Healthy Life Newsletter, November 2022
Patient of the Month: Jim Thompson
I had stiffness and soreness in my neck and upper back for a year and a half. My neck mobility was limited. The severity of the symptoms was about 8 or 9 on a scale of 1 to 10.
I have known Dr. Mha Atma for decades but had not seen him for treatment in about 13 years. When I returned to his office I felt confident he could help. I was impressed by his office from day one. He recommended weekly adjustments and stretches for my neck and back. Within the first few weeks I began to experience increased mobility in my neck.
My symptoms continued to steadily improve and after about 3 months we reduced treatment frequency to twice monthly and eventually once monthly. I kept feeling improvement, and after about 10 months I was completely cured.
I recommend chiropractic care to anyone with a back or neck problem and I’ve told many people about it over the years. I’m glad chiropractic is there when I need it. Dr. Mha Atma is a caring, skilled practitioner and I would recommend him to anyone who needed good chiropractic care.
What Your Chiropractor Knows – That Your Medical Doctor Doesn’t
By Donald M. Petersen Jr., BS, HCD(hc), FICC(h)
An interesting study recently published in The Spine Journal examined what is important to patients as they seek care for their low back pain.1 The study included 419 patients who were surveyed, with each asked to rate (from 0 to 4) the importance of: “improvement in level of pain, improvement in ability to perform daily tasks, explanation of what is causing your problem, thorough physical examination, diagnostic testing, medication, physical therapy, surgery.” The investigators also surveyed 198 medical physicians, asking them to rate what they thought would be most important to their patients.
What Patients Want
In descending order, the top three most important items for patients are:
\1. Improvement in level of pain (3.48)
\2. Improvement in ability to perform daily tasks (3.31)
\3. Explanation of what is causing their problem (3.27)
And at the bottom of the list in terms of what patients consider important:
\7. Medication
\8. Surgery
A Disturbing Disparity
In comparing the ratings of the patient responses with those of the medical physicians, the investigators found statistically significant differences between the two. Specifically, physicians “underestimated the importance of an explanation of what is causing the problem” and overestimated the importance of diagnostic tests, medications and surgery.
What Chiropractors Know Better than Anyone
Knowing the cause and addressing it clearly matters to patients, much more than even a physical examination or diagnostic testing. This is why chiropractic continues to be appreciated and trusted by chiropractic patients.
The fact that back pain patients considered medications and surgery to be least important also points to their expectation and desire to see their condition cared for and resolved without the potential harm that many times accompanies drugs and surgery. This also underscores the importance of the chiropractic philosophy from the patient’s perspective.
What is likely a surprise for medical doctors is their patients’ lower regard for diagnostic testing. While this is certainly important from a pathology standpoint, it suggests many patients believe they know the problem(s) and that additional diagnostic tests do not play as prominent a role as MDs might expect.
At the end of the day, the majority of back pain patients want pain relief, improved function and a clear understanding of the cause of their back pain. They’re not interested in surgery or medication, and are likely suspect of their potential side effects. These patients want what chiropractic offers.
Reference
Smuck M, Barrette K, Martinez-Ith A, et al. What does the patient with back pain want? A comparison of patient preferences and physician assumptions. Spine J, 2022 Feb;22(2):207-213.
Coffee - How Many Cups?
For many readers, the simple answer may be, “As many cups as it takes to wake up and make it through the day!” But in this case, we’re referring to the amount of coffee that increases longevity relative to drinking less.
After all, coffee isn’t just a wake-up beverage; it also contains multiple compounds (nearly 100 biologically active components, in fact) that promote health. That’s why research suggests drinking coffee can lower risks of type 2 diabetes, cardiovascular disease and other significant health issues.
As you might imagine, reducing your risk of suffering a significant health issue increases your longevity - your ability to live a longer (presumably healthier) life. A new study quantifies the ideal number of cups of coffee to accomplish that, and we won’t drag out the answer any further: it’s two to three cups a day. Research published in the European Journal of Preventive Cardiology determined that compared to not drinking coffee, drinking 2-3 cups daily resulted in a longer lifespan, including a reduced risk of heart disease.
The study divided nearly 450,000 adults ages 40-69 into six groups based on self-reported daily coffee intake: none, less than one cup, one cup, 2-3 cups, 4-5 cups, and more than five cups. Drinking 2-3 cups per day was associated with the greatest benefit compared to drinking none, with all types of coffee (decaffeinated, ground, instant) reducing death from any cause (although drinking ground coffee yielded the biggest benefit).
The study divided nearly 450,000 adults ages 40-69 into six groups based on self-reported daily coffee intake: none, less than one cup, one cup, 2-3 cups, 4-5 cups, and more than five cups. Drinking 2-3 cups per day was associated with the greatest benefit compared to drinking none, with all types of coffee (decaffeinated, ground, instant) reducing death from any cause (although drinking ground coffee yielded the biggest benefit).
Walking: Your #1 Easy Wellness Tip
According to a growing body of research, it’s something so simple, yet so-often overlooked: Walk more. Here’s what multiple studies published in 2022 alone demonstrate about the health and wellness power of walking.
Walk the Risks Away
What risks? How about the risks of death from cardiovascular disease, cancer or another cause. New research suggests those health “complications” (we consider death the ultimate health “complication”) can be significantly reduced simply by walking.
But how much walking – and how fast? Good questions. According to a recent study published in JAMA Internal Medicine, more steps (up to approximately 10,000 per day, the recommended daily amount) is best, associated with lower risks of death from the above conditions. The same study also found that stepping cadence (intensity) correlated with lower death risks.
In other words, more steps = increasingly reduced risks; greater intensity while stepping = increasingly (and independently) reduced risks as well.
But that’s not all. According to a separate study, walking also reduces the risk of cognitive decline, an increasingly concerning health issue that may seem worse than death, depending on the severity. Published in JAMA Neurology, this study came to similar conclusions as the first study with regard to step count and step intensity: Walking just under 10,000 steps per day reduces dementia risk, with even stronger associations when steps are performed at a higher intensity.
The risk reduction? How about cutting your dementia risk in half just by getting in the requisite number of steps; and an even greater risk reduction by walking fewer steps (around 6,000 per day), but at a high intensity.
Sources
* del Pozo Cruz B, et al. Prospective associations of daily step counts and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality. JAMA Intern Med, Sept. 12, 2022 (online first ahead of print).
* del Pozo Cruz B, et al.Association of daily step count and intensity with incident dementia in 78â?¯430 adults living in the UK. JAMA Neurol, Sept. 6, 2022 (online first ahead of print).
Two Minutes After Eating
“I don’t have the time” is repeatedly mentioned as a top reason for not exercising consistently, failing to start an exercise program or discontinuing one. While we’re not claiming to understand how busy your patients’ average day is or what can complicate their ability to exercise, we hope you can agree that two minutes isn’t impossible, right? Good, because those two minutes can make a big difference.
We’re talking about two minutes of walking after eating, and the big difference it can make relates to blood glucose and insulin. The diabetes epidemic is in full swing, with projections suggesting it will only get worse in the next few decades. The body’s ability to regulate blood sugar is key to diabetes (type 2 diabetes) prevention.
According to a new analysis of previous studies, light-intensity walks after eating (two to five minutes per bout) reduces not only blood glucose, but also insulin; more so than simply standing. Doing either was superior to sitting; something too many people do during the course of the day and following meals. Findings appear in the journal Sports Medicine and are based on a review of seven one-day studies involving adults ages 18 and older who were generally overweight or obese (and thus at higher risk for blood glucose / insulin issues to begin with).
Source
* Buffey AJ, et al. The acute effects of interrupting prolonged sitting time in adults with standing and light-intensity walking on biomarkers of cardiometabolic health in adults: a systematic review and meta-analysis. Sports Med, 2022;52:1765-1787.
Walking for Knee Osteoarthritis
Osteoarthritis is the most common form of arthritis – swelling and tenderness in one or more joints. With osteoarthritis, the cartilage that cushions and protects the ends of bones wears down with time, which is why OA is often referred to as “wear and tear” arthritis. Regardless of the moniker, pain is a major consequence of OA, particularly pain affecting the hands, hips, spine and knees.
With that said, you would think walking would be difficult, if not impossible (or at least not contraindicated) for OA sufferers if their joint pain involves the knees, but research recommendations suggest walking is actually beneficial for people with knee OA.
Study findings published in Arthritis & Rheumatology demonstrate that knee OA sufferers (ages 50 and older) who walk regularly are 40 percent less likely to experience frequent new knee pain compared to non-walkers.
