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Nutrition Q&A with Dan Lukaczer

Q: What can be done to decrease the risk of kidney problems in diabetics?

A: One of the main complications of diabetes is kidney failure—a large percentage of patients are on kidney dialysis because of the damage wrought by diabetes.2 While there are many important diet, exercise and lifestyle changes that have been shown to reduce the risk for developing diabetes, a new study suggests that high-dose thiamine (vitamin B1) may protect specifically against kidney damage secondary to diabetes.

High-dose thiamine may protect against kidney damage secondary to diabetes.

A particular kidney problem that can result from diabetes is microalbuminuria, which occurs when small amounts of albumin—the most abundant protein in human serum—leaks from the kidney into the urine. It is a marker of early kidney-disease development in diabetics. In a small, placebo-controlled trial, 300 mg a day of thiamine taken for three months was found to reduce the rate of albumin excretion in type 2 diabetics by 41 percent. The results also showed that 35 percent of patients with microalbuminuria returned to normal urinary-albumin excretion after being treated with thiamine.3

It should be noted that in this study, patients' blood sugars weren't changed—so clearly thiamine alone is not the answer for diabetes. But it may help with the kidney damage complications that arise from diabetes. While these results need to be replicated, I think if you have diabetes, you should consider increasing your dose of thiamine. High-dose thiamine is a water-soluble vitamin, and there is no upper limit set by the U.S. Food and Drug Administration.

Q: Is there anything smokers can do to protect themselves from lung cancer?

A: Bottom line: Don't smoke (brilliant insight), but if you do, small health-promoting activities can help make up for some of the risk.

Past research has shown that cruciferous vegetables such as broccoli, Brussels sprouts and their cousins confer some protective effect against a number of cancers.1 A new, as-of-yet-unpublished study shows that consumption of cruciferous vegetables modestly helped protect smokers from developing lung cancer in particular. The vegetables' protective action is derived at least in part from a group of carcinogen-modulating phytochemicals called isothiocyanates.

The study was presented by Li Tang, Ph.D., from the Roswell Park Cancer Institute in Buffalo, N.Y., at the 2008 American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research. It suggests that the risk of developing lung cancer (specifically squamous or small-cell) was reduced by 22 percent to 50 percent among smokers who consumed at least four-and-a-half servings of raw cruciferous vegetables in a month, compared with those who consumed less than two-and-a-half servings per month. In this study, researchers examined 948 patients diagnosed with primary lung cancer and 1,743 healthy controls. Study participants completed questionnaires that detailed their intake of total fruits and vegetables as well as cruciferous vegetables specifically. After controlling for smoking status and other known risk factors, the researchers only observed strong associations between cruciferous-vegetable consumption and those who smoked or had smoked. Put another way, eating lots of vegetables is always a good idea, but if you are or were a smoker, eating cruciferous vegetables might confer some specific benefit.

An important caveat was that the intake in this study was from eating the vegetables raw. It appears that you get more of the protective effects from these phytonutrients if they are not cooked.

References are available at

Dan Lukaczer is a doctor of naturopathic medicine in Fife, Wash.

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