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Fasting is a buzzword these days because of its potential benefits when it comes not only to weight loss, but also overall health and longevity. Fasting also may be a literal lifesaver for patients who have a heart condition that requires cardiac catheterization – a procedure in which a long, thin tube is threaded from an artery or vein in the groin, neck or arm through blood vessels to the heart.

Catheterization may be done to diagnose a cardiovascular condition, but it also may be done to help treat one, such as in the case of coronary angioplasty or stenting. Regardless, a patient who requires cardiac catheterization generally doesn’t have an altogether healthy heart, which increases the risk of a cardiac event such as a heart attack or stroke.

Enter fasting, which research suggests lowers the risk of heart failure or cardiac-related death in patients who’ve undergone catheterization. Among patients tracked for nearly five years following the procedure, those who fasted on a regular basis were more likely to survive compared to patients who did not fast. Other factors that could have impacted survival rates, such as medications, lifestyle behaviors (including heart healthy vs. risky behaviors) and other health issues were taken into account.

Far too often, people attribute neck pain to stress and take medication to mask the symptoms. Sound familiar? Fortunately, if you’re a chiropractic patient, you know there’s a better, safer way.

“My neck feels OK right now. I can turn my head left and right and down and back. Well, that bending back thing actually doesn’t feel very good right now. So, maybe my neck does get a little annoying sometimes. But I have no idea when this periodic discomfort started.”

Sound familiar? You’re not alone. A report published recently in the medical journal Spine revealed many people are often a little hazy on when their neck pain started. This monumental study, sponsored by the World Health Organization (WHO), started about seven years ago. WHO launched the Bone and Joint Decade and assigned a special task force the job of reviewing all the research about neck and associated disorders, and then evaluating the best treatment options. They reviewed 31,878 citations, 1,203 reviewed papers and four research projects.

Sure enough, most people often don’t remember when their neck discomfort or pain really got started. Researchers concluded, “There is usually no single cause of neck pain.” Unless you have had an injury to your neck like “whiplash” from an auto accident, neck pain usually sneaks up on you. The study notes neck pain is quite common, and most people simply carry on with their activities of daily living. However, about 5 percent to 10 percent of people develop debilitating symptoms. Unfortunately, even among those folks who do not have disabling pain, the majority find their neck pain is stubborn and recurrent to some degree.

The task force also came up with a new classification of neck pain, which seems to be one of those things researchers like to do. They suggested four grades of neck problems, no matter whether it comes from injury, arthritis or any other cause. To paraphrase:

Grade I: Neck pain that doesn’t interfere with living.
Grade II: Neck pain that does significantly interfere with living.
Grade III: Neck pain associated with a “pinched nerve,” causing radiating pain, weakness or numbness in the arm.
Grade IV: Neck pain associated with tumors, infections, fractures and other serious conditions.

As you might guess, most neck discomfort is Grade I and II. However, what was quite gratifying from the task force report was the acknowledgement of what doctors of chiropractic already know: “Cervical manipulation is a reasonable option for people with Grade I or II neck pain.”

On a near-daily basis, a patient with a significant neck disorder tells me their pain has decreased and they are more functional as a result of chiropractic care. Recently, a patient with chronic neck pain told me he had been sleeping in a recliner chair since he could not get comfortable enough in bed to sleep through the night. “Hands-on” manual treatment in my office finally improved his condition to the point he could once again join his wife (and their Rottweiler) in bed.

Chiropractors “adjust” the joints, muscles and connective tissues of the body in order to improve motion by reducing restrictions and nerve irritation. Concerning patients with Grade III neck problems including “pinching” or crowding of larger nerves, the Spine article suggests more research is needed to identify the best candidates for manual or manipulative treatment. Of course, chiropractors are the recognized experts in this type of care and are best trained to make that determination.

The renewed interest in neck disorders among clinical researchers has spurred some interesting studies. In the March/April issue of the Journal of Manipulative and Physiological Therapeutics (JMPT), Canadian scientists have shown that arthritis in the neck might affect balance. This could mean that in cases of poor balance or repeated falls among the elderly, treatment of the cervical spine might have value. This could represent a “top down” strategy, which is a bit different from the “bottom up” approach to balance training more commonly utilized in rehabilitation.

