Most do not meet heart health targets

Less than 2% of Americans meet seven recommended heart health targets that could dramatically reduce their risk of heart disease. The number of people has actually dropped. The seven behaviors include:

• Not smoking
• Being physically active
• Having normal blood pressure (under 120/80)
• Healthy fasting blood-glucose levels (below 100)
• Total cholesterol levels below 200
• Maintaining a healthy weight
• Eating a healthy diet

People who met six of the seven goals had a 76% lower risk of heart-related death and a 51% lower risk of death from any cause, compared with those who met one or fewer.

The study appeared in the Journal of the American Medical Association.

Bonnie: the only one we do not agree with is the total cholesterol below 200. There is so much much more to heart health than just total cholesterol. I would have liked to have seen high triglycerides included.

Warning for strontium supplement users

The European Medicines Agency's Committee for Medicinal Products for Human Use today recommended that the osteoporosis drug strontium ranelate no longer be used in immobilized patients or patients with venous thromboembolism. The committee also recommended updated warnings regarding serious skin reactions with strontium ranelate. It is not approved for the treatment of osteoporosis in the United States but is sold as a dietary supplement.

Want your kid to lose weight?

Then lose weight yourself.

A study appearing in journal Obesity shows that a parent's weight change is a key contributor to the success of a child's weight loss in family-based treatment of childhood obesity. After looking at parenting skills and styles, as well as changing the home food environment, the number one way in which parents helped an obese child lose weight was to lose weight themselves.

The researchers conclude that clinicians should focus on encouraging parents to lose weight to help their overweight or obese child in weight management.

In another study in Pediatrics, low carb diets work for kids, but they are tough to stick to. Obese 7- to 12-year-olds were assigned to one of three eating plans: one that followed the conventional wisdom of portion control; a low-carb diet; or a reduced glycemic load plan that cut down on certain carbs that typically cause surges in blood sugar -- like white bread, sweets and white potatoes. Over one year, all three plans worked equally well in controlling kids' weight gain. The difference, researchers found, was that the low-carb plan was tough to stick with. The reduced portion or reduced glycemic load diets were not.

All three diet groups ended up with healthier cholesterol levels. The low-carb group had a dip in triglycerides, another type of blood fat. And kids who focused on portion control or cutting glycemic load had signs of better blood sugar control.

Bonnie: What you should take away from both studies is that implementing a "family plan" for weight loss is ideal, and, focusing on eliminating high glycemic carbs is a priority.

Going with the flow of bio-energy

http://www.dailyherald.com/article/20120319/entlife/703199987/

Healthy 20s, Healthy 40s

Maintaining a healthy lifestyle from young adulthood into your 40s is strongly associated with low cardiovascular disease risk in middle age, according to a new study in journal Circulation.

According to the study's authors, even people with a family history of heart problems were able to have a low cardiovascular disease risk profile if they started living a healthy lifestyle when they were young. This supports the notion that lifestyle may play just as prominent a role as genetics.

This is the first study to show the association of a healthy lifestyle maintained throughout young adulthood and middle age with low cardiovascular disease risk in middle age. The majority of people who maintained five healthy lifestyle factors from young adulthood (including a lean body mass index (BMI), no excess alcohol intake, no smoking, a healthy diet and regular physical activity) were able to remain in this low-risk category in their middle-aged years.

In the first year of the study, when the participants' average age was 24 years old, nearly 44 percent had a low cardiovascular disease risk profile. Twenty years later, overall, only 24.5 percent fell into the category of a low cardiovascular disease risk profile. Sixty percent of those who maintained all five healthy lifestyles reached middle age with the low cardiovascular risk profile, compared with fewer than 5 percent who followed none of the healthy lifestyles.

Bonnie: This is how a preventive study should be structured. Twenty years is the ideal time to gauge the impact of optimal lifestyle adherence. The fact that the study started in young people was key.

Men: Cut out soda. Reduce CVD risk

Men who drank a daily 12-ounce sugar-sweetened beverage had a 20 percent higher risk of heart disease compared to men who didn't drink any sugar-sweetened drinks, according to research in Circulation. The Harvard School of Public Health researchers, who studied 42,883 men aged 40-75 years over a 22 year period, found that the increase persisted even after controlling for other risk factors, including smoking, physical inactivity, alcohol use and family history of heart disease. Less frequent consumption -- twice weekly and twice monthly -- didn't increase risk.

Multivitamins improve memory recall

Complementary medicine use is becoming increasingly popular with multivitamins being the most commonly used vitamin supplement. Although adequate vitamin and nutrient concentrations are necessary for optimal health and cognitive functioning, there is no scientific consensus as to whether multivitamin use prevents cognitive decline or improves mental functioning. The aim of the February 2012 Journal of Alzheimer's Disease study was to determine if multivitamins can be used efficaciously to improve cognitive abilities. Results indicated that multivitamins were effective in improving immediate free recall memory but not delayed free recall memory or verbal fluency.

New Pap smear guidelines

The annual Pap smear is now officially a thing of the past, as new national guidelines recommend cervical cancer screening no more often than every three years. The new guidelines, issued on Wednesday by the United States Preventive Services Task Force, replace recommendations last issued in 2003 and use more decisive language to advise women to undergo screening less often. The new guidelines were published in Annals of Internal Medicine.

Cost is not a factor in the task force recommendations. Instead, its members focus on the effectiveness of a screening test to reduce cancer deaths, balanced against the potential harms that accompany the screening. The worry about frequent Pap smear screening is that tests can result in a large number of false positives that lead to sometimes painful biopsies and put women at risk for pregnancy complications in the future, like preterm labor and low-birth-weight infants.

Beauty in a Bowl: Produce and Your Skin Tone

http://healthland.time.com/2012/03/12/beauty-in-a-bowl-eating-fruits-and-veggies-may-improve-skin-tone/

The worst place to be if you're sick

http://www.aarp.org/health/doctors-hospitals/info-03-2012/protect-yourself-from-hospital-errors.html

Do statins make it tough to exercise?

http://well.blogs.nytimes.com/2012/03/14/do-statins-make-it-tough-to-exercise/?ref=health

Bonnie: All the more reason to take CoQ10 if you are taking a statin.

