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In This Issue:

• Latest Research - Maintenance Care
• Cell Power
• Rheumatoid Arthritis and Exercise
• New Diet and Exercise Guidelines
• Fruit Good for the Bones
• Cartoon

To ignore the facts does not change the facts. - anonymous

Benefits of Maintenance Care - Latest Research
It is estimated that in the United States, the annual costs associated with the treatment of low back pain (LBP) total approximately $100 billion. High recurrence rates and chronic disability are believed to play a large role in the overall cost of back pain; studies have shown that only a fraction of low-back pain patients remain pain free and recover completely from the disabilities associated with LBP, even one year after the problem first occurred.

In this Journal of Manipulative and Physiological Therapeutics study, 30 patients with chronic, nonspecific low back pain lasting at least six months were separated into two groups. The first group received 12 treatments (three treatments per week, consisting of side-posture manipulations of the lumbar and sacroiliac joints) over a one-month period, but no treatments for the subsequent nine months. The second group also received 12 treatments over a one-month period, along with "maintenance spinal manipulation" every three weeks for the following nine months.

Results: Patients in both groups experienced significant decreases in low back pain scores after the first series of treatments. The greatest difference, however, was seen in disability scores over the duration of the study. Analysis of the data showed that in patients who received maintenance spinal manipulation, the disability scores were significantly lower after the 10-month period than before the initial phase of treatment. In the other group, however, the mean disability scores went back to their pretreatment level.

Conclusion: "This study appears to confirm previous reports showing that LBP and disability scores are reduced after spinal manipulation. It also shows the positive effects of preventive chiropractic treatment in maintaining functional capacities and reducing the number and intensity of pain episodes after an acute phase of treatment."
Journal of Manipulative and Physiological Therapeutics, October 2004;27(8):509-514.

The  "War" Between Health and Medicine
"There's a war going on in North America between the forces of 'Health' and 'Medicine.' 'Health' is winning, not because it has more  money and power, but because the people of North America, and the world, have found out that there is a definite difference  between the two -- and that it is better to be healthy than medicated. In fact, it is becoming clear that the two are opposites." - Tim Bolen, consumer advocate

Cell Power
Mitochondria are cell organelles (literally; organs of the cell) that serve as powerplants, processing nutrients and oxygen that feed the cells. But toxins and diseases weaken mitochondria, often reducing cellular efficiency, as we grow older. The results range from the typical signs of aging to chronic and debilitating illnesses.

Fortunately there are simple steps we can take to prevent the breakdown and loss of vitally important mitochondria.

Disorders sometimes associated with mitochondrial dysfunction include chronic fatigue syndrome, dementia, cardiomyopathy (heart muscle disease), and kidney ailments. To that list we can now add type 2 diabetes.

Knowing that the accumulation of fat in liver and muscle tissue is an accurate predictor of insulin resistance (a precursor of type 2 diabetes), a team of scientists at Yale University School of Medicine used non-invasive scans to examine the muscles and livers of 29 people. Subjects were made up of two groups: 13 were between the ages of 18 and 39, and 16 were between the ages of 61 to 84. All subjects were healthy and showed no signs of pre-diabetic conditions such as excessive body weight.

Results showed that the group of older subjects not only had a higher accumulation of fat in their liver and muscle tissue than the younger group, but also an average of 40 percent lower metabolic activity of the mitochondria. This is significant because one of the key jobs of mitochondria is to convert both fatty acids and glucose into energy.

The Yale researchers' conclusion - that a lack of the mitochondria necessary to burn fat promotes a lowered sensitivity to insulin - leads to this practical advice: Get up and exercise. Because studies have shown that regular physical activity stimulates and even increases the amount of mitochondria within your cells.

A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses. - Hippocrates

Rheumatoid Arthritis and Exercise
Rheumatoid arthritis (RA) is a painful joint disease characterized by inflammation and swelling of the synovial membrane, or lining, of the joints. Although the disease usually occurs between the ages of 40 and 60 and is diagnosed in women twice as much as in men, RA can affect anyone at any age, including children. A person living with the debilitating affects of RA may not feel inclined to exercise; however, a recent study published in the Annals of the Rheumatic Diseases has found that high-intensity exercise does not increase joint damage in RA patients, and may even be beneficial.

Researchers from the Leiden University Medical Centre in the Netherlands conducted the Rheumatoid Arthritis Patients in Training (RAPIT) study, which compared 145 usual care (UC) physical therapy patients with 136 patients engaged in high-intensity weight-bearing exercises over a period of two years. All study participants were evaluated for the rate of radiologic joint damage of the hands and feet. Disease activity, use of drugs, changes in physical capacity and bone mineral density (BMD), and participant attendance at exercise sessions were all factors that had been determined could possibly affect the study outcome.

Results: Participants in the high-intensity weight-bearing exercise group developed less radiologic damage after two years compared to the UC group. A separate analysis determined that the joints in the feet showed more pronounced rates of increase in damage. Rate of damage was found to be associated with less disease activity, use of fewer drugs, and improved aerobic fitness.
Annals of the Rheumatic Diseases, 2004; 63:1399-1405.

Don't be afraid to take a big step when one is indicated. You can't cross a chasm in two small steps.
                                                                                                                       - David Lloyd George

New Diet and Exercise Guidelines
The federal government issued new dietary guidelines for Americans in January, and for the first time since the recommendations were introduced in 1980. Finally, the conventional medical paradigm may be indeed GETTING IT in terms of the amount of daily exercise one needs to lose weight, according to the revised Dietary Guidelines for Americans along with a new Food Pyramid unveiled yesterday. Now, they recommend allotting 60-90 minutes EACH DAY to exercise.

That's a smart move, considering the key factor in building optimal health in people who have insulin resistance and need to lose weight is a 90-minute "dose" of exercise daily!

Most of the two-thirds of the country who are overweight and tens of millions of others with high blood pressure, high cholesterol and diabetes, desperately need more exercise to revitalize their health. In fact, unlike typical commercial drugs, exercise can actually cause one to go into permanent remission for diabetes.

Other highlights of the new standards:

• Lowering your intake of trans fats as much as possible.
• Cutting back on sugar.
• Increasing your daily intake of fruits and vegetables to 5-13 servings.
• Eat fiber-rich whole fruits and vegetables and whole grains.
• Exercise 30-90 minutes every day.

I particularly enjoyed hearing Health and Human Services Secretary Tommy Thompson's quote from the news conference where the new standards were announced about a "miracle weight-loss" drug: "There's not going to be a pill."
USA Today January 13, 2005

When wealth is lost, nothing is lost; when health is lost, something is lost; when character is lost, all is lost.
                                                                                                                                 – Billy Graham

Fruit Good for the Bones
Osteoporosis is a significant public health problem, which grows in importance as the population ages. Augmenting bone mass during adolescence has been suggested as a strategy to prevent osteoporosis, because this stage of life may be the last chance to substantially increase bone mass before the skeleton consolidates. Bone mineral density (BMD) is affected by a variety of factors, including genetics, nutritional intake, and endocrine!  and mechanical conditions. The nutritional factors are considered to be especially important because they have the potential to be modified.

Researchers in Northern Ireland recently conducted a study to determine whether usual fruit and vegetable intakes reported by adolescents have any influence on BMD. The study showed that adolescent girls who consumed high amounts of fruit had significantly higher BMD compared to girls with moderate or low fruit consumption.

Here is another of the many good reasons to consume plenty of fruits and vegetables.
American Journal of Clinical Nutrition, 2004;80(4):1019-1023.