Fish Oil Prevents Aging

A study from the American Journal of Medicine demostrates an association between blood levels of Omega 3 fatty acids and a lower rate of DNA ‘wear and tear’.

Antidepressants work…if you really need them

A new meta-analysis was published in the Journal of the American Medical Association that suggests that antidepressants might only be effect for moderate to severe depression.  The study used only studies that used the Hamilton rating system to determine depression severity.

Platelet Rich Plasma Therapy May Not Work

A popular treatment for tendon injuries is still under question as to whether it works or not.  This latest study compared it to salt water injections – another study that suggests that the injects alone may be what is therapeutic, not the actual agent injected.

MMR Vaccine and Autism – The Lancet takes back the 12 year old paper

The Lancet medical journal had finally taken back its 12-year old paper that suggested links between the MMR vaccine and Autism.  The backlash to this article is significant, with authorities considering legal action against the physician responsible for the article.  The avoidance of the MMR vaccine due to fears of Autism has led to an increased incidence of measles infections worldwide.

Is the Jury Still Out on a Low Sodium Diet?

This NYT article talks about the hot debate over whether ‘anti-salt’ campaigns should be increased or decreased.  Too much salt is probably bad, but too little salt is also bad.  For now, keep checking your blood pressure from time to time and watch your salt intake if your numbers start to climb.

Fitter Students do Better on Exams

A group of researchers showed that students who had better cardiorespiratory fitness also did better academically.  Reportedly, more studies need to be done to prove a causal relationship before schools start to bring back physical education into their curriculum.  In the meantime, more than 1/3 of our children are overweight or obese…but, I guess we need more proof!

Stress EKG’s Help, but Who Wants to Pay for it?

Electrocardiograms can save lives in young athletes by alerting them that they may have an unknown heart condition.  Because these heart conditions are fairly rare, screening is not advocated because it would not be cost effective.  If you perform regular, intense physical activity, the test deserves serious consideration.

Interesting Research Ties Appetite to Your Gut Bacteria

Altering the bacteria in your intestines may lead to better digestion, lower appetite, and weight loss…some day.

A Good Review of Reasons to Exercise

Jane Brody of the NYT reviews the scientific evidence that supports the use of exercise for good health.

Vit D – More Evidence

Every month or two another study comes out to reinforce the importance of having adequate Vit D.  This article highlights the mechanisms through which Vit D may be helping to prevent cancer and autoimmune disease.

PSA – Should it be Used to Screen for Prostate Cancer?

The PSA test is costing the US billions of dollars per year with limited success in fighting prostate cancer.  The author of this NYT article does a good job at reviewing the evidence.   Click here to view some of the follow up from this article.

Breast Cancer Screening Works – Rarely

“Evidence now suggests that for every 2,000 women who are screened over 10 years, only one stands to have her life saved by the mammogram program, he said, whereas the risk of getting an unnecessary breast cancer diagnosis is 10 times that”.

Following the adjustments to the recommended screening age for mammography in the US (from 40-50 years of age), some are questioning the use of mammography altogether.

Statins Become Preventive Medicine

The FDA has approved the use of Crestor, a medication used to lower cholesterol, for preventive medicine uses.  It has been long been known that statins can act like anti-inflammatories in the body with can theoretically help to prevent a heart attack or a stroke.  Crestor’s main mechanism of action is to block the body’s production of cholesterol, an essential lipid that the body uses to make cell membranes, hormones, and other things in the body.  Time will tell if this drug will do more harm than good in patients with normal cholesterol levels.

Weak Preventive Medical Screening Policies Lead to Debate

Why is there so much debate about cancer screening tests like the PSA and Mammogram?  Because they don’t seem to be very effective.  So what’s the solution?

Hormone Therapy Protects Against Colon Cancer

Another study confirms that hormone replacement therapies can protect against colon cancer.  Long term users experience over a 50% reduction in cancer rates.

Diet Prevents 40% of Alzheimer’s Cases

A diet rich in fruits and vegetables, olive oil, nuts, seeds and fish is shown to lead to less cases of Alzheimer’s disease.

Processed Meats, not Red Meats are Associated with Cancer

A new harvard study had found an association between eating processed and developing cancer.  The same study was not able to show a significant association between those that ate unprocessed meats like beef, pork or lamb and those that developed cancer.

