November 9, 2013

Ecological Medicine

By Les Cole, MD

 “If someone blew up a hospital or infected a water supply, we’d view it as an act of health terrorism. But pumping persistent organic pollutants into the atmosphere, clearing forests, over-using resources and contributing to global warming are equally inimical to health.”

– Howard Frumkin, MD, Emory Medical School

 “Science is only man’s approximation of knowledge of nature, which will forever be beyond our comprehensive abilities. With every intervention taken, based on this perceived “knowledge”, there will be unintended consequences. It is only the humility of this insight that make us nimble and courageous enough to undo our mistakes.” 

– Les Cole, MD

 In 2000, Kofi Annan initiated the UN Millennium Ecosystem Assessment commissioning 1360 natural and social scientists to investigate the status of the world’s ecosystems as a result of human related activities. The findings reported in 2005 revealed that:

  • Over the last 50 years, humans have changed ecosystems more rapidly and extensively than ever, resulting in a substantial and largely irreversible loss of biological diversity.
  • In the same time, there has been an abrupt alteration in water quality.
  • 25% of mammals and 30% of amphibians are threatened with extinction.
  • Growing pressures from overharvesting, climate change, invasive species, and nutrient loading place an unprecedented burden on the earth’s ecosystems.

Their conclusion: “At the heart of this assessment is a stark warning. Human activity is putting such a strain on the natural functions of Earth that the ability of the planet’s ecosystems to sustain future generations can no longer be taken for granted.”

Every living organism is dependent on the organisms beneath them in the food chain in order to sustain and maintain their species. Man is at the top of the food chain, which makes us – you and me – dependent on all the other species that we share a planet with. For example, we do not eat bees, but we eat honey which they produce, but even more importantly we are dependent on them for pollination of much of what grows on the planet. According an article in the Renewable Resources Journal, 30% of the world’s crops and 90% of wild vegetation depend on cross-pollination. So what happens to man if bees are one of the species threatened with extinction?

Equally alarming is the finding that the average sperm count of today’s young men is only 50% of what it was in the young men of just 50 years ago…

How is this happening? What is causing these changes?

Let’s begin by looking at the smallest living common denominator to all organisms, both plant and animal – the cell. When you look at any living organism (other than viruses, etc.), all of its parts are made up of cells. So, in order for any organism to thrive, its cells have to thrive. How do cells work? The genes in the nucleus code for proteins that, once transcribed, go out and do the gene’s bidding. Proteins thus make everything within the cell happen. Proteins either form structure, like connective tissue; signaling molecules, like hormones; or enzymes, which direct every chemical reaction in the cell. There are millions of these chemical reactions that require nutrients, which they convert into important molecules that go on to other enzymes for further conversion and, in so doing, do the work of making the cell “live”. Without all of these chemical reactions the cells wouldn’t live and neither would any organisms made of them – including you and me. These chemical reactions are called “cellular metabolism” and they have an absolute dependence on getting the right kind and amount of nutrients to occur optimally. So, if cellular metabolism is optimal, the organism thrives. Then, if you are the organism, say, and you are getting all the right macronutrients, micronutrients, vitamins, minerals, etc., your cells should thrive, right? Well, maybe yes and maybe no.

It depends on whether your cells are also taking something into them that blocks or disrupts their natural metabolism. This could be something that damages the genes so that abnormal enzymes are made that don’t function well or at all. This could be something that temporarily or irreversibly binds an enzyme so it can’t function. This could be something that damages or replaces a necessary nutrient that the enzyme needs to work on. It could be something that depletes or replaces important minerals that work as cofactors to enzymatic reactions. It could be something that causes oxidative stress using up vitamins that are antioxidants. There are literally thousands of these toxic chemicals and thousands of ways they disrupt metabolism.

So what are Toxins AKA Metabolic Disruptors?

This is the part we need to educate ourselves about so we can make informed personal decisions that will protect us and our families and children. This is especially true in our children because metabolic disruption during critical developmental periods can be especially damaging.

There is no way to address every toxic substance in this short article, but here are a few and a good place to begin your education:

