© Whole Foods Magazine

December 2005

Practical Guidelines From the Cutting Edge

Jack Challem, “The Nutrition Reporter,” offers practical guidelines based on the latest nutritional research.

By Richard A. Passwater, Ph.D.


It’s always a joy for me to chat with Jack Challem about new, state-of-the-art medical and nutritional information coming from leading scientists that has not yet sunk into the knowledge of the mainstream. Most of those in practice are going by what they were taught years ago and have not been able to keep up with the groundbreaking research outside of their very narrow specialties. Jack Challem and I always lament over what has to happen for most practitioners in the field to understand the new discoveries and begin to incorporate these life-saving findings into practice. Jack once again has consented to chat with us on the practical guidelines regarding various new developments since our last chat in March, 2005.

Jack Challem is a prolific health industry author and owner/editor of The Nutrition Reporter, a trademarked industry newsletter. I have known Jack Challem since the days when he wrote nutrition articles for Bestways, starting in 1974, and Let’s Live, starting in 1978. Jack, who calls himself, as well as his publication, “The Nutrition Reporter,” has written for many periodicals, including GreatLife, Modern Maturity, and the Saturday Evening Post. He also has written more than a dozen books including Feed Your Genes Right (Wiley, March 2005), The Inflammation Syndrome: The Complete Nutritional Program to Prevent and Reverse Heart Disease, Arthritis, Skin Problems, Allergies and Asthma (Wiley, March 2003), Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance, with co-authors Burt Berkson, M.D. Ph.D., and Melissa Diane Smith (Wiley, 2000), and The Natural Health Guide to Beating the Supergerms, with Dr. Richard Huemer (Simon Schuster, 1997).

Jack’s body of work includes his books, his newsletter (accessible at www.nutritionreporter.com) and more than 1,000 magazine articles. Jack is currently the series editor for the Basic Health Publications’ User’s Guide Series of health books, a collection of paperbacks that is available in many health food stores.

On four previous occasions, Jack was our guest in this space. In June 1997 we discussed “Supergerms;” in March 2000, we had a conversation about “Syndrome X;” in March 2003 it was about “The Inflammation Syndrome” and most recently, in March 2005, we chatted about “Feeding Your Genes Right.”

The importance of feeding your genes right is still not understood by most. It is this area of research that I feel is now so important. This is a revolution that started in the mid-1990s, but still hasn’t reached mainstream nutrition. Researchers began reporting that certain nutrients interacted with genes and often determined whether a gene became active or not. The implication is obvious. This explains how antioxidants affect health and disease in profound ways, much more than could previously be explained by the role of nutrients in enzyme function or structural function. Yes, nutrients at the lower levels, required for structure, growth and repair, are very important to health. But, much higher levels of some nutrients, especially antioxidant nutrients, not only reduce the damage from free radicals, but determine whether or not genes are expressed that in turn determine whether or not one’s risk for cancer or arthritis or heart disease increases. You may have good genes, but if they are not expressed, then they don’t help you. You may have bad genes, but if they are not expressed, they won’t hurt you. Let’s see what Jack Challem has to say about this revolution now.


© 2005 Whole Foods Magazine and Richard A. Passwater, Ph.D.

This article is copyrighted and may not be re-produced in any form (including electronic) without the written permission of the copyright owners.


Passwater: We discussed your book, The Inflammation Syndrome, in this space a little over two years ago (March 2003). Since then, inflammation has become the watchword in heart disease and many other diseases that had not previously been considered inflammatory. You seemed to be a little ahead of the curve. Would you explain what the “inflammation syndrome” is?


Challem: For many years, the definition of inflammatory diseases was pretty much limited to arthritis, allergic rhinitis, and other “-itis” diseases. Over the past five years, the medical understanding of inflammation has broadened considerably. Heart disease is now believed to be the result of low-grade inflammation of the arteries. At least 30% of all cancers result from chronic inflammation or infection, the latter causing inflammation. Alzheimer’s disease is now considered the consequence of inflammation in the brain. Basically, inflammation plays a fundamental role in all disease processes. It’s one of the key common denominators in diseases, either as a cause or promoter of the disease process. So reducing inflammation would be an essential step in reversing most diseases.


Passwater: How did you come up with the concept of the inflammation syndrome?


Challem: I had long been interested in the anti-inflammatory properties of omega-3 fish oils and gamma-linolenic acid (GLA). I was curious about the mechanism, but it took me a number of years to piece things together in terms of an “inflammation syndrome.”

