Carta de Samuel Hahnemann (fundador de la homeopatía) a un ministro francés de la época (1835)

Señor Ministro:

Acabo de leer en el Moniteur que os proponéis consultar a la Academia de Medicina, sobre la cuestión de “si es conveniente establecer en París dispensarios y un hospital en donde los enfermos sean tratados según los principios de la medicina homeopática”.



El bien de los hombres me interesa demasiado vivamente para que sea indiferente a una cuestión tan importante. Mi conciencia, señor Ministro, me obliga a esclarecer la vuestra, cuya noble iniciativa se propone acoger la verdad y proteger la más importante de todas las ciencias, la que devuelve y conserva la vida. La Homeopatía es una verdad nueva que lastima, como todo nuevo descubrimiento, algunos intereses particulares, y por eso mismo encuentra por todas partes donde quiera establecerse, oposiciones que, para detener su marcha, se esfuerzan en poner en duda la realidad de su principio.


Todos los sistemas inventados hasta hoy en medicina, consideran las enfermedades como susceptibles de anonadamiento material por medios violentos, que debilitan la fuerza vital, con emisiones sanguíneas y evacuaciones de todo género. Por el contrario, la Homeopatía, obrando dinámicamente sobre dicha fuerza, anonada las enfermedades de una manera dulce, imperceptible y duradera. No se trata sólo de un invento ingenioso, de una hábil combinación que produce algunos resultados más o menos felices en su aplicación, sino que es un principio constante de la naturaleza, el único capaz de dar al hombre la salud perdida. La ciencia establecida sobre este principio, que se resume en la sentencia Similia Similibus Curantur, está y seguirá estando en oposición con todas las doctrinas médicas y con todos los que las practiquen. Por consiguiente, señor Ministro, vos no podéis tomar por jueces a aquéllos que la ignoran, o que están interesados directamente en oponerse a sus progresos.


Los miembros de la Academia de Medicina de París son personas recomendables, pero es preciso no olvidar que una larga costumbre les apega a la práctica de una ciencia defectuosa que, a falta de otra mejor hasta hoy, ha gobernado la salud de los hombres. Ignoran lo que es la Homeopatía; sin conocerla, la juzgan quimera, y rehusando su estudio, no pueden concebir ni sus efectos ni su aplicación. Yo les hago justicia, la de creer que los resultados felices de sus ensayos podrían convertirlos. Pero aún no están consiguiendo estos resultados, y para conseguirlos, es preciso estudiar y experimentar.


Lo único que demanda la Homeopatía de sus detractores es ser admitida a sus experiencias y comprobaciones; prueba que será tanto más concluyente cuanto mayor número de individuos la procuren y obtengan. Un Hospital Homeopático, por exiguo que sea, si está bien dirigido y exclusivamente sometido a las influencias de esta medicina, es probablemente el medio más seguro para convencerse de su excelencia. Yo os conjuro, señor Ministro, a seguir en esta importante circunstancia vuestra propia convicción, que podéis esclarecer acudiendo a los miembros de la Sociedad Homeopática de París. Consultadles sobre el principio que nos dirige, y proporcionarles el medio de procurar su realización, confiándoles una clínica sin intervención antagónica de los médicos de la antigua escuela.


Ningún interés personal me guía en los consejos que me atrevo a dirigiros; sería una dicha para mí responder a las indagaciones que creáis necesarias para informaros más ampliamente.


Vuestro poeta Béranger ha dicho:


¡Combien de temps une pensée,
vierge obscure, attend son époux!.
Les sots la traitent d´insensée;
Le sage lui dit: cachez vous.
Mais la rencontrant loin du monde
un fou qui croit au lendemain
l´épousse; elle deviant féconde
pour le bonheur du genre humain.



He aquí mi historia, señor Ministro. A los ochenta años, todavía tengo que pedir perdón a los hombres por el bien que les he hecho.


Si mis observaciones os son gratas, erigid en París un Hospital Homeopático, independiente y sometido únicamente a vuestra jurisdicción, y así llenaréis el vacío de mis votos y recompensaréis mis inmensos trabajos.


Soy, con la más perfecta consideración, vuestro muy humilde y obediente servidor,


Samuel Haheneman.


En Coethen, ducado de Anhalt, 15 de Febrero de 1.835.

Fuente: Blog de Medicina Natural del portal digital Tendencias21. Editor del blog: Dr. Carlos Rubio Sáez. Fundador de la Sociedad Española de Médicos Homeópata (SEMH).

Homeopathic Treatment of Type 1 Diabetes Mellitus (Insulin Dependent Diabetes Mellitus) Patient

A thirteen year old girl with Insulin Dependent Diabetes Mellitus responds to homeopathic remedies which also ameliorate her general constitution.
Introduction
Type 1 (formerly Insulin Dependent Diabetes Mellitus), usually juvenile onset but may occur at any age. Cause: Insulin deficiency due to selective destruction of secreting pancreatic beta cells. Patients always need Insulin and are prone to ketoacidosis and weight loss. It is associated with other auto immune disease (> 90% carry HLADR 3 and/or DR4).

Analysis of the patient
A 13 yr old school girl suffering from this disease for 8 years, was referred to me. Her parents were both nurses and very worried about their daughter’s condition. She was very alert and cooperative. Spells of nightly hypoglycemia, her hopelessness of improvement which had led her to disregarding her diabetic diet and controlling her FBS regularly and a high HA1c of 10 and a 230 mg/dl FBS revealed the family’s poor control and their tiredness and aversion to regular supervision of their duties. She used to reproach her brothers before other people and was aggressive towards them when she got angry; cramped states especially during sleep was another symptom. After taking the case, Nux vomica was found to be the most similar remedy. Prescription: Nux-v. 30c in liquid form, 20 drops was prescribed and taken by the patient.

Report of course of treatment
After prescribing the remedy, her Insulin was continued and not tapered, until her FBS decreased from 230 mg/dl to the normal range of 110 mg/dl after 60 days of taking the remedy. Of course she had experienced an aggravation of her blood sugar which had risen to 290 mg/dl after 3 days of taking the first dose of Nux-v. Thereafter it began to decrease, coming close to the normal range of 110mg/dl after about 2 months on the 13th of December 2008. Her remedy was repeated every other day after potentizing. I started to decrease her Insulin one unit by one unit along with strictly monitoring her FBS and evening BS for about 3 more months. Of course I talked to her and suggested her to try to follow her diabetic and homeopathic diets ,too. Her second remedy was Sulphur according to her new situation after taking Nux-v. Fortunately she helped me by following her diets. She had become more energetic and more hopeful to continue her good cooperation. I promised to give her a gift for her nice effort and cooperation. After one year of treatment, I called her up and asked about her condition and her feelings. She was happy and content with her treatment .She had not experienced hypoglycemic spells after taking Sulphur. Her father said that her last tests have been: FBS of 135, HA1c of 8 and blood pressure of 110/70 mmHg. They were all happy about her significant healing and cure. She is taking 10 units of NPH Insulin in mornings and 4 in the afternoon. i.e. 4 units have been tapered during the last year and a decrease of 95 mg/dl has been earned.

Discussion
I prescribed 20 drops of the remedy with potency of 30c and recommended a special diet appropriate for a juvenile diabetic patient. First she experienced an aggravation in her blood sugar but an inner calmness. So I waited until her FBS decreased to 110 mg/dl in 2 months by repeating the first remedy. She continued to take 18 units of NPH Insulin, without any change until 13th of December 2008 when she came with a normal FBS of 110. Sometimes she experienced even lower FBS in the mornings. So I started to decrease her NPH Insulin carefully and gradually . After about 2 months of taking Nux-v, again I took her case and prescribed Sulphur 30c to be taken 2 drops biweekly and after dynamizing, by shaking it vigorously. It continued for about 2 months and no other remedy was prescribed. Her last FBS has been 135, with a HA1c of 8 and her blood pressure 110/70 mmHg.

Conclusion
The results of this case report, as an observational study, reveal multi- potential characteristics and capabilities of the prescribed homeopathic remedies , Nux-v. and Sulphur. They not only decreased the patient’s FBS but also improved her mental situation especially her hopelessness altered to being hopeful and cooperative, as well as some physical symptoms. The homeopathic treatment has not only been effective in decreasing her blood sugar, but also has improved part of her totality of symptoms and changed her mood condition from low mood to good mood which is very significant.

References
1- The Organon of Medicine 6th edition,2006, by Dr.Samuel Hahnemann compiled by Dr.Kamran Jalali
2- The Science of Homeopathy, by George Vithoulkas Translated by M.Asefi, 2003
3- Boericke’ s new manual of Homeopathic Materia Medica, 9th edition, 2000 by William Boericke
4- Synoptic Materia Medica, , 2006 by Vermeulen F. compiled by Dr.Kamran Jalali
5- Oxford Handbook of Clinical Medicine, 7th edition, 2007 by Longmore et al


Author: Seyedaghanoor Sadeghi M.D., Hom. Graduated from Tehran University of Medical Sciences and Health Services and Iran Homeopathic Learning Center. He is a Certified medical doctor in Iran, and Official member of the Iranian Homeopathy Association.
Source: Hpathy.com

Acerca de la mortalidad perinatal

El argumento más utilizado para legitimar el alto grado de intervencionismo obstétrico es la afortunada reducción de la mortalidad perinatal de madres y bebés que se ha producido durante el último siglo.

