August 30, 2002 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Comparing Benefits of Diet and Exercise in Treatment of Dyslipidemia

While the finding that lifestyle recommendations can affect cholesterol levels is nothing to write home about (mainly because similar mail is stacked up by the crate on this subject already...) the sad part is that this article appeared on Medscape with the title "Standard Lifestyle Recommendations Have Little Effect on Cholesterol Levels." Well...pack up the diet and exercise bike and just whip out the prescription pad!! The truth of the article is that the Step II NCEP program translated into a 6-8% reduction in cardivascular risk via reductions in total and LDL cholesterol, weight as well as blood pressure. And keep in mind that I personally think the NCEP guidelines are a weak attempt by a national organization making a politically correct recommendation based on only the most solid, accepted literature findings. Keeping in mind that it takes about 40 years for research info to make it into recommendations such as these, there are many additional recommendations for lowering risk that would trivialize the results of this intervention.

10.1006/pmed.2002.1052

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Prognosis, Determinants of Survival in Patients Newly Hospitalized for Heart Failure

For those of you with strong faith in mainstream medicine's advances in treatment and technology, this article should be an eye opener. Zillions of dollars for research, tens of zillions in new drug development and use, and we still have numbers as high as 60.7% one year mortality rate for the oldest persons in this study (with 7.6% mortality in the youngest groups). The odds ain't too good that you'll survive more than one year after hospitalization for heart failure. Try adding in natural therapeutics such as CoQ10, hawthorn and carnitine and I'm sure the survival rates will climb...

Prognosis and Determinants of Survival in Patients Newly Hospitalized for Heart Failure: A Population-Based Study

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Financial Ties, Conflicts of Interest Between Pharmaceutical, Tobacco

No need to elaborate on this. But it does get a little scary when two separate powerful industries collaborate to the detriment of the human race...

Financial Ties and Conflicts of Interest Between Pharmaceutical and Tobacco Companies

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Abnormal Measles-Mumps-Rubella Antibodies and CNS Autoimmunity in Children with Autism

The safety of the MMR vaccine has been called into question on several fronts over the past years. The research is always sound but rarely reproduced by the "mainstream" researchers. Much like the water flouridation issue, if there is enough of a concern about the safety of an intervention, than mandating and forcing that intervention on the general public should be a crime. In the cases of both vaccination and flouridation, however, the interventions are viewed as near-miracles and life saving. I firmly believe that a healthy immune system is the best way to combat any infection and vaccinations are rarely needed (especially in the sheer volumes that are used at today). Current research does point to a subset of children who may be genetically '"primed" to respond adversely to the MMR vaccine; resulting in such outcomes as autistic spectrum disorders. Unfortunately, until we find a way to identfiy these children (of course, first we need to admit they even exist!) the MMR vaccine will remain a crapshoot with the child's well being at risk.

Karger Online : Journal of Biomedical Science

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Randomised study of long term outcome after epidural versus non-epidural analgesia during labour

This procedure continues to surprise me. As a chiropractor, there have been instances when I have referred patients for lumbar spine epidurals. These decisions were made with care and only after we are sure conservative care on its own is not effective. Even then patients are very nervous are some flat out refuse. With labor, however, the procedure (which is similar but not exactly the same) is done without second thought!! My only guess as to why this discrepency in attitude exists has to do with cultural norms and what is "in" at the time. Nothing else makes sense. Of course, none of this takes into account the effect of the epidural on the newborn's ability to interact with their environment fresh out of the womb...

bmj.com Abstracts: Howell et al. 325 (7360): 357

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CRP Attenuates Nitric Oxide Production and Inhibits Angiogenesis

Here is another perfect but sad example of research moving past the acceptance of a risk factor and moving onto the "why" portion of the equation. CRP is now widely accepted as an independent risk factor for CVD (and a modifiable one at that!) and yet has not made it into clinical practice. Ditto for homocysteine. I had a new patient in my office this week that had an angioplasty 10 years ago and is still on medications related to this event. He had never heard of homocysteine. There is no excuse or rational explanation as to why this should still be the case. It is unacceptable and contributes to the poor outcomes of CVD seen in the above article.