In the February issue of JMPT, a complementary study by New Zealand and Canadian researchers suggested spinal manipulation of the neck can relax muscles in the arms and could be useful in relaxation of the whole body. This implies anything causing tightness in the neck joints also might cause muscle pain in the arms or elsewhere. Since manipulation and manual therapy are primary treatments for neck problems, a doctor of chiropractic should be among the first providers consulted for this type of pain.

So, how fast can a patient with neck pain expect to feel better with chiropractic care? By chance, in the same March issue of JMPT, British authors studied which neck symptoms might respond the quickest to hands-on treatment. Overall, considering all possible neck area complaints, about 70 percent of patients reported immediate favorable responses to manipulation. However, if patients complained about more specific things like headaches, shoulder or arm pain, reduced arm or neck movement, neck pain, or upper or middle back pain, the percentage of those who reported immediate improvement in pain rose to an incredible 95 percent!

The popular humorist Nora Ephron wrote a book titled I Feel Bad About My Neck, in which she describes her thoughts about being a woman getting older. This also has been called the “I Hate My Neck” book. Well, hating your neck won’t make it better, but chances are a trip to the chiropractor will.

John Hanks, DC, is a board-certified chiropractic orthopedist and is certified as a chiropractic sports physician. He currently serves as the senior chiropractic consultant in the Department of Complementary Medicine, Kaiser Permanente, Rocky Mountain Region.

The New Year is traditionally a time when many of us reflect on our goals and set resolutions for the year to come. From losing weight to getting more organized, these resolutions often come with good intentions, but aren’t always followed through.

Inevitably, we become bogged down with life’s many responsibilities and stresses, and many people lose track or even forget about the goals they set for themselves at the start of the year.

A New Year’s resolution that’s worth making this year is making room for daily meditation and reflection. Meditation is easy to learn and incorporate into your daily life, and can be practiced in as little as 10 minutes a day. While the benefits of meditation are more than one article can list, here are the top five reasons why making mindfulness your resolution will change your mental, emotional and physical health.

1. Accessible to All

It’s a common misconception that meditation takes formal training or deep knowledge in order to practice. Meditation is for everyone, and can be accessed by anyone who is willing to carve out time for it. Begin by setting a designated time in the day for meditation, preferably when you know you won’t be interrupted or rushed. Create a place in your home that’s calming and free of distractions, such as a bedroom or backyard; and incorporate candles or other forms of aromatherapy if you find it relaxing.

Begin by sitting cross-legged or in a chair with your spine upright and head up. With closed eyes, put all of your focus on your breathing and try to be aware of wandering thoughts. If you feel distracted, don’t get frustrated; bring yourself back to your breath work and forgive yourself. Start doing this for 10 minutes a day, adding 1 minute to your practice every week.

2. Reduces Stress Naturally

It’s normal to feel under pressure at times at work, school or in relationships, but feeling stressed out on a day-to-day basis is unhealthy, as it takes a toll on emotional, physical and mental health. In a survey done by the American Psychological Association in 2012, researchers found that 20 percent of Americans experience extreme levels of stress, while 64 percent agreed managing stress is important (but only 37 percent of them felt they were managing it well).

Meditation is a wonderful way to reduce stress by calming the nervous system: Putting away stress-inducing thoughts, distracting devices and our work responsibilities while meditating slows down the heart rate and allows your blood pressure to drop. This “relaxation response” is restorative to the body and allows you to feel a sense of calmness that lasts throughout the day.

3. Sparks Creativity

If you feel you’ve lost your inspiration for creation, meditation may be key to helping you get back on track. Meditation gives your mind a “break” from the constant insight needed to churn out new ideas or solutions. Meditation calms the chatter in the mind and allows you to get back to content creation with a renewed perspective – and even creates space for further insight.

4. Maintains Good Health

Practicing mindfulness meditation could help you curb cravings and the urge to grab junk food. In fact, practicing meditation could even help you lose weight, as it emphasizes concentrating your time and energy on enjoying a meal instead of multitasking. Eating and watching TV, driving or surfing the Internet are just a few ways our attention shifts from the food on our plate to other priorities.

At your next meal, put away distractions such as your phone or favorite TV show, and instead focus on the flavors and textures of your food. By keeping awareness on your food, you’re less likely to overeat or make poor food choices.

5. Sharpens Your Focus

Have you ever experienced a midday crash of energy? Instead of grabbing a coffee or sugary snack as a pick-me-up, give 10 minutes of steady breath-work meditation a try. It’s common at times for our focus to blur, especially when we juggle so many daily priorities. Learning to meditate can significantly change your ability to focus whenever you’re feeling distracted.

