To Your HealthTYH Archives

January 1, 2003 [Volume 4, Issue 1]

 

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In this issue of To Your Health:

A Failure to Communicate

Patients who exaggerate their pain or set unreasonable expectations of their chiropractors are known to be at a higher risk for long-term disability. For the most effective treatment from your doctor of chiropractic, he or she must have a clear knowledge of your symptoms and concerns.

A recent survey of 30 chiropractors and 336 patients in Sweden showed that both groups had many similar goals and expectations for treatment. For example, both doctors and patients expected the practitioner to identify and explain a problem, and both expected treatment to reduce symptoms and make patients feel better overall.

There were several differences in treatment expectations, however. Patients had significantly lower expectations of treatment success than their doctors, yet higher expectations for advice and exercise. Patients also disagreed with their doctors of chiropractic on how many treatments were necessary. Out of options ranging from 1-2, 3-5, 6-10, or more than 10 treatments (or no opinion), most chiropractors felt that 3-5 treatments are necessary for "substantial" improvement. Patients expected improvement after 1-2 treatments, or had no opinion on what to expect.

Poor communication between the patient and doctor can negatively affect treatment outcomes. With any health practitioner you seek, be sure to understand one another and have similar treatment expectations for the best results possible.

Reference: Sigrell H. Expectations of chiropractic treatment: What are the expectations of new patients consulting a chiropractor, and do chiropractors and patients have similar expectations? Journal of Manipulative and Physiological Therapeutics 2002:25(5), pp. 300-305.

Go to https://www.chiroweb.com/find/archives/general for more studies like this one.

Heart Failure Risk Doubled in Obese

Very obese people have been shown to face a much higher risk for heart failure than people of normal weight. With more and more Americans considered overweight or obese, the authors of a recent study in The New England Journal of Medicine wanted to determine if being overweight to a lesser degree also puts a person at a greater risk for heart failure.

Using body-mass index (BMI) to classify a person's weight, almost 6,000 people were divided into one of three categories: normal weight, overweight, or obese. Incidence of heart failure was compared among the groups, who averaged 55 years old.

Overweight women were 50% more likely to experience heart failure than women of normal weight, based on an average of 14 years of follow-up. Obese women and men were approximately twice as likely to have heart failure. The risk for heart failure rose consistently for both genders as BMI increased, regardless of other factors like smoking, alcohol consumption, or age.

To figure out your BMI, multiply your weight (in lbs.) by 703, then divide twice by your height (in inches). Normal weight is considered a BMI of 18.5 to 25; "overweight," 25 to 30; and over 30 is considered "obese."

This measure of "healthy" weight has been criticized, however, as some people who work out regularly and are dense with muscle may be healthy despite a high BMI.

Reference: Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. The New England Journal of Medicine 2002:347(5), pp. 305-313.

For more general health studies, check out https://www.chiroweb.com/find/archives/general.

Which Vitamins Prevent Chronic Disease?

Inadequate levels of some vitamins can lead to chronic diseases, including cancer and heart disease. Many Americans get most of the vitamins they need from the foods they eat, but deficiencies involving even one vitamin can lead to problems.

The authors of this report in the Journal of the American Medical Association reviewed nine vitamins key to preventative care in adults (vitamins A, B6, B12, C, D, E, and K; folate; and provitamin A carotenoids) based on studies published from 1966-2002. The following is a list of health conditions and vitamins that may alter their progression:

  • Osteoporosis: Vitamin D, along with calcium, has been shown to reduce bone loss and fracture risk in the elderly.
  • Heart Disease: Folic acid, B6, and B12 may decrease risk for heart disease; results from studies on vitamin E preventing heart disease are less conclusive. Beta-carotene (vitamin A) may raise risk in smokers.
  • Cancer: Lycopene, although technically a non-vitamin antioxidant, may be superior to vitamin E in helping prevent prostate cancer. It is found in tomatoes and tomato products. Folic acid has been shown to decrease risk for colon cancer in both genders, and breast cancer in women who drink alcohol. Beta-carotene may increase risk for lung cancer in smokers.
  • Birth Defects: Folic acid appears to reduce risk for spinal birth defects in infants whose mothers take these supplements. Excessive vitamin A during pregnancy may cause negative side effects.

The elderly, vegans, and alcoholics are especially at risk for inadequate intake of some vitamins. The best natural sources for these vitamins include: Leafy greens, whole grains, and fortified grain products for folate; fish, poultry, and legumes for vitamin B6; fish, eggs, and milk for vitamin B12; citrus fruits for vitamin C; and margarine, nuts, and salad oils for vitamin E.

Reference: Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults: Scientific review. Journal of the American Medical Association 2002:287(23), pp. 3116-3126.

For detailed information on the benefits of vitamins and minerals, go to https://www.chiroweb.com/tyh/nutrients.html.

Preemptive Strike

Did you know you can actually protect your baby before she's even born? By taking folic acid supplements before and during pregnancy, you can prevent birth defects, based on a recent study in the Canadian Medical Association Journal.

Birth defects in an infant's developing central nervous system are called "neural tube defects" (NTDs). These defects result when the spine and brain, or the bones that protect the two, don't form correctly during pregnancy. In 1994, Canada recommended that prior to and during pregnancy, all women should include folic acid supplementation in their diets because it has been shown to help prevent NTDs. The authors of this study tracked the success of Canada's recommendation by looking at all births in Nova Scotia from 1991-2000, and comparing the incidence of NTDs:

  • before the 1994 recommendations;
  • after the recommendations; and
  • after November 1998, when Canada began fortifying grain products with folic acid because of little response from mothers to follow recommendations.

The study revealed that following government recommendations to take folic acid supplements, the incidence of NTDs remained the same as before. However, following government fortification of grain products, the risk for these defects dropped by over 50%.

Folic acid is vital for a healthy baby. Women who could become pregnant should take folic acid daily, in addition to a healthy diet, for at least two months prior to a planned pregnancy until at least the end of the first trimester of pregnancy. Everybody should include folic acid in their diet for its many health benefits; simply taking a multivitamin provides enough for most people.

Reference: Persad VL, Van den Hof MC, Dubé JM, et al. Incidence of open neural tube defects in Nova Scotia after folic acid fortification. Canadian Medical Association Journal 2002:167(3), pp. 241-245.

To learn about staying healthy while pregnant, go to https://www.chiroweb.com/find/archives/women/pregnancy/index.html.

 

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