Diabetes

A research study has shown that individuals with pre-existing diabetic   conditions are more likely to either have, or be more susceptible to periodontal  disease. This is because uncontrolled diabetes (high blood sugar level) suppresses one’s immune and reparative systems. Periodontal disease  can increase blood sugar levels which makes controlling the amount of glucose  in the blood difficult. This factor alone can increase the risk of serious diabetic  complications.  Conversely, diabetes thickens blood vessels and therefore  makes it harder for the mouth to rid itself of excess sugar. Excess sugar in the mouth creates a breeding ground for the types of oral bacteria that cause gum disease.

Heart Disease

There are several theories which explain the link between heart disease and periodontitis. One such theory is that         the oral bacteria strains which exacerbate periodontal disease attach themselves to the coronary arteries when they     enter the bloodstream. This in turn contributes to both blood clot formation and the narrowing of the coronary arteries, possibly leading to a heart attack.
A second possibility is that the inflammation caused by periodontal disease causes a significant plaque buildup. This can swell the arteries and worsen pre-existing heart conditions. An article published by the American Academy of Periodontology suggests that patients whose bodies react to periodontal bacteria have an increased risk of developing heart disease.

Pregnancy Complications

Women in general are at increased risk of developing periodontal disease because of hormone fluctuations that occur during puberty, pregnancy and menopause. Research suggests that pregnant women suffering from periodontal disease are more at risk of preeclampsia and delivering underweight, premature babies.
Periodontitis increases levels of prostaglandin, which is one of the labor-inducing chemicals. Elevated levels prostaglandin may trigger premature labor, and increase the chances of delivering an underweight baby. Periodontal disease also elevates C-reactive proteins (which have previously been linked to heart disease). Heightened levels of these proteins can amplify the inflammatory response of the body and increase the chances of preeclampsia and low birth weight babies.

Respiratory Disease

Oral bacterium linked with gum disease has been shown to possibly cause or worsen conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD). Oral bacteria can be drawn into the lower respiratory tract during the course of normal inhalation and colonize; causing bacterial infections. Studies have shown that the repeated infections which characterize COPD may be linked with periodontitis.
In addition to the bacterial risk, inflammation in gum tissue can lead to severe inflammation in the lining of the lungs, which aggravates pneumonia. Individuals who suffer from chronic or persistent respiratory issues generally have low immunity. This means that bacteria can readily colonize beneath the gum line unchallenged by body’s immune system.

In terms of eating a healthy diet, the American Heart Association (AHA) said earlier this week that Americans need to cut back dramatically on sugar consumption. The AHA recommended that women eat no more than a 100 calories of added processed sugar a day (representing 6 teaspoons, 25 grams) while most men should limit sugar caloric intake to no more than 150 calories (9 teaspoons of sugar) daily. Unfortunately, the average American consumes 22 teaspoons of added sugar a day, representing over 350 calories. No wonder Americans hold the dubious distinction of being some of the heaviest people on the planet with very high rates of poor blood sugar and poor cardiovascular health.

Even our teenagers and young children, on average, are excessively overweight. I can’t tell you how many times I have seen patients come in with their small children, who even at the age of 6 or 8, were already at an unhealthy weight. Invariably, the child was eating some candy product or drinking a sugar laden beverage. There have been many studies that have shown a correlation between higher intake of sweetened beverages and unhealthy weight. The absolutely most dangerous and commonly consumed offender is high fructose corn syrup (HFCS). HFCS is far more toxic to the body in excessive amounts when compared to regular sugar and without question should be avoided like a toxic chemical should be avoided. HFCS is the main ingredient in soda and many processed foods. I also recall a study from many years ago that indicated consuming more than 100 grams of sugar per day dramatically impaired the healthy function of the immune system.

Turning to supplements for a moment, vitamin D is in the news again. It has been well known that low levels of vitamin D increased the risk of poor cardiovascular health in individuals with known elevated blood sugar. The underlying mechanism for this until recently was unknown. However, a report² in the August 25, 2009 issue of the journal Circulation found that vitamin D appears to inhibit the uptake of cholesterol in cells called macrophages. Dr. Leon Bernel-Mizrachi, the lead researcher in this study, indicated that when people are deficient in vitamin D, their macrophage cells eat more cholesterol and can’t get rid of it. The macrophages get clogged with cholesterol and become what scientists call foam cells which are the earliest markers of the declining health of the circulatory system. Vitamin D3 is also essential for healthy bones and immune function. Recent evidence indicates the vast majority of children and adults are terribly deficient in vitamin D. It appears adults require 5 to 20 times the RDA/DV level of vitamin D in the form called D3. This level would be 2,000 – 8,000 IU for adults and for children about 1,000 IU per 25 lbs weight. It is recommended women who intend to become pregnant or are pregnant consume 5,000 IU per day of vitamin D3.

Great news was announced this week regarding the omega-3 fatty acids found in fish oil. In a study³ published in the September 2009 edition of the Journal of Hypertension, 85 patients were provided 4,000 mg per day of omega-3 (EPA and DHA) which was found to promote healthy blood pressure and triglyceride levels. There are now hundreds, if not thousands, of studies which prove fish oil containing EPA and DHA at levels of 1,000 – 4,000 mg per day is safe and effective for promoting both cardiovascular and neurological health.

Don’t put it off any longer. All of you need to make a conscious effort to dramatically cut back on your sugar intake. Instead of reaching for a can of soda, have a glass of water or some unsweetened green tea. There are very safe and natural sweeteners that use stevia for those requiring a sweet taste. The Smart Basics brand offers several different organic healthy juices, such as aloe vera, noni, acai and goji. In terms of healthy snacks, the Best of All™ brand offers an excellent selection of nuts, seeds, dry fruits and vegetables, many of which are organic. And don’t forget, you need a core nutritional supplement.