  • Air Pollution – nitrogen oxides, sulfur dioxide, carbon dioxide (at current levels), carbon monoxide (CO), particulates, volatile organic compounds (VOCs), heavy metals (lead, mercury, arsenic, cadmium, etc.), second hand smoke, radon, mold, negative ion depletion, off-gassing of formaldehyde-containing furniture and carpets, solvents, cleaning solutions, pesticides.
    • There is a positive correlation between air pollution and neurodegenerative diseases (Parkinson’s, Alzheimer’s, and others).
    • As air pollution increases, so does cardiovascular disease and related events (MI, stroke, death).
    • Mice exposed to air pollution developed increased adipose inflammation and insulin resistance (precursors of type 2 diabetes).
    • Air pollution is directly associated with increased inflammation.
    • High CO levels are associated with increased hospital admissions for heart failure.
    • Almost 1,000,000 people (doesn’t include other animals or ecosystems) die annually worldwide from air pollution alone.
  • Water & Soil (thus Food) Pollution – Including the polar ice caps & glaciers, only 3% of the Earth’s water is fresh. Much of that liquid 3% has been contaminated by pesticides, herbicides, pharmaceutical drugs (hormones, antibiotics, antidepressants, statins, NSAIDs, etc), industrial solvents, heavy metals, VOCs, radon, nitrates, dioxin, PCBs, DDE, trans-Nonachlor, hexachlorobenzene, hexachlorocyclohexanes, DDT, other persistent organic pollutants (POPs), perchlorate, bacteria, BPAs, phthalates, etc.
    • Bottled water costs up to 10,000 times as much as tap water and creates 1.5 tons of plastic waste per year.
      • By regulation, it is held to the exact same standards as tap water, so you only have the company’s word that it is any better. Some studies have shown unacceptable coliform bacterial levels.
      • The plastic contamination of our waters is becoming a big problem.
      • Plastics leach BPAs & phthalates.
      • For every 1 standard deviation increase of BPA concentration in the urine, there is a 39% increased risk of type 2 diabetes (T2D).
      • POPs are stored in fat. The higher up the food chain you are (we are at the top), the greater the concentrated these are in the organisms stored fat.
        • People with the highest exposure to POPS have a 3800% increased occurrence of T2D compared to those with the lowest exposure.
      • People with the highest amounts of arsenic in their urine have a 358% increased occurrence of T2D compared to those with the lowest amount.
      • Lead is known to cause brain damage, especially in developing children, but it causes so many other problems. Mercury is even more dangerous. Both cause: Atherosclerosis, High Blood Pressure, Coronary Heart Disease, Carotid Artery Disease, and Peripheral Vascular Disease among other conditions including neurodegeneration.

These are just a few of the toxins we and every other ecosystem are exposed to. We’ve all seen movies about toxic dump sites where the nearby communities start coming down with varied illnesses including cancers. “Erin Brockovich” was a movie about one of the rare cases that found for the injured victims. Usually these cases are too costly to even pursue. But that is after the Earth and Ecosystems (including human) are already damaged. The Genie is already out of the bottle, so to speak. The best way to protect your family is to educate yourself. The Environmental Working Group is one good place to start at

There are thousands of these metabolic disruptors to which we are exposed every day. Fortunately, our bodies are designed to detoxify most (but not all i.e. mercury) metabolic disruptors, however, one problem is that fat soluble toxins store in fat. The liver is the primary detoxifying organ. Removal of these metabolic disruptors can be enhanced through chelation and detoxification. When undergoing either procedure, it is extremely important to replenish both specific types and amounts of nutrients so that further or additional metabolic injury does not occur. For example, detoxifying through fasting causes fat loss and thus release of fat soluble toxins, but quickly uses up vital nutrients used in the detoxification process. Because you are not eating, these nutrients are not replenished and now there are higher toxin levels circulating in your tissues that have lower nutrient levels to combat them. This can cause even more damage. We offer both chelation and detoxification in our office along with the appropriate replenishment of vital nutrients.

Written by Dr. Les Cole. Copyright 11/9/13


September 5, 2013

Diabetes – How Did I Get Here?

By Dr. Les Cole


If you have Type 2 Diabetes (T2D), you’ve probably seen a doctor and been put on a blood sugar lowering medication (such as Metformin) for it. If you asked how you got it, you may not have gotten an answer, other than been told to diet, lose weight and exercise. If you’ve tried these but failed, it may not be your fault. You simply may not have had enough information. So let’s start at the beginning with how our body’s cells normally work and then how T2D begins. (This information does not apply to Type 1 Diabetes, which occurs for totally different reasons.)

Normally, your cells use glucose for energy. Glucose is the end product of 90+% of all the sugar and non-fibrous carbohydrates you eat. Muscle and heart cells also use fat for energy, but your brain can only use glucose for energy. This total requirement of your brain for glucose means that if your glucose drops too low, you’re in trouble – you can become unconscious and even die.  So, it is very important for your blood glucose (aka Blood Sugar or BS) level not to drop too low – generally not below 50. Thankfully your body is exceedingly good at preventing this. It has 5 hormones that prevent this from happening – Glucagon, Adrenaline, Norepinephrine, Cortisol and Growth hormone. These 5 hormones are called Counter-Regulatory Hormones because they counter the effects of the single hormone that lowers BS – Insulin. Yes, we only have one major hormone to lower BS, compared to 5 that increase it. You can probably see that if Insulin isn’t working right, there’s a problem – elevated BS, which leads to all the problems associated with T2D, discussed later.

So, how does Insulin stop working in T2D?

