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bulletIs Chiropractic the Answer for Knee Pain?

That pain in your knee is often what doctors call patellofemoral pain syndrome (PFPS). Simple activities such as running, jumping, or going up and down stairs can contribute to knee pain, which means that most of us will eventually suffer from some form of PFPS. 

It has been suggested that PFPS can be relieved by sufficient stretching and lengthening of tight structures around the patella (the kneecap). A study in the Journal of the Neuromusculoskeletal System investigated this potential intervention in 30 patients with PFPS. Patients were divided into two groups: The first group received “patella mobilization” (extension of the knee with pressure and movement applied for 10 minutes, followed by patellar adjustment in the direction of restricted movement); the second group received detuned ultrasound as placebo (five minutes of ultrasound, but with the intensity set at zero). 

Patients receiving mobilization had positive improvements in PFPS symptoms compared with the placebo group. The authors note that this type of conservative care may be useful when combined with other treatment options such as exercise, orthotics and activity modification. If you’re suffering from knee pain and would like to know more about nonsurgical approaches to relieving your pain, contact your doctor of chiropractic.

Rowlands BW, Brantingham JW. The efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome. Journal of the Neuromusculoskeletal System 1999: Vol. 7, No. 4, pp142-49.


Bed Rest for Aches and Pains? Not an Effective Prescription

Bed rest has been recommended for many conditions, including low back pain and rheumatoid arthritis. The idea of prescribing bed rest for illness perhaps stemmed from a quote by the “father of medicine,” Hippocrates: “In every movement of the body, whenever one begins to endure pain, it will be relieved by rest.”

Hippocrates’ advice was proffered in the 4th century B.C., but the practice of prescribing bed rest remains, despite little evidence of its effectiveness. In a review published in the journal Lancet, authors evaluated 39 different studies on bed rest prescribed for 15 different conditions, involving a total of 5,777 patients.

Results of the analysis revealed that bed rest was not an effective treatment recommendation. In 24 trials investigating bed rest following a medical procedure, no patients improved significantly and eight worsened significantly. And in 15 trials investigating bed rest as a primary treatment, no patients improved significantly, while nine worsened significantly.

Healing involves much more than rest, a fact which this study seems to emphasize but which many doctors seem to ignore. Don’t settle for quick medical advice (pills, bed rest, etc.) that may end up doing more harm than good, or no good at all. Consult with your doctor of chiropractic for information on active, noninvasive approaches to managing a variety of health problems.

Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet 1999: Vol. 354, pp1229-33.


Can Chiropractic Help Relieve PMS?

Headache, backache, abdominal bloating, cramping, fatigue and mood swings are just some of the symptoms associated with premenstrual syndrome (PMS). Most women suffer some symptoms of PMS during their childbearing years, but between 10-20% experience severe or disabling symptoms. 

Drugs, vitamin supplements and psychotherapy have proven ineffective or undesirable treatment options, with many patients reporting unpleasant side effects and only minimal relief of symptoms. Previous research has suggested the potential benefit of chiropractic care (see “Chiropractic for PMS” in the August 1999 issue of To Your Health), and a recent study provides further evidence of this association. 

In a nine-month clinical trial involving 25 women with diagnosed PMS, 16 patients received active chiropractic treatment (spinal manipulation and soft-tissue therapy) 2-3 times in the week before menses for at least three menstrual cycles; the remaining nine patients received a placebo in the form of chiropractic “adjustments,” using an instrument set for minimum force, such that patients did not effectively receive treatment. 

The two groups eventually changed over, so that both groups received treatment and placebo during the study period. In both groups, results showed that PMS symptom scores decreased after chiropractic manipulation, with a significant decrease in scores for the active treatment phase compared to the nontreatment (placebo) phase. 

Walsh MJ, Polus BI. A randomized, placebo-controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome. Journal of Manipulative and Physiological Therapeutics, Nov/Dec 1999: Vol. 22, No. 9, pp582-85.


Smoking Linked to Back Pain in Children 

Even if you’ve been confined to a deserted island for 50 years, you’re no doubt aware of the dangers of smoking. Overwhelming evidence links smoking to terminal diseases (including lung cancer and emphysema) and the risk of premature death, including several recent studies mentioned in this publication. (See “Long-Term Smoking Linked to Arthritis,” Oct. 1999, and “Cigars Just as Dangerous as Cigarettes,” Dec. 1999 in the News Archive)

Smoking may also influence back pain, a suggestion also supported by recent evidence (See “Another Reason Not to Smoke,” Aug. 1999) and a study that appeared in the December 1 issue of Spine. Students from three high schools in Montreal, Canada were monitored for one year to evaluate the incidence of low back pain (LBP) and its potential association with smoking. 

Back pain (pain occurring at least once a week in the previous six months) was twice as likely in smokers than nonsmokers. Additionally, moderate-to-heavy smokers (25 or more cigarettes per week) experienced more pain than light-to-moderate smokers (1-25 cigarettes per week). 

Far too many people suffer from low back pain, and far too many people continue to smoke despite the warnings. With increasing numbers of our children smoking and suffering from back pain, isn’t it time to lead ourselves and our children down a healthier path? 

Feldman DE, Rossignol M, Shrier I, et al. Smoking: a risk factor for the development of low back pain in adolescents. Spine, Dec. 1, 1999: Vol. 24, No. 3, pp2492-96.


Hormone Therapy May Contribute to Breast Cancer

It is estimated that cancer ends a human life every minute in the United States, and that more than three million others currently suffer from some form of the disease. Among women, breast cancer is the second most common cancer and the leading cause of cancer deaths.

After menopause, many women use hormone replacement therapy (HRT) to compensate for the body’s natural decline in hormone production. However, as a study in the Journal of the American Medical Association suggests, the risks associated with HRT use may end up outweighing the benefits.

As part of a nationwide breast cancer screening program called the Breast Cancer Detection Demonstration Project, 46,355 postmenopausal women were evaluated for duration and type of hormone use and monitored for the incidence of breast cancer. Of particular interest was the influence of estrogen, progestin, or a combination of the two hormones on the risk of developing the disease.

During the 15-year study, 2,082 cases of breast cancer were identified. Women taking the progestin-estrogen combination were at higher risk for the disease than women taking estrogen alone, and this risk increased more rapidly in the combination therapy group vs. the estrogen group per year of use.

The authors note that their data suggest that “the estrogen-progestin regimen increases breast cancer risk beyond that associated with estrogen alone.” Talk to your doctor about the risks and benefits associated with hormone replacement therapy.

Schairer C, Lubin J, Troisi R, et al. Menopausal estrogen and estrogen-progestin replacement therapy and breast cancer risk. Journal of the American Medical Association, Jan. 26, 2000: Vol. 283, No. 4, pp485-91.


Zinc: An Important Mineral for Children and Adults

Most people aren’t aware of the importance of zinc in their diet. Zinc deficiency can contribute to acne, fatigue, growth impairment, slow wound healing, delayed sexual maturation, hair loss, high cholesterol, and many other health problems. 

Zinc deficiency can also impair the body’s ability to fight infection. In children, 
this can greatly increase the risk of suffering from two of the more common infectious childhood diseases: pneumonia and diarrhea. But there may be a solution, and it could be as easy as making sure you and your children get enough zinc. 

A study in the Journal of Pediatrics reviewed previous research on the benefits of zinc supplementation, finding 10 trials worthy of analysis. In seven studies, zinc supplementation was provided at 1-2 times the recommended daily allowance (RDA), 5-7 times per week. In the remaining three studies, zinc supplementation amounted to 2-4 times the RDA daily for two weeks. 

Zinc supplementation reduced the risk of developing diarrhea and pneumonia in both sets of trials. The authors note that these results emphasize the importance of adequate daily zinc intake, and add that their findings are especially significant to developing countries where zinc deficiency is common (and where diarrhea and pneumonia represent the two leading causes of death). 

