Curing Insomnia Without the Pills

Better sleep doesn’t have to come in a pill.

For people with chronic insomnia, studies show that simple behavioral and psychological treatments work just as well, and sometimes better, than popular medications, according to a report in The Journal of Family Practice.

The medical journal Sleep last year reported on five high-quality trials that showed cognitive behavioral therapy helped people suffering from insomnia fall asleep sooner and stay asleep longer. Another American Journal of Psychiatry analysis of 21 studies showed that behavioral treatment helped people fall asleep nearly nine minutes sooner than sleep drugs. In other measures, sleep therapy worked just as well as drugs, but without any side effects.

The behavioral strategies for better sleep are deceptively simple, and that’s one reason why many people don’t believe they can make a difference. One of the most effective methods is stimulus control. This means not watching television, eating or reading in bed. Don’t go to bed until you are sleepy. Get up at the same time every day, and don’t nap during the day. If you are unable to sleep, get out of bed after 15 minutes and do something relaxing, but avoid stimulating activity and thoughts.

So-called sleep hygiene is also part of sleep therapy. This includes regular exercise, adding light-proof blinds to your bedroom to keep it dark and making sure the bed and room temperatures are comfortable. Eat regular meals, don’t go to bed hungry and limit beverages, particularly alcohol and caffeinated drinks, around bedtime.

Finally, don’t try too hard to fall asleep, and turn the clock around so you can’t see it. Watching time pass is one of the worst things to do when you’re trying to fall asleep.

It may be hard to believe, but studies show these simple steps really do make a meaningful difference for people with sleep problems. These interventions are based on the notion that thoughts and behaviors can “hyper-arouse” the central nervous system and deregulate sleep cycles, resulting in chronic insomnia, reports Family Practice.

If these steps don’t work, talk to your doctor about a referral to a sleep therapist, who can also teach you additional relaxation techniques to help bring on sleep. Sometimes, a therapist might work with you to reset your sleep-wake schedule, a more involved process whereby patients adjust their bedtime each night over the course of a few weeks.

Thousands of Future Doctors Say No to Big Pharma

About 90 percent of the pharmaceutical industry’s $21 billion marketing budget is directed at physicians, according to JAMA. There are more than 90,000 pharmaceutical representatives that visit U.S. physicians, providing free lunches, gifts, marketing paraphernalia and free medication samples. These enticements are designed to influence doctors to prescribe more drugs and more expensive drugs and have often become a substitute for objective medical evidence.

Launched in 2002, AMSA’s PharmFree Campaign encourages medical schools and academic medical centers to develop policies that limit the access of pharmaceutical company representatives to their campuses and prohibit medical students and physicians from accepting gifts of any kind from these representatives. In May 2007, AMSA released its PharmFree Scorecard, which was a first-of-it’s-kind ranking of medical schools according to their pharmaceutical influence policies. Of all the medical schools in the United States, five received a grade of “A,” which translates into comprehensive school policy that restricts pharmaceutical representatives to both the medical school campus and its academic medical centers. Forty schools received an “F” for their lack of policy.
Sources:

* American Medical Student Association

Are Artificial Joint Makers Bribing Doctors?

The hips and knees are synthetic, but it's real money changing hands. Five makers of artificial joints have paid more than $200 million this year to doctors and hospitals, often the same ones who are deciding which company's joints to buy, according to an Associated Press calculation of disclosures required this week by a settlement with federal prosecutors.

