Healthy Life Newsletter, February 2019
Chiropractic Better than Medication for Neck Pain
A study published in the research journal Annals of Internal Medicine and widely reported by mainstream media suggests chiropractic spinal manipulation is more effective than over-the-counter and prescription medication for relieving acute and subacute neck pain.
Spinal manipulative therapy was more effective than medication in both the short and long term.
The study involved 272 adults ages 18-65 with neck pain of two to 12 weeks’ duration. Participants were recruited from a university research center and a pain management clinic in Minnesota. Spinal manipulation was provided courtesy of a doctor of chiropractic. According to the study, six chiropractors, each with at least five years’ experience, provided treatment, with the specific spinal level to be treated and the number of treatments provided left to the discretion of the individual chiropractor.
Instead of chiropractic care, some patients in the study group received medication as monitored by a licensed medical physician. Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (aspirin), or both served as the first line of pharmacological therapy. With patients who did not respond to or could not tolerate these drugs, narcotic medications and muscle relaxants were prescribed. With each patient, the MD determined the type of medication administered and the number of patient visits.
Self-reported outcomes, including pain, were measured six times during the 12-week treatment period: at two initial (baseline) appointments; two, four, eight and 12 weeks after treatment began; and on two occasions post-treatment (weeks 26 and 52). Objective measures of cervical spine motion were measured at four and 12 weeks by seven trained examiners who were unaware of which treatment the patients were receiving.
After 12 weeks of treatment, a significantly higher proportion of the SMT group experienced reductions of pain of at least 50% [compared to the medication group]. Specifically, at week 12, more than 82 percent of the SMT group reported a 50 percent or greater reduction in pain; 57 percent reported at least a 75 percent reduction and 32 percent reported a 100 percent reduction. By comparison, the medication group reported reductions of only 69 percent, 33 percent and 13 percent, respectively.
In terms of long-term improvement, 75 percent of the SMT group reported at least a 50 percent reduction in pain after 26 weeks, while nearly 81 percent reported at least a 50 percent reduction at 52 weeks. The medication group’s improvement fluctuated from 59 percent reporting pain reduction of 50 percent or more at 26 weeks to 69 percent reporting the same reduction at 52 weeks.
“Participants who received medication seemed to fare worse, with a consistently higher use of pain medications for neck pain throughout the trial’s observational period,” said the study authors. In other words, chiropractic was a much better choice than medication for neck pain.
Interestingly enough, a third group of patients who received home exercise advice instead of chiropractic care or medication also fared better than the medication group during the study period. That means two forms of conservative, drug-free care - both of which are commonly provided by doctors of chiropractic - were more effective than over-the-counter and/or prescription drugs. The moral of the story? The next time you or someone you know is suffering from neck pain, don’t turn to the medicine cabinet or a medical doctor; turn to your doctor of chiropractic.
Back Pain Associated with Increased Mortality in Older Women
Findings in a new study featuring more than 8,000 older women underscore the important role that chiropractors can play in improving public health through the treatment of back pain, exercise and lifestyle interventions and coordination of care for older adults. Researchers at Boston Medical Center found that women with more frequent, persistent back pain had a 24 percent increase in mortality risk. Back pain is also the leading cause of disability worldwide. “Being unable to perform, or avoiding, daily activities could lead to weight gain, development or progression of other chronic health conditions, and ultimately earlier death,” notes study author Eric Roseen, DC.
How Sugar, Alcohol and Caffeine Affect Inflammation
We know by now that chronic inflammation is a culprit for almost every single disease on the planet. Even though there are many factors that drive inflammation, the food and beverages we have each day are some of the biggest culprits. Chronic inflammation affects the gut, but eventually, it also becomes systemic, which means that it affects almost every organ in the body.
Many people start their day with caffeine (stimulant) and end their day with relaxants (such as wine, beer or other comfort foods). People believe that this will help them to cope with stress, help them to get through their day and they, therefore, repeat the cycle over and over again. We also tend to have more and more sugar throughout the day, often included in sneaky sources such as ketchup and sweetened almond milk. These things all have a cumulative effect on inflammation—let’s look at the three major foods/beverages that cause inflammation: alcohol, caffeine and sugar:
Sugar
Sugar causes massive amounts of inflammation and is detrimental to your gut and your overall health. It causes low-grade inflammation which contributes to many chronic conditions such as cardiovascular disease and type 2 diabetes. It can also contribute to obesity which is characterized by low-grade chronic inflammation both systemically and in fatty tissues. We often see an increased immune response with obese people within fat tissue which is called metabolic inflammation. (Find out more about what natural supplements that can be used to help reduce sugar cravings— Review Critic).
