There's a fruit that dates back to ancient Egypt, Greece, and Rome where people used it both as a food and as medicine. The Bible mentions it, as do the writings of all the major religions. And it's used in folk medicine throughout the Middle East and India.

Now this fruit is gaining unprecedented popularity in the U.S. This is due to recent scientific studies that found it protects against heart disease, cancer, high blood pressure, and other illnesses. I'm talking about one of my very favorite fruits: pomegranates.

I like the sweet-tart flavor of pomegranate seeds and look forward to finding the fruit in markets each fall. While many people find them messy and difficult to peel, I have always found pomegranates worthy of the time and trouble they take to pry the seeds from the leathery skin. Fortunately, that's no longer necessary. Many markets and health food stores across the country now sell pomegranate juice.

Two years ago, I predicted that pomegranate juice would become one of the leading products for 2004. It did. Since then, its popularity has grown. In addition to pomegranate juice, there are now supplements containing pomegranate extract and pomegranate seed oil. If you've read this newsletter for very long, you know that I'm not in favor of new foods and extracts with no science to back up exaggerated claims. Well, there's science behind the pomegranate.

Some of its benefits come from its particular antioxidants. Pomegranate juice has three times as many antioxidants as either green tea or red wine.

Heart disease

In addition to their great taste, another reason pomegranates are growing in popularity is their ability to protect your heart.

Once we thought that high cholesterol was a strong predictor of heart disease. Now we know high amounts of LDL (low-density lipoprotein) cholesterol — not total cholesterol – is most harmful. LDL is the sticky cholesterol that can contribute to a buildup of plaque in your arteries. LDL can also oxidize and create free radicals — nasty substances that damage cells. If you have too many free radicals, or not enough antioxidants to destroy them, you could be heading toward heart disease or cancer.

The antioxidants in pomegranates protect your LDL from oxidizing. They also increase the activity of a substance found in healthy cholesterol (HDL) that protects against oxidation.

In a preliminary study, researchers gave atherosclerotic mice pomegranate juice. They found the mice given the juice had 90% less oxidation than the control mice. That's a huge reduction!

But what can this juice do for people? Researchers recently studied a small group of people with hardening of the arteries. They found that pomegranate juice reduced their oxidation 59-90% after one year. However, it didn't take this long for the benefits to begin. This reduction in oxidation began after they drank the juice for just one month. But the longer the participants drank it, the better their results. They didn't drink that much of it, either — less than two ounces a day! If you're drinking pomegranate juice (not the concentrate) specifically for its health benefits, you may want to increase the amount to six ounces a day for added protection.

Other studies with both mice and humans found that pomegranates' antioxidants also prevent and reduce atherosclerotic plaque. One human study found that the juice actually decreased LDL's ability to cause atherosclerosis. It prevented plaque from forming.

But that's not all. You know that blocked arteries often lead to heart disease. Well, the patients with narrowing arteries who drank pomegranate juice for a year showed a 44% improvement. However, those who took a placebo ended up with thicker, narrower arteries. The implications are astounding. Just drinking pomegranate juice could help un-block your arteries! It certainly appears that adding pomegranate juice to a heart-protective diet is worthy of serious consideration.

If you have high blood pressure, you may be interested to know that when study participants drank pomegranate juice for three years it lowered their systolic blood pressure by more than 20%. While I wouldn't use this as my only way to keep blood pressure down, it certainly is an added benefit.

Cancer

In ancient times, people used every part of the pomegranate medicinally. Now, modern science is looking for applications beyond the juice. One such application is the prevention of skin cancer. A 5% solution of pomegranate seed oil significantly reduced skin cancers after it was applied to laboratory animals twice a week for five months.

Based on some of the early studies using parts of the pomegranate in cancer therapy, I believe the usefulness of pomegranates in breast cancer prevention and treatment could be just around the corner. Here's just one reason why. One early laboratory study suggests that both fermented and non-fermented pomegranate juice concentrate, as well as extracts of both the fruit and seed, block the effects of estrogen in estrogen-positive breast cancer cells.