Good sources of zinc include fish, egg yolks, lima beans, meats, pecans, poultry, soybeans and whole grains. Your chiropractor can evaluate the nutritional needs of you and your children and help ensure that your family gets the vitamins and minerals necessary to stay healthy and fight disease.

Bhutta ZA, Black RE, Brown KH, et al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. Journal of Pediatrics 1999: Vol. 135, pp689-97.


The Road to Recovery Is Paved with Nutrition

If you’ve recently suffered an injury, you’re probably all too familiar with the physical rigors of rehabilitation. Regaining strength and endurance in injured muscles, joints or tissue is a complex process requiring consideration of physical, biological, physiological and nutritional factors.

Speaking of nutrition, a review paper in the Journal of Sports Chiropractic & Rehabilitation addresses the value of nutrition in returning patients to preinjury status. Various nutritional considerations are discussed, including:

 specific energy and nutrient requirements


 ways of reducing inflammation (enzymes, amino acids, herbs/botanicals)


repairing/strengthening tissue (glucosamine sulfate, chondroitin sulfate)


avoiding potential food sensitivities (corn, wheat, milk products, red meat, etc.)

Whether you’re recovering from injury or just trying to maximize health and wellness, proper nutrition is a good place to start. Consult with your chiropractor to develop nutritional and exercise guidelines appropriate to your needs. 

Simon JJ. Rehabilitative nutrition. Journal of Sports Chiropractic & Rehabilitation, Dec. 1999: Vol. 13, No. 4, pp145-49.



Views on Chiropractic Maintenance

Doctors of chiropractic are recognized as capable, efficient providers of health care services, particularly for their emphasis on preventing illness and promoting health and wellness. 

A recent two-part study sought to specify the role and use of maintenance care (MC) within the chiropractic profession. Part I focused specifically on chiropractors’ attitudes toward MC and the preferred types of MC provided in U.S. chiropractic offices; part II addressed the frequency of MC use by the elderly. 

Results from part I:

Chiropractors agree that the primary functions of maintenance care are to optimize health, prevent conditions from developing, reduce/relieve conditions, and minimize the recurrence of such conditions


They also agree that MC should combine exercise, chiropractic adjustments/manipulation, and dietary and lifestyle changes


While MC is recommended to nearly 80% of chiropractic patients, only 34% actually receive such care.

Results from part II: 

Elderly patients make an average of 17 visits per year for chiropractic MC


These patients report making only half the annual number of visits to medical doctors compared with the national average


Stretching exercises, aerobic exercises, dietary advice and other prevention strategies are also recommended for this age group.

The moral to this story is simple: Chiropractors believe in providing well-balanced preventive care that focuses on maintaining wellness and dealing with potential health problems. Many people take advantage of this opportunity, but many more have yet to receive the benefits chiropractic can offer. Do you have friends or family who’ve never been to a chiropractor? Tell them about your experiences and help them follow the same road to wellness you’ve chosen.

Rupert RL. A survey of practice patterns and the health promotion and prevention attitudes of U.S. chiropractors. Maintenance care, part I. Also: Rupert RL, Manello D, Sandefur R. Maintenance care: health promotion services administered to U.S. chiropractic patients aged 65 and older: part II. Journal of Manipulative and Physiological Therapeutics, Jan. 2000: Vol. 23, No. 1, pp1-9 and 10-19.

bulletNot Safe Enough?

Technology and research advancements have taken surgery to a new level as we enter the 21st century. However, the dangers associated with such invasive procedures remain a discomforting reality, a fact emphasized by a recent study that appeared in the journal Surgery.

Researchers examining data from 15,000 hospital discharges in Utah and Colorado in 1992 found that three percent of patients undergoing an operation or child delivery experienced an adverse event, and that 5.6% of those patients died as a result. Most distressing perhaps is some of the specific data on such events:
bulletTechnique-related complications accounted for nearly 25% of all adverse surgical events;
bulletDrug-related errors, diagnostic errors, and errors in therapy of choice accounted for 12% of these events; and
bulletFifty-four percent of these complications were considered “preventable.”

Doctors always warn patients that surgical procedures carry a certain risk independent of the condition or injury being treated, but these results seem to suggest that the surgeons could be doing more to reduce the risk. If you or a loved one is considering surgery or has been advised to undergo a surgical procedure, make sure you get a second opinion and investigate nonsurgical alternatives. Your doctor of chiropractic can provide you with information on conservative care that may be as effective as (and definitely safer than) going under the knife.

Gawande AA, Thomas EJ, Zinner MJ, et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999: Vol. 126, No. 1, pp66-75.

bulletMore than Low Back Care?

Far too many people still believe that chiropractic care isn’t necessary unless they’re suffering excruciating low back pain. The millions who do receive regular adjustments know that chiropractic can resolve their back pain, and more and more may also be learning about the potential nonmusculoskeletal benefits.

Take as an example the patients in a recent study in the Journal of Manipulative and Physiological Therapeutics. Twenty consecutive patients from each of 87 Swedish chiropractor’s offices (1,504 total patients) completed questionnaires within two weeks of previous treatment. The questionnaires documented numerous reported improvements in nonmusculoskeletal symptoms, including:
bulleteasier to breathe (98 patients);
bulletimproved digestive function (92 patients);
bulletclearer/better/sharper vision (49 patients);
bulletimproved circulation (34 patients);
bulletless ringing in the ears (10 patients);
bulletacne/eczema better (8 patients);
bulletdysmennorhea (painful menstruation) better (7 patients); and
bulletasthma/allergies better (6 patients).

The number of spinal areas adjusted was also related to the number of positive reactions. Fifteen percent of patients reported positive reactions after having a single area adjusted; 35% of patients reported positive reactions after having four areas adjusted. Overall, 23% of chiropractic patients reported experiencing positive changes in symptoms that were not musculoskeletal in nature.

Have you experienced nonmusculoskeletal benefits following chiropractic care, and if so, have you told your doctor of chiropractic? Always report any reactions (good or bad) you experience during or following an adjustment.

Leboeuf-Yde C, Axen I, Ahlefeldt G, et al. The types and frequencies of improved nonmusculoskeletal symptoms reported after chiropractic spinal manipulative therapy. Journal of Manipulative and Physiological Therapeutics, Nov./Dec. 1999: Vol. 22, No. 9, pp559-64.

bulletReduce Sodium Intake, Reduce Heart Disease

Almost everything we eat contains at least a little sodium, although many foods, especially the processed variety, contain way too much. Our bodies only need about 500 milligrams (mg) of sodium a day; although current dietary recommendations allow for 2,000 - 4,000 mg (1-2 teaspoons of salt), statistics show that the average adult consumes almost double that amount.

Limiting your sodium intake can reduce your risk of developing high blood pressure and cardiovascular disease, especially if you’re overweight, according to a study in the Journal of the American Medical Association. Researchers estimated dietary sodium intake in 2,688 overweight subjects and 6,797 nonoverweight subjects, then assessed incidence of and/or death from cardiovascular disease over 19 years of follow-up.

Results: Among overweight participants, a relatively small increase in sodium intake was associated with substantial increases in disease risk: 32% higher risk of stroke; 44% higher risk of heart disease; 61% higher risk of death from heart disease; and a 39% higher risk of death from all causes. Dietary sodium intake was not significantly associated with cardiovascular disease risk in nonoverweight participants.

If you already have high blood pressure or a developing heart condition, restricting your sodium intake is even more imperative. Your doctor can give you more information on sodium and provide nutritional guidelines suitable to your specific needs. 

He J, Ogden LG, Vupputuri S, et al. Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. Journal of the American Medical Association, Dec. 1, 1999: Vol. 282, No. 21, pp2027-34.


Exercise Reduces Diabetes Risk in Postmenopausal Women

The natural changes associated with menopause can be accompanied by added risk for osteoporosis, heart disease and diabetes. Fortunately, evidence also suggests that consistent exercise may be one of the ways to reduce the risk of developing these debilitating, chronic conditions. (See “Maintain Strong Bones with Exercise” in the Sept. 1999 issue of To Your Health, and “Keep Your Heart Healthy with Resistance Training” in the Aug. 1999 issue.)

