Samme Sez

Mediterranean Diet to Prevent Alzheimer’s Disease?

Dear Samme: I’m a 55-year old retired surfer who has tried every diet fad out there from Atkins to Zen-Vegan. In order to keep up with the waves I need a healthful plan, but I can’t tell if I should go high-carb, low-carb, or no-carb.

Then yesterday my yoga instructor told me I should go "Mediterranean," that it might even prevent Alzheimer’s Disease. Sounds like it’s a bunch of fruits and vegetables – but she called them "legumes." I don’t even remember what a legume is… is my brain slipping already? My dad had Alzheimer’s and I’ll do anything to keep from getting it myself. Is this new diet legit or what?
Legumed in Laguna

Dear Legumed: Diets can be tricky and everyone is pitching a gimmick. Can you believe someone once tried to make me swallow my food whole? Have no fear – stick with me and you’ll be hanging ten for years to come.

First, let’s clear up the legumes. A legume is a pod-type fruit – like soy and vanilla bean – but for some reason now it means vegetable (Samme still shakes a tail at that one). The Mediterranean diet contains many legumes (vegetables) as well as fruits, nuts, and whole-grain cereal. It allows for moderate wine consumption – which Samme loves – uses plenty of olive oil, lots of fish, and low amount of red meat and poultry. For decades people in and around the Mediterranean said it worked, and recently scientific evidence proves it.

In 2008, Francesco Sofi, MD and Francesca Cesari, MD published a study in the British Medical Journal that clearly demonstrated the benefits of the Mediterranean diet. They examined over 500,000 patients and found that greater adherence to the Mediterranean diet was associated with a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), and incidence of mortality from cancer (6%). Sounds like a good start.

The study also hinted at protective effects against Alzheimer’s Disease -- an idea that was re-tested in this month’s Journal of the American Medical Association. This separate study found that people who had high adherence to the Mediterranean diet had higher Mini-Mental State Examination (MMSE) scores at the end of the five-year follow-up period. That may not prove the diet prevents Alzheimer’s Disease, but Samme still likes the sound of it!

Samme Sez: The Mediterranean diet has been associated with a number of healthful outcomes including reduced risk of cardiovascular disease, cancer, and mortality. It may be a part of a healthful lifestyle that reduces the risk of Alzheimer’s Disease.

Soy to Prevent Breast Cancer?

Dear Samme: I am a 35-year old woman of Irish ancestry that has been going crazy for soy sauce! The reason is that my best friend, Julie, is Asian. She states it is common knowledge among the Asian population that soy in high doses prevents breast cancer. Since my mother was diagnosed with breast cancer at age 50, I know that I am at high risk for the disease and thought I should do everything I can to reduce my risk.

So, about six months ago, I started putting soy sauce on everything! I splashed it on my morning yogurt, poured it over my salads, dipped by bread in it, and used it in every recipe I cooked. I even keep a small bottle in my purse that I take to restaurants and douse my entire plate! I certainly hope I am reducing my chance of breast cancer. The main reason I am writing to you now, Samme, is that everything tastes like soy sauce. Even things that I do not put the soy on, such as my morning coffee, are beginning to taste like soy. I even had a dream last night that I was swimming in a pool full of soy sauce.

So, oh, wise Samme, I have two questions: 1) exactly how much soy sauce do I need to have to prevent breast cancer; and 2) can you confirm that Irish whiskey prevents breast cancer, too?
Soy Soused in Stanton

Dear Soused: As much as Samme loves the family dinner at the Imperial Palace, I must admit that after reading your letter I have no desire to visit a Chinese restaurant for the next six months. So, let Samme give you the skinny on soy:

It is true that in populations with high soy consumption, such as China and Japan, prostate cancer is much lower. Unfortunately, Asian immigrants to the United States have the same rates of prostate cancer as any other American. There are many factors that may account for this but it should be noted that Asian populations consume 15 times the amount of soy per day as US populations. It makes sense that researchers would study soy in preventing breast cancer, given how common the occurrence of cancer is here in the US. A recent study in the Journal of Nutritional Sciences showed that in women who consumed at least 25 grams of soy per day, their risk for breast cancer was reduced by 25%. Additionally, this same intake of soy appeared to improve bone density in post menopausal women and decrease menopausal “hot flashes.”

