Health and Nutrition

Oral Vitamin D Boosts Intranasal Steroid Effect in Rhinitis

Doc Joe — Wed, 28 Mar 2012 18:20:46 +0000

www.medscape.com

Kate Johnson

March 12, 2012 (Orlando, Florida) — Adding an oral vitamin D supplement to regular intranasal corticosteroid dosing can improve symptoms of seasonal allergic rhinitis beyond that seen with corticosteroids alone in patients who are not vitamin D deficient, according to study results presented here at the American Academy of Allergy, Asthma and Immunology 2012 Annual Meeting.

The findings add to a number of reports at the meeting suggesting that vitamin D supplementation might be beneficial in patients with allergies.

“Vitamin D has been shown to play a role in innate immunity and the generation of antimicrobial peptides. It also has a number of immunological effects on T cells, dendritic cells, and macrophages,” said James Lane, BA, a researcher at the University of Chicago, Illinois, who presented the findings.

These findings must be viewed with caution, said lead investigator Fuad Baroody, MD, a pediatric head and neck surgeon at the University of Chicago. “This was a small study, a pilot study. More work needs to be done before people can run out and add vitamin D to intranasal steroids,” he said in an interview with Medscape Medical News.

In the double-blind placebo-controlled study, patients 18 to 45 years of age with seasonal allergic rhinitis received fluticasone propionate 200 µg/day, and were randomized to receive either vitamin D 4000 IU/day for 2 weeks (n = 17) or placebo (n = 18).

Subjects had at least a 2-year history of seasonal allergic rhinitis and a positive skin test to tree, grass, and/or ragweed.

At baseline, serum 25-hydroxy-vitamin D levels were within the normal range and similar in the vitamin D and placebo groups (29.6 vs 29.4 ng/dL). After 2 weeks, levels in the vitamin D group rose significantly from baseline to 37.2 ng/dL (P = .001); in the placebo group, there was no rise.

“There’s variation on what people consider appropriate levels of vitamin D,” explained Dr. Baroody. “Most recommendations are for levels around 30 or so. These were not vitamin-deficient people, but we bumped it up a little bit to within a still reasonable range, and nobody had side effects from having too much vitamin D.”

According to daily self-rated nasal symptoms, including sneezing, nasal congestion, and drip, subjects in both groups noted significant daytime improvements from baseline.

However, subjects in the vitamin D group noted a decreased symptom score of 6.9 points from baseline, which was statistically significant and superior to the 3.7 point drop in the placebo group (P = .04).

“Just giving vitamin D on top created a significant drop — almost a 50% drop,” said Dr. Baroody. “The magnitude is impressive, actually. If that is duplicated in a big trial, it would be pretty spectacular.”

Nighttime symptoms were not presented at the meeting, but Dr. Baroody said they were “not as spectacular.” As a result, the reduction in 24-hour symptom relief was not statistically different between the vitamin D and placebo groups (11.3 vs 7.6 points; P = .09).

Similarly, although there was a statistically significant improvement from baseline in quality of life in both groups (P = .0028), there was no significant difference between the vitamin D and placebo groups (2.5 vs 2.0 points).

“A change of 0.5 is considered to be clinically meaningful, and both groups had improvements well beyond that,” said Lane.

In response to a comment from the audience, Dr. Baroody acknowledged that perhaps the real strength of vitamin D supplementation in this group was not in better, but rather in faster, symptom control; all measures showed patients in the vitamin D group responding within 2 days and sustaining their response level.

“That’s an interesting way of looking at it. I will examine that in more detail,” he said.

“I think people don’t really know what the vitamin D story is,” Rachel Miller, MD, associate professor of medicine in pediatrics and environmental health sciences at Columbia University Medical Center in New York City, told Medscape Medical News.

“My bias is to do a randomized trial and see what vitamin D supplementation does, because most of the work so far has been observational. I know people are already doing it, but I personally look forward to more evidence from randomized trials.”

The study received no funding from industry. Mr. Lane and Dr. Miller have disclosed no relevant financial relationships. Dr. Baroody reports being on the speaker’s bureau for Merck and GlaxoSmithKline.

American Academy of Allergy, Asthma and Immunology (AAAAI) 2012 Annual Meeting: Abstract 510. Presented March 4, 2012.

