Living Well Blog: Saratoga's Holistic Health Forum


 

How Many People Really Are Effected?

Previously, I reviewed the various problems regarding the current diagnostics and estimates of number of people affected by Lyme disease. As far as surveillance, the CDC lists the limitations of their methods on their website which includes: under-reporting, lack of state funds to classify and monitor cases, different times of closing of estimates per year (between the CDC and different states), changes in case definitions throughout the years, and surveillance by county of residence, not county of exposure. (So, is it really 300,000?) Due to the fact that our biodiversity of deer, rodents, and mammalian creatures is declining due to our environmental fingerprint, we will probably see a continued rise in cases in the years to come.


Then, There's the Issue of Testing...

This is a huge controversy. Actually, for any diagnosis and lab use, there are issues with validity and reliability. I discussed that more in previous blog (http://dr-lobisco.com/the-problem-with-lab-numbers-labels/). According to one article in the Journal of Clinical Microbiology (1999), the following issues crop up in diagnosis using the CDC's two-tier diagnostic system for Lyme disease. These can occur within and among different labs on the immunoblot testing due to:

  1. Subjective interpretation by the lab technicians
  2.  Antigen extract validity (measurements vary with different forms of B. burgdorferi and different antigens can be read and misinterpreted due to their same molecular mass)
  3. The expression of the antigen is related to how it is cultured in the lab and the growth phase of the critter, this can vary between labs and specimens

Many argue that this method is meant to be for surveillance only. In fact, the National Notifiable Disease Surveillance Data System for Lyme Disease (Borellia burgdorferi) CSTE Position Statement(s) states on the CDC site, "This surveillance case definition was developed for national reporting of Lyme disease; it is not intended to be used in clinical diagnosis." (https://wwwn.cdc.gov/nndss/conditions/lyme-disease/case-definition/2011/)

 

The Diagnosis Issues and More Lyme Controversies

So, the diagnosis of Lyme disease is based on a test that many feel is inadequate. Furthermore, even if the tests were 100% valid and reliable, different people have different immune responses. This makes one single test relating to one aspect of the immune response lacking in usefulness for many. I discussed why this critter is so hard to catch previously. Here is a review of these factors:

1.    Immunosuppression agents with entry of the tick saliva, making it hard to detect at "first bite."

2.    Genetic, phase, and antigenic variation makes the critter the "master of disguises" using unique mechanisms to evade antibiotics and the immune system's detection. Furthermore, most tests only look for one species, but different species with differing genetics can lead to different symptoms and differing immune responses (Borellia garini, Borellia afezlii, Borellia hammseli, Borellia miyamotoi)!!

3.    There's some evidence that Borellia is becoming resistant to antibiotics in vitro, meaning the bug may be getting smarter to our attempts to kill it.

4.    Physical seclusion which means not only can spirochetes and bacteria change forms and trick our immune system, they can also hide in our bodies by binding to certain substances in the body. This makes them "invisible" to the immune system.

5.    Borellia can secrete proteins to adhere to cells and pierce through their walls so they can "hibernate." Then, they come out of hiding when the immune system least expects it.

6.    This bug has become so smart it can go around iron poor environments and thrive on manganese. It can also produce a DNA base critical for its survival!

You can read more about this in this blog, where I gave a brief summary of Lyme disease, its complex and various symptoms (it is known as "the great mimicker"), the problem with its "posse" of co-infections, the controversy with treatment, and the existence of chronic Lyme disease (which I get into more below).

Thankfully, there are some new methods and tests for Lyme disease which offer some promise. These new methods are evaluating the person's genomics, searching for the actual protein in the serum (verses the immune response to it), a urinary antigen test, and more. I wrote about some of these on this site here. This may help with finding the critter faster, which could prevent chronic issues. However, will it help with treatment? I do not know for sure.

So, as you can see there are a lot of "issues" and many factors involved for one little bugger, right?

 

The Big One... Controversy That Is...

Speaking of chronic Lyme disease, there is a schism about this that runs pretty deep in society and in medicine. It ranges from indifference or lack of knowledge of the disease to those afflicted and suffering hopelessly. On the medical forefronts, there are many "Lyme literate physicians" (LLMDs) who have education in the chronicity of Lyme disease and dig into the treatment and pathology of the critter with antibiotics and other methods. The opposing position is one in which some physicians feel that Lyme cannot be chronic and that other factors are at play related to the symptoms:

These facts would seem to support that individuals with different genetic variations and immune robustness will respond differently to an infection with the spirochete.  Still, the Infectious Disease Society of America (IDSA) does not believe in chronic Lyme and typically will not treat a Lyme patient beyond acute management. On the other hand, the International Lyme and Associated Diseases Society (ILADS) group does believe that Lyme can and often persists beyond a few weeks, and are willing to treat someone beyond the four-week period. These two groups represent the schism in LD and differ in treatment.27

According to Interdisciplinary Perspectives on Infectious Disease, the evidence for chronic Lyme Disease (CLD) is robust, 28-35 and recognizing it could facilitate efforts to avoid diagnostic delays of two years and durations of illness 4.7-9 years...

Interestingly, the Centers for Disease Control (CDC) also acknowledges a chronic form of Lyme disease called "Post-Treatment Lyme Disease Syndrome." Their website states here:

The Centers for Disease Control (CDC) also acknowledges a chronic form of Lyme disease called "Post-Treatment Lyme Disease Syndrome." (http://www.cdc.gov/lyme/postlds/index.html)

 

The Power of Holism: A Naturopathic and Functional Medicine Perspective

With the complexity in diagnosis, various symptomology, immune evasion by the critter, and chronicity, many Lyme disease sufferers struggle with finding solutions and physicians who will understand their concerns. My method is to treat the whole person and balance their body, mind and spirit, not just go after the bug.

Click here to learn about a new model and integrative perspective on my homepage blog where I go into detail about treating the whole person versus killing the bug.  

 

References:

Center for Disease Control and Prevention. Lyme Disease. http://www.cdc.gov/lyme/

http://www.cdc.gov/lyme/stats/survfaq.html

http://dr-lobisco.com/as-summertime-hits-here-comes-the-ticks/

http://dr-lobisco.com/that-unwanted-bite-lyme-disease/

J Clin Microbiol. 1999 Dec; 37(12): 3990-3996.

Clin Infect Dis. 1997 Jul;25 Suppl 1:S31-4.

Infect Drug Resist. 2011; 4:1-9.

BMJ. 2007 Nov 3; 335(7626): 910-912. http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf

http://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html

http://www.cdc.gov/mmwr/preview/mmwrhtml/00038469.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/00038469.htm

https://wwwn.cdc.gov/nndss/conditions/lyme-disease/case-definition/2011/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440571/

https://www.tgen.org/home/news/2016-media-releases/congressional-support-sought-for-tgen-lyme-test.aspx#.V0OQ1uQaC4I

http://www.ceresnano.com/#!nanotrap-lyme-test/c64d

http://www.ncbi.nlm.nih.gov/pubmed/18989271/

http://www.lymeresearchalliance.org/find_doctors.html

http://www.ilads.org/lyme/lyme-quickfacts.php

Infect Dis Clin North Am. 2008 Jun; 22(2): 217-234.

IFM. APM: Immune Module. Lyme Disease. Rancho Mirage, CA. March 2015.

Infection and Drug Resistance. 2011;4:97-113.

Infectious disease clinics of North America. 2008;22(2):217-234.

Journal of Biological Chemistry, 2013.

ScienceDaily. March 21, 2013.

The Difference Between Quality Control and Standardization with Essential Oils

In my homepage blog, I discussed the importance of essential oils quality and safety. Essential oils are regulated by their intended use in the United States; therefore, they can be regulated under the category of cosmetics, fragrances, or "others." This makes consistency and quality an important consideration when using them for wellness purposes.

