Healthy Back. Healthy Life.

By Julie L. Lyles, DC

One of the least understood but most important parts of the human body is the spine.  The spine is the lattice work and foundation for every other soft tissue and organ.  The spine is composed of 26 moveable segments.  Hear that?  Moveable! Each joint is angled in a certain way to provide optimal motion and optimal protection.  When loaded correctly and free of fixation, there is nothing more brilliant!   So, why such confusion?  Why such a lack of respect?  Why so little education on the value and importance of healthy joint mobility and postural balance?  Maybe it’s a lack of understanding of the complex simplicity of the spine and its care.

When a child is born, she has 2 curves in her spine:  the mid-back and the sacrum.  As the child starts to get nosey, she lifts her head while on her belly and starts to develop the curve in her neck.  The forces that the back part of her neck feels is what triggers her body to pour calcium in the right places until the age of 25.  (Wolff’s Law” of Physics states that bone models and remodels in response to the mechanical stresses it experiences so as to produce a minimal-weight structure that is ‘adapted’ to its applied stresses.”)

Later on, she gets a little more nosey and goes to all fours, dropping her belly with her head lifted up, developing the curve in her low back.  And, off she goes…through a stage of crawling, building necessary brain and body strength, and mechanical and neurological synchronization.  Then, only when she and her spine are ready, she will start to pull up, with ideally, a properly curved spine that has been fortified by normal instinctive motions and body positions.

When the curves in the spine are not properly formed, as is becoming the norm due to a decrease in “belly-time,” walking too soon without first crawling, more sedentary lifestyles and of course, technology posture, the body reacts profoundly!  Look at the body this way, the back or posterior, is the foundational structure, whereas, the front or the anterior, is where all of the organs and pipes are that supply the body with nutrition and eliminate waste.  If you place the weight of your head, shoulders, and hips in the back and heels, you are correctly putting stress in the purposefully larger, denser bones intended to carry such weight and leaving the front to “flow.”  If you place the weight of the head, shoulders, and pelvis in the front, you are blocking flow of nerve supply, blood supply, and lymphatic supply and compressing all of your vital organs, ultimately leading to dysfunction and disease.

What are common symptoms of joint fixation and postural distortion?  Headaches, neck and back pain, numbness, tingling, and weakness in the upper and lower extremities.  Big deal?  Motrin or Tylenol can help you live with those symptoms, right?  Well, every seven years when the body remodels bone and every year when your organs try to replace their tissues, you are allowing dysfunction and disease to continue…until, of course, you get the symptoms that you can no longer cover up and no longer live with.  What are some conditions that are on the rise, linked to postural distortion and joint fixation: hypertension, migraine headaches, ADD/ADHD, sinusitis/allergies/asthma, reflux and GERD, osteopenia/osteoporosis, infertility, and constipation to name a few.  All of these conditions typically lead to a less active you.  The decreased motion in your body further accelerates the deterioration of the joints and the organs through fixation and stagnation.

What can you do?  Look at yourself and your family and notice if the center of your ear is close to the back of your neck and in line with your shoulders?  Are your shoulders lined up with your hips?  Are your hips lined up with your heels?  Do you have any of the aforementioned conditions and use a lot of over the counter medications? Do you have trouble turning your head or bending it forward, backward, or sideways?  Do you avoid bending over or leaning back? Have you become less active and accepted “feeling bad” as your norm?  Or, has disease set in?

Seek out a health care professional whose specialty is the structure and function of the human form, one whose skills, through manual correction, proper education, and physical retraining can help restore your body to the strong balanced flowing structure capable of brilliant healing powers: The Doctor of Chiropractic.

Image from: www.masharosen.com

Dr. Julie Lyles, DC is a doctor of chiropractic who practices chiropractic care and also owns GetWell Solutions which is focused on Nutrition Counseling, Well Coaching, and Corporate Wellness Programs. For more information, contact Dr. Lyle directly at drjulie@askdoctorjulie.net.  

 

 

 

Concierge Medicine: Personalized Health Care

 

By John Varga, M.D.