Preliminary findings showed that the antioxidants in fermented pomegranate juice were twice as effective in blocking the spread of cancer cells as the fresh juice. Pomegranate seed oil inhibited cancer cell growth by 90%.

I predict we'll hear more about the cancer prevention and cancer-fighting qualities of pomegranate products in the next few years. This early research is encouraging, but I caution you to wait until we have more studies — on humans, not just with cancer cells — before rushing out to buy pomegranate extracts or other products that claim they have any benefits beyond supporting heart health. There are still a lot of unknowns. What part of the pomegranate is protective? How much should be used and for how long? And are there any side effects or contraindications if you use a supplement with high levels of one or more ingredients?

Of course, there's nothing wrong with drinking a small glass of pomegranate juice every morning instead of orange juice. Or enjoying the fruit when it comes into stores every fall. Stay tuned for updates on this subject as they become available. I'll be following them carefully.

Aviram, M, et al, "Pomegranate juice flavonoids inhibit low-density lipoprotein oxidation and cardiovascular diseases: studies in atherosclerotic mice and in humans," Drugs Exp Clin Res, 2002.

Aviram, M., et al. "Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice," Amer Journ of Clin Nutr, May 2000.

Aviram, M., et al. "Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation," Clinical Nutrition, 2004.

Hora, J.J., et al. "Chemopreventive effects of pomegranate seed oil on skin tumor development in CD1 mice," Journal of Medicinal Food, October 2003.

Kim, N.D., et al. "Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer," Breast Cancer Research and Treatment, February 2002.

The Top New Products and Trends for 2006-2007

Every year, I walk my feet off for three days at the largest trade show in the country featuring natural products — from foods to supplements, raw materials, and cosmetics. I do this to bring you the latest information on the health trends you're likely to see in the coming year, and also to tell you about a few products I think are outstanding.

This year, there were more than 3,000 exhibits and dozens of lectures by people in the field of health and nutrition. I was one of more than 43,000 people attending the National Products Expo West trade show and I saw most of the booths. It was exhausting.

The only trends I saw on the horizon were for functional foods. Functional foods are foods that have nutrients added to them to raise their nutritional content. Sometimes a company is just trying to find a gimmick to sell an old product. Like adding a berry extract to coffee or water to raise its antioxidant levels. Often, these products don't have enough added nutrients to improve your health.

In my opinion, we need better whole foods, not better functional foods. So I went searching for some good quality whole foods. I came away with a few that impressed me — and my faithful panel of taste testers. All of these products should be available in health food stores throughout the country, and possibly in other stores as well. If you have difficulty finding them, you can order them by phone.

Healthy energy bars

Some people grab them instead of having a meal. Others use them for a mid-afternoon lift. Nutrition bars, sometimes called energy bars, have become more popular than ever. The problem is that most of them are high in sugar.

In my opinion, most of these bars are candy. Don't get me started on "organic pure cane sugar juice." It's sugar. It still causes insulin levels to spike and drop.

This year, I found more energy bars with healthy ingredients than ever. My tasters liked all but two. Here are the ones all of us liked, with pertinent information about each. Most of them are made from fruit, nuts, and seeds. Some have a little added grains or protein. These bars are not as high in protein as the sugar-laced bars, but they're much healthier. They also don't taste like candy bars because they're not candy — they're whole foods. They taste like fruit and nuts.

Because honey causes insulin to rise and then drop sharply, I eliminated energy bars containing honey. I also passed on the bars that are made with a little cane sugar — with one exception.

Non-Organic Bars:

Perfect 10: This bar, made in Canada, gets its name from its ingredients. Each flavor contains three fruits, three nuts, and four seeds. It comes in cranberry, lemon, apple cinnamon, apricot, and cherry. Each raw bar contains five grams of protein (210 calories) and was the favorite of many testers for both taste and texture. (866-800-9930)

Larabar: Made from unsweetened fruits, nuts, and spices, these bars are also raw and free from gluten, dairy, and soy. Lemon, ginger snap, cinnamon roll, pecan pie, and cherry are just a few of their flavors. Their only fats come from nuts. These are a great meal replacement if you're on the go. (877-527-2227)

