Acupuncture May Help With Chronic Pain

 

One of the most significant health and social problems facing the United States in 2019 is the growing opioid crisis. Data from CDC, AHRQ, and U.S. Health and Human Services show that more than 1000 people are treated in emergency rooms each day across the U.S. for misusing prescription opioids. As many as 1 in 5 people receive prescription opioids long-term for non-cancer pain in primary care settings. Even more telling is a study that appeared in JAMA (September 17, 2017) which showed that although life expectancy in the U.S. has increased overall between 2000 and 2015, 0.21 years were lost due to opioid related deaths.

As awareness of the staggering toll of the opioid crisis increases, so does interest in medical treatments which do not involve pain medications. Acupuncture for instance is now given more consideration for treatment of different pain syndromes, rather than relying on opioid medications.

A well-designed study from 2018 looked at using acupuncture for chronic pain. A group of researchers from the Acupuncture Trialists’ Collaboration, composed of scientists from the U.S., U.K., and Europe looked specifically at acupuncture for chronic headache, musculoskeletal pain, osteoarthritis, or shoulder pain.

This research group had published a previous study in 2012 (Archives of Internal Medicine). For the 2018 meta-analysis an additional 13 studies were included (published between December 2008 and December 2015), yielding nearly 21,000 subjects from a total of 39 trials. The distribution of study participants was quite widespread, including those from Australia, China, Germany, the U.S. and U.K.

Results of the study demonstrated that acupuncture has a clinically relevant impact compared to the control group of no acupuncture. In addition, the effects of acupuncture tended to persist over at least a year-long period. Interestingly, acupuncture appeared to most effective on upper body musculoskeletal pain.

Given that acupuncture is generally thought to be a safe and well tolerated treatment, it may deserve consideration for treatment of chronic pain syndromes.

(Source- The Journal of Pain, Vol 19, No. 5, May)

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 May Help With Opioid Abuse

As we head into 2019 one of the most significant problems facing the U.S. is the on-going opioid crisis. Data from the CDC illustrates the enormity of the opioid epidemic. On average, 130 Americans die each day from an opioid overdose. More than 2/3rds of the 70,000 drug overdose deaths in 2017 were due to an opioid. Finally, in financial terms, the economic burden of prescription opioid misuse in the U.S. is estimated to be $78.5 billion annually.

As awareness of the opioid crisis increases, interest in other medical treatments which do not involve pain medications has increased as well. For instance, acupuncture is now given more consideration as a possible treatment for various pain syndromes, versus opioid medications.

A recently published study by a group of Chinese researchers examined the use of acupuncture for treating opioid use disorder (OUD) in adults. This was a meta-analysis, including nine studies and over 1000 participants in total. The studies were completed in China, the U.K., and the U.S. Various forms of acupuncture were used including electroacupuncture, manual acupuncture, auricular (ear) acupuncture, and transcutaneous accupoint electrical stimulation.

Results of the meta-analysis showed that acupuncture could be effective in treating opioid use disorder among adults. The mechanism by which acupuncture treats OUD is not clear, but may be related to release of the body’s endogenous peptides, which have opiate-like activity. These include dysmorphins, endorphins, and enkephalins.

In general acupuncture has been found to be a safe and well-tolerated treatment for a number of medical conditions. Given this, and the positive results of the above study, acupuncture may prove to be a helpful tool for opioid use disorder treatment.

(Source- Evidence-Based Complementary and Alternative Medicine, Volume 2018, ID 3724708)

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.

Chocolate May Prevent Heart Attack and Stroke

February is National Heart Health Month. In recognition of heart health, and in honor of Valentine’s Day, this post is about research on chocolate, specifically chocolate consumption and the risk of cardiovascular disease.

For this study, researchers from the United Kingdom (UK) enrolled a group of nearly 21,000 healthy men and women. The participants chocolate consumption was assessed by a food frequency questionnaire. This group was followed for over 11 years, with the clinical outcomes of interest heart attacks, stoke, and angina monitored during this period.