The trouble is getting 25 grams per day of soy protein. This would be the equivalent of 13 tablespoons per day of soy sauce. However, it sounds like you might be close to that. As an alternative, you could eat one cup per day of edamame (whole cooked soybeans). You could also eat two soy veggie burgers per day instead of the soy sauce. And, if you are a tofu fan, four thick slices will give you the 25 grams per day you need.

As for whether Irish whiskey can prevent breast cancer, I can only say, "Oh Bushmills!"

Samme Sez: Studies show that 25 grams per day of soy may reduce the risk of breast cancer as well as improve bone density in postmenopausal women and decrease "hot flashes."

Aortic Valve Replacement?

Dear Samme: I am a 52-year old business owner who enjoys biking on weekends. My favorite comedian of all-time is Robin Williams, and I had the privilege of riding with him in a charity event several years ago. I was amazed at his stamina and how fast he could cycle, so you can imagine my surprise when I heard that he had his aortic valve replaced due to shortness of breath.

Now I can’t get it out of my head that I may also need my aortic valve replaced. After all, I bike just like he did and people do say I am fairly funny. I need to find out what my aortic value looks like. Can you help me, Samme?
Nanu Nanu in Norwalk

Dear Nanu: Nanu, you must be a riot! As a matter of fact, Samme couldn’t pull himself off of the floor laughing after reading your letter. You think that because you bicycle and have a knack for humor like Robin Williams that your aortic valve is also bad? You are hilarious!! Oh, wait—I think you are serious…

Relax. The three most common causes of aortic narrowing – which is what Robin Williams had – are a history of rheumatic fever, obesity or a positive family history. No, Robin Williams had none of these risk factors. Let me guess- neither do you.

However, there is a definitive link with a condition called "aortic sclerosis," a type of calcification of the aortic valve, with drug use, specifically cocaine. Robin is certainly well-known for his cocaine-infused youth. So, unless you also have had an affinity for the white powder, I would think that your risk is very low.

To answer your question, however, an echocardiogram is the recommended test of choice for the symptoms of aortic stenosis . If the echocardiogram is normal, it is a safe bet that the aortic valve does not need to be replaced. So, you should consider having an echocardiogram if you become short of breath easily -- especially with exercise – or experience significant chest pains.

So, here is hoping you have a Good Will Hunting, your physician is Patch Adams, your girlfriend is named Mindy, and you drive a Cadillac, Man. As to whether you have aortic sclerosis--- I Doubtfire it.

Samme Sez: The test of choice to rule out aortic valve disease is an echocardiogram, which should be reserved for patients with symptoms of aortic valve disease.

Pacifiers and Ear Infections

Dear Samme: I need you to settle a bet I have with my sister. We are both in our 20s and, as a coincidence, both have 2-year old and 4-year old children. I have been careful to not give my children pacifiers; I heard a dentist on "Oprah," say they might cause the need for braces in the teens. My sister says that’s hogwash and that she is pretty sure she heard Dr. Phil say that they were safe. We have a week of babysitting riding on this one, Samme. What do you say, oh sage snake?
No Binkees on Beach Boulevard

Dear Beach Binkees: Start preparing yourself for a week away from the terrible 2s and formidable 4s. Samme says you are right and he can prove it. In a recent study of the Journal of the American Dental Association, regular use of pacifiers resulted in a higher degree of malocclusion (need for braces) after 24 months. It wasn’t just a small increase, it was a whopping 41% increase. Several review articles published at the same time confirm these results.

Both the American Academy of Family Practice and the American Academy of Pediatrics recommends reducing or stopping pacifier use after six months of age to prevent ear infections. This precaution lasts from six months to two years. However, after two years of age, the risk of mal-alignment of the teeth and cross-bite are much higher, so it appears clear that pacifiers should be weaned after six months of age. Interestingly, the same data appears to be valid for chronic thumb-sucking. And, in case you are wondering, Samme raised his little snakes pacifier-free, and we did not have to worry about thumb-sucking since – obviously—snakes don’t have them.

Samme Sez: Evidence supports weaning of pacifiers in children after six months of age to prevent ear infections as well as dental malocclusion.

Can Wine Prevent Diabetes?

Dear Samme: I am a 30-year-old Orange County housewife, married to a wonderful man. He is kind, gentle and intelligent. Years ago, when we were dating, we declined to drink alcohol, feeling that was a healthful lifestyle choice.