In this blog, I want to help you understand the differences between standardization and quality more. Let's first look at an industry which has both, pharmaceuticals. I reviewed several reasons previously on how standard of care does not necessarily mean it is without risk. For example, medications are regulated, have standardization, and quality, yet still can lead to medical errors, side effects, and toxicities.

In regards to safety of regulated, standardized, and approved drugs, the FDA (Food and Drug Administration) states the following limitations on their own site in approval of safety for drugs (bold emphasis mine):

·         FDA provides guidance to companies during the various phases of the human clinical trials. Even so, the number of people in a clinical trial of a new drug is usually small in comparison to the number of people who may take the drug if it reaches the market. This makes it difficult to detect rare side effects.

·         Even though data from human trials are analyzed by a team of experts before a drug is approved, it can be impossible to anticipate all bad reactions--especially very rare safety risks--unless they had also happened with use of a similar drug.

·         Complicating matters is the fact that after they are approved, drugs are often taken by sick people who are on other medications at the same time, making it difficult to predict how they will react to the drug. And the drug's effect on the patient may change over the course of years.

·         There are hundreds of thousands of adverse events reported via MedWatch each year, but this reporting system is voluntary and there are serious drug reactions that are never reported.

·         Because the nation's healthcare system is not integrated, there is no standard way to track the adverse effects of a medicine in any given health system or across different health systems. Health insurance databases can be helpful in this regard, but they are only accurate as long as a patient has the same job and is enrolled with the same insurance system since many people are insured through their employer.  This limits FDA's ability to monitor the safety of medications taken over many years.  However, FDA, through its Sentinel Initiative, is currently working to develop capabilities to use data from different health systems to better understand the safety of drugs in clinical practice.   

Interesting, isn't it?

 

Standardization in Essential Oils

Currently, there are some sets of standards and certifications regulating essential oils through the agencies of ISO (which is the International Organization for Standardization) and the Association Française de Normalisation (AFNOR).

According to the ISO website: "ISO is an independent, non-governmental international organization with a membership of 161 national standards bodies. Through its members, it brings together experts to share knowledge and develop voluntary, consensus-based, market relevant International Standards that support innovation and provide solutions to global challenges."

AFNOR is the French national organization for standardization and its International Organization for Standardization member body. They develop their international standardization activities, information provision, certification and training through a network members of the association. According to their website,

AFNOR, the French standardization organization, directs and coordinates the establishment of national standards (NF) and participation in the definition of European standards (EN) and International standards (ISO and IEC). It is the French member of European and international non-governmental standards organizations such as CEN and CENELEC in Europe, and ISO and IEC internationally. Thanks to the investment of all the players in the French economy, AFNOR is one of the most influential members of these organizations, strategically and technically.

 

The Quality Caveat with Standards and Essential Oils

Unfortunately, ISO standards exist for only approximately 50 EOs. According to a source I had with one well known company, the ISO standards for EOs were created, in most cases, because an AFNOR standard existed. If an EO meets the ISO/AFNOR standard, it will probably be a high quality oil; however, this is not always the case. There is a difference between standards and quality. Standardizations can imply quality, but they don't necessarily have. They can exist solely for consistency in labeling and selling across manufacturers. The AFNOR does claim to seek to ensure quality.

To complicate matters more, different companies consider different constituents as "quality" essential oils. This may make them not "standardized" but still "quality" in regards to raw materials, distillation technique, testing, manufacturing, and distribution.


The bottom line- know and trust your supplier and ask about quality control, then do some of your own research.


Read more about essential oil safety on my homepage here and get more references.

 

References:

Food and Drug Administration. Aromatherapy. FDA Web site: http://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm127054.htm. Accessed December 28, 2015.

Food and Drug Administration. Fragrances in Cosmetics. FDA Web site: ttp://www.fda.gov/Cosmetics/ProductsIngredients/Ingredients/ucm388821.htm. Accessed December 28, 2015.

Food and Drug Administration. CFR - Code of Federal Regulations Title 21. FDA Web site: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=182.20

Food and Drug Administration. How FDA Evaluates Regulated Products: Drugs. FDA Web site: http://www.fda.gov/AboutFDA/Transparency/Basics/ucm269834.htm

Food and Drug Administration. Pharmaceutical Quality/Manufacturing Standards (CGMP). FDA Web site: http://www.fda.gov/drugs/guidancecomplianceregulatoryinformation/guidances/ucm064971.htm

International Standardization Organization. ISO/TC 54 - Essential oils. ISO Web site: http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_tc_browse.htm?commid=48956..

Association of French Normalization Organization. Standards- All Published Standards. AFNOR Web site: http://www.afnor.org/en/profiles/activity-area/industry/normes/normes/%28limit%29/25/%28page%29/2

Association of French Normalization Organization. ISO 9001 Certification - Quality. AFNOR Web site: http://www.afnor.org/en/certification/smq001#p17578

Association of French Normalization Organization. Normes. AFNOR Web site: http://www.boutique.afnor.org/recherche/resultats/categorie/normes/ics/huiles-essentielles-71.100.60%20?utm_source=portail&utm_medium=referral&utm_campaign=editions. 

 

 

 


In my homepage blog, I discussed the flaws and biases in supplement and drug trials. This is part II of the discussion.

A 2005 review tilted, "Why Most Published Research Findings Are False," provides a good summary of factors that influence conclusions of studies (bold emphasis mine):

"There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research." (http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124)


So, Do We Ignore the Data?

No, no, and no...there's ways to use this information to make informed decisions about what the "evidence" is actually saying. But, it takes a lot of detective work. Most of my research and looking into studies has come from my own review of studies reporting on biases and lessons learned from my mentors and teachers. In no way am I methodology whiz, but I do have a basic grasp of why our model and interpretations need to be interpreted with caution.

These are some of the considerations that I always review when applying studies to my clients:

1. Read the actual study and be wary of media spin. In one cross-sectional analysis of 130 studies of health news reported on google and found the following:

In total, 78% of the news did not provide a full reference or electronic link to the scientific article. We found at least one spin in 114 (88%) news items and 18 different types of spin in news. These spin were mainly related to misleading reporting (59%) such as not reporting adverse events that were reported in the scientific article (25%), misleading interpretation (69%) such as claiming a causal effect despite non-randomized study design (49%) and overgeneralization/misleading extrapolation (41%) of the results such as extrapolating a beneficial effect from an animal study to humans (21%). We also identified some new types of spin such as highlighting a single patient experience for the success of a new treatment instead of focusing on the group results. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608738/)

 

2. Consider methods used.

Subjects: Who were the participants/what population was studied (differences in gender/ethnicity/health status)? What were their characteristics? What was the dropout rate? Who was excluded and why? What were the factors controlled for in the subjects?

Type of study: Was it observational and correlational study which look for relationships verses cause-and-effect or was it a case-control randomized trial? Was there a control or was it a comparison trial? (Too much or too little control both have weakness. For example, too much control prevents extrapolation of the intervention to the real world and too little prevents interpretation that the intervention caused the change.)

Intervention: What is the form of intervention? Was it the appropriate dosage? How long was the study? How was it taken? What was the placebo effect?

 

3. Search the results for inconsistencies:

How are the results reported? For example, is it the use of an odds ratio, is it relative or absolute risk? What is the NNT? Is the p-value of significance truly reflective of compatible data with the statistical model?

Do the charts and statistics match the author's conclusions?


4. More can be found here for the geeks...

·         Epidemiological study interpretation (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077477/)

·         Biases to search for (http://www.ncbi.nlm.nih.gov/pubmed/18582622)

·         Design, analysis and interpretation of method-comparison studies (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944826/)

·         Quasi-experimental study designs (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380192/)

 

 

Where to Go from Here?

1. Physicians and practitioners need to be honest about interventions and be transparent about what they have experience with. Both parties should look up the NNT and find a few studies to examine if the intervention is new.