The researchers found that higher chocolate consumption was associated with a statistically significant lower risk of angina, heart attack, and stroke.

Interestingly, the chocolate consumed in the UK is generally of the high fat and sugar variety, not dark chocolate. In general it is felt that dark chocolate offers more benefits than milk chocolate.

So on Valentine’s Day enjoy some chocolate with those you love. You might want to make it dark chocolate to get the best heart benefits. Happy Valentine’s!  

(Source- Heart 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. Discuss any health concerns with your personal physician.

 

Vitamin D May Prevent Progression of Age-Related Macular Degeneration

February is AMD/Low Vision Awareness Month and in recognition of this, today’s post will examine recently published research regarding vitamin D intake and progression to advanced age-related macular degeneration (AMD).

A group of researchers from France and the US published a study in 2017 in which they examined the relationship between vitamin D intake and progression from early or intermediate AMD to advanced disease. All participants were part of a longer term longitudinal study of AMD, which began in 1998.

Over 2100 subjects were enrolled in this particular study. Average follow-up period was over nine years. Dietary intake was assessed from food frequency questionnaires which were completed by each participant. Ocular imaging was used to determine baseline AMD grade.

Upon conclusion of the study, researchers found that high dietary vitamin D intake was associated with a 40% lower risk of progression to advanced AMD.

It should be emphasized that the key element of the study was dietary vitamin D intake, and not supplements. Foods high in vitamin D include fatty fish such as salmon, sardines and herring. Other sources include egg yolks, oysters, and shrimp. Mushrooms are the only plant source of vitamin D. Wild mushrooms are an excellent source of vitamin D, while commercially grown mushrooms which are raised in the dark may not contain much vitamin D, unless they are treated with UV light. 

Age-related macular degeneration is one of the leading causes of vision loss in the US. It is estimated that approximately 1.75 million Americans age 40 and older suffer with macular degeneration. The World Health Organization ranks AMD as the third leading cause of blindness worldwide, after cataracts and glaucoma. AMD is characterized by the loss of the central field of vision. Risk factors for AMD include advanced age, smoking, high blood pressure, and a diet low in fruits and vegetables. Family history is also a factor.

Given the results of this interesting study, a diet with more vitamin D rich foods may be a consideration in those with early AMD.

(Source- Investigational Ophthalmology & Visual Science, Sept. 2017, Vol. 58, No. 11)

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.

 

Glucosamine May Help Prevent Colorectal Cancer

Glucosamine is a popular supplement, and thought to have anti-inflammatory properties, which may be helpful for osteoarthritis. In our second post in honor of World Cancer Day we will examine a study which looked at the use of glucosamine supplements and the risk of colorectal cancer.

Researchers from the US combined data from the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). They examined the use of glucosamine and chondroitin supplements and subsequent development of colorectal cancer. The NHS is an ongoing prospective cohort study, which began in 1976, and initially included nearly 122,000 RNs. On the other hand, the HPFS is an ongoing prospective cohort study of over 51,000 male health professionals.

This study began in 2002, and included over 68,000 women, and nearly 28,000 men. Data was collected until 2010. Questionnaires were completed at the initiation of the NHS and HPFS studies, and re-assessed every two years afterwards.

What researchers found was that any glucosamine use was associated with a significant 30% reduced risk of colorectal cancer, and any use of chondroitin was associated with a 31% reduced risk, in age-adjusted models. The combined use of glucosamine+chondroitin yielded a 32% reduced risk of colorectal cancer. All of these results were statistically significant. The results did not vary greatly by gender.

Given these profound results, consideration of glucosamine and/or chondroitin supplements would seem a low risk way to prevent colorectal cancer.

(Source- International Journal of Cancer: 139, 2016)

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.

 

HIgh Glycemic Index Diet Increases Cancer Risks

In honor of World Cancer Day, today’s post will examine research from Italy published last year, regarding dietary glycemic index, glycemic load, and subsequent cancer risk.

