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April 9, 2001 Research Update |
James Bogash, D.C. Mesa, AZ
info@lifecarechiro.com
www.lifecarechiro.com
Skin Wrinkling: Can Food Make a Difference?
I have discussed before how important the overall health of the body is to the health of the skin, and many times the best way to healthy skin is paying attention to what we are putting into our bodies. Higher intakes of vegetables, olive oil and legumes protected against skin wrinkling, while diary products, meat and butter increase the risk. Try adding essential fatty acids and making sure the gut is healthy to have a well rounded approach to skin health.
Skin Aging and Food Intake in Elderly http://www.am-coll-nutr.org/jacn/vol_20/no_1/pg71.htm
One in Five US Adults Report Disability
These are pretty scary statistics and I think represent two factors. First, we are handling chronic diseases very poorly in this country. Second, even if I turn out to be wrong and life expectancy will actually increase over the next few decades, our quality of life (morbidity) will definately be going down the tubes. These statistics will continue to worsen unless we begin to look at healthcare in an entirely different matter--most (if not all) chronic diseases are a result of numerous factors and need to be treated as such. No more "one cause, one cure" philosophy.
Prevalence of Disabilities and Associated Health Conditions Among Adults --- United States, 1999 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5007a3.htm
Deleterious effect of sex on athletic performance
Being involved in athletics most of my life, from gymnastics to fighting in the ring, I have heard the promotions for abstination numerous times. However, as it turns out, this recommendation is about as weak as many other athletic-related dogmas. This review shows no reduction in sports performance with intercourse.
Clinical Journal of Sport Medicine, 2000; 10:233-4 The evidence supporting the deleterious effect of sex on athletic performance is about as substantial as a negligée, according to a recent review. Athletes as mismatched as Muhammad Ali and Marty Liquori advocated sexual abstinence the night before competition. Does sex have a detrimental physiological effect on competitors? Is sex mentally bad? Or, as Casey Stengel suggested in more laymanly terms, is sex just a marker for other behavior that hurts performance? (Stengel said, "It's not the sex that wrecks these guys, it's staying up all night looking for it.") The literature is not exactly bulging with evidence. Only three scientific studies have investigated the topic, note authors Samantha McGlone and Ian Shrier, MD, PhD. The results (all in cross-over trials) suggest that sex has no impact on physical measures such as grip strength, balance, lateral movement, reaction time, or aerobic power. (See McGlone and Shrier, 2000.)"All of these studies showed that sex the night before competition does not alter physiological testing results," they observe. What about the influence of sex on competitive stress? Sports psychologists generally believe "there is an optimal level of alertness/anxiety before a competition, and a poor performance will result from either being too anxious or not alert enough," note the authors. Under this theory, sex might be beneficial for a stressed athlete, yet deprive another athlete of a needed night's sleep."Clearly, there is a need for more research on this topic," conclude McGlone and Shrier. Future investigators will have plenty of methodological issues to ponder (e.g. is a repeated-measures cross-over design appropriate?). And, as one veteran team physician noted, "probably a lot of willing subjects."
Arthroscopic Sx for Knee OA No More Effective Than Sham Sx
Think the surgeons are going to like this one? With more and more studies coming out on the effectiveness (or lack of) of surgery we are starting to see that one of the most important factors for surgery is only doing surgery on patients that meet strict critieria for that specific surgical procedure. The rates certain types of surgery in the US fare exceed that of other countries. This particular article actually did surprise me a little. The old "roto-rooter" for the knee may not be an effective approach. Of course, I am somewhat biased in this regard, and know that knee pain can respond very well and rapidly with chiropractic therapy...
