Decreasing Heart Attack Risk by Tackling Inflammation

Recent research in the New England Journal of Medicine looked at 10,000 patients who had had a heart attack AND a positive hsCRP result. (This is a blood test for inflammation.)

All of the patients received high doses of statins, which is the present standard of care, then they were split into two groups. Half of the patients received an injection every three months of a drug called Canakinumab, the other half received a placebo injection of normal saline. This trial went on for four years.

Canakinumab is a form of anti-inflammatory medication. It’s used predominately in those with rheumatoid arthritis. But according to the research, when you give it to people with heart attack risk you get some interesting results:

  • 15% reduction in risk of a cardiovascular event like a fatal or non-fatal heart attack or stroke
  • 30% reduction in the need for expensive interventional procedures like bypasses or stents
  • No change in death rates in the 2 groups.

You can read some mainstream coverage of the news here, including the impact on cancer rates.

The short story? Reducing inflammation is good for your health, in particular your heart.

What’s the Catch?

All of this sounds like good news, and in theory, it is. But nothing comes for free. The problem with Canakinumab is that it decreases inflammation by suppressing the immune system. That means patients who take it may be more susceptible to infections, require increased healing time if injured.

Enter the Better News

Chronic inflammation is often lifestyle-related. A poor diet, being sedentary, being over-stressed and under-slept, smoking and/or exposures to other toxins—all of these things contribute to your overall inflammatory set point. And the magic of lifestyle issues is that they can often be fixed without medication.

Dealing with inflammation is a big part of what Naturopathic Doctors do. We have written about it often, and dealing with it in some form or another is a common part of our treatment plans.

It stands to reason that dealing with and improving your inflammatory lifestyle challenges would be helpful in decreasing inflammation. If you could reduce your risk without the need for intense anti-inflammatory medicines that suppress your immune system, wouldn’t you want to?

The starting point is easy. Finding out if inflammation is a problem for you is as simple as a quick and inexpensive blood test called hsCRP–the same one used in the study. All you need to do is get started!

For information on hsCRP testing or inflammation reduction, book online or call 705-444-5331.

Get Those Kids Moving!

A new study published in the Frontiers of Physiology in July offers a glimpse into the possible long-term importance of getting our young ones moving.

The study fed a group of baby lab rats a high-fat diet and then separated them into three groups. One group was denied exercise for their whole life, one group was denied exercise until they were adults, and the last group was allowed to exercise from the very beginning.

  • The researchers found that early exercise positively impacted the way the rat’s metabolism responded to the high-fat diet. They were able to transform fat into energy more effectively. This effect lasted for 60 days after the exercise stopped. No big surprise here.
  • But, the interesting part was that early exercise decreased overall inflammation as an adult. Even though the rats still all got fat from a diet that was too calorically rich, they did not seem to have the same negative health effects of a high-fat diet without exercise.

Clearly, kids aren’t rats, and no one is going to run a lifetime study denying humans exercise (although the fact that 1 in 10 kids meets the physical activity guidelines suggest we might be working towards it, sadly.)

But although it might be difficult to know what the long term studies will tell us for sure about humans, while you’re waiting there’s almost zero downside to getting kids moving!

This is one time when it’s probably quite reasonable to compare your kids to rats. 🙂

Reflux Meds: the Good, the Bad and the Ugly

Last month, the medical journal BMJ Open published research linking the use of PPI’s, or proton-pump inhibitors, with increased risk of death.

PPI’s are frequently used to treat serious gastrointestinal issues like ulcers, GI bleeds and reflux, and are one of the most commonly used classes of drugs. They’re a powerful tool, but research continues to show that long-term use is a bad idea.

PPI’s are generally meant to be short-term prescriptions, but people often end up taking them for months or years to control symptoms, especially in the US where they’re available over the counter in various forms.

According to the study, however, the longer the drugs are used, the higher the risk of mortality. Past research has also linked this class of drugs to kidney damage, dementia, and bone fractures.

The moral of the story? Take it when you need it and no more!

But My Digestive Issues are Ruining My Life!

GI issues can be extremely challenging to live with. It’s no wonder people turn to whatever works. But there are other solutions for many sufferers. Issues of the gastrointestinal tract are where naturopathic medicine shines, and there are many ways to treat upper GI complaints without prescription medications.

The place to start, of course, is your diet. That may seem obvious, but astonishingly, this is still frequently discounted in conventional medicine. Despite the fact that your entire GI tract exists to deal with food, we seemed determined to not see food as a GI issue. It is.