New to 2010 is Dr Oughtred’s annual health assessment: a comprehensive health assessment that includes a medical assessment, a physical therapy type of assessment, and a fitness and lifestyle assessment. Patients will receive a 15 page booklet outlining and explaining their results, and it comes complete with a comprehensive plan that includes dietary recommendations, supplement and medication recommendations, exercise programs and tips, stretching advice, or recommendations for physical therapies or other hands on techniques.

The center piece of your assessment is the summary page, which quickly displays and colour codes your results alongside your recommended goals for the following year. This page gives you a comprehensive, yet simple ‘snapshot’ of your current state of health and fitness, and can act as a great motivator for the future.

For those of you who have extended medical insurance, your coverage will likely cover you for all, if not part of the assessment.

Assessment overview:

• Review and assessment of your current and past health concerns
• Relevant physical examination
• Orthopedic Assessment (Joint Alignment, Range of Motion, Posture, Strength, Stability)
• Fitness Assessment (Everything from grip strength and body fat to cardiorespiratory fitness and lactate threshold testing)
• Nutritional and Lifestyle Assessment
• Disease Risk Assessment (Framingham score, diet, biometrics, other)
• When indicated, referral to other health professionals, physicians or laboratories.

Your assessment acts like an annual membership, and you will be reminded when you are due for follow ups and important preventive medical screening tests and visits.

For fitness enthusiasts, the process involves measurement of lactate thresholds for precise assessment of endurance over time and selection of future training intensities. For those who want to manage their disease risk over time, the assessment gives you a framingham score, estimating your 10 year risk for developing coronary artery disease. This is the perfect annual health screen for someone who is looking for an executive health assessment with a strong focus on fitness, lifestyle, and athletic performance. Together with the advice and medical testing of your family doctor, your assessment will leave you feeling as though no ’stone is left unturned’ with regard to your health.

Aside from your assessments with your medical doctor, all parts of your annual assessment are performed by Dr Oughtred himself which provides for a 5-star professional experience which you won’t forget. Take the time for your assessment now, and see what new avenues of health open up for you.

Lactate Testing is quickly becoming the preferred test for people that want to assess their aerobic capacity and determine how to make the most of their exercise program. I began to offer lactate testing to all of my patients in 2009 and I have found it effective not only for athletes but also for anyone that wants to take a more precise, deliberate approach to their exercise program.

Testing blood lactates is a relatively new practice in sport that has become popular in the last 10-20 years, especially in sports such as swimming, rowing, speed skating and endurance sports like marathons, triathalons, cycling, etc. At first, even the best trainers in the world were often confused with the use of lactate testing, but over the last 10 years, some consensus seems to have been reached on some topics and experts agree that lactate testing is a superior tool for 3 key purposes:

1 – Measurement of Endurance Performance:

Traditionally the preferred performance test for endurance activities has been the VO2 max test. A drawback to the VO2 max test is that it assesses aerobic power at a maximal intensity over a short period of time – this is not reflective of a true endurance activity which requires a longer duration of activity at a submaximal effort. Other downsides to VO2 max testing is that it can be very expensive (good equipment is very costly) and the devices used to breath in and out of can cause anxiety and discomfort in for the athlete. Aside from the minor discomfort of finger tip blood sampling, lactate testing suffers from none of these drawbacks, and is probably a better performance indicator at submaximal efforts.

2 – Assessment of changes in aerobic fitness over time:

The lactate test measures your lactate levels at many different levels of exertion. As you become more fit, your lactate levels will be lower at each of these individual exertion points; the test demonstrates that you are doing the same amount of work at lower intesities than before. This shift in lactate levels over time is a very sensitive indicator of training adaptation.

3 – A tool to opimize training intensities:

Because lactates can be used to estimate your intensity levels during exercise, it is probably the best method to determine and prescribe future training intensities or ‘training zones’. This is especially useful for fitness professionals so they can avoid overtraining or undertraining an athlete. Learning your ‘Lactate Thresholds’ can essentially make your training more specific to your goals. Whatever your goals, lactates can be used to help get reach them quicker; you can more precisely improve your endurance, your V02 max, your ability to heal and recover, or your ability to burn fat during a workout.

In his book, “The Science of Winning”, Jan Olbrecht talks about how he uses the lactate tests with elite athletes prior to big events in order to properly balance their aerobic and anaerobic systems. Although this use is less popular, it is very enticing; it is hard to argue with the 40 olympic medals that Olbrecht was part of in the Athens Olympics!

