Folic Acid Before Pregnancy is Beneficial for Delivery Health
By Greg Arnold, DC, CSCS, May 26, 2009, abstracted from “Preconceptional Folate Supplementation and the Risk of Spontaneous Preterm Birth: A Cohort Study” in the 2009 issue of the Public Library of Science
Pre-term birth puts both the health of the baby and the mother at risk. In the newborn, pre-term birth increases the risk of health complications as well as lasting disabilities such as mental retardation, cerebral palsy, lung and gastrointestinal problems, vision and hearing loss, and even death (1). For the mother, pre-term birth increases the risk of cardiovascular disease later in life. Specifically, women who have delivered pregnancies before 37 weeks of pregnancy have a 300% increased risk of cardiovascular death (2).
More than a half million infants were born pre-term in 2004, the highest number reported since comparable national data on gestational age have been available (1981) (3). While some ways to help maintain pregnancy health have been found, including maintaining healthy cholesterol levels (4) and increasing omega-3 fat intake (5), a new study (6) has found that taking folic acid before pregnancy may help with a healthy pregnancy.
In the study, researchers conducted interviews with more than 34,000 women during the first three months of their pregnancy and asked them whether or not they had taken folic acid supplements before conception. They then followed the mothers through pregnancy and found that. compared to those who had not taken any folic acid supplements, those supplementing for more than a year had a 70% reduced risk of pre-term birth between 20 and 28 weeks of pregnancy and a 50% reduced risk of preterm birth between 28 and 32 weeks. There was no reduced risk beyond 32 weeks with supplementation.
For the researchers, folic acid supplementation before pregnancy “is associated with a 50%–70% reduction in the incidence of early spontaneous preterm birth.” Unfortunately, the researchers did not state what the average folic acid supplement dose was during the year before conception, but the current recommendation is 600 micrograms per day during pregnancy
Thursday, September 24, 2009
Tea Tree Gel Gets Rid of Head Lice
Tea Tree Gel Gets Rid of Head Lice The beginning of school can be new and exciting, but it is also the peak season for head lice.
Head lice occur most frequently in young children between 3 and 10 years old. In the U.S., approximately 6 to 12 million children undergo treatment for head lice per year. Head lice are spread through direct contact between an infected person and an uninfected person. Although there are prescription medications that are effective in treating head lice, you might be surprised to learn that one nontraditional treatment, tea tree gel, may be as good as or even better at killing head lice.
The most common method of killing head lice is to treat the scalp and hair with a medication, permethrin. It is very effective and has few side effects. However, there are increasing reports of head lice developing resistance to permethrin, and stronger chemicals come with more side effects. Many people are looking to nontraditional alternatives: eucalyptus oil, echinacea, tea tree oil and extracts from other herbs.
Are these nontraditional therapies effective, however, and how do they compare to permethrin?
These questions were addressed in a recent medical study comparing the effectiveness of a number of nontraditional therapies to the permethrin approach. This study (published in the medical journal Medical and Veterinary Entomology) was done in Australia where head lice is a serious problem. In some schools, up to 30 percent of children are affected and permethrin resistance is increasingly common. Using very stringent methods for evaluating head lice mortality, the researchers discovered that most of the nontraditional therapies were relatively ineffective, except for tea tree gel.
Surprisingly, in this study, tea tree gel actually was better at killing head lice than permethrin. Almost 100 percent of head lice were killed by tea tree gel compared with 82 percent with permethrin. There were no significant side effects reported by either tea tree gel or permethrin.
Tea tree gel comes from tea tree oil, derived from the leaves of the tea tree, a native of Australia. Tea tree oil has been used for centuries as a treatment for many conditions including sore throats, open wounds and skin diseases. Now we can add head lice.
Even though there are few side effects to permethrin, not everyone wants to use a pesticide on their children - especially if nontraditional therapies for the treatment of head lice are as effective. Therefore, this study is timely and important: Head lice are increasingly resistant to permethrin; tea tree gel actually kills head lice and may be more effective than permethrin.
