Will Miracle Fruit restore sense of taste?
DEAR DR. ROACH: In a recent column regarding the woman with Parkinson’s disease experiencing a loss of taste, I was wondering if you have read about the Miracle Fruit. It’s an African berry known for enhancing flavour experience, and cancer patients reportedly have experienced an ability to taste food after eating this. I am curious of your thoughts on this.
ANSWER: I have to admit to a little skepticism when I first read about Miracle Fruit. But that really is the name for Synsepalum dulcificum. The active ingredient is a glycoprotein called “miraculin.” (My hat is off to the public-relations genius who named these.)
I found several small studies about it. For a few hours after eating even a single berry, the way taste is perceived, especially sour taste, is profoundly changed. It has been used for people with taste changes due to chemotherapy, as you suggest.
However, it is effective at improving taste sensation in only about 30 per cent of people, and it did not help people gain weight. (In fact, it was shown in a separate study to enhance sweetness, allowing people trying to lose weight to eat less).
Although the berries are available all year, they go bad within a few days of picking.
Extracts of miraculin are available, but all the published research I found is on the fresh berries. These are available commercially but are expensive, especially considering shipping charges.
DEAR DR. ROACH: I’m a 70year-old avid golfer with arthritis in both knees. The left knee is the worst, so I wear a brace while golfing. I normally walk to get the exercise I need. I’m also on a blood thinner, so I cannot take Aleve, which seems to be the only thing that helps.
I recently saw an ad for curcumin, which you appear to endorse. Any additional thoughts or comments on its use?
ANSWER: Curcumin, an extract of turmeric, has been proven to reduce pain and swelling in some people, but may interfere with anticoagulants, especially Coumadin and the newer anticoagulants, so don’t use it without discussing it with whoever is prescribing your medication.
It doesn’t work for everybody (nothing does), but it works for some and is safer than many of the arthritis treatments.
I wouldn’t use the term “endorse:” I haven’t ever endorsed a product. I try only to identify some risks and benefits in hope that readers can get enough information or will be motivated to talk to their doctors to help decide whether a particular treatment might be appropriate.
DEAR DR. ROACH: I have had tonsillitis for 10 years now. I have tried antibiotics, but they give only temporary relief. What do you recommend?
ANSWER: That’s a very long time to have had tonsillitis. At this point, I certainly would refer you to an ear, nose and throat doctor to consider tonsillectomy. (I’m not a surgeon, so I don’t order surgery. When I think it appropriate, I refer to a surgeon, who makes that determination.)
There are only a handful of adults whom I have ever referred for tonsillectomy, but persistent or recurrent infection is a clear indication for surgery.
Surgery reduces recurrence rate of tonsillitis from 24 per cent to three percent in the 90 days following surgery. I don’t know of longterm studies, but my clinical experience says surgery has a dramatic effect at reducing long-term symptoms.
DEAR DR. ROACH: A column discussed the safety of high heart rates. My exercise partners and I do high-intensity interval training (on a bike) that takes us up to 95 per cent of absolute max (160) for intervals of 10 to 60 seconds, six to 10 sets at a time.
In light of your comments on enlargement of the aortic root, are we putting ourselves in danger?
Suddenly I am interested in all things heart, having had a very unexpected heart attack, resulting in placement of two stents. Not sure I will ever be the same, but I am concerned that my “road back” regimen may end badly. ANSWER: High-intensity interval training is a great way of improving performance, but for middle-age or older men (especially those with known coronary artery disease), it might not be the best way of staying alive longer. The concern has been that high levels of exertion could cause a heart attack in those who are at high risk.
Recent studies have suggested the risk of HIIT is low, even in people with coronary artery disease (who often have been excluded from previous trials). In a 2012 study in people with CAD, the risk of heart attack during or within one hour of exercise was about one in 20,000 hours of exercise, but that was about six times greater risk than in those exercising at moderate levels.
There are two ways to look at this: High-intensity exercise is pretty safe; or high-intensity exercise is more likely to lead to a heart attack. Both are true.
The studies are hard to translate to real life, since the exercise was done under supervision in a cardiac rehab program. Based on these data, and on many years of epidemiologic data showing a small increase in mortality among men who exercise at very high levels, I recommend moderate- rather than high-intensity exercise among those at highest risk for a heart attack. However, this is an individual decision, to be considered with the help of their doctors.