2. Consumers and patients need to be aware that some of the studies and standard of care physicians are using could be flawed. Don't just accept treatment that isn't helping without studying the data or asking your doctor for more information. Most importantly, look for if you're getting results with an intervention (nutrient, herb, oil, supplement, medication) and use that in your basis for the final decision.


Get the references here on my homepage.

 

 

 

 

 

 

 

 

 

Mom's Gifts of Giving and Her Impact & Some Stress-Free Relief for Her

When you think of May, does it remind you of your mom? In case you forgot, May 8th is the day to celebrate the important mother figures in our lives. Unfortunately, in our society we can sometimes tend to blame our mom more than praise her for certain traits and health issues.

Although our mothers can affect our health outcomes, as I wrote about here, we do have the power to modulate this... even at the level of genetics! It can also be soothing to realize that regardless of the characteristics our mom provided in her genes (and dads too) and personality, this combination makes us unique individuals. We can use these experiences and knowledge to understand ourselves better, give gratitude to our past, heal wounds for the future, and rise to better health. Furthermore, the healing and profound power of a mother's touch as something which is vital for optimal development.  If someone didn't receive it when we needed it, there are ways to soothe ourselves now through understanding, epigenetics, and mind-body medicine.

Regardless of if your mother was amazing (like I am fortunate to claim), if you learned lessons from your parental relationship and grew, or if your mom is no longer with you, celebrating love and the strong women in our lives is very healing for our own physical health. In fact, you can read 10 science-based reasons gratitude will benefit you here. (Did you know "an attitude of gratitude" can even help student's GPA.)

 

More on the Mom-Body Connection

A few studies this month also highlighted the importance of mom's impact on our future generations. One study showed that the risks associated with a later birth in moms was outweighed by the environmental benefits. This means, a mom's attitude and here resources impact her child's development. Science Daily reported on this change as follows:

Both public health and social conditions have been improving over time in many countries. Previous research on the relationship between maternal age and child outcomes has ignored the importance of these macro-level environmental changes over time. From the perspective of any individual parent, delaying childbearing means having a child with a later birth year. For example, a ten-year difference in maternal age is accompanied by a decade of changes to social and environmental conditions. Taking this perspective, this new MPIDR-study shows that when women delay childbearing to older ages their children are healthier, taller, and more highly educated. It shows that despite the risks associated with childbearing at older ages, which are attributable to aging of the reproductive system, these risks are either counterbalanced, or outweighed, by the positive changes to the environment in the period during which the mother delayed her childbearing.

Still, it's not just about money and environment. The gift of love is free. Science Daily also cited a study that showed that moms who nurtured their little ones had babes with bigger brains:

Children whose mothers were nurturing during the preschool years, as opposed to later in childhood, have more robust growth in brain structures associated with learning, memory and stress response than children with less supportive moms.

According to the study researchers, the children of moms who were viewed as more nurturing exhibited growth in the hippocampus region as determined by three MRI scans. This area in the brain is associated with emotional regulation, memory, and learning. In this study with 127 youths, emotional regulation was the key factor reported on for improvement.

 

It's Not Just Mom's Love- It's Community

Another recent study showed the impact of children's friends and social connections on their stress. We all know the health impacts of stress! The researchers indicated by studying different aspects of the stress response, they had a better comprehensive view of how our environment and connection modulates our physiology. Science Daily states:

For this focused study, Ponzi and Flinn chose a sample of 40 children ranging in ages from 5 to 12 and who represented about 80 percent of the total children in the village. Each child was asked a series of questions about their friends to measure their perceived density and closeness of their social networks. Three samples of saliva were collected before, during and after the interview and cortisol and alpha-amylase levels were measured.

"We found that, using the data we collected from the one-on-one interviews, children who were stressed about the size and density of their perceived social networks had elevated anticipatory cortisol levels, and responded by secreting more alpha-amylase," Flinn said. "Our study was in line with past research on stress, loneliness and social support in adults, but we strengthened past research by applying it to children. Future research should consider a multi-system approach like this one to study cognitive and biological mechanisms underlying children's perception."

 

Supporting Mom's Health with Aromatherapy

Now, time to give our moms or mother figures some hints on self-care, because they do so much for us! Here are some abstracts on the use of essential oils and aromatherapy to soothe moms.

1. Improving Sleep During the Postpartum Period

What mom doesn't need more sleep? This study in the Iranian Red Crescent Medical Journal evaluated the impact of aromatherapy on moms in the postpartum period:

This study was a randomized clinical trial with the control group. A total of 158 mothers in postpartum period (with certain inclusion criteria) were enrolled in the study and assigned randomly to two groups of control and intervention. Lavender fragrance (made by Barij Essence Pharmaceutical Co.) was used by participants in the intervention group nightly before sleeping. The fragrance was dropped on cotton balls, which were placed on a cylindrical container at mothers' disposal. Keeping the container at a projected distance of 20 cm, the participants inhaled 10 deep breaths and then the container was placed beside their pillow until morning. This procedure was done 4 times a week for 8 weeks. For the control group, the same intervention was done with the placebo. The instrument for collecting data was Pittsburgh sleep quality index, which was completed at the baseline, fourth, and eighth weeks after the intervention. Data were analyzed using independent t test and repeated measures analysis of variance calculated by SPSS16....

Conclusions: Considering the effects of aromatherapy on the improvement of mother's sleep quality during postpartum period, aromatherapy has been suggested as a non-pharmacological method for the improvement of the maternal health.

 

 

2. Calming Anxiety in Labor and Reducing Blood Pressure Readings with Geranium

Methods: In study, was carried out on 100 nulliparous women admitted to Bent al-Hoda Hospital in the city of Bojnord in North Khorasan province of Iran during 2012-2013. The women were randomly assigned to two groups of equal size, one experimental group (geranium essential oil) and one control (placebo) group. Anxiety levels were measured using Spielberger' questionnaire before and after intervention. Physiological parameters (systolic and diastolic blood pressure, respiratory rate, pulse rate) were also measured before and after intervention in both groups. Data analysis was conducted using the x2 test, paired t-test, Mann-Whitney U test, and Wilcox on test on SPSS 11.5.

Results: The mean anxiety score decreased significantly after inhalation of the aroma of geranium essential oil. There was also a significant decrease in diastolic blood pressure.

Conclusion: Aroma of essential oil of geraniums can effectively reduce anxiety during labor and can be recommended as a non-invasive anti-anxiety aid during childbirth.

 

3. Burnout Relief

A small randomized, controlled, double-blind pilot study that included 14 participants was done to "determine the effectiveness of a mixture of essential oils (peppermint, basil, and helichrysum) on mental exhaustion, or moderate burnout (ME/MB) using a personal inhaler."  The study from the Journal of Alternative and Complementary Medicine abstract reads:

DESIGN: This was a randomized, controlled, double-blind pilot study. Data were collected 3 times a day for 3 weeks (Monday-Friday). The first week was baseline for both groups, the second week was intervention (aromatherapy or placebo), and the third week was washout...

INTERVENTIONS: Participants were randomized to receive a personal inhaler containing either a mixture of essential oils or rose water (as used in Indian cooking).

OUTCOME MEASURES: The outcome measures were a 0-10 scale with 10=worst feeling of burnout, 0=no feeling of burnout. There was a qualitative questionnaire rating aroma and a questionnaire listing perceived stressors.

RESULTS: While both groups had a reduction in perception of ME/MB, the aromatherapy group had a much greater reduction.

CONCLUSIONS: The results suggest that inhaling essential oils may reduce the perceived level of mental fatigue/burnout. Further research is warranted.

 

A One Sentence Summary

Therefore, our health can start with our moms, be impacted by our own attitude and behaviors, and supported by our nose.

 

Catch the Latest News

This week, on my homepage, I wrote about the need for change in healthcare from sick-care to well-care. Just as I was in my writer's flow, an article on how Medical Errors are the Third Cause of Death in the United States popped up in my inbox. Serendipity!! You can read all about how this is connected to empowering patients' health and changing our approach to medicine.

