alternative treatments

Do alternative medicine treatments help us save money?

October 24, 2012 By sh648 2 Comments

As our society continues to debate how to improve the U.S. health care system, some researchers and policy makers are asking whether alternative therapies such as massage, acupuncture and aromatherapy are effective, and whether they help save money by resolving medical problems.

On a personal note, I’ve always been intrigued by medical treatments that fall outside of western medicine. I received acupuncture when I was pregnant with my son. He was breech, and there is some evidence that acupuncture can help babies to turn into the right position. (After trying several other treatment options including chiropractic adjustments and yoga, he did turn around, although it’s difficult to determine exactly what helped.)

A new systematic review published in British Medical Journal Open analyzes cost studies on complementary and integrative medicine from 2001-2010. For the analysis, the researchers found 204 cost analysis studies of alternative medicine treatments. But only 22 of the studies met quality standards to be included in the review.

In an analysis that reviews broad array of medical conditions, it’s difficult to come up with a single conclusion. But the review did find that some alternative treatments yielded the same or better results as traditional medical treatments. In total, ten treatments showed cost savings. Among them are acupuncture for breech delivery, acupuncture for low back pain, tai chi for avoiding hip fractures and nutritional supplements to prevent cataracts.

The review concludes that there is some real potential in saving money in our health care system and helping people heal faster through alternative medicine treatments. But more high-quality studies are needed that measure economic as well as health outcomes, and combine alternative treatments with typical care methods to measure how they work together.

Filed Under: Evidence-Based Living Tagged With: alternative treatments, economics, evidence-based practice, Health and Wellness

Slimming it down? New evidence on low-calorie diets

September 4, 2012 By sh648 5 Comments

Over the past few years, you may have heard the buzz about the potential for a low-calorie diet to prolong life and prevent chronic medical conditions like heart disease and cancer.

While the concept of restricting calories has been around for decades, a longitudinal study of monkeys published in 2009 seemed to provide definitive evidence that eating less was good for you. The study by researchers at the University of Wisconsin found a diet of moderate caloric restrictions over 20 years lowered the incidence of aging-related deaths and reduced the incidence of diabetes, cancer, cardiovascular disease, and brain atrophy.

But last week, a new longitudinal study of different species of monkey raised questions about the idea of restricting calories to improve health. The study included 121 monkeys split into two groups. The experimental group was fed 30 percent fewer calories than the control group.

In the study published last week, which was sponsored by the National Institute on Aging, the monkeys on restricted diets did not live any longer than those with normal diets. Rates of cancer and heart disease were the same for monkeys on restricted diets and normal diets. While some groups of monkeys on restricted diets had lower levels of cholesterol, blood sugar and triglycerides, they still did not live longer than the monkeys who ate normally.

The study is interesting from a health perspective because it raises questions about the notion of restricting calories to improve health. But it’s also a prime example of why it’s important to collect data from more than one study.

“This shows the importance of replication in science,” Steven Austad, interim director of the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center, told the New York Times. Austad, who was not involved in either study, also explained that the first study was not as conclusive as portrayed in the media.

The take home message: It’s important to collect evidence from multiple studies before drawing conclusions, even when the data seems extremely convincing.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: alternative treatments, food and nutrition, Health and Wellness, nutrition, research methods, science in the media

New evidence: Vitamin D helps prevent falls

August 9, 2012 By sh648 1 Comment

Vitamin D is one of those supplements that makes it into the news media frequently. Here on EBL, we’ve written before about the U.S. Institute of Medicine’s recommendations on Vitamin D intake.

Now there is a new recommendation that taking Vitamin D supplements can help prevent falls in people over 65 years old with a higher risk of falling.

In a review of nine separate studies, the United States Preventative Services Task Force came to the conclusion a daily dose of 800 international units reduced the risk of falling by about 17 percent, compared with those who did not take the vitamin.

“The exact mechanism is not known, but it seems to help muscle strength and balance,” Dr. Al Siu, vice chairman of the task force and chairman of the geriatrics and palliative medicine department at Mount Sinai School of Medicine, told the New York Times.

The panel also made two other recommendations. Doctors should do a comprehensive assessment of patients’ risk of falling – including asking about falling history and observing patients stand up and walk – to identify those at higher risk. And patients’ should exercise to improve strength and balance.

