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Dr. Lane’s Thoughts XXXIX

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Dr. Lane’s Thoughts XXXIX

1) We have made it absurdly hard for young people to get ahead in this country.  “Good” jobs (this used to be a joke where GOOD stood for “get out of debt) involve putting off adulthood until you finish college (because there are really no jobs for people who don’t go to college). Then, you have to start off in a low-paying job (unless you find an interest in jobs that pay well, like finance or engineering). Rents are out of range for those without a decent income and home purchasing is impossible.  We have all heard what that means – finishing college and moving back in with your parents.

Once a person finishes college, they are now saddled with student loan repayment, which further erodes the small income that they make.  So, you continue to live at home into your late 20s and early 30s.

There are jobs that don’t involve going to college, like those in manufacturing, but companies have cleverly sent them “off-shore” [jobs sent outside the USA] (no jobs = no unions), then “on-shored” them [brought them back but now there is no union to deal with]. 

Jobs that paid $35 in the 1970s and 1980s (an unbelievable amount for that time and the reason that many people could afford a middle-class lifestyle of starting a family with a home and cars) now pay $17 to start (which is not enough to live on your own).  In addition, companies routinely offer work on an “on-call” scheduling [the company will call the employee when they need the employee to come in, usually a call made only a few hours before the hours will be offered] leaving employees with inadequate hours and no chance to take another job for fear that they will miss a call to come to work (and then be fired).

We have young people who find apartments squeezed by inadequate space and high rents alongside elderly people living in large homes who are unable to sell them for what they are worth (after all, who can buy a house when making rent is impossible).  In addition, the elderly people can’t afford to buy a smaller house because (once again) even the smaller houses are not affordable.




MONEY

How Much Do Millennials Make Across America?

Median incomes for young people can vary wildly depending on the state they live in—with the difference between some states peaking at more than $20,000.
Business Insider released a map that shows just how hard Millennials have been hit in the years since 2008’s Great Recession. With student debt at an all-time high and young people not making nearly as much as their parents did, here’s a visual representation of the median income of Millennials across the U.S.

2) As a chiropractor, I have worked for less-than-respectable older doctors (practicing more than 20 years).  What most of them had in common with each other was their dependence on practice-management companies.  These companies go by many names (often with the words “master”, “practice”, “builders” as part of the name) and all purport to be able to increase your patient population and, of course, make you more money.
As far as I am concerned, the only people guaranteed to make money are the practice management companies!
I was forced many times to listen to these people speak on videos and in person because the doctors I worked for had purchased lifetime memberships and felt it necessary that I learn these “truths” of chiropractic marketing and patient retention from these “masters”. 


What I found was that the speakers repeated plain truths that were just common sense (“you must practice your best work with each and every patient!”, “never make a patient wait in the waiting room, but it they do have to wait, tell them why and give them a chance to reschedule!”, “always look neat and professional!’  I need to put the (!) because these people always YELLED their platitudes in the videos. I can only guess that yelling conveyed truth and excitement.  It did not do this for me, but it did make me turn down the volume or turn it off altogether.

Have you noticed a trend here?  This advice was just common sense to chiropractors, this is “kindergarten 101″-level advice.  For some reason these doctors I worked for needed to be told these easy and simple ideas and felt that their ignorance must have been universal and that I needed to hear it as well.  


At a steep price tag!  These “systems” or “programs” cost thousands of dollars!

Still, there was more.  Their advice extended to the suggestion that a doctor should be calling a patient up months after their visit to get them to return to your office.  I have to suppose that this is to remind the patient that they have pain in their body and need to be reminded or told to return to care.  I think that the idea of this call (according to the management companies) was because the patient was completely unaware of their pain until the chiropractor’s office reminded them!  Why else would you need to call people to remind them to return to care?  Are the patients supposed to be too stupid to know that they need care?

I did not make these calls to any patients but the support staff where I worked were required to make the calls.

We do not make these calls in my office at Chiropractic Lane (we have a great deal more respect for patients and their capability to come in when they need our services), but I have to wonder what actually happened on these calls.  

Did patient come back to the office to resume care because the staff reminded them that they had pain?

Office: “Hello Mr. Smith, this is the ABC chiropractic office calling to suggest that you return for care”

Mr. Smith: “I am so glad you called, I am crippled over in back pain and have been for  the last 15 days, but I didn’t know it until you called.  Now I know what to do!”

or

Mr. Smith: “I have been suffering with neck pain for the last 3 months but couldn’t figure out what to do about it – I am so glad you called”

That never happens.  The most common response is probably, “thanks for the call, I will call you when I need you” as the line goes dead as the (now, former) patient hangs up the phone. 
This call is an insult to a thinking person and they will probably seek future care in another chiropractor’s office, if they ever do return to any chiropractor’s office in the future.  Any person would see this as a blatant attempt to get money from a patient, or maybe just an insult to the intelligence of the patient.

At least the doctor thinks he is being smart and proactive.  This is the real job of these patient management and practice management companies – to make the doctor feel like he is doing something to help himself succeed!

My message to these doctor’s seeking the holy grail of success; how about you just treat the patients for longer at each session and use better techniques and modalities?  How about you don’t waste their time with multiple visits to resolve their problem and try to get them on their way in less than 5 visits?  How about you understand that many people have jobs and coming to your office is an inconvenience, especially when they are in pain?

At Chiropractic Lane we make it our job to resolve the musculoskeletal complaint and move the patient on to wellness and a life pain-free.  We accept insurance or a cash price of $60.00 a visit (volume discounts can be arranged).

The truth is, people call your office when they actually need your services.  Any call from a chiropractor’s office that is not initiated by the patient is disturbing their peace and insulting them by making it clear that you don’t believe that they are intelligent enough to know what to do when they are in pain, or even that they are in pain.  Plainly, it is irritating to the patient to hear from us when it is unnecessary. 

The chiropractic marketing and patient retention companies that sell their services to my colleagues are useful only to doctors who are clueless about common business practices and desperate for any patient volume no matter how ill-earned and unnecessary.

One more thing, to all those chiropractors using those practice management services and their (painfully stupid) advice: KEEP DOING IT!  Keep on listening to those companies and following their advice.

That advice is making your patient abandon you and come to my office (SMILES!)

3) I am proud thatto my many patients at Chiropractic Lane and Safety Lane, we are considered a rare find – an office with integrity and honesty.  We treat a patient in as few visits as possible to restore them to their good health and our DOT exams are done from the greeting at the door to the final stage of handing them their medical card in only 30 minutes.

We are a “no bullshit zone” office.

I can’t say that about my competitors.  Every day I hear stories from the men and women who come to my office about what they have to deal with at other places from being harassed to come to the office more often (long after they are restored to good health – see the article above) or made to wait an hour or more to be seen and then the exam takes another hour to do.

