by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Chiropractic, Integrative Functional Wellness, Integrative Medicine
A Natural Cholesterol-Lowering Supplement Red Yeast Rice Poses Same Health Risks As Statin Drugs
a new study contends.
Red yeast rice could increase risk of muscle injury or liver damage, Italian researchers reported after reviewing 13 years of patient data.
“These findings raise the hypothesis that the safety profile of red yeast rice is highly similar to that of synthetic statins and warrants further investigations to finally characterize the safety profile of red yeast rice,” the researchers concluded.
American heart experts said it’s not surprising that the researchers discovered adverse reactions to red yeast rice that are similar to those produced by statins.
That’s because one of the compounds in red yeast rice — monacolin K — has the same chemical structure as the statin drug lovastatin, said Dr. Paul Thompson.
“Statins actually exist in nature, in fungi and molds and stuff like that,” said Thompson, an American College of Cardiology fellow. “Patients need to know there is lovastatin in this product.” (Brand names for lovastatin are Mevacor and Altoprev.)
However, the new report only details 55 reports of adverse reactions during the entire study period. To Thompson, this indicates they are “a very rare problem.”
“It’s a tempest in a teapot,” Thompson said of the new study.
Red Yeast Rice Is Concocted From Yeast Grown On Rice
U.S. sales of red yeast rice dietary supplements totaled about $20 million a year in both 2008 and 2009, the most recent years for which data are available, according to the U.S. National Center for Complementary and Integrative Health (NCCIH).
The U.S. Food and Drug Administration views red yeast rice products containing more than trace amounts of monacolin K as unapproved new drugs, since they are chemically identical to lovastatin, and cannot be sold legally as dietary supplements.
But dozens of red yeast rice products remain on the market. And products tested as recently as 2011 have been found to contain monacolin K in substantial amounts, the NCCIH says.
For the new study, the Italian researchers reviewed government data collected on natural health products between April 2002 and September 2015.
Reports of muscle pain came from 19 patients, including some who experienced an increase in levels of creatine phosphokinase, an enzyme released when muscle tissue is damaged, the researchers said.
Thirteen of 14 “serious” cases required hospitalization. Ten patients suffered liver damage, the researchers found.
In addition, 12 patients reported gastrointestinal reactions that included upset stomach, nausea, vomiting and diarrhea.
The researchers noted that muscle pain and liver damage are common side effects of statins, which countless people take to lower their cholesterol and their risk of heart attack and stroke.
Study Doesn’t Directly Tie Red Yeast Rice To Any Of These Health Problems
“There’s no way to be absolutely guaranteed certain that most of these cases were related to the red yeast rice,” he said. Thompson is chief of cardiology at Hartford Hospital in Connecticut.
Patients with high cholesterol often buy red yeast rice over the counter when they’re concerned about the side effects of prescription statins, said Dr. Robert Eckel, a spokesman for the American Heart Association.
“You have to let them know that, well, you’re actually taking a statin,” said Eckel, who’s also a professor at the University of Colorado School of Medicine.
The Council for Responsible Nutrition, a supplement manufacturer trade group, recommends that people talk with their doctor before taking red yeast rice to lower cholesterol.
“For the small percentage of people who may have an adverse response to red yeast rice, a doctor can help to determine whether it can be tolerated, and if not, to seek other alternatives,” said Duffy MacKay. He’s the council’s senior vice president of scientific and regulatory affairs.
Some clinical trials have shown that people with a history of statin intolerance seem to tolerate red yeast rice, Eckel said.
Thompson said he prescribes a fair amount of red yeast rice in his clinic as a way to ease reluctant patients into statin treatment.
But because it’s a supplement, the amount of active ingredient in red yeast rice can vary widely from brand to brand and even batch to batch, Thompson and Eckel said.
“The products are not as well-controlled and the dosages are variable,” Eckel said.
Red yeast rice also can prove expensive if taken regularly, because it isn’t covered by insurance, Thompson said.
“My advice is people should take regular statins, even if they have to take it at very low doses,” Thompson said.
The new study appears in the British Journal of Clinical Pharmacology.
SOURCES: Paul D. Thompson, M.D., chief, cardiology, Hartford Hospital, Hartford, Conn., and fellow, American College of Cardiology; Robert Eckel, M.D., professor, University of Colorado School of Medicine, and spokesman, American Heart Association; Duffy MacKay, senior vice president, scientific and regulatory affairs, Council for Responsible Nutrition; Jan. 19, 2017, British Journal of Clinical Pharmacology, online
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Health, Integrative Functional Wellness, Integrative Medicine, Nutrition, Wellness
Let’s face it, sometimes there’s nothing better at the end of a long day than a glass of wine. But sipping much more than that can wreak havoc with your shape, and not just by adding hundreds of calories to your diet. Alcohol temporarily keeps your body from burning fat, explains integrative medicine specialist Pamela M. Peeke, MD, author of The Hunger Fix. The reason is that your body can’t store calories from alcohol for later, the way it does with food calories. So when you drink, your metabolic system must stop what it’s doing (like, say, burning off calories from your last meal) to get rid of the booze.
