Friday, October 30, 2015

During Menopause, ‘Good’ Cholesterol May Lose Protective Effect on Heart

HDL cholesterol is commonly called the “good” cholesterol, but new research suggests that it could be harmful to women going through menopause.

The new study finds that rather than helping to inhibit the formation of dangerous plaque in the arteries, HDL cholesterol may increase its buildup during menopause. This process is known as hardening of the arteries, or atherosclerosis, and can lead to heart trouble.

“This was surprising,” said lead researcher Samar El Khoudary, an assistant professor of epidemiology at the University of Pittsburgh.

“We know that the good cholesterol is supposed to protect women,” she said. And, before menopause, good cholesterol does help protect against heart disease, El Khoudary said.

But during menopause, HDL cholesterol seems to add to the plaque buildup. She explained. “This was independent of other factors such as body weight and levels of bad cholesterol,” El Khoudary said.

It’s not clear why good cholesterol may turn bad, she said. “There are many biological changes that happen to women during the menopausal transition,” she said.

Among these changes is the addition of fat to the abdomen and around the heart. “This could put women in a state of chronic inflammation that could change the good cholesterol,” El Khoudary suggested.

Wednesday, October 28, 2015

Wisdom Wednesday: Treatment Before the Diagnosis?

This is an abbreviated case history to illustrate some of the unique features of the QA (Quintessential Applications) protocol.

A 34 four-year-old female came to my office with a chief complaint of severe pain under her left jaw. She had been to her primary care physician who thought it was a salivary gland but found no evidence of infection.

On palpation I could elicit pain but not from the salivary gland but actually from a small area just adjacent to a salivary gland. The area did not feel inflamed or abnormal in any sense, except she reacted to the pain.

Chiropractors are very good at palpation. It’s skill that is honed in school by palpating a hair through pages of Gray’s Anatomy. With practice, you can feel the distortion through about 80 pages of text. Now add 38 years of practice, palpating spines all day long.

So I was just as confused as her PCP. I could not identify the tissue from palpation.

Using the QA protocol, I looked for an injury reflex. However, Autogenic Facilitation was intact (any weak muscle strengthened when the nerve supply to that muscle was stimulated) eliminating an injury.

TL (therapy localization) to the jaw was active – if she placed her hand on the location of pain, any weak muscle became strong. Now I had a tool to evaluate her symptoms.

Next I checked to see what inflammatory pathway might be active. She was negative for prostaglandins but positive for both leukotrienes and cytokines. These pathways stimulate the immune system and when both are active can be autoimmune in nature. Typically, such cases will not respond favorably to ginger or boswellia, requiring a supplement that modulates the immune system.

Monday, October 26, 2015

For a Better Calorie Burn, Adjust Your Speed While Walking

New research, from Ohio State University, found that changing your pace could burn up to 20% more calories than maintaining a steady stride.

“Most of the existing literature has been on constant-speed walking. This study is a big missing piece,” study co-author Manoj Srinivasan, a professor of mechanical and aerospace engineering, said in a university news release.

“Measuring the metabolic cost of changing speeds is very important, because people don’t live their lives on treadmills and do not walk at constant speeds. We found that changing speeds can increase the [caloric] cost of walking substantially,” Srinivasan explained.

People may also be underestimating the number of calories they burn while walking in daily life or playing sports, the study authors said. The researchers estimated that starting and stopping may account for up to 8% of the energy used during normal daily walking. This caloric cost is often not included in calorie-burning estimations, Srinivasan’s group said.

Study lead author Nidhi Seethapathi, added that “walking at any speed costs some energy, but when you’re changing the speed, you’re pressing the gas pedal, so to speak. Changing the kinetic energy of the person requires more work from the legs and that process certainly burns more energy.” Seethapathi is a doctoral fellow in mechanical engineering at the university.

Wednesday, October 21, 2015

Wisdom Wednesday: “All Natural” Alternatives for Erectile Dysfunction

I wrote this blog prior to the incident with Lamar Odem and the use of herbal sexual enhancement products. This blog is more timely than I had imagined and his case should serve as a warning for all men.