Of course the biggest insult occurs at my competitor Concentra Medical Clinics (they are nationwide, so you are probably near one).  Their exam takes 3 hours to get through!  

Yes – we do in 30 minutes what they do in 90 minutes!

To add insult to injury, if you lose your medical card or paperwork (which happens more often than you may realize), Concentra will charge you $40 to replace that paperwork and you have to return the next day to pick it up!

At Safety Lane, if you lose your paperwork just call us so we can make a copy for you and then come in and pick it up.  No charge.  We like our patients and CDL drivers and we do not consider it a burden to assist you with replacement paperwork.

And we charge the same amount for the DOT CDL Medical card as our competitors, so why go there when we are so much better, faster, and nicer?  And you get a nice t-shirt!




4) I consider it an honor to treat our DOT drivers, and that includes the people who speak mostly Spanish.  Our exams can always be done 100% in Spanish!  It is not a problem to us if you are not comfortable in English.

I have young women here who I hire based on the fact that Spanish is their first language, and English is their second language.  I want fluent language proficiency so that communication is always correct and no misunderstandings occur either during a chiropractic visit or a CDL exam.  This is more than my own version of a legal requirement (it is not required in NJ to offer services in any language other than English) but actually more of a desire to be polite.

You cannot have an office in the Ironbound section of Newark, NJ and not have Spanish speakers in the office.  If you think that you can exist as English-only you will be out of business soon – especially if some other business owner has Spanish-speakers working there!

Also, language is more than the words said.  My employees know how to speak in the manner that makes our office friendly and kind.  Simply, South American women speak to each other in a familiar way that is not found in the north and I encourage that.

More than that, healing is more than what I do in my office; it is the atmosphere in which I do it.  Spanish speakers want to be in a place where they can communicate easily.

That is what my employees do – make my office warm and friendly (there is a Yiddish word for this, “HEIMISH” which translates to “warm, homey, friendly”).

5) As a doctor with an office and a phone number, my world is constantly interrupted with people trying to sell me bullshit and lies.  From outright scam artists who mail and call me to those “chiropractic marketing gurus” I mentioned above, I have become both inured and accustomed to the crap that comes to me as a constant river.

6) The conflicts around the world, from actual wars down to fundamentalist suicide bombers who seemed to feel that they have nothing to live for are always based on the same thing: old people who would never put their own families or themselves in harm’s way telling young people who they barely know to die for a cause.  These same old men always join their people in mourning when there is retaliation for their instigations to to war and their attacks on other people.

7) This issue of old men compelling young people to live odd lives that result in death is done on a lesser scale, even just in the strange ways that unbalanced parents can cause their children anguish because of the parents’ odd compulsions.

During my first marriage, I soon learned that my wife’s father had created an odd dialogue with my wife (his daughter) which found her revealing private issues with him for no apparent reason except his own interests.  In most households, adult children are allowed some privacy around their marriage or their bodily integrity.

I would overhear her revealing our sex life and her menstrual cycles with what I assumed was her mother (why a mother needed to know her daughter’s intimate details and why a woman would want to talk these things over with her mother was something I had simply chalked up to the lives that women lead with each other).  

When I questioned why she felt compelled to share this information with her mother she shocked me with her answer!  Imagine my surprise when she informed me that these conversations were not with her mother but with her father!  And before anyone assumes that my wife was very young, puzzled and seeking answers from a learned medical professional I need to tell you that my wife was 40 at that time and her father was a retired high school history teacher.

She told me many times (crying) that she had spent a lifetime trying to distance herself from her father’s prying questions, but always ending up telling him what he wanted to know. The question will never be answered why he felt a need to bother his daughter until she answered such personal queries!  I divorced her very soon after discovering one odd thing about her family dynamics after another.  It got to be too much!

We also need to wonder where her (very much alive and married to her father) mother was in all of this and why she felt that these questions to her perimenopausal daughter was both pertinent and legitimate of her husband, her daughter’s father.

Our marriage ended and my ex-wife moved back in with her parents. The way I say it, both the father and the daughter are my ex-wife now!  

There is nothing healthy about old people ruining the lives of young people for their own selfish needs.

8) Rapes on college campuses are a far more frequent and a far worse problem than anyone can comprehend, especially if the university or college has a vested interest in the rapist. Whether he is a college athlete, or child of an alumni with great wealth who pays the enormous tuition these places charge; in any case, the school wants to protect the rapist, not the student who was raped!

When these events occur, the women soon find themselves not only the victim of sexual assault, but also a victim of the school’s administration as it uses all resources (the campus counseling center’s private records, the school nurse’s private files – both supposedly protected by HIPAA laws but, in actuality, property of the school itself) to create a case against the raped woman!

The woman soon learns that campus employees are beholden to the school that pays their salary! This woman finds herself with no avenues of relief and all trusted people are compelled by their personal economic concerns to assist in the employer’s (the university) devaluing as a human being and the elevation and protection of the campus in which she was attacked!

Schools will never let a single woman be the basis for their problems.  Issues involving sex continue to be viewed through the lens of 1950s values which can be summed up as a “good” woman never allows herself to be placed in a position that she should have had the wisdom and guidance to have avoided.  The school acts as if the knowledge and wisdom of a 19 year old woman should be superior to that of an equally-19 year old male!

Horny star athletes and privileged boys of wealth, neither of whom have heard the word “no” fin the brief lives are now who are also considered to have no responsibility when a woman complains about their behavior.  Layers of lawyers, provided by the alumni, the school, and their parents work hard to quash any investigation, and obstruct the release of evidence, and important things that are both lost and misplaced to keep this “golden and privileged” man-child out of trouble. 

Soon, the rape case disappears and all the powers go back to “normal”.  The true power structure of male-centric universities are revealed as have never changed and not a ripple remains where a young woman once stood.

9)  Walnuts each day keep the doctor away? – Eating a handful of walnuts each day might help keep the doctor away, at least for some people who are at risk of developing diabetes, a U.S. study suggests.

10) Tumeric is great for you but it does not absorb well.  Buy Turmeric with piperine or add black pepper to your food to release  the wonderful powers of tumeric.

11) A new study reveals that when you’re older, your brain health is directly tied to your cardiorespiratory fitness. Seems having a healthy heart and lungs beefs up connections between various regions of your brain, and that’s key to thinking clearly. 

Fortunately, you don’t have to be Jack LaLanne (a chiropractor, graduated from Lincoln Chiropractic College in 1932) to reap the senior cerebral benefits of aerobic endurance. (At 70, he swam 1.5 miles wearing shackles while towing 70 rowboats holding 70 people!) Instead, try these three tips to help you achieve a younger RealAge and better brain function. 

