Physical Education Gets an "F"

With obesity and diabetes rates in American children on the rise, parents are more concerned than ever about their children's fitness levels. Poor habits in children can lead to the development of chronic diseases in adulthood; children active in sports or other physical activities are also less likely to engage in risky behaviors. Current recommendations are for children to perform at least an hour of physical activity every day, and that at least 50% of physical education (PE) classes consist of moderate-to-vigorous activity.

To evaluate the activity levels of third-graders in PE classes, more than 800 kids from a wide range of socioeconomic and cultural backgrounds at hundreds of elementary schools across the U.S. were individually observed for one day. Researchers recorded the amount of PE class time children spent sitting, standing, walking, performing vigorous exercise, etc., and how many PE classes the school mandated children take each week.

On average, the 9-year-olds only took two PE classes per week, instead of the recommended five; only 6% of these children had PE every weekday. While in PE class, the third-graders averaged merely five minutes of vigorous activity and 12 minutes of moderate-to-vigorous physical activity per session (25 minutes per week) - far short of the recommended levels.

Make sure your child isn't sitting through physical education hour. If he or she is not getting enough exercise at school, encourage physical activities at home. Learning sports and being active at a young age allows kids to develop coordination, muscle and skeletal strength, and good life habits, and best of all - to have fun!

Reference: The National Institute of Child Health and Human Development Study of Early Child Care and Youth Development Network. Frequency and intensity of activity of third-grade children in physical education. Archives of Pediatrics and Adolescent Medicine 2003:157(2), pp. 185-190.

For more information about pediatric issues, click here.

Not a Drop!

Alcohol use during pregnancy increases an infant's risk for premature birth and physical or mental retardation; at higher alcohol levels, fetal alcohol syndrome (FAS) and even death may occur. In spite of growing public awareness about the harmful effects of drinking alcohol while pregnant, the number of expectant mothers who continue to drink may actually be rising.

Most previous studies on alcohol use during pregnancy have drawn data from high-risk, low-income clinics. However, a recent study on alcohol use during pregnancy analyzed over 1,100 pregnant women (18 years or older) from a wide variety of obstetrics clinics in Michigan. Participants completed brief questionnaires while waiting for prenatal care.

Alcohol use during pregnancy was reported by 15% of the women. The majority of these women reported very little alcohol consumption (over 85% claimed only one drink or less per week) - yet 6% of the women reported binge drinking during pregnancy, or having at least five drinks on one occasion while pregnant. These women were more likely to smoke and to be in the early stages of their pregnancy than other participants. Surprisingly, over half of the women who admitted drinking during pregnancy said their health care provider had talked to them about alcohol use during pregnancy.

Women in this study from Alcoholism: Clinical and Experimental Research may have been more honest than they would have been with their health care provider, since they were informed the results of this study would remain confidential. These statistics are frightening. If you are pregnant, don't drink even a single drop of alcohol during pregnancy, and don't hesitate to inform others of the dangers, either - many women are simply unaware of the risks of a drink or two. If you need help confronting the issue (or confronting someone else), don't be afraid to speak to your doctor.

Reference: Flynn HA, Marcus SM, et al. Rates and correlates of alcohol use among pregnant women in obstetrics clinics. Alcoholism: Clinical and Experimental Research 2003:27(1), pp. 81-87.

For more information on prenatal health, click here.

Unsafe Supplements

An estimated 29,000 dietary supplements are available in the United States. These supplements include all ingested health products (botanical, nonbotanical, herbal or traditional cultural remedies in pill or other forms) and are usually intended for maintaining health, rather than treating existing conditions (as most pharmaceutical drugs do). Many of these supplements may produce adverse events: unwanted side-effects that cause injury or illness. Dietary supplements do not have to endure the same mandatory registration or safety testing as prescription drugs, and adverse events related to them are difficult to monitor.

In a study in The Lancet, 11 poison control centers recorded details about approximately 1,500 telephone calls related to dietary supplements (or over 60% of all calls), nearly 800 of which involved symptoms. Through a review process, approximately 500 of these reports were analyzed based on evidence that the adverse events were related to dietary supplements. People taking supplements named reasons including disease treatment (over one-quarter of callers); anxiety prevention; cognitive or athletic performance enhancement; sleep or stress aid; or boosting of the immune system.

One-third of adverse events from supplement use were considered moderately severe or worse, including symptoms such as heart attack, seizures, coma, liver failure and death. Ingredients most frequently associated with adverse events were the botanicals ma huang, ginseng, guarana and St. John's wort, and the substances zinc, melatonin and chromium. The more ingredients being taken, the more severe the symptoms, and about half of calls were related to more than one ingredient taken. Most of the supplements did not appear in the database used by the poison control centers.

This study raises a few points. Most importantly, be careful when considering any supplement not regulated by the Food and Drug Administration (FDA), and take it only after talking to your doctor and researching it on your own. Don't take multiple supplements together or with medications, or negative reactions may occur. Also, as this study showed, the longer you take a supplement, the more concentrated it may become, and the more likely it will be to cause an adverse reaction.

Reference: Palmer ME, Haller C, et al. Adverse events associated with dietary supplements: An observational study. The Lancet 2003:361, pp. 101-106.

To browse more studies on consumer safety, click here.

Be Low-Fat and Fit

Adult physical activity levels remain low, even as obesity rates continue to soar. Both of these factors lead to an increased risk for many forms of cancer later in life. Exactly how does each of these traits affect risk for cancer deaths?

Researchers recently evaluated the effects of cardiorespiratory fitness and obesity on all forms of cancer for approximately 5,500 men and women. In the study, appearing in Medicine & Science in Sports & Exercise, cardiorespiratory fitness (based on heart rate produced during a treadmill test) and body mass index (or BMI, calculated from weight and height measurements) were recorded between 1972-1976; participants were followed until 1998 to determine cancer deaths.

Men who had the best cardiovascular fitness based on treadmill tests were 53% less likely to die from cancer than the least-fit men, while obese women with the highest BMI were 1.5 times more likely to die from some form of cancer than other women. Body weight had no effect on cancer risk in men, however, and fitness did not significantly affect women's risk for cancer.

Men with low fitness levels and obese women may have significantly increased risks for multiple forms of cancer. Nonetheless, both men and women should maintain a healthy body weight and cardiovascular fitness, as many studies have shown the benefits of each for either gender. Your chiropractor can help you put together the best fitness program to meet your individual needs.

Reference: Evenson KR, Stevens J, et al. The effect of cardiorespiratory fitness and obesity on cancer mortality in women and men. Medicine & Science in Sports & Exercise 2003:35(2), pp. 270-277.

For more sports and fitness information click here.

The Best of the Best

Exercise therapy is highly effective for treating chronic low-back pain - but that doesn't necessarily mean there isn't an even better treatment out there. A recent study in the scientific journal Spine provides further evidence of the power of spinal manipulation for back pain.

In the study, approximately 50 patients with chronic low-back pain who had been sick-listed for between eight weeks and six months received either exercise therapy or manual therapy. The patients, ages 20-60, were administered sixteen 45-minute treatments over eight weeks; patient improvement was measured before and after treatment and at four weeks, six months and one year after treatment.

Patients in the manual-therapy group received mobilization and high-velocity, low-amplitude manipulation from trained physiotherapists (a form of treatment chiropractors also utilize) and performed general exercises for the trunk, spine and legs. Exercise-group patients trained with a 35-minute focus on the trunk and legs following 10 minutes of warm-up on an exercise bicycle.

Both groups showed significant improvements; however, the manual-therapy group experienced much greater improvements than the exercise group in all areas of improvement (pain, functional status, etc.) at every point in follow-up. For example, average reduction in pain was doubled for manual-therapy patients, compared to exercise patients. Also, immediately following the treatment period, the manual-therapy group was significantly more likely to have returned to work (67%, vs. 27% for the exercise group). One year later, exercise-therapy patients were over three times more likely to still be sick-listed than manual-therapy patients.

If you suffer from low-back pain, spinal manipulation may be the best form of treatment. Talk to your local chiropractor about the benefits of spinal adjustments.

For more information on back pain, click here.

Reference: Aure OF, Nilsen JH, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: A randomized, controlled trial with 1-year follow-up. Spine 2003:28(6), pp. 525-532.

Rest Easier

Frequent headaches have been linked to an assortment of sleep disorders. Up to 4% of adults suffer from chronic daily headache (CDH), or headaches 15 or more days each month (that's over 180 headache days per year). Some types of CDH generally last over four hours per episode, including chronic migraines and tension-type headaches.