My blog also provides lots of nerd-out opportunities for your skimming pleasure on the Top Holistic and Integrative Health News for April 2016.


Be sure to read it here.  

 

References:

10 Reasons Why Gratitude is Healthy. Huffington Post. July 12, 2014.

Journal of Personality and Social Psychology. 2003; 84(2):377-389. http://greatergood.berkeley.edu/pdfs/GratitudePDFs/6Emmons-BlessingsBurdens.pdf

Gratitude and the Reduced Cost of Materialism in Adolescents. J Happiness Stud. 2010; 12:289-302. DOI 10.1007/s10902-010-9195-9

Advanced Maternal Age and Offspring Outcomes: Reproductive Aging and Counterbalancing Period Trends. Population and Development Review, 2016; 42 (1): 69.

Max-Planck-Gesellschaft. Children of older mothers do better: The benefits associated with being born in a later year outweigh the biological risks associated with being born to an older mother. ScienceDaily, 12 April 2016.

Washington University School of Medicine. Nurturing during preschool years boosts child's brain growth: Mothers' support linked to robust growth of brain area involved in learning, memory, stress response. ScienceDaily, 25 April 2016.

Luby JL, Belden A, Harms MP, Tillman R, Barch DM. Preschool is a sensitive period for the influence of maternal support on the trajectory of hippocampal development. PNAS. 2016.

University of Missouri-Columbia. Children react physically to stress from their social networks: A 28-year study reveals that the social relationships nurtured in childhood may have physiological consequences. ScienceDaily. 2 May 2016.

Cortisol, salivary alpha-amylase and children's perceptions of their social networks. Social Neuroscience, 2015; 11 (2):164.

Keshavarz Afshar M, Behboodi Moghadam Z, Taghizadeh Z, Bekhradi R, Montazeri A, Mokhtari P. Lavender Fragrance Essential Oil and the Quality of Sleep in Postpartum Women. Iranian Red Crescent Medical Journal. 2015;17(4):e25880. doi:10.5812/ircmj.17(4)2015.25880.

Rashidi Fakari F, Tabatabaeichehr M, Kamali H, Rashidi Fakari F, Naseri M. Effect of Inhalation of Aroma of Geranium Essence on Anxiety and Physiological Parameters during First Stage of Labor in Nulliparous Women: a Randomized Clinical Trial. Journal of Caring Sciences. 2015;4(2):135-141. doi:10.15171/jcs.2015.014.

Varney E, Buckle J. Effect of inhaled essential oils on mental exhaustion and moderate burnout: a small pilot study. J Altern Complement Med. 2013 Jan;19(1):69-71. doi: 10.1089/acm.2012.0089.


This week's blog on my homepage discussed the downfalls of basing healthcare on diagnosis and managing diseases and sickness symptoms. In it, I reviewed the importance of individualizing treatment and considering the interplay between genes and environment. In fact, I reported on a pivotal study that provided evidence that even in those with a genetic mutation that could result in disorders such as cystic fibrosis and Tay-Sachs disease, there were individuals found who were healthy in spite of them.

We have a current epidemic now in painkiller abuse. Recently, Health Day reported:

The Obama administration announced Tuesday additional measures in its $1.1 billion funding request to expand medication-based treatment for Americans addicted to prescription painkillers and heroin.

President Barack Obama is scheduled to propose the measures at the National Rx Drug Abuse & Heroin Summit in Atlanta. The White House said the increased initiative could offer hope to tens of thousands of Americans addicted to prescription painkillers, such as OxyContin, Vicodin and Percocet, as well as illegal drugs like heroin.

Therefore, our reliance on medications to soothe our pain has financial and social implications. For example, it has been shown that opioids may cause changes in the brain in a small 2010 study, though the authors hypothesized this may be reversible:

Following the month of morphine administration, reduced gray matter was observed in the right amygdala. The amygdala, together with the hippocampus, drive reward-related learning processes via modulatory influences on the nucleus accumbens [17, 21]. The amygdala is involved in drug-induced associative learning, drug craving, reinforcement, the development of dependence, and the experience of acute withdrawal... Gray matter increase was widely-distributed throughout the brain and, in contrast to regions demonstrating volumetric decrease, was located outside of reward-processing networks.

Furthermore, it isn't just a concern for heroin and other painkillers. Many are using common over-the-counter medications to control pain that may have negative side effects, such as harming the brain. According to a recent article in Science Daily:

It's been known for more than a century that acetaminophen is an effective painkiller, but according to a new U of T study it could also be impeding error-detection in the brain.

The research, authored by a team including postdoctoral fellow Dan Randles and researchers from the University of British Columbia, is the first neurological study to look at how acetaminophen could be inhibiting the brain response associated with making errors.

"Past research tells us physical pain and social rejection share a neural process that we experience as distress, and both have been traced to same part of the brain," says Randles.

Recent research has begun to show how exactly acetaminophen inhibits pain, while behavioural studies suggest it may also inhibit evaluative responses more generally. Randles own past research has found that people are less reactive to uncertain situations when under the effect of acetaminophen.

It's a sad state in America when interventions which may be effective and have positive side effects are overlooked.  For example, I discussed how mindfulness practices can assist with low back pain. A 2013 study reviewed some of the evidence on how meditation may affect pain processing looking at more than just the physical aspect of pain perception:

The cognitive modulation of pain is influenced by a number of factors ranging from attention, beliefs, conditioning, expectations, mood, and the regulation of emotional responses to noxious sensory events. Recently, mindfulness meditation has been found attenuate pain through some of these mechanisms including enhanced cognitive and emotional control, as well as altering the contextual evaluation of sensory events. This review discusses the brain mechanisms involved in mindfulness meditation-related pain relief across different meditative techniques, expertise and training levels, experimental procedures, and neuroimaging methodologies. Converging lines of neuroimaging evidence reveal that mindfulness meditation-related pain relief is associated with unique appraisal cognitive processes depending on expertise level and meditation tradition. Moreover, it is postulated that mindfulness meditation-related pain relief may share a common final pathway with other cognitive techniques in the modulation of pain.

Another recent study showed how mindfulness may also be helpful in emotional pain. HealthDay reported:

This study included 23 U.S. veterans of the Iraq and Afghanistan wars who all received some form of group therapy. After four months of weekly sessions, many had reductions in their PTSD symptoms.

However, some of the participants received mindfulness training, and only those veterans showed brain activity changes that could be detected on functional MRI brain scans. Before mindfulness training, when the veterans with PTSD were resting quietly, they had extra activity in brain regions involved in responding to threats or outside problems, the study authors said.

Pain is isolating and can have implications in other diseases, such as an increased risk of heart disease. This cycle continues of not looking at the need for connecting all the dots and the whack-a-mole medicine game of suppressing symptoms.

Most doctors may not ask you about another tool used in healing by more than half Americans- prayer. Shouldn't faith and belief be factored in and incorporated into the art of medicine along with the science? Maybe then we'd really have true holistic, integrated, healthcare. I think it's coming, but we still have a way to go.

 

References:

Augliere B. Mystery factors protect lucky few from severe genetic disorders: Massive genomic study picks up disease-linked mutations in otherwise healthy people. Nature. 11 April 2016. http://www.nature.com/news/mystery-factors-protect-lucky-few-from-severe-genetic-disorders-1.19719

Steele M. Obama Administration Steps Up Efforts to Beat Painkiller, Heroin Epidemic. Health Day. March 29, 2016. http://consumer.healthday.com/mental-health-information-25/addiction-news-6/obama-steps-up-efforts-to-beat-painkiller-heroin-epidemic-709474.html

University of Toronto. Is a popular painkiller hampering our ability to notice errors? ScienceDaily. 8 April 2016. <www.sciencedaily.com/releases/2016/04/160408163734.htm>.

