Could Diet & ADHD Be Related?

14 Dec

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over both the  quality and length of your life.

The age-old question — which came first the fried chicken or the ADHD? — is not easy to answer. We know obese moms give birth to kids with ADHD (attention deficit hyperactivity disorder ) more often; people with ADHD (kids or adults) are more likely to be overweight (impulse control issues?); and consuming refined grains like white bread, sweet sodas, red meats, and whole dairy increases a child’s risk for ADHD.

Now, it seems that kids who eat diets high in saturated and trans fats (think fried food and red and processed meats) have a greater chance of developing several childhood disabilities including impulsivity, depression, anxiety, and ADHD.

Five to eight times as many kids are depressed today as they were 50 years ago (less play, more pressure, more obesity?) and anxiety is increasingly diagnosed. ADHD affects millions of U.S. children with diagnosis up 66%, especially among boys. These issues often lead to more problems in their teenage years and major depression in adulthood.

So, for your kids–and you too–adopt an eating plan packed with fruit, vegetables, 100% whole grains, healthy fats (olive oil, omega-3 rich salmon and ocean trout, and DHA supplements, and ALA in walnuts, avocados, and cannola and walnut oil).

Go for portion control: Keep servings of animal protein about the size of your palm; fill 2/3rds of your plate with veggies and whole grains.

Get moving with 30 minutes of aerobics (minimum) daily for you and your kids, and  perform strength training exercise with weights or stretch bands (for you, the parent) 2 to 3 times a week.

Thanks for reading,

Young Dr. Mike Roizen (aka, The Enforcer)

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

 

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Nutritional Post-Surgical Management of CTS.

14 Dec

Obviously, the goal of all health care providers, including chiropractic management of Carpal Tunnel Syndrome (CTS), is to AVOID surgical intervention, but this is not always possible. Last time, we looked at herbal approaches to reduce inflammation with the focused goal of preventing surgical need. But, as chiropractors, we also care for patients post CTS surgery, and one of our treatment approaches beyond manual therapies includes nutritional management.

As we all know, during the surgical process, tissue damage occurs due to incisions, removal of injured tissue, and other factors. Depending on the “success” of the surgical procedure, damage to the nerves causing numbness, weakness, and/or other nerve related symptoms can occur. Often, nerves will regenerate during the healing process but not always 100%. This may be due to factors such as the amount of tissue damaged during the surgery, the length of time CTS had been present pre-surgery, how well the patient follows post-surgical instructions, as well as the general health and overall condition of the patient. A healthy diet along with certain specific vitamins can play a positive role in tissue healing and nerve regeneration. Here are some examples:

Folate or vitamin B9 has been reported to have beneficial effects on the genes located within the nerve cells that help to regulate the healing process. One study published in 2010 reported that folate helped to promote nerve repair in the central nervous system (CNS) in rats, which is unique as typically nerve damage in the CNS does not usually regenerate. Anti-inflammatory benefits have also been reported with vitamins B6, B9, and B12.

Cobalamin or Vitamin B12 has also been reported to facilitate nerve regeneration after injury. This, along with the anti-inflammatory benefits, supports the use of B12 in the post-surgical CTS patient.

Vitamin D may also play a significant role in nerve regeneration after surgery. In one study, vitamin D2 was found to have a positive effect on nerve regeneration. Another study reported that D3 and calcium together has strong anti-inflammatory benefits.

Vitamin B6: There is evidence that supports the use of B6 both before and after surgery. Some feel B6 acts directly on nerve repair and others report a diuretic (fluid reducing) benefit. One cause and/or complication of CTS is fluid retention, which commonly occurs in conditions such as pregnancy, the use of birth control pills, obesity, diabetes, and others. Thus, keeping fluids in our tissues under control can certainly help CTS patients. Most studies agree that less than 200mg of B6 per day is safe. The dosage should be carefully monitored as numbness/tingling (a common CTS symptom) can be a sign of B6 toxicity.

Vitamin C has long been reported to facilitate in the wound healing process. It also is an effective anti-inflammatory agent, a common problem in the cause of CTS as well as a negative post-surgical side effect. A dose of 1000-3000mg/day spread out throughout the day is beneficial to the post-surgical healing process.

Vitamin E: As far back as 1967, Vitamin E been reported to reduce inflammation. More recent studies report that when used in combination with vitamin C, the two together works even better in reducing inflammation than either one alone. Also, this combination was found to improve the body’s ability to use insulin, which may also facilitate healing in the post-surgical CTS patient.

There are many others we didn’t get to (such as B1, 3, 5; zinc, Bromelain, and Quercetin). Bottom line: Eat healthy, exercise, don’t smoke, and fortify your diet with these nutrients!

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

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Low Back Pain and Common Mistakes (Part 2).

14 Dec

Last time, we started a great discussion on “what NOT to do” for low back pain (LBP). Let’s continue that focus!

5. STAY STILL: You’ve heard, “…don’t do that – you’ll get a bad back!” There is something to be said about being careful, but one can be too cautious as well. In order to determine how much activity vs. rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short (within minutes to hours), then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.” Talk to us about the proper way to bend, lift, pull, push, and perform any activity that you frequently have to do that often presents problems. There is usually a way to do that activity more safely!