I hope you and your family will never experience head lice, but if you do, it is good to know that there are effective nontraditional therapies.
Head lice occur most frequently in young children between 3 and 10 years old. In the U.S., approximately 6 to 12 million children undergo treatment for head lice per year. Head lice are spread through direct contact between an infected person and an uninfected person. Although there are prescription medications that are effective in treating head lice, you might be surprised to learn that one nontraditional treatment, tea tree gel, may be as good as or even better at killing head lice.
The most common method of killing head lice is to treat the scalp and hair with a medication, permethrin. It is very effective and has few side effects. However, there are increasing reports of head lice developing resistance to permethrin, and stronger chemicals come with more side effects. Many people are looking to nontraditional alternatives: eucalyptus oil, echinacea, tea tree oil and extracts from other herbs.
Are these nontraditional therapies effective, however, and how do they compare to permethrin?
These questions were addressed in a recent medical study comparing the effectiveness of a number of nontraditional therapies to the permethrin approach. This study (published in the medical journal Medical and Veterinary Entomology) was done in Australia where head lice is a serious problem. In some schools, up to 30 percent of children are affected and permethrin resistance is increasingly common. Using very stringent methods for evaluating head lice mortality, the researchers discovered that most of the nontraditional therapies were relatively ineffective, except for tea tree gel.
Surprisingly, in this study, tea tree gel actually was better at killing head lice than permethrin. Almost 100 percent of head lice were killed by tea tree gel compared with 82 percent with permethrin. There were no significant side effects reported by either tea tree gel or permethrin.
Tea tree gel comes from tea tree oil, derived from the leaves of the tea tree, a native of Australia. Tea tree oil has been used for centuries as a treatment for many conditions including sore throats, open wounds and skin diseases. Now we can add head lice.
Even though there are few side effects to permethrin, not everyone wants to use a pesticide on their children - especially if nontraditional therapies for the treatment of head lice are as effective. Therefore, this study is timely and important: Head lice are increasingly resistant to permethrin; tea tree gel actually kills head lice and may be more effective than permethrin.
I hope you and your family will never experience head lice, but if you do, it is good to know that there are effective nontraditional therapies.
Wednesday, September 23, 2009
Folic Acid Found to Help Mental Health
Migraine headaches are a dysfunction of the nerves and blood vessels in the brain and are characterized by nausea and vomiting, pain with exposure to light (photophobia) and sound (phonophobia) and severe recurrent headache (1). The International Headache Society has divided migraines into two types - migraine without aura* (75% of sufferers) and migraine with aura (25% of sufferers) (1). Migraine headaches affect 12% of Americans and cost our healthcare system $24 billion each year (2)
Although the exact cause of migraines is not known, there are natural ways to help treat migraine headaches, including Coenzyme Q10 (3) and butterbur extract (4). Now a new study (5) has found that folic acid may also help mental health.
Existing research suggests that homocysteine levels may contribute to migraines by disrupting blood vessel function (6). Building on these findings, 47 patients with migraine headaches with aura or a family history of migraine headaches with aura received either vitamin supplementation (2 mg of folic acid, 25 mg vitamin B6, and 400 micrograms of vitamin B12) or placebo for six months. The researchers kept a diary of the patients’ headache occurrences and took blood samples before and after the study to measure homocysteine levels.
By the end of six months, those in the vitamin group had an average decrease of 39% in homocysteine levels (4 micromoles/liter). This drop was double that of the placebo group, which experienced a 2 micromoles/liter drop. Those in the vitamin group also had a 50% drop in how often their migraines impaired their activity (dropping from 60% disability to 30% disability) compared to no reduction in the placebo group. Finally, there was a 75% decrease in migraine frequency compared to no decrease in the placebo group.
When analyzing the blood samples, the researchers noted that those with a certain gene defect that causes low levels of folic acid in the body (called an “MTHFR C677T polymorphism”)) experienced the greatest benefits from the vitamin supplementation. For the researchers, “This study provides some early evidence that lowering homocysteine through vitamin supplementation reduces migraine disability in a subgroup of patients.”
