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Research Isn’t Always Good Science.

Patients often come see me because they are confused about all of the conflicting information they are getting about nutrition. Last week, tomatoes were good. This week, they will make your pancreas explode. Last week, fish were full of mercury and should be eaten only every third Sunday in months with the letter "t" in them. This week, damn the mercury, get those omega 3 fatty acids! It seems that every day there is a new study coming out that conflicts with last week's study.

There are two sources of this confusion. The first is the demands of mainstream news processing and distribution. By the time the media is finished with a useful news item, it has usually been stripped of any valuable content, much like what happens to an ear of corn on its way to becoming a Doritos chip. It is then unsurprising that conflicting information should appear, sometimes stemming from the same study.

The second source of confusion is the frequent poor quality of the research itself. If you have a background in the sciences, and you actually read the articles themselves, rather than the abstract, you often begin to wonder how on earth the authors reached the conclusions that they did.

It is a little bit like looking at a painting and thinking to yourself, "what a beautiful study in yellow I see here," then having the artist walk up and tell you how red the whole thing is. You just have to shake your head and wonder.

Which is exactly what I did when I came across this little gem of an article, "A High-Fat Meal Increases Cardiovascular Reactivity to Psychological Stress in Healthy Young Adults." (Article here.)

At first blush, this is right up my alley. Nutrition, mind/body interaction, cardiovascular disease, gee, I couldn't ask for more out of a journal. And the conclusion was very interesting. "The consumption of high levels of saturated fat over the course of several weeks may lead to exaggerated cardiovascular reactivity," the authors wrote. In fact, "the consumption of a single high-fat meal has been associated with a transient impairment of vascular function."

Translation: A high-fat meal is bad for your heart and arteries.

It would seem to be common wisdom, after all, that's the party line that has been thrown at the public over the past 20 years. But the party line, as we know all too well, is rarely the whole truth.

Comparing junk to junk

Which it turns out, is the case here. The high fat meal consisted of 2 McDonald's hash brown patties, a Sausage McMuffin and an Egg McMuffin. Holy Toledo! But wait -- the "healthy" meal included Kellog's Frosted Flakes, skim milk, Source fat-free yogurt, a Kellogs Fruit Loops Fruit Bar and Sunny Delight orange juice.

In short, both meals were nutritionally unsound. The low-fat meal turns out to be a high-sugar meal, also accompanied by hormones, antibiotics and a cornucopia of chemical additives, most of which have unknown effects on physiology.

Perhaps that did not matter to these investigators. However, were I conducting nutritional research, I would choose a nutritionally balanced and healthy meal as my baseline. All we are doing here is comparing junk to junk.

"All well and good," some might say, "but it still tells us about the effects of fat on the heart."

It actually tells us nothing of the kind. There were no controls in place for any of the following:

1. Hormones, which are known to exist in physiologically effective concentrations in the meat sources used by McDonald's and other fast-food chains;

2. Antibiotics, also present in physiologically effective concentrations;

3. Trans fats and unsaturated fats, which have significantly different cardiovascular effects;

4. Sugar. Although the long-term ingestion of high amounts of sugar eventually lead to ongoing high blood pressure, the immediate effect of eating sugar is to temporarily lower blood pressure.

So not only were the researchers comparing junk to junk, they also failed to control for significantly important nutrients which could influence the outcome, and in particular, chose a baseline meal that would have the effects of exaggerating the outcome of the experiment.

In short, in addition to using junk nutrition, these researchers produced junk science.

Nonetheless, it  will be cited in yet other journal articles as yet more proof that high-fat diets are bad for your health.

When, actually, this research said much and proved nothing.

Infertility

I have been getting a number of requests from people for information on the topic of infertility and treating it with acupuncture. I have helped several patients with fertility treatment, and have done well. But when I looked at the literature, I was surprised to see that the success rate for treatment of infertility was much higher with acupuncture than with standard medical treatment. So I've decided to offer a public lecture on the topic. For more information, go here.

I like medicine. Really.

Honestly, sometimes I get a little tired of having to constantly proclaim that the emperor has no clothes. And I suspect that because I do it so much, many people get the wrong impression of my opinion of mainstream medicine. I don't oppose mainstream medicine, in fact, I'm all for it. For many acute diseases, certainly for trauma care, and for survival through heart attack or stroke, mainstream medicine has no peer. Indeed, I have friends for whom surgery and medicine have permanently transformed their lives for the better.