6.  SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but non-surgical care at least for 4-6 weeks and maybe several months is usually the best approach. As the old saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as: a) bowel or bladder weakness &/or, b) progressive neurological losses (worsening weakness in the leg). If there are no “surgical indicators” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this group. There are guidelines that we all should follow and they all support non-surgical care initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic carries the highest patient satisfaction.

7. DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner, reduce your ability to lift heavy weight (if you’re a weight lifter), or cycle as fast.  Though this seems obviously silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears (at least at present), that is applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic competitive activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, as stated last month, there is a “right vs. wrong” time to exercise and WAY to exercise. For example, when LBP occurs in flexion but reduces in extension, there is plenty of evidence published that performing exercises INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Low Back Pain and Common Mistakes.

14 Dec

We often read about what to do for low back pain (LBP), but do we look at LBP from the perspective of “what NOT to do!”

ICE vs. HEAT: If you ask your doctor, “what’s better for my back, ice or heat?” the answer is either one or the other or, “…whichever you like better.” This leaves the LBP patient at a loss of who or what to believe. So, let’s settle this once and for all. Ice should be tried first because it will rarely make the LBP worse, whereas heat can. Ice is an “anti-inflammatory” agent, meaning it reduces swelling. Ice reduces congestion or pushes painful chemicals and fluids that accumulate out of the injured area when there is inflammation and usually feels good (once it’s numb), maybe not initially because it’s cold. Heat does the opposite of ice. It’s a vasodilator meaning it pulls fluids INTO the area. Sure, it feels “good” initially, but often people will say it makes them worse later. That’s because the additional fluid build up in an already inflamed area is kind of like throwing gasoline on a fire. When LBP is chronic (it’s been there >3 months), heat MAY be preferred. Contrast therapy or, alternating between the two can work as an effective “pump” pushing out fluids (with ice) and pulling in fluids (with heat). Here, start and end with ice so the first and last things done are “anti-inflammatory.”

IGNORE YOUR LBP: The comment, “I was just hoping it would go away,” has been used by all of us at some point. Though LBP can get better over time, it’s simply impossible to know when or if it will. If you have suffered from back pain previously, then you already know that getting in quickly for a chiropractic adjustment BEFORE the reflex muscle spasm sets up can stop the progression, often before it reaches a disabling level. If you want to reduce the chances of missing work or a golf game due to LBP, come in immediately when the “warning signs” occur – you know, that ‘little twinge’ in your back that’s telling you, “…be careful!”

BED REST: There is a time for rest and a time for exercise, but knowing what to do when is tricky. Another “true-ism” is the best exercise when done too soon may harm you, but when done at the right time will really help. So, here are some general guidelines: a) no more than 24-48 hours of mostly bed rest; b) walking is usually a great, safe starting activity after or even during the first 48 hours; c) avoid activities that create sharp pain (like bend, lift, twist combinations); d) use ice or contrast therapies a lot during that initial 48 hours; e) follow our exercise instructions and treatment plan – we’ll guide you through this process.

FOCUS ON X-RAY OR MRI FINDINGS: Did you know that about 50% of us have bulging disks, and 20% of us have herniated disks in our low back and yet have NO pain? That’s right! Many of us have “disk derangement” but no symptoms whatsoever. Similarly, the presence of arthritis on x-rays may have no relationship to an episode of LBP. It’s easy to blame an obvious finding on an image for our current trouble, but it may be misleading. In fact, it can even make a person fearful of doing future activities that may be just fine or even good for us. The WORST thing for some types of arthritis is to do nothing. That will just lead to more stiffness and pain! More later!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Carpal Tunnel Syndrome & Herbs.

14 Dec

Carpal Tunnel Syndrome (CTS) is a condition caused by the compression of the median nerve as it travels through the carpal tunnel in the wrist. The “source” of median nerve compression can be soft tissue swelling, such as tendonitis, bursitis, synovitis, capsulitis, etc. Last month, we discussed nutritional supplementation for CTS in general. This month, the focus is on specific herbs that can help this potentially disabling condition.

Chamomile functions as a natural “tranquilizer.” It’s used for muscle pain (as a relaxant), but can also help other problems such as menstrual disorders, headaches, and tension. Chamomile facilitates relaxation of tight muscles and has an anti-inflammatory property that soothes cramps.

Kava Root is an herbal plant that is well known for its muscle relaxing benefits. It is particularly helpful with extreme muscle pain.

Valerian is a very effective relaxant that dates back to the medieval times for curing ailments associated with muscle spasms such as muscle cramps and neck problems.

Catnip is also a natural muscle relaxant, and is a member of the mint family. It is used as a sedative and muscle relaxer. Headaches due to tension have been treated using a poultice containing catnip. Catnip has also been found to reduce swelling in joints and reduce soft tissue injuries such as tendonitis, bursitis, and capsulitis.

Cayenne Pepper is a popular herb used in cooking and can be found in many recipes. Cayenne pepper has been found to significantly relieve the pain of muscle cramping.