Falls are the leading cause of injury in adults 65 and older. While there’s no sure-fire way to prevent them, we have evidence that some interventions do work. That’s important information for all of us to know.

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: aging, alternative treatments, evidence-based practice, food and nutrition, Health and Wellness, nutrition

Probiotics and antibiotics: A good combo?

May 15, 2012 By sh648 Leave a Comment

If you have taken antibiotics or cared for a small child taking them, you have likely seen first-hand the effects the medicines can have on the digestive system. The problem comes from the antibiotics – which are designed to kill bacteria – wiping out the productive bacteria that help the digestive system function properly.

One treatment doctors have explored is using probiotics – live microorganisms that can be consumed – to replenish the body’s productive bacteria. But what does the evidence say?

A systematic review this week in the Journal of the American Medical Association compiled data from 82 randomized, controlled clinical trials to come up with the best advice we have on using probiotics together with antibiotics.

The review concluded that probiotics do reduce the prevalence of diarrhea associated with taking antibiotics, but the data available didn’t provide additional details.

An article in the publication Family Practice News did note that most of the studies included in the review did not demonstrated a significant benefit from using probiotics when looked at on their own. But the complication of data show a benefit.

The review also noted that, on the whole, the quality of the research on probiotics is considered low. Many of the studies lacked enough evidence to evaluate the risk of probiotics and did not report on adverse events related to them.

The bottom line: Probiotics are a good avenue for treating diarrhea associated with taking antibiotics, but much more evidence is needed to develop solid clinical guidelines. Sometimes a systematic review serves the purpose of spotlighting areas that need additional research. That seems to be the case here.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: alternative treatments, Health and Wellness, research translation, science in the media

Building and maintaining relationships is one key to healthy aging

April 30, 2012 By sh648 Leave a Comment

There are some clear risk factors that lead to an earlier death such as smoking, alcohol consumption and obesity. But are there other factors that influence health and wellness later in life – behaviors that researchers have yet to study?

Until recently, one of those unknown factors was social relationships. Anecdotal evidence suggested that people with strong social relationships reduced their risk of mortality, but there was little evidence to back up the suggestion. While many medical studies included a measure of social isolation, no one had looked at the issue on a broader scale.

That is, until researchers at Brigham Young University conducted a systematic review of the literature on how social relationships impact the risk of dying later in life. They reviewed 148 studies that included more than 300,000 participants that included information about how people died, their initial health status and pre-existing health conditions, as well as type of assessment of social relationships.

Over all the data they reviewed, they found a 50 percent increased likelihood of survival for participants with stronger social relationships. The lack of social relationships had more influence on mortality rates that other risk factors like physical activity and obesity.

The researchers noted that more complex measurements of social relationships – instead of simple indications such as marital status – were more predictive of death.

The take-home message is that your relationships later in life are just as important as what you eat and drink, how much exercise you get, and other important health behaviors. More research is needed to determine how relationships improve well-being, and specific characteristics that contribute to the trend. In the meantime, it’s important for medical professionals to consider social relationships in their treatment plans for older adults.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: aging, alternative treatments, behavior change, Community, Health and Wellness

What we know about mindfulness and meditation

March 29, 2012 By sh648 1 Comment

The phrase “living in the moment” is a buzz word in our modern society that denotes a life well-lived. With its roots lie in Buddhism, the idea of “mindfulness” and “living in the moment” has taken root in modern American culture.

From best-selling books like Eat, Pray, Love to yoga classes offered at nearly every gym in the country, the idea of living in the moment is en vogue. But does it really lead to a happier life?

A systematic review of the evidence found that mindfulness-based therapy – which encourages patients to focus on their breathing and their body, to notice but not judge their thoughts and to generally live in the moment – does yield positive benefits.

The review, published last year in the Journal of Consulting and Clinical Psychology, is focused on mindfulness as a treatment for psychological disorders. It looked at 39 studies involving 1,140 participants who received mindfulness-based therapy for a range of conditions including cancer, generalized anxiety disorder and depression.

The review concluded that mindfulness-based therapy somewhat helped ease the mental stress of people recovering from cancer and other serious illnesses. The treatment had the strongest benefits for people diagnosed with mood disorders, including generalized anxiety disorder and recurring depression.

That’s not to say that a daily meditation session can help cure severe depression or anxiety disorders, but it is a useful tool along with other treatment and for patient with more mild cases.