Here are a few suggestions from the naturopathic toolkit:

  • Food intolerances and inflammatory foods are real culprits here. Get yourself tested, and avoid reactive foods strictly.
  • Avoid coffee, cigarettes, and booze. They all stimulate acid secretion and an inflammatory response. If you are doing these things and also NOT eating, that makes things worse. You are stimulating the digestive tract and not putting anything in it–a double whammy.
  • Cultivate a healthy flora. Probiotics and foods that support healthy flora, like fermented foods, keep the digestive tract working well and help prevent H.pylori and other imbalances of GI bacteria that can cause trouble.
  • Talk to your chiropractor or osteopath. Sometimes the “valve” that keeps the contents of the stomach in the stomach gets stuck open. This can be made worse by sitting too much. An adjustment can get things back in line.
  • Better still, as always, stay active and maintain a healthy weight for your body type.

Digestive issues are among the most challenging to diagnose, and they often mean difficult lifestyle changes, at least in the short term. But compared to the side-effects of long-term PPI use, the sacrifices are small!

To uncover your food intolerances, or get to the root cause of your digestive troubles, book an appointment with one of our Collingwood naturopathic doctors. 

Whooping Cough Prevention and Treatment

In the last week, we have seen a couple of little ones show up with confirmed cases of whooping cough.

Whooping cough, or pertussis, is an infection of the respiratory tract caused by the bordetella pertussis bacteria. It starts out looking like the common cold–runny nose, fever, mild cough. This is then followed by severe coughing fits, sometimes with the characteristic “whoop” sound at the end of the fit. These coughing fits can go on for 10 weeks, giving it the nickname “the 100-day cough”.

You can hear the sounds of pertussis here.

But…I thought we had vaccines for pertussis?

Whooping cough is actually the second most common infectious childhood disease in Canada, after influenza. It’s endemic, meaning it’s always around, but it usually doesn’t show itself much–just in minor periodic outbreaks.

This isn’t unusual–the vaccine isn’t perfect. It’s estimated to have about an 80-85% effectiveness after three doses, and that effectiveness wears off over time. As a result, whooping cough re-emerges occasionally.

For an in depth look at the research on this, Dr. Suzanne Humphries, MD does a good job of outlining the issues. It is a long article but worth the read if you are a worried parent.

Prevention of Pertussis

Vaccination is currently the prevention method of choice. It is part of the infant vaccination schedule, which is important. There is a 0.5% mortality rate in infants under 1 year of age who contract pertussis. Before regular pertussis vaccination, moms who contracted the infection in childhood would be immune to it when they had their babies (a natural infection confers immunity for over 30 years). When they breastfed their babies they little ones would get the benefit of that immunity from their mothers.

Many mothers now have been part of public vaccination programs and their immunity is likely to have worn off, resulting in increased risk. A blood test can show if mom is immuno-competent.

Treatment

Conventional treatment is generally antibiotics, but they generally have very little positive effect. In fact, more and more evidence is coming forward about the negative effect of using antibiotics, especially when they are not needed. We’ve written about this before.

As naturopaths, we like to support the immune system in its efforts to deal with the infection, and Vitamin C is the core treatment tool.

The pertussis bacteria makes a “toxin” that is at least partly responsible for the lung symptoms. Vitamin C does a pretty good job of neutralizing that toxin. Again, Dr. Humphries does a great job discussing this issue. In our little ones, we use oral dosing, but in our teens and adults with the “100 day cough” weekly to bi-weekly treatments can decrease the duration of the illness.

Remember: If you are suspecting whooping cough in your child it is very important to seek assistance from a regulated health professional.

World Hypertension Day

The international society of hypertension initiated World Hypertension Day in 2005 and has promoted it yearly ever since.

Why?

Hypertension–you might know it better as high blood pressure–is called the silent killer because people who have it often don’t know it. And it’s a big deal, because the risk of stroke is four times greater in those with high blood pressure, and the risk of a heart attack is two times greater. Put it this way: as your blood pressure increases above the normal range, so do your chances of dying.

So what to do?

First of all, understand your risk. Then make sure you know what your blood pressure is. Normal range is 120/80 to 140/90. If it’s over 140/90 visit your health care provider.

Next, prevent or reduce hypertension. The biggest causes are lifestyle factors such as physical inactivity, a diet high in processed and fatty foods, and alcohol and tobacco use.