In Gretchen Reynolds article, "Do Statins Make it Tough to Exercise," she eloquently brought attention to side effects patients must endure while taking statin medication. Statins' effect on mitochondria can be detrimental to muscles, especially in those who exercise regularly. The research she cites, in which joggers saw an extreme rise in free radical production, is well known to the manufacturers of statins as well as health professionals. Unfortunately, Ms. Reynolds missed a golden opportunity to present one crucial aspect of this issue. Co-enzyme Q10, or CoQ10, ensures optimally functioning mitochondria because it quenches excess free radical production. CoQ10 is depleted by statin medication.

Merck, maker of the popular Zocor, applied for patents in 1989 and 1990 for CoQ10-simvastatin combination products. The company’s 1989 patent application states that a combined statin-CoQ10 product might be effective against not only cardiomyopathy, but also elevated levels of the enzyme transaminase, which reflects liver damage. The company has thus far declined to exercise these patents, and the FDA and other major drug manufacturers have yet to acknowledge the risk of CoQ10 depletion from statins.

Many cardiologists recommend CoQ10 supplements to patients taking statin medications because humans do not produce CoQ10. It can only be obtained through meat products and supplements.

Statin medication is currently being considered by the FDA to be sold over-the-counter. The public must know every detail of these medication, even if the truth is not as rosy as we would like it to be.

A Dairy Farm's Disneyland

One of our clients forwarded this to us. Amazing.

http://www.youtube.com/watch?v=JJRy82i8e5Q&feature=email

NIH announces database for genetic test info

The National Institutes of Health (NIH) has unveiled its Genetic Testing Registry, a database of information on genetic tests that will be voluntarily submitted by test producers. According to the NIH, there are now genetic tests available for some 2,500 diseases, including those tests that can be directly purchased by consumers.

The registry is meant to provide patients and health-care providers with a centralized repository for details on the myriad of disease-specific tests that are now available. It will serve as a resource for “all who are struggling to make sense of the complex world of genetic testing”.

The NIH is now asking for genetic-testing companies to submit to the registry on a voluntary basis. The registry can be queried by the name of a genetic test, the name of the test’s provider or, more generally, by a condition (for example, cardiomyopathy or hearing loss) or gene. It also links to National Library of Medicine descriptions and data.

The Council for Responsible Genetics (CRG) commends the NIH for creating the database, which offers consumers previously inaccessible information. However, the group is concerned by the lack of oversight to ensure that the data are accurate. The NIH does not keep this point secret. At the bottom of every page of the online registry, the agency notes that “NIH does not independently verify information submitted to the GTR; it relies on submitters to provide information that is accurate and not misleading.”

Bonnie: Keep in mind that even though genes that appear on this registry may be associated with certain health conditions, it in no way means that you will get those conditions. In fact, there is still so little yet known about how certain genes work in conjunction with one another that there are very few, if any certainties. For example, one gene, BRAC, once thought to be iron clad in its link to breast cancer, has recently come into question. Stay tuned.

More men are grocery shopping. I'm one of them!

Steve: According to consumer research from Schnuck Markets, six percent more men are doing the primary grocery shopping in their household versus five years ago. As someone who took over the reins about 18 months ago, I am that six percent.

What's fascinating about this research is that it corroborates with what I have found since I started buying the food.

• While men make significantly more routine and immediate needs trips than women, female shoppers spend more money during these excursions than men. Steve: I agree. While food prices have increased significantly since I took over, and my kids are eating more, I have kept the food budget in line with where it was 18 months ago.
  
  
• Women also spend more time shopping with the largest difference coming from routine trips. Steve: I agree. I cannot count how many times my kids have said after coming out of the grocery store, "Dad, Mom would have taken at least twice as long." No offense babe :)
  
  
• Men shop later in the day, and are more likely than women to make a fill in trip after 6 p.m. Steve: I disagree. I like to get it out of the way early in the morning on a Saturday or Sunday. I will go to Trader Joes, Sunset Foods/Whole Foods, and Costco in a span of ninety minutes to two hours. And I only go to these locations once a week!
  
  
• Steve: While Shcnuck's did not explore this issue, I thought I would: impulse purchases. One thing that makes my shopping more efficient is to get only what I need. I have my shopping list on my iPhone and I remove each item as I go. No impulse purchases are allowed. This allows me to go into Costco at 10AM and be checking out at 10:10AM. Boom, done!

Feel free to share your grocery shopping tips.

Gadgets in the bedroom can hurt your sleep

http://www.huffingtonpost.com/2012/03/13/ipad-use-bedroom-sleep_n_1339346.html?ref=healthy-living

Red Meat Mortality Study: So Right and So Wrong

Bonnie and Steve: A study published Monday in the Archives of Internal Medicine from some of the most respected nutrition researchers in the world confirmed what most of us already know. The more conventional red meat you eat, the higher your risk of dying.

Conventional raw red meat is comprised of inflammatory omega-6 fats, antibiotics, hormones, and chemical byproducts. Processed red meat includes the aforementioned as well as nitrates, excess sodium, sugar, and a host of other chemicals.

Unfortunately, the Harvard researchers lost an amazing opportunity to offer a solution for the future of red meat. There was no mention or distinction between how conventional animals are raised and how organic animals are raised.

The diet of conventional animals raised for red meat consumption is diametrically opposed to how they should be eating genetically. This produces sickly, inflammatory, chemical-laden meat.

Domesticated animals raised for red meat consumption that are provided with diets that are genetically harmonious produce healthful, nutrient dense meat. Furthermore, the majority of these animals are provided the opportunity to exist in an open, stress-free environment.

Instead of categorically denouncing red meat, which the mainstream media will certainly feed upon, the researchers missed a golden opportunity to offer an alternative to the way red meat is currently presented to the world.

Weight-loss supplements ineffective

Researchers have reviewed the body of evidence around weight loss supplements and has bad news for those trying to find a magic pill to lose weight and keep it off -- it doesn't exist. The study appears in International Journal of Sport Nutrition and Exercise Metabolism.