I'm even friends with a few medical doctors, and I know them to be upstanding, intelligent people with a great deal of integrity, compassion and the desire to help their patients as best they can with the tools that they have.

The problem is that success in acute/critical care has allowed drugs and surgery to become the answers to health problems where they really are not that effective. Daily, research shows us that prevention and elimination of some of our leading killers, as well as the chronic diseases that afflict our society, lies in alterations of diet and lifestyle. And daily, that research is ignored in favor of more drugs, more surgery.

If I had my druthers -- and I'm old enough to recognize that I won't -- I would like to see a tiered healthcare system, where most of the primary care physicians were chiropractic doctors such as myself. Study after study has shown the safety, effectiveness and cost-effectiveness of the techniques we use for a wide variety of disorders, whether it be physical medicine such as adjusting, nutrition and herbal therapy, or acupuncture.

For those patients who don't respond to my form of care, I could then refer them to my medical colleagues for their form of care. Which, although it is riskier, more expensive and may be more invasive, may also be exactly what the patient needs.

There is not a single individual who would not benefit from a health care system so constructed. It would be less expensive. It would be more effective. It would be safer, and medicine would no longer be the fourth leading cause of death in this country. And, slowly, the lifestyle diseases which plague us could be overcome.

Wouldn't that just be the ticket.

Lowering the Bar

Exercise and diets are to me what antidepressants, statins, insulin and beta-blockers are to a medical doctor. They are my most powerful tools for treating the major chronic diseases. In fact, the research demonstrates that for the leading chronic disorders in the U.S., exercise and nutrition should be the first line of treatment. So when a major study about either of those subjects comes out, I'm usually on it like spandex on a cyclist. Thus, when the Centers for Disease Control (CDC) published a report on the prevalence of physical activities among adults in the U.S., I grabbed it. And, at first blush, it paints an amazingly positive picture.

According to this report, between 2001 and 2005, "the prevalence of regular physical activity increased 8.6% among women overall (from 43.0% to 46.7%) and 3.5% among men (from 48.0% to 49.7%)," the study said. In short, almost one-half of all adult males are engaging in regular physical activity.

"Wow," I thought to myself. "That's some incredible progress," and for an all-to-brief moment I glowed with pride at the very small role I have played in that achievement.

But as I thought more about it, these results did not gibe with other epidemiological data. If we are exercising more, why is heart disease still so prevalent? And diabetes? And, for that matter, obesity, where the U.S. population hovers around the 35% mark? If we were, in fact, exercising more, there would be less of each of those diseases; instead, they have increased, dramatically so. Nor is this data consistent with my personal, albeit anecdotal, observations.

So I dug a little bit further. And found, to my horror, what the researchers were defining as "regular physical activity."

According to this study, regular physical activity includes doing "anything that causes some increase in breathing or heart rate" for 10 minutes once per week. Among the examples given were vacuuming. Now, I'm not one for derogating the value, or difficulty, of housecleaning. But I just cannot wrap my mind around the idea that 10 minutes of vacuuming a week could be considered "regular physical activity."

I mean, Holy Cow! By that standard, getting up off the couch during a commercial to get another bag of Doritos qualifies as "regular physical activity" if you have to go upstairs to the pantry to do it!

Vigorous physical activity, according to the study, was self-referentially defined as "10 minutes of vigorous activity" the report said, "such as...heavy yard work."

I must -- must! -- put forward the argument that, when raking leaves has become "vigorous physical activity," something has gone very, very wrong in our perception of things.

There are other problems with the study which limit its utility, but to me, the distorted view of what constitutes physical activity sufficient enough to positively influence health overrides every other consideration.

If we have lowered the bar that far, simply in order to pat ourselves on our overfed backs, then it makes me wonder if this country will ever get back on its feet again health-wise, so to speak.

Based on this superficially reassuring study -- I'm not very optimistic.

Prevent Colds and Flus — Skip the Vaccine

At this time of the year, the get-your-flu-shot sales pitch is in full roar. In fact, the roar is so loud, you can only barely hear the sound of science getting bulldozed in the process.

You can reduce the risk of getting colds and influenza this winter. Unfortunately, getting a flu shot is a bad way to do it. You see, according to the research, the flu shot doesn't really work that well.