Los partos que actualmente transcurren en casa o en maternidades atendidos por comadronas y con poca o ninguna utilización de medidas invasivas tienen una excelente tasa de salud materno-infantil, similar y en ciertos aspectos superior a los partos hospitalarios atendidos por tocólogos o matronas basándose en la tecnología más dura. La tasa de intervenciones es considerablemente inferior en el caso de los partos en casa. Los partos problemáticos que no pueden prescindir de ayuda obstétrica no sobrepasan el 10%, según estimaciones de la Organización Mundial de la Salud. Estos son los que en otro tiempo estarían incluidos dentro del grupo de riesgo de muerte.

Ello prueba que el actual mejor conocimiento de la fisiología del parto, tanto por parte de las madres como del personal asistente es un factor importante que ha permitido mejorar las condiciones en que da a luz la mujer. En el hospital de Pithiviers, donde no se realiza ningún procedimiento obstétrico más que en escasos casos de urgencia, la mortalidad perinatal es inferior al resto de Francia.

Que la mujer de hace varios siglos pariera de una manera natural y asistida por su instinto y por su vecina más experta implica que efectivamente se respetaban tanto la intimidad y libertad de la parturienta como su propia dignidad y capacidad como madre para llevar a cabo el proceso. Sin embargo la mortalidad perinatal era más alta que ahora … pero no más alta que la de la población en general, frecuentemente golpeada por las epidemias. Las infecciones postparto se llevaban a madre y recién nacidos con dolorosa frecuencia.

Sin embargo, atribuir a la obstetricia el mérito total del descenso de la mortalidad perinatal implicaría dejar fuera algunas otras variables que han influido de manera importante. Sería lo mismo que atribuir a los antibióticos y vacunas todo el mérito de la disminución de las epidemias que diezmaban una y otra vez las poblaciones de nuestros antepasados, cuando un análisis riguroso demuestra que la intervención de otras variables fueron mucho más decisivas a la hora de mejorar la salud pública.

Y la variable más importante fue, sin lugar a dudas, la higiene. El factor sanitario que más contribuyó a la drástica disminución de las enfermedades infecciosas acaecida desde finales del siglo XIX no fue la introducción de los antibióticos, sino la instalación de las redes de agua corriente y de alcantarillado en las ciudades europeas, así como la pasteurización de la leche. No hay que olvidar que en Europa, hasta hace pocos siglos, los contenidos de las letrinas caseras se arrojaban a las calles de ciudades y pueblos, generando un medio ambiente insalubre y propicio a las infecciones.

Según René Dubos (1), la mortalidad infantil por enfermedades infecciosas en los países desarrollados disminuyó en un 90 por 100 varias décadas antes de la aplicación de las medidas de control de la medicina "antimicrobiana" —antibióticos y vacunas-. La incidencia de cólera, difteria, disentería y tifus, por ejemplo, disminuyó notablemente después de la introducción del agua corriente y de la red de alcantarillado para la evacuación de aguas residuales, mucho antes del uso de antibióticos y de las campañas de vacunación, que comenzaron a partir de los años 30. En EEUU, por ejemplo, la difteria causó la muerte de 900 niños por millón en 1900, pero sólo de 200 en 1938. Sin embargo, las campañas de vacunación no comenzaron hasta 1942. La escarlatina descendió de 2.300 muertes por millón de niños en 1860 a 100 en 1918, pero las sulfamidas no estuvieron disponibles hasta la década de los 30, y la vacunación no comenzó hasta los años 60, en que los casos se habían reducido a una docena por millón, aproximadamente.

Por lo que se refiera a la asistencia al parto, el desconocimiento de la importancia de la suciedad en la transmisión microbiana daba lugar a una gran mortalidad de madres y bebés, muy superior en los hospitales que en casa. En realidad, puede decirse que los comienzos de la obstetricia como especialidad médica se siguieron de un aumento significativo de la mortalidad perinatal, al menos en lo que se refiere a los partos en hospital. Este aumento se debió principalmente a dos causas: la pasión del médico por intervenir de la forma que fuera en el recién invadido cuerpo de la mujer, y la total ausencia de asepsia.

En los siglos XVIII y XIX la tocología que se practicaba en los hospitales era fiel reflejo de la posición que ocupaba la mujer en la sociedad y de la opinión que los hombres /médicos tenían de ella. En los albores de la obstetricia la mujer se convirtió en un dócil y entretenido campo de experimentación. Los médicos más "activos" practicaban cruentas y arriesgadas operaciones a las parturientas, de dudosa eficacia y seguridad (2): dilatación artificial del cuello del útero con incisiones profundas en el cuello, cesárea vaginal, dilatación manual, dilatación instrumental, sección de la sínfisis púbica, cesáreas (morían casi todas); extracción del feto de nalgas con ganchos o con asas, etc.

Puede decirse que la actual corriente humanizadora del parto no es nueva, sino que comenzó con la misma obstetricia. Parte de los tocólogos —los "conservadores"- estaban alarmados de la manera de proceder de sus colegas "activos". El doctor Boer, por ejemplo, afirmaba: "Parece como si la naturaleza hubiese abandonado la obra de la parturición a favor de las técnicas del obstetra". El español Babil de Gárate publicaba en 1765 el Nuevo y natural medio de auxiliar a las mujeres en los lances peligrosos de los partos sin operación de manos ni instrumentos. El doctor Ahfeld, en 1888 advertía: "Las manos fuera del útero":

Una tan cruenta atención al parto, unida a la falta total de higiene dio lugar a una elevada mortalidad, en parte debido a que los médicos practicaban autopsias a las mujeres muertas por fiebre puerperal, y a continuación atendían partos sin lavarse las manos. Las infecciones se extendían con facilidad y las mujeres, que sufrían heridas de consideración durante el parto, morían como moscas. Cuando en el siglo XIX se descubrió el papel del médico en la transmisión microbiana, y el doctor Holmes aconsejó a sus colegas observar una limpieza escrupulosa en la atención a la parturienta, se desencadenó una violenta polémica en Europa que duró decenas de años, durante los cuales pocos servicios de obstetricia se molestaron en tomar medidas de higiene. Suponer que el médico podía actuar de transmisor era más de lo que se podía aceptar. El doctor Holmes sufrió el escarnio y la marginación de la mayoría de sus colegas y las medidas de higiene tardaron años en tomarse. Más mujeres murieron.

Una vez conocida y aceptada la existencia de los microorganismos y la importancia de la higiene, la simple medida de lavarse y desinfectarse las manos motivó que la mortalidad de las parturientas disminuyera considerablemente. Pero es preciso recordar que en París, por ejemplo, hace tan sólo un siglo, en 1884, sólo cinco hospitales disponían de agua corriente.

Además de los problemas de higiene en el parto, la frecuencia y cantidad de los embarazos, a menudo no deseados, el pesado trabajo de las madres de familia numerosa que además cuidaban del campo y los animales, las malas condiciones higiénicas y de calefacción de las viviendas, las fluctuaciones alimentarias naturales a lo largo de las estaciones, y la difícil posición de la mujer dentro de una sociedad opresiva ponían a ésta en una situación, cuando menos, algo precaria para hacer frente a las frecuentes maternidades. Ello no impidió, sin embargo, que numerosas mujeres tuvieran seis, ocho o más hijos sin sufrir complicaciones en el parto.

El Dr. Wagner, ex comisario de la OMS en materia de salud materno-infantil, afirmaba a este respecto: "Durante los últimos veinte años la mortalidad perinatal ha disminuido muchísimo, y los médicos lo atribuyen a que los partos tienen lugar en los hospitales. No hay ninguna prueba de que esto sea cierto. La evidencia científica es que mueren menos bebés porque hay una mejor nutrición, una mayor salud en la mujer, mejores condiciones de vivienda y algo muy importante, porque las mujeres tienen menos hijos y los tienen cuando los desean a través de la planificación familiar. Esta es probablemente la mejor razón por la que mueren menos niños que hace veinte años. La explicación está en lo que hacen las mujeres, no los médicos".

El informe "Tener un hijo en Europa", de la OMS, concluye "no está demostrado científicamente que ninguna de estas explicaciones (la medicalización del parto) haya sido la causa de la reducción de la mortalidad, aunque en todos los casos se ha dicho que la reducción demostraba el éxito de la intervención… La mortalidad perinatal empezó a reducirse mucho antes de la llegada de estos recursos médicos y, según parece, la tecnología más moderna simplemente se ha incorporado a la tendencia ulterior, en vez de producirla".