Low Serum Vitamin D Levels and Recurrent Inflammatory Spinal Cord Disease

Doc Joe — Mon, 28 Nov 2011 15:29:37 +0000

Maureen A. Mealy, RN, BSN; Scott Newsome, DO; Benjamin M. Greenberg, MD, MHS; Dean Wingerchuk, MD, MSc; Peter Calabresi, MD; Michael Levy, MD, PhD

Arch Neurol. Published online November 14, 2011. doi:10.1001/archneurol.2011.1974

Background Low 25-hydroxyvitamin D levels have been associated with a higher risk of developing multiple sclerosis and increased relapse rates in patients with multiple sclerosis. As a sterol hormone involved in multiple immunologic pathways, vitamin D may play a role in preventing monophasic immune-mediated central nervous system attacks from developing into recurrent disease.

Objective To investigate the association between low serum vitamin D levels and recurrent spinal cord disease.

Design, Setting, and Patients We performed a retrospective analysis at Johns Hopkins Transverse Myelitis Center, Baltimore, Maryland, evaluating 25-hydroxyvitamin D levels in 77 patients with monophasic and recurrent inflammatory diseases of the spinal cord.

Main Outcome Measure Levels of 25-hydroxyvitamin D.

Results Vitamin D levels are significantly lower in patients who developed recurrent spinal cord disease, adjusting for season, age, sex, and race.

Conclusions This study provides a basis for a prospective trial of measuring 25-hydroxyvitamin D levels in these patient populations and assessing the influence of vitamin D supplementation on the frequency of relapses in those with recurrent inflammatory spinal cord disease.

Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.

Doc Joe — Sun, 20 Nov 2011 15:42:17 +0000

J Toxicol Environ Health A. 2008;71(21):1415-29.

Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS.

Source

Department of Pharmacology, Duke University Medical Center, Durham, North Carolina 27708, USA. donia@duke.edu

Abstract

Splenda is comprised of the high-potency artificial sweetener sucralose (1.1%) and the fillers maltodextrin and glucose. Splenda was administered by oral gavage at 100, 300, 500, or 1000 mg/kg to male Sprague-Dawley rats for 12-wk, during which fecal samples were collected weekly for bacterial analysis and measurement of fecal pH. After 12-wk, half of the animals from each treatment group were sacrificed to determine the intestinal expression of the membrane efflux transporter P-glycoprotein (P-gp) and the cytochrome P-450 (CYP) metabolism system by Western blot. The remaining animals were allowed to recover for an additional 12-wk, and further assessments of fecal microflora, fecal pH, and expression of P-gp and CYP were determined. At the end of the 12-wk treatment period, the numbers of total anaerobes, bifidobacteria, lactobacilli, Bacteroides, clostridia, and total aerobic bacteria were significantly decreased; however, there was no significant treatment effect on enterobacteria. Splenda also increased fecal pH and enhanced the expression of P-gp by 2.43-fold, CYP3A4 by 2.51-fold, and CYP2D1 by 3.49-fold. Following the 12-wk recovery period, only the total anaerobes and bifidobacteria remained significantly depressed, whereas pH values, P-gp, and CYP3A4 and CYP2D1 remained elevated. These changes occurred at Splenda dosages that contained sucralose at 1.1-11 mg/kg (the US FDA Acceptable Daily Intake for sucralose is 5 mg/kg). Evidence indicates that a 12-wk administration ofSplenda exerted numerous adverse effects, including (1) reduction in beneficial fecal microflora, (2) increased fecal pH, and (3) enhanced expression levels of P-gp, CYP3A4, and CYP2D1, which are known to limit the bioavailability of orally administered drugs.

Low Vitamin D Common in Spine Surgery Patients

Doc Joe — Fri, 18 Nov 2011 17:28:57 +0000

November 2011

A new study indicates that many patients undergoing spine surgery have low levels of vitamin D, which may delay their recovery.

In a study of 313 patients undergoing spinal fusion surgery, orthopedic surgeons at Washington University School of Medicine in St. Louis found that more than half had inadequate levels of vitamin D, including one-fourth who were more severely deficient.

The researchers reported their findings at the 26th Annual Meeting of the North American Spine Society.

“Our findings suggest it may be worthwhile to screen surgery patients for vitamin D,” says Jacob M. Buchowski, MD, the study’s principle investigator. “We think those with insufficient levels of vitamin D may benefit from taking 50,000 international units of the vitamin once a week for eight weeks before surgery as this may help the recovery after spinal fusion surgery.”

Vitamin D helps with calcium absorption and patients with a deficiency can have difficulty producing new bone. They are at risk for a condition called osteomalacia. Unlike osteoporosis or osteopenia, which result from low bone mineral density, osteomalacia interferes with new bone formation.