The five companies were scrutinized by the U.S. attorney's office in New Jersey over allegations they gave money and trips to surgeons who used their products. Four of them -- Biomet Inc., DePuy Orthopaedics Inc., Smith & Nephew Inc. and Zimmer Holdings Inc. -- had their charges dropped when they paid a total of $310 million in fines and agreed to monitoring in a settlement announced in September. The fifth company, Stryker Corp., was never charged and paid no fines but agreed to disclose its payments.
Sources:

* The Washington Post November 2, 2007

The Stem Cell and Autism Connection

What are stem cells?
Stem cells are primal cells that can divide and differentiate to
become like any other more specialized cells in your body. The three
types of stem cells are embryonic stem cells, adult stem cells and
cord blood stem cells.
Embryonic stem cells are the most controversial because they are
harvested from human embryos, while the other stem cells can be
obtained from adult tissue or from the umbilical cord and placenta of
newborn babies and their mothers without damage to them.
Why use stem cells for children with autism?
Children with autism suffer from two major conditions:
1. Hypoperfusion
2. Immune dysregulation
Hypoperfusion is decreased blood flow to the brain, meaning that the
brain does not receive enough oxygen and cannot function normally.
Any time there is not enough blood flowing to the brain, the brain
cells become inflamed and make more nitric oxide. This opens up the
cells to receive too much calcium, which damages the mitochondria
(that make the energy for cells). As a result, the brain cells die
from lack of food.
Immune dysregulation in children with autism means that their immune
systems do not respond normally to stimulation. When the body signals
to the immune system that it needs help (like when the brain becomes
inflamed) the proper immune response and subsequent healing do not
occur in children with autism.
Instead, children with autism often have continually suppressed
immune systems, chronic inflammation and suffer from autoimmune
responses.
An autoimmune response happens when your body does not recognize your
cells as your own and actually attacks the good cells. Autoimmune
disorders include Crohn's disease and multiple sclerosis, in addition
to autism.
Immune dysregulation is very apparent in the gastrointestinal health
of children with autism.
Most suffer from symptoms ranging from diarrhea, gas, and bloating to
intestinal lesions and inflammation of their gastrointestinal system.
Researchers have discovered that two kinds of stem cells can
specifically address the hypoperfusion and immune dysregulation that
are characteristic of children with autism.

The Stem Cell Therapy - Autism Theory
Dr. Fabio Solano has used CD34+ stem cells from cord blood and
mesenchymal stem cells (MSC) as a successful autism treatment.
Cord blood CD34+ stem cells injected into the patient improve blood
flow to the brain, which supplies the brain with more oxygen and
results in improved central nervous system functioning.
Mesenchymal stem cells are used to heal immune dysregulation in
people with Crohn's disease and can also suppress the inflammation in
children with autism and address their fundamental immune abnormality.
Using these two kinds of stem cells together can heal both the brain
and the gut for a unique treatment that has great potential!
To learn more about the research that Dr. Leonard Smith and his
colleagues performed, go to the Journal of Translational Medicine to
read Stem Cell Therapy for Autism.

Leonard Smith, M.D., is a renowned gastrointestinal, vascular and
general surgeon as well as an expert in the use of nutrition and
natural supplementation. His research on stem cell therapy as an
autism treatment is ground breaking, but he still believes that it is
only one part of conquering the autism epidemic. Donna Gates and Dr.
Leonard Smith are teaming up to create a better solution for autism
that combines stem cell therapy with a healing Body Ecology diet and
lifestyle program.