Try taking 10 minutes out of your workday to sit quietly and in a comfortable position, and center your thoughts and energy on the sounds and feelings of your breath. Observe how deeply you can breathe in and out, and how your breath feels when your abdomen rises and shrinks. By paying sole attention to breathing and blocking out distracting thoughts and sounds, you can sharpen your focus for the next task at hand with peace of mind.

Resource

• “The Impact of Stress.” American Psychological Association, 2012.

Dr. Julie T. Chen is board-certified in internal medicine and fellowship-trained and board-certified in integrative medicine. She has her own medical practice in San Jose, Calif. She is the medical director of corporation wellness at several Silicon Valley-based corporations, is on several medical expert panels of Web sites and nonprofit organizations, is a recurring monthly columnist for several national magazines, and has been featured in radio, newspaper, and magazine interviews. She incorporates various healing modalities into her practice including, but is not limited to, medical acupuncture, Chinese scalp acupuncture, clinical hypnotherapy, strain-counterstrain osteopathic manipulations, and biofeedback.

Smartphones, tablets and everything in between – chances are high that if your child’s over the age of 6 (and in some cases, even younger these days), they’re spending a considerable (read: unhealthy) amount of time engaged with portable electronic devices. At the same time, we’re finding that kids are suffering from sleep deprivation in terms of time spent asleep and quality of sleep enjoyed. Is there a connection? Yes, say researchers who reviewed various studies on the topic – and the news is even worse than you might imagine.

After reviewing 20 studies, researchers found that kids who used portable electronic devices near bedtime had more difficulty falling or staying asleep, and experienced poor daytime function because of sleepiness. Device use also contributed to lack of sleep compared to non-use: less than 10 hours per night for children and less than nine hours for teens.

But here’s the kicker: Even kids who didn’t use the devices, but had access to them, still experienced shorter sleep times. Children with bedtime access to devices close to bedtime three or more times a week also experienced less sleep and lower quality of sleep compared to children with less or no device access. Researchers speculate that access, even without use, can exert an influence on sleep because children are thinking about different aspects of the device, such as text messaging (e.g., “Has someone responded to that message I sent earlier?”).

Ready to limit your children’s (or your own) screen time? Click here for three ways to get started. For more information on another potential negative health consequence of excessive smartphone / tablet use, click here.

Vitamin D deficiency officially emerged as an important risk factor for chronic disease in the early 2000s. This finding was a product of scientific research, rather than a consensus statement from a health policy group or government organization.

It was not until around 2010 that the Institute of Medicine (IOM) of the National Academies of Sciences, Engineering and Medicine came out with an updated official statement about vitamin D needs.¹ The IOM [now known as the National Academy of Medicine] is actually a private entity that advises the U.S. government. The IOM set the estimated requirement at 400 IU/day for all age groups and set the upper-level intake at 4,000 IU/day for anyone age 9 or older.

What’s the Basis for the RDA?

This IOM report was met with harsh criticism from vitamin D researchers, none of whom was invited to participate in process that led to the recommendations. For example, Drs. R.P. Heaney and M.F. Holick stated:²

The IOM recommendations for vitamin D fail in a major way on logic, on science, and on effective public guidance. We have deliberately avoided a mind-numbing laundry list of the vast number of factual inaccuracies and misinterpretations of the report. For now, our recommendation to the American public is that the IOM report should be taken with a grain of salt (another nutrient the IOM finds risky).

In short, by following the IOM guidelines, many people will still not achieve adequate vitamin D levels [measured as 25(OH)D], which most labs set at 30-100 ng/mL. Some vitamin D researchers argue that 40 ng/mL should be considered the low end of normal, likely because many people do not achieve the bone protection effect of vitamin D until this level is achieved.² My personal impression is that we should try to maintain a 25(OH)D level of at least 70 ng/mL.³

Adequate Levels, Toxicity and Other Considerations

To achieve adequate vitamin D levels, we must either get adequate sun exposure or take a vitamin D₃ supplement. Unnecessary fear often enters a person’s mind when they consider how much supplemental vitamin D₃ is safe. Dr. Heaney, whom I mentioned above, has explained that 10,000 IU/day should be the safe upper limit.⁴ I realize 10,000 may see like a lot, but that is because we typically think of supplementation in milligram (mg) or gram (g) amounts.