Horseradish has been reported to relieve extreme muscular stress involved in cramps and muscle pain. One approach is mixing a few drops of horseradish oil in bath water to reduce soreness associated with muscle aches.

Lavender flower oil is well known as a very effective muscle relaxant that provides relief caused by muscular tension. Using a circular motion while massaging the oil over the achy muscle can be particularly soothing. In addition to the mind/body relaxation benefits, an increase in circulation allows the tense muscles to relax and heal.

Licorice has the ability to reduce inflammation associated with muscle pain.

Devil’s Claw is a very popular anti-inflammatory herb that dates back to the 18th century for the treatment of arthritis and many other painful conditions. It’s also used as an effective muscle relaxer.

Peppermint oil has been used to treat conditions associated with muscles aches. Pouring some drops of peppermint oil in a hot bucket of water to soak a foot, ankle or lower leg (possibly combined with Epson salt) can be very relieving.

Other natural muscle relaxants include Cramp bark, Passiflora, Bergamot, Cardamom, Basil, Ginger root, and others.

It is appropriate to COMBINE these natural herbal approaches with other treatments that are known to work well in the treatment of CTS. Chiropractic can provide: 1. Manipulation and mobilization of the neck, shoulder, elbow forearm, wrist, hand, and fingers; 2. Cock-up splints to be worn at night and at times during the day such as driving; 3. Physical therapy modalities such as electric stim, ultrasound, light or laser therapy, magnetic field; 4. Work station and other ergonomic modification recommendations; 5. Exercise training, and more.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

 

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The Ethics of Not Hiring Smokers.

14 Dec

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over both the  quality and length of your life.

This month, I want to talk about something you might advocate for your business that was featured in two recent New England Journal of Medicine op-eds that highlighted what we had done at the Cleveland Clinic (so forgive me if I use us and Ohio as a parochial example).

Those two recent New England Journal of Medicine op-eds asked a question: “Was it ethical for employers not to hire smokers?” That’s the wrong question.  It should be: Is it ethical for employers to hire those who smoke, a practice that fosters ill health, and therefore makes America less competitive in an international marketplace?

The expense of healthcare in the United States represents over 18 percent of GDP, more than any other country, threatening our sustainability as a nation, and now squeezing out social programs, education, and defense.  Therefore, we must do everything we can to bring down costs while improving quality.  At Cleveland Clinic, we have been able to do that by creating a culture of wellness, which promotes personal healthcare accountability and reduces the burden of chronic disease.  A significant component of chronic disease is tobacco use– accounting for one in every five deaths each year in the USA and in North America.

With a mission to heal the sick and cultivate a healthier community, Cleveland Clinic felt it had to encourage wellbeing to combat disease.  To us, supporting a habit that ultimately leads to death would be unethical.  In 2006, we began offering free smoking cessation to our employees; the following year we offered the same to Northeast Ohio (free, absolutely free).  In 2008, we stopped hiring smokers – a natural progression towards building a healthier community.

Self-reported tobacco use by employees showed that the rate of smoking declined from 15.4 to 6 percent, resulting in a savings of $2,000 per year for each smoker who quit – or $7.4 million less in medical expenses from 3,800 fewer smokers.  Savings are passed on to employees through lower health insurances costs.  By ridding our campuses of second-hand smoke, savings for non-smokers equally translate.

Cuyahoga County’s smoking rate decreased by 11.2 percent by 2009, generating a savings of about $260 million every year for our taxpayers and corporations.  Cost-savings such as this allow our community to remain competitive in the marketplace, create jobs, and fund social programs.

In contrast, the largest cost increase in our state (Ohio) that’s  causing the largest need for increased taxes is the removal by the prior Governor of the $40 million for tobacco prevention programs.  Ohio now spends less for tobacco prevention than any other state. As a result, we have gone from 20.2 % smoking rate for adults in our state (similar to the national average) to 25.4% while the rest of the USA has fallen to 19.2%  (CDC data from bi-annual surveys).  That will soon (there is a delay in costs of about 5 years though we have some increased costs now) result in a extra $1.1 billion in health care costs per year for the state of Ohio and our businesses, and taxes required from our citizens.  Yes, smoking is an addiction, but the fact that over 60 million smokers have quit and have stayed tobacco free means we have the ability to help most, if not all, to breath free, and even more possible to motivate many to never smoke.

What can be the incentive for the individual… if better health or more disposable income aren’t enough? The Gallup organization says the greatest feeling of self-worth and the greatest incentive is to have a job.  If the states and federal governments quit hiring smokers, and offered free smoking cessation to everyone they cover for health care, then that would be a strong incentive for the individual to quit or not start. We could take off over $100 billion a year from our health care bill (and maybe much more if you include things like our disability bills) to allow medical care for those who need it most, and to pay for those things we need like education and defense.

As a health system whose inherent mission is to heal the sick and cultivate wellbeing, does it make sense to support a habit that causes chronic disease and ultimately, higher healthcare costs for all?  At Cleveland Clinic, we don’t believe so.

Thanks for reading,

Young Dr. Mike Roizen (aka, The Enforcer)

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

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