“Drinking presses ‘pause’ on your metabolism, shoves away the other calories, and says, ‘Break me down first!'” Dr. Peeke explains. The result is that whatever you recently ate gets stored as fat.
What’s worse: “Research has uncovered that alcohol especially decreases fat burn in the belly,” Dr. Peeke adds. “That’s why you never hear about ‘beer hips,’ you hear about a ‘beer belly.'”
So can a girl ever enjoy a drink without putting on pounds? Absolutely, if you imbibe the right way. In fact, large, long-term studies published in the Archives of Internal Medicine and International Journal of Obesity found that middle-aged and older women who drank moderately (about one drink a day) gained less weight over time than those who never imbibed at all; they were also less likely to become obese.
It’s a complex topic, but JoAnn Manson, MD, professor of medicine at Harvard Medical School and co-author of the studies, says that the moderate drinkers appeared to be more likely to compensate for the occasional drinks by taking in fewer calories from other sources and also tended to be a little more physically active. (In other words, they didn’t get blitzed on margaritas, then dive in to a bowl of fried ice cream.) What else beyond basic exercise and calorie-counting can keep happy hour from turning into hefty hour? Health dug into the research and grilled the experts on how you can have your sips and jeans that still zip.
Rule #1: Always eat when you drink
While the Harvard research suggests it’s wise to factor in those cocktail calories, it’s actually more important to eat right than to eat less, the experts stress. Skimping on food in order to “make room” for drinks will only backfire and send you straight to the bottom of the candied nut bowl. Here’s why: Most cocktails are loaded with simple carbohydrates, “so during a night of drinking, people end up with soaring blood sugar, followed by a ‘crash’ that leaves them ravenous,” says Jason Burke, MD, an anesthesiologist and hangover researcher who runs a hangover treatment clinic in (where else?) Las Vegas.
You can help counteract that effect by nibbling foods that provide long-lasting energy. “Before you go out, have dinner or a snack with protein, fiber, and healthy fat,” says Karlene Karst, RD, author of The Full-Fat Solution. “They stabilize your blood-sugar levels without slowing down your metabolism.” Karst recommends Greek yogurt with berries, almond or hemp butter with an apple, or a protein shake. An added benefit of grabbing a bite beforehand, she says, is that that Pinot or appletini will be absorbed more slowly into the bloodstream, minimizing its diet-damaging effects.
In addition to revving your appetite, tippling also makes you lose your eating inhibitions (“I only live once�I’ll have the steak frites!”). “It temporarily impairs the prefrontal cortex, the smarty-pants part of the brain that allows you to think clearly and rein in impulsivity,” Dr. Peeke says. “So after a certain amount of alcohol (and it’s different for everyone), you’re going to feel yourself not caring and letting it rip with food and probably drinks.” A cocktail (or three) can make you forgetful, too�as in, forgetting that the Death by Chocolate dessert is not on your eating plan.
The trick is to have an easy-to-follow strategy in place before you take that first sip. Scout out the bar or restaurant menu ahead of time and note your picks on your phone. Then set an alert to remind you to order wisely�that way you won’t have to think too much (or rely on that alcohol-impaired prefrontal cortex!) to stay on track.
As with your pre-partying meal, go for something with fiber, protein, and a little bit of healthy fat to help control blood-sugar levels and make you feel satisfied, Karst says.
Rule #2: Know that some drinks make you hungrier than others
When it comes to waist-friendly cocktails, the simpler the drink, the better. Not only do the sweet-and-fancy ones tend to have more calories, but the additional sugar can make you even hungrier: Your blood sugar skyrockets higher than it does on beer, wine, or a shot of something, making the plummet (and the resulting cravings) worse.
And then there are the calories! Booze has 7 calories per gram, making it the second-most calorie-dense macronutrient. (That’s just below pure fat, which has 9 calories per gram.) This means a measly 1.5-ounce jigger of vodka has almost 100 calories. Mix that up with some club soda and lime, and it’s a reasonable tipple, but when you start tossing together a whole bunch of different liquors�whether it’s a hipster fizz made with bourbon, elderflower liqueur, and house-made bitters, or a dive-bar Long Island iced tea loaded with vodka, rum, tequila, and gin�it really adds up (to the tune of 300 calories, in the case of a Long Island).
