What causes allergies?
You have an allergy when your body overreacts to things that don't cause
problems for most people. These things are called allergens. Your body's
overreaction to the allergens is what causes symptoms. For example,
sometimes the term "hay fever" is used to describe your body's allergic
reaction to seasonal allergens in the air, such as grass or pollen.
Your family doctor may want to do an allergy skin test to help determine
exactly what is causing your allergy. An allergy skin test puts tiny amounts
of allergens onto your skin to see which ones you react to. Once you know
which allergens you are allergic to, you and your family doctor can decide
the best treatment. Your family doctor may also decide to do a blood test,
such as the radioallergosorbent test (called RAST).
Common Allergy Symptoms:
* Runny nose
* Watery eyes
* Itchy nose, eyes and roof of mouth
* Sneezing
* Stuffy nose
* Pressure in the nose and cheeks
* Ear fullness and popping
* Dark circles under the eyes
* Hives
What are the most common allergens?
Pollen from trees, grass and weeds.
Mold. Mold is common where water tends to collect, such as shower curtains,
window moldings and damp basements. It can also be found in rotting logs,
hay, mulches, commercial peat moss, compost piles and leaf litter. This
allergy is usually worse during humid and rainy weather.
Animal dander. Proteins found in the skin, saliva, and urine of furry pets
such as cats and dogs are allergens. You can be exposed to dander when
handling an animal or from house dust that contains dander.
Dust. Many allergens, including dust mites, are in dust. Dust mites are tiny
living creatures found in bedding, mattresses, carpeting and upholstered
furniture. They live on dead skin cells and other things found in house
dust.
Things that can make your allergy symptoms worse
* Aerosol sprays
* Air pollution
* Cold temperatures
* Humidity
* Irritating fumes
* Tobacco smoke
* Wind
* Wood smoke
How can I avoid allergens?
Pollens. Shower or bathe before bedtime to wash off pollen and other
allergens in your hair and on your skin. Avoid going outside, especially on
dry, windy days. Keep windows and doors shut, and use an air conditioner at
home and in your car.
Mold. You can reduce the amount of mold in your home by removing houseplants
and by frequently cleaning shower curtains, bathroom windows, damp walls,
areas with dry rot and indoor trash cans. Use a mix of water and chlorine
bleach to kill mold. Open doors and windows and use fans to increase air
movement and help prevent mold.
Don't carpet bathrooms or other damp rooms and use mold-proof paint instead
of wallpaper. Reducing the humidity in your home to 50% or less can also
help. You can control your home air quality by using a dehumidifier, keeping
the temperature set at 21 degrees, and cleaning or replacing small-particle
filters in your central air system.
Pet dander. If your allergies are severe, you may need to give your pets
away or at least keep them outside. Cat or dog dander often collects in
house dust and takes 4 weeks or more to die down.
However, there are ways to reduce the amounts of pet dander in your home.
Using allergen-resistant bedding, bathing your pet frequently, and using an
air filter can help reduce pet dander. Ask your veterinarian for other ways
to reduce pet dander in your home.
Dust and dust mites. To reduce dust mites in your home, remove drapes,
feather pillows, upholstered furniture, non-washable comforters and soft
toys. Replace carpets with linoleum or wood. Polished floors are best. Mop
the floor often with a damp mop and wipe surfaces with a damp cloth. Vacuum
regularly with a machine that has a high-efficiency particulate air filter.
Vacuum soft furniture and curtains as well as floors. Install an air cleaner
with a high-efficiency particulate or electrostatic filter. Wash carpets and
upholstery with special cleaners, such as benzyl benzoate or tannic acid
spray. Wash all bedding in hot water (hotter than 130°F) every 7 to 10 days.
Don't use mattress pads. Cover mattress and pillows with plastic covers.
Lower the humidity in your home.
What medicines can I take to help relieve my symptoms?
Antihistamines help reduce the sneezing, runny nose and itchiness of
allergies. They're more useful if you use them before you're exposed to
allergens.
Some antihistamines can cause drowsiness and dry mouth. Others are less
likely to cause these side effects, but some of these require a
prescription. Ask your family doctor which kind is best for you.
Decongestants, such as pseudoephedrine and phenylephrine help temporarily
relieve the stuffy nose of allergies. Decongestants are found in many
medicines and come as pills, nose sprays and nose drops. They are best used
only for a short time. Nose sprays and drops shouldn't be used for more than
3 days because you can become dependent on them. This causes you to feel
even more stopped-up when you try to quit using them.
You can buy decongestants without a family doctor's prescription. However,
decongestants can raise your blood pressure, so it's a good idea to talk to
your family doctor before using them, especially if you have high blood
pressure.
Cromolyn sodium is a nasal spray that helps prevent the body's reaction to
allergens. Cromolyn sodium is more helpful if you use it before you're
exposed to allergens. This medicine may take 2 to 4 weeks to start working.
It is available without a prescription.
Nasal steroid sprays reduce the reaction of the nasal tissues to inhaled
allergens. This helps relieve the swelling in your nose so that you feel
less stopped-up. They come in nasal sprays that your family doctor may
prescribe. You won't notice their benefits for up to 2 weeks after starting
them.
Your family doctor may prescribe steroid pills for a short time or give you
a steroid shot if your symptoms are severe or if other medicines aren't
working for you.
Eye drops. If your other medicines are not helping enough with your itchy,
watery eyes, your family doctor may prescribe eye drops for you.
What are allergy shots?
Allergy shots (also called immunotherapy) contain small amounts of
allergens. They're given on a regular schedule so that your body gets used
to the allergens and no longer overreacts to them.
Allergy shots are only used when the allergens you're sensitive to can be
identified and when you can't avoid them. It takes a few months to years to
finish treatment, and you may need to have treatments throughout your life.
[AAFP]
Monday, October 20, 2008
Tuesday, October 14, 2008
alternative medicine
Alternative Medicine
Peter Saunders, MBBS
General Secretary, UK Christian Medical Fellowship
How should we respond to alternative medicine?
Alternative medicine is rising rapidly up the heathcare agenda. One in four
people use at least one form of alternative medicine and three out of four
people are in favour of alternative therapies.
One study cited by a recent report suggested that there may be millions of
consultations to non-conventional therapists each year, with about 2.5% of
the population receiving treatment. In addition, many doctors have received
some training in alternative medicine. In most member states of the European
Union the practice of medicine by non-recognised health professionals is
illegal.
When one considers the tight controls on the training and practice of
orthodox medical practitioners there is clearly a double standard operating.
If there are no proper controls for alternative medicine practitioners, then
the way is open for charlatans, profiteers and tricksters to operate
alongside those who are genuinely providing service of proven value.
What is alternative medicine?
Problems of definition
The report of the Board of Science and Education's working party,
Complementary Medicine, New Approaches to Good Practice defines
non-conventional therapies as 'those which are not widely used by orthodox
medical professionals nor widely taught at undergraduate level in medical
and paramedical courses' - but some therapies regarded as alternative are
taught formally in medical schools elsewhere.
The three terms complementary, alternative and holistic are used almost
interchangeably - but convey different messages. 'Alternative' implies an
either/or relationship with orthodox medicine; 'complementary' a both/and
relationship while 'holistic' implies that non-orthodox therapies treat the
'whole person'. All these assumptions are controversial.
The Diversity of Therapies
The report says that as many as 160 different forms of non-conventional
therapy have been identified. An A to Z of some of the most common includes:
Acupuncture, Acupressure, Alexander Technique, Aromatherapy, Auricular
Therapy, Bach Flower Remedies, Chiropractic, Crystal Therapy, Herbs,
Homeopathy, Hypnosis, Iridology, Macrobiotics, Massage, Naturopathy,
Osteopathy, Reflexology, Shiatsu, Therapeutic Touch, Transcendental
Meditation (TM), Yoga, Zen and Zone Therapy.
On first glance there seems to be very little similarity between one form of
alternative medicine and another; but what unifies most of them is the idea
of a 'life force' or 'vital energy' which ensures health, becomes disrupted
in disease and can be manipulated by various means.
For example, underlying acupuncture is the belief that there is a vital
force or energy called 'Chi' which flows freely through the body in twelve
meridians or channels. The flow of this energy depends on the balance
between two opposite forces; an active, 'male' force called 'yin' and a
passive, 'female' force called 'yang'. When the flow of the Chi energy is
free and uninterrupted health is ensured but if the balance between yin and
yang is disturbed or if there is any blockage to energy flow then disease
results.
These ideas have their roots in the ancient Chinese religion of Taoism which
has Chi, yin and yang as fundamental concepts.
