Author Archives: ewperttulamd

Acupuncture for Depression- More Evidence

May is National Mental Health Month in the U.S., and today’s post is the 2nd in a series addressing mental health issues.

Today’s post highlights research published earlier this year, which examined acupuncture and counseling for depression. The research was conducted in the UK, and was designed to determine both the clinical effectiveness and cost effectiveness of a short course of acupuncture or counseling for depression, compared to usual care. 

Patients were recruited into the study from the primary care population in the UK. Patients were adults and had been seen in the past 5 years for depression and were continuing to experience symptoms of depression. Patients needed to score in the moderate to severe depression range to be considered for entry into the study.

Up to 12 sessions of acupuncture or counseling were offered, usually on a weekly schedule. The primary endpoint of the study was at 3 months. Data was collected at baseline, and again at 3, 6, 9 and 12 months.The Patient Health Questionnaire-9 (PHQ-9) was used. The PHQ-9 is a validated tool used to diagnose as well as monitor treatment for depression.

Results of the study showed statistically significant improvements in depression at 3 months with both acupuncture and counseling, when compared to usual care. 33% of the acupuncture patients and 29% of the counseling patients achieved a successful treatment outcome. Only 18% of the usual care group achieved this result. In addition, acupuncture was found to be a cost-effective treatment for depression.

This well-designed study shows that acupuncture is a well-tolerated and cost-effective treatment for depression, over the short to medium time frame. Given the worldwide burden of depression, acupuncture seems an option worthy of consideration for treatment.

(Source- Programme Grants for Applied Research 2017, Vol. 5 No.3)

This blog is a review of the medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

High Glycemic Index Diet a Risk Factor for Depression in Post-Menopausal Women

May is National Mental Health Month in the U.S., and in recognition several of this month’s posts will address mental health topics.

In 2015 a group of researchers associated with a number of universities including Columbia, Duke, the University of Minnesota, NYU, Stony Brook University and UC-Davis published a prospective cohort study examining the high glycemic diet as a possible risk factor for depression in post-menopausal women. The research group examined data from the Women’s Health Initiative Observational Study, which included over 80,000 women enrolled at over 40 clinical centers across the U.S.

Participants in the study completed a food frequency questionnaire at baseline, which consisted of 145 items. Participants also completed the Burnam 8-item questionnaire which measured depressive symptoms, both at baseline and then again at 3 year follow-up.

Results of the study showed that a higher glycemic index diet was associated with increasing odds of depression incidence in this group of post-menopausal women. In addition, researchers found that added sugars were strongly associated with depression incidence.

There were some other interesting findings of the study. Increased consumption of lactose, a sugar found in milk, was associated with significantly lower odds for depression incidence. Lactose is a lower glycemic index sugar. Also, both higher dietary fiber content and increased consumption of fruits and vegetables were also associated with lower odds for depression.

The glycemic index (GI) ranks carbohydrates on a scale of 0 to 100, based on how they raise glucose levels after eating them. Glucose is given a score of 100. GI scores for some common foods for comparison purposes include 36 (apples), 13 (peanuts), 56 (potato chips), and 111 (baked russet potatoes, a favorite of Idahoans), based on a standard serving size. 

It has been established that diets high in sugars and refined starches are a risk factor for cardiovascular disease, and increased inflammation, and it is perhaps through this relationship that the risk for depression is increased. 

Depression is a common problem world-wide. The World Health Organization estimates as many as 300 million adults suffer from depression, and it is more common in women. This well-designed study incorporates a large group of women across multiple study sites in the U.S. The results would seem applicable to a large group of post-menopausal women. Monitoring and reducing the glycemic index of one’s daily diet appears to be a simple way to lower the risk for developing depression.

(Source- American Journal of Clinical Nutrition 2015; 102)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Soft Drinks, Asthma and Adults

This is the third and final post in recognition of World Asthma Day, Tuesday May 2nd. This post looks at research from the University of Adelaide in South Australia. In particular, the researchers examined the relationship between soft drink consumption and asthma as well as chronic obstructive pulmonary disease (COPD) among a sample of adults in South Australia.

