note to self: pull beverage portion of last nutrit lecture to here
Dr M says keep your thoughts to yourself
don't give too much info
do what he says not what he does
too much info causes people to worry
internet causing this--self-diagnosis disorder
BEVERAGES
FRUIT JUICES
beware esp for kids and pts with hyper/hypo glycemia
dilute by 80-90% with water, better for everyone
he recommends teas from plants with flavonoids
VEGGIE JUICES
better tolerated than fruit dt lower sug
can cause gas (insoluble fiber)
high in potassium, trace elements, generally hypoallergenic
can cause diarrhea
ALCOHOLIC BEVERAGES ALCOHOLIC BEVERAGES ALCOHOLIC BEVERAGES ALCOHOLIC BEVERAGES
ALCOHOL
long hx of use in all cultures
a good solvent esp for flavonoids, used for extracts
a toxin to the body
wood (methyl) alcohol is metabolized 1/7 as fast as ethyl-OH (what most people drink)
but both cause damage
incr permeability of cell membranes
causes foam cells-->atherosclerotic plaques
ALCOHOLISM DEFINED BY US Departpment of Health and Human Services
1) tolerance is developed: want more to get same effect
2) physical dependence when consumption interrupted-->characteristic withdrawal syndrome (mood swings, poor sleep quality awakening 2-4am, 3am is liver time in chin med, the delirium tremens)
3) impaired ability to regulate alcohol intake once drinking has begun (incl rare binges)
4) discomfort of abstinence, a craving that can lead to relapse
Charles Bates
ENZYMES
LA-->GLA-->DHGLA-->PGE1
delta 6 desaturase converts Linoleic Acid to Gamma Linolenic Acid (18:3w-6)
alcohol inhibits this enzme
cyclooxygenase converts DHGLA to PGE1
alcohol increases the fx of this enzyme
some pts have strong feeling of wellbeing with alcohol
because it increases conversion of DHGLA to PGE1
but they have lass PGE1 because it's not being made, so they don't feel good in the end
GLA in borage, black currant, evening primrose, human milK
cytotec is synthetic analog of PGE1: incr plt agg, mucin in stomach, less tumor growth, chol syn, phospholipase A2, decr RBC fragility, dilates smooth muscle, decr BP
alcoholics do quite well on cytotec
SUPPLEMENTATION FOR ALCOHOLICS
EPO, Zinc, B Vits
5HTP (for depression, sleep)
Magnesium (esp for DTs)
Milk Thistle-->more glutathione peroxidase
EFAS
EPO or borage oil, sounds like EPO is best
Essential Fatty Acids, Immunity and Mental Health Charles Bates
ZINC
zinc def causes dysfx of delta 6 desaturase
zinc oxide most common, in ointment for skin
for oral take citrate or picolinate, picolinate helps transport into tissue
30mg of zinc picolinate = 60 mg of zinc oxide
zinc citrate also inhibits stone formation
skin conditions are common
get more prostate problems
zinc is concentrated in the prostate
need simultaneous copper supplementation, 15-30mg Zn to 1mg Cu
to prevent decrease in HDL
if HDL already low, increase amount of Cu supplementation relative to zinc
increase zinc and vit A during winter
B VITAMINS, B1, B3, B6
daily B-vitamin injections incl Thiamine B1 (RDA is 1mg, injx is 100mg)
NIACINAMIDE
**if depressed or trying to quit smoking take niacinamide 1-3grams
check liver enzymes, doses over 1 gram can cause hepatitis in some: monitor!!
may greatly enhance cognitive function
ALCOHOL = LEADING CAUSE OF DEATH
leading cause of death from age 2-33 is MVAs
1/2 of all fatal MVA's involve alcohol
40% of violent crimes involve alc
18 million Americans fit criteria for alcohol abuse or alcoholism
in 2002 160 million alcohol related drivign drips
116 million in 1997
get caught 1/1000 trips
2 DUIs-->you're an alcoholic (put DUI's on intake form? addiction screening form?)
for every DUI there are 200-2000 DUIs that have not been caught
80% of alc related fatalities involve primarily beer consumption
BAC = BLOOD ALCOHOL
measured for enforcement
Blood alc .08% in OR to get DUI
Or if the officer feels you are impaired-->can still get DUI
for 150 lb person this takes 4 drinks/hour (or less)
1 drink = 1 oz hard liquor = 4 oz wine = 12 oz beer
food decreases absorption
each drink-->.025% incr in BAC
normally metabolize about .02%/hour
How much does metabolism vary? I would bet a LOT:
Faster: activity, males, habitual drinking.
Slower: females, NASH, smoking, toxic envir, liver challenge.
