Archive for January, 2012

When Ice is Better than Heat to Treat Pain

Is ice better than heat to treat the pain of a sports injury?

The answer is it depends.

The reason it depends is that heat and cold do different things to your body, says Julie Silver, MD, Assistant Professor, Harvard Medical School, Physical Medicine and Rehabilitation.

Cold works by decreasing the temperature of the tissues.

This causes the area to become numb.

Dr. Silver explains that cold acts as a local anesthetic, which can be very helpful in relieving pain.

Also, cold causes blood vessels to narrow, called vasoconstriction, and lessens swelling and inflammation.

For a new injury in the first 24-48 hours Dr. Silver says the goal is to limit swelling and inflammation.

Icing is used in the common sports medicine mnemonic RICE, which stands for Rest, Ice, Compression, and Elevation.

If you have any cuts, lacerations, open wounds or any risk of internal bleeding, then heat isn’t a good idea as it promotes more bleeding.

But don’t keep ice on for longer than 20 minutes or so because this can cause tissue damage or “burns.”

Also, it’s important to avoid using ice on fingers and toes if you have circulation problems.

The ice causes even less blood to flow and may permanently injure these parts of the body.

When to Use Heat

Heat causes the temperature in your tissues to increase, which relaxes your muscles and also allows the blood vessels to expand.

This, she explains, is called vasodilation.

Heat delivers more oxygen and nutrients to an injured area.

Since heat increases blood and lymph flow, warmer tissues may have more swelling and become inflamed.

After the first day or two, the muscles around the injury may get very tight.

Then, heat can really be helpful.

For chronic injuries, heat is often the best modality to use to relax the muscles and improve flexibility.

However, in chronic joint pain, such as arthritis, then cold may be better because it numbs the area and reduces inflammation.

If you aren’t sure whether to use hot or cold packs, talk to your doctor.

If you have a chronic injury, consider which one of these has helped you the most in the past – that’s probably the one to use regularly for the best relief, says Dr. Silver.

Milk Makes You Smarter

A glass of milk a day could benefit your brain, according to new research that found milk drinkers scored better on memory and brain function tests.

Pouring at least one glass of milk each day aids nutrition and boosts your intake of much-needed key nutrients.

The 2010 Dietary Guidelines for Americans recommend 3 glasses of low-fat or fat-free milk daily for adults to support bone and heart health.

Now there’s the possibility that milk could also positively impact your brain and mental performance, according to a recent study in the International Dairy Journal.

Adults with higher intakes of milk and milk products scored significantly higher on memory and other brain function tests than those who drank little to no milk.

Milk drinkers were 5 times less likely to “fail” the test, compared to non-milk drinkers.

Researchers at the University of Maine put nearly 1,000 men and women, ages 23 to 98, through a series of brain tests – including visual-spatial, verbal and working memory tests – and tracked the milk consumption habits of the participants.

In the series of 8 different measures of mental performance, regardless of age and through all tests, those who drank at least 1 glass of milk each day had an advantage.

The highest scores for all 8 outcomes were observed for those with the highest intakes of milk and milk products compared to those with low and infrequent milk intakes.

The benefits persisted even after controlling for other factors that can affect brain health, including cardiovascular health and other lifestyle and diet factors.

In fact, milk drinkers tended to have healthier diets overall, but there was something about milk intake specifically that offered the brain health advantage, according to the researchers.

The potential to stave off mental decline may represent a novel benefit with great potential to impact the aging population.

“Diet modification to alter the course of age-related cognitive decline is becoming increasingly important,” the researchers wrote.

While more research is needed, they suggest some of milk’s nutrients may have a direct effect on brain function and that “easily implemented lifestyle changes that individuals can make present an opportunity to slow or prevent neuropsychological dysfunction.”

Foster Positivity By Organizing Your Mind

Wellness coaches work with people to improve their health and well-being in a way that lasts.

One of the nation’s top wellness coaches, Margaret Moore, aka Coach Meg, is the founder and CEO of Wellcoaches Corporation, a leader in building international standards for professional coaches in health and wellness.

She is the co-author of a new book, Organize Your Mind, Organize Your Life, with Harvard Medical School psychiatrist Paul Hammerness, MD, and writer John Hanc.

