Federal dietary guidelines recommending that Americans of all ages consume three cups per day of reduced fat milk or other dairy products may be influenced more by lobbying from the dairy industry than by scientific evidence, according to a new commentary co-authored by Walter Willett, Professor of Epidemiology and Nutrition at Harvard School of Public Health. He and co-author David Ludwig of Boston Children’s Hospital argue that a broader range of recommendations for milk consumption may be more appropriate. The commentary was published online July 1, 2013 in JAMA Pediatrics. They note that adults who eat a healthy diet may already be getting sufficient vitamin D and bone-building calcium from other sources such as kale or fortified orange juice. Children may need the recommended daily glasses of milk if they have poor diets; however whether they should be drinking whole or skim milk is up for debate. The authors note that ‘Humans have no nutritional requirement for animal milk, an evolutionarily recent addition to diet. Anatomically modern humans presumably achieved adequate nutrition for millennia before domestication of dairy animals, and many populations throughout the world today consume little to no milk for biological reasons (lactase deficiency), lack of availability, or cultural preferences’.
The common cold and influenza are two of the most common respiratory tract infections. Though the causative factor in these two distinct cases is viral, they are often treated with antibiotics. Antibiotic resistance, which is in large part attributed to antibiotic overuse, has encouraged investigators to seek for alternative methods for either preventing or treating the common cold and influenza. One promising prevention strategy to these viral infections is probiotics. Probiotics are live microorganisms that when consumed in sufficient amounts, offer health benefits. Immune system regulation is among the most recognized benefits of probiotics. The gut microbiota, and the associated immune system have been the major targets for ingested probiotics. A recent editorial in the journal Nutrition concludes that ‘on the basis of the available evidence, it appears that probiotics (at least those investigated thus far in clinical trials), when administered at a dose between 10^7 and 10^9 CFU/d for at least 30 d, can decrease the incidence and the duration of the common cold and influenza, as well as decrease the severity of the symptoms. The underlying mechanism for such effect is, without a doubt, associated with the impact that probiotics have on different arms of the immune system.’
Aging is a highly complex process that is influenced by a large number of factors. Essential components for successful aging of the brain include: 1) controlling the amount of food we ingest as well as the components of our diet; 2) the incorporation of aerobic physical activity into our daily routine and; 3) the reduction of stress. Aging of the brain is a process that is not only intrinsic to the anatomy of the brain itself, but also influenced by important hormones and neuromodulators that are released from peripheral organs and endocrine glands. Caloric restriction (a reduction of food intake by 20% to 40% without malnutrition) has been shown to decrease the rate of aging of the brain. Frequent aerobic physical exercise is a way of maintaining brain health and plasticity throughout life, and particularly during aging. Brain circuitry can be remodeled by experience, and stressful experiences have functionally relevant effects on many brain regions. These regions include the hippocampus, amygdala, and the prefrontal cortex (PFC), with effects not only on cognitive function but also on emotional regulation and other self-regulatory behaviors and upon neuroendocrine and autonomic function. A major problem facing modern societies is how to change lifestyle and habits, particularly in the older population. According to Dr. Mora from the Carver College of Medicine, University of Iowa, research is providing powerful evidence for the idea that prevention of many diseases can be diminished by a healthy diet and lifestyle that includes cognitive exercise, stress management, and a reduction in cardiovascular risk through regular physical exercise.
Risk of death increases with greater sitting time. Prolonged sitting has been engineered into our lives across many settings, including transportation, the workplace, and the home. There is new evidence that too much sitting is adversely associated with health outcomes, including cardio-metabolic risk biomarkers, type 2 diabetes and premature mortality. Importantly, these detrimental associations remain even after accounting for time spent in leisure time physical activity. Too much sitting should now be considered an important stand-alone component of the physical activity and health equation, particularly in relation to diabetes and cardiovascular risk. Excessive sitting warrants a public health concern. The irony is that the volume of physical activity in society is declining just as we have been learning about how important physical activity is for health. Physical activity improves health. Let’s get active and stay active!
There is now increasing evidence that diet and lifestyle play a critical role in prostate cancer biology and tumor development. Many nutrients and herbs also show signiﬁcant promise in helping to treat prostate cancer by slowing progression and reducing recurrence, ultimately reducing the risk of morbidity and mortality from the disease. Furthermore, for all grades of prostate cancer, nutritional interventions complement conventional treatment to improve response and quality of life. With high incidence (currently affecting one in six men in the United States), a long latency period, and strong environmental inﬂuences, prostate cancer is an ideal target for chemopreventative approaches. In this context, the term chemoprevention is used to describe nutritional interventions (i.e., changes in diet and the use of speciﬁc nutritional supplements) to slow or reverse the progression of premalignant lesions. Reversing premalignancies with chemopreventative agents could be the best primary defense against prostate cancer, preventing it from occurring in the ﬁrst place. Current evidence supports the notion that the most effective prostate cancer protective diet is low in red meat and dairy and high in fruits, vegetables, whole grains, herbs (especially Asian herbs like turmeric and ginger), and green tea. Research also suggests that the following natural substances may be of some beneﬁt in prostate cancer prevention: phytoestrogens (e.g. soy, kidney beans, lentils, chick peas), lycopene, silymarin, delphinidin, quercetin, fiber, cruciferous vegetables (e.g. broccoli, cauliflower, cabbage), fish and fish oils, green tea, pomegranate juice, curcumin, ginger, vitamin E, vitamin D.