Syndromes refer to clusters, or consistent groupings, of symptoms. As I researched inflammation for the book, I realized that different inflammatory diseases were related to each other. For example, rheumatoid arthritis increases the risk of heart disease, and prostatitis increases the risk of prostate cancer. Inflammation is one of the main underlying mechanisms, and there are several more mechanisms as you go down to the next layer, including turning on genes that promote inflammation and cell-to-cell communication (signaling) that leads to more inflammation. If you happen to suffer from several inflammatory diseases, such as heart disease, arthritis, periodontitis, and allergies, you would normally see a different doctor for each condition. The inflammation syndrome is really the grand unifying concept. If you treat inflammation correctly—that is, through nutrition and supplements—all of the different expressions of the underlying inflammatory disorder should improve.

Another example of the inflammation syndrome involves obesity, diabetes, and heart disease. Obesity is the leading risk factor for diabetes, and both obesity and diabetes are the leading risk factors for heart disease. High levels of inflammation are intertwined in all three conditions. Inflammation is the common thread, and the progressive cell deterioration in a mild inflammatory disorder sets the stage for a more serious inflammatory disease.


Passwater: Most people don’t see obesity as an inflammatory disorder.


Challem: Fat cells secrete various pro-inflammatory compounds, which then migrate throughout the body. Recently, researchers found that fat cells also attract immune cells, which enter the matrix of fat cells, particularly in the belly, and then release a variety of pro-inflammatory compounds. It looks as though the immune system responds to large amounts of body fat as if it were a bacterial infection.


Passwater: Now that’s an interesting fresh approach that deserves looking into. What do you think are the best ways for a person to lose weight?


Challem: Interestingly enough, this is a theme that runs through my three major books, Syndrome X, The Inflammation Syndrome, and Feed Your Genes Right. It’s of personal interest, also, because in 1999 I was on the verge of being prediabetic and was 20 pounds overweight. I lost 20 pounds within three months of giving up pasta, which is really nothing more than starch. My blood sugar has since been perfectly normal. And my insulin levels, which are probably the best indicator of glucose control, are absolutely perfect.

I think the three top dietary evils are trans fats, various types of refined sugars, and refined carbohydrates. Trans fats interfere with how the body processes healthy fats, such as the omega-3s and gamma-linolenic acid. These healthy fats are part of our anti-diabetes defense. The refined sugars and carbs increase blood sugar and insulin levels. Insulin promotes fat accumulation around the belly. And blood sugar and insulin swings make people hungrier, so they eat more and gain more weight.

I recommend a protein-rich diet that’s relatively low in saturated fat. The emphasis should be on fish, chicken, and turkey. I also recommend eating a lot of high-fiber, nonstarchy vegetables and fruit. The fiber helps dampen spikes in blood sugar and insulin. A little brown rice or one of the other unprocessed rice varieties, such as red or purple rice, is good—but a person who is overweight really has to watch these high-starch “empty” calories. My focus is on nutrient density—that is, getting the most nutrition from every bite or every calorie of food.


Passwater: And so how do you approach the issue of weight in these three books?


Challem: Syndrome X is essentially prediabetes. The focus in the Syndrome X book is on shifting to a more nutrient-dense diet. Part of what I addressed in The Inflammation Syndrome was how refined carbohydrates promote inflammation. The mechanism seems to be partly through insulin. Insulin increases levels of pro-inflammatory cell-signaling compounds such as interleukin-6 and C-reactive protein. In addition, trans fats interfere with the body’s handling of omega-3 fats, thereby disabling one of the body’s key anti-inflammatory mechanisms. In Feed Your Genes Right, I explained some of the underlying genetic mechanisms. Basically, refined sugars and carbs turn on genes involved in inflammation and obesity.

The diet plans are similar in each of the books. Supplementation is essential to improve how well our genes and cells function and to repair some of the accumulated damage. In Feed Your Genes Right, I described three groups of supplements: the B-complex vitamins, energy nutrients (including CoQ-10), and antioxidants.


Passwater: Any other thoughts on this “weighty” issue?


Challem: There is a multigenerational effect from eating junk food that, generation after generation, increases the risk of obesity and diabetes. The first hints of this multigenerational effect of bad nutrition came out of Francis Pottenger’s cat studies in the 1930s. There is now clearer scientific evidence about how this occurs. When nutrition is poor from generation to generation, there is a deterioration in gene integrity. But there is something else at play also. There is a subdiscipline in genetics called epigenetics. It deals with how nutrients and the environment change gene function without changing the gene itself. It’s a little like changing the software programming without changing the hardware.

The implications are profound, and I think this is the real future of genetics research.