Using a random sample of South Australians phone interviews were conducted with adults ages 16 and older, with a mean of 47 years. In all, nearly 17,000 adults were interviewed.

Respondents were questioned regarding any diagnosis of asthma that was associated with symptoms over the past year, or use of typical asthma medications over the past year. Respondents were similarly queried regarding COPD diagnosis. Soft drink intake was associated by asking about the amount of soft drinks and sports drinks consumed in a typical day.

Results showed that higher levels of soft drink consumption were associated with a higher prevalence of asthma and COPD. Respondents who drank a half liter or more of soft drinks each day had a substantially higher prevalence of asthma (14.7%) compared to those who did not consume soft drinks (11.9%) A similar relationship was seen in COPD where those who drank a half liter or more of soft drinks each day had a prevalence of asthma of 6.0%, compared to only 4.2% in those who did not consume soft drinks.

In the U.S. the CDC estimates 1 in 12 adults has asthma. Women are more likely than men to have asthma. Given these statistics moderating our soft drink intake seems like a simple way to potentially limit one’s risk of asthma.

(Source- Respirology (2012) 17)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Sugary Beverages, Asthma and Children

This is the 2nd post in recognition of World Asthma Day, Tuesday May 2nd. This post highlights research from The Netherlands. Researchers took data from the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort. For the PIAMA project pregnant mothers were recruited from the general population in The Netherlands, for children born in 1996/1997. Parents were asked to complete questionnaires each year until the children were 8, then again at age 11. The children completed a questionnaire themselves at age 11 as well.

 

For this cross-sectional study, 2651 children completed their questionnaires. This included questions regarding consumption of six different beverages including diet drinks, energy drinks, 100% fruit juice, sports drinks, sugar added drinks (including soda), and sweetened milk products. Concurrently, parents completed a questionnaire that included questions about asthma diagnosis and symptoms. 

Results of the study demonstrated that high consumption of 100% fruit juice, sugar added drinks (including soda), and high total sugar containing beverages in general was associated with increased asthma in children. In particular, as the consumption of 100% fruit juice and total sugar containing beverages went up, the risk for asthma increased as well.

The CDC estimates 10% of all children in the U.S. have asthma. The highest rate of asthma is 17% in non-Hispanic black children. Boys are more likely to have asthma than girls. With statistics this alarming, cutting back on sugar containing beverages seems like a simple way to help limit asthma in our children.

(Source- European Journal of Clinical Nutrition 2015, 69)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health care concerns with your personal physician.

 

Acupuncture Helps with Allergic Asthma

Tuesday May 2nd is recognized as World Asthma Day, and in recognition of this today’s posts will focus on asthma and it’s treatment. 

A recently published study from Germany looked at the use of acupuncture in a group of patients who had previously been diagnosed with allergic asthma. 357 subjects were randomized to either an acupuncture group (184) or a control group (173). In the acupuncture group subjects received three months of acupuncture. In the control group the first three months consisted of usual care for asthma, followed by three months of acupuncture.

In addition to the 357 randomized subjects there was an additional non-randomized group of 1088 subjects who were allocated only to acupuncture.

The primary endpoint of the study was the Asthma Quality of Life Questionnaire (AQLQ). The AQLQ is a validated questionnaire designed to assess the impact of functional problems on those adults with asthma. In addition to the AQLQ the Short Form-36 (SF-36) survey was administered. The SF-36 is designed to assess quality of life measures.

What the researchers discovered was that the allergic asthma patients treated with acupuncture had clinically significant improvements in both disease specific and general quality of life measures compared to those patients who only received routine care, after three months of treatment.

Two other interesting findings- the improvements in both the randomized and non-randomized acupuncture groups were stable at six months. Also, the level of training or experience of the acupuncturist did not seem to influence the results.

 Another finding of this study was that any side effects from acupuncture were minor, such as bruising or needle pain.

This well designed study from Germany provides support for the use of acupuncture as an additional therapy for those afflicted with asthma. Acupuncture appears well tolerated and effective in this study population.

(Source-Journal of Alternative and Complementary Medicine, Vol 23, Number 4, 2017)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

More Health Benefits of Tea

April 21st is designated National Tea Day in the UK, and in recognition of this our posts today will address some of the possible health benefits of tea.

Tea is derived from the leaves and buds of the evergreen shrub Camellia sinensis. It is the most widely consumed drink in the world, other than water.

Chinese researchers recently published results of a meta-analysis of several prospective cohort studies, examining the relationship between tea consumption and mortality of all cancers, as well as tea consumption and cardiovascular disease.

The researchers identified 62 published articles, and then narrowed this down to 18 studies. These studies involved thousands of subjects, with a follow-up period ranging from 3 to 28 years. The studies encompassed both black and green tea.

A dose-response analysis was performed which showed that a one cup unit of green tea per day was associated with a 5% lower risk of cardiovascular disease, while a one cup per day increment of black tea was associated with a 8% lower risk of cardiovascular mortality.

The inverse association between green tea consumption and cardiovascular mortality was more apparent in women than men. The reason for this is not clear.

In looking at tea consumption and all-cause mortality the dose-response analysis showed that a one cup per day increment of black tea was associated with a 3% lower risk of all-cause mortality, whereas a one cup per day unit of green tea consumption was associated with a 4% lower risk of all-cause mortality.

Given these possible health benefits of both black and green tea, let’s have a cup in honor of National Tea Day!

 

(Source- British Journal of Nutrition, 2015, 114)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Acupuncture as a Adjunct Treatment for Depression

The World Health Organization (W.H.O.) has designated April 7th as World Health Day, with this year’s focus on depression. In recognition of this important day, our posts today will discuss depression and it’s treatment.

According to the results of the 2010 Global Burden of Disease study, depressive disorders rank 2nd in terms of global disability.

 Recently researchers from Taiwan conducted a meta-analysis of randomized trials in which the effects of antidepressant medications for adults diagnosed with depressive disorder was compared to a combination therapy of antidepressant medications plus acupuncture. The initial literature search yielded 661 possibly relevant research papers, which eventually was narrowed down to 13 studies, with a total of 1046 subjects.

Types of acupuncture included electro-acupuncture, manual acupuncture, and acupuncture with moxibustion. The number of acupuncture sessions varied from 9 to 36 with most treatment regimens lasting about six weeks. Various antidepressants were used including amitriptyline, fluoxetine, and paroxetine. Outcome measures included the Hamilton rating scale for depression (HAMD-17) and the self-rating depression scale (SDS), among others.

What the researchers found after their analysis of the 13 different randomized trials was that the combination of acupuncture plus medication is more effective than medication alone, for the treatment of depression in the first six weeks.

 Given depression’s massive burden to both the individual and society it would seem acupuncture may warrant some consideration as an add-on treatment to conventional therapy. Acupuncture is generally well tolerated and may help mitigate side effects of antidepressant medications as well.

(Source- Journal of Affective Disorders, 176 (2015))

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone.

 

Low Magnesium Associated with Depression in Younger Americans

April 7th has been designated as World Health Day by the World Heath Organization, and this year’s focus is on depression. In recognition of this day our posts will focus on depression and its treatment.

Researchers affiliated with the University of Vermont examined the relationship between magnesium intake and depression in adults. Using data from the National Health and Nutritional Survey (NHANES) researchers looked at subjects ages 20 and older, which included nearly 9,000 records. The NHANES is a population-based survey, which was designed to collect information on the nutrition and health habits of the U.S. population, using a random sampling method.

Magnesium intake was estimated from a 24-hour diet and supplement recall. The Patient Health Questionnaire was used as a tool to assess depression in adults. 

What the researchers found was a bit unexpected- in those subjects younger than age 65 low magnesium was associated with greater depression, while in those subjects 65 and older low magnesium seemed to be protective of depression. The reason for this is not clear.

In addition, the researchers also found that over half of the adults in the survey do not consume adequate daily amounts of magnesium.

