Avoid Alcohol During Pregnancy

Even a Single Drinking Binge May Cause Brain Damage

Don't drink when you're pregnant - we've all heard the general warnings, but exactly how much is too much? Some health experts claim that expectant mothers can safely consume small amounts of alcohol (one drink per day) and still deliver a healthy baby, while others warn of the potential effects of fetal alcohol syndrome (FAS) - impaired growth, learning and coordination difficulties, and deformed facial features.

According to a study published in the February issue of Science, even the smallest amount of alcohol can jeopardize fetal health. Researchers administered a 20% solution of alcohol to seven-day-old rats in two separate treatments given two hours apart; a control group was treated with a saline solution for comparison. Twenty-four hours after the initial treatment, large numbers of neurons had been deleted from several major regions of the developing brain in the group exposed to alcohol. 

Although the study involved rats, the authors are quick to point out that this developmental stage (the first two weeks of birth in rats) coincides with human fetal development from the sixth month of pregnancy until birth. They warn that if a pregnant mother consumes alcohol for even a few hours in a single drinking episode, she could be putting her developing fetus at risk for neurological damage. Consult your team of health care professionals during pregnancy to ensure the health and safety of your child.

Ikonomidou C, Bittigau P, Ishimaru MJ, et al. Ethanol-induced neurodegeneration and fetal alcohol syndrome. Science, Feb. 11, 2000: Vol. 287, pp1056-60.

Lots of Antibiotics, Little Success 

Otitis media refers to inflammation of the middle ear area just behind the eardrum. Two out of three children under the age of three suffer at least one episode of otitis media, and up to one third experience six or more episodes by the time they start school. Common symptoms include irritability, difficulty sleeping, fussiness (in younger children), and ear pain and hearing loss (in older children). 

Antibiotics are standard treatment for this condition, even though little scientific evidence supports their use. A case in point comes from the British Medical Journal, which published a study comparing antibiotic treatment vs. placebo (no treatment) for acute otitis media. Among 53 general practices in the Netherlands, 240 children between six months and two years of age were randomly selected to receive either amoxicillin or placebo. Results showed only slight differences between the two groups with regard to symptom resolution (more common in the antibiotic group at day four, but similar by day 11); duration of fever (shortened by one additional day in the antibiotic group); and crying and/or pain (no differences between the two groups).

The authors conclude that if seven to eight children with acute otitis media are given amoxicillin treatment, only one child will experience symptom improvement by day four. They suggest that the effectiveness of antibiotics for this condition is limited, especially in children under two years of age. Contact your chiropractor for information on nonmedical approaches to resolving otitis media.

Damoiseaux RAMJ, van Balen FAM, Hoes AW, et al. Primary-care-based randomized, double-blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. British Medical Journal, Feb. 5, 2000: Vol. 320, pp350-54.

On the Safety of the Chiropractic Adjustment

The term "chiropractic" comes from the Greek word "Chiropraktikos," meaning "effective treatment by hand." Effective treatment by hand is exactly what chiropractors do, delivering gentle adjustments to the spine and musculoskeletal system to maximize wellness and prevent dysfunction. 

Complications resulting from any procedure are always unfortunate, regardless of the health care professional administering care. While a certain degree of risk accompanies all health interventions, specific concerns have been raised over the safety of spinal manipulation.

But have no fear: As a study in the Chiropractic Journal of Australia professes, the chiropractic adjustment is "one of the most conservative, least invasive and safest of procedures within the health care professions." The study compared complication rates, specifically cerebrovascular accidents(CVAs)and/or death attributable to spinal manipulation, nonsteroidal anti-inflammatory drugs (NSAIDs), and numerous medical procedures. The author emphasizes that the potential risk of "catastrophic" side-effects from spinal manipulation is substantially lower than most common medical procedures.

Rome PL. Perspectives: an overview of comparative considerations of cerebrovascular accidents. Chiropractic Journal of Australia, Sept. 1999: Vol. 29, No. 3, pp87-102.

Too Much Added Sugar

Carbohydrates, including sugars, comprise the body's primary source of energy. Sugar occurs naturally in many foods (i.e., fruits and dairy products), but there are countless processed foods that contain high amounts of refined sugar. A little sugar is OK, but too much can contribute to poor overall diet and poor health. The figures show that Americans consume far too much sugar on a daily basis.

As part of the U.S. Department of Agriculture (USDA) 1994-1996 Continuing Survey of Food Intakes by Individuals, 15,010 people two years of age and older recorded a 24-hour recall of dietary intake. Researchers calculated intake of added sweeteners, paying specific attention to average intake from all sources and from specific categories; contribution of added sweeteners to total energy intake; and percentage contribution of each food category to total added sweetener intake. 