This well-written book does a great job in describing the latest neuroscience research on the brain’s extraordinary built-in system of organization, and translates that science into solutions.

One section on “Foster Positivity” hit home with me.

Moore mentions research by Barbara Fredrickson, a leader in the field of positive psychology, that states you need at least a 3:1 ratio of positive emotions to negative emotions for your brain to function at its best.

In other words, you need a 75/25 positive energy ratio to succeed.

Moore lists some ways you can work on the most common positive emotions that Fredrickson has identified:

— Cultivate curiosity about and interest in the challenge of change.

— Seek inspiration form others who have been successful.

— Be grateful for something, anything.

— Savor small moments on the journey.

— Enjoy the pride of doing something well — appreciate even small steps forward.

— Celebrate early wins.

It’s very easy to ruminate on the negative.

It’s less familiar to focus on the positive.

— Have fun.

Making positive changes in your life can be extremely enjoyable, says Moore.

Discover joy in the process of changing, and you probably will change.

Isolating the 8 Active Ingredients of Tai Chi

Perhaps what makes Tai Chi so special is that it is a holistic, multi-component exercise that impacts us at physical, psychological, social, and philosophical levels.

Based on his research and 35 years of Tai Chi training, Peter Wayne, PhD, Research Director for the Osher Center for Integrative Medicine jointly based at the Harvard Medical School and Brigham and Women’s Hospital, has put into words what he describes as the 8 Active Ingredients of Tai Chi.

“Like the components of a multidrug combination to lower cholesterol and blood pressure, each ingredient has a unique impact on the physiology of the body,” says Wayne.

“However, in Tai Chi, there are many more components, and each of these factors is inseparable from, and synergistic with, each other.”

In a recent blog Dan Kleiman, a fellow Tai Chi instructor in the Boston area, discussed the concept of 8 Active Ingredients with Wayne.

Here are some excerpts from that interesting discussion between the two Tai Chi instructors:

The concept of isolating active ingredients is common in other medical research. But does it really make sense to think of Tai Chi within this framework?

Great question…..and I think absolutely so.

Part of why I chose this language is to bend the ear of my medical colleagues—to try to communicate in their language.

Even if we see positive clinical effects in Tai Chi trials, without plausible mechanisms–– that is, being able to attribute clinical health effects to specific ‘active ingredients’, research results often have little traction in the medical community.

Mechanisms are part of what we call the totality of evidence.

Additionally, by using this language, we’ve been able to emphasize Tai Chi’s richness—that it includes not just one active ingredient—but many—including those related to neuromuscular control, breathing, cognitive processes, etc.

This may explain why it’s helpful for so diverse a set of health issues.

Finally, as a teacher, thinking in terms of active ingredients has helped me shape a curriculum that tries to maximize the ‘dosage’ of essential Tai Chi principles in as short a period of time as is possible.

This is key for teaching in clinical trials which are often constrained in length due to funding limitations; but also relevant to community-based classes where we want people to get a real taste of deep Tai Chi as quickly and efficiently as possible.

Living in the research world and the Tai Chi world at the same time allows Peter to apply lessons from one to the other. Here he explains how his scientific education influences the way he understands teaching Tai Chi:

My formal academic training was in evolutionary biology and ecological modeling, and my research for the first 15 years was with plants.

So shifting to medical research 12 years ago was a big change for me.

Consequently, I bring a somewhat unique perspective to the teams of medical researchers I work with.

My training to think ecologically, in terms of systems, is more like Chinese Medicine in that it focuses on ecological interactions within the body—how systems interact to create a complex whole that is greater than the sum of its parts.

In contrast, Western medicine has traditionally emphasized reductionist thinking, focusing on smaller and smaller parts, often at the cost of not seeing the whole person.

Interestingly, systems biology is being increasingly appreciated in medicine, and Tai Chi research fits beautifully into this more ecological framework of health.

Can you give an example?

Sure…breathing is a really important element in our Tai Chi and qigong training.

But there’s no way you can substantially change your breathing without changing your posture and how you hold your structure.

And your breathing deeply affects you nervous and cardiovascular system, and many aspects of your mood; it can be a great tool for focusing the ‘monkey mind’ and becoming more sensitive to the inner landscape of our body.

