Preventative Medicine Clinic

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I just want to feel better but how?

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Have you been experiencing weight gain, mood swings, sleep disorders, low or absent sex drive, memory disorder, the feeling of being tired or sluggish?

Have you been told that you have chronic fatigue, depression, thyroid disorder or fibromyalgia?

These and a host of other very common health problems can usually be traced to underlying deficiencies or imbalances of hormones in the body. Our bodies’ hormones must be in proper balance and harmony for us to function properly and feel our best. In fact, it is the imbalance and insufficiency of these hormones that cause us to age.

That’s right, we age because our hormones decline, not vice versa.

Rebalancing our bodies’ hormones with safe and natural Bio-Identical Hormone Therapy has shown tremendous health benefits that can often correct the health problems mentioned above while allowing us to live longer, age more gracefully, and with better health. This is precisely what Complementary and Alternative Medicine (CAM) is all about. CAM treats the whole body as a system to restore balance and ideal function, and to eliminate disease at the root. This is not like the usual medical approach where a patient reports a symptom and the doctor prescribes a drug to suppress that symptom – without addressing the imbalances that are at the root of the problem. CAM has given hope, health and relief to many patients who were being
treated unsuccessfully for their symptoms.

Because Bio-Identical Hormones are exact clones of the hormones produced and metabolized within the body, the risks that are associated with “synthetic hormone treatments” are not seen. Benefits of Bio-Identical Hormones include increased sex drive, improved sleep, improved exercise tolerance, improved muscle tone and weight loss, improvement in memory, reduced risk of cancer and heart disease and more.

Bioidentical Hormone Replacement Bioidentical hormones offer a natural, effective way to supplement hormone levels and treat symptoms of hormone imbalance without the reported side effects of conventional HRT.

In Depth: Hypothyroidism
Subclinical Hypothyroidism is a state of underactive thyroid gland activity that is not detected by conventional laboratory means. Well over 65% of the cases of hypothyroidism go undetected for years until the patient is so ill with symptoms that they themselves suggest the diagnosis to the doctor. All too often, physicians miss the diagnosis of hypothyroidism despite several classic symptoms because they rely solely on a single predetermined lab value (TSH) that was established over 50 years ago! In response to this, the Endocrinology Society Association of America revised the diagnostic levels of TSH thus “allowing” for more people to meet the criteria for diagnosis of hypothyroidism. Actually, subclinical hypothyroidism can be diagnosed by an astute physician through physical examination, patient based symptomatology, and evaluation of urine temperatures. Lab values should just be used as an aid in the diagnosis rather than the key to diagnosis. There have been advances in lab evaluation utilizing saliva, which is much less expensive than blood testing, but the key factor in testing is to be sure that your doctor obtains levels of both free T3 and free T4. These measure the actual thyroid hormones rather than the messenger brain hormone (TSH) currently used as the gold standard in conventional medicine.

Treatment is directed at supplementing what is missing. Traditional physicians most often prescribe Synthroid or Levoxyl, which is strictly T4. T4 is the most abundant thyroid hormone but it is not very active. T3, which comprises less than 15% of all the thyroid hormone in the body, is the active hormone. T3 is what is responsible for preventing, treating, and reversing symptoms of hypothyroidism. I prefer to use animal-based desiccated thyroid hormone containing both T3 and T4 in a ratio that is physiologic to the body. Also available is a synthetic non-animal based combination with a similar ratio of T3/T4. Each has their role and treatment should be individualized.

Untreated hypothyroidism can significantly affect quality of life and lead to misdiagnoses since many doctors attribute the constellation of patient symptoms to Chronic Fatigue Syndrome, Fibromyalgia, Lyme disease and most unfortunately and too frequently, Depression. Don’t let yourself be a victim of this easily treatable disease. If you think you fit some of the criteria mentioned in this article, insist that the diagnosis be entertained.

For more information about hypothyroidism call us at 541-383-3424

Hot Ozone Therapy

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From pacemakers to artificial hearts and limbs to stem cells, America has found its rank in the world health league for being an innovator of medical technology. Unfortunately, the cost of these medical therapies prohibit those who would benefit most from obtaining them thus contributing to one of the several reasons our country- USA, ranks 38th in world healthcare. But what would you say to the idea of steering away from conventional medical thinking and open your eyes and minds to therapies that are considered “alternative” or “outside the box”? You know, medical modalities that offer a cure for an underlying condition rather than a Band-Aid to mask the symptoms of disease?

