by Carole Jackson, Bottom Line Health

No one wants to be overweight, have diabetes or grow old prematurely. Well, a new study shows that there’s a simple strategy that may help prevent all three that is actually quite fun and relaxing.

A massage might do the trick!

And I’m not talking about an expensive, hour-long massage, either—the latest research shows that an inexpensive massage lasting just 10 minutes can be beneficial.

MASSAGING YOUR MUSCLES TO FIGHT DISEASE

Researchers were interested in studying massage immediately after exercise for two reasons. For one thing, practically speaking, that’s a common time for people to get a massage, since many people say that massage helps reduce muscle soreness from exercise. Another reason is that, biologically, it’s easier to measure differences in the effect of massage on cells after exercise, because exercise puts the body into a state of temporary stress.

Volunteers in the study included 11 healthy, active men in their 20s who provided a bit of muscle tissue from one thigh for a baseline biopsy. Then researchers had the volunteers do 70 minutes of fast-paced cycling on a stationary bike. The volunteers rested for 10 minutes and then had a 10-minute massage on one thigh only. Immediately after the massage, researchers took second muscle biopsies, but this time from both thighs in order to compare massaged tissue versus nonmassaged tissue. Two and a half hours after the second biopsies, the volunteers underwent a third set of biopsies on both thighs to capture any changes that might have occurred a bit later after their massages.

To learn about the findings, I called Mark Tarnopolsky, MD, PhD, a professor of medicine and head of neuromuscular and neurometabolic disease at McMaster University in Canada, who was a coauthor of the study published in Science Translational Medicinethis past February.

STOP THE DAMAGE!

Dr. Tarnopolsky told me that the researchers found two very interesting differences in the muscles that had been massaged…

• A gene pathway that causes muscle inflammation was “dialed down” in these muscles both immediately after the massage and 2.5 hours after the massage. (Specific genes can be present in our tissues but not always active.) Dr. Tarnopolsky said that this is helpful knowledge because muscle inflammation is a contributor to delayed-onset muscle soreness, so it confirms biologically what we’ve always believed through anecdotal observation—a post-exercise massage can help relieve muscle soreness.
• Conversely, another sort of gene was “turned on” by the massage—this is a gene that increases the activity of mitochondria in muscle cells. You probably know that mitochondria are considered the “power packs” of our muscles for their role in creating usable energy. Now, it’s true that better mitochondrial functioning has been shown by other studies to help decrease insulin resistance (a key risk factor for type 2 diabetes) and obesity and even to slow aging. When I asked Dr. Tarnopolsky about whether or not it’s a stretch to link post-exercise massage to these benefits, he said that it’s not unreasonable—there is a potential connection, and future research will need to be done to confirm it.

TREAT YOURSELF TO MASSAGE

The massage type that Dr. Tarnopolsky and his colleagues used was a standard combination of three techniques that are commonly used for post-exercise massage—effleurage (light stroking)…petrissage (firm compression and release)…and stripping(repeated longitudinal strokes). It’s easy to find massage therapists in spas, salons, fitness centers and private practices who use these techniques. Or you could ask your spouse or a friend to try some of these moves on you (even if his or her technique isn’t perfect) because there’s a chance that it could provide the benefits, said Dr. Tarnopolsky—he just can’t say for sure, since that wasn’t studied.

Dr. Tarnopolsky studied massage only after exercise, so that’s when he would recommend getting one, but it’s possible that massaging any muscles at any time may have similar benefits—more research will need to be done to find out.

Remember, you don’t have to break the bank on a prolonged 60-minute massage—a simple 10- or 20-minute rubdown (which usually cost $10 to $40) can do the trick.

Source: Mark Tarnopolsky, MD, PhD, professor of medicine, department of kinesiology, McMaster University, Ontario, Canada.

by Carole Jackson, Bottom Line Health

If I had a nickel for every time I heard someone say, “Oh man, I ate too much. I shouldn’t have had that second serving,” I would have quite a few nickels!

Obviously, excessive eating is no good for your waistline…neither are all of the associated ailments of obesity. But, it gets worse. All that overeating actually may be making you forgetful. According to a new study—it can double the risk for memory loss. In other words, how much you put into your stomach greatly affects your brain.

I checked out the research to find out just how many extra calories put us at risk…

MILD BUT MEASURABLE MEMORY LOSS

While past studies have suggested that caloric intake is linked to Alzheimer’s disease, this report was one of the first to examine whether there is a link between high-caloric intake and a less severe form of memory loss called mild cognitive impairment (MCI). MCI is more than just age-related forgetfulness—it’s a bit more serious. People with MCI are generally able to function normally, but they might occasionally forget an event from the recent past or a future engagement. People with MCI, for example, may not be able to recall what they had for dinner the night before or they may forget about a planned trip later in the day.