The first step occurs in food choices. If you eat a diet of processed foods (as opposed to whole foods) and don’t exercise much, then it is likely you are taking in more sugar than your body can use. Sugar is hidden in many processed foods like high fructose corn syrup. All carbohydrates (90+%), when digested – with the exception of fiber – turn into sugar and are absorbed becoming BS. So a situation is developing where you are taking in more sugar than your cells (primarily your muscle cells because they make up the largest metabolically active group of cells in your body) can use. Insulin works to drive glucose into your cells for use and is released when the BS increases after a meal. The more sugar absorbed, the more Insulin released. If your muscle cells are full of sugar and don’t need any more, they resist the effects of Insulin and are then said to be Insulin Resistant. This is the first step in the development of T2D – Insulin resistance of the muscle cells. With less exercise, your muscle cells need less sugar to power them. With less exercise, they grow smaller and therefore need less energy (sugar). And because they run off fat as well, the more fat stores in your body, the less sugar they use for energy. Each of these factors add to muscle’s Insulin Resistance (IR) as you continue to take in the same amounts of sugar (non-fibrous carbohydrate).

Where then does the sugar go?

Your liver and fat cells remain sensitive to Insulin and are said to be Insulin Sensitive. So, the Insulin causes a small amount of glucose to go into your fat cells, but fat cells have low energy needs, being mainly storage depots for fat. Now the majority of glucose is taken up by your liver cells where it is converted mainly into Triglycerides (TG) – the main storage form of fat – and some into Cholesterol (C). Both your TG and C are sent back out into the blood to be transferred to the fat cells for storage. Your Insulin also causes fat cells to take up TG and C where they are stored because your fat cells are still Insulin Sensitive (IS). At this stage your BS, TG & C blood levels are still normal because your BS is removed from the blood and turned into TG & C and these are removed from the blood by Insulin into fat cells. This maintains normal levels of each. At this stage you gain weight and without a change in lifestyle or food choices, continue gaining weight becoming overweight or obese. With a change from processed foods to whole foods and improved exercise, this stage can be reversed. The earlier you catch it, the easier it is to reverse.

The next stage in the development of T2D occurs when your fat cells become Insulin Resistant (IR). We don’t yet understand why some people’s fat cells become IR and others don’t. Some people’s fat cells remain Insulin Sensitive and they just keep gaining weight, developing severe obesity. But it is more likely your fat cells become IR and at this stage the TG & C have no place to go. Since your liver always stays Insulin Sensitive (IS), your BS will continue to be converted to TG & C and this is the stage when these blood levels begin to increase and your doctor likely puts you on a lipid lowering medication (statins and fibrates are examples) to lower them. Many of these medications work by preventing the conversion of BS to TG & C and so this then contributes to the back-up of sugar in your blood if you are IR. (Please do not stop a medication without consulting a doctor for your own safety.)

Not only do your fat cells need to be IS to take up TG & C, but also to hold on to the stored TG. When your fat cells are IR, they begin to leak smaller components of the TG stored in them. These smaller components – Free Fatty Acids (FFA) – begin to rise in your blood along with the TG & C levels. The elevated Free Fatty Acids (FFA) are toxic to the pancreas and so begin to damage your cells that produce Insulin. This damage tends to take time and so your BS at this stage is still normal since your BS is still being converted to TG & C. At some point between the IR of the muscle cells and the IR of the fat cells and before significant damage to the pancreas, Insulin production goes up in an effort to overcome the IR of these two cell groups and here your insulin levels become elevated.

The last stage occurs when there has been sufficient damage to your pancreas that it can no longer produce enough insulin to force the liver to convert all the BS to TG & C. At this stage your BS begins to rise – first after you eat, then between meals and lastly after fasting overnight. This means that in this process of developing T2D the Fasting Blood Sugar (FBS) is the last test to become positive. And this is the test most doctors use to determine if you are developing Diabetes. As a matter of fact, the definition of Diabetes Mellitus is a FBS > 126. As you can see, at this point the Genie is already out of the bottle! At this stage, since not all your BS is being converted to TG & C, these levels may drop a little and you may even lose a little weight. If you didn’t know your BS was elevating and insulin decreasing from pancreatic damage, you might think this was a good thing, but it’s not because the reasons for it happening are increasing damage and disease progression.

How do the Counter-Regulatory Hormones contribute?

Stress is a major contributor. Stress causes elevation of your Cortisol, Adrenalin & Norepinephrine. All 3 of these hormones cause the breakdown of the protein in your body. The majority of protein is located in your muscles and so over prolonged periods of stress there is muscle wasting and you have less need for sugar for energy. The broken down proteins are used by these hormones to make more sugar that raises your BS even more. Also, many people ascribe to high protein diets and if you eat a high protein and low carbohydrate diet, you turn on Glucagon and worsen Insulin Resistance. Glucagon converts these proteins into sugar and Insulin is important to build muscle. Just like it causes cells to take up sugar and fat (TG & C), it causes them to take up protein for building. And when your muscles are IR they also can’t take up protein to build muscle.

“Is it too late once I have T2D?”