Specifically, I am referring to the use of oxygen to enhance the treatment and cure of nearly every medical condition known to man. Ozone is a form of Bio-Oxidative Therapy which simply means that we are introducing oxygen into the body. Of the various vehicles used to expose the body to ozone, the topical, rectal and intravenous routes are the most commonly prescribed.

 

Hot Ozone can deliver a nuclear warhead to the ailing body ridding it of nearly every toxin, inflammatory invader, autoimmune disorder or chronic condition the body may develop and do so safely at a concentration of ozone that is more than 10 times what was previously recognized as safe.  It has miraculous healing effects for ailments ranging from allergies, arthritis, cancer, Lyme disease and everything in between.

 

Are interested in investing in your health and obtaining this therapy whether it be for enhancing a weakened immune system, improving overall energy, treating an established acute or chronic medical condition or just as a prophylactic therapy to ensure health, longevity and quality of life?

Bio-Oxidative Therapy

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Currently at Preventative Medicine @ Bend we offer two Ozone therapies.

  1. MAH: MAJOR AUTO- HEMOTHERAPY This procedure involves introducing ozone into your blood by removing blood via an IV catheter in a vein connected to a sterile bag of saline containing approximately 250 cc. of sterile saline. This is a closed sterile system. Ozone is then introduced into the blood/saline mix, and then under gravity is infused back into the patient.  This prodecure takes approximately 45 minutes.  The effect last approximately 72 hours. This procedure is indicated in: infections, eg, Lyme, herpes,  fungal, viral and bacterial, and inflammation (eg. MS) This therapy is often done with UV light.  UV therapy has a 100 year history. In the early 1900 ’s a Danish physician won the NOBEL PRIZE for using UV light to treat infection.It improves the functions of our blood in pour bodies; oxygen carrying capacity, cell count, normalizing clotting, decreasing viscosity, increasing blood volume.  It inhibits Bacteria, viruses and decreases the inflammatory process.Ozone + UV may be very effective in treating infections, cancer, diabetes and circulatory disorders.
  2. HYPERBARIC BIO-OXIDATIVE THERAPY (HOT OZONE, or TEN PASS)  This is OZONE treatment under pressure. Ozone attaches to the Red Blood Cells and plasma. Current studies are underway in Europe attempting to prove the ozone instigates or stimulates the bodies to produce its own stem cells. The treatment takes approximately an hour. The effects of Hyperbaric ozone lasts approximately 7 days after treatment. There are currently less than 2 dozen physicians in the US offering this procedure. Other ozone therapies include: Sinus injections, prolozone ( ozone injected into soft tissues and/or joints) rectal, bladder, and vaginal ozone. Limb bagging is done more specifically to treat wound infections of limbs often seen in diabetes and/or MERSA.

A Brief History of Hormone Replacement Therapy

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Due to today’s longer life spans, women can expect to spend a third of their life — or more — in their postmenopausal years.

While the women of yesteryear were forced to “grin and bear it” when it came to hot flashes, night sweats, irritability, and mood swings, the arrival of hormone replacement therapy (HRT) in the 1960s liberated millions of women from “l’enfer des femmes” (a woman’s hell).

The Early Promise of Estrogen

In 1966, Robert A. Wilson, M.D.’s book, Feminine Forever, informed women that “menopause is completely preventable” and advised them to take estrogen. The promise of remaining “feminine forever” was met with enthusiasm, and synthetic estrogen became the standard therapy for women undergoing “the change.”

When it later became obvious that estrogen encourages the growth of the uterine lining, which could increase the risk of cancer, the medical community suggested progesterone to protect the uterus. But rather than combine natural, bioidentical progesterone (which is identical to the progesterone produced in the body) with estrogen, pharmaceutical companies added progestin, a synthetic form of progesterone that was patentable.

Synthetic Hormones Hit the Scene

As a result, Prempro was born. It combined synthetic progesterone (progestin) with Premarin, a drug composed of three estrogens (estrone, equilin, and equilenin) that are derived from horse urine. These horse estrogens (also called CEE) are natural but not bioidentical to those found in the human body.

While the drugs relieved menopausal symptoms for millions of women, the long-term effects were unknown. That changed in 2002  when the results of the Women’s Health Initiative (WHI) came out.