Younger JW, Chu LF, D'Arcy N, Trott K, Jastrzab LE, Mackey SC. Prescription opioid analgesics rapidly change the human brain. Pain. 2011;152(8):1803-1810. doi:10.1016/j.pain.2011.03.028.

Rettner R. Mindfulness Meditation May Reduce Low Back Pain. Huffington Post. March 24, 2016. http://www.huffingtonpost.com/entry/mindfulness-meditation-may-reduce-low-back-pain_us_56f4279de4b04c4c37619965

Zeidan F, Grant JA, Brown CA, McHaffie JG, Coghill RC. Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain. Neuroscience letters. 2012;520(2):165-173. doi:10.1016/j.neulet.2012.03.082.


Preidt R. Mindfulness Training May Ease PTSD. HealthDay. April 1, 2016. http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/mindfulness-training-can-ease-ptsd-709555.html

Reinburg S. Lonely, Isolated People May Be Prone to Heart Disease, Stroke. Health Day. April 19, 2016. http://consumer.healthday.com/mental-health-information-25/psychology-and-mental-health-news-566/lonely-isolated-people-may-be-more-prone-to-heart-disease-stroke-710140.html

Preidt R. Most Americans Turn to Prayer for Healing, Survey Finds. Health Day. April 22, 2016. http://consumer.healthday.com/public-health-information-30/religion-health-news-577/most-americans-turn-to-prayer-for-healing-710117.html


Many of us heard that stress is "bad for us." It is true that long-term, chronic stress can have many negative effects on all systems of the body.1 In my current blog on my homepage, I review what happens in the body when someone has an allergy or experiences respiratory symptoms. I also discuss how the body's immune response is intricately connected to all systems. In this blog, I review the connection between the nervous and immune systems.

 

Stress and Allergy Flares

A study with 179 university employees suffering allergic symptoms and the influence of lifestyle factors on their manifestation concluded:

These findings suggest that individuals with persistent emotional stress have more frequent allergy flares. Furthermore, those with more flares have greater negative mood.2.

Of course, there is also direct biochemical evidence of this link.3-5 Modern Healthcare Practitioner reported on how stress can impact immune function:

First, sympathetic fibers descend from the brain into both primary and secondary lymph tissue. These fibers release substances that bind to receptors on white blood cells. Second, the adrenal hormones epinephrine, norepinephrine and cortisol bind to specific receptors on white blood cells and have regulatory effects on their distribution and function. Finally, one's efforts to manage the demands of stress often result in coping strategies that have a secondary negative effect on the immune system - such as alcohol use or changes in sleeping patterns. Thus behavior can be an important pathway linking stress with the immune system.3

 

Stress and Colds

A two-part study was done to assess the effect of stress on symptoms from exposure to a virus. The first part of the experiment consisted of 125 men and 151 women. The subjects were quarantined for 24 hours and then were given "nasal drops containing a low infectious dose of either RV21 (N = 129) or RV39 (N = 147)."

In the second study, there were 39 men and 43 women who were also quarantined and then given the virus strain, RV39. All participants were paid $800 for getting infected.

The authors concluded the following in relationship to glucocorticoid receptor resistance (GCR), which occurs as a result of chronic stress hormones "hitting the receptors":

Study 1: After covarying the control variables, those with recent exposure to a long-term threatening stressful experience demonstrated GCR; and those with GCR were at higher risk of subsequently developing a cold. Study 2: With the same controls used in study 1, greater GCR predicted the production of more local proinflammatory cytokines among infected subjects. These data provide support for a model suggesting that prolonged stressors result in GCR, which, in turn, interferes with appropriate regulation of inflammation. Because inflammation plays an important role in the onset and progression of a wide range of diseases, this model may have broad implications for understanding the role of stress in health.6

There are various ways to mitigate the stress response. I wrote about some overlooked ways here and also highlighted how essential oils not only impact stress through olfaction, but also through biochemical responses. In other words, essential oils can modulate our immune response while calming our brain.

In another article, Dr. Rosen also reviews some integrative approaches to allergies. These include eating an anti-inflammatory diet, the use of fish oil, and supportive herbals.7 These are all also important for overall health.


To read more about supporting your immune system, make sure you check out my blog here.


References:

1. American Psychological Association. Stress Effects on the Body. http://www.apa.org/helpcenter/stress-body.aspx

2. Patterson AM, Yildiz VO, Klatt MD, Malarkey WB. Perceived stress predicts allergy flares. Ann Allergy Asthma Immunol. 2014 Apr;112(4):317-21

3. Labrix. Stress and Immune Function. Modern Healthcare Practitioner. October 30, 2015. http://www.modernhcp.com/stress-and-immune-function/

4. Hussain D. Stress, Immunity, and Health: Research Findings and Implications. International Journal of Psychosocial Rehabilitation. 2010. 15(1) 94-100.

5. Segerstrom SC, Miller GE. Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological bulletin. 2004;130(4):601-630. doi:10.1037/0033-2909.130.4.601.

6. Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS. 2012 109 (16) 5995-5999. doi:10.1073/pnas.1118355109

7. Rosen D. Seasonal Allergies: An Integrative Approach to Atopic Disorders. Integrative Practitioner. http://www.integrativepractitioner.com/topics/environmental-health/seasonal-allergies-an-integrative-approach-to-atopic-disorders/

 


Last week, I discussed How Integrative HealthCare May Save Medicine. Specifically, I reviewed how diet, lifestyle, and supplements can modulate disease risk, yet they still seem to get the back seat to conventional methods. This is unfortunate considering our current medical approach is not producing a healthy America. In fact, our healthcare system ranks last overall among many other industrialized nation, according to a recent analysis published by the Common Wealth Funds. In regards to health care spending, supply, utilization, prices, and health outcomes. The report states:

In 2013, the U.S. spent far more on health care than these other countries. Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions."
The analysis reported health care spending at 17.1 percent of the U.S. GDP, making our country devote at least 50 percent more of its economy to health care than other countries.1

True prevention is not about utilizing more screenings and diagnostics to find the diseases earlier. This ignores the lifestyle processes that caused the imbalances to begin with.2 It is well-known that many chronic diseases are preventable through lifestyle. Harvard T.H. Chan of Public Health reports:

Chronic diseases --including heart disease, stroke, diabetes, and cancer-- account for some of the most common health problems in the United States, according to statistics from the Centers for Disease Control and Prevention (CDC). Yet many of these chronic diseases are preventable, as they're linked to poor diet and lifestyle choices including tobacco use, excessive alcohol consumption, and inadequate physical activity.3

 

The Best Technology to Remedy Results Can't Effect Cause: A Short Look at Diet

In a recent editorial in JAMA, Dr. Lustig commented on the decline in our lifespan and quality of life in relationship to diet:

Obesity and poor-quality diet predispose to all of the major chronic diseases, but these risks have been mitigated over the past few decades by an increasingly powerful and expensive array of treatments. To delay disease progression, millions of individuals in the United States depend on medications to lower levels of cholesterol, blood pressure, and blood glucose; surgical procedures to open or bypass blocked arteries; and dialysis.

The data from the latest CDC report suggest that a tipping point has been reached beyond which technological advances may no longer compensate. Indeed, higher-resolution data show that this trend has probably been under way for years.4

Many studies have shown how diet impacts many chronic disease outcomes.5-6 One study even reported on the reversal of diabetes type 2 in a small study of 11 individuals:

Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake.5

In an upcoming two-part article series on the Natural Path, I review specifically how diet and lifestyle can modulate health outcomes in more detail.

 

Food for Your Bones

In a recent study, reported in Health Day, the Mediterranean Diet was linked to lower hip fracture risk in women. This is important because many women fear osteoporosis and many chronic diseases impact bone strength. Health Day reports:6

Eating a Mediterranean diet may at least slightly lower an older woman's risk for hip fracture, a new study suggests. Women who most closely followed a Mediterranean diet -- one high in fruits, vegetables, nuts, legumes and whole grains -- had a 20 percent lower risk for hip fractures compared to women who didn't follow this regimen, the researchers found.

