The research on vibration plate exercises continues to build. For those of you who have never used whole body vibration, it’s quite an experience.
In our office, the best way to describe vibration plate exercises is to have someone try the plate out for themselves. There really isn’t any adequate way to describe what happens. Either way, it’s unique.
The benefit of vibration exercise vary and some is more hype than reality. Fall prevention and muscle building (especially for the knees) top the list of benefits that have been demonstrated in the medical research. However, my personal belief has always been that vibration plate exercises were the most beneficial for those who were not active. That is why I have always considered it somewhat contradictory to have a whole body vibration unit in a health club.
This particular study, however, may expand my thoughts just a wee bit. Researchers looked at the hormone irisin and vibration plate exercises. Irisin, for those of you who did not know (and include myself as one of them), is a hormone released from muscle in response to exercise. It is believed that irisin then helps muscle rebuild stronger and fight off obesity and diabetes.
Irisin does this is by turning white fat (the lazy abdominal fat that contributes to diabetes, heart disease and cancer) into brown fat. Brown fat burns calories to produce heat. Generally a very good thing and it helps fight off diabetes and obesity.
Even more interesting relates to a blog post that I wrote a short while ago, relating the shivering response (basically keeping the room temperature at 60 degrees for 6 hours a day) to an increase in calorie burning from having more brown fat.
So what if the shivering response and vibration plate exercises produce the same response?? A very interesting line of thought and one that is supported by the research in this study.
In it, researchers put a group of healthy, untrained females through a 6-week program of whole-body vibration exercise training. Blood was checked before and right after a session of vibration plate exercises at the state of training and after 6 weeks. Here’s what they found:
• Pre-exercise irisin levels were not different at the beginning of the study and after 6 weeks of training.
• However, at the beginning of the study, after a vibration exercise session, irisin levels increased by 9.5%.
• Even better, after 6 weeks of training, post-vibration exercise irisin levels increased 18.1%.
Much of this begins to make more sense. This brings together the research on vibration plate exercises and shivering / cold exposure and puts it under the umbrella of brown fat. Considering that most people would not want to expose themselves to shivering cold temperatures for weeks on end and that whole body vibration is a fun and easy therapy, it would seem that we have a better approach to management and prevention of obesity in vibration plate exercises.
Pretty much everyone knows that you should drink cranberry juice for a urinary tract infection. But is this an old wives tale?
The quick answer is no—it is not an old wives tale. The research on the benefits of cranberry juice has been around for a long time. And actually, it is one of the sugars, D-mannose, that is present in cranberry juice, that does all the work.
A clarification is important here. We are talking about REAL cranberry juice, not the cocktail junk loaded with added sugars. If anything, this type of drink will promote urinary tract infections. In addition to helping with urinary tract infections, cranberries are loaded with antioxidants. Which brings us to this particular study. In it, researchers looked at the effects of a single dose of either a placebo drink, a cranberry leaf extract beverage (CLEB) or low calorie cranberry juice cocktail (LCJC). All participants were given one of the drinks one week apart. Here’s what they found:
• The cranberry drink increase blood glutathione peroxidase activity (a marker of antioxidant protection).
• The cranberry cocktail increased glutathione concentrations and superoxide dismutase activity (antioxidant activity).
• Interestingly, within the first 3 hours of drinking either cranberry beverage there was a strong ability to block the attachment of the bacteria E. coli to the wall of the bladder.
Personally, I was surprised that the cranberry juice cocktail had similar protection as the real stuff, but it is what it is. Either way, I would still steer patients towards the use of the real stuff.
In case you’re not aware of what constitutes the “real stuff,” look for the most expensive cranberry juice you can find. And it’s going to be very, very sour. More than what the average person would enjoy drinking. This is why it is typically mixed with other juices or with added sugars.
In addition to cranberry juice (or the straight up href=”http://www.amazon.com/gp/product/B003LYMGHW/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B003LYMGHW&linkCode=as2&tag=lifecarchirop-20″>D-mannose, which can be bought separately from places like Amazon), I also recommend probiotic douches, to make sure that the normal, protective bacterial flora is present in the vaginal vault to keep future injections at bay.
After your heart attack you want to do everything possible to prevent a second event. But few things will be as powerful as the choices you will make now.
Whether you had an actual heart attack with resulting damage to the heart, or had a stent put in or the full blown open heart surgery you are still in a very high danger level. Your cardiologist will certainly put you on statins (regardless of your cholesterol level) and make sure your blood pressure is under control. But these are the primary tools of the cardiologist. And yet, they are not the most powerful tools.