All the patients in the study had spinal fusion surgery. In that procedure, surgeons remove discs between two or more vertebrae. The bones in the spine are then attached with hardware and treated with growth factors. As the spine heals, new bone begins to form and the vertebrae fuse together.

Dr. Buchowski became aware of the vitamin D problem when a patient in her 40s experienced a slow recovery after spinal fusion surgery.

“I was examining her and trying to figure out why the vertebrae didn’t fuse,” he said. “She mentioned that she had recently been diagnosed with vitamin D deficiency, and it was like a ‘light bulb’ went off.”

As a result, Dr. Buchowski, an Associate Professor of Orthopedic Surgery and Neurological Surgery, and his Washington University colleagues at Barnes-Jewish Hospital started routinely screening spinal fusion surgery patients for vitamin D deficiency.

Low vitamin D levels are known to be common in elderly patients. Surprisingly, in this study, the patients most likely to have inadequate levels of the bone-building vitamin were younger.

Those in the study averaged 55 years of age, 56% were female, 41% were obese and 95% were white. Although an earlier study had shown inadequate vitamin D levels in 43% of patients undergoing orthopedic procedures, this is the first look solely at spine surgery patients.

As a follow-up, Dr. Buchowski and his colleagues are planning a study to see whether there is a link between low vitamin D and poor outcomes following spinal fusion. In the meantime, he’s recommending that patients having orthopedic surgery ensure they’re getting enough vitamin D.

Presented at the 26th Annual Meeting of the North American Spine Society in Chicago, IL.

Prescription vitamin D (D2) less effective than over-the-counter vitamin D (D3) according to a meta-analysis.

Doc Joe — Wed, 16 Nov 2011 16:38:30 +0000

Meta-analysis looks at efficacy of D2 vs D3
Prescription vitamin D (D2) less effective than over-the-counter vitamin D (D3) according to a meta-analysis.

Written by John J. Cannell, M.D.
November 16, 2011
Permission to reprint

SAN LUIS OBISPO, CA — Many people write me and ask, “My doctor prescribed Drisdol, is that OK?” Drisdol is D2 and the form of vitamin D that doctors write prescriptions for. The body doesn’t produce vitamin D2 in response to sun exposure. It is made by irradiating fungus and plant matter. When you take it, a number of metabolic forms of D2 are found in the body, and some studies show D3 (produced by the skin) is more potent, meaning it is more effective at raising blood levels than D2, while some show they are equal. However, there are few studies comparing the efficacy of D2 vs. D3. Or in other words, which form has better health outcomes, better mortality rates?

Recently, a review and meta-analysis address this question. The meta-analysis study was led by Professor Dr. Goran Bjelakovic.

Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD007470.

He analyzed 50 randomized controlled trials (RCTs) with a total of 94,000 participants that used some form of vitamin D and reported mortality rates as either primary or secondary outcomes. Within these RCTs, 32 of the studies used D3 (74,000 subjects) and 12 of them used D2 (18,000 subjects). He found there was a 6% relative risk reduction when supplementing with vitamin D3, as opposed to a 2% relative risk increase when supplementing with vitamin D2

Amazingly, this study somehow slipped under the radar and neither the press nor I picked up this study in July. Luckily, Professor Dr. Harvey Murff of Vanderbilt University reviewed this study yesterday in the Annals of Internal Medicine recently, allowing the general public to examine the study once again.

Murff HJ. Review: Cholecalciferol (vitamin D₃) reduces mortality in adults; other forms of vitamin D do not. Ann Intern Med. 2011; 155:JC5-04.

You would think a paper that took a look at tens of thousands of subjects and analyzed the efficacy of prescription vitamin D (D2) and over-the-counter vitamin D (D3) would warrant a news story or two. To my knowledge, these papers are the first to paint such a clear picture about the efficacy between D3 and D2. While there may be explanations for D3’s superiority other than improved efficacy, for the time being, these papers send doctors a message: use D3, not D2.

Contacts:

Vitamin D Council: newsletter@vitamindcouncil.org

Professor Harvey Murff, Vanderbilt University: harvey.j.murff@vanderbilt.edu

Professor Dr Goran Bjelakovic G, University of Nis, Serbia: g.bjelakovic@ctu.rh.dk or goranb@junis.ni.ac.yu

Omega-3 Supplements May Lower Anxiety

Doc Joe — Mon, 01 Aug 2011 14:33:37 +0000

Deborah Brauser

July 22, 2011 — Increasing omega-3 intake may lower both anxiety symptoms and proinflammatory cytokines in healthy young adults, new research suggests.