 

The Importance of Social Connections and Access

Beyond diet and lifestyle, social connection and one's environment has been found to impact disease processes. Unfortunately, this is often ignored, yet social isolation and depression have been shown to be independent risk factors for death from cardiac disease.7-8

One recent study in JAMA reports:

In an impressive analysis based on mortality data and deidentified tax records with more than 1.4 billion person-year observations and nearly 7 million deaths among individuals living in the United States during the 15 years between 1999 and 2014, Chetty et al confirm the long-observed association between higher income and longer life expectancy, as well as the recent increase in the gap in life expectancy between the richest and poorest 5% of the US population.1 Looking specifically at the lowest income quartile, Chetty et al also found little association between life expectancy and various measures of access to medical care, physical environments, employment conditions, or levels of income inequality.

On the other hand, the authors found significant geographic variations in life expectancy among those in the lowest income quartile, including significant disadvantages conferred by the prevalence of unhealthy behaviors, such as tobacco use and obesity, and community characteristics, such as government expenditure levels and the proportions of college graduates and immigrants. In this low-income group, life expectancy variation by community ranged from a high of about a 4-year gain to a low of a more than 2-year loss in life expectancy during the 15-year period. Community is powerfully associated with life expectancy.9

Interesting, the authors also state, "in the aggregate, medical care is not a strong determinant of the health of populations."9

 

Summary:

As Benjamin Franklin is quoted for saying, "An ounce of prevention is worth a pound of cure." Therefore, it is time to look at how our choices and lifestyle can impact our health by preventing the disease process to begin with. This could save our nation from the downward health spiral it is headed using the same ineffective approach. It is time for a truly integrative healthcare system. It can start with our own choices.

 

A Free Summit to Learn More

Join me on May 16th-May 23rd for the Natural Cancer Prevention Summit which includes 30+ experts that review all the ways we can empower our health and BreakFree from the viewpoint that we are victims of our body. In the summit, I discuss essential oils, which I just blogged about here as well.

 

 

 

 

References

1. The Common Wealth Fund. U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries. 2015. http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective/

2. Center for Disease Control and Prevention (CDC). CDC Prevention Checklist. May 8, 2005. http://www.cdc.gov/prevention/

3. Harvard T.H. Chan of Public Health. Disease Prevention. http://www.hsph.harvard.edu/nutritionsource/disease-prevention/

4. Ludwig D. Lifestyle Weighed Down by Diet. JAMA. April 04, 2016. doi:10.1001/jama.2016.3829

5. Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. American Journal of Clinical Nutrition. 2008. http://m.ajcn.nutrition.org/content/87/3/627.full

6.  Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011;54(10):2506-2514. doi:10.1007/s00125-011-2204-7.

7. Mediterranean Diet May Help Lower Hip Fracture Risk in Older Women. Health Day. March 28, 2016. http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/briefs-emb-3-28-11amet-med-diet-hip-fracture-jama-im-release-batch-2596-709336.html

8. Friedmann E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS. Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J. 2006 Nov;152(5):940.e1-8.

9. McGinnis J. Income, Life Expectancy, and Community Health: Underscoring the Opportunity. JAMA. Published online April 10, 2016. doi:10.1001/jama.2016.4729.

I've written extensively about the power of our gut bugs for modulating our health and wellness. These little critters have been found to impact everything from our mood to cancer risk. However, with all the focus on our belly, many are forgetting that digestion begins in the mouth. Did you know that we have a wide array of critter residents there as well and some of them correlate to our belly bugs! Still, there is much to be learned about what lies in our oral cavity.

According to a 2013 article in Pharmacology Research:

The human mouth harbours one of the most diverse microbiomes in the human body, including viruses, fungi, protozoa, archaea and bacteria. The bacteria are responsible for the two commonest bacterial diseases of man: dental caries (tooth decay) and the periodontal (gum) diseases. Archaea are restricted to a small number of species of methanogens while around 1000 bacterial species have been found, with representatives from the phyla Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria, Spirochaetes, Synergistetes and Tenericutes and the uncultured divisions GN02, SR1 and TM7. Around half of oral bacteria are as yet uncultured and culture-independent methods have been successfully used to comprehensively describe the oral bacterial community.

Our mouth microbiota can serve a helpful function. One small study reported that these little guys can help us with the production of nitric oxide. Cass Nelson Dooley, a respected researcher in the oral microbiome states, "Certain oral bacteria convert nitrate to nitrite from the leafy greens we eat in the diet. Humans cannot do this biochemical step so we rely on oral bacteria to help us make nitric oxide. Amazingly, these bacteria in the mouth may contribute up to 25% of systemic levels of nitric oxide. Veillonella and Actinomyces appear to have the strongest nitrate-reducing activity. Given the important role of nitric oxide in healthy cardiovascular function and blood pressure regulation, we have to promote these bacteria by eating leafy greens and avoiding antibacterial mouthwash, when possible."

 

The Bad Bugs in the Mouth

On the unhappy side, studies have connected some not-so-good mouth bacteria to various disease processes. These include a link to heart disease (especially endocarditis), respiratory infections, cancer, and even obesity.

According to a 2000 review:

Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. The purpose of this review is to evaluate the current status of oral infections, especially periodontitis, as a causal factor for systemic diseases. Three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed: (i) metastatic spread of infection from the oral cavity as a result of transient bacteremia, (ii) metastatic injury from the effects of circulating oral microbial toxins, and (iii) metastatic inflammation caused by immunological injury induced by oral microorganisms. Periodontitis as a major oral infection may affect the host's susceptibility to systemic disease in three ways: by shared risk factors; subgingival biofilms acting as reservoirs of gram-negative bacteria; and the periodontium acting as a reservoir of inflammatory mediators. Proposed evidence and mechanisms of the above odontogenic systemic diseases are given.

A recent article in Health Day reported that our mouth residents could also impact our brain:

In a new report, investigators reviewed studies on oral health and cognition published between 1993 and 2013. Some of the studies found that oral health indicators -- such as the number of teeth, the number of cavities and the presence of gum disease -- was associated with a higher risk of mental decline or dementia, while other studies did not find any association.

 

How to Have a Happy Mouth

What we eat has a huge impact on our whole body microbiome. Here is a link to a previous article on some ways to keep your mouth bugs happy and you smiling. Furthermore, smoking was just recently found to affect our mouth microbiome- could that be another reason why it is so bad for us?

 

 

 

References:

O'Mahonya AM, Clarkea G, Borrea YE, Dianan TG, Cryana JF. Serotonin, tryptophan metabolism and the brain-gut-microbiome axis. Behavioural Brain Research. 277(15): 32-48. January 15, 2015. http://www.sciencedirect.com/science/article/pii/S0166432814004768

Cryan JF1, O'Mahony SM. The microbiome-gut-brain axis: from bowel to behavior. Neurogastroenterol Motil. 2011 Mar;23(3):187-92. doi: 10.1111/j.1365-2982.2010.01664.x.

Tillisch K, Labus J, Kilpatrick L, Zhiguo J, Stains J, Ebrat, B, et al. Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity. Gastroenterology. 2013; 144 (7): 1394-1401.

Schmidt K, Cowen P, Harner CJ, Tzortizis G, Errington S, Burnet PWJ. Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers. Psychopharmocology. December 2014. http://link.springer.com/article/10.1007%2Fs00213-014-3810-0

Gut microbes may play a role in colorectal cancer. MNT. March 4 2014. http://www.medicalnewstoday.com/articles/273472.php

Zackular JP, Rogers MA, Ruffin MT 4th, Schloss PD.The human gut microbiome as a screening tool for colorectal cancer. Cancer Prev Res. 2014 Nov;7(11):1112-21. doi: 10.1158/1940-6207.CAPR-14-0129. Epub 2014 Aug 7.

