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Stephen B. Strum M.D. also see
RECOMMENDATIONS: VITAMINS, MINERALS & TRACE ELEMENTS
Practice of Internal Medicine, Medical Oncology & Hematology
9808 Venice Blvd. Suite #503, Culver City, California

In 1981 I wrote what I considered to be the latest concepts of nutrition. Essentially all of the areas I cited now have become widely accepted. I would like in this paper to reemphasize certain areas and add new suggestions to the previous ones. One of the most glaring errors in health care in this country and perhaps the world, is the lack of attention to the concept of "prevention". It seems that part of human nature is to deny the possibility of illness until it occurs. Once it occurs we will do and pay just about anything to regain what we lost. If our families, schools and media would focus on a few of these areas we would reduce pain and suffering and reduce billions of dollars spent after the fact on health care.

First of all, we are a country of excess. The average American is obese and under-exercised. We orient ourselves around the TV and with the watching of the TV comes the eating. A recent article in Prevention magazine noted that one easy way to reduce weight is to decrease television time to one hour a day. The people of this country in general eat to the point of being stuffed rather than content. We also eat our biggest meal at dinner when our activity and caloric needs are the least. As mentioned in the last nutrition paper, "Eat breakfast like a King, lunch like a Prince and dinner like a Pauper." I would go further to say that one should never eat to the point of being distended but rather to feeling no longer hungry. Think French when eating. Savor your food and eat slowly. Learn to push away part of your meal and be served smaller amounts. This will also help your pocketbook.

Secondly, change the quality of what you eat to a low, low fat diet. Fat is likely the culprit with the epidemic proportions of breast, colon and prostate cancer in this and other Western countries. The incidence of these cancers and others is decreased in cultures eating a low fat, high fiber diet. In Seventh day Adventists prescribing to a vegetarian type diet the incidence of cancer in general is markedly decreased. Even in women already having a diagnosis of breast cancer, obesity is an adverse prognostic factor, i.e. women who are overweight do not respond as well as do women of normal weight. When you are in the market read the labels regarding fat content. Strive for the lowest fat diet you can reach. Animal meat consumption should be avoided as much as possible. Fish, turkey and chicken should be your source of non-vegetable protein. The majority of medical articles now suggest that we eat complex carbohydrates- starches that require digestion to break them down to simpler carbohydrates and eventually sugars. Simple sugars should be avoided. Their consumption results in jumps in blood sugar with the body reacting with insulin production and frequently hypoglycemia. Eating complex carbohydrates avoids this. Coarse-grained breads, whole wheat and bran cereals, raw or lightly steamed vegetables, fresh fruits are all in this class. Learn to use a Wok or skillet and when using it try using Pam. It contains no fat.

Increase the fiber in your diet as much as possible. When doing so you speed the transit through the intestine and decrease the tendency towards constipation. You also decrease your chances for getting colon cancer. High fiber in your diet also lowers serum cholesterol. Fiber is filling and low in calories. Patients with diabetes eating large amounts of fiber can lower or eliminate their need for insulin. Fruits and vegetable and cereals are high in fiber. Their are commercially available fiber bars as well as psyllium seed products and bran wafers. I would suggest taking 6 to 10 grams of dietary fiber in the form of bran wafers mixed with apple sauce. Drink plenty of water when on a high fiber diet and supplement your diet with calcium, zinc and iron. Substances called phytates in the fiber will bind with these elements and possibly create a deficiency unless supplements are taken.

Salt should be minimized in your diet. Foods high in salt are frequently high in nitrosamines which by themselves cause cancer. Salted, smoked and pickled foods are not advised. Therefore avoid bacon and sausage and ham. These are also high in fat. High salt intake in many individuals leads to water retention and the need for diuretics ("water pills") and potassium supplements. Salt is dangerous for people with hypertension. Instead of salt use a salt substitute that is rich in potassium rather than in sodium. Cosalt, light salt and other salt substitutes are available in your market. Their labels should indicate their contents to be potassium chloride. Only patients with kidney disease need to be concerned about potassium excess in their diets. Potassium recently has been shown to have a blood pressure lowering effect. Low potassium resulting from diuretics taken without supplementation results in weakness and lethargy. In patients with heart disease, low potassium can cause disturbances in heart rhythm.

Cigarettes should be totally avoided as should the inhalation of passive smoke. These are cancer producing without question and one of the major causes of illness and death in the world. Not only cancer but cardiac disease and vascular disease all result from and are aggravated by cigarette smoking. Lung cancer and bladder cancer are related closely to cigarette smoking. If you want off cigarettes have your physician prescribe one of the nicotine patch products to you.

Alcohol intake should be minimized to 1 or 2 ounces a day. Alcohol will wash out many of the water soluble vitamins as well as increase the consumption of Vitamin C, zinc, selenium, magnesium, calcium and potassium. Alcohol in excess will increase fat deposits in the heart and decrease immune function. Alcohol is a toxin to the bone marrow and can cause liver injury leading to hepatitis and cirrhosis.

Please note that the recommendations made here are based on medical reports and on personal observations. Many of these reports are viewed with skepticism by members of the medical profession. If you review the recommendations made in the 1981 handout you will note that at that time most of the suggestions regarding dietary modifications and vitamins and trace elements would be laughed at. Today, many if not all, of these suggestions are considered good medicine.

Stephen B. Strum M.D.
September 1994

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