Sugar can also cause insulin resistance which will cause your pancreas to work overtime as it has to secrete more and more insulin in order to stabilize blood sugar. Insulin resistance, in turn, can lead to metabolic syndrome, which is a major cause of diabetes, vascular and heart disease. All of these health problems will destroy and influence your quality of life. If your body is chronically inflamed, it will fuel insulin resistance even further.
Most people know what the effect of sugar is on their health and they know to try to avoid or reduce their sugar intake, but the so-called healthy sugars seem to be more of a problem nowadays as people aren’t always aware that these sugars also cause inflammation and that they are harmful to your overall health. These are the sugars that can be found in fruit, nut milk etc. Large amounts of fruits (fructose) can definitely also create or worsen inflammation and insulin resistance.
Insulin resistance also leads to many other imbalances which will increase inflammation levels even more. The hormone leptin—which regulates the feelings of satiety—is a good example. You should be less hungry if you have many leptin hormones in circulation. However, people who are obese do not respond to leptin, even if they do have high levels of leptin hormones in circulation. The high levels are, therefore, not sensed by the brain in order to let their bodies know that they are full and should stop eating. This leads to yet another problem namely leptin resistance, which leaves you hungry even though you’ve had more than enough food. A lot of sugar leads to insulin resistance and this can lead to leptin resistance and this can result in weight gain—and all of this will increase inflammation.
So, how much sugar per day would be safe to consume? You can get away with less than 25 grams of sugar per day if you want to keep your inflammation under control.
Caffeine
People tend to react very differently to caffeine intake. This all depends on whether you are a fast or slow metabolizer—some people do fine on three cups of coffee per day while others get jittery by just smelling coffee. It is important to listen to your body in order to find out what signals it is giving you.
How you drink your coffee also matters—if you are drinking it with a lot of sugar and non-dairy creamers which contain a lot of sugar, it will have a completely different effect than black coffee would have. The effect it has on inflammation will also vary greatly.
The reason why you might want or feel that you need caffeine is also an important factor to consider. If you need your cup of coffee in order to get moving in the morning, it might be important to look at other factors such as stress management as well as sleep habits. It might also show you that you should start paying attention to finding a balance between rest and activity.
Caffeine is also very dehydrating, so make sure to drink plenty of water. So, how much caffeine should we be having each day to keep inflammation at bay? More or less 50 grams of caffeine/ one cup of coffee per day would be a safe bet, but more than this amount would push insulin secretion, which will lead to all the problems mentioned above. It will also increase your cravings for refined carbohydrates and sugar and eventually lead to weight gain.
Alcohol
It is believed that moderate or light alcohol consumption can have an anti-inflammatory effect, however, large amounts can cause intestinal inflammation. An occasional organic glass of red wine will have a different effect on your body than a sugary alcohol drink would. Inflammatory response exacerbates with alcohol-induced organ damage which will affect your gut and overall health. Alcohol can also be dehydrating, so it’s once again very important to drink enough water when consuming alcohol. You can get away with one drink three times a week without causing too much inflammation.
It’s important that we should find balance in life and have our occasional drink, pastry, coffee or glass of red wine—but try to be mindful and in a low-stress environment when consuming these little pleasures. In this way, they will minimally affect inflammation. You can keep your cells young and manage inflammation by treating sugar, alcohol and caffeine as luxuries to enjoy only in moderation.
Just 6 Months of Walking May Reverse Cognitive Decline, Study Says
By Sandee LaMotte, CNN
December 20, 2018
(CNN)Worried about your aging brain? Getting your heart pumping with something as simple as walking or cycling just three times a week seems to improve thinking skills, new research says. Add a heart-healthy diet, and you maximize the benefits, possibly shaving years off your brain’s functional age, according to the study published Wednesday in the journal Neurology.
“Our operating model was that by improving cardiovascular risk, you’re also improving neurocognitive functioning,” said lead study author James Blumenthal, a clinical psychologist at Duke University. “You’re improving brain health at the same time as improving heart health.”