(article) In a study of 180 patients with osteoarthritis of the knee, Houston surgeons found that those who received "sham" arthroscopic surgery reported as much pain relief and improved mobility as patients who actually underwent the procedure. In fact, the group that did not receive surgery reported better short-term functioning compared with the other patients, Dr. Bruce Moseley, Jr. reported here at the annual meeting of the American Academy of Orthopedic Surgeons. It has been unclear why arthroscopic surgery for knee osteoarthritis helps some people with the condition. Dr. Moseley and his colleagues at Baylor College of Medicine, in Houston, decided to test whether arthroscopic surgery might be associated with a placebo effect. After 2 weeks, patients assigned to sham surgery were doing better than the true surgery patients--probably, Dr. Moseley said, because they had been spared the trauma of surgery. After 2 years, the groups had made similar gains in walking and stair climbing, and their pain had eased to comparable degrees. Because all patients received pain-killing drugs and none underwent physical therapy after their actual or sham surgery, Moseley credited the placebo effect for helping the sham-surgery group. "I was surprised," he said, noting that when colleagues first proposed the possibility to him, he discounted it. While this research is not the final word on arthroscopic surgery for knee arthritis, Dr. Moseley said it does suggest it may be time for surgeons to take a closer look at it. "We, as surgeons," he said, "may need to put our time into finding better and more effective treatments."
Topical Solution for Osteoarthritis May Challenge COX-2 Inhibitors
We are starting to see a large number of "miracle" creams for arthritis hitting the market. Remembering back to the old Ben-gay type preparations, these were purely skin irritants designed to flood the spinal cord with "touch" sensations and prevent pain transmissions for reaching the spinal cord first. New preparations have included many additional topicals ranging from glucosamine/chondroitin to capsaicin. The studies on these types of therapies, to my knowledge, are still scarce. However, the safety of many of these topicals is very good and may warrant a personal clinical trial.
(article) British biotechnology firm Provalis plans to launch its novel topical osteoarthritis solution Pennsaid in the UK this month, saying the product will compete with all nonsteroidal anti-inflammatory drugs (NSAIDs), including COX-2 inhibitors. The UK is the first market for the new product. Provalis has acquired from Canadian firm Dimethaid research the right to sell the compound in the UK and Ireland. Provalis chief executive Dr. Phil Gould told a news conference in London that Pennsaid had been approved for first-line treatment of osteoarthritis by the UK's Medicines Control Agency and would be approved in the rest of Europe under the mutual recognition procedure. Dimethaid is seeking distributors for the other European countries and has signed a deal with Johnson & Johnson for marketing in the United States. Dimethaid's technology uses the cell's tubule system to deliver drugs cell-to-cell. As a result, localised conditions, such as osteoarthritis, can be treated while limiting the body's absorption of the medication. Dr. Gould said that comparative data showed that pain relief is as least as good with Pennsaid as with the COX-2 inhibitor celecoxib and oral formulations of the NSAIDs diclofenac and naproxen.
Allergy Reports of Dubious Value in Pediatric Asthma
In my opinion, the authors of this article have it all backwards. They compare the parents' and childrens' report of allergies to skin prick testing and found poor correlation. This is not surprising since skin prick testing looks for immediate onset allergy, and I believe that this is not the major contributor to chronic diseases. The delayed type hypersensitivity appears to be much more practical of a measure of sensitivities to foods and environmental influences. I have run IgG4 tests on patients that have almost no reaction in the immediate onset category and yet show a delayed hypersensitivity to almost all items tested.
J Asthma 2000;37:685-690 Reports of allergies by young asthma patients and their parents are "no better than chance" in predicting reaction to skin tests for common allergens, according to findings published in a recent issue of the Journal of Asthma. Despite a well-documented association between allergy and asthma, "little is known concerning how well allergy history actually agrees with skin testing," Dr. Edward R. Carter and colleagues, from Madigan Army Medical Center, Tacoma, Washington, explain. To investigate, the researchers studied 95 children, aged 4 to 18 years, with physician-documented asthma. Parents and children answered a series of questions on allergy history. The children then underwent skin testing for allergy to cat, dust mite and grass. Comparison of allergy history and skin test reactivity showed that reports had a 65% diagnostic accuracy in identifying allergy to cat. Corresponding figures for dust mite and grass were 50% and 56%. Outcome was not affected by the severity of asthma. Given the poor predictive performance of such reports, Dr. Carter told Reuters Health that "a patient's allergy history does not predict skin test reactivity, and, thus, one should not base allergy control measures for patients with asthma on skin test results or allergy history alone." Furthermore, he added that the findings emphasize "the need of performing formal allergy testing...and combining this with allergy history and asthma severity to come up with an individualized plan for allergy control measures in each patient with asthma."