Researchers enrolled nearly 48,000 subjects into this study, from five different clinical centers in Italy. Subjects completed food frequency questionnaires, and were followed for an average of nearly 15 years. The questionnaires were designed to access glycemic Index, as well as glycemic Load, of the diet of each participant.

The Glycemic Index is a measure of the ability of different types of carbohydrate containing foods to raise blood glucose levels within two hours. Pure glucose is given the value of 100. High Glycemic Index foods cause more rapid rise in blood glucose levels. High Glycemic Index foods include white bread, white rice, high fructose corn syrup, and sodas. Low Glycemic Index foods include beans, most vegetables, and nuts such as cashews, peanuts, and walnuts. High Glycemic foods elevate blood glucose as well as insulin levels, and in turn promote fat storage. Low Glycemic Index foods tend not to overly elevate blood glucose levels or insulin levels in the body.

The Glycemic Load on the other hand is a function of the amount of carbohydrate and the Glycemic Index of that particular food. The Glycemic Load is calculated as the Glycemic Index multiplied by the grams of carbohydrate per serving size.

What the Italian researchers found was a high Glycemic Index diet increased risk of colon cancer, bladder cancer, and melanoma, among others. High Glycemic Load diets were related to a high risk of developing colon cancer, liver cancer, cervical cancer, and endometrial cancers, among others.

This study provides evidence that limiting carbohydrates may be a strategy for limiting risk of certain cancers later in life.

(Source- Scientific Reports, 7:9757)

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 and health concerns with your personal physician.

 

 

Let’s Help Prevent Diabetes in Women-Just Say No to Soda for 2018 Part 3

On Wear Red Day 2018, we will review a recently published study that examined the relationship between beverages, both artificially sweetened and sugar-sweetened, and subsequent development of diabetes, in a group of menopausal women. This is our third recent post regarding the ill effects of drinking soda.

The research group examined data from the Women’s Health Initiative, a massive study of more than 90,000 women spread out at over 40 clinical centers throughout the US. Nearly 65,000 women were eventually part of this prospective observational study, with over 8 years of follow-up on average.

Participants were queried about their intake of artificially sweetened beverages, sugar-sweetened beverages, and plain water, via questionnaires. Subjects were assessed for diabetes at enrollment, and at annual follow-up.

Even when researchers controlled for other risk factors such as body mass index or total energy intake, their analysis showed both artificially sweetened beverages and sugar-sweetened beverages were associated with an increased risk of developing diabetes, in this group of post-menopausal women.

Both artificially sweetened and sugar-sweetened beverages showed a dose-dependent increase risk of diabetes. The more soda one drank, the higher the risk of developing diabetes.

One of the most interesting “take-home messages” from this study was that while the risk of developing diabetes was a bit lower in the artificially sweetened group, compared to the sugar-sweetened group, there still was an increased risk. This casts doubt over whether or not artificially sweetened beverages are a safer alternative to the sugar-sweetened ones. Both should be avoided.

Data from the American Heart association show that adults with diabetes are two to four times more likely to die from heart disease than those without diabetes. In addition, of those 65 and older with diabetes, 68% will die from some sort of heart disease. So on Wear Red Day 2018 let’s take a step in avoiding diabetes and heart disease by eliminating or avoiding entirely soda, both the artificially and sugar-sweetened varieties.

(Source- American Journal of Clinical Nutrition 2017; 106)

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.

Smoking Increases Risk of Erectile Dysfunction in Men

A common New Year’s resolution is to quit smoking, as it should be, as this may be the most important intervention to improve one’s health. A study from 2013 may provide some incentive to men who are considering quitting smoking in 2018.

This was a meta-analysis, which included 8 studies in total, with over 28,000 participants. The studies were from the U.S., Brazil, Jamaica, and Finland. The researchers reviewed the studies in an effort to analyze the association between smoking and the risk of erectile dysfunction (ED).

The reviewers had some issues with combining data from the various studies, due to differences in study design. They felt the data from the prospective studies was more accurate. Using these prospective studies, it was estimated that the risk of ED was increased 51% for current smokers, and 20% for ex-smokers, when compared to never smokers.