A few products, including green tea and fiber, can have a modest weight loss benefit of 3-4 pounds. Researchers looked at supplements that fell into four categories: products such as chitosan that block absorption of fat or carbohydrates, stimulants such as caffeine or ephedra that increase metabolism, products such as conjugated linoleic acid that claim to change the body composition by decreasing fat, and appetite suppressants such as soluble fibers. Most of the products showed less than a two-pound weight loss benefit compared to the placebo groups.

Some were found to have side effects ranging from the unpleasant, such as bloating and gas, to very serious issues such as strokes and heart problems. According to the researchers, adding fiber and drinking green tea can help, but will not have much effect unless one addresses whole body lifestyle change, including exercise, dietary modification, stress management, environmental modification, and pharmaceutical management.

Pink slime meat being bought for school lunches

http://chicagoist.com/2012/03/07/pink_slime_meat_rejected_by_mcdonal.php

Magnesium intake in the US: suboptimal.

In comparison with calcium, magnesium is an “orphan nutrient” that has been studied considerably less heavily. Low magnesium intakes and blood levels have been associated with type 2 diabetes, metabolic syndrome, elevated C-reactive protein, hypertension, atherosclerotic vascular disease, sudden cardiac death, osteoporosis, migraine headache, asthma, and colon cancer. Almost half (48%) of the US population consumed less than the required amount of magnesium from food in 2005–2006, and the figure was down from 56% in 2001–2002.

Surveys conducted over 30 years indicate rising calcium-to-magnesium food-intake ratios among adults and the elderly in the United States, excluding intake from supplements, which favor calcium over magnesium. The prevalence and incidence of type 2 diabetes in the United States increased sharply between 1994 and 2001 as the ratio of calcium-to-magnesium intake from food rose.

Dietary Reference Intakes determined by balance studies may be misleading if subjects have chronic latent magnesium deficiency but are assumed to be healthy. Cellular magnesium deficit elicits calcium-activated inflammatory cascades independent of injury or pathogens. Refining the magnesium requirements and understanding how low magnesium status and rising calcium-to-magnesium ratios influence the incidence of type 2 diabetes, metabolic syndrome, osteoporosis, and other inflammation-related disorders are research priorities. Nutrition Reviews, March 2012

Hypomagnesemia
Hypomagnesemia is relatively common, and most patients are asymptomatic. Causes of hypomagnesemia include inadequate magnesium intake, increased gastrointestinal or renal loss, and drugs such as PPIs and loop diuretics. Patients with symptomatic hypomagnesemia frequently have other electrolyte disturbances that are resistant to treatment until the hypomagnesemia has been reversed. Clinical Endocrinology, December 2011

Gluten, casein-free diet helps with autism

A gluten-free, casein-free diet may lead to improvements in behavior and physiological symptoms in some children diagnosed with an autism spectrum disorder (ASD), according to research in the journal Nutritional Neuroscience.

The research team asked 387 parents or primary caregivers of children with ASD to complete a 90-item online survey about their children's GI symptoms, food allergy diagnoses, and suspected food sensitivities, as well as their children's degree of adherence to a gluten-free, casein-free diet. They found that a gluten-free, casein-free diet was more effective in improving ASD behaviors, physiological symptoms and social behaviors for those children with GI symptoms and with allergy symptoms compared to those without these symptoms.

Specifically, parents noted improved GI symptoms in their children as well as increases in their children's social behaviors, such as language production, eye contact, engagement, attention span, requesting behavior and social responsiveness, when they strictly followed a gluten-free, casein-free diet.

According to the researchers, autism may be more than a neurological disease -- it may involve the GI tract and the immune system. "There are strong connections between the immune system and the brain, which are mediated through multiple physiological symptoms," they said. "A majority of the pain receptors in the body are located in the gut, so by adhering to a gluten-free, casein-free diet, you're reducing inflammation and discomfort that may alter brain processing, making the body more receptive to ASD therapies."

The team also found that parents who implemented the diet for six months or less reported that the diet was less effective in reducing their child's ASD behaviors. Parents who completely eliminated both gluten and casein from their child's diet, as opposed to just on of them, reported the most benefit.

Bonnie: Progressive health professionals have known for years that the gut and brain are inextricably linked. However, it is always nice to see the research validate what we have seen clinically.

The Sleep Quandary: Is Melatonin Safe?

With all the recent issues with sleeping pills, Melatonin has shown to have a solid safety record.

Children
A review article in the March 1 issue of Natural Medicine Journal covers key studies on the use of melatonin in pediatrics, including its use for children’s sleep disorders, pediatric anesthesia, epilepsy and febrile seizures, adolescent idiopathic scoliosis, neonatal care, and the feeding of newborns.

Key Findings:
Melatonin use in children has been well-studied to date, and research suggests efficacy for several conditions. Melatonin has been most studied for its chronobiotic (sleep modulation) effects in various pediatric populations. No significant side effects of melatonin use in children have been reported.

Most interesting is the use of melatonin in children’s insomnia, a condition for which there are no approved pharmaceutical drugs. Most pediatricians and primary care physicians rely on behavioral treatments for insomnia, but a growing number of physicians are recommending melatonin. Administration of melatonin has been associated with faster sleep onset, as well as increased sleep duration. The greatest effect is seen with advancing sleep onset, and the most benefit is achieved when melatonin is dosed approximately 30–60 minutes before desired bedtime.

In the area of pediatric anesthesia, melatonin has been studied as an alternative to general anesthesia for diagnostic procedures such as MRI or brainstem audiology. It has also been studied as a premedication to general anesthesia for surgical procedures.

Most importantly, the body of evidence reviewed highly suggests that melatonin administration is very safe, even in the youngest children.

Melatonin Safe for Post-Menopausal Breast-Cancer Survivors
In the March issue of Cancer, Causes, and Control, researchers examined compliance with and the effects of melatonin supplementation on breast cancer biomarkers (estradiol, insulin-like growth factor I (IGF-1), insulin-like growth factor–binding protein 3 (IGFBP-3), and the IGF-1/IGFBP-3 ratio) in postmenopausal breast cancer survivors.

