April 24, 2008

6 Min Read
Nutrition Q & A

Q: Customers often ask about lactobacillus for recurrent canker sores. Can it help?

A: Recurrent aphthous ulcers, or canker sores, are very common. These shallow, painful ulcers, visible on the mucous membranes, typically last one or two weeks. Large ulcers may last several weeks to months.1 They are different from cold sores, which are caused by a herpes virus. The cause of canker sores is not clear, although allergies, dentures, HIV and certain cancers have all been associated. No matter what causes a canker sore, it is clear that while they are self-limiting, they can be quite painful. While there's no definitive clinical evidence, probiotics in the form of lactobacillus have been used for quite some time. No one is really sure how they work in this regard. They may be helping by crowding out bacteria in the mouth that may exacerbate the ulcer.2,3,4 I generally recommend opening a couple of capsules, adding a little water to make a thick paste and then applying it directly to the canker sore, and letting it sit until it dissolves. Apply that four or five times a day. I've found that this can sometimes significantly improve the healing time.

Q: What is burning mouth syndrome and what can be done about it?

A:Burning mouth syndrome is a chronic painful condition of the oral mucous membranes that is not accompanied by lesions or systemic disease. BMS occurs most often among women and is often accompanied by dry mouth and loss of taste. There is only limited research on the cause of BMS. Some BMS sufferers have an oral candidal (thrush) infection (not readily apparent), nutritional deficiencies (B1, B2, B6, B12, folic acid and iron) or diabetes that may be associated with burning. Therefore all of these factors should be evaluated. Some researchers think BMS may be a form of neuropathy. Since some neuropathies have responded to ALA there have been trials using this antioxidant. One double-blind, placebo-controlled study using 600 mg of ALA for one month showed significant improvement in two-thirds of BMS patients receiving the ALA.6 Another placebo-controlled study using ALA at 600 mg daily found significant symptomatic improvement, compared with placebo, after two months. The improvement was maintained in more than 70 percent of patients at the one year follow-up.7 I therefore think ALA is worth a try.

Q: Can arginine really help with elevated blood pressure?

A:Arginine, through its conversion to nitric oxide, may have a vasodilatory effect on arteries. Some animal work has shown a positive effect, and preliminary evidence suggests it can slightly lower blood pressure in people given an arginine-enriched diet.8 But the data is quite mixed. One study looked at supplementing individuals with cortisol-induced hypertension (which may be likened to stress-induced elevations in blood pressure). Administration of 21 grams of l-arginine did not prevent cortisol-induced increases in blood pressure.9 In another trial, patients with hypertension received either 6 grams l-arginine or placebo, and researchers found that l-arginine did not significantly change blood pressure.10 In yet another study, this time with diabetics, six patients with mild hypertension were given three grams of arginine per hour for 10 hours over two days resulting in a modest reduction of blood pressure.11 These are very large dosages, which make treatment a bit unwieldy, and the long-term effects of these dosages require further investigation. More evidence is required to use l-arginine for hypertension.

Q: Do organic fruits and vegetables taste better than those conventionally grown?

A:Many people believe that organically grown fruits and vegetables taste better than conventional produce. But according to studies, when you compare apples to apples, if you will, this doesn't appear to be the case. In the handful of carefully designed taste-offs reported in the last few years, including one last May,12 people were often unable to identify the organic foods and didn't prefer them.

Such results have always puzzled me because organic produce generally does pack more antioxidants and other healthful—and potentially flavorful—phyto?chemicals such as catechins, lutein, etc., than conventional produce.13 What do these phyto?chemicals have to do with flavor? Phytochemicals are created by plants in part to defend against microbes and insects. Organic plants have higher phytochemical-levels because they are unprotected by pesticides and fungicides. Most of the aromas of vegetables, herbs and spices come from these phytochemicals. So you would think this factor would add to a plant's flavor sensation, but it doesn't seem to translate that way.

Still, I can say unequivocally that I think organic produce is better for you. Numerous studies show phytochemicals have a variety of health benefits, and other studies suggest that organic crops are better for you. For instance, a recent review showed that organic crops contained significantly more vitamin C, iron, magnesium and phosphorus as well as significantly less nitrates than conventional crops.14 There appear to be genuine differences in the nutrient content of organic and conventional crops. Of paramount importance is that organic products are much better in promoting a sustainable planet on which to live.

1. Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am. Jan 2005;49(1):31-47, vii-viii.
2. Gertenrich RL, Hart RW. Treatment of oral ulcerations with Bacid (Lactobacillus acidophilus). Oral Surg Oral Med Oral Pathol. Aug 1970;30(2):196-200.
3. Lichtenstein J, Kopp WK, Hirsch N. The Therapeutic Value of Lactobacillus Acidophilus in Acute Primary Herpetic Gingivostomatitis: Clinical Impressions. J Oral Ther Pharmacol. Nov 1964;54:308-12.
4. McCord WF. Treatment of children for primary acute herpetic gingivostomatitis with lactobacillus in aqueous suspension. Pediatr Dent. Dec 1988;10(4):307-8.
5. Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Mar 2007;103 Suppl:S39 e31-13.
6. Femiano F, Gombos F, Scully C, Busciolano M, De Luca P. Burning mouth syndrome (BMS): controlled open trial of the efficacy of alpha-lipoic acid (thioctic acid) on symptomatology. Oral Dis. Sep 2000;6(5):274-7.
7. Femiano F, Scully C. Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy. J Oral Pathol Med. May 2002;31(5):267-9.
8. Siani A, Pagano E, Iacone R, Iacoviello L, Scopacasa F, Strazzullo P. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens. May 2000;13(5 Pt 1):547-51.
9. Kelly JJ, Williamson P, Martin A, Whitworth JA. Effects of oral L-arginine on plasma nitrate and blood pressure in cortisol-treated humans. J Hypertens. Feb 2001;19(2):263-8.
10. Lekakis JP, Papathanassiou S, Papaioannou TG, et al. Oral L-arginine improves endothelial dysfunction in patients with essential hypertension. Int J Cardiol. Dec 2002;86(2-3):317-23.
11. Huynh NT, Tayek JA. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. J Am Coll Nutr. Oct 2002;21(5):422-7.
12. Zhao X, et al. Consumer sensory analysis of organically and conventionally grown vegetables. J Food Sci 2007;72(2):S87-91.
13. Asami DK, et al. Comparison of the total phenolic and ascorbic acid content of freeze-dried and air-dried marionberries, strawberry, and corn grown using conventional, organic, and sustainable agricultural practices. J Agric Food Chem 2003;51(5):1237-41.
14. Worthington V. Nutritional quality of organic versus conventional fruits, vegetables, and grains. J Altern Complement Med 2001;7(2):161-73.

Natural Foods Merchandiser volume XXIX/number 2/p. 37

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