Ideologies which underly other forms of medicine use different words for the
same general concept of 'life force'. Shiatsu is based on Shintoism and
calls the energy 'Ki'. Yoga and TM are based on Hinduism and call the force
'prana'. Homeopathy uses the term 'vital energy', chiropractic 'innate
intelligence' and Maori medicine terms the life force 'mana'.
The common theme of 'correcting imbalance'
In most alternative therapies health is believed to be restored by relieving
blockage and restoring flow in the 'life force', but the means whereby this
is achieved vary widely as listed below:
Needling: Acupuncture
Homeopathy: Minute doses of diluted medicine
Reflexology: Foot massage
Aromatherapy: Aromatic Oils
Yoga: Adopting Body Postures
Transcendental Meditation: Meditation
Therapeutic Touch: Hovering hands
Macrobiotics: Diet
Why is Alternative Medicine so popular?
There are seven main factors accounting for the rise in popularity of
alternative medicine in the Western World.
1. Changes in the Western worldview
Two hundred years ago in Britain most people had a Christian worldview; they
believed in a creator God who made us, intervened in our world and to whom
we were accountable. But with the publication of Darwin's Origin of the
Species and the rise of biblical criticism, this theistic world view gave
way to an atheistic one.
People began to doubt the existence of God and life after death. Man came to
be seen simply as a clever monkey, the product of matter, chance and time in
a directionless and purposeless universe. Morality became relative ('what's
right for me') rather than absolute.
Now we are seeing another worldview shift from atheism into pantheism.
Pantheism is the ideology which lies behind Eastern religions like Hinduism
and also the New Age Movement. God is an impersonal force of which we are
all simply a part. Death leads to reincarnation, and morality simply means
being in harmony with nature. All is one and all is God. This has meant an
increasing openness to all sorts of non-Christian spiritual belief along
with a scepticism and suspicion about science.
The change of worldview from theism, to atheism and then pantheism has had
profound effects on the way that medicine is practised. While Christian
doctors see human beings as a tri-unity of spirit, soul (or mind) and body
(1 Thes 5:23), atheistic doctors see them as consisting of just body and
mind. By contrast, New Age or alternative medicine practitioners see human
beings as an integrated whole; but from a pantheistic rather than a theistic
perspective.
Much of alternative medicine has its roots in the New Age Movement which in
turn is rooted in Astrology. Exponents believe that for the last 2,000 years
we have been in the age of Pisces (the fishes), but that now we are moving
into the age of Aquarius (the water-carrier). The Age of Pisces was
characterised by rationality, logic, objectivity and black and white
analytical 'left brain' thinking. By contrast the Age of Aquarius is
characterised by intuitional, subjective, grey 'right brain' thinking.
Sociologically the New Age Movement spawned the counterculture of the 1960s
with 'flower-power', peace protests, drug experimentation and the Hippie
movement. Spiritually it paved the way for a wide acceptance of Eastern
religious ideology, Astrology and the Occult. Medically the New Age Movement
has meant an ncreasing disillusionment with and scepticism about scientific
medicine.
As Christians we reject both the atheistic and pantheistic worldviews. They
are quite simply not the way the world is. God does exist. We are made in
his image, yet fallen; and death leads to judgement. We embrace the
scientific method as a gift of God, but we also see human beings as being
more than simply the sum of their parts.
2. Failings of orthodox medicine
There have been great advances in orthodox medicine over the last two
centuries which have led to the eradication and alleviation of many diseases
which were previously neither preventable nor curable: immunisations for
smallpox, antibiotics for infection, anti-psychotics for schizophrenia,
chemotherapy for cancer, drugs for heart failure and surgery for a whole
host of structural and anatomical problems.
But medicine also has its limits. With many illnesses we have a long way to
go. Solid tumours (eg lung, breast and bowel) are in general difficult to
treat if surgery fails. There is still much progress to be made in chronic
diseases like multiple sclerosis and rheumatoid arthritis, and there is
still no orthodox cure for musculoskeletal back pain and the common cold. If
we also consider that 75% of people seeing their doctor do not have any
defined organic illness, it is easy to see why people may decide to consult
alternative practitioners. Patients may also become impatient or
disillusioned with the NHS system of referrals and waiting lists.
With some diseases alternative medicine fares no worse than orthodox
medicine and it is in these areas that alternative medicine thrives.
3. Medical arrogance
Doctors have not always been ready to admit failure; and on occasions may go
on using treatments of doubtful value, or with potential side-effects rather
than being honest that nothing else can be done. The inappropriate use of
some chemotherapeutic agents or radical surgery for advanced cancer, for
instance, may cultivate distrust in patients who then seek other solutions.
4. The side effects of orthodox medicine
Orthodox medicines and surgery can produce side effects and complications
which are sometimes fatal. Examples are often widely publicised by an
unforgiving press. By contrast most alternative medicine has little in the
way of side-effects.
5. Loss of a whole person perspective
Advances in the science of medicine may be at the expense of the art of
medicine. Doctors have less time for the patient, touch patients less often,
and are tempted much more now to treat their patients simply as anatomical
structures or biochemical machines. There is much less in medicine now of
the ritual handshake, pulse-taking, hand on the shoulder etc. Too often the
doctor is now esconced behind his PC and perhaps a formidable desk; while
many alternative therapies involve plenty of 'hands-on' diagnosis and
treatment.
Alternative medical practitioners generally are able to give much more in
terms of time and touch, thereby engendering more trust. Homeopaths, for
example, may spend up to 90 minutes in a first consultation and 45 minutes
on follow up. Patients naturally assume, 'He must know what he is doing
because he spends so much time with me'.
6. Costs of high-tech medicine
High tech medicine is expensive, while often the only cost of alternative
medicine is the therapist's time. This is one feature making alternative
therapies increasingly attractive to health insurance managers looking to
cut costs.
7. Consumer demand
Patients are prepared to pay for therapies which promise what orthodox
medicine has failed to deliver; especially for incurable cancer or chronic
pain. This demand means that there is plenty of room in the market place for
more practitioners.
Why does alternative medicine seem to work?
Why is it that so many people are seeking alternative medicine therapies
when so many of them have been shown not to work in clinical trials? There
are at least eight reasons why.
1. Genuine therapeutic effects
Some alternative medicines genuinely work. Over half of prescription and
over-the-counter drugs originate as natural compounds or are based on them
(eg aspirin, digitalis, morphine, adrenaline, curare, all antibiotics except
the quinolones etc); and the natural world may hold many more therapeutic
treasures.
It is quite conceivable that some alternative medicine practitioners are
using useful compounds or techniques which are not yet known to orthodox
medicine. But if this is the case then we need to discover what they are so
that they can be isolated and given in the correct dose!
2. The placebo effect
If we strongly believe that something (or someone) has the power to help us,
then we are much more likely to experience benefit. It is a fact that one
third of people given an inert compound to relieve a particular symptom will
report relief of that symptom. This is called the placebo effect. In the
same way patients who share the therapist's belief in New Age pantheism or
the existence of 'life force' will be more likely to benefit from their
therapy.
3. Concurrent use of therapies
Belief in an alternative therapy's effectiveness may develop when it is used
concurrently with another more effective orthodox therapy. The effect is
then wrongly ascribed to the alternative therapy.
4. Psychosomatic illness
Many illnesses are psychosomatic; in other words a patient's stress level or
mental state can aggravate the symptoms. Asthma, eczema, peptic ulcer and
rheumatoid arthritis fall in this category. Alternative therapies which
induce relaxation may then improve the symptoms.
5. Spontaneous remissions
Many diseases get better by themselves. Viral infections (eg warts, common
cold) and some tumours (eg malignant melanoma) are examples of conditions
which may spontaneously regress. In such cases people may well then
attribute therapeutic effect to the remedy they were trying at the time of
recovery, when it fact their improvement at that time may just have been
coincidence. This is called the 'post hoc, propter hoc' fallacy; in other
words 'because B followed A, then A must have caused B'.
6. Dietary influences
There is a strong link between diet and health, and many alternative
therapists recommend that patients drink less coffee or alcohol, eat less
fat or more fibre or take vitamins. The resulting improvement may then be
due to the change in diet, rather that the alternative therapy being used
concurrently.
7. Imagined improvement
Some patients, especially if open to suggestion from others that they 'look
better', may simply imagine that they 'feel better'; especially if the
symptoms were of a vague nature in the first place. Alternatively they may
simply get better at tolerating symptoms, and imagine that the symptoms
themselves have diminished.