As an example, we all have around 1,700 oncogenes that can promote cancer. Most of the time these genes are suppressed by “methyl groups,” which consist of one carbon and three hydrogen atoms. These methyl groups are produced from the B vitamins. There have been intriguing animal studies showing that an obesity gene can be turned off with extra B vitamins. That raises a big question: could today’s epidemic of obesity be related to low intake of B vitamins, along with intake of too many sugars and carbs?


Passwater: Let’s get back to inflammation. The role of inflammation in heart disease keeps getting a lot of headlines.


Challem: You’re right. Many of these studies have measured levels of high-sensitivity C-reactive protein (CRP), a substance that is both a promoter and marker of low-grade inflammation. CRP is part of the family of cytokines, which are cell-communication molecules. CRP tells cells to release all sorts of other pro-inflammatory substances. It’s now clear that inflammation, not cholesterol, is a key cause of heart disease. But many doctors have become so wedded to the cholesterol theory that they cannot acknowledge that the research has shifted dramatically under their feet.


Passwater: And the drug companies?


Challem: The drug companies have spent billions of dollars promoting statin drugs and other drugs to lower cholesterol. It has been so profitable for them that they don’t want to give up on the cholesterol message, even though it doesn’t explain heart disease. Elevated cholesterol is more a symptom of something awry than a cause. I think the drug companies are trying to slowly segue from recommending statins for lowering cholesterol to recommending statins for lowering C-reactive protein.

Statins, of course, have been the theme of many of your interviews, and these drugs interfere with the body’s production of coenzyme Q-10, which is why they so often cause muscle weakness and liver problems. Statins also reduce levels of vitamin E and other nutrients and essential vitamin-like compounds. Statins change a symptom of inflammation, not the symptom’s underlying cause.


Passwater: You make the point in The Inflammation Syndrome that the real cause of inflammation is dietary.


Challem: It’s a combination of dietary problems plus an injury, and that injury could be serious wear and tear on the knees or damage to arteries from high blood pressure. Biologically, inflammation is the body’s short-term response to injury. But chronic low-grade inflammation breaks down tissues.

The key dietary problem is that most people are now eating diets that promote inflammation. Trans fats, large amounts of highly refined omega-6 fats, and refined sugars and carbohydrates prime people for inflammatory reactions. The average person is now eating 20 to 30 times more omega-6 fats than anti-inflammatory omega-3 fish oils, compared with diets in the past. All the pro-inflammatory foodstuffs are like creating a field of dry grass, and an injury is like holding a match to the field.


Passwater: How does a person correct the situation?


Challem: The two approaches I recommend involve eating habits and supplements. A diet that emphasizes fresh fish, grass- or range-fed meat, and a lot of vegetables provides plenty of omega-3 fats, which are the building blocks of the body’s anti-inflammatory prostaglandins. Grass-fed meats have omega-3 levels that approach those of salmon. In contrast, corn-fed meat has very high levels of pro-inflammatory omega-6s as well as saturated fats.

You also have to avoid trans fats, because they totally mess up the body’s anti-inflammatory chemistry. Many studies have shown that people who eat a lot of trans fats—which are found mostly in refined and processed foods—have the highest levels of inflammation.


Passwater: What supplements do you recommend?


Challem: There are many helpful supplements. At the top of my list are the omega-3 fish oils. Many people will benefit from 3 to 5 grams daily, but a few will need 20 to 25 grams daily. At those high dosages, the citrus flavored oil becomes easier to take by the teaspoon or tablespoon than 20 or 25 capsules. Gamma-linolenic acid (GLA) is very helpful for people with rheumatoid arthritis, usually in the range of 1.4 grams. Also toward the top of my list is vitamin E, which works well but a bit more slowly as an anti-inflammatory nutrient.

Glucosamine and chondroitin seem to have some anti-inflammatory properties, especially in osteoarthritis. Virtually every antioxidant also has anti-inflammatory effects. I happen to like the anti-inflammatory properties of Pycnogenol—you need at least 150 mg daily to have this effect. Some of the B vitamins lower homocysteine, which is pro-inflammatory. Other B vitamins function as coenzymes for antioxidants, so they also have anti-inflammatory benefits.


Passwater: There is continuity in your books that I really like. How does your Syndrome X book tie in with inflammation?


Challem: In restrospect, my Syndrome X, Inflammation Syndrome and Feed Your Genes Right books are an unintentional nutritional trilogy. They reflect my own evolution in thinking and how I’ve put together different pieces of the puzzle about why we get sick.