Circulation -- Abstracts: Verma et al. 106 (8): 913

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High-protein diets and acid-base balance, stone-forming propensity, and calcium metabolism

Ever known anyone trying to pass a kidney stone? Very few things are considered as painful as this. High protein diets trade short term weight loss for long term health. The diet is dangerous and should be avoided by all but a very select few (I have recommended a high protein diet to only 2 patients). This article supports the dangerous potential long term effects of the diet.

American Journal of Kidney Diseases Online

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Infrared ear thermometry compared with rectal thermometry in children

I I have never liked the ear thermometers and have never relyed on the results obtained with them. While they are much quicker and easier to use, this does not compensate for their lack of accuracy. Next time you bring your child to the doctor, insist against using those types of thermometers.

The Journal : Current Issue

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Ginkgo for Memory Enhancement

This article has generated much press and I figured I should give my take on it. To fully understand this article, the definition of an adaptogen is needed. Many herbs have properties that normalize function. Give the right amount of garlic to a patient with high cholesterol levels or high blood pressure and that patient may return to normal values. Give a truckload to a patient with normal cholesterol and blood pressure and garlic won't touch it (the same goes for the patient after that much garlic, however..). An adaptogenic herb brings things back to normal. Stimulates enzymes to fill in the gaps if function is slow, slows down enzymes if function is too high. This study gave ginko to NORMAL functioning elderly patients. The design of this study shows a general lack of understanding for herbal medicine. And keep in mind that ginko has shown benefits in patients with Alzheimer's and dementia...

Ginkgo for Memory Enhancement: A Randomized Controlled Trial

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DHEAS, Insulin Levels, And Body Temperature Prognostic For Survival

This study identifies biomarkers that appear to be related to longevity. As would be expected, high DHEAS, low insulin and low body temp are related to longer life span. It may be that higher levels of DHEAS are actually a marker of normal adrenal function (i.e. no effect of chronic stress with increased cortisol and decreased DHEA). The authors of this study relate the findings back to the metabolic effects of caloric restriction--the only method consistently shown to increase longevity in mammals.

Science 2002;297:811

Metabolic indicators of calorie restriction in other mammals are associated with extended longevity in human beings--even when no dietary restrictions are in place, according to a report from the National Institute on Aging. Dr. George S. Roth and colleagues in Baltimore compared the survival of healthy men in the Baltimore Longitudinal Study of Aging in relation to low or high levels of body temperature and blood levels of insulin, and to high or low serum levels of dehydroepiandrosterone sulfate (DHEAS). The investigators note in the August 2nd issue of Science that these three factors are associated with longer life span in rhesus monkeys fed a 30% calorie-restricted diet. After 3 to 5 years, mortality in the calorie-restricted animals is about 15%, compared with 24% in monkeys fed a normal diet. Men in study who remained in good health after 3 years in the study were followed for up to 25 years. When stratified into the upper and lower halves of the distribution for each of the three biomarkers, men with lower levels of insulin, lower body temperature and higher levels of DHEAS had higher cumulative survival rates (p < 0.05 for each biomarker). Average daily energy intake was 2300 calories; none of the participants was known to be on a restricted diet. "The fact that these men apparently weren't practicing caloric restriction is important because it means that there may be other ways to achieve biological hallmarks without having to undergo drastic dietary changes," Dr. Roth said in a statement issued by the NIH. "Although we don't yet know what these pathways are, this finding suggests it may be possible to develop compounds that offer the benefits of caloric restriction without having to resort to it," he added. While it is not clear exactly what environmental or genetic factors cause the men to have factors that mimic calorie restriction, it appears that those factors are related to longevity and are "therefore worthy of further investigation," the authors conclude.