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Avian Influenza (Bird Flu)
Reference: Centers for Disease Control and Prevention
Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
This fact sheet provides general information about bird flu and information about one type of bird flu, called avian influenza A (H5N1) that is infecting birds in Asia and has infected some humans. Also see the Frequently Asked Questions (FAQs) on the World Health Organization (WHO) website.
What is avian influenza (bird flu)?
Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Do bird flu viruses infect humans?
Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.
How are bird flu viruses different from human flu viruses?
There are many different subtypes of type A influenza viruses. These subtypes differ because of certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 different HA subtypes and 9 different NA subtypes of flu A viruses. Many different combinations of HA and NA proteins are possible. Each combination is a different subtype. All known subtypes of flu A viruses can be found in birds. However, when we talk about “bird flu” viruses, we are referring to influenza A subtypes chiefly found in birds. They do not usually infect humans, even though we know they can. When we talk about “human flu viruses” we are referring to those subtypes that occur widely in humans. There are only three known A subtypes of human flu viruses (H1N1, H1N2, and H3N2); it is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.
What are the symptoms of bird flu in humans?
Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of bird flu may depend on which virus caused the infection.
How does bird flu spread?
Infected birds shed flu virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions. It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and transmission has not been observed to continue beyond one person.
How is bird flu in humans treated?
Studies done in laboratories suggest that the prescription medicines approved for human flu viruses should work in preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to prove the effectiveness of these medicines.
What is the risk to humans from bird flu?
The risk from bird flu is generally low to most people because the viruses occur mainly among birds and do not usually infect humans. However, during an outbreak of bird flu among poultry (domesticated chicken, ducks, turkeys), there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with excretions from infected birds. The current outbreak of avian influenza A (H5N1) among poultry in Asia and Europe (see below) is an example of a bird flu outbreak that has caused human infections and deaths. In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry. For more information about avian influenza and food safety issues, visit the World Health Organization website. In rare instances, limited human-to-human spread of H5N1 virus has occurred, and transmission has not been observed to continue beyond one person.
What is an avian influenza A (H5N1) virus?
Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds. Like all bird flu viruses, H5N1 virus circulates among birds worldwide, is very contagious among birds, and can be deadly.
What is the H5N1 bird flu that has been reported in Asia and Europe?
Outbreaks of influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos , South Korea , Thailand , and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreak. By March 2004, the outbreak was reported to be under control. Beginning in late June 2004, however, new outbreaks of influenza H5N1 among poultry were reported by several countries in Asia (Cambodia, China [ Tibet ], Indonesia, Kazakhastan, Malaysia, Mongolia, Russia [ Siberia ], Thailand, and Vietnam). It is believed that these outbreaks are ongoing. Most recently, influenza H5N1 has been reported among poultry in Turkey and Romania. Human infections of influenza A (H5N1) have been reported in Cambodia, Indonesia, Thailand, and Vietnam.
What is the risk to humans from the H5N1 virus in Asia and Europe?
The H5N1 virus does not usually infect humans. In 1997. However, the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong, Special Administrative Region. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Recent human cases of H5N1 infection that have occurred in Cambodia, Thailand, and Vietnam have coincided with large H5N1 outbreaks in poultry. The World Health Organization (WHO) also has reported human cases in Indonesia. Most of these cases have occurred from contact with infected poultry or contaminated surfaces; however, it is thought that a few cases of human-to-human spread of H5N1 have occurred.
So far, spread of H5N1 virus from person to person has been rare and has not continued beyond one person. However, because all influenza viruses have the ability to change, scientists are concerned that the H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If the H5N1 virus were able to infect people and spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
How is infection with H5N1 virus in humans treated?
The H5N1 virus currently infecting birds in Asia that has caused human illness and death is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamavir and zanamavir, would probably work to treat flu caused by the H5N1 virus, but additional studies still need to be done to prove their effectiveness.
Is there a vaccine to protect humans from H5N1 virus?
There currently is no commercially available vaccine to protect humans against the H5N1 virus that is being seen in Asia and Europe . However, vaccine development efforts are taking place. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005, and a series of clinical trials is underway. For more information about the H5N1 vaccine development process, visit the National Institutes of Health website.