A study in the American Journal of Public Health suggests that exercise may also help prevent diabetes in postmenopausal women. Nearly 100,000 women (aged 55-69 years of age) completed a diet and lifestyle questionnaire in January 1986, and subsequent questionnaires mailed, completed and returned over the next 12 years documented new diagnoses of diabetes. 

For the 41,836 women who completed all questionnaires, greater leisure-time physical activity was associated with a reduced risk of type II (adult) diabetes. This association was stronger with increasing levels of activity, such that the most active women had approximately half the risk as the least active women in the study. These results were maintained even after the authors considered other potential factors such as smoking, alcohol intake, hormone replacement therapy, and family history of the disease.

Folsom AR, Kushi LH, Hong CP. Physical activity and incident diabetes mellitus in postmenopausal women. American Journal of Public Health, Jan. 2000: Vol. 90, No. 1, pp134-38.

bulletWatching and Learning

Who’s teaching your children these days? Are you teaching them? As parents, you can exert more influence over their lives than anyone else, and your children will learn from the good examples you provide - as well as the bad ones. 

If you don’t believe that, consider a recent study that examined the potential for 
health-risk behaviors to be transmitted from parents to offspring. More than 300 children and their parents participated in the study, which focused on five specific negative health behaviors:
bulletpoor eating habits;
bulletexcessive drinking;
bulletinadequate sleep; and
bulletphysical inactivity.

The authors selected families from a rural eight-county area in North Central Iowa from 1989-1994. Families chosen had at least two children in 1989: one child in seventh grade (the focus child of the study), and a sibling within four years of age of the seventh grader. Results are presented below:
bulletParents behaviors significantly influenced the health-risk behaviors of their children.
bulletThis influence occurred in two ways: by transmitting (teaching) specific behaviors and by sharing the health-risk lifestyle with them.
bulletFathers’ specific negative behaviors seemed to affect only boys.
bulletMothers’ specific negative behaviors seemed to affect only girls. 

If you think your kids don’t listen or learn from anything you say or do, you’re not giving yourself or them enough credit. Your children are watching and learning from you, so point them in the direction of health and wellness -- chances are they’ll follow. 

Wickrama KAS, Conger RD, Wallace LE, et al. The intergenerational transmission of health-risk behaviors: adolescent lifestyles and gender moderating effects. Journal of Health and Social Behavior, Sept. 1999: Vol. 40, pp258-72.


bulletFighting Prostate Cancer with Vitamins

Prostate cancer strikes nearly a quarter of a million men each year, making it the most commonly diagnosed form of cancer. Evidence suggests that male hormones may contribute to the development of this disease as we age. Studies of dietary antioxidants have provided encouraging data on the prevention of prostate cancer, an observation supported by a study published by the Journal of the National Cancer Institute.

In the study, various antioxidants, were applied to cell cultures to evaluate their effect on cell growth and other characteristics. Vitamins C and E decreased cancerous activity on a cellular level, especially when high doses were administered; other antioxidants included in the study were not as effective in suppressing cancer growth.

These findings add to considerable evidence promoting antioxidants as cancer-fighting agents. Where can you find good sources of vitamin C and E? Look no further than the produce section of your local grocery store: fruits and leafy green vegetables contain significant amounts of these powerful antioxidants. Your chiropractor can tell you more about what foods to eat (and what foods to avoid) to ward off disease.

Ripple MO, Henry WF, Schwarze SR, et al. Effect of antioxidants on androgen-induced AP-1 and NF-kB DNA-binding activity in prostate carcinoma cells. Journal of the National Cancer Institute, July 1999: Vol. 91, No. 14, pp1227-32.

bulletSwatting Away the Tennis Injury Bug

Tracking down a ball on the baseline, lunging at a passing shot, straining to reach a lob - almost every aspect of tennis involves a certain amount of risk. Even the repetitive motions of serving and hitting groundstrokes can cause painful injury, turning you from active participant to unhappy spectator.

According to an article in the Journal of Sports Chiropractic & Rehabilitation, stretching and strengthening exercises can help minimize your risk of sustaining a tennis-related injury. The authors present various techniques in a photographic format with text explanations. Included is a review of easy exercises you can perform at home or in the gym, such as:
bullettorso stretch;
bulletpelvic tilt;
bullethamstring stretch;
bulletlumbar extension;
bulletside bend;
bulletshoulder rotation;
bulletknee flexion;
bullethip extension; and
bulletscapular retraction

You’re probably familiar with some of these techniques already, but your chiropractic can give you more specific information and outline an exercise program to maximize health and reduce your risk of injury.

Baron SH, Washington KW. Tennis injuries: lower the risk through stretching and strengthening. Journal of Sports Chiropractic & Rehabilitation 1999: Vol. 13, No. 4, pp164-70.

bulletArterial Disease Linked to Back Pain

Atherosclerosis, the buildup of fatty deposits in your arteries, can lead to high blood pressure, chest pain, heart attack or stroke. Evidence suggests that insufficient blood circulation associated with atherosclerosis may contribute to another serious condition: erosion/degeneration of the discs in your spine.

Speaking of spines, a study published in a journal by the same name investigated whether atherosclerotic lesions in the abdominal aorta were more advanced in patients with low back pain (LBP) vs. those without pain. From 1991-1993, 29 patients (21-58 years of age) were evaluated with a diagnostic procedure called CT discography. 

Results showed that 55% of LBP patients had atherosclerotic damage visible on CT scan, compared with only 21% of patients without LBP. This difference was further emphasized when examining a specific group of patients (50 years of age or younger): 48% of LBP patients had aortic damage vs. only 8% of patients without low back pain.

Atherosclerosis is so common that many people assume it’s a normal consequence of aging, but don’t be fooled: overwhelming research suggests that diet and lifestyle can play a major role in preventing this disease. Your chiropractor can provide you with more information on low back pain, atherosclerosis, and how you can avoid both.

Kurunlahti M, Tervonen O, Vanharanta H, et al. Association of atherosclerosis with low back pain and the degree of disc degeneration. Spine, October 15, 1999: Vol. 24, No. 20, pp2080-84.

bullet The Chiropractic Answer to Whiplash

Whiplash is an all-too-common consequence of the more than one million rear-end collisions that take place in the United States every year. Although the classic symptoms of whiplash (headache, dizziness, neck, shoulder, jaw and/or arm pain) may subside after a few weeks of appropriate care, it's estimated that nearly one in four cases will become chronic, resulting in long-term discomfort and disability.

Chiropractic may offer the best opportunity for relief from the pain of whiplash, according to a study published in the Journal of Orthopaedic Medicine. Ninety-three patients with chronic whiplash symptoms were divided into three groups based upon the nature and severity of their symptoms. All 93 patients received an average of 19.3 chiropractic adjustments over the study period (about four months).

Results showed that two of the three groups (patients with neck pain, restricted neck range of motion and/or neurological symptoms) improved under chiropractic care, with 85.5% reporting "some benefit," 33.5% improving by two symptom grades, and 31% being relieved of all symptoms. 

If you or a loved one is suffering from whiplash, make an appointment with a doctor of chiropractic. As the authors of this study conclude, when it comes to treating whiplash, "chiropractic is the only proven effective treatment."

Khan S, Cook J, Gargan M, et al. Asymptomatic classification of whiplash injury and the implications for treatment. Journal of Orthopaedic Medicine 1999: Vol. 21, No. 1, pp22-25.

bullet Watching Our Children Get Fat

At the Children's Television Conference in 1996, President Bill Clinton underscored America's obsession with television when he noted that "a typical child watches 25,000 hours of television before his or her 18th birthday. Preschoolers watch 28 hours of television a week." If you tend to shrug off this fascination with the tube as harmless, consider a recent study in the Journal of the American Medical Association that examined the potential connection between TV viewing and obesity. 