With this in mind, it should be understood that 40,000 IU of vitamin D₃ is just 1 mg. In other words, 10,000 IU is just .25 mg or 250 mcg.

The IOM’s report states that “very high levels of vitamin D (above 10,000 IUs per day) are known to cause kidney and tissue damage.” In contrast, the DRI [Dietary Reference Intakes] book published by the IOM5 says 10,000-40,000 IU per day is the threshold for toxicity.⁵

It is important to understand that vitamin D toxicity cannot be determined based on how much vitamin D₃ is taken on a daily basis; it is correlated to serum 25(OH)D levels. The IOM’s DRI book for vitamin D and calcium states that vitamin D toxicity is not identified until serum 25(OH)D reaches 200-240 ng/mL or higher. Based on this, you can see why it is foolish to worry about the supplemental dose of vitamin D₃. Even worse, it is especially problematic that the IOM would suggest taking 10,000 IU/day causes kidney and tissue damage.

The, dare I say, sole focus related to vitamin D supplementation should be one’s 25(OH)D level. The minimum goal should be to reach at least 40 ng/mL, all the while knowing 100 ng/mL is within the normal range and signs of toxicity will not typically appear until at least 200 ng/mL is exceeded.

This means there should be zero emotion about taking vitamin D₃ supplements. If you have normal serum 25(OH)D because you are in the sun a lot, then there is no need to supplement. Otherwise, your supplemental level should be tailored to keep your 25(OH)D at 40 ng/mL higher. This is why the RDA or RDI fails: for vitamin D, it is not about your intake, it is about achieving a proper 25(OH)D level.

Why Vitamin D Matters: A Profound Micronutrient

Here is why you should care about your 25(OH)D level. Vitamin D is involved in the modulation of more than 1,000 different genes. In particular, vitamin D modulates immune cell expression. A deficiency in vitamin D leads to an overproduction of pro-inflammatory Th1 cells and an underproduction of anti-inflammatory Th2 and T-regulatory cells. The outcome is an overproduction of pro-inflammatory cytokines, such as IL-1, IL-6 and tumor necrosis factor; and an underproduction of IL-10, which is a key anti-inflammatory cytokine.³

The same shift to overproduce pro-inflammatory cytokines occurs when one lacks magnesium and omega-3 fatty acids. Obesity also leads to the same state of chronic inflammation. This should alert you to the reason why just supplementing with vitamin D to achieve normal levels may not relieve patients from pain, depression and other pro-inflammatory conditions.³ Studies that report about the ineffectiveness of vitamin D do not comment on the other nutritional factors that promote the same state of chronic inflammation as vitamin D deficiency.

My suggestion is to normalize the many pro-inflammatory markers that are easy to measure, of which vitamin D is just one. Lipids, glucose, body mass index and waist-to-hip ratio are other examples to take into account. Talk to your doctor for more information.^3,6

References

1. Dietary Reference Intakes for Calcium and Vitamin D. Institute of Medicine of the National Academies, Brief Report, November 2010.
2. Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res, 2011;26:452-54.
3. Seaman DR. The DeFlame Diet: DeFlame Your Diet, Body, and Mind. Wilmington, NC: Shadow Panther Press, 2016: p.p. 213-218.
4. Hathcock JN, Shao A, Vieth R, Heaney RP. Risk assessment for vitamin D. Am J Clin Nutr, 2007;85(1):6-18.
5. DRI Dietary Reference Intakes: Calcium and Vitamin D. Institute of Medicine of the National Academies. Washington, D.C.: National Academies Press, 2011.
6. Seaman DR. Body mass index and musculoskeletal pain: is there a connection? Chiro Man Ther, 2013;21:15.

David Seaman, MS, DC, DACBN, is the author of Clinical Nutrition for Pain, Inflammation and Tissue Healing. He has a master’s degree in nutrition from the University of Bridgeport, Conn., and lectures on nutrition for Anabolic Labs.

As we’ve discussed several times already this year (and on an annual basis), the holidays bring not only the joy of the season, but unfortunately, their fair share of stress as well. Running through malls, organizing events, wrapping up end-of-year work details, and myriad other activities specific to the holiday season can take their toll on even the most calm, low-stress person.

But it doesn’t have to be that way.