Imagine a medical practice designed to not only take care of you when you’re ill but also to provide the ultimate in preventative medicine.  One where your entire history (medical, surgical, dietary, exercise, alcohol, tobacco, stress, sexual, family/genetic) is reviewed in detail regardless of the time it takes.  One where diagnostic tests can be ordered based on their merit instead of the possibility of them being reimbursed by your insurance policy.  One where all of this information can be summarized and personalized specifically for you.  One where a plan of action can be formulated, taught, and followed up to completion.  This is the idea behind our new retainer-based internal medicine practice, OneMD.

My partner, Dr. Mark Wheeler, and I have long been frustrated with our inability to practice truly preventative medicine.  It has not been for a lack of desire or effort, but rather because the current medical system is not designed to promote prevention.  It is instead constructed to treat patients after they become sick.  Because of dramatically increasing overhead (including skyrocketing malpractice premiums) as well as declining reimbursements (Medicare payments to physicians have gone down 4-5% each of the last two years), physicians are forced to increase their patient load to anywhere between 3000 and 5000 patients each.  Primary care physicians are therefore forced to prioritize caring for the acutely and chronically ill, leaving very little time to attend to preventative issues.  This only snowballs into more medical problems since they cannot be addressed in their infancy.

Consider the following:  17 million Americans have diabetes, 102 million have a total cholesterol over 200, 50 million smoke, 60% are overweight, and over 60% are not regularly active.  Obviously not all illness can be prevented but certainly a great deal can be, and should be.  The reason it isn’t can be partly explained by time constraints and poor reimbursement.  Current patient loads don’t allow for much time to counsel each patient and make it difficult to clear space for adequate follow up.  Counseling for obesity, exercise, and smoking cessation is insufficient, and medications for obesity and smoking in general are not reimbursed.  Is it any wonder the Surgeon General has said obesity is the number one health concern in America?  Yet the current medical system is incapable of addressing it.

The current state of medicine has everyone frustrated and perplexed:  patients, physicians, office staff, hospitals, nursing homes, employers, and politicians.  In our case, at the end of the usual long day in the previous system, we would find that everyone was unhappy.  Patients were unhappy waiting two weeks to get an appointment and then up to 90 minutes in the waiting room just to see us for 5-15 minutes.  Our staff was unhappy because the patients were upset with them and we were running behind and stressed.  Our families were unhappy because we were never home, and when we were, our frustrations were evident.  We wondered if there wasn’t a better way.

Enter OneMD.  Dr. Mark Wheeler and I have had the opportunity to develop what we believe is the ideal practice:  from the physical office space to the patient flow to the ancillary services.  The entire emphasis is on providing premium service for our patients and putting the “health” and “care” back in healthcare.  By charging an upfront fee, we are able to maintain a total of only 600 patients between two physicians.  This allows us to spend much more time with our patients:  performing an annual complete physical exam more detailed than those performed at the Mayo Clinic, allowing same day appointments with no waiting, enabling 24/7 access to the physicians who can personally return calls promptly, and insuring personalized service that we were unable to provide in the past.  Patients have a physician to help them navigate the healthcare maze of referrals, overrides, and precertifications.  Sure we obviously still take care of sick patients, but we are also now able to devote more time to those that put staying healthy at a premium.  Both patients and physicians are happy and fulfilled.

We in Louisville have been blessed in the past with excellent healthcare, in some instances world-renowned healthcare.  Physicians in our area work very hard within the system to provide the very best for their patients, but they are constrained by the current healthcare crisis just as we have been.  We in no way mean to belittle the diligent efforts of our colleagues who are struggling through the current system.  Instead OneMD is offering an alternative to those patients that put their health at a premium.  Our practice is not going to solve everything that is wrong with healthcare, but it certainly provides a venue for the delivery of medical care that allows ample time for prevention as well as treatment of problems in a comfortable, relaxing, and satisfying environment.

Image from: ehwell.com/easyblog/entry/what-your-concierge-doctor-can-do-for you

John Varga, M.D.,  has been an internist in Louisville for over 11 years.  He plays golf and is an avid runner.  He has run 4 marathons as well as numerous mini-marathons and was a varsity tennis player at the University of Kentucky.  He can be reached at his office at 899-7163 or by e-mail at john.varga@myonemd.com.

 

Barefoot Running: Just Hype or Legit?

By Dr. Chris Sharrock, PT, DPT, CSCS

 The barefoot fitness revolution continues to gain speed with increasing numbers of people deciding to forgo their ‘fitness’ footwear for a more natural approach.   At the office, you may have stared strangely at the girl wearing those weird looking ‘toe shoes’ or maybe you chuckled under your breath at the power-lifting brute in the gym wearing the old-school Chuck Taylors.  Even in your own neighborhood you may have warned your kids to watch out for the ‘strange’ barefoot runner who dashes down your street.  These sightings along with the growing media advertisement for shoes promoting the ability to train as if you are barefoot are evidence of a new, yet old, phenomenon.

There is a growing body of scientific evidence to support barefoot training along with thousands of amazing testimonials from the barefoot faithful.  In fact, human beings have been participating in athletic events (and everyday life for that matter) without shoes far longer than we have been concerned about purchasing the most supportive running shoe.  Proper foot development of young children is well documented to be directly linked to learning/practicing walking barefoot.   Competitive weightlifters and track athletes have long capitalized on the greater force production and mechanical advantage that training barefoot can provide.  Many experts believe the modern day running shoe is responsible for weakening the musculature of our feet and lower extremities, changing our natural walking/running pattern, and causing increased rates of overuse injuries.  Currently, scientists around the world have turned their attention to the barefoot running craze in hopes of gaining a better understanding of its principles.

Shod vs. Unshod?

Research studies have demonstrated several important differences between running mechanics when shod and unshod.  When running in shoes, the foot tends to land more on the rear of the foot due to the elevated heel and cushioned arch of the shoe design.  You may have heard this referred to as a “heel-toe pattern.”  Barefoot runners tend to land more on their forefoot and mid foot before the heel becomes in contact with the ground.  This is significant because it allows the foot to be more plantar flexed or pointed downwards like pushing on the gas pedal of a car and thus more flexible at impact. This action allows the feet to better absorb energy and decrease peak landing forces.  Barefoot running has demonstrated lower ground impact forces as compared to shod running even on hard surfaces which is thought to be related to the decreased injury rate in barefoot running.  Unshod runners have been shown to have shorter strides, increased stride frequency, and spend less time in contact with the ground than their shod counterparts.  Several studies have reported that shoes can excessively limit the normal ability of the foot to roll inward, or pronate, as the foot contacts the ground.  This limitation of movement leads to the inability to properly distribute forces across joint surfaces and use muscles efficiently.  The result, is a decrease in the efficiency of the running pattern, or ease of running, and can lead to muscular imbalances as well as increased stress to the joints.  Barefoot running is thought to be more efficient due to studies that have reported lower heart rates during running, better abilities to use oxygen, and lower self-reported exertion levels as compared to those running with shoes.   In addition to these benefits, higher levels of activity of the muscles of the lower leg and foot have been documented in barefoot running as compared to when wearing shoes.  It is important to note that research analyzing differences between these two forms of running is still in its infancy at this time.

Is Barefoot Running Right for You?

Barefoot running/walking is certainly not for everyone.  The spectrum of “normal” walking/running patterns as well as foot and ankle function is very broad.  It should be noted that athletes who participate in sports which traditionally wear shoes/cleats to protect the foot should only use barefoot exercise as a training tool to increase performance and not attempt to be barefoot during actual competition.  Barefoot exercise can be used during the rehabilitation of many injuries as long as it is over seen by a licensed Physical Therapist.  It is recommended that you always consult with your Physician or Physical Therapist prior to beginning an exercise program or new competitive season of any kind.

Here are a few medical conditions and symptoms that require further evaluation by a medical professional prior to beginning barefoot running/walking:  history of chronic foot pain, bunions, plantar fasciitis, Achilles tendonitis, plantar neuromas, decreased sensation of the foot, numbness and tingling in the leg/foot, shin splints, arthritic conditions, and metal hardware in the foot or lower extremity.  If you are in doubt, make sure you check with a professional first.