Syndrome X is a pre-diabetes, pre-heart disease condition. The most obvious sign is being overweight—which describes two-thirds of Americans. Inflammation is an undercurrent in obesity and diabetes. Fat cells secrete large amounts of C-reactive protein, and white blood cells infiltrate fat deposits and release still more C-reactive protein.

In Syndrome X, a big part of the problem goes back to the consumption of large amounts of refined sugars and starches. These foodstuffs—I hate to refer to them as actual foods—increase blood sugar levels. High blood sugar levels generate large numbers of free radicals and “advanced glycation endproducts” (AGEs), which reflect sugar damage to proteins. Both free radicals and AGEs stimulate inflammation.


Passwater: And how does your most recent book, Feed Your Genes Right, tie in with inflammation?


Challem: The fundamental playing field for what goes wrong occurs at the genetic level. Free radicals and AGEs stimulate the activity of genetic transcription factors, such as “nuclear factor kappa beta” (NF-kB) and “activator protein-1” (AP-1). NF-kB, AP-1, and several other transcription factors turn on genes involved in promoting inflammation. When these genes get turned on, they start programming the production of various pro-inflammatory proteins, such as CRP.

But we don’t have to be at the mercy of these things. Our gene function depends on nutrients. Many antioxidants, such as vitamin E and alpha-lipoic acid, turn off NF-kB and other transcription factors that stir up and promote inflammation.


Passwater: Isn’t inflammation related to the aging process?


Challem: Yes, and unfortunately more tends to go wrong with our bodies as we age. Levels of inflammation increase with age. Some of this is related to eating poorer diets and not absorbing nutrients well. But some of it is also related to an increasing number of dead cells, which the immune system tries to clean up. With a lot of dead or dysfunctional cells, the immune system gets revved up—inflammation is part of the mechanism used to clean up these unneeded cells.

However, recent research has found that centenarians tend to have the “1082 gene,” and this gene helps maintain high levels of interleukin-10, an anti-inflammatory cytokine. Those of us who don’t have this gene just have to make sure we eat a lot of anti-inflammatory foods—mainly fish and vegetables—and take the anti-inflammatory supplements I mentioned earlier. The key is keeping a tight rein on pro-inflammatory genes and chemicals.


Passwater: As I remember, you weren’t very fond of the Cox-2 inhibitor drugs long before the recent news of their adverse effects.


Challem: These drugs are very dangerous. Vioxx was withdrawn from the market last year because it doubled the risk of heart attack and stroke. Other Cox-2 inhibitor drugs increase the risk as well. The drug companies have tried to make the Cox-2 enzyme look like the bad guy, but it does many beneficial things in the body. The drug companies knew the risks of Cox-2 inhibitors early on and they withheld full disclosure of the risks from both the Food and Drug Administration (FDA) and the medical journals.

The drug companies developed Cox-2 inhibitors as a way of trying to make patented high-profit drugs, instead of pursuing the most direct line therapeutically. I don’t have a profit motive—I’m not involved in the sale of any supplements or drugs. So when I look at the situation, it seems far more efficient to increase the dietary building blocks of the body’s natural anti-inflammatory compounds. These building blocks are fish oils, GLA, and antioxidants. But nutritional supplements make a fraction of the billions of dollars a year that Vioxx and Celebrex earned for their makers, and most supplements can’t be patented the way proprietary drugs can be.


Passwater: Any final thoughts?


Challem: Conventional medicine has a habit of ignoring the obvious. In this case, the obvious is that all of the building blocks of our body come from nutrients. Without nutrients, our bodies can’t make new DNA and we can’t make anti-inflammatory compounds. And yet doctors rarely look at whether their patients have nutritional deficiencies. I think any doctor who fails to do a nutritional workup of patients should have his license taken away for malpractice. Seventy-five percent of Americans are deficient in folic acid, 68% are deficient in magnesium, 55% don’t get enough vitamin A, 48% lack enough vitamin C, and 86% are deficient in vitamin E. These statistics are based on Reference Daily Intakes (RDIs), which are notoriously conservative. If we used less conservative criteria, the percentages of people with deficiencies would be far higher.

Most of our health is related to what we put in our mouths, and much of the rest is related to our physical activity and stress levels. After I wrote The Inflammation Syndrome, I wrote Feed Your Genes Right, and it became clear that good food improves how our genes function, regardless of the types of genes you’ve inherited. When we treat our bodies with respect and eat healthy foods, we keep our genes humming along and lower our risk of inflammation.


Passwater: Thank you for chatting with us again. Readers may wish to go to  www.inflammationsyndrome.com and www.feedyourgenesright.com for more information, in addition to re-reading your books. WF