ProBar: Although this bar was designed for endurance athletes, it's a great-tasting natural bar with chunks of whole grains, fruits, and nuts that my testers really liked. This bar is twice a big as some of the others. Half a bar is plenty for a satisfying, crunchy snack packed with large pieces of nuts and fruit. Its ingredients aren't completely organic yet, but ProBars contain around 63% organic ingredients and the manufacturers are moving in that direction. One of the company's suppliers of granola uses a tiny amount of organic cane sugar juice. The folks at ProBar want to replace this when they can. These bars come in berry blast, coffee, lemon, banana, apple, and original flavors. (800-921-2294)

Organic Bars:

Zen Organic Food Bar: These bars contain Jerusalem artichoke powder and agave nectar among other natural ingredients. Both of these help regulate blood sugar. This means that you can eat this bar without having a spike or drop in your energy. Rice protein increases its protein content to eight grams per bar, and each bar has around 170 calories. If you're looking for a meal replacement, you may want to consider the Organic Veggie Tropical Twist. It's packed with vegetable powders as well as dates, figs, and pineapple. In fact, one bar equals four servings of fruit and vegetables. (604-464-4511)

Maya food bars are made with organic chocolate, nuts, and dates from the folks at Larabar (877-527-2227). If chocolate is your passion, you may want to try their chocolate orange, chocolate mint, chocolate coffee, or just plain chocolate and see which one you like the best. But remember, these are food bars, not candy. Since their sweetener comes from dates, you'll find these bars have their own unique taste — not like candy, but like chocolate in a wholesome food bar.

Healthy crackers

I'm tired of mediocre tasting crackers. I like crackers with a satisfying "crunch!" to eat with a dip, an occasional piece of cheese, or just by itself. A lot of crackers masquerading as being healthy are made with enriched wheat flour and sugar. I found two truly whole-grain crackers my testers and I particularly liked.

Dr. Kracker: You want fiber plus taste? Try these crackers — either the flatbread or the small squares called Snacker Krackers (my favorite). They're made with organic wheat, spelt (a non-allergenic form of wheat), and oats. Then bran and flaxseeds are added. Choose from a variety of flavors including Muesli (with fruit), three seed, and pumpkin seed cheese. I can eat handfuls of ordinary crackers without feeling satisfied. Eight squares of Dr. Kracker (120 calories) are plenty for me. (214-503-1971)

Mary's Gone Crackers: No wheat, no gluten, but plenty of crunch. These thin rounds are made from organic rice and quinoa and are peppered with flaxseeds and sesame seeds. They come in several flavors: herb, caraway, onion, and black pepper. Other rice crackers I've eaten are boring. These are not. (888-258-1250)

How Patients Can Help Any Therapy Work Better!

Years ago, I was driving my cat home from the veterinarian. He was howling, unhappy, and frightened from being caged in a moving vehicle. "It's all right, Splayfoot," I reassured him. "We're just two blocks away from home. We're almost there!" But he didn't understand that home was just around the corner.

Like Splayfoot, we often don't realize that we're "almost there." I see many patients who stop a therapy, diet, supplement, or exercise plan just before I think they should be seeing results. Their impatience gets in their way. In fact, it prevents many of us from getting and staying well.

Instead of continuing a little longer with what they're doing, many people reach for the pharmaceutical drugs they'd rather avoid out of frustration. I can understand why. Drugs work fast. For anyone who's impatient, this is a real plus. Natural therapies tend to take longer to work because they often address the source of a problem rather than its symptoms.

Before you opt for a drug that may have unpleasant side effects, take a look at whether or not you're stopping a perfectly good therapy or nutrient a little too soon. You may not need a new doctor, or treatment, or supplement. You may just need to continue with what you're doing a little longer.

Take time to find the right therapy for you

Whatever worked for your best friend or someone in your office will not necessarily work for you. Whatever worked for a Hollywood celebrity is not necessarily your solution. You may want someone to tell you what to do right now, but finding the right therapy can take patience.

A prominent doctor once told me that most of his cancer patients could and should take their time before beginning any treatment. He has his patients sit with all their options and think about all of them before beginning any protocol. This gives them the time and space to pay attention to their feelings about possible decisions. It also helps them notice minor signals that help him fine tune their treatment. This doctor knows that it's more important for his patients to feel comfortable with what they're doing than to rush into any treatment and regret it later.

