Michael Phelps is Right to Have Cupping Therapy

Michael Phelps and the purple dots on his back and shoulders have gotten a ton of media attention lately, but instead of the time-honoured practice of cupping gaining positive publicity, you get articles telling him not to do it. This is despite the fact that he is an adult who can make his own decisions, and the vast majority of reporters have no natural health (or any health) qualifications. So are the writers of the Atlanticton Post or whatever right, or does cupping have evidence to back it up?

Actually, there are studies that show cupping to be effective. One of these included 50 people with chronic neck pain, who received either cupping or no treatment for two weeks. Among those who received cupping, there was significant pain relief and improvement of the Short Form Health Survey scores for body pain. Another study that also involved 50 people with chronic neck pain compared cupping to standard medical treatment. Both resulted in equal, significant improvements in pain, functional disability and quality of life, so the only deciding factor is the all-important personal choice. Yet another trial, this time involving 40 people with neck pain caused by looking at video screens at work, randomised them into either cupping or use of a heating pad. Cupping was superior to heating pads in relieving pain and discomfort. In one trial comparing cupping, done at home, to muscle relaxation on 61 people with chronic neck pain, both significantly reduced pain. However, cupping was more effective in boosting wellbeing and improving pressure pain thresholds. Impressive considering that it was performed by family members, not Traditional Chinese Medicine practitioners. One of the reasons why I studied naturopathy and not TCM was how precise you have to be with points and meridians.

Semi-relevant Tang Dynasty (8th century) painting.

Don't have neck pain, but suffer from back pain instead? An uncontrolled (but still valid, life isn't controlled) trial of 21 people with lower back pain had cupping therapy in an attempt to treat their condition. On average, they saw significant improvement in pain pressure threshold, as well as pain while doing a straight leg raising test and testing lumbar flexion range of motion.

What about osteoarthritis? Symptom relief was more pronounced in the cupping group when one trial tested it against no treatment in patients with knee osteoarthritis. In a second study, cupping showed more benefit than taking acetaminophen at a dose of 650mg, three times a day. These benefits were especially superior in relief of pain, swelling, stiffness and disability.

As for meta-analyses of trials, one looked at seven randomised trials of cupping in the treatment of pain. Six of the seven showed significant (related to the treatment) positive effect, including two for lower back pain and two for brachialgia. Brachialgia is pain in the arm commonly caused by a pinched or compressed nerve. The researchers concluded that cupping was found to be effective compared to conventional treatment. Another review on research into cupping also found that it is an effective treatment. The authors proposed that some of the benefit is caused by improved blood and lymph flow, immune system activation and nerve stimulation. So all of this research in fact validates the therapy choices of some athletes; cupping is not a silly trend.

Container Gardening for Organic Food

Previously, I wrote about how even going organic for a week can be an effective detox, and later posted an infographic of the most and least pesticide-contaminated foods. A cost-effective way to at least partially change to an organic diet is by growing your own food, but how can we grow food in containers, if land is not available?

Carrots need anywhere from 9-18 inches depth.

Because there isn't unlimited space, root depth and plant spacing are important considerations. Carrots and radishes can be planted as little as 2 inches (5cm) apart, while beets, onions and peas can be 3 inches (7.5cm) apart and spinach and beans can be 5 inches apart. Leafy lettuce, Swiss chard and potatoes can be planted 6 inches apart. Others, such as broccoli, eggplant, cherry tomatoes and cabbage, need 12 inches (1 foot, 30cm) between them. As for root depth, beets, leafy lettuce, onions, radish, spinach and Swiss chard need 9-12 inches of depth. Broccoli and cabbage need 12-14 inches; cherry tomatoes, eggplant and peas need 14-16 inches of depth. Beans, cucumbers and potatoes require much greater depths, of 16-18 inches. Outdoor containers should be at least 8-12 inches in diameter because smaller pots dry out much easier (really bad in a hot, dry climate such as most of Australia), but they could do fine in part shade. Leafy plants can be okay in partial shade, fruit-bearing plants need at least six hours - this includes eggplant, chilli and squash. Colour of containers should also never be ignored. Light colours reflect heat, dark containers absorb more heat, and thick wood is the best insulator (e.g. all the log houses in the Swiss alps). The tiny, hairlike feeder roots can be fried in the summer heat, or anytime heat in many parts of the world. Without feeder roots, the plant will wilt and die even if you're watering the soil.

