Your Health Bulletin is information from scientific literature to make sense of the right choices for your health. It is a reminder to consider periodic check-ups of your spine, joint mechanics and appropriate exercise. Maintenance is better than repair!
BIOLOGICAL MEDICINE: FOOD AND EXERCISE
COUNTER INFLAMMATION WITH FOOD—THE EICOSANOIDS
BUTT TO LEG PAIN—GLUTEUS MAXIMUS ADHESIONS
IT’S SPRING—INVEST IN YOUR SELF —GROW YOUR FOOD— IF UNABLE TO GROW YOUR OWN THEN BUY LOCALLY GROWN ORGANIC
BULLETIN 4 CONTENT
Addition of chiropractor to australian rules sports medicine team
Chiropractic vs Medicine for acute low back pain: no contest
Dirt poor: Have fruits and vegetables become less nutritious
Tai Chi beats back depression
Antidepressants may increase the risk for heart disease
Blood pressure may be unnecessarily labeled abnormal
Gut bacteria can control organ function
Citrus show anti inflammatory potential
Your waist size predicts heart disease
Low back and butt pain —the gluteus maximus
The process of pain/discomfort
gluteus maximus–anatomy, pain pattern, stretch and strenthening exercise
Addition of chiropractor to Australian Rules Sports Medicine Team
Remember the Australian Rules Football study discussed June 2010, Bulletin 7. The study noted the addition of a chiropractor to the Sports Medicine team looking after the Australian teams. They had accumulated 15 years of statistics demonstrating that back pain,hamstring injuries,lower limb injuries and knee injuries were being poorly managed. With the addition of a Chiropractor the most telling statistic was that the average game loss of 28 per season decreased to 1 game loss. The following stats resulted from the addition of the Chiropractor to the Sports Med Team:
Lower limb muscle strain: sports medicine group plus chiropractic care (intervention group)—injury rate 3.6%
sports medicine group (control group ) —injury rate 27.6%
Hamstring injuries: intervention group — injury rate 3.6%
control group — injury rate 17.2%
Non- contact knee injury: intervention group— injury rate 3.6% number of matches missed — 1
control group — injury rate 24.1% number of matches missed — 24
Low back pain: at mid-season there was a significant reduction in the intervention group but not the control.
Now read the following recently published research further acknowledging the most effective way to correct/manage low back pain. Be certain to read the last article,in this bulletin, on the gluteus maximus adhesions in low back pain. Remember these adhesions form in both muscles and joints and both must be corrected with appropriate exercise to help as demonstrated in the discussion.
Chiropractic vs. Medicine for Acute LBP: No Contest
Acute low back pain patients demonstrate significantly greater improvement with chiropractic than “usual care.”
With the publication of the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study1 in The Spine Journal, one of the most frequently cited spine research journals in the world,2 the health care community at large may finally appreciate what the chiropractic profession has known for more than a century: Patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little to no improvement with the usual care they receive from a family physician.
Published in the December 2010 edition of The Spine Journal, the study found that after 16 weeks of care, patients referred to medical doctors saw almost no improvement in their disability scores, were likely to still be taking pain drugs and saw no benefit with added physical therapy – and yet were unlikely to be referred to a doctor of chiropractic.
The study is “the first reported randomized controlled trial comparing full CPG [clinical practice guidelines]-based treatment, including spinal manipulative therapy administered by chiropractors, to family physician-directed UC [usual care] in the treatment of patients with AM-LBP (acute mechanical low back pain).” (Evidence-based clinical practice guidelines have been established for acute mechanical low back pain in many countries around the world, but sadly, most primary care medical doctors don’t follow these guidelines.)
The Chiropractic Hospital-based Interventions Research Outcome (CHIRO) initiative was “designed to evaluate the outcomes of spinal pain patient management strategies that involve a component of chiropractic assessment and/or spinal manipulative therapy, administered in a hospital-based spine program outpatient clinic.
CPG “study care” (SC) was compared with the usual care (UC) provided by family physicians.