Take the elderly population, for example, who are the hardest-hit target of the vaccination sales pitch. According to the popular wisdom, this group is the most susceptible to getting the flu, and also the group most likely to die from the flu. Therefore, everyone over the age of 65 should be getting a flu shot, right?

Wrong. According to the most comprehensive study done to date, flu vaccination does not reduce mortality among the elderly. (Archives of Internal Medicine, Feb. 14, 2005) In other words, the flu shot does absolutely nothing to reduce the risk of death from getting the flu.

That's ok, you say, at least the kids should get it, right?

Well, not really. Again, let's look at the research. The second group being targeted by the drug companies for influenza vaccination are children. But according to the world-respected Cochrane Reviews,  neither spray vaccines nor injected vaccines prevent the flu very well, stating that there is "no evidence that injecting children...with flu vaccines is any more effective than placebo." The study additionally noted that inadequate safety studies have been conducted on the use of influenza vaccines on children.

Do you really want your child to be part of a mass experiment?

Finally, what about healthy adults? Here again, the research is clear. As summarized by the Cochrane Reviews, "there is not enough evidence to decide whether routine vaccination to prevent influenza in healthy adults is effective."

Which is a polite way of saying don't bother.

Interestingly, in comparison, alternative medicine has a number of well-researched, well-documented ways of helping you to avoid winter's infections. To discover what they are, your best bet would be to make an appointment to see your chiropractic physician.

 

Fattening Pharmaceuticals

Last night, I delivered a talk to the Litchfield county chapter of the Connecticut Medical Assistants Society. This is an association of terrific women and men who daily turn your doctor's office into a functioning enterprise. If you think your last visit to a mainstream doctor was bad, try it at an office without the top-notch kind of staff that the CMAS represents. My lecture was titled, rather cleverly I thought, "What's Weighing You Down: Or, what to do when weight loss diets fail."

I think it is abundantly clear that Americans' weight problem sits squarely in our own ample laps. We eat too much, watch too much television, drive too much and exercise too little. The majority of the overweight population would see a significant reduction if they took the following simple steps:

1. Unplug the television. Take it to the attic, basement or garage or town dump and don't bring it back for six months.

2. Spend 1/2 of the time you spent lollygagging in front of the television in some form of physical activity. Walk, run, stretch, jog, do yoga, bench press with a can of peas -- I don't care, just move.

3. Do not drive your car for any trip under two miles. Walk or bicycle. You've got plenty of time, now that you aren't turning your brain into jelly in front of the television.

4. Spend the remaining extra time you've gained preparing home-cooked, nutritious meals. From fresh, raw ingredients.

(To those enquiring minds who want to know: Yes, I follow my own guidelines).

Even if you do 3 out of 4, you are almost guaranteed to lose weight. I say almost, because there are many people for whom some confounding factor is inhibiting their best efforts to shed pounds. Many of them end up in my office, and over the years, I have been able to pinpoint some common causes.

However, there is one cause of intractible weight gain that is consistently overlooked and ignored. For one simple reason: Too many people would stand to lose too much money if it became widely known that obesity is frequently a result of prescribed medications.

It is a somewhat horrifying reality, at least to me, to know that 45% of all Americans have taken a prescription drug in the past month.

And when you look at the top 10 classes of drugs prescribed, every single one of them is for a problem whose first-line treatment should be non-pharmaceutical.

The top ten on your friendly pharmaceutical hit list are:

1. Antidepressants 2. Non-Steroidal Anti-Inflammatories (e.g. Tylenol, Ibuprofen) 3. Antiasthmatics 4. Blood pressure control 5. Cholesterol control 6. Antihistamines 7. Stomach acid control 8. Antiarthritics 9. Blood sugar control 10. Non-narcotic analgesics

So, let's do a quick breakdown. These 10 drugs represent about 90 percent of the drugs that 45 percent of the population is taking. And every single one of these drugs can cause weight gain as a side effect. (I find it particularly interesting that drugs used for diabetes treatment cause weight gain; an excellent example of the often muddle-headed logic that clouds much medical thinking).

Granted, not everyone taking one of these drugs will experience this side effect. But the enormous number of people involved makes it a sure bet that a significant portion of the American population is overweight as a direct result of the drugs that they are taking.

Odds are you won't see that critical piece of information in the mass media anytime soon.