In a double-blind, placebo-controlled study, postmenopausal women with a prior history of stages 0-III breast cancer who had completed active cancer treatment (including hormonal therapy) were randomly assigned to either 3 mg oral melatonin or placebo daily for 4 months. Melatonin was well tolerated without any grade 3/4 toxicity. Overall, among postmenopausal women with a prior history of breast cancer, a 4-month course of 3 mg melatonin daily did not influence circulating estradiol, IGF-1, or IGFBP-3 levels.

Vitamin D and Crohn's prevention

Increased intake of vitamin D may significantly reduce the risk for Crohn's disease (CD) in women, according to an article published in the March issue of Gastroenterology.

Investigators found that 72,719 vitamin D–sufficient women were 62% less likely to be diagnosed with CD during a 22-year period compared with those deemed deficient. The direct relationship between vitamin D ingestion and reduction in CD risk was not affected by smoking status or contraceptive use. According to the article, results strengthen the rationale for considering vitamin D supplementation both for treatment of active CD or prevention of disease flares.

According to a Mayo Clinic physician not associated with the study, "Many patients are worried about medication safety, so any vitamin that might either reduce the risk of Crohn's or might decrease relapse rates is going to be well received by patients."

Removing BGH from milk lowers diabetes risk

Bonnie - the dairy lobby cannot claim there is no data showing that BGH may affect children adversely, as this week's Archives of Pediatric and Adolescent Medicine study exhibits.

Researchers wanted to know whether weaning to a bovine insulin–free cow's milk formula (CMF) reduces type 1 diabetes mellitus–associated autoantibodies in children at genetic risk. The randomized, double-blind pilot trial examined 1113 infants over three years with HLA-conferred susceptibility to type 1 diabetes were randomly assigned to receive the CMF, whey-based hydrolyzed formula (WHF) (n = 350), or whey-based FINDIA formula essentially free of bovine insulin during the first 6 months of life whenever breast milk was not available.

6.3% of children in the CMF group, 4.9% of those in the WHF group, and 2.6% of children in the FINDIA group were positive for at least 1 autoantibody by age 3 years. In comparison with ordinary CMF, weaning to an insulin-free CMF reduced the cumulative incidence of autoantibodies by age 3 years in children at genetic risk of type 1 diabetes mellitus.

Catching hepatitis B infection at the nail salon

http://www.aol.com/video/catching-hepatitis-b-infection-at-the-nail-salon/517286124/?ncid=webmail3

Look for nutrition labels on meats today

The next time you shop at the grocery store, you may see something new– nutrition labels on meat. The same types of labels you already find on other foods. The U.S. Department of Agriculture made nutrition labeling mandatory today for all raw meats. The new rule affects all ground meat and poultry and 40 of the most popular cuts of meat in the United States such as chicken breasts, steaks, pork chops, roasts, lamb and veal. If the nutrition facts are not on the package, as in the case of some larger cuts of meat, look for posters or signs at the meat counter for this information.

Mitigating preventable chronic disease....in 6 weeks!

Nutrition Metabolism, February 2012

Cleveland Clinic ran a study with their Lifestyle 180 program. Participants had at least one of 8 chronic conditions (obesity, hypertension, hyperlipidemia, diabetes, non-alcoholic fatty liver disease, multiple sclerosis, early stage breast or prostate cancer.

An initial 48 hours of lessons curriculum was taught twice per week, in four-hour sessions each over the first six weeks, called an Immersion Phase. During this period, the first four-hour session of the week was divided into 60 minutes of participant physical activity and 90 minutes of participant cooking and nutrition as well as stress management classes, while during the second session of the week, 60 minutes period was devoted to participant exercise and practice of cooking/nutrition, stress management and biometric one-on-one sessions each. The follow-up phase included three components to help maintain behavioral changes. These included 1) on-site classes at weeks 10, 18 and 30 that followed the same four-hour structure as occurred during the Immersion phase on the second day of the week, 2) a weekly e-mail newsletter and 3) the buddy system. Buddies were assigned within each group during the initial six-week session and were asked to keep in daily contact.

Nutritional aspects of the program most closely align with the Mediterranean diet. The Lifestyle 180 program eliminates trans fats as well as added sugars and syrups, limits saturated fat and substitutes only 100% whole grains/grain products for processed grain foods. Besides complex carbohydrates, Lifestyle 180 nutritional approach promotes an increase in intake of plant foods to provide a spectrum of phytochemicals exerting diverse beneficial biological functions.

The nutritional component of Lifestyle 180 was team-taught, with a chef and a dietitian. First, the chef worked with participants in the teaching kitchen. In an adjoining dining room/classroom, while participants were eating a meal they helped prepare, the dietitian conducted a seminar and guided a discussion about the nutritional aspects of what they had cooked as well as a covered topic of the day. To motivate participants to change how and what they eat, they were engaged into meal preparation in the kitchen. Gaining confidence with the kitchen equipment and different types of foods as well as learning how to manage time during meal preparation were considered important elements of the efforts to increase the likelihood that participants will change their dietary habits.

As part of the nutrition education of participants, one class during the Immersion Phase involved a grocery store experience. In this environment, participants learned how to read nutrition and ingredient labels, what to avoid in packaged foods and how to "shop" a grocery store (i.e. what aisles to avoid, which to frequent).

An exercise instructor led the class in the Lifestyle 180 Fitness Center that included progressive cardiovascular and endurance training as well as resistance training. Patients were encouraged to wear pedometers that were provided at start of the Program, with a goal of 10,000 steps per day and to record their steps on a daily diary sheet.

This component was team-taught, with a restorative yoga therapist and a behavioral health specialist. To sustain healthy lifestyle modifications, behavioral interventions were implemented during the course of the program. Those included goal setting, keeping records of lifestyle practices, social support, cognitive restructuring and problem solving. Patients learned meditation and mindfulness practices and performed simple yoga poses initially sitting or standing and at later stages of the program lying down. Regular elicitation of the "relaxation response", the physiological opposite of the "fight or flight response", may reduce psychological distress and improve medical symptoms in patients with any of a wide array of medical conditions.