What is the risk to people in the United States from the H5N1 bird flu outbreak in Asia and Europe ?
The current risk to Americans from the H5N1 bird flu outbreak in Asia is low. The strain of H5N1 virus found in Asia and Europe has not been found in the United States . There have been no human cases of H5N1 flu in the United States . It is possible that travelers returning from affected countries in Asia could be infected if they were exposed to the virus. Since February 2004, medical and public health personnel have been watching closely to find any such cases.
What does CDC recommend regarding the H5N1 bird flu outbreak?
In February 2004, CDC provided U.S. health departments with recommendations for enhanced surveillance (“detection”) in the U.S. of avian influenza A (H5N1). Follow-up messages, distributed via the Health Alert Network, were sent to the health departments on August 12, 2004 , and February 4, 2005 ; both alerts reminded health departments about how to detect (domestic surveillance), diagnose, and prevent the spread of avian influenza A (H5N1). The alerts also recommended measures for laboratory testing for H5N1 virus. CDC currently advises that travelers to countries with known outbreaks of influenza A (H5N1) avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. CDC does not recommend any travel restrictions to affected countries at this time. For more information, visit Travelers' Health.
What is CDC doing to prepare for a possible H5N1 flu pandemic?
CDC is taking part in a number of pandemic prevention and preparedness activities, including:
Providing leadership to the National Pandemic Influenza Preparedness and Response Task Force, created in May 2005 by the Secretary of the U.S. Department of Health and Human Services. Working with the Association of Public Health Laboratories on training workshops for state laboratories on the use of special laboratory (molecular) techniques to identify H5 viruses. Working with the Council of State and Territorial Epidemiologists and others to help states with their pandemic planning efforts. Working with other agencies such as the Department of Defense and the Veterans Administration on antiviral stockpile issues. Working with the World Health Organization (WHO) and Vietnamese Ministry of Health to investigate influenza H5N1 in Vietnam and to provide help in laboratory diagnostics and training to local authorities. Performing laboratory testing of H5N1 viruses. Starting a $5.5 million initiative to improve influenza surveillance in Asia . Holding or taking part in training sessions to improve local capacities to conduct surveillance for possible human cases of H5N1 and to detect influenza A H5 viruses by using laboratory techniques. Developing and distributing reagents kits to detect the currently circulating influenza A H5N1 viruses. Working together with WHO and the National Institutes of Health (NIH) on safety testing of vaccine seed candidates and to develop additional vaccine virus seed candidates for influenza A (H5N1) and other subtypes of influenza A virus.
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Caution over HIV 'cure' claims
Caution over HIV 'cure' claims
Doctors say they want to investigate the case of a British man with HIV who apparently became clear of the virus.
Andrew Stimpson, 25, was diagnosed HIV-positive in 2002 but was found to be negative in October 2003 by Chelsea and Westminster Healthcare NHS Trust.
Mr Stimpson, from London, said he was "one of the luckiest people alive".
The trust said the tests were accurate but had been unable to confirm Scotsman Mr Stimpson's cure because he had declined to undergo further tests.
A statement from the trust said: "This is a rare and complex case. When we became aware of Mr Stimpson's HIV negative test results we offered him further tests to help us investigate and find an explanation for the different results.
I think I'm one of the luckiest people alive
Andrew Stimpson
"So far Mr Stimpson has declined this offer."
A trust spokeswoman added: "We urge him, for the sake of himself and the HIV community, to come in and get tested.
"If he doesn't feel that he can come to Chelsea and Westminster then he should please go to another HIV specialist."
'Miracle'
There have been anecdotal accounts before from Africa of people shaking off the HIV virus.
Mr Stimpson, who is originally from Largs in Ayrshire, said: "There are 34.9 million people with HIV globally and I am just one person who managed to control it, to survive from it and to get rid of it from my body.
"For me that is unbelievable - it is a miracle. I think I'm one of the luckiest people alive."
Mr Stimpson told the News of the World and Mail on Sunday that he became depressed and suicidal after being told he was HIV-positive but remained well and did not require medication.
Further tests
Some 14 months later he was offered another test by doctors, which came back negative.
He sought compensation but has apparently been told there is no case to answer because there was no fault with the testing procedure.
He has told the papers he would do anything he could to help find a cure.
Deborah Jack, chief executive of the National Aids Trust, said: "This appears to be a highly unusual case and without further tests it is impossible to draw any conclusions for people living with HIV.
"The virus is extremely complex and there are many unknowns about how it operates and how people's bodies react to it.
"Therefore, if this case were able to shed further light, it could be extremely valuable for research into treatments or a cure."
Vaccine clue
Aids expert Dr Patrick Dixon, from international Aids group Acet, said the case was "very, very unusual".
"I've come across many anecdotal reports of this kind of thing happening in Africa, some quite recently, but it's difficult to verify them," he told BBC News 24.
"You have to be rock-solid sure that both samples came from the same person, no mix-up in the laboratory, no mistakes in the testing, etc.
"This is the first well-documented case."
He said the case was important because "inside his immune system is perhaps a key that could allow us to develop some kind of vaccine".
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Food For Thought
Radio Review: Camille Guy
"In the US, the food industry spends $US34 billion on marketing processed foods"
In a previous career, I was a food writer. That is not the soft journalistic option it sounds. Parliamentary politics is for sissies compared to food politics. I once found myself on a yacht with British wine writer Oz Clarke (okay, there were some sybaritic moments in this arduous working life). When I mentioned that I wrote about food politics when permitted, Clarke intimated that writing about the food industry was tantamount to being posted to Iraq. I came to agree.
So I was intrigued to hear food politics discussed boldly when Kim Hill interviewed Marion Nestle, a professor of nutrition and food studies at New York University, one recent Saturday. Nestle made no bones about the fact that obesity in her country was a direct result of unbridled corporatism and colluding government policies. It is collateral damage from agribusiness.
Since US agriculture began producing twice as much food as the country needed, she explained, competitive food companies have had to figure out ways of persuading Americans to eat more. And profit lies in processed foods, not basic staples. That is partly because the US Government subsidises corn and soybeans, so using these ingredients in processed foods is incredibly cheap. "It costs manufacturers practically nothing to throw some com sweeteners and flavourings into water and call it a soft drink," says Nestle.
Turn a potato into a potato crisp and you have gone from something with a tiny profit margin to a problematic food-stuff that has an enormous one. In other words, processed foods are largely cheap and nasty. Yet, they dominate our supermarket shelves. We have to trudge through entire aisles of low-nutrient food products to search out the smaller stocks of basic foods.
Since losing most of my useful sight, I feel this even more keenly. What is all this junk, I grumble to myself, peering along the shelves in search of basic flour, grains, nuts and rice. Not that I can claim any virtue in having a trolley in which the most processed food is pasta. Diminished sight has rendered me virtually invulnerable to advertising and marketing. Had this not happened, I would be as easily seduced as the next supermarket shopper.
The other way food companies try to expand their market share, says Nestle, is by making low-fat, low-carb and nutriceutical or disease-prevention claims. We are confused and bamboozled. Hill protests that nutrition messages have been simple and clear, yet we still do not take the healthy option.
That is because the food industry spends $US34 billion on persuading people that they need processed foods, not basic foods, says Nestle. Not only is there no equivalent countervailing force, but try to recommend that people eat less of foods like sugar and you are threatened with lawsuits. Besides, she says, as a result of government subsidies, processed foods seem cheaper than basic foods like fruit and vegetables. That amounts to government pressure to eat more of those processed products. Usually, if I know something about a topic, I am dissatisfied with interviews. But Hill did this one brilliantly.
Over on Nine to Noon, Linda Clark interviewed another American with a different approach to the same topic. Super Size Me doco-maker Morgan Spurlock, who ate nothing but McDonald's for a month, told Clark that he did it because he had concerns about the company's marketing, product content and failure to fully disclose nutritional information. His was a wacky and provocative approach to what can otherwise bore the pants off us.