La investigadora Marjorie Tew publicó en 1990 un libro decisivo, Safer Childbirth: A critical history of maternnity care, fruto de un trabajo de investigación que pretendía en su inicio demostrar que el aumento de los índices de seguridad en el nacimiento estaba asociado al traslado de los partos al hospital. El estudio fue realizado en un momento en que prácticamente todo el mundo creía más seguro el parto en hospital que en casa, simplemente por el acceso a la atención médica y los recursos tecnológicos. Sin embargo, sus descubrimientos cambiaron totalmente el curso de su investigación.

La Dra. Tew estudió la relación entre la evolución de la atención al parto en Europa y las cifras de las tasas de mortalidad, y la sorpresa fue que constató que el traslado de los partos al hospital se correspondió con un aumento de las tasas de mortalidad materna e infantil. Entre los años 1958 y 1970, exceptuando los partos de alto riesgo, la mortalidad perinatal en hospital era 17.2 por 1000 nacimientos y 6.0 por 1000 en partos en casa.

Este cuadro resume sus descubrimientos:


Tasa de mortalidad materna por 1000 partos (8)

Riesgo Hogar (partera) Hospital
Riesgo muy bajo 3.9 8.0
Riesgo bajo 5,2 7,9
Riesgo moderado 3,8 32,0
Riesgo alto 15,5 53,2
Riesgo muy alto 133,3 162,6
Todos 5,4 28,8


La conclusión de Marjorie Tew es que una intervención obstétrica puede salvar la vida de determinadas mujeres y bebés, pero cuando interviene en casos de bajo riesgo, esa intervención incrementa considerablemente el riesgo de complicación. La conclusión es que el parto en casa es tan seguro como en el hospital para mujeres de bajo riesgo, pero en el hospital las mujeres de bajo riesgo estarían expuestas a mayores complicaciones durante y después del parto.


Notas
  1. Dubos, R. Mirages of health, utopías, progress and biological change. N.Y. Harper & -Row
  2. Usandizaga, J.A.. La obstetricia y la ginecología durante el romanticismo. Historia Universal de la Medicina (Laín Entralgo), tomo V, 1971, edición 1981.
  3. Usandizaga, J.A. La obstetricia y la ginecología. Historia Universal de la Medicina (Laín Entralgo), tomo VI, 1971, edición 1981.
  4. Peset J.L. y D. Gracia: Obstetricia, ginecología y pediatría. Historia Universal de la Medicina (Laín Entralgo), tomo VI, 1971, edición 1981.
  5. Wagner. OMS. Nacer en Europa, realidad y perspectivas. Ponencia presentada en las I Jornadas Mediterráneas de Embarazo y Parto. Valencia, 1989.
  6. OMS. Tener un hijo en Europa, Informe Sanidad Pública de Europa, 26. 1985.
  7. Marjorie Tew. Safer childbirth: a Critical History of Maternity Care. Marjorie Tew. Oxford University Press. 1990
  8. Marie Tyndall. Mortalidad materna: la seguridad se encuentra en el protagonismo de las mujeres mismas. Midwifery Today.

Autora: Isabel F. del Castillo, autora de "La Revolución del Nacimiento". Ed. Granica.
Fuente: Holistika.net

L’homéopathie en Espagne: ses débuts, ses progrés, ses difficultés dans le contexte socio-politique et culturel du pays

Le dix-neuvième siècle est un síècle glorieux pour l'Europe. On sent souffler des vents de liberté, un nouvel ordre social s'est établi et on assiste à d'énormes progrés dans toutes les sciences: la théorie de l'évolutionnisme, la révolution industrielle, la naissance d'un double sentiment européen: le nationalisme et le romanticisme.



Mais pour l'Espagne, le dix-neuvième siècle est un siècle de décadence où les luttes sociales et politiques se suivent, contribuant à la perte des derniers restes de son Empire colonial en Amérique. Le peuple, dépourvu d'instruction, et de sentiment patriotique, monarchiste, traditionnel et catholique. Un évident desequilibre entre la révolution de ce siècle et la réalité sociale en Espagne. Le romanticisme fut, au sens strict, un style littéraire et artistique, mais aussi un ensemble d'attitudes et d'images grandement répandues. C'est pour cela que l'Espagne, avec le rétard et le pittoresque, ses brigands et son folklore, son caciquisme et ses soulévements militaires, fut considérée par beaucoup d'européens comme un pays essentiellement romantique.
Pendant ces années le développement économique fut très faible et une grande partie de la population resta à l'écart de la modernisation.
A la suite de l'influence du Centre de l'Europe, qui est à ce moment-là le centre de la culture et la science, l'homéopathie arrive en Espagne. La première nouvelle apparait dans le Journal General des Sciences Medicales, en 1827.
C'est à travers Cádiz, la ville placée le plus au Sud de l'Espagne, gràce à son emplacement privilegié pour le commerce - spécialement pour le commerce maritime -, que l'homéopathie est introduite. Cette ville était devenue la plus ouverte aux nouvelles idées et, en même temps, le passage vers le Nouveau Monde.
Ce fut un riche commerçant de cette ville, M. Fernando Iriarte, affligé d'une maladie, qui ayant entendu parler de cette nouvelle science n'hésita pas à partir pour Koethen dans le but d'être traité par le docteur Hahnemann en personne. Intéressé par l'homéopathie il acheté de nombreux livres qu'il distribué à ses amis, une fois retourné en Espagne.
La première traduction de l'Organon en espagnol appartient au docteur Prudencio Querol, médecin de Badajoz, qui peut être consideré comme le précurseur des homéopathes espagnols.
Autre personnage remarquable  le docteur Rino y Hurtado qui fut le premier à publier une revue d'homéopathie, Les archives de la médecine homéopathique.
En 1829, à l'occasion du mariage de Marie-Christine de Bourbon, fille du roi de Naples, François I, avec le roi d'Espagne Ferdinand VII, le docteur Cosme Horatis, médecin de la Cour de Naples qui pratiquait déjà l'homéopathie, arrive en Espagne avec le cortège. Là, il fait la connaissance d'autres médecins qui se rallient à son enthousiasme pour l'homéopathie.
II faut aussi faire ressortir l'influence décisive de la France à travers les Ecoles de Paris, Lyon, Montpellier et Bordeaux, représentées par les docteurs Des Guidi, León Simón, Rapou, Petroz, Jahr, Crosiero, Mûre, Dessait, Chaza, Perrusel..., les précurseurs de l'homéopathie en France.
Plusieurs médecins espagnols se trouvaient exilés en France à cause de leurs idees libérales. Ils y étudient l'homéopathie. Parmi eux, les docteurs Núñez, López Pinciano, Larios, etc.
C'est aussi en 1832, qu'en Espagne l'homéopathie se construit sur des bases fermes pour sa théorie et sa pratique. Elle est déjà exercée par beaucoup de médecins. A cette époque-là le docteur Hahnemann voyage à Paris et s'y installe jusqu'à sa mort en 1843. En 1835, âgé de 80 ans, il épouse Mélanie d'Hervilly.
C'est avec Isabelle II, fille de Ferdinand VII et Marie-Christine - qui régna en Espagne vers le milieu du XIXe siècle - que l'homéopathie connaît son plus grand éssor et que commence la période la plus importante de l'homéopathie en Espagne.
Dans les six décades comprises entre 1835 et 1900 des livres sont traduits, des sociétés, des dispensaires et des hópitaux sont creés, des revues sont éditées.
Gràce à la protection de cette reine, on bâtit l'Hôpital San José de Madrid. A la fin de son regné (1868), elle s'exile alors à Paris, oû gràce à son appui économique on construit l'Hôpital Saint-Jacques.
La personnalité la plus remarquable est celle du docteur José Núñez qui en provenance de Bordeaux arrive à Madrid en 1845, oû il s'installe après son exil en France.
Il fonde la premiére société homéopathique d'Espagne: La Société Hahnemannienne Matritense, et c'est à lui que l'on doit la pathogénésie d'un grand rémede homéopathique: la taréntule espagnole.
II fut médecin de l'Aristocratie et de la reine Isabelle II en personne, qui lui accorda le titre de Marquis.
Napoleón III le décora aussi de la Legion d'Honneur. Et c'est à lui également qu'on doit la création du premier hôpital homéopathique, l'Hôpital San José de Madrid en 1878, dans lequel réposent ses restes.
Autre précurseur, le docteur Joaquín Hysern, professeur à l'Université de Madrid et médecin de chambre de la reine Isabelle II. En 1840, il part pour Paris. Il y vécut pendant deux ans et fonda l'Institut homéopathique espagnol.
Mais les dissidences sur différents points de méthode marquent dès le debut deux tendances dans l'homéopathie espagnole, provocant une instabilité qui dura plus d'un siècle et qui continue encore aujourd'hui. Celui qui l'exprima le mieux fut le docteur Anastasio García López dans un congrés à Paris en 1889 avec ees mots: «On connait peu de pays oû l'homéopathie ait trouvée pour sa propagation autant de résistance qu'en Espagne, et les obstacles ne sont que ceux entramés par les luttes internes aux homéopathes, qui servent aux allopathes pour avoir plus de raisons de la combatre, ce qui provoque de rudes discussions entrainant la division des associations qui se rejoignent pour se desunir à nouveau.»
Les controverses firent beaucoup de bruit pendant ce temps-là dans les Universités de Madrid, Valladolid, Barcelone... Les Drs Rino y Hurtado, Sebastián Coll et Joaquín Hysern parmi d'autres, participèrent à ces disputes face aux professeurs de l'Université.
Le docteur Anastasio Garcia López fut condamné par l'Eglise à cause d'un de ses livres, ce à quoi il répondit: «Comme democrate et républicain, je ne peux pas m'empécher de sympathiser et de me ranger à tout cela qui en mène équivaut aux grandes idées symbolisées. L'homéopathie est en train de lutter contre les décisions injustes de la médecine officielle, contre la dictature et l'autocratie de l'école allopathique.»
Les revues medicales de cette époque-là se faisaient l'écho de ces disputes acadèmiques entre homéopathes et allopathes, et d'une façon bien imagée montraient et ridiculisaient une telle conduite.
Du côté pharmacéutique, beaucoup vendaient des médicaments homéopathiques. Certains médecins faisaient même leurs propres médicaments, provoquant ainsi de violentes confrontations.
Les pharmacies de « Grau Sala » à Barcelonne, « Somolinos » à Madrid et « Rubiales » à Badajoz, parmi d'autres, sont trés renommées. En 1878, par ordre royal, le premier hôpital homéopathique est creé à Madrid, l'Hôpital San José qui resta prospère en tant qu'hôpital et comme institut d'enseignement jusqu'en 1930. En 1903 on fit quelques 14.000 consultations.
L'influence de l'homéopathie en Catalogne a été décisive et digne de mention.
La personnalité la plus remarcable de l'homéopathie catalane a été, peût-étre, celle du docteur Juan Sanllehy, président fondateur et fondateur de l'Académie médico homéopathique de Barcelonne en 1890. En 1901 l'hôpital homéopathique de l'Enfant-Dieu fut creé à Barcelonne.
À la fin du XIXe. siècle, il y avait environ 600 médecins homéopathes qui exergaient en Espagne. L'homéopathie était déjà bien enracinée. En 1924 le premier Congrés International d'Homéopathie eut lieu à Barcelonne oû les homéopathes les plus réputés du monde furent présents. En 1933, il y en eût un autre à Madrid.
En pleine République le docteur Torres Olivero fut nommé directeur de l'Hôpital San José de Madrid par le gouvernement de ce moment-là, et il fut chargé d'organiser et de rendre officiel l'enseignement de l'homéopathie en Espagne. Cela ne dura pas longtemps. Les espagnols s'affrontèrent à nouveau dans la guerre civile de 1936. Et jusqu'en 1975, période de la dictature, l'enseignement et la pratique de l'homéopathie sont interdites.
Livres et revues dont on pouvait disposer auparavant, étaient devenus impossibles à trouver.
II convient aussi de souligner l'influence que l'Espagne eût en Amérique latine. Il est juste qu'il soit reconnu par tous les homéopathes du monde la notable importance que l'Espagne a eû quant au développement et à l'expansion de l'homéopathie à Cuba, au Mexique, en Colombie, au Venezuela, au Chili...
C'est ainsi qu'il fut le premier pays au monde à reconnaître officiellement l'homéopathie. Ces vingt dernières années ont vu une Espagne démocratique avec une Monarchie parlamentaire.
Il existe aujourd'hui une vraie reconnaissance de cette médecine, de nombreuses sociétés d'homéopathie dans tout le pays, des cours dans certaines écoles et universités et elle est exercée par environ 1.500 homéopathes.
Depuis le 28 novembre 1994, et la publication du Décret Royal 2208/1994, les produits homéopathiques fabriqués industriellement ont obtenu le statut de médicament, par application, en Espagne, de la Directive Européenne 92/73/CEE. Il s'agit bien d'une reconnaissance officielle de l'homéopathie, dont le développement s'est fortement accéléré durant ces 15 dernières années, avec l'implantation de nombreux laboratoires spécialisés.
Malgré les divergences, toujours présentes, entre la médecine allopathique et homéopathique, celle-ci à sa propre histoire.
A tous ceux qui ont fait que ce soit possible, notre gratitude et hommage les plus sincères.
Que les générations suivantes n'oublient pas ceux qui ont rendu possible le fait que de nos jours, deux siècles aprés, on continué à parler d'homéopathie en Espagne: les docteurs Querol, Rino y Hurtado, Núñez, Hysern, Girela, García López, Vélez, Carrera, Folch, Marios, Romero, Sanllehy, Pellicer, Peiró, Cruxent, Pio Hernández...