However, over the past year he has been having one glass of wine with dinner every night. I told him I don’t approve of this, but he states he is doing it for health reasons; in fact, he claims it will lower his chance of getting diabetes. Since both of his parents have diabetes, he believes by having his nightly glass of wine he will avoid this disease. I say he is full of hooey. Am I right?
Suspicious in San Juan

Dear Suspicious: On the one hand, Samme totally sympathizes with you. After all, who would be more suspicious than a snake? On the other hand, your husband is right on the money.

A recent study in the Journal of Diabetes Care took 109 participants and randomly assigned them in two groups of wine drinkers and non-alcoholic drinkers. The drinkers were allowed to have one glass of red or white wine. Their blood glucose levels as well as the A1c level were measured before the study and then after 12 weeks. There was a startling nearly 10% decrease in the glucose and A1c levels in the one glass of wine group. So perhaps instead of suspicious, you should sympathize with Syrah to share with your spouse in San Juan!

Samme Sez: One study shows moderate alcohol intake may directly improve fasting glucose control without increasing the risk of hypoglycemia.

Can Doctor Visits Cure Cancer?

Dear Samme: I am a 52-year-old female that has become very good friends with the women in my romance book club. My best friend in the club, Josie, revealed the shocking news that she had just been diagnosed and was undergoing treatment for breast cancer. Although she states she was caught fairly early and has been given a good prognosis, we are naturally very worried for her.

Josie shared with us that she has been seeing her oncologist regularly, but has not gone back and seen her family doctor since her diagnosis was made. I encouraged her to be seen by both her oncologist as well as her family doctor, but she seems to think that all she needs to do is to follow her oncologist’s advice. Can you help me show Josie the error of her ways?
Wanting to Keep our Book Club Intact

Dear Wanting: Josie is indeed fortunate to have you as a friend. Based on the evidence, Samme feels Josie should slither to her family doctor as soon as possible, and here is why.

A recent study was done at Johns Hopkins University in Baltimore. Surveillance and trends in nearly 24,000 survivors of stage 1 through 3 breast cancer were investigated. During the first year of survivorship, the highest rate of survival were followed by both a primary care physician and oncologist. Survivor rates were lower if they were followed by only one of the two specialists. This study was funded by the American Cancer Society so hopefully Josie will follow your advice. And by the way, should you want another member of your book club, good old Samme has been known to succumb to a romance novel from time to time.

Samme Sez: Breast cancer survivors are more likely to receive recommended care when they see both an oncologist as well as a primary care physician.

Numb Mammogram Pain?

Dear Samme: I am a 40-year-old woman who is scheduled to have her first mammogram next month, and I am scared to death! I have heard awful stories of how you are squished and smashed, and I have even heard that women are sore for many days after a mammogram. I went to a blog which recommended using a topical lidocaine to rub on the breast to reduce discomfort during the mammogram. However, I am worried if I ask my family doctor for a prescription for this he will think I am nuts. I am sure if you say it is okay I can show him this article and he will prescribe it.
Numb Nipples in Newport

Dear Numb: Please follow my instructions to the letter: Go to your computer, open that blog and delete it from your computer forever. Nothing makes Samme hiss louder than uninformed web content.

The FDA has put out an alert of significant danger associated with the use of topical anesthetics over significant parts of the body. This stems from a February 2007 FDA advisory that described two young women who died after applying a topical anesthetic to their legs after laser hair removal. The FDA had significant concern, enough to state, “We remain concerned about the potential for topical anesthetics to cause serious and life-threatening adverse effects when applied to a large area of skin or when the area is covered.” So plain and simple, don’t do it. As an alternative, Samme knows of a hen-pecked wine lover in San Juan that may be willing to share a glass of Syrah with you prior to your procedure.

Samme Sez: The use of topical lidocaine products to mitigate pain during mammograms and other tests has a potential to cause life-threatening events.

Does Mayo Clinic Support Acupuncture?

Dear Samme: I have been diagnosed with fibromyalgia and was told in a chat room that acupuncture is effective for this. Any opinion, Samme?
Achey for Needles

Dear Achey: I have good news for you. A recent blinded control study (no bias) was performed using acupuncture specifically for fibromyalgia . and this was not done just anywhere. This was at the world famous Mayo Clinic itself! Although only 60 patients participated in the study, the results were quite dramatic. In fact, the pain relief was identical to most of the medications currently used. I would say it is worth a try.

Samme Sez: A 6 session acupuncture treatment significantly improves fibromyalgia symptoms compared to placebo. However, after 7 months these effects wear off.

