People’s Pharmacy: Soap keeps players’ muscles from cramping. 2D
HealthToday
T H U R S D A Y , S E P T E M B E R 3 , 2009
SECTION D
WWW.TUSCALOOSANEWS.COM
Healing
STUDIES & RESEARCH
New drug may cut stroke risks
— The Associated Press
TIP
POWERS?
Chiropractors divided on extent of medical treatments By Julie Deardorff Chicago Tribune
C
hiropractors are best known for treating back and neck pain. But can their hands-on manipulations of the spine also help with colic, asthma, ear infections, allergies and digestive issues? Though it’s a controversial notion, some chiropractors are aggressively marketing themselves as holistic, primary-care healers who can treat a broad scope of ailments ranging from acid reflux to infertility. Others in the field say chiropractors should focus on musculoskeletal disorders such as back pain, where evidence for efficacy is the strongest. The internal philosophical divide has given the profession a confusing image, making it difficult for consumers to know when, if ever, they should visit a chiropractor. “We often hear from chiropractors that ‘chiropractic is more than just back pain.’ But is it?” Rhode Island chiropractor Donald Murphy asked in a commentary published last year in the journal Chiropractic and Osteopathy. “And more importantly, does it have to be?” Though conventional practitioners have often scorned them for making unfounded claims, chiropractors are now established as mainstream health-care providers. Many health plans and Medicaid now cover their services, and they regularly care for clients ranging from the chronically ill to professional and Olympic athletes. An estimated 8.6 percent of adults in the U.S. use chiropractic or osteopathic manipulation, according to the National Center for Complementary and Alternative Medicine. Chiropractors typically apply a sudden force to a region of the spine to help loosen a stiff joint, which they say allows the body’s natural healing process to take over. During an initial visit, the chiropractor typically takes a health history and performs a physical exam, focusing on the spine. X-rays may be taken, and spinal “adjustments” SEE HEALING | 6D
CHOOSING A CHIROPRACTOR ■ Be careful about sweeping spinal manipulation claims. ■ Be wary of those who say spinal manipulation can cure whatever ails you. ■ Ask whether exercise is part of the program. ■ Ask friends and relatives for recommendations. “The best reference is still a personal one,” said Jim Winterstein, president of the National University of Health Sciences. ■ Get more than an adjustment. Find a chiropractor who also offers other therapeutic procedures, including nutrition, exercise, lifestyle management and laboratory testing.
STAFF ILLUSTRATION | ANTHONY BRATINA
BARCELONA, SPAIN | An experimental drug reduces the stroke risk in patients with irregular heartbeats by more than three times, compared with the popular drug warfarin — but possibly at a cost, according to new research released Aug. 30. Patients taking the new drug dabigatran etexilate, made by German pharmaceutical Boehringer Ingelheim, also were slightly more likely to have heart attacks or stomach pain, according to the research presented at the European Society of Cardiology meeting in Barcelona. Patients with irregular heartbeats are up to five times more likely to have a stroke than healthy people. About one-sixth of all strokes occur in patients with irregular heartbeats who also have other risk factors such as smoking or obesity. In the United States, there are about 2 million people with such a condition. Until now most such patients have been given warfarin, which has been around since the 1950s and has side effects including bleeding risks and requires lifestyle changes such as dietar y restrictions. Doctors hope the new drug can help improve treatment for patients, who must be monitored continuously if they are put on warfarin and avoid alcohol and foods such as spinach and cranberries. The new research on dabigatran — which has not yet been approved in the United States but is sold as Pradaxa in 40 countries to prevent blood clots — was compiled after doctors monitored more than 18,000 patients with irregular heartbeats, or atrial fibrillation, worldwide for about two years starting in 2005. The patients took either dabigatran or warfarin, at varying doses. On warfarin a patient’s risk of stroke drops dramatically to about 0.38 percent per year, according to the study, also published online in the New England Journal of Medicine. Warfarin has invited complications, however, because it is difficult to dose and may be confusing for patients to take, doctors have said. On dabigatran, that risk is slashed even further to about 0.10 percent per year, the study says. “It is certainly a big step forward,” said Dr. Fausto Pinto, director of the Cardiovascular Institute at the University of Lisbon, Portugal, and program chairman of the European Society of Cardiology. Dabigatran “probably will replace warfarin,” as it is easier for both doctors and patients to use, said Pinto, who was not involved in the study. Last year, the market for anticlotting drugs was about $13.6 billion globally.