Understanding Blood Lactate

Lactate is a byproduct of glucose, or ‘sugar’ in your body. As lactate accumulates during exercise, we can assume that you are using glucose as an energy source. As the intensity of an activity increases, the percentage of energy that comes from glucose will increase, and you will produce more lactate, which can be measured in the blood. At low intensities of exercise, your body uses its aerobic energy systems (using oxygen for energy) which spares glucose and keeps lactate levels low. The more aerobically fit you are, the harder you can push yourself without accumulating lactate. Over time, as you become more aerobically fit, you will be able to achieve higher levels of intensity and keep your lactate levels the same. If we graphed this over time, your lactate curve would shift downwards, and to the right.

As you increase your intensity during exercise, you will eventually overwhelm your body’s ability to recycle or remove lactate from the blood. The highest intensity at which you can create lactate in the body and still remove it from your blood is called your lactate balance point. This is an important intensity to learn, and it has many other names; ‘anaerobic threshold’, ‘lactate threshold’, or just ‘threshold’ are the other most common names used. As you push yourself beyond this intensity, your body’s energy systems will actually become inhibited and your performance will suffer if you hope to perform much longer than 5-8 minutes. Getting to know this balance point is critical for everyone, not just athletes, exceeding your balance point in training could have negative effects to your health, your performance or even your ability to lose body fat.

How Lactate Testing is Done

So what does a blood lactate test look like? The most widely used method involves an endurance test that has incremental increases in intensity. Each stage can be anywhere from 2-5 minutes, and at the end of each stage a small blood sample is taken by a fingerprick and placed into an analyzer. The total test length can vary anywhere from 20-60 minutes, depending on the fitness of the athlete and the length or increments of the stages. Testing is usually performed on a bicycle ergometer or a treadmill.  As stated previously, the test is approximating intensity at all stages, and so it does not require the participant to go ‘all out’, but it does require the participant to go up to at least an 8 or a 9/10 on the exertion scale.

Becoming more popular is the FACT method, which involves an initial staged performance test as outlined above and then follows that up with a another staged approach that is thought to better isolate the balance point between lactate production and removal from the body. I utilize both methods, as I find the traditional method effectively demonstrates fitness adaptations over time and the FACT method is excellent for determining future training intensities or ‘training zones’.

Set Your Targets and Optimize Your Training Time

After your lactate test, you will have objective information from which you can set future targets for improvements. You will also have an outline of your individualized training zones that you can use to effectively target your weaknesses and make the most of your limited training time.

Fish Oils Prevent Vision Loss

Ensuring that you get small amounts of fish oil on a regular basis can decrease your chances of getting age related macular degeneration, according a recent study.

My recommendation for everyone is to take 1-2 tsp of fish oil per day in order to decrease total body inflammation and prevent chronic disease.  Individuals who consume more than 3 servings of fatty, cold water fish per week, probably don’t need to take fish oils.

Its Not Just About Cholesterol

This article discusses another type of blood marker that is used to measure your heart disease risk.

Knowing your risk for heart disease or stroke is about much more than just measuring your cholesterol.  Other significant factors include your blood pressure, blood sugar levels, your waistline and overall body shape, your family history, your physical activity levels, your diet, and your avoidance of risky behaviors like smoking or drinking excessive amounts of alcohol.

More Reasons to Screen for Thyroid

This article talks about the association between longer labors and lower levels or circulating thyroid hormones in women.

Thyroid problems are quite common, they can have many different symptoms depending on the patient, and they often go undiagnosed.

Low Acid Diet for Bone Health

Jane Brody writes an excellent article about the theories and evidence behind eating a low acid diet for healthy bones.  The short version: eat more vegetables, eat less garbage.

Treating Depression Balances Blood Sugar?  Huh?

Diabetic patients treated with antidepressants experienced a 2% drop in HgA1c levels – this is a big drop.  I would take this as a reminder that mental health is very much connected our physical health.

Happiness of your friends, your friend’s friends, and your friend’s friend’s friends can make you happier

A Harvard team was able to demonstrate that when the happiness of your friend increases, it can directly increase your happiness, and in turn improve your overall health.  Not only that, but people you don’t even know that are indirectly associated with you via other people can also affect your state of happiness.  This BBC link has an audio interview with the lead author.

