Exercise Key to Keeping Back Pain Away

If there's one health problem most people will suffer from at some point in their lives, it's back pain. Back pain accounts for more than half of all musculoskeletal disorders, and chronic low back pain (LBP) accounts for the majority of the health care costs associated with repeated treatment, long-term work absenteeism and early retirement. What can be done about back pain? Exercise may be one answer, according to a recent study involving 125 LBP patients. All patients had previously participated in a 12-week low-back rehabilitation program. Results showed that patients who exercised consistently following treatment suffered from less pain and missed less work, compared with patients who remained inactive following treatment. You may not be able to avoid back pain, but when it hits, there's definitely something you can do about it. Your doctor can provide you with more information on the causes and treatment for back pain. Information can also be accessed on line at http://www.chiroweb.com/tyh/backpain.html Reference: Taimela S, Diederich C, Hubsch M, et al. The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain: a follow-up study. Spine 2000: Vol. 25, No. 14, pp1809-16.

Less "Whaa" with Whey

If you're a first-time parent unaccustomed to dealing with a crying baby, just imagine caring for a baby suffering from colic - inconsolable bouts of crying lasting for three hours or more, three or more days a week for three weeks or more. Other symptoms associated with infantile colic include facial flushing, abdominal distention, and gastrointestinal difficulties. Cow's milk has been suspected as a culprit in infantile colic. In a study designed to investigate whether alternative formulas may help ease colic, 43 colicky infants received standard formula milk or whey formula (made from a byproduct of cheese manufacturing) for one week, with improvements documented at 10-minute intervals around the clock. Results showed that infants receiving whey formula cried an average of 63 minutes less per day than infants receiving standard formula, leading the authors to conclude: "Substitution of cow's milk formula by an extensively hydrolyzed whey formula is effective in the treatment of infantile colic." If you have a healthy newborn showing any of the symptoms of colic, talk to your doctor about possible solutions, including substituting cow's milk with whey formula. For additional online information on colic and other childhood conditions, go to http://www.chiroweb.com/tyh/childhood.html. Reference: Lucassen PLBJ, Assendelft WJJ, Gubbels JW, et al. Infantile colic: crying time reduction with a whey hydrolysate: a double-blind, randomized, placebo-controlled trial. Pediatrics, Dec. 2000: Vol. 106, No. 6, pp1349-54.

The Long and Short of It

An estimated 60% of U.S. adults fail to participate in regular physical activity, and nearly one in four aren't active at all -- despite the established associations between exercise and the risk of coronary heart disease (CHD), cancer, and numerous other life-threatening conditions. If time and/or energy constraints keep you from exercising, take note of the results of the Harvard Alumni Health Study. More than 7,000 healthy men reported the number of city blocks and flights of stairs they walked each day, and their weekly participation in recreational activities (frequency and duration). Follow-up questionnaires were used to determine how many men had developed CHD or related heart conditions. Exercise duration had little or no effect on CHD risk, after adjusting for total energy and other variables. Specifically, longer sessions of exercise were no more effective than shorter sessions in reducing risk, when total energy expenditure remained constant. So get off that couch and start exercising! If multiple short exercise sessions are as efficient as a single long session, you've got no excuse for staying inactive. Ask your doctor to help outline a fitness regimen suitable to your needs. Reference: Lee I-M, Sesso HD, Paffenbarger Jr. RS. Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk? Circulation 2000: Vol. 102, pp981-96.

Third-Generation Oral Contraceptives Increase Clot Risk

What's a "third-generation" oral contraceptive? Basically, it's the latest form of the birth control pill, containing a combination of the hormones desogestrel or gestodene and small doses of estrogen. Earlier forms of the pill, specifically "second-generation" oral contraceptives, contain different hormones (levonorgestrel and low-dose estrogen) in different amounts. The distinction between second and third-generation oral contraceptives is important because previous research (three studies in 1995) links the latter form of the pill to increased risk for blood clots. A more recent study in the British Medical Journal, involving more than 361,000 women monitored from 1993-1999, supports this notion. The study noted approximately double the risk in women taking third-generation contraceptives vs. women taking second-generation contraceptives. These results were maintained after considering other potential causes of blood clots. Talk to your doctor about the pros and cons of oral contraception and other forms of birth control. For more information on women's health issues, visit http://www.chiroweb.com/tyh/women.html. Reference: Jick H, Kaye JA, Vasilakis-Scaramozza C, et al. Risk of venous thromboembolism among users of third-generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995: cohort and case-control analysis. British Medical Journal, Nov. 11, 2000: Vol. 321, pp1190-95.

When Pain Strikes at the Workplace

Complaints of musculoskeletal pain (especially low back pain) account for more than 300 million physician visits annually in the U.S. alone, despite advances in research, treatment and rehabilitation. More than 50% of women experience at least one episode of low back pain (LBP) by age 18; 50% of men experience the same by age 20.

In a study designed to investigate potential workplace factors contributing to musculoskeletal pain, 6,626 men completed a questionnaire and physical and psychological examinations at age 18 (1979-1980). In 1999, 6,266 of the original subjects were located and completed a follow-up questionnaire. Both the baseline and follow-up questionnaires focused on back and neck pain and exposure to physical load in the work environment; the follow-up questionnaire also contained a self-administered test of physical function.