	An average of 82 grams of carbohydrates per day came from added sweeteners, accounting for 16% of total energy intake. (Nutritional guidelines recommend that between 6-10% of carbohydrates come from sugars.)
	Adolescents consumed the most added sweeteners as a percentage of energy (20% of total energy intake).
	The primary sources of added sweeteners were soft drinks (33%), sweets (candies, syrups, honey, table sugar - 16.1%), and sweetened grains (cookies and cakes - 12.9%).

If you're consuming a lot of sugar, you're probably not getting enough of the vitamins, minerals and other nutrients your body needs to function properly. In fact, the sweeteners Americans seem to consume most frequently (non-diet soft drinks, candy, syrups and jellies, etc.) possess no nutritional value whatsoever except for the sugar. Teach your children about the importance of a balanced diet that minimizes consumption of refined sugar. Your doctor of chiropractic can evaluate the nutritional status of your family and suggest appropriate modifications to maximize wellness.

Guthrie JF, Morton JF. Food sources of added sweeteners in the diets of Americans. Journal of the American Dietetic Association 2000: Vol. 100, pp43-48, 51.

Body Fat and Breast Cancer

A number of factors have been implicated as substantial risk factors for breast cancer, including family history of the disease and early onset of menstruation. Recent research also hints at a link between hormone replacement and breast cancer (See "Hormone Therapy May Contribute to Breast Cancer" in the News Archives). 

A study in the American Journal of Epidemiology reveals another possible contributor to this devastating disease: body fat distribution. As part of the Nurses' Health Study (1986-1994), 47,382 U.S. registered nurses reported their waist and hip circumferences at entrance and were monitored for the next eight years for incidence of breast cancer.

Increasing waist circumference was significantly related to breast cancer in postmenopausal, but not premenopausal, women. This association was maintained even when considering overall obesity and other breast cancer risk factors, and was even stronger among women who had never received hormone replacement therapy. Consult with a health care professional to learn how to minimize your risk of developing breast cancer.

Huang Z, Willett WC, Colditz GA. Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses' Health Study. American Journal of Epidemiology, Dec. 1999: Vol. 150, No. 12, pp1316-24.

Losing Weight with Green Tea

Green tea is rich in flavonoids, a group of plant pigments commonly known as bioflavonoids. Flavonoids function as antioxidants, protecting the body against some types of cancer; evidence that a subclass of flavonoids called "tea catechins" helps control fat oxidation suggests that green tea may play a role in weight management. 

The December 1999 American Journal of Clinical Nutrition included a study that explored this potential influence of green tea on weight loss. The authors began by explaining that "fundamentally, there are only two ways to treat obesity: reduce energy intake or increase energy expenditure." Relying on this premise, they compared the effect of green tea vs. placebo on 24-hour energy expenditure (EE - a higher EE means the body is burning more calories) and respiratory quotient (RQ - a lower RQ means the body is metabolizing more fat).

On three separate occasions, subjects (10 men) randomly received one of three treatments at breakfast, lunch and dinner: green tea extract (50 mg caffeine, 90 mg epigallocatechin gallate); caffeine (50 mg); or placebo. Subjects who ingested the green tea extract demonstrated a significant increase in EE and a significant decrease in RQ compared to subjects who ingested caffeine or placebo. The authors note that caffeine had no effect on EE or RQ, even in amounts equivalent to those found in the green tea extract (50 mg). Their results emphasize the potential ability of green tea (independent of caffeine) to "influence body weight and body composition."

Dulloo AG, Duret C, Rohrer D, et al. Efficacy of a green tea extract rich in catechins polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. American Journal of Clinical Nutrition, Dec. 1999: Vol. 70, pp1040-45.

Get Out of Bed and Stay ACTIVE

Rest has been standard recommendation for low back pain (LBP) for years, especially within the medical community. This recommendation persists despite research evidence (see "Sciatica: Bed Rest vs. Watchful Waiting" in the April 1999 issue of ToYour Health) suggesting that prolonged rest serves no purpose and may delay return to work and resumption of normal activities.

This report from the International Paris Task Force on Back Pain outlines the role of activity in the treatment of back pain. In addition to presenting numerous recommendations and summaries, the authors offer the following key points as summary to their findings:

	Bed rest is contraindicated in subacute and chronic cases of LBP.
	In acute cases, bed rest should neither be enforced nor prescribed.
	If authorized (based on pain indication), bed rest should be for the shortest duration possible.
	Patients whose pain is intense enough to justify bed rest should be referred for a specialized back pain evaluation if daily activities have not been resumed after 10 days of strict bed rest (defined as getting up only to go to the bathroom) and adequate pain therapy.

Are you suffering from low back pain? If you think bed rest is the solution to your pain, think again. As the authors note (see above), if your pain is in tense enough to justify bed rest, schedule a "specialized back pain evaluation" with an expert in managing and resolving back pain -- your doctor of chiropractic!