As Spurlock ate all that energy-dense food, his cholesterol and blood pressure soared, his liver became fatty, and he gained 11 kilos. He felt lethargic, headachy and depressed. His sex life fell apart. When he began having bad chest pains, the three doctors monitoring him urged him to stop the diet.
We are all affected by this global dietary madness, the manufacturing of our consent to obesity. But never fear. Later in the week, Nine to Noon drew our attention to discussion between a corporate and our own government over a remedial intervention. The proposal is that we may no longer need a doctor's prescription to purchase the dieting drug Xenical.
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Glycemic Index
Mark RevingtonNutritional experts now say that you should eat at least one food with a low glycemic index at every meal. The Gl is a scientifically proven way of measuring how carbohydrates in foods affect blood glucose levels. So, how can you use it to boost your energy and health?
No one ever made a fortune selling self-control, according to Aucklander Paul Jeffreys Which may be true, but Jeffreys did pretty well selling everything - in a former incarnation as a high-flying ad man. With success came the lifestyle: flash cars, houses, travel, stress, large lunches, a fantastic wine cellar and a stomach the size of a large hill. At the peak of his excess, he weighed a whopping 168kg.
"It's been two and a half years since I lost 64 kilograms and I've kept that weight off. I directly attribute that to GI. It's a magical way of eating." - Paul Jeffreys
Then the wake-up call. "The ultimatum was really simple - lose weight or die. There's no grey area there. The next trick was, how do I do this, because I had tried before. Then I found this book."
It was a revelation. Jeffreys says the book told him that carbohydrates weren't the enemy, that he could lose weight by eating foods with a low glycemic index, foods that his body digested slowly, that raised his blood sugar level slowly and made him feel full - foods like fruit, vegetables and wholegrain bread.
Move over Atkins. It was called The New Glucose Revolution, part of a
best-selling series co-authored by Jennie Brand-Miller, a professor of nutrition at Sydney University, that preaches the benefits of carbohydrates and a diet based on the glycemic index as a way of staying healthy, losing weight, boosting fertility and controlling diabetes.
The New Glucose Revolution - co-authored by Jennie Brand-Miller
For more information, Click Here.
Jeffreys told his story in Diary of a Fat Man, a book published last year, and a television documentary called Fat Man Slim. He revealed how he chucked in his job as boss of M&C Saatchi, sold his house and cellar of fine French wines to fund a year of dieting and exercise, moved his family to a bach at Muriwai Beach on the West Coast near Auckland, and lost 64kg in a year.
Three years later and he's still a relatively svelte figure, almost half the man he used to be, and a knowledgeable, confident speaker who travels the country telling his story and preaching the benefits of the glycemic index, or GI as it's often referred to.
"What GI did was give me absolute knowledge of what to do and how to eat and why. For me, when I was 168 kilos, it was like a light-bulb going on in my head. I thought, 'Right, I now get it. I can do this', and what it does is give you the belief you can do it, which is crucial. Unless you believe you can do it, you will last about a week. What The New Glucose Revolution shows you is, if I eat like this, which is not that hard, I can lose that weight. Hey, that's something I can actually do. I don't mean to sound like a zealot, but I've never found anything so powerful in my whole life in terms of managing weight. It's amazing."
IMPROVING FERTILITY: "About 20 percent of women have multiple cysts on their ovaries - most never have any problems. But for some women, PCOS (polycystic ovarian syndrome) can cause fertility problems. In most women, PCOS is caused by high blood levels of the hormone insulin, due to insulin resistance. It's now known that more than half the population is insulin resistant - men and women. The condition can vary from only mildly abnormal blood tests to severe diabetes. By using the GI, women with PCOS can improve their insulin sensitivity - and greatly reduce the chances of pregnancy loss."
Every diet story needs an aspirational figure. How about a celebrity speaker to preach the benefits of weight loss? Of course, Jeffreys is your man. Sixty-four kilograms? There are adults who weigh less than that. Jeffreys, who is signed up with Celebrity Speakers and had just returned from delivering a speech in Christchurch when the listener caught up with him, cannot help but mention CA when he tells his story. He reckons it is the story.