A significantly higher risk of frequent back, neck and/or shoulder problems was noted at follow-up in men who performed heavy work or who described a "great effect of back pain on everyday activities" at baseline. Specifically, early back pain causing work absence, reduced activity, and heavy workload corresponded with higher risk for future back pain.

What can you do to combat musculoskeletal pain? For tips on prevention and management of this all-too-common condition, schedule an appointment with your doctor of chiropractic! For more information on back pain, visit http://www.chiroweb.com/tyh/backpain.html.

Reference: Hellsing AL, Bryngelsson IL. Predictors of musculoskeletal pain in men. A twenty-year follow-up from examination at enlistment. Spine 2000: Vol. 25, No. 23, pp3080-86.

Physical Activity: Good for Your Baby's Bones

A fair amount of research, some of which we've reported in previous issues, suggests that exercise can positively affect bone content. The majority of this research has investigated bone mineralization in adults. However, because evidence supports the notion that mechanical loading on bones and joints can stimulate growth, the authors of this study in Pediatrics evaluated whether exercise could exert the same bone-building influence in infants.

The study group consisted of 32 preterm infants at substantial risk for inadequate bone mineralization because of their premature entry into the world. Sixteen infants were assigned to a physical activity (PA) subgroup, with the remaining 16 comprising the control group. Physical activity involved range of motion against passive resistance to all extremities, five to 10 minutes daily.

Infants in the physical activity group showed greater gains in body weight, forearm bone length, bone area, bone mineral content, and fat-free mass compared with infants in the control group. These results were noted despite similar nutrient intake between groups at baseline and throughout the study period. Additionally, biomarkers of bone formation remained constant in the PA group, but dropped in the control group, suggesting that improved rates of bone formation corresponded to physical activity. The authors summarize their findings by recommending that "A daily active program for healthy preterm infants promotes increased forearm length and bone area."

Reference: Moyer-Mileur LJ, Brunstetter V, McNaught TP, et al. Daily physical activity program increases bone mineralization and growth in preterm very low birth weight infants. Pediatrics, Nov. 2000: Vol. 106, No. 5, pp1088-92.

Spontaneous Abortion: Caffeine May Be a Culprit

Spontaneous abortion is defined as "a spontaneously occurring termination of pregnancy before the 20th week with expulsion of the fetus." research aimed at preventing spontaneous abortions has focused on several potential culprits, including caffeine - a substance known to pass readily through the placenta to the fetus. A study in The New England Journal of Medicine investigated this premise, dividing 1,515 women into two groups for comparison. The first group included 562 women who had suffered spontaneous abortion at 6-12 weeks' gestation; the second group consisted of 953 women who had not suffered spontaneous abortion.

Interviews served to gather data on sources and amount of caffeine intake, including coffee; tea; cocoa; chocolate; soft drinks; and caffeine-containing medications. Smoking status, a potential conflicting variable (because of its influence on birth outcomes), was also determined.

Among nonsmokers, spontaneous abortion occurred at a significantly higher rate in women who ingested at least 100 milligrams of caffeine per day, compared to women who ingested less than 100 mg per day. Among smokers, caffeine ingestion was not associated with an increased risk of spontaneous abortion. The authors note that the first group consisted mostly of women who had suffered spontaneous abortions in the second trimester, and suggest that caffeine may be even more detrimental to the developing fetus in the first trimester.

If you're expecting a child, talk to your doctor about what steps you can take to ensure a smooth pregnancy and delivery. For more information on women's health, visit http://www.chiroweb.com/tyh/women.html.

Reference: Cnattingius S, Signorello LB, Anneren G, et al. Caffeine intake and the risk of first-trimester spontaneous abortion. The New England Journal of Medicine 2000: Vol. 343, No. 25, pp1839-45.

Preventing Allergies with vitamin E

The antioxidant properties of vitamin E make it an important weapon against cancer and cardiovascular disease. vitamin E also promotes normal blood clotting, helps reduce blood pressure, and promotes healthy skin and hair, along with a variety of other functions.

The value of vitamin E may also extend to the battle against allergy symptoms, according to the results of a recent study published in the British journal The Lancet. Data drawn from a random sample of 2,633 adults (18-70 years old) showed that increased intake of vitamin E reduced levels of the allergy-related antibody IgE. This relationship proved incremental, such that each one-milligram increase in vitamin E (up to a maximum of seven milligrams) corresponded with more than a five percent decrease in serum antibody levels.

Good sources of vitamin E include cold-pressed vegetable oils, dark-green leafy vegetables, nuts, seeds and whole grains. So what are you waiting for? If you're an allergy sufferer, visit your local market today and get yourself some vitamin E! To learn more about the benefits of nutrition, talk to your doctor, and visit http://www.chiroweb.com/tyh/nutrients.html.

Reference: Fogarty A, Lewis S, Weiss S, et al. Dietary vitamin E, IgE concentrations, and atopy. The Lancet, Nov. 4, 2000: Vol. 356, pp1573-74.