8. Demonic involvement
There may be real spiritual forces operating to bring healing through
demonic power. Such healings may be the bait that Satan then uses to draw a
person more deeply into the occult, or into accepting a pantheistic
worldview.
How do we assess individual modalities?
It is not possible in this brief review to comment on each and every
alternative therapy; but here are some principles which can be generally
applied.
1. Do the claims fit the facts?
Any new orthodox medicine has to undergo extensive pharmacological testing
to assess its therapeutic potential, side-effects and interactions with
other drugs. Tests are first carried out in animals, then in human
volunteers and only then are short and long term studies carried out on real
patients.
If a drug passes these tests it must then be approved by the Licensing
Authority. This ensures that drugs reaching the public are both safe and
effective.
In the same way medical practitioners must undergo a five year undergraduate
training and then work for a further year before they are registered and
able to practice independently of an institution.
Similar safeguards for alternative medicines and practitioners are largely
absent. There is simply no comparison between the double-blind, randomised,
placebo-controlled cross-over trials which many orthodox drugs undergo and
the subjective anecdotal 'evidence' supporting much alternative medicine.
Furthermore, when proper trials are employed the results are often
unconvincing.
A Department of Complementary Medicine has recently been set up at the
University of Exeter to review trials on alternative and complementary
therapies. The contents pages of their quarterly journal FACT (Focus on
Alternative and Complementary Therapies) are available on the internet and
make interesting reading. Many of the published studies give inconclusive
results.
A 1990 French review of 40 controlled trials on homeopathy concluded that
the majority were flawed by small sample size and subjective measures of
improvement. A 1991 review of 107 trials was similarly inconclusive.
By contrast there is evidence that patients with low back pain treated with
chiropractic derive more benefit and long term satisfaction than those
treated by hospitals; and that, according to a consensus panel of the US
National Institutes of Health, acupuncture is an effective treatment for
nausea and vomiting induced by anaesthesia, pregnancy or chemotherapy.
The biblical injunction to 'enquire, probe and investigate thoroughly' (Dt
13:14ff) must surely be relevant here. We should always ask, 'What is the
evidence that this therapy really works?'
2. Is there a rational scientific basis?
We know how most orthodox drugs work. They may stimulate receptors (eg b
agonists in asthma), modify cell transport (eg probenecid), block enzymes
(eg allopurinol), replace missing compounds (eg vitamin B12) or chelate
toxins (eg penicillamine). The action of any given drug is determined by its
concentration at the site of action; and the actions are understandable in
view of their known biochemical and physiological effects. By contrast the
majority of alternative medicines have no rational scientific basis.
Homeopathy involves diluting an active compound to such a degree that the
resulting 'potency' contains not even a molecule of the original active
ingredient.
Iridology claims to link each area of the iris with a separate part of the
body when it is known that no such anatomical links exist. Reflexology is
based on the belief that there are connections between the sole of the foot
and internal organs; again in the absence of any scientific evidence.
There is similarly no evidence for the existence of the 'meridians' (energy
channels) of acupuncture or the 'chakras' (psychic spinal centres) of yoga.
In some cases an alternative therapy may be working because of some
scientific reason unknown to the therapist. It has been suggested, for
instance that the therapeutic effects of acupuncture could be explained by
the release of endogenous (naturally produced) pain-killers called
endorphins. If this is indeed confirmed, then acupuncture will be shown to
have a scientific basis, but this will not, by any means prove that Taoist
ideology is true or that Chi energy exists.
3. Is it the improvement due to the therapy or some other factor?
Transcendental Meditation lowers blood pressure, but why? Is it because it
enables the Goddess Kundalini to migrate up the spine and unite with Brahman
in the head (as Hindus believe); or is it simply that meditation induces
relaxation and reduces the sympathetic output that raises blood pressure?
Similarly, chiropractic has been shown to help low back pain, but is this
because manipulation of the spine alters the flow of 'innate intelligence'
or because it helps to alleviate musculoskeletal trigger points?
In each of these cases it seems to be the methodology rather than the
principle of prana or innate intelligence that brings the therapeutic
effect.
There is thus a world of difference between the GP who makes a diagnosis by
taking a history and doing an examination and the alternative medicine
practitioner who does it by examining an iris or swinging a pendulum. There
is also a huge gulf between the GP who uses acupuncture on the basis of its
proven effectiveness in clinical trials and the practitioner who uses it
because he believes it alters the balance of yin and yang.
4. What is the worldview behind it?
What is the worldview behind the therapy? As mentioned acupuncture has its
roots in Taoism, yoga in Hinduism and therapeutic touch in New Age ideology.
This alone should make us suspicious.
What was the motivation of the therapist who developed the treatment?
Hahnemann, the German physician who developed homeopathy, was a freemason.
Kreger, the New York Nursing Professor who invented therapeutic touch, is a
Buddhist; and her collaborator Kunz was Vice President of the Theosophical
Society and an occultist and psychic. Edward Bach (of 'flower remedy' fame)
was a doctor who trusted his 'spirit self' for knowledge and guidance.
It might be objected here that much orthodox medicine has been developed by
atheists with an atheistic worldview and yet that does not stop us
benefiting from their insights. This is true. We are not saying that
pantheists are unable to discover beneficial treatments which are God-given;
but simply that their worldview should make us wary in assessing their
therapies.
5. Does it involve the occult?
Are occult means of divination used in deciding on diagnosis or treatment?
We should heed the biblical warnings about Mediums and Spiritists (Lv 9:31,
20:6; Acts 16:16-21), Astrology (Is 47:13-15), Magic Charms(Ezk 13:20-23),
Diviner's Wands (Ho 4:12),Sorcery (Acts 19:19), Witchcraft (Gal 5:20), Magic
Arts (Rev 9:21, 21:8, 22:15) and the Occult(Dt 18:10-12) generally.
6. Is it medically safe?
Most alternative therapies have little in the way of side effects, but there
are exceptions. Acupuncture, for example, may cause pneumothaorax or
transmit infection. Chiropractic neck manipulation has been associated with
vertebral artery obstruction and some herbal therapies result in toxicity or
even death. But perhaps the greatest danger is that alternative therapies
can create a false sense of security which leads to delay in diagnosis or in
implementation of effective orthodox medicine.
7. Has it stood the test of time?
This is not a guarantee, as clearly many occult devices stand the test of
time, but we can be equally sure that something which genuinely works or is
of God will stand the test of time.
Applying the tests
As an example of applying the tests above let us consider homeopathy. First,
there is no clear evidence that it actually works. Second, it has no
rational scientific basis; there is no reason known to science why a
solution containing not a single molecule of a given active substance should
have any therapeutic effect. Third, it is based on a pantheistic worldview
with the concept of 'vital energy' playing a prominent role. Fourth,
practitioners will often use occult means (such as pendulums) in diagnosis.
While it does appear to be safe and to have stood the test of time, these
other considerations should make us very wary indeed.
Difficult Questions
Finally let us finish by considering some of the objections which Christians
might raise to the kind of critique I have just given.
1. Weren't many medical treatments initially 'natural' anyway?
This is correct (eg aspirin (willow bark), digitalis (foxglove), Morphine
(poppies)) but the natural ingredient needs to be clearly identified and
given in the right dose. Many useful natural drugs are toxic if given in too
high a dose (eg digitalis, opium).
Decisions about which compound to give must also not be based on occult
practices (eg rituals, spells, charms, astrology, clairvoyance, pendulums,
spirit guides etc) as previously mentioned.
2. How can something be wrong if it actually works?
First, we need to be sure that the given therapy does actually work. Have
there been properly controlled clinical trials carried out showing that it
is better than placebo, or is it supported simply by anecdotal testimony?
Second we need to ask why it works. Is it working as a result of occult
power? (Dt 13:1-6; Ex 7:11,22, 8:7, 18,19; Mt 24:24). If so it may be
leading to the bondage, rather than to the liberation, of the patient. We
must be ready to test everything (1 Thes 5:21).
3. Isn't there some good in it?
It's often objected that we should not throw out the baby with the bath
water; and there is some truth in this... but is the baby and bath water
really a good analogy? It is very easy to see the difference between baby
and bath water but often extremely difficult to separate out the good and
bad in alternative medicine.
A better analogy is the poison mushroom. While poison mushrooms contain
plenty of good fat, carbohydrate and protein we recommend that people don't
eat them because it is impossible to separate out the good and the bad.
Everything that does not proceed from faith is sin; so if we have doubts it
may well be better to abstain (Rom 14:23).