Preventable chronic diseases continue to drive health care costs substantially and importantly upward, in part due to a lack of sustainable treatment options. Specific medications, such as cholesterol-lowering and diabetes medications target mostly one chronic disease-associated abnormality of elevated LDL cholesterol or plasma glucose, respectively, rather than the cause of the abnormality.

While surgical interventions successfully treat obesity and a spectrum of associated metabolic changes, they poorly address the behavioral and lifestyle-related factors that led to the development of chronic conditions in the first place. In contrast, comprehensive lifestyle interventions may result in multiple physiological systems changes including behavior modifications that support long-term healthier lifestyle choices.

The researchers report findings that a tri-pronged lifestyle intervention consisting of diet, physical activity and stress management improves disease-associated markers of participants with multiple chronic conditions. All measured biometric and laboratory variables significantly improved after just 6 weeks of intervention. Beneficial changes in blood pressure and glucose were observed in many participants by the second week of the program, thus supporting previously reported observations of the quick onset of measurable benefits that follow a comprehensive lifestyle intervention.

At week 30, HDL cholesterol is significantly higher than at the baseline and the total cholesterol/HDL ratio improves further. Fasting triglyceride level is also significantly reduced at both points in time (week 6 and 30) compared with baseline, reflecting the observations that triglycerides improve after weight loss.

Lifestyle 180 intervention resulted in significantly healthier markers of glucose metabolism and inflammation. Insulin and CRP show large percentage decreases. It is therefore, not surprising that the percent of participants with metabolic syndrome was significantly lower after 6 months of lifestyle interventions (an estimate relative 32 percent lower, from 54% to 37%).

One caveat: less than 25% of participants paid out of their pocket for participation in the program.

Medication changes at 30 weeks

	Diabetes	Hyperlipidemia	Hypertension	Total
Stopped	33	39	79	151
Decreased	47	12	30	89
Avoided	3	18	3	24
Total	83	69	112	264
Started	12	14	36	62
Increased	9	3	6	18
Total	21	17	42	80

Participation in a comprehensive Lifestyle 180 program resulted in significant and rapid, as well as clinically and biologically relevant improvements in biometric and laboratory outcomes, including reduced need for medications, for adults with multiple chronic conditions.

Bonnie: none of what was accomplished here is difficult to do outside of a hospital setting. Many of us live under these healthy lifestyle parameters each week, including reading our weekly eNewsletters. It just reaffirms that when done properly, dramatic change in health can occur rapidly and definitively.

Kids get 16% of calories from added sugar

They are downing an average of 322 calories a day from added sugars, or about 16% of their daily calories. Boys consume 362 calories a day from them; girls, 282 calories. The data from the National Center for Health Statistics, released today, show 59% of added-sugar calories come from foods and 41% from beverages. But soft drinks are still the biggest single source of added sugars in children's diets. Added sugars include table sugar, brown sugar, high-fructose corn syrup, maple syrup, honey, molasses and other caloric sweeteners in prepared and processed foods and beverages, such as cakes, candy, cookies, muffins, soft drinks, jams, chocolates and ice cream.

Not included in this analysis are sugars in fruit and 100% fruit juice.

Steve: add the fact that sugar is as addictive as drugs and that addicts need more to be satiated, we have a serious issue.

Researchers at the Oregon Research Institute in Eugene tested whether eating ice cream would lead the brain to require more and more of it before sending signals that it's an enjoyable treat. They surveyed 151 adolescents about their food cravings, and then scanned their brains while showing them images of a chocolate milkshake to determine how strong their cravings were. The researchers also measured brain activity when the subjects drank a tasteless liquid as a comparison. The teenagers were then fed actual milkshakes.

The participants who reported eating more ice cream over the previous two weeks enjoyed the shakes less -- at least according to the brain scans. The scans showed less activity in the area of the brain associated with reward."We believe that means the more an individual is consuming a high-fat, high-sugar and high-energy food, they develop a tolerance of it in a similar fashion that you see happening with drug addiction or alcohol addition," said the researchers.

Nations' health not improving

The nation's overall health is not improving, a recent national report finds. Worrisome increases in obesity, diabetes and the number of children living in poverty are offsetting modest improvements in overall health, according to "America's Health Rankings."

The report, which is published annually, found that for every person who quit smoking in 2011, someone else became obese. Moreover, the number of U.S. children living in poverty continued to climb in 2011, as did the number of Americans who lacked health insurance. "The health of America is in serious, serious trouble," Reed Tuckson, MD, executive vice president and chief of medical affairs at United Health Group, said at a Washington, D.C., news conference releasing the report in December. "This ordinarily would be a celebratory moment, but quite frankly, my heart is heavy. We are delivering a tsunami of preventable chronic illness into the hands of a delivery system that America cannot afford."

Overall, the report is a mixture of good and bad news. Tobacco use has declined 3.4 percent since 2010 and 25.4 percent since 2001. However, while 1.4 million Americans quit smoking last year, another 1.4 million Americans became obese. Overall, the prevalence of obesity has increased 137 percent, rising from 11.6 percent of the population in 1990 to 27.5 percent of the population in 2011. More than one in four American adults — or 65 million people — are considered obese today. If current trends continue, 43 percent of Americans will be obese by 2018.

In 2011, 8.7 percent of American adults, or more than 20 million people, had been told by a physician that they have diabetes. The number is almost double the 4.4 percent diabetes prevalence seen in 1996. If the diabetes trend continues, 10 percent of all health care dollars will be spent managing the complications of diabetes by 2020.

The rankings are published jointly by American Public Health Association, the United Health Foundation and Partnership for Prevention. The report assesses the nation's health based on 23 factors, including binge drinking, prenatal care, violent crime, occupational fatalities and obesity. This is the first time in the report's 22-year history that not a single state has a prevalence of obesity less than 20 percent.