Patients in the SC group received —– up to four weeks of chiropractic spinal manipulative therapy by a chiropractor.
Patients assigned to the UC group received treatment from “a variety of professionals including family physicians, massage therapists, kinesiologists, and/or physiotherapists.”
All care was provided at a hospital-based spine program outpatient clinic.
After 16 weeks, “78% of patients in the UC group were still taking narcotic analgesic medications on either a daily or as needed basis.”
Condition-specific improvement after 16 weeks “clearly favored the SC group.
Both groups showed improvement in bodily pain and physical functioning, but “patients in the UC group uniquely showed no improvement whatsoever in back-specific functioning throughout the entire study period.”
The inclusion of NSAIDs and manipulation/mobilization performed by physical therapists were no more effective in treating patients than family doctors who offered patients advice and acetaminophen.
The study criticizes a 2007 report that had derided the efficacy of spinal manipulation by pointing out that the older report based its conclusions on the outcomes of therapies performed by non-chiropractors. The 2007 study concluded that patients “do not recover more quickly with the addition of diclofenac or spinal manipulative therapy.”3 By contrast, the CHIRO study noted: “Although spinal-manipulative therapy is currently administered by many different healthcare professionals, including: chiropractors, osteopaths, orthopedic surgeons, family physicians, kinesiologists, naturopaths, and physiotherapists, the levels of training and clinical acumen vary widely. The study design used by Hancock, et al., therefore, differs from our study because [their study] did not use chiropractic spinal manipulation, and current guideline based care does not endorse any forms of spinal manipulation administered by any other practitioners.”
Bishop PB, Quon JA, Fisher CG, Dvorak MFS. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine Journal, 2010;10:1055-1064. http://www.ncbi.nlm.nih.gov/pubmed/20889389
Brunarski D. “Impact of the Chiropractic Literature.” Dynamic Chiropractic, Dec. 2, 2010;28(25).
Hancock MJ, Maher CG, Latimer J, McLachlan AJ, Cooper CW, Day RO, Spindler MF, McAuley JH. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial. Lancet, 2007 Nov 10;370(9599):1638-43. http://www.ncbi.nlm.nih.gov/pubmed/17993364
Source: Dynamic Chiropractic Canada Vol.4 No.3
Dirt Poor: Have Fruits and Vegetables Become Less Nutritious?
Because of soil depletion, crops grown decades ago were much richer in vitamins and minerals than the varieties most of us get today
| April 27, 2011
Fruits and vegetables grown decades ago were much richer in vitamins and minerals than the varieties most of us get today. The main culprit in this disturbing nutritional trend is soil depletion: Modern intensive agricultural methods have stripped increasing amounts of nutrients from the soil in which the food we eat grows. Sadly, each successive generation of fast-growing, pest-resistant carrot is truly less good for you than the one before.
A landmark study on the topic by Donald Davis and his team of researchers from the University of Texas (UT) at Austin’s Department of Chemistry and Biochemistry was published in December 2004 in the Journal of the American College of Nutrition. They studied U.S. Department of Agriculture nutritional data from both 1950 and 1999 for 43 different vegetables and fruits, finding “reliable declines” in the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C over the past half century.
The Organic Consumers Association cites several other studies with similar findings: A Kushi Institute analysis of nutrient data from 1975 to 1997 found that average calcium levels in 12 fresh vegetables dropped 27 percent; iron levels 37 percent; vitamin A levels 21 percent, and vitamin C levels 30 percent. A similar study of British nutrient data from 1930 to 1980, published in the British Food Journal,found that in 20 vegetables the average calcium content had declined 19 percent; iron 22 percent; and potassium 14 percent. Yet another study concluded that one would have to eat eight oranges today to derive the same amount of Vitamin A as our grandparents would have gotten from one.
The key to healthier produce is healthier soil. Alternating fields between growing seasons to give land time to restore would be one important step. Also, foregoing pesticides and fertilizers in favor of organic growing methods is good for the soil, the produce and its consumers. Those who want to get the most nutritious fruits and vegetables should buy regularly from local organic farmers.