And of course changes in all these processes feedback on how we move and socially respond and interact with others.

All these processes are ecologically intertwined with each other.

But I also still think it’s useful to unpack the interconnected components—for example to teach breathing exercises on their own and to study the physiological impacts of breathing exercises, in isolation of the larger package of Tai Chi.

As a teacher, focusing on individual components helps brings awareness to finer scale processes, and it helps make a clearer teaching intention.

Also talking about the physiology of breathing in classes helps some students appreciate the work, and for the students, there can be a lot of power in knowing.

Most of us like to be told why we are doing a given practice in a given way.

It really helps if students are informed.

It creates buy in.

I really love building bridges between traditional practices and modern science for this reason.

Listening to Your Inner Rhythms Through Tai Chi

Tai Chi answers the call for a practice that honors and connects the whole person, body, mind, and spirit.

Here are excerpts from a great description of what it’s like to make that connection through inward “listening,” written by Dan Kleiman, Program Director at Brookline Tai Chi in Brookline, MA, near Boston, in the January issue of Yang-Sheng.

One of my earliest memories of really getting hooked on Tai Chi took place in a class where we were practicing the form as a big group.

In one very fleeting moment, I felt three interlaced rhythms all at once: my heartbeat, the rhythm of my breath, and the cadence of the form as we all moved through it together.

Each one was distinct, but layered on top of the others.

It was one of those experiences where, as soon as you stop and realize you’re having it, it vanishes, but the effects of that brief moment of the integrated harmony of breath, heartbeat and movement lingered.

Now I had a touchstone to come back to in my practice.

I didn’t really understand how this experience worked.

Later, I was surprised to see how harmonizing movement, breath, and intention created internal space that filled up other areas of my life too.

Let me see if I can explain it.

When you see people practicing the flowing movements of Tai Chi in the park, on some level you understand that the way they are moving on the outside resonates on the inside.

Intuitively, you know that calming your body may lead to a calmer mind, but until I started learning Tai Chi, I couldn’t get into that state in a reliable, reproduceable way.

Essentially, the stillness you find inside the graceful movements of Tai Chi comes from an inward listening — referred to in Tai Chi as “ting jin” or “listening energy”.

By harmonizing the rhythm of your form and the rhythm of your natural internal processes, you reach a still point.

Finding the still point is different every time you practice.

Think of it like going to the ocean.

Are the waves smooth or angry today? Is it windy? What about the deeper currents in the water?

Doing the form is like going to the same spot on the beach every day.

By returning to the same frame of reference over and over again, you notice more subtle shifts and changes in all these intertwined layers.

First, you notice your breathing.

Learning to slow down and smooth out your breathing is incredibly powerful because you see immediate carryover into everyday activities.

You sit at your desk and find yourself holding your breathing and shrinking into your chair.

Breathing becomes a regular cue for restoring your posture.

Later in the process, other internal rhythms become apparent.

Over the years, I’ve come to believe that the act of listening to your inner rhythms and waiting for the still point to reveal itself is what is so powerfully restorative about Tai Chi practice.

Beyond the physical benefits – relaxed muscles, stable joints, and springy ligaments – having an internal reference point as you move through your day creates some extra space between you and the chaos of the world around you.

By having a daily Tai Chi practice where inward listening is a major focus, I’ve found that this quality of mind becomes my default and that it is relaxing, rewarding, and completely refreshing as I move throughout my day.

Training Tips On Meditation

Meditation can generate many health benefits.

Those health benefits, according to Yang Yang, PhD, a noted New York Tai Chi researcher and author, include:

• kindness toward ourselves and the rest of the world

• enhancement of mental and physical agility

• better sleep, digestion, bowel function, and sexual function

• cultivation of tranquility, joy, and resilience in daily life

• awareness of our mind, body, and spirit

• awareness of reality

• acceptance of differences between ourselves and others

In the January issue of Yang-Sheng, Yang outlines how he cultivates awareness, which includes meditating on one or another of these maxims, choosing the one that best applies to the situation:

1. The world is yin and yang; we are all different.

2. Everyone is seeking his or her best interests or happiness, including ourselves.

3. Nothing is personal.

4. The meaning and purpose of life.

He also works on the following principles:

1. Gratitude.

2. Kindness and love.

3. Acceptance of differences between self and the rest of the world, and acceptance of imperfection in life.

4. Forgiveness.

5. The golden rule.

“There are no fixed ways to apply these maxims and principles,” Yang writes.