First, let me say it’s never too late. It isn’t over till it’s over! Much of the time the entire process can be completely reversed. It depends on how much damage has been done to your pancreas, how much of that damage can be reversed, and how much pancreatic reserve you have relative to what and how you eat. There are many consequences of long term T2D including High Blood Pressure, Heart Disease, MI, Stroke, Peripheral Vascular disease, Loss of Limb, Peripheral Neuropathy, Diabetic Retinopathy, Blindness and many more. If any of these secondary conditions have developed, correcting the underlying diabetes or secondary condition may not be completely possible, but healthier food choices, lifestyle and proper nutritional supplementation must be considered the primary solution since they were the cause of the problem in the first place. Additional medication may be necessary to prevent further damage as lifestyle and proper nutrition are instituted. In the short term, IV nutrition may help because studies show that when you are overweight you have high risk of micronutrient deficiency (malnutrition), inflammation and oxidative stress, which all contribute to the development of T2D. To be lasting, lifestyle changes generally take time and personal patience. Once implemented, you and your doctor may find you need less medication or no medication at all and that your T2D, as well, as your secondary health condition has stabilized or reversed.

“I don’t have T2D but I am overweight so I can see that I am at risk. What can I do?”

If you begin eating primarily whole foods and few processed foods, exercise, don’t smoke and reduce stress, the likelihood of developing T2D is minimal and you will likely lose weight. These answers are simple but not easy. Educate yourself on real health. Initiate small steps. You absolutely can make healthy choices and healthy changes.

Written by Dr. Les Cole. Copyright  9/5/13 


August 20, 2013



by Les Cole, MD

Some Perspective

There has been an explosion in nutritional research in the last decade and, by year, the number of scientific articles has increased exponentially. What this research is showing, and the CDC confirmed in 2000, is that health and its inverse, disease, is a product of our individual genetic makeup and our individual environments. It is also showing us that many genetic variants can be worked around or overcome with proper nutrition and/or nutraceuticals. When you think of your environment, what do you think of? Do you think about what you eat and drink? Well, approximately 90% of your external environment, that you internalize, is the foods that you eat. And your environmental inputs by far outweigh most genetic variants. With that understanding, it becomes obvious that personal nutrition is the greatest contributor to health and disease.

Nutritional scientific literature is also confirming that most chronic diseases are associated with some form of malnutrition. These diseases encompass diabetes, overweight, obesity, high blood pressure, heart disease, neurologic disorders, chronic fatigue, fibromyalgia and many more. In fact, other than the need for genetic work-a-rounds and toxins, malnutrition may be the major contributor to all disease. The 2 most common forms of malnutrition in our country are micronutrient deficiency and over-nutrition. Micronutrient deficiency comes from eating too few whole-food, fresh fruits and vegetables. Over-nutrition is a misnomer and is the result of eating too few whole-food, fresh fruits and vegetables and too many micronutrient poor, macronutrient (carbohydrates, fats and proteins) packed, processed foods or eating primarily an animal product rich diet.

What Does All This Mean For You?

To understand this on a meaningful level, we need to look first at how your cells are designed to work. Our genes are the final common pathway for directing everything that happens in the cell. They do this by producing proteins that form structures, enzymes or signaling molecules. Enzymes are responsible for essentially every chemical reaction that occurs within your cells – your cells’ metabolism. Nutrients (food) are the chemicals that these enzymes work on to produce the metabolic products that our cells need to survive and function. To function optimally, they need optimal nutrition.

So What Is Optimal Nutrition?

First, it means the right foods in the right amounts. Your body (cells) needs a certain amount of macronutrients (carbohydrates, fats and protein) to produce energy and structural molecules, but not too much. You also need micronutrients – vitamins, minerals, antioxidants and a multitude of yet to be discovered molecules your cells evolved to work with long before industrial farming and industrial food processing evolved. Most of these can only be found in plant sources. Let’s take antioxidants For example. Most antioxidants are found in plant sources – fruits and vegetables.

Why Does Your Body Need Antioxidants?

In order for your cells to function, they need energy. Inside your cells are large numbers of minute energy factories called mitochondria. Carbohydrate (in the form of glucose) and fat are the primary fuels for this energy. The other important component is oxygen, which is used by the mitochondria to burn these fuels in a process called oxidation. Examples of oxidation outside of the body are fire and rust. In a sense, what is happening in your mitochondria is a controlled fire. It is actually an amazing design, if you think about it! During this oxidation process, however, there are side products called reactive oxygen species (ROS) and reactive nitrogen species (RNS) that are produced and, collectively, they are referred to as ROS.  Some of these have important functions in the body, but if there are too many that escape the mitochondria or other places they are supposed to be, they react with other molecules that they should not and destroy them. This is called oxidative stress and is like a wildfire burning out of control in the cells of your body. This in turn increases inflammation.

How Do Antioxidants Work?

Some antioxidants quench (as in put out a fire) ROS in a 1 to 1 fashion, taking 1 molecule of antioxidant to quench 1 molecule of ROS. Some examples of this are vitamin C or E or alpha lipoic acid. These are very important in keeping oxidative stress under control. Other antioxidants work in a totally different way and are much more powerful in their effect because a single molecule can by its action cause the quenching of many ROS! This occurs via the Nutrigenomic pathway.