The study included 1,233 men and women without Alzheimer’s between the ages of 70 and 90. Participants completed a questionnaire, which asked how much of specific foods and drinks they consumed and how often they consumed them, on average. Researchers used that information to calculate the caloric quantity each person consumed—they did not examine caloric quality (carbs, fats, protein, etc). Then researchers divided the participants into three equal-sized groups that represented the lowest, moderate and highest calorie intake. Each group contained both men and women. The first group consumed between 600 and 1,525 calories per day (the low-intake group)…the second group consumed between 1,526 and 2,142 calories per day (the moderate-intake group)…and the final group consumed more than 2,142 calories per day (the high-intake group). Later, an expert panel reviewed the brain function of the participants and 163 were classified as having MCI.

The researchers found that people in the high-intake group (those who ate more than 2,142 calories per day) had a significantly higher risk for MCI, with double the risk compared to the low-intake group. The results remained the same even after accounting for gender, body mass index, history of stroke and other risk factors. People in the low-intake and moderate-intake groups did not have a significantly higher risk for MCI.

To learn more about the findings, I called the lead author, Yonas E. Geda, MD, an associate professor of neurology and psychiatry at the Mayo Clinic in Scottsdale, Arizona. His research was presented in April at the annual meeting of the American Academy of Neurology in New Orleans.

MODERATION IS KEY

Dr. Geda explained that although the study didn’t try to answer the question of why more calories raise the risk for memory loss, one possibility is that consuming more calories increases the body’s production of reactive oxygen species (molecules containing oxygen). These cause damage to cell structure (oxidative stress), and that can lead to changes in the brain that affect memory.

So what’s the magic number of calories that you should try to stay under each day?

You might look at this study and assume that it’s 2,143 calories, but it’s important to remember that the study was looking only at people over the age of 70. Your age andyour activity level—as well as your gender, height and weight—can all affect how many calories you need, said Dr. Geda, so it’s best to figure out how many you need for energy and then make sure that you don’t go over that maximum. To figure out how many calories you need, follow this link from the Baylor College of Medicine:http://www.bcm.edu/cnrc/caloriesneed.htm

Source: Yonas E. Geda, MD, associate professor, neurology and psychiatry, Mayo Clinic, Scottsdale, Arizona.

by Carole Jackson, Bottom Line Health

Mmm, citrus. There’s nothing like a refreshing orange, a tangy tangerine or a sweet pink grapefruit. It really does taste like sunshine.

But these juicy fruits aren’t just delicious—they may actually help you ward off a stroke, according to new research.

And you may be surprised to hear that it’s not because of the vitamin C…

HONING IN ON FLAVONOIDS

A zillion studies have shown the health benefits of eating fruit, including studies that have shown that people who eat five or more servings of fruits and vegetables have a 25% lower risk for stroke (both ischemic and hemorrhagic) compared with those who eat three or fewer servings. Researchers have suspected that flavonoids, antioxidant compounds found in many fruits and vegetables, are one key to their power since they reduce inflammation and improve blood vessel function.

But there are six different types of flavonoids found in foods, and each has a subtly different chemical structure. Given the variety, researchers from England, Italy and the US wanted to learn which specific flavonoids and which fruits or vegetables, in particular, are most beneficial for preventing stroke.

To learn more about the study, I spoke to one of the authors—Kathryn M. Rexrode, MD, MPH, a physician in the division of preventive medicine at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School, both in Boston.

THE FLAVONOID THAT CAME OUT ON TOP

The researchers used information from 70,000 women who were followed for 14 years as part of the Nurses’ Health Study. Every two years, the participants completed questionnaires that covered their medical histories and lifestyles. And every four years, the women completed food questionnaires, which asked how much of certain foods and drinks they consumed and how often they consumed them.

The women’s diets were analyzed for the six different types of flavonoids, and their medical histories were reviewed for the number and type of strokes that the women had. What they found was that high consumption—more than about 63 milligrams per day of a certain subclass of flavonoids called flavanones (the amount found in about one to two servings of citrus per day)—was associated with a 19% reduced risk for ischemic stroke (the type caused by a clot, not by a bleed), compared with low flavanone consumption (under 13.7 milligrams per day). And this was after adjusting for other stroke risk factors, such as smoking, age, body mass index and others. The other five flavonoids studied reduced stroke risk, too, but not by as much (only by 4% to 13%).

Dr. Rexrode said that one reason that the flavanones may have been associated with decreased risk for ischemic stroke is that flavanones may inhibit platelet function and clotting factors. The researchers didn’t study whether citrus affected risk for hemorrhagic stroke, but Dr. Rexrode said that it’s unlikely that eating citrus would lead to an increased risk for hemorrhagic stroke. She said that it takes a relatively small amount of clotting to cause an ischemic stroke, but, on the other hand, it takes a relatively large amount of excessive bleeding to cause a hemorrhagic stroke.

Although this study, which was published this past February in Stroke, looked only at women, Dr. Rexrode said that there is no reason to think that these findings wouldn’t apply to men, too.

PICK YOUR CITRUS

Dr. Rexrode said that you can get all the flavanones you need (about 63 milligrams) from eating one or two servings of citrus each day. Whole fruits are always better than juices or smoothies, she said, because the bulk of the flavanones are found in the inner membranes of the fruit and the pith or white part of the fruit. The pith is generally removed when the fruit is juiced or cleaned for smoothies.

The USDA provides information about the amount of flavanones in every 100 grams of edible fruit, so to save you the trouble of weighing your fruits, here are estimates of the flavanone content for some common citruses:

Dr. Rexrode doesn’t recommend supplements—she said sticking to whole fruit is best. And don’t overdo it on citrus, or else your stomach or teeth might suffer from the acid. Just a serving or two a day is all you need!

Source: Kathryn M. Rexrode, MD, MPH, physician, division of preventive medicine, Brigham and Women’s Hospital, and associate professor of medicine, Harvard Medical School, both in Boston.

by Carole Jackson, Bottom Line Health

How many times have you said, “I don’t have time to exercise”? I’m sorry to tell you, but after you read this story, that excuse won’t work anymore.

A new study found that just three 30-minute sessions a week of a fancy-sounding type of activity called Modified High-Intensity Interval Training (MHIT) is an effective way to strengthen your cardiovascular system, which can lead to increased fitness, strength and weight loss. (It’s a lot like regular interval training, which you’ve surely heard of, but the intervals are even shorter.)

If it sounds hard, don’t sweat it. Researchers found that even cardiac rehab patients can handle MHIT—and gain from it.

GOING “ALL OUT”

The gist of MHIT is that it requires just three 30-minute sessions a week, ideally spaced a few days apart. So each workout is quick, but you work very hard during those short spans. Beyond a five-minute warm-up and a five-minute cool-down, it always involves some sort of aerobic activity, generally running, cycling or rowing. You alternate going at an easy pace for one minute with going “all-out” the following minute, repeating that two-minute pattern 10 times in a row.

Researchers in Canada were curious to see if a three-month regimen of short bursts of MHIT might help people who were in cardiac rehab (for either heart disease or heart attack) strengthen their cardiovascular systems more than they would by following a longer, standard exercise program done at a more moderate pace.

Here’s how the study worked: Researchers placed 22 male cardiac patients in either an MHIT program or a standard “moderate endurance” program. Both groups focused on stationary cycling, but the MHIT group did three weekly 20-minute sessions that consisted of the intervals described above, while the traditional exercise group did three longer weekly sessions (30 to 50 minutes) at a consistent moderate pace the entire time. Each group did a five-minute warm-up and a five-minute cool-down before and after each exercise session.

The findings: By the end of three months, both groups of exercisers showed virtually equal improvement. Blood flow improved by 41% in the MHIT group and 42% in the endurance group, and oxygen consumption improved 27% in the MHIT group and 19% in the endurance group. But the interesting part is that the MHIT group did it with just 90 total minutes of exercise per week, while it took the moderate exercise group a total of 120 to 180 minutes a week to achieve the same goal.

To discuss the study results, I called the study author, Maureen MacDonald, PhD, associate professor in the kinesiology department at McMaster University in Hamilton, Ontario. She explained that when your heart is forced to work at a higher-intensity level during MHIT, you can reap the same benefits in less time. I was surprised that cardiac rehab patients could handle such intensity, but Dr. MacDonald said that MHIT actually does not put any more stress on the heart than the standard exercise routine, because the “rest” intervals allow the heart to recover, so the heart doesn’t get overworked.

ADDING MHIT TO YOUR REGIMEN

If you’re interested in trying MHIT yourself but you have a serious health condition, Dr. MacDonald advises that you check with your doctor first. (Dr. MacDonald did not include people with chronic heart failure in her study due to the severity of the condition.) Otherwise, why not give MHIT a shot? MHIT needs to be done only three days a week, so you still can do strength training and stretching on other days of the week.

To try MHIT, choose your favorite aerobic exercise—whether it’s jogging, cycling or rowing—and follow these guidelines from Dr. MacDonald…

• Warm up for five minutes by lightly doing whatever aerobic activity you choose, so your breathing is light.
• For the one-minute intensity cycles, either increase your speed, increase your incline (such as running uphill) or increase the resistance if you are using gym equipment such as a stationary bicycle or elliptical machine. If you can keep track of your heart rate, either through a monitor that you wear or through a monitor on the machine that you’re using, increase your heart rate to 80% to 90% of your maximum rate. To determine your maximum heart rate, subtract your age from 220. It should be very difficult to carry on a conversation at this pace, and your muscles should feel like they are working very hard.
• For the one-minute recovery cycles, do not stop the activity, but simply slow your speed or reduce your incline or resistance back to normal. Your heart rate should be about 10% of your maximum (or about your “warm-up” pace). You should be able to carry on a conversation easily at this pace.

