September 24, 2002 [Volume 3, Issue 19]

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In this issue of To Your Health:

• Which Activities Cause Your Kids Pain?
• Folate Is First-Rate
• More Side Effects in Newer Drugs
• Light at the End of the Tunnel?

Which Activities Cause Your Kids Pain?

Have your kids ever complained to you about persistent neck or shoulder pain? More than one in 10 adolescent boys, and one in five girls, suffer from long-term neck and shoulder symptoms; some data suggests that these problems may appear in more than half of adolescents. The repetitive movements involved with playing musical instruments, working, and participating in sports have been considered possible causes of these conditions.

On three occasions, each spaced six months apart, researchers collected data from approximately 500 adolescents in Montreal, Canada, regarding musculoskeletal health and participation in various activities. The students, all in grades 7-9, were assessed for neck or upper-limb (including upper back, shoulders, and arms) pain occurring at least weekly in the preceding six months.

Upper-limb pain appeared weekly in almost one-third of the students. Risk factors that increased the likelihood for neck/upper-limb pain were involvement in childcare (more than doubled risk); holding a job (nearly doubled risk); and lower mental health. In this study, involvement in sports or music was not associated with developing these forms of pain.

Interestingly, students were more likely to develop neck/upper-limb pain in the period from fall to spring, as opposed to spring to fall. It is possible that these types of pain are more common during the school year due to the additional stresses of making friends, getting good grades, and having other responsibilities.

Reference: Feldman DE, Shrier I, Rossignol M, et al. Risk factors for the development of neck and upper limb pain in adolescents. Spine 2002:27(5), pp. 523-528.

For more information about pediatric health, go to https://www.chiroweb.com/find/archives/pediatrics.

Folate Is First-Rate

Did you know that if you have a family history of colorectal cancer, you're twice as likely as the average person to suffer from the condition? You may be able to reduce your chances for colorectal cancer by moderating your alcohol intake and eating foods high in folate, according to a recent study in Cancer Epidemiology, Biomarkers and Prevention.

The authors studied the diets of close to 90,000 30- to 55-year-old women, using a food-frequency questionnaire. Diets were examined for consumption of folate, multivitamins, alcohol, and methionine (an essential amino acid). The women were followed for 16 years to determine cases of colon cancer.

Women with a family history of colorectal cancer who consumed at least the U.S. recommended daily allowance (RDA) of folate each day, or took a multivitamin supplement daily for at least five years, were approximately 50% less likely to suffer from colon cancer than those who consumed less than half the RDA for folate. Those without a family history of colorectal cancer also showed a decrease in colon-cancer risk when taking the RDA of folate. Moderate-to-heavy alcohol intake increased risk for colon cancer in those with family history by nearly four times, though.

The RDA for folate is 400 micrograms, which is about the amount found in 3-4 servings of foods high in folate, such as leafy greens, citrus fruits, asparagus, beans, chicken, and whole grains. As this study suggests, necessary folate can also be obtained from vitamin supplements. Check out https://www.chiroweb.com/find/archives/nutrition for more studies on the benefits of good nutrition.

Reference: Fuchs CS, Willett WC, Colditz GA, et al. The influence of folate and multivitamin use on the familial risk of colon cancer in women. Cancer Epidemiology, Biomarkers and Prevention 2002:11, pp. 227-234.

More Side Effects in Newer Drugs

Prior to approval from the Food and Drug Administration (FDA), possible negative side effects of prescription drugs are often determined in only small groups of people over short time periods. Pharmaceutical companies also often publicize a drug before all of its side effects are known. As a result, many new drugs may be approved by the FDA without full knowledge of their side effects, and previously unknown side effects are reported to the administration only after some drugs have already hit the market.

A study in the Journal of the American Medical Association determined the relationship between new prescription drugs and the addition of "black box warnings" (warnings required by the FDA to be placed on drug packaging that indicate potentially severe or life-threatening side effects) or removal from the market. The authors examined all new drugs approved from 1975-1999, and all drugs withdrawn from the market for safety reasons from 1975-2000.

An estimated 20% of prescription drugs released to the public during that time received a black box warning or were removed from the market. Half of changes to drug warning labels occurred within seven years of introduction; half of withdrawals from the market took place within two years of introduction.

The safety of new drugs is uncertain until they have been widely used for many years. Don't be one of the first people to suffer a previously unknown side effect of a drug. If you must take a prescription drug, opt for one that is tried and true -- not the heavily marketed, newer one. Also, consider alternative therapies besides drugs to treat your condition.

Reference: Lasser KE, Allen PD, Woolhandler SJ, et al. Timing of new black box warnings and withdrawals for prescription medications. Journal of the American Medical Association 2002:287(17), pp. 2215-2220.

For more general health studies, go to https://www.chiroweb.com/find/archives/general.

Light at the End of the Tunnel?

Roughly 5% of pregnant women suffer from major depression, which may lead to health risks for the mother and developmental problems in the child. The safety of antidepressant use during pregnancy is uncertain, which has prompted searches for alternative treatments. Preliminary studies on daily bright-light exposure have shown it may successfully treat depression during pregnancy.

Morning bright-light therapy was self-administered by pregnant women suffering from major depression. The subjects underwent one hour of light treatment with a white fluorescent light approximately one foot from their faces, initiated within 10 minutes of waking, for at least three weeks. A depression rating scale was used to evaluate depression levels in this study from the American Journal of Psychiatry.

Following three weeks of bright-light therapy, average depression ratings in the women improved by about 50%. For women who were followed through five weeks of treatment, an additional improvement to almost 60% over initial scores was observed. Light therapy did not negatively affect pregnancies, although two women experienced nausea as a side effect to therapy. But withdrawal from the light treatment was linked to an increase in depressive symptoms.

This form of treatment needs to be further investigated, but it does suggest that there may be ways to treat depression besides taking antidepressant drugs. In the meanwhile, do your best to avoid taking any drugs while pregnant, perform light exercises at least several times per week, and maintain a healthy diet.

Reference: Oren DA, Wisner KL, Spinelli M, et al. An open trial of morning light therapy for treatment of antepartum depression. American Journal of Psychiatry 2002:159(4), pp. 666-669.

For more information on women's health, visit https://www.chiroweb.com/find/archives/women.

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