In a small randomized controlled trial of medical students, those who received omega-3 supplements for 3 months showed a 20% reduction in anxiety scores and a 14% reduction in stimulated interleukin 6 (IL-6) production.

According to the investigators, the study “provides the first evidence that omega-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis.”

“We were impressed by the magnitude of the anxiety effect and the evidence for its anti-inflammatory effects, suggesting that it might have broader benefits,” lead study author Janice Kiecolt-Glaser, PhD, professor of psychiatry and psychology and S. Robert David Chair of Medicine at the Institute for Behavioral Medicine Research at Ohio State University College of Medicine (OSUMC) in Columbus, told Medscape Medical News.

She noted that the significant reduction in IL-6 is especially important because the young study population had low rates to begin with.

“So our findings could possibly be much more significant in a group that was older and had more health problems.”

The study was published online July 19 in Brain, Behavior and Immunity.

Fish Oil Benefits the Body

“Chronic inflammation has been linked to a broad spectrum of health problems, including cardiovascular disease, stroke, and rheumatoid arthritis,” write the researchers.

“Large population studies suggest that greater fish consumption may help control or protect against the onset of these and other inflammatory conditions,” they add.

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are 2 key omega-3 polyunsaturated fatty acids (PUFAs) found in fish oil, which may also benefit mood.

In fact, previous research, including a study reported on last year by Medscape Medical News, has suggested that omega-3 can lower depressive symptoms in patients diagnosed as having clinical depression.

Because both depression and anxiety have been found to increase the production of proinflammatory cytokines, the current investigators hypothesized that giving omega-3 PUFA supplementation to healthy subjects would lead to a decrease in this production.

Secondary outcome measures were lowered anxiety and depressive symptoms, as well as lowered negative mood symptoms associated with taking stressful exams.

A total of 68 first- and second-year medical students (56% male; mean age, 23.65 years) were enrolled and randomized to receive 3 times daily either omega-3 supplement capsules (consisting of 2085 mg of EPA and 348 mg of DHA, n = 34) or fish-flavored placebo capsules (n = 34) for 12 weeks.

“We chose the 7:1 EPA/DHA balance because of evidence that EPA has relatively stronger anti-inflammatory and antidepressant effects than DHA,” explain the investigators.

“The supplement was probably about 4 or 5 times the amount of fish oil you’d get from a daily serving of salmon,” added coauthor Martha Belury, PhD, RD, professor of human nutrition at Ohio State University, in a release.

All participants were interviewed 6 times, and serial blood samples were scheduled to be taken during lower-stress days and on the days before major exams.

In addition, the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory were administered at all visits.

Reduced Anxiety, Cytokines

Results showed no significant differences between stress and nonstress days across all outcomes for either group.

“Thus, the ability of omega-3 supplementation to dampen stress response could not be tested,” write the researchers.

They note that this was probably due to a sudden change in the medical school’s curriculum. Instead of distributing the major tests during a 3-day period, as done in the past, the exams were given throughout the year.

“This group was notably unstressed, which was a severe disappointment and a study limitation. We just didn’t get the stress effect we had expected,” said Dr. Kiecolt-Glaser.

Still, the treatment group showed a significantly greater reduction in anxiety symptoms at 20% than did the placebo group (P = .04).

They also had a greater decrease in their amounts of stimulated IL-6 production (0.15 units lower, P = .04).

“Anything we can do to reduce cytokines is a big plus in dealing with the overall health of people at risk for many diseases,” said coauthor Ron Glaser, PhD, professor of molecular virology, immunology, and medical genetics at OSUMC.

There were no significant changes in depressive symptoms for either group.

“Again, this was not a depressed group, and without more severe depression, you may not see an effect,” said Dr. Kiecolt-Glaser.

“Overall, that both anxiety and inflammation were altered is notable, especially in a group that was not clinically anxious,” she added.

Even so, the investigators are not yet ready to suggest that everybody should start taking fish oil pills.

“It may be too early to recommend a broad use of omega-3 supplements throughout the public, especially considering the cost and the limited supplies of fish needed to supply the oil. [Instead], people should just consider increasing their omega-3 through their diet,” said Dr. Belury.

Dr. Kiecolt-Glaser reported that the investigators have just finished another trial that examined the effects of increasing omega-3 in a population between the ages of 40 and 85 years who have an average body mass index of 30.

Omega-3 for All Psychiatric Disorders?