Given this profound increased risk of ED in smokers, perhaps this will provide the additional incentive needed for men smokers to finally give up cigarettes in 2018.

(Source- PLOS ONE, April 3, 2013)

This blog is a review of medical and scientific literature, and should only be used to information 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.

 

Just Say No to Soda for 2018- Part II

In our second post regarding sodas and soft drinks, we will review research from China which examines the association between sugar-sweetened beverages and the development of Type 2 Diabetes.

The research group pooled data from 8 studies published between 2004 and 2014. This comprised over 286,000 participants. Of the 8 studies, one was from Asia, two from Europe, and five from the US. In general, the studies included in the meta-analysis were considered to be of “high-quality”.

Researchers found that those subjects with a higher-intake of sugar-sweetened beverages had a 30% greater risk of developing Type 2 diabetes. When the data was adjusted for body mass index, the increased risk for developing Type 2 diabetes continued to be significantly positive, at 26%. The follow-up period varied from 5 to 20 years.

This is a compelling study, with a huge number of subjects, spread out over three continents, and included both men and women.

The statistics for Type 2 diabetes in the US are staggering. According to the CDC’s National Diabetes Statistical Report approximately 30 million people in the US have diabetes, making up more than 9% of the population. Complications of diabetes include cardiovascular disease (heart attacks and strokes) and kidney disease. It is estimated that the cost of diabetes in the US in 2012 was $245 billion.

US per capita soda consumption is approximately 41 gallons per person. While this is a substantial decrease from the 1998 peak consumption of 53 gallons per capita, it still represents nearly 500 cans of soda per year for the typical American. These are calories which are devoid of nutritional value, but do substantially increase your risk of Type 2 diabetes. Cutting back or eliminating soda for 2018 might go a long way towards improved health, and may reduce your risk of developing diabetes in the future.

(Source- Journal of Diabetes Investigation, Vol 6 No 3, May 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. Discuss any health concerns with you personal physician.

Just Say No to Soda for 2018- Part I

As 2018 begins a common inquiry from patients at the start of a new year is what can be done to improve health going forward. Often these questions fall into discussion about proper diet or exercise regimens, or some combination of these. The onset of a new calendar year gives us another opportunity to reflect on what we can do to improve our overall health status.

One area of diet that offers a fairly simple and painless way to better health is to limit or eliminate soda (aka soft drinks), both sugar-sweetened and artificially sweetened.

A study from 2016 supports the limiting of sodas. Korean researchers looked at the association of both sugar-sweetened and artificially sweetened beverages with the risk of development of hypertension. The research group identified six studies, with over 246,000 participants, for their analysis of sugar-sweetened beverages and hypertension. For artificially sweetened beverages and hypertension, a total of 4 studies involving over 227,000 subjects were identified. Most of the studies were conducted in the US, while one was conducted in Spain. Most of the studies included were considered to be of “high quality”.

The age at initiation into the study ranged from 18 to 84 years, while the duration of follow-up ranged from 4 to 38 years. Both men and women were included. Food frequency questionnaires were used for dietary assessments.

What the researchers found was a positive association between both sugar-sweetened beverages and hypertension, and artificially sweetened beverages and hypertension as well. More telling, when the lowest intake groups for sugar-sweetened beverages and artificially sweetened beverages were compared to the highest intake groups, it was found that each additional serving of sugar-sweetened beverage per day was associated with an 8% increased risk of hypertension, while each additional serving of an artificially sweetened beverage per day was associated with a 9% increased risk of hypertension. When researchers analyzed the groups based on gender, body mass index, and duration of follow-up period these positive associations continued to hold.

Recent figures indicate Americans consume an average of nearly 500 cans of soda each year. The US is second only to Argentina in per capita soda consumption. 500 cans of soda per year is a staggering total. Cutting back or going soda-free may be a great first step in making 2018 a healthier year for you.

(Source- Archives of Cardiovascular Disease (2016) 109)

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 an physician-patient relationship with anyone. Discuss any health concerns with your personal physician.