“You can apply one maxim and one principle on one day, and apply another on the following day until you apply all of them.

Or, you can apply more than one maxim and principle to the same situation.

However, one maxim and one principle may be easier for beginners.

After I have meditated through several of these notions, I feel energized, peaceful, joyful and ready to start out a new day to do something for myself, my family, and my community.

I find this method of categorized meditation leads me easily into quiet.

It does this not only by improving my ability to manage my daily stress, but also — and more importantly — by reducing the stressors.

Meditation helps me realize that I have created stressors through my rumination, and that those stressors should never have been stressors at all.

New stressors can arise every day.

The good news is that we can develop a habitual mental pattern to neutralize them.

In this way, we can make some stressors less stressful, and eliminate others entirely.

We can reduce the stress of our daily lives.

And we can make positive thinking our way of life.”

Junk Food in Schools Doesn’t Cause Weight Gain

Weight gain in middle school students has nothing to do with the junk food they purchase at school, according to a new study.

“We were really surprised by that result and, in fact, we held back from publishing our study for roughly two years because we kept looking for a connection that just wasn’t there,” said Jennifer Van Hook, a Professor of Sociology and Demography at Pennsylvania State University and lead author of the study, which appears in the January issue of Sociology of Education.

The study relies on data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, which follows a nationally representative sample of students from the fall of kindergarten through the spring of 8th grade (the 1998-1999 through 2006-2007 schools years).

Van Hook and her coauthor Claire E. Altman, a sociology and demography doctoral student at Pennsylvania State University, used a subsample of 19,450 children who attended school in the same county in both 5th and 8th grades (the 2003-2004 and the 2006-2007 school years).

The authors found that 59.2% of 5th graders and 86.3% of 8th graders in their study attended schools that sold junk food.

But, while there was a significant increase in the percentage of students who attended schools that sold junk food between 5th and 8th grades, there was no rise in the percentage of students who were overweight or obese.

In fact, despite the increased availability of junk food, the percentage of students who were overweight or obese actually decreased from 39.1% to 35.4%.

“There has been a great deal of focus in the media on how schools make a lot of money from the sale of junk food to students, and on how schools have the ability to help reduce childhood obesity,” Van Hook said in a press release.

“In that light, we expected to find a definitive connection between the sale of junk food in middle
schools and weight gain among children between 5th and 8th grades.

But, our study suggests that—when it comes to weight issues—we need to be looking far beyond schools and, more specifically, junk food sales in schools, to make a difference.”

According to Van Hook, policies that aim to reduce childhood obesity and prevent unhealthy weight gain need to concentrate more on the home and family environments as well as the broader environments outside of school.

“Schools only represent a small portion of children’s food environment,” Van Hook said.

“They can get food at home, they can get food in their neighborhoods, and they can go across the street from the school to buy food.

Additionally, kids are actually very busy at school.

When they’re not in class, they have to get from one class to another and they have certain fixed times when they can eat.

So, there really isn’t a lot of opportunity for children to eat while they’re in school, or at least eat endlessly, compared to when they’re at home.

As a result, whether or not junk food is available to them at school may not have much bearing on how much junk food they eat.”

Van Hook believes more emphasis should be placed on younger children developing eating habits and tastes for certain types of foods when they are of preschool age.

“Those habits and tastes may stay with them for their whole lives,” Van Hook said. “So, their middle school environments might not matter a lot.”

Six Ways to Control Your Weight

Healthy Weight Week (January 15 to 21) kicks off today to celebrate healthy diet-free living habits that last a lifetime and prevent weight problems.

Two-thirds of the American population is overweight or obese, and obesity numbers will continue to rise unless Americans stop eating more calories than they use, according to Brian Sharkey, a leading fitness researcher and author of Fitness Illustrated (Human Kinetics, 2011).

“In ages past, when the human food supply was unpredictable, people could not count on three square meals a day; as a result, the human body learned how to store energy in the form of fat,” Sharkey says.

“Today, most of us enjoy access to a dependable and plentiful food supply, but our bodies still store energy even though the need for doing so is gone.”