Acupuncture Reported Better than Aspirin for Headaches

A recent study with chronic headaches found that those using acupuncture reported improvement in 65% of patients vs. 40% of those who were taking aspirin.

Television and Video Games Linked to Poor Health in Children

A meta-analysis of over 170 studies publised since 1980 found strong correlations between increased media exposure through television and video games, and obesity, early sexual activity, teen pregnancy, drug use, smoking, and poor academic performance.

During my athletic career, I was impressed by the knowledge and understanding of the physical therapists that helped me.  Unfortunately, I almost always had to be injured before I would benefit from their expertise.  It made no sense to me to wait until I was hurt before addressing my physical weaknesses ; I wanted something more pro-active.  Prehabilitation (prehab) is the act of applying rehab principles to healthy individuals in order to prevent injury and enhance physical performance.

Rehabilitative principles are applied in a step-by-step fashion, to ensure that the body is not forced to do anything that it is not ready for.  I will outline some of these steps, and give you examples of why each could be important to you:

Reduce Pain and Inflammation

Pain or inflammation in a joint causes key muscles to be deactivated, as well leads to patterns of avoidance.  Running with a sore back for instance can train key stabilizing muscles not to work, leading to instability of the back long term, and can cause you to adopt habits that could make you a slower runner in the long term.

Ensure Proper Joint Motion and Stability

Tight ankles, especially one sided, can cause rotation through the entire body, cause unequal wear and tear of joints, overuse of other joints, and poor balance.  Weak hamstring muscles can increase your likelihood of tearing ligaments in your knee.

Efficient Movement and Posture

Your technique when you exercise determines which muscles get strong, which ones stay long and supple, which joints get stressed, and how tired you get.  Anti-inflammatory herbs or medications may help for your knee pain, but if the cause of the knee pain is the way you walk or run, then your pain will always recur.

Notice that none of the above steps have much to do with general fitness; someone can be very strong or fit, and still fail some of these steps.  Every day, people are exercising or performing simple daily tasks with limitations in the above categories, and those seemingly healthy activities can be making them unhealthy.  Don’t wait until you are unsatisfied with your physical health; learn about your physical limitations and what you can do about them right now.

Take a look at this clip which highlights some of the exercises that Mike did during his recent visit with Dr Oughtred, in Vancouver, BC.

Professor Gilbert Welch, MD, wrote a very interesting article in the New York Times recently about the current state of preventive medicine and how it pertains to the US presidential campagnes.

Today, Preventive Medicine should really be called early disease detection.  People are encouraged to come in to see the doctor at various ages in order to make sure they don’t have an illness that they are unaware of.  This approach is effective at detecting some diseases before they are out of control, but it does little to prevent disease and it ends up costing us more money.

In contrast, health promotion prevents disease.  The best preventive medicine involves educating patients (the word doctor means teacher) about how to care for their bodies, eat properly, exercise properly, and encouraging them to adopt healthy lifestyle habits and a positive outlook on life.

So next time you hear someone talking about preventive medicine, you may want to clarify: are they talking about disease detection or are they talking about promoting health so that disease is less likely to occur.

At his medical practice at the Sage Clinic in Vancouver, Dr Oughtred emphasizes health promotion, disease prevention and the enhancement of athletic performance.

St John’s Wort Shown shown to be effective for depression

-The herb St John’s Wort has shown to be better than placebo, comparable to pharmaceutical antidepressants in effectiveness, and has less side effects than standard antidepressant medications.  This from a recent Cochrane review that compared 29 scientific studies with over 5,000 patients.

Ginko may offer protection from the damaging effects of Stroke

-The herb Ginko Biloba, well known for its ability to promote vascular health, has been shown to mitigate the brain damage in mice who have had a stroke.  Researches showed the herb to be effective if used both before or after a stroke.  This recently from the journal, Stroke.

Pregnant women may be gaining too much weight

-A recent study published in the Journal of the American Dietetic Association suggests that habitual dieters and overweight women were more likely to put on too much weight during pregancy.  The authors suggested that these women may be looking at pregnancy as an excuse to eat whatever they want, and should be instructed not to increase their caloric intake during the first trimester of pregnancy.

Topical Antioxidants may Prevent Skin Cancer

-In September’s issue of the American Academy of Dermatology, an antioxidant cream containing Vitamin C, E and ferulic acid prevented skin from burning, an established cause of skin cancer.