Although the exact cause of migraines is not known, there are natural ways to help treat migraine headaches, including Coenzyme Q10 (3) and butterbur extract (4). Now a new study (5) has found that folic acid may also help mental health.
Existing research suggests that homocysteine levels may contribute to migraines by disrupting blood vessel function (6). Building on these findings, 47 patients with migraine headaches with aura or a family history of migraine headaches with aura received either vitamin supplementation (2 mg of folic acid, 25 mg vitamin B6, and 400 micrograms of vitamin B12) or placebo for six months. The researchers kept a diary of the patients’ headache occurrences and took blood samples before and after the study to measure homocysteine levels.
By the end of six months, those in the vitamin group had an average decrease of 39% in homocysteine levels (4 micromoles/liter). This drop was double that of the placebo group, which experienced a 2 micromoles/liter drop. Those in the vitamin group also had a 50% drop in how often their migraines impaired their activity (dropping from 60% disability to 30% disability) compared to no reduction in the placebo group. Finally, there was a 75% decrease in migraine frequency compared to no decrease in the placebo group.
When analyzing the blood samples, the researchers noted that those with a certain gene defect that causes low levels of folic acid in the body (called an “MTHFR C677T polymorphism”)) experienced the greatest benefits from the vitamin supplementation. For the researchers, “This study provides some early evidence that lowering homocysteine through vitamin supplementation reduces migraine disability in a subgroup of patients.”
Monday, September 14, 2009
orthopedic procedure
Scheduling a prime daytime slot to undergo an orthopedic procedure may lower your risk of an unplanned follow-up surgery later on, a new study has found.
The study, published in the September issue of The Journal of Bone and Joint Surgery, found little difference otherwise for healing, recovery time and major complication rates between certain orthopedic surgeries done during the day (between 6 a.m. and 4 p.m.) and those done after hours (4 p.m. to 6 a.m.).
"Although everyone wants to be treated immediately, it may be in a patient's best interest to wait until morning. The reality is that the on-call night surgical team may not be well rested, as it is likely they had just finished a normal day shift," study lead author Dr. William M. Ricci, chief of the Orthopaedic Trauma Service at the Washington University School of Medicine in St. Louis, said in a news release issued by the American Academy of Orthopaedic Surgeons.
The study of 203 surgeries to repair either a fractured thigh or shin bone found a higher incidence of follow-up surgery to remove painful hardware (often a supportive rod called an intramedullary nail fixation that was placed to stabilize the broken bone) in the after-hours patients than the daytime patients -- 27 percent versus 3 percent, respectively.
"The results of the study suggest that the system is working fairly well and it is not always best to rush a patient to the OR in the middle of the night. Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day," Ricci said in the news release.
"For non-emergent fracture care, sufficient daytime resources should be made available to avoid unnecessary night-time surgery," he added.
The study, published in the September issue of The Journal of Bone and Joint Surgery, found little difference otherwise for healing, recovery time and major complication rates between certain orthopedic surgeries done during the day (between 6 a.m. and 4 p.m.) and those done after hours (4 p.m. to 6 a.m.).
"Although everyone wants to be treated immediately, it may be in a patient's best interest to wait until morning. The reality is that the on-call night surgical team may not be well rested, as it is likely they had just finished a normal day shift," study lead author Dr. William M. Ricci, chief of the Orthopaedic Trauma Service at the Washington University School of Medicine in St. Louis, said in a news release issued by the American Academy of Orthopaedic Surgeons.
The study of 203 surgeries to repair either a fractured thigh or shin bone found a higher incidence of follow-up surgery to remove painful hardware (often a supportive rod called an intramedullary nail fixation that was placed to stabilize the broken bone) in the after-hours patients than the daytime patients -- 27 percent versus 3 percent, respectively.
"The results of the study suggest that the system is working fairly well and it is not always best to rush a patient to the OR in the middle of the night. Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day," Ricci said in the news release.