But what's important is that you know it. And you probably know somebody who has exactly this problem -- whether they realize it or not.

So pass the word. Odds are that with the help of an alternative medicine physician such as a chiropractor, they can find a way to manage their disorder without using drugs. And they could lose weight at the same time.

On Being A Quack

The patient sat in front of me and told me her story. It took quite a while, thirty minutes, in fact, but that wasn't unusual for a patient's initial visit in my office. You see, I'm a quack.

At least that was the term applied to me and my chiropractic colleagues by the American Medical Association, until we took them to court in the 1970s and won an anti-trust lawsuit.

Today, the AMA isn't allowed to brand chiropractic physicians with such epithets. But, as with all forms of illogical bigotry, it will take a few generations before the stain which mainstream medicine painted on us begins to fade. Even today, we have misguided individuals branding our care as “dangerous,” when in fact, no procedure taking place in the chiropractic doctor's office is even as dangerous as taking an over-the-counter painkiller.

So, to many people, I'm still a quack. Which is why it took so many patients, such as the one in front of me today, so long to tell me their stories. Because of the anti-chiropractic sentiment fostered by mainstream medicine, I was the last of a very long list of doctors that she had seen.

On the Medical Merry-Go-Round

As she had trudged from one (medical) doctor to the next, undergoing ever more expensive diagnostic procedures and treatments, her condition simply worsened.

By the time she reached me, she was not only sick, but sick of being sick. And resigned to the fact that she would always be sick, as the last few of her high-powered, high-priced specialists advised her.

The fact of the matter was that this patient's symptoms began to take on a familiar shape to me. Although her primary complaint was gastrointestinal, I began to interject questions about her allergies, her fatigue, her depression. As she finished, I had a pretty good idea of what might be going on.

My examination of her did not take that long. I needed to rule out a couple of possible diagnoses that her previous doctors should also have ruled out. But I've been in practice long enough to not make assumptions like that.

So I poked and prodded, measured and weighed, listened and provoked various body parts and organs, just like mainstream doctors used to do before they were seduced by HMOs into selling their patients short.

After her exam, I told the patient I wanted to do a single laboratory test. She said she had already had all the tests that there were. She said she did not want to pay for it, because insurance would not. We discussed it.

I knew she had never had this test before, because I know of no medical doctors who have the necessary training to even interpret the results. Finally she agreed.

Two weeks later, I got the test results back. I called the patient.

No Drugs Required

“I know what's wrong with you,” I said, “and I think we can fix it.” We set up an appointment during which I outlined some dietary changes, recommended an herb, and suggested some nutritional supplements.

Three weeks after beginning her treatment, her symptoms, years in the making, began to disappear. Two months later she was symptom-free. She was amazed. I didn't think that much about it; I've treated the same problem hundreds of times, and usually get  similar results.

Of course, her insurance covered none of the examination, treatment or lab test, even though the total cost of her entire course of care at my office was less than it would cost to say hello to the receptionist at one of those high-powered specialist offices.

A Shameful Secret

Studies have found that when chiropractic physicians are their primary care providers, patients end up less dependent on drugs and surgery. Under the care of a chiropractic physician, the studies show, patients become healthier while their health care costs go down.

But as the debate regarding universal health insurance picks up steam in many states around the country, the twin benefits of improved health and decreased costs offered by chiropractic physicians gets lost.

It's the shameful secret that the AMA tried for so many years to keep hidden. And the secret the drug companies today don't want you to know.

This patient, and many others, see me as a lifesaver. But to the pharmaceutical companies, insurance companies, and most mainstream doctors, I'm a quack.

And damn proud of it.

Career Day Chiropractic

I wrote this handout for a recent career day I was asked to attend. The children were all very interested, and it was gratifying to see that many of them had seen a chiropractor for their health problems.

What Is A Chiropractor?

A chiropractor, or chiropractic doctor, is a primary care physician who uses spinal adjustments, nutrition and herbs and other methods to help your body heal from injuries or illness. Chiropractic is the second largest form of health care in the U.S., and chiropractors are the only doctors who have chosen not to prescribe drugs. They prefer to use all-natural methods that have been proven both through research and centuries of use.

Chiropractic doctors examine how their patients move and walk to help their patients get out of pain. They do physical exams to find problems before they become worse and to make sure their patients can play on a sports team or drive safely.