"hi all my talks. I talk about GI and all the questions afterwards are about GI. Lots of people come up and say they have read the book. My whole message is about GI. it's not about me. It's about how I was able to change my life through this eating regime, and I really am a staunch advocate of the programme, in much the same way as the opposite is the case for the Atkins diet, which I call a stunt diet. How can you take a diet seriously when the originator died morbidly obese?"
Good question. The rapid weight loss possible on an Atkins diet has ensured its popularity in the battle of the bulge. Look at the New Zealand bestseller lists and you will discover that two Atkins books featured in the top 10 non-fiction titles for 2003.
That may be about to change. Carbohydrates are coming back into their own. In New Zealand, publishers Hodder Moa Beckett say that sales of The New Glucose Revolution series were initially slow, but have really taken off this year.
The glycemic index has been around since 1981, when David Jenkins and Tom Wolever at Canada's University of Toronto conceived a way of measuring the glycemic potential of carbohydrates, or how quickly the body converts 50g of carbohydrate to blood glucose, as a tool to manage diabetes.
Foods with a high glycemic index include potatoes, white bread and white rice. They break down quickly and release high levels of glucose into the bloodstream very quickly after a meal. Low GI foods include rolled oats, pasta, most fruits and legumes.
Until then, conventional belief had held that simple sugars were quickly digested with a corresponding increase in blood glucose levels, while starches such as rice and potatoes were digested more slowly with small rises in blood glucose levels. Jenkins and Wolever also found that most sugar in foods often produced lower blood glucose responses than starchy foods did.
Critics take issue with the complexity of a GI diet and say that it isn't a recipe for a healthy lifestyle on its own. They note that the GI of foods like rice, potatoes and bananas can change with the variety, cooking and processing, and that it is also affected by the mix of foods in any meal.
However, it does seem more like a common-sense philosophy than a fad diet. You can get caught up in the numbers, but the basic principles are to eat sparingly of starchy foods like white bread and potatoes and to eat a lot more unrefined foods that are high in fibre, like vegetables, fruit and grains.
"I'm glad you say that [about common sense]," says Brand-Miller, on the line from Sydney, "because I think it's just logical. Long before anyone used the term 'glycemic index', people said slowly digested and absorbed foods were good for you. But they made the erroneous assumption that all forms of starch would be slowly digested and absorbed and they assumed that sugars would be quick. While that's wrong, the principle of aiming for slowly digested and absorbed food is a good one.
"Basically, the point is that GI is not just about glycemic response. It's about a lot of things that happen to accompany most foods that have a low glycemic index. They are generally less processed and generally closer in their packaging to nature's original packaging. Good examples are things like the legumes, which have lots of fibre."
It's not about completely overhauling your diet to include all low GI foods and no high GI foods, says Brand-Miller. Try eating just one low GI food at every meal.
The Low GI Diet Cookbook - co-authored by Jennie Brand-Miller
For more information, Click Here.
"When we use that approach in our research, we've shown that level of modification brings about clinical improvements like in blood glucose control for people with diabetes, or in terms of weight loss. We've produced faster rates of weight loss, although that hasn't been published yet.
"But you get a clinical improvement, you get hard outcomes. So, it's not about dumping all the high GI carbs. It's about balancing them better. It's about moderation. Take the saturated fat story - you don't have to avoid it all together, in fact it's almost impossible to avoid saturated fat, but just improving the ratio of saturated to unsaturated gives you better cardiovascular protection. It's about moderation, sensible messages."
That may come as a relief to nutritionist Sarah Ley, who is sceptical of anything heralded as the latest and greatest development in weight loss. There's always a new diet book, she says. A new fad, often simplistic, appeals to anyone looking for a quick fix.
"Food is far more complex than that," says Ley, who runs a programme called HUGS, aimed at developing sensible eating patterns.
"I see a lot of people counting calories and grams of fat or points or whatever, and they don't enjoy eating any more. They're often on a yo-yo diet and that's a problem for a lot of people. I encourage people to enjoy food, to understand what is happening to their bodies. The idea that a particular food is banned only tends to make people want it more.
"It's more about what's triggering people to eat and the psychological issues around eating. People who have tried diets know all the healthy foods, but if they've tried lots of diets and they haven't worked, they tend to feel dreadful about themselves."