"For non-emergent fracture care, sufficient daytime resources should be made available to avoid unnecessary night-time surgery," he added.
Thursday, September 10, 2009
Real healthcare reform!
I just read a revolutionary article by David Goldhill in the September issue of The Atlantic, entitled “How American Health Care Killed My Father.”
In his appropriate indictment of mainstream, conventional healthcare (i.e., the healthcare business), Goldhill begins his call-to-action commentary by telling what happened to his 83-year-old father: from the time he entered a “well-regarded” New York City hospital with pneumonia, through his development of hospital-acquired sepsis 36 hours later, to his death five weeks later.
Nearly two years after his father’s death, Goldhill does not blame the doctors, or the nurses, nor any one person or institution. “There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy,” writes Goldhill.
Goldhill instead points to our “massively subsidized” healthcare system that is full of structural distortions and with incentives that “inexorably generate terrible and perverse results.” He notes that the biggest problem of all is the fact that consumers have been removed from their “irreplaceable role as the ultimate ensurer of value.”
In my July 2000 editorial in Better Nutrition magazine, “Escape From the E.R.,” I shared my own emergency room experience—-in my case not tragic, just demoralizing and disappointing—I talked about what I experienced as I made my way through two emergency rooms, triage, tests and waiting, a lot of waiting. I saw “victims of a world without a family doctor, statistics at the periphery of an HMO universe.”
I wrote, at the time, that my experience represented “the very worst and the very best of what's horribly wrong and allegedly right about mainstream medicine today. It's high-tech but ‘low-heart,’ the apex of empirical skill yet the nadir of compassionate medicine.”
As the healthcare reform debate looms and town hall forums ignite hope and conversation (and also some pessimism and shouting) across the land, what better time is there than now to take a look as some bills that were introduced in 2009 (in some cases re-introduced several years running) that warrant inclusion in the reform debate, pieces of legislation that have (in most cases) not attracted the level of Congressional interest or consumer awareness that they deserve:
H.R. 1869, title: “To require the President to call a White House Conference on Food and Nutrition”; introduced by Rep. James P. McGovern on April 2, 2009; cosponsors: 81. This conference’s goals would be to: end hunger; reduce food insecurity; coordinate government and community programs to improve nutrition; bring attention to the medical, developmental, educational, economic; and psychosocial impact of inadequate nutrition. See also related bill, H.R. 2297. Take away? This bill has real potential, provided (a) the focus is on optimal (best possible) nutrition and (b) the critical importance of supplements to maternal, infant, child and general nutrition is spotlighted.
H.R. 3263, title: “To amend the Internal Revenue Code of 1986 to provide that amounts paid for foods for special dietary uses, dietary supplements or medical foods shall be treated as medical expenses”; introduced by Rep. Dan Burton on July 20, 2009; cosponsors: 0. With the proposed name of “Tax Supplement Fairness Act,” this bill has the potential to do much good, especially in allowing tax deductions for dietary supplements, especially if the supplements serve a “special dietary use” or are considered “medical foods.” Take away: If this bill is broad or inclusive enough, many people will be helped. Concerns? If restricted to special dietary use or medically supervised diets, however, it could serve to medicalize food supplements and place the rationing of them under medical control.
H.R. 3406, title: “To amend the Internal Revenue Code of 1986 to exclude from gross income amounts reimbursed by an individual’s employer for certain dietary supplements and meal replacement products”; introduced by Rep. Earl Blumenauer on July 30, 2009; cosponsors: 1. This bill would exempt the purchases of health-claim-backed dietary supplements (for example, calcium, folic acid, omega-3s, selenium and vitamin D) from gross personal incomes via Flexible Spending Accounts (FSAs). Take away: This is a great start and a good bill. Concerns? Hopefully the consumer take-away would not be that only supplements for which there is a health claim are effective, science-based or legitimate.
Gormley Take-Away: While it appears that, among these bills, some version of Congressman McGovern’s H.R. 1869 stands the best chance of gaining sufficient support for passage, it will be vital for us to make sure that our Congresspeople and Senators know that we will continue to support these bills and other similar legislation in 2010. Because, legislation that emphasizes nutrition and optimal wellness (especially pro-supplement bills such as these) and keeps more money in our pockets is what I would truly call healthcare reform!