Auteur: Dr. Alfredo García D. Ansorena.
Fuente: Procan XXI
Révision et corrections: Dr. Isidre Lara.

Mitos dietéticos

Esto es un resumen del artículo publicado previamente en este blog, Old and new concepts of healthy eating. Para ampliaciones y detalles dirigirse pues al artículo original. Se resumen un conjunto de ideas y prácticas dietéticas establecidas por consenso sin sostenerse en una evidencia suficiente.

1- Beneficios de la restricción de grasas, sobre todo saturadas, para prevenir el sobrepeso y la enfermedad aterosclerótica.

2- Beneficios de las dietas con alto contenido en fibra (cereales integrales), ni siquiera para la prevención del cáncer de colon.

3- No hay evidencia que una ingesta baja de frutas y vegetales sea causa de enfermedad en Occidente.

4- Restricción calórica mejora los factores de riesgo cardiovascular, pero no está claro si no es más bien debido al tipo de alimentos que se evitan y no a la restricción calórica en ella misma.

5- Beneficios de la pérdida de peso.

6- Beneficios de la dieta mediterránea (vs. la dieta paleolítica)

7- Beneficios de los ácidos grasos poliinsaturados Omega-3 (del pescado azul) como prevención de enfermedad cardiovascular.

8- Beneficios del aumento de la ingesta de vitaminas, minerales y elementos traza (oligoelementos), que en algunos casos pueden incluso llegar a ser perjudiciales.

9- Beneficios de la restricción de carbohidratos, sobre todo sin tener en cuenta el índice glicémico.

10- Beneficios del vino tinto.

11- Beneficios de la soja y sus derivados.

El artículo concluye:
"Alimentos que han formado parte de la dieta básica de la humanidad durante menos de 10.000 años deberían ser analizados críticamente antes de ser recomendados como alimentos básicos. Incluso los riesgos con alimentos que eran accesibles durante el Paleolítico (Edad de Piedra, aprox. 2.5 millones-10.000 años atrás), pero que pueden contener sustancias antinutritivas, deberían ser cuidadosamente estudiadas, en particular los alimentos que se consumen en grandes cantidades de forma diaria."

Old and new concepts of healthy eating

Six concepts, most of which are overlapping, are widely recognized by health authorities today:
Low-fat high-fiber diets, Fruit and vegetables, Calorie restriction, Mediterranean-style diets, Omega-3 enriched diets and Sodium restriction. A number of additional concepts exist, such as enrichment with vitamins and minerals, low glycemic index, carbohydrate restriction, red wine and many others.


