Another clue to Acupuncture’s method of action December 5, 2009

One of the failings I see in many acupuncture studies is that the “sham” acupuncture is too close to real acupuncture treatment.  Often in such studies the outcomes reflect this similarity showing that both placebo and treatment groups produce similar results.

Today I stumbled across a study from September of this year exploring the difference in the pain reducing mechanisms of both sham and real acupuncture.  This research could help inform future acupuncture research methods, lead to more large scale studies into the method of action found in this study, and shed light on previous confusing or conflicting result data.

The researchers performed eight treatment sessions over a four week period on 20 female fibromyalgia patients.  PET scans were used after the first treatment and again after four weeks.  Both sham and real acupuncture groups reported similar reductions in pain over time; however, the sham group reductions were more consistent with those seen in general placebo groups, while the true acupuncture group showed more significant clinical pain reduction. The scans showed that real acupuncture increased the opiod (the body’s inherent pain killing neurotransmitter) binding potential of the mu-opiod receptors in several key areas of the brain.  The sham acupuncture actually showed a decrease in that potential.  The NCCAM (National Center for Complementary and Alternative Medicine) stated in their review of the study that this would indicate that true acupuncture increases the brain’s ability to effectively use opiods while the sham acupuncture helps signal the brain to simply make more opiods.

The study abstract can be found Here. The NCCAM review can be found Here.

New breast health screening recommendations November 20, 2009

NPR’s All Things Considered broadcast yesterday brought to my attention the US Preventive Services  Task Force’s newly released guidelines for clinical breast screenings and self examinations.

 

According to their webpage on the US Department of Health and Human Services website, the new guidelines change the age recommendation of biennial mammography to

 

50-74 years of age.  They recommend against routine mammography for women 40-49, and eliminate the recommendation to teach women self breast exams.

 

The task force came to these new conclusions based on a meta-analysis of recent research that indicated that routine screening did not statistically decrease mortality rates in women ages 40-49 in relation to the risks associated with those screenings.  They found the greatest impact on mortality rates in the 60-69 age group.   The risks they are referring to are the high number of false positives associated with mammograms and their resulting biopsies or other unnecessary and often expensive interventions.

 

Both guests of the NPR program believed that insurance companies would be more likely to reduce their coverage of screenings for women 40-49 as a way to save money in light of the new guidelines.  The health advocates that disagree with the new guidelines fear that blocking access to screening in this way will have a negative impact on breast cancer mortality.

 

The recommendation against teaching self breast exam is founded on evidence that the exam has not shown to decrease mortality rates from breast cancer.  There were a few reasons given for this finding.  First, evidence shows that women generally do not perform self exams even they are taught how to.  Second, detection of lumps during self exams does not equate to early detection of cancer.  Treatment and prognosis are similar for self screening and clinical screening.  Last, “breast awareness” is more likely to lead to discovery of breast lumps as women already typically become aware of changes in their breasts during normal daily routines, such as showering, putting on clothes, etc…

 

Personally these new guidelines remind me of another recent developement in cancer screening guidelines regarding the PSA test for prostate cancer.  Recommendations came down to reduce or eliminate testing because the test was leading to too many false positives; and the benefits did not outweigh the risks of unnecessary interventions (often life changing).  During the NPR program for this topic doctors stated that they had been, or were in fear of being, sued for not screening by patients with late stage cancers that were found too late.  While the medical evidence showed that the testing did not increase survival statistically, there was plenty of anecdotal evidence showing that many individuals did live longer due to PSA testing catching fast growing cancers (prostate cancer is typically very slow to develop and progress).  I suspect that similar results will show up as these new breast screening recommendations go into effect.

 

Both parties on the NPR program quite eloquently stated each side of the debate on recommending routine mammography screenings for women age 40-49.  From Dr. BARRON LERNER (Internist, Columbia University Medical Center; Author, “Breast Cancer Wars: Hope, Fear and the Pursuit of a Cure in Twentieth-Century America”): “…in order to save one life from women in their 40s, you need to screen something like 1,900 women for 10 years…there’s a lot of potential harm along the way to potentially only save one life.”  From Dr. THERESE BEVERS (Medical Director, Cancer Prevention Center, M.D. Anderson Cancer Center):  “In my opinion, my colleagues, other clinicians that see patients – breast cancer patients and screening patients for breast cancer, we’re willing to accept a number of false positives to be able to save one woman’s life.”

 

For me, this is a prime example of why each of us needs to make sure we are fully informed about our health choices.  When I am a 45 year old woman I want to know all of the risks and benefits of receiving early breast screening so that I can decide for myself if it is right for me, taking into account family and personal health history and my lifestyle.  I also want to make sure that my doctors are giving me all the information I need without the bias of insurance reimbursement issues or fear of malpractice lawsuits.

 

To see the transcript of the All Things Considered 11/19/09 program, click Here.

Some balsamic vinegars a lead hazard November 9, 2009

First the good news:

According to Environment Health News

“These vinegars do not violate California’s Prop. 65 limits for lead. All were tested by the supplier in 2007, except for Archer Farms, which was tested in 2009:

