Chiropractic: Good Even for "Minor" Pains

About half of all children will suffer from low-back pain at some point, with nearly 15% experiencing frequent or ongoing pain. In North America, the primary providers of spinal manipulation are chiropractors. More studies are now being done to evaluate the role of chiropractic in treating back pain in minors.

In a study appearing in the Journal of Manipulative and Physiological Therapeutics, 15 randomly chosen Canadian chiropractors provided data on their pediatric patients between the ages of 4 to 18 and suffering from lower back pain. Information was gathered on treatment type and outcome of care, based on patient-rated pain scales. Characteristics of the children with back pain included:

• The average age of sufferers was 13 years old.
• Nearly 60 percent were male.
• Half attributed pain onset to trauma (usually sports-related).
• One in four reported pain of over three months duration.

The most common diagnosis was a "subluxation," appearing in half of these children. Patients were almost universally treated with spinal adjustments, with few requiring other forms of therapy. After six weeks of treatment, major improvement (defined as "much improved" or "resolved") was seen in nearly 90% of patients, based on one of the pain scales, and there were no reported complications in any of the patients.

In children, as in adults, chiropractic treatment is extremely effective for back pain, regardless of the cause or characteristics. Your doctor of chiropractic can provide more information about treating childhood back pain.

Reference: Hayden JA, Mior SA, Verhoef MJ. Evaluation of chiropractic management of pediatric patients with low back pain: A prospective cohort study. Journal of Manipulative and Physiological Therapeutics 2003:26(1), pp. 1-8.

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Consider the Alternative

Prostate and colorectal cancer each kill approximately 30,000 men in the U.S. every year. However, colorectal cancer accounts for a larger majority of premature deaths, and regarding screening for the two cancers, only colorectal cancer screening has been clearly proven through thorough research to reduce the risk of death, according to a recent study appearing in the Journal of the American Medical Association. If medical practice guidelines are based on research, colorectal cancer screening should be much more common than screening for prostate cancer.

Utilizing a 2001 annual health survey of adults in all 50 states conducted by the Centers for Disease Control and Prevention, information was gathered on 50,000 men age 40 or older. Researchers focused on the percentage of men screened for prostate cancer using PSA (prostate-specific antigen) testing and colorectal cancer using fecal occult blood testing (FOBT), colonoscopy or sigmoidoscopy.

Men were more likely to have ever been screened for prostate cancer than colorectal cancer (75% vs. 63% of subjects, respectively) in those age 50 or older. Subjects of all ages also more commonly had received PSA screening in the past year than FOBT in the past year or colonoscopy/sigmoidoscopy in the last five years. Men were significantly more likely to be up-to-date on prostate-cancer testing than colorectal-cancer testing in 27 states, compared to being more up-to-date on colorectal screening in only one state.

Men may be more willing to submit to a simple PSA blood test because it is less convenient and more invasive than testing required to detect colorectal cancer. Men also may perceive their risk of death from prostate cancer to be higher because they know others suffering from the condition. Consider the alternative to avoiding colorectal cancer screening, however: You may be allowing a cancer to develop until it is no longer treatable. Talk to your doctor for more information about the importance of screening for bowel cancers.

Reference: Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: Does practice reflect the evidence? Journal of the American Medical Association 2003:289(11), pp. 1414-1420.

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Brewing Problems?

When a woman becomes pregnant, she needs to avoid some actions that increase health risks for the developing child, namely consuming alcohol, eating certain types of seafood and smoking (if she's a smoker). Exposure to caffeine during pregnancy has also been linked to pregnancy problems, including spontaneous abortion and low infant birth weight. Other lifestyle choices associated with high caffeine consumption, including drinking alcohol and smoking while pregnant, have been implicated as the actual causes for these birth problems. Is caffeine alone dangerous for your baby?

In an eight-year Danish study, almost 20,000 pregnant women visiting a department of obstetrics and gynecology provided information about coffee consumption before and 16 weeks into pregnancy. Coffee consumption was classified as 0, 1-3, 4-7 or 8 or more cups per day. Researchers looked for a possible association between coffee consumption and stillbirth or infant death in the first year in this British Medical Journal study.

Pregnant women consuming eight or more cups of coffee daily while pregnant were three times more likely to experience a stillbirth than women drinking no coffee, not considering smoking and alcohol consumption. After adjusting for these and other factors, women drinking eight or more cups daily still remained over two times more likely to have a stillborn child, and women drinking 4-7 cups daily still showed a 40% increase in risk.

