Understanding Whiplash

Whiplash is a severe injury to the vertebrae, muscles, or ligaments of the neck caused by a sudden forward and backward jerking of the head and neck. It is the most common injury following car accidents, usually happening in rear-end collisions, and causes long-term pain and stiffness in the neck. Other possible symptoms of whiplash include back pain, headache, dizziness, and blurred vision.

A recent edition of the journal Spine offered an updated whiplash review from the Canada-based Quebec Task Force, and proposed regular reviews of known predictive factors. The review included 13 whiplash studies published since 1995. The studies revealed the most common predictors associated with delayed whiplash recovery. Patients with slower recovery times were most likely to be older and female, and to have initial head, neck, or other chronic pain.

Doctors of chiropractic have the skills and training to effectively relieve the pain and other debilitating symptoms of whiplash by restoring your full range of motion, realigning your spine, and increasing the strength and flexibility of your neck muscles. If you experience the symptoms of a whiplash injury in a rear-end car accident - even at 5 mph - seek treatment immediately, no matter how minimal the pain. Don't wait for the symptoms to go away: By avoiding treatment, you will only prolong your recovery and lower your quality of life.

Talk to your doctor of chiropractic about whiplash, or click here for more information.

Reference: Cote P, Cassidy JD, Carroll L, et al. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001:26(19), pp. e445-e458.

Haste Doesn't Make Waste

With age, people experience a progressive loss of muscle mass and strength that can seriously reduce functional abilities. Weight training can be an important way to counteract this process. Proper diet, especially consuming protein after a workout, can also help to gain muscle size and strength. Does it matter when this protein is ingested, though?

A recent study in The Journal of Physiology determined the importance of when a protein supplement was taken after exercise in seniors. Thirteen 70- to 80-year-old men completed a resistance-training program consisting of three strength exercises (leg press, knee extension, and lat pulldown - a back exercise) done on fitness equipment, performed three times per week. Seven of the men took a protein supplement within five minutes of exercise, while the remaining six took the supplement two hours later.

After 12 weeks, leg muscle size, isokinetic strength (force against a nonmoving object), and overall lean body mass increased in the immediate-supplementation group only. Both groups increased the amount of weight used in their workouts - but the immediate-supplementation group increased their strength by a larger margin.

If you are advancing into your senior years, it's especially important that you maintain a regular workout to retain your ability to perform daily physical tasks. Regular resistance training or weightlifting can successfully prevent or slow muscle and tissue loss. Also, be sure to eat a protein supplement or high-protein food - poultry, fish, eggs, milk, beans - immediately after you work out. Protein is the building block your muscles require for repair and growth.

Reference: Esmarck B, Andersen JL, Olsen S, et al. Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans. The Journal of Physiology 2001:535, pp. 301-311.

For more information on senior health issues click here.

Can Birth Control Pills Weaken Your Bones?

Oral contraceptives, or birth control pills, are taken by countless women in an effort to avoid unwanted pregnancy. Bone mineral density (BMD) is a measure of how strong bones are - and how likely they are to break. Studies have shown an association between these pills and changes in BMD and fracture rates. Although most data regarding oral contraceptives suggest that they increase BMD, few of these studies have focused on premenopausal women who use the pill for birth control.

A study in the Canadian Medical Association Journal focused on the bone densities of young women using birth control. Over 500 women ages 25 to 45 were evaluated for oral contraceptive use, lifestyle trends, sociodemographics, and medical histories in the Canadian Multicentre Osteoporosis Study. Only women who had used birth control pills for at least three months were considered users. BMD was measured in the spine, upper leg, and pelvis using a type of x-ray.

BMD values were lower at all measurement sites in women who used oral contraceptives, compared to women who had never used them. BMD was reduced 2- 4%, which may not sound like much. Decreases in BMD this large may translate into an increased fracture risk of 20-30%, however. Eighty-seven percent of the women in this study had used oral contraceptives at some point in their lives for at least three months.

If you or anyone you know is taking birth control, be aware of all possible risks and side effects of the drugs. Talk to your doctor of chiropractic for more information or click here.

Reference: Prior JC, Kirkland SA, Joseph L, et al. Oral contraceptive use and bone mineral density in premenopausal women: Cross-sectional, population-based data from the Canadian Multicentre Osteoporosis Study. Canadian Medical Association Journal 2001:165(8), pp. 1023-1029.