* Practice deep breathing. Close your eyes. Breathe in slowly for a count of four; hold it for a two-count. Exhale slowly and evenly for an eight-count. Repeat 5 times, twice a day. 

* Walk, walk, walk. Aim for 10,000 steps a day; so grab a pedometer and a buddy and enjoy! 

*Maintain a healthy weight with a Mediterranean diet. Healthy weight reduces strain on heart and lungs, eases cardio-damaging inflammation and helps oxygenate your brain and body! 



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Young Adults Are at Highest Risk of Obesity

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Young Adults Are at Highest Risk of Obesity
Individuals aged 18-24 years are at the highest risk of weight gain and developing overweight or obesity over the next 10 years compared with all other adults, and should be a target for obesity prevention policies, say UK researchers.
In the United States, the rate of body mass index change in children nearly doubled from March to November 2020 compared to the rate of BMI change before the Covid-19 pandemic, according to a study published Thursday in the US Centers for Disease Control and Prevention’s report on morbidity and mortality.
The research, published online September 2 in The Lancet Diabetes and Endocrinology, showed that factors more traditionally associated with obesity — such as socioeconomic status and ethnicity — play less of a role than age.
“Our results show clearly that age is the most important sociodemographic factor for BMI change,” said lead author Michail Katsoulis, PhD, Institute of Health Informatics, University College London, UK, in a press release.
Co-senior author Claudia Langenberg, PhD, agreed, adding young people “go through big life changes. They may start work, go to university, or leave home for the first time,” and the habits formed during these years “may stick through adulthood.”

Current obesity prevention guidelines are mainly directed at individuals who already have obesity, the researchers say in their article.
“As the evidence presented in our study suggests, the opportunity to modify weight gain is greatest in individuals who are young and do not yet have obesity,” they observe.
“If we are serious about preventing obesity, then we should develop interventions that can be targeted and are relevant for young adults,” added Langenberg of the MRC Epidemiology Unit, University of Cambridge, UK, and Berlin Institute of Health, Germany.
“Preschool and school-aged children, particularly those with obesity, had larger pandemic-associated increases in BMI than did adolescents,” wrote corresponding author Samantha Lange, an epidemiologist in the CDC’s population health and health care team.
This may be due to closure of many child care centers and elementary schools during the pandemic, which reduced access to healthier food choices and organized exercise programs, according to the report.
In children with obesity, the rate of change was 5.3 times higher during the pandemic, which could lead to significant weight gain, the report said.
Risks for Higher BMI Substantially Greater in the Youngest Adults
The researchers gathered data on more than 2 million adults aged 18-74 years registered with general practitioners in England. Participants had BMI and weight measurements recorded between January 1, 1998, and June 30, 2016, with at least 1 year of follow-up. Overall, 58% were women, 76% were White, 9% had prevalent cardiovascular disease, and 4% had prevalent cancer.
Changes in BMI were assessed at 1 year, 5 years, and 10 years.
At 10 years, adults aged 18-24 years had the highest risk of transitioning from normal weight to overweight or obesity compared with adults aged 65-74 years, at a greatest absolute risk of 37% versus 24% and an odds ratio of 4.22.
Moreover, the results showed that adults aged 18-24 years who were already overweight or obese had a greater risk of transitioning to a higher BMI category during follow-up versus the oldest participants.
They had an absolute risk of 42% versus 18% of transitioning from overweight to class 1 and 2 obesity, at an odds ratio of 4.60, and an absolute risk of transitioning from class 1 and 2 obesity to class 3 obesity of 22% versus 5%, at an odds ratio of 5.87.
Online Risk Calculator and YouTube Video Help Explain Findings 
While factors other than age were associated with transitioning to a higher BMI category, the association was less pronounced.
For example, the odds ratio of transitioning from normal weight to overweight or obesity in the most socially deprived versus the least deprived areas was 1.23 in men and 1.12 in women. The odds ratio for making the same transition in Black versus White individuals was 1.13
The findings allowed the researchers to develop a series of nomograms to determine an individual’s absolute risk of transitioning to a higher BMI category over 10 years based on their baseline BMI category, age, sex, and Index of Multiple Deprivation quintile.
“We show that, within each stratum, the risks for transitioning to higher BMI categories were substantially higher in the youngest adult age group than in older age groups,” the team writes.
From this, they developed an open access online risk calculator to help individuals calculate their risk of weight change over the next 1, 5, and 10 years. The calculator takes into account current weight, height, age, sex, ethnicity, and socioeconomic area characteristics.
They have also posted a video on YouTube to help explain their findings.
COVID and Obesity Pandemics Collide
Co-senior author Harry Hemingway, MD, PhD, also of University College London, believes that focusing on this young age group is especially critical now because of the COVID-19 pandemic.

Lancet Diabetes Endocrinol. Published online September 2, 2021. Full text

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A new injectable hydrogel for cartilage repair

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A new injectable hydrogel for cartilage repair

hydrogel
Credit: Pixabay/CC0 Public Domain

A team of researchers affiliated with a host of institutions in China has developed an injectable hydrogel for use in repairing damaged cartilage. In their paper published in the journal Science Advances, the group describes how they made their hydrogel, how it can be applied and how well it worked when tested on mice and pigs.

Repair of torn or eroded cartilage has improved dramatically in recent years as scientists have learned to grow chondrocytes (cells that grow into cartilage) and to use them to encourage growth of new cartilage. They are typically grown on structures in patches which are then applied to the area in need of repair. One major drawback to such treatment, however, is the need to cut through the skin and lay open the area to be treated. Such treatment can lead to a painful recovery over several months. In this new effort, the researchers have developed a type of hydrogel that can be used for the same type of treatment without the need for surgery.

The hydrogel developed by the team involved using light-initiated polymerization as well as light-induced cross-linked imine organic compounds. The result was a gel that could be applied to a scaffold and which would harden only when exposed to ultraviolet light. This meant that a scaffold could be rolled into a very small shape and inserted by injection to the site needing repair. The gel could then be injected onto the scaffolding. Once in place, all that was needed for the gel to harden in place was to shine a UV light onto the impacted area. The gel would harden within ten seconds allowing the scaffolding with its load of chondrocytes to grow new cartilage.

The researchers tried a variety of scaffolding shapes using lab mice and finally settled on a star-shape. They then further tested their gel by injecting several mice and allowing cartilage to grow for eight weeks. They next tested their approach using pigs that had defective cartilage and monitored the growth of cartilage using MRI scans. They found that after approximately six months, the cartilage in the pigs was restored.

The researchers plan to continue testing their  approach and expect to begin  soon—if all turns out well, they expect their approach to become  for  repair.