In his appropriate indictment of mainstream, conventional healthcare (i.e., the healthcare business), Goldhill begins his call-to-action commentary by telling what happened to his 83-year-old father: from the time he entered a “well-regarded” New York City hospital with pneumonia, through his development of hospital-acquired sepsis 36 hours later, to his death five weeks later.
Nearly two years after his father’s death, Goldhill does not blame the doctors, or the nurses, nor any one person or institution. “There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy,” writes Goldhill.
Goldhill instead points to our “massively subsidized” healthcare system that is full of structural distortions and with incentives that “inexorably generate terrible and perverse results.” He notes that the biggest problem of all is the fact that consumers have been removed from their “irreplaceable role as the ultimate ensurer of value.”
In my July 2000 editorial in Better Nutrition magazine, “Escape From the E.R.,” I shared my own emergency room experience—-in my case not tragic, just demoralizing and disappointing—I talked about what I experienced as I made my way through two emergency rooms, triage, tests and waiting, a lot of waiting. I saw “victims of a world without a family doctor, statistics at the periphery of an HMO universe.”
I wrote, at the time, that my experience represented “the very worst and the very best of what's horribly wrong and allegedly right about mainstream medicine today. It's high-tech but ‘low-heart,’ the apex of empirical skill yet the nadir of compassionate medicine.”
As the healthcare reform debate looms and town hall forums ignite hope and conversation (and also some pessimism and shouting) across the land, what better time is there than now to take a look as some bills that were introduced in 2009 (in some cases re-introduced several years running) that warrant inclusion in the reform debate, pieces of legislation that have (in most cases) not attracted the level of Congressional interest or consumer awareness that they deserve:
H.R. 1869, title: “To require the President to call a White House Conference on Food and Nutrition”; introduced by Rep. James P. McGovern on April 2, 2009; cosponsors: 81. This conference’s goals would be to: end hunger; reduce food insecurity; coordinate government and community programs to improve nutrition; bring attention to the medical, developmental, educational, economic; and psychosocial impact of inadequate nutrition. See also related bill, H.R. 2297. Take away? This bill has real potential, provided (a) the focus is on optimal (best possible) nutrition and (b) the critical importance of supplements to maternal, infant, child and general nutrition is spotlighted.
H.R. 3263, title: “To amend the Internal Revenue Code of 1986 to provide that amounts paid for foods for special dietary uses, dietary supplements or medical foods shall be treated as medical expenses”; introduced by Rep. Dan Burton on July 20, 2009; cosponsors: 0. With the proposed name of “Tax Supplement Fairness Act,” this bill has the potential to do much good, especially in allowing tax deductions for dietary supplements, especially if the supplements serve a “special dietary use” or are considered “medical foods.” Take away: If this bill is broad or inclusive enough, many people will be helped. Concerns? If restricted to special dietary use or medically supervised diets, however, it could serve to medicalize food supplements and place the rationing of them under medical control.
H.R. 3406, title: “To amend the Internal Revenue Code of 1986 to exclude from gross income amounts reimbursed by an individual’s employer for certain dietary supplements and meal replacement products”; introduced by Rep. Earl Blumenauer on July 30, 2009; cosponsors: 1. This bill would exempt the purchases of health-claim-backed dietary supplements (for example, calcium, folic acid, omega-3s, selenium and vitamin D) from gross personal incomes via Flexible Spending Accounts (FSAs). Take away: This is a great start and a good bill. Concerns? Hopefully the consumer take-away would not be that only supplements for which there is a health claim are effective, science-based or legitimate.
Gormley Take-Away: While it appears that, among these bills, some version of Congressman McGovern’s H.R. 1869 stands the best chance of gaining sufficient support for passage, it will be vital for us to make sure that our Congresspeople and Senators know that we will continue to support these bills and other similar legislation in 2010. Because, legislation that emphasizes nutrition and optimal wellness (especially pro-supplement bills such as these) and keeps more money in our pockets is what I would truly call healthcare reform!