For the fifth year in a row, the report ranked Vermont as the healthiest state, followed by New Hampshire, Connecticut, Hawaii and Massachusetts. Vermont's strengths include a high rate of high school graduation, a low violent crime rate, a low rate of infectious disease, a high usage of early prenatal care, high per capita public health funding, a low rate of uninsured residents and ready availability of primary care physicians. Vermont has low immunization coverage.

More omega-3 equals larger brain volume

Courtesy of the New York Times

Low blood levels of omega-3 fatty acids are associated with smaller brain volume and poorer performance on tests of mental acuity, even in people without apparent dementia, according to a new study in the journal Neurology. Scientists examined 1,575 dementia-free men and women whose average age was 67. The researchers analyzed the fatty acids of the subjects’ red blood cells, a more reliable measurement than a plasma blood test or an estimate based on diet. They used an M.R.I. scan to measure brain volume and white matter hyperintensities, a radiological finding indicative of vascular damage.

People in the lowest one-quarter for omega-3 levels had significantly lower total cerebral brain volume than those in the highest one-quarter, even after adjusting for age, body mass index, smoking and other factors. They also performed significantly worse on tests of visual memory, executive function and abstract memory than those in the highest one-quarter.

Citrus fruits reduce stroke risk

High intake of flavanones, a subclass of flavonoids found in the greatest concentrations in oranges and grapefruit, is associated with a 19% lower risk for ischemic stroke in women, a new analysis from journal Stroke has shown. Although oranges are the best source of flavanones, North Americans tend to drink the juices of these fruits, which do not provide adequate flavonone content.

The average intake of total flavonoids was 232 mg/d, the lowest intake was 96.8 mg/d, and the highest was 761.2 mg/d. Tea was the main contributor to total flavonoid intake, with apples and oranges also contributing significant amounts. Blueberries were the main source of anthocyanins, and oranges were the main contributors to flavanone and flavone intake.The study found that flavanone intake was inversely related to the risk for ischemic stroke.

Bonnie - as good as citrus can be, one has to be careful. Because of its acidity and allergy potential, many people do not tolerate citrus well. You also need to be careful regarding citrus and certain medications.

FDA Warns on Statins

The Food and Drug Administration raised safety concerns about the popular class of cholesterol-fighting drugs called statins, warning that patients taking the drugs may face a "small increased risk" of higher blood sugar levels and of being diagnosed with diabetes. The FDA is also adding language that memory loss may occur as well. Full story below.

http://online.wsj.com/article/SB10001424052970203833004577251392001194250.html

http://healthland.time.com/2012/02/29/fda-warns-statin-users-of-memory-loss-and-diabetes-risks/

Bonnie - if the FDA comes out with a warning on the most popular class of drugs on earth, take heed. Believe me, it took a 500 pound weight of data dropped on their heads to make this announcement.

According to a recent study in Therapeutic Advances in Drug Safety, this is how many patients it takes to treat with statins to save one life or prevent one cardiac event:

• All-cause mortality: 28
• Coronary heart disease mortality: 34
• Nonfatal myocardial infarction: 38
• Need for revasculariztion: 24
• Stroke: 58

With the mounting number of side effects, does this seem fair to the patients who will not benefit?

Dr. Altman: dermotologist says acne linked to diet

Bonnie and Steve: We've said this for years. However, if you did not take our advice, maybe you'll listen to a dermatologist. This is Dr. Altman's column word for word at the blog entitled "Rash Decisions".

Should we talk to our acne patients about diet?

by Emily Altman, MD, Dermatology

For years I sat in exam rooms with parents and teens and told them there was no relationship between diet and acne to the great delight of the kids. Parents begged me to tell their kids that too much of potato chips, pizza, chocolate, soda or any junk food at all was what was causing the kids to break out. But from what I knew at that point, there was no scientific evidence of a link between diet and acne. Well, little did I know!

Acne vulgaris, the most common skin condition, is a highly prevalent, multifactorial disorder of the pilosebaceous unit. The epidemiology data from 2001 showed that approximately 45 million people in the United States have acne, with an estimated prevalence of 85% in those between ages 15 and 24 (1).Acne affects 60-70% of Americans at some time during their lives. Twenty percent have severe acne with permanent physical and possibly psychological scarring (2).

Acne forms as a result of obstruction and inflammation of hair follicles and their accompanying sebaceous glands (pilosebaceous units). There are multiple factors involved, including the biology of the sebaceous gland itself, sebum production, hyperkeratinization of the hair follicle, bacterial influences, the immune functions of the sebaceous gland, neuropeptides, cytokines and toll-like receptors, hormones and nutritional factors (3).

Although familial studies have demonstrated that hereditary factors are important in determining susceptibility to acne (4), twin studies have suggested that developing clinical acne is partially under environmental control (5).

Nutrition is one of those environmental factors that can and should be controlled in any acne treatment regimen. So what is the evidence for the role of nutrition in the pathogenesis of acne?

In one of the first papers to be published on the subject of the relationship of acne and diet, Cordain et al examined the prevalence of acne in two nonwesternized societies: The Kitavan Islanders of Papua New Guinea and the Ache hunter-gatherers of Paraguay (6). No cases of acne were found among the 1200 Kitavan (including 300 15-25 year olds) or 115 Ache (15 15-25 year olds) examined. The authors observed that both the Ache and Kitavan diets were composed of minimally processed plant and animal foods, virtually devoid of typical Western-diet high glycemic loads that may acutely or chronically elevate insulin levels. Neither society had any evidence of insulin resistance. Kitavans were also not found to be overweight or hypertensive. Previous studies have demonstrated that diet-induced hyperinsulinemia elicits an endocrine response that promotes unregulated tissue growth and enhanced androgen synthesis. Based on that the authors concluded that dietary interventions with low glycemic loads may have a therapeutic benefit in acne treatment.

Interestingly, in the Eskimo and Zulu populations, acne was absent when they were living and eating in traditional manner, but became a problem when these populations moved from their villages to the cities (7).