Even simple mixed drinks like rum-and-Cokes and screwdrivers pack extra calories because of the sugary soda and juice. “So if you’re going to drink, have something straight up and simple like wine or beer,” Dr. Peeke advises. Any wine or beer works, but to trim about 10 calories per glass, choose a ros� or white wine instead of a heavier red. A whole pint of a dark beer is around only 170 calories (compared with 195 for the same amount of regular beer) and may leave you feeling fuller than, say, Champagne, because it’s so starchy and rich, Karst notes. Vodka, gin, or bourbon with club soda and a twist are pretty good bets, too. Club soda is calorie- and sugar-free and dilutes the alcohol and its effect on your cravings. Avoid juices, liqueurs (which are sweet and syrupy), colas, tonics, and super-sugary bottled mixes like the ones for a lot of bar-made margaritas and daiquiris.
Rule #3: Stick to a drink or two, tops
One drink a day is the widely accepted definition of moderate drinking for women, but there’s a misconception among some bar-hoppers that you can go without alcohol all week and save your seven drinks for the weekend. “That’s the worst thing you can possibly do for your weight,” Dr. Peeke says. (And, of course, for your health.) “It has a much bigger effect than one drink a day.”
When you down three or four drinks in one night, your body has many hundreds of alcohol calories to process before it can continue to break down food calories or stored fat. Plus, all those drinks throw your blood sugar even more out of whack so you’re hungry as heck�and because you’re tipsy, your prefrontal cortex is misfiring and you now have zero compunction about ordering the fried mozzarella sticks with a side of ranch (and keeping them all for yourself). The extra calories alone are enough to pile on the pounds; have four drinks every Saturday night and you’ll be up about 10 pounds in a year.
Rule #4: Beware that gnawing, starving feeling the next day
The morning after poses a new diet challenge. As if a hangover weren’t punishment enough, you’re fighting cravings for large amounts of cheesy, greasy fast food. Part of the problem is that you’re dehydrated (don’t forget, alcohol is a diuretic), and that can make you feel even hungrier, Karst notes. But that’s not the only thing at play. “The body needs energy to resolve the effects of a big night of drinking, so it wants the richest source of energy it can find, which is fat,” Dr. Burke says. “Also, greasy foods tend to settle the stomach a bit.”
To avoid that: When you’re out, drink a big glass of water for every drink you have. Then, before going to bed, have some more, along with a snack that is high in fiber and protein such as high-fiber cereal or oatmeal, Dr. Burke suggests. “You’ll get important nutrients into the body that were lost during alcohol consumption,” he adds. “Plus, foods rich in fiber stay in the stomach longer, so you’ll be less prone to hunger in the morning.” With any luck, you’ll also be less likely to overdo it in the a.m., ensuring your figure won’t have to pay the price for a night out.
by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Chiropractic, Integrative Functional Wellness, Integrative Medicine
Lt. Col. Scott Griffith, MD, and Army�s pain management consultant, quoted in a recent interview, �Chronic pain can be very challenging so we focus a lot on their functionality, being able to restore their function as well as bringing their pain down to the extent that we can. Even for people who cannot have their pain eliminated, many of them can have an improvement in the quality of their life.�
For military healthcare providers, managing acute and chronic pain has become a tremendous problem than ever before. In a June 2014 report in JAMA Internal Medicine, of 2,597 evaluated individuals, researchers found that 44 percent of troops experienced chronic pain symptoms after being deployed for combat while 15.1% of those individuals reported regularly using opioids. Furthermore, Veterans Affairs administrators gave a testimony before a Congress hearing that chronic pain was among the most common medical complication in veterans returning from the last decade of conflict. The frequent cause for chronic pain is due to musculoskeletal injury, which is usually unrelated to battlefield wounds. Causes for musculoskeletal injury include training and job performance with the use of increasingly heavy protective equipment as well as sports and recreation.
The challenge for federal medicine providers still lies on relieving chronic pain symptoms among active duty military members and veterans while also decreasing the chance of opioid addiction and abuse among individuals. In 2003, the Defense & Veterans Center for Integrative Pain Management (DVCIPM) was established to support and regulate pain research and education as well as improving pain management methods. Six years later, the Army surgeon general organized a pain task force membership that included representatives from military services, TRICARE and VHA, to give guidance and approval for a comprehensive pain management strategy. That same task force distributed a report in May 2010 recommending the military to use a holistic, multimodal and multidisciplinary approach to pain management, including complementary and alternative medicine.
Through the project, the VA will analyze the extent and cost-effectiveness of complementary and alternative medicine utilization among veterans being treated at the Veterans Affairs Medical Clinics for musculoskeletal disorder-related pain and other related conditions. On a wider spectrum, changes in drug development are giving clinicians other means to helping active-duty service members and veterans as well as others avoid opioid addiction.
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
Both acute and chronic pain relating to trauma from an injury, have constantly been a common complication among troops. Fortunately, in recent years, efforts by the United States Department of Defense and Veterans Affairs officials to solve the issue of pain among active duty service members and veterans have started offering a larger variety of non-drug alternative methods. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.�
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