On a personal note, I don’t suffer from depression or mood disorders, but I do find that a few minutes spent focused on my breath and calming my mind helps me to focus and stay positive for the rest of the day. I find it’s a habit worth cultivating.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: alternative treatments, behavior change, evidence-based practice, Health and Wellness, social trends

Sniff, sniff: What the evidence says about colds

November 29, 2011 By sh648 Leave a Comment

Have you got your first cold of the season yet? Our family has cycled through an entire round already – each of us taking turns coping with runny noses, hacking coughs and sore throats.

While typically not a life-threatening illness, the common cold is one of the most widespread diseases in the world and a leading cause of doctor visits and absenteeism from school and work. Beyond that, having a cold is just plain uncomfortable. So of course, I was on the hunt a treatment that actually works.

I immediately turned to the Cochrane Collaboration, which has published dozens of reports on preventing and treating the common cold. Here are a few that interested me most;

The data on heated, humidified air is completely split. The Cochrane Collabortion review, which included six trials with a total of 387 participants, found that in some studies inhaling steam helped symptom and in others it did not.
I’ve long increased my orange juice intake when I have a cold with hopes that the extra Vitamin C would help. But a systematic review found no consistent effect on the duration or severity of cold symptoms.
A review of seven trials found that over-the-counter nasal decongestants like Sudafed do help, but only slightly. Users reported a 6 percent improvement in symptoms after one dose, and a 4 percent improvement over several days. For me, personally, I wonder if such a small improvement is worthwhile.
The most promising treatment for the common cold, according to the evidence, is zinc. The systematic review of 15 randomized controlled trials found that zinc lozenges and syrup are both effective in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms.

Needless to say, my medicine cabinet is now stocked with zinc lozenges so that our family is ready for any other colds that come our way this season.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: alternative treatments, evidence-based practice, Health and Wellness, research translation

The simple facts on layway – and a grateful reminder

November 22, 2011 By sh648 Leave a Comment

During undoubtedly the biggest shopping week of the year, several major retailers – including Walmart, Sears and Toys R Us – are bringing back a purchasing tool of by-gone days: layaway.

The concept is simple. If you can’t afford a purchase, the store will set it aside for you (for a fee, or course) and allow you to make payments on it. Once you’ve paid off the item, you’re free to take it home. The system was set up before credit cards were common-place in American homes.

But there’s a problem with layaway. Compared to credit card interest rates, layaway fees are exorbitant. Louis Hyman, an assistant professor at Cornell’s School of Industrial and Labor Relations, explains in a New York Times column:

“Imagine a mother going to Walmart on Oct. 17 and buying $100 worth of Christmas toys. She makes a down payment of $10 and pays a $5 service fee. Over the next two months she pays off the rest. In effect, she is paying $5 in interest for a $90 loan for two months: the equivalent of a credit card with a 44 percent annual percentage rate, a level most of us would consider predatory.

“In comparison, even a card with an 18 percent A.P.R. would charge only half as much interest — and she could take those presents home the same day.

“Then consider what would happen if she couldn’t finish all the payments. Walmart would give her the money back, less $10. If she borrowed that $90 and paid $15 in interest for two months, she would have the equivalent of a jaw-dropping interest rate of 131 percent.”

The bottom line is that most layway program don’t pay. Instead, it’s better to save up for your holiday presents.

***

During this week of Thanksgiving, we’d also like to remind you that the feeling of thankfulness or gratitude is actually good for you. Before you head out the door for those Black Friday sales, take a few minutes to remember what you’re grateful for.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: alternative treatments, economics, financial management, social trends

New evidence on yoga

October 20, 2011 By sh648 2 Comments

Here on EBL, we’ve written plenty about alternative treatments like T’ai Chi and meditation. They’re always popular topics, maybe because many of us are looking for ways to improve our health.

So I was excited to see a New York Times blog post about the evidence surrounding yoga and pain relief. For one, it’s great news that major media outlets like the New York Times are touting the importance of systematic reviews. And it’s also good to hear that an alternative treatment practiced by so many people – myself included – actually works.

The actual analysis, conducted by researchers in the United Kingdom and published in the Journal of Alternative and Complementary Medicine, reviewed ten randomized clinical trials that measured whether yoga helped reduce pain among patients with a variety of ailments. Nine of the trials found yoga led to significantly greater pain reduction than other therapies such as standard care, therapeutic exercises, touch and manipulation, or no intervention at all.