Tips to Get Started Properly

If you are interested in adding barefoot running/walking to your exercise program, there are a few things you should consider first.  The following is a list of helpful tips to get you started off on the right foot:

  • Call your local KORT Physical Therapy clinic to schedule a complimentary running/foot screen performed by a Physical Therapist to assess if barefoot running is appropriate for you.
  • If you are obese or have poor body composition it is recommended that you begin with dieting and low impact exercise for a period of time until improvements are made.
  • Allow yourself adequate time to transition.  Begin with walking barefoot for a period of time during the day and gradually increase as you are able.  Listen to your body and give it time to adapt.
  • Try barefoot shoes first such as the Nike Free and Vibram Five Fingers.  Barefoot mimicking shoes need to have a flexible sole with no raised heel or arch support.
  • Plan barefoot running into your normal program by incorporating it for a period of time either before or after your usual run.  Gradually build up the duration, distance, and intensity over time.  Do not increase any of these variables more than 10% per week to avoid injury.
  • Incorporate barefoot time into your strength training routine.  Everyone, especially those who only run, should perform a total body strength routine several times per week to increase performance and prevent injury.
  • Begin on soft surfaces such as grass and sand before progressing to nature trails or concrete.   Keep time on concrete to a minimum.  Be attentive to foot hazards such as nails, glass, rocks, and holes in your path.
  • Plan to be sore!  Especially in your calf and foot muscles.  Always perform a light dynamic warm-up prior to running as well as more focused stretching and soft tissue work after running.  Use ice as needed.

Image from: www.timarndtfitness.com/2012/07/03/does-barefoot-running-reduce-risk-of-injury/

Chris Sharrock PT, DPT, CSCS, received his Bachelors of Science degree from Georgetown College in Exercise Science and his Doctor of Physical Therapy degree from the University of Kentucky. Chris specializes in Sports Medicine and Sports Performance and has worked with athletes of all ages, abilities, and sports. His clinical interests include ACL rehab and prevention, Concussion Management, Manual Therapy, Complex Shoulder and Knee rehab, Fall Prevention in the elderly, and Low Back Pain Disorders.Dr. Sharrock is the clinic director of the  KORT Winchester Physical Therapy.  For more info, go to www.kort.com.

 

What is Red Yeast Rice? Should I take it as a supplement?

By Barbara Day, M.S., R.D., C.N.

Red Yeast Rice is a substance made by fermenting rice with a species of yeast called monascus purpureus. It contains a variety of compounds known as monacolins which are known to inhibit the enzyme HMG-CoA reductase, which is necessary to make cholesterol. One monacolin in Red Yeast Rice is lovastin which is the key ingredient in statin drug Mevacor®. When taken over a 2 -3 month period, it may lower total cholesterol, LDL (lousy) cholesterol and triglycerides but you need to check with your physician about the use of this supplement. Research studies suggest 1.2 to 2.4 grams per day can be effective in lowering cholesterol. Do not take this supplement if you are also taking a statin!  Red Yeast Rice may share some of the same risks as statins such as elevated liver enzymes, muscle problems and liver problems. Buyer beware. Not all supplements are created equal. Check out www.consumerlab.com to find a supplement that contains the correct amount of monacolin, which is the most important active ingredient.

 

Barbara Day, M.S., R.D., C.N, is a registered dietitian who has been teaching healthy lifestyles strategies to consumers for over 35+ years. Barbara has a new health and wellness online magazine as well.

Can Your Diet Help to Prevent Inflammation in Your Cell Walls?

By Barbara Day, M.S., R.D., C.N.