Preventing Diabetes in Kids

Dear Samme: I am a 12 year-old boy with a special appreciation of 4x4 animal-style burgers. Unfortunately, this may have lead to a slight problem with my weight. My science teacher told me I should ask my pediatrician about a diabetic pill to help me lose weight. I told her I was not diabetic, but she said it wouldn’t matter. Is she nuts, or what?
Plump in Placentia

Dear Plump: According to a researcher named Dr. Linda French, your science teacher is right on the money. Several recent studies showed that obese patients age 9 to 18 years old who did not meet the criteria for diabetes still had significant benefits taking a medication called Glucophage. It is an oral pill for diabetes . I would definitely contact your pediatrician. A better option might be to follow the lead of Jared and switch to the six-inch subs.

Samme Sez: for obese patients, age 9 to 18 years old, six months of Glucophage can result in an average weight loss of 10 pounds. More studies should be done to support the effectiveness and safety of this drug.

Caffeine- Filler Up!

Dear Samme: I can’t seem to drive by a coffee house without stopping to get the latest caffeine concoction. Although I have been told I am very healthy, I am concerned my coffee intake may increase my chance of heart disease. What does Samme say?
Concerned about Caffeine

Dear Concerned: Ever since I was a baby snake, I have been told to watch the caffeine intake or risk some sort of unknown heart malady. But, I must be honest, good, ole Samme has been known to enjoy a cappuccino as I slither around Orange County. Fortunately there is a recent huge study of over 120,000 patients that began in 1976 and had 20 years of follow-up with patients. It was just published in an excellent article in the Journal of Circulation. After the researchers adjusted for age, smoking, and other risk factors, no association was found between caffeine and heart disease of any type. So, enjoy your next macchiato and be sure to make a toast to Samme. Thanks a latte.

Samme Sez: There is no evidence that coffee consumption increases the development of heart disease. However, caffeine intake can worsen or cause heart conditions that have palpitations or arrhythmias.

Perk-Up and Drink Raging Bull?

Dear Samme: I am a 21-year-old law student who is part of a study group that uses Raging Bull so we can stay awake late (and party!). In case you are not hip, a Raging Bull is equal parts of the energy drink Red Bull and vodka. The idea is to decrease the effects of intoxication while providing the .perk. We want for studying. Since both of these ingredients are over-the-counter, can I assume this is a safe concoction for our needs?
Buzzed in Brea

Dear Buzzed: FYI, Samme is the hippest snake around! For example, Samme knows that this concoction is also called a V-Bomb or Friday Flattener. A recent study in the journal, Alcohol Clinics, showed that students drinking this concoction reported feeling less intoxicated than they actually were. This leads to more rapid dehydration and a potential for alcohol poisoning with repeated use. Therefore, your study group may want to do what Samme does when he needs to be awake for one of his famous all-nighters: take two ice cold glasses of Mountain Dew. First chug one down, and with the second, splash it on your face. Never failed me yet.

Samme Sez: Combining energy drinks with alcohol or prescription sedatives is shown to increase potential for dehydration, delayed reaction time, and alcohol poisoning. Energy drinks should be used in moderation and not in combination with other sources of caffeine, prescription sedatives, or alcohol.

Chocolate and Heart Health?

Dear Samme: I am a mother of 3 (not telling how old I am!) who loves her mid-day snacks. By far my favorite is chocolate, but everyone tells me it.s loaded with fat and that I shouldn’t eat it. Then, I was thrilled to hear on the news that some types are actually good for you! Is that true? Does that mean they taste bad?
Crazy for Chocolate

Dear Crazy: You are not crazy. Samme is also a huge fan of the cocoa bean. In fact, both bits of information you have are true. As you know, most chocolates come in dark, milk or white varieties. Many chocolates have a high content of calories and fat, making it a tempting but heavy snack item. Dark chocolate, however, has the majority of its fat in the form of stearic acid, a type of fat that appears to have little effect on bad cholesterol. Dark chocolate is also rich in a substance called flavenoids. Last year the Journal of Cardiovascular Pharmacology studied this type of chocolate. They found that consumption of flavanol-rich cocoa has cardiovascular benefits for postmenopausal women who already have high cholesterol. And it tastes great!

Samme Sez: Moderate consumption (1-2 pieces per day) of dark chocolate may provide cardiovascular protection and increase antioxidant activity. For best results choose brands with >60% dark chocolate and low amounts of saturated fat.