The FDA (U.S. Food and Drug Administration) issued their consumer health information for October, 2015. It was a warning about products marketed as “dietary supplement” or “foods” that promise to enhance your sexual performance or increase sexual stimulation. The concern is that hidden drug ingredients or other undisclosed ingredients can endanger your health.

This year the FDA lab tests have found that nearly 300 of these products contain undisclosed drug ingredients. These often include the same active ingredients found in prescription drugs like Viagra, Cialis, and Levitra. Sometimes they contain combinations of undisclosed drugs in excessively high doses.

For example, one of these tainted products included 31 times the prescription dose of tadalafil (the active ingredient in Cialis), in combination with dapoxetine, an antidepressant that is not approved by the FDA.
“Some of these products have as many as six different ingredients contained in FDA-approved prescription drugs. We don’t know what danger this poses because these combinations have never been studied before they are sold to unsuspecting consumers,” says Gary Coody, R.Ph., FDA’s national health fraud coordinator.

Monday, October 19, 2015

Forget Three Square Meals – Americans Eat All Day Long

New research found that most folks were eating for 15 or more hours while awake, and the lion’s share of calories were eaten well after 6 PM.

“Most participants thought they don’t eat or drink that regularly outside their breakfast-lunch-dinner routine,” said study co-author Satchidananda Panda, an associate professor in the Regulatory Biology Laboratory at the Salk Institute for Biological Studies in La Jolla, Calif. Most people also assumed that they had been confining their eating routine to a 10-12 hour window, he added.

The study’s results are in the Sept. 24 issue of Cell Metabolism.

The findings stem from a new effort to track real-world eating behavior by means of a newly designed mobile app.

For three weeks, 150 healthy men and women continuously snapped photos of all the food, drinks and nutritional supplements they consumed. In turn, the app tracked all caloric intake, along with the exact time and place food was consumed, the researchers said. After 21 days, investigators determined that food intake was generally both erratic and continuous.

In essence, the study authors found that whenever they were awake, people ate. More than half of the participants spread their food intake over a roughly 15-hour period each day. Fasting tended to occur only during sleep, the study found.

Less than a quarter of daily caloric intake happened before noon. By contrast, more than a third of food was consumed after 6 p.m.

Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said the study findings are “not much of a surprise.”

“Basically this new study helps confirm what we already suspect,” she said. “Eating sporadically and at all hours is just not good for our health."

Friday, October 16, 2015

Coffee May Not Risk Irregular Heartbeat

New research suggests that drinking coffee doesn’t seem to up the odds of a common type of irregular heartbeat called atrial fibrillation.

The study included 75,000 people who reported their coffee consumption in 1997. Their average coffee consumption was three cups a day. The researchers followed the participants’ health for the next 12 years. The researchers also reviewed findings from four previous studies that followed nearly 250,000 people for up to 12 years. All studies were done in Sweden or the United States.

The investigators found no link between drinking coffee and atrial fibrillation in any of the studies. That was true even among those with the highest levels of coffee consumption. The findings were published September 22 in the journal BMC Medicine.

“This is the largest prospective study to date on the association between coffee consumption and risk of atrial fibrillation. We find no evidence that high consumption of coffee increases the risk of atrial fibrillation,” study author Susanna Larsson said in a journal news release.

Larsson is an associate professor of epidemiology at the Karolinska Institute in Sweden.

Wednesday, October 14, 2015

Wisdom Wednesday: Food Sequencing

The concept of food sequencing has been around for about 50 years. The original theory was if you ate your foods one at a time rather than a bite of this and a bite of that, the food would layer in the stomach. Because various foods break down at much different rates (animal protein is very slow, fruits are fast), eating in sequence could markedly improve digestion.