What Are Nutrigenomics?

The study of how nutrients turn on and turn off genes! Yes, there are foods that actually activate and inactivate specific genes in your cells! This means that food is not only the source for all the structure, energy, and metabolic molecules in your body/cells, but that it tells which genes to be expressed or not expressed! Remember, this design, which you’ve inherited, evolved in your ancestors and was passed down to you long before industrial farming and packaged, processed, artificial food evolved. During this time the diet consisted of mostly whole organic fruits and vegetables and meat in smaller quantities, when it was available. These are the foods your body is optimized for. Your automobile is optimized to run on gasoline. Would you go out tomorrow and put water in its gas tank?!

Why Is This Important?

Because eating these foods that used to be staples of your Paleolithic ancestors activated and inactivated specific genetic pathways that kept them healthy. Genes tend to change very little over millennia and your genes operate for the most part like your Paleolithic ancestors. There certainly hasn’t been nearly enough time for your body to redesign its genes to function on the nutrient and antioxidant poor, highly processed, artificial and otherwise adulterated food that is part of the Standard American Diet (SAD)! There are likely to be many of these Nutrigenomic pathways that we will discover and there are two that are important to you right now.

The NRF2 Nutrigenomic Pathway

This pathway is activated by many different antioxidant molecules found in fruits and vegetables (click on this link to find a listing of them). These Nutrigenomic antioxidants stimulate the cell to activate the NRF2 transcription factor, which turns on many antioxidant genes causing them to produce antioxidant proteins throughout your cells and body. So a small amount of these Nutrigenomic antioxidants produce an exponential amount of your body’s own endogenous (internally produced) antioxidants.

The NF-kB Nutrigenomic Pathway

NF-kB is the transcription factor that turns on inflammation. Like oxidation, inflammation is important in your body when it is appropriate, as in when you get an infection. Unfortunately, like oxidative stress, it becomes excessive when eating SAD foods. As with foods that turn on the NRF2 pathway most micronutrients that turn off the NF-kB pathway are found in fruits and vegetables (click the link to find a listing of them). Since oxidative stress is a major contributor to inflammation, the foods that turn on the NRF2 pathway will down-regulate the NF-kB pathway, as do 1 to 1 antioxidants. There are also many paths to both up-regulating (SAD foods) and down-regulating (micronutrient rich foods – whole raw fruits and vegetables) the NF-kB pathway.

Why Is All Of This Information Important And How Does It Apply To Me?

Your genes evolved to function with primarily raw, whole fruits and vegetables with some animal products thrown in occasionally to maintain healthy cells/metabolism. The burning of energy to fuel your cellular metabolism produces ROS and inflammation. Your genes are designed to offset these based on the foods available at the time your genes evolved in your ancient ancestors. If you eat the foods high in micronutrients and antioxidants (whole fruits and vegetables), you will live a much healthier and possibly longer life than if you do not!

The opposite effect occurs if you eat the SAD food. Not only are you not eating the foods needed to turn on the NRF2 and off the NF-kB pathways and give you 1 to 1 anti-oxidants, but you are eating foods that increase oxidative stress – trans and saturated fats; artificial, processed & adulterated foods; too many macronutrients that get stored as fat, which increases oxidative stress and inflammation.

Give your body the micronutrients it needs and it will be good to you! If you have symptoms or a disease process, however, you will likely require more. A proper evaluation of Functional, Metabolic, Hormonal and Nutritional imbalances can be addressed with Nutritive, Nuturative (psycho-social-spiritual), Physical and Environmental solutions. These can then be identified and applied, tailored to your individual health needs.

Nutrigenomic Foods – Super-Foods On “Steroids”

Nutrigenomic foods are foods that effect the expression of your genes! They actually turn on or off whole sets of genes that have similar functions. Oxidative stress and inflammation can both be diminished in this way. These are foods that are most powerful in their anti-oxidant and anti-inflammatory effects because they turn on your antioxidant genes or turn off your inflammation genes (click here to read the article that explains these pathways in more detail). This is only a partial list and there may be foods that are more powerful and there are certainly others. If you search for foods that turn on the NRF2 pathway or turn off the NF-kB pathway, you will find more. The Linus Pauling Institute is a great resource.

To work, These pathways require a majority of your diet to be rich in vegetables and fruits (in a 60/40 ratio) in order to work. Without enough foods high in micronutrients (vegetables and fruits) your cellular metabolism becomes sick and so does your body.

Foods That Turn On The NRF2 Antioxidant Nutrigenomic Pathway

NRF2 – turns on antioxidant genes – your bodies own internal antioxidant protection mechanism. Many examples are given below, but this is not an exhaustive list.

