Vinegar & Acids Help Lower Blood Sugar

The "Really?" column in today's Science Times (NY Times) reports on studies showing that including vinegar in a meal will help lower blood sugar. One Italian studies showed including vinegar as salad dressing with a meal that includes bread and other carbs will reduce blood sugar by 30%. The results were verified in another study by the American Diabetes Association. You can check the results yourself by eating 2 identical carb meals. With one, add 2 teaspoons vinegar with the other do not use vinegar. Check your blood sugar after each meal, and see if there's a drop in the meal eaten with vinegar.


The author's of the ADA study concluded that:

The data indicates that vinegar can significantly improve postprandial insulin sensitivity in insulin-resistant subjects. Acetic acid has been shown to suppress disaccharidase activity (3) and to raise glucose-6-phosphate concentrations in skeletal muscle (4); thus, vinegar may possess physiological effects similar to acarbose or metformin. Further investigations to examine the efficacy of vinegar as an antidiabetic therapy are warranted.

These findings help explain why Dr. Richard Tan's recommendation of drinking lime water throughout the day lowers blood sugar for diabetics.

To do this, juice a lime and pour the juice in a bottle of water and sip throughout the day. Apparently the 'white part' is important, so keep the pulp. Dr. Tan says that within 3 months blood sugar levels will drop. I have a current patient who is using key limes and after 3 weeks has been noticing lower blood sugar levels.

Reporter Anahad O'Connor astutely points out in the aforementioned Really? column that amongst other perils of the Holiday Madness season, are the difficulties diabetics face navigating social gatherings and work place break rooms during the last 6 weeks of the year.


Here are a few abstracts of other studies relating to vinegar and blood sugar levels by the authors of the cited study. KB

J Am Diet Assoc. 2005 Dec;105(12):1939-42.

Vinegar and peanut products as complementary foods to reduce postprandial glycemia.

Johnston CS, Buller AJ.

Department of Nutrition, Arizona State University, Mesa 85212, USA. carol.Johnston@asu.edu

Diabetes Res Clin Pract. 2009 May;84(2):e15-7. Epub 2009 Mar 9.

Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus.

Johnston CS, White AM, Kent SM.

Studies Show Meditation Reduces Heart Attacks, Strokes & Hypertension

Two recent studies have demonstrated that meditation reduces heart attacks, strokes and hypertension. Many past studies have shown health benefits of meditation, including decreased depression, anxiety and improved sleep and ability to handle stress. These two studied the effects of the Transcendental Meditation technique. I have posted the NY Times report about the studies and abstracts of them below.

Here's a little bit about TM from Wikipedia:

The Transcendental Meditation technique, or TM technique is a form of mantra meditation introduced in India in 1955^[1][2][3][4] by Maharishi Mahesh Yogi (1917-2008).^[5] It is reported to be the most widely researched and one of the most widely practiced meditation techniques in the world today.^[6][7][8][9] Taught in a standardized seven-step course by certified teachers, the technique involves the use of a sound or mantra and is practiced for 15–20 minutes twice per day, while sitting comfortably with closed eyes.^[10]

In 1957, Maharishi Mahesh Yogi began a series of world tours during which he introduced and taught his meditation technique.^[11] In 1959, he founded the International Meditation Society and, in 1961, he began to train teachers of the Transcendental Meditation technique.^[11][12] From the late 1960s through the mid 1970s, both the Maharishi and the TM technique received significant public attention in the USA, especially among the student population.^[13][14] During this period, a million people learned the technique, including well-known public figures. . . .

Beginning in 1968, a number of celebrities such as Donovan, The Beatles, members of the The Beach Boys, The Rolling Stones, Doug Henning, Clint Eastwood, Deepak Chopra, Andy Kaufman, Jane Fonda, Mia Farrow, Shirley MacLaine, Joe Namath, Stevie Wonder, and Howard Stern . . .

The Beatles, of course, were the most famous of these. They stayed at the Maharishi's ashram in India for more than 8 months from August of 1967 to April of 1968. A well known riff developed btwn them, causing the Beatles to leave. The time spent with the Maharishi was a prolific one for the Beatles. The Maharishi helped them to get off LSD: Lennon had a heavy user. While they were with him, and after they returned to England the Beatles wrote and recorded the 30 songs on the double "White Album".

The hallmark of the TM technique is it's reliance on an mantra or sacred sound. From Wiki:

During the initial personal instruction session, the student is given a specific sound or mantra. The sound is utilized as a thought in the meditation process,^[23] allowing the individual’s attention to be directed naturally from an active style of functioning to a less active or quieter style of mental activity.^[23]

An important distinction between the Transcendental Meditation technique and other practices that involve mantras is in the way the mantra, or sound, is used. In Transcendental Meditation the mantra is not chanted—either verbally or mentally, but is instead a vehicle on which the attention rests.^[24][19]

According to Russell, the sounds used in the Transcendental Meditation technique are taken from the ancient Vedic tradition.^[24] Maharishi Mahesh Yogi explains that the selection of a proper thought or mantra "becomes increasingly important when we consider that the power of thought increases when the thought is appreciated in its infant stages of development".^[25] William Jefferson in The Story of the Maharishi, explains the importance of the "euphonics" of mantras. Jefferson says that the secrets of the mantras and their subsequent standardization for today's teachers of the technique were unraveled by Maharishi Mahesh Yogi after his years of study with his own teacher, Guru Dev (Brahmananda Saraswati) so that selection is foolproof, and that the number of mantras from the Vedic tradition, which could number in the hundreds, have been brought by Maharishi to a minimum number. . .

In 1975, Time Magazine reported that each TM meditator is instructed to keep their mantra private. Each TM teacher assigns each student's mantra based on a formula that is presumed to include temperament and profession. The article says that there are 17 mantras.^[13] In his 1997 book, The Sociology of Religious Movements William Sims Bainbridge wrote that the mantras given for Transcendental Meditation are "supposedly selected to match the nervous system of the individual but actually taken from a list of 16 Sanskrit words on the basis of the person's age".^[28]

The 1995 expanded addition of Conway and Siegelman's Snapping: America's Epidemic of Sudden Personality Change describes a teacher of Transcendental Meditation who says: "I was lying about the mantras — they were not meaningless sounds they were actually the names of Hindu demigods - and about how many different ones there were — we had sixteen to give out to our students".^[30] In the 1977 court case Malnak vs. Yogi (see below), an undisputed fact in the case was that the mantras are meaningless sounds.^[31]

In a speech the Maharishi gave in Kerala, India, in 1955, he mentions a connection between the mantras and personal deities and occasionally similar references can also be found in his later works.^[32][33] More commonly, the Maharishi describes the mantras as working automatically.^[33]

Jonathan Shear in his book The Experience of Meditation: Experts Introduce the Major Traditions, characterizes the mantras used in the TM technique as independent of meaning associated with any language, and are used for their mental, sound value alone.^[18] A 2009 article published in the International Journal of Psychophysiolgy says that "unlike most mantra meditations, any possible meaning of the mantra is not part of Transcendental Meditation practice".^[17]

In his book Alternative Religions: A Sociological Introduction, author Stephen Hunt says that the mantra used in the Transcendental Meditation technique has no meaning but that the sound itself is sacred.

I don't believe that you must do the TM technique to gain health benefits from meditation. In fact, a current patient has a 15y history of hypertension. After 4-6 weeks of guided meditation she saw her blood pressure return to normal during a period of high stress.

The important thing is to begin a regular practice. In the beginning, the discipline of sitting regularly and listening to the mind chatter is difficult. But if you stick with it, you'll find in time the mind will calm. This can take years, but you will reap the rewards of your continued effort.

Commonly breath meditation is done, where one focuses on the in and out breath as a mechanism to calm the mind. Especially worriers and those experiencing much stress and anxiety have particular difficulty with this because the mind chatter and dramas continue to play. For those people I recommend beginning with a guided meditation recording, or even just beginning by listening to quiet, relaxing music and concentrating on the notes and sounds.

Over time, one works through the disturbing memories and emotions that come up during meditation and begins to tire of the repetitive tape of the mind chatter. Then one becomes more able to reject the drama of the mind and increases the ability to quiet the mind. This process can take years, but the effort is worthwhile. Once mastered, meditation becomes a way to leave the daily stresses and come into a calm peaceful state of mind. I have found that more regular meditation helps to keep the mind calm. I notice a difference when meditating twice a day verses once daily, or between daily meditation and meditating several times a week or weekly.

If you have difficulty developing the discipline of the practice, you might seek out a group of mediators in your area to sit with. Wednesday nights seems to be a common meeting time for meditation and spiritual groups. KB

Here's the NY Times article about the TM studies on reducing heart attacks:

http://well.blogs.nytimes.com/2009/11/20/can-meditation-curb-heart-attacks/?scp=1-b&sq=&st=nyt


Here's the one of the studies sited in the Times article presented at the American Heart Association:

http://circ.ahajournals.org/cgi/content/meeting_abstract/120/18_MeetingAbstracts/S461-a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=transcendental+meditation&searchid=1&FIRSTINDEX=0&volume=120&issue=18+Supplement&resourcetype=HWCIT

Here's another study from the American Journal of Hypertension, also available on pubmed:

http://www.nature.com/ajh/journal/v22/n12/abs/ajh2009184a.html

Chinese Medicine for Cold and Flu Prevention

I've been getting questions about flu vaccines and Chinese herbs for flu.

The decision to vaccinate is a personal one. One must weigh the risks of side effects from the vaccine against the risk of contracting the flu. For those who are weak, frail or immune deficient there is a stronger argument to vaccinate. Those who are healthy and could mount a strong defense against the flu might want to forgo the vaccine and the risk of side effects incurred.

Chinese medicine can support you in 2 ways:

1. Acupuncture and Chinese herbs can strengthen your overall health and immune function, better preparing you to ward off an attack.
2. Chinese medicine can treat the flu symptoms should you contract it. Patients are generally pleased, even amazed by the results of acupuncture and herbs in treating colds, flu and other respiratory conditions.

I have a few formulas that have been advised in Beijing for use in treating H1N1. All are to be taken upon suspected contact. One is a gargle for sore throat that could be used for any sore throat. The others are specific for the most venerable patient populations: children, seniors and pregnant women. These formulas could be used prophylactically for any suspected contact with cold or flu. They are only to be used for 4 or 5 days as a preventative upon contact.

One frequently used preventative formula for any cold, flu or respiratory illness, including allergies is called Jade Windscreen. It is comprised of 3 herbs (astragalus is one) that are considered a precious (hence the word 'jade') formula to boost immune function and ward off viruses, bacterias and irritants brought in from the external environment (wind-screen). It is often begun in August or early September, 6-10 weeks before the flu or allergy season, and continued through the winter for those who frequently contract colds, flu and allergies or sinusitis. Generally the herbalist will add other herbs to build a constitutional formula suitable for the individual patient being treated.

Periodic acupuncture treatments strengthen the immune system and alleviate stress, which depletes immune function. Making sure you eat well, get adequate rest, don't overwork, exercise regularly and engage in stress reduction activities will keep your body and immune system healthy and strong.

When disease symptoms occur, acupuncture and Chinese herbal formulas can effectively treat the symptoms and strengthen the bodies ability to mount an defense against the attack. KB

Study Shows Qi Gong Effective for Cancer Patients

A recent study published in Annals of Oncology shows that medical Qi Gong improves the quality of life, mood and inflammation in cancer patients.
 
There is no definition given for medical (vs non-medical?) Qi Gong, but I understand that the patients in the study practiced 2x/week with an instructor and were asked to do additional practice at home between classes. If you are interested in taking qi gong classes with a teacher be sure to tell the instructor about your disease and purpose for learning qi gong so that more specific instruction can be tailored to your needs. In fact, a private or series of private lessons, interspersed with group lessons might be optimal. If for whatever reason working with an instructor in person is not an option for you, then look for a Qi Gong DVD.

Qi Gong is meditation exercises, preformed slowly in repetition, designed to build, cultivate and move one's qi. The term 'qi gong' literally translates as qi work. Just as acupuncture circulates one's qi, so do these relaxing exercises. Qi gong builds qi, eliminating fatigue. The meditative quality of the exercises hones, focuses and calms the mind. All cancer patients are under a tremendous amount of stress and can thus benefit from these gentle exercises. KB

Boundaries Create the Ego

Boundaries create the ego.

Or put another way: the ego is comprised of boundaries between self and other.

To weaken or destroy the ego, one must first dissolve the boundaries, carefully. The id and ego do not take well to threats, and due to this fear will fight hard to protect their existence. This inner struggle can be quite difficult to endure. KB

Study Shows Acupuncture as Effective as Drugs for Carpel Tunnel Syndrome

A study published in May 2009 in The Clinical Journal of Pain compared acupuncture to the steroid drug prednisone for treatment of pain in carpal tunnel syndrome. The study concluded that:

"Short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice."

This is big for a western medical study to recommend acupuncture as an effective alternative to drug therapy. For the symptoms of night time awakening due to pain and for motor function, the acupuncture group had better results. I've included an abstract of the article below.

Carpal Tunnel Syndrome is a repetitive use injury, commonly caused by excessive computer use (typing on the keyboard). The carpal tunnel is the hole that the (median) nerve travels through, located on the inside of the wrist where the wrist and hand meet. When the wrist is flexed, the carpal tunnel compresses, and the ligament on the roof of the tunnel presses on the median nerve, causing pain. The median nerve controls the thumb, index and middle fingers and the thumb (radial) side of the ring finger. Carpal tunnel patients experience pain in those fingers and palm area, not the pinkie finger as the median nerve which travels through the carpal tunnel does not affect the last finger or the pinky (ulna) side of the palm. Pain can also radiate into the arm. KB

Could Women Use Smaller Vaccine Doses?

The decision to vaccinate is a personal one. Do your own research and weigh the side effects and disease risks against the benefits of the vaccine. Keep in mind that those who are immuno-compromised, weak or frail are in a higher risk group than healthy young and middle aged adults. The authors of this NY Time's Op-Ed piece contend that clinical studies are showing that women produce as many antibodies to half the dose of flu vaccine that men do at the full dose, and that the rule holds up for other diseases such as measles, mumps, rubella, hepatitis A & B and herpes simplex. If women were given a lower dose they might suffer fewer side effects than they do at the higher dose. In the case of H1N1, where there is a shortage of the vaccine, giving women a lower dose, the authors argue, would make the limited quantities of vaccine available for more people.

Drugs are usually only tested on men age 18-45 before they are given FDA approval. Ethically the drug companies can't give a new drug that much about the potential side effects are unknown to higher risk groups. These groups include women in their reproductive years because if they were to become pregnant while taking the drug, the drug may have detrimental effects on the fetus. Children, older adults and seniors have weaker immune systems to which an unknown drug could potentially cause harm. This means that most drugs are not tested on children, elderly or women before they are released onto the public. For this reason, I do not recommend using a new drug unless it is the only alternative. It has only been tested in a small group of men, and there are a lot of unknowns about it. KB

Here's the NY Time's piece on flu shot dosing for women:

http://www.nytimes.com/2009/10/28/opinion/28klein.html?_r=1&scp=1&sq=&st=nyt

Stanford Research Study Shows Acupuncture Reduces Hot Flashes

Here's a study published a few years ago by a Stanford researcher showing the benefits of acupuncture for hot flashes. The study followed patients for seven weeks of treatment. In Chinese Medicine we treat in courses: a clinical course of treatment being 10-12 visits or weeks of herbal medicine. I have found in clinic that the first course of treatment tends to be 10-15 visits. In that amount of time I can usually get mild or acute symptoms resolved, and more chronic symptoms reduced and under control. Inexplicably this study tracked patients for only 7 visits. I'm sure the results would have dramatically increased had the patients continued treatment for a full course, or longer.

I have noticed that studies usually show a lower percentage effectiveness than what I and others in the field see in clinic. I've discussed this paradox with colleagues, and our explanation is that in studies the researchers choose one simple protocol and give it to everyone in the study, often not a protocol actually used in clinic. One of the hallmarks of Chinese medicine is individualized treatments. So although 10 women may all come in for hot flashes, they would get different treatments based on their constitutional differences in clinical presentation.

That being said, I do have a simple point combination that I have found generally effective for most all women with hot flashes. However, I potentiate the treatment by adding additional points to treat the constitutional individualities.

I don't like to quote percentages of effectiveness of my treatments, because I've noticed phenomenally that as soon as I do, someone comes in who is a non-responder. But I will say, based on my clinical experience that hot flashes is a condition I expect to respond well and eradicate with Chinese medical treatment that includes a combination of acupuncture and individualized Chinese herbal formulas. KB


Acupuncture reduces nighttime hot flashes caused by menopause, according to a study published in the journal, Fertility and Sterility.

Researchers found that seven weeks of acupuncture treatment reduced the severity of nighttime hot flashes by twenty-eight percent among menopausal women compared with a six percent decrease among women who had a sham acupuncture treatment.

The effects of acupuncture vs. a sham acupuncture treatment on the severity and frequency of nighttime hot flashes were compared. Taking part in the study were twenty-nine menopausal women experiencing at least seven moderate to severe hot flashes per day.

All of the women underwent nine treatments from trained acupuncturists in sessions over seven weeks. Twelve of the women received real acupuncture using points selected to target hot flashes and sleepiness. The rest of the women received a sham acupuncture treatment using non-penetrating needles at random acupuncture channel points.

Throughout the study, the women reported the number and severity of their hot flashes. The results showed that nighttime hot flash severity decreased significantly (twenty-eight percent) among the women who received acupuncture vs. a six percent drop among the women who got the sham treatment. However, they did not see a similar finding in the frequency of nighttime hot flashes between the two groups.

Researcher Mary Huang, M.S., of Stanford University, and colleagues say the results suggest acupuncture deserves further study as an alternative treatment for menopausal hot flashes.

Source:
Huang, M. Fertility and Sterility, September 2006; Vol. 86: pp. 700-710. News release, American Society of Reproductive Medicine.

Food for Thought: Better to Eat a Cow than a Fish

I am vegan; however I often talk to folks who are sometimes vegetarians, or those who abstain from red meat. I think for them, the idea of eating a mammal is abhorrent, but occasional fish or chicken seems a tolerable or even desirable protein source. Even for those on an unabashed meat-based diet, the following discussion about which meats to eat may be insightful:

I was fortunate to attend a reading of a discourse read by Ven. Zhaxi Zhuoma Rinoche a couple of Sundays ago. Periodically, she paused to add in editorial comments and take questions that further illuminated and clarified the text. At one point she made a comment which spoke to me. That is that if one is going to eat meat, it is preferable to eat a large mammal which can feed many, such as a cow, rather than smaller life forms such as fish or shrimp. The logic is that if one eats a large animal, only one life is lost to feed many. With the consumption of smaller life forms, such as shrimp or shellfish, it takes many lives to feed one.

I thought this point was important to consider when making food choices. According to this idea, if one does eat fish or foul, larger animals such as tuna, swordfish, salmon, turkey or goose would be preferable to smaller species such as chicken, game hen, trout, catfish, lobster, and so on.

Do not get me started on the lobster.

And do remember if you are eating animals, to be sure they are humanly raised and slaughtered (no slaughter houses) and that they have eaten an organic diet that is hormone and pesticide free. (I will write a future blog post about this issue. Until then, see my September post regarding ways to lower risk of breast cancer for some preliminary thoughts on this topic.)

Eat happy, relaxed, humanely, nutritiously and be fully involved in your food. KB

Studies Show Acupuncture More Effective than Drugs for Headaches

In a December 2008 two doctors from the Department of Anesthesiology at Duke University Medical Center published the results of their systematic review of 25 studies on the use of acupuncture for treatment of headaches in Anesthesia and Analgesia. The authors concluded that acupuncture is more effective than drug therapy in relieving headaches. Here's a short NY Time's piece on their work. KB

Words to Live By

Abstain from all that is evil.
Perform all that is good.
Purify your thoughts.
This is the teaching of the Buddhas.

Common Cold Remedy

Dr. Tan, with whom I study, recommends this implausible remedy for common cold. I'm assured it is effective. You must do it early, when you first notice symptoms:

1 clove garlic
1 lemon, juiced
1 shot hard alcohol

You eat the clove of garlic, mix the lemon juice into a glass of water and drink it and the shot of alcohol. You can do this in any order, but you might want to do the garlic first, and follow it with the lemon water. Or you could chop the garlic into small pieces, and then swallow it like a pill using the lemon water. Go directly to bed, and when you wake the cold symptoms should be relieved or gone. You must do this in the early stage.

This NY Times Really? column may explain just why this implausible remedy works: the garlic. Anahad O'Conner sites a 2001 British study of 146 volunteers where 2 groups were given garlic capsules or a placebo during cold season (November-February). the control group (no garlic) had 75% more colds, lasting longer (5 days vs 1.5 day average for garlic group) and 3x as many virally challenged days as the garlic group. (This study was preformed by Peter Josling, who runs a website promoting garlic supplements).

Garlic has many purported virtues. Odes could be written extolling the virtues of garlic, from warding off vampires to a boon for longevity. Yogis love it and devouring it daily. The Delany Sisters of NY, who both lived to be over one hundred (you may recall their book, and subsequent Broadway play Having Our Say) attributed their longevity in part due to daily garlic, yoga practice and remaining single. (Women live longer if they don't get married, men live longer if they do).

I welcome a review of your experiences using this remedy. KB

Health Reform?

Why is it ok to have mandatory auto insurance and mandatory flood insurance but those who are against health care reform think it's not ok to require mandatory health insurance to ensure that everyone has access to affordable health care? And why is it that those who are against universal health care are the one's who already have health insurance? KB

Cinnamon Oil is Antiseptic

Here's an interesting one: essential oils have antiseptic properties and have such medical uses as hand cleaners in physicians offices to preventing post surgical infections (rather than antibiotics) in hospitals. Intrigued, I googled around on the subject and found a few additional recipes to the Thieves Oil discussed in the Time's article. I made one up using lemon, rosemary, eucalyptus and tea tree oils (12 drops or so each/ 4oz of water in a mister bottle) that I use as a hand sanitizer in my clinic.

The one I made also seems to be keeping the ants out of the kitchen. I mist the counters with the spray. Last year someone some recommended cinnamon for ants, so i got a few 12" sticks and placed them around the kitchen where the ants hang out. It seemed to reduce the population markedly. I got the idea of using the spray from my eco-exterminator who says wintergreen, thyme and rosemary deter insects, especially ants.


Here's a link to the NY Time's article about cinnamon oil's antiseptic uses:

http://www.nytimes.com/2009/09/08/health/08real.html?_r=1&scp=1&sq=%20The%20Claim:%20Cinnamon%20Oil%20Kills%20Bacteria.%20By%20ANAHAD%20O%92CONNOR&st=cse

Here's a video from NBC that shows how to easily make the thieves oil discussed in the Times article:

http://www.nbcnewyork.com/station/as-seen-on/Hand_Sanitizer_-_The_Home_Version_New_York.html

Below is an abstract of one of the studies cited in the Times article.

KB

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJ1-4WCK090-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=600f12f33c67850b96579ade8b543ed0

Here's an abstract of the French study, cited in the Times article:

http://www3.interscience.wiley.com/journal/121385599/abstract?CRETRY=1&SRETRY=0

Reducing Breast Cancer Risk: Excercise, Veg Diet & Limited Alcohol. New York Times Article

Here's a short piece from the NY Time's Science section about a study showing that living a healthy life style decreases breast cancer risk. This study emphasizes maintaining a normal body weight.

Obesity dramatically increases a woman's risk of developing breast cancer by 50-100%, the risk increasing "the older the woman gets and the longer she remains obese." (1) The reason being is that the abdominal fat cells convert steroid (fat soluble) hormones to estrogen. In the breasts, the additional estrogen created binds to the breast cells, promoting "cell division and potentially tumor growth." (2) Cancer cells are abnormal cell growth: the additional cell division cause the tumor growth. Adipose tissue (fat) contains an enzyme, aromatase, that converts steroid hormones into estrogen. After menopause, the ovaries and pituitary gland are no longer signaling for estrogen production through the monthly menstrual cycle. To compensate, the amount of aromatase in the adipose tissue increases to step up estrogen production. Obese women have higher levels of estrogen production taking place in the body fat of the hips and stomach, which increases during menopause, which raises the risk of tumors developing in the breast.

"Glucose [blood sugar] is the preferred substrate for cancer cells. . . [In a study] mice injected with aggressive mammary [breast] tumors were placed on 3 diets. After 70 days 95% of the mice on the low-sugar diet were alive. Of the mice on the moderate-sugar diet 67% were alive. And only 33% on a high-sugar diet were alive. Also 'moderate' alcohol consumption is associated with elevation in the risk for breast cancer from 50-100%." (3)

Phytoestrogens have a chemical structure similar to estrogen. They bind to the receptor sites on the breasts, preventing the body's estrogen from binding and causing tumor cell growth. The phytoestrogens that bind to the breast cell estrogen receptor sites have a weaker influence on breast cell production, so that it is less likely that tumors will form. Common food sources of phytoestrogens include: soy (tofu, tempeh, miso), flax and raw pumpkin seeds, clover and mung bean sprouts. Avoid powdered soy concentrate, these have caused some to develop Hashimoto's thyroid disease. (4)

Studies have shown that phytoestrogens increase the effectiveness of breast cancer treatments. Borage oil has shown to decrease the growth of breast cancer cells. (5)

Eating an organic diet, and limiting exposure to chemicals, including household cleaners, detergents, pesticides, food packaging (plastics leach into foods, especially when warm foods are put into plastic containers) is also important to reduce cancer risk. Chemicals and pesticides can change the DNA of cells, causing them to mutate into cancer cells. Studies have shown higher levels of pesticides and pollutants in fat and blood of women with breast cancer than in healthy women. (6) KB

1-6. Lahans, T. Integrating Conventional and Chinese Medicine in Cancer Care. Elsevier 2007; 92-102.

Study Shows How Acupuncture Stops Pain

This article from the Medicine.net website discusses a western scientific study designed to explain acupuncture's pain relieving effect. It's a quick, interesting read. I would offer the caveat that no acupuncturist would recommend using morphine or other opiates after treatment, a conclusion a quoted researcher mistakenly draws from the study findings. It is validating to see western studies that scientifically verify acupuncture's results. KB

Imaging Sheds Light on How Acupuncture Works

SOURCE: University of Michigan Medical School, news release, August 2009

Studies Show Chinese Herbs as Effective or Better than Drugs for Endometriosis with Fewer Side Effects

Endometriosis is a condition where endometrial tissue, which normally lines a woman's uterus, is found outside of the uterus. This tissue can grow and shed during a menstrual cycle and cause pain, heavy menstrual bleeding, and infertility. "Medical treatment of endometriosis ranges from symptomatic management with nonsteroidal anti-inflammatory drugs and analgesics to hormonal manipulations that include continual oral contraceptives, progestins, danazol, and gonadotrophin-releasing hormone agonists. However [according to the below study], the benefits are short lived, and symptoms often return to pretreatment levels within six months. Under the best of circumstances, more than a third of patients have symptom recurrence within two or three years after stopping therapy."

Symptoms of endometriosis have been treated with Chinese medicine for hundreds of years. Treatment involving herbal medicine, acupuncture, and dietary therapy have afforded women reduced pain, lighter periods, and restored fertility. While more severe cases of endometriosis may require surgery, Chinese medicine may offer an effective treatment for many women.

Gerry Harringon, Harmony TCM Weblog

Chinese Herbs Show Promise for Endometriosis

By Charles Bankhead, Staff Writer, MedPage Today
Published: July 08, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

HOUSTON, July 8 -- Chinese herbal medicine provided relief to symptoms of endometriosis that was equivalent or superior to conventional therapies following laparoscopic surgery, a systematic review indicated.

Action Points

---

• Explain to patients that Chinese herbal medicine appeared to relieve postsurgical endometriosis symptoms at least as well as conventional medical therapy.



• The findings were based on a retrospective review of a large database and involved a small number of patients.

Herbal medicine achieved symptom relief comparable to that of gestrinone but with fewer side effects, Andrew Flower, PhD, of Southampton University in Ringmer, England, and colleagues reported in the Cochrane Database of Systematic Reviews. The pregnancy rate was similar with either treatment.

Compared with danazol, Chinese herbal medicine led to better postsurgical symptom control with fewer side effects.

"These findings suggest that Chinese herbs may be just as effective as certain conventional drug treatments for women suffering from endometriosis, but at present we don't have enough evidence to generalize the results," Dr. Flower said in a statement.

The authors noted that more rigorous research is needed to assess the potential role of Chinese herbal medicine in treating endometriosis. Investigators initially identified 110 studies for their review. However, all but two had to be excluded because of methodologic flaws.

Medical treatment of endometriosis ranges from symptomatic management with nonsteroidal anti-inflammatory drugs and analgesics to hormonal manipulations that include continual oral contraceptives, progestins, danazol, and gonadotrophin-releasing hormone agonists.

Hormonal therapies provide comparable symptom relief and reduction of endometriosis-related lesions, the authors said.

However, the benefits are short lived, and symptoms often return to pretreatment levels within six months. Under the best of circumstances, more than a third of patients have symptom recurrence within two or three years after stopping therapy, the authors noted.

Additionally, the benefits of conventional therapy have to be balanced against potentially serious adverse effects, the authors continued.

Surgery also carries a risk of serious adverse events, such as bowel perforation and peritonitis, and offers no assurance of long-term symptom relief.

"In summary, current treatments all have high rates of recurrence and their short-term benefits have to be balanced with concerns over immediate and longer-term side effects," they said.

Chinese herbal medicine has a clinical history that dates back to ancient times. Among the medical applications is treatment of symptoms associated with endometriosis.

The origin of Chinese herbs' activity in endometriosis is unclear. Suggested mechanisms have included regulation of endocrine and immune systems, improved circulation, and anti-inflammatory activity.

But no English-language systematic review had been conducted to determine whether Chinese herbal medicine has a role in the treatment of endometriosis.

To address that void, Dr. Flower and colleagues searched multiple databases for randomized controlled trials of Chinese herbal medicine versus placebo, conventional medical therapy, another Chinese herb, or as an add-on to conventional therapy.

Of 110 studies originally considered, only two met the authors' inclusion criteria. All 110 studies were conducted in China and were reported in Chinese.

The two studies involved a total of 158 women whose mean age was 30. Diagnostic criteria included laparoscopic diagnosis, American Fertility Society staging, and vaginal or rectal B-ultrasound.

Additionally, all of the patients had been diagnosed according to traditional Chinese medicine as having stagnation of Qi (vital energy) and blood with an underlying kidney deficiency.

All patients had laparoscopic surgery as primary therapy.

One study compared a Chinese herbal medicine enema and gestrinone. In the second trial, patients were randomized to Chinese herbal medicine pills alone, herbal pills plus an herbal enema, or danazol.

Gestrinone led to a symptomatic relief rate of 93.87% compared with 95.6% for the Chinese herbal medicine enema.

During 24 months of follow-up, 69.6% of women assigned to the enema became pregnant, as did 59.1% of patients treated with gestrinone. Neither difference achieved statistical significance.

No adverse events occurred in patients treated with the Chinese herbal medicine enema. In contrast, 13 of 49 patients treated with gestrinone developed acne, while19 had elevated liver enzymes, and 31 had oligomenorrhea.

In the second trial, oral Chinese herbal medicine alone or in combination with an herbal enema led to significantly greater symptom relief compared with danazol (RR 5.06, 95% CI 1.28 to 20.05 and RR 5.63, 95% CI 1.47 to21.54, respectively).

Additionally, the combined Chinese herbal medicine reduced dysmenorrheal pain significantly more than danazol and resulted in a significantly higher rate of disappearance or shrinkage of adnexal masses (MD -2.90, 95% CI -4.55 to -1.25, RR 1.70, 95% CI 1.04 to 2.78, respectively).

Four of 16 patients randomized to Chinese herbal pills alone had dry mouth, and one patient developed acne. Among 24 patients randomized to herbal pills and an herbal enema, two had dry mouth, while 11 developed rectal tenesmus during the first two weeks of treatment, and one patient had weight gain of 3 kg.

Of 18 patients treated with danazol, 13 developed acne, while three had weight gain of 3 kg, two gained 2 kg, one gained 1.5 kg, two had elevated liver enzymes, and four had oligomenorrhea.

The authors reported no relevant financial disclosures.

Primary source: Cochrane Database of Systematic Reviews
Source reference:
Flower A et al. "Chinese herbal medicine for endometriosis" Cochrane Database Syst Rev 2009; DOI: 10.1002/14651858.CD006568.pub2.

Should Junk Food Be Sin-Taxed?

Let me take this opportunity to discuss the proposed surtax on soft drinks to help pay the costs of universal health care. First off, I'm for it, and here's why:

If we go to a universal health care plan, that would mean that we are all in the same insurance pool: we all put money in, and the sick and infirm take money out as needed to provide for their health care. That means that those of us who do preventative care, live a healthy lifestyle and cultivate our health are subsidizing the health care expenses of those who do not take care of their health. Obesity is at epidemic proportions in this country, and has been for some years. The costs of obesity in terms of disease has proportionally been on the rise, namely diabetes is now epidemic also. Other obesity related conditions include hypertension and hypercholesterolemia. These diseases lead to increased incidents of strokes, heart attacks and in the case of diabetes, kidney failure (requiring dialysis and transplants), blindness, peripheral neuropathy due to poor circulation, leading to amputations and so on. Obviously the dollar costs of these procedures as well as on going pharmaceutical use to treat these conditions is high: 150-200 billion $/annually in the US. (Smoking, for comparison, costs 120-150 billion annually). In a universal system that gets averaged out to all who pay in, meaning the healthy subsidize these costs as the rates rise for everyone in the system in order to pay out for those requiring the care.

Obesity is caused by poor diet. The cheap junk foods are the cause of the obesity epidemic. The government subsidizes wheat, corn, soy and tobacco. All of these contribute to poor health, and the heavily subsidized foods are used to make junk food cheap. Corn is used to make corn syrup, the cheap sugar substitute heavily utilized in junk food. Junk food is mainly purchased because it is cheap, so price directly correlates to its use. When price increases, usage decreases. As junk food is a direct cause of obesity and it's related diseases (diabetes, hypertension, hypercholestemia), decreasing the use of junk food will have a direct effect of reducing these diseases and the costs to society (under a universal health care system) for treating them. And because folks choose to eat these offending foods largely because they are cheap, one of the most direct results one can have in affecting behavior that causes obesity is too raise the price of the foods that cause it: junk foods. (Which by the way isn't really food: contrary to popular belief soda, red wine, chocolate and potato chips are not the 4 food groups, and corn chips do not count as a serving of vegetables).

Therefore I feel not only that the cost of soft drinks ought to be taxed, but all junk foods: fast food, donuts, pizza, Twinkies, chips, candy and so on, with the proceeds going to pay for the universal health care/insurance, to offset the costs of additional health care that the consumption of those offending foods cause are incurred by society.

It seems to me that in a society that sin taxes smoking and drinking (cigarettes and alcohol) obesity should be similarly sin-taxed by taxing junk foods.

In addition, I advocate for tax breaks to companies and individuals rewarding preventative care, such as gym memberships, healthy foods at cafeterias and menus, weight loss, smoking cessation, acupuncture, chiropractic and nutritional counseling, stress management, meditation, yoga, tai qi and qi gong classes. Tax breaks should be given when healthy foods are displayed prominently at eye level in stores and cafeterias, with junk foods and sodas/alcohol placed at the bottom/floor level of display cases, or high on shelves where children are present. Rather than subsidizing foods that cause disease, thereby increasing costs to the health care system that we all must incur, namely tobacco, soy, corn and wheat (these subsidized foods become the cheap, raw material of junk foods), the government should instead be subsidizing produce and organically grown foods (which have higher nutritional content and incur less cost to the environment). Remembering that fresh produce is often unavailable or entirely unaffordable in impoverished neighborhoods. As the NY Times reports in the article pasted below, the cost of produce has risen 40% in the past 3 decades, while the price of soda (made with government subsidized corn syrup) has fallen 33% during that same time period. Combined with an increasingly sedentary lifestyle and increased use of restaurants and fast food = a fool proof recipe for our obesity epidemic.

The following article from today's Sunday magazine section of the NY Times: Fat Tax by David Leonhardt lays out a well reasoned argument for surtaxing soft drinks. He postulates such a tax to lower the epidemic obesity and related diseases, such as diabetes, facing our country. These diseases are expensive to treat, increasing costs for everyone thru medicare, medicaid and raising private insurance premiums as the aggregate health care costs increase. Leonhardt argues that sodas (and i would say all junk food) have similar public health costs by causing obesity as cigarettes in causing lung cancer. KB

3 Tempeh Recipes

Occasionally patients mention that they would like to try tempeh, but aren't sure how to cook it. Tempeh is a soy product, made with fermented soybeans and formed into cakes. Often times other ingredients are added, such as grains or seaweed (sea veg). Tempeh has a strong flavor and needs to be marinated or cooked in sauces to moderate the taste. Here are 3 of my favorite tempeh recipes, taken form Peter Berley's cookbook "The Modern Vegetarian Kitchen". Berley is a vegetarian chef who cooked for many years at Angelica's Kitchen, one of New York's original and favorite veg restaurants. I love his cookbook and all of the recipes in it.

In his book Peter recommends using unpasteurized tempeh, which he claims is available in the freezer section. I have never seen it in Asheville. He praises its' texture and ability to absorb marinades.



Barbecued Tempeh

I have brought this to pot lucks and the plate always comes home empty. Non-vegs like to try it and always like it.

1lb tempeh
1/2 C cider vinegar
1/2C soy sauce (i use tamari)
1/2C olive oil
1/3C pure maple syrup
2t ground cumin
2t ground chipoti chili (i sub a Koren red chili i have on hand)
1t dried thyme
1t sweet paprika

I usually double this and bake it in a 9x12 pan.

Preheat oven to 350 degrees.

Slice each block of tempeh in half horizontally, then slice each piece in half. Use a baking dish that will hold the slices in a snug, single layer.

Whisk together the liquids and spices. Pour half the marinade in the baking dish. Place the tempeh on top and cover with remaining marinade. Cover dish with foil, shiny side down, creating a tight seal. Bake 35min in a convection oven or 45-50min in a conventional oven, until most of the marinade is absorbed. Uncover and bake an additional 10 min (conventional oven). Convection: turn off oven and bake additional 9min, until well browned.

Remove and cool. If you are bringing it to a bar-be-que, i like to thrown it on the grill for a few min.

Peter recommends making Bar-be-qued Tempeh into sandwiches with toppings such as: chopped lettuce, sliced kirby or pickling cucumber, clover spouts, watercress and shredded carrots.

I like it as a main dish, served over a bed of brown basmati rice and steamed veggies on the side.

This dish freezers well. Peter advises that it keeps up to 10 days in the refridge.




Apple-Mustard Baked Tempeh Sandwich Filling

I generally double this recipe. The Natural Import Store in Asheville as wonderful, high quality sesame oil, avail mail order or pick-up. I have a link to their website on the bottom of the Resources page of my website www.AcupunctureAsheville.com



1lb tempeh
1 1/3C apple juice or fresh cider
1/3C olive or light sesame oil
3T soy sauce (i use tamari)
3T mustard (i use brown)
1t ground caraway seeds
1t ground cumin (i have successfully subbed curry pwd for the spices)
1/4 t black pepper
Sour kraut


Preheat oven to 350 degrees.

Slice each block of tempeh in half horizontally, then slice each piece in half. Transfer to a steamer and steam over boiling water for 8min.

Whisk together the liquids and spices. Place the tempeh a baking dish that will hold the slices in a snug, single layer. Pour the marinade over the tempeh and bake uncovered 28min in a convection oven or 35-40min in a conventional oven, until most of the marinade is absorbed and tempeh is nicely browned.

To serve, spread tahini and mustard (i use brown) on sandwich bread. Top with tempeh, sour kraut, and spouts or lettuce (i like dandelion greens). I think this makes great summer sandwiches.



Tempeh Simmered in Broth

This simple dish is surprisingly lite. Peter suggests adding a few chopped veggies and some leftover grains or pasta to the broth for a one-pot meal. I like to serve it over a bed of rice with steamed vegs on the side.

1lb tempeh, sliced in bite sized pieces
4C water
3T soy sauce (i use tamari)
1T olive oil
3-4 garlic cloves, lightly bruised with the side of the knife (apparently bruising affects the taste of garlic)
2-3 quarter-sized ginger root slices
1 sprig rosemary
1 sprig thyme
thinly sliced green onions (scallion) for garnish

Combine all ingredients, excepting scallion) in a pot and bring to boil. Reduce to simmer, cover and cook 30min. Remove herb sprigs and serve with sprinkled scallion.

4-6 servings

On the Hidden/Real Costs of Healthcare/Insurance: NY Times Article

I avoid getting political in matters relating to my practice, which would include on this blog. In the case of universal health care, the political relates to my practice, and I find myself no longer able to restrain my urge to speak out.

I suppose first off I should straight out say that I am emphatically for universal health care because it is the humane and compassionate thing to do. With the advances in western medical technology causing health care costs to rise astronomically, I can not see any reason why the so called 'most advanced nation on earth' does not provide health care/insurance for all members of it's society. The notion of not providing health care to all, and rather only providing it to the 'haves', is medieval, IMO.

On the day that Obama will address the nation regarding providing universal health care for all, the New York Times has published an article regarding the hidden costs of health care, which it reports has risen annually to $7,500/person, $15,000/household. Up 5x the cost, from about $1,500/person, in 1960. KB

Mahatma Gandhi Kitcharee: Rice & Grain Dish Works Well for Poor Appetite

In TCM (Traditional Chinese Medicine) we often prescribe a rice porridge called congee for those with poor appetite or difficult digestion, esp. for chronic illness, cancer or chemotherapy. Congees are traditionally made with rice, although any grain can be uses. They are cooked with lots of water (8:1 water: rice) and cooked for a long time (4-8hr: a crock pot is often used). Herbs, meats, dried fruits, sweeteners and nuts are added for flavor and medicinal effect. A respected teacher of mine gave accounts of bedridden patients with cancer brought back from the precipice through the use of congee.

In India, they make a traditional dish called kitcharee, which is similar to the medicinal effect of congee, but less water and cooking time is involved. Kitcharee works well for those who can eat solid foods, but have poor appetite. It's an Indian comfort food. I also think it's a spiritual food, being merely rice and dal (lentils), which may explain why Gandhi enjoyed this simple, nourishing dish.

2:1 rice to dal (yellow lentils)

Any long-cooking rice can be used: basmati, jasmine. I suggest long-grained rice. Being as this is an Indian dish, traditionally basmati rice is used. With loose stools use white rice, with hard or difficult stools use brown.

1: 1 1/2 rice & dal (pre-soaked): water/stock. I suggest soaking the rice for 24h in advance to make it more digestible. According to Paul Pitchford, author of "Healing With Whole Foods" soaking grains for 24h helps to prevent fatigue.

1:2 - 2 1/2 rice/grain: water/stock Use this proportion when using unsoaked grains.

I suggest using 50/50 water & stock (vegetable, beef or chicken). For vegetarians & meditators use vegetable stock. I believe eating a meatless diet aids the transcendence to the spiritual realms. You'll find many spiritual peoples - Buddhists, hindis - eat a vegetarian diet.

Example: 1C long-grain rice: 1/2C dal (yellow lentils). 1 1/2C rice (soaked)/dal: 2 1/4C water/stock or 1 1/2C rice (unsoaked)/dal: 3 - 3 3/4C water/stock.

+ salt (1/2t) I suggest sea salt because it is high in valuable trace minerals. I like to add a few sprigs of fresh parsley.

Pressure cook 15min (low pressure) with soaked rice, longer (30-40min) unsoaked grain. If you are not using a pressure cooker, cook it longer: 40m-1h, until lentils are soft and all the water is absorbed. (First bring to a boil, then turn down to a simmer and cook).

Here's the special favor enhancer:

As soon as the grain has finished cooking heat some high heat oil (1T - olive, sunflower) in a small frying pan on medium heat. As soon as the oil is hot (just a few minutes on a gas stove) add cumin seeds (1/2t) and let them fry for 10 seconds until the aroma arrives and they are foaming. Immediately lift the lid on the grains and pour in the fried cumin seeds, and quickly replace the lid. Let them sit in the pot for 1 minute or so. Then stir and serve. I like to garnish with fresh, chopped parsley or pesto.

Kitcharee can be eaten for any meal - breakfast, lunch or dinner. You can make up a larger quantity and reheat it at meal time. It travels well for brown bagging. KB

Dangers of Using Cellphone While Driving, NY Times Article

The New York Times is running a series on the dangers of using cellphones while driving. This article tells the heart wrenching story of a young man who caused a deadly auto accident because he never saw the red light while engaged in a cell phone conversation.

According to the NY Times research, studies show cell phone drivers have an equal crash risks as a drunk driver. The article cites a 2003 Harvard study asserting that "cellphone distractions caused 2,600 traffic deaths every year, and 330,000 accidents that results in moderate or severe injuries."

"Five states and the District of Columbia require drivers who talk on cellphones to use hands-free devices, but research shows that using headsets can be as dangerous as holding a phone because the conversation distracts drivers from focusing on the road."

"Last year, the federal agency dealing with road safety, the National Highway Traffic Safety Administration, published a study, based on researchers’ observations of drivers, suggesting that at any time during daylight hours in 2007, 11 percent — or 1.8 million drivers — were using a cellphone.
And in a survey of 1,506 people last year by Nationwide Mutual Insurance, 81 percent of cellphone owners acknowledged that they talk on phones while driving, and 98 percent considered themselves safe drivers. But 45 percent said they had been hit or nearly hit by a driver talking on a phone. "

"Seven years ago, when cellphones and services like texting were less common, federal researchers estimated that drivers using cellphones caused about 1,000 fatalities and played a role in 240,000 crashes. (In 2007, drunken driving caused 13,000 fatalities.) "

"University of Utah, Professor Strayer has spent a decade studying driver distraction.
Mr. Strayer’s research, showing that multitasking drivers are four times as likely to crash as people who are focused on driving, matches the findings of two studies, in Canada and in Australia, of drivers on actual roads."

"The highway safety administration estimates that drivers using a hand-held device are at 1.3 times greater risk of a crash or near crash, and at three times the risk when dialing, compared with others who are simply driving. The agency based its conclusions on research from the Virginia Tech Transportation Institute, which placed cameras inside cars to monitor drivers for more than a year. The study found cellphones to be the most common cause of driver distraction.
Research also shows that drivers conversing with fellow passengers do not present the same danger, because adult riders help keep drivers alert and point out dangerous conditions and tend to talk less in heavy traffic or hazardous weather. "

"July 2003, researchers at the National Highway Traffic Safety Administration . . . in a proposed draft of a cellphone policy for the agency as a “a significant body of research worldwide.”
The draft policy said: “We are convinced that legislation forbidding the use of handheld cellphones while driving will not be effective since it will not address the problem. In fact, such legislation may erroneously imply that hands-free phones are safe to use while driving.”
The agency’s current advice is that people should not use cellphones while driving and that hands-free devices do not eliminate the risks of distracted driving. "


"the big device companies even offer warnings [of the dangers of cellphone driving] that remind them of labels on cigarette packs. Verizon Wireless, for instance, posts instructions on its Web sites not to talk while driving — with or without a headset."

". . .Some states have overcome opposition to pass restrictions. Joe Simitian, a state senator in California, managed to get his hands-free legislation, an effort he began in 2001, passed in 2006. . .his bill requiring use of headsets while driving took effect in July 2008. In the first six months the California law was in effect, a preliminary California Highway Patrol estimate showed that fatalities dropped 12.5 percent — saving 200 lives. "

KB

Studies Show Childhood Stress & Trauma Increase Risk For Auto Immune Diseases & Asthma

There have been some interesting studies published recently showing a positive correlation between childhood stress & trauma and auto immune diseases and asthma. Deepak Chopra has been discussing the findings of one of these studies on auto immune diseases on various news channels lately. I have pasted abstracts from a few of these studies published in Psychosomatic Medicine below for your perusal.

As an acupuncturist, this information has peaked my interest.

There are a couple of reasons I wanted to learn more about these findings. First, as a holistic medicine (meaning one that treats the whole: mind/body/spirit, and considers the organism to be inseparable or part of its surrounding environment) Traditional Chinese Medical (TCM) theory has long recognized the relationship between emotions and diseases. In fact, TCM considers the 7 emotions (joy, grief, sorrow, anger, worry, fright, fear) to be a direct cause of disease and pathology in the body. Trauma (coming from the exterior environment) would involve fright, fear, anger, sorrow, grief and worry all of which bind qi (prevent energy in the body from circulating smoothly) causing disease processes to set in: when qi, and hence blood & fluids (it takes qi or energy to move blood & fluids) do not flow smoothly, pain arises, growths (tumours) develop, phlegm accumulates (causing allergy & asthma symptoms) and so on. So a top priority in TCM treatment of any disease is to keep the qi (and hence blood and fluids) flowing smoothly.

The 7 emotions cause qi (blood & fluids) to stagnate (slow down or stop moving). I'll demonstrate this idea with anger: when we get angry we get tense and tighten up. This tightening prevents qi from moving smoothly. Likewise grief and sorrow result in emotional and physical depression, meaning qi slows down or stops moving. With fear & fright we stop, or freeze. Animals demonstrate this physically when they realize there is a predator near. When worrying, we get stuck in a feedback loop, going over and over the same thoughts: like an eddy in a river. The river of qi swirls around itself rather than moving forward with the current.

The studies mentioned here have focused on pediatric factors, but the implications are not limited to childhood trauma. The results can be extrapolated to include adult traumas & stresses as well, according to TCM theory of the 7 emotional causes of disease.