Patricia vs. Autism
Dr. Fabio Solano regularly treats patients with CD34+ stem cells and
mesenchymal stem cells.
In fact, you can see the progress of one of his young patients on
YouTube! Patricia Cabrera is a young girl who has had successful stem
cell therapy to treat autism.
Under the supervision of Dr. Solano, her healing is remarkable, and
her verbal and interpersonal skills visibly improve. For Patricia and
other patients, stem cell therapy is an amazing solution that offers
hope for a normal life.
Is stem cell therapy a viable autism treatment?
Stem cell therapy appears to be a safe way to treat autism, though it
does take several treatments over the course of a year and may not be
covered by insurance.
Stem cell therapy does have the potential to help a large number of
children with autism; however, it is a major intervention, and
children with autism need to be healthy from the inside out.
As Dr. Smith says, "Stem cell therapy is the dessert, not the main
course," and nutrition and lifestyle should support optimal health.
Indeed, autism is a complex disorder, with complex causes. Even
doctors are not sure exactly why it happens.
I believe that a subset of children have genomic variations in their
detoxification pathways as well as serious immunologic issues. In
addition, children whose mothers had candida, viruses or heavy metal
toxins in their blood during pregnancy pass those issues on to their
children. Then, these children with already weak immunity are exposed
to toxins through vaccinations.
Exposure to candida, viral infections and heavy metals puts some
children more at risk, and with the continual environmental and
dietary toxins in our modern world, we are seeing more and more
neurological disorders in both children and adults.
To learn more about the causes of autism read
The Root Causes of Autism: A Supposed Mystery That is Not So
Mysterious
Fortunately, the human body is very flexible, and autism does not
happen to everyone. I do believe that we can heal this condition,
from the inside out.

Is Your Appendix Really a Useless Organ?

Your appendix, long touted by doctors to have no apparent purpose, turns out to be good for something after all. Surgeons and immunologists from Duke University Medical School believe your appendix produces and protects the good bacteria in your gut.

There are more bacteria in your body than cells, and much of it is used to help you digest food. However, if your good bacteria dies, as the result of cholera or dysentery for instance, your appendix appears to restore good bacteria to your gut.

Your appendix acts like a “bacteria factory” that “cultivates good germs,” according to the study’s authors.

They pointed out that this function is not needed in industrialized society, because if your gut flora dies you can easily repopulate it with germs from other people. In the past, however, the appendix came in handy when disease epidemics affected entire regions, and the good bacteria was not easy to repopulate.

In modern times, appendixes may still be useful in less developed countries.

If your appendix becomes infected, it can lead to death, which is why surgeons have removed them routinely for generations. Even with the new theory for your appendix’s purpose, the researchers said you should have yours removed if it becomes inflamed.

About 300 to 400 Americans die, and about 321,000 are hospitalized, due to appendicitis each year, according to the Centers for Disease Control and Prevention.

Cut Sugar and Supplements -- and Live 15 Years Longer?

Restricting the simple sugar glucose from your diet, while avoiding vitamin supplements, may extend your lifespan, according to German researchers.

While your body needs glucose, a sugar found in high amounts in sweets, too much of it is harmful.

When the researchers used a chemical to block worms’ ability to process glucose, their lifespan was extended by up to 25 percent, which is equal to 15 human years.

The beneficial effect came from an unlikely source: free radicals. Typically, free radicals are thought to cause damage to your body, and many consume antioxidants and vitamins to fight them.

However, when the worms were unable to use glucose for energy, they increased energy power from other cells -- a process that generated more free radicals than normal.

In response, the worms generated enzymes that fought the free radicals and strengthened their long-term protection against the damaging molecules.

The study also points to a reason why antioxidants may not be beneficial in the long run.

When some of the worms were given antioxidants, the free radicals were neutralized. However, this also prevented the worms from generating the beneficial, long-term defenses.

Cell Metabolism October 2007, Vol 6, 280-293, 03

Reuters October 2, 2007

Diet and Fat: A Severe Case of Mistaken Consensus

In 1988, the surgeon general, C. Everett Koop, proclaimed ice cream to a be public-health menace right up there with cigarettes. Alluding to his office’s famous 1964 report on the perils of smoking, Dr. Koop announced that the American diet was a problem of “comparable” magnitude, chiefly because of the high-fat foods that were causing coronary heart disease and other deadly ailments.

He introduced his report with these words: “The depth of the science base underlying its findings is even more impressive than that for tobacco and health in 1964.”

That was a ludicrous statement, as Gary Taubes demonstrates in his new book meticulously debunking diet myths, “Good Calories, Bad Calories” (Knopf, 2007). The notion that fatty foods shorten your life began as a hypothesis based on dubious assumptions and data; when scientists tried to confirm it they failed repeatedly. The evidence against Häagen-Dazs was nothing like the evidence against Marlboros.

