Healthy Life Newsletter, June 2023
A Note from Dr. Mha Atma
The last piece, on osteoarthritis, is a bit long but important if you or someone you care about has those common arthritic issues in knee, hip, back, shoulder or other joints. It talks about the pitfalls of treatments with anti-inflammatory meds and steroids. One patient of ours, a woman in her late 60’s, often has episodes of pain in her back, legs, and other parts. She told me that she visited her sister who, with her husband, eats a very healthy and mostly plant based diet. After several days eating only their food, all her pain went away! That’s some food for thought!
The Right Way to Lose Weight
If you’re trying to lose weight and find yourself overwhelmed not only at the prospect of doing so, but also at the myriad strategies to choose from, you’re not alone. And what happens if (as is so often the case) if the strategy you choose to pursue doesn’t “work” within the time frame you feel it should? Believe it or not, there’s a “right” way to lose weight: here it is, courtesy of new research that examined the behavior patterns of people who achieve clinically significant weight loss.
Researchers have made it simple: Eating a healthier diet and doing more exercise lead to weight loss, while skipping meals and taking prescription diet pills do not. (This study was conducted prior to the widespread use of Ozempic and similar medications for weight loss, which do appear to work, at least in the short term – albeit with a variety of short-term side effects, and unknown dangers in the long term.) These two simple changes resulted in clinically significant weight loss, defined as at least 5% of body weight among the more than 20,000 adults in the study.
Participants who lost weight to this degree reported higher diet quality (higher protein intake, lower intake of refined grains and added sugar) and more moderate and vigorous physical activity compared to participants who did not achieve clinically significant weight loss. Findings appear in the Journal of the American Heart Association.
While acceptance of body weight and body differences is a goal individuals and society should strive to embrace, the reality is that an abundance of research clearly links excess weight / high body-mass-index (and the health behaviors that often contribute to it) to poor health outcomes. You might accept your body for what it is, but you’re also accepting the health consequences that may come with it if you don’t do something to change. If your weight is putting your health at risk, do something about it. As this study suggests, ramping up your diet and exercise is a great place to start.
Chiropractic for Babies: Mother Approved
Babies can’t tell us how important chiropractic is for their health and wellness, so let’s listen to what their mothers are saying. A survey of mothers whose infants received chiropractic care reveals high levels of satisfaction relative to improvements in infant behavioral issues such as feeding problems, excessive crying, sleep issues, problems with supine sleep position (on the back; the recommended position to minimize SIDS risk), time performing prone positioning (on stomach; an important position for developing early motor skills ) and restricted cervical (neck) range of motion.
On average, mothers reported two problems affecting their child at the first visit, and took their infants (80 percent of whom were 12 weeks of age or younger) to the chiropractor approximately 3-4 times during the study period. Overall, mothers were overwhelmingly satisfied with the impact chiropractic care had on their infants:
More than 80 percent reported definite improvements on a global impression of change scale.
91 percent rated their satisfaction with care received as an eight or higher on an 11-point scale.
95 percent felt the care provided by the chiropractor was cost-effective.
What’s more, maternal ratings of depression, anxiety and satisfaction with motherhood also improved during the study period. In other words, healthier baby, healthier – and happier – mother!
Published in the Journal of Manipulative and Physiological Therapeutics , this was no small study, with nearly 1,100 mothers completing both intake and follow-up surveys. So take the researchers’ findings to heart: “The infant’s care was reported by the mothers who completed follow-up as effective, safe, and cost-effective.”
Raise Your Hand If You Have Back Pain
As adults, we get used to a variety of daily or near-daily aches and pains, particularly as we age. But what about our children? Don’t they seem immune to many, if not all, of the pain complaints we have – despite the fact that for the most part, they’re exponentially more active?
Maybe not. A study ( pubmed.ncbi.nlm.nih.gov ) of schoolchildren ages 12-15 revealed a startling statistic: More than half (57 percent) reported experiencing back pain in the past year. As you might expect, “remaining seated at school” was a primary pain trigger, particularly for back pain lasting up to seven days.