CONTACTS: Journal of the American College of Nutrition, http://www.jacn.org; Kushi Institute, http://www.kushiinstitute.org; Organic Consumers Association, http://www.organicconsumers.org.
If you can’t grow your own then invest in locally grown organic— refer to bulletin board in office.
Tai Chi Beats Back Depression in the Elderly, Study Shows
ScienceDaily (Mar. 20, 2011) — The numbers are, well, depressing: More than 2 million people age 65 and older suffer from depression, including 50 percent of those living in nursing homes. The suicide rate among white men over 85 is the highest in the country — six times the national rate.
Researchers at UCLA turned to a gentle, Westernized version of tai chi, a 2,000-year-old Chinese martial art. When they combined a weekly tai chi exercise class with a standard depression treatment for a group of depressed elderly adults, they found greater improvement in the level of depression — along with improved quality of life, better memory and cognition, and more overall energy — than among a different group in which the standard treatment was paired with a weekly health education class.
Movement stimulates the brain and we feel better—its that simple. Tai chi movement is fine but walking does it too—even better is interval walking—as fast as comfortable to out of breath then reduce to normal breath and repeat as many times as comfortable.
Antidepressants may increase the risk of heart disease by thickening artery walls By Thomas H. Maugh II, L.A.Times: April 2, 2011
Taking antidepressants may raise the risk of heart disease in men by producing a thickening of artery walls, researchers said Saturday. Although a potential mechanism for the action is not obvious, the drugs appear to accelerate atherosclerosis by increasing the thickness of what is known as the intima media, the inner and middle layers of the arteries, particularly the carotid arteries that feed blood to the brain, researchers from Emory University in Atlanta reported at a New Orleans meeting of the American College of Cardiology.
Out of breath exercie is more effective for mood disorders. Also completely removing gluten from your diet gets rid of a major cause of depression.
Blood Pressure: 100 Million Americans May Be Unnecessarily Labeled Abnormal
ScienceDaily (Mar. 21, 2011) — As many as 100 million Americans may currently be misclassified as having abnormal blood pressure, according to Dr. Brent Taylor from the Veterans Affairs Health Care System in Minneapolis and the University of Minnesota and his colleagues. Their findings show that these people are not actually more likely to die prematurely than those with ‘normal’ blood pressure, i.e. below 120/80.
Taylor and colleagues’ article in the Journal of General Internal Medicine, published by Springer, also shows that in those under 50, diastolic blood pressure*(DBP) is the more important predictor of mortality, whereas in those over 50, systolic blood pressure*(SBP) is the stronger predictor. The authors argue it is time to consider a new definition of ‘normal’ blood pressure.
The authors looked at data for 13,792 people from the National Health and Nutrition Examination Survey, which enrolled participants in 1971-76 and followed them up for two decades — they studied DBP, SBP and long-term survival data specifically. In order to assess the underlying distribution of untreated blood pressure in American adults by age, Taylor and team also looked at data for 6,672 adults from the first National Health Examination Survey carried out between 1959 and 1962.
They found that in people aged over 50, those with SBPs above 140, independent of DBP, were significantly more likely to die prematurely. In those aged 50 or less, DBPs above 100 were linked to significant increases in premature death. The authors’ analysis offers alternative cut-off points for the definition of ‘normal’.
Dr. Taylor concludes: “Our findings highlight that the choice of approach used to define normal blood pressure will impact literally millions of Americans. If we cannot reliably see an effect on mortality in a large group of individuals followed for nearly 20 years, should we define the condition as abnormal? We believe considering this kind of approach represents a critical step in ensuring that diagnoses are given only to those with a meaningful elevation in risk, and targeted towards individuals most likely to benefit.”
Gut Bacteria Can Control Organ Functions
ScienceDaily (Mar. 21, 2011) — Bacteria in the human gut may not just be helping digest food but also could be exerting some level of control over the metabolic functions of other organs, like the liver, according to research published this week in the online journal mBio®. These findings offer new understanding of the symbiotic relationship between humans and their gut microbes and how changes to the microbiota can impact overall health.