In dry countries such as Australia, water is almost always a concern. Plants with similar water needs should be grouped together. Organic matter in soil, mulch and water crystals can slow water loss, and self-watering pots can also stop water from drying out. Water should be considered even before planting; watering the day before planting as well as planting early in the morning are both advisable. It is best to water plants, even shallow-rooted herbs, thoroughly on an occasional basis than it is to sprinkle them every day. Watering in the morning can both keep them going all day while preventing fungus from growing overnight. Additionally, trees should be kept within 3 metres of height and width, with compact, thicker growth. Drought-tolerant fruits, which require less water, include figs, pomegranates, olives, grapes and mulberries. Vegetables that are productive for their water use are tomatoes, beans, cucumbers, squash, eggplants, capsicum (bell pepper), zucchini and pumpkins. Herbs with low water requirements include rosemary, thyme, sage, lavender and oregano.

While it takes some learning and often creativity, you can grow some of your own food! Whether you are a doomsday prepper or just want to save a little bit of money, it is worthwhile. Why let corporations make it increasingly harder for you to afford fresh food?

Spinach May Fight Macular Degeneration

Many of us remember (or still watch!) the old Popeye cartoons where the title character would instantly gain much greater physical strength by eating a can of spinach. But did you know that it could also build the strength of the macular pigment, a shield against vision loss?

Source: Robert Lynch

Macular degeneration is a common age-related complaint, partly because the macula in the centre of our eyes can easily become damaged by prolonged bright light exposure, or looking directly at strong light sources such as the sun, without protection. As we rely on our eyes for so many things, including driving, any threat to our vision is rightfully a great concern. The risk of this damage, however, can be reduced by increasing the amount of yellow pigment that shields the macula primarily from “blue” light. This blue light is the dominant type of light emitted by computers and many TVs, and is one part of sunlight. The yellow pigment that protects the macula from blue light is made of three carotenoids: lutein, zeaxanthin and meso-zeaxanthin. Zeaxanthin is 75%of the pigment in the central area of the macula, while lutein makes up two-thirds of the macular pigment towards the edges. This pigment can wear down with age, possibly due to poorer digestion, or from poor dietary intake of these three carotenoids. The thickness of this pigment is measured as Macular Pigment Optical Density, and is scored from 0 to 1. Less than 0.21 is considered to be “low”, 0.22-0.44 is medium, and 0.45-1 is “high”, and the healthiest range. A thicker pigmentation can not only protect against macular degeneration, the most common form of blindness, but also prevent photosensitivity, help us see at night and improve vision in natural environments. 

So in theory, carotenoids may protect against blindness, but what about in practice? In a Japanese study (Ozawa et al. 2016), 11 healthy non-smokers had their macular thickness and vision (as visual acuity) tested, then were instructed to eat 75 grams of frozen spinach, containing 10mg of lutein, every day for two months. At both one and two months, visual acuity and macular pigment density were significantly increased, and higher blood levels of lutein helped to confirm the relationship. Despite appearances, spinach is a source of yellow carotenoids, but the green chlorophyll overpowers the yellow pigmentation. Additionally, a study testing the effect of kale extract on 20 patients with macular degeneration also found a significant increase in pigment density. After stopping the extract, macular pigment density dropped, showing the importance of regularly eating these foods. Like the previous study the amount of lutein in this extract was also 10mg, and was accompanied by 3mg of zeaxanthin. Meso-zeaxanthin may strengthen the effects of lutein and zeaxanthin, with a trial involving patients with early age-related macular degeneration (AMD) showing greater improvements in pigment density and contrast sensitivity, and continuing improvement in the second and third year of supplementation. No supplemented patients progressed to AMD. As for prevention, a meta-analysis of research on carotenoid consumption and AMD found a 26% reduced risk of AMD in those consuming the highest levels of carotenoids compared to those with the lowest intake. Overall, the yellow carotenoids have an increasing amount of evidence behind their effects on vision preservation, though increasing dietary intake should be the first line of action. If you are looking to increase your intake of the yellow carotenoids, spinach, kale, broccoli, green peas and collard and turnip greens are the richest sources.  

Wow! Acupuncture May Beat Morphine

Acupuncture has been recognised by the World Health Organisation since 1996 as a safe and effective treatment for a range of complaints, including pain and discomfort. Unfortunately, its use in a hospital setting, where patients usually must take whatever treatment they can get, is still very rare, but an amazing new study in the American Journal of Emergency Medicine will hopefully change more attitudes towards the practice.

Titled “Acupuncture vs intravenous morphine in the management of acute pain in the ED,” the study was performed over a 1-year period in the Fattouma Bourguiba University Hospital in Tunisia. Three hundred patients presenting to the emergency department were included, with 150 in the acupuncture group and 150 in the morphine group used as a control. The only significant difference between the two was that there were more abdominal pain cases in the morphine group, and more lower back pain cases in the acupuncture group. Otherwise, age, sex and other health problems were similar. What else was significant? The results! The acupuncture group had a 92% success rate, compared to the 78% success rate in the morphine group. Average resolution time was 16 minutes in the acupuncture group, against 28 minutes for those receiving morphine; both this and the success rate difference were clinically significant. This means that the acupuncture was responsible for the superior effects. From the 5-minute point, the acupuncture group reported a clinically significant, greater drop in pain scores, which lasted for the entire study period of one hour. Heart rate, breathing, blood pressure and blood oxygen levels were not significantly affected in either group. However, there was still a more than noticeable difference in side effects. The morphine group reported a total of 85 negative side effects, with the vast majority of these being dizziness, nausea and vomiting. Only 4 negative effects were reported in the acupuncture group; 3 of these were needle breakage and 1 was a patient fainting (four fainted in the morphine group). The conclusion to this study was that acupuncture is safer and at least as effective as intravenous morphine; it can be used to control acute pain in those presenting to emergency departments; and more research should be conducted on international populations to strengthen the evidence base. That's not all! The World Health Organisation reports that a number of other studies have shown acupuncture to be effective for pain, among other symptoms, in a range of conditions from ulcerative colitis to tennis elbow to rheumatoid arthritis and neck pain - with little to no side effects. It's no surprise that acupuncturists are now practising as registered health professionals in Australia.  On the other hand, it is estimated that 69,000 people die every year from opioid overdose, so it makes sense to also study the use of acupuncture as a replacement for chronic opioid use. Opioids can cause respiratory depression.

In my experience, acupuncture is no more painful than getting your eyebrows waxed, and once saved a day of flash mobbing from being ruined. This is one of the three performances on YouTube; I'm on one of the ends and was wearing a light purple flower. Compare this to the results you get from searching "after morphine"(I may have just wasted one hour of your time); it seems that one side effect that the researchers did not mention was "embarrassing video uploaded to the internet".

Infographic: Which Foods Should I Buy Organic?

 

The top 12 most pesticide-contaminated fruits and vegetables, and the top 15 least contaminated, according to the Environmental Working Group's 2016 data. After my previous post, I thought I would like to share this with you. If going 100% organic is unaffordable, then it is important to focus on the most contaminated foods in order to get the best value for money. Or, you may be interested in growing some of your own food and like most of us, simply do not have the space to grow everything.

One Week of Going Organic and Pesticide Accumulation

Organic food has become increasingly popular in recent years, with a growing range of available products, growing acceptance and sometimes even a reduction in prices. This is partly because of the negative health effects of pesticides, but how long does it take to make a dent or two in the amount of pesticides that we have all accumulated over the years?

A small study conducted in my country, Australia, shows that an organic diet may work its magic faster than you think. Thirteen participants were assigned to diets that were either 80% organic, or 80% conventional, for one week before switching to the other. The metabolites of six organophosphate pesticides were measured by urine tests on the last day of each week, then compared between the two groups. The average reduction in metabolites among those on the 80% organic diet was 89%; with a 96% reduction in the "dimethyl" metabolites and the "diethyl" metabolites falling by half. While the study size was too small to be deemed "clinically significant", it shows how fast some people are able to detoxify when given the chance to avoid toxic chemicals, even if we cannot say the same is true for everyone. 

