Dex's Blog

Good morning all. I hope everyone enjoyed his or her weekend. I don't know about anyone else reading this, but last week felt like the longest short week ever, it seemed as if that 4-day week was never going to end. I think part of the reason why last week dragged on was because I was still getting over a cold that I came down with the weekend prior.

Speaking of the cold I came down with, I'd like to share how I treated myself like a guinea pig with my remedy. So a couple of Thursdays ago, I started the day with a ton of sinus congestion that progressed to a nagging headache by later that afternoon. That night as the headache persisted, my throat began to hurt, and I developed a low-grade fever. Friday morning, Dr. Rudy Heiser wisely sent me home so that I didn't get anyone else sick. But before I took off, I was reminded of Dr. David Seaman's cold remedy by my pal and 8th tri intern Khong Lamvichit.

The regime consists of mega-dosing vitamin D (1600 IU, approximately 4mg), zinc (100mg to 250 mg), vitamin C and a ton of fluids for three days. The solution sounded a little extreme, but what better way to see if a remedy works for your patients than to try it on yourself. So I did. The idea behind the treatment regime is to kick-start your immune system. The zinc prevents bacteria adhesion, the vitamin D helps the body produce its own natural anti-biotic, cathelicidin, the vitamin C helps the immune system vitality, and the fluids flush the system.

By Saturday afternoon I had no more fever, and my sore throat was gone. Monday morning came around and, aside from my usual allergy congestion, I felt darn close to being back to normal. So I suppose the moral of the story is that this regime worked for me. I'm not saying this is the cure-all for all colds, but at least now you may have a tool in your mind to help out your future patients who would rather not try the prescribed antibiotic route. As with any intervention, there are inherent risks with benefits, and should not be prescribed without a past medical history and exam of the current issue.

This weekend I felt great and was at the Trop cheering on the Rays from the third baseline against the Baltimore Orioles. Of course the only game of the series I attended, we got spanked, but it was a good time none-the-less. I hope everyone enjoys the blog today and hopefully it helps some people developing a cold of their own. Any questions, don't hesitate to send me an email. Hope everyone has a good week, and a relaxing weekend.

Catch y'all on the flip side,
Dex

Hello, everyone. These three-day weekends are the best. This weekend was perfect for work and play. Half of the weekend the weather was horrible, perfect for studying, and the other half was gorgeous, perfect for some daytime bar action. I took full advantage of both aspects of the weekend.

This week, I thought I'd share an essay I wrote on the obesity situation in our country and possible complimentary treatments that we as alternative medicine practitioners could offer our prospective patients. This is just my take on the situation and treatment I believe could help, so please take it with a grain of salt, and if anyone has any questions or comments, please shoot them my way.

Obesity: A multifactorial disease in need of a multifactorial treatment.

The most serious threat to public health in the United States today can easily be attributed to chronic illness and health problems either wholly or partially caused by diet. The estimated number of deaths linked to obesity in the United States is 280,184 per year. Sixty-five percent of adults 20 years of age or older are considered either overweight or obese. The leading cause of mortality in our country is cardiovascular disease (38.5% of all deaths). Cancer is the second leading cause of death in America (25% of all deaths), one-third of which are ascribable to nutritional factors and obesity (1). How has our society succumbed to this modifiable risk factor of obesity? More importantly, how can we combat this issue?

The first step in attacking this epidemic is to realize that there is no one "magic bullet" to cure the overweight person. It has been proven time after time, that monotherapies are not effective. Obesity is a multifactorial disease in need of multifactorial treatment. There are a slew of inherent barriers to weight loss and controlling appetite. The most important of these road blocks to health being the instinctual drive to eat, hypothalamic inflammation, and regulation of satiation hormones.

Chiropractic care and its philosophy of treating the whole person, provides a unique and effective avenue in the world of weight management. As a physician, one of our roles will be to use education as a key component of treatment. We must relate to our patients that overeating is instinctual, because historically, food was a scarce commodity. Our genome has not had the time to adapt to the fact that food is readily available to us.

