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Chronic Health Conditions and Solutions

September 17, 2010 Written by JP       [Font too small?]

Natural medicine tends to excel in managing chronic health conditions. On the other hand, acute circumstances such as a broken bone, a ruptured appendix or a heart attack are clearly better suited to conventional care. But there’s a third category of treatment which falls between the two seemingly distinct philosophies. There are certain therapeutic practices that are natural but not the exclusive domain of alternative and complementary practitioners. For instance, it’s not unusual for all types of physicians to recommend limited sugar consumption and regular aerobic exercise. The difference that I find is in how such recommendations are made. Are they mentioned in passing or suggested as a first-line intervention to improve and/or protect against serious health conditions?

Insomnia is the most commonly reported sleep disorder affecting an estimated 30-50% of the adult population. There are numerous over-the-counter and prescription medications that aim to address this inability to fall and stay asleep. New research out of Northwestern University suggests a different approach to dealing with this potential health crisis: regular aerobic exercise. The study in question enrolled 17 older adults who were classified as “sedentary” at the beginning of the trial. They also all suffered from primary insomnia for at least 3 months prior to the start of the study. Half of the test subjects were asked to participate in aerobic physical activity and educated about good sleep hygiene. The remainder did not engage in added physical activity, but received the same sleep hygiene education. (1,2,3)

  • A sleep quality survey known as the Pittsburgh Sleep Quality Index (PSQI) was used to assess baseline and post-trial changes in insomnia symptoms.
  • The physical activity group demonstrated improvements in: daytime dysfunction, overall PSQI scores, sleep duration, sleep efficiency and sleep latency.
  • The group that exercised also noted benefits in depressive symptoms including daytime sleepiness and vitality.

It’s reassuring to note that exercise appears to benefit sleep quality in diverse populations. Recent investigations have discovered profound benefits of exercise in patients with chronic primary insomnia and in those with insomnia that is related to other health conditions, including cancer and cardiovascular disease. In each instance, various “side-benefits” have also been reported, including reduced anxiety and bodily pain, and an elevation in the “mental health dimension of quality of life”. (4,5,6)

This next news item is a bit controversial and may pit me against many physicians out there. Several studies of late have proposed an inverse-association between alcohol consumption and inflammatory conditions such as rheumatoid arthritis (RA). Could it be that something as simple as a daily glass of red wine may reduce the risk of developing RA and slow its progression? Allow me to simply report the facts. The July issue of the journal Rheumatology reports that “non-drinkers” were 4-times more likely diagnosed with RA than those who consumed alcohol at least 10 days per month. Alcohol consumption showed a correlation to milder RA-related (joint) damage and symptom severity. A Swiss examination of 2,908 RA patients reveals that “daily consumers” and “occasional consumers” display lesser joint degeneration than heavy drinkers and non-drinkers based on radiographic images. The final study I wish to address “highlights the potential role of lifestyle in determining the risk of developing RA, and emphasizes the advice to stop smoking, but not necessarily to abstain from alcohol in order to diminish risk of RA. The evidence of potential RA prevention should prompt additional studies on how this can be achieved.” (7,8,9)

Alcohol Consumption May Activate Anti-Inflammatory Genes
Source: Nutrition Journal 2010, 9:14 (link)

Obesity is perhaps the single most destructive chronic health concern of all. It’s especially insidious when it takes hold in youth. Thankfully, small steps in the right direction are beginning to address a major contributing factor to obesity: fructose consumption. A pilot study presented in the September 2010 issue of Pediatrics International investigated whether reducing dietary fructose by 50% would result in weight loss in a group of 15 overweight children. Caloric and carbohydrate consumption was not altered beyond the shift away from fructose. The experimental diet lasted 12 weeks and resulted in statistically significant weight loss in the 5-8 year olds taking part in the trial. Another recent study published in the European Journal of Clinical Nutrition offers yet another way to improve body composition: increase dietary fiber and protein intake. The comparison trial  evaluated the relative merits of a “standard low-fat, high-carbohydrate” diet vs. a diet that included more protein (up to 30% of total calories) and higher fiber (>35 grams daily). The study volunteers that were on the higher fiber and protein diet lost more abdominal/total fat and body weight. They also exhibited a more impressive decline in LDL (“bad”) and total cholesterol concentrations. (10,11,12)

It’s hard to imagine any doctor who would be unwilling to consider exercise as a possible remedy for insomnia. What could possibly be the downside in otherwise healthy individuals? Improved cardiovascular health? A reduction in anxiety and depression? Weight loss? Fructose can be another story. Some physicians are still convinced of the supposed health benefits of a diet rich in fruit, fruit juice and fructose-sweetened “health” foods. This will probably change in time. However, it might take a few decades to become fully integrated into the mainstream of medicine. Please don’t wait for that day to come to reduce the fructose content in your own diet, especially if you’re overweight. Last, but not least, is the issue of alcohol. There are obviously upsides and downsides to this traditional beverage. My suggestion is to review the data I’ve presented with your doctor if you’re living with or are at risk for RA and enjoy an occasional drink. In this instance, the benefits may outweigh the risks.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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3 Comments & Updates to “Chronic Health Conditions and Solutions”

  1. Urine Health Says:

    I think also the western medical profession has the argument that natural solutions, while good, are not “quantifiable” while western medicine tends to be dose-based and that enables better measurement and monitoring of treatments.

  2. JP Says:

    That’s a good point. Natural medicine certainly can be harder to quantify. But I think it’s well worth the effort. :)

    Be well!

    JP

  3. JP Says:

    Updated 05/23/16:

    https://cjon.ons.org/cjon/20/3/self-administered-sleep-intervention-patients-cancer-experiencing-insomnia

    Clin J Oncol Nurs. 2016 Jun 1;20(3):289-97.

    A Self-Administered Sleep Intervention for Patients With Cancer Experiencing Insomnia.

    BACKGROUND: Sleep-wake disturbances are experienced by as many as 75% of patients with cancer and are associated with poor symptom management, lower functionality, and decreased quality of life. Although promising sleep interventions exist, they require extensive resources and time.

    OBJECTIVES: The objectives of this study were to develop a brief, self-administered sleep intervention and to evaluate the feasibility and potential efficacy of its implementation with adult patients with cancer who were about to receive, were receiving, or had received radiation therapy in an ambulatory cancer care setting.

    METHODS: Pre- and postintervention surveys and qualitative interviews were conducted with patients with cancer experiencing insomnia (N = 28) and receiving radiation treatment within the past six months. Patients received instruction on breathing, visualization, and intonation. Adherence and sleep quality were primary study outcomes. Analyses included descriptive statistics and repeated measure regression analysis. Thematic analysis was conducted on qualitative data.

    FINDINGS: Adherence to the sleep intervention was high (75%), and significant improvement was found in global sleep quality (p < 0.0001) regardless of level of adherence. Sleep onset latency (p = 0.0005), sleep duration (p = 0.0016), and sleep quality (p < 0.0001) were significantly improved. Age was significantly correlated with sleep quality (p = 0.0094), with older participants reporting greater benefit from the intervention. Participants reported that the intervention was easy to learn and implement and that it “calmed the mind.”

    Be well!

    JP

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