It may seem bizarre that a surgeon general could go so wrong. After all, wasn’t it his job to express the scientific consensus? But that was the problem. Dr. Koop was expressing the consensus. He, like the architects of the federal “food pyramid” telling Americans what to eat, went wrong by listening to everyone else. He was caught in what social scientists call a cascade.

We like to think that people improve their judgment by putting their minds together, and sometimes they do. The studio audience at “Who Wants to Be a Millionaire” usually votes for the right answer. But suppose, instead of the audience members voting silently in unison, they voted out loud one after another. And suppose the first person gets it wrong.

If the second person isn’t sure of the answer, he’s liable to go along with the first person’s guess. By then, even if the third person suspects another answer is right, she’s more liable to go along just because she assumes the first two together know more than she does. Thus begins an “informational cascade” as one person after another assumes that the rest can’t all be wrong.

Because of this effect, groups are surprisingly prone to reach mistaken conclusions even when most of the people started out knowing better, according to the economists Sushil Bikhchandani, David Hirshleifer and Ivo Welch. If, say, 60 percent of a group’s members have been given information pointing them to the right answer (while the rest have information pointing to the wrong answer), there is still about a one-in-three chance that the group will cascade to a mistaken consensus.

Cascades are especially common in medicine as doctors take their cues from others, leading them to overdiagnose some faddish ailments (called bandwagon diseases) and overprescribe certain treatments (like the tonsillectomies once popular for children). Unable to keep up with the volume of research, doctors look for guidance from an expert — or at least someone who sounds confident.

In the case of fatty foods, that confident voice belonged to Ancel Keys, a prominent diet researcher a half-century ago (the K-rations in World War II were said to be named after him). He became convinced in the 1950s that Americans were suffering from a new epidemic of heart disease because they were eating more fat than their ancestors.

There were two glaring problems with this theory, as Mr. Taubes, a correspondent for Science magazine, explains in his book. First, it wasn’t clear that traditional diets were especially lean. Nineteenth-century Americans consumed huge amounts of meat; the percentage of fat in the diet of ancient hunter-gatherers, according to the best estimate today, was as high or higher than the ratio in the modern Western diet.

Second, there wasn’t really a new epidemic of heart disease. Yes, more cases were being reported, but not because people were in worse health. It was mainly because they were living longer and were more likely to see a doctor who diagnosed the symptoms.

To bolster his theory, Dr. Keys in 1953 compared diets and heart disease rates in the United States, Japan and four other countries. Sure enough, more fat correlated with more disease (America topped the list). But critics at the time noted that if Dr. Keys had analyzed all 22 countries for which data were available, he would not have found a correlation. (And, as Mr. Taubes notes, no one would have puzzled over the so-called French Paradox of foie-gras connoisseurs with healthy hearts.)

The evidence that dietary fat correlates with heart disease “does not stand up to critical examination,” the American Heart Association concluded in 1957. But three years later the association changed position — not because of new data, Mr. Taubes writes, but because Dr. Keys and an ally were on the committee issuing the new report. It asserted that “the best scientific evidence of the time” warranted a lower-fat diet for people at high risk of heart disease.

The association’s report was big news and put Dr. Keys, who died in 2004, on the cover of Time magazine. The magazine devoted four pages to the topic — and just one paragraph noting that Dr. Keys’s diet advice was “still questioned by some researchers.” That set the tone for decades of news media coverage. Journalists and their audiences were looking for clear guidance, not scientific ambiguity.

After the fat-is-bad theory became popular wisdom, the cascade accelerated in the 1970s when a committee led by Senator George McGovern issued a report advising Americans to lower their risk of heart disease by eating less fat. “McGovern’s staff were virtually unaware of the existence of any scientific controversy,” Mr. Taubes writes, and the committee’s report was written by a nonscientist “relying almost exclusively on a single Harvard nutritionist, Mark Hegsted.”

