Archive 2005 2006 2007 2008

Q: You didn’t mention red tea in your recent tea article. What is it, and does it have health benefits?

A: Red tea comes from a South African plant, rooibos (pronounced roy-boss, meaning “red bush” in Afrikaans)—not the plant that black, green, and oolong teas come from (Camellia sinensis). As such it is an herbal tea (a “tisane”), not real tea. It’s somewhat sweet and nutty—and caffeine-free.

Like black and green tea, rooibos is rich in phytochemicals called polyphenols, such as rutin and quercetin. Cell and animal studies, mostly from South Africa, have shown that rooibos extracts have antioxidant, immune-stimulating, and anti-cancer properties.

But according to a 2007 review from Tufts University in Phytotherapy Research, studies of red rooibos tea in people are limited. There’s little or no evidence to back claims that it relieves constipation, headaches, eczema, asthma, insomnia, high blood pressure, mild depression, ulcers, diabetes, and so on. One published study found no anti-allergy benefit.

A tea by any other name. Red tea is also called bush tea or red bush tea. Another popular tea from South Africa is honeybush, which is similar to red tea but comes from a different plant. To confuse things further, black tea in Asia is often called red tea.

Q: What’s the latest news about aspirin or other pain relievers as a way to prevent Alzheimer’s disease or preserve mental function?

A: The picture remains muddy about the role of nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin, ibuprofen, naproxen, and some prescription drugs). One theory is that NSAIDs may help by preventing or reducing the chronic inflammation found in the brains of those with Alzheimer’s.

Many observational studies, which look at people who have been taking NSAIDs for a variety of purposes, suggest that the drugs can help protect the brain. But so far clinical trials, which rigorously compare drugs to a placebo, have not found a benefit.

Two clinical trials published last April found no protective effect. The ADAPT study found that neither naproxen (brand name Aleve) nor celecoxib (Celebrex) reduced the risk of Alzheimer’s in 1,400 people over 70 with a family history of the disease, though this study was halted after four years because of the increased cardiovascular risk seen in subjects taking celecoxib. The large Women’s Health Study found that women over 65 who took low-dose aspirin for nearly 10 years did no better on cognitive tests than those taking a placebo.

Because the studies have focused on a variety of NSAIDs, doses, time frames, and cognitive problems, it is hard to get a clear picture of what, if any, regimen works. It may be necessary to take relatively high doses and start in midlife, rather than at older ages. But then the risks are greater: these include gastrointestinal bleeding as well as increased blood pressure and heart attacks (see Wellness Letter, June 2007).

Bottom line: We do not recommend NSAIDs for the prevention of Alzheimer’s disease, since the benefits remain unproven while the risks are real.

Q: Why do you rarely mention the ratio of total cholesterol to HDL when you discuss blood cholesterol?

A: The individual levels of total cholesterol, HDL (“good”) cholesterol, and LDL (“bad”) cholesterol are more important than the ratio. A ratio is simply a comparison of two numbers. If your total cholesterol is 200 and your HDL is 50, your ratio is 200/50, which equals 4. Most experts, including the National Cholesterol Education Program, have de-emphasized the ratio.

The ratio of total cholesterol to HDL (or sometimes the ratio of LDL to HDL) may appear on your lab report when you have a full blood test for coronary risk. It is still a useful tool—more so than total cholesterol alone, since it does factor in your HDL level. According to the Framingham Heart Study, a ratio of 5 puts a man at average risk; 4.4 puts a woman at average risk. Ideally the number should be 3.5 or lower.

What you really need to know are your HDL and LDL levels. Your LDL should be below 130 (or below 100 if you’re at high risk for heart disease). HDL should be over 40 for a man, over 50 for a woman; HDL over 60 is considered protective.

Q: How is an osteopath different from a doctor?

A: An osteopath is a doctor. In the U.S. a physician can be either an M.D. (doctor of medicine, also called allopathic medicine) or a D.O. (doctor of osteopathy). About 5% of doctors here are osteopaths. Both M.D.s and D.O.s go through four years of specialized schooling, studying the same subjects (such as biochemistry, anatomy, and pathology), and then get postgraduate training. Osteopathic schools emphasize primary care; thus most osteopaths are family practitioners, internists, pediatricians, or gynecologists. Like M.D.s, osteopaths can prescribe drugs and perform surgery in this country. In Canada and some other countries, however, osteopaths are not licensed as “doctors.”

Osteopaths differ from M.D.s mainly in that osteopathic medicine traditionally stressed the role of the musculoskeletal system in a wide variety of disorders and instructed practitioners in hands-on manipulation treatment. Many osteopaths today, however, do not use manipulation therapy.

UC Berkeley Wellness Letter, March 2008