February 27, 2012
I have had many requests to revisit this topic.
Meat! Grass fed/naturally fed versus grain fed and unnaturally fed cows.
The answer to this question exists. In the British J Nutrition in September 2010, Dr. Gary Egger published his data on the Differences in postprandial inflammatory responses to a 'modern' v. traditional meat meal: a preliminary study.
In 10 human subjects he compared the bodies immune inflammatory response after eating 100 grams of kangaroo meat versus Wagyu beef. Kangaroo is a surrogate marker of a historical naturally fed meat while the Wagyu beef is an unnaturally grain fed animal.
The results showed an immune inflammatory response 1 hour after eating the Wagyu beef but not after the kangaroo.
What does this mean for you? In simple terms, we are learning that when we mess with a natural food source we suffer the consequences of that choice. Our bodies are perceiving the grain fed meat to be abnormal from the immune system's perspective and reacting with inflammation. If you eat grain fed meat frequently, then you are more likely to develop a low level chronic inflammation. Depending on your genetic risks, this will worsen an inflammatory illness like coronary artery disease, arthritis, Alzheimer's, etc...
ADHD & Medicine Use
February 20, 2012
ADHD, attention deficit hyperactivity disorder, is real and becoming more prevalent with every passing year. The causes are myriad, but suffice it to say that the data is pointing towards an in utero insult (occuring during pregnancy). I think that we will find that chemicals and poor quality maternal diets are turning on the cassette of genes responsible for inattention and dysfunctional executive brain functions.
At Salisbury Pediatrics, we focus on all possible avenues to treat these disorders without defaulting to medicine use. However, at times medicine seems to be the only effective avenue. For those who are taking medicine, here is some good news.
In the past 5 years there has been a flurry of concern regarding heart problems in people taking ADHD medicines. To allay these fears we have a study by Cooper et al. in the New England J Medicine 2011, showing data that children taking ADHD medicines do not have an increase risk of adverse cardiac events. They followed people for the equivalent of 2.5 million person years and found that the rate of serious heart complications was 3.1/100,000 person years.
February 20, 2012
Blissful ignorance! Back when I was a child, I can remember caring less about what my dad was listening to on talk radio or what my parents were conversing about at home. The world's or my town's politics, drama and issues were a foreign concept.
I spent my days finding frogs, eating whatever I could get my mouth around and just being silly. Oh! What a time to be at peace. I was fortunate enough to have two loving parents and only semi-quarrelsome siblings. My parents rules were simple:
1) Love God
2) Love your family and friends
3) Listen to your elders - euphemism for listen to us and you will be smart
4) Study hard
5) Eat what is put in front of you even if you want to throw it across the room
6) Stay out of trouble
I had the biggest trouble with number 6. I talked too much to honor that rule.
Today, I marvel at how difficult it is to instill the same beliefs in my own children. Most days I feel that I am sending a clear and loving message. However, often I feel unheard and abused. In reality, my father felt the same way and I turned out ok (according to me).
Herbs for Sleep
February 13, 2012
If all of the interventions in the Sleep Soultions article have proved unsatisfactory at producing adequate sleep, then here are some herbs that can help.
*Consult your physician for children's doses.
Chamomile herbal tea - this herbal infusion has been used for centuries to induce relaxation and calmness that can lead to sleep onset. Try drinking 12 ounces of tea 1 hour before bedtime while you are reading to dim light.
Valerian - an herb used for sleep induction and to combat insomnia. It can be taken as a tincture, capsule or tea. http://ods.od.nih.gov/factsheets/valerian/
For insomnia, valerian may be taken 1 - 2 hours before bedtime, or up to 3 times in the course of the day, with the last dose near bedtime. It may take a few weeks before the effects are felt.
•Tea: Pour 1 cup boiling water over 1 teaspoonful (2 - 3 g) of dried root, steep 5 - 10 minutes.
•Tincture (1:5): 1 - 1 1/2 tsp (4 - 6 mL)
•Fluid extract (1:1): 1/2 - 1 tsp (1 - 2 mL)
•Dry powdered extract (4:1): 250 - 600 mg
•For anxiety, 200 mg 3 - 4 times per day
Sleep- The Solutions
February 13, 2012
Sleep - The solutions.
I have always marveled at how resilient we are when we are sleep deprived. After finishing my pediatric residency where I averaged 90+ hours of work a week (with a max of 114 hours on pediatric surgery rotations), I left the states with my wife to backpack Europe. One week into our travels, I recall telling her that I had forgotten what it felt like to be rested and peaceful. Here we were sitting in the mountains of Switzerland and I had this overwhelming feeling of restfulness. How strange it was.