May test + for alcohol in pts w/ yeast overgrowth
(after eating simple sugars-->converts to aldehydes)
funny DUI online:
http://video.google.com/videoplay?docid=-2061097655191972206&hl=en# TEST CPY450 PATHWAY
with caffeine challenge test
or 1 shot/minute of beer--even heavy drinker won't tolerate 2 beers at this rate
we will see more sustained release supps in the future
COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE COFFEE
COFFEE STATS
1999 108 million coffee drinkers
$9.2 billion in retail, $8.7 billion in foodservice/year
average 1.5 cups/day
average over $1000/year
54% of all US adults drink coffee daily in 2000, average 3.1 cups/day
25% drink coffee occasionally
average per capita consumption in US is 4.4kg/year
don't give it to kids, teens, affects brain development
18% drink gourmet coffee daily
2.4 billion pounds/year for last 5 years
Swedes consume 25lbs beans/person/year, highest in world, 3x US level
ENVIRONMENTAL CONCERNS
need to know where it comes from, that it doesn't destroy environment
want free trade coffee, not rape and pillage of land
paper filters may contain dioxin, if white avoid, use the brown stuff
paper filtering eliminates some pathogens from the coffee
Finnland drinks lots of coffee and has high CV dz dt not using paper filters
cowboy coffee to be avoided
CAFFEINE CONTENT OF VARIOUS COFFEE BEVERAGES
decaf 2-4mg
drip/brewed 75-200mg
instant 65-120mg
espresso 1oz 30-50mg
coffee people 60-120mg
Seattle's best 100-125mg
Starbucks short 200mg
Starbucks tall 12oz 300mg
Starbucks venti 20oz 500mg
TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA TEA
mostly contain theophyyline
CAFFEINE CONTENTS
green 14mg
iced canned 22-36
brewed 20-90
instant 40-48
import brew 25-110
brew iced 70mg
java water 88mg
krank 20 72mg
water joe 45mg
aqua java 35-42mg
CHOCOLATE
choc milk 5mg
milk choc 6mg
cocoa 3-32mg
dry unsweet cocao 1 TBS 12mg
dark chock 5-35
bakers choc 25
baking unsweet 35-58
Green & Blck espresso choc (100gms) 183
G&B 70% (100gms) dark 158mg
SOFT DRINK CAFFEINE CONTENT
(12 oz cans)
Barq's rootbeer 23mg
RC cola 18mg
Diet pepsi 36mg
Pepsi cola 38mg
Dr pepper 40mg
Sunkist orange 40mg
Diet coke 46mg
Coca cola 46mg
Mtn dew 54mg
Jolt cola 72mg
MISC CAFFEINE CONTAINING
Dannon coffee yog 45mg
Dristan 30
Midol 32
No-doz 100
Excedrin 65
Vivarin 200mg
COMING OFF COFFEE COMING OFF COFFEE COMING OFF COFFEE COMING OFF COFFEE COMING OFF
over 4.5 cups/day may cause CV dz, insomnia, etc
if low intake can just stop, if no withdrawal sx then no addiction
if high intake come down slowly! don't do cold turkey
may take up to 6 weeks to detox, be gentle
other addictive compounds in coffee: phenylethylamine causes withdrawal sx
side effects: headache, fatigue, what else?
SUPPORT FOR COFFEE DRINKERS AND WITHDRAWAL PERIOD
MNFM p518
support adrenal function: licorice solid extract or tea
IV magnesium for headache
hypoallergenic diet (fasting is ill advised, will increase sx)
DHEA for adrenal support, low dosage
male 15-20mg, female 5-10mg
silymarin
antioxidants
((oxyquench = his formulation, incl 80% extract of silymarin enhances ability of liver to process caffeine, make more alcohol dehydrogenase, plus has antioxidants)
B complex esp B5 (concentrated in adrenal glands) 500-1000 mgs (RDA is 2mg)
vit E w/ mixed tocopherols (for leg cramps, enhance peripheral circulation)
acupunture detox
vit B12, B complex, pantothenic acid (1CC=250mg) either orally or IM
most B complex injectables only have 2mg B5 so add more for coffee pts
magnesium & calcium (IV Mg+ for headache)
potassium
COFFEE
phenols in coffee are beneficial
some coffees have very high levels
PEA, caffeic acid, both good for you
Marz isn't mentioning it but I read that coffee intake reduces amyloid deposition
is preventative of alzheimer's
movie called "the addict" of coffee shops in Seattle
craving for sweets esp choc mbdt Mg def
coffee is addictive, diuretic
HEALTH IMPACTS OF COFFEE
osteoporosis, migraines, GERD, gastritis, agitation
arthritis/joint sx/inflam dt incr serum acidity
muscle pains, panniculofibrositis, depression
CV dz incl HTN, arrhythmias, palpitation
diuretic-->decr K & Mg
COFFEE USE IN ATHLETES
caffeine is vasodilator, increases blood flow to muscles, used by athletes
best for short term activities
can result in hypoglycemia if used for longer events
COFFEE REPLACEMENTS
Caffix
Caff-lib
Inca
Roma
Pero
Roastaroma
Chia
Posum
Tecchino
many of these are roasted barley
I can think of more: dandelion, mate, etc