about you but this time of year (autumn) I am consuming pomegranate juice every day. I make it in my Champion juicer. I realize that I could just eat the pomegranate seeds and pulp, but the seeds are rather gritty, which I don't like. So, I prefer to make juice. Sometimes, I just drink the juice by itself, but often I make a smoothie consisting of fresh pomegranate juice, organic tofu made from sprouted soybeans, and ripe bananas. Talk about a great smoothie! It is like a jolt of energy.

I hope you are making the most of this pomegranate season.

A reader has asked my opinion about the use of retinol, which is Vitamin A, in skin creams, and whether it might cause cancer.

 

The use of retinol in skin creams has been around for quite a long time- at least 25 years. The prescription forms of it usually contain an analogue of Vitamin A, such as Retin-A, and the over the counter forms contain regular Vitamin A, retinol.

 

Whether it's the natural Vitamin A or an analogue, the benefit from using it comes from its mildly irritating effect, which causes the outer skin cells to shed. A comparison has been made to an onion. If you peel the outer, dry, crusty layers of an onion, you get to a layer that is smooth and soft and moist. And it certainly looks much younger.

 

As to whether the use of retinol might cause or increase the risk of skin cancer, it is, after all, an irritant, and chronic irritation is a factor in many cancers. Moreover, it increases sun sensitivity, and the sun is obviously a factor in skin cancer. That's the reason why the use of sunscreen is recommended to all those using Vitamin A creams.

 

But, you should also know that some dermatologists prescribe Retin-A as an ancillary treatment for some kinds of skin cancer. The same is true for pre-cancers such as actinic keratosis.  And I mean they have the patient apply the Retin-A directly on the affected skin.

 

I feel that as long as the individual pays attention to the signs of excess irritation (such as redness, excessive shedding, peeling) and backs off when necessary, and so long as sunscreen is applied daily, that there should be no cause for concern. I think it's safe, and used properly and cautiously, it may actually reduce the risk of skin cancer.

 

However, I would not use a sunscreen that contained retinol. We're talking apples and oranges here. An anti-aging skin cream with retinol or one of its derivatives is one thing. A sunscreen is something else. They're two separate products, or at least they should be.  

 

Again, used properly, I feel that retinol creams are safe, and I have no compunction to discourage their use.     

The USDA issued new salt guidelines in 2010 advising all Americans not to exceed 1500 mgs in their daily salt consumption. This was in sharp contrast to their previous advice which allowed most people to consume up to 2400 mgs daily. A lot of people, including some doctors, are screaming bloody murder about this, and the online community seems particuarly incensed about it. But, let me give you my take.

We know how much sodium the human body actually needs each day. It's about 500 mgs, and the body can actually get by on less by ratcheting up its sodium-conserving mechanisms. The body can squeak by on 250 mgs/daily if it has to. But, the body gets by with ease on 500 mgs/day with no strain at all. So, even 1500 mgs is 3x as much as required. However, the sodium-excreting mechanisms of the body are so efficient that most people can handle that much sodium load without a problem. But, I'll tell you, honestly, that there is no good reason to go higher than that. So in this case, I don't have a problem with the government's decree, and what I mean is that I think it's a good target to aim for.

In my life, I try to control my sodium intake, and I'm sure that on many days, I do consume less than 1500 mgs. However, I know that there are some days that I do go a bit higher, maybe as high as 2000 mgs. That is still below average because the average American consumes 3000 to 5000 mgs of sodium daily, and heavy salt users may go as high as 10,000 mgs or higher. But, I don't mind being reminded to keep trying to lower my salt intake because it's a worthy endeavor.

What's the harm from sodium? Well, obviously high blood pressure is an issue. It has not been a problem for me. My blood pressure has stayed low despite moderate salt intake. But if my pressure were to start rising, I would indeed lower my salt intake dramatically. But besides that, we know that excess sodium is bad for the bones. You know how salt corrodes the underside of cars and the surfaces of roads when they salt them in the winter? You might say it does the same thing to bones. Salt is an irritant, and it irritates the stomach. The high rate of stomach cancer in Japan is believed to be due to the high salt consumption. And salt may play a role in hardening of the arteries- not in the plaquing, which is soft, but in the hardening which comes later.

So, there are good reasons for all of us to limit our salt intake- even if we are lucky enough not to experience a rise in blood pressure from it.

Is sea salt better than standard table salt? I believe it is because it does contain other minerals. However, keep in mind that it's still 97% sodium chloride, and sodium chloride is sodium chloride whether it's mined from the sea or from the land. So, I'm all for sea salt, but let's not get over-enthused about it. Let's not mistakenly think that we can use it willy-nilly just because it's from the sea.