4. How can it be wrong if good Christians I know use it?
Good Christians may be ignorant or deceived or simply have their consciences
blunted from habitual sin. There is no-one with perfect discernment who is
right in all their words, let alone all their beliefs (Jas 3:1). Good
Christians may also have a lot personally invested in a therapy if a friend
or relative is practising in it or has benefited from it and their
objectivity may be accordingly clouded.
Summary
We have reviewed the rapid rise in popularity in alternative medicine, and
seen that while therapies are diverse, there is a pantheistic ideology
behind many of them.
Alternative medicine is popular because of changes in the Western worldview,
the perceived failings, arrogance, costs and side effects of orthodox
medicine, and because it appears to bring a 'whole person' perspective.
While some therapies may genuinely work, apparent improvements are often due
to other reasons such as spontaneous remissions, the use of concurrent
orthodox medicine or the placebo effect.
Each branch of alternative medicine needs to be assessed individually to
determine its effectiveness, scientific basis, mode of action, safety,
underlying worldview and links with the occult.
We should be wary, but we must be careful also that we do not miss genuine
gifts which God has given. The biblical injunction to 'test everything...
hold on to the good... avoid every kind of evil' (1 Thes 5:21,22) is surely
as relevant here as in any other area of the Christian life.
Peter Saunders, MBBS
General Secretary, UK Christian Medical Fellowship
How should we respond to alternative medicine?
Alternative medicine is rising rapidly up the heathcare agenda. One in four
people use at least one form of alternative medicine and three out of four
people are in favour of alternative therapies.
One study cited by a recent report suggested that there may be millions of
consultations to non-conventional therapists each year, with about 2.5% of
the population receiving treatment. In addition, many doctors have received
some training in alternative medicine. In most member states of the European
Union the practice of medicine by non-recognised health professionals is
illegal.
When one considers the tight controls on the training and practice of
orthodox medical practitioners there is clearly a double standard operating.
If there are no proper controls for alternative medicine practitioners, then
the way is open for charlatans, profiteers and tricksters to operate
alongside those who are genuinely providing service of proven value.
What is alternative medicine?
Problems of definition
The report of the Board of Science and Education's working party,
Complementary Medicine, New Approaches to Good Practice defines
non-conventional therapies as 'those which are not widely used by orthodox
medical professionals nor widely taught at undergraduate level in medical
and paramedical courses' - but some therapies regarded as alternative are
taught formally in medical schools elsewhere.
The three terms complementary, alternative and holistic are used almost
interchangeably - but convey different messages. 'Alternative' implies an
either/or relationship with orthodox medicine; 'complementary' a both/and
relationship while 'holistic' implies that non-orthodox therapies treat the
'whole person'. All these assumptions are controversial.
The Diversity of Therapies
The report says that as many as 160 different forms of non-conventional
therapy have been identified. An A to Z of some of the most common includes:
Acupuncture, Acupressure, Alexander Technique, Aromatherapy, Auricular
Therapy, Bach Flower Remedies, Chiropractic, Crystal Therapy, Herbs,
Homeopathy, Hypnosis, Iridology, Macrobiotics, Massage, Naturopathy,
Osteopathy, Reflexology, Shiatsu, Therapeutic Touch, Transcendental
Meditation (TM), Yoga, Zen and Zone Therapy.
On first glance there seems to be very little similarity between one form of
alternative medicine and another; but what unifies most of them is the idea
of a 'life force' or 'vital energy' which ensures health, becomes disrupted
in disease and can be manipulated by various means.
For example, underlying acupuncture is the belief that there is a vital
force or energy called 'Chi' which flows freely through the body in twelve
meridians or channels. The flow of this energy depends on the balance
between two opposite forces; an active, 'male' force called 'yin' and a
passive, 'female' force called 'yang'. When the flow of the Chi energy is
free and uninterrupted health is ensured but if the balance between yin and
yang is disturbed or if there is any blockage to energy flow then disease
results.
These ideas have their roots in the ancient Chinese religion of Taoism which
has Chi, yin and yang as fundamental concepts.
Ideologies which underly other forms of medicine use different words for the
same general concept of 'life force'. Shiatsu is based on Shintoism and
calls the energy 'Ki'. Yoga and TM are based on Hinduism and call the force
'prana'. Homeopathy uses the term 'vital energy', chiropractic 'innate
intelligence' and Maori medicine terms the life force 'mana'.
The common theme of 'correcting imbalance'
In most alternative therapies health is believed to be restored by relieving
blockage and restoring flow in the 'life force', but the means whereby this
is achieved vary widely as listed below:
Needling: Acupuncture
Homeopathy: Minute doses of diluted medicine
Reflexology: Foot massage
Aromatherapy: Aromatic Oils
Yoga: Adopting Body Postures
Transcendental Meditation: Meditation
Therapeutic Touch: Hovering hands
Macrobiotics: Diet
Why is Alternative Medicine so popular?
There are seven main factors accounting for the rise in popularity of
alternative medicine in the Western World.
1. Changes in the Western worldview
Two hundred years ago in Britain most people had a Christian worldview; they
believed in a creator God who made us, intervened in our world and to whom
we were accountable. But with the publication of Darwin's Origin of the
Species and the rise of biblical criticism, this theistic world view gave
way to an atheistic one.
People began to doubt the existence of God and life after death. Man came to
be seen simply as a clever monkey, the product of matter, chance and time in
a directionless and purposeless universe. Morality became relative ('what's
right for me') rather than absolute.
Now we are seeing another worldview shift from atheism into pantheism.
Pantheism is the ideology which lies behind Eastern religions like Hinduism
and also the New Age Movement. God is an impersonal force of which we are
all simply a part. Death leads to reincarnation, and morality simply means
being in harmony with nature. All is one and all is God. This has meant an
increasing openness to all sorts of non-Christian spiritual belief along
with a scepticism and suspicion about science.
The change of worldview from theism, to atheism and then pantheism has had
profound effects on the way that medicine is practised. While Christian
doctors see human beings as a tri-unity of spirit, soul (or mind) and body
(1 Thes 5:23), atheistic doctors see them as consisting of just body and
mind. By contrast, New Age or alternative medicine practitioners see human
beings as an integrated whole; but from a pantheistic rather than a theistic
perspective.
Much of alternative medicine has its roots in the New Age Movement which in
turn is rooted in Astrology. Exponents believe that for the last 2,000 years
we have been in the age of Pisces (the fishes), but that now we are moving
into the age of Aquarius (the water-carrier). The Age of Pisces was
characterised by rationality, logic, objectivity and black and white
analytical 'left brain' thinking. By contrast the Age of Aquarius is
characterised by intuitional, subjective, grey 'right brain' thinking.
Sociologically the New Age Movement spawned the counterculture of the 1960s
with 'flower-power', peace protests, drug experimentation and the Hippie
movement. Spiritually it paved the way for a wide acceptance of Eastern
religious ideology, Astrology and the Occult. Medically the New Age Movement
has meant an ncreasing disillusionment with and scepticism about scientific
medicine.
As Christians we reject both the atheistic and pantheistic worldviews. They
are quite simply not the way the world is. God does exist. We are made in
his image, yet fallen; and death leads to judgement. We embrace the
scientific method as a gift of God, but we also see human beings as being
more than simply the sum of their parts.
2. Failings of orthodox medicine
There have been great advances in orthodox medicine over the last two
centuries which have led to the eradication and alleviation of many diseases
which were previously neither preventable nor curable: immunisations for
smallpox, antibiotics for infection, anti-psychotics for schizophrenia,
chemotherapy for cancer, drugs for heart failure and surgery for a whole
host of structural and anatomical problems.
But medicine also has its limits. With many illnesses we have a long way to
go. Solid tumours (eg lung, breast and bowel) are in general difficult to
treat if surgery fails. There is still much progress to be made in chronic
diseases like multiple sclerosis and rheumatoid arthritis, and there is
still no orthodox cure for musculoskeletal back pain and the common cold. If
we also consider that 75% of people seeing their doctor do not have any
defined organic illness, it is easy to see why people may decide to consult
alternative practitioners. Patients may also become impatient or
disillusioned with the NHS system of referrals and waiting lists.
With some diseases alternative medicine fares no worse than orthodox
medicine and it is in these areas that alternative medicine thrives.
3. Medical arrogance
Doctors have not always been ready to admit failure; and on occasions may go
on using treatments of doubtful value, or with potential side-effects rather
than being honest that nothing else can be done. The inappropriate use of
some chemotherapeutic agents or radical surgery for advanced cancer, for
instance, may cultivate distrust in patients who then seek other solutions.