In the time of our ancestors, the hunter-gatherers, the meal they were eating could have very well been their last. The body therefore creates a set point of weight over time to preserve itself. In the obese, this set point is set at an increased weight (1-2). This method was advantageous to the lean person in an environment where food is scarce and physical activity was needed to produce a meal. In society today, where over-processed fast food is so readily available and little if any physical activity is required to gather, weight gain isn't that surprising. Educating our patients to the fact that weight management is an active process should be the first step in treatment.

Education provides a solid base from which to build a healthier society. The next tier of treatment is aimed to combat the postprandial inflammation that occurs in the hypothalamus. It has been studied and published, that systemic, and hypothalamic inflammation can affect key neuronal systems that govern energy homeostasis, and defend the level of body weight (3). Seventy-two percent of the total daily energy consumed by an average American consists of dairy, cereals, refined sugars, refined vegetable oils and alcohol (1). These dietary choices translate to release of the amino acid, arachidonic acid during their digestion, which leads to the advent of inflammation in the body. This global inflammation leads to disruption of satiety mechanism, via insulin/leptin resistance, so people feel hungry even if they overeat (3). Diet modification is key in this component of treatment.

A Paleo-Mediterranean diet has been shown to satiate as well as keep levels of inflammatory mediators at a minimum (5). This proposed diet, takes the best of the "Paleo" and Mediterranean" style diets, with emphasis on fresh whole fruits, vegetables (raw or minimally cooked), omega-3-rich lean meats, seeds, olive oil, red wine in moderation, and the avoidance of starchy foods. This diet has been consistently associated with improvements in insulin sensitivity and reductions of cardiovascular disease, diabetes, and cancer (5). Foods included in this diet provide the patient with adequate nutrients, anti-inflammatories, anti-oxidants, as well as favorably modifies gut microbiota. By providing our bodies with the whole foods it needs, in a form that it is genetically equipped to process, health and obesity is ours to control.

As much as our diets promote obesity, our mood contributes just as much. Stress and lack of sleep promote increased ghrelin release from the stomach (4). Ghrelin is a hormone that has the ability to up-regulate appetite and down-regulate satiety by decreasing insulin release. In order to fight back against ghrelin, it is imperative to have patients get six to nine hours of sleep a night (4), and manage their stress preferably with exercise, or meditation.

A country composed of healthier people is a very attainable goal, but it requires work by all parties. Managing this public health issue will be effective if a multifactorial approach is used to attack it. By educating our patients that they will have an innate drive to overeat that they will have to overcome, providing them with adequate anti-inflammatory diet options, and helping them overcome stress and sleep deprivation, the obesity epidemic in our country could be controlled. Weight gain and a healthy lifestyle are modifiable risk factors that can be used to save over 250,000 lives per year (1).

References:

1. Loren Cordain, S Boyd Eaton, Anthony Sebastian, Neil Mann, Staffan Lindeberg, Bruce A Watkins, James H O'Keefe, and Janette Brand-Miller."Origins and evolution of the Western diet: health implications for the 21st century". American Journal of Clinical Nutrition2005; 81:341-54.
2. Sumithram P et al. "Long-term persistence of hormonal adaptations to weight loss". New Eng J Med. 2011.
3. Wisse BE, Schwartz MW. "Does hypothalamic inflammation cause obesity?" Cell Metab. 2009; 10:241-42.
4. Lisa Morselli, Rachel Leproult, Marcella Balbo, Karine Spiegel. " Role of sleep duration in the regulation of glucose metabolism and appetite". Endocr Dev. 2010; 17:11-21.
5. Vasquez, A. "Integrative Rheumatology. Concepts, Perspectives, Algorithms, and Protocols. 2^nd edition. 2007; 90-92.

I hope everyone has a great week, and enjoyed the essay. If nothing else, maybe it will give you something to consider with future patients.

Catch ya on the flip side,
Dex