After 10 of these two-minute cycles, cool down for about five minutes (or until your heart rate goes below 100 beats per minute) by lightly continuing the aerobic exercise to bring your heart rate down.

Source: Maureen MacDonald, PhD, associate professor, department of kinesiology, McMaster University, Hamilton, Ontario, Canada.

by Carole Jackson, Bottom Line Health

At your annual physical, after your doctor wraps that blood pressure cuff around one of your arms, does he or she then wrap it around your other arm?

If your physician is anything like mine, then he probably doesn’t.

So what? Well, a new British study adds to the growing body of research showing that blood pressure measurements inboth arms are critical, because each arm may have a different measure—and the size of that difference can play a large role in your risk for cardiovascular problems.

THE HEART OF THE MATTER

Researchers at the Peninsula College of Medicine & Dentistry in England analyzed data from more than 20 studies on blood pressure monitoring. What they found: After five to 16 years of follow-up, researchers found that a difference of 15 mmHg of systolic pressure (the top blood pressure reading) between the two arms indicated 2.5 times the risk for peripheral artery disease…a 60% higher risk for stroke…and a 70% higher risk of dying of heart disease, compared with those whose left- and right-arm systolic pressure differed by less than 15 mmHg. And the risk for these events increased as the difference in systolic blood pressure increased over 15 mmHg.

Those particular increased risks were the same whether a patient’s two systolic numbers were, say, 115 and 100 or 170 and 155. But hypertensive patients, those with blood pressure readings over 140/90, are still at more overall risk, the researchers noted.

DOUBLE CHECKING

Here’s what had me baffled… If so many studies keep showing that the difference in blood pressure between the two arms matters, then why aren’t more doctors measuring both arms? I called lead study author Christopher E. Clark, MD, clinical academic fellow at the college, to hear his thoughts on the topic.

If your systolic pressure varies between arms, what’s likely going on? Dr. Clark said that, just like with past research, he and his coauthors suspect that there is a narrowing of the arteries (or a full-on blockage) on one side of the body compared to the other—the result of arterial disease—and that this narrowing can cause the systolic blood pressure to drop on that side.

Dr. Clark said that doctors in Europe and in the US are taught that taking blood pressure on both sides is a good idea, but it’s not mandatory in either place. In fact, fewer than half of doctors in Britain say that they regularly measure blood pressure in both arms, said Dr. Clark. He doesn’t have statistics for the US, but he speculates that the data is probably similar here. “Most doctors probably perceive taking a second measurement in the other arm as needlessly time-consuming. And, until now, the importance of doing so hasn’t been well-publicized,” he said. Hopefully, since his findings were published in January in The Lancet, the practice will become more widespread.

SPEAK UP

You could be at higher risk for cardiovascular problems than you realize. So on your next trip to the doctor, ask that your blood pressure be measured in both arms, said Dr. Clark. And in case the nurse or your doctor asks why, bring this article with you.

If you do have a dangerous difference in the measurements between arms, knowing early matters, because the sooner you are aware of your risk, the sooner you can start discussing lifestyle changes with your doctor, such as quitting smoking, exercising more and eating healthier foods—and possibly, pursuing cardiovascular medical treatment.

So don’t be shy—be a proactive patient!

Source: Christopher E. Clark, MBChB, MSc, FRCP, FRCGP, clinical academic fellow, Primary Care Research Group at the Peninsula College of Medicine & Dentistry, University of Exeter and Plymouth, England.

by Carole Jackson, Bottom Line Health

It’s bad enough that people are so desperate for sleep that they resort to taking any of a long list of pharmaceuticals in an effort to help them get a good night’s rest. Even worse is that these theoretical helpers come with a long list of associated dangers, including addiction.

Well guess what? The list of dangers just got longer.

Research, conducted by physicians at the Scripps Clinic Viterbi Family Sleep Center in San Diego and Jackson Hole Center for Preventive Medicine (JHCPM) in Wyoming, has shown that use of sleeping pills has been associated with an increased risk for cancer and death.

The most troubling part is that this study found that it’s not just daily users who are at risk—those who use them less than twice a month may even be at risk.

IT TAKES A WHILE FOR SIDE EFFECTS TO SURFACE

I called Robert Langer, MD, MPH, principal scientist and medical director at JHCPM, to learn more about these frightening findings. He told me that most studies on the safety of sleeping pills last only six months or less. “That’s not enough time to examine the risk for many serious health consequences, such as cancer or death,” said Dr. Langer. “Our research is more long-term, and we didn’t just look at whether or not people were taking sleeping pills. We also looked at which type they were using and how often they were taking the pills.”

The researchers looked at the electronic medical records of the population served by the Geisinger Health System (GHS) in Pennsylvania, the largest rural integrated health system in the US. Subjects (mean age 54 years) were 10,529 male and female patients who received prescriptions of sleeping pills as sleep aids (on-label), and 23,676 matched controls with no prescriptions of sleeping pills. They were followed for an average of 2.5 years.