 And, of course, don’t forget  omega-3 fatty acid. I recommend most people consume two softgels per day, but if you have concerns related to cardiovascular, neurological or joint health, I recommend four softgels per day. 
 

1. Mandic S, Myers J, Oliveira R, et al., Characterizing Differences in Mortality at the Low End of the Fitness Spectrum, Medicine and Science in Sports and Exercise, August 2009, Pp 1,573–1,579.

2. Oh J, Weng S, Felton S, et al., 1,25(OH)2 Vitamin D Inhibits Foam Cell Formation and Suppresses Macrophage Cholesterol Uptake in Patients With Type 2 Diabetes Mellitus, Circulation, August 2009, Pp 687–698.

3. Mori T, Burke V, Puddey I, et al., The effects of [omega] 3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial, Journal of Hypertension, September 2009, Pp 1,863–1,872.

U P D A T E

The Impact of Market Declines

It certainly doesn’t seem fair. You’ve done your part by diligently setting

aside funds for your child’s college education. But if your child

will be entering college soon, market declines may have reduced your

investments so much that you’ll need to find other ways to pay those college

costs. Some tips to consider include:

ü Realize that everything doesn’t have to be finalized by your

child’s freshman year of college. College expenses will be paid

out over a four-year period, so you have time for investments to recover.

ü Consider alternative strategies to pay for college. For instance,

you can keep your investments in stocks, obtaining loans to pay for

college. Then, if your stock investments recover, you can sell them.

ü Keep saving for your child’s college expenses. The average cost

of tuition at a four-year public university was $6,585 for the

2008–09 school year (Source: Trends in College Pricing, 2008). Saving

$550 per month for one year will pay that tuition.

ü Reevaluate your child’s and your expectations. If your preferred

college is out of your price range, there are many colleges providing

a good education at a reasonable price. Look into other ways to reduce

college costs, such as starting at a community college or accelerating studies

to complete a four-year degree in three years.

ü Have your child work part-time during college. Make your child

responsible for some of his/her expenses, perhaps books, room and

board, or personal expenses.

How Much Can You Withdraw in Retirement?

How much to withdraw

annually from your retirement

assets is probably one

of the most important decisions

you’ll make when you retire. Several

factors need to be considered

when calculating your withdrawal

rate, including your life expectancy,

expected long-term rate of return,

expected inflation rate, and how

much principal you want remaining

at the end of your life. Unfortunately,

life expectancies, rates of return,

and inflation are difficult to predict

over a retirement period that can

span decades. Keep these points in

mind:

ü Your life expectancy.

While it’s easy enough to find out

your actuarial life expectancy, life

expectancies are only averages.

Approximately half the population

will live longer than those tables

suggest. How long close relatives

lived and how healthy you are can

help you gauge your life expectancy.

Just to be safe, you might want to

add five or 10 years to that age.

After all, you don’t want to run out

of money at age 75 or 80, when you

Continued on page 2

ü Rate of return.

Expected rates of return are often

derived from historical rates of return

and your current investment allocation.

Historical rates of return are

averages of returns over a period of

time. You might want to be more

conservative than that, assuming a

rate of return lower than long-term

averages. Even if you get the average

return correct, the pattern of

actual returns can significantly affect

your portfolio’s balance. For

instance, if you experience higher

returns in the early years of retirement

when your portfolio balance is

higher and lower returns in the later

years when your portfolio’s balance

is lower, you’ll have a higher ending

balance than if the opposite occurred.

ü Expected inflation.

While inflation has been relatively

tame recently (2.7% over the past 10

years), it was 4.1% in 2007. Over the

past 30 years, inflation has averaged

4.2% (Source: Bureau of Labor Statistics,

2008). Inflation of 4% can

have a dramatic impact on your

money’s purchasing power over a

long retirement. For instance, at 4%

inflation, $1 is worth 68¢ after 10

years, 46¢ after 20 years, and 31¢

after 30 years.

So what is a reasonable percentage

to withdraw on an annual basis?

To be conservative, it is typically recommended

that you only withdraw

modest amounts from your retirement

savings, especially in the early

years of your retirement. A common

rule of thumb is to withdraw no more

than 4% in your first year of retirement,

adjusting that amount annually

for inflation.

With an asset allocation of 60%

stocks and 40% bonds, one study

found that over a 30-year period,

withdrawing 4% initially and

increasing withdrawals by 3% annually

would result in an 87% probability

of ending that period with assets

remaining. A 5% withdrawal rate

would reduce the probability to 63%,

with the probability going down to

38% with 6% withdrawals and 19%

with 7% withdrawals (Source: AAII

Journal, August 2008).

Consider these tips when deciding

how much to withdraw:

ü Use a modest withdrawal

percentage to ensure you

don’t deplete your assets.

While you should go through the process of

determining how much to withdraw

based on your unique circumstances,

be prepared for modest withdrawal

percentages. With a $1,000,000

portfolio, a 4% withdrawal equals

$40,000.

ü Review your calculations

every year. This is especially

important during your early retirement

years. If you’re depleting your

assets too rapidly, you can make

changes to your portfolio, reduce

your expenses, or consider going

back to work. As you age, your

options tend to become more

limited.

ü Work as long as you can.

Supporting yourself for a

retirement that could span 25 or 30

years requires huge sums of money.

Consider working at least a couple of

years longer than originally planned.

During those years, you continue to

build your retirement assets, and you

delay making withdrawals from

those assets. Once you retire, consider

working at least part-time to

reduce your withdrawals from your

retirement assets. Even modest earnings

can help tremendously. For

instance, if you earn $20,000 annually,

that is the equivalent of a 4%

withdrawal from a $500,000 portfolio.

Please call if you’d like help with

this decision.