4. The side effects of orthodox medicine
Orthodox medicines and surgery can produce side effects and complications
which are sometimes fatal. Examples are often widely publicised by an
unforgiving press. By contrast most alternative medicine has little in the
way of side-effects.
5. Loss of a whole person perspective
Advances in the science of medicine may be at the expense of the art of
medicine. Doctors have less time for the patient, touch patients less often,
and are tempted much more now to treat their patients simply as anatomical
structures or biochemical machines. There is much less in medicine now of
the ritual handshake, pulse-taking, hand on the shoulder etc. Too often the
doctor is now esconced behind his PC and perhaps a formidable desk; while
many alternative therapies involve plenty of 'hands-on' diagnosis and
treatment.
Alternative medical practitioners generally are able to give much more in
terms of time and touch, thereby engendering more trust. Homeopaths, for
example, may spend up to 90 minutes in a first consultation and 45 minutes
on follow up. Patients naturally assume, 'He must know what he is doing
because he spends so much time with me'.
6. Costs of high-tech medicine
High tech medicine is expensive, while often the only cost of alternative
medicine is the therapist's time. This is one feature making alternative
therapies increasingly attractive to health insurance managers looking to
cut costs.
7. Consumer demand
Patients are prepared to pay for therapies which promise what orthodox
medicine has failed to deliver; especially for incurable cancer or chronic
pain. This demand means that there is plenty of room in the market place for
more practitioners.
Why does alternative medicine seem to work?
Why is it that so many people are seeking alternative medicine therapies
when so many of them have been shown not to work in clinical trials? There
are at least eight reasons why.
1. Genuine therapeutic effects
Some alternative medicines genuinely work. Over half of prescription and
over-the-counter drugs originate as natural compounds or are based on them
(eg aspirin, digitalis, morphine, adrenaline, curare, all antibiotics except
the quinolones etc); and the natural world may hold many more therapeutic
treasures.
It is quite conceivable that some alternative medicine practitioners are
using useful compounds or techniques which are not yet known to orthodox
medicine. But if this is the case then we need to discover what they are so
that they can be isolated and given in the correct dose!
2. The placebo effect
If we strongly believe that something (or someone) has the power to help us,
then we are much more likely to experience benefit. It is a fact that one
third of people given an inert compound to relieve a particular symptom will
report relief of that symptom. This is called the placebo effect. In the
same way patients who share the therapist's belief in New Age pantheism or
the existence of 'life force' will be more likely to benefit from their
therapy.
3. Concurrent use of therapies
Belief in an alternative therapy's effectiveness may develop when it is used
concurrently with another more effective orthodox therapy. The effect is
then wrongly ascribed to the alternative therapy.
4. Psychosomatic illness
Many illnesses are psychosomatic; in other words a patient's stress level or
mental state can aggravate the symptoms. Asthma, eczema, peptic ulcer and
rheumatoid arthritis fall in this category. Alternative therapies which
induce relaxation may then improve the symptoms.
5. Spontaneous remissions
Many diseases get better by themselves. Viral infections (eg warts, common
cold) and some tumours (eg malignant melanoma) are examples of conditions
which may spontaneously regress. In such cases people may well then
attribute therapeutic effect to the remedy they were trying at the time of
recovery, when it fact their improvement at that time may just have been
coincidence. This is called the 'post hoc, propter hoc' fallacy; in other
words 'because B followed A, then A must have caused B'.
6. Dietary influences
There is a strong link between diet and health, and many alternative
therapists recommend that patients drink less coffee or alcohol, eat less
fat or more fibre or take vitamins. The resulting improvement may then be
due to the change in diet, rather that the alternative therapy being used
concurrently.
7. Imagined improvement
Some patients, especially if open to suggestion from others that they 'look
better', may simply imagine that they 'feel better'; especially if the
symptoms were of a vague nature in the first place. Alternatively they may
simply get better at tolerating symptoms, and imagine that the symptoms
themselves have diminished.
8. Demonic involvement
There may be real spiritual forces operating to bring healing through
demonic power. Such healings may be the bait that Satan then uses to draw a
person more deeply into the occult, or into accepting a pantheistic
worldview.
How do we assess individual modalities?
It is not possible in this brief review to comment on each and every
alternative therapy; but here are some principles which can be generally
applied.
1. Do the claims fit the facts?
Any new orthodox medicine has to undergo extensive pharmacological testing
to assess its therapeutic potential, side-effects and interactions with
other drugs. Tests are first carried out in animals, then in human
volunteers and only then are short and long term studies carried out on real
patients.
If a drug passes these tests it must then be approved by the Licensing
Authority. This ensures that drugs reaching the public are both safe and
effective.
In the same way medical practitioners must undergo a five year undergraduate
training and then work for a further year before they are registered and
able to practice independently of an institution.
Similar safeguards for alternative medicines and practitioners are largely
absent. There is simply no comparison between the double-blind, randomised,
placebo-controlled cross-over trials which many orthodox drugs undergo and
the subjective anecdotal 'evidence' supporting much alternative medicine.
Furthermore, when proper trials are employed the results are often
unconvincing.
A Department of Complementary Medicine has recently been set up at the
University of Exeter to review trials on alternative and complementary
therapies. The contents pages of their quarterly journal FACT (Focus on
Alternative and Complementary Therapies) are available on the internet and
make interesting reading. Many of the published studies give inconclusive
results.
A 1990 French review of 40 controlled trials on homeopathy concluded that
the majority were flawed by small sample size and subjective measures of
improvement. A 1991 review of 107 trials was similarly inconclusive.
By contrast there is evidence that patients with low back pain treated with
chiropractic derive more benefit and long term satisfaction than those
treated by hospitals; and that, according to a consensus panel of the US
National Institutes of Health, acupuncture is an effective treatment for
nausea and vomiting induced by anaesthesia, pregnancy or chemotherapy.
The biblical injunction to 'enquire, probe and investigate thoroughly' (Dt
13:14ff) must surely be relevant here. We should always ask, 'What is the
evidence that this therapy really works?'
2. Is there a rational scientific basis?
We know how most orthodox drugs work. They may stimulate receptors (eg b
agonists in asthma), modify cell transport (eg probenecid), block enzymes
(eg allopurinol), replace missing compounds (eg vitamin B12) or chelate
toxins (eg penicillamine). The action of any given drug is determined by its
concentration at the site of action; and the actions are understandable in
view of their known biochemical and physiological effects. By contrast the
majority of alternative medicines have no rational scientific basis.
Homeopathy involves diluting an active compound to such a degree that the
resulting 'potency' contains not even a molecule of the original active
ingredient.
Iridology claims to link each area of the iris with a separate part of the
body when it is known that no such anatomical links exist. Reflexology is
based on the belief that there are connections between the sole of the foot
and internal organs; again in the absence of any scientific evidence.
There is similarly no evidence for the existence of the 'meridians' (energy
channels) of acupuncture or the 'chakras' (psychic spinal centres) of yoga.
In some cases an alternative therapy may be working because of some
scientific reason unknown to the therapist. It has been suggested, for
instance that the therapeutic effects of acupuncture could be explained by
the release of endogenous (naturally produced) pain-killers called
endorphins. If this is indeed confirmed, then acupuncture will be shown to
have a scientific basis, but this will not, by any means prove that Taoist
ideology is true or that Chi energy exists.
3. Is it the improvement due to the therapy or some other factor?
Transcendental Meditation lowers blood pressure, but why? Is it because it
enables the Goddess Kundalini to migrate up the spine and unite with Brahman
in the head (as Hindus believe); or is it simply that meditation induces
relaxation and reduces the sympathetic output that raises blood pressure?
Similarly, chiropractic has been shown to help low back pain, but is this
because manipulation of the spine alters the flow of 'innate intelligence'
or because it helps to alleviate musculoskeletal trigger points?
In each of these cases it seems to be the methodology rather than the
principle of prana or innate intelligence that brings the therapeutic
effect.
There is thus a world of difference between the GP who makes a diagnosis by
taking a history and doing an examination and the alternative medicine
practitioner who does it by examining an iris or swinging a pendulum. There
is also a huge gulf between the GP who uses acupuncture on the basis of its
proven effectiveness in clinical trials and the practitioner who uses it
because he believes it alters the balance of yin and yang.
4. What is the worldview behind it?
What is the worldview behind the therapy? As mentioned acupuncture has its
roots in Taoism, yoga in Hinduism and therapeutic touch in New Age ideology.
This alone should make us suspicious.
What was the motivation of the therapist who developed the treatment?
Hahnemann, the German physician who developed homeopathy, was a freemason.