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Brief, intense, effective IRT can lower your blood pressure

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Brief, intense, effective IRT can lower your blood pressure

IRT — isometric resistance training — can help you run longer and stronger, too. It does that by placing tension on muscles without any motion in your surrounding joints or any lengthening and contracting of the muscles.

According to a new study published in Nature, IRT is a safe and effective way to lower your blood pressure. Looking at data from 24 trials, the researchers found that regularly doing IRT using a simple handgrip lowered systolic blood pressure by almost 7 mmHg and diastolic by almost 4 mmHg. Bonus: You can easily sneak IRT into your day! It takes only 12 minutes two to three days a week to see positive results using a handgrip device (or just making a fist very intently).

Other forms of IRT include planks, ab/core contractions and the wall sit — a workout for quadriceps, hamstrings and glutes. 1. Stand about 2 feet from a wall and lean your back against it. 2. Sink down so your thighs are parallel with the floor, if possible. 3. Hold for 15 seconds. 4. Aim for five rounds of 15 seconds each. For other IRT exercises, Google “isometric exercises”; go to videos. Start slowly. You want to contract your muscles, not contract an injury.

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Eating Omega-3s Is Directly Connected to Longevity

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Eating Omega-3s Is Directly Connected to Longevity

Here Are the Top 7 Foods.

The solution to aging isn’t just in increasing the longevity of life but being able to remain healthy and active as you grow older. 

One way you can do this is by increasing your intake of omega-3 fatty acids. 

It’s no coincidence that researchers, doctors, and dietitians are recommending them, particularly for brain and heart health.

Omega-3 and Longevity

Evidence that Omega-3s are important for healthy aging can be seen in a Cardiovascular Health study published in the British Medical Journal. 

In this recent study, researchers set out to determine if there was an association between omega-3 levels and healthy aging. 

They did this by tracking over 2,600 participants over a span of 23 years, analyzing the omega-3 levels in their blood. 

Researchers found that a higher level of DHA and EPA in the body was associated with a higher likelihood of healthy aging. (1)

So, what are omega-3 fatty acids? 

Omega-3s are essential fats, which means the body cannot make them on its own. The good thing is these essential fatty acids come from some of the most nutrient-rich foods. 

There are three main omega-3 forms that are associated with health benefits. These are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha linolenic acid (ALA). 

EPA and DHA are found in seafood, while ALA comes from plant-based foods. (2)

It’s not just the omega-3s that play a role in healthy aging, but the ratio between omega-3 and another fatty acid called omega-6. 

While both fatty acids can improve heart health, higher consumption of omega-6 fats is more common (3).

This is because foods containing omega-6s are more abundant in the typical Western diet found in the United States. 

Consuming more omega-6 fats than omega-3 fats has been linked to inflammation and an increased risk of disease. 

This makes the intake of foods rich in the nutrient omega-3 very important. 

Here Are 3 Ways Omega-3 Fatty Acids Can Extend Your Lifespan

Lowers Risk of Heart Disease

Research shows that omega-3 fats can help reduce the risk of heart disease and reduce the risk of sudden cardiac death. 

In one particular study, scientific evidence suggested that early intake of as little as 1 gram per day of omega-3s reduced the risk of heart disease by 25%. It also reduced the risk of sudden cardiac death by about 45%. (4) 

People who eat fatty fish and other seafood regularly, also have a higher chance of lowering other risk factors for heart disease. 

For example, consuming more omega-3s may help lower blood pressure, lower triglyceride levels, lower bad cholesterol (LDL), and raise good cholesterol (HDL).

Reduces Inflammatory Response 

Inflammation is a normal defense response that protects the body from infection and other injuries. 

However, if inflammation becomes chronic, it can lead to cardiovascular disease and other serious health conditions. 

Studies indicate that omega-3s have anti-inflammatory properties and are useful in managing inflammation and auto-immune diseases. 

Individuals with Rheumatoid arthritis have seen significant benefits including decreased stiffness and lower use of medications (5).

Improves Cognitive Function

The omega-3 fatty acids EPA and DHA are important for normal brain function and development. As we age, it is not uncommon to see a decline in cognitive function. 

With over 50 million people worldwide currently living with dementia, it makes you wonder what can be done to slow the decline. (6)

Evidence suggests that a healthy diet full of omega-3s may slow the decline and help protect against dementia. (7)

Curious to see if your eating habits are hitting the mark? Here are the seven top omega-3 foods that are good for heart health and healthy aging:

Top 7 Food Sources of Omega-3s

1. Fatty Fish

Fish is a great source of protein and is low in saturated fat. 

Fish (particularly oily fish) like albacore tuna, salmon, trout, herring, sardines, and swordfish provide significant amounts of EPA and DHA. Fatty fish also provides good amounts of Vitamin D and selenium.

Along with this variety of fish, mackerel also has a high omega-3 content. However, king mackerel contains a high level of mercury, so pregnant women and young children are advised to avoid this fish. (9)

To get the full benefits of omega-3 fats, the AHA recommends eating two 3.5-ounce servings of fatty fish every week. (9)

2. Shellfish 

Shellfish also provides significant amounts of EPA and DHA. 

Shrimp, crab, and lobster contain the highest amount of omega-3s of all shellfish. They are also a great source of zinc. 

Although not technically considered shellfish, oysters, clams, and scallops are also enjoyed as seafood that have a high omega-3 content. (9)

3. Walnuts

Walnuts are the only tree nut that are a good source of ALA. 

As one of the best plant-based sources of omega-3 fats, a one-ounce serving of walnuts provides 2.5 grams of ALA. (10) Walnuts are also rich in antioxidants. 

4. Flaxseeds

Flaxseed is one of the richest plant sources the omega-3 fatty acid ALA.

 Known for its nutty flavor, these brown little seeds can be added as an ingredient to practically any food. 

Add whole flaxseed to your cereal or trail mix or grind up the flax and add it to baked goods or a smoothie. 

Benefits of ALA can be seen with a serving size of 1 Tbsp (7 grams). (11)

These tiny but powerful seeds are also packed with whole grains and are a great source of dietary fiber. 

5. Chia Seeds

Chia seeds are another great source of ALA. They are also a good source of magnesium, phosphorus, protein, and a good source of fiber – which helps with digestion (10).

Like flax, it is a very versatile seed that can be added to just about any whole food. Sprinkle chia seeds on yogurt or add them to salads or salad dressings. 

Mix it with water and make a chia pudding. 

For the benefits of chia seeds, use 1-2 tablespoons. 

If you decide to start adding chia and flax seeds to your diet, it is best to add them in small amounts. 

Since they are both good sources of fiber, eating too much too quickly can cause stomach discomfort. 

6. Edamame 

Another great plant-based source of omega-3 foods is edamame. They are not only rich in omega-3s but are a great source of plant-based protein. (10)

Boiled or steamed edamame work well in a salad or as a snack or appetizer. 

Other soy foods like tofu are a rich source of omega 3. Tofu is made of soybean curds and is a good source of iron and calcium. 

7. Algae

Algae and seaweed are important sources of omega-3s, as they are one of the few plant sources that contain DHA and EPA. 

Seaweed can be eaten as a salty, crispy snack or as wrap-around sushi. It can also be used for cooking in the form of algae oil. 

Algae Oils are a rich source of omega-3 fats. Other oils that have a high omega-3 content are flaxseed oil, hemp seed oil, canola oil, and walnut oil. (12)

Omega-3 supplementation has also gained quite a bit of popularity over the past decade. Fish oil pills, made from the tissue of oily fish, also have a high omega-3 content. 

Fish oil supplements may be helpful to ensure you are getting an adequate intake of omega-3s, especially if you are vegan or do not consume seafood. 

Not all pills and dietary supplements are created equal though, so make sure to look for brands with higher amounts of EPA and DHA.

Summary 

Supporting bone and joint health, as well as cognitive function, fighting inflammation, and reducing the symptoms of heart disease are all important in the success of healthy aging. 

Regularly consuming adequate amounts of foods with omega-3s, especially the ones listed above, is a great way to start ensuring that success. 

References 

  1. Lai H T, de Oliveira Otto M C, Lemaitre R N, McKnight B, Song X, King I B et al. Serial circulating omega 3 polyunsaturated fatty acids and healthy ageing among older adults in the Cardiovascular Health Study: prospective cohort study BMJ 2018; 363 :k4067 doi:10.1136/bmj.k4067 
  2. Omega-3 supplements: In depth. National Center for Complementary and Integrative Health. https://bit.ly/3z7ENIW. 
  3. Simopoulos AP. Importance of the ratio of omega-6/omega-3 essential fatty acids: Evolutionary aspects. World Review of Nutrition and Dietetics. 2003:1-22. doi:10.1159/000073788
  4. Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105(16):1897-1903. doi:10.1161/01.cir.0000014682.14181.f2
  5. Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans. 2017;45(5):1105-1115. doi:10.1042/BST20160474
  6. Dementia. World Health Organization. https://bit.ly/3hpfaxv. Published September 2020. 
  7. Abubakari AR, Naderali MM, Naderali EK. Omega-3 fatty acid supplementation and cognitive function: are smaller dosages more beneficial?. Int J Gen Med. 2014;7:463-473. Published 2014 Sep 19. doi:10.2147/IJGM.S67065
  8. Fish and omega-3 fatty acids. https://bit.ly/38Zdwhd. https://bit.ly/3k1rNQL. Published March 23, 2017. eat right .org citation
  9. The dietary guidelines for Americans 2015-2020. https://bit.ly/3E8ijLM. 
  10. Plant sources of omega-3s. Cleveland Clinic. https://cle.clinic/3lfVi0J. 
  11. Rodriguez-Leyva D, Dupasquier CM, McCullough R, Pierce GN. The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol. 2010;26(9):489-496. doi:10.1016/s0828-282x(10)70455-4
  12. Scott D. Doughman, Srirama Krupanidhi, Carani B. Sanjeevi. Omega-3 fatty acids for nutrition and MEDICINE: Considering MICROALGAE oil as a vegetarian source of EPA and DHA. Current Diabetes Reviews. 2007;3(3):198-203. doi:10.2174/157339907781368968 

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Fighting Cholesterol – The Next Generation of Medicine

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Fighting Cholesterol – The Next Generation of Medicine

By Stephen L. Kopecky, MD, as told to Susan Bernstein

Stephen L. Kopecky, MD, is a professor of medicine and a consultant for the Division of Preventive Cardiology, Department of Cardiovascular Medicine, at the Mayo Clinic in Rochester, MN. He is the author of Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer’s, and More, publishing in August 2021.

We want patients with high cholesterol to know three things. deal with them. One, high cholesterol is really a culprit in heart disease. If the cells in your body don’t get cholesterol, it’s harmful. But too much can be worse. The second thing to know is that there is cholesterol in the plaque that’s inside your arteries, and we have medications that are treatments for this. The third thing to know is that these treatments are safe and effective. If there are side effects, we can deal with them.

The New Landscape of Cholesterol Medications 

While statins are the mainstays of treatment, one of the most helpful of the newer medications is ezetimibe (Zetia). It’s a generic now, so it’s less expensive than it used to be. It’s especially helpful in people who are 75 or older.

PCSK9 drugs, which are monoclonal antibodies, are another game-changer in cholesterol management. These drugs block the PCSK9 protein. As low-density lipoprotein (LDL) cholesterol — what people call “bad” cholesterol — goes into your liver, the PCSK9 will hold the LDL and the LDL receptor together.

What usually happens is the LDL fits into the LDL receptor on the surface of the liver cell. When the LDL fits into the LDL receptor on the liver, the PCSK9 protein will hold the receptor and the LDL together so the liver metabolizes them both. The receptor can’t be used again.

With these drugs, both the receptor and the LDL go into the cell. The liver metabolizes the LDL, but the receptor is freed up to be used again to process more LDL. Usually, the receptor can be reused around 200 times total. This markedly reduces your LDL cholesterol levels.

PCSK9 inhibitors have the same side effect profile as statins, including myalgias (muscle pains) and nasal stuffiness, although this usually goes away. These drugs have also started to come down in price, and more insurance companies are accepting them. This treatment is very helpful for patients with familial hypercholesterolemia (FH) who may not be able to get to their cholesterol goals with a combination of a statin and ezetimibe alone. The PCSK9 drug works on top of the statin and ezetimibe for these patients.

Long-Acting Treatment

Inclisiran is as close as we have to a vaccine for high cholesterol in the near future. It works on your RNA — one of the nucleic acids that carries your genetic code. It helps your body do what it’s supposed to do. This may be especially helpful for FH patients, who have high cholesterol because of genetics. My patients with FH often say to me, “Why do I always feel like I’m being blamed for my high cholesterol?” We need to do a better job of making sure that people don’t feel that way.

Inclisiran (Leqvio) is currently in phase III studies. It can lower cholesterol, but it remains to be seen if it lowers the incidence of cardiovascular events such as heart attacks. We have had other medications that lower your numbers or raise HDL (“good”) cholesterol but didn’t lower cardiovascular events. This is a small, RNA-interfering drug — it makes it so the body can’t use the RNA, so you make less PCSK9.