Abenhaim L, Rossignol M, Valat JP, et al. The role of activity in the therapeutic management of back pain: Report of the International Paris Task Force on Back Pain. Spine, Feb. 15, 2000 (supplement): Vol. 25, No. 4S, pp1-25.

DTP, Tetanus Vaccinations Cause Allergy Symptoms?

Infants and young children have been routinely vaccinated against diptheria, tetanus and pertussis since the late 1940s. Such vaccination practices have reduced the incidence of disease, although they have not come without a price.

A case in point comes from a recent study published in the Journal of Manipulative and Physiological Therapeutics. Data from the Third National Health and Nutrition Examination Survey (1988-1994) provided information on diptheria-tetanus-pertussis
(DTP) or tetanus vaccination, allergy history, and allergy symptoms in 13,944 children (two months to 16 years old).

Results showed that vaccinated children were twice as likely to have a history of asthma, and 63% more likely to suffer an allergy-related symptom in the previous 12 months, compared with unvaccinated children. These associations were particularly
strong in younger children (5-10 years of age).

The authors conclude that the number of allergies or allergy-related conditions attributable to vaccination may be high, as nearly all children in the United States receive at least one dose of DTP vaccine. Considering that chronic sinusitis, asthma and allergic rhinitis account for nearly 10 million care visits annually among children 15 and younger, parents should consult with their doctor to discuss the potential benefits and risks of vaccination. 

Hurwitz EL, Morgenstern H. Effects of diptheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. Journal of Manipulative and Physiological Therapeutics, Feb. 2000: Vol. 23, No. 2, pp81-90.

Weight Training: Is One Set Enough?

The physiological benefits of resistance training include increased strength, muscle size, lean body mass, bone mass, and overall physical function. Millions of Americans spend a number of hours each week at the local gym or health club, grinding out set after set in the quest for lifelong health and fitness.

The American College of Sports Medicine and the Surgeon General recommend a weight-training program requiring a minimum of one set of 8-12 repetitions for each muscle trained per exercise, and some research suggests that multiple sets may maximize the physical benefits. However, a recent study in Medicine & Science and Sports & Exercise adds to the mounting evidence that one set per exercise may be just as effective as two or more sets. Forty-two recreational weightlifters (20-50 years old, averaging 6.2 years of previous training) were divided into two groups and participated in a nine-exercise resistance training circuit. Group 1 performed one set of 8-12 repetitions for each of the nine exercises; Group 2 performed three sets under the same conditions. No significant differences were noted between the two groups after 13 weeks of training, with both groups improving significantly in terms of muscular endurance, one-repetition maximum strength, lean body mass, and overall body composition.

Your doctor of chiropractic can evaluate your current exercise regimen and outline nutritional and exercise guidelines suitable to your needs.

Hass CJ, Garzarella L, de Hoyos D, et al. Single versus multiple sets in long-term recreational weightlifters. Medicine & Science in Sports & Exercise 2000: Vol. 32, pp235-42.

Vitamin C Lowers Women's Risk of Gallbladder Disease

The gallbladder's most important function is to store bile, a substance manufactured in the liver which helps the body digest fatty foods. Cholesterol is a normal component of bile; if too much cholesterol accumulates in the gallbladder, gallstones eventually result.

Because estrogen is an important risk factor for gallstone formation (it increases the concentration of cholesterol in bile), women are at particular risk for the disease. Experimental animal studies suggest that ascorbic acid (vitamin C) may play a role in preventing gallstones, an observation that led to a recent study published in the Archives of Internal Medicine.

As part of the Third National Health and Nutrition Examination Survey, 7,042 women and 6,088 men provided data on vitamin C intake and the incidence of gallbladder disease. Results showed that increasing serum levels of ascorbic acid were related to a reduced risk for clinical and asymptomatic gallbladder disease in women, but not in men. Specifically, each standard increment increase in ascorbic acid level reduced the risk of a woman getting the disease by 13%.

Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among U.S. adults. The Third National Health and Nutrition Examination Survey (NHANES III). Archives of Internal Medicine 2000: Vol. 160, pp931-36.

NSAIDs May Contribute to Congestive Heart Failure

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for migraines, sprains, strains, and countless other conditions in which pain and/or inflammation result. NSAIDs have come under fire in recent years, with mounting evidence suggesting possible dangerous side effects associated with their use.

One of the most severe potential side effects may be congestive heart failure (CHF) in susceptible patients, according to a study in the March 27, 2000 issue of the Archives of Internal Medicine. Patients admitted to hospitals with a primary diagnosis of CHF (365 cases) were compared with patients without CHF (658 cases) admitted to the same hospitals for other conditions. Patients were interviewed to gather data on recent use of aspirin and other NSAIDs.