Kreger, the New York Nursing Professor who invented therapeutic touch, is a
Buddhist; and her collaborator Kunz was Vice President of the Theosophical
Society and an occultist and psychic. Edward Bach (of 'flower remedy' fame)
was a doctor who trusted his 'spirit self' for knowledge and guidance.
It might be objected here that much orthodox medicine has been developed by
atheists with an atheistic worldview and yet that does not stop us
benefiting from their insights. This is true. We are not saying that
pantheists are unable to discover beneficial treatments which are God-given;
but simply that their worldview should make us wary in assessing their
therapies.
5. Does it involve the occult?
Are occult means of divination used in deciding on diagnosis or treatment?
We should heed the biblical warnings about Mediums and Spiritists (Lv 9:31,
20:6; Acts 16:16-21), Astrology (Is 47:13-15), Magic Charms(Ezk 13:20-23),
Diviner's Wands (Ho 4:12),Sorcery (Acts 19:19), Witchcraft (Gal 5:20), Magic
Arts (Rev 9:21, 21:8, 22:15) and the Occult(Dt 18:10-12) generally.
6. Is it medically safe?
Most alternative therapies have little in the way of side effects, but there
are exceptions. Acupuncture, for example, may cause pneumothaorax or
transmit infection. Chiropractic neck manipulation has been associated with
vertebral artery obstruction and some herbal therapies result in toxicity or
even death. But perhaps the greatest danger is that alternative therapies
can create a false sense of security which leads to delay in diagnosis or in
implementation of effective orthodox medicine.
7. Has it stood the test of time?
This is not a guarantee, as clearly many occult devices stand the test of
time, but we can be equally sure that something which genuinely works or is
of God will stand the test of time.
Applying the tests
As an example of applying the tests above let us consider homeopathy. First,
there is no clear evidence that it actually works. Second, it has no
rational scientific basis; there is no reason known to science why a
solution containing not a single molecule of a given active substance should
have any therapeutic effect. Third, it is based on a pantheistic worldview
with the concept of 'vital energy' playing a prominent role. Fourth,
practitioners will often use occult means (such as pendulums) in diagnosis.
While it does appear to be safe and to have stood the test of time, these
other considerations should make us very wary indeed.
Difficult Questions
Finally let us finish by considering some of the objections which Christians
might raise to the kind of critique I have just given.
1. Weren't many medical treatments initially 'natural' anyway?
This is correct (eg aspirin (willow bark), digitalis (foxglove), Morphine
(poppies)) but the natural ingredient needs to be clearly identified and
given in the right dose. Many useful natural drugs are toxic if given in too
high a dose (eg digitalis, opium).
Decisions about which compound to give must also not be based on occult
practices (eg rituals, spells, charms, astrology, clairvoyance, pendulums,
spirit guides etc) as previously mentioned.
2. How can something be wrong if it actually works?
First, we need to be sure that the given therapy does actually work. Have
there been properly controlled clinical trials carried out showing that it
is better than placebo, or is it supported simply by anecdotal testimony?
Second we need to ask why it works. Is it working as a result of occult
power? (Dt 13:1-6; Ex 7:11,22, 8:7, 18,19; Mt 24:24). If so it may be
leading to the bondage, rather than to the liberation, of the patient. We
must be ready to test everything (1 Thes 5:21).
3. Isn't there some good in it?
It's often objected that we should not throw out the baby with the bath
water; and there is some truth in this... but is the baby and bath water
really a good analogy? It is very easy to see the difference between baby
and bath water but often extremely difficult to separate out the good and
bad in alternative medicine.
A better analogy is the poison mushroom. While poison mushrooms contain
plenty of good fat, carbohydrate and protein we recommend that people don't
eat them because it is impossible to separate out the good and the bad.
Everything that does not proceed from faith is sin; so if we have doubts it
may well be better to abstain (Rom 14:23).
4. How can it be wrong if good Christians I know use it?
Good Christians may be ignorant or deceived or simply have their consciences
blunted from habitual sin. There is no-one with perfect discernment who is
right in all their words, let alone all their beliefs (Jas 3:1). Good
Christians may also have a lot personally invested in a therapy if a friend
or relative is practising in it or has benefited from it and their
objectivity may be accordingly clouded.
Summary
We have reviewed the rapid rise in popularity in alternative medicine, and
seen that while therapies are diverse, there is a pantheistic ideology
behind many of them.
Alternative medicine is popular because of changes in the Western worldview,
the perceived failings, arrogance, costs and side effects of orthodox
medicine, and because it appears to bring a 'whole person' perspective.
While some therapies may genuinely work, apparent improvements are often due
to other reasons such as spontaneous remissions, the use of concurrent
orthodox medicine or the placebo effect.
Each branch of alternative medicine needs to be assessed individually to
determine its effectiveness, scientific basis, mode of action, safety,
underlying worldview and links with the occult.
We should be wary, but we must be careful also that we do not miss genuine
gifts which God has given. The biblical injunction to 'test everything...
hold on to the good... avoid every kind of evil' (1 Thes 5:21,22) is surely
as relevant here as in any other area of the Christian life.
Wednesday, September 24, 2008
A Sane Approach to Exercise
Only 20% of people are currently doing enough exercise to get health
benefits from it. A sane approach is easy. A sane approach is just difficult
enough to produce benefits for the heart, lungs and muscles.
Working regular exercise into your busy life takes a real commitment. Even
the greatest enthusiasm does not last for long. So it is good to make a
habit of exercising at the same time of day. Whenever possible, exercise
with others.
Running is not a good choice for exercise because up to four of every ten
adults who run will have an injury to their legs or feet in a year. In the
long run running increases arthritis. Better for most people to walk
regularly...it's something you can do for the rest of your life.
Walk without stopping, use a stationary cycle, or do any continuous activity
for 20 minutes, 3 times a week to make your heart beat a little faster and
to make you breathe a little harder. This activity does not need to be all
at once; it can be spread throughout the day.
How you feel is a better guide for walking than a "target heart rate". If
you can sing, you are walking too slowly. If you are too short of breath to
talk, you are walking too fast.
Slow stretching relaxes muscles and increases flexibility. This is
especially true when muscles are warm with increased blood circulation after
exercise. Gentle movement lubricates joints and reduces pain. Stretching
should be slow and not cause pain. [AAFP]
benefits from it. A sane approach is easy. A sane approach is just difficult
enough to produce benefits for the heart, lungs and muscles.
Working regular exercise into your busy life takes a real commitment. Even
the greatest enthusiasm does not last for long. So it is good to make a
habit of exercising at the same time of day. Whenever possible, exercise
with others.
Running is not a good choice for exercise because up to four of every ten
adults who run will have an injury to their legs or feet in a year. In the
long run running increases arthritis. Better for most people to walk
regularly...it's something you can do for the rest of your life.
Walk without stopping, use a stationary cycle, or do any continuous activity
for 20 minutes, 3 times a week to make your heart beat a little faster and
to make you breathe a little harder. This activity does not need to be all
at once; it can be spread throughout the day.
How you feel is a better guide for walking than a "target heart rate". If
you can sing, you are walking too slowly. If you are too short of breath to
talk, you are walking too fast.
Slow stretching relaxes muscles and increases flexibility. This is
especially true when muscles are warm with increased blood circulation after
exercise. Gentle movement lubricates joints and reduces pain. Stretching
should be slow and not cause pain. [AAFP]
Thursday, August 28, 2008
Acetylsalicylic Acid Linked to Lower Risk of Cancer and Heart Disease
Regular acetylsalicylic acid use may significantly reduce the incidence of
both cancer and heart disease, according to a large new study, but other
nonsteroidal anti-inflammatory drugs, or NSAIDs, have no effect.
Researchers studied 22,507 postmenopausal women, following them for 10
years. All reported their acetylsalicylic acid and NSAID use as part of a
detailed physical and behavioral health questionnaire. None of the women had
cancer or heart disease at the start of the study.
After controlling for age, exercise, diet and other factors, those who used
acetylsalicylic acid had a 16 percent reduced risk of getting cancer, and a
13 percent reduced risk of cancer death, compared with women who never used
it. Acetylsalicylic acid use was also associated with a 25 percent reduced
risk of dying from coronary artery disease and an 18 percent reduction in
all-cause mortality compared with those who never took acetylsalicylic acid.
But use of other NSAIDs like ibuprofen and naproxen had no effect, and there
was no significantly reduced risk among acetylsalicylic acid users who were
currently smoking. The study was published in the Journal of the National
Cancer Institute.
The authors acknowledged that the study was not a randomized trial, that the
questionnaire did not assess duration of acetylsalicylic acid use, and that
the participants were all postmenopausal women, most of whom were white.
"It would be premature at this point to advise women to take acetylsalicylic
acid," said Dr. Aditya Bardia, the lead author.
"The study does produce provocative evidence that acetylsalicylic acid can
reduce mortality, but for now it would be best that women talk to their
health care provider about the risks and benefits of acetylsalicylic acid
use." [AAFP]
both cancer and heart disease, according to a large new study, but other
nonsteroidal anti-inflammatory drugs, or NSAIDs, have no effect.
Researchers studied 22,507 postmenopausal women, following them for 10
years. All reported their acetylsalicylic acid and NSAID use as part of a
detailed physical and behavioral health questionnaire. None of the women had
cancer or heart disease at the start of the study.
After controlling for age, exercise, diet and other factors, those who used
acetylsalicylic acid had a 16 percent reduced risk of getting cancer, and a
13 percent reduced risk of cancer death, compared with women who never used
it. Acetylsalicylic acid use was also associated with a 25 percent reduced
risk of dying from coronary artery disease and an 18 percent reduction in
all-cause mortality compared with those who never took acetylsalicylic acid.
But use of other NSAIDs like ibuprofen and naproxen had no effect, and there
was no significantly reduced risk among acetylsalicylic acid users who were
currently smoking. The study was published in the Journal of the National
Cancer Institute.
The authors acknowledged that the study was not a randomized trial, that the
questionnaire did not assess duration of acetylsalicylic acid use, and that
the participants were all postmenopausal women, most of whom were white.
"It would be premature at this point to advise women to take acetylsalicylic
acid," said Dr. Aditya Bardia, the lead author.
"The study does produce provocative evidence that acetylsalicylic acid can
reduce mortality, but for now it would be best that women talk to their
health care provider about the risks and benefits of acetylsalicylic acid
use." [AAFP]
Monday, August 18, 2008
Vitamins Don't Stop Eye Disease
A healthy diet rich in vitamins and minerals does not protect against the world's leading cause of sight loss, a study has found. Antioxidants have long been thought to help guard against age-related macular degeneration (AMD), a debilitating condition which blurs central vision over time.
Patients don't go blind but the progressive breakdown of light-sensitive cells at the back of the retina makes it increasing impossible to read, drive or carry out daily tasks.
A new international review by researchers has now found that dietary nutrients do nothing to stop a person developing the disease.
This leaves age, genetics and smoking as the only proven factors connected to onset of the disease, which affects one in seven people aged over 50. Most have the slower moving "dry" form of the condition.
Researchers from the Centre for Eye Research analysed evidence from 11 studies involving almost 150,000 people who were tracked for an average of nine years.
The studies looked at intake of various antioxidants such as vitamin C found in fruit, vitamin E in foods such as nuts, zinc found in many meats and carotenoids found in many root vegetables.
The pooled results showed that people with higher intakes of vitamin A, vitamin C, vitamin E, zinc, lutein, zeaxanthin, a-carotene, b-carotene, b-cryptoxanthin and lycopene were no more or less likely to develop the condition than those consuming less.
Three of the studies also found little effect if the antioxidants were taken as supplements.
"There is insufficient evidence to support the role of dietary antioxidant supplements for the primary prevention of early AMD," the authors concluded in an article published in the British Medical Journal.
"Cigarette smoking remains the only widely accepted modifiable risk factor for the primary prevention of AMD, and patients seeking advice should be encouraged to stop smoking."
Eye expert Jennifer Evans, from the International Centre for Eye Health, supported the findings but suggested there was still some evidence that antioxidant supplements could be useful to people already in the early stages of the disease.
Blackmores director of research and prevention Philip Daffy said the study had "serious deficiencies".
"Sufferers of macular degeneration who take antioxidant supplements formulated to slow the progression of this disease should not be alarmed by this study," he said.
"The study has some serious deficiencies and only relates to antioxidant intake for the prevention of AMD, not it's treatment."
Blackmores sells products containing antioxidants, which it markets as helping to maintain healthy eyes. [SMH]
Patients don't go blind but the progressive breakdown of light-sensitive cells at the back of the retina makes it increasing impossible to read, drive or carry out daily tasks.
A new international review by researchers has now found that dietary nutrients do nothing to stop a person developing the disease.
This leaves age, genetics and smoking as the only proven factors connected to onset of the disease, which affects one in seven people aged over 50. Most have the slower moving "dry" form of the condition.
Researchers from the Centre for Eye Research analysed evidence from 11 studies involving almost 150,000 people who were tracked for an average of nine years.
The studies looked at intake of various antioxidants such as vitamin C found in fruit, vitamin E in foods such as nuts, zinc found in many meats and carotenoids found in many root vegetables.
The pooled results showed that people with higher intakes of vitamin A, vitamin C, vitamin E, zinc, lutein, zeaxanthin, a-carotene, b-carotene, b-cryptoxanthin and lycopene were no more or less likely to develop the condition than those consuming less.
Three of the studies also found little effect if the antioxidants were taken as supplements.
"There is insufficient evidence to support the role of dietary antioxidant supplements for the primary prevention of early AMD," the authors concluded in an article published in the British Medical Journal.
"Cigarette smoking remains the only widely accepted modifiable risk factor for the primary prevention of AMD, and patients seeking advice should be encouraged to stop smoking."
Eye expert Jennifer Evans, from the International Centre for Eye Health, supported the findings but suggested there was still some evidence that antioxidant supplements could be useful to people already in the early stages of the disease.
Blackmores director of research and prevention Philip Daffy said the study had "serious deficiencies".
"Sufferers of macular degeneration who take antioxidant supplements formulated to slow the progression of this disease should not be alarmed by this study," he said.
"The study has some serious deficiencies and only relates to antioxidant intake for the prevention of AMD, not it's treatment."
Blackmores sells products containing antioxidants, which it markets as helping to maintain healthy eyes. [SMH]
Thursday, August 14, 2008
Case for Real Food
Is there more to a carrot than beta carotene? Is lycopene the best we get
from tomatoes? And when we heap our plates with salmon, are we serving up
something other than omega-3s?
For years the scientific community has viewed individual vitamins and
nutrients as the best that food has to offer. Nutrition studies have
isolated beta carotene, calcium, vitamin E and lycopene, among other
nutrients, in order to study their health benefits in the body.
But now, after several vitamin studies have produced disappointing results,
there's a growing belief that food is more than just a sum of its nutrient
parts. In a commentary for the journal Nutrition Reviews, professor of
epidemiology David R. Jacobs argues that nutrition researchers should focus
on whole foods rather than only on single nutrients. "We argue for a need to
return to food as the source of nutrition knowledge,'' writes Dr. Jacobs
with co-author Linda C. Tapsell, a nutrition researcher.
Dr. Jacobs believes that nutrition science needs to consider the effects of
"food synergy,'' the notion that the health benefits of certain foods aren't
likely to come from a single nutrient but rather combinations of compounds
that work better together than apart. "Every food is much more complicated
than any drug,'' said Dr. Jacobs. "It makes sense to want to break it down.
But you get a lot of people talking in the popular press about carbohydrates
and fats in particular as if they were unified entities. They're not. They'
re extremely complicated.''
The narrow focus on the health effects of single nutrients stems from the
earliest days of nutrition research. In 1937, two scientists won a Nobel
Prize for identifying vitamin C as the essential component in citrus fruit
that prevents scurvy. The finding spurred interest by the scientific
community to study other biologically active nutrients in foods.
For as long as observational studies have shown that diets rich in fruits
and vegetables, unsaturated fat and fish, among other things, are associated
with better health, nutrition researchers have been busily deconstructing
these foods to identify the most potent nutrients. For example, vitamin E
has been widely studied as a heart protector.
But attributing the broad health benefits of a diet to a single compound has
proven to be misguided. Several studies have suggested an association
between diets rich in beta carotene and vitamin A, for instance, and lower
risk for many types of cancer. But in a well-known 1994 Finnish study,
smokers who took beta carotene were found to have an 18 percent higher
incidence of lung cancer. In 1996, researchers gave beta carotene and
vitamin A to smokers and workers exposed to asbestos. But the trial had to
be stopped because the people taking the combined therapy showed markedly
higher risks for lung cancer and heart attacks.
Since then, studies of other vitamins, notably vitamins E and B, have also
failed to show a benefit. Manufacturers say the problem is that vitamins are
too often examined in sick people while the real benefit may be in
preventing disease. But Dr. Jacobs notes that the better explanation may
simply be that food synergy, rather than the biological activity of a few
key nutrients, is the real reason that certain diets, like those consumed in
the parts of the Mediterranean and Japan, appear to lower the risks of heart
disease and other health problems.