Low-fat high-fiber diets
Restriction of dietary fat, in particular saturated fat, has been promoted since the mid 20th century in order mainly to prevent atherosclerotic disease and overweight, which became increasingly common during the first half of the century [1]. The benefits of dietary fiber were proclaimed around 1970 although proponents of ’coarse food’ have been heard long before. The idea largely emerged from belief systems concerning disturbed bowel function, bloating and ”autointoxication” in the 19th and early 20th century [2]. The popularity of the hypothesis increased dramatically around 1970 when Hugh Trowell, an internist, and Denis Burkitt, a surgeon, launched the idea that dietary fiber would prevent certain age-related, degenerative diseases [3, 4]. For more than 20 years, working at clinics in Kenya and Uganda, both men noted that Western diseases were largely non-existent among the native population. Burkitt, above all, had the greatest success positing the fiber hypothesis. He was a good speaker and also the first to characterize the type of lymphoma that later carried his name, which gave extra weight to his credibility.
The notion that fat is unhealthy has essentially been based on epidemiological studies, in particular the Seven Countries Study [5]. In this study, 12,095 men aged 40-59 were followed for 10 years starting around 1960. The incidence of ischemic heart disease was positively associated with total and saturated fat intakes, which, respectively, explained 25% and 70% of the disease rates among the study populations.
However, despite widespread consensus among nutrition experts today, there is no solid evidence of fat enrichment or fiber depletion being important causes of Western disease. In the Seven Countries Study, US men had more than 100-fold higher incidence of ischemic heart disease than Cretan men despite identical fat intake, 40 percent of dietary energy (E%) [5]. In one large randomized controlled study of nearly 49,000 US women, the Women’s Health Initiative Dietary Modification Trial, no beneficial effect was seen on cardiovascular disease, cancer or total mortality during 8 years’ follow-up by a low-fat, high fiber diet [6]. For the 3.4% of women with diagnosed cardiovascular disease at the start of the trial, a statistically significant increased risk of worsening of cardiovascular disease was seen in the intervention group (relative risk 1.26; 95% confidence interval 1.03-1.54). Diet changes at 6 years after study start (evaluated from food frequency questionnaires), in the intervention group as compared with the control group, were as follows: fruit/vegetables +30%, grains +11%, fiber +16%, total fat –8%, trans fat –22%, saturated fat –23%, monounsaturated fat –23%, carbohydrate +18%. The intervention and control groups differed with regard to intensity of dietary education but not with regard to type of dietary advice.
In contrast to these disappointing findings, in two other studies, subjects with impaired glucose tolerance had a lower risk of being diagnosed with diabetes during 3 years after advice to eat a low-fat, high-fiber diet and to increase their physical activity [7, 8]. The study design precludes any opinion about the independent roles of diet and exercise. In a meta-analysis of randomized controlled trials in humans, restriction of total and saturated fat apparently had no positive overall effect on total mortality or cardiovascular disease [9]. However, in trials with at least 2 years’ follow-up, a 24% reduction of premature death or cardiovascular events was seen (relative risk 0.76; 95% confidence interval 0.65-0.90), although no effect on total mortality was found. In published studies of changing fat intake in the treatment of overweight or obesity, fat restriction seems equally effective as calorie restriction for long-term weight loss [10]. Studies in animals have shown high-fat diets to be a partial cause of both atherosclerosis [11] and insulin resistance [12, 13]. In some of these studies, a rather moderate increase in dietary fat has caused abdominal obesity and insulin resistance, one of the main culprits in Western disease [13]. In other animal experiments, a high-fat diet has led to intracellular fat accumulation, which is suspected of leading to long-term loss of cell function by way of lipotoxicity [14, 15]. This disturbance is closely related to insulin resistance and the metabolic syndrome [16].
With regard to dietary fiber, the evidence from intervention studies is even less convincing. The only published randomized controlled study of increased fiber intake, mainly from whole-grains, resulted in non-significantly (p=0.10) increased risk of death from heart disease among patients with established atherosclerotic heart disease at study start [17]. In several prospective epidemiological studies people who prefer whole-grain cereals to more refined ones have a lower risk of cardiovascular disease [18], but this may possibly represent confounding by other lifestyle factors, rather than a direct effect of dietary fiber. Somewhat surprisingly, the long held notion that colon cancer is prevented by dietary fiber is not supported by available evidence [19-21].
In summary, these and other studies suggest that low-fat diets are slightly better than the average Western diet, while there is less convincing evidence in support of a high fiber intake.
 
Fruits and vegetables
For people on a Western diet, fruits and vegetables may provide an important source of essential vitamins, minerals and trace elements. However, once nutrient requirements are met it is uncertain whether these foods are important for long-term health in the prevention of Western disease. The high water content of fruits and vegetables is expected to prevent obesity by way of satiation [22]. Several studies found beneficial effects on health-related variables of lifestyle or dietary advice which included increased amounts of fruits and vegetables [23]. In the successful Lyon Diet Heart Trial, fruits and vegetables were some of the foods recommended to the intervention group, which conceivably explained some of the reduced mortality in that group [24]. Epidemiological prospective studies suggest a slightly reduced risk of cardiovascular disease and several types of cancer.
However, no randomized controlled trial has specifically addressed the independent effects of fruit and/or vegetables on the incidence of death or serious disease such as cardiovascular disease or cancer. In a study on males with angina pectoris, Burr and coworkers found no effect on total mortality or cardiovascular disease of advice to eat 4-5 portions of fruit and vegetables and drink at least one glass of natural orange juice daily, and also increase the intake of oats [25]. Hence, there is as yet no strong evidence that a low intake of fruits or vegetables is an independent cause of Western disease.
 
Calorie restriction
In animal experiments, restriction of dietary energy has been found to increase lifespan in dogs, rats, mice, fish, worms, yeast and fruit flies, but not (yet) in primates [26, 27]. In studies on non-human primates, calorie restriction has not been shown to retard atherosclerosis or prolong life, but markedly beneficial effects have been noted on cardiovascular risk factors [28, 29]. A study on Rhesus monkeys (8 calorie-restricted and 109 controls) starting in 1977 found a relative risk of death of 0.42 (95% CI 0.1-1.4) during the first 25 years in the calorie restricted group. Although the difference is far from statistically significant, it is conceivable that a larger trial or longer duration would be able to show a beneficial effect.
An observational study in 18 middle-aged calorie-restricted humans suggest that the atherosclerotic process can be attenuated [30]. At age 50 years, after an average of 6 years of calorie restriction, the thickness of the intima-media part of the carotid artery (the large neck artery) was 0.5 ±0.1 mm compared to 0.8 ±0.1 mm in 18 comparison subjects. Cardiovascular risk factor levels were excellent, including C-reactive protein at 0.3 ±0.2 µg/mL in the calorie restricted group compared to 1.6 ±2.2 in the comparison group.
However, interpretations of these studies are not straightforward, since people on calorie restriction also change their food choices. In the mentioned study, calorie restricted subjects strictly avoided processed foods, such as refined carbohydrates, desserts, snacks, and soft drinks [30]. Furthermore, one prospective observational study in the general Swedish population found that moderately high caloric intake was associated with lower total mortality in women, and a similar trend in men [31]. In addition, most observational studies do not support the idea that weight loss is beneficial. It is therefore premature to state that eating less without altering food choices is healthy.
In spite of these controversies, calorie restriction is widely believed to promote health for the average Westerner, and a common conception is that they do so independently of which foods are consumed. Energy intakes in excess of expenditures are often thought to be the sole explanation of the high rates of overweight in Western populations. One of the laws of thermodynamics is then often cited, the one saying that energy is constant and cannot disappear. However, other laws of thermodynamics, stating that energy can take various forms, including heat, and that conversion from one form of energy to another is more or less efficient, are rarely considered [32]. Metabolic utilization of energy from foods can be more or less efficient, depending on whether it is stored in the form of protein, fat or carbohydrate [32]. Highly relevant in this context is the finding in animal experiments of decreased body temperature on a low-calorie diet [33].
The emerging notion that calorie restriction is not independent of food composition finds additional support from recent findings in the fruit fly Drosophila, one of the most extensively studied species in this context [34]. In these experiments, reduction of either dietary yeast or sugar reduced mortality and extended life span, but to an extent that was unrelated to the calorie content of the food, and with yeast having a much greater effect per calorie than sugar. Recent experiments with caloric restriction in rats suggest that protein intake should be maintained at reasonably high levels in order to improve mitochondrial cell function and prevent loss of muscle mass (sarcopenia) [35].
To summarize, calorie restriction, in accordance with the guidelines of The Calorie Restriction (CR) Society (calorierestriction.org), has several apparent benefits, but only counting calories may sometimes be misleading. Reduction of waist circumference and fat mass is preferable to crude weight loss. If overweight persons restrict their food intake they should be advised to concomitantly change their consumption patterns. Substituting fruit, vegetables, root vegetables and lean meat for bread, pasta and other Western staple foods generally leads to decreased energy intake despite increased or unaltered amounts of food.
 
Mediterranean-style diets
International comparison from the second half of the 20th century found lower rates of ischemic heart disease in Mediterranean countries like Greece, Italy, Spain and former Yugoslavia, most notably before the age of 65. In the Seven Countries Study, Crete had the lowest incidence of ischemic heart disease at follow-up after 10 years [5] and after 20 years [36]. After 25 years, total mortality was lowest in the Cretan men, although ischemic heart disease mortality now had slightly surpassed the two Japanese groups [37]. For these reason, the Cretan diet has become a standard model for Mediterranean-style diets [38]. In 1948, 12 years before the beginning of the Seven Countries Study, the major sources of energy in the Cretan diet were cereals (mainly sourdough bread), nuts, pulses, olives, olive oil, vegetables and fruit, together with limited quantities of goat meat and milk, game, and fish [39]. Wine was consumed regularly. The intake of ß-casein A1, a protein in milk which has been proposed to cause atherosclerotic disease, was particularly low, less than 0.5 g/day [40].
The Lyon Diet Heart Study found reduced mortality and morbidity (non-fatal disease) of ischemic heart disease after advice to follow a Mediterranean-style diet [24]. However, the Mediterranean group was given more intense lifestyle education than the control group, who received ”usual care", posing a possible bias to the study. In addition, the Mediterranean group was provided with a margarine based on rapeseed-oil, enriched with alpha-linolenic acid (plant-based omega-3 fat).
Today, diabetes type 2, and possibly ischemic heart disease, are apparently common in Crete [41]. Hypertension and stroke have been prevalent a long time in Mediterranean populations, including the Cretans [42, 43].
In conclusion, Mediterranean diets are apparently a step in the right direction for many people, but they may not be the best choice for long-term human health.
 