That report impressed another nonscientist, Carol Tucker Foreman, an assistant agriculture secretary, who hired Dr. Hegsted to draw up a set of national dietary guidelines. The Department of Agriculture’s advice against eating too much fat was issued in 1980 and would later be incorporated in its “food pyramid.”

Meanwhile, there still wasn’t good evidence to warrant recommending a low-fat diet for all Americans, as the National Academy of Sciences noted in a report shortly after the U.S.D.A. guidelines were issued. But the report’s authors were promptly excoriated on Capitol Hill and in the news media for denying a danger that had already been proclaimed by the American Heart Association, the McGovern committee and the U.S.D.A.

The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the food industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.

With skeptical scientists ostracized, the public debate and research agenda became dominated by the fat-is-bad school. Later the National Institutes of Health would hold a “consensus conference” that concluded there was “no doubt” that low-fat diets “will afford significant protection against coronary heart disease” for every American over the age of 2. The American Cancer Society and the surgeon general recommended a low-fat diet to prevent cancer.

But when the theories were tested in clinical trials, the evidence kept turning up negative. As Mr. Taubes notes, the most rigorous meta-analysis of the clinical trials of low-fat diets, published in 2001 by the Cochrane Collaboration, concluded that they had no significant effect on mortality.

Mr. Taubes argues that the low-fat recommendations, besides being unjustified, may well have harmed Americans by encouraging them to switch to carbohydrates, which he believes cause obesity and disease. He acknowledges that that hypothesis is unproved, and that the low-carb diet fad could turn out to be another mistaken cascade. The problem, he says, is that the low-carb hypothesis hasn’t been seriously studied because it couldn’t be reconciled with the low-fat dogma.

Mr. Taubes told me he especially admired the iconoclasm of Dr. Edward H. Ahrens Jr., a lipids researcher who spoke out against the McGovern committee’s report. Mr. McGovern subsequently asked him at a hearing to reconcile his skepticism with a survey showing that the low-fat recommendations were endorsed by 92 percent of “the world’s leading doctors.”

“Senator McGovern, I recognize the disadvantage of being in the minority,” Dr. Ahrens replied. Then he pointed out that most of the doctors in the survey were relying on secondhand knowledge because they didn’t work in this field themselves.

“This is a matter,” he continued, “of such enormous social, economic and medical importance that it must be evaluated with our eyes completely open. Thus I would hate to see this issue settled by anything that smacks of a Gallup poll.” Or a cascade.

Amazing New Research on the Progression of Scoliosis

It isn't often that anyone, even a doctor, gets emotional over a research paper, but a very recent study published in the highly-prestigious & internationally recognized scientific journal Spine at the beginning of this month may very well stir the souls of those who understand the importance of what these incredible scientists & doctors have done.

The study, entitled, "Natural History of Progressive Adult Scoliosis," aims to establish a clear prognosis for individuals living with scoliosis. Research on this topic up to this point has been discordant, even contradictory, leaving people living with scoliosis without a clear answer to the question, "Will my scoliosis get worse?" This new study examined 51 patients over a span of 27 years, and introduced the ground-breaking new concept of different "types" of scoliosis. The first type, Type A, developed an abnormal rotatory subluxation (misalignment) of the spine during the onset of scoliosis. In the words of the authors, "Type A corresponds to adolescent scoliosis which continues to progress after skeletal maturity at a rate specific to each curve." In the second type, Type B, the rotatory subluxation was found to develop prior to the onset of scoliosis, and the rate of progression was much higher in this incidence. Type B was described by the authors as, "a degenerative scoliosis, which progresses late in adulthood: either a pre-existing stable adult scoliosis that progresses late or a de novo late-onset scoliosis." (De novo is Latin, meaning "new.") There was also a subgroup of Type B that was found to progress at menopause. In all cases, however, the rate of progression was found to be linear - that is, it could be predicted on a graph in a straight line.