Many experts “are already convinced about the benefits of lifestyle interventions to reduce risk of Alzheimer’s and cardiovascular dementia,” said Dr. Richard Isaacson, who directs the Alzheimer’s Prevention Clinic at Weill Cornell Medicine. “But for those who are not, this study is a randomized, clinical trial that illustrates the benefits.
“You can do something today for a better brain tomorrow,” said Isaacson, who was not involved in the research.
Diet, Exercise or Nothing at All
The study was a first, said Blumenthal, who has long studied the effects of diet and exercise on depression and overall cardiac health.
“I don’t think there is another study that looked at the separate and combined effects of exercise and diet in slowing cognitive decline in patients who are vulnerable to develop dementia in later life,” he said.
The study enrolled 160 adults who had high blood pressure or other risks for cardiovascular disease, who never exercised and who had verified cognitive concerns such as difficulty making decisions, remembering or concentrating. Participants were an average age of 65, two-thirds female and equally divided between whites and minorities. Anyone diagnosed with dementia or unable to exercise was excluded.
Researchers randomly divided participants into four groups for the six-month study. One group started the DASH diet, short for Dietary Approaches to Stop Hypertension. DASH is a widely respected heart-healthy diet that cuts salt, fatty foods and sweets while emphasizing vegetables, fruits and whole grains. This group received nutritional guidance on how to stick to the diet but was not encouraged to change their couch-potato habits.
A second group exercised but was not encouraged to diet. For the first three months, this group was supervised at a cardiac rehab facility where they did non-strenuous exercise three times a week: They warmed up for 10 minutes and then did 35 minutes of continuous walking or stationary cycling. During the last three months of the study, this group exercised at home, filling out compliance logs that were monitored by research staff.
The third group did both: They exercised three times a week and followed the DASH diet. The fourth group received only advice on reducing their cardiovascular risk during a 30-minute call with a health educator but was told not to change their diet and exercise habits.
Before starting their assigned path, participants underwent a battery of cognitive tests, a treadmill stress assessment and a dietary analysis. In addition, their blood pressure, blood sugar and lipids were recorded. The tests were repeated at the conclusion of the study.
Change in Only Six Months
The group who only exercised saw significantly greater improvements in their executive functioning skills than the group who did no exercise.
“The results showed that controlled aerobic activity within a very short period of time can have a significant impact on the part of the brain that keeps people taking care of themselves, paying their bills and the like,” Isaacson said. “Not only can you improve, but you can improve within six months!”
From grassrootshealth.net
Science Speaks: What Causes a Low Vitamin D Response?
On occasion we have participants who experience a lower than expected vitamin D level. In this blog we will explore possible causes of a low or slow to rise vitamin D response.
\1. UVB exposure
If you’re relying more heavily on sun exposure (or indoor tanning) for vitamin D, not exposing enough skin, high sunscreen use, or lack of mid-day (10 am - 2 pm) exposure will limit vitamin D production. Environmental factors such as smog and cloud cover or residing in a higher latitude will also reduce exposure to UVB radiation. Additionally, the amount of melanin in the skin influences vitamin D production. Someone with more melanin (darker skin) might need 30 minutes in the sun to achieve the same production of vitamin D that someone with less melanin (lighter skin) will achieve in 10 minutes. While some people can achieve very high levels (~70 ng/ml) of vitamin D through sun exposure alone, others cannot achieve these levels without supplemental vitamin D.
\2. Dietary intake of vitamin D
Certain foods that have naturally occurring vitamin D (e.g. fish, meat, and eggs) or are fortified with vitamin D (e.g. milk and other dairy products, some orange juice and cereals) can impact vitamin D levels. Reduced consumption of these foods many lower vitamin D levels. Additionally, some foods contain vitamin D2 (not D3) such as mushrooms and some fortified foods (e.g. rice milk and soy milk) and while our body can use this form, it isn’t as effective as vitamin D3. Further, the amount of vitamin D available in food is rather small compared to what most people need to achieve a blood level of at least 40 ng/ml (e.g. salmon has ~450 IU/serving and fortified milk has ~120 IU/cup).
\3. Vitamin D co-factors and competitors
The intake of other nutrients has been shown to impact vitamin D levels. For example, a lack of key vitamin D co-factors such as magnesium, vitamin K, boron, and zinc can reduce vitamin D adsorption and production. On the other hand, a high intake of certain vitamins that compete with vitamin D, such as Vitamin A in the form of retinol or retinyl palmitate (not beta-carotene), can cause a reduction in vitamin D levels. This form of vitamin A is found in food from animal sources (especially liver) and some supplements. Also, some drugs including statins, prednisone and weight-loss drugs can block vitamin D.