Hypertension is largely preventable and treatable through lifestyle change. The list should sound familiar:

  • Lose weight
  • Eat foods that nature makes – LOTS of fruits and veggies
  • Exercise regularly
  • STOP SMOKING
  • Drink alcohol sensibly – no more than 2/day for men and 1/day for women

What about salt? The connection between salt and hypertension is a story that’s been told for decades, but, as we’ve written about before, the connection is more complicated than it seems. A better approach? Focus on cooking your own meals and eating lots of whole food–good nutrition and exercise are the best tools you have.

If you’re curious about your cardiovascular health or have questions about lifestyle changes, contact the clinic anytime at 705-444-5331 or feelbetter@stonetreeclinic.com.

Heart and brain walking

Memory Issues? More Evidence that Exercise Helps

We have written endlessly about the value of exercise for overall health.

If you read through the research, it comes up over and over again. It’s good for our hearts. It helps moods. It keeps our bones strong. It keeps our weight stable. It even makes our brains bigger.

Here is more evidence to suggest it also makes our memory better.

In this study, they took women between 70-80 years old, all of whom were complaining of memory problems, or as the researchers referred to it, Mild Cognitive Impairment (MCI).

These women were divided into three groups. One did aerobic exercise, one did strength training and a third was a control group. The treatment groups engaged in activity twice a week for 60 minutes.

Compared to controls the treatment groups both had improved verbal and spatial memory, with the best gains being in the group who did the aerobic activity.

The findings make sense. Move the body, move the blood, get more oxygen to the brain, as well as more fuel and nutrients for the old thinker to work.

But this might be the most important takeaway: “aerobic activity” wasn’t intensive marathon training. It was a 60-minute walk outside at 60% of max heart rate TWICE a WEEK. That’s basically a brisk-ish walk.

The average Canadian spends dozens of hours a week in front of conventional TV and the web combined, consuming media of one type or another. Converting just TWO of those to walking seems like an achievable goal.

Migraines and Bacteria in Your Mouth

New research out of the University of California San Diego School of Medicine points to a potential link between certain bacteria in the mouth and the incidence of migraine headaches.

The bacteria, Rothia mucilaginosa and Haemophilus parainfluenzae, actually convert nitrates (found in chocolate, wine, and cured meats) into nitric oxide (a powerful vasodilator in the body).

These two bacteria are part of the normal flora of the body, but when given an opportunity they can cause trouble. (Just like another critter we know, candida albicans, which causes yeast infections!) The researchers suggest that the production of nitric oxide by these bacteria may be the cause of the migraines by increasing vasodilation in the head.

Of course, more research needs to be done to confirm this theory, but it’s yet another example of why a healthy microbiome is so important to our overall health.

Balanced flora keeps opportunistic bacteria in check and playing nice. When things get out of balance from antibiotics, hormones, chemical exposures and stress, it can throw the bacterial balance off and lead to all kinds of health complaints.

How to Support a Healthy Microbiome

  • Eat plenty of fermented food and fiber. This feeds our microbiome and helps to re-populate it.
  • Get outside and get your hands dirty. Garden, stack wood, rack leaves, move rocks.  Exposure yourself to nature and the wonderful bacteria that live it in. This inoculates our microbiome with lots of healthy critters.
  • Avoid antibiotics when you can, and take a probiotic when you can’t. Much research now has demonstrated the benefits of taking a probiotic, especially after and exposure to an antibiotic. Taking at least 10 billion for 2 weeks post antibiotics is a no brainer.
  • Lay off the antibiotic soaps. They’re not helping.

Ditch the Antibacterial Soaps

Last week the FDA announced that the use of antibacterial agents in soaps will no longer be permitted in the US.

Why?

The manufacturers of antibacterial soap products have failed to establish that they are any more effective than just regular soap and water, and there is also some question of their safety. There are 19 different ingredients on the list including triclosan and triclocarban, which have been linked to microbial resistance and hormone disruption.

Health Canada has not followed suit with this ban, though we hope they do in short order. In the meantime, read labels and vote with your dollars. Avoid all products with these ingredients in them.

The 19 banned ingredients are:

  • Cloflucarban
  • Fluorosalan
  • Hexachlorophene
  • Hexylresorcinol
  • Iodophors, which are iodine-containing ingredients
  • Iodine complex, which is ammonium ether sulfate and polyoxyethylene sorbitan monolaurate
  • Iodine complex of phosphate ester of alkylaryloxy polyethylene glycol
  • Nonylphenoxypoly, or ethyleneoxy, ethanoliodine
  • Poloxamer, an iodine complex of Povidone-iodine 5 percent to 10 percent
  • Undecoylium chloride iodine complex
  • Methylbenzethonium chloride
  • Phenol greater than 1.5 percent
  • Phenol less than 1.5 percent
  • Secondary amyltricresols
  • Sodium oxychlorosene
  • Tribromsalan
  • Triclocarban
  • Triclosan
  • Triple dye

Alternatives are easy to find. Visit our local farmers’ markets, Georgian Health Foods, Good Health Mart, The Environment Network, Creemore 100 Mile Store, From the Blue House in Creemore for a wide array of safe and natural soaps and skin care products.