Inflammation is the root cause of many age related diseases such as heart disease, stroke, cancer and neurodegenerative disease. Inflammatory status is strongly influenced by diet. Eating foods high in omega-3 fatty acids which are found in salmon, sardines or herring, omega-3 enriched eggs, walnuts and flaxseeds help reduce inflammation. Drinking green tea and using spices like turmeric, curry powder (which contains turmeric) and ginger can also help prevent inflammation. Dark chocolate (70% pure cocoa) provides polyphenols which are strong antioxidants but keep in mind they contain calories and being overweight significantly increases your risk of all age-related diseases.  Use Extra-virgin olive oil which is rich in polyphenols but 1 tablespoon contains 120 calories. Soy foods contain isoflavones that have antioxidant activities and seem to be protective against cancer. Soy is high in protein and contains fiber as well. Beans and legumes are also effective at lowering inflammation because they are a low glycemic load food, contain protein and also high in fiber.

Image from: www.avivagen.wordpress.com

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 12 grandchildren.     

Can Yoga Alleviate Back Pain?

By Laura Spaulding

Whether your back pain is a result of working in the garden or a long-standing condition, yoga exercises taught by a qualified instructor can be of real help.  Yoga exercises, or postures, have evolved over many centuries of practice. The postures have been observed, studied and developed by dedicated practitioners who analyzed their effects on different kinds of people. In some cases, the form or method of performing the postures has been changed to make them more effective at building strength and restoring natural flexibility. An experienced, trained yoga teacher also has the knowledge to modify postures or use props or aids to meet the specific needs of individuals. How does yoga help back pain?

 

Normal Flexibility

Normal flexibility is sufficient for yoga classes. Extreme flexibility can cause problems, too, such as a tendency to develop arthritis in joints that have become de-stabilized.  Many new yoga students have lost normal flexibility with resulting back pain and dysfunction.  Stiffness can be the result of long periods of inactivity, a chronic illness, being sedentary or working long hours at a desk. Many leisure activities like jogging or biking can also reduce normal flexibility in the hamstrings and hip muscles, causing stiffness in the back.

The good news is that normal flexibility can be restored, and studies have shown that people regain flexibility at the same rate, whether they’re age 16 or 60. Yoga postures gently restore flexibility by returning muscles to their normal length and increasing the range of motion of joints. Yoga postures create beneficial changes in muscle tissues; old injuries gradually improve or disappear completely. Students also learn how to intelligently stretch and move. Movements become easier, more balanced and fluid.

 

Strength, Resilience and Endurance

While most people associate yoga with flexibility, it also builds strength. Many of the pretzel-like postures we think of as yoga actually require more strength than flexibility. Many postures are isometric exercises in which muscles must be held in contraction to maintain the posture. Other postures require the student to lift his or her own body weight.

Most classes begin with standing postures, which build strength in the major muscle groups in the hips, legs, shoulders and arms.  Beginner classes include these postures everyday to build strength, stability and endurance.  Students gradually develop the ability to hold postures for longer periods with ease and steadiness.

 

Posture, Alignment and Balance

Experienced, trained teachers are always observing students’ alignment in the postures. If the body is correctly aligned, joints work more efficiently and there is more freedom and joy in the posture. Yoga improves posture through realignment and by enhancing the student’s awareness of how the body is standing, sitting and moving.

 

Relaxation and Stress Management

One of the most effective and easiest relaxation techniques is to stretch while breathing deeply – yoga!  Deeply held tension has been released by the postures, and during the class the instructor has gently reminded everyone to breathe deeply. I always tell new students, “Just crawl in here and I guarantee you’ll float home!”  All yoga classes end with a deep relaxation period, often guided by the instructor. Most students say this is their favorite part of class.

 

Total Self Awareness

We often speak of the mind and body as if they were two separate things.  Through yoga we come to understand that they are indeed one. What affects one must affect the other.  Yoga helps us to be more aware of how we feel – mentally, emotionally, spiritually and physically. We learn to attune to ourselves and our surroundings more quickly and perceptively and make the required adjustments.  As one of my teachers said, “Listen to your body while it’s whispering; don’t wait until it’s yelling.”