One attraction of the "Glucose Revolution" for Jeffreys was its longevity. "It's been two and a half years since I lost 64 kilograms and I've kept that weight off. I directly attribute that to GI. It's a magical way of eating." A normal day for Jeffreys starts with porridge, followed by an apple or a banana a couple of hours later. "Then at lunchtime I might have a small bowl of spaghetti with some olive oil and a very small sprinkling of parmesan to give it some flavour. In the afternoon, I would probably have a low-fat muffin, which is a recipe I got from the GI book. Then a couple of hours later, I would probably have a pita bread with some tuna, and in the evening I would probably have a piece of meat with a pile of vegetables.
"I try to eat seven times a day. The reason you do that is that you treat your body like a furnace and you feed it small, regular meals. You get a sustained release of energy that keeps you going all day. This means that the '4.30 in the afternoon moment' that people have when they need something sweet because their sugar levels are low, I never have that."
Yes, he does sound like a zealot. Others aren't so sure of the efficacy of a GI diet. Scientists at the New Zealand Institute for Crop and Food Research are working on a measure called the glycemic load or GL, which takes serving sizes into account and is, they say, far more accurate for anyone wanting to lose weight. Just the glycemic index by itself can be mislead ing as a tool for losing weight, says Dr Alison Wallace, of Nutrition and Health for Crop and Food, because it doesn't take into account how many carbohydrates someone may eat in a sitting.
"The glycemic index is just a ratio based on 50 grams of available carbo-hydrate. If you test six or 10 slices of bread, the GI stays the same, but your blood glucose levels are affected by how much carbohydrate you consume. Most people assume that a low GI means that they can eat a product safely, but they're not taking into account the amount of carbohydrate. The glycemic load takes that into account."
She also stresses that GL is just one factor in healthy eating. Others include the amount of energy the food provides, the amount and type of fat, the nutrients provided and the salt content.
Brand-Miller bristles at the mention of the Crop and Food research, although she and her colleagues have calculated the glycemic load of 750 foods for which they had already calculated the glycemic index.
However, she believes that there can be too much emphasis on the GI of foods and portion sizes. "You will basically have a message that carbohydrates are bad and in fact they are not."
Which is where Atkins comes in. The Atkins diet has always been controversial, but what couldn't be denied was that dieters who cut out all carbohydrates lost weight faster than they did on any other diet apart from fasting. Nutritionists worried about the possible long-term effects.
Author and professor Jennie Brand-Miller: "Cutting out all carbohydrates is not a long-term option."
Brand-Miller believes that Atkins was partly right. "But his solution was the wrong one. He realised well before anyone else that high insulin levels made weight loss exceptionally hard and his solution to bringing downinsulin levels was to cut out carbohydrates altogether.
"I think if Atkins knew what we know now, then he wouldn't have said, ditch all the carbohydrates, he would have said, aim for low glycemic carbohydrates. And he began to talk about the glycemic index quite a lot in his later books. As he learnt more, he allowed people to eat more and more carbohydrates.
"There is no point in losing weight if three months later you are back to where you were, with interest. And the science says that people lose weight faster on an Atkins diet, but end up putting it back on. Cutting out all carbohydrates is not a long-term option."
But don't all diet books promise a healthy eating lifestyle with astonishing changes in body shape? Atkins promised rapid weight loss and a corresponding feeling of well being. The Low Starch Diet, which takes aim at high-carb diets, has surged up the bestseller list. Then there's The South Beach Diet, The Zone and Good Carbs, Bad Carbs, which all agree that carbs are a good thing.
"There are lots of sensible nutrition books out there, but they don't sell," says Brand-Miller. "I feel that by selling the low glycemic index package, we are promoting a whole package that is much healthier than your average fast diet. I call it the healthy low GI diet, because you could design a low GI diet that was full of sugar. You have to be sensible about it and that's what we try to do with our books so they promote a healthy message about food in general. Basically, you need to adopt a philosophy for life that is liveable and flexible."
As for Jeffreys, his weight loss was a fairly extreme case. But he's happy and slim. So, how's his wine cellar?
