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Archive for March, 2010

 

Decoding an Ancient Therapy

High-Tech Tools Show How Acupuncture Works in Treating Arthritis, Back Pain, Other Ills

  • By MELINDA BECK

Acupuncture has long baffled medical experts and no wonder: It holds that an invisible life force called qi (pronounced chee) travels up and down the body in 14 meridians. Illness and pain are due to blockages and imbalances in qi. Inserting thin needles into the body at precise points can unblock the meridians, practitioners believe, and treat everything from arthritis and asthma to anxiety, acne and infertility.

WSJ’s health columnist Melinda Beck tests out acupuncture as an alternative means to reduce her neck and back pain.

Does It Work?

While scientists say further research is essential, some studies have provided evidence of acupuncture’s effects.

  • Arthritis of the Knee: Acupuncture significantly reduced pain and restored function, according to a 2004 government study.
  • Headaches: Two 2009 reviews found that acupuncture cut both tension and migraine headaches.
  • Lower Back Pain: Acupuncture eased it in a big study last year, but so did a sham treatment where needles didn’t penetrate the skin.
  • Cancer: Has proven effective in reducing nausea and fatigue caused by chemotherapy.
  • Infertility: Improves the odds of pregnancy for women undergoing in-vitro fertilization, according to a 2008 review of seven clinical trials.
  • Addiction: Often used to help quit smoking, drinking, drug use and overeating, but there is no conclusive evidence that it works.

 

After decades of cynicism, Western medical experts are using high-tech tools to unravel the ancient mysteries of how acupuncture works. WSJ’s Health columnist Melinda Beck joins Simon Constable on the News Hub to discuss.

As fanciful as that seems, acupuncture does have real effects on the human body, which scientists are documenting using high-tech tools. Neuroimaging studies show that it seems to calm areas of the brain that register pain and activate those involved in rest and recuperation. Doppler ultrasound shows that acupuncture increases blood flow in treated areas. Thermal imaging shows that it can make inflammation subside.

Scientists are also finding parallels between the ancient concepts and modern anatomy. Many of the 365 acupuncture points correspond to nerve bundles or muscle trigger points. Several meridians track major arteries and nerves. “If people have a heart attack, the pain will radiate up across the chest and down the left arm. That’s where the heart meridian goes,” says Peter Dorsher, a specialist in pain management and rehabilitation at the Mayo Clinic in Jacksonville, Fla. “Gallbladder pain will radiate to the right upper shoulder, just where the gallbladder meridian goes.”

Many medical experts remain deeply skeptical about acupuncture, of course, and studies of its effectiveness have been mixed. “Something measurable is happening when you stick a needle into a patient—that doesn’t impress me at all,” says Edzard Ernst, a professor of complementary medicine at the University of Exeter in England and co-author of the book, “Trick or Treatment.” Acupuncture “clearly has a very strong placebo effect. Whether it does anything else, the jury is still out.”

Even so, the use of acupuncture continues to spread—often alongside conventional medicine. U.S. Navy, Air Force and Army doctors are using acupuncture to treat musculoskeletal problems, pain and stress in stateside hospitals and combat zones in Iraq and Afghanistan. Delegations from Acupuncturists Without Borders are holding communal ear-needling sessions to reduce stress among earthquake victims in Haiti. Major medical centers—from M.D. Anderson in Houston to Memorial Sloan-Kettering in New York—use acupuncture to counteract the side effects of chemotherapy.

In a 2007 survey, 3.2 million Americans had undergone acupuncture in the past year—up from 2.1 million in 2001, according to the government’s National Center for Complementary and Alternative Medicine.

The most common uses are for chronic pain conditions like arthritis, lower back pain and headaches, as well as fatigue, anxiety and digestive problems, often when conventional medicine fails. At about $50 per session, it’s relatively inexpensive and covered by some insurers.It is also generally safe. About 10% of patients experience some bleeding at the needle sites, although in very rare cases, fatalities have occurred due to infections or injury to vital organs, mostly due to inexperienced practitioners.

Most states require that acupuncturists be licensed, and the Food and Drug Administration requires that needles be new and sterile.

Diagnoses are complicated. An acupuncturist will examine a patient’s tongue and take three different pulses on each wrist, as well as asking questions about digestion, sleep and other habits, before determining which meridians may be blocked and where to place the needles. The 14 meridians are thought to be based on the rivers of China, and the 365 points may represent the days of the year. “Invaders” such as wind, cold, heat, dampness, dryness factor into illness, so can five phases known as fire, earth, metal, water and wood.

Using Acupuncture to Treat Stress

“It’s not like there’s a Merck Manual for acupuncture,” says Joseph M. Helms, who has trained some 4,000 physicians in acupuncture at his institute in Berkeley, Calif. “Every case is evaluated on an individual basis, based on the presentation of the patient and the knowledge of the acupuncturist.”

Dr. Helms notes that Western doctors also examine a patient’s tongue for signs of illness. As for qi, he says, while the word doesn’t exist in Western medicine, there are similar concepts. “We’ll say, ‘A 27-year-old female appears moribund; she doesn’t respond to stimuli. Or an 85-year old woman is exhibiting a vacant stare.’ We’re talking about the same energy and vitality, we’re just not making it a unique category that we quantify.”

Studies in the early 1980s found that acupuncture works in part by stimulating the release of endorphins, the body’s natural feel-good chemicals, much like vigorous exercise does. Now, a growing body of research suggests that it may have several mechanisms of action. Those include stimulating blood flow and tissue repair at the needle sites and sending nerve signals to the brain that regulate the perception of pain and reboot the autonomic nervous system, which governs unconscious functions such as heart beat, respiration and digestion, according to Alejandro Elorriaga, director of the medical acupuncture program at McMaster University in Ontario, which teaches a contemporary version to physicians.

[healthcolJ] Vitaly NapadowA specialized MRI scan shows the effects of acupuncture. The top two images show the brain of a healthy subject. In the middle two images, a patient with carpal tunnel syndrome registers pain (indicated by red and yellow). The bottom images show the calming effect (indicated by blue) in the brain after acupuncture.

“You can think Western, you can think Eastern. As long as your needle goes to the nerve, you will get some effect,” Dr. Elorriaga says.

What’s more, an odd phenomenon occurs when acupuncture needles are inserted into the body and rotated: Connective tissue wraps around them like spaghetti around a fork, according to ultrasound studies at the University of Vermont. Helene Langevin, research associate professor of neurology, says this action stretches cells in the connective tissue much like massage and yoga do, and may act like acupuncture meridians to send signals throughout the body. “That’s what we’re hoping to study next,” she says.

“ My former spouse had shingles. Doctors told her that the terrible pain would probably last 2 or 3 years. She got acupuncture treatments, plus some Chinese herbs, and the pain was totally gone with 6 weeks.:

—Alan Agardi

Meanwhile, neuroimaging studies at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital in Boston have shown that acupuncture affects a network of systems in the brain, including decreasing activity in the limbic system, the emotional part of the brain, and activating it in the parts of the brain that typically light up when the brain is at rest.

Other studies at the Martinos Center have shown that patients with carpal tunnel syndrome, a painful compression of nerves in the wrist, have heightened activity in parts of the brain that regulate sensation and fear, but after acupuncture, their brain patterns more closely resemble those of healthy subjects. Brain scans of patients with fibromyalgia show that both acupuncture and sham acupuncture (using real needles on random points in the body) cause the release of endorphins. But real acupuncture also increased the number of receptors for pain-reducing neurotransmitters, bringing patients even more relief.

The fact that many patients get some relief and register some brain changes from fake acupuncture has caused controversy in designing clinical trials. Some critics say that proves that what patients think of as benefit from acupuncture is mainly the placebo effect. Acupuncture proponents counter that placebos that too closely mimic the treatment experience may have a real benefit.

“I don’t see any disconnect between how acupuncture works and how a placebo works,” says radiologist Vitaly Napadow at the Martinos center. “The body knows how to heal itself. That’s what a placebo does, too.”

Write to Melinda Beck at HealthJournal@wsj.com

 

 

 

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So, you ate your beans just like me and then thought to yourself, “I wonder what the health benefits of these lovely beans are?” Lucky for you, I too had this thought, and then thought I’d pass some info along to you.

Beans help lower cholesterol (lots of bile binding fiber), in turn fighting heart disease, and lowering the risk of heart attack. A study conducted at the University of Kentucky has shown that only three weeks of increased bean intake (3/4 cup of navy and pinto beans) lowered the men’s cholesterol by an average of 19%. This reduces the risk of heart attack by almost 40%. Studies have also shown that there is a decreased risk of type 2 diabetes, high blood pressure, breast and colon cancers.

Beans are high in protein and fiber but low in fat and surprisingly high in antioxidants. Black and pinto beans beat out powerhouses like blueberries! Here’s a comprehensive post on the health benefits of beans. http://heart-healthy-recipes.fitsugar.com/Health-Benefits-Common-Beans-1090505 (Why reinvent the wheel I say!)

Here’s a excerpt…

“In one analysis of dietary data collected by validated food frequency questionnaires in 1991 and 1995 from 90,630 women in the Nurses Health Study II researchers found a significant reduced frequency of breast cancer in those women who consumed a higher intake of common beans or lentils. That was not surprising, what was surprising was that only beans and lentils seemed to offer protection. Intake of tea, onions, apples, string beans, broccoli, green pepper, or blueberries had not protective effect. Eating beans or lentils two or more times per week was associated with a 24% reduced risk of breast cancer.”

And… check this out

USDA Ranking of Foods by Antioxidant Capacity

1 Small Red Bean (dried) Half cup: 13727
2 Wild blueberry 1 cup: 13427
3 Red kidney bean (dried) Half cup: 13259
4 Pinto bean Half cup: 11864
5 Blueberry (cultivated) 1 cup: 9019
6 Cranberry 1 cup (whole): 8983
7 Artichoke (cooked) 1 cup (hearts): 7904
8 Blackberry 1 cup: 7701
9 Prune Half cup: 7291
10 Raspberry 1 cup: 6058
11 Strawberry 1 cup: 5938
12 Red Delicious apple One: 5900
13 Granny Smith apple One: 5381
14 Pecan 1 ounce: 5095
15 Sweet cherry 1 cup: 4873
16 Black plum One: 4844
17 Russet potato (cooked) One: 4649
18 Black bean (dried) Half cup: 4181
19 Plum One: 4118
20 Gala apple One: 3903

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Today I’m making some heirloom beans and lamb burgers for dinner. Heirloom beans (and other friuts and vegetables)are varietes that for whatever reason have fallen out of cultivation. This is usually due to lower yeilds, or a less than  perfect supermarket product in comparion to say, a conventional kidney bean. The payoff for trying these less common varieties is in the remarkably diverse flavor and texture. Who knew a bean could be so good? Even with all this beautiful spring weather it’s still cool enough to snuggle into a tasty bean.

Don’t know how to cook a dried bean? Here’s a link to a great 3 minute video that shows just how easy it is! http://ranchogordo.com/html/rg_cook_index.htm Scoll down the page to the video that says ” When the vegetables are soft add the beans and cover with water by about 1 inch.” Added bonus is the kitchy mexican fiesta music in the background. Happy cooking!

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This past weekend I had the pleasure of connecting with a couple older friends. The topic turned to health, aging and their complaints surrounding getting old. It got me thinking about healthy aging. What does it mean to age gracefully? What are some keystones in the healthy aging process?

Of course my first thought is diet. (Exercise too but that’s for another rant.) Just as they’ve done to everything else the boomers are changing the way we think about aging. They are searching for answers and solutions about their health. But this is fraught with controversy and conflicting information. From my perspective there is no right diet for everyone. Food sensitivities, organics, seasonality, locality, sustainability all need to be taken into consideration. As a general rule, less processed more whole foods are better. Being a foodie, of course I think it should taste delicious, but I’m not immune to the power of convenience either. I don’t believe the two to be mutually exclusive.  Eat from the farmer’s market people!! http://www.seattlefarmersmarkets.org/ Or consider having your produce delivered by one of the many Community Supported Agriculture programs. In Seattle there’s almost no excuse for not enjoying delicious, healthful eating.

Even my well educated friends I saw this weekend, who ARE diet conscious have trouble knowing what to focus on. Low fat? Low Carb? Weight watchers?(This one makes me cringe, but hey, it works and obesity isn’t healthy either.) Culturally we’ve become disconnected from our food, and we’ve certainly lost the idea of food as medicine.

Then there is the question of supplements. Which ones to take? How often to take them? Fish oil has hit mainstream awareness but other healthy heavy weights like fermented foods and beverages (Kombucha!!) are still on the fringe.(Though not for our wise readers!) Check out the book “Nourishing Traditions” for more info on the benefits of fermented foods.

I checked our Dr. Andrew Weil’s website. I’m not his biggest fan but he’s instituted a shift in the public awareness around alternative medicine which I think is good. He has created a new food pyramid which I think is useful in conceptualizing what foods to eat and in what ratios. Here’s the link. http://www.drweil.com/drw/u/ART02995/Dr-Weil-Anti-Inflammatory-Food-Pyramid.html Here’s what he has to say about it.

  • It is a practical eating guide that consumers of all ages can use, with tips on how to reduce risks of age-related diseases and improve overall health through diet.
  • It is an interactive educational graphic to help today’s families prevent disease while eating well.
  • It is a simple tool that promotes optimum health and healthy aging by providing dietary advice that addresses inflammation.

 What is hard for me to see is that in their quest for healthier happier lives consumers’ pill boxes are filling up. I feel that it’s easy to underestimate the power of food, to discount food as viable medicine. More and more we are seeing the interactions of various medicines having unwanted and unhealthy results. Why not try a diet change first or at least concurrently with medications? I believe this to be especially important in all chronic diseases with an inflammatory component. A good resource for this is the “Anti inflammatory diet and recipe book” which we carry at our office. It explains that MOST diseases have an inflammatory component, not just the obvious ones like a stiff, swollen knee or allergies. This is one reason that acupuncture can treat such a wide variety of illnesses as well. It reduces the inflammatory response.

I guess my point is, don’t underestimate the power of the foods you eat. While medications can take care of symptoms, they can also have nasty side effects and unwanted interactions. Your diet is the foundation of your health, and a simple way to give yourself the best chance to age gracefully and healthfully.

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