Nothing about chronic sleep deprivation is healthy. So what are the solutions to last weeks common problems?
1) Make your bedroom a sanctuary for sleep. Get dark shades and a comfortable bed.
1.5) Remove all video devices and unnecessary lights, i.e. bright alarm clocks, TV, computers, etc...
2) If you need to be up at 5 am, then get to bed by 9pm. Teenagers need more sleep and should catch up on the weekend if they are struggling to get to sleep early enough during the week. Young children are best served by a routine sleep time and wake time. Their resilience for a lack of sleep is very low.
February 6, 2012
Sleep - Why are we having such trouble??? Why do we care?
If you are a parent, you are acutely aware of the demon in the child that arises when they are sleep deprived. You know that your fuse is shorter when you lack restful restorative sleep. How often do we get sick within a week of sleep deprivation?
What are the causes?
1) getting to bed too late and then needing to be up at a specific time - not enough sleep
2) an untreated medical issue - sleep apnea, obesity, restless leg syndrome/iron deficiency, asthma, viral infections, pain, etc... - poor quality sleep/not enough
3) alcohol overuse - poor quality sleep
4) caffeine overuse - sleep onset issues and poor quality sleep
5) behavioral issues - co sleeping, poor limit setting, oppositional attitude - poor quality and sleep onset
Acetaminophen & Asthma
January 30, 2012
Acetaminophen and lung disease - Is there a link?
Acetaminophen/Tylenol/paracetamol - we use this drug to help with pain, fever or malaise. It was developed in the early 1900's and was brought to market in 1953. It is believed to inhibit the enzyme cyclooxygenase 2 which in turn reduces the production of pro inflammatory chemicals like arachadonic acid,
thereby, providing it's user with relief. It is removed from the body by the liver and also utilizes glutathione for clearance. Our cells need glutathione to detoxify unwanted chemicals in our system. Here is where the rub comes in.
It happens to be the subject of much controversy regarding the asthma epidemic. In a recent Pediatrics article from December 2011, the author, John McBride, a pulmonologist, reviews the data. He sees a plausible mechanism for the hypothesis that asthma is on the rise because of the overuse of Tylenol in young children when they are sick with respiratory viral infections. The acetaminophen is depleting the glutathione in the lungs and reducing the bodies natural toxin clearing mechanism. This makes the child's lung tissue susceptible to the chemical.
January 23, 2012
The wonders of historical medicine.
I have been collecting old medical tomes for years now and always marvel at the crazy things that we called medicine back in the day.
Think about leaches and blood letting or purging evil spirits with emetics or sanitariums for tuberculosis! Back in the early 1900's to 1950's there was a condition known as enlarged thymus and thymic asthma. The thymus is a gland in the neck that is critical to immune function. Doctors believed that this enlarged gland was a cause of sudden infant death and other disorders. The treatment was radiation to the thymus the equivalent of 10 modern CT scans! The result - cancer and autoimmunity in these patients and early death.
Fast forward to the 1970's and beyond. Enlarged tonsils and adenoids must be a problem of the tissue and thus they started to be removed. Few people are looking in to "why are these glands enlarged?" Again we have an organ that is important in immune function being pulled out. I find that in my practice the enlarged immune glands are a response to immune dysregulation and are overactive. The root cause needs to be established.
Often we see this with milk protein intolerance or wheat intolerance. In a 2011 study by Van Den Aardweg et al in the British Medical Journal they showed that removal of the adenoid has no effect on recurrent upper respiratory infections, colds. Removing the tonsils and adenoids will help reduce ear infections but at what cost? Use this treatment as a last resort after exhausting other food elimination options. Ideally, the answer is not removal but understanding the root cause.
High Fructose Corn Syrup
January 9, 2012
From Dr. Weil's Newsletter. I wanted to pass this information along.
The HFCS debate rages on:
""High fructose corn syrup (HFCS) is a cheap sweetener chemically derived from corn. This ubiquitous ingredient of junk food has been in the news lately, in part due to a proposed name change by the Corn Refiners Association - the group wants to rename it "corn sugar."
Whatever you call it, HFCS is a marker for low-quality food and has no place in a healthy diet. But unfortunately, it is widely used: HFCS is found as a primary ingredient in soft drinks and often hidden in processed foods including salad dressings and ketchup, jams, jellies, ice cream, bread and crackers. It is one of the biggest sources of calories in the American diet.