Omega-3 enriched diets
One of the strongest beliefs held about healthy food is that fatty fish prevents heart disease, and that omega-3 polyunsaturated fatty acids are the main reason [44, 45]. However, the evidence is not by far as solid as it may seem. In 2004, a Cochrane meta-analysis of randomized controlled trials found no net benefit on cardiovascular disease, total mortality, or cancer [46]. A shorter report of this meta-analysis was later published in the British Medical Journal [47]. Criticism of these findings has largely focused on the fact that exclusion of one trial, DART-2 [25], seems to change the results in favor of omega-3 [48, 49]. However, DART-2 is not the only trial showing negative effects of omega-3 fat in patients with ischemic heart disease [50]. Furthermore, the results of the Cochrane review suggest the presence of publication bias, such that large trials do not show a positive effect [46]. Much of the criticism of the short report <http://www.bmj.com/cgi/content/abstract/332/7544/752>is taken into account in the long one [46]. The debate will most certainly continue.
Even the statement that cardiovascular disease was uncommon in the Greenland Inuit and related populations, as long as they pursued their traditional lifestyle, has recently been questioned [51]. In a review of 20th century clinical and autopsy studies, and mortality statistics, from Greenland, Canada and Alaska, atherosclerosis and cardiovascular disease was not lower among the Inuit than among white comparison populations.
 
Sodium restriction
A starting point for discussions about salt and health was a French experiment 100 years ago showing raised blood pressure after high salt intake roughly [52]. Considerable evidence now suggests that restriction of dietary sodium below 100 mmol Na/day (<6 g sodium chloride or <2.4 g sodium per day) will reduce blood pressure and prevent cardiovascular disease in people with hypertension [53]. Since only a minority of middle-aged and elderly Westerners have optimal blood pressure (<120/<80 mm Hg), and since low levels are more healthy than average or high levels, most people would seem to benefit from a low salt intake. Several studies suggests that dietary salt is a contributing factor in the development of stroke and heart failure, particularly among overweight people, and possibly independently of blood pressure (See sections 4.2 and 4.9). A correlation between sodium intake and stroke has also been noted among Europeans [54], as well as in China and Japan [55]. The influence of dietary salt on ischemic heart disease is more controversial, but here, again, the risks with high salt intake may highest for overweight subjects.
 
Vitamins and minerals
Ever since the discovery of man’s dependence on vitamins and minerals, and the abundance of such substances in fruit and vegetables, there has been much interest in their role for human health. Deficient intakes of many vitamins and minerals, including a number of trace elements, have been suggested as underlying causes of Western disease, as will be noted in the following chapters. Much of the evidence comes from epidemiological studies. However, when these nutrients later have been given in large-scale randomized double-blind controlled trials, essentially no beneficial effects have been seen [56]. A recent Cochrane meta-analysis found that supplementation with vitamin A and vitamin E may actually increase mortality, while the impact of vitamin C and selenium needs further study [57].
 
Low glycemic index (GI) foods and carbohydrate restriction
In the year 1825, Brillat-Savarin, the influential French writer on food, cooking and nutrition, suggested that high-starch foods were a major cause of corpulence in his book ”The Physiology of Taste” (http://www.gutenberg.org/etext/5434). His authority reached a few of the medical practitioners in France and England, and, in 1862 in London, the now famous William Banting was advised by his physician to ”...abstain as much as possible from bread, butter, milk, sugar, beer, and potatoes...”, and lost 21 kg in the following 12 months. By tradition, this often cited diet has been described as a low-carbohydrate diet rather than one based on meat, fish, fruit and vegetables, which it was. The proceeding history of carbohydrate restriction includes proponents such as Stefansson in the 1920s, Pennington, Cleave and Mackarness in the 1950s, Donaldson and Lutz in the 1960s, Atkins in the 1970s (and again in the 1990s), and more recently dietary programs such as the Zone, the Carbohydrate Addict’s Diet, Protein Power, South Beach Diet, Sugar Busters and many others.
A low GI food is one that, despite being rich in carbohydrates, does not increase blood sugar as much as another food with the same amount of carbohydrate. Carbohydrate restriction refers to reduction of the amount of carbohydrate in the food without necessarily changing the GI. If you multiply the GI by the absolute amount of carbohydrate you get the glycemic load [58]. The rationale behind low GI and restriction of carbohydrates is to reduce the rise in blood sugar and insulin secretion after a meal, which in turn is intended to prevent insulin resistance, overweight, glucose intolerance, type 2 diabetes, dyslipidemia and the metabolic syndrome [59].
However, an independent beneficial effect, irrespective of food source, on these variables is not unequivocally supported by available evidence [60-67]. In people with diabetes, avoiding excess increases in blood sugar after meals is undeniably beneficial, but exchanging carbohydrate for fat may pose other long-term threats. In overweight or obese subjects, initial weight loss in the first few months is usually more pronounced on a very, very low-carbohydrate diet such as the Atkins diet, but energy intake and adherence seem to be more important than choice of dietary program for long-term (>1 year) weight maintenance [61, 62]. Generally, serum triglycerides are reduced, while low density lipoprotein (LDL) cholesterol is slightly increased [66]. Although triglycerides usually decrease more than LDL increases, the net health benefit of this is uncertain [68]. Exclusively changing the GI seems to have little impact on body weight [69] and cardiovascular risk factor levels [70].
A large, randomized, high-quality trial compared four weight-loss diets with varying carbohydrate content in women with average BMI 32 (range 27-40), i.e. the Atkins (very-low carbohydrate), Zone (moderate carbohydrate), LEARN (traditional high carbohydrate), and Ornish (very-high carbohydrate) diets [71]. Weight loss, the primary outcome, was modest in all groups: after one year, weight loss in the Atkins group was 4.7 kg (95% confidence interval 6.3-3.1 kg), compared to 1.6 kg (2.8-0.4 kg) in the Zone, 2.6 kg (3.8-1.3 kg) in LEARN, and 2.2 kg (3.6-0.8 kg) in the Ornish group. There was no statistically signifcant difference in weight loss between the Atkins and LEARN programs at 12 months. However, secondary outcome variables were comparable or more favorable in the Atkins group. For example, systolic blood pressure was reduced by 7.6 (±11.0) mm Hg in the Atkins group, compared to 3.1 (±9.3) mm Hg in the LEARN group (p<0.05). No effect was found on fasting insulin or glucose. This study does not suggest that a traditional high-carbohydrate diet program is more beneficial than the Atkins diet.
However, the long primate history of fruit eating [72], the high activity of human salivary amylase for efficient starch digestion [73] and some other features of human mouth physiology [74], as well as the absence of Western disease among starch-eating traditional populations [75, 76], including the Kitavans that we studied, suggest that humans are well prepared for a high carbohydrate intake from non-grain food sources. Although restriction of all types of carbohydrates may provide some benefit for subjects with diabetes type 2, it seems unlikely that dietary carbohydrate is a primary cause of Western disease.
 
Red wine
The claimed benefits of red wine are so often reported that they may seem to be a proven fact, and the critical voices do not get much attention. As always, we have a possible bias in the form of confounders. Furthermore, in order to get a true protection against cardiovascular disease you may need to drink so much every week that your brain and liver are damaged [77]. In epidemiological studies, the difference in mortality between people who drink 2 glasses of wine per day and those who drink once a month is negligible or non-existent. Enthusiastic reports about resveratrol, a substance in red wine which prolongs life in mice that are fed high-fat/sucrose diets, often forget to mention that the doses used correspond to more than 700 bottles of wine per day [78].
 
Other concepts
There is a large number of additional philosophies about diet and health, many of which will be commented upon in my later writing. The idea that Soy foods are healthy is largely based on the Vegetarian tradition, and both have had considerable impact on nutritional science despite inconsistent research findings. Red meat is basically an epidemiological story without strong evidence from other research areas. The Antioxidant story mainly emerged from intriguing hypotheses in molecular biology, but randomized double-blind controlled trials with antioxidants have essentially failed to show any benefit [56].
 
Conclusions
Foods that are generally perceived as healthy, most notably fruit and vegetables, are apparently a better choice than foods that are not perceived as healthy. Nevertheless, many of the prevailing concepts are not firmly based on good evidence. Nutritional recommendations for public health are resting on such unstable ground that evolutionary medicine may provide an important complement to traditional scientific methods [79, 80]. Reading the scientific literature through the lens of evolutionary biology can make it easier to understand the extremely complex relationships between diet and health.
Dietary advice to prevent and treat common western diseases should be designed in accordance with human's biological heritage as much as possible. Foods that have been part of the human staple diet for less than 10,000 years should be critically examined before they are recommended as staple food. Even the risks with foods that were available during the Paleolithic era (Old Stone Age, approximately 2.5 million - 10,000 years ago), but which may contain anti-nutritional substances, should be carefully examined, in particular foods that are consumed in large quantities on a daily basis.
 