"Unfortunately, I'm not in the same income bracket as I was all those years ago, but I'm twice as happy. So, the downside is that my material status is at an all-time low, but my state of mind is at an all-time high. It's fantastic. I wake up every day and look in the mirror and think, 'You're the luckiest guy on the planet, because you got a second chance to have a life.'"
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Oestrogen Dominance
In women it is important that the balance between oestrogen and progesterone is maintained. An imbalance may cause a host of symptoms and disease. Excess oestrogen called oestrogen dominance is associated with increased risk of breast cancer, fibroids, ovarian cysts, endometriosis and PMS. Early warning symptoms of oestrogen dominance include PMS, depression, loss of sex drive, sweet cravings, heavy periods, weight gain, breast swelling and water retention.10
Oestrogen dominance can be brought on by exposure to oestrogenic substances, or a lack of progesterone; or a combination of both. Today we find more oestrogen dominance together with the related symptoms because oestrogenic compounds are found in meat and dairy products as the animals are hormone fed; in many pesticides and the breakdown of such products such as DDT and Vincloxaline; and in soft plastics where the oestrogen leeches into food when it is used for packaging. Hormones are readily dispensed as oestrogen is found in most birth control pills and hormone replacement therapy (HRT).10
Progesterone is produced in the sac that contains the ovum and is secreted once the ovum is released. Should a woman not ovulate, no progesterone will be produced. If no progesterone is produced there will be an oestrogen dominance. Stress produces cortisol from the Adrenal glands which competes with progesterone and more and more women are found to be “stressed out” trying to cope with work and financial pressures as well as running a family.
Symptoms such as depression, tension, headaches, breast tenderness, water retention, bloating, low energy and irritability occuring pre-menstrually were thought to be the result of hormonal changes. Yet research done at the Institute for Optimal Nutrition in the UK found that following a strict o-sugar, no-stimulant diet, while eating complex carbohydrates or fruit, little and often, can relieve symptoms of PMS altogether. In another group a supplemental program of Vitamin B6, zinc, magnesium and GLA’s (gamma linolenic Acid) had a substantial improvement of 55-85%.10
“Doctors have now invented a scenario in which the menopause is an illness and woman are naturally “missing” a vital hormone at a certain age. The widely viewed opinion is that women weren’t meant to live past about 45, our bodies begin sputtering then because they are in effect, past their sell-by date. They obviously never walked in 17th century graveyards to see that if people survived infectious diseases, they had a good chance of living out their three score years and ten.”9
What Doctors Don’t Tell You: The Truth About the Dangers of Modern Medicine
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Menopause results from a falling off in the production of the female hormones, oestrogens and progestogens. As these hormones diminish, the body will eventually adjust to the lower level. Many women experience some symptoms of menopause such as hot flushes; night sweats; tiredness, headaches, irritability, depression, joint pains, vaginal dryness; cervical, vaginal and uterine atrophy; and lack of libido. These symptoms may occur for a few months, up to 18 months.
An increased need for replacement therapy may arise as a result of oestrogen-sensitive cells in the body, continually being blasted with high doses of hormones such as the early use of oestrogens to control PMT; or, as included in the Pill; or, in Hormone Replacement Therapy (HRT); or, intake of oestrogenic substances. Once affected these cells may lose the ability to respond.
HRT employs artificial or “natural” oestrogens and progestogen to trick the body into thinking it is still pre-menopausal, in order to postpone, reduce or eliminate the symptoms of the change. These days HRT is marketed as having a complement of added benefits to treating menopause and future diseases such as heart disease, osteoporosis, stroke and senile dementia.
“The latest study of HRT and osteoporosis shows that women taking the drug for 10 years are not protected any more than those not taking any drugs, as soon as women stop the drug, even after a decade of use, bone mineral density catches up in its rapid decline, so that by age 75 it is virtually the same as it is in women who have never taken the drug. One large scale review of 31 studies on osteoporosis concluded that oestrogen didn’t have a significant benefit in slowing the onset of osteoporosis. Another found it didn’t strengthen bones in women even when they had used it for 16 years. As regards heart disease, data on mortality from coronary heart disease shows that there is no acceleration in coronary heart disease in women after the age of 50. It has also been found that women with heart disease didn’t have lower levels of oestrogen than those with healthy hearts.”9
Without all these claimed benefits, all HRT offers is a list of potentially fatal side-effects. Women taking HRT orally may experience a number of gastro-intestinal symptoms such as nausea, vomiting, abdominal cramps, bloating – and may even develop jaundice. HRT is associated with the added risk of breast and endometrial cancer.