“The gut microbiota enhances the host’s metabolic capacity for processing nutrients and drugs and modulates the activities of multiple pathways in a variety of organ systems,” says Sandrine Claus of the Imperial College of London, a researcher on the study.
Claus and her colleagues exposed germ-free mice to bedding that had previously been used by conventional mice with normal microbiota and followed their metabolic profiles for 20 days to observe changes as they became colonized with gut bacteria.
Over the first 5 days after exposure, the mice exhibited a rapid increase in weight (4%). Colonization also triggered a number of processes in the liver in which sugars (glucose) are converted to starch (glycogen) and fat (triglycerides) for short-term and long-term energy storage. Statistical modeling between liver metabolic functions and microbial populations determined that the levels of glucose, glycogen and triglycerides in the liver were strongly associated with a single family of bacteria called Coriobacteriaceae.
“Here we describe the first evidence of an in vivo association between a family of bacteria and hepatic lipid metabolism. These results provide new insights into the fundamental mechanisms that regulate host-gut microbiota interactions and are of wide interest to microbiological, nutrition, metabolic, systems biology and pharmaceutical research communities,” says Claus.
Another important finding in the paper, according to Claus, is that gut colonization strongly stimulated the expression and activity of the cytochrome P450 3A11, an essential enzyme in drug-detoxification pathways.
Although she warns about being careful to extrapolate the specific findings from mice to humans, Claus notes the results of this research will provide a basis to further develop new strategies to beneficially modulate host metabolism by altering microbial communities in the gut.
1. S. P. Claus, S. L. Ellero, B. Berger, L. Krause, A. Bruttin, J. Molina, A. Paris, E. J. Want, I. de Waziers, O. Cloarec, S. E. Richards, Y. Wang, M.-E. Dumas, A. Ross, S. Rezzi, S. Kochhar, P. Van Bladeren, J. C. Lindon, E. Holmes, J. K. Nicholson. Colonization-Induced Host-Gut Microbial Metabolic Interaction. mBio, 2011; 2 (2): e00271-10 DOI: 10.1128/mBio.00271-10
Citrus flavonoids show anti-inflammatory potential: Study
By Stephen Daniells, 05-Apr-2011
Increased intakes of compounds called flavonoids from citrus may be associated with lower levels of markers of inflammation, according to a new study from researchers at Harvard, Sweden and Singapore.
Citrus consumption was linked to lower levels of inflammatory compounds
Data from between 1,200 and 1,600 women showed that women with the highest intakes of total flavonoids, which includes various subclasses such as flavones, flavonols, flavanones, flavan-3-ols, anthocyanidins, and polymeric flavonoids, were associated with an 8 percent lower level of the pro-inflammatory compound interleukin-18 (IL-18), compared with women with the lowest intake.
“Higher intakes of selected flavonoid subclasses were associated with modestly lower concentrations of inflammatory biomarkers,” wrote the researchers in the Journal of Nutrition.
“In particular, flavonoids typically found in citrus fruits were modestly associated with lower plasma IL-18 concentrations,” they added.
If the study can be repeated in further studies and intervention trials, it may offers promise for reducing the risk of chronic inflammation, brought about by an over-expression or lack of control of the normal protective mechanism. Chronic inflammation has been linked to range of conditions linked to heart disease, osteoporosis, cognitive decline and Alzheimer’s, type-2 diabetes, and arthritis.
The flavonoids family
A vast body of epidemiological studies has linked increased dietary intake of antioxidants from fruits, vegetables, wine, chocolate, coffee, tea, and other foods to reduced risks of a range of diseases including cancer, cardiovascular disease and diabetes.
Flavonoids can be split into a number of sub-classes, including anthocyanins found in berries, flavonols from a variety of fruit and vegetables, flavones from parsley and thyme, for example, flavanones from citrus, isoflavones from soy, mono- and poly-meric flavonols like the catechins in tea, and proanthocyanidins from berries, wine and chocolate.