 

Back pain is complicated and can result from different causes: traumatic injury resulting from a fall or auto accident, strain from improper lifting or poor posture and degenerative diseases such as arthritis, just to name a few. Stress-related back pain is also common. When back pain lingers for several days, it’s wise to check with your medical professional to rule out a serious condition. Also check with your medical professional for permission before beginning yoga classes. Advise your yoga teacher of any restrictions at the start of class. In most cases, you can do yoga, and it will help.

Image from: www.yoga.maxupdates.tv

Laura Spaulding began practicing yoga in 1967.  She was authorized in 2004 by K. Pattabhi Jois to teach Ashtanga Yoga and is currently in India studying yoga at the KPJ Ashtanga Yoga Institute.  Laura has a B.A. from the University of the South, Sewanee, and a law degree from Georgetown University Law Center in Washington, D.C.  She is a Yoga Alliance E-RYT 500SM  teacher and president of Yoga East, Inc.

 

Acupuncture for Back Pain

By James Patrick Murphy, M.D.

 As a Pain Specialist, I see people every day with numerous ailments.  Most often however, when I ask my patient to focus on the primary source of the pain, the response is usually, “It’s my back!”  Back pain is exceedingly common. In fact, only the common cold keeps more people off from work.  If an attack of back pain has been ongoing for less than a month, it can be considered “acute.”  If it has been ongoing for more than three months it is considered “chronic.”  Throughout the course of an “attack” of back pain, people turn to a variety of remedies.  These range from doing nothing… to taking anti-inflammatory meds… to massage and physical therapy… to powerful pain killers… to injections… to surgery.  Another option that is growing in favor amongst patients is acupuncture.

One can turn to acupuncture at any point in the process.  Acupuncture can be helpful with something as simple as a muscle spasm or as complex as an inflamed spinal nerve.  Acupuncture can at times be the only therapy necessary, but usually is considered a “complementary” treatment – meaning it is useful in conjunction with other treatments.

Acupuncture has been used for over 4000 years. Almost every ancient civilization has practiced some form of acupuncture. The National Institutes of Health inWashington,D.C.provided a convincing report in 1997 when the panel concluded that acupuncture “may be useful as an adjunct treatment or an acceptable alternative” in treating muscular pain (Acupuncture. NIH Consensus Development Statement, November 3-5, 1997). This NIH consensus paper stands as a legitimate recognition of acupuncture’s therapeutic benefits.

How acupuncture works is still unclear. The Chinese tradition says that energy (“chi” – pronounced chee) courses through the body in much the same way blood travels through vessels. When some unhealthy process such as inflammation blocks the flow of chi, symptoms develop. For example, after an activity like gardening the inflammation in sore back muscles can block chi, just like a clogged artery can cause a heart attack by depriving the heart muscle of oxygen.  An acupuncture needle, by penetrating the cellular membranes, aids the flow of energy through the blockage.

A more contemporary explanation is that acupuncture causes the release of naturally occurring pain-fighting substances in the brain (i.e. endorphins, dynorphins, serotonin and other such chemicals) responsible for the well-known “runners high,” which is associated with “feel-good” chemicals in the body. Increased blood flow in the vicinity of the needles delivers more of these pain-fighting substances to the areas where they are most needed.

When an injury has persisted for more than three months it can be categorized as “chronic.” Physical therapy, longer acting pain medications, and “co-analgesics” such as Cymbalta, Lyrica, and Celebrex might be used. Acupuncture can be very valuable in enhancing and directing the body’s own natural “holistic” versions of these medications to the appropriate sites of action.

In many states, licensed acupuncturists can provide treatments. InKentucky, the medical board oversees this activity.  Physicians and osteopaths can perform acupuncture themselves or provide coverage for a licensed acupuncturist.  Proceed with caution, as there are many who “fly under the radar” by practicing acupuncture outside the bounds of any oversight.  Avoiding these unlicensed acupuncturists makes good sense.  While generally very safe, acupuncture can cause side effects and have complications that could be dangerous.  Seek only the services of someone who has been properly trained and licensed in your state.

Given the often ambiguous and subjective nature of back pain, and the many options now available for care, this is truly an area where treatment can rise to the level of art, and relief can generally be found.  Acupuncture is a recognized, legitimate, and effective treatment that can complement any of a number of other remedies.