“This study reveals 2 remarkable, clinically solid findings,” Capt. Joseph R. Hibbeln, MD, acting chief, Section on Nutritional Neurosciences at the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health (NIH), Bethesda, Maryland, told Medscape Medical News.

The first, “which cannot be understated,” is the reduction of anxiety scores in a normative population, said Dr. Hibbeln, who was not involved with this study.

“Many trials of omega-3 fatty acids in depression have confused the field because it’s very difficult to reduce depression in people who don’t have the disorder. And it’s also very difficult to reduce anxiety in those who don’t have clinically manifest anxiety,” he explained.

“The second was that they probed the question of whether or not omega-3 fatty acids at least work in part through changes in the immune system and neural-immune interactions by measuring the effects of cytokine release in the patients’ white blood cells ex vivo.”

He noted that the “very marked decrease” in cytokine production in the treatment group was impressive.

“This is absolutely consistent with the hypothesis that one of the mechanisms of action for omega-3 fatty acids is not necessarily central but is through down-regulating the immune system. The study begs the question: is increased anxiety a manifest symptom of omega-3 fatty acid deficiencies? And their answer is yes.”

Dr. Hibbeln said that the current 2010 US Department of Agriculture Dietary Guidelines recommend omega-3 PUFAs for the protection of heart disease and for pregnant mothers to prevent deficiencies in their offspring.

In 2006, the treatment committee for the American Psychiatric Association (APA), of which he was a member, issued recommendations that all patients with a psychiatric disorder should take at least 1 gram a day of omega-3 PUFAs to prevent the medical complications that often co-occur for them, such as cardiovascular disease and metabolic problems.

“This paper should be another signal that the practicing psychiatrist should follow the 2006 APA recommendations,” concluded Dr. Hibbeln.

The study was funded in part by a grant from the National Center for Complementary and Alternative Medicine, which is part of the NIH. The study authors and Dr. Hibbeln have disclosed no relevant financial relationships.

Brain Behav Immun. Published online July 19, 2011. Abstract

Low Vitamin D Linked to Atherosclerosis, Study Finds

Doc Joe — Mon, 01 Aug 2011 14:27:22 +0000

Allison Gandey

July 28, 2011 — Investigators have identified new evidence from the Northern Manhattan Study connecting low vitamin D levels to atherosclerosis. They found that low 25-hydroxyvitamin D levels were associated with increased intima-media and maximal carotid thickness in those with plaque.

“Our report demonstrates an independent effect of low vitamin D on subclinical indices of carotid atherosclerosis,” senior investigator Shonni Silverberg, MD, from the Columbia University College of Physicians and Surgeons in New York, told Medscape Medical News. “It is, however, important to note that our observations do not provide insight into the nature of the interaction of low vitamin D with the atherosclerotic process.”

The work will be published in the August issue of Stroke but was released early online.

The investigators studied 203 adults from the Northern Manhattan Study who had serum measurements and carotid ultrasonography. They looked at 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, calcium, phosphorus, and parathyroid hormone.

After adjusting for cardiovascular risk factors, the researchers found that plaque number was associated with phosphorus levels (beta, 0.39 per 1-mg/dL increase; P = .02) and calcium-phosphorus product (beta, 0.36 per 10-U increase; P = .03).

The majority of those studied — 57% — had plaque, and investigators found the association of plaque number with phosphorus and calcium-phosphorus product persisted.

Vitamin D and Carotid Thickness

They found that 25-hydroxyvitamin D was inversely associated with both intima-media thickness (beta, -0.01 per 10-ng/mL increase; P = .05) and maximal carotid plaque thickness (beta, -0.10 per 10-ng/mL increase;P = .03).

In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures.

“We confirmed prior data showing a relationship of carotid measures with calcium-phosphorus product,” Dr. Silverberg said. “More importantly, we found a robust association of vitamin D levels with subclinical markers of carotid atherosclerosis.”

Dr. Silverberg pointed out that some of the prior literature in this area did not adequately control for cardiovascular risk factors and renal function, and most of the available data did not account for the interaction of vitamin D with other indices of mineral metabolism.

Asked by Medscape Medical News to comment, Michal Melamed, MD, from the Albert Einstein College of Medicine in New York, said she was glad the authors looked at multiple bone minerals and not just vitamin D. “The sample size was small, but it is encouraging they still found an association.”

Limitations

Dr. Melamed complimented the study but acknowledged that more work is needed. “This is a nice study, but it is still cross-sectional. We cannot establish a causal relationship and many questions remain regarding optimum vitamin D levels.”