The researchers found that the more sleeping pills that subjects took, the greater their risk for death from all causes and, shockingly, even people who were taking them only sporadically were at higher risk for death. For example, compared with those who did not take sleeping pills, people who took…

• One to 18 sleeping pills a year were 3.6 times more likely to die within the 2.5-year follow-up period.
• 19 to 132 sleeping pills a year were 4.4 times more likely to die.
• 133 or more pills a year were 5.3 times more likely to die.

These results did not differ whether the subjects were using older sleeping pills, such as temazepam (Restoril), or newer ones, such as zolpidem (Ambien), eszopiclone(Lunesta) and zaleplon (Sonata), which are marketed as being shorter-acting and safer.

Researchers also found an increased risk for all major cancers among moderate and heavy users of any sleeping pill. There was a 20% increased risk among any users who took 19 to 132 pills a year and a 35% increased risk among any users who took more than 132 pills a year.

It’s important to note that none of these results prove cause and effect, but they certainly reveal an unsettling association.

UNDERSTANDING THE CONNECTION

I asked Dr. Langer whether the results could simply be due to the fact that patients who take sleeping pills are usually in worse health—for example, perhaps they don’t eat well or exercise as much as they should or maybe they’re more stressed. His response was no. “We controlled for every possible variation, matching subjects and controls by age, gender and health history, yet the results remained the same,” Dr. Langer said.

So why the increased risk for death and cancer? The authors did not have adequate information to assess possible mechanisms. However, based on prior studies, potential mechanisms include increases in sleep apnea, accidents related to sleep walking/driving, aspiration pneumonia and depression of respiratory function.

NOW WHAT?

This is a finding of major consequence, because 6% to 10% of American adults took a sleeping pill in 2010, the most recent year for which statistics are available. But the complicating factor is that sleeping pills do provide health benefits. In other words, not taking a sleeping pill and potentially not getting enough sleep comes with its own set of risks—for instance, insomnia can raise the risk for heart disease, stroke, diabetes, obesity, depression and other serious health conditions. So if you’re taking sleeping pills, what do you do?

First, consult your prescribing physician, said Dr. Langer. “Don’t stop cold turkey, because that can cause withdrawal symptoms and agitation, as well as sleepless nights. Figure out a plan with your doctor about how to taper off,” he said. And then ask your doctor about safer alternatives, such as melatonin or manipulating light exposure, he said. You can also try cognitive behavioral therapy from an informed primary care doctor, behavioral therapist or sleep medicine physician, he added. And check out these lifestyle tips on how to get a good night’s sleep from the February 1, 2011 issue of a Bottom Line sister publication Bottom Line/Health “Can’t Sleep? A Pill Is Not the Answer”.

Source: Robert Langer, MD, MPH, principal scientist and medical director, Jackson Hole Center for Preventive Medicine, Wyoming.

by Carole Jackson, Bottom Line Health

Let me guess—you bought an iPad or another electronic tablet or received one as a gift, and now you feel pain in your neck and upper back.

There’s no doubt that tablet computers are fun and useful gadgets (in fact, around 70 million people bought them in 2011). But a new study shows that, depending on how you position one when you use it, you could be seriously straining your neck and upper back.

The study was coauthored by Jack T. Dennerlein, PhD, director of the Occupational Biomechanics and Ergonomics Laboratory and a senior lecturer on ergonomics and safety at Harvard School of Public Health in Boston. If you use a tablet, I think it’s important for you to know about his findings…

PICK YOUR POSTURE

To study how head and neck postures vary when using a tablet, the researchers asked 15 experienced tablet users to use two different tablets—the Apple iPad2 and the Motorola Xoom—while they were seated in armless chairs and hooked up to an infrared motion analysis system that precisely measured their head and neck postures. They were given cases that allowed the tablets to be propped up at a variety of angles, and they were asked to perform typical tablet tasks such as browsing the Internet…reading newspaper articles…playing solitaire…reading and writing e-mail…and watching videos. Each user tried four different positions that are popular among tablet users out in the real world…

• Lap-Hand: The tablet was held on the user’s lap without its case.
• Lap-Case: The tablet was put in its case at its lowest angle setting and was held in the user’s lap.
• Table-Case: A table was placed in front of the chair. The tablet was placed on the table in its case at its lowest angle setting.
• Table-Movie: Again, a table was placed in front of the chair. The tablet was placed on the table in its case at its highest angle setting (what lots of tablet owners do when they watch movies or other videos.)

WHY YOUR NECK ACHES

What the researchers found was that, except for when the tablet was in Table-Movie position, the users’ neck flexion (a measure of how much the chin points towards the chest) was quite large, about 15 to 25 degrees beyond a comfortable, looking-straight-ahead position. And this isn’t good! The concern, said Dr. Dennerlein, is that that level of neck flexion can strain the muscles in the back of the neck and the upper back, especially if a person uses the tablet in that position for more than just a few minutes at a time.