1. Kritchevsky, D. History of recommendations to the public about dietary fat. J Nutr, 1998; 128: 449S-452S
2. Whorton, J. Civilisation and the colon: constipation as the "disease of diseases". Bmj, 2000; 321: 1586-9
3. Trowell, HC and Burkitt, DP. eds. Western diseases: their emergence and prevention. 1981, Harvard University Press: Cambridge.
4. Burkitt, DP, Walker, AR, and Painter, NS. Dietary fiber and disease. Jama, 1974; 229: 1068-74.
5. Keys, A. Seven Countries. A Multivariate Analysis of Death and Coronary Heart Disease. 1980, Cambridge, Mass.: Harvard University Press. 381.
6. Howard, BV, Van Horn, L, Hsia, J, Manson, JE, Stefanick, ML, Wassertheil-Smoller, S, Kuller, LH, LaCroix, AZ, Langer, RD, Lasser, NL, Lewis, CE, Limacher, MC, Margolis, KL, Mysiw, WJ, Ockene, JK, Parker, LM, Perri, MG, Phillips, L, Prentice, RL, Robbins, J, Rossouw, JE, Sarto, GE, Schatz, IJ, Snetselaar, LG, Stevens, VJ, Tinker, LF, Trevisan, M, Vitolins, MZ, Anderson, GL, Assaf, AR, Bassford, T, Beresford, SA, Black, HR, Brunner, RL, Brzyski, RG, Caan, B, Chlebowski, RT, Gass, M, Granek, I, Greenland, P, Hays, J, Heber, D, Heiss, G, Hendrix, SL, Hubbell, FA, Johnson, KC, and Kotchen, JM. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Jama, 2006; 295: 655-66
7. Tuomilehto, J, Lindstrom, J, Eriksson, JG, Valle, TT, Hamalainen, H, Ilanne-Parikka, P, Keinanen-Kiukaanniemi, S, Laakso, M, Louheranta, A, Rastas, M, Salminen, V, and Uusitupa, M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med, 2001; 344: 1343-1350
8. Knowler, WC, Barrett-Connor, E, Fowler, SE, Hamman, RF, Lachin, JM, Walker, EA, and Nathan, DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 2002; 346: 393-403.
9. Hooper, L, Summerbell, CD, Higgins, JP, Thompson, RL, Capps, NE, Smith, GD, Riemersma, RA, and Ebrahim, S. Dietary fat intake and prevention of cardiovascular disease: systematic review. Bmj, 2001; 322: 757-63.
10. Pirozzo, S, Summerbell, C, Cameron, C, and Glasziou, P. Advice on low-fat diets for obesity (Cochrane Review). Cochrane Database Syst Rev, 2005; 2
11. Kritchevsky, D. Diet and atherosclerosis. J Nutr Health Aging, 2001; 5: 155-9
12. Chalkley, SM, Hettiarachchi, M, Chisholm, DJ, and Kraegen, EW. Long-term high-fat feeding leads to severe insulin resistance but not diabetes in Wistar rats. Am J Physiol Endocrinol Metab, 2002; 282: E1231-8
13. Kim, SP, Ellmerer, M, Van Citters, GW, and Bergman, RN. Primacy of hepatic insulin resistance in the development of the metabolic syndrome induced by an isocaloric moderate-fat diet in the dog. Diabetes, 2003; 52: 2453-60
14. Westerbacka, J, Lammi, K, Hakkinen, AM, Rissanen, A, Salminen, I, Aro, A, and Yki-Jarvinen, H. Dietary fat content modifies liver fat in overweight nondiabetic subjects. J Clin Endocrinol Metab, 2005; 90: 2804-9
15. Park, SY, Cho, YR, Kim, HJ, Higashimori, T, Danton, C, Lee, MK, Dey, A, Rothermel, B, Kim, YB, Kalinowski, A, Russell, KS, and Kim, JK. Unraveling the temporal pattern of diet-induced insulin resistance in individual organs and cardiac dysfunction in C57BL/6 mice. Diabetes, 2005; 54: 3530-40
16. Unger, RH. Lipid overload and overflow: metabolic trauma and the metabolic syndrome. Trends Endocrinol Metab, 2003; 14: 398-403
17. Burr, ML, Fehily, AM, Gilbert, JF, Rogers, S, Holliday, RM, Sweetnam, PM, Elwood, PC, and Deadman, NM. Effects of changes in fat, fish, and fiber intakes on death and myocardial reinfarction: diet and reinfarction trial (DART) [see comments]. Lancet, 1989; 2: 757-61
18. Truswell, AS. Cereal grains and coronary heart disease. Eur J Clin Nutr, 2002; 56: 1-14.
19. Michels, KB, Fuchs, CS, Giovannucci, E, Colditz, GA, Hunter, DJ, Stampfer, MJ, and Willett, WC. Fiber intake and incidence of colorectal cancer among 76,947 women and 47,279 men. Cancer Epidemiol Biomarkers Prev, 2005; 14: 842-9
20. Park, Y, Hunter, DJ, Spiegelman, D, Bergkvist, L, Berrino, F, van den Brandt, PA, Buring, JE, Colditz, GA, Freudenheim, JL, Fuchs, CS, Giovannucci, E, Goldbohm, RA, Graham, S, Harnack, L, Hartman, AM, Jacobs, DR, Jr., Kato, I, Krogh, V, Leitzmann, MF, McCullough, ML, Miller, AB, Pietinen, P, Rohan, TE, Schatzkin, A, Willett, WC, Wolk, A, Zeleniuch-Jacquotte, A, Zhang, SM, and Smith-Warner, SA. Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. Jama, 2005; 294: 2849-57
21. Asano, T and McLeod, RS. Dietary fiber for the prevention of colorectal adenomas and carcinomas. Cochrane Database Syst Rev, 2002: CD003430
22. Lappalainen, R, Mennen, L, van Weert, L, and Mykkanen, H. Drinking water with a meal: a simple method of coping with feelings of hunger, satiety and desire to eat. Eur J Clin Nutr, 1993; 47: 815-9
23. Writers of Nordic Nutrition Recommendations. Nordic Nutrition Recommendations. 4 ed. 2004, Copenhagen: Nordic Council of Ministers.
24. de Lorgeril, M, Renaud, S, Mamelle, N, Salen, P, Martin, JL, Monjaud, I, Guidollet, J, Touboul, P, and Delaye, J. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet, 1994; ii: 1454-1459
25. Burr, ML, Ashfield-Watt, PA, Dunstan, FD, Fehily, AM, Breay, P, Ashton, T, Zotos, PC, Haboubi, NA, and Elwood, PC. Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr, 2003; 57: 193-200
26. Fontana, L and Klein, S. Aging, adiposity, and calorie restriction. Jama, 2007; 297: 986-94
27. Heilbronn, LK and Ravussin, E. Calorie restriction and aging: review of the literature and implications for studies in humans. Am J Clin Nutr, 2003; 78: 361-9
28. Cefalu, WT, Wagner, JD, Bell-Farrow, AD, Edwards, IJ, Terry, JG, Weindruch, R, and Kemnitz, JW. Influence of caloric restriction on the development of atherosclerosis in nonhuman primates: progress to date. Toxicol Sci, 1999; 52: 49-55
29. Bodkin, NL, Alexander, TM, Ortmeyer, HK, Johnson, E, and Hansen, BC. Mortality and morbidity in laboratory-maintained Rhesus monkeys and effects of long-term dietary restriction. J Gerontol A Biol Sci Med Sci, 2003; 58: 212-9
30. Fontana, L, Meyer, TE, Klein, S, and Holloszy, JO. Long-term calorie restriction is highly effective in reducing the risk for atherosclerosis in humans. Proc Natl Acad Sci U S A, 2004; 101: 6659-63
31. Leosdottir, M, Nilsson, P, Nilsson, JA, Mansson, H, and Berglund, G. The association between total energy intake and early mortality: data from the Malmo Diet and Cancer Study. J Intern Med, 2004; 256: 499-509
32. Feinman, RD and Fine, EJ. "A calorie is a calorie" violates the second law of thermodynamics. Nutr J, 2004; 3: 9
33. Lane, MA, Baer, DJ, Rumpler, WV, Weindruch, R, Ingram, DK, Tilmont, EM, Cutler, RG, and Roth, GS. Calorie restriction lowers body temperature in rhesus monkeys, consistent with a postulated anti-aging mechanism in rodents. Proc Natl Acad Sci U S A, 1996; 93: 4159-4164
34. Mair, W, Piper, MD, and Partridge, L. Calories do not explain extension of life span by dietary restriction in Drosophila. PLoS Biol, 2005; 3: e223
35. Zangarelli, A, Chanseaume, E, Morio, B, Brugere, C, Mosoni, L, Rousset, P, Giraudet, C, Patrac, V, Gachon, P, Boirie, Y, and Walrand, S. Synergistic effects of caloric restriction with maintained protein intake on skeletal muscle performance in 21-month-old rats: a mitochondria-mediated pathway. Faseb J, 2006; 20: 2439-50
36. Menotti, A, Keys, A, Blackburn, H, Aravanis, C, Dontas, A, Fidanza, F, Giampaoli, S, Karvonen, M, Kromhout, D, Nedeljkovic, S, and et al. Twenty-year stroke mortality and prediction in twelve cohorts of the Seven Countries Study. Int J Epidemiol, 1990; 19: 309-15
37. Menotti, A, Blackburn, H, Kromhout, D, Nissinen, A, Adachi, H, and Lanti, M. Cardiovascular risk factors as determinants of 25-year all-cause mortality in the seven countries study. Eur J Epidemiol, 2001; 17: 337-46