The study, which included over 16,000 postmenopausal women, found the combination of non-bioidentical estrogen and progestin to significantly increase the risk of breast cancer and heart attack.1 It also found an increased risk of stroke in non-bioidentical estrogen users.2

Here is a summary of other findings:

  • The risk of dying from breast cancer almost doubled among Prempro users in comparison to those taking a placebo.
  • Among those taking estrogen plus progestin, the death rate from breast cancer almost doubled in comparison with the placebo group.3
  • Overall, there was a 25 percent increase in the risk of invasive breast cancer in non-bioidentical HRT users.
  • The use of CEE was associated with a reduced risk of hip fractures.
  • Estrogen/progestin users had a reduced risk of hip fracture and colorectal cancer in comparison with users of a placebo.

Because of these study results, female hormone replacement therapy became a sinking ship that women began abandoning in droves. However, the WHI’s findings have recently been called into question.

Bioidentical Hormones Are a Safer Option

Bioidentical hormones, which have the same molecular structure as the hormones produced in the body, have actually been shown to have a protective effect against some diseases, including those whose risk is increased by non-bioidentical hormones.

In a study, women who used non-bioidentical estrogen and progestin had a 69% greater risk of developing invasive breast cancer over an eight-year period in comparison with non-HRT users. Those who used bioidentical estrogen and progesterone experienced a similar risk as non-HRT users.4

References:

1. JAMA. 2002 Jul 17;288(3):321-33.
2. JAMA. 2004 Apr 14;291(14):1701-12.
3. JAMA 2010; 304(15):1684–1692.
4. Breast Cancer Res Treat. 2008 Jan;107(1):103-11.

The Primary Roles Of Sex Hormones

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Your body is composed of a variety of different hormones, including growth and sex hormones, which carry messages between your organs and cells. Hormones are secreted by glands in the endocrine system to help the body stay balanced and function optimally. The main sex hormones include estrogen, progesterone, testosterone, pregnenolone, and DHEA.1Aging is associated with a loss of sex hormones in both men and women. Replacing those lost hormones can restore feelings of well-being, sex drive and sexual pleasure, energy levels, plus reverse muscle and bone loss along with other functions that are associated with aging. By doing this, we can age more slowly and have a better quality of life into old age.2-4

Estrogen

Estrogen is found in greater amounts among women. As a pro-growth hormone, its main function in the body is growth and development. This hormone stimulates fat cells to grow and is a key component in reproduction. There are three different forms of estrogen: estradiol, estrone, and estriol. Estradiol is considered the main player in physiological function. A deficiency can cause several health concerns, including decreased libido, fatigue, inflammation, hair loss, mood swings, wrinkles, brittle bones, and dry skin.5-10 Excessive amounts of estrogen can cause bloating, bleeding, breast tenderness and  mood swings.11

Progesterone

Progesterone is considered the counterpart to estrogen. It is the antagonizer to estrogen-driven growth in the lining of the uterus.12 Progesterone is essential to the premenstrual cycle. It rises during the second part of the cycle to reduce premenstrual syndrome and prepares the uterus for implantation of a fertilized egg. Additionally, progesterone is needed to support a healthy pregnancy, as low levels can result in a miscarriage.13,14 Progesterone is also neuroprotective.15 An imbalance in the ratio of estrogen to progesterone can lead to many problems with PMS symptoms like irritability, bloating, fluid retention, headaches, and fibroids.12,16,17 It works with estrogen to strengthen bones, sustain cholesterol levels, and support libido. Too much progesterone can cause fatigue, dizziness, and an increased appetite.

Testosterone

As the predominant hormone in men, testosterone helps to maintain healthy muscle mass, stamina, and strength. It also supports libido, energy, bone density, memory, and well-being.18,19 Testosterone is also necessary in proper balance for women. A deficiency of testosterone can also have negative effects on women, including low energy, decreased libido and well-being.20-22 A testosterone deficiency in men can cause fatigue, mood swings, low libido, and irritability.23-26 This hormone starts to decline in men around 35 years old, causing an imbalance between testosterone and estrogen. Too much testosterone can cause aggression, depression, impotence, and excessive libido.

Pregnenolone

Pregnenolone is produced from cholesterol and is a precursor to other steroid hormones, including progesterone, estrogen, testosterone, and DHEA. Pregnenolone levels decline with age, and a deficiency can lead to anxiety, mood imbalances, greater perceived stress, and poor cognitive function.27-30 Pregnenolone levels can be restored to benefit cognitive function, mood, memory, and cardiovascular health. By converting to DHEA, too much pregnenolone may cause acne.