Nearly 200 third and fourth-grade students from two public elementary schools participated in the study, in which children from one school received an 18-lesson, six-month classroom curriculum to reduce television, videotape and video game use. The intervention was based solely upon teaching the children to budget their entertainment time and did not include other lifestyle modifications such as exercise. The second school received no curriculum to modify TV viewing and was compared with the initial group after six months.

Children from the first school showed significant decreases in body-mass index, triceps skin-fold thickness, waist circumference and waist-to-hip ratio following the six-month educational program, especially compared to the second school that received no intervention to decrease TV viewing. Children from the first school also reported significant decreases in overall television viewing and meals eaten in front of the television.

These findings add to considerable evidence suggesting that television can influence our children, and the news isn't good. As parents, let's take the opportunity to do something about it. It's time to stop watching our children get fat.

Robinson TN. Reducing children's television viewing to prevent obesity. Journal of the American Medical Association, Oct. 27, 1999: Vol. 282, No. 16, pp1561-67.

bullet Maternal Drinking Might Influence Attention Deficit Disorder

Children with attention deficit hyperactivity disorder (ADHD) can have problems completing tasks, staying organized and keeping track of things. Problems with hyperactivity and/or impulsivity may also surface, including fidgeting, squirming, excessive talking and frequent interrupting. Because most children display these behaviors from time to time, it's not easy to determine whether a child has ADHD or is just going through the normal adjustments of "growing up." 

The problems associated with ADHD can be persistent and severe, and while it's not clear exactly what causes this condition, a recent study suggests that maternal drinking may play a role. Twenty-eight children were selected from three subject groups: children with fetal alcohol syndrome (FAS), a condition characterized by facial deformities due to maternal drinking; children with prenatal exposure to alcohol; and children with no prenatal exposure to alcohol. Researchers evaluated all 28 children in terms of "executive functioning" (EF) -- sequencing and self-monitoring, planning, ability to engage in goal-directed behaviors, critical thinking, etc. -- and found that those children exposed to alcohol (children with FAS or prenatal exposure) performed worse on tests of EF than children without prenatal exposure to alcohol. 

These findings add to the considerable evidence that drinking alcohol during pregnancy can have profound negative consequences. Consult with your doctor before, during and after pregnancy to ensure the health of your child.

Mattson SN, Goodman AM, Caine C, et al. Executive functioning in children with heavy prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research, Nov. 1999: Vol. 23, No. 11, pp1808-1815.

bullet What's Causing That Headache?

We all get headaches at one time or another, but figuring out why we're suffering or how to get rid of them isn't always easy. Millions of Americans take daily or near-daily doses of pain relief medications to combat headaches, often providing only temporary relief and causing a variety of unpleasant side effects.

A number of clinical studies note the effectiveness of chiropractic manipulation in relieving headache symptoms, an observation confirmed by a recent literature review that provided evidence of a potential spinal cord connection. Specifically, the authors' search of previous research revealed that dysfunction in the upper part of the cervical spine has the potential to create cranial pain -- headaches. 

Evidence points to a variety of possible causes of headache pain, including stress, muscle tension, nutritional deficiencies, and hormonal imbalances, but most headache sufferers turn to over-the-counter drugs as their only form of relief. You don't have to be one of the millions dependent on pain medications. If you suffer from headaches, schedule a comprehensive evaluation with your doctor of chiropractic. If neck and spine dysfunction is causing your pain, regular adjustments might be an effective solution.

Alix ME, Bates DK. A proposed etiology of cervicogenic headache: the neurophysiological basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. Journal of Manipulative and Physiological Therapeutics, Oct. 1999: Vol. 22, No. 8, pp534-39.

bullet Don't Forget about Vitamin E

How important is vitamin E? It helps fight cardiovascular disease and cancer, it can improve circulation, relax leg cramps, aid normal blood clotting and healing, and it promotes healthy hair and skin. And if that isn't enough, a study published in the American Journal of suggests that vitamin E might also be able to prevent memory loss.

The authors examined the relationship between antioxidants (vitamins A,C,E, the carotenoids, and selenium) and memory performance by evaluating 4,809 seniors who visited a specific examination center over a six-year period. Memory was assessed using delayed recall of six points and three specific words from a story, and antioxidant status, including vitamin E, was measured at entrance to the study and again six years later.

Results showed a consistent association between low levels of vitamin E and poor memory, but not with the other antioxidants studied. This association was evident even after considering age, education, income, vascular risk factors, and the contribution of other vitamins and trace elements.

Good sources of vitamin E include leafy green vegetables, nuts, seeds, brown rice, eggs, soybeans and whole grains. Your doctor of chiropractic can outline nutritional guidelines specific to your needs and tell you more about how to maintain health and wellness with age. 

Perkins A, Hendrie HC, Callahan CM, et al. Association of antioxidants with memory in a multiethnic elderly sample using the Third National Health and Nutrition Examination Survey. American Journal of Epidemiology 1999: Vol. 150, No. 1, pp37-44.

bullet High Blood Pressure Linked to Bone Loss?

Recent issues of To Your Health have included several studies detailing the importance of maintaining strong, healthy bones as we age. (See "Road to Strong Bones Paved with Nutrition," Aug. '99; "Maintain Strong Bones with Exercise," Sept. '99; and "Bone Loss Linked to Mental Decline," Jan. 2000.) We continue this trend in the current issue by reporting on a study that appeared in the September 18th issue of the Lancet. 

The authors note that bone loss, often related to calcium deficiencies, is a primary cause of fractures in postmenopausal women and the elderly, and that problems with our ability to metabolize calcium has been linked to high blood pressure. They use this background data to explore the potential relationship between bone loss and high blood pressure in 3,676 elderly Caucasian women.

By comparing initial measurements of blood pressure and bone mineral density (BMD) with BMD measurements taken 3-5 years later, the authors discovered that rates of bone loss increased with increasing blood pressure. These findings were maintained even after taking other variables into consideration, including age, weight, smoking and regular use of hormone replacement therapy (all of which can influence bone loss). 

Cappuccio FP, Meilahn E, Zmuda JM, et al. High blood pressure and bone mineral loss in elderly white women: a prospective study. The Lancet, Sept. 18, 1999: Vol. 354, pp971-75.


bullet Preventing Birth Defects with Folic Acid

Few things can cast a more frightening shadow over the joy of childbirth than finding out that your child is afflicted with a birth defect such as anencephaly or spina bifida. Babies with anencephaly never develop a brain and are stillborn or die shortly after birth; those afflicted with spina bifida have a defect in the spinal column that can lead to paralysis and/or mental retardation. 

Evidence suggests that folic acid can help prevent these two major birth defects, and a recent study in The New England Journal of Medicine echoes this hypothesis. As part of a public health campaign conducted in China, birth defects were evaluated among the fetuses or infants of women who took folic acid (at any time before or during pregnancy) compared with those whose mothers did not take folic acid. Results supported a protective effect:

* Folic acid supplementation: 0.8 defects per 1,000 pregnancies;

* No folic acid supplementation: 2.9 defects per 1,000 pregnancies.

These results are especially important because, as the authors note, the baseline rate of defects in China, especially in the southern region, is similar to rates in the United States and other countries. If you're expecting the birth of a child, consult 
with your team of health care professionals on a comprehensive exercise and nutrition program that can help ensure a healthy, happy newborn.

Berry RJ, Zhu L, Erickson JD, et al. Prevention of neural tube defects with folic acid in China. The New England Journal of Medicine, Nov. 11, 1999: Vol. 341, No. 20, pp1485-90.


Missing Work Because of Back Pain

An estimated 150 million workdays are lost each year because of back pain, accounting for billions of dollars each year in lost wages and workers' compensation claims. Of course, the issue of back pain goes far beyond dollars and cents -- it's about the frustration, discomfort and disability millions of endure for months and sometimes years.

What specifically determines time loss from work following a back injury? To answer that question, the authors of a study in Spine evaluated the incidence of back injury and resultant work loss in a group of nurses employed at a large teaching hospital in Canada. Over a two-year period, 320 nurses suffered 416 documented back injuries, with the results of 218 interviews presented as follows:

* Perceived disability (i.e., thinking you were injured) contributed to time loss following the injury;

* Self-reported pain was strongly related to the length of time lost; and 

* Type of injury, specifically back injury caused by lifting patients, resulted in greater time loss.

This study serves as yet another example of the magnitude of the back pain problem and the effects it can have on our physical, psychological and economic well-being. It's a reminder that prevention is the best way to avoid a back injury, and that a proven, successful way to prevent back pain (or relieve back pain after injury) is with regular adjustments from a doctor of chiropractic.

Tate RB, Yassi A, Cooper J. Predictors of time loss after back injury in nurses. Spine, Sept. 15, 1999: Vol. 24, No. 18, pp1930-36.

bulletBaby's Crying? Take a Trip to the Chiropractor

The most widely accepted definition of "colic" is uncontrollable crying in babies, especially from the ages of 0-3 months, and often lasting for more than three hours a day, more than three days a week for three weeks or more. 

No matter how long the condition lasts, parents know that struggling with a colicky child can be frustrating and exhausting. But there is hope, and it could come from your doctor of chiropractic. A recent study divided 50 infants with colic into two groups. The first group received chiropractic spinal manipulation for two weeks; the second group received traditional drug treatment (dimethicone) over the same two weeks.

Results revealed that the chiropractic group improved more than the drug group (less hours spent crying) after the first five days of the study. After day five, the dimethicone group showed little or no reduction in average colic hours per day. Specifically:
bulletDays 4-7: Hours of crying were reduced by a total of 2.4 hours in the manipulation group compared with only one hour in the drug group.
bulletDays 8-11: Hours of crying were reduced by 2.7 total hours in the manipulation group, compared with one hour in the drug group.

Even more revealing, five infants in the dimethicone group dropped out before the end of the study, described by their patients as having "worsened" or "much worsened" colic. The authors suggest that if these severe cases had been included in the results, the drug intervention would have appeared even less effective than chiropractic for reducing the symptoms of colic.

Wiberg JMM, Nordsteen J, Nilsson N. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. Journal of Manipulative and Physiological Therapeutics, October 1999: Vol. 22, No. 8, pp517-22.

bulletCommunicate with Your Chiropractor

Whether you're fighting through traffic, paying the monthly bills, dealing with the noisy next-door neighbor or struggling with illness or disease, it can all add up to a considerable amount of stress. Stress is basically what we feel whenever we are faced with a difficult, unpleasant or challenging situation, and the way we deal with all this stress can substantially influence our overall health and well-being. 

If stress is affecting your life, it's time to make an appointment with a doctor of chiropractic. Here's why: A study in the Journal of Manipulative and Physiological Therapeutics (JMPT) examined the contribution of stress as a potential disease trigger among 138 chiropractic patients attending one of 10 chiropractic clinics. Patients completed two questionnaires that asked about how their current stress affected their ability to function emotionally, mentally and physically. 

Results showed that nearly one in three patients viewed their lives as moderately to severely stressful, and more than 50% felt that stress had a moderate or severe impact on their current health problem. Nearly three-quarters (71%) of the patients said that it would be helpful if their chiropractic care included strategies to help them cope with stress.

Chiropractic care might be just what you need to help relieve some of that stress in your life. And remember, evidence suggests that low back pain, a condition that chiropractors are experts at managing, may be caused or worsened by stress. So talk to your chiropractor about stress and about all of your health care needs. Trust and communication are important in any relationship, but perhaps no more so than between patient and doctor. After all, you're placing your health and wellness in their hands. 

Jamison J. Stress: the chiropractic patient's self-perceptions. Journal of Manipulative and Physiological Therapeutics, July/August 1999: Vol. 22, No. 6, pp395-98.

bulletCan Exercise Help Prevent Breast Cancer?

Mothers, sisters, friends and daughters can be affected by breast cancer. Regardless of age, race or economic status, an estimated 180,000 women will be diagnosed with breast cancer this year and nearly 45,000 will die from the disease. Although there is currently no known cure, researchers are working diligently to give women a fighting chance against this frightening, life-threatening disease.

A study published in the Archives of Internal Medicine examined the role exercise may play in reducing the risk of breast cancer. Researchers analyzed data from the Nurses' Health Study, which followed 121,701 women (aged 30-55) from 1976-1992. Women were surveyed at different points during the study period to gather data on physical activity, including the average number of hours per week spent participating in moderate or vigorous "recreational physical activity" (walking, jogging, cycling, swimming, aerobic dance, tennis, etc.).

Surveys also were used to identify cases of breast cancer during the 16-year study. Women who were more physically active showed a lower risk of breast cancer than women who were less active. The intensity of physical activity did not seem to be as important as consistent activity; women reporting four or more hours of vigorous physical activity each week had only a 10-15% lower risk of breast cancer than women reporting one hour or less of moderate-to-vigorous activity per week.

Early detection of breast cancer can play a major role in saving your life or the life of someone you love, and these research findings suggest that consistent physical activity may help as well. If you'd like more information on the value of health and wellness in preventing disease, make an appointment with your doctor of chiropractic.

Rockhill B, Willett WC, Hunter DJ, et al. A prospective study of recreational physical activity and breast cancer risk. Archives of Internal Medicine, 1999: Vol. 159, pp2290-2296.

bulletMothers with High Cholesterol = Children with High Cholesterol?

Cholesterol is critical to many bodily functions (cell membrane production, sex hormones, digestive processes), although most people don't think of it in such a positive light. That's because excess cholesterol in the bloodstream can also cause hardening of the arteries, otherwise known as atherosclerosis, which is associated with an increased risk of heart disease and stroke.

Children generally have low cholesterol concentrations and don't develop atherosclerosis. However, atherosclerotic "lesions" (evidence of thickening in the arteries caused by the buildup of excess cholesterol) have been noted in some young adults and infants, even without a family history of the disease. This suggests that other factors may be involved.

A study published in the October 9, 1999 issue of The Lancet examined whether hypercholesterolemia (high cholesterol levels in the blood) in mothers could be linked to the same condition in their children. More than 150 children age 1-3 were classified by whether their mother had normal or high levels of cholesterol during pregnancy; the children were then examined for evidence of atherosclerotic lesions.

Results showed that lesions were more pronounced and developed more rapidly in children whose mothers had high cholesterol levels, and this observation could not be explained when accounting for the conventional risk factors (high-cholesterol diet, family history, etc.). 

These findings add to the considerable evidence emphasizing the importance of a healthy lifestyle during pregnancy. What you do while you're pregnant doesn't just affect you -- it can affect the health and safety of your child. Consult with your team of health care professionals to optimize your prenatal care.

Napoli C, Glass CK, Witztum JL, et al. Influence of maternal hypercholesterolemia during pregnancy on progression of early atherosclerotic lesions in childhood: fate of early lesions in children (FELIC) study. The Lancet, October 9, 1999: Vol. 354, No. 9186, pp1234-41.

bulletBone Loss Linked to Mental Decline?

Bone mass increases during childhood and adolescence, reaching its greatest mass when we're in our 30s and declining slowly but steadily as we age. Women have less bone mass than men at all ages and lose bone mass rapidly following menopause. In fact, after menopause this bone loss can occur at a rate of up to five percent per year, putting women at risk for osteoporosis (bone loss to the point that they become thin, brittle and prone to fracture).

If the threat of osteoporosis isn't distressing enough, consider a recent study published in the Journal of the Geriatric Society. More than 8,000 elderly women (all 65 years of age or older) evaluated the potential association between bone mineral density (BMD) and cognitive decline. BMD was measured at the beginning of the study (baseline) and again 4-6 years later, and vertebral fractures were determined with x-rays at year six. Women were also monitored for cognitive changes via several questionnaires given at different points during the study period.

Women with low BMD at baseline had up to 8% worse cognitive scores at baseline and up to 6% worse scores at follow-up than women with higher BMD at baseline. Woman with vertebral fractures also revealed lower test scores and a greater overall risk of cognitive decline than women without any fractures. 

Exercise and dietary supplementation (calcium) are potential options for women trying to prevent bone loss following menopause. This study suggests that preventing bone loss might help prevent some of the mental declines normally associated with aging. 

Yaffe K, Browner W, Cauley J, et al. Association between bone mineral density and cognitive decline in older women. Journal of the American Geriatric Society, 1999: Vol. 47, pp1176-1182.

bulletAn Important Reason to Lose the Weight 

Body-mass index (BMI) is basically a measure of your weight in proportion to your height. BMI is regarded as an important indicator of overall fitness and health, although the specific nature of BMI as it relates to disease is not clear-cut and the "optimal" BMI is highly subjective.

More than one million U.S. adults (457,785 men and 588,369 women) participated in a 14-year study that examined the relationship between BMI and the risk of death from all causes. Results showed a distinct association between BMI and disease, including the following:
bulletA high BMI was most strongly linked with death from cardiovascular disease, especially in men.
bulletOverall, heavier (higher weight in proportion to height) women and men in all age groups had an increased risk of death compared to those with lower BMIs.
bulletAmong men and women with the highest BMIs, Caucasian men and women had a significantly higher risk of death compared with African-American men and women, although both groups had an elevated risk compared with those with a lower BMI.

Keep in mind that the "ideal" should always be considered in terms of one's height and overall body size, shape and frame. And of course, exercise and diet are also important factors which BMI doesn't consider. Lean muscle mass weighs more than fat, so good health is more than just weight in proportion to height. 

Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of U.S. adults. The New England Journal of Medicine, October 7, 1999: Vol. 341, No. 15, pp1097-1105.

bulletGood for the Body, the Mind and the Wallet 

Obesity has been linked to a number of serious conditions, including high blood pressure, type II (adult-onset) diabetes, coronary heart disease and stroke. Despite these associations, obesity is increasing in the United States, rising from an already unacceptable 25.4% from 1976-1980 to the staggering rate of 35.2% from 1988-1994.

In a study published in the October issue of the American Journal of Public Health, researchers evaluated the potential lifetime health and economic benefits of a sustained 10% reduction in body weight in men and women (35-64 years of age and suffering from mild, moderate or severe obesity). They estimate that this type of weight loss would:
bulletreduce the expected number of years of life with high blood pressure by up to three years; years with elevated cholesterol levels by almost one year; and years with type II diabetes by from 1/2 a year to nearly two years per person;
bulletreduce the expected lifetime incidence of coronary heart disease by 12-38 cases per thousand and stroke by 1-13 cases per thousand;
bulletincrease average life expectancy by 2-7 months per person; and
bulletreduce expected lifetime medical care costs associated with these diseases by $2,200-$5,300 per person.

Most of us need to lose a few pounds, but don't starve yourself for a temporary fix. If you want to live longer and avoid disease, get on a sensible diet that will take the pounds off steadily and keep them off. 

Oster G, Thompson D, Edelsberg J, et al. Lifetime health and economic benefits of weight loss among obese persons. American Journal of Public Health, October 1999: Vol. 89, No. 10, pp1536-42.

bulletWhen Work Causes Back Pain

We're all subject to back problems - it's one of the drawbacks (no pun intended) of walking upright on two legs. Couple that with life's variety of daily stresses, and it's all but guaranteed that most people eventually suffer from back pain. 

No matter what your occupation is, it's a source of daily or near-daily stress. Work-related factors have long been implicated as potential contributors to back pain, a hypothesis supported by recent research in the journal Spine. Four hundred and eighty-four men and women participated in a 24-year study to determine specific occupational factors related to low back pain (LBP). The study also evaluated whether interactions between psychosocial and physical factors, and between work-related and leisure-related factors, affected LBP. Results showed that:
bulletHeavy physical workload and sedentary work (i.e., jobs involving prolonged sitting or limited movement) increased the risk of LBP among men and women.
bulletAmong women, smoking and the combination of "whole-body vibrations" (a phrase used by researchers to designate jobs involving driving or operating machinery, etc.) and low influence over work conditions increased the risk of LBP.
bulletAmong men, high perceived load outside work (i.e., exercising, household responsibilities and/or repair, etc.) and the combination of poor social relations and overtime increased risk of LBP.

What can you do about back pain? First, be aware of "red flags" - factors at work and at home that may increase your risk. Second, schedule regular chiropractic appointments. Your doctor of chiropractic will evaluate any current back pain you might be experiencing and help prevent future back pain from occurring.

Thorbjornsson CB, Alfredsson L, Fredriksson K, et al. Physical and psychosocial factors related to low back pain during a 24-year period. Spine, Feb. 1, 2000: Vol. 25, No. 3, pp369-75.



Avoid Alcohol During Pregnancy

Even a Single Drinking Binge May Cause Brain Damage

Don't drink when you're pregnant - we've all heard the general warnings, but exactly how much is too much? Some health experts claim that expectant mothers can safely consume small amounts of alcohol (one drink per day) and still deliver a healthy baby, while others warn of the potential effects of fetal alcohol syndrome (FAS) - impaired growth, learning and coordination difficulties, and deformed facial features.

According to a study published in the February issue of Science, even the smallest amount of alcohol can jeopardize fetal health. Researchers administered a 20% solution of alcohol to seven-day-old rats in two separate treatments given two hours apart; a control group was treated with a saline solution for comparison. Twenty-four hours after the initial treatment, large numbers of neurons had been deleted from several major regions of the developing brain in the group exposed to alcohol. 

Although the study involved rats, the authors are quick to point out that this developmental stage (the first two weeks of birth in rats) coincides with human fetal development from the sixth month of pregnancy until birth. They warn that if a pregnant mother consumes alcohol for even a few hours in a single drinking episode, she could be putting her developing fetus at risk for neurological damage. Consult your team of health care professionals during pregnancy to ensure the health and safety of your child.

Ikonomidou C, Bittigau P, Ishimaru MJ, et al. Ethanol-induced neurodegeneration and fetal alcohol syndrome. Science, Feb. 11, 2000: Vol. 287, pp1056-60.


Lots of Antibiotics, Little Success 

Otitis media refers to inflammation of the middle ear area just behind the eardrum. Two out of three children under the age of three suffer at least one episode of otitis media, and up to one third experience six or more episodes by the time they start school. Common symptoms include irritability, difficulty sleeping, fussiness (in younger children), and ear pain and hearing loss (in older children). 

Antibiotics are standard treatment for this condition, even though little scientific evidence supports their use. A case in point comes from the British Medical Journal, which published a study comparing antibiotic treatment vs. placebo (no treatment) for acute otitis media. Among 53 general practices in the Netherlands, 240 children between six months and two years of age were randomly selected to receive either amoxicillin or placebo. Results showed only slight differences between the two groups with regard to symptom resolution (more common in the antibiotic group at day four, but similar by day 11); duration of fever (shortened by one additional day in the antibiotic group); and crying and/or pain (no differences between the two groups).

The authors conclude that if seven to eight children with acute otitis media are given amoxicillin treatment, only one child will experience symptom improvement by day four. They suggest that the effectiveness of antibiotics for this condition is limited, especially in children under two years of age. Contact your chiropractor for information on nonmedical approaches to resolving otitis media.

Damoiseaux RAMJ, van Balen FAM, Hoes AW, et al. Primary-care-based randomized, double-blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. British Medical Journal, Feb. 5, 2000: Vol. 320, pp350-54.


On the Safety of the Chiropractic Adjustment

The term "chiropractic" comes from the Greek word "Chiropraktikos," meaning "effective treatment by hand." Effective treatment by hand is exactly what chiropractors do, delivering gentle adjustments to the spine and musculoskeletal system to maximize wellness and prevent dysfunction. 

Complications resulting from any procedure are always unfortunate, regardless of the health care professional administering care. While a certain degree of risk accompanies all health interventions, specific concerns have been raised over the safety of spinal manipulation.

But have no fear: As a study in the Chiropractic Journal of Australia professes, the chiropractic adjustment is "one of the most conservative, least invasive and safest of procedures within the health care professions." The study compared complication rates, specifically cerebrovascular accidents(CVAs)and/or death attributable to spinal manipulation, nonsteroidal anti-inflammatory drugs (NSAIDs), and numerous medical procedures. The author emphasizes that the potential risk of "catastrophic" side-effects from spinal manipulation is substantially lower than most common medical procedures.

Rome PL. Perspectives: an overview of comparative considerations of cerebrovascular accidents. Chiropractic Journal of Australia, Sept. 1999: Vol. 29, No. 3, pp87-102.


Too Much Added Sugar

Carbohydrates, including sugars, comprise the body's primary source of energy. Sugar occurs naturally in many foods (i.e., fruits and dairy products), but there are countless processed foods that contain high amounts of refined sugar. A little sugar is OK, but too much can contribute to poor overall diet and poor health. The figures show that Americans consume far too much sugar on a daily basis.

As part of the U.S. Department of Agriculture (USDA) 1994-1996 Continuing Survey of Food Intakes by Individuals, 15,010 people two years of age and older recorded a 24-hour recall of dietary intake. Researchers calculated intake of added sweeteners, paying specific attention to average intake from all sources and from specific categories; contribution of added sweeteners to total energy intake; and percentage contribution of each food category to total added sweetener intake. 

An average of 82 grams of carbohydrates per day came from added sweeteners, accounting for 16% of total energy intake. (Nutritional guidelines recommend that between 6-10% of carbohydrates come from sugars.)


Adolescents consumed the most added sweeteners as a percentage of energy (20% of total energy intake).


The primary sources of added sweeteners were soft drinks (33%), sweets (candies, syrups, honey, table sugar - 16.1%), and sweetened grains (cookies and cakes - 12.9%).

If you're consuming a lot of sugar, you're probably not getting enough of the vitamins, minerals and other nutrients your body needs to function properly. In fact, the sweeteners Americans seem to consume most frequently (non-diet soft drinks, candy, syrups and jellies, etc.) possess no nutritional value whatsoever except for the sugar. Teach your children about the importance of a balanced diet that minimizes consumption of refined sugar. Your doctor of chiropractic can evaluate the nutritional status of your family and suggest appropriate modifications to maximize wellness.

Guthrie JF, Morton JF. Food sources of added sweeteners in the diets of Americans. Journal of the American Dietetic Association 2000: Vol. 100, pp43-48, 51.



Body Fat and Breast Cancer

A number of factors have been implicated as substantial risk factors for breast cancer, including family history of the disease and early onset of menstruation. Recent research also hints at a link between hormone replacement and breast cancer (See "Hormone Therapy May Contribute to Breast Cancer" in the News Archives). 

A study in the American Journal of Epidemiology reveals another possible contributor to this devastating disease: body fat distribution. As part of the Nurses' Health Study (1986-1994), 47,382 U.S. registered nurses reported their waist and hip circumferences at entrance and were monitored for the next eight years for incidence of breast cancer.

Increasing waist circumference was significantly related to breast cancer in postmenopausal, but not premenopausal, women. This association was maintained even when considering overall obesity and other breast cancer risk factors, and was even stronger among women who had never received hormone replacement therapy. Consult with a health care professional to learn how to minimize your risk of developing breast cancer.

Huang Z, Willett WC, Colditz GA. Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses' Health Study. American Journal of Epidemiology, Dec. 1999: Vol. 150, No. 12, pp1316-24.


Losing Weight with Green Tea

Green tea is rich in flavonoids, a group of plant pigments commonly known as bioflavonoids. Flavonoids function as antioxidants, protecting the body against some types of cancer; evidence that a subclass of flavonoids called "tea catechins" helps control fat oxidation suggests that green tea may play a role in weight management. 

The December 1999 American Journal of Clinical Nutrition included a study that explored this potential influence of green tea on weight loss. The authors began by explaining that "fundamentally, there are only two ways to treat obesity: reduce energy intake or increase energy expenditure." Relying on this premise, they compared the effect of green tea vs. placebo on 24-hour energy expenditure (EE - a higher EE means the body is burning more calories) and respiratory quotient (RQ - a lower RQ means the body is metabolizing more fat).

On three separate occasions, subjects (10 men) randomly received one of three treatments at breakfast, lunch and dinner: green tea extract (50 mg caffeine, 90 mg epigallocatechin gallate); caffeine (50 mg); or placebo. Subjects who ingested the green tea extract demonstrated a significant increase in EE and a significant decrease in RQ compared to subjects who ingested caffeine or placebo. The authors note that caffeine had no effect on EE or RQ, even in amounts equivalent to those found in the green tea extract (50 mg). Their results emphasize the potential ability of green tea (independent of caffeine) to "influence body weight and body composition."

Dulloo AG, Duret C, Rohrer D, et al. Efficacy of a green tea extract rich in catechins polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. American Journal of Clinical Nutrition, Dec. 1999: Vol. 70, pp1040-45.


Get Out of Bed and Stay ACTIVE

Rest has been standard recommendation for low back pain (LBP) for years, especially within the medical community. This recommendation persists despite research evidence (see "Sciatica: Bed Rest vs. Watchful Waiting" in the April 1999 issue of ToYour Health) suggesting that prolonged rest serves no purpose and may delay return to work and resumption of normal activities.

This report from the International Paris Task Force on Back Pain outlines the role of activity in the treatment of back pain. In addition to presenting numerous recommendations and summaries, the authors offer the following key points as summary to their findings:

Bed rest is contraindicated in subacute and chronic cases of LBP.


In acute cases, bed rest should neither be enforced nor prescribed.


If authorized (based on pain indication), bed rest should be for the shortest duration possible.


Patients whose pain is intense enough to justify bed rest should be referred for a specialized back pain evaluation if daily activities have not been resumed after 10 days of strict bed rest (defined as getting up only to go to the bathroom) and adequate pain therapy.

Are you suffering from low back pain? If you think bed rest is the solution to your pain, think again. As the authors note (see above), if your pain is in tense enough to justify bed rest, schedule a "specialized back pain evaluation" with an expert in managing and resolving back pain -- your doctor of chiropractic!

Abenhaim L, Rossignol M, Valat JP, et al. The role of activity in the therapeutic management of back pain: Report of the International Paris Task Force on Back Pain. Spine, Feb. 15, 2000 (supplement): Vol. 25, No. 4S, pp1-25.


DTP, Tetanus Vaccinations Cause Allergy Symptoms?

Infants and young children have been routinely vaccinated against diptheria, tetanus and pertussis since the late 1940s. Such vaccination practices have reduced the incidence of disease, although they have not come without a price.

A case in point comes from a recent study published in the Journal of Manipulative and Physiological Therapeutics. Data from the Third National Health and Nutrition Examination Survey (1988-1994) provided information on diptheria-tetanus-pertussis
(DTP) or tetanus vaccination, allergy history, and allergy symptoms in 13,944 children (two months to 16 years old).

Results showed that vaccinated children were twice as likely to have a history of asthma, and 63% more likely to suffer an allergy-related symptom in the previous 12 months, compared with unvaccinated children. These associations were particularly
strong in younger children (5-10 years of age).

The authors conclude that the number of allergies or allergy-related conditions attributable to vaccination may be high, as nearly all children in the United States receive at least one dose of DTP vaccine. Considering that chronic sinusitis, asthma and allergic rhinitis account for nearly 10 million care visits annually among children 15 and younger, parents should consult with their doctor to discuss the potential benefits and risks of vaccination. 

Hurwitz EL, Morgenstern H. Effects of diptheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. Journal of Manipulative and Physiological Therapeutics, Feb. 2000: Vol. 23, No. 2, pp81-90.