38. Kafatos, A, Verhagen, H, Moschandreas, J, Apostolaki, I, and Van Westerop, JJ. Mediterranean diet of Crete: foods and nutrient content. J Am Diet Assoc, 2000; 100: 1487-93.
39. Allbaugh, LG. Crete: A case study of an undeveloped country. 1953, Princeton: Princeton University Press.
40. Laugesen, M and Elliott, R. Ischaemic heart disease, Type 1 diabetes, and cow milk A1 beta-casein. N Z Med J, 2003; 116: U295
41. Lionis, C, Bathianaki, M, Antonakis, N, Papavasiliou, S, and Philalithis, A. A high prevalence of diabetes mellitus in a municipality of rural Crete, Greece. Diabet Med, 2001; 18: 768-9
42. Feigin, VL, Lawes, CMM, Bennett, DA, and Anderson, CS. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol, 2003; 2: 43–53
43. Menotti, A, Blackburn, H, Kromhout, D, Nissinen, A, Karvonen, M, Aravanis, C, Dontas, A, Fidanza, F, and Giampaoli, S. The inverse relation of average population blood pressure and stroke mortality rates in the seven countries study: a paradox. Eur J Epidemiol, 1997; 13: 379-86.
44. De Backer, G, Ambrosioni, E, Borch-Johnsen, K, Brotons, C, Cifkova, R, Dallongeville, J, Ebrahim, S, Faergeman, O, Graham, I, Mancia, G, Manger Cats, V, Orth-Gomer, K, Perk, J, Pyorala, K, Rodicio, JL, Sans, S, Sansoy, V, Sechtem, U, Silber, S, Thomsen, T, and Wood, D. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J, 2003; 24: 1601-1610
45. Smith, SC, Jr., Blair, SN, Bonow, RO, Brass, LM, Cerqueira, MD, Dracup, K, Fuster, V, Gotto, A, Grundy, SM, Miller, NH, Jacobs, A, Jones, D, Krauss, RM, Mosca, L, Ockene, I, Pasternak, RC, Pearson, T, Pfeffer, MA, Starke, RD, and Taubert, KA. AHA/ACC Scientific Statement: AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation, 2001; 104: 1577-9
46. Hooper, L, Thompson, RL, Harrison, RA, Summerbell, CD, Moore, H, Worthington, HV, Durrington, PN, Ness, AR, Capps, NE, Davey Smith, G, Riemersma, RA, and Ebrahim, SB. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev, 2004: CD003177
47. Hooper, L, Thompson, RL, Harrison, RA, Summerbell, CD, Ness, AR, Moore, HJ, Worthington, HV, Durrington, PN, Higgins, JP, Capps, NE, Riemersma, RA, Ebrahim, SB, and Davey Smith, G. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. Bmj, 2006; 332: 752-60
48. Psota, TL, Gebauer, SK, and Kris-Etherton, P. Dietary omega-3 fatty acid intake and cardiovascular risk. Am J Cardiol, 2006; 98: 3i-18i
49. Mozaffarian, D and Rimm, EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. Jama, 2006; 296: 1885-99
50. Brunner, E. Oily fish and omega 3 fat supplements. Bmj, 2006; 332: 739-40
51. Bjerregaard, P, Young, TK, and Hegele, RA. Low incidence of cardiovascular disease among the Inuit--what is the evidence? Atherosclerosis, 2003; 166: 351-7
52. Ambard, L and Beaujard, E. Causes de l'hypertension arterielle. Arch Gen Med, 1904; 1: 520-33
53. Williams, B, Poulter, NR, Brown, MJ, Davis, M, McInnes, GT, Potter, JF, Sever, PS, and Mc, GTS. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens, 2004; 18: 139-85
54. Perry, IJ and Beevers, DG. Salt intake and stroke: a possible direct effect. J Hum Hypertens, 1992; 6: 23-5
55. Ueshima, H, Zhang, XH, and Choudhury, SR. Epidemiology of hypertension in China and Japan. J Hum Hypertens, 2000; 14: 765-9.
56. McCormick, DB. The dubious use of vitamin-mineral supplements in relation to cardiovascular disease. Am J Clin Nutr, 2006; 84: 680-1
57. Bjelakovic, G, Nikolova, D, Gluud, LL, Simonetti, RG, and Gluud, C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. Jama, 2007; 297: 842-57
58. Foster-Powell, K, Holt, SH, and Brand-Miller, JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr, 2002; 76: 5-56.
59. Brand-Miller, J, Hayne, S, Petocz, P, and Colagiuri, S. Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care, 2003; 26: 2261-7
60. Reaven, GM. The insulin resistance syndrome: definition and dietary approaches to treatment. Annu Rev Nutr, 2005; 25: 391-406
61. Dansinger, ML, Gleason, JA, Griffith, JL, Selker, HP, and Schaefer, EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. Jama, 2005; 293: 43-53
62. Astrup, A, Meinert Larsen, T, and Harper, A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet, 2004; 364: 897-9
63. Kennedy, RL, Chokkalingam, K, and Farshchi, HR. Nutrition in patients with Type 2 diabetes: are low-carbohydrate diets effective, safe or desirable? Diabet Med, 2005; 22: 821-832
64. Gannon, MC and Nuttall, FQ. Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition. Nutr Metab (Lond), 2006; 3: 16
65. Noakes, M, Foster, PR, Keogh, JB, James, AP, Mamo, JC, and Clifton, PM. Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk. Nutr Metab (Lond), 2006; 3: 7
66. Volek, JS, Sharman, MJ, and Forsythe, CE. Modification of lipoproteins by very low-carbohydrate diets. J Nutr, 2005; 135: 1339-42
67. Brand-Miller, J. Optimizing the cardiovascular outcomes of weight loss. Am J Clin Nutr, 2005; 81: 949-50
68. Taskinen, MR. LDL-cholesterol, HDL-cholesterol or triglycerides--which is the culprit? Diabetes Res Clin Pract, 2003; 61 Suppl 1: S19-26
69. Raben, A. Should obese patients be counselled to follow a low-glycaemic index diet? No. Obes Rev, 2002; 3: 245-56
70. Kelly, S, Frost, G, Whittaker, V, and Summerbell, C. Low glycaemic index diets for coronary heart disease. Cochrane Database Syst Rev, 2004: CD004467
71. Gardner, CD, Kiazand, A, Alhassan, S, Kim, S, Stafford, RS, Balise, RR, Kraemer, HC, and King, AC. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA, 2007; 297: 969-77
72. Bloch, JI and Boyer, DM. Grasping primate origins. Science, 2002; 298: 1606-10
73. Samuelson, LC, Wiebauer, K, Snow, CM, and Meisler, MH. Retroviral and pseudogene insertion sites reveal the lineage of human salivary and pancreatic amylase genes from a single gene during primate evolution. Mol Cell Biol, 1990; 10: 2513-20
74. Lucas, PW, Ang, KY, Sui, Z, Agrawal, KR, Prinz, JF, and Dominy, NJ. A brief review of the recent evolution of the human mouth in physiological and nutritional contexts. Physiol Behav, 2006; 89: 36-8
75. Lindeberg, S and Lundh, B. Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: a clinical study in Kitava. J Intern Med, 1993; 233: 269-275
76. Sinnett, PF and Whyte, HM. Epidemiological studies in a total highland population, Tukisenta, New Guinea. Cardiovascular disease and relevant clinical, electrocardiographic, radiological and biochemical findings. J Chronic Dis, 1973; 26: 265-90
77. Jackson, R, Broad, J, Connor, J, and Wells, S. Alcohol and ischaemic heart disease: probably no free lunch. Lancet, 2005; 366: 1911-2
78. Baur, JA, Pearson, KJ, Price, NL, Jamieson, HA, Lerin, C, Kalra, A, Prabhu, VV, Allard, JS, Lopez-Lluch, G, Lewis, K, Pistell, PJ, Poosala, S, Becker, KG, Boss, O, Gwinn, D, Wang, M, Ramaswamy, S, Fishbein, KW, Spencer, RG, Lakatta, EG, Le Couteur, D, Shaw, RJ, Navas, P, Puigserver, P, Ingram, DK, de Cabo, R, and Sinclair, DA. Resveratrol improves health and survival of mice on a high-calorie diet. Nature, 2006;
79. Eaton, SB, Strassman, BI, Nesse, RM, Neel, JV, Ewald, PW, Williams, GC, Weder, AB, Eaton, SB, 3rd, Lindeberg, S, Konner, MJ, Mysterud, I, and Cordain, L. Evolutionary health promotion. Prev Med, 2002; 34: 109-118
80. Eaton, SB, Cordain, L, and Lindeberg, S. Evolutionary health promotion: a consideration of common counterarguments. Prev Med, 2002; 34: 119-123
 
 
Author: Staffan Lindeberg, MD PhD,  Department of Medicine,  University of Lund,  Sweden.
Source:  http://www.staffanlindeberg.com/OldAndNew.html