If you really, really do NOT want to have another cardiac event, lifestyle HAS to be a factor in your recovery. Granted, if you are a smoker it will be made very clear to you that quitting is not an option. Any provider you see will make this recommendation. However, the depth of knowledge on the specifics of nutrition and exercise is not usually there for most cardiologists (I am, of course, generalizing here). Many will refer you to a nutritionist, but most nutritionists will stick with the “party line” of salt restriction and saturated fat reduction (ok, ok…so I’m generalizing AGAIN).
Here’s the reality. The recommendations we give for both primary and secondary prevention of heart disease still suck. They are general recommendations that don’t get down to the specifics that can make a very large difference. We hear about eating nuts to protect your heart, but not about how these nuts should be raw with no added omega-6 oils (cottonseed, peanut, soybean). It’s these subtle differences that can make all the difference in outcomes.
The same goes for aerobic exercise. I have made it no secret that I’m a big fan of short-burst aerobic activity, and yet the general recommendations are still limited to sustained-type aerobic exercise like walking for 30 minutes a day.
So what’s the point of my rant? That, even though the recommendations given are general, they are still very, very powerful. And this particular article outlines just how powerful. Researchers followed 4,174 patients for just over 4 years who were undergoing cardiac rehab after an acute event to see how much adoption of ideal lifestyle factors had on the risk of another heart attack or death (which is, arguably, worse). The ideal lifestyle factors were:
1. Physical activity ≥4 times/week
3. Sticking with a Mediterranean diet (highest compliance)
4. Waist circumference under 35 inches for women and 40 inches for men
Here’s what the researchers found:
• Exercise (versus sitting on your butt) led to a 31% lower rate of a future cardiac event and 29% lower risk of death.
• Not smoking (versus keeping your life insurance premiums paid) led to a 50% lower risk of a future event and 47% lower risk of dying.
• Those who were more strict with a Mediterranean diet (versus not at all) had a 23% lower risk of another heart event and 16% lower risk of death.
• Waist circumference, however, did not make a difference.
• But, when patients had 3 of the ideal factors that made a difference (versus none), the risk for another cardiac event 62% lower and risk of death was a respectable 49% lower.
It is clear from this that the approach is NOT about a single change. Rather, it is the combination of multiple positive changes that goes a very long way towards making sure you’re going to be alive in 5 years.
Ever since it has been commercially available, formula manufacturers have made an attempt to equate formula with breast milk.
Let me clarify that I understand that not every new mom will be able to nurse. However, many times the problem is not an unfixable problem. Rather, the new mom needs to be matched with a non-hospital based lactation consultant (maybe I’m biased, but they just don’t seem as motivated) to make sure that every avenue is explored. Formula needs to be the LAST option, not the first.
That being said, the question arises as to which type of formula if nursing is really not an option. Personally, I think that both soy and dairy based formulas are a problem. It is too much of the same proteins getting thrown at a developing immune system again and again and again, day after day. For this reason, I recommend a hydrolyzed formula like Nutramigen or Alimentum. These formulas are “pre-digested” and have less proteins for an infant’s delicate immune system to react to.
To further complicate the issue, this particular study looks at a pretty surprising link between soy based formulas and seizures. Admittedly, this relationship came as quite a big surprise and had been forwarded to me by a colleague who knows that I have an interest in seizures. In the study, researchers looked at the influence that infant formula had on seizures in a population of autistic children. Here’s what they found:
• In autistic children fed soy-based formula, there was a 2.6-fold higher rate of febrile seizures (4.2% versus 1.6%).
• There was a 2.1-fold higher rate of epilepsy comorbidity (3.6% versus 1.7%).
• There was a 4.8-fold higher rate of simple partial seizures (1.2% versus 0.3%).
• There was no relationship with IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures.
The authors seem to blame the phytoestrogens in soy for the lowering of seizure threshold in this study. However, there is extremely scant evidence for any type of relationship between phytoestrogens and seizures in the medical literature (2 studies to be exact, both on rats and done by the same author). Besides that, I just don’t know that I’ve come across a mechanism by which phytoestrogens could contribute to seizures.
However, from this study, there is a strong suggestion that soy-based formulas played a role in the risk of certain types of seizures. I just disagree that it is caused by the phytoestrogens. Rather, minerals like manganese (known to be higher in formula) could play a role as well as the development of a food allergy to soy from too much exposure to the same protein over and over.
Either way, it would seem that this is yet another reason for parents to do everything they possibly can to support the use of exclusive breastfeeding for at least 3 months, preferably 6-12 months.
A visit to the ER for abdominal pain in a child can be scary. Most often it’s something simple, but appendicitis can lurk in the shadows.