Alcohol and Cancer

I hate to be a bummer, especially during the hottest summer in a while, but…it seems that alcohol might cause cancer.

A paper published this month in the journal Addiction aimed to qualify the strength of the evidence that alcohol is causative in cancer.

A review of recent research showed evidence that:

  • Alcohol was causative in seven types of cancer: oropharynx, larynx, oesophagus, liver, colon, rectum and breast.
  • There was also evidence of “gradient effects” meaning that the more you drink, the greater your risk.
  • There was some evidence of reversibility of risk in cancers of the larynx, pharynx and liver, which means when the consumption was stopped the risk decreased.

At any rate, the study conclusion is an ominous paragraph:

“There is strong evidence that alcohol causes cancer at seven sites in the body and probably others. Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8% of all cancer deaths world-wide.”

The biological mechanism–how alcohol actually causes cancer–is yet to fully be determined by research, but what the study suggests is that drinking and cancer are linked whether we like it or not.

What About the Health Benefits of Wine?

The study does say this:

“The same, or similar, epidemiological studies also commonly report protection from cardiovascular disease associated with drinking but a high level of scepticism regarding these findings is now warranted.”

What Should I Do?

Those of you in my practice know me to be a reasonable and moderate doctor. So what does this mean for the lovely gin and tonic you were planning to have on the dock this afternoon?

That depends.

Is that lovely gin and tonic a treat or a habit? Is it a daily occurrence that is turning into two (Fine, three.) gins on the dock and a glass of wine with dinner and an ounce of scotch as a night cap?

There are all kinds of reasons, why sustained daily use of alcohol is not good for you. We have written about it before. This is just another reason to do a “vice check” and make sure that your habits are not hurting you more than you intend.

Dear Furniture, This is Your Thyroid

We’ve written about thyroid many times in the past (see links at the end of this post), but a new study this spring from researchers at Harvard T.H. Chan School of Public Health is the first one to suggest that there may be a link between polybrominated diphenyl ethers (PBDEs) and increased risk of thyroid problems in post-menopausal women.

Wait! What’s a PBDE?

PBDEs are flame retardants that are used in the manufacture of furniture, beds, clothes and other consumer items. They are also known endocrine disruptors, which means they interfere with the normal function of our hormones. PBDEs mess around with estrogen levels in the body, and that has a downstream effect on the thyroid. As the Harvard T.H. Chan School of Public Health reported in their article:

PBDEs have been used as flame retardants for decades, largely in furniture, in quantities up to 20% of the weight of the product. Over time, they migrate out of the furniture into the air, settle into dust in homes, schools, offices, and the outdoors, and accumulate in people’s bodies. Previous research has shown that these chemicals accumulate in fatty tissue and interfere with hormonal functions, including interference with thyroid hormones. Because it’s known that estrogen levels regulate thyroid hormones, researchers theorized that post-menopausal women may be particularly vulnerable to PBDE-induced thyroid effects.

To test their hypothesis, the researchers used data from The National Health and Nutrition Examination Survey (NHANES).

That study began in the 1960’s and uses a combination of interviews and physical examinations to assess the health of the US population in everything from cardiovascular disease and infectious disease to environmental exposures. The scientists looked at nationally representative sample of women whose blood was taken in the 2003-2004 and had the levels of four common PBDEs measured.

What the researchers found was that the women with the highest flame retardant concentrations in their blood were far more likely than those with lower concentrations to have a thyroid problem.

If the women were post-menopausal, the chances of thyroid trouble in highly exposed women were even higher.

The study isn’t perfect–one limitation is its reliance on survey participants to accurately recall and report on any thyroid problems. Like many studies, it also doesn’t prove flame retardants cause thyroid damage, only that there appears to be an association between these two things. Another limitation is that the study was looking at the older flame retardant chemicals as the NHANES data is from 2003-04 and doesn’t report effects from newer chemicals.

What to do about it

What do you do? First, don’t panic. Almost everyone on the planet has PBDE exposure. But that doesn’t mean you shouldn’t try to reduce yours, and look closer if you feel there’s a problem. Here’s how to get started: