February 21, 2006 [Volume 7, Issue 5]

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In this issue of To Your Health:

• The Rehabilitation of Low Back Pain: What Works Best
• A Grapefruit a Day Keeps Heart Disease at Bay
• Here's the Dish on Candy

Back pain is an extremely common condition; by most estimates, 80 percent of all people experience it at some point in their lives. Chronic low back pain is an especially common disorder. Evidence suggests that using rehabilitation techniques to treat low back pain patients is more effective than doing nothing. The question is, which types of rehabilitation work best?

In this randomized, controlled trial, 212 people with chronic low back pain were assigned to one of four groups: active physical exercise, cognitive behavioral therapy, a combination of the two therapies, or no treatment. Patients undergoing active physical exercise rode a bicycle and performed back exercises to improve fitness levels and increase back strength, while patients used cognitive behavioral therapy to help them cope with the pain and overcome their reluctance to perform physical activities.

At the end of the trial, patients in all of the treatment groups saw an improvement in function and a reduction in pain levels compared to the group that received no treatment. In addition, the ability to perform certain physical tasks improved in patients who received active physical exercise or combined therapy, but not cognitive behavioral therapy.

While exercise and cognitive therapy appear effective in helping to rehabilitate people with low back pain, they are by no means the only therapies available. Your doctor of chiropractic can draw up a treatment program that combines chiropractic adjustments with techniques such as those listed above to provide a safe, effective form of rehabilitation. For more information on the methods doctors of chiropractic use in the treatment of low back pain, visit www.chiroweb.com/find/archives/musculoskeletal/backpain.

Smeets RJEM, Vlaeyen JWS, Hidding A, et al. Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial. Musculoskeletal Disorders Jan. 20, 2006;7:5.

Consider the grapefruit. While most people know grapefruit is good for you, they still prefer to eat other citrus fruits because of grapefruit's bitter taste. A new study published in the Journal of Agricultural and Food Chemistry has elevated the status of the lowly grapefruit to new heights by showing that it can reduce cholesterol levels in the blood significantly, which helps to lower the risk of other conditions that could lead to heart disease.

The study involved 57 postoperative heart bypass patients who had high levels of triglycerides in the blood. The patients were divided into three groups. All three groups followed a standard anti-atherosclerosis diet for 30 consecutive days. In two of the groups, patients also consumed one white or red grapefruit each day. The third group did not receive any grapefruit and served as a control population.

While eating either kind of grapefruit appeared to reduce cholesterol levels, the cholesterol-lowering effects were much greater among patients who consumed red grapefruit. In red grapefruit patients, total cholesterol levels were reduced 15.5 percent compared to the control patients, and total triglyceride levels were reduced more than 17 percent.

There are a number of ways to reduce your risk of heart disease. One of the easiest ways is eat a diet high in grapefruit and other foods that are high in antioxidants, which can lower cholesterol levels and provide other benefits that will keep your heart healthy. Make sure to talk to your doctor of chiropractic about antioxidant-rich foods as part of a balanced diet. For more information, visit www.chiroweb.com/find/archives/nutrition.

Gorinstein S, Caspi A, Libman I, et al. Red grapefruit positively influences serum triglyceride levels in patients suffering from coronary atherosclerosis: studies in vitro and in humans. Journal of Agricultural and Food Chemistry, ASAP article (doi:10.1021/jf058171g), published online Feb. 3, 2006.

"Out of sight, out of mind." It's an old phrase that can apply to a lot of situations. A recent study shows that this phrase can easily be applied to the number of candies a person eats at work, with people being more likely to consume more candy per day when it's in plain sight and within easy reach.

In the study, 40 adult workers (all female) volunteered to take part in a four-week study of chocolate consumption from an office candy dish. In one phase of the study, 30 Hershey's chocolate kisses were placed either on the volunteer's desk, or 6.5 feet away (but clearly visible). In the second phase, the candies were placed in covered bowls that were either clear or opaque, again on the volunteer's desk or 6.5 feet away.

People ate an average of 2.2 more candies each day when they were visible compared to being hidden, and 1.8 candies more per day when they were on the person's desk compared to 6.5 feet away. While this may not seem like much, consider that one Hershey's kiss contains approximately 25 calories. Over a five-day work week, this could add up to 275 extra calories to a person's diet, not to mention the extra sugar and fat due to candy consumption.

While the results of this study don't mean the end of the workplace candy dish, they do mean that the closer and more visible food is, the more likely a person is to eat a lot of it. If you're going to eat snacks at work, why not snack on healthy foods such as fruits and vegetables, or items that have fewer calories and are low in fat and sugar? For more information, visit www.chiroweb.com/find/archives/nutrition/foods.

Wansink B, Painter JE, Lee Y-K. The office candy dish: proximity's influence on estimated and actual consumption. International Journal of Obesity, advance online publication (doi: 10.1038/sj.ijo.0803217), published Jan. 17, 2006.

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