The effects of caffeine from other sources, including chocolate, cola and tea consumption, were unknown in this study, because the women involved were noted to consume very little caffeine from these sources. Regardless of pregnancy, drinking eight or more cups of coffee daily is unhealthy for other health reasons. Limit your caffeine intake to one or two cups of coffee or tea per day, especially if you're carrying a child.

Reference: Wisborg K, Kesmodel U, et al. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: Prospective study. British Medical Journal 2003:326, pp. 420-423.

Learn more about women's health issues click here.

A Potential Consequence of High-Protein Diets

In a world of countless diet fads and programs, perhaps none is as well-known as the "Atkins Diet," which severely limits carbohydrate consumption but allows for high levels of dietary protein and fats. The possible long-term side-effects of a high-protein, low-carbohydrate diet are still uncertain, although recent American Heart Association guidelines suggest that a long-term, high-protein diet may adversely affect kidney function.

To evaluate a possible association between dietary protein intake and functional decline of the kidneys over an 11-year period, researchers examined approximately 1,600 women ages 42-68. Protein intake was determined twice over the study period using a food-frequency questionnaire; renal function was evaluated through measurements of kidney filtration ability. About 500 women displayed a slight but harmless weakened kidney function at the start of the study.

In women with mild kidney deficiency, high protein consumption was associated with a significant decline in kidney function over time; those who consumed the most protein showed the greatest functional decline. Intake of nondairy animal protein, in particular, was associated with accelerated renal decline in these women. High protein intake was not related to kidney function in women with normal initial kidney function.

Long-term, high-protein diets may have substantial negative side-effects on kidney function. Roughly one-fourth of all Americans are considered to display mild renal insufficiency; most of these individuals are unaware of this. Exercise caution when considering any fad diet or weight-loss remedy. If you choose a high-protein, low-carb diet to lose weight, consider only adhering to it for a short time. A well-balanced diet combined with exercise is still the safest, most effective way to maintain long-term weight control.

Reference: Knight EL, Stampfer MJ, et al. The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Annals of Internal Medicine 2003:138(6), pp. 460-467.

To learn more about how the nutritional choices you make can affect your health click here.

Better With Age

It's widely known that some things improve over time, such as a fine wine or a strong marriage. A recent study on chiropractic patient populations shows that chiropractic treatment may be another example. There have been radical changes in chiropractic legislation and integration with other forms of health care in the last half-century, and chiropractors increasingly practice at hospital clinics and in government positions. This study in the Journal of Manipulative and Physiological Therapeutics evaluated the characteristics of a typical chiropractic patient over this same time period.

Researchers compared 1962 and 1999 surveys of the Danish chiropractic population. The majority of chiropractors (approximately 50) in Denmark in 1962 had been evaluated; data from over 1,100 patients were available on the location and duration of pain, number of treatments and treatment outcome. In 1999, similar data were gathered for almost 2,000 patients.

In 1962, nearly 50% of chiropractic patients had suffered from their condition for over one year. However, only 20% of patients suffered for over one year in 1999. Also in 1962, 11% of patients complained of headache, compared to just 4% in 1999. The authors found the results of the surveys to otherwise be "remarkably similar." Approximately 70% of patients had lower-back or neck disorders in both surveys, and less than 10% of patients complained of other disorders (asthma, neurologic disorders, allergies, etc.) in each survey.

Most chiropractors today principally treat pain syndromes related to the spine, as they always have. This study also shows that patients visiting chiropractors now are less likely to still be suffering after one year than patients in the past. The fact that chiropractors have stayed focused on the treatment methods unique to this form of health care may help explain this improvement over time.

Reference: Hartvigsen J, Bolding-Jensen O, et al. Danish chiropractic patients then and now - A comparison between 1962 and 1999. Journal of Manipulative and Physiological Therapeutics 2003:26(2), pp. 65-69.

For more information on the benefits of chiropractic care click here.

The Greatest Thing IS Sliced Bread

By 2030, approximately one in five Americans (70 million people) will be 65 years or older. Besides being the fastest-growing segment of the population, seniors suffer from the most cases of cardiovascular disease (CVD), including stroke, heart disease and heart attack. Preventive health measures have been thought to have a lesser effect on this population than on younger individuals. Thanks to a recent study in the Journal of the American Medical Association, that view may change, however.