Gut bacteria linked to immune system cancer, lymphoma. MNT. July 17, 2013. http://www.medicalnewstoday.com/articles/263484.php

Yamamoto ML1, Maier I, Dang AT, Berry D, Liu J, Ruegger PM, Yang JI, Soto PA, Presley LL, Reliene R, Westbrook AM, Wei B, Loy A, Chang C, Braun J, Borneman J, Schiestl RH. Intestinal bacteria modify lymphoma incidence and latency by affecting systemic inflammatory state, oxidative stress, and leukocyte genotoxicity. Cancer Res. 2013 Jul 15;73(14):4222-32. doi: 10.1158/0008-5472.CAN-13-0022.

Wade WG. The oral microbiome in health and disease. Pharmacol Res. 2013 Mar;69(1):137-43. doi: 10.1016/j.phrs.2012.11.006. Epub 2012 Nov 28.

Nelson Dooley, C. The Mouth-Body Connection: Why We Shouldn't Ignore the Oral Microbiome. Ask the Dentist. November 18, 2015. http://askthedentist.com/oral-microbiome/

Hyde ER, Andrade F, Vaksman Z, et al. Metagenomic analysis of nitrate-reducing bacteria in the oral cavity: implications for nitric oxide homeostasis. PLoS ONE. 2014;9(3):e88645.

Preidt R. Is Seniors' Dental Health Tied to Mental Health? Health Day. April 1, 2016. http://consumer.healthday.com/dental-and-oral-information-9/misc-dental-problem-news-174/could-dental-health-be-tied-to-mental-health-in-seniors-709520.html

Science Daily. How Bacteria Found in Mouth May Cause Colorectal Cancer. Sciencedaily.com. August 14, 2013.

Health Day. Smoking Triggers Big Changes in Mouth Bacteria, Study Finds. March 29, 2016. http://consumer.healthday.com/cancer-information-5/misc-tobacco-health-news-666/smoking-triggers-big-changes-in-mouth-bacteria-709469.html

Goodson JM, Groppo D, Halem S, Carpino E. Is Obesity an Oral Bacterial Disease? Journal of Dental Research. 2009;88(6):519-523. doi:10.1177/0022034509338353.

Gomes-Filho IS, Passos JS, Seixas da Cruz S. Respiratory disease and the role of oral bacteria. Journal of Oral Microbiology. 2010;2:10.3402/jom.v2i0.5811. doi:10.3402/jom.v2i0.5811.

Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic Diseases Caused by Oral Infection. Clinical Microbiology Reviews. 2000;13(4):547-558.


Still Too Many Harms in Health Care

According to a recent study:

Avoidable harm to patients is still too high in healthcare in the UK and across the globe -- making safety a top healthcare priority for providers and policy makers alike. These are the findings of two reports launched today by researchers from Imperial College London. (Imperial College London. Too many avoidable errors in patient care, says report: Avoidable harm to patients is still too high in healthcare in the UK and across the globe. Science Daily. 7 March 2016)

I just wrote a blog about how we are stuck in a healthcare model that isn't working. What is needed is true integration of medicine with access to different tools and the formation of a therapeutic partnership between the patient and the doctor. These are critical for our healthcare system to thrive. I also reported on all the top health and integrative medicines in March, and, of course, mentioning the release of my book, BreakFree Medicine. (Read all about this here.)

Another of the big topics in the news was the epidemic of pain drug abuse. Below are a few excerpts to summarize the issue and how integrative and alternative therapies may be able to fill a gap.

 

Feds Aim to Cut Painkiller Drug Abuse

Earlier this month, the epidemic of painkiller drug abuse and the CDC advisory was discussed:

Hoping to stem an epidemic of drug abuse tied to prescription narcotic painkillers such as Oxycontin, Percocet and Vicodin, federal officials on Tuesday issued tough new prescribing guidelines to the nation's doctors.

The new advisory, from the U.S. Centers for Disease Control and Prevention, stresses that doctors -- especially primary care physicians -- should try to avoid these addictive "opioid" painkillers whenever possible for patients with most forms of chronic pain. (Mundell and Reinburg. CDC Issues Tough New Guidelines on Use of Prescription Painkillers. Health Day News.  March 15, 2016.)

 

New Warning on Opioid Drugs

Health Day recently reported on a new warning on narcotics:

Hoping to curb a national epidemic of prescription painkiller abuse, U.S. officials on Tuesday announced that certain drugs will get new "boxed warnings" about the dangers of misuse.

The move by the U.S. Food and Drug Administration comes one week after the U.S. Centers for Disease Control and Prevention announced tough new guidelines to doctors for "opioid" drugs such as Oxycontin, Percocet and Vicodin. (Mundell and Reinburg. FDA Orders Warning Labels on Prescription Narcotic Painkillers. Health Day News. March 22, 2016. )

 

Making Generic Opioids Less Likely to Be Abused, FDA

Furthermore, in a recent report by Health Day, the authors discuss another attempt to deter painkiller drug abuse:

Continuing their push to combat the nation's epidemic of prescription painkiller abuse, U.S. officials on Thursday urged generic drug makers to take steps to redesign potent drugs such as hydrocodone and oxycodone to make them harder to abuse.

U.S. Food and Drug Administration officials said they were encouraging the generic drug industry to develop pain medicines with "abuse-deterrent properties." For instance, this would make it harder to crush a tablet to snort the contents or dissolve a capsule to inject its ingredients. (Reinburg. FDA Wants Generic Narcotic Painkillers to Be Abuse-Deterrent. Health Day News. March 24, 2016.)

 

 

How Meditation Can Help Pain and Fill the Gap

Two studies highlighted the role of the mind-body connection in connecting meditation to improvements in pain. According to Science Daily:

In this randomized, double-blinded study, 78 healthy, pain-free volunteers were divided into four groups for the four-day (20 minutes per day) trial. The groups consisted of: meditation plus naloxone; non-meditation control plus naloxone; meditation plus saline placebo; or non-meditation control plus saline placebo...Zeidan found that the participants' pain ratings were reduced by 24 percent from the baseline measurement in the meditation group that received the naloxone. This is important because it showed that even when the body's opioid receptors were chemically blocked, meditation still was able to significantly reduce pain by using a different pathway, he said. Pain ratings also were reduced by 21 percent in the meditation group that received the placebo-saline injection. (Wake Forest Baptist Medical Center. Mindfulness meditation provides opioid-free pain relief, study finds. Science Daily. 15 March 2016.)

 

Meditation for Pain 2

Health Day reports:

Meditation may work better than painkillers when it comes to soothing chronic low back pain, a new clinical trial suggests. The study found that a program called mindfulness-based stress reduction (MBSR) beat standard medical care for managing low back pain.

After one year, people who attended MBSR classes were more than 40 percent likely to show "meaningful" improvements in their pain and daily activities compared to people who sought conventional care for their aching backs. (Norton. Meditation May Help Ease Chronic Low Back Pain. Health Day News. March 22, 2016.)

 

Mood- Enhancing Approaches with Alternative Medicine

Drumming for Depression and Dropping Inflammation

PLoS One Reports:

Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04). All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health. (Fancourt D, Perkins R, Ascenso S, Carvalho LA, Steptoe A, Williamon A. Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users. PLoS ONE. 2016; 11(3): e0151136. doi:10.1371/journal.pone.0151136)

 

Combining Exercise and Meditation for Mood Boost

Mens Journal reports:

Regular aerobic exercise and meditation are both proven mood boosters, but done together, they're extra effective at combating depression. In the first study ever to examine the two therapies in tandem, the combination approach reduced symptoms of clinical depression by an astounding 40 percent. (Junttti, M.The Insane Power of Combining Exercise and Meditation. Mens Journal. 2016. )

 

Summary:  The example of pain abuse (and how this can lead to mood issues) is one way to demonstrate how integrative medicine may fill a gap in conventional medicine. Rather than just placing warnings on bottles, perhaps it's time to look at the root causes of pain and alternative tools to assist those suffering. After all, according to a headline in Health Day, "Nearly All U.S. Doctors 'Overprescribe' Addictive Narcotic Painkillers: Survey." (Health Day News. March 25, 2016)

 

Exercise and movement have been demonstrated to be very effective for brain health.25

In my homepage blog, I review the many factors involved in cognitive health and preventing dementia risk. In this blog, I review the impact of exercise on the brain.