To lose weight, Sharkey says people often turn to restrictive diets, which can backfire and cause weight gain.

“When you diet, your body becomes more fuel efficient and your metabolic rate declines,” Sharkey explains.

“As a result, even more dieting or exercise is required in order to reduce excess weight.

During this cycle, your weight loss slows, and you regain weight three times faster.”

When a person is on a diet, the body uses protein for energy, which means a person can lose muscle protein with each dieting cycle.

As muscle is lost, the capacity to burn calories is reduced.

“Thus, each time you diet to lose weight, you lose lean tissue and must therefore decrease your caloric intake in order to avoid subsequent weight gain,” Sharkey adds.

“As a result, the only way to minimize the loss of lean tissue while dieting is to exercise.”

The safest way to lose weight and keep it off is to eat fewer calories and burn more with physical activity.

In Fitness Illustrated, Sharkey offers six keys to maintaining a healthy weight:

1. If you are active, consume 55 to 60 percent of each day’s calories in the form of complex carbohydrate (beans, brown rice, corn, potatoes, or whole-grain products) and fruit.

2. Limit your fat intake and avoid saturated fat and trans fat.

3. Eat a sufficient amount of lean, high-quality protein (15 percent of your daily caloric intake) to meet your protein needs during training.

4. Achieve weight control by balancing your caloric intake with your caloric expenditure.

5. Since metabolic rate declines with age, you will have to eat less, engage in more activity, or do both in order to maintain a healthy weight.

6. Remember that dieting often leads to future weight gain, especially when it is done without physical activity.

Tai Chi Now Integrated into Medical Schools

Tai Chi has found its way into the curriculum of nearly all universities in China.

In the U.S., Tai Chi is beginning to make its way into colleges, medical schools, and nursing schools as part of the trend toward more mind-body training.

Dozens of academic health centers in the U.S. and Canada, as well as many others around the world, are now offering Tai Chi in their integrative medicine clinics.

Some students are coming to medical programs already interested in complementary and alternative medicine (CAM) and want to integrate Tai Chi into their future medical practices.

A new generation of doctors and nurses will have the knowledge of how and when to prescribe Tai Chi to improve the health of their patients.

More than 50 large, academic medical centers now have some program in integrative medicine.

For example, at integrative medical clinics with most hospitals affiliated with the Harvard Medical School, patients can get mind-body therapies, acupuncture, and lifestyle coaching.

At the Brigham and Woman’s Hospital Osher Clinic for Complementary and Integrative Therapies, Tai Chi is often prescribed after patients have resolved an acute episode of back pain to stabilize the back, address any underlying imbalances, and prevent a recurrence.

Tai Chi is also commonly recommended to heart disease patients as a way to get moderate exercise and reduce stress.

Perhaps most importantly, Tai Chi skills are now widely being taught in public and private schools, colleges and universities, hospitals, and senior centers.

Preventing the effects of stress through Tai Chi may have a huge impact on reducing the already high costs of health care in the future.

Freezing Embryos May Result in Healthier IVF Babies

More evidence that using frozen embryos may result in healthier IVF babies than using fresh embryos comes from a new British study.

The researchers found that babies born following IVF using frozen embryos may be born later and weigh more than babies born from fresh embryos, according to a presentation at the British Fertility Society last week.

They looked at nearly 400 babies born after fresh embryo transfer and just more than 100 born after frozen embryo transfer.

On average, babies born from frozen embryos weighed 253g more and were born 4 to 5 days later than babies born from fresh embryos.

“This is important because prematurity and low birth weight are both risk factors for poorer health later in life and are linked to higher rates of behavioral and learning difficulties,” said Suzanne Cawood, who led the study at the Centre for Reproductive and Genetic Health in London.

“This means that resulting babies may potentially be healthier if frozen embryos are transferred rather than fresh embryos.”

She hypothesizes that the difference may be in the uterine environment between fresh cycles when embryos are transferred soon after the eggs have been collected compared to frozen cycles when the uterus has not been stimulated in the days before transfer.

This hypothesis needs to be tested further, she said.

Previously, Danish scientists had found that babies from frozen embryos were heavier and suggested this could be due to only top quality embryos surviving the freezing procedure.