A 2006 prospective cohort study by Adebamowo et al. that examined 6094 girls aged 9-15 years showed that a greater consumption of milk was associated with a higher prevalence of acne (8). The results were not associated with the fat content of the milk. The authors postulated that the milk intake affected acne though the insulin-like growth factor-1 pathway and through the bioactive molecules milk contains, such as androgens, 5 alpha reduced steroids and other steroid hormones. The sebaceous gland has a full complement of enzymes that can produce testosterone from cholesterol or from its precursors found in milk. Similar results were shown when the Adebamowo team looked at dairy consumption and acne in teenage boys (9).

In 2007 Smith et al. compared the effect of an experimental low glycemic-load diet with a conventional high glycemic-load diet on clinical and endocrine aspects of acne vulgaris. In that study 43 male patients with acne completed a 12-week, parallel, dietary intervention study with investigator-masked dermatology assessments. Primary outcomes measures were changes in lesion counts, sex hormone binding globulin, free androgen index, insulin-like growth factor-I, and insulin-like growth factor binding proteins. The study found that at 12 weeks, total lesion counts had decreased more in the experimental group compared with the control group. The experimental diet also reduced weight, reduced the free androgen index, and increased insulin-like growth factor binding protein-1 (which reduced the bioavailability of IGF-1) when compared with a high glycemic-load diet. The study suggested that nutrition-related lifestyle factors play a role in acne pathogenesis (10).

The evidence for the role of insulin, insulin-like growth factor-1, hyperglycemic food and milk consumption in the pathogenesis of acne was summarized in a viewpoint paper by Melnik and Schmitz (11). Authors wrote, "A growing body of evidence underlies the role of insulin resistance with increased insulin/IGF-1 signalling in the pathogenesis of acne. IGF-1 is the key hormonal mediator regulating adreno-gonadal androgen synthesis, amplifying cutaneous androgen activity and stimulating proliferation of sebaceous follicle."The authors provided an overview of conditions associated with increased IGF-1 serum levels. Many of these conditions are frequently associated with acne.

• Large for gestational age newborns of mothers with milk consumption during pregnancy
• Large for gestational age newborns of mothers with diabetes during pregnancy
• Cow milk formula-fed newborn infants
• Recombinant IGF-1 therapy for dwarfism
• Precocious pubarche
• Puberty
• Adolescents or adults who were small for gestational age or had low birth weight
• PCOS
• Milk and milk protein consumption
• High glycemic foods
• Acromegaly
• Obesity
• States of hyperinsulinemia and insulin resistance
• IGF-1 gene variations like absence of IGF-1 CA 19/19 allele
  

In 2011 Veith and Silverberg looked conducted a meta-analysis of the data on the impact of diet on acne reported in the literature (12). Dietary factors included high glycemic load; milk and dairy; chocolate; salty, oily, and fatty foods. The impact of obesity on acne was also examined. The authors concluded that of all the factors looked at, there is strong evidence for an association between high glycemic load foods and acne. A similar association was found with milk. Dairy products contain approximately 60 other growth factors and micronutrients that can influence acne (3).With all this evidence, the conclusion seems very clear. In addition to prescribing medications, counseling about dietary modifications, such as elimination of dairy products and high glycemic foods must be part of treating acne patients in order for have optimal treatment outcomes.

References:
Agency for Healthcare Research and Quality. Management
of acne. Summary, evidence report D technology assessment: number 17. AHRQ publication no. 01-E018, March 2001.http://archive.ahrq.gov/clinic/epcsums/acnesum.htm
Fulton J. Acne Vulgaris. eMedicine 2011 http://emedicine.medscape.com/article/1069804-overview#a0101
Kurokawa I et al. New developments in our understanding of acne pathogenesis and treatment. Experimental Dermatology 2009;18:821-832
Goulden V, McGeown CH, Cunliffe WJ. The familial risk of adult acne: a comparison between first-degree relatives of affected and unaffected individuals. Br J Dermatol. 1999;141:297-300.
Walton S, Wyat EH, Cunliffe WJ. Genetic control of sebum excretion and acne: a twin study. Br J Dermatol. 1989;121:144-145.
Cordain et al. Acne Vulgaris. A Disease of Western Civilization.Arch Dermatol. 2002;138:1584-1590
Ghodsi SZ et al. Prevalence, severity, and severity risk factors of acne in high school pupils: a community-based study. J Invest Dermatol. 2009 Sep;129(9):2136-41
Adebanowo CA et al. Milk consumption and acne in adolescent girls. Dermatol Online J. 2006 May 30;12(4):1.
Adebamowo CA. Milk consumption and acne in teenaged boys.J Am Acad Dermatol. 2008 May;58(5):787-93.
Smith RN et al. The effect of a high-protein, low glycemic-load diet versus a conventional, high-glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007;57(2):247-56
Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Experimental Dermatology2009;18:833-41.
Veith WB, Silverberg NB. The Association of Acne Vulgaris With Diet. Cutis 2011;88:84-91

How many Americans blow off breakfast?

A national survey conducted by StrategyOne sought to understand breakfast habits and the role breakfast plays in providing Americans with the sustained morning energy they need. Sixty-one percent of American adults believe breakfast to be the most important meal of the day, yet only 48 percent eat breakfast every morning.

• Breakfast skipping is more common in major Southern cities, with Dallas-Fort Worth (54 percent) and Houston (60 percent) residents forgoing breakfast most frequently.

• New Yorkers (69 percent) and Los Angelenos (66 percent) suffer most from morning energy drain, while residents of Washington, D.C. (44 percent) and Boston (46 percent) are least likely to be sluggish in the morning.

• Among those who eat breakfast daily, men seem to get more out of their breakfast, with 53 percent of men feeling more productive after breakfast versus 44 percent of women.

• Almost two in three Americans admit to having low levels of energy in the morning, with 57 percent looking to breakfast to help provide fuel for their morning.
  

Dr. Schuster's eBrief: 10 Steps to Prepare for Birth

I have been working with pregnant women since 1989 and here are 10 suggestions to help prepare mom and newborn for the best birth possible.