Signs and symptoms of appendicitis can include slight fever, right sided abdominal pain as well as nausea and vomiting. Almost certainly, a visit to the ER will include a CT scan, despite the strong evidence that the radiation doses from handing out CT scans along with the Halloween candy is creating some 29,000 new cases of cancer per year, half of which will be fatal.
And we just don’t seem to be learning the lesson here. Despite evidence that CT scanning used to diagnose appendicitis in children does not actually change anything, the numbers of scans done in the ER continue to climb.
But is there a better way? You bet. Ultrasounds have been shown to be very helpful in picking up appendicitis cases in children. The problem is that ER physicians take the results of the ultrasound (which, by the way, have NO radiation exposure and are far less expensive than that $3,000 CT scan) with a grain of salt and still order the CT scan for “confirmation.”
This particular study helps to clarify that the CT scan approach is the wrong direction. In this study, researchers looked back on a group of 662 kids with suspected appendicitis to see if there was a difference in outcomes between those who went the CT route (high radiation exposure) and the ultrasound to MRI route (no radiation exposure). Here’s what they found:
• 265 went the CT scan route and 397 had ultrasounds and MRI.
• Negative appendectomy rate (the # of surgeries performed for no reason) was 2.5% for the CT group and 1.4% for the US / MRI group.
• Perforation rate was no different between the groups and the time it took to move to antibiotic administration and operation was no different either.
In other words, the US/MRI route was just as fast and just as safe, but results in almost half the number of children undergoing a surgical procedure to remove an organ they were born with for no reason. Worse, recent research indicates that the appendix may be a reservoir for good bacteria to repopulate the gut after an episode of diarrhea or other gastrointestinal illness. Removing this organ removes this source of good bacteria.
So, the next time you have a doctor recommend a CT scan with high radiation doses for your child, it may be time for a quick second opinion.
The typical answer for sleep problems or anxiety is medication. But in no way do these drugs actually fix anything.
Rather, the underlying brain damage that stress causes is allowed to run amok, unchecked. And make no mistake–stress destroys your brain. Shrinks it. Kills off healthy brain cells. Shortens memory. Accompanying the brain damage is damage to the rest of your body as well. Increased risks of obesity, diabetes, heart disease and cancer.
In summary, not good.
In my opinion, stress is the leading cause of sleep problems. How is your body supposed to sleep when all the cortisol-based alarms in your head are screaming that there is a saber-toothed pacing in the hallway. Managing stress is key to anxiety and sleep problems. Exercise and eating right for your body. Meditation, self-hypnosis or biofeedback for your brain.
Using medication to cover this up is a recipe for disaster and is associated with over a half MILLION deaths per year. I’ve written about this in a previous blog article that can be found by clicking here. So, with this in mind, this particular article is nothing new and just reinforces this dangerous association and puts the damaging effects of stress on your health into perspective.
Here are the details of this study looking at 34,727 patients 16 years of age and older who were prescribed anxiolytic or hypnotic drugs and followed for an average of 7.6 years:
• Most common drugs were benzodiazepines (think diazepam) and the “Z” drugs (zaleplon, zolpidem, and zopiclone – think Ambien).
• Those taking one of these drugs had a 346% higher risk of dying in the study period.
• The higher the dose, the greater the risk.
• To put in more plainly, there were about four excess deaths for every 100 patients using one of drugs.
If this was not the first study to find an association between the use of these 2 types of drugs (for anxiety and sleep problems) we could maybe blow off the results. But we can no longer ignore the fact that taking a drug in this class WILL increase your risk of dying. Period. Maybe it’s the stress or maybe some aspect of the drugs themselves. Either way, it doesn’t change the outcome. Dead is dead regardless of how it happened.
I hate to beat a dead horse, especially if he dropped dead from too much aerobic exercise, but society just does not seem to be getting the point about aerobic exercise.
Quite frankly, we’re doing too much.
I know that many of you are disappointed to hear this. After all, in today’s rush-rush society everyone is getting the recommended 30 minutes minimum of aerobic exercise at least 3 times per week, right? Yeah. Reality check–most Americans still do not have regular exercise as part of their lifestyle routine. And, even if they are, it’s likely they are not doing the most beneficial type.
The research continues to support a short-burst, high intensity, aerobic activity rather than a single bout of light to moderate intensity workout. Personally, when I’m doing one of my short bursts on the treadmill or elliptical, I’m going all out for that 30 second session. It’s not a leisurely pace at which I could maintain a conversation on my cell phone to some out of the country customer service rep for my mortage. When I’m done with my burst, it takes some time (1-2 minutes) to recover somewhat from the oxygen debt I have accumulated.