Wednesday, September 2, 2009
Mediterranean-style diet is more effective
A low-carbohydrate, Mediterranean-style diet is more effective than a typical low-fat, calorie-restricted diet for diabetes management, according to a study released Monday.
Not only did the Mediterranean diet lead to greater weight loss, it also resulted in better blood sugar control, delayed the need for blood sugar-lowering medication, and improved some heart disease risk factors, the study team found.
Mediterranean-style eating generally means plenty of fruits, vegetables and whole grains, limited amounts of red meat and processed foods, and a relatively high amount of fat from olive oil and nuts and few carbohydrates. A typical low-fat diet advises cutting down on all types of dietary fat.
Both Mediterranean and low fat diets are recommended for weight loss in overweight and obese patients with type 2 diabetes. However, there have been few direct, long-term studies comparing the two.
This led Dr. Dario Giugliano, from the Second University of Naples, Italy, and associates to randomly assign 215 type 2 diabetic patients to follow either a low carbohydrate, Mediterranean-style diet or a low-fat diet for four years.
Nutritionists and dietitians counseled both groups of patients in monthly sessions for the first year and bimonthly sessions for the next three years.
After four years, 44 percent of patients in the Mediterranean-style diet group required medication to lower their blood sugar compared to 70 percent in the low-fat diet group, the researchers report in the September 1st issue of the Annals of Internal Medicine.
After 1 year, patients in the Mediterranean diet group also experienced greater weight loss. The absolute difference in weight loss between the two groups was -2.0 kg (-4.4 lbs). The Mediterranean dieters also had trimmer waistlines.
In addition, significantly greater increases in "good" HDL-cholesterol levels and greater decreases in harmful blood fats called triglycerides were seen in the Mediterranean diet group and these heart-healthy benefits were maintained for the duration of the study.
These findings, the investigators conclude, "reinforce the message that benefits of lifestyle interventions should not be overlooked despite the drug-intensive style of medicine fueled by the current medical literature."
SOURCE: Annals of Internal Medicine, September 1, 2009.
Not only did the Mediterranean diet lead to greater weight loss, it also resulted in better blood sugar control, delayed the need for blood sugar-lowering medication, and improved some heart disease risk factors, the study team found.
Mediterranean-style eating generally means plenty of fruits, vegetables and whole grains, limited amounts of red meat and processed foods, and a relatively high amount of fat from olive oil and nuts and few carbohydrates. A typical low-fat diet advises cutting down on all types of dietary fat.
Both Mediterranean and low fat diets are recommended for weight loss in overweight and obese patients with type 2 diabetes. However, there have been few direct, long-term studies comparing the two.
This led Dr. Dario Giugliano, from the Second University of Naples, Italy, and associates to randomly assign 215 type 2 diabetic patients to follow either a low carbohydrate, Mediterranean-style diet or a low-fat diet for four years.
Nutritionists and dietitians counseled both groups of patients in monthly sessions for the first year and bimonthly sessions for the next three years.
After four years, 44 percent of patients in the Mediterranean-style diet group required medication to lower their blood sugar compared to 70 percent in the low-fat diet group, the researchers report in the September 1st issue of the Annals of Internal Medicine.
After 1 year, patients in the Mediterranean diet group also experienced greater weight loss. The absolute difference in weight loss between the two groups was -2.0 kg (-4.4 lbs). The Mediterranean dieters also had trimmer waistlines.
In addition, significantly greater increases in "good" HDL-cholesterol levels and greater decreases in harmful blood fats called triglycerides were seen in the Mediterranean diet group and these heart-healthy benefits were maintained for the duration of the study.
These findings, the investigators conclude, "reinforce the message that benefits of lifestyle interventions should not be overlooked despite the drug-intensive style of medicine fueled by the current medical literature."
SOURCE: Annals of Internal Medicine, September 1, 2009.
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