Source: Oyvind Holmstad

But, why should we avoid pesticides as much as possible? The authors of this study wrote that long-term exposure to organophosphate pesticides can impair neurobehavioural functioning, as well as impair intellectual development and even contribute to ADHD in children. Fortunately, children have shown rapid detoxification rates of these pesticides. A study of farmers who had occupational exposure to OP pesticides also found lower vital capacity and expiratory volume, which are two measures of lung function. The fishermen who participated as a control group had much lower levels of exposure, so any reduced lung function wasn't seen as significant. On top of this, OP pesticides may even increase the risk of some cancers. Research involving thirty thousand women whose husbands worked as pesticide applicators showed a 20% increased risk of breast cancer with exposure to any OP. The most common OP, Malathion, was associated with around double the risk of thyroid cancer (and somehow the risk of non-Hodgkin's lymphoma was reduced by a third, but there are better ways to prevent cancer). Diazinon use was linked with an 87% rise in ovarian cancer risk. These three cancers are all associated with hormone imbalances too, meaning that further research is needed on their possible effects as endocrine disruptors. Overall, with these and other studies demonstrating the harm caused by pesticides, it makes sense to eat an organically-grown diet as much as possible.

The Safety of Bioidentical Hormones

As someone with a passion for antiaging, the issue of whether or not to use hormone replacement therapy from menopause is a concern to me. While it has helped improve the lives of many women, conventional HRT has also been linked to increased risk of cardiovascular problems, some cancers and even cognitive decline. But can bioidentical hormone replacement therapy, which is heavily promoted by celebrities such as Suzanne Somers, be a better alternative?

Black cohosh, one of our herbal treatments
for menopause. Source: H. Zell

Evidence discussed in an article from The Journal of the American Osteopathic Association suggests that yes, bioidentical HRT could be safer, and possibly more effective, but only when prescribed properly. For example, research on 17beta-oestradiol, the most studied bioidentical hormone, found that 1mg of this hormone (with 2mg of drospirenone) improved perfusion in women with angina compared to placebo, where perfusion actually worsened. This goes against the idea that all HRT has negative effects on cardiovascular health. Another positive effect of 17beta-oestradiol is that it could protect against osteoporosis, though the correct dosage has been debated. One study had found that a daily dose of 1.25mg in gel, or 0.75mg orally, prevented bone loss in naturally menopausal women, while double that was needed for women post-hysterectomy. A second one found that only 0.014mg daily was enough to stop bone loss in 77.3% of women. In fact, there was an average increase in bone density of 2.4%. Only 1% of the over 200 women receiving bioidentical HRT had signs of uterine tissue growth, and the increase in breast tissue density was 19.8% compared to 19% in the "control" group receiving raloxifene. Similar improvements in bone density were seen in yet another, with no cases of breast cancer or uterine growth, but a higher risk of abnormal mammograms. Some women may have elevated liver enzymes from taking 17beta-oestradiol orally, meaning that gel application could be best for some. Oestriol, another form of oestrogen, has in some studies been associated with reduced menopausal symptoms and improved bone mineral density too, but is not always without the risk of uterine tissue growth. One "unique" study found that women with relapsing-remitting MS experienced shrinking of brain lesions and a reduction in symptoms after taking oestriol. Finally, a Danish study of 700,000 women found that there was no association between hormone therapy and heart attacks, but the majority of women on HRT were taking the bioidentical 17beta-oestradiol. A lowered risk, however, was found in women taking progesterone in a cyclical pattern, and women taking HRT as a cream.

The article then moves on to progesterone, which may oppose the negative effects of oestradiol. A study of 358 postmenopausal women found that the risk of uterine tissue growth was only 6% when oestrogen (this was conventional HRT) and progesterone were combined, compared with a 64% risk when only oestrogen was taken. By "conventional HRT", I mean a horse's oestrogen. A Belgian study mentioned found that progesterone could also reduce the risk of breast tissue growth. Additionally, the use of testosterone may protect against the unwanted effects of oestrogen replacement, though the studies discussed showed a lesser effect of testosterone compared to progesterone. Read more of my thoughts on testosterone here. DHEA replacement produced mixed results, though it did show benefit as a cream for skin health.

So, unlike some naturopaths, I do support the use of bioidentical HRT if herbal and nutritional support do not give the desired results, or if it's just your personal choice. However, I would recommend liver support to maintain healthy hormone metabolism, and I recommend that you always arrange a formal consultation with someone who can prescribe these hormones first, instead of self-medicating.