More research on this topic is needed, particularly to determine why the effect of magnesium on depression is somehow moderated by age. However, it is clear from this study that low magnesium intake in the 20-64 age population in the U.S. is associated with higher rates of depression.

(Source- Journal of the Board of Family Medicine, 2015.02.140176)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Drinking Tea May Help with Depression

April 7th has been designated World Health Day by the World Health Organization, and this year’s focus is on depression. In recognition of this today’s posts will examine depression and its treatment.

An estimated 15 million Americans suffer from depression, with nearly 7% of the adult population affected in a given year. Worldwide more than 300 million are affected, and depression is a leading cause of disability worldwide. Depression contributes to the nearly 800,000 suicides which occur worldwide each year.

A recent study published in the Australian and New Zealand Journal of Psychiatry examined the relationship between tea consumption and the risk of depression. Researchers from the Huazhong University of Science and Technology in Wuhan China performed a meta-analyisis of eleven studies with 13 reports, involving nearly 23,000 subjects. These subjects were from China, Finland, Japan, Singapore, and Taiwan.

The meta-analysis showed that higher consumption of tea was associated with a lower risk of depression. There was a linear association between tea consumption and risk of depression, as every 3 cups per day unit in tea consumption was associated with a 37% decrease in risk of depression.

Given the potentially devastating impact of depression on an individual’s health, drinking tea would seem to be a safe and simple way to help lower one’s risk.

(Source- Australian&New Zealand Journal of Psychiatry 2015, Vol. 49(4) 334-345)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with you personal physician. 

Curcumin May Help Prevent Diabetes Type 2

 

In recognition of American Diabetes Alert Day, today’s posts will be covering diabetes, and in particular focusing on prevention strategies. Diabetes mellitus Type II (DM2) is increasing not only in the U.S., but worldwide as well. It is estimated that in 2012, 29 million Americans had DM2, and as many of 8 million of these were undiagnosed. 

Pre-diabetes is defined as a fasting plasma glucose of 100-125 mg/dl, or a two-hour oral glucose tolerance test with a reading of 140-199 mg/dl. It was estimated in 2012 that as many as 86 million Americans fell into the pre-diabetes category.

There is much research activity focusing on identifying those at risk for developing DM2 (such as those with pre-diabetes) and for ways to help prevent or forestall it’s progression. A recent study examined the use of curcumin extracted from turmeric as a way to prevent development of DM2 in those already diagnosed with pre-diabetes.

Curcumin is an active ingredient of the Asian spice turmeric, which is a member of the ginger family. Turmeric is a widely used spice in South Asian and Middle Eastern cooking and is grown in India, Nepal, Indonesia, Thailand, Vietnam and elsewhere. Turmeric is also used in Ayurvedic Medicine, and is currently being studied in Western Medicine for possible uses. Curcumin has been shown to have antioxidant and anti-inflammatory properties.

In this study conducted in Thailand. 240 individuals who were diagnosed with pre-diabetes were enrolled. These included both men and women, with an average age of 57. Enrollees were randomly assigned to either the placebo group, or the curcumin treated group. Those in the curcumin group took capsules containing curcumin powder twice a day.

Data was collected for both groups at baseline (prior to initiation of treatment), and at 3, 6, and 9 months. The primary outcome measure was development of DM2. Other measures included changes in beta-cell function, c-peptide (an inflammatory marker), insulin resistance, adiponectin (an anti-inflammatory cytokine), and obesity.

At nine months, 0% of the curcumin group developed DM2, whereas 16.4% in the placebo group developed DM2. This was statistically significant.

In addition, in the curcumin group beta-cell function improved, c-peptide dropped, insulin resistance decreased, and adiponectin increased, all of which represent potential beneficial improvement. Also important, no significant adverse effects of curcumin treatment were noted.

Given the results of this study, curcumin would seem to be a possible way to help prevent diabetes in those at risk.

 

(Source- Diabetes Care 2012 Nov; 35 (1); 2121-2127)

This blog is a review of medical and scientific literature, and should only be used to informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.