"People ask me what vitamins they should take,'' said Dr. Jacobs. "I say
'Don't take any. Just make sure you have a nutrient-rich diet.' '' [NYT]
from tomatoes? And when we heap our plates with salmon, are we serving up
something other than omega-3s?
For years the scientific community has viewed individual vitamins and
nutrients as the best that food has to offer. Nutrition studies have
isolated beta carotene, calcium, vitamin E and lycopene, among other
nutrients, in order to study their health benefits in the body.
But now, after several vitamin studies have produced disappointing results,
there's a growing belief that food is more than just a sum of its nutrient
parts. In a commentary for the journal Nutrition Reviews, professor of
epidemiology David R. Jacobs argues that nutrition researchers should focus
on whole foods rather than only on single nutrients. "We argue for a need to
return to food as the source of nutrition knowledge,'' writes Dr. Jacobs
with co-author Linda C. Tapsell, a nutrition researcher.
Dr. Jacobs believes that nutrition science needs to consider the effects of
"food synergy,'' the notion that the health benefits of certain foods aren't
likely to come from a single nutrient but rather combinations of compounds
that work better together than apart. "Every food is much more complicated
than any drug,'' said Dr. Jacobs. "It makes sense to want to break it down.
But you get a lot of people talking in the popular press about carbohydrates
and fats in particular as if they were unified entities. They're not. They'
re extremely complicated.''
The narrow focus on the health effects of single nutrients stems from the
earliest days of nutrition research. In 1937, two scientists won a Nobel
Prize for identifying vitamin C as the essential component in citrus fruit
that prevents scurvy. The finding spurred interest by the scientific
community to study other biologically active nutrients in foods.
For as long as observational studies have shown that diets rich in fruits
and vegetables, unsaturated fat and fish, among other things, are associated
with better health, nutrition researchers have been busily deconstructing
these foods to identify the most potent nutrients. For example, vitamin E
has been widely studied as a heart protector.
But attributing the broad health benefits of a diet to a single compound has
proven to be misguided. Several studies have suggested an association
between diets rich in beta carotene and vitamin A, for instance, and lower
risk for many types of cancer. But in a well-known 1994 Finnish study,
smokers who took beta carotene were found to have an 18 percent higher
incidence of lung cancer. In 1996, researchers gave beta carotene and
vitamin A to smokers and workers exposed to asbestos. But the trial had to
be stopped because the people taking the combined therapy showed markedly
higher risks for lung cancer and heart attacks.
Since then, studies of other vitamins, notably vitamins E and B, have also
failed to show a benefit. Manufacturers say the problem is that vitamins are
too often examined in sick people while the real benefit may be in
preventing disease. But Dr. Jacobs notes that the better explanation may
simply be that food synergy, rather than the biological activity of a few
key nutrients, is the real reason that certain diets, like those consumed in
the parts of the Mediterranean and Japan, appear to lower the risks of heart
disease and other health problems.
"People ask me what vitamins they should take,'' said Dr. Jacobs. "I say
'Don't take any. Just make sure you have a nutrient-rich diet.' '' [NYT]
Tuesday, August 12, 2008
Experts Recommend Eat Fish While Pregnant
Pregnant and breast-feeding women should eat at least 340 grams of fish and
other seafood a week because the benefits for infant brain development
outweigh any worries about mercury contamination, a group of experts said.
The recommendations contradict warnings that these women should consume no
more than 340 grams of fish and other seafood weekly due to concerns that
mercury -- which can harm the nervous system of fetuses -- might exist in
trace amounts in this food.
But the group of 14 obstetricians and nutritionists said the threat of
mercury poisoning remains only theoretical, while the warnings have scared
many pregnant women into not eating fish at all, robbing them and their
babies of vital nutrients like omega-3 fatty acids, known to help brain
development.
The nutrients in fish and seafood are important for brain and motor skill
development in children and can help prevent postpartum depression in
mothers, the experts said.
No Case of Fetal Mercury Toxicity
The coalition said it received $60,000 from a seafood industry trade group,
but the experts defended the independence of their work.
"There has been no case of fetal mercury toxicity due to fish consumption
reported," said one of the experts, Dr. Ashley Roman, a professor of
obstetrics and Gynecology.
The group urged that women who want to become pregnant, are pregnant or are
breast-feeding should eat a minimum of 340 grams per week of fish like
salmon, tuna, sardines and mackerel and seafood like shrimp, lobster and
clams.
That amounts to about two to three servings a week. It did not state a
recommended upper limit for consumption.
"There are some fish that have been shown to be higher in mercury and in
other important trace elements such as shark and swordfish," Roman said.
"Those might be sources of fish women still might want to stay away from.
But the vast majority of fish out there present in the diet, those are
generally very healthy fishes."
"We're not saying that women should eat 21 meals a week of fish. That's not
the message here," added nutritionist Thomas Brenna, another member of the
group.
The experts cited a study published in the Lancet medical journal finding
that children whose mothers ate more fish and other seafood while pregnant
were smarter and had better developmental skills than those whose mothers
ate less or none.
It looked at children of 8,000 British women to see how children fared if
their mothers ate more than 340 grams a week.
The Food and Drug Administration and Environmental Protection Agency issued
advisories telling women who were pregnant, breast-feeding or trying to
become pregnant, as well as young children, to eat no more than 340 grams
weekly of some types of fish due to mercury concerns.
Estimates on the dangers posed by mercury come from people exposed in
chemical spills. No major studies have shown that mercury from food or
vaccines has caused brain damage to mothers or children.
"While it's recognized that fish is an important source of protein,
especially for pregnant women, this new emphasis on eating more than 12
ounces of fish per week, without mention of the need to avoid
mercury-contaminated fish, appears to throw the baby out with the bath
water," Michael Bender, director of the Mercury Policy Project advocacy
group that believes mercury exposure has damaged children, said in a
statement. [RT]
other seafood a week because the benefits for infant brain development
outweigh any worries about mercury contamination, a group of experts said.
The recommendations contradict warnings that these women should consume no
more than 340 grams of fish and other seafood weekly due to concerns that
mercury -- which can harm the nervous system of fetuses -- might exist in
trace amounts in this food.
But the group of 14 obstetricians and nutritionists said the threat of
mercury poisoning remains only theoretical, while the warnings have scared
many pregnant women into not eating fish at all, robbing them and their
babies of vital nutrients like omega-3 fatty acids, known to help brain
development.
The nutrients in fish and seafood are important for brain and motor skill
development in children and can help prevent postpartum depression in
mothers, the experts said.
No Case of Fetal Mercury Toxicity
The coalition said it received $60,000 from a seafood industry trade group,
but the experts defended the independence of their work.
"There has been no case of fetal mercury toxicity due to fish consumption
reported," said one of the experts, Dr. Ashley Roman, a professor of
obstetrics and Gynecology.
The group urged that women who want to become pregnant, are pregnant or are
breast-feeding should eat a minimum of 340 grams per week of fish like
salmon, tuna, sardines and mackerel and seafood like shrimp, lobster and
clams.
That amounts to about two to three servings a week. It did not state a
recommended upper limit for consumption.
"There are some fish that have been shown to be higher in mercury and in
other important trace elements such as shark and swordfish," Roman said.
"Those might be sources of fish women still might want to stay away from.
But the vast majority of fish out there present in the diet, those are
generally very healthy fishes."
"We're not saying that women should eat 21 meals a week of fish. That's not
the message here," added nutritionist Thomas Brenna, another member of the
group.
The experts cited a study published in the Lancet medical journal finding
that children whose mothers ate more fish and other seafood while pregnant
were smarter and had better developmental skills than those whose mothers
ate less or none.
It looked at children of 8,000 British women to see how children fared if
their mothers ate more than 340 grams a week.
The Food and Drug Administration and Environmental Protection Agency issued
advisories telling women who were pregnant, breast-feeding or trying to
become pregnant, as well as young children, to eat no more than 340 grams
weekly of some types of fish due to mercury concerns.
Estimates on the dangers posed by mercury come from people exposed in
chemical spills. No major studies have shown that mercury from food or
vaccines has caused brain damage to mothers or children.
"While it's recognized that fish is an important source of protein,
especially for pregnant women, this new emphasis on eating more than 12
ounces of fish per week, without mention of the need to avoid
mercury-contaminated fish, appears to throw the baby out with the bath
water," Michael Bender, director of the Mercury Policy Project advocacy
group that believes mercury exposure has damaged children, said in a
statement. [RT]
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