January 2, 2012
As I sat and watched my children and nephews open their presents on Christmas morning, I enjoyed the beauty of the day, giving and our lives in America. We are so blessed to live in a country with the freedoms that we have. We can celebrate Christ's birth, Hanukkah, Ramadan and be at peace with each other.
I also thought about the difficult problems technology has brought to parenting. In the not so distant past we had to worry about toy guns, Barbie and JARTS. Fast forward to 2011 and we have ipods, computers (our children are so savvy with all devices), phones, etc...
All of these machines are great, but they bring a few problems to the table that need to be addressed.
1) Ear buds and other headphones are concentrating sound directly to the ears and we are seeing increased hearing loss in young adults.
2) Computers and touchscreen devices are being used by our kids to view very graphic and violent games.
3) Kids are checking out far too often with tunes or texting or movies or youtube or whatever.
4) Radiation risks still concern me.
The carbohydrate dilemma - when, how much and why?
When we exercise our muscles need to burn sugar to work effectively. Our muscles store sugar in the form of muscle glycogen. The concentration of glycogen in the muscle pre exercise will dictate how much energy can be released during a work out. This storage form of sugar is depleted in long and intense work outs. Unfortunately, we cannot transport this sugar from one muscle to another. So when you cycle you can only get sugar from the muscles of the legs or the liver. Therefore, maximizing the muscles glycogen is a key to peak performance.
Our liver also stores sugar as glycogen and can transfer this sugar anywhere, but it cannot store as much as a muscle can for exercise. When an athlete says that he hit the "wall", they are telling you that they ran out of muscle glycogen for an energy source and start to burn lean tissue to produce sugar which is very inefficient.
Carbohydrate loading pre exercise, post exercise and during exercise are all key.
A New Year
December 26, 2011
Here we go with a New Year of newsletters. What are our goals for 2012?
I would like to propose that above all we stay focused on the task of being positive. New Years resolutions always come and go, yet a belief system can take root. Approach everyday in 2012 with the thought that life is moving forward and that we are positively expanding as a person, group, culture and society. What a nice thought! - to go back to peace and harmony in one's self first and then our country.
Think back to the sad period following 9/11. There seemed to be a shift in society toward a collective unity and belief in honor above the normal status quo. Slowly over the last 10 years we have seen a slow shift back toward selfishness and negativity. Our economic downturn and the wonderful media feeds this discontentment. We are inundated with far too much drama and dysfunction of the few. Let us instead pay attention to the good members of our local family unit and society. Honor them with kind words that affirm their goodness and fosters more positivity.
Final Newsletter of Volume 1
Merry Christmas and Happy Holidays to all!
I wish everyone a healthy and joyous holiday season. God Bless.
December 19, 2011
Well it is hard to believe that this is the 52nd newsletter. A year of writing has come and gone and I am thankful. What a joy it is to be a part of your lives and your health.
Thank you for allowing me to teach you and learn from you as well. The initial goal of this newsletter was to keep you up to date with modern medicine, nutrition and the mind/body connection. We have seen a metamorphosis to the style and content of the newsletter as ideas of your desires found their way to me.
I have appreciated the emails with stories of your families and your ideas. Keep them coming and let us continue this growth together.
This last issue of Volume 1 will be the beginning of a series on sports nutrition and performance. This has been a highly requested topic and it is high time we tackled it. We will also be starting a series on the physical side of sports with a friend of mine, Joel Burgess, a master physical therapist and sports training specialist.
Girls & Society
December 12, 2011
Girls and our Society
Problem: when a person's value comes only from his or her sexual appeal or behavior, to the exclusion of other characteristics, how do they feel?
As far back as history can record we have seen a constant sexualization of girls in society. Modern TV, movies, music, clothing, video games, etc., frequently promote the message of sex and beauty. Listen to modern music and hear the glorification of a woman's beauty and sexual prowess and not her merit or brains. Listen to girls talk at school and you fall into a world were beauty is everything.
Don't get me wrong, our society is dramatically better today then any time in the past millennia. Yet, girls are still focused on looking "hot". Too often they are bombarded with the powerful message of "your looks define you".
You can imagine the psychological problems that can arise in a girl if she bases her self worth on her beauty and then she is told that she is less than by a boyfriend or a girlfriend that is mad at her. Or, God forbid, she becomes disfigured with acne, an injury or just aging. Where does she fall back to if her self esteem source was just ruined? Where was her guidance in loving who she is?
December 5, 2011
Arsenic and Lead in Juice.