You can take inclisiran only once every 6 months, which may appeal to some patients. But I have some FH patients in my clinic who say, “I’ll have this drug in my system for 6 months? Will I have side effects for 6 months?” We encourage people to ask such questions about their medications.

Other New Treatments

Another new treatment that may come out soon is one that blocks lipoprotein-a. It’s in studies now. You would take these drugs as one shot under the skin every 6 months. Lipoprotein-a is part of the LDL family, but it’s also pro-inflammatory and promotes clotting. This combination can be devastating. This si-RNA drug would block that process from happening — it’s very targeted.

Never forget about your lifestyle if you have high cholesterol. It’s important that patients do all they can through their lifestyle to try to modify their cholesterol levels. STEPHEN L. KOPECKY, MD

PCSK9 drugs were game-changers. For the first time in the history of our species, people with familial hypercholesterolemia have a treatment option. Lipoprotein-a drugs will be a game-changer too.

There are some other newer treatments, including bempedoic acid, which is an adenosine triphosphate-citrate lyase (ACL) inhibitor. It’s like a statin but works earlier in the cholesterol formation pathway than statins. It doesn’t have the same myalgia side effects as statins, but it may raise uric acid levels and make gout worse in people who have that condition. It may also have a link to an increased risk of tendon rupture.

Bempedoic acid is appropriate for many patients on the maximum dose of statins and those with genetic causes of high LDL. But we have to be careful, talk about the side effects, and watch them carefully, especially if they have a history of tendon rupture.

There is another exciting newer treatment, a fish oil called Vascepa. This is purified EPA, unlike classic fish oil. It’s a fish oil, but it’s prescription only. It seems to lower your risk of heart attacks and strokes if you’re on a statin for your LDL, but your triglyceride levels are high.

Lifestyle Changes Are Still the Key

Even with these treatment advances, never forget about your lifestyle if you have high cholesterol. It’s important that patients do all they can through their lifestyle to try to modify their cholesterol levels. If you already have heart disease, or if you have had a heart attack or have a stent, there’s no time to wait. You do need to start taking medications early.

Dietary changes can help, especially eating foods that help lower cholesterol or avoiding processed foods and processed meats. About 58% of the calories we eat in the U.S. are classified as ultra-processed foods. If you don’t eat healthfully — including more fruits and vegetables, less red meat, and less processed food — your cholesterol numbers may look better, but your risk of a heart attack or your eventual need for a stent doesn’t go down to an equal degree.

It’s all about having good lifestyle habits. The advances we’re making are great, and the si-RNA molecules in particular will be very helpful for some people. But a pill doesn’t replace a healthy lifestyle.

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Injectable Liraglutide Plus Lifestyle Changes Reduce Visceral Fat in Overweight, Obese Adults

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Injectable Liraglutide Plus Lifestyle Changes Reduce Visceral Fat in Overweight, Obese Adults

NEW YORK (Reuters Health) – In overweight and obese adults at high cardiovascular risk, once-daily subcutaneous liraglutide plus changes in diet and physical activity reduced visceral fat, a single-center phase 4 placebo-controlled trial showed.

“We have good evidence that visceral fat is associated with a higher risk for diabetes and heart disease than subcutaneous fat,” Dr. Parag Joshi of the UT Southwestern Medical Center in Dallas told Reuters Health by email. “We knew liraglutide helps with weight loss; however, we didn’t know how it affects these different types of fat.”

“It is reassuring to know that the type of weight that is lost (with liraglutide) is associated with higher risk, and this is an effective way to lose that type of fat,” he said. “It would be great to show that the more visceral fat lost led to better outcomes (fewer heart attacks or new diagnoses of diabetes) but that would take a very large study.”

As reported in The Lancet Diabetes and Endocrinology, Dr. Joshi and colleagues randomized 185 adults with a BMI of at least 30 kg/m2 or BMI of at least 27 kg/m2 with metabolic syndrome but without diabetes to 40 weeks of once-daily subcutaneous liraglutide 3.0 mg or placebo, in addition to a 500 kcal-deficient diet and guideline-recommended physical activity counseling.

One hundred and twenty-eight participants were included in the final analysis: mean age, 50; 92% women; 37%, Black; 24%, Hispanic; and mean BMI, 37.7 kg/m2.

The primary endpoint was percentage reduction in visceral fat measured with MRI.

The mean change in visceral fat over a median 36.2 weeks was −12.49% with liraglutide versus −1.63% with placebo.

The authors note, “The relative effects of liraglutide on fat reduction were two times greater in the abdominal viscera and six times greater in the liver than seen on overall bodyweight.”

The effects seemed consistent across subgroups of age, sex, race/ethnicity, BMI, and baseline prediabetes.

The most frequently reported adverse events were gastrointestinal-related (47% with liraglutide and 13% with placebo) and upper respiratory tract infections (11% versus 15%).

The authors conclude, “Visceral fat reduction may be one mechanism to explain the benefits seen on cardiovascular outcomes in previous trials with liraglutide among patients with type 2 diabetes.”

Dr. Vincent Fong of the UC College of Medicine in Cincinnati, a specialist in internal medicine and endocrinology-diabetes and metabolism, commented on the study in an email to Reuters Health. “We have known for some time that visceral and ectopic fat were much more associated with metabolic dysfunction when compared to subcutaneous fat, and that liraglutide has shown ability to reduce both in previous studies in patients with diabetes. There are some data that other medications of the same class (GLP1 receptor agonists) also have similar effects.”

“What is good about this study is that it was a prospective randomized controlled trial with a relatively large sample size and detailed measurements of different fat depots,” he said. “What is new is that none of the participants had diabetes, and most did not even have prediabetes.”

“So, as a physician, if that was a distinction that you used to decide whether or not to prescribe liraglutide, then this study would make a very big difference in your practice,” he said. “If not, then it is still helpful in that it is provided high quality data supporting its benefits reducing metabolically active fat, but maybe does not drastically change prescribing practices.”

However, he noted that “in reality, liraglutide is very cost-prohibitive and that is a much larger factor in prescribing decisions.” Very few payors cover the 3 mg dose, which is indicated for obesity, and was the dosage used in the study, he said. “It would be very difficult for most people to afford the treatment, so if cost doesn’t change, then it doesn’t matter what the benefit is if patients can’t afford it.”

“Similar studies using medications of the same class are needed to prove whether this is a class effect, as many believe, versus a liraglutide-specific benefit,” he added.

“It is my opinion that it is likely a class effect, so in agreement with ADA Standards of Care for treatment of diabetes, GLP1 receptor agonist medications should be considered early in patients with established cardiovascular disease or high risk of cardiovascular disease,” Dr. Fong concluded.