This particular study is yet another one to chalk up for the short-burst aerobic crowd. This small study looked at 11 obese individuals (aged 18–35 years) who were prediabetic and had them performed differently on three different days:
1. Sedentary behavior with no exercise
2. Otherwise sedentary behavior with 1-hour of morning exercise at 60%–65% peak VO2
3. Same sedentary behavior with 12-hourly, 5-min intervals of exercise at the same intensity
Researchers than checked sugar and insulin levels in the bloodstream. Here are the results:
• Glucose levels were actually lower in the interval exercise and sedentary situations.
• Glucose levels were higher in the 1 hour exercise situation than in the sedentary situation for about 2.5 hours.
• Glucose levels were also higher in the 1 hour exercise situation than the interval exercise situation for about 4 hours.
• The production of insulin was 20% higher with the interval exercise when compared to the other two situations.
While this study was not on high-intensity aerobic activity, it does demonstrate the benefit of breaking up the exercise routine into small groups instead of a single time period.
How do YOU spend your time exercising??
I’ve had many people ask me about this “gluten free” thing and whether it’s “real.” Or is it just a fad?
First and foremost, the entity known as celiac disease is nothing new. The traditional acceptance of celiac disease is a condition where the immune system of the gut attacks the gluten containing portion of grains (namely wheat, but also to a certain degree in oats, barley and rye). This attack results in the lining of the gut (the villa) being flattened out. While a normal gut may have the area of a tennis court, in someone with celiac disease that eats gluten, the destruction of the lining of the gut leaves you with a ping pong table.
The shrinkage of the area that is needed to absorb nutrients wreaks havoc long term and leads to most of the issues associated with traditional celiac disease (osteoporosis, neurological disturbances, shortened life span, etc…). This is the far end of the spectrum and is usually diagnosed via biopsy of the lining of the gut. Moving up the spectrum (from worst to less-worser), the blood markers anti-transglutaminase and anti-gliadin antibodies will be elevated and can be checked in a blood test.
This is generally where mainstream medicine stops at the definition of celiac disease. However, as I mentioned, it is a spectrum and not a set point. As you move away from the biopsy proven gluten allergy to the other end of the spectrum, “sensitivity” becomes a much better word to use. At this end, the number of people with sensitivity to gluten is quite high and it is very real.
And the numbers of people with gluten sensitivity keep going up. But why?
A portion of this may due to a cross reaction between a protein found in the yeast Candida albicans and a protein found in gluten. This means that a prescription for antibiotics, which will increase the number of yeast in your gut, can initiate the onset of celiac disease in genetically susceptible patients.
Combine the wanton use of antibiotics with conventionally grown grains given high amounts of nitrogen-based fertilizer (more nitrogen leads to more gliadin for the gut to react to) and you’ve got a recipe for more gluten problems.
But it turns out the story may be more complicated. This particular article looks at the role of glyphosphate (the principle component of the herbicide Roundup used heavily in GMO crops) and the realionship to celiac disease. While the article is quite complex, here are the high points:
• Fish exposed to glyphosate develop digestive problems that are similar to celiac disease.
• Glyphosphate triggers imbalances in gut bacteria (reduced Lactobacillus and Bifidobacterium, which break down gluten).
• Disrupts detox P450 enzymes, interrupting the activation of vitamin A and D, the maintenance of bile acid production as well as the breakdown of environmental toxins.
• Glyphosphate chelates and leads to deficiencies in iron, cobalt, molybdenum and copper.
• Glyphosphate leads to deficiencies in the amino acids tryptophan, tyrosine, methionine and selenomethionine.
• In addition, both celiac patients and glyphosphate exposure increase risk of non-Hodgkin’s lymphoma.
• Both are associated with reproductive issues like infertility, miscarriages, and birth defects.
Making matters worse, glyphosphate residues in wheat and other crops are likely increasing due to the growing practice of crop desiccation just prior to the harvest.
So, is it glyphosphate toxicity or gluten sensitivity? I’m pretty sure that this article didn’t entirely clear things up for many of you. The bottom line is that the answer likely lies somewhere in between. Either way, it would seem smart to take away two needed changes from this article. First, living a naturally gluten-restricted diet is a good idea. This does NOT mean buying the same types of foods you have always eaten but just buying them gluten-free. Not a good idea.
Second, if you do take in any gluten-containing grains, make sure they are organic or at least GMO free to reduce the likelihood that you will be exposed to glyphosphate.
Ezetimibe, aka Zetia, hit the market in 2002 based on its ability to lower LDL cholesterol levels. Scripts skyrocketed 180 TIMES over the next 6 years.