Source
* Lo GH, et al. Association between walking for exercise and symptomatic and structural progression in individuals with knee osteoarthritis: data from the Osteoarthritis Initiative Cohort. Arthr Rheumatol, October 2022;74(10):1660-67.
10 Minutes a Day for Seniors
On the one hand, getting older generally means you have more time to do things – including exercise. On the other hand, getting older also can mean health issues that limit one’s ability to do things – again, including exercise.
Since we know how important physical activity is (at all stages of life), how can we make sure we participate … even when we’re in our 80s? Even 10 minutes a day can make a difference.
Ten minutes a day helps people live longer when they’re 85 or older, according to research presented at the European Society of Cardiology’s (ESC) 2022 Congress. It doesn’t have to be high-impact, strenuous activity; we’re talking 10 minutes of slow walking – a little over one hour per week.
During the study period, octogenarians who walked 10 minutes or more per day had 40 percent and 39 percent lower relative risks of all-cause and cardiovascular mortality, respectively, compared to similarly-aged inactive seniors. Of note, less than 8 percent met the guideline recommendations for moderate-to-vigorous intensity physical activity.
Source
* “Octogenarians Should Walk 10 Minutes a Day to Prolong Life.” European Society of Cardiology, based on research presented at ESC Congress 2022.
Benefits of Broccoli by Dr. Michael Greger
When I used to teach medical students at Tufts, I gave a lecture about this amazing new therapeutic called “iloccorB.” I’d talk about all the evidence supporting it, the great things it could do, and its excellent safety profile. Just as the students would start scrambling to buy stock in the company and prescribe it to their future patients, I’d do the big reveal. Apologizing for my “dyslexia,” I would admit that I’d gotten it backward. All this time, I had been talking about broccoli.
I mentioned broccoli more than any other food in my book How Not to Die, and for good reason. Cruciferous vegetables like broccoli can potentially prevent DNA damage and metastatic cancer spread, activate defenses against pathogens and pollutants, help to prevent lymphoma, boost your liver detox enzymes, target breast cancer stem cells, and reduce the risk of prostate cancer progression. The component responsible for these benefits is thought to be sulforaphane, which is formed almost exclusively in cruciferous vegetables.
This is why broccoli and other cruciferous vegetables get their own spot on my Daily Dozen. I recommend at least one serving a day (typically a half cup) of crucifers and at least two additional servings of greens a day, cruciferous or otherwise. Serving sizes for other greens and vegetables are a cup for raw leafy vegetables, a half cup for other raw or cooked vegetables, and a quarter cup for dried mushrooms.
Quick summary update from Dr. Mha Atma on steps to reduce chronic inflammation (which can lead to pain and disease) in your body:
I recommend reading the book by Dr. David Seaman, “The Deflame Diet.” It is a comprehensive overview of the causes of inflammation and the foods that both cause and reduce it. Some people are reactive to nightshades but most folks aren’t–we eat lots of tomatoes, eggplant, peppers and potatoes and they do not cause us problems. The most common causes of inflammation are refined sugar, grain flour products (ie all bread, crackers, chips etc) and vegetable oils (excluding olive oil) which are in almost all processed food. Many people can get away with eating these foods but eventually they catch up with us. And when you have a condition like osteoarthritis, auto-immune disease and others, you may need to be rigorous about avoiding them to feel better. Also anti-inflammatory supplements can be extremely helpful especially when you also eliminate inflammatory foods. The chief supplements are vitamin D (at least 5,000/day and often up to 10,000/day which I took for a long time), magnesium (glycinate or citrate), Omega-3 (ie hi quality fish oil or DHA/EPA) and turmeric + ginger. There are others. Like vitamin K, which helps vitamin D work better. The book covers this too. You can bypass Amazon and get it directly from the author at deflame.com. I have a review of the book at Book Review: A New Look at the Number One Cause of Pain, Disease and Premature Death in the U.S.. Also see Anti-Inflammation Diet Steps - and Natural Non-Drug Remedies for Inflammation and Ideas for Good Health for more information
The last link. to the “anti-inflammation recipe” is a great way to imbibe a lot of turmeric and ginger and way less expensive than taking turmeric capsules. I do it every evening but I’ve had patients do it 2 or even 3 times daily. A powerful and natural anti-inflammatory.