There is one important caveat: There are people with salt-wasting diseases, such as Addison's disease, where the adrenal glands fail to signal the kidneys to conserve sodium. These people lose copious amounts of sodium in their urine and hence have an unusually large daily requirement. But fortunately, Addison's disease is quite rare, and if you had it, you'd know about it by now.

Keep in mind that many people consume a lot of sodium without ever picking up a salt shaker. Cheese, bread, chips, canned foods, commercial soups, frozen dinners, and almost all restaurant dishes are loaded with salt. They add salt to everything. You don't think of cookies as being salty, but they are. Did you know that they add salt to ice cream? In my life, I avoid most of that stuff. I do eat whole grain bread which has about 100 mgs of sodium per slice. That's actually considered low by commercial standards. I eat canned beans, but I buy ones that are low in salt. Yet, they still have about half as much salt as the regular ones.  The saltiest thing I eat is a frozen vegetarian dinner which has 700 mgs. It's the nights I eat that that my total daily consumption may exceed 1500 mgs.

So, I don't consider myself a purist about salt by any means. But, if I were having major health problems, I would immediately cut way back to less than 1000 mgs a day.

Anyway, the bottom line is that when you do the Math, you realize that it really does make sense to minimize your salt consumption. And I can tell you that just from writing this little article, I am feeling empowered and motivated to try harder to get my salt consumption down.

This is a good follow-up to the previous article which covered the use of diuretics to treat high blood pressure. I am opposed to that practice, and I am opposed to all the drugs that are used to treat high blood pressure, except in emergencies. Many of the anti-hypertensive drugs affect the kidneys in one way or another. But think about it: for most hypertensives, the disease exists in their arteries. It is the condition of their arteries that causes the elevated pressure. So, why treat the kidneys? Instead, why not take actions to make the arteries healthier? Isn't that the logical thing to do? Moderate hypertension should be treated with diet, lifestyle, and specific nutritional practices to improve arterial health. And there are so many safe and constructive ways that you can lower your blood pressure without causing havoc in your body.

One of the most healthful things you can do is to eat walnuts regularly, as I do. I eat walnuts almost daily and throughout the year.

A new study done at Pennsylvania State University found that adding 1.3 ounces of walnuts and 1 tablespoon of walnut oil to people's diets lowered their resting blood pressure significantly. However, it also produced a lower blood pressure response to stress- when the individuals were placed under stressful conditions.

Some of the participants were also given a vascular ultrasound test which measures arterial dilation. The walnut diet was found to significantly improve vascular function. They also found that the walnuts lowered C-reactive Protein or CRP, which is a cardinal sign of inflammation, which means that the walnuts were having an anti-inflammatory effect.

The trial lasted for 6 weeks, during which the control group was fed the standard American diet. The experimental group was fed the same diet except that some of the fat and protein were replaced with the walnuts and walnut oil, so that calorically, the diets were equal. However, it should be noted that there was no attempt to optimize the entire diet. The benefits accrued even though the subjects were still eating standard fare- except for the small portion of their diet comprised of the walnuts.

Of course, in real life, a person would be wise to eat walnuts and other raw nuts, and also to optimize their entire diet by eating a lot of fresh produce (fruits and vegetables), wholesome carbohydrates (such as whole grains and legumes) and minimizing or excluding all the bad foods.

My point is that if noticeable improvement occurred just from adding a small handful of walnuts to an otherwise mediocre diet, imagine if you really tried to eat healthfully in all respects. That's when the "power of your plate" can really turn your life around.

I'm not inclined to use walnut oil. Why bother? It's in the walnuts, so I say just eat them. I don't see any advantage in taking the oil separately. I think we should be quite restrained in our use of oils, period. And for what limited use I make of oil, I prefer to use extra virgin olive oil because I think it's superior, and I think it's far more practical.

Of course, walnuts is one of many fine nuts, and I don't doubt that it is one of the best. But in sizing up nuts, surely the almond has got to be near or at the top of the list. Nutritionally, almonds are in every sense a super-food. If I were limited to just 5 foods and no others- say for the rest of my life- I can assure you that raw almonds would definitely be one of my choices.

And when I say raw almonds, I do mean totally raw almonds, and they are increasingly difficult to find. You can't find them in stores. Those almonds have all been pasteurized. You can only buy raw almonds online. But, it's worth the trouble because almonds, like all nuts with the exception of chestnuts, should be eaten raw.

Frankly, at age 60, I have the blood pressure of a 20 year old, and I've been eating raw nuts daily for 40 years!