MEDICAL MYTHOLOGY

THOSE 10,000 STEPS

If you’ve heard that getting 10,000 steps per day is the recipe for optimal health, you may have wondered if it’s true or if it’s medical mythology.

As you may know, a Japanese company introduced a pedometer back in 1965 that they named (as translated into English) “10,000 steps meter.” The name was simply a marketing gimmick, but it caught on to the extent that all over the world nearly 60 years later people still view 10,000 steps as the gold standard for physical activity.

Even though the step count was dreamed up as a sales tool, that doesn’t necessarily mean it’s mythology. It could be true.

In May 2019 JAMA Internal Medicine published a study by a Harvard Medical School professor. She had already been studying physical activity and health in older women, so she continued her research on the 10,000 step question with that same population.

16,741 women between the ages of 62 and 101 were included in the study, all of whom wore an activity monitor during waking hours for 7 days. After their activity was measured the women were followed for an average of 4.3 years in search of two long-term findings:

• were higher step counts associated with fewer deaths?

• did the intensity of the step count matter in terms of health? In other words, if one woman got 5,000 steps during a brisk power walk and another woman got her 5,000 steps a couple hundred at a time just puttering around the house, did the power walk woman enjoy more health benefits than the woman who took all day to get her steps?

The answer to the second question first: all steps are created equal. There was no measurable benefit to power walking versus an equal number of steps taken a few at a time to its despicable nature. Who are these little monsters and full-grown adults who choose to deliberately torture another human being for their own pleasure and entertainment?

As for the connection between steps and fewer deaths, within the confines of the specific population included in the study, compared to sedentary women there were 41% fewer deaths among women who averaged 4,400 daily steps. In fact, the more steps the women recorded the lower their mortality rates were, but the benefits leveled off at approximately 7,500 steps per day.

Granted, the scope of the study was fairly narrow, but it did suggest that cutting those 10,000 steps by 25% still offered worthwhile benefits.

Since the study also found that all steps matter, getting in extra steps all day long is a worthwhile pursuit. How? Take the stairs instead of the elevator. Park farther away from the store or office entrance. Bring in groceries a bag or two at a time instead of trying to haul in all 18 bags in a single trip.

Another step-count research finding: those 7,500 steps that represent a more realistic and reachable goal for many of us can offer their benefits even if we only reach them once or twice a week.

It’s complicated. Some researchers have identified personality disorders as the cause, in plain English things like arrogance and narcissism, low self-esteem, depression, and inordinate pride which breeds envy and resentment of others. Studies have also identified family factors, best summarized as “bullies learn how to bully by being bullied at home.”

What can be done to stop bullies? Let’s start with parents. Make sure your children know they can talk to you if they’re being bullied. If they don’t mention it, ask them pointedly if they are being bullied, and do so on a regular basis. It’s not always easy to extract information. Note possible red flags like sudden personality changes or plummeting grades, and if it comes to light that your son or daughter is being bullied — or is a bully— take action. Talk to your child; get help; talk to people at their school.

Speaking of school, according to the Stop Bullying Now Foundation, only 25% of bullied students say teachers did anything to help. But in the same study, 71% of teachers say they do intervene. The message seems to be: if the in- tervention isn’t enough for the student to know about or notice effects from, it’s probably inadequate. Don’t look the other way or assume kids will just work it out. The same admonition applies to nurses, whether in a clinical setting or at school. Bruises and frequent injuries with suspicious explanations are grounds for further investigation. Your school undoubtedly has a policy addressing bullying. Make sure it is being enforced.

Sadly, the consequences for failure to intervene can be severe. Bullying is a major factor in youth suicides. Even without bullying, suicide is a leading cause of death for the 15 to 24 age group. A quick internet search turns up absolutely heartbreaking stories of children, kids like Megan Meier (age 13), Ryan Halligan (13), Rebecca Ann Sedwick (12), Sladjana Vidovic (15), Amanda Todd (15), and many others who endured extreme physical and psychological torture until death was actually preferable to living

That leads us to address our final group. Kids, there is never an excuse for bullying. It is never ok. Tell your parents, tell your teachers. Keep telling them. Do everything you can to put a stop to the abuse. Help is available. Get it, and using that help, remember this: it will get better. You can reclaim your life. +

WHAT IS KRATOM?

Judging by the signs advertising kratom (KRAY-tum) popping up left and right, this stuff — whatever it is — might seem like it’s worth checking into.

But you might want to do it soon. Or not at all. Note the following: In 2016, the U.S. Drug Enforcement Administration (DEA) announced plans to classify kratom as a Schedule I controlled substance. Compounds in this category are said to have no currently accepted medical use and a high potential for abuse

What is a Schedule I controlled substance? The DEA’s website lists some examples: heroin, LSD, ecstacy, and peyote, among others. So kratom is in some very sketchy company indeed. Despite the DEA’s 2016 announcement, kratom is still unregulated in the U.S.

What is the stuff?

Kratom is the familiar name for a tree in the coffee family native to Southeast Asia and Africa. Traditional medicine in those parts of the world has long used various concoctions from kratom leaves to, at low doses, make users feel more energetic, and at higher doses, to relieve pain and bring on eurphoria. At still higher doses kratom acts as a sedative.

Because it acts on the same opioid receptors in the brain as drugs like heroin and oxycodone, doctors are concerned about kratom’s potential for addiction. Ironically, its interaction within the brain is same reason many people turn to kratom for help in overcoming opioid addiction.

The FDA has actively pursued kratom sellers who make specific claims about its benefits. In official language, it is illegal “to advertise that a product can prevent, treat, or cure human disease, including addiction to alcohol, nicotine, or drugs, unless you possess competent and reliable scientific evidence, including, when appropriate, well-controlled human clinical studies, substantiating that the claims are true at the time they are made.” That’s a direct quote from a letter the FDA sent to a major kratom-selling online store. There is currently no clinical evidence backing any specific claims of health benefits provided by kratom, and its unregulated status means that there are no standards for dosage or purity.

For the Mayo Clinic, at least, the assessment of kratom is simple: they call it “unsafe and ineffective.”

+