Dr. Melamed says she hopes some of these questions will be answered by the VITAL study. Also known as the Vitamin D and Omega-3 Trial, the research study is designed to include 20,000 men and women across the United States.

Investigators from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, are studying whether daily dietary supplements of vitamin D3 or omega-3 fatty acids reduce the risk for developing heart disease, stroke, and cancer in people who do not have a history of these illnesses. Recruitment began in January 2010 and is continuing through 2011.

This study was funded by the National Institutes of Health. Coauthor Dr. Tatjana Rundek reports receiving speaking fees from Bristol-Myers Squibb. The other authors have disclosed no relevant financial relationships.

Stroke. 2011;42:2240-2245. Abstract

Support for Chiropractic maintenace care?

Doc Joe — Wed, 13 Apr 2011 14:28:05 +0000

Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?

Senna, Mohammed K.; Machaly, Shereen A.

Abstract

Study Design. A prospective single blinded placebo controlled study was conducted.

Objective. to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic non-specific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low-back conditions after an initial phase of treatments.

Summary of background. SMT is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP but the efficacy of maintenance SMT in chronic non-specific LBP has not been studied.

Subjects and Methods. 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized to receive either (1) 12 treatments of sham SMT over a one-month period, (2) 12 treatments, consisting of SMT over a one-month period, but no treatments for the subsequent nine months, or (3) 12 treatments over a one-month period, along with “maintenance spinal manipulation” every two weeks for the following nine months. To determine any difference among therapies, we measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline and at 1-month, 4-month, 7-month and 10-month intervals.

Results: Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029 respectively). However, only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the no maintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.

Conclusion. SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy.

Jerusalem Artichokes, a healthy potato substitute

Doc Joe — Sat, 04 Dec 2010 15:00:49 +0000

Jerusalem Artichokes are also known as Iroquois Potatoes and Sunchoke

Sunchokes are a good choice for diabetics. They possess a complex carbohydrate called INULIN that is metabolized differently than other complex carbohydrates. Fructose, not glucose, is the building block of inulin, so there is a smaller rise in blood sugar levels after eating sunchokes than there is with potatoes or rice. Inulin is a naturally occurring substance found in over 35,000 plants and vegetables worldwide. Chemically, inulin is a non-digestible carbohydrate in the class of fiber substances called fructans. Inulin, and its subgroup fruit oligosaccharides (FOS), promote the health and balance of good bacteria in the colon by serving as a “food” for these organisms. The health benefits of lactobacillus acidophilus and bifidobacteria are well known. Through its role as a food source (also called a pre-biotic) which promotes proliferation of these organisms, INULIN-FOS helps maintain normal bowel function, regularity and urinary tract health. Recent studies have also found that INULIN-FOS supports proper mineral absorption (especially important for women), cardiovascular health and immune function, as well as proper blood sugar and blood fat metabolism.
A 3 1/2 ounce serving of fresh harvested roots provides about 35 calories. In storage, however, the roots mature, or ripen, and inulin turns to sugar, so the calorie content increases to about 75 calories. Sunchokes provide nutritious amounts of iron, potassium, thiamine and niacin.
For some individuals, sunchokes, like legumes, may be a source of intestinal gas, or flatulence. To remedy this eat smaller portions of cooked, not raw, sunchokes or wait until spring to eat stored sunchokes, when they are sweeter and easier to digest.

Recipes:
ROSEMARY-ROASTED SUNCHOKES AND TOMATOES
Oven roasting softens sunchokes and adds a caramelized flavour that is enhanced by the rosemary, green onions and tomatoes.

2 lb. sunchokes cut into 1 1/4 inch chunks
6 ripe plum tomatoes, halved crosswise
2 cloves garlic, finely chopped
1 tablespoon olive oil
1/2 teaspoon salt
1/4 teaspoon ground black pepper
6 green onions cut into 1-inch lengths

1. Heat oven to 400 F. In casserole dish toss sunchokes, tomatoes, garlic, rosemary(1 tablespoon of fresh rosemary or 1 teaspoon of dried), oil, and salt & pepper. Arrange sunchokes around edge of pan and tomatoes in centre. Roast vegetables for 20 minutes. Gently stir green onions into sunchokes and continue to roast until sunchokes are tender and browned about 10 min longer.

2. Cool roasted vegetables 10 min, or until tomatoes are easy to handle. With fork or fingers, remove skins from tomatoes and discard. Stir tomatoes in with sunchokes and transfer to serving dish.