Many nutritional doctors, including those with great experience in treating women during the menopause, argue that the kind of menopause you experience, like your degree of morning sickness or PMT, simply reflects your nutritional state. They believe that a difficult menopause is a “deficiency disease” but not of oestrogen. The root of the problem is deficiency in one of a number of vital micronutrients, food intolerance, or inefficient function of certain organs.9
According to Dr Ellen Grant, author of Sexual Chemistry: “Hot flushes are not a sign of oestrogen deficiency .. but a result of allergic reaction. Flushes are similar to headaches, migraine and rises in blood-pressure.” John Mansfield, a British allergy specialist concurs that many menopausal symptoms are related to food sensitivity: “Once we put women on an elimination diet, the severe symptoms stop. In some cases, we find that women have a candida albicans overgrowth.” Patrick Kingsley another nutritional specialist finds that a wholefood diet and supplement programme helps relieve many menopausal symptoms.
Dr Grant suggests avoiding calcium mega doses as they interfere with the absorption of zinc and iron, and that menopausal women take 500mg of Magnesium, 30mg of Zinc, 3mg of Boron, which help the body make its own oestrogen; and at least 10mg of mangnese and 1mg of vitamin C daily. If accelerated bone formation is desired you also need Vitamin K, Vitamin D, Folic Acid, 50-100mg of B6, essential fatty acids and “first class proteins”. Dr Kingsely says the idea that women get old and haggard after the menopause is “absolute rubbish”. Although there is slightly more oestrogen diminuation after menopause, the body is still producing it from the Adrenal glands.
Rhubarb and hops both contain oestrogen-like hormones, known as phytoestrols, which have been shown to relieve menopausal symptoms. Soya beans and soya products – such as tofu and miso are also a good source of oestrogen. Other sources of phytoestrols include anise, celery, fennel, ginseng, alfalfa, red clover and liquorice.
A reason why the West may be plagued with Osteoporosis is our tendency to eat excessive amounts of protein. As calcium is needed to metabolize protein; a high-protein diet means calcium is constantly leeched from bones.
From the point of view of Traditional Chinese Medicine, oestrogen and progesterone imbalances and their associated symptoms as well as the side-effects of HRT (such as depression, irritability, mood swings, sleep disorders, metabolic disorders, digestive problems, darkened facial pigmentation, breast pain, lumps, sexual dysfunctions, cervical or vaginal problems, candida, and osteoporosis) all reflect an imbalance in the wood element. Interestingly all the mentioned symptoms occur along the meridian pathways of the wood organs of the gallbladder and liver.
The wood element is responsible for nutrition of the body, mind and spirit from an energetic intake provided by food, water, sunshine, air, and positive thoughts. Thus, if there is an imbalance along one of the wood element meridians, it can be said that there is an imbalance in energetic and nutritional intake. Therefore TCM can be said to be in agreement with the previous statements made about oestrogen and progesterone imbalances being due to an imbalance in nutritional intake brought about by lack of adequate nutrition; nutrition being tainted with artificial hormones either directly in the food or from leeching of oestrogens from packaging; and artificial additives which cause allergic reactions in the body. It is therefore recommended to address these imbalances when treating the symptoms of hormone imbalances.
References:
4. International School of Reflexology & Meridian Therapy
Study Notes 2003
9. What Doctors Don’t Tell You by Lynne McTaggart
ISBN 0-7225-3024-2, pages 161-182
10. The Optimum Nutrition Bible by Patrick Holford
ISBN0-7499-1855-1 pages 215 – 219
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Oestrogen Dominance Symptoms
from Dr Lee 's book "What your doctor may not tell you about menopause "
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