Results: Use of NSAIDs in previous week doubled the risk of hospital admission for CHF. Additionally, patients who reported taking higher levels of NSAIDs in the previous week were more likely to be admitted for CHF than patients taking lower levels.

Why this relationship exists is unknown, although the authors speculate that possible drug interactions (NSAIDs and other drugs used by heart patients) may contribute to the problem. They emphasize that "NSAIDs should be used with caution in patients with a history of cardiovascular disease." Talk to your doctor about the potential dangers of NSAIDs and other commonly prescribed drugs.

Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Archives of Internal Medicine, March 27, 2000:160, pp777-84.

Olive Oil Helps Prevent Colon Cancer?

According to mythology, the olive tree was brought to Greece from the goddess Athena. Olive oil has long been considered a symbol of excellence and purity, and increasing evidence points to its value in maintaining a healthy lifestyle and preventing disease.

Precisely this type of evidence appeared in a recent issue of the journal Gut, which published a study espousing the benefits of olive oil in preventing colon cancer. Rats were randomly assigned to receive a diet rich in one of three types of fatty acids found in oil (safflower oil, olive oil, fish oil). After one week receiving a 5% fat diet, each dietary group was redivided, with half of the animals receiving a cancer-causing agent and half receiving harmless saline.

Rats fed a diet supplemented with olive oil had a lower risk of colon cancer than those fed diets supplemented with safflower oil -- nearly as low as those supplemented with fish oil (an established colon cancer-fighting agent).

These findings add to the considerable evidence linking good nutrition with health promotion and disease prevention. Your chiropractor can provide you with more information on the value of nutrition in fighting disease, and help you develop a comprehensive wellness program for you and your family.

Bartoli R, Fernandez-Banares F, Navarro E, et al. Effect of olive oil on early and late events of colon carcinogenesis in rats: modulation of arachidonic acid metabolism and local prostaglandin E2 synthesis. Gut 2000: Vol. 46, pp191-99.

Never Too Late to Start Exercising

No doubt you've heard about the many documented benefits of physical activity: decreased incidence of disease and increased vitality and wellness. Are you participating in a consistent exercise routine? If you're not, it's never too late to start.

Consider a study that appeared in the British Journal of Sports Medicine last year which examined the potential relationship between balance and postural control deficits and the incidence of falls. Specifically, the authors sought to determine whether it is of value for the elderly to start physical and sporting activities=20 (PSA).

Sixty five men and women (aged 60-85) were divided into four groups based on reported levels of PSA (always practiced; never practiced; lately begun; or stopped at an early age), and a series of posture tests provided information on overall balance control and other variables.

Consistent participation in physical and sporting activities optimized balance control. Subjects who never practiced PSA had the worst balance control; subjects who always practiced PSA had the best control. Most interesting perhaps was the observation that subjects who had begun PSA late in life had nearly the same postural control as those who had always practiced PSA

As the authors suggest in their conclusion, "...PSA are extremely useful for elderly people even if it has not been a lifelong habit." These findings are particularly important, as accidental falls are the primary cause of death among the elderly population. Whatever your age, take advantage of the many benefits of consistent physical activity. For more information, contact your chiropractor.

Perrin PP, Gauchard GC, Perrot C. Effects of physical and sporting activities on balance control in elderly people. British Journal of Sports Medicine 1999:Vol. 33, No. 2, pp121-26.

Arthritis Sufferers: Get the Facts on Chondroitin Sulfate

Thin, brittle bones can break without warning - one of the most distressing complications associated with arthritis. There are more than 100 different types of arthritis. The common misconception holds that the disease only affects the elderly, but millions of young people, including children, are also affected.

Previous research suggests that exercise (see "Maintain Strong Bones with Exercise" in the News Archive), and nutritional factors  can help fight arthritis by improving bone strength. Further evidence of this potential nutritional role comes from the Journal of Rheumatology, which published a study evaluating the utility of chondroitin sulfate (CS) in the management of osteoarthritis.Chondroitin sulfate is the substance that gives cartilage (the spongy portion of bone) its elasticity and fluidity, suggesting its potential usefulness in influencing bone strength. This study reviewed previous controlled trials of CS in the treatment of hip and knee osteoarthritis (OA), finding that:
B7 In seven reviewed trials, reported pain was only 57% of original baseline scores in groups taking CS; and B7 Patients taking CS reported reductions in consumption of nonsteroidal anti-inflammatories (NSAIDs) and/or analgesics compared to baseline.

The authors emphasize that their results require additional support, but note that "There is evidence that chondroitin sulfate can reduce pain and improve function in patients suffering from osteoarthritis." If you or someone you know suffers from arthritis, talk to your doctor about the potential benefits of chondroitin sulfate.

Leeb FG, Scheweitzer H, Montag K, et al. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. Journal of Rheumatology, Jan. 2000: Vol.=2027, pp205-211.