Nutrition per serving: protein 3 grams, fat 4 gm, carbohydrates 24 gm, fibre 3 gm, sodium 144 mg, cholesterol 0, calories 137
Serves 8

SUNCHOKE SOUP
Peeled sunchokes take on a potato-like appearance in this onion-flavoured soup. Crusty whole grain bread and cheese would complete this meal.

1 tbsp. olive oil
2 med. size onions, chopped
1 1/2 lb. sunchokes, peeled and cut into 1/2 inch cubes
1 clove garlic finely chopped
2 tbsp. all purpose flour
1/2 teaspoon dried thyme leaves
4 cups chicken or vegetable broth
1 1/2 tsp. Worcestershire sauce
2 tbsp. chopped fresh parsley

1. In 4-quart saucepan heat oil over med heat. Add onions and sauté 5 min. Add sunchokes and garlic. Sauté 5 min longer.

2. Stir in flour and thyme until well mixed. Add broth and Worcestershire sauce increase heat to high. Cover and heat to boiling; reduce heat to low. Simmer 30 min. Sprinkle parsley and serve.

Nutrition per serving: protein 6 grams, fat 3 grams, carbohydrates 25 grams, fibre 2 grams, sodium 539 milligrams, cholesterol 0, calories 153
Makes 6 – 1 cup servings.

Soy dangers and myths

Doc Joe — Sat, 04 Dec 2010 14:58:43 +0000

by The Weston A. Price Foundation -
The Weston A. Price Foundation provides accurate information about nutrition and is dedicated to putting nutrient-dense foods back on American tables.

Members receive a lively and informative quarterly journal and email updates on current issues and website events. Visit their at www.westonaprice.org

Are you confused about soy?

The Weston A. Price Foundation has compiled a list of soy dangers and myths to get the truth out once and for all.

Soy Dangers Summarized

High levels of phytic acid in soy reduce assimilation of calcium, magnesium, copper, iron and zinc. Phytic acid in soy is not neutralized by ordinary preparation methods such as soaking, sprouting and long, slow cooking, but only with long fermentation. High-phytate diets have caused growth problems in children.

Trypsin inhibitors in soy interfere with protein digestion and may cause pancreatic disorders. In test animals, soy containing trypsin inhibitors caused stunted growth.

Soy phytoestrogens disrupt endocrine function and have the potential to cause infertility and to promote breast cancer in adult women.

Soy phytoestrogens are potent antithyroid agents that cause hypothyroidism and may cause thyroid cancer. In infants, consumption of soy formula has been linked to autoimmune thyroid disease.

Vitamin B12 analogs in soy are not absorbed and actually increase the body’s requirement for B12.

Soy foods increase the body’s requirement for Vitamin D. Toxic synthetic Vitamin D2 is added to soy milk.

Fragile proteins are over-denatured during high temperature processing to make soy protein isolate and textured vegetable protein.

Processing of soy protein results in the formation of toxic lysinoalanine and highly carcinogenic nitrosamines.

Free glutamic acid or MSG, a potent neurotoxin, is formed during soy food processing and additional amounts are added to many soy foods to mask soy’s unpleasant taste.

Soy foods contain high levels of aluminum, which is toxic to the nervous system and the kidneys.

Myths and Truths About Soy

Here we dispel the myths of the “Diet Dictocrats” and reveal the scientific validity behind our wise ancestors’ nutrient-dense diets.

Myth: Use of soy as a food dates back many thousands of years.

Truth: Soy was first used as a food during the late Chou dynasty (1134-246 BC), only after the Chinese learned to ferment soybeans to make foods like tempeh, natto and tamari.

Myth: Asians consume large amounts of soy foods.

Truth: Average consumption of soy foods in Japan and China is 10 grams (about 2 teaspoons) per day. Asians consume soy foods in small amounts as a condiment, and not as a replacement for animal foods.

Myth: Modern soy foods confer the same health benefits as traditionally fermented soy foods.

Truth: Most modern soy foods are not fermented to neutralize toxins in soybeans, and are processed in a way that denatures proteins and increases levels of carcinogens.

Myth: Soy foods provide complete protein.

Truth: Like all legumes, soybeans are deficient in sulfur-containing amino acids methionine and cystine. In addition, modern processing denatures fragile lysine.

Myth: Fermented soy foods can provide vitamin B12 in vegetarian diets.

Truth: The compound that resembles vitamin B12 in soy cannot be used by the human body: in fact, soy foods cause the body to require more B12

Myth: Soy formula is safe for infants.