Dr. James Patrick Murphy is founder and director of Murphy Pain Center and is a clinical professor with the University of Louisville School of Medicine.  He was fellowship trained in Pain Medicine at the Mayo Clinic and is board-certified in Pain Medicine and Anesthesiology.  He can be reached at (502) 736-3636.

 

 

What is Resveratrol?

By Barbara Day, M.S., R.D., C.N.

Resveratrol is a plant chemical found in red grape skins and grape seeds, purple grape juice, red wine and a very small amount in peanuts. Antioxidants in red wine called polyphenols may help protect the lining of blood vessels in your heart. Because red wine is fermented with grape skins longer than white wine, red wine contains more resveratrol than white wine. Red and purple grape juices may contain some resveratrol.  Resveratrol might help prevent damage to blood vessels, reduce “bad” cholesterol and prevent blood clots but most of the research has been done with animals.  Supplements are available but should not be used by children or pregnant women. Resveratrol may reduce the activity of some enzymes involved in drug metabolism. In addition, resveratrol acts like a blood thinner so individuals taking blood thinners should consult with their physician if interested in taking a supplement.  Check www.consumerlab.com to determine if your supplement contains the amount of resveratrol as the label says it does.

Image from: dailymail.co.uk

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.    

 

What is Adult Celiac Disease?

By Andy Bailey, M.D.

                        If one were to hitch a ride in an intestinal capsule, he would first travel down the esophagus into the stomach. After spending maybe an hour or two there, he would then enter the small intestine. In the small intestine, nutrients are absorbed into the blood stream. Our intraintestinal traveler would see fields upon fields of finger-like projections called villi. These villi dramatically increase the surface area of the small intestine, giving the body a tremendous ability to absorb nutrients, vitamins, and minerals from what we eat.

 

What if our traveler looked out and instead saw a flattened surface, as if all the finger-like projections had fallen off? The small intestine would have a very difficult time absorbing nutrients from the diet. Unfortunately, most of the nutrients would pass on, along with our capsule traveler, to points south without doing the body any good.

 

Celiac disease is a disease in which the villi of the small intestine are severely damaged and take on such a flattened appearance. Much of the patient’s nutrition is not absorbed at all. The expected result is diarrhea and weight loss. Sometimes the symptoms are much more subtle. The patient might just have a condition related to poor absorption of a particular nutrient, such as iron-deficiency anemia or osteoporosis. Sometimes the patient develops even more subtle symptoms related to vitamin deficiency, such as fatigue or depression.

What causes all this mischief? Individuals with celiac disease inherit a defect in which a dietary substance called gluten triggers an inflammatory reaction against the intestinal villi. Not all individuals with the inherited defect develop celiac disease, and many patients do not develop the condition until late in life. Exactly what triggers the condition in susceptible individuals is still the focus of intense research.

 

Where do we find gluten? Unfortunately for the celiac patient, one does not have to look far at all. Gluten is found in wheat, rye, and barley. These products are found almost everywhere. Rice and oats are safe, although patients with celiac disease are so sensitive to gluten that even the small amount of gluten that might contaminate oats can trigger the disease.

 

So you think you might have celiac disease? After all, the symptoms described above are common. Why not just eliminate wheat from your diet and see what happens? As tempting as this may sound, I do not recommend it. First, gluten is so common that it takes a concerted effort to avoid the substance. Second, we now have blood tests that are very accurate in screening for the diagnosis. Any physician can order an endomyseal IgA antibody, or a tissue transglutaminase IgA, along with serum IgA levels. If these tests are normal, you are not going to have the disease. Third, the diagnosis of celiac disease is lifelong; we cannot cure or outgrow the disease yet.

What if the blood tests are positive? These days we would perform an endoscopy and obtain biopsies of the small intestine. This is a safe and straightforward procedure, technically easier than a colonoscopy to perform.