  • Flavinoids
    • Anthocyanidins
      • Cyanidin, Delphinidin, Malvidin, Pelargonidin, Peonidin, Petunidin
        • Red, blue, purple berries
        • Red and purple grapes
        • Red wine
    • Flavanols
      • Catechins: Epigallocatechin gallate (EGCG), Epigallocatechin, Epicatechin gallate, Catechin, Gallocatechin,  Epicatechin,
        • Teas (especially green & white)
        • Chocolate (make sure dark for lower sugar content and higher catechin content and research your product for lead content!)
        • Grapes
        • Berries
        • Apples
      • Theaflavins and Thearubigins
        • Teas (especially black & oolong)
      • Proanthocyanidins
        • Chocolate
        • Apples
        • Berries
        • Red grapes
        • Red wine
    • Flavanones
      • Hesperetin, Naringenin, Eriodictyol
        • Citrus
    • Flavonols
      • Quercetin, Kaempferol, Myricetin, Isorhamnetin
        • Yellow onions
        • Scallions
        • Kale
        • Broccoli
        • Apples
        • Berries
        • Teas
        • Others
    • Flavones
      • Apigenin, Luteolin
        • Parsley
        • Thyme
        • Celery
        • Hot peppers
    • Isoflavones
      • Daidzein, Genistein, Glycitein
        • Soybeans
        • Legumes
  • Non-flavonoid Polyphenols
    • Curcuminoids: Curcumin
      • Tumeric
    • Resveratrol
      • Grapes
  • Phenolic acids or Phenolic diterpenes
    • Rosmarinic acid, Carnosic acid
      • Rosemary
  • Organosulfur compounds
    • Isothiocyanate
      • L-sulforaphane
        • Cruciferous or Brassica vegetables
          • Sprouts of Broccoli & Cauliflower have the highest content
          • Kale
          • Broccoli
          • Brussels sprouts
          • Cabbage
          • Cauliflower
          • Bok choy
          • Collards
          • Chinese broccoli
          • Broccoli raab
          • Kohlrabi
          • Mustard
          • Turnip
          • Radish
          • Arugula
          • Watercress
    • Thiosulfonate
      • Allicin
        • Garlic
        • Aged garlic is fermented garlic that converts allicin to S-allylcysteine & S- allylmercaptocysteine, which are more bioavailable, water soluble and stable.
  • Cinnaminic aldehyde
    • Cinnamon

Foods That Turn Off The NF-kB Inflammatory Nutrigenomic Pathway

NF-kB – is the pathway that turns on inflammation, so you want to eat foods that turn this pathway off:

  • Eugenol
    • Clove
  • Sulforaphane
    • Cruciferous (Brassica) vegetables
  • Curcuminoids
    • Turmeric
  • Allicin
    • Garlic/Aged garlic
  • Polyphenols
    • Coffee
    • Walnuts
    • Cacao
    • Thyme
    • Sage
    • Marjoram
    • Oregano
  • Quercetin
    • Capers
    • Lovage
    • Apples
    • Chamomile
    • Citrus
    • Onions
    • Parsley
    • Sage
    • Tea
    • Red wine
    • Olive oil
    • Grapes
    • Dark cherries
    • Dark berries
  • Genistein
    • Soy
  • Resveratrol
    • Red & purple grapes
  • ECGC & other catechins
    • Green & white tea
  • Lycopene
    • Tomatoes
    • Watermelon
    • Red papaya
    • Pink grapefruit
    • Red carrots
  • Avenanthramide
    • Oats
  • Vitamin C
    • Hot peppers
    • Guavas
    • Bell Peppers
    • Thyme
    • Parsley
    • Cruciferous vegetables
    • Kiwi
    • Papaya
    • Oranges & Tangerines
    • Strawberries
  • Vitamin E
    • Sunflower seeds
    • Paprika & red chili powder
    • Almonds
    • Pine nuts
    • Peanuts
    • Basil
    • Oregano
    • Dried apricots
    • Green olives
    • Cooked spinach
    • Cooked taro root
  • Vitamin D
    • Fish
    • Oysters
    • Caviar
    • Eggs
    • Mushrooms
    • Pork tenderloin
    • Liver
    • Shrimp
    • Goat cheese
    • Fortified foods – these are actually higher on the list but as natural, unprocessed they are much lower
      • Dairy
      • Cereal
      • Orange juice
      • Tofu & soy milk
  • Vitamin B6
    • Dried herbs
      • Chili powder
      • Garlic powder
      • Tarragon
      • Sage
      • Spearmint
      • Basil
      • Chives
      • Turmeric
      • Bay leaves
      • Rosemary
      • Dill
      • Onion powder
      • Oregano
      • Marjoram
    • Pistachios
    • Raw garlic
    • Liver
    • Fish
    • Sunflower & sesame seeds
    • Pork tenderloin
    • Molasses & Sorghum Syrup
    • Hazel Nuts & Filberts
  • Folic acid
    • Liver
    • Dried herbs
      • Spearmint
      • Rosemary
      • Basil
      • Chervil
      • Coriander
      • Marjoram
      • Thyme
      • Bay leaf
      • Parsley
    • Sunflower seeds
    • Edamame
    • Dark leafy greens
      • Spinach
      • Turnip
      • Collards
    • Bean sprouts
      • Soy
      • Pea
    • Beans
      • Pinto
      • Garbanzo
      • Mung
    • Asparagus
    • Peanuts
  • Alpha Lipoic acid – it is difficult to get significant quantities from food sources
    • Broccoli
    • Spinach
    • Collards
    • Chard
    • Liver
    • Heart
    • Kidney
    • Red meat
  • CoQ10
    • Heart
    • Liver
    • Kidney
    • Red Meat
    • Fish
    • Oils
      • Soybean
      • Rapeseed
      • Sesame
      • Cottonseed
      • Corn
    • Nuts
      • Peanuts
      • Pistachios
      • Walnuts
      • Hazelnuts
    • Beans
      • Soy
      • Azuki beans
    • Sesame seeds
    • Chicken & eggs
    • Vegetables
      • Spinach
      • Broccoli
      • Sweet potato
      • Sweet pepper
      • Garlic
      • Peas
      • Cauliflower
      • Carrots
    • Fish
  • Carnosine
    • Red meat
  • L-carnitine
    • Red meat
  • These come in nutraceutical formulation
    • Pycnogenol
    • Ashwagandha
    • Ginkgo biloba
    • Astragalus
    • Boswellia
    • Avena sativa (avenanthramide)
    • Grape seed extract
    • Stinging nettle
    • Benfotiamine
    • Melatonin – can also be enhanced with good sleep habits
      • Good sleep hygiene – totally dark room
      • 8 hours of sleep