Dodge Diabetes with D

Type 1 diabetes is a condition in which the body does not properly produce or utilize insulin, a hormone that helps us digest the food we eat. People with type 1 diabetes (usually children) experience a build-up of blood sugar that passes out of their body in their urine, draining the fuel they need. As a result, diabetics must regulate their bodies' insulin levels through careful monitoring and injections of the hormone. Infants' diets can affect their likelihood of developing type 1 diabetes later, and studies have suggested that adequate vitamin D intake may help prevent diabetes.

The purpose of a recent study in The Lancet was to determine if infant vitamin D deficiency is linked with the onset of type 1 diabetes. The mothers of over 10,000 children in Finland completed a questionnaire to determine vitamin D intake. Infants who received the Finnish minimum recommended daily intake of 2,000 international units (IU) of vitamin D were 80% less likely to develop type 1 diabetes over 30 years than those with lower vitamin intakes.

Current guidelines in America only recommend providing 200 IU of vitamin D to infants daily. Why do Americans require less vitamin D? Due to the geographic location of Finland (a far northern latitude), the country's inhabitants receive little sunlight. The sun stimulates a chemical reaction in the body that creates vitamin D, so individuals in Finland synthesize less vitamin D in their own bodies than individuals who receive ample sunlight on their skin regularly, justifying the higher supplementation recommendations.

Be sure your baby receives adequate vitamin D in the first year, but don't exceed the guidelines: Excessive levels of vitamin D are potentially toxic. For most children and adults, just 15-20 minutes of sunlight on the face or arms two to three times per week is enough to provide the body with adequate vitamin D. Foods containing high amounts of vitamin D include vitamin D-fortified milk, eggs, and fish.

Reference: Hypponen E, Laara E, Reunanen A, et al. Intake of vitamin D and risk of type 1 diabetes: A birth-cohort study. The Lancet 2001:358, pp. 1500-1503.

To learn more about the benefits of vitamins and minerals click here.

Possible Side Effects Include...

You've probably seen numerous television commercials lately advertising new prescription drugs - advertisements that often include lengthy segments covering possible side effects of the drugs. Although drug therapies may offer cure and relief, negative side effects often accompany therapy. Drugs can even cause death in some cases; adverse drug events (ADEs), or negative side effects from drugs, are one of the six leading causes of in-hospital death in the U.S.

To assess the incidence of death from doctor-administered drugs in a Norwegian hospital and identify patient characteristics that increase odds of drug-related death, the authors of a recent study in the Archives of Internal Medicine examined approximately 750 in-hospital fatalities over a two-year period. Clinical records, autopsy results, and pre- and post-mortem drug analyses were ascertained to determine death from drug side effects.

Drug-related deaths were directly or indirectly linked with one or more drugs in 18% of the patients. Likelihood of fatal drug use was directly related to increases in age, number of diseases, and number of drugs used. The most dangerous drugs were cardiovascular and anti-clotting drugs, and drugs that stimulate the function of internal organs. Over 200 patients, or 25%, were using 12 or more drugs at the time of death; the average number of drugs per patient increased significantly upon arrival at the hospital.

The authors of this study noted that only eight of these drug-related deaths were reported to the health authorities as required by official regulations. Drugs are often necessary for life-threatening conditions, but if you are making a decision on which drugs you will and will not take for your health, consider the saying "Less is more."

Reference: Ebbesen J, Buajordet I, Erikssen J, et al. Drug-related deaths in a department of internal medicine. Archives of Internal Medicine 2001:161(19), pp. 2317-2323.

To find out more about the dangers of drugs, click here.

Which Foods Raise Stomach Cancer Risk?

Rising rates of cancer of the stomach and esophagus (the muscular tube connecting your throat to your stomach) have led to large-scale studies over the last decade designed to identify risk factors for these cancers. Some of this evidence suggests that dietary factors may play a significant role in the development of stomach/esophagus cancers.

The goal of a recent study appearing in the journal Cancer Epidemiology, Biomarkers & Prevention was to determine dietary patterns related to the development of four types of stomach/esophagus cancer. Approximately 1,100 patients with one of the four forms of cancer and almost 700 healthy individuals completed a demographic and food-frequency questionnaire.

