Friday, September 21, 2007

New Health Check Lists-=evidence based

http://www.bankixsystems.com/articles/article/4020285/74632.htm

The link provided will direct you to a checklist for men and women that is evidence based . This is worthwhile having. From the Bankix website announcement: "The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) has released two new evidence-based checklists aimed at helping men and women understand which medical checkup tests they need to remain healthy at any age. The men's and women's versions of Your Checklist for Health show at a glance the recommendations of the U.S. Preventive Services Task Force regarding screening tests, preventive medicine, and other healthy lifestyle behaviors."

Wednesday, September 5, 2007

Nutritional News, etc.

Evidence-based/Science-based healthcare: Okay, so here's one of my rants about alternative healthcare. I am unusual in the alternative healthcare arena! I am a strong proponent and user of evidence-based or best evidence available healthcare. In the alternative healthcare arena there are a lot of fads and questionable practices. Chiropractic healthcare is no exception. Many of my colleagues make claims and do things that have little basis in science and evolve out of a philosophical point of view in the profession that has little validity. It's a problem for the profession and its image. However, there are many DCs (doctors of chiropractic) that focus on practicing with the best evidence available and avoid questionable practices. Why is this important? Money for one. Nobody wants to spend money on things that have not been shown to work, or at least appear to with the best evidence available. Here is one example. Using muscle testing to determine vitamin deficiencies and even worse-what is referred to as surrogate testing. In other words, having you hold a vial (glass bottle) of a low dose of a substance (heavily diluted) while another person touches you and then the "doctor" muscle tests the person touching you. There is absolutely no evidence whatsoever that I am aware of that shows this being a valid diagnostic tool. It's only known benefit is to increase the income of the person selling the vitamins. Laboratory blood tests are the gold standard in determining nutritional deficiencies. Caveat Emptor-buyer beware. PhD nutritionist told us when I was in school that we needed to abandon this useless practice-little has changed.

Why am I commenting on something like this which is definitely not favorable to my profession? The reason is I have seen many of my elderly patients on fixed income who can ill afford to waste money get duped. The people doing these things really do believe it works. However, without evidence that it does, the practice should be treated as experimental at best and in my opinion they should not charge for it. Don't get me wrong. Vitamin supplementation or what is sometimes referred to as nutraceuticals is valid for many cases. Modern diets generally do not provide adequate nutrition. However, muscle testing to establish vitamin deficiency has not shown to be valid. There are too many ways to skew the results and it is very subjective.

Calcium and Osteoporosis: It's in the bones.

As the population continues to live longer, the issue of bone loss or osteoporosis becomes important for both men and women. Failure to maintain bone loss can cause collapse of vertebrae, hip fractures, and other fractures. In addition to exercise, supplementation may help slow or stop the loss. Medication may be needed in some cases.

  • According to Lancet-People aged 50 and older who take calcium supplements are 12% less likely to fracture a bone than their peers who don't take those pills.
  • That protection rate doubles when calcium supplements are taken correctly, report the researchers, who included Benjamin Tang, MD, of the Centre for Complementary Medicine Research at Australia's University of Western Sydney
  • "For best therapeutic effect, we recommend minimum doses of 1200 milligrams [mg] of calcium, and 800 IU [international units] of vitamin D (for combined calcium plus vitamin D supplementation)," Tang's team writes. The studies used 64,000 people.
  • People aged 70 and older, those who didn't get much calcium from their diets, thin people, and those at high risk of bone fractures were particularly likely to benefit from taking calcium supplements.
  • A February American Journal of Clinical Nutrition new study shows that women who took a red clover-derived dietary supplement containing substances called isoflavones (Promensil) experienced significantly slower bone loss in the spine compared with women who took a placebo. The supplement also appeared to have protective effects on bones in the hip, but these effects were not statistically significant.

More on Vitamin D Supplementation: New England Journal of Medicine review article July 19, 2007 information.

  • Between 40% and 100% of elderly in US & Europe have insufficient or deficient levels of Vitamin D.
  • Rates of Diseases affected by vitamin D status
  • 78% reduction in Type I diabetes in children taking 2000 IU/day in 1st year of life
  • 200% increase in Type I diabetes in Vitamin D deficient children.
  • 33% reduction in Type II in those taking 800 IU/day of D plus calcium
  • 72% reduction in number of falls in elderly people taking higher-dose vitamin D
  • 30-50% more cancers in vitamin D deficient people
  • 42% reduction in multiple sclerosis in women taking more than 400 IU/day of D.
  • Increased incidences of autoimmune diseases, osteoarthritis, depression, hypertension, pulmonary disorders, schizophrenia and cardiovascular diseases in those with less optimal Vitamin D status.
  • Human diets don't provide sufficient vitamin D
  • Minimum vitamin D blood levels needed to reduce disease risk are 30 ng/dl.

Miscellaneous Nutritional News

  • Eating more magnesium-rich foods, like green leafy vegetables and nuts, may reduce diabetes risk
  • A Women's Health Initiative study found estrogen therapy associated with less coronary plaque.
  • Cinnamon prevents blood sugar spikes.
  • Omega 3 FAs may protect against prostate cancer. They also relieve depression and agitation in Alzheimer's patients.
  • Flavinoid consumption slows cognitive decline.
  • Low levels of folate (B vitamin) is associated with depression risk
  • Pomegranate shows promise in averting lung cancer.
  • Genistein (soy phytoestrogen) boosts bone mineral density
  • Tumeric or Curcumin a spice has many potential health benefits: antibacterial, antifungal, antiviral, anti-inflammatory, anti-cancer, cardiovascular protection, neurodegenerative protection (Alzheimer's and Parkinson's), reversing damage from high blood sugar, potential treatment for multiple sclerosis, may protect against cataracts, shows promise for skin disorders such as psoriasis and in wound treatment.