Food sequencing is not to be confused with food combining, although that’s easily done. Food combining takes various foods and groups them together based on how quickly they break down. For example, protein can be eaten with vegetables, but not with starches. Starches can be eaten with vegetables and fruits must be eaten alone.

Dr. Harvey Diamond and his wife, Marilyn, published a New York Times #1 best seller in 1987 on this topic entitled “Fit For Life”. They made the process very easy by recommending all fruit be consumed in the morning, then switch to protein and vegetables or vegetables and starch for lunch and dinner.

For most of my patients, food combining is not necessary. However, for those with persistent digestive issues, food combining often provides a marked reduction in digestive symptoms like gas, bloating, constipation, and diarrhea.

So let’s get back to food sequencing. Recently, a patient of mine who is diabetic began a food sequencing program to reduce her blood glucose levels. Within two weeks, her fasting blood glucose dropped 35 points with no change in the foods she eats, just modifying the sequence.

Monday, October 12, 2015

DNA Damage May Play a Role in Gulf War Syndrome

Unexplained chronic fatigue, muscle pain and problems with thinking are experienced by a quarter of Gulf War veterans, and new research suggests exposure to DNA-damaging chemicals may cause this condition, known as Gulf War Syndrome.

Previous studies have suggested that the symptoms stem from a malfunction of mitochondria, the site in cells where molecules that power the body are made. The mitochondria have their own DNA, separate from the cell’s.
Researchers analyzed blood samples to measure the amount of mitochondrial DNA and degree of damage to this DNA among veterans with Gulf War Illness (GWI)

The vets not only had more mitochondrial DNA, but also more mitochondrial DNA damage than otherwise healthy adults, the researchers found.

Study author Yang Chen, a doctoral researcher at Rutgers Biomedical and Health Sciences in New Jersey, presented the findings at a recent meeting of the American Psychological Association in Tampa, Fla.

“Future studies are necessary to confirm these findings and determine their association with mitochondrial function. Work in this area may guide new diagnostic testing and treatments for veterans suffering from GWI,” the study’s authors wrote.

Friday, October 9, 2015

Potatoes, Tomatoes Make Up Bulk of Americans’ Veggie Intake

The U.S. Department of Agriculture, finds that potatoes now make up 30% of the vegetables grown and processed for Americans each year, while tomatoes make up 22%.

“Variety is so important in a healthy diet across the board,” said registered dietitian Dana Angelo White. “While focusing on only a small number of fruits and vegetables is better than nothing, it still makes it difficult to meet your needs for essential nutrients.”

A diet highly focused on potatoes, especially, can be harmful said White, who is assistant clinical professor of athletic training at Quinnipiac University in Hamden, Conn. “If the majority of potato consumption comes from processed sources like French fries and potato chips, they may be doing more harm than good,” she said.

The new data, from the USDA’s Economic Research Service, seems to bear that out. White potatoes accounted for about 115 pounds of the 384 pounds per person of vegetables and legumes eaten by the average American in 2013. However, two-thirds of those potatoes were used for French fries, potato chips and other processed or frozen potato products.

The same trends were seen for tomatoes. Of the 66 pounds of tomatoes consumed by the average American, only 20 pounds were for fresh tomatoes. The other 46 pounds were processed in a number of ways, including canned tomatoes, tomato sauces (such as ketchup), or as ingredients in processed stews, soups and other items.

Another nutrition expert suggested that consumers vary the “color” in their diet.

Wednesday, October 7, 2015

Wisdom Wednesday: A Simple Case of Sciatica?

A forty-nine year old male presented at my office with complaints of chronic low back pain with radiation down the right leg into the foot. He states that the back pain began almost a year ago. He was treated 2-3 times a week by a chiropractor but noted no benefit after a month and discontinued care.

Seven weeks ago, after sneezing, the pain shot down the right leg. The leg pain has been constant ever since, but varies in intensity. His orthopedic surgeon diagnosed a herniated disc and prescribed muscle relaxants and anti-inflammatory medication that failed to provide any relief.

An MRI performed two days prior to his initial visit in my office shows desiccation of the L4/L5 and L5/S1 discs with apparent prolapse at L5/S1 impinging the thecal sac.

Based on the history and MRI, I had several questions (please review my blog “The Patient History” posted September 16, 2015):
  • Why didn’t he respond to a month of fairly intensive chiropractic care?
  •  His pain radiates along the course of the femoral nerve, not the sciatic nerve. Why was he diagnosed with sciatica?
  • If sneezing caused the prolapse at L5/S1, why isn’t the sciatic nerve affected and why are both discs desiccated? That takes at least a year, maybe as much as five years to show on imaging studies.
  • The femoral nerve does exit from L4/L5 but that disc looks much healthier than the L5/S1 disc that supplies the sciatic nerve. Is this really a disc problem?

On examination, he had great difficulty arising from a chair (Minor’s Sign – imagine an old coal miner arising from a rocking chair) and exhibited marked antalgic posture (he leaned forward and to the left about 45 degrees) favoring the right leg to walk. Both these findings are secondary to protective muscle spasm.

Monday, October 5, 2015

Lowering Beta-Blocker Dose May Boost Survival After Heart Attack

People treated with low-dose beta blockers after a heart attack may fare better than those given the standard dose of this commonly prescribed medication, a new study shows.

Heart attack patients given just one-fourth of the dosage used in clinical trails lived just as long as patients on a higher dose, according to researchers at Northwestern University in Chicago. And in some cases, those on a low dose lived even longer, with 20-25% increase in survival.

“We set out on a mission to show if you treat patients with the doses that were used in the clinical trials, they will do better. We expected to see patients treated with the lower doses to have worse survival,” lead investigator Dr. Jeffrey Goldberger said in a university news release. “We were shocked to discover that they survived just as well, and possible even better.”

Goldberger is a professor of medicine at Northwestern’s Feinberg School of Medicine and a cardiologist at Northwestern Memorial Hospital. He also directs the cardiac arrhythmia program at Feinberg’s Center for Cardiovascular Innovation.

“We now need to figure out how to dose it in individual patients. That’s something no one has considered in the decades that we have been using this medication,” Goldberger said. “This huge gap in knowledge has been completely unexplored. Since this is the medicine we use in every single heart attack patient, we ought to figure out how to use it properly,” he said in the news release.

Roughly 90% of people treated for a heart attack are given a beta blocker, the study authors noted. This class of medication, which includes metoprolol (Toprol XL) and acebutolol (Sectral), is used to improve survival and prevent further heart attacks.

Friday, October 2, 2015

More Americans Getting Knees Replaced, And at Younger Ages

The National Hospital Discharge Survey, shows that between 2000 and 2010, more than 5.2 million total knee replacements were performed in the United States. By 2010, the operation had become the leading inpatient surgery performed on adults aged 45 and over.

The rate at which middle-aged and older Americans got their knees replaced almost doubled over the years covered by the study, for men and women, the researchers found.

People aren’t putting off the procedure for as long, either. In 2000, the average knee replacement patient was about 69 years old, but by 2010 that age had dropped to just over 66, the finding showed.

“In the past, the tread amongst orthopedic surgeons was to delay performing a joint replacement on a patient until a person was so hindered by their joint pain that they were nearly incapacitated in their activities of daily living (ADL),” said Dr. Neil Roth, an orthopedic surgeon at Lenox Hill Hospital in New York City.

However, “that philosophy has evolved,” he said, so that nowadays surgeons “perform joint replacements sooner, to prevent physical deterioration and deconditioning, and to try to maintain activity levels.”

Why is the operation becoming more popular for both genders? According to Roth, aging boomers are demanding more mobility as they age. Joint replacements are getting better, too, he added.

“Technologically, the longevity of knee and hip implants has also improved, lasting sometimes up to 15 years or longer,” Roth said. “While that still may necessitate revision surgery for those patients in the younger age groups, 45 to 64, it may not require two revision surgeries.”