Written by Dr. Les Cole. Copyright  8/20/13


May 9, 2013

High Blood Pressure & Reversible Nutritional Deficiencies

by Les Cole, MD

What is Blood Pressure?

When your heart contracts it squeezes all the blood inside it into a tube (the aorta) that is much smaller in size. That causes pressure. Think of a hose used to wash your car as your heart and the nozzle on the end of it as your blood vessels (aorta). As the water gets pushed into the nozzle from the hose the pressure goes up sky high, which is why the water can shoot so far and feel so powerful, if you put your hand in front of it. So blood pressure is caused by pushing the blood into the blood vessels from the heart.

What is the purpose of blood pressure?

Before the heart contracts, the pressure inside it is around zero. As it contracts the pressure increases until it reaches a certain level that forces the valve to the aorta open and blood enters the aorta. The sudden increased pressure causes the aorta, which is elastic, to expand. Two things cause the blood to flow from the aorta to the arteries downstream. The pressure downstream is somewhat lower than in the aorta and fluid (blood) flows from higher to lower pressure. Secondly, and most importantly, the stretched aorta contracts to its original size pushing the blood downstream, so it acts as a secondary heart! So, you can see how important this elasticity is! Each successively smaller set of arteries downstream act in the same way to keep pushing the blood through the tissues.

What is normal blood pressure (BP)?

From the above information you can see that the pressure in your aorta is higher than in your arm. So where we measure your BP is important. When someone has a heart catheterization, we measure the pressure in the heart and in the aorta. In everyday practice we measure it in the artery in your upper arm, which is transmitted to the surface of your arm. When the heart first contracts the BP is at its highest. This is called systolic BP. Just before it contracts again, the BP is at its lowest. This is called diastolic BP. So, normal blood pressure measured in your upper arm is currently defined as: systolic between 90 – 119 mm Hg and diastolic between 60 – 79 mm Hg normally recorded as systolic / diastolic . (mm Hg = millimeters of mercury – the weight of a column of liquid mercury).

  • Normal BP: As low as 90/60 up to 119/79

How is “normal” determined?

A bunch of experts in the field get together and by consensus define “normal” and what is “high”. This group is known as the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.

What is high blood pressure?

According to this committee there are several stages of high blood pressure.

  • Pre-hypertension is anywhere from 120/80 to 139/89
  • Stage 1 HBP is from 140/90 to 159/99
  • Stage 2 HBP is > 160/100

It used to be that you either had or didn’t have HBP. Now there are different stages? Well, it is even a bit more complex – and easier – than that! The scientific literature on hypertension has shown that over a BP of 115/70 there is an increasing risk that doubles for each 20/10 mm Hg increase in BP. “What does this mean for me?” If your blood pressure is 135/80 you have twice the risk (200%) of heart disease as someone with a BP of 115/70. At 155/90 the risk of heart disease is 4 times (400%) that of someone with a BP of 115/70! At 175/100 it is 8 times (800%) the risk. These numbers are greatly affected by other cardiovascular risk factors such as cholesterol, LDL, HDL, triglycerides, weight, diet, exercise, blood glucose, tobacco, alcohol and a number of other measureable risk factors.

What causes HBP?

About 5% of patients with HBP have a single abnormality that can be pinpointed as the cause. For example, if the artery going to one of the kidneys is narrowed or blocked there won’t be enough blood flow to the kidney and it will send chemical messengers out to raise the BP to get the right amount of blood flow to it so it can do its job correctly – clean the blood of waste products so our bodies don’t get toxic. Another example is a tumor that produces abnormal chemical messengers that raise blood pressure. These are rare.