Chiropractic doctors also use laboratory tests, x-rays and other tests to diagnose their patients' problems. Many patients prefer chiropractic care because it is very safe and has few side effects.

A Chiropractic Education

The chiropractic doctor's education is very similar to a medical doctor's education. Both types of doctors usually have a bachelor's degree before they are admitted to chiropractic or medical school. And for the first two years, the education of a chiropractic doctor is identical to that of a medical doctor.

After the first two years, each type of doctor begins to focus on their core skills. While the medical doctor begins to learn about drugs and surgery, the chiropractic doctor begins to learn how to adjust the spine and other joints, and learns about nutrition in taking care of patients. Then the chiropractic doctor does an internship, where he begins treating patients under the supervision of an experienced doctor.

Chiropractic doctors love to help people. They get to see people go from being very sick or in pain to being healthy again. Most chiropractic doctors own their own practices or work in a small group with 1 or 2 other doctors. Some chiropractors are on staff at hospitals.

Many chiropractors get additional education to become specialists in certain fields or techniques. Chiropractic specialties include pediatrics (treating children), sports medicine, orthopedics (bone and joint problems), internal medicine, clinical nutrition and acupuncture.

Chiropractors may work long hours, and have to be “on call,” or constantly available to speak to patients. As primary care doctors, they will see patients for most of their lives. Helping patients live healthier lives is one of the chiropractic doctor's greatest rewards.

Zyprexa Boasts 28,500 Victims

Zyprexa Maker Eli Lilly Settles with 28,500 victims for $1.2 Billion to date: Since Zyprexa's introduction in 1996, Eli Lilly has paid out $1.2 Billion--yes, that's Billion--in settlement claims to a whopping 28,500 victims of the drug's major and life-threatening side effects including high blood sugar, weight gain and diabetes. But with annual sales of $4.2 Billion, $100 million a year in claim payouts doesn't worry Lilly. What does worry the drug company is the incriminating, image-tarnishing evidence used in these trials that has been made public despite lawyer protective orders and confidentiality agreements signed by victims.

Novartis to release banned drug in U.S.

Another one bites the dust: Australia's drug regulators have banned the Novartis drug Prexige because of severe liver-related side effects, including two deaths--possibly a third--and two transplants. Patients were advised to stop taking Prexige, a COX-2 inhibitor, immediately. Novartis said it would comply with the authority's decision but that it felt the benefits of Prexige still outweigh its risks. The drug isn't yet approved for use in the U.S. and Novartis says it still intends to apply to market Prexige here. However, Prexige is already facing an uphill battle because of the COX-2 taint; Prexige is only the latest in a series of COX-2 inhibitors to fall under post-market scrutiny. And the Australian's ban is another link in a chain of pain for Novartis, which had to withdraw its bowel drug Zelnorm in March.

Chiropractic Primary Care Better Than MD

I will guarantee you that you will not hear about the following research on any of the news channels. Nor will you read about it in the New York Times, the Washington Post, or the Hartford Courant for that matter. But anyone who is not a chiropractic patient should know this. According to a recently-published, 7-year study, if your primary care physician is a chiropractor, you are less likely to need surgery; you are less likely to need drugs; and your health care will cost less. And it is not a small difference. Patients of primary care chiropractors required 85% fewer drugs. They had 60% fewer hospitalizations. If any of these patients did require hospitalization, their stay was reduced by 59%.Those are phenomenal numbers. And the study sample wasn't small. The study encompassed seven years and included more than 70,000 patient-months.

In a country that is searching for ways to reduce health care costs, you would think that this study would be Big News. Look at it this way:

If private and public health care policies encouraged the use of chiropractic doctors, rather than disparaging chiropractic care, the savings would amount to $112 Billion every year. And that's only in the savings resulting from decreased dependence on prescription drugs.And that is precisely why you won't see this reported in any major news outlet. Just take a look through any magazine, from Newsweek to Prevention, and count up the number of pages of drug ads. That alone pretty much tells you who controls the health news agenda -- and it isn't chiropractic.

The idea that chiropractic physicians should be primary care physicians is not exactly a new idea. In the first 60 years of our existence, that is exactly the role we filled throughout the country.

It has only been over the past 30-40 years that we have been pigeonholed into "back and neck" doctors. But the research is in and the facts are clear. If you want better primary care at lower cost--call your chiropractic physician today!