DHEA

As the most abundant steroid hormone in the body, DHEA is the precursor to testosterone and estrogen. It is released in the body by the adrenal glands. As we age, DHEA levels decline leading to fatigue, mood swings, and cognitive ailments. DHEA helps to stimulate protein synthesis, decrease visceral fat, support bone health, and maintain cardiovascular health.31,32DHEA levels that are too high can cause acne, increased facial hair, skin rashes, and liver dysfunction.

References

  1. Rouzier N. How to achieve healthy aging. 2nd ed. Salt Lake City: Worldlink Medical Publishing; 2007.
  2. Hortsman AM, et al. The role of androgens and estrogens on healthy aging and longevity.J Gerontol A Biol Sci Med Sci. 2012 Nov;67(11):1140-52.
  3. Velders M, et al. How Sex Hormones Promote Skeletal Muscle Regeneration. Sports Med. 2013 Jul 26. [Epub ahead of print]
  4. Cameron DR, Braunstein GD. Androgen replacement therapy in women. Fertil Steril. 2004; Aug;82(2):273-289.
  5. Simon JA. Identifying and treating sexual dysfunction in postmenopausal women: the role of estrogen. J Womens Health (Larchmt). 2011 Oct;20(10):1453-65.
  6. Calleja-Agius J, et al. Skin connective tissue and ageing. Best Pract Res Clin ObstetGynaecol. 2013 Jul 10. pii: S1521-6934(13)00074-6.
  7. Mirmirani P. Managing hair loss in midlife women. Maturitas. 2013 Feb;74(2):119-22.
  8. Tiidus PM, et al. Estrogen Replacement and Skeletal Muscle: Mechanisms and Population Health. J Appl Physiol. 2013 Jul 18. [Epub ahead of print]
  9. Graziottin A, et al. Depression and the menopause: why antidepressants are not enough?Menopause Int. 2009 Jun;15(2):76-81.
  10. Martín-Millán M, et al. Estrogens, osteoarthritis and inflammation. Joint Bone Spine. 2013 Jul;80(4):368-73.
  11. Bitzer J. Hormone withdrawal-associated symptoms: overlooked and under-explored.Gynecol Endocrinol. 2013 Jun;29(6):530-5.
  12. Kim JJ, et al. Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer. Endocr Rev. 2013 Feb;34(1):130-62.
  13. Dodd JM, et al. The role of progesterone in prevention of preterm birth. Int J Womens Health. 2010 Aug 9;1:73-84.
  14. Spencer TE, et al. Biology of progesterone action during pregnancy recognition and maintenance of pregnancy. Front Biosci. 2002 Sep 1;7:d1879-98.
  15. Singh M, et al. Progesterone and neuroprotection. Horm Behav. 2013 Feb;63(2):284-90.
  16. Rosenfeld R, et al. Hormonal and volume dysregulation in women with premenstrual syndrome. Hypertension. 2008 Apr;51(4):1225-30.
  17. Silberstein SD. Sex hormones and headache. Rev Neurol (Paris). 2000;156 Suppl 4:4S30-41.
  18. Carruthers M. Time for international action on treating testosterone deficiency syndrome.Aging Male. 2009 Mar;12(1):21-8.
  19. Araujo AB, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007 Nov;92(11):4241-7.
  20. Pluchino N, et al. Androgen therapy in women: for whom and when. Arch Gynecol Obstet. 2013 Aug 3. [Epub ahead of print]
  21. Basson R. Testosterone therapy for reduced libido in women. Ther Adv Endocrinol Metab. 2010 Aug;1(4):155-64.
  22. Glaser R, et al. Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale (MRS). Maturitas. 2011 Apr;68(4):355-61.
  23. Harman SM. Testosterone in older men after the Institute of Medicine Report: where do we go from here? Climacteric. 2005 Jun;8(2):124-135.
  24. Miner MM, et al. 12-Month observation of testosterone replacement effectiveness in a general population of men. Postgrad Med. 2013 Mar;125(2):8-18.
  25. Lejeune H, et al. [Hypoactive sexual desire and testosterone deficiency in men]. Prog Urol. 2013 Jul;23(9):621-8.
  26. Borst SE, et al. Testosterone replacement therapy for older men. Clin Interv Aging. 2007;2(4):561-6.
  27. Semeniuk T, et al. Neuroactive steroid levels in patients with generalized anxiety disorder.J Neuropsychiatry Clin Neurosci. 2001;13:396-398.
  28. Morgan CA 3rd, et al. Relationships among plasma dehydroepiandrosterone sulfate and cortisol levels, symptoms of dissociation, and objective performance in humans exposed to acute stress. Arch Gen Psychiatry. 2004 Aug;61(8):819-25.
  29. Ritsner MS. Pregnenolone and dehydroepiandrosterone as an adjunctive treatment in schizophrenia and schizoaffective disorder: an 8-week, double-blind, randomized, controlled, 2-center, parallel-group trial. J Clin Psychiatry. 2010 Oct;71(10):1351-62.
  30. Heydari B, et al. Low pregnenolone sulphate plasma concentrations in patients with generalized social phobia. Psychol Med. 2002 Jul;32(5):929-33.
  31. Kroboth PD, et al. DHEA and DHEA-S: a review. J Clin Pharmacol. 1999;39(4):327–348.
  32. von Mühlen D, et al. The Dehydroepiandrosterone And WellNess (DAWN) study: research design and methods. Contemp Clin Trials. 2007 Feb;28(2):153-68.