These findings not only point to the universality of back pain – and the need for it to be addressed by qualified health care professionals such as doctors of chiropractic; but also the need to recognize and avoid situations that may increase the risk of experiencing an episode of back pain.
For example, evidence implicates ergonomic flaws both in the school and workplace (desk / chair height, etc.) in back pain, not to mention carpal tunnel syndrome, neck pain and other conditions. What’s more, the act of sitting alone creates undue stress on the spinal column and encourages poor posture whether at school, work or home, a major initiator of back pain and related conditions.
If anyone in your family is suffering from back pain, do something about it. Talk to your doctor about the potential causes and solutions.
The Real Relationship Between Skin Cancer, Sunshine and Vitamin D
The sun has gotten a bad reputation because of the association between ultraviolet (UV) exposure and skin cancers. However, two important distinctions should be made: 1) intermittent, or sudden, drastic exposure to high intensity sunlight (resulting in sunburn) does increase the risk of skin cancer, and 2) regular, moderate, non-burning exposure to sunshine (sensible sunshine exposure) has been associated with lower risk of skin cancer.
Melanoma itself accounts for approximately 1-7% of all skin cancers (depending on the country) and is more dangerous than other skin cancers because it is more likely to spread to other parts of the body if not caught early. The sun has been to blame for an increased risk of melanoma, however, studies are now clearly showing that the incidence of melanoma and the risk of death due to melanoma are actually decreased with increased, regular, non-burning sun exposure and higher vitamin D levels.
Several studies have confirmed an inverse relationship between increased occupational or regular, sensible sunshine exposure and the risk of melanoma. A meta-analysis of 57 studies on sun exposure and melanoma risk by Gandini et al. found a positive association between intermittent, high intensity sun exposure and increased risk for melanoma and an inverse association between high occupational sun exposure and risk for. This means that as occupational sun exposure increased, the risk of melanoma decreased. As stated by the authors, “Intermittent sun exposure and sunburn history were shown to play considerable roles as risk factors for melanoma, whereas a high occupational sun exposure seemed to be inversely associated to melanoma.”
For the full article and references see grassrootshealth.net
Chiropractic: The Best Choice for Seniors with Spinal Pain
Compared to what? How about pain medication, including opioids, which continue to be associated with misuse, abuse, addiction and death in simply unacceptable numbers. Opioid use within the senior population is particularly concerning because older adults are often already taking multiple medications (known as polypharmacy); and because many seniors suffer acute and chronic pain. Here’s one big reason why the best choice is chiropractic.
Seniors with spinal pain who receive chiropractic care are considerably less likely to use opioids, suggests research; we’re talking more than 50 percent less likely. Among 55,000+ Medicare beneficiaries 965-99 years of age) diagnosed with spinal pain whose claims were analyzed over a five-year period, the odds of filling an opioid prescription within one year of diagnosis were 56 percent lower among chiropractic care recipients vs. non-recipients. The study authors’ conclusion speaks for itself:
“Older Medicare enrollees with spinal pain who saw both a chiropractor and a primary care physician had less than half the risk of filling an opioid prescription, as compared to those who received primary medical care alone. The association was most pronounced among those who saw a chiropractor within the first 30 days of care.”
What these study findings, published in Chiropractic & Manual Therapies, don’t mention is that avoiding opioids isn’t the only reason chiropractic is seniors’ best choice; chiropractic is also incredibly effective for both treating and preventing spinal pain! That’s a win-win every senior deserves
Anti-Inflammatories and Oseteoarthritis: Are the Rewards Worth the Risks?
by Thomas Michaud, DC
What You Need to Know
While many people would argue that diet and exercise interventions are too difficult to follow and compliance is low, the risks associated with pharmacological management are too great.
Osteoarthritis (OA) is the most common of all joint diseases, affecting more than 30 million Americans. In the next few decades, the number of people suffering with osteoarthritis is expected to skyrocket, as people are living longer and the percentage of the population that is overweight continues to increase.