While the analysis gave preliminary indications that yoga works for pain relief, it concluded that more research is needed. The yoga practices in each of the studies varied widely, as did the type and intensity of pain experienced by patients.

Dr. M. Cary Reid is a geriatrician at Weill Cornell Medical Center and director the Translational Research Institute for Pain in Later Life, an evidence-based center in New York City to help older adults prevent and manage pain. He recently completed his own systematic review of alternative therapies including yoga for the treatment of osteoarthritis, which is submitted for publication.

Dr. Reid shared his thoughts on yoga for pain relief: “The good news is there appear to be few downsides to doing yoga, so my thinking is that we should be offering it routinely to patients, particularly those who are reluctant to try pain medications.” He echoed the need for larger, more definitive studies.

Until then, I’ll still be frequently my local yoga studio.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: alternative treatments, evidence-based practice, Health and Wellness, science in the media

The facts on mosquito-bite prevention

June 28, 2011 By sh648 1 Comment

As we enter full-fledged summer here in Ithaca, my family is spending more and more time outside. While we love the sunshine and fresh air, we do not love the mosquitoes that come along with our outdoor adventures. My two-year-old son and I both have more severe reactions than most people – sizeable, itchy welts that last for several days.

Since I’m already fed up with the bites (and summer has really just begun), I went searching for an evidence-based solution to our problem. What is the best way to prevent mosquito bites?

What I found put our own itchiness into perspective. There is an ever-growing body of research on mosquito-bite prevention that has nothing to do with our summer annoyances. In many parts of the world, preventing mosquito bites is a life-or-death issue because mosquitoes carry infectious diseases – most commonly malaria.

The first piece of evidence I came across is one prevent technique that clearly doesn’t work: electronic mosquito repellents that supposedly repel mosquitoes by emitting high-pitched sounds. Other non-chemical repellants such as citronella work moderately well, according to a review of the academic literature on the subject.

The chemical N, N-diethyl-m-toluamide, or DEET, appears to be the best way to ward off mosquitos, according to the evidence. Developed by the U.S. Army for use after World War II, it became available to civilians in 1957.

In more recent years, there have been concerns about the safety of DEET because it has lead to neurological problems such as seizures in some people. But a complete review of the evidence by the U.S. Center for Disease Control found that using DEET following the proper guidelines is safe and does help prevent mosquito bites. They’ve developed a great fact sheet that summarizes all of the evidence. And you can find even more evidence about insect repellents here.

So it’s bug spray for our family this summer, in moderation of course.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: alternative treatments, evidence-based practice, Health and Wellness

Proof positive: T’ai chi helps improve health

May 23, 2011 By sh648 1 Comment

Even if you’ve never practiced t’ai chi before, you’ve probably seen other people making the graceful, flowing movements that define this martial art.

T’ai chi is a Chinese exercise system that uses slow, smooth body movements and deep breathing to achieve a state of relaxation of body and mind. The practice is based on the Confucian and Buddhist belief that health is controlled by two opposing life forces, yin and yang.

For at least 700 years, and likely much longer, people have been practicing t’ai chi as a way to improve health and achieve balance in their lives. While the practice has stood the test of time, is there any evidence that it really works?

The answer is yes.

A new paper published in the British Journal of Sports Medicine evaluates of 35 individual systematic reviews of t’ai chi to determine if the practice contributes to improvement of any disease or clinical symptoms. The paper looked at a wide range of medical conditions – cancer, Parkinson’s disease, osteoarthritis and cardiovascular disease, to name a few.

Several of the systematic reviews reviewed in the publication reached conflicting conclusions. But there are two areas where health benefits of t’ai chi are clearly present – preventing falls in older adults and improving psychological well-being and overall health in people of all ages.

If you’re looking for a gentle way to improve your health, why not give t’ai chi a try?

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: aging, alternative treatments, Health and Wellness, research translation

Do alternative medicine treatments help us save money?

Slimming it down? New evidence on low-calorie diets

New evidence: Vitamin D helps prevent falls

Probiotics and antibiotics: A good combo?

Building and maintaining relationships is one key to healthy aging

Sniff, sniff: What the evidence says about colds

New evidence on yoga

The facts on mosquito-bite prevention

Proof positive: T’ai chi helps improve health

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