Recently, researchers sought information about a possible link between CDH and snoring. Using a randomly generated list of telephone numbers in the Atlanta, Philadelphia and Baltimore areas, nearly 3,000 adults with CDH and over 50,000 others with less-frequent headaches (anywhere from none to about 100 days each year) were questioned about sleep and lifestyle habits. Participants also reported on the frequency of snoring in this study in the journal Neurology: never, less than half of nights, more than half of nights, always or unknown.

Habitual snoring, as defined by answering "always" on the snoring-frequency survey, appeared in 24% of CDH sufferers compared to only 14% of nonsufferers. In fact, individuals suffering from chronic daily headache were almost three times more likely to be habitual snorers than non-sufferers, after ruling out other factors associated with snoring.

Do headaches cause sleep disorders, or do sleep disorders cause headaches? We still don't have all the answers. But the researchers cited one preventable cause of CDH: overuse of medications, specifically sedatives for pain and depression. Go easy on the medications, find a safe way to prevent snoring and try to sleep more hours, and maybe you'll have fewer headaches and better sleep. Talk to your chiropractor for more information.

Scher AI, Lipton RB, Stewart WF. Habitual snoring as a risk factor for chronic daily headache. Neurology 2003:60, pp. 1366-1368.

For more general health studies, click here.

Fibromyalgia May Be Overdiagnosed

In the past decade, fibromyalgia has become a well-known ailment that causes reduced pain tolerance, musculoskeletal pain, sleep disturbances, fatigue and morning stiffness in sufferers. The estimated prevalence of fibromyalgia has been determined to be around 2%, with 10 times more women affected than men. Recent information suggests that this syndrome may be overreported as a "fashionable diagnosis," however, while other medical conditions are overlooked.

To examine fibromyalgia diagnostic accuracy, researchers evaluated all 76 new patients referred to a rheumatology clinic over a six-month period with an initial diagnosis of fibromyalgia, or a final diagnosis of fibromyalgia after ruling out a previously incorrect diagnosis.

At final evaluation, diagnostic accuracy for fibromyalgia at a patient's initial visit was correct in only one-third of cases. Of the patients initially (but incorrectly) diagnosed with fibromyalgia, 59% suffered from other inflammatory conditions, such as rheumatoid arthritis. True fibromyalgia sufferers tended to have many more tender points and were more fatigued than those suffering from other conditions. The authors of this study from Rheumatology concluded that there is a "disturbing inaccuracy" in the diagnosis of fibromyalgia, which might in part explain the current high rates reported for this condition. By accepting an incorrect diagnosis of fibromyalgia, many people may be inadvertently overlooking other inflammatory conditions. If you have been diagnosed with fibromyalgia and don't seem to be responding to treatment, you may want to get a second opinion.

Reference: Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: Analysis of referrals. Rheumatology 2003:42(2), pp. 263-267.

To read more about different types of common body aches and pains, click here.

DON'T Keep Your Head Above Water

That lifeguard may be able to save you from drowning, but he or she probably can't protect you from a swimming injury. Shoulder overuse injuries in particular are the main culprit in swimmers - accounting for approximately one-third of all injuries in competitive swimmers each year. These injuries are common even in many recreational swimmers who think they are using the proper freestyle stroke technique.

An overview of swimming injuries, published in The Physician and Sportsmedicine, dispels some widely accepted techniques used by freestyle swimmers, such as keeping your head up out of the water. Some tips are offered to help you avoid pain in the pool:

• Begin each stroke with your hand entering the water finger- or pinky-first (not thumb-first).
  
  
• Continue your stroke downward in a straight line.
  
  
• Roll your body equally to each side approximately 45 degrees during strokes.
  
  
• Keep your head down in the water for proper spinal alignment (not "eyes forward" as many coaches have encouraged).

Paddling on a surfboard can help you develop the proper stroke. If you have existing shoulder pain, have a chiropractor examine you for rotator-cuff injury, shoulder impingement or other causes. Core strength (of the back, stomach and upper legs) and shoulder strength are necessary for proper stroke technique. Shoulder flexibility is also important. Yoga, abdominal strengthening exercises, and shoulder strengthening exercises (push-ups, rowing and overhead presses) can be combined with chest and shoulder stretches to keep you swimming like a fish.

Reference: Johnson JN, Gauvin J, Fredericson M. Swimming biomechanics and injury prevention. The Physician and Sportsmedicine 2003:31(1).

For additional information on exercise and sports, click here.