Truth: Soy foods contain trypsin inhibitors that inhibit protein digestion and affect pancreatic function. In test animals, diets high in trypsin inhibitors led to stunted growth and pancreatic disorders. Soy foods increase the body’s requirement for vitamin D, needed for strong bones and normal growth.

Phytic acid in soy foods results in reduced bioavailabilty of iron and zinc, which are required for the health and development of the brain and nervous system. Soy also lacks cholesterol, likewise essential for the development of the brain and nervous system.

Megadoses of phytoestrogens in soy formula have been implicated in the current trend toward increasingly premature sexual development in girls and delayed or retarded sexual development in boys.

Myth: Soy foods can prevent osteoporosis.

Truth: Soy foods can cause deficiencies in calcium and vitamin D, both needed for healthy bones. Calcium from bone broths and vitamin D from seafood, lard and organ meats prevent osteoporosis in Asian countries—not soy foods.

Myth: Modern soy foods protect against many types of cancer.

Truth: A British government report concluded that there is little evidence that soy foods protect against breast cancer or any other forms of cancer. In fact, soy foods may result in an increased risk of cancer.

Myth: Soy foods protect against heart disease.

Truth: In some people, consumption of soy foods will lower cholesterol, but there is no evidence that lowering cholesterol with soy protein improves one’s risk of having heart disease.

Myth: Soy estrogens (isoflavones) are good for you.

Truth: Soy isoflavones are phyto-endocrine disrupters. At dietary levels, they can prevent ovulation and stimulate the growth of cancer cells. Eating as little as 30 grams (about 4 tablespoons) of soy per day can result in hypothyroidism with symptoms of lethargy, constipation, weight gain and fatigue.

Myth: Soy foods are safe and beneficial for women to use in their postmenopausal years.

Truth: Soy foods can stimulate the growth of estrogen-dependent tumors and cause thyroid problems. Low thyroid function is associated with difficulties in menopause.

Myth: Phytoestrogens in soy foods can enhance mental ability.

Truth: A recent study found that women with the highest levels of estrogen in their blood had the lowest levels of cognitive function; In Japanese Americans tofu consumption in mid-life is associated with the occurrence of Alzheimer’s disease in later life.

Myth: Soy isoflavones and soy protein isolate have GRAS (Generally Recognized as Safe) status.

Truth: Archer Daniels Midland (ADM) recently withdrew its application to the FDA for GRAS status for soy isoflavones following an outpouring of protest from the scientific community. The FDA never approved GRAS status for soy protein isolate because of concern regarding the presence of toxins and carcinogens in processed soy.

Myth: Soy foods are good for your sex life.

Truth: Numerous animal studies show that soy foods cause infertility in animals. Soy consumption enhances hair growth in middle-aged men, indicating lowered testosterone levels.

Myth: Soybeans are good for the environment.

Truth: Most soybeans grown in the US are genetically engineered to allow farmers to use large amounts of herbicides.

Myth: Soybeans are good for developing nations.

Truth: In third-world countries, soybeans replace traditional crops and transfer the value-added of processing from the local population to multinational corporations.

Soy Infant Formula: Birth Control Pills for Babies

Babies fed soy-based formula have 13,000 to 22,000 times more estrogen compounds in their blood than babies fed milk-based formula. Infants exclusively fed soy formula receive the estrogenic equivalent of at least four birth control pills per day.

Male infants undergo a testosterone surge during the first few months of life, when testosterone levels may be as high as those of an adult male. During this period, baby boys are programmed to express male characteristics after puberty, not only in the development of their sexual organs and other masculinity traits, but also in setting patterns in the brain characteristic of male behavior.

In animals, studies indicate that phytoestrogens in soy are powerful endocrine disrupters. Soy infant feeding — which floods the bloodstream with female hormones that inhibit testosterone — cannot be ignored as a possible cause of disrupted development patterns in boys, including learning disabilities and attention deficit disorder.

Male children exposed to DES, a synthetic estrogen, had testes smaller than normal on maturation and infant marmoset monkeys fed soy isoflavones had a reduction in testosterone levels up to 70 percent compared to milk-fed controls.

Almost 15 percent of white girls and 50 percent of African-Americans girls show signs of puberty, such as breast development and pubic hair, before the age of eight. Some girls are showing sexual development before the age of three. Premature development of girls has been linked to the use of soy formula and exposure to environmental estrogen-mimickers such as PCBs and DDE.

Intake of phytoestrogens even at moderate levels during pregnancy can have adverse affects on the developing fetus and the timing of puberty later in life.