Polycystic Ovarian Syndrome and Risk of Type 2 Diabetes
It is generally accepted that insulin dysregulation is a major contributor to polycystic ovary syndrome (PCOS). Insulin acts by shunting more precursor hormones over to testosterone instead of estrogen. These elevated levels of testesterone then lead to the findings of PCOS. The authors suggest an insulin to glucose ratio to determine whether insulin resistance is present; this is one of the most accurate ways to identify impaired glucose tolerance decades before diabetes may develop.
J Pediatr 2001;138:38-44 Profound metabolic derangements, which can be detected early in young, obese adolescent girls with polycystic ovarian syndrome, appear to increase the risk of type 2 diabetes mellitus, report physicians in Pennsylvania. Dr. Silva Arslanian and colleagues, of the Children's Hospital of Pittsburgh, determined in vivo insulin sensitivity, insulin secretion, and fasting hepatic glucose production in 22 girls, average age 12.0 years, whose body mass index was 90% or greater for their age. Twelve subjects had been diagnosed with polycystic ovarian syndrome after exhibiting hyperandrogenism, while the remaining 10 girls served as controls. Fasting glucose levels were normal in all subjects, the investigators report in the January issue of the Journal of Pediatrics. Hepatic glucose production was also similar between the two groups. However, among the girls with the ovarian syndrome, fasting insulin levels were about twice as high, while insulinlike growth factor binding protein-1 and fasting glucose-to-insulin ratios were lower, compared with those in the control subjects. Dr. Arslanian and associates conclude that the reduction in peripheral tissue insulin sensitivity, hepatic insulin resistance, and compensatory hyperinsulinemia puts obese adolescents with polycystic ovarian syndrome at risk for type 2 diabetes. The investigators recommend oral glucose tolerance testing in patients with this syndrome and suggest that the fasting glucose-to-insulin ratio may be of use in screening for insulin resistance.
Ascorbic acid and mortality
This rather large study looked at the effects of vitamin C levels in the blood and all-cause mortality. Ascorbic acid was shown to protect against all causes of death. Quite a feat for something as simple, safe and cheap as Vit C. It's just a shame that Linus Pauling did not get the respect he deserved for his research on Vit C while he was alive. Truly a pioneer that changed the face of prentative medicine, Dr. Pauling's ideas are only now beginning to truly show fruit.
Lancet 2001; 357: 657-63 Ascorbic acid (vitamin C) might be protective for several chronic diseases. However, findings from prospective studies that relate ascorbic acid to cardiovascular disease or cancer are not consistent. We aimed to assess the relation between plasma ascorbic acid and subsequent mortality due to all causes, cardiovascular disease, ischaemic heart disease, and cancer. We prospectively examined for 4 years the relation between plasma ascorbic acid concentrations and mortality due to all causes, and to cardiovascular disease, ischaemic heart disease, and cancer in 19496 men and women aged 45-79 years. Plasma ascorbic acid concentration was inversely related to mortality from all-causes, and from cardiovascular disease, and ischaemic heart disease in men and women. Risk of mortality in the top ascorbic acid quintile was about half the risk in the lowest quintile (p<0·0001). The relation with mortality was continuous through the whole distribution of ascorbic acid concentrations. 20 µmol/L rise in plasma ascorbic acid concentration, equivalent to about 50 g per day increase in fruit and vegetable intake, was associated with about a 20% re