So, if you have HBP, you are likely to be in the 95% who have what has been known as “essential hypertension”. This name meant that if your BP was high then it must be because the body needed it that high to work for some reason and we didn’t know what that reason was. Well, we do know many of the reasons now. HBP is due to:

  1. Increased oxidative stress in the blood vessels
  2. Inflammation of the blood vessels
  3. Autoimmune dysfunction of the blood vessels
  4. Abnormal blood vessel biology with
    1. Endothelial dysfunction (ED) – the cells that line the blood vessels that can be damaged and are functionally very active
    2. Abnormal vascular smooth muscle (VSM) – which then does not dilate well

These combined actions of not dilating well, inflammation that causes atherosclerosis especially when cholesterol is high, and calcium deposition in the arteries causes them to be “hard” – to lose their elasticity. (Remember the elasticity in the aorta makes it work like a second heart?) So, you can see that when the heart constricts forcing blood into an aorta and blood vessels that no longer expand – the pressure will go up!

So what causes the oxidative stress and inflammation that leads to HBP?

To answer that, we need to understand how the body works at the cellular level. Our genes, yours and mine, produce proteins. Proteins do one of 2 things. They form structures in our cells and body (like collagen to form connective tissue) or enzymes that cause chemical reactions to occur. Our cells are essentially an organized chemical soup of thousands of chemical reactions. All of these chemical reactions have to occur correctly for our cells and thus our bodies to stay healthy. There are 4 things that ensure this:

  1. The genes that code for the enzyme are correct meaning they have no mutations
  2. We put the correct/healthy chemicals into our bodies – through our mouth, our lungs and our skin
    1. The chemicals the enzymes need to work on in the right amounts – macronutrients
    2. And those that help the enzymes do their job – micronutrients
  3. We avoid putting incorrect/unhealthy/toxic chemicals into our bodies – through our mouth, our lungs and our skin – herbacides, pestacides, heavy metals, tobacco, sugar, high-fructose corn syrup, processed foods, some medications that cause nutritional deficiencies, etc.
  4. Exercise – for some reason we are wired to “use it or lose it”! Exercise, in the right amounts, increases all the hormones that cause our cells and bodies to be healthy.

One other way that the right micronutrients, macronutrients and exercise work is that they turn on anti-oxidant genes and turn off inflammatory genes! Amazing, Right?!

Why is controlling my blood pressure important?

From the information above, obviously it is important to prevent heart disease; however, oxidative stress and inflammation are the underpinnings for most of the chronic, disabling diseases associated with increasing years. The following picture shows how they are related:

Does this mean, if I have HBP, I can improve it with the right nutrients and lifestyle?Absolutely! A recent study out of Vanderbilt shows that micro and macronutrient deficiencies, which can be measured and corrected and some genetic “deficiencies” (for example enzymes that don’t work as well as they should because of minor or moderate mutations), which can be overcome by increasing the enzyme’s micro or macronutrients in combination with lifestyle changes allowed 62% of the patients to control their BP without medication! These changes will also likely help with other chronic diseases you may have like type 2 diabetes.

This is great news for you, if you are among a majority of HBP patients who have a nutritional deficiency or a correctable genetic cause for your HBP. It is important to identify the deficiency with functional micronutrient testing or genetic testing. Please do not stop your medications on your own and to have a doctor monitor and guide you through the proper steps.

Written by Dr. Les Cole. Copyright 5/20/13


October 12, 2013

Nutritional deficiencies can affect more than just your immediate health. According to a recent research article published in Science Translational Medicine Journal, Vitamin D deficiency can increase the initiation and propagation of cracks of the bone by 22 to 31 percent. The article concluded that Vitamin D deficiency is not only associated with diminished bone mass, but also decreases fracture resistance1. In other words, keeping your vitamin D levels up may decrease your risk of bone fracture. Nutritional deficiencies such as these can be reversed and healed with proper guidance. Be sure to mark your calendar for a free Health Seminar where Dr. Les Cole will be giving a  special lecture on high blood pressure and reversible nutritional deficiencies on November 20th at 6:00 at the historical arcade hotel building downtown Tarpon Springs.
At Vital Well-Being Center we are committed to help patients reach optimal vitality and wellness through integrative medicine. Our physicians are committed to continuous education enabling them to uncover root causes for health disruptions to combat and eliminate underlying issues.  Let our knowledgeable physicians and our compassionate care team help guide you through your personalized healing path to get you feeling at your best! We use advanced diagnostic testing and offer services from chelation therapy to bio-identical hormones. For more information see our website at
Written by Jennilea Steffens
 1B. Busse, H. A. Bale, E. A. Zimmermann, B. Panganiban, H. D. Barth, A. Carriero, E. Vettorazzi, J. Zustin, M. Hahn, J. W. A. III, K. Püschel, M. Amling, R. O. Ritchie, Vitamin D Deficiency Induces Early Signs of Aging in Human Bone, Increasing the Risk of Fracture.Sci. Transl. Med. 5, 193ra88 (2013).