NSAIDS: Commonly Used for OA – But Lacking Research Support
A common treatment intervention for osteoarthritis is anti-inflammatory medication (NSAIDs) such as aspirin, ibuprofen,and naproxen. Given their widespread use in the management of OA, you would think there would be an abundance of scientific evidence suggesting these drugs are actually useful. This is not the case.
In a six-year study of nearly 1,700 people with hip and knee arthritis, researchers from The Netherlands determined that individuals who routinely took NSAIDs for pain management had a 240% increase in the development of hip arthritis and a 320% increase in the development of knee arthritis compared to individuals who rarely used these drugs. The authors state, “Whether this occurs because of a true deleterious effect on cartilage or because of excessive mechanical loading following pain relief remains to be investigated.”
Putting aside the accelerated development of arthritis, routine use of NSAIDs to manage joint pain significantly increases the risk of GI bleeds, hypertension, coronary artery disease, atrial fibrillation, and even congestive heart failure. Disturbingly, 14% of high-school and college football players take nonsteroidals daily despite the proven health risks.
Corticosteroids Aren’t Any Better
To reduce potential side effects, physicians frequently prescribe short-term oral corticosteroids (i.e., less than two weeks) with the belief that the complication rates will be extremely low due to the short duration of treatments.
To test this theory, researchers from Taiwan looked at 2.6 million people who received a short steroid burst during the study period. These were all low-risk people with an average age of 38. Regardless of their overall health and young age, the rates of GI bleeds, sepsis and heart failure were alarmingly high, with 2.7% of the treated population developing GI bleeds, and 1.3 per thousand suffering heart failure.
The authors of this study acknowledge that these numbers may represent an underestimation, because they excluded people over the age of 64, who are at high risk for complications following corticosteroid interventions.
Another common treatment intervention for osteoarthritis is to inject corticosteroids directly into the arthritic joint. In spite of the popularity of this treatment intervention, the relative safety of intra-articular corticosteroids has not been adequately studied.
In 2019, doctors from Boston University injected 459 patients presenting with hip and knee arthritis with intra-articular corticosteroids. Over the next two to 15 months, 8% of these patients developed serious complications, the most common being accelerated joint destruction.
While an 8% percent complication rate is high, the authors only followed up on 241 of the 459 individuals injected, so the complication rates were most likely appreciably higher. The authors of this study were surprised by the high prevalence of adverse events, but a recent study of 70 patients by Simeone, et al., showed that the 44% of patients receiving intra-articular corticosteroid injection had accelerated progression of osteoarthritis and a shocking 17% developed articular surface collapse.
Note that the Simeone, et al., study was controlled in that the authors compared outcomes between two groups with similar degrees of arthritis. One group received the intra-articular corticosteroid and the other group did not. In the group that did not receive the injection, 24% had radiographic progression of arthritis, but only 1% suffered joint collapse.
Although the exact mechanism for adverse events remains unclear, there is some evidence that corticosteroid injections, especially when combined with an anesthetic, can be toxic to cartilage.
Preferred Options for OA
Rather than bombard an arthritic joint with potentially harmful anti-inflammatories, a safer approach is to encourage regular exercise (which has been proven to reduce pain) and recommend simple dietary changes.
In a 2013 study evaluating the effectiveness of diet, diet plus exercise, or exercise alone in the management of osteoarthritis in overweight and obese, elderly individuals, nearly 90% of the 454 people who began this 18-month study had significant reductions in pain and achieved more than 10% loss in body mass.
Not surprisingly, the combination of diet and exercise achieved the best outcomes, as these individuals had less pain, better function, faster walking speeds, and a better self-reported quality of life than the diet alone group. The diet and exercise group also had greater reductions in interleukin-6, which is a marker of systemic inflammation that correlates strongly with the progression of osteoarthritis.
Clinical Takeaway
The bottom line with all of these studies is that the most effective way to manage osteoarthritis is not with medication, but with diet and exercise. While many people would argue that diet and exercise interventions are too difficult to follow and compliance is low, it still has to be presented as an option, as the risks associated with pharmacological management are too great.
For references see dynamicchiropractic.com