1. It has been shown that chiropractic care during pregnancy helps to decrease labor time, keeps women comfortable during pregnancy and keeps baby in the best position for birth. Therefore, I recommended getting adjusted monthly in the first and second trimester, every two weeks during the third trimester and then weekly during the last few weeks of pregnancy.
2. To prepare the body and mind to be strong and flexible for birth, take yoga, guided meditation and or other classes that are specifically geared towards pregnant women.
3. Consider taking birth classes that are outside of the hospital. These are often more comprehensive and offer more helpful tools for both the new mom and new dad.
4. Along with having one’s husband or partner at the birth consider adding a doula or a trusted friend. These people add an element of experience; support and advocacy that can help create a more fulfilling birth experience. Some doulas also come to the home a few days after the baby is born to check up on everything.
5. Pain has been associated with something wrong, with injury to the body. Labor is not injury; a woman’s body is designed to accommodate birth. What causes the “pain” of labor? The ligaments of the uterus and the surrounding muscles are stretching and the baby puts pressure on the cervix, low back and birth canal. Understanding this and then training the mind to describe these feeling of labor as strong sensations can help reduce the fear that is often associated with delivery. Consider taking Hypnobirthing classes and reading books that are written by Ina May Gaskin. These help prepare the mind and body to open up during birth and delivery.
6. Prepare the body for a smoother labor by doing 100 kegel exercises a day. These can be done sitting, standing, lying down, any time, anywhere. To help reduce the likelihood of tearing, massage the perineum and the labia with non-irritating vegetable oil and apply a warm washcloth there as well. This is great to do at nighttime before sleep. Putting a warm compress there during delivery also helps keep the area as pliable as possible. GLA, also known as Evening Primrose Oil can also be used to help soften the cervix.
7. Tone the uterus with red raspberry leaf tea. 1 cup daily during pregnancy and a few cups daily in the last month is recommended. Continue to drink it daily after birth to allow the uterus to get back to normal size in a shorter period of time.
8. If there is any back pain during labor or if there are premature contractions a few weeks before labor there are exercises to help with that. These can be found in the book “Hands of Love” written by Dr. Carol Phillips. These hands on postures can be done by one’s husband, doula or chiropractor. These are very effective in taking pressure off of the spine to help reduce pain, stop premature contractions and to help ease labor.
9. If one is carrying a breech baby then this warrants to get adjusted by one’s chiropractor with the “Webster In-Utero Constraint Technique”. This is a specific chiropractic adjustment that is highly effective in balancing the hips. This helps the baby to be in the best alignment for delivery and often takes between 2 to 6 adjustments for the baby to turn. Adding acupuncture to this technique also helps those who have breech presentations.
10. To help enhance dilation of the cervix during labor, a) stimulate the nipples, b) get intimate with one’s partner, c) walk around, d) massage the jaw, e) use aromatherapy such as the scents of lavender with neroli to create a sense of deep relaxation of the mind and allow the body to open up, g) apply acupressure to the web of the thumb and a few inches above the inner ankle, h) change postures during labor, because certain positions will open the hips up more than others, and sometimes just moving into a different position will get labor back on track, i) get onto ones knees and elbows, this is another way to change the hips and the baby to be in a better position for labor.

May these 10 steps help you or someone you know have the most wonderful birth experience for mom and baby!

In health and happiness,

Dr. Liselotte Schuster
(847)509-9067

drliloschuster@sbcglobal.net

www.liloschuster.com

Antibiotics proves to be no help for sinusitis, again.

Bonnie: while these studies seem to publish at a rapid pace, many people, including our own clients, simply do not listen. Aside from providing no help for sinusitis sufferers, antibiotics can do so much short and long-term damage. It is astonishing that doctors keep acquiescing to the patient in this regard because sinusitis is almost always viral or fungal, not bacterial.

A study in Journal of the American Medical Association found patients with acute rhinosinusitis had no differences in symptoms or quality of life three days after starting on amoxicillin compared with patients who received a placebo instead. "It provides further evidence for what we've really suspected for a long time -- that in the management of patients with acute sinusitis, antibiotics do not convey any additional benefit," said the lead researcher.

The study's authors also criticized physicians who prescribe azithromycin (Zithromax Z-Pak) for sinus infections."If anything, it's less effective," he said. "The prevalence of its prescribing represents sloppy practice."

Review: Probiotics for IBS

An Alimentary Pharmacology & Therapeutics review summarized and critically evaluated current knowledge of probiotics used to treat Irritable Bowel Syndrome (IBS). Of the 42 trials evaluated examining the efficacy of probiotics in IBS, 34 reported beneficial effects in at least one of the endpoints or symptoms examined. The review suggests the future holds much promise for the use of lactic acid bacteria (probiotics) in the treatment of irritable bowel syndrome. The selection of probiotic strains for use in clinical trials (predominately lactobacillus acidophilus and bifidobacterium) has largely been based on those with a historical profile free of harmful side effects, so it is not surprising that they exhibited an excellent safety record.

There is now a strong rationale behind their use, solid evidence for strain specific efficacy and emerging data identifying potential mechanism of action for agents that have an enviable safety profile compared with pharmacological agents.

Steve: you and I have known this for a while. However, it is always nice to see it published in a respected, peer-reviewed, medical journal polished off with a parting shot at pharmaceutical safety.

Splenda Essentials: don't be fooled

Bonnie: I can just picture Splenda's executives patting themselves on the back. Don't be fooled. The paltry amount of vitamins in their new product does not even scratch the surface in limiting the damage it can do.

http://www.anh-usa.org/toxic-chemical-being-sold-as-a-health-conscious-sweetener/

Op-Ed: breast cancer research alternatives

http://opinion.latimes.com/opinionla/2012/02/komen-alternatives-for-a-cure.html

Hospital food getting a makeover?

http://online.wsj.com/article/SB10001424052970204642604577213390021632180.html?mod=WSJ_hpp_MIDDLE_Video_Top

No single diabetes diet fits all

Bonnie - This is the quote of the week: For the first time, a spokesperson for the American Diabetes Association admitted that "there is no one diet that is consistently better at helping people manage diabetes." It based upon individual needs.

I'm glad they are finally coming into the 21st century!