Secondly, I find it interesting that the recent study showed a high correlation between autoimmune diseases and stress & traumas. Let's explore this idea for a moment.

With autoimmune diseases, the immune system is attacking itself. It misidentifies it's own tissues, marking them as foreign bodies (pathogens) that must be attacked and neutralized. Deepak Chopra's interpretation of the study's results is that in the case of abuse or trauma, esp. for a child, one's boundaries begin to blur regarding who is friend and foe: most often the abuser is a family member. The confusion is registered in the body's immune system.

I would postulate that when under stress, this effect is amplified. We feel we are under attack by the outside force who's interaction with us becomes stressful, and due to that stress, we begin an inner dialogue which may in someways be self-abusive. We ruminate, are fearful, depressed and in perpetuating and nurturing these adverse emotions we are attacking ourselves, impeding our own inner peace and harmony. Thus our immune system identifies ourselves (physically) as a pathogen, or a disease causing agent. In a way, in the case of those who have a positive correlation between compromised immunity and high stress or trauma, the immune system can be seen as doing it's job by diagnosing/identifying ourselves (emotions & thoughts) as the disease pathogen, and it then goes on with its mission to attack and destroy the offending agent.

Maybe the lesson here with immune disorders (or any disease process for that matter) is to see if there is something we are doing in mind or lifestyle that is detrimental to the homeostasis of our well being and if so address it.

I realize that I am going out on a limb here with this extrapolation of the study findings. I am not suggesting that all autoimmune diseases can be cured merely by correcting poor life habits and state of mind. Or even that all autoimmune disease are correlated with stress & trauma in every case. What I am saying is that in TCM we know that lifestyle and emotions are a causative factor in the formation of diseases, and that an important component of any treatment plan is to address the role of these adverse factors in the disease process. KB

Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society

ORIGINAL ARTICLES

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: skd7@cdc.gov

Objective:

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult.

Methods:

Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005.

ACEs included

• childhood physical
• emotional
• or sexual abuse
• witnessing domestic violence
• growing up with household substance abuse
• mental illness
• parental divorce
• and/or an incarcerated household member.

The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress.

The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings:

• T- helper 1 (Th1) (e.g., idiopathic myocarditis)
• T-helper 2 (Th2) (e.g., myasthenia gravis)
• Th2 rheumatic (e.g., rheumatoid arthritis)
• and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia).

Results:

Sixty-four percent reported at least one ACE.

The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men.

First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05).

Compared with persons with no ACEs, persons with 2 ACEs were at a

• 70% increased risk for hospitalizations with Th1,
• 80% increased risk for Th2,
• and 100% increased risk for rheumatic diseases (p < .05).

Conclusions:

Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood.

These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Key Words: childhood abuse • traumatic stress • autoimmune diseases • stress • inflammatory response

Abbreviations: ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone

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Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

^{From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.}

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: kd7@cdc.gov

^{http://www.psychosomaticmedicine.org/cgi/content/abstract/71/2/243}

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Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society

ORIGINAL ARTICLES

Received August 5, 2008
Returned for revision November 20, 2008

Double-Exposure to Acute Stress and Chronic Family Stress is Associated With Immune Changes in Children With Asthma

Teresa J. Marin , MA, Edith Chen , PhD, Jennifer A. Munch , BA, Gregory E. Miller , PhD

Address correspondence and reprint requests to: Teresa J. Marin, MA, E-mail: teresamarin@psych.ubc.ca.

	Abstract

Objective: To understand how psychological stress heightens risk for asthma flare-ups, we examined the relationship between acute stress, chronic family stress, and the production of asthma-related cytokines. Methods: Seventy-one children with asthma and 76 medically healthy children completed interviews regarding life stress, and peripheral blood samples were collected. After mononuclear cells had been mitogenically stimulated, production of the cytokines interleukin (IL)-4, IL-5, IL-13, and IFN- was measured. All measurements were repeated every 6 months for 2 years. Children reported on their asthma symptoms for 14 days after each study visit. Results: Children with asthma who had higher levels of chronic family stress showed increased production of IL-4, IL-5, and IFN- at times when they had experienced an acute event compared with times when they had not. These stress-related changes did not occur in asthmatic children with lower levels of chronic family stress, or in healthy controls. The combination of acute and chronic stress was also associated with increased asthma symptoms. Conclusion: These findings suggest that acute negative life events have a particularly strong impact among a subgroup of children with asthma who are under high chronic family stress. The heightened inflammatory profile in this group suggests an explanation for why children experiencing life stressors are at greater risk for asthma exacerbations.

Psychosom Med 2009, doi:10.1097/PSY.0b013e318199dbc3

© 2009 by American Psychosomatic Society


Psychosomatic Medicine 70:1035-1043 (2008)
© 2008 American Psychosomatic Society

ORIGINAL ARTICLES

Childhood Adversity, Early-Onset Depressive/Anxiety Disorders, and Adult-Onset Asthma

Kate M. Scott, PhD, Michael Von Korff, ScD, Jordi Alonso, MD, PhD, Matthias C. Angermeyer, MD, Corina Benjet, PhD, Ronny Bruffaerts, PhD, Giovanni de Girolamo, MD, Josep Maria Haro, MD, PhD, Ronald C. Kessler, PhD, Viviane Kovess, MD, PhD, Yutaka Ono, MD, Johan Ormel, PhD and José Posada-Villa, MD

From the Department of Psychological Medicine (K.M.S.), School of Medicine and Health Sciences, Otago University, Wellington, New Zealand; Center for Health Studies (M.V.K.), Group Health Cooperative of Puget Sound, Seattle, Washington; Health Services Research Unit (J.A.), Institut Municipal d'Investigacio Medica (IMIM) and CIBER en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain; Center for Public Mental Health (M.C.A.), Gösing am Wagram, Austria; National Institute of Psychiatry (C.B.), Calzada Mexico Xochimilco, Mexico City, Mexico; Department of Neurosciences and Psychiatry (R.B.), University Hospital, Gasthuisberg, Leuven, Belgium; Regional Health Care Agency (G.G.), Emilia-Romagna Region, Bologna, Italy; Sant Joan de Deu-SSM (J.M.H.), RETICS RD06/0011 REM-TAP, Barcelona, Spain; Department of Health Care Policy (R.K.), Harvard Medical School, Boston, Massachusetts; Fondation MGEN pour la Santé Publique (V.K.), Université Paris 5, Paris, France; Health Center (Y.O.), Keio University, Tokyo, Japan; Department of Psychiatry (J.O.), University Medical Center, Groningen, Netherlands; and Colegio Mayor de Cundinamarca University (J.P.-V.), Bogota, Colombia.

Address correspondence and reprint requests to Kate M. Scott, Department of Psychological Medicine, School of Medicine and Health Sciences, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. E-mail: kate.scott@otago.ac.nz

Objectives: To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity.

Methods: Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset ( for current age, sex, country, education, and current smoking.

Results: Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49–1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67–2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43–1.91).

Conclusions: Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

Key Words: asthma • childhood adversity • comorbidity • depressive disorders • anxiety disorders

Abbreviations: CIDI = Composite International Diagnostic Interview; HR = hazard ratio; WMH = World Mental Health; HPA = hypothalamic-pituitary-adrenal; CI = Confidence Interval.