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February 2009

Acupuncture reduces headaches
Thigh exercises help knee arthritis
Animal fat increases small intestine cancer
Fiber/whole grains lower cancer risk
Vitamin D helps the brain
Eggs increase diabetes risk
Meat increases lung cancer

Acupuncture reduces headaches

Previous reviews have not been clear on the benefits of acupuncture for headaches, but researchers revisited the subject, including some further studies that have been done since their earlier review. The two new evaluations show that acupuncture treatments are valuable for both tension- and migraine-type headaches.

Randomized trials of at least eight weeks in patients with tension headaches compared acupuncture treatment combined with conventional care to conventional care alone or sham acupuncture. They evaluated number of headaches, days of pain, pain intensity, and analgesic use. (Linde K, et al., Acupuncture for tension-type headache. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD007587.)

Eleven studies were included, with a total of 2317 participants. They found a small but significant advantage of acupuncture over sham therapy (but not apparently over other therapies) over a three-month period, but longer treatment programs were not evaluated in this review.

In another report by the same group, acupuncture was found to be valuable for prevention of migraine headaches. They evaluated number of migraine attacks, number of days with migraine headache pain, and the use of pain medication. (Linde K, et al., Acu-puncture for migraine prophylaxis. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD001218.) The review included 22 trials with a total of 4419 subjects over at least eight weeks.

In this review, they found that over three to four months acupuncture patients had fewer headaches and a higher response rate to treatment than those receiving routine care or no treatment. In one of the studies, the benefits persisted with nine months of treatment. In both of these reviews, the acupuncture patients had fewer side effects than those on medications.

Thigh exercises help knee arthritis

Osteoarthritis of the knees causes pain and difficulty walking. Drug therapies have numerous side effects, among them serious gastrointestinal symptoms, such as gastric bleeding, from the common pain killers. In the long term it often leads to knee replacement therapy. Now, research shows that patients who have strong thigh muscles (quadriceps) have better physical functioning and less pain. (Amin S, et al., Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum. 2009 Jan;60(1):189-98.)

The researchers followed 265 people with knee arthritis for 30 months, with strength evaluations of their quadriceps muscles at the start of the study and again at 15 months and at the end of the study. They also did MRIs to assess cartilage loss at the same intervals.

They found that those in the upper third of strength at the start of the study had better physical functioning and less pain than those with the least strength. Those with better strength also had better cartilage retention in some areas of the knee but not all. A good physical therapist or exercise coach should be able to make good recommendations for exercises to improve quadriceps strength without harming the knees.

Animal fat increases small intestine cancer

Yet another study reveals some of the dangers of animal fat consumption. In the NIH-AARP Diet and Health Study of about 500,000 men and women followed for eight years, researchers showed that diets high in saturated fat were associated with an increased risk of small intestine cancers. (Cross AJ, et al., A prospective study of meat and fat intake in relation to small intestinal cancer. Cancer Res. 2008 Nov 15; 68(22):9274-9.) Previous studies have associated meat and saturated fat with cancers of the large intestine.

In this research, the subjects with the highest level of saturated fat intake had a nearly fourfold increase in the risk of carcinoid tumors and an increased risk of adenocarcinomas. Red and processed meats are among the highest sources of saturated fat in the diet, but it is also found in chicken, dairy products, and eggs. Tumors in the small intestine are much less common than in the large intestine, perhaps because toxic substances in the diet and digestive-process byproducts remain there longer.

Fiber/whole grains lower cancer risk

The same study of nearly 500,000 subjects was also analyzed for the risks of small intestine cancer related to fiber and whole grain consumption. Over an eight-year period, those subjects with the highest whole-grain dietary fiber intake had about half the risk of small intestine cancer compared to those with the lowest intake, while those with the highest total fiber intake had a strong trend to lower cancer risk that did not reach statistical significance. (Schatzkin A, Prospective study of dietary fiber, whole grain foods, and small intestinal cancer. Gastroenterology. 2008 Oct;135(4):1163-7.)