Researchers compared risk for cardiovascular disease with fiber intake from cereals (including whole-grain breads and wheat bran), fruit and vegetable sources in seniors. More than 3,500 men and women 65 years or older were surveyed for dietary fiber consumption, then followed for about a decade to record the development of cases of CVD.

Eating more cereal fiber was associated with a significantly reduced risk of cardiovascular disease, with those eating the most cereal fiber 21% less likely to develop the condition than those eating the least. Dark breads, including whole wheat, rye and pumpernickel, reduced CVD risk the most. Fiber intake from fruits and vegetables did not appear to similarly reduce the risk for cardiovascular disease.

The authors of this study mention that eating just two additional slices of whole-grain bread daily would have been enough to raise individuals from the lowest to the highest cereal-fiber group. Since nutritional changes are less expensive and less dangerous than medical or surgical solutions down the road, heed this information and be sure to eat plenty of whole grains. Obtaining enough cereal fiber is easy: Simply replace refined-grain breads with whole-grain ones and eat whole-grain cereals instead of sugary cereals, muffins or doughnuts.

Reference: Mozaffarian D, Kumanyika SK, et al. Cereal, fruit and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. Journal of the American Medical Association 2003:289(13), pp. 1659-1666.

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Share and Share Alike

Married couples share many common traits and habits - if one spouse smokes, the other often does; if one exercises, so does the other. Adult-onset diabetes is increasingly being shown to be based on lifestyle factors, rather than genetic ones. By examining married couples - people who are not genetically related but share many similar habits - an association between diabetes and its causes may be found.

A recent study in Diabetes Care determined the presence of adult-onset (type 2) diabetes and high blood sugar in the spouses of known diabetics attending a specialized clinic. The 245 spouses in this first group were then compared to 234 spouses of nondiabetic individuals.

People married to diabetics were more than twice as likely to have diabetes and glucose intolerance themselves than spouses of people without diabetes. Spouses of diabetics were also more likely to be obese or overweight and to have high blood pressure than the healthy individuals' spouses - both risk factors for the development of type 2 diabetes.

We've long known that if you have a parent or sibling with diabetes, you are at an increased risk for the condition. This study shows that lifestyle clearly has a significant influence on diabetes risk; the increased odds of sharing diabetes with a family member may be due more to similar habits than to genetics. To avoid developing type 2 diabetes, maintain a healthy weight, exercise regularly, and keep your blood pressure and cholesterol levels in check - and make sure your significant other does the same.

Reference: Khan A, Lasker SS, Chowdhury TA. Are spouses of patients with type 2 diabetes at increased risk of developing diabetes? Diabetes Care 2003:26, pp. 710-712.

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Gender Bias

Women active in sports that involve jumping and pivoting (e.g., volleyball or basketball) are up to eight times more likely to rupture their anterior cruciate ligament (or ACL - a primary knee ligament) than men participating in the same sports. Ligaments are the durable tissues that hold our bones together; the ACL and its counterpart, the posterior cruciate ligament (PCL), provide stability in the knee joints, and injuries to them can be painful and debilitating.

Researchers evaluated why female athletes are prone to knee ligament injuries in a recent study published in The Journal of Bone and Joint Surgery. Higher muscle stiffness helps brace the knee joint and reduces strain on the knee ligaments; therefore, the researchers examined muscle stiffness of the knee joint during muscle activation in 12 female and 12 male athletes competing for the National Collegiate Athletic Association (NCAA) in basketball, volleyball or soccer, and compared these athletes to 28 collegiate athletes involved in endurance sports, including bicycling and running, which are low-risk for cruciate ligament injury. Women and their male athlete counterparts were matched for size, weight and activity level.

Rotations of the leg were greater in female than in male athletes when participating in sports and when passively rotated at rest. In addition, measurements indicated that women demonstrated significantly lower knee muscle stiffness under rotational stress than their male counterparts. During jumping and pivoting maneuvers, which are the most likely time for a cruciate ligament injury, the difference in protective muscle stiffness around the knee was the most pronounced between the men and women.

Women are more prone to serious injuries of the knee ligaments than men, possibly due to less muscle protection. If you are a female athlete, talk to your doctor of chiropractic about methods for strengthening the stabilizing muscles around your knees. Also, adhere to proper techniques and form when performing your sport to minimize the risk for injury.

Reference: Wojtys EM, Huston LJ, et al. Gender differences in muscular protection of the knee in torsion in size-matched athletes. The Journal of Bone and Joint Surgery 2003:85(5), pp. 782-789.

For more information about women's health issues click here.