\4. Time of supplement intake
Since vitamin D is a fat-soluble vitamin, taking it with a meal that contains fat can increase adsorption. Also, adding a probiotic supplement can help with digestion in general and improve absorption of vitamin D.
\5. Demographic characteristics
With increased age comes a reduced ability to absorb vitamin D though the skin and a reduction in the kidney’s ability to convert vitamin D to its active form. Also, smokers and those with a high BMI tend to have lower levels.
\6. Medical conditions
A recent illness or injury may result in a lower vitamin D level. Also, digestive conditions such as irritable bowel disease, Crohn’s disease, leaky gut, or celiac disease can limit the absorption of vitamin D in the gut. Those with diseases of the liver (e.g. fatty liver) or pancreas, who have had their gallbladder removed, or who have had bariatric surgery bypassing the small intestine are more likely to have trouble absorbing or metabolizing vitamin D. For these individuals, an increased dosage or other vitamin D metabolites may be needed (please consult with your physician if this is the case).
If you have been consistently taking the same supplemental dose of vitamin D and experience a lower than expected vitamin D level, it’s possible that a change in diet, behavior, health, or the environment over the prior few months could have reduced your levels. Or, if you are having difficulty increasing your levels, try increasing your dose, taking it with your largest meal, and optimizing vitamin D co-factors to improve your levels.
Death by Opioid Overdose: The Odds Aren’t in Your Favor
If that can’t be true is your immediate thought after reading this title, we admit it certainly sounds a bit far-fetched at first blush, considering our generally unhealthy and downright dangerous world.
But bear with us, because this is where things get interesting – disturbingly interesting. According to new findings from the National Safety Council, your lifetime odds of dying from an accidental opioid overdose (1 in 96) are actually higher than your odds of dying from any of the following:
Motor vehicle crash: 1 in 103
Fall: 1 in 114
Gun assault: 1 in 285
Pedestrian incident: 1 in 556
Drowning: 1 in 1,117
Fire or smoke: 1 in 1,474
Choking on food: 1 in 2,696
Bicyclist: 1 in 4,047
Accidental gun discharge: 1 in 8,527
What about the major health conditions that strike Americans? Well, the lifetime odds for the top three are definitely higher than the opioid overdose risk (#4 on the list), but it’s not as large a discrepancy as you’d think: heart disease (1 in 6 lifetime risk of dying), cancer (1 in 7) and chronic lower respiratory disease (1 in 27). But considering that opioid overdose is the only risk to your health / life on the list that can be completely eliminated, simply by not taking opioids, it’s a wonder doctors continue to prescribe, and patients continue to take, oxycodone, codeine, morphine and other forms of this dangerous and often-addictive medication.
As we’ve talked about numerous times in the recent past, opioid use, abuse and misuse has become an epidemic, and while the tide is turning away from opioids and other pain medications, and toward conservative, nondrug alternatives for pain (such as chiropractic care), it’s slow going at best. In fact, research suggests it can take up to a decade for doctors to catch up with policy / guidelines. Not soon enough in the case of opioids, which continue to kill more than 100 Americans each and every day.
It also doesn’t help that opioids are big business - both for the pharmaceutical companies that make them and the doctors who prescribe them. A recent CNN / Harvard University analysis revealed that opioid manufacturers pay doctors large amounts to prescribe opioids, with higher prescription rates tied to higher payments.
If your medical doctor tries to prescribe an opioid for your pain, always ask about nondrug alternatives to relieve your pain, and be sure to mention chiropractic. Public policy is rapidly embracing chiropractic and other conservative means as the first options for managing pain, but as we alluded to, policy and doctor prescribing habits don’t always mesh.
If you and your doctor ever believe it necessary to take a pain medication, make sure it is not an opioid and is prescribed for only a short time. Also ensure your doctor and the pharmacist who fills the prescription completely explain the appropriate dosage so your risk of an accidental overdose is minimized.
Finally, keep in mind that if you visit a chiropractor for your pain first, you won’t be prescribed an opioid or other pain medication, and your risk of an overdose will be eliminated altogether. Sounds like the best option to us.