In a new Consumer Reports investigation they found that 88 samples of apple juice and grape juice purchased in New York, New Jersey, and Connecticut were contaminated with arsenic and lead. Both of these heavy metals affect our brains negatively and promote cancer. They found that most of the arsenic was inorganic (the dangerous type) and the total arsenic levels were higher than what the FDA allows in water. Consumer Reports found that 10 percent of those samples had total arsenic levels exceeding federal drinking-water standards of 10 parts per billion (ppb) and 25 percent had lead levels higher than the 5 ppb limit for bottled water set by the Food and Drug Administration.
These toxic effects are realized over a long period of time. We are talking about trying to prevent long term accumulation issues like we saw during the issues with lead and other heavy metals in the past.
It is unfortunate that we have to even think about a juice being contaminated. The answer to the problem is government intervention. Based on the FDA's history, I think that we are in trouble.
My response to the problem is as follows:
November 28, 2011
The American Academy of Pediatrics and the National Institute of Health are now encouraging universal cholesterol screening at 10 years of age. The previous guidelines were targeted towards screening high risk groups which seemed to make much more sense, but this mass screening may pick up a few unknown familial high cholesterol patients. The fact that the government is interested in spending this money on mass screening speaks to the problem at hand.
The thrust of our intervention has to be focused on teaching all people a heart healthy diet and exercise. It is not prudent to just target those people who have abnormal screening tests.
When a child fails lifestyle modification and has a familial history of or risk factors for diseases like premature coronary artery narrowing, diabetes, high blood pressure, etc... what do we do at this point? Did we fail because of poor teaching? Poor compliance? What?
Are we really going to start high risk drugs in these children if their cholesterol level is elevated? I think that this is a dubious choice and requires some thought into what are the risks of providing cholesterol lowering drugs to a child from age 10 years until what? 70? This may be necessary for some, but for the majority it is likely that persistent education is the answer. We know that for almost all people a healthy diet works.
November 21, 2011
Tis the week for Thanksgiving. Although it is hard to tell by the commercial holiday overlap with Christmas, this is the week that we teach our kids to be thankful for God, their lives, their country and everything that they hold dear.
At the Magryta house during dinner time, we routinely ask our children what they are thankful for and how they feel about life. They often respond with very profound statements that make us smile.
What does it mean to be thankful?
To be thankful really is being in a place of peace within one's self no matter what state of life you find yourself in. Stress or no stress, wealth or its absence, health or disease and so on. Each of us has the ability to love something and many things about our lives at any point. This choice is a blessing.
November 14, 2011
It is that time of year to discuss viral illness and prevention. This is another highly requested topic.
Top ten ways to avoid a winter viral illness:
1) Eat an anti inflammatory style diet - keeps the immune system humming
2) Keep your vitamin D level above 40 ng/dl. Vitamin D is highly necessary for immune function and seasonal mood
3) Wash Your hands and do not touch your face!!!!!!! (this is really #1)
4) Get adequate sleep. For most of us that is 7-8 hours per night. Children need 1 to 4 hours more
November 7, 2011
The ever present world of advertising is dramatically affecting our population. In a new study by the Rudd Center for Food Policy we see a persistent effort by companies that produce high calorie, low quality sugar beverages to target children.
"Beverage companies have pledged to improve child-directed advertising," said lead researcher Jennifer Harris, PhD, MBA, Director of Marketing Initiatives at the Rudd Center. "But we are not seeing a true decrease in marketing exposure. Instead companies have shifted from traditional media to newer forms that engage youth through rewards for purchasing sugary drinks, community events, cause-related marketing, promotions, product placements, social media, and smartphones."
In 2010, teens viewed 18% more TV adds and heard 48 % more radio adds for energy drinks than adults. From 2008 to 2010, children and teens were exposed to twice the amount of soda adds on TV. It seems that despite a pledge not to target children, these companies have continued the onslaught. Children who view the most TV are at the greatest risk.
October 31, 2011
Happy Halloween. What a beautiful day it is!!!! Enjoy the fellowship with your children and friends tonight.
Today's letter is in response to the many recent questions I have fielded on diets and meat intake.
First, let me say that this is only my opinion based on the facts as I understand them.
Being a vegetarian, a vegan or a meatatarian for most people is based on what there taste buds tell them. The vast majority of Americans are not eating for health, they are eating for taste. I think that we need to merge the two. Health and quality taste can coexist.
Do we need to eat meat? Many nutrition specialists say NO. (See the China Study or read Dr. Neal Barnard's work.) This is hard for me to swallow when you go back to a natural understanding of life. Why do we have canine teeth if we were supposed to be vegetarians? All omnivores on the earth eat meat. Why therefore should we be different?