If cancer patients have time to check out various therapies, so do you. Your condition may feel urgent, but that doesn't mean you need to start it today. Seek information from the most knowledgeable people you can find whether in person, through a phone consultation, or through other means, like this newsletter.

To get an idea about how long it should take for any therapy to work, ask for an estimate, and add on some extra time. Everyone's constitution is different. Some respond more slowly than others. Also, the older you get, the longer it takes for your body to repair itself.

Don't fixate on time. The physical therapy exercises you're doing to correct a frozen shoulder may take a year or longer to resolve. But if you're doing the right exercises often enough, one day you'll find you can move without pain.

If you don't feel you're getting the results you're seeking, don't just stop your program and switch to another. Talk with your health care provider. Like Splayfoot, you may be "almost there."

Take enough of the right supplements

A subscriber wrote to me that she was disappointed in the medicinal mushrooms I recommended. She took them and came down with a lingering upper respiratory infection. Now she's given up on them and no longer trusts me.

How sad. Medicinal mushrooms are my very favorite supplement because they work so well for so many people. I have seen them stop colds, flu, and more serious immune problems. This woman may be short changing herself. The infection she contracted after taking the mushrooms indicates that her immune system was already compromised. She might need to take an immune-booster, such as medicinal mushrooms, for many months before seeing results. And as I've said before, it's often im-portant to take larger doses (six capsules) of a mushroom formula two or three times a day at the first sign of a cold to stop it in its tracks.

Would mushrooms have been enough for her? Perhaps not. Usnea, called "The Lungs of the Earth" by Native Americans, is an herb found in tincture form that directly affects the lungs. I would have used this supplement as well. Then there are antibacterial herbs, as well as probiotics (friendly bacteria) that can help fight bacterial infections.

Take a look at your supplements and make sure you're taking the most appropriate ones for your condition. Then take them for as long as your body needs them. You may need to take a detoxification formula for a year or more if you've been exposed to a lot of pesticides, mercury, or other toxins. If you haven't been exposed to them, three months may be sufficient.

Ask your health care provider or supplement manufacturer for an idea of how long you should take any product before noticing improvements. Then, extend that time by half as long.

Begin today

A teacher of mine once told me, "You want to be patient, but you want it right now!" How right he was. Patience has been one of my life's most important lessons. I still catch myself trying to rush things that can't get rushed. On the other hand, there are times when I find myself so patient that it surprises me.

Patience brings many rewards: less stress, less worrying, and better results. The next time you feel impatient over a health issue, take a few deep breaths. Look at what you're doing to solve the problem and take the time to methodically take each step. Don't skip any of them. Don't rush. You may just need to remain where you are a little longer, doing what you're already doing.

Health Detective

Update: The Latest Information on Cinnamon and Type-2 Diabetes

In December 2004, I wrote an article about three herbs that were being used to treat type-2 diabetes. Cinnamon was one of them. At that time, I said there weren't enough studies to convince me of its safety and efficacy. Most of the positive press given to cinnamon was based on laboratory tests or animal studies. I've recently been reading a number of articles in health publications touting the effectiveness of cinnamon. Is there better information now, or is some of this enthusiasm premature?

A human study has surfaced that causes me to question its use. In it, a group of postmenopausal women with diabetes were either given 1.5 grams of cinnamon a day or a placebo. Glucose tolerance tests were given before and after weeks two and six. This study found that there was no change in glucose tolerance or insulin sensitivity in any of the study participants.

My original article mentioned that cinnamon has toxic compounds. Cinnamon expert with the FDA, Richard Anderson, warns against taking more than half a gram at a time until we have more information. However, a higher amount may be necessary to get the desired results.

My recommendation is to wait for more human studies before taking large amounts of cinnamon to help manage your blood sugar. It may be safe; it may be effective. But as of now, I'm not convinced of either.

Vanschoonbeek, K., et al. "Cinnamon supplementation does not improve glycemic control in postmenopausal type-2 diabetes patients," J Nutr, April 2006.