Why You Need Supplements

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Americans spend over $34 billion on alternative medicine each year.1 The bulk of this expense goes toward nutritional supplements. As the supplement market continues to expand, questions about vitamin use persist: “Do you really need 12 different supplements a day? If you eat relatively healthy, including fresh fruits and vegetables in your diet, shouldn’t that be enough?”

Here are four main reasons to consider taking supplements:

1. Nutrient-Deficient Diet

Many Americans neglect eating the most nutrient-rich foods, such as fresh fruits, vegetables, nuts, seeds, and whole grains, which are needed for the body to stay healthy. Instead, most individuals eat processed, easy-to-grab foods that are high in calories and low in nutrition. It is understandable that most Americans are nutritionally deficient, when the two main vegetables in their diet are tomatoes and potatoes in the form of ketchup and French fries.2

According to a National Health and Nutritional Survey, the majority of Americans fall short on nutrition. This survey reported that on average, Americans consume fruits and vegetables only 1–2 times per day. Not surprisingly, approximately 10% or less of the population met the USDA guideline of eating a minimum of five servings of fruits and vegetables a day.3-5

2. Quality of Food

The nutritional content of our food has significantly changed over the years. Unless you have your own garden, most likely you rely on commercial agriculture for fruits and vegetables.6,7 In the post-World War II era, commercial farmers discovered that healthy-looking, colorful crops could be produced with less effort by replacing standard mulch and manure fertilizers with nitrogen (N), phosphorus (P), and potassium (K) fertilizer. Over time, the NPK fertilizer yielded crops that were deficient in many other essential micronutrients.

If the nutrients are deficient in our soil, they will be deficient in our foods. It may not be coincidental to note that these changes have paralleled a sharp rise in many chronic degenerative diseases, including heart disease, diabetes, and cancer. Nutrient-deficient food has also contributed to sub-clinical nutritional deficiencies that affect the world population.8

The change in the modern diet from a hunter-gatherer has also had an impact on health. A diet higher in cereal grains has become a double-edged sword. While providing food and calories for a growing world population, the change has led to a decrease in the actual ratios of highly nutritious foods to less dense nutrition being consumed. Increasing carbohydrates and decreasing protein, vitamins, minerals, and macronutrients that were once readily consumed has resulted in poorer health. In most parts of the world, wherever a cereal-based diet has replaced a primarily animal-protein diet, there is a noted reduction in stature, an increase in infant mortality, anemia, incidence of infectious disease, bone disorders, and cavities, plus a decrease in life span.9

Furthermore, as foods are processed, the nutrients are stripped down further. This makes foods that seem healthy truly devoid of nutritional value. Commercial milling of cereal grains removes the bran and germ from the starchy endosperm, the latter being what is ground into flour. This process reduces the amount of vitamins, minerals, and fatty acids.10 And by removing the fatty acid content from the flour, any resulting bread will last longer on a store shelf, passing itself off as food but really offering little health value.

3. Varied Nutritional Needs

When it comes to nutritional requirements, what your body needs is determined on an individual basis. The recommended dietary allowances (RDAs), developed back in the 1940’s when our food and soil were very different, are an overall guideline to follow. It is truly impossible for the RDA estimate to meet the needs of every individual. In 2004 a study showed that in order to improve weight loss in adults, protein levels above the RDA would be necessary, depicting the RDA levels as inadequate.11 Therefore, supplementation may be needed to replenish specific nutritional shortfalls.