In a review of literature, the authors sought to examine the evidence of the "cognitive neuroprotective effect of exercise." The authors reported the following: significant results with exercise and brain health including reduced risk of dementia and mild cognitive impairment, better cognitive scores in those already with dementia, a positive association of aerobic exercise in healthy adults and cognitive scores, a larger hippocampal volume and better spatial memory in a randomized trial of seniors using aerobic exercise. Other randomized trials in seniors showed attenuation of gray matter volume loss with aerobic exercise. There were also cross-sectional studies to support the effect of exercise on hippocampal and gray matter in seniors. Furthermore, functional magnetic resonance imaging displayed improved connectivity after 6 to 12 months of exercise. As if the above wasn't enough, the authors continue on with more support of exercise for the brain:

Animal studies indicate that exercise facilitates neuroplasticity via a variety of biomechanisms, with improved learning outcomes. Induction of brain neurotrophic factors by exercise has been confirmed in multiple animal studies, with indirect evidence for this process in humans. Besides a brain neuroprotective effect, physical exercise may also attenuate cognitive decline via mitigation of cerebrovascular risk, including the contribution of small vessel disease to dementia. Exercise should not be overlooked as an important therapeutic strategy.26

In an analysis of literature, researchers reported that exercise has a protective effect on aging and cognitive decline. They believed that more studies were needed to determine preservation of function, yet it may be a matter of finding better ways to measure how exercise impacts the brain beyond preservation. There was actually an earlier study that demonstrated reduced mortality risk in Alzheimer's disease. 27

This was a population-based study of 357 New Yorkers sixty-five years or older in which researchers prospectively assessed standard neurological and neuropsychological evaluations (every ~1.5 years). The purpose was to determine the association between physical activity (PA) and Alzheimer's disease progression risk. The researchers weighted in the effect of light, moderate, and severe exercise. They found that during the approximate 5 year follow up, those who were physically active had a lower mortality risk, even among those diagnosed with Alzheimer's. Adjusting for APOE genotype, smoking, other diseases, and cognitive performance didn't affect the association. The authors concluded:

Exercise may affect not only risk for AD but also subsequent disease duration: more PA is associated with prolonged survival in AD.28

In a cross-sectional study in four U.S. states with 9,344 women 65 years old or older, researchers sought to determine the association between physical activity during lifespan and cognitive impairment. The authors found physical activity was associated with lower prevalence of cognitive impairment, with teenage activity most strongly associated with lower odds. Still, those who became active later in life also had lower risk than the sedentary. 29

In the National Long Term Care Survey (NLTCS) level of exercise was measured at baseline (1994) and cognitive impairment was compared at baseline and 5-10 years at follow up.

Results At 10-year follow-up, the number of different types of exercises performed was inversely associated with the onset of cognitive impairment (p=0.002) as was the number of exercise sessions lasting at least 20 minutes (p=0.007).

Conclusion Study results from NLTCS data provide evidence supporting the potential for exercise to lower the risk of dementia. 30

The Mayo Clinic Study of Aging, a population-based-case-control study of 1,324 non-demented subjects completed a questionnaire on physical exercise. The authors assessed frequency and intensity of physical exercise. Interestingly, the authors only found a positive association with moderate intensity exercise.31

One study with twenty-one subjects used a combination of training exercises in coordination exercises and cognitive training. After 13 weeks, changes were observed in connectivity in the visual cortex, premotor area, and cingulate gyrus, supporting the impact on brain health. The authors concluded:

Premotor area and cingulate gyrus were also affected. We can conclude that the constant challenge of unfamiliar combinations of coordination tasks, combined with visual perception and working memory demands, seems to induce brain plasticity expressed in enhanced connectivity strength of brain regions due to coactivation.32

Now, click here to read the continuation of my blog on Eating, Exercise, and Essential Oils for Brain Health.

 

 

References:

25. Bergland C. Why Is Physical Activity So Good for Your Brain? Exercise improves the structure, function, and connectivity of your brain. Psychology Today. Sep 22, 2014. https://www.psychologytoday.com/blog/the-athletes-way/201409/why-is-physical-activity-so-good-your-brain

26. Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. Mayo Clinic Proceedings. 2011;86(9):876-884. doi:10.4065/mcp.2011.0252.

27. Duzel E, van Praag H, Sendtner M. Can physical exercise in old age improve memory and hippocampal function? Brain. 2016;139(3):662-673. doi:10.1093/brain/awv407.

28. Scarmeas N, Luchsinger JA, Brickman AM, et al. Physical Activity and Alzheimer's disease course. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry. 2011;19(5):471-481. doi:10.1097/JGP.0b013e3181eb00a9.

29. Middleton LE, Barnes DE, Lui L-Y, Yaffe K. Physical Activity Over the Life Course and its Association with Cognitive Performance and Impairment in Old Age. Journal of the American Geriatrics Society. 2010;58(7):1322-1326. doi:10.1111/j.1532-5415.2010.02903.x.

30. Jedrziewski MK, Ewbank DC, Wang H, Trojanowski JQ. Exercise and cognition: Results from the National Long Term Care Survey. Alzheimer's & dementia: the journal of the Alzheimer's Association. 2010;6(6):448-455. doi:10.1016/j.jalz.2010.02.004.

31. Geda YE, Roberts RO, Knopman DS, et al. Physical Exercise and Mild Cognitive Impairment: A Population-Based Study. Archives of neurology. 2010;67(1):80-86. doi:10.1001/archneurol.2009.297.

32. Demirakca T, Cardinale V, Dehn S, Ruf M, Ende G. The Exercising Brain: Changes in Functional Connectivity Induced by an Integrated Multimodal Cognitive and Whole-Body Coordination Training. Neural Plasticity. 2016;2016:8240894. doi:10.1155/2016/8240894.

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About Dr. Sarah Lobisco

Dr. LoBisco has been in holistic healthcare for over 10 years. She became interested in holistic medicine when she was able to heal two herniated discs through nutrition, yoga, supplementation, and chiropractic. She has mentored with holistic practices throughout New York, Vermont, and Connecticut. In addition to her Naturopathic and Functional Medical training, Dr. LoBisco has extensive training in a variety of healing modalities, including therapeutic essential oils, nutraceuticals, herbs, whole food supplements, nutritional medicine, and mind-body therapies. She is a graduate of the accredited, four year post-graduate program in Naturopathic Medicine at the University of Bridgeport in Connecticut. This program includes clinical rotations and a demanding scientific curriculum in integrating conventional and natural medicine. Dr. LoBisco holds her license from the state of Vermont.

Dr. LoBisco has completed her postdoctoral training as a certified functional medicine practitioner. She is also certified in Applied Kinesiology and holds a BA in psychology from SUNY Geneseo. She has contributed as an item writer for the North American Board of Naturopathic Examiners (NABNE)and has several articles that have been published in the Naturopathic Doctor News and Review Digest (NDNR) and the Townsend Letter, both physician- based journals. Dr. LoBisco is also a hired speaker on integrative medical topics for medical professionals.

Dr. LoBisco currently incorporates her training in holistic medical practices and conventional medicine through writing, researching, private practice, and through her independent contracting work for companies regarding supplements, nutraceuticals, essential oils, and medical foods. She has a small, private wellness consultation practice through telephone and Skype. Dr. LoBisco also enjoys continuing to educate and empower her readers through her blogs and social media. Her new book, BreakFree Medicine, is now available on Amazon and through Barnes & Noble. Please inquire here for more specific information.



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