So how are you supposed to use your tablet without straining your neck?

• If you’re watching a video…The best thing to do, said Dr. Dennerlein, is to put the tablet on a table or other surface in front of you in a case that lets you keep the tablet perpendicular or nearly perpendicular (at its high angle)—as if it were a laptop screen. That way, your head will stay in a more neutral position, putting less strain on your neck and back. If you don’t have a case, you can put the tablet on the surface and prop it up with whatever’s handy—a rolled-up coat, a purse, a backpack.

• If you’re touching the screen…While sitting, instead of holding the laptop flat on your lap, try putting your bag or a few pillows on your lap and then putting the tablet on top of those things (ideally in its case at its low angle), said Dr. Dennerlein. That way, the tablet will be higher up so you don’t have to slump over as much to use it. While standing, try to hold the tablet like a clipboard, or rest it on a high counter if you can, as opposed to holding it horizontally at waist level.

But no matter which posture you choose, try to switch it up every 15 minutes if you can, said Dr. Dennerlein—that way you’ll vary which muscles you’re using and avoid straining one particular set.

For shoulder and neck stretches, read “Simple Stretches That Really Do Relieve Pain,”from our sister publication, Bottom Line Health.

Source: Jack T. Dennerlein, PhD, director, Occupational Biomechanics and Ergonomics Laboratory, senior lecturer on ergonomics and safety, Harvard School of Public Health, Boston.

By Carole Jackson, Bottom Line Health

There’s a new way to potentially prevent Alzheimer’s—a disease that we know frustratingly little about—and it’s not some exotic, expensive or potentially dangerous drug. It’s actually an affordable, natural component that’s found in everyday foods. For the first time, there’s a human study that confirms an association between dietary choline, an amino acid found in eggs and some other foods, and better cognitive performance. The study, from Boston University School of Medicine, appeared in the November 2011 issue of theAmerican Journal of Clinical Nutrition.

BRAIN BOOSTER

Researchers investigated the dietary habits of 744 women and 647 men ranging from 36 to 83 years of age. None had dementia when the study started. In the early 1990s and then again between 1998 and 2001, participants filled out a questionnaire about their diets—they were asked how often they had eaten particular foods in the past year. After the second questionnaire was given, the researchers performed neuropsychological tests to evaluate the participants’ cognitive skills, including verbal memory (remembering a story) and visual memory (remembering images). They also did MRI brain scans to see if there were any tell-tale lesions in the white matter areas called white-matter hyperintensities (WMH). WMH in the brain is considered a marker of vascular disease and is strongly associated with cognitive impairments that precede Alzheimer’s disease.

The results: First, this study demonstrated that people who were currently eating the most choline performed better on tests of verbal and visual memory, compared with those who currently had the lowest choline intake. Researchers also found that those who had eaten the highest amounts of choline years earlier (as demonstrated by the first questionnaire) were more likely to have little or no WMH. In other words, eating lots of choline may make your memory sharper, and it also may reduce the risk for damage to the brain and even Alzheimer’s disease.

HOW THE NUTRIENT PROTECTS YOUR NOGGIN

To learn more, I called study coauthor Rhoda Au, PhD, associate professor of neurology at Boston University. Dr. Au emphasized that this is an observational study, so it doesn’t prove cause and effect, but it does show a link between choline and memory. Why? Choline’s crucial contribution to cognition, said Dr. Au, may be as a building block for a neurotransmitter called acetylcholine, which is known to help transmit information between neurons faster.

DIET “DOs”

How much choline do you need each day? The recommendation from the Institute of Medicine for men is a daily intake of 550 mg and for women, 425 mg. The richest food sources are…

• 3.5 ounces of beef liver—430 mg
• One large egg—126 mg
• 3.5 ounces of salmon—91 mg
• 3.5 ounces (just under one-half cup) of broccoli, Brussels sprouts, cauliflower or navy beans—approximately 40 mg.

Other sources of choline include cod, almonds, tofu, milk and peanut butter.

Supplements of choline are available, but high doses (more than 3,500 mg per day for adults over age 18, according to Institute of Medicine) can cause symptoms like vomiting and excessive sweating. So if you want to take a supplement, talk to your doctor first—discuss how much you eat in your diet already so you can figure out whether (and what amount of) a supplement is necessary.

What’s so exciting about this research, in my view, is that while most studies concerning dementia are performed with people who already show signs of it, this study set out to investigate what people can do that might prevent dementia—and the choline connection seems promising. It’s so easy to get more choline in our diets—it’s in our refrigerators right now!