4. Antioxidant Protection

Our environment bombards us with an increasingly high level of oxidative stress. Oxidative stress comes from air and water pollution, consumption of fats and fried foods, diets high in sugar, smoking, alcohol, illegal drugs, medications, sleep deprivation, emotional stress, and excessive exercise.

The accumulation of oxidative stress leads to chronic diseases, including cancer. We know that cancer is a preventable disease that requires long-term lifestyle commitments to better habits. Pharmaceutica Research in 2008 reported that 1 million Americans and more than 10 million people worldwide were expected to be diagnosed with cancer. Of those figures, only 5–10% of all those cancers will have been caused by genetic defects whereas 90–95% of them are rooted in environment and lifestyle. The report goes further stating that tobacco will account for 25–30% of cancer deaths; diet will be related to 30–35%; and infections will likely cause 15–20%. The remaining cancer deaths would be due to environmental pollutants, stress, radiation, and other factors.12

According to former U.S. Surgeon General, Dr. C. Everett Koop, our current dietary practices contribute to many of these chronic diseases:

The preponderance of the evidence … substantiates an association between dietary factors and rates of chronic disease. In particular, the evidence suggests strongly that a dietary pattern that contains excessive intake of foods high in calories, fat (especially saturated fat), cholesterol, and sodium, but that is low in complex carbohydrates and fiber, is one that contributes significantly to the high rates of major chronic diseases among Americans. It also suggests that reversing such dietary patterns should lead to a reduced incidence of these chronic diseases.13

While supplements help maintain nutrient levels and provide greater protection from chronic ailments, don’t expect them to counterbalance a diet of fried, sugar-laden foods. A balanced diet, exercise, and supplements are essential to a healthy lifestyle, as the body needs all the help it can get to sustain energy, immunity, cognitive function, and overall health.

Preventative Medicine Clinic is located at 1245 NW Galveston in Bend, Oregon and can help you plan for health success.

References

  1. Horrigan BJ. Americans spent $33.9 billion out-of-pocket on CAM. Explore (NY). 2009 Nov-Dec;5(6):324-5. Retrieved on August 12, 2013 from http://nccam.nih.gov/news/2009/073009.htm
  2. USDA. Economic Research Service. Retrieved on August 12, 2013 from http://www.ers.usda.gov/topics/crops/vegetables-pulses/potatoes.aspx
  3. Centers for Disease Control and Prevention (CDC). State-specific trends in fruit and vegetable consumption among adults — United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2010 Sep 10;59(35):1125-30.
  4. State Indicator Report on Fruits and Vegetables 2013. Retrieved on August 12, 2013 http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf
  5. State Indicator Report on Fruits and Vegetables 2009. Retrieved on August 12, 2013 http://www.cdc.gov/nutrition/downloads/StateIndicatorReport2009.pdf
  6. Esther G. Dirt Poor: Have Fruits and Vegetables Become Less Nutritious? Because of soil depletion, crops grown decades ago were much richer in vitamins and minerals than the varieties most of us get today. Sci Am. April 27, 2011. Retrieved on August 12, 2013 http://www.scientificamerican.com/article.cfm?id=soil-depletion-and-nutrition-loss&print=true
  7. Davis DR, et al. Changes in USDA food composition data for 43 garden crops, 1950 to 1999. J Am Coll Nutr. 2004 Dec;23(6):669-82.
  8. Serdula M, et al. Flour fortification with iron, folic acid, vitamin B12, vitamin A, and zinc: Proceedings of the Second Technical Workshop on Wheat Flour Fortification. Food Nutr Bull. 2010;31(1 Suppl):3S-96S.
  9. Cordain L. Cereal Grains: Humanity’s Double-Edged Sword. World Rev Nutr Diet. Basel, Karger, 1999, vol 84, pp 19–73.
  10. Slavin J. Grain Processing and Nutrition. Crit Rev Food Sci Nutr. 2000 Jul;40(4):309–326. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr. 2004 Dec;23(6 Suppl):631S-636S.
  11. Anand P, et al. Cancer is a Preventable Disease that Requires Major Lifestyle Changes.Pharm Res. 2008 September;25(9):2097–2116.
  12. Koop CE. The Surgeon General’s Report on NUTRITION AND HEALTH Summary and Recommendations 1988 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service DHHS (PHS) Publication No. 88-50211. Retrieved August 13, 2013 http://profiles.nlm.nih.gov/ps/access/NNBCRT.ocr