SNACKS FOR ATHLETES
One of the toughest balancing acts for a sports family is having good, healthy food on hand for before and after a good, healthy workout. The drive-through window may beckon, but with just a little advance planning, you can bring along some suitable snacks to tide over your athlete. Granola: Fill some plastic baggies with either a store-bought brand such as Kashi GoLean, or save money and possibly calories by making your own mix of cereal, raisins, chocolate chips and nuts. Pair it with a carton of milk for a filling snack. Bagels: A cinnamon-raisin bagel smeared with peanut butter or cream cheese provides a balance of carbs and protein. Try the “Elvis bagel” of peanut butter and bananas, and on hot days, a salt bagel adds some much-needed sodium. The 3-inch mini bagels are a good option for kids. Chocolate milk: Your kids will love to hear that marathon runners swear by this preschool staple to restore muscles after a hard workout. Peanut butter and honey sandwich: Another favorite of Olympic athletes, it’s a bit higher in calories but more filling than most energy bars. — McClatchy-Tribune News Service
BARCELONA, SPAIN | Working up a sweat may be even better than angioplasty for some heart patients, experts say. Studies have shown heart patients benefit from exercise, and some have even shown it works better than surgical procedures. At a meeting of the European Society of Cardiology on Aug. 30, several experts said doctors should focus more on persuading their patients to exercise rather than simply doing angioplasties. Angioplasty is the top treatment for people having a heart attack or hospitalized with worsening symptoms. It involves using a tiny balloon to flatten a blockage and propping the heart artery open with a mesh tube called a stent. Most angioplasties are done on a nonemergency basis, to relieve chest pain caused by clogged arteries cutting off the heart’s blood supply. “It’s difficult to convince people to exercise instead of having an angioplasty, but it works,” said Rainer Hambrecht of Klinikum Links der Weser in Bremen, Germany. Hambrecht published a study in 2004 that found that nearly 90 percent of heart patients who rode bikes regularly were free of heart problems one year after they started their exercise regimen. Among patients who had an angioplasty instead, only 70 percent were problem-free after a year. Hambrecht is now conducting a similar trial, which he expects to confirm his initial findings: that for some heart patients, exercise is more effective than a surgical procedure. Other experts agreed that would likely be the case. An angioplasty “only opens up one vessel blockage,” said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology. He was not linked to Hambrecht’s research. “Exercise does a lot more than fixing one little problem.” — The Associated Press
FILE | THE ASSOCIATED PRESS
Harvey “Chip” Reed lifts weights at the Hilton Club, connected to Chicago’s O’Hare International Airport in May 2005. Some experts say exercise may be better for heart patients then surgery.
FITNESS
Makers say FitFlop offers workout while walking
lose weight. “The key message that exercise is not a pathway to weight loss? Ridiculous,” said Grabiner, the director of the university’s Clinical Biomechanics and Rehabilitation Laboratory. The article also overlooks that there are two main types of exercisers in the world: Those who have found the type of workouts they love and those who haven’t. If you don’t like running on a treadmill because it hurts your knees, don’t do it. Find something that fits your lifestyle, your body and your temperament. For some, that might mean walking. For others, it might mean group exercise classes or taking the stairs instead of the elevator at work. — McClatchy-Tribune News Service
— The Associated Press
Some people may not lose weight by exercising ing to Cloud: Exercise is so boring and painful that we reward ourselves with fattening food when we’re done. The basis for much of the ar ticle was this recent study published in Public Librar y of Science in which three groups of obese women exercised at three dif ferent intensity levels. The findings showed that the women who exercised did not lose significantly more weight than the control subjects did. But as Mark Grabiner, a professor in the Department of Kinesiology and Nutrition at the University of Illinois at Chicago, pointed out, the article failed to mention the study participants were postmenopausal women, not the 20-something pictured on the cover. As we age, changes in the body make it harder to
Exercise beats surgery for some heart patients
MIAMI | A flip-flop that firms and tones as you walk sounds too good to be true. Is it? The makers of FitFlop — the shoe sold at 4,500 stores around the world — say the sandal was designed to be a workout while you walk, with “side effects” of comfort and relief from chronic lower back pain. The premise of the FitFlop’s rubber sole with different densities (also known as the micro-wobble board) is that it helps tone because it creates instability during walking, forcing leg muscles to work harder to maintain posture and balance. Skechers and Dr. Scholl’s make their own versions. Dr. Phil GrahamSmith, head of the Directorate of Sport THE ASSOCIATED PRESS at the University of Salford, did an in- Data indicates that FitFlops dependent study on activate calf and thigh musthe shoe. He said cles for longer during walking data has indicated than regular shoes. that calf and thigh muscles were activated for longer during walking with these shoes, and that the speed of walking was slightly faster. He’s still studying the effects. “I think the comfort element of it is that you probably feel more motivated to do more exercise as well,” he said. The idea was to mimic the natural rollover of the foot, said Dr. David Cook, senior lecturer of biomechanics at London South Bank University, who along with a doctoral student created the FitFlop. Cook also said toning depends on a person’s diet, exercise and duration of wearing the shoe. A Miami-based orthopedic surgeon and a podiatrist who were asked to examine the shoe both said that wearing an uneven shoe could actually create more problems for people with foot conditions and that sandals are not the safest shoes to wear. As for an extra workout in a walk? They said it is possible theoretically, but hard to quantify. “The big question in my mind is to what extent is this enough of a wobble that it actually produces a medical effect, where you’re actually toning muscles and building strength,” said Marc Umlas, an orthopedic surgeon at Mount Sinai Medical Center in Miami Beach. “The other question is to what extent does it cause damage? We don’t know how much this can increase in sprains or strains or other muscular skeletal injuries.”
LIFESTYLES
Time Magazine’s intriguing cover piece “Why exercise won’t make you thin” by John Cloud is still one of the top 10 most read stories on its Web site, in part because we’re desperate for a magic bullet. For years, food manufacturers have been telling us not to blame cheap and processed food for the obesity crisis. Instead, we all just need to move more and to get recess back into the schools. Now here comes Cloud, insisting that it might be better to sit in a chair and knit because exercise can make you hungry. Since most of us burn far fewer calories than we think during a workout, a postexercise treat could negate the whole workout. Another problem, accord-
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