Source: Rhoda Au, PhD, associate professor of neurology, Boston University School of Medicine, and director of neuropsychology, Framingham Heart Study.

by Carole Jackson, Bottom Line Health

Everyone knows about calcium and fish oil, but there are a whole lot more healthful supplements out there—ones that you may never have heard of but that might do your body some good. To uncover some of these lesser-known supplements, I called five health-care providers who are experts in natural and complementary health—and each one told me about one of his/her favorites. Before you take any of these supplements, always talk to your doctor, because some might negatively interact with drugs or other supplements that you’re taking or cause unwelcome side effects. And first check your multivitamin to see if you’re already getting at least some of these nutrients.

SELENIUM TO BOOST OUR IMMUNE SYSTEM

Andrew Rubman, ND, founder and medical director of Southbury Clinic for Traditional Medicines in Southbury, Connecticut, said that consuming more of the mineral seleniumis a must for many people. It boosts immunity, but we often don’t get enough in our diets—sometimes because common stomach problems interfere with the digestion of the mineral. Selenium is found naturally in soil, so it’s in foods like grains and vegetables (and in some meats, since animals feed on those foods), but unless you eat a lot of those foods and have robust digestion, you’re likely deficient. Plus, due to regional variations in selenium concentrations in soil, even some foods that contain the mineral may not have much. For his patients, Dr. Rubman may prescribe four drops daily of Aqua Sel, a selenium supplement—this provides 380 mcg of selenium. Dr. Rubman prefers this brand because it’s inexpensive and well-absorbed and has a clean taste.

NAC TO DETOX THE LIVER AND LUNGS

Richard Firshein, DO, director of the Firshein Center for Comprehensive Medicine in New York City, prescribes N-acetylcysteine (NAC) for people with certain health problems (mentioned below). NAC is a building block of the antioxidant glutathione that helps detoxify foreign substances in our liver and lungs and also fights damaging free radicals. In his practice, Dr. Firshein prescribes a daily dose of 500 mg to 1,000 mg of NAC for patients with chronic asthma or certain liver problems (usually due to excessive alcohol consumption or elevated liver enzymes), and it shows promise as a supportive treatment for chronic obstructive pulmonary disease (COPD). If you meet any of these criteria, ask your doctor if NAC can help. NAC is found in small amounts in a variety of protein-rich foods (such as meat, poultry, seafood and others), but Dr. Firshein says that to achieve “therapeutic levels,” it’s best to consume it in supplement form.

CoQ10 FOR EXTRA ENERGY

I spoke with Thomas Kruzel, ND, of the Rockwood Natural Medicine Clinic in Scottsdale, Arizona, about coenzyme Q10 (CoQ10). Dr. Kruzel said that it may be wise to start taking it as you get older if you find that it boosts your energy (some people don’t feel a difference, he said). CoQ10, found naturally in foods such as meat and fish, helps cells produce energy, and as we age, our bodies’ ability to manufacture CoQ10 decreases—unfortunately just as our bodies require more of it to function properly. On top of that, Dr. Kruzel said, commonly prescribed cholesterol-lowering statin drugs deplete natural stores of CoQ10. So he prescribes it for patients on statins, those who suffer from fatigue and anyone who requires an extra boost (such as athletes in training). Long-term use is not necessary, he said, except for those on statins, because once you start taking CoQ10 for a little while, the body eventually replenishes its supply. For those of his patients in need, he typically prescribes between 100 mg and 200 mg per day in capsule or gel-cap form.

IODINE TO GET RID OF ACHES AND PAINS

Jamison Starbuck, ND, in family practice in Missoula, Montana, told me why she often prescribes supplemental iodine. Iodine is a mineral found mostly in seafood that helps the body synthesize hormones, including thyroid hormone. But many of us aren’t getting enough, she said, because iodine has been slowly but steadily leaving our food stream. The chemicals in fertilizers used in modern farming and chlorine added to water bind to iodine and prevent it from being utilized by our bodies. And many people avoid foods with ordinary table salt due to cardiac risk factors, so they don’t get the healthful iodine that has been added to it. Not having enough iodine can lead to symptoms of an underactive thyroid, such as sluggishness, dry hair, a goiter (a swelling in the thyroid gland) and fibromyalgia (aches and pains all over the body). So Dr. Starbuck prescribes up to 50 mg a day in liquid form for people whom she has diagnosed by a urine test as significantly iodine deficient. Caution: Too much iodine can be harmful, So Dr. Starbuck watches her patients for adverse reactions such as headache, rash and racing heartbeat.

ALPHA-LIPOIC ACID FOR DIABETICS

Richard Horowitz, MD, of the Hudson Valley Healing Arts Center in Hyde Park, New York, said that alpha-lipoic acid, which is found in foods such as red meat and liver, works as an antioxidant, so it fights disease all over the body. It also regenerates other antioxidants, such as vitamins A and E, and improves insulin sensitivity, so it reduces your risk for cardiovascular disease and diabetes, and it may help reduce blood sugar levels. Dr. Horowitz typically prescribes 300 mg to 600 mg per day in pill form…while those patients with diabetes and/or cardiovascular risk factors will often be prescribed up to 1200 mg per day.