In the US in 2002, 6 out of 100,000 people were given prescriptions for Zetia; by 2008, this number vaulted to 1082 per 100,000 persons. A mind blowing increase for a drug that had not yet been shown to save lives, just shown merely to lower LDL cholesterol. In Canada, over similar timeframes, use jumped from 2 per 100,000 to 495, an even more massive increase of 247.5 TIMES as many prescriptions. Again–for a drug that really hadn’t been shown to do anything just yet.
And it is chiropractors who are sometimes accused of being unscientific.
This should have all changed in 2008 with the release of the data from the ENHANCE trial. In the ENHANCE trial, ezetimibe was added to a statin (the combination being called Vytorin) to further force cholesterol levels down, because that is really all that is important. Disappointingly, the trial showed no benefit from ezetimibe.
Just in case this wasn’t enough, in 2009 in the ARBITER 6–HALTS trial, the combination was actually shown to INCREASE plaguing in the carotid arteries of the neck. Not a good thing. Surely, by this point prescriptions for Zetia fell to nonexistent levels, right?
This particular study looked at how much the publication of the ENHANCE trail data affected physicians’ use of ezetimibe in both the US and Canada. In the US, after the publication of these two trials, prescriptions fell from the aforementioned 1082 per 100,000 people down to 572, a drop of 47.1%. In Canada, however, the increase in the number of prescriptions slowly and steadily moved up (from 2 to 495 per 100,000 people) even after the publication of the trials.
This is not the first example of mainstream medicine ignoring the evidence that is supposed to guide the practice of medicine. But this one seems particularly bothersome. This drug launched itself from zero to near superstar status on pretty much nothing but the ability to lower a single lab value 20%. And, I might add, this particular lab value is LDL cholesterol, which has now lost favor as a lab value that has any real ability to predict risk of heart disease.
The bottom line is that you should ONLY see a physician who keeps up with the medical literature. Maybe not to the DSM-V worthy level that some of us do, but at LEAST the basics. If you doctor has written you a prescription for either Zetia or Vytorin, he or she is not in this group.
Now, before I state that our office does very well with disc bulges in the neck, I need to preface this with the fact that we’ve had 2 patients in the past 6 months end up in surgery.
That being said, the vast majority of patients who have cervical disc bulges accompanied by pain in the arm due to that disc bulge that are seen in our office recover nicely. Because back and leg pain are more widely publicized, there is more knowledge about sciatica from back pain; patients frequently come in stating that his or her “Atica” or “schizophrenia” is flared up. Most of these cases are not actually true sciatica (despite what he or she has been told) but are either local pain (no leg pain) or a referred pain from the hip or sacroiliac joint.
Pain in the arm originating from the neck is also very common, but less patients who walk through the door seem to be aware of this relationship. The typical patterns of disc pain in the arm or leg follow a very typical pattern called dermatomes. The problem is that there are many other things that also cause pain into the arm such as the rotator cuff, problems in the forearm such as carpal tunnel and problems stemming from the muscles around the neck such as the anterior scalene or pec minor.
Because there are so many causes of pain into the arm, it can be challenging to nail down exactly what may be causing your problem. For me, sometimes the answer isn’t clear on the first visit or two, but rather, takes some time to clarify exactly what’s causing the pain. Disc bulges in the neck causing pain in the arm can look an awful lot like a rotator cuff referral into the arm. If I work on the rotator cuff for a visit or two and nothing changes, we shift gears towards a treatment of a disc bulge.
Treatment of a cervical disc bulge in our office involves soft tissue work (Graston, stretching, fascial work), chiropractic adjusting and traction. I’m a big fan of home traction devices as well that can allow you to treat the disc bulge several times a day (we recommend this one from Amazon: Instapark® Cervical Neck Traction).
With this approach, the vast majority of patients respond well. This particular study supports this position. In it, chiropractic researchers looked at a group of studies to get a better idea of how long it takes someone to recover from a cervical disc herniation. Here’s what they found:
• On the down side, they found that complete recovery could take as long as 24-36 months.
• Luckily, patients were already noting substantial improvements within the first 4-6 months.
• Overall 83% of patients resolved completely.
• Patients with a workers’ compensation claim appeared to have a poorer prognosis.
Before you start getting depressed about the 4-6 months timeframe, in our office, if we are going to be able to help a disc pain patient, improvement starts within a few visits and usually progresses forward from there. The use of the traction device helps.
As for the worker’s compensation portion of the equation, I wonder if the poorer prognosis has to do with less of these patients making it into chiropractic offices in a timely matter. Many primary care doctors don’t consider chiropractic for disc problems and will usually use medications and pain injections first.