More Links Between Low Vit D and MS

-The evidence for supplementing with Vit D is becoming overwhelming.  Now the question is, how much should you take?  Your health care provider can do diagnostic tests as well as functional tests to help you choose your best dose.

Acupuncture More Effective than Medications for Hot Flashes

-Dr. Eleanor Walker and researchers of Henry Ford Hospital in Detroit found that acupuncture was just as effective as medications used to treat hot flashes in breast cancer patients, and the effects lasted longer without the negative side effects.

Eating fish can prevent eczema in children

-A recent finding the British Medical Journal states that fish consumption in children before the age of 9 months is associated with less cases of eczema.  Fish, a common aldult allergen, is often avoided at such an early age in infants because it is thought that allergies to fish could be result in later life.  Whatever the reasons, it appears that small amounts of fish before the age of 1 may be a good idea for your infant.

Do doctors have time for empathy?  Does it improve outcomes?

-The answers are yes, and yes.  This was an interesting article in the New York Times written by a medical doctor, reviewing the benefits of taking short periods to express empathy for their patients in their busy schedule.  This article is a reminder the of the importance of the doctor-patient relationship, and the positive effects that it can have for the health of patients.

Health on the Web

-An interesting article in the New York Times that outlines 6 intersting, online health resources.

Cortisol Levels Linked to Antisocial Behavior

-University of Cambridge researchers have been able to show that teenaged boys who lack the normal surge in the stress hormone cortisol, experience more antisocial behaviors.  This is an interesting finding because Naturopathic Physicians have been marginalized over the years by the medical community for its philosophies and treatment strategies around this hormone.  The idea that the adrenal gland (the main producer of cortisol in humans) could be weak in some patients, seemed to be far fetched.  I look forward to more research on Corticol and behavior.

Aerobic exercise may prevent age related changes in the brain

- The research to support the benefits of exercise continues to mount, this time in support of enhanced cognition and executive function in the aging brain.  With all of the positive research findings for exercise, you would think people would become more active, but that is not the case.  Perhaps some of that research should move toward discovering the best methods to get our society more active; telling people that exercise is good for them is clearly not enough.

In the December 2007 issue of Scientific American, Body, there was an article titled, “The Ultimate Blood Test”.  The article was a review of a new blood test called the Biophysical 250, the most comprehensive blood test available to date.  I was intrigued, and eventually I decided to call Biophysical Corp to learn more about the test.  After a few conversations, I was convinced that this was a test that I would be comfortable offering to my patients.

It’s called the Biophysical 250, because it measures 250 things in your blood, all at once.  For those afraid of having blood drawn, you can rest assured that the test requires only 2 tablespoons of blood.  The test covers blood markers for cancer, heart disease, autoimmune disease, infectious disease, nutritional status, hormonal status, inflammation, blood diseases, osteoarthitis, and organ dysfunction.  Biophysical Corp does not advocate testing anything that there is no treatment for, so they don’t test markers for alzheimers for instance.  Biophysical reports that in a trial of 120 clients who received the Biophysical, 27 clients had a moderate health risk, and another 15 had a major health risk.  The Biophysical 250 can help discover problems before they become problems, and there are many markers that wouldn’t normally be tested for until the disease was already apparent.   Some examples are:

• H-pylori (a bacteria associated with stomach ulcers)
• Autoimmune markers (For lupus, scleroderma, or rheumatoid arthritis)
• Insulin (high insulin levels are thought to precede type 2 diabetes)
• Cancer markers (Breast, Prostate, Colon, Pancreas, Liver, Testicular)
• Ferritin (high ferretin can be assymptomatic, and represents high iron stores, which can be harmful to the body over time)
• Thyroid Markers (thyroid disease is common, and can go a long time before being diagnosed)
• Hepatitis markers

The trouble with waiting until you get a disease, is that you stand the risk of not being able to reverse the disease process once it is diagnosed.  Cancer and autoimmune diseases are classic examples of diseases that have much better outcomes if treated earlier.

The Biophysical 250 does not replace a comprehensive annual health screen with your physician, but for those who can afford it, it can be a great, low risk adjuct to a comprehensive medical assessement for the patient that wants to know more about their existing state of health.

To learn more about the test, visit: http://www.biophysicalcorp.com/ .  The company has also come up with an abreviated version of the test that is priced more competitively, and still screens for several of the same markers.