Weight Training: Is One Set Enough?

The physiological benefits of resistance training include increased strength, muscle size, lean body mass, bone mass, and overall physical function. Millions of Americans spend a number of hours each week at the local gym or health club, grinding out set after set in the quest for lifelong health and fitness.

The American College of Sports Medicine and the Surgeon General recommend a weight-training program requiring a minimum of one set of 8-12 repetitions for each muscle trained per exercise, and some research suggests that multiple sets may maximize the physical benefits. However, a recent study in Medicine & Science and Sports & Exercise adds to the mounting evidence that one set per exercise may be just as effective as two or more sets. Forty-two recreational weightlifters (20-50 years old, averaging 6.2 years of previous training) were divided into two groups and participated in a nine-exercise resistance training circuit. Group 1 performed one set of 8-12 repetitions for each of the nine exercises; Group 2 performed three sets under the same conditions. No significant differences were noted between the two groups after 13 weeks of training, with both groups improving significantly in terms of muscular endurance, one-repetition maximum strength, lean body mass, and overall body composition.

Your doctor of chiropractic can evaluate your current exercise regimen and outline nutritional and exercise guidelines suitable to your needs.

Hass CJ, Garzarella L, de Hoyos D, et al. Single versus multiple sets in long-term recreational weightlifters. Medicine & Science in Sports & Exercise 2000: Vol. 32, pp235-42.


Vitamin C Lowers Women's Risk of Gallbladder Disease

The gallbladder's most important function is to store bile, a substance manufactured in the liver which helps the body digest fatty foods. Cholesterol is a normal component of bile; if too much cholesterol accumulates in the gallbladder, gallstones eventually result.

Because estrogen is an important risk factor for gallstone formation (it increases the concentration of cholesterol in bile), women are at particular risk for the disease. Experimental animal studies suggest that ascorbic acid (vitamin C) may play a role in preventing gallstones, an observation that led to a recent study published in the Archives of Internal Medicine.

As part of the Third National Health and Nutrition Examination Survey, 7,042 women and 6,088 men provided data on vitamin C intake and the incidence of gallbladder disease. Results showed that increasing serum levels of ascorbic acid were related to a reduced risk for clinical and asymptomatic gallbladder disease in women, but not in men. Specifically, each standard increment increase in ascorbic acid level reduced the risk of a woman getting the disease by 13%.

Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among U.S. adults. The Third National Health and Nutrition Examination Survey (NHANES III). Archives of Internal Medicine 2000: Vol. 160, pp931-36.


NSAIDs May Contribute to Congestive Heart Failure

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for migraines, sprains, strains, and countless other conditions in which pain and/or inflammation result. NSAIDs have come under fire in recent years, with mounting evidence suggesting possible dangerous side effects associated with their use.

One of the most severe potential side effects may be congestive heart failure (CHF) in susceptible patients, according to a study in the March 27, 2000 issue of the Archives of Internal Medicine. Patients admitted to hospitals with a primary diagnosis of CHF (365 cases) were compared with patients without CHF (658 cases) admitted to the same hospitals for other conditions. Patients were interviewed to gather data on recent use of aspirin and other NSAIDs.

Results: Use of NSAIDs in previous week doubled the risk of hospital admission for CHF. Additionally, patients who reported taking higher levels of NSAIDs in the previous week were more likely to be admitted for CHF than patients taking lower levels.

Why this relationship exists is unknown, although the authors speculate that possible drug interactions (NSAIDs and other drugs used by heart patients) may contribute to the problem. They emphasize that "NSAIDs should be used with caution in patients with a history of cardiovascular disease." Talk to your doctor about the potential dangers of NSAIDs and other commonly prescribed drugs.

Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Archives of Internal Medicine, March 27, 2000:160, pp777-84.


Olive Oil Helps Prevent Colon Cancer?

According to mythology, the olive tree was brought to Greece from the goddess Athena. Olive oil has long been considered a symbol of excellence and purity, and increasing evidence points to its value in maintaining a healthy lifestyle and preventing disease.

Precisely this type of evidence appeared in a recent issue of the journal Gut, which published a study espousing the benefits of olive oil in preventing colon cancer. Rats were randomly assigned to receive a diet rich in one of three types of fatty acids found in oil (safflower oil, olive oil, fish oil). After one week receiving a 5% fat diet, each dietary group was redivided, with half of the animals receiving a cancer-causing agent and half receiving harmless saline.

Rats fed a diet supplemented with olive oil had a lower risk of colon cancer than those fed diets supplemented with safflower oil -- nearly as low as those supplemented with fish oil (an established colon cancer-fighting agent).

These findings add to the considerable evidence linking good nutrition with health promotion and disease prevention. Your chiropractor can provide you with more information on the value of nutrition in fighting disease, and help you develop a comprehensive wellness program for you and your family.

Bartoli R, Fernandez-Banares F, Navarro E, et al. Effect of olive oil on early and late events of colon carcinogenesis in rats: modulation of arachidonic acid metabolism and local prostaglandin E2 synthesis. Gut 2000: Vol. 46, pp191-99.


Never Too Late to Start Exercising

No doubt you've heard about the many documented benefits of physical activity: decreased incidence of disease and increased vitality and wellness. Are you participating in a consistent exercise routine? If you're not, it's never too late to start.

Consider a study that appeared in the British Journal of Sports Medicine last year which examined the potential relationship between balance and postural control deficits and the incidence of falls. Specifically, the authors sought to determine whether it is of value for the elderly to start physical and sporting activities=20 (PSA).

Sixty five men and women (aged 60-85) were divided into four groups based on reported levels of PSA (always practiced; never practiced; lately begun; or stopped at an early age), and a series of posture tests provided information on overall balance control and other variables.

Consistent participation in physical and sporting activities optimized balance control. Subjects who never practiced PSA had the worst balance control; subjects who always practiced PSA had the best control. Most interesting perhaps was the observation that subjects who had begun PSA late in life had nearly the same postural control as those who had always practiced PSA

As the authors suggest in their conclusion, "...PSA are extremely useful for elderly people even if it has not been a lifelong habit." These findings are particularly important, as accidental falls are the primary cause of death among the elderly population. Whatever your age, take advantage of the many benefits of consistent physical activity. For more information, contact your chiropractor.

Perrin PP, Gauchard GC, Perrot C. Effects of physical and sporting activities on balance control in elderly people. British Journal of Sports Medicine 1999:Vol. 33, No. 2, pp121-26.


Arthritis Sufferers: Get the Facts on Chondroitin Sulfate

Thin, brittle bones can break without warning - one of the most distressing complications associated with arthritis. There are more than 100 different types of arthritis. The common misconception holds that the disease only affects the elderly, but millions of young people, including children, are also affected.

Previous research suggests that exercise (see "Maintain Strong Bones with Exercise" in the News Archive), and nutritional factors  can help fight arthritis by improving bone strength. Further evidence of this potential nutritional role comes from the Journal of Rheumatology, which published a study evaluating the utility of chondroitin sulfate (CS) in the management of osteoarthritis.Chondroitin sulfate is the substance that gives cartilage (the spongy portion of bone) its elasticity and fluidity, suggesting its potential usefulness in influencing bone strength. This study reviewed previous controlled trials of CS in the treatment of hip and knee osteoarthritis (OA), finding that:
B7 In seven reviewed trials, reported pain was only 57% of original baseline scores in groups taking CS; and B7 Patients taking CS reported reductions in consumption of nonsteroidal anti-inflammatories (NSAIDs) and/or analgesics compared to baseline.

The authors emphasize that their results require additional support, but note that "There is evidence that chondroitin sulfate can reduce pain and improve function in patients suffering from osteoarthritis." If you or someone you know suffers from arthritis, talk to your doctor about the potential benefits of chondroitin sulfate.

Leeb FG, Scheweitzer H, Montag K, et al. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. Journal of Rheumatology, Jan. 2000: Vol.=2027, pp205-211.


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