The study was funded by NovoNordisk. Dr. Joshi and one coauthor have received fees from the company.

SOURCE: https://bit.ly/3mGbQ4b and https://bit.ly/2WAOceO Lancet Diabetes and Endocrinology, online August 3, 2021.

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Dr. Lane’s Thoughts XXXVII

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Dr. Lane’s Thoughts XXXVII

1) I was just at the largest meeting of chiropractors in the world, The National in Orlando Florida between August 25 and 29, 2021.  Ostensibly, this meeting belongs to the Florida Chiropractic Association (FCA) but it offers credits for other states and I can attend because all those credits are accepted in NJ.  Also, without a doubt, it is much nicer to be in Orlando than NJ with my family so it counts as a vacation for my wife and I.

This is where I go to learn about my profession, learn new things in my profession, and get lots of cool stuff from vendors (more in this meeting that in more local meetings, perhaps as many as 200 compared to the 30 or so that go to other state association meetings) and get my fill of chiropractic philosophy.

It is this subject that I want to touch on because it relates to the pandemic of COVID-19.  Because of the outstanding ideas of chiropractic many of my colleagues are against masks and vaccinations in the time of national calamity.  For the record, I LOVE MASKS and I LOVE VACCINES.

Chiropractic philosophy preaches (yep, I used that word) that a healthy person does not need to use protection from outside the body because if you are healthy your natural immunity will cause you to be able to avoid illness or, if you become ill, the illness will be short-term and leave no lasting problems.

I do not doubt for a minute that they are right: if a person can devote their whole life and actions to maintaining a healthy personal world of good food, adequate exercise, good life choices in terms of stress and occupation, and gets lots of chiropractic adjustments  – they should be able to fight infections of all kinds.  No doubt that I saw hundreds of health men and women (more than 80% white) at this gigantic convention and it is easy for me to assume that they will remain healthy though this pandemic and any other pandemic that will occur in the future; no doubt these are very healthy people ‘living la vida loca’ with their good choices in life.

My many lovely ELITIST colleagues.  So nice to look down on the rest of our mutual shared world by telling everyone that they are not meeting some strong recommendations about making better health choices in their life; that these ‘others’ are in violation of the Vertebral Subluxation Complex (a made-up term from 100 years ago that is more of a sales pitch than a real health/medical emergency).

My patients are not wealthy, well-educated mostly white people living in nice communities with easy access to fresh fruits and vegetables, clean lead-free water, comfortable jobs with stress-minimizing accommodations, and plenty of vacation days for when things get a little rough.  My patients live here, in Newark NJ and the surrounding area.

I work in Newark, NJ with patients who are mostly truck drivers and cleaning ladies, a majority who do not speak English or speak it well-enough to get better jobs or even access to greater occupations, or even an education to grab those better jobs.

I do not intend to belabor the issue of being immigrants, language, opportunities, white privilege and all the other myriad socioeconomic issues that I cannot presume to be an expert in.  This is not the issues I ponder daily.

What I can do is this: wear a mask and gloves in my office, put my patients in masks and gloves in my office, and set an example to wash your hands and wear a mask in public and carry hand sanitizer and use it.  In other words, do everything that the CDC and President Biden and Dr. Fauci suggest.

I will never look down or talk down to the thousands of patients who trust me to answer their questions and show them compassion in their visits to my office.  I will never tell them that they are making mistakes by not doing more in terms of their health or waste their time with reams of information about chiropractic philosophy (I trust chiropractic philosophy but still get my vaccines and use masks).

To my colleagues: this is medical profession and not a religion.  Do not talk to me as if I need to be ‘saved’ and trust that the greatest gift you have through your graduate education and your faith is your intelligence to make wise choices and to teach others to also make wise choices.  You will do more by teaching people to make good health and food choices than to put your blind faith into the actions of others or tell your patients to trust your invisible truths.

2) We will soon be offering CBD products through our website cbd-lane.com.  There is a great deal of confusion about CBD (Cannabidiol is a phytocannabinoid discovered in 1940. It is one of 113 identified cannabinoids in cannabis plants, along with tetrahydrocannabinol, and accounts for up to 40% of the plant’s extract.) which affects the ECS (The endocannabinoid system (ECS) is a complex cell-signaling system identified in the early 1990s by researchers exploring THC, a well-known cannabinoid. Cannabinoids are compounds found in cannabis.).

The ECS system exists inside your body parallel and equivalent to your nerve pathways and acts on different areas of your health and well-being than the neuromuscular systems that we already familiar with. It is a group of neuromodulatory lipids and their receptors, which are widely distributed in mammalian tissues. ECS regulates various cardiovascular, nervous, and immune system functions inside cells.

Lets get our terms correct:

THC (marijuana) is Delta-9 and makes you ‘high’.  It can be detected in a drug screen.

CBD is Delta-8 (read that again: it is DELTA-8) and cannot be detected on a drug screen. a LABORATORY drug screen.  It will be read as marijuana (THC) on a ‘quick test’ drug screen and appear as a ‘positive’ – if you are only using Delta-8 then you should ask for a laboratory test to show that you are only using Delta-8.

If you are using both Delta-8 and Delta-9 then understand that you will show up as a positive.  This can lead to you losing your job or going to jail.

I am not going to go into detail about all the crappy and non-working products out there labelled as “Delta-8) or “CBD” or “Hemp Extract”.  There is a lot of garbage products out there but I intend to educate you and explain why our products are superior.

Things you need to know:

A) My gummy products will give you a small ‘high’.  This capability cannot be removed from my products so either enjoy this feeling or don’t use them.

Why can’t the ‘high’ be removed?  If I took away your right arm and left leg would you still be you?  Yes, you would still be yourself but handicapped.  The complete you with both legs and arms works better and is more efficient.  One part of my products cannot be removed; it will lose efficiency, efficacy, and effects.

This not heroin or any other addictive drug.  The high wears off and you are fine.

Personally, I have found no trouble working, driving, or communicating when I have this ‘high’.

To be safe: use half a gummy when you start using it in order to assess how much is the right amount for you.

B) My products are inspected and have a COA (certificate of authenticity) which can be viewed using a smartphone.  This is proof from a laboratory that what I state is in the products is actually there.  This is a LEGAL proof and any kind of deception in this level is a federal crime.

Not you can look at all the products being sold online and in stores and just about anywhere and you will see that they do not have a COA.  This is how you know that they are garbage and do not work.  It does not matter where they are (Amazon, Walmart, etc.) or what they are called “Hemp”, “CBD” “Hemp Extract” if they do not have a COA they are not lab-tested because the manufacturer knows that there is nothing inside of them to support the claims they make.

So why not just fake a COA?  That is illegal and a violation of federal law.