Physical activity has well documented health benefits. Population studies have shown that people who exercise enjoy a higher quality of life and improved health status compared to those with sedentary behaviors. Large scale observational studies have established a clear association between exercise and reductions in mortality. Despite the evidence of effectiveness of physical activity and lifestyle on health, the rate of prescription drug use continues to rise sharply. In fact, so many people are on medications that US statistics from the CDC estimate that 48.5% of persons have used at least one prescription drug in the past month. A recent study sought to determine the comparative effectiveness of exercise versus drug interventions on mortality outcomes. The authors found that existing evidence on exercise interventions suggests exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes.
Hip osteoarthritis (OA) is a common joint disease and when symptomatic can have significant impact on regular daily activities. Recently, hip OA has been linked to higher mortality rates. Non-surgical interventions with documented effectiveness become essential for patients who do not need, or choose not to have surgery. A recent study investigated the effectiveness of a patient education (PE) program with or without the added effect of manual therapy (MT) compared to a minimal control intervention (MCI). The study involved 118 patients with clinical and radiographic unilateral hip osteoarthritis (OA) from primary care who were randomized into one of three groups: PE, PE plus MT or MCI. The education was taught by a physiotherapist involving five sessions. The manual therapy was performed by a chiropractor involving 12 sessions and the MCI included a home stretching program. A total of 111 patients were included in the analyses at the primary end point at 6 weeks, and follow up was performed at 12 months. Results of the study showed that manual therapy performed by a chiropractor combined with education demonstrated a clinically relevant pain reduction and improvement in self-reported activities of daily living and quality of life when compared to the control group receiving a minimal intervention of home stretching.
Ankle sprains often occur when running, walking on uneven ground, or jumping. Usually, people are told to rest, elevate the foot, apply ice, and use an elastic wrap to reduce swelling. This treatment is typically followed by exercises that can be performed at home. Although the pain and swelling usually improve quickly, more than 70% of people who sprain their ankles continue to have problems with them and up to 80% will sprain their ankles again. This suggests that it is important to better care for ankle sprains. One recent study found that for acute ankle sprains, manual joint mobilization/manipulation diminished pain and increased dorsiflexion range of motion. For treatment of subacute/chronic lateral ankle sprains, these techniques improved ankle range-of-motion, decreased pain and improved function. Another recent study found that a manual therapy and exercise program was superior to a home exercise program in the treatment of inversion ankle sprains.
Previously, based on 1984 data developed from reviews of medical records of patients treated in New York hospitals, the Institute of Medicine estimated that up to 98,000 Americans die each year from medical errors. A new study published in the September, 2013 issue of the Journal of Patient Safety used modern data to re-estimate harms associated with medical care in hospitals.
Using a weighted average of 4 recent studies, a lower limit of 210,000 deaths per year was associated with preventable harm in hospitals. However, the study author estimated the true number of premature deaths associated with preventable harm to patients was more than 400,000 per year. In addition, serious harm (including requiring prolonged hospital stay, permanent harm, life sustaining intervention required, or contributing to death of patient) seems to be 10- to 20-fold more common than lethal harm.
The author of the study concludes that any of the estimates demands action on the part of providers, legislators, and people who will one day become patients. Yet, the action and progress on patient safety is frustratingly slow. It seems to the author that the epidemic of patient harm in hospitals must be taken more seriously if it is to improve.
High blood pressure is the most common primary diagnosis in America and is one of the major risk factors for heart disease and stroke, the first and third leading causes of death. Nutrient deficiencies are very common and may be even more common in patients with high blood pressure and cardiovascular disease due to genetic and environmental causes and prescription drug use. These deficiencies will have an enormous impact on present and future cardiovascular health as well as overall health costs. According to the latest scientific evidence, the diagnosis and treatment of these nutrient deficiencies can reduce blood pressure; improve vascular health, endothelial dysfunction, and vascular biology; and decrease cardiovascular events.
A recent article in the journal Alternative Therapies in Health and Medicine makes the following conclusions. Nutrition by way of natural whole food, nutraceutical supplements—can prevent, control, and treat hypertension through numerous vascular-biology mechanisms. Antioxidants can prevent and treat hypertension. A role exists for the select use, based on scientifically controlled studies, of single and component nutraceutical supplements, vitamins, antioxidants, and minerals in the treatment of hypertension as a complement to optimal nutritional, dietary intake from food as well as other lifestyle modifications. Exercise, weight reduction, smoking cessation, and alcohol and caffeine restriction as well as other changes in lifestyle must be incorporated.
Watch the author of this recent article discuss a practical and functional medicine approach to heart health at http://youtu.be/Wp26t8t2IS0