Can Acupuncture Help Fibromyalgia?

Fibromyalgia, non-specific muscle pain, can be debilitating. Recently, a study at the Mayo Clinic found that it significantly reduces pain in people with mild to moderate fibromyalgia when all other treatments have failed.

Fifty people with fibromyalgia who had no relief from other therapies were divided into two groups. One group received six acupuncture treatments over two to three weeks while the other didn't. The people who had acupuncture had less pain, fatigue, and anxiety that lasted about one month.

Dr. David Martin, who headed this study, was surprised at the outcome. He expected that the participants who were given acupuncture would have less pain, but not improved energy and reduced anxiety. Still, it's evident that acupuncture isn't the whole answer. This short study didn't result in more physical function. Perhaps this is because it's difficult to make lifestyle changes even after pain and other discomfort has lessened. Then again, it may be that these patients didn't continue acupuncture treatments long enough.

I have found acupuncture extremely effective in reducing many sources of pain, but it rarely works quickly. I find it remarkable that this study showed improvement in only two or three weeks. It suggests to me that a longer treatment – say, six months to a year – could result in dramatic changes. If you have fibromyalgia or other pain, consider acupuncture. It's not as painful as you might think. In fact, there are times when you won't even feel the needles.

www.mayoclinic.org.

Ask Dr. Nan

Q: I am 48 years old and was diagnosed with osteoporosis one year ago. I've been quite intrigued with your theory about 1:1 calcium/magnesium, and not megadoses of calcium. The problem is, I was diagnosed a few years ago with hemachromatosis (high iron) and was told not to take any iron supplements, as well as not to supplement with vitamin C, because supposedly the vitamin C helps the body absorb iron! Can you help? — C.M., Brooklyn, NY

A: It's confusing when you have more than one condition. Let me help you understand your situation better. The acid in vitamin C does help your body absorb iron. But it also helps absorb calcium and magnesium, the minerals you need for healthy bones.

If you use a multivitamin without iron, such as Vitality Plus, there's no risk of absorbing iron from your supplement.

This leaves dietary iron, which is best absorbed in the presence of any acid (including lemon juice, tomatoes, and vinegar). If you cook in iron pots or pans with lemon juice or tomatoes, eat a hamburger when you take your vitamins, or have a spinach salad with oil and vinegar dressing, you're increasing iron absorption.

Drinking black tea, however, blocks the absorption of iron by about 50%! Have a glass of iced or hot tea (decaf is fine) with a high-iron meal.

If you don't know which foods are high in iron — like green leafy vegetables, for instance — make it a habit to drink tea with all meals. Don't cook acid foods in iron pots. And be sure you don't take any supplement with extra iron.

Q: What is the difference between the omega-3 oils in fish oil versus flax oil? Are the essential fats in flaxseed as valuable as those in fish oil? I grind flaxseed daily and add it to my apple juice. Should I also be taking fish oil supplements? — B.B., West Lafayette, IN

A: Simply put, omega-3 and omega-6 fats are two categories of fatty acids. Within each category are various nutrients. Flax oil contains alpha linolenic acid (ALA), linoleic acid (LA), and oleic acid.

Fish oil, on the other hand, contains eicosapentaenoic acid (EPA) and docosahetaenoic acid (DHA). Each has its own job and helps make other substances. Some essential fats help your body manufacture needed hormones and feed your brain, retina, and heart. But no source of essential fats covers all of these areas.

We need a balance of the nutrients found in both flax oil and fish oils. In fact, our bodies also need gamma linolenic acid (GLA), and omega-6 fat that isn't found in either flax or fish oils. GLA is essential for good heart health. It keeps your blood from being too sticky or too slick.

If you enjoy grinding flaxseeds, and if you use three tablespoons of the ground meal a day, you can add several fish oil capsules to your supplements.

Please make sure that the company that sells it guarantees it's free from mercury and pesticides. All fish oils are not safe.

One formula that is guaranteed to be safe is the Women's Preferred Mixed Fatty Acid formula that contains all three essential fats (800-728-2288). This formula is the same one that is included in the Vitality Plus packets. You can find others in health food stores.