Once the diagnosis of celiac disease is established, nutritional counseling is crucial. The patient must stay on a gluten-free diet or face certain relapse and even worsening of the condition. Even small amounts of gluten can trigger a relapse. Fortunately, many local grocery and health food stores now either have a section dedicated to the gluten-free diet, or individuals who can assist the patient in maintaining the proper diet. Organizations such as the Celiac Disease Foundation (www.celiac.org)

can be very helpful as well.

 

Within weeks or months of adhering to the proper diet, the intestinal villi grow back and the patient’s ability to absorb nutrients returns to normal. Nevertheless, nutritional deficiencies may remain, so it is very important to make sure that the patient is getting an adequate intake of calcium, vitamin D, iron, and the B vitamins. The wonderful restorative powers of the human body do the rest. It is satisfying to the patient and physician alike to have the patient report at their three-month office visit that they have gained ten pounds and have not felt so well in years!

Read Food Ingredient Labels.  Potential Harmful Ingredients Include:

 

•           Brown Rice Syrup (frequently made from barley)

•           Caramel color (infrequently made from barley)

•           Dextrin (usually corn, but may be derived from wheat)

•           Flour or cereal products (containing wheat)

•           Malt or malt flavoring (usually made from barley. Okay if made from corn)

•           Malt vinegar

•           Modified food starch (from unspecified or forbidden source)

•           Soy sauce or soy sauce solids (many soy sauces contain wheat)

 

From: www.celiac.org

 

Andrew Bailey, M.D., is a graduate of Davidson College and Vanderbilt University School of Medicine. He did his postgraduate training at Brooke Army Medical Center in San Antonio, Texas and is board-certified in both Internal Medicine and Gastroenterology.  He practices in Louisville since 1990.

 

Stay Healthy During the Holidays

By Kim Evans APRN CNS-BC AHN-BC CNAT

The Holidays are upon us! These are great times to reconnect with family and friends. It can also be a time when your healthy eating habits are challenged! Here are some ideas to stay healthy during the Holidays.

  1. Be prepared to keep your health a priority. Think twice before you go back for that second desert. Nothing tastes as good as being healthy feels. Keep your health goals first and foremost.
  2. Make the gathering more about the experience of being together than what you are eating or drinking. Enjoy your family and friends.
  3. Eat healthy foods BEFORE you attend a Holiday gathering. This prevents you from jumping into those appetizers and perhaps overeating the Holiday treats.
  4. Choose the healthiest options at the Holiday gatherings. It is not necessary to eat everything!
  5. Bring a healthy dish to share. I have modified many of my favorite recipes to make them much healthier. See my stuffed mushroom recipe and the pumpkin dip recipe.
  6. Chew your food slowly. This helps with digestion, can prevent overeating and promotes more enjoyment of food.
  7. Limit your alcohol intake. Sip your alcoholic beverages. Drink plenty of water before and after any alcohol. Consider some of the nonalcoholic wines. “12” is one of my favorites. It comes in 2 flavors and can be purchased at Whole Foods. Another option is sparkling water such as Perrier.  Add a lime for a delightful beverage.
  8. Continue your exercise program! The weather is getting colder so your exercise routine may have to move indoors. Keep your body moving! Perhaps you can park a bit further away in the parking lot at the grocery stores or department stores. When shopping at the Malls, do a couple laps inside the Mall. Create a 40 day exercise challenge. Finish out the year with daily exercise the rest of 2011! It’s not as hard as you think. It’s just a mindset. Set your mind that you are going to exercise the rest of the year and “Just do it!”

Image from: www.psychcentral.com

Kim Evans APRN CNS-BC AHN-BC CNAT is an advanced practice nurse with over 34 years of clinical experience in multiple roles including staff nurse, nurse manager and critical care clinical nurse specialist. She has an advanced practice license as a clinical nurse specialist with board certification in Adult Health.  She is also certified as a nurse Amma Therapist, which is acupressure based on Traditional Chinese Medicine.  She completed a fellowship Program in Integrative Medicine through the University of Arizona with Dr. Andrew Weil in 2006. Kim is one of the founders and owner of the Institute for Integrative Medicine (www.integrativemedicine4u.com) in Louisville, KY