Sources: Richard Firshein, DO, founder and director, Firshein Center for Comprehensive Medicine, New York. www.firsheincenter.com twitter: @DrFirshein

Richard Horowitz, MD, Hudson Valley Healing Arts Center, Hyde Park, New York.

Thomas Kruzel, ND, Rockwood Natural Medicine Clinic, Scottsdale, Arizona.

Andrew Rubman, ND, founder and medical director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut. www.SouthburyClinic.com

Jamison Starbuck, ND, naturopathic physician in family practice, Missoula, Montana.

by Carole Jackson, Bottom Line Health

A friend who is undergoing treatment for breast cancer gave me a book that she had just finished reading. She found it so helpful that she thought I would want to share it with Daily Health News readers. I read it over the weekend, and she’s right — it’s quite a story. It’s filled with unusual ideas that may help patients with all kinds of cancer — not only breast cancer — beat their disease. What gives the story a unique twist is that the author, Kim Allison, MD, is the director of breast pathology at the University of Washington Medical Center in Seattle… and Dr. Allison had been promoted into this position just a few weeks before learning, at age 33, that she had an aggressive form of breast cancer with an average five-year survival rate of only 40%.

Today, four years later, she is healthy — and the book, Red Sunshine: A Story of Strength and Inspiration from a Doctor Who Survived Stage 3 Breast Cancer, explains how she got that way. I called her to find out more.

Knowing how serious her cancer was, Dr. Allison told me, she chose a “take no prisoners” treatment plan that included chemo, radiation and surgery. She decided to have both breasts removed even though she had cancer on only one side. But those aren’t the parts of her treatment that make her story so unique and valuable… it’s the things that she did in addition to that — which doctors almost never tell their patients to do!

ADDING A SECOND APPROACH

As a specialist, Dr. Allison knew as much as anyone could about how to treat her disease medically, but she decided to also develop her own “alternative” treatment strategy so she could feel that she was marshaling every possible resource that might improve her odds of survival.

Even as a healthy person not facing cancer or any other serious illness, I found her approach inspiring. It’s important to note that Dr. Allison isn’t sure that any of the following actions helped cure her cancer, but she did tell me that they made the journey less onerous. “These strategies changed my perspective and helped me get through each day,” she said. Here are some highlights from the book and our conversation…

THREE BIG IDEAS

I adjusted my attitude. Early on, Dr. Allison decided that she wanted to consider her fight an “opportunity to grow and learn about how tough I can be” rather than just questioning why something so bad had happened to her. She decided that the poison being dripped into her veins — a potent drug called doxorubicin, nicknamed the “Red Devil” because of its deep, red color and horrible side effects — should be considered her ally, so she renamed it “Red Sunshine.” “That was an important mental switch, because it made me want to show up for treatment,” she said.

I recruited several great teams. As a busy working mother — with a four-year-old daughter, an infant son and a husband who had recently opened a restaurant — Dr. Allison needed all the help that she could get with her disease and her life. She was fortunate to have friends and family members who were available and willing to assist her. This isn’t always possible, she said, but it never hurts to ask for help. She appointed these people to be “gurus” of different things. For example, one was in charge of music (downloading tunes onto her iPod for her to listen to during chemo) and another, who still lived near her parents in California, was assigned the task of helping her parents cope from afar.

Dr. Allison’s medical treatment team included a pathologist, an oncologist and two surgeons. But she also worked with a physical therapist, who taught her techniques to avoid complications like lymphedema (swelling in the arms) after surgery… a nutritionist (who helped her eat a well-balanced diet)… a personal trainer (who helped her continue to work out by encouraging her to walk and do strength training and yoga)… a naturopath (who advised her on supplements that might help with treatment side effects)… and an acupuncturist (who helped her keep her stress and pain levels under control). This was an expensive group, no doubt, but Dr. Allison told me that many major cancer centers offer some of this support for free — and you often can get insurance to cover at least part of the cost.

I believed in “magic.” Though her career is all about science, Dr. Allison said that she was willing to believe in magic, too. She visited a shaman — a spiritual adviser — an experience she found enriching in ways that she never expected. And, with the help of her mother (who visited regularly) and a friend, she created a “healing ritual” in her backyard. “We stated out loud in a united way that I was planning to destroy the cancer that had grown inside of me. Then I burned an image of my cancer in a fire,” she said.

I’m so glad that Dr. Allison’s cancer is now considered “most likely cured,” since there was no residual cancer after chemotherapy was completed — and she’s feeling great. Only future research can determine whether or not her unusual, two-tiered psychological and medical approach can make a significant difference, in terms of fighting off cancer — but in my opinion, I’m sure it didn’t hurt.

Source(s):

Kim Allison, MD, director of breast pathology, University of Washington Medical Center, Seattle, and author of Red Sunshine: A Story of Strength and Inspiration from a Doctor Who Survived Stage 3 Breast Cancer (Hatherleigh).