With the right attention to stress-reducing strategies, you can avoid the madness (or at least mitigate its impact on your quality of life) and keep your holidays sane. Here are four ways to do it:

1. Two for the Price of One: When you’re crumbling under the weight of an oppressive To-Do List you think you’ll never complete, multitasking can be your best friend. It all starts by organizing that list to group responsibilities / to-do’s that can be accomplished at the same time or in close proximity. Need to run to the mall for a few gifts, grab some lights for the tree and stop by the in-laws for dinner? Determine the best route to ensure you’re not running around town or consuming your entire day. Simple scheduling tactics can help, too: perhaps a holiday lunch can be switched to breakfast if you have other duties to attend to in the morning, so you can take care of everything in the a.m. and have your p.m. to enjoy, stress-free.

2. Stick to the Plan: Now is definitely not the time to stop exercising and eating right. You may think this is actually the perfect time to take a well-deserved break … but how will you feel? For most people, routine is a source of comfort and self-confidence, particularly when it involves how they look and feel. So stick to the plan that’s worked all year; your body and mind will thank you for it.

3. Rise and Shine: No, we’re not recommending you wake up early every day during the holiday season, although many people find getting up early and going to sleep at a reasonable hour is preferable to the other way around from a stress perspective. We’re actually talking about reducing your stress this time of year by getting things done early. No doubt you’ve got your fair share of things to do in addition to your “regular” daily responsibilities. One thing’s certain: If you leave things until the last minute, you’ll increase the likelihood that you won’t get everything done, and you’ll undoubtedly elevate your stress levels.

4. The More the Merrier: We’ll end today’s lesson with the one too many people completely overlook, not only during the holiday season, but throughout the year. A top cause of stress is feeling overwhelmed; thinking you have to get too much done all by yourself. But why? Unless you’re a hermit, you’re not alone, so rely on friends, family and loved ones – the very people whose company you should be enjoying and celebrating this season – to help with the kids, your shopping list, meal preparation, or just giving you an hour or two of peace and quiet. It’s a great way to keep stress at bay as the year winds down.

Despite increasing public and professional awareness, revised pain-management guidelines and other signs of change, the numbing numbers still stand out: an estimated 130 deaths a day due to an opioid overdose.

Could a lasting solution be as simple as visiting a doctor of chiropractic or other conservative care provider first? You probably know the answer, but now research is proving it. Case in point: a new national study comparing first provider choice with early- and long-term opioid use in patients with low back pain.

Published in BMJ Open, this study evaluated short- and long-term opioid use based on initial provider type seen: conservative care practitioner (chiropractor, acupuncturist or physical therapist) or primary care medical physician (PCP). Participants included 215,000-plus U.S. adults diagnosed with new-onset low back pain and “opioid naive.”

The study defined early opioid use as “an opioid fill within 30 days of the index visit” and long-term use as “an initial opioid fill within 60 days of the index date and either 120 or more days’ supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months.”

Researchers evaluated inpatient / outpatient claims from patient visits and pharmacy claims to correlate first provider type seen with opioid use, finding that LBP patients whose initial visit was with a DC were a staggering 90 percent less likely to use opioids early compared to patients who saw a PCP first.

Significantly reduced odds for early opioid use were also noted for acupuncture and physical therapy patients. LBP patients who first visited a doctor of chiropractic or other conservative provider were also less likely to use opioids long term compared with patients visiting a PCP.

ER physicians, orthopedic surgeons, neurosurgeons and rehab physicians were also included in the analysis. Patients visiting any of the above MD specialists first also had lower odds of early opioid use compared to primary care physicians (although not as significant as visiting a conservative-care provider), with the exception of ER physicians (dramatically higher odds for early use compared with PCPs). However, odds for long-term use were not significantly different compared to primary care providers for all of the above specialist types, with the exception of rehab physicians (still significantly lower odds compared to PCPs).

If that’s not enough proof, a second study, this one published in Pain Medicine, reviewed six previous studies involving more than 60,000 participants with spinal pain, finding that patients who saw a chiropractor were 64 percent less likely to use opioids compared to patients who visited another type of health care provider.

It makes sense that patients who visit chiropractors are less likely to use opioids, since chiropractors provide nondrug, nonsurgical care. But the bottom line is, visit a chiropractor, reduce your risk of using a dangerous opioid! In light of the sobering statistics on opioid deaths, visiting a chiropractor for your pain could be a life-saving decision.