Source: Journal of Nutrition
Published online ahead of print, , doi: 10.3945/ jn.110.133843
“Selected Dietary Flavonoids Are Associated with Markers of Inflammation and Endothelial Dysfunction in U.S. Women”
Authors: R. Landberg, Q. Sun, E.B. Rimm, A. Cassidy, A. Scalbert, C.S. Mantzoros, F.B. Hu, R.M. van Dam
Refer to Foods That Fight Cancer by Belliveau
J Am Coll Cardiol. 2011 May 10;57(19):1877-86.
Central obesity and survival in subjects with coronary artery disease a systematic review of the literature and collaborative analysis with individual subject data.
The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients.
In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality
In other words: Your Waist Size Predicts Heart Disease Death Better than Your Weight
Researchers found that heart patients with a high ratio of waist-to-hip circumference or a large waist size — greater than 35 inches for women, or 40 inches for men — were 70 percent more likely to die during the study period than those with smaller waists. The combination of a large waist and a high BMI upped the risk of death even more.”
Source CNN May 2, 2011
Too many carbs, lack of regular exercise especially out of breath exercise, abnormal gut microflora(infecto-obesity)
Solution(s): increase quality protein and fat;decrease, better yet, eliminate grain(refer to dangerous grains — in office or newsletter 4,5,6—archives 2007 on webpage
Chiropractic), remove intolerant inflammatory foods—-if you want more detailed information consider measuring urine and saliva for ph(acidity),energy(redox) and
congestion(resistivity) —- ask for office handout 210; supplement with high potency multiple species gut microflora
Low Back and Butt pain — the Gluteus Maximus
The last email focused on the gluteus minimis adhesions—–referral pain pattern of pseudosciatica
The following illustrations show the anatomy of the gluteal muscles,the gluteus maximus referral pattern,gluteus stretch and strenthening exercises— if you are not doing these exercises or need help with them then ask next time you are in the office.
Reasons for gluteal adhesions/tightening involve excessive load from stair climbing/hill climbing,weight lifting as in squats and of course too much sitting. An indication that the gluts are involved is that it is difficult to get up from a seated position but this is also an indication of poor sacro-iliac joint movement in fact any time we feel discomfort ther are multiple muscles and joints involved and all of them must be corrected. Just like your foot hurts due to stones in your shoe if you remove 7 stones and there is 10 then your foot still hurts.
The process of pain/discomfort
Adhesions form anywhere in the muscles and joints when they become too tight. This can be due to acute trauma but is most often just due to repetitive action of day to day activities.
Thus non-contact injury is the most common reason for pain or discomfort.
The tightness in the muscle/joint reduces the circulation resulting in mechanically induced inflammation and development of scar-like tissue or adhesions. These adhesions then inhibit the signal from the movement sensors to the brain which then allows pain sensor signals to reach the brain. The brain then furthers the process by sending out signals to the muscle-joint to tighten more as a protective response.
Eventually we get pain at 5 on a 0 to 10 scale. We do not feel these these adhesions from 0 to 4.9 but may experience a tightening or heaviness and reduced ability to perform an activity.
The brain has to tighten the rest of the muscles and joints to the initially tightened area and secondary adhesions develop. The brain learns to do this like any other skill it learns and the longer it does this the stronger the pattern or record. This is why it can be so difficult to correct pain patterns .
The brain likes to do what it has learned and resists change be it a skill from a pain pattern or a skill to play a sport/musical instrument etc. If the brain learns the wrong skill/pattern/technique then it takes repeated stimulis to correct the pattern and this is why physical therapy such as joint/muscle manipulation requires repetition and exercise and the longer it has been going on the longer it takes. This is why the sooner you have muscle/joint problems corrected the easier it is and the shorter the time of correction. And this is also why it is easier to have body mechanics checked and corrected on a regular maintenance basis to avoid the development of pain .
gluteal pain patterns