Barengo Imported Balsamic Vinegar, 6 percent acidity
Acetum Star B Quality Two Leaves Imported Balsamic Vinegar, 6 percent acidity
Best Choice Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Big Y Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Excellence Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Holland House Imported Balsamic Vinegar, 6 percent acidity
Nakano Seasoned Rice Wine Balsamic Blend Vinegar, 4 percent acidity Barengo Red Wine Vinegar, 7.5 per acidity
Albertson’s Red Wine Vinegar, 5 percent acidity
Fancifood Red Wine Vinegar, 5 percent acidity
Chef’s Review Red Wine Vinegar, 5 percent acidity
Great Value Red Wine Vinegar, 5 percent acidity
Safeway Select Red Wine Vinegar, 5 percent acidity
Western Family Red Wine Vinegar, 5 percent acidity
Four Monks Red Wine Vinegar, 5 percent acidity
Holland House Red Wine Vinegar, 5 percent acidity
Four Monks Domestic Balsamic Vinegar, 6 percent acidity
Four Monks Red Wine Vinegar, 6 percent acidity
S & W Red Wine Vinegar, 6 percent acidity
Western Family Red Wine Vinegar, 6 percent acidity
Acetum 4 Star Quality Imported Balsamic Vinegar, 6 percent
Wegmans Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Western Family Imported Balsamic Vinegar, 6 percent acidity
Best Choice Imported Balsamic Vinegar, 6 percent acidity
Barengo Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Albertson’s Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Shaw’s Balsamic Vinegar Imported Balsamic Vinegar, 6 percent acidity
Nakano Italian Seasoned Red Wine Vinegar, 6 percent acidity
Four Monks Red Wine Vinegar, 5 percent acidity
FSA Red Wine Vinegar, 5 percent acidity
Chef’s Review Red Wine Vinegar, 5 percent acidity
Katy’s Kitchen Red Wine Vinegar, 5 percent acidity
Pocahontas Red Wine Vinegar, 5 percent acidity
Sysco Classic Red Wine Vinegar, 5 percent acidity
US Foodservice Red Wine Vinegar, 5 percent acidity
Nugget Red Wine Vinegar, 5 percent acidity
Barengo Balsamic Vinegar, 6 percent acidity
FSA Balsamic Vinegar, 6 percent acidity
Barengo Red Wine Vinegar, 7.5 percent acidity
Unbranded industrial/bulk product Red Wine Vinegar, 10 percent acidity
Four Monks Red Wine Vinegar, 7 percent acidity
Four Monks Premium Burgundy Wine Vinegar, 7 percent acidity
Regina Imported Balsamic Vinegar, 6 percent acidity
Regina Imported Raspberry Balsamic Vinegar, 6 percent acidity
Unbranded industrial/bulk product Red Wine Vinegar, 7 percent acidity
Unbranded industrial/bulk product Cabernet Sauvignon Wine Vinegar, 7 percent acidity
Unbranded industrial/bulk product Imported Balsamic Vinegar, 6 percent acidity
Archer Farms Balsamic Vinegar of Modena

Source: Environmental Law Foundation”

 

Now the bad news:  other balsamic and red wine vinegars not on that list may have unsafe levels of lead.  Vinegars were tested in 2007 and 2009 as part of a lawsuit brought by the Environmental Law Foundation against suppliers and retailers of the vinegars they tested in 2002 which contained lead in excess of standards set in California as part of Prop 65.

 

More good news, according to the article:   “White vinegars and vinegars made from rice, raspberries or figs didn’t have lead levels that would trigger warnings.”

 

Learn more Here

6 Flu prevention tips from Dr. Oz November 5, 2009

Swine Flu – Good Advice / H1N1 Preventive Methods … from Dr.Oz, on TV

“The only portals of entry are the nostrils and mouth/throat. In a Global epidemic of this nature, it’s almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.

While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of Symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced (instead of Focusing on how to stock N95 or Tamiflu):

 

1. Frequent hand-washing (well highlighted in all official communications).

 

2. “Hands-off-the-face” approach. Resist all temptations to touch any part of face (unless you want to eat or bathe.)

 

3. Gargle twice a day with warm salt water (use Listerine or Hydrogen Peroxide if you don’t trust salt). *H1N1 takes 2-3 days after initial infection in the throat / nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don’t underestimate this simple, inexpensive and powerful preventative method.

 

4. Similar to 3 above, *clean your nostrils at least once every day with warm salt water, or hydrogen peroxide.. *Not everybody may be good at cleaning nasal cavities), but *blowing the nose softly once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.*

 

5. *Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). *If you have to supplement with Vitamin C and Vitamin D tablets make sure that it also has Zinc to boost absorption. 6. *Drink as much of warm liquids (tea, coffee, etc) as you can. *Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.”

 

Thank you Adina Dabija, L.Ac. for transcribing this info and forwarding it to the PCOM alumni community!

6 quick and easy snack ideas August 16, 2009

Breakfast may be the most important meal, but mid-morning and mid-afternoon are the most important snack times of the day.  They are the perfect times for a little pick me up between meals, and the perfect time to make healthy choices.

Here are 6 quick snacks that are easy to store, transport and eat:

1) Avocado- Cut in half at home, leave pit in and store with halves placed back together.  Eat later with a spoon or fork right out of the rind.

2) Trail Mix- get a good mix of low salt nuts, seeds and dried fruit.

3) Cottage cheese or yogurt- low fat if you’re worried about your less healthy fat intake.

4) A handful of lightly or unsalted nuts.

5) Natural/organic/grass-fed beef (or turkey or salmon) jerky-  steer clear of big commercial brands that use preservatives and loads of sodium.

6) Banana- it comes in its own packaging!

Besides the banana, these snacks offer a good balance of sugar, protein and fat.  Foods with this kind of balance break down slower than foods high in simple carbohydrates; this keeps your blood sugar from spiking and gives more long lasting energy.  These snacks are perfect alternative to cookies, chips, soda and other common sugary afternoon treats.

Keep in mind that high glycemic index and processed foods, such as rice cakes, bread and crackers, and sugar (don’t forget how much is in that specialty coffee drink) may give you a lot of energy up front, but they come at a price.  Poor blood sugar regulation, mood swings, fatigue and empty calories are not a good trade for the quick sugar fix.  Instead, let your snacking give you sustained energy, improved mood, nutrients, and healthy calories.  Your body and mind will thank you.