Nutrition Q&A

with Dan Lukaczer, N.D.

Food as Medicine
Can a vegetarian diet help my customers with rheumatoid arthritis?

Yes. There is little doubt from the literature that some people—though I would not say all—benefit considerably from a vegetarian diet. Exactly why diet modification works is not exactly clear, but some rheumatoid arthritis (RA) patients may be allergic to something in their diet, and removing that will improve symptoms. Other research suggests the change to the types of oils in the vegetarian diet helps decrease inflammation. A third theory is that certain gut bacteria may be problematic in some people who are susceptible to this disease. If these bacteria proliferate, they can cause an autoimmune reaction that triggers the body to attack its own joints.

This last theory was supported by a recent Norwegian trial in which 27 RA patients were put on a vegetarian diet for a year and 26 others were not. Not everyone in the group responded to diet modification, but of those who did, the vegetarian diet caused a significant decrease in IgG antibody activity against the Proteus mirabilis bacteria.¹ (The decline in antibodies suggests the gut is harboring less of this bacteria since antibodies are the body's immune system responding to an invader.) Those with a significant decrease in these bacterial antibodies significantly improved their RA symptoms.

The gastrointestinal surface area is about the size of a tennis court, and there are 400 to 500 species of bacteria, numbering around 10 trillion, that live on that surface. Thus, a single layer of epithelial cells is all that separates the immune system from this enormous source of bacterial triggers. Given that there don't appear to be any toxic side effects to vegetarianism, telling your customers to try a meat-free diet is a great way to let food be their medicine.

Herbal Gas Relief
Customers with irritable bowel syndrome (IBS) often complain of uncomfortable gas and bloating after meals. What can I suggest?

There is no one answer for IBS, but in this case I would suggest peppermint oil. Peppermint (Mentha piperita) has traditionally been used as a carminative, which is an herb that removes accumulated gas from the stomach and intestines.

A number of studies show peppermint oil extract, standardized to the essential oil menthol, improves the gas and bloating symptoms associated with IBS. Peppermint oil inhibits intestinal smooth-muscle hyperactivity by reducing calcium ion influx into smooth muscle cells, facilitating gas expiration. In plain English, peppermint oil causes gas trapped in the colon and intestine to be absorbed into the body, hence no feelings of trapped gas or passing gas.

Two meta-analyses of peppermint oil studies show positive results.^2,3 The second and more recent of the two looked at eight trials and combined the results, which showed a significant overall improvement of IBS symptoms in patients treated with peppermint oil compared to placebo.

While peppermint oil is in no way the single answer to IBS, because IBS seems to have many different causes, it can provide dramatic results for some patients. (For more information on IBS, please see NSN 1999 Mar;4(3):110 and NSN 2000 Mar;5(3):127.)

Co-Q10 Lowers Blood Pressure
Can Co-Q10 lower blood pressure in addition to its touted benefits as an antioxidant and aid for congestive heart failure and chronic fatigue?

Research dating to the 1980s suggests coenzyme Q10 (Co-Q10) may affect blood pressure. Results from these studies were generally positive but the trials were small and often not controlled.^4,5 An eight-week trial completed in 1999 certainly adds evidence to support the use of Co-Q10 in hypertension and may provide a better understanding of its action.⁶

In this trial, conducted at the Centre of Nutrition at the Medical Hospital and Research Centre in India, 59 men with hypertension were randomized to receive 120 mg/day Co-Q10 or placebo. Both systolic and diastolic pressure decreased significantly in the Co-Q10 group—an average of 16 and 9 points, respectively—while the placebo group saw no change.

The researchers also measured glucose and insulin levels and saw significant decreases in those as well. There is increasing evidence that as many as 50 percent of individuals with hypertension may also be insulin resistant. When insulin is not working effectively, the body produces more. High insulin levels have been shown to increase blood pressure. This trial suggests Co-Q10 may improve the way insulin works and, as a beneficial side effect, lower blood pressure.

Dan Lukaczer, N.D., is director of clinical services at the Functional Medicine Research Center, a division of HealthComm International Inc., in Gig Harbor, Wash.

References

1. Kjeldsen-Kragh J. Rheumatoid arthritis treated with vegetarian diets. Am J Clin Nutr 1999;70(Suppl.):594S-600S.

2. Poynard T, et al. Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 1994;8:499-510.

3. Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: A critical review and meta-analysis. Am J Gastroenterol 1998;93:1131-5.

4. Folkers K, et al. Bioenergetics in clinical medicine. XVI. Reduction of hypertension in patients by therapy with coenzyme Q10. Res Commun Chem Pathol Pharmacol 1981;31:129-40.

5. Digiesi V, et al. Coenzyme Q10 in essential hypertension. Molec Aspects Med 1994;15(Suppl):S257-63.

6. Singh R, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Human Hypertens 1999;13:203-8.