While some of the data for total fiber intake was not statistically significant, combining this information with other studies strongly suggests the value of increasing dietary fiber and whole grains for prevention of both small and large intestine cancers. Most grains have a mixture of soluble and insoluble fiber that provide a host of other benefits, such as reducing both cholesterol and inflammation.

Vitamin D helps the brain

Many recent studies have shown a wide variety of benefits from increasing vitamin D consumption. A new one shows that low levels of vitamin D are associated with age-related mental deterioration. (Llewellyn DJ, et al., Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment. J Geriatr Psychiatry Neurol. 2009 Feb 4.)

In the Health Survey for England 2000, 1766 adults aged 65 years and older were evaluated with the Abbreviated Mental Test Score. A total of 212 participants were cognitively impaired. Those with the lowest serum level of  25-hydroxy vitamin D (8-30 nmol/L) had 2.3 times the likelihood of having cognitive impairment compared to those with the highest levels (45-65 nmol/L).

Those subjects in the middle two groups of vitamin D had odds of impairment that corresponded to their level, showing a definite trend. Although we produce vitamin D (really a hormone rather than a true vitamin) by the action of sunlight on cholesterol in the skin it is difficult to produce enough to achieve all its health benefits. This is particularly true for the elderly who do not make it as efficiently as younger people and for those who live in northern climates where sun is less abundant in certain seasons.

Food sources include salmon (wild is best), which has 360 IU per 3.5 oz, sardines (250 IU per 1.75 oz), and cod liver oil (1360 IU/Tbsp). Fortified foods often have synthetic vitamin D (D2, or irradiated ergosterol) which is not as good as natural vitamin D (D3, or cholecalciferol). Supplements often contain 400 to 2000 IU. Given all its benefits, I now take 4000 IU daily.

Eggs increase diabetes risk

A new report derived from data on 20,703 men from the Physicians’ Health Study and 36,295 women in the Women’s Health Study examined the relationship of egg consumption to the risk of type 2 diabetes. The subjects were followed for an average of 20 years for the men and 12 years for the women. Egg consumption was determined using validated food-frequency questionnaires. (Djoussé L, et al., Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care. 2009 Feb;32(2):295-300.)

Those women subjects who ate 7 or more eggs per week had a 77 percent higher risk of developing diabetes than those who consumed no eggs at all. For men the increase was 58 percent for the high egg group. For those subjects who averaged one egg or less per week, there was virtually no change in diabetes risk. The reasons for this relationship are not clear.

Cholesterol and fat intake are both related to diabetes risk. High levels of dietary fat can raise blood sugar and insulin levels. The most important factors in preventing diabetes are maintaining normal weight, eating a high-fiber, low-fat diet of natural, unprocessed foods, and getting regular exercise. Vegetarians have a lower risk of diabetes as well as other illnesses.

Meat increases lung cancer

A study of red meat, processed meat, and meat mutagens shows that meat consumption increases the risk of developing lung cancer (in addition to the other cancer risks associated with meat). In the Environment and Genetics in Lung Cancer Etiology population-based case-control study, 2101 cancer patients in Italy were compared to matched controls from the same region of the country. The investigators evaluated red and processed meat consumption as well as estimates of the intake of two meat-derived carcinogens – heterocyclic amines (HCA) and benzo(a)pyrene (BaP). (Lam TK, et al., Intakes of Red Meat, Processed Meat, and Meat Mutagens Increase Lung Cancer Risk. Cancer Res. 2009 Jan 13).

Compared to those with the lowest red meat consumption, those with the highest had a nearly doubled risk of lung cancer, and this association was strongest among those who had never smoked. (Smoking increases the risk so much that the increase from meat would be obscured.) HCA and BaP, produced when meat is cooked at high temperatures, were both independently associated with increased risk.

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From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.

Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.