Why not just go through the steps of getting a COA?  This COA is very expensive.  Expensive as in less profit for the manufacturers who just want to make money and not provide a service.  It also means that you actually know what is in your (possibly fake) CBD product.  And even if you do know what is in your product, you also need to have it consistently have the same levels of Delta-8 from sample to sample which a COA informs the buying public.

C) I have only 3 products, not a dozen in different flavors.  I stand behind the products I sell that they will do what I state on the label.  My products are manufactured for me and are my brand.  We may add new products in the future.

D) I use my own products because I know that they work – all the time and every time.  I get muscle aches, stress, and pain like every other human.  I only endorse things that work.

One more area of elucidation, “Full Spectrum” versus “Broad Spectrum”.

Full spectrum: the complete product and non-adulterated.  This product will deliver the full benefits of CBD.

Broad spectrum: The manufacturer altered the CBD in some way in order to deliver his product.  Most likely he altered it to be less narcotic or to enhance some aspect he thinks is beneficial to the consumer.  Do not expect this product to deliver the full benefits of CBD.

3) Michael K. Williams died.  He was 54.  He is most famous for playing the character of Omar Little on the show “The Wire”.  Intimidating and unpredictable living by his code code of conduct, beyond the idea of good and bad Omar scared everyone on the show as he walked the streets of Baltimore.

What was unique about this character was that he robbed drug dealers on the show.  He was also gay and had a boyfriend – this was long before a gay character was acceptable on network TV who wasn’t a lisping parody of actual gay people and Omar Little was anything but the standard gay character.  The audience for “The Wire” loved the Omar character.

Michael K. Williams will be missed.


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Implanted Stimulator a ‘Paradigm Shift’ for Low Back Pain?

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Implanted Stimulator a ‘Paradigm Shift’ for Low Back Pain?

A safe and minimally invasive implanted stimulation device is getting mostly positive reviews from neurosurgeons, with some experts saying it represents a “paradigm shift” in the treatment of mechanical low back pain.

Results from a multicountry study show that the ReActiv8 device (Mainstay Medical Limited) is efficacious, improving function and reducing pain for up to 2 years for patients with back pain caused by loss of function in the multifidus muscle.

“We’re really getting a muscle that wasn’t going to fire again,” co-investigator Chris Gilligan, MD, chief of the Division of Pain Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, told Medscape Medical News.

The intervention represents the first restorative neurostimulation for back pain, Gilligan said. Conventional spinal cord devices stimulate sensory nerves and merely cover up pain, he noted.

“This isn’t covering up pain. This is restoring function of the strongest stabilizing muscle of the lumbar spine and in that way returning neuromuscular control and stability such that the patient’s pain improves,” Gilligan said.

The findings were discussed at the American Association of Neurological Surgeons (AANS) 2021 Annual Meeting, which was held online.

“Like a Pleasant Massage”

Patients with chronic neuropathic low back pain may be candidates for surgical procedures, such as fusion or decompression. However, these are not options for the larger population of individuals with nociceptive mechanical pain, many of whom have dysfunction of the multifidus muscle.

The current study included 204 relatively young patients (mean age, 47 years) who were enrolled at 26 sites around the world, including 16 sites in the United States. Baseline score on a low back pain visual analogue scale (VAS) was 7.3 cm, and the baseline Oswestry Disability Index (ODI) score was 39 points.

Participants had had low back pain for about 14 years and had experienced pain on 97% of days in the prior year. Virtually 100% had previously undergone physical therapy without success.

For all patients, pain medication had failed: 37% were taking opioids at the start of the study, and interventional pain therapies, such as steroid injections, had failed for 52% of the patients.

The participants were randomly assigned either to the therapeutic stimulation group or to a sham stimulation group.

FDA Approval

On the basis of these results, the US Food and Drug Administration (FDA) approved the device last year, as reported by Medscape Medical News at the time.

For 156 patients, their condition continued to improve at 2 years, said Gilligan. “The longer you treat, the greater the benefits,” he said.

Some patients found they needed less and less stimulation, to the point where the implant was removed. Others continue to regularly use the stimulator. One patient in Australia has had it for 7 years, Gilligan reported.

During the sponsored session featuring the research, Robert M. Levy, MD, PhD, president of the International Neurostimulation Society, said the stimulator should “have a great impact” because neurosurgeons have had little to recommend to back pain patients who are not good candidates for a spinal operation.

“For the very first time, there is a minimally invasive, safe, and yet highly effective procedure to offer these patients,” Levy said.

Other session speakers agreed that the device represents “a paradigm shift” in treating such patients.

American Association of Neurological Surgeons (AANS) 2021 Annual Meeting. Lunch and Learn Session, August 23, 2021.

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More Evidence Ties Gum Disease With Heart Disease

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More Evidence Ties Gum Disease With Heart Disease

By Robert Preidt
HealthDay Reporter

FRIDAY, Aug. 27, 2021 (HealthDay News) — New research offers further evidence of a link between gum disease and heart disease.

The ongoing Swedish study previously found that gum disease (“periodontitis“) was much more common in first-time heart attack patients than in a group of healthy people.

In this follow-up study, the researchers examined whether gum disease was associated with an increased risk of new heart problems in both heart attack survivors and healthy people the same age and sex, and living in the same area.

“The risk of experiencing a cardiovascular event during follow-up was higher in participants with periodontitis, increasing in parallel with the severity. This was particularly apparent in patients who had already experienced a [heart attack],” said study author Giulia Ferrannini, from the Karolinska Institute in Stockholm.

The researchers suspect that damage to the gum tissue in people with gum disease may allow germs to enter the bloodstream. “This could accelerate harmful changes to the blood vessels and/or enhance systemic inflammation that is harmful to the vessels,” Ferrannini added.

In total, the study included nearly 1,600 participants with an average age of 62. Dental examinations between 2010 and 2014 showed that 985 had good dental health, 489 had moderate periodontitis and 113 had severe periodontitis.

During an average follow-up of just over six years, people with gum disease were 49% more likely to die from any cause, have a nonfatal heart attack or stroke, or to develop severe heart failure.

The risk of those outcomes increased with the severity of gum disease, according to the study presented Friday at a virtual meeting of the European Society of Cardiology. Such research is considered preliminary until published in a peer-reviewed journal.

When assessed separately, the relationship between gum disease severity and the risk of negative outcomes was significant only for those who had experienced a heart attack in the past.

“Our study suggests that dental screening programs including regular check-ups and education on proper dental hygiene may help to prevent first and subsequent heart events,” Ferrannini concluded in a meeting news release.

More information

The American Academy of Periodontology has more on gum disease.

SOURCE: European Society of Cardiology, news release, Aug. 25, 2021

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