Higher intakes of cholesterol, animal protein and fat, and vitamin B12 increased risk of all four forms of cancer. Taking vitamin C supplements reduced the risk of cancer in the middle and lower stomach by 40%. Taking vitamins A, B6, and folate, as well as eating polyunsaturated fats, fiber, and carbohydrates, significantly decreased the risk of the four forms of cancer. Obesity was also strongly associated with these cancers.

To reduce your risk for cancers of the stomach and esophagus, minimize the amount of fatty meats in your diet. Instead, eat plant-based proteins, such as soy and other beans, and plant-based fats, such as avocados, nuts, and olive oil. In addition, eat plenty of fruits and vegetables to ensure adequate amounts of fiber, carbohydrates, and vitamins in your diet. Your doctor of chiropractic can help you come up with the diet that's right for you.

Reference: Mayne ST, Risch HA, Dubrow R, et al. Nutrient intake and risk of subtypes of esophageal and gastric cancer. Cancer Epidemiology, Biomarkers & Prevention 2001:10, pp. 1055-1062.

Shed Pounds by Shedding Excuses

For some people, life seems just too hectic to meet the recommended 30 continuous minutes per day of aerobic exercise. The American College of Sports Medicine and the Centers for Disease Control have changed the previous exercise guidelines to meet the demands of an increasingly busy society. A more practical approach: 30 minutes of total moderate physical activity - continuous or intermittent - should be performed most days of the week. The effectiveness of these new guidelines was recently tested, with particular emphasis on cardiovascular fitness and weight loss.

The study, which appeared in the Journal of the American College of Nutrition, compared the effects of variations of a 30-minute exercise program on aerobic fitness and weight loss in college women. Forty-eight overweight women were divided into four groups: no exercise; 30 minutes of continuous exercise per day; two 15-minutes sessions of exercise per day; and three 10-minute sessions per day. Measures of fitness, weight loss, skinfold thickness, and body circumference were taken initially and after three months of exercise training on a stationary bicycle.

All three exercise groups demonstrated significant fitness improvement, weight loss, and decreased body measurements at the end of the study. The results were similar between all three exercise groups. The nonexercise group did not show any significant changes.

Exercise may have similar effects on weight loss and aerobic fitness, whether performed in one long bout or several cumulative short sessions. If your schedule doesn't allow for a long block of time to get in an effective workout, now you have an alternative to stay fit.

Reference: Schmidt WD, Biwer CJ, Kalscheuer LK. Effects of long versus short bout exercise on fitness and weight loss in overweight females. Journal of the American College of Nutrition 2001:20(5), pp. 494-501.

For more information on sports and fitness, click here.

"High-Normal" Blood Pressure Not Normal

Blood pressure (BP) is generated when blood is pumped through your body, which exerts force against the inside walls of your blood vessels. It is measured in millimeters of mercury (mm Hg) - how high the pressure can raise a column of mercury, and is based on two numbers: systolic (pumping heart) and diastolic (between pumps) BP.

"High-normal" BP, defined as a systolic pressure of 130 to 139 mm Hg and/or a diastolic pressure of 85 to 89 mm Hg, has long been considered a safe range. Yet studies have shown that very high BP is related to a higher risk for cardiovascular disease. The authors of a recent study in The New England Journal of Medicine asked the question: Are those with high-normal BP also more likely to develop cardiovascular disease?

The authors examined data on nearly 7,000 adults in the Framingham Heart Study. For the study, initial BP and cardiovascular disease rates 12 years later were considered. The results for those with high-normal BP are listed below:

Women were 2.5 times more likely and men were 1.6 times more likely to have heart disease than those with optimal BP. Four percent of women and 8% of men ages 35 to 65 with high-normal BP had some form of heart disease, and older individuals with high-normal BP were even more likely to have heart disease. A quarter of those studied had high-normal BP.

If your BP falls within the high-normal range, you may not be safe from cardiovascular disease. Have your BP checked regularly, and be sure it falls within "normal" levels, especially if you are elderly or diabetic.

Reference: Vasan RS, Larson MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. The New England Journal of Medicine 2001:345(18), pp. 1291-1297.