What is the relevance of this new information? First, even if your scoliosis stabilized after adolescence, that is no guarantee that it will not begin to progress again in adulthood. Second, the aforementioned rotatory subluxation appears to cause this late-progression in previously stable scoliosis cases, although menopause may also be a contributing factor in some regard. Third, and perhaps most importantly, it is possible to establish an individual prognosis for each scoliosis case, and predict its progression, with much greater accuracy than was previously believed.

The graphs demonstrating the linear progression of scoliosis, as well as the complete text of this article, are available at:

http://www.medscape.com/viewarticle/558628_print

Backpacks & Scoliosis

Backpacks & Scoliosis

Although this may seem like a rather mundane topic, one might be surprised at the amount of research that has been conducted on the effect of heavy loads carried in a backpack by people with scoliosis. While standard recommendations state that the amount of weight carried in a backpack should not exceed 10% of the person's body weight, the research concludes that this may not apply to students living with scoliosis. Loads as small as 5% of the person's weight, less than half of the typical load limit, were found to have a significant, negative effect upon the compression of the spine, and also on the functions of the heart & lungs. This occured even in patients with mild scoliosis (Cobb angles of 10-25 degrees).

This information should be particularly relevant to parents of students with scoliosis. Schoolgoing patients treated by CLEAR-certified doctors are provided with a doctor's note that they provide to their school authorities, specifically stating that the patient must have two sets of books - one for use at studying at home, and one to be stored in their locker at school (the only other option, using a rolling suitcase, seems to be much more popular at airports than at educational institutions).

New England Journal of Medicine review concludes vitamin D deficiency is common yet preventable

The July 19, 2007 issue of the New England Journal of Medicine published a review authored by renowned vitamin D expert Michael Holick, MD, PhD, which concluded that vitamin D deficiency is widespread although easily prevented. An estimated 1 billion people have levels of the vitamin that are either insufficient or deficient.

Dr Holick, who is a professor of medicine, physiology, and biophysics, and director of the General Clinical Research Center at Boston University School of Medicine and Director of the Bone Healthcare Clinic at Boston Medical Center, introduces his subject by stating that “rickets can be considered the tip of the vitamin D deficiency iceberg.” While reduced levels of the vitamin in utero and childhood can cause growth retardation, skeletal deformities and increased hip fracture risk later in life, a deficiency in adults can result in osteopenia, osteoporosis, muscle weakness, fractures, autoimmune diseases, infectious diseases, cardiovascular disease, and some cancers.

Having insufficient vitamin D means that only 10 to 15 percent of calcium and 60 percent of the phosphorus we consumed are absorbed. Diminished absorption of these minerals is reflected in low bone mineral density, which is associated with fractures, decreased muscle strength, and falls. Individuals living at higher latitudes whose skin is unable to produce adequate amounts of vitamin D have been found to be at greater risk of Hodgkin’s lymphoma, colon, pancreatic, prostate, ovarian, breast, and other cancers.

Fortification of dairy products with vitamin D has helped lower the incidence of rickets, yet Dr Holick believes the current recommended Adequate Intakes for vitamin D need to be increased to at least 800 IU vitamin D3 per day. Greater amounts are needed to treat deficiency states or specific conditions.

“Providing children and adults with approximately at least 800 IU of vitamin D3 per day or its equivalent should guarantee vitamin D sufficiency unless there are mitigating circumstances, he writes. “Unless a person eats oily fish frequently, it is very difficult to obtain that much vitamin D3 on a daily basis from dietary sources. Excessive exposure to sunlight, especially sunlight that causes sunburn, will increase the risk of skin cancer. Thus, sensible sun exposure (or ultraviolet B irradiation) and the use of supplements are needed to fulfill the body’s vitamin D requirement,” he concludes.