Is Your Job Giving You Low Back Pain?

Is your job giving you back pain?

There are many factors that contribute to low back pain.  Some obvious, some not so.  But in many cases, these factors are under your control.

However, without some serious reworking of your life, you occupation is not easily changed.  But does your job contribute to your back pain?  Sometimes.

I hear it almost daily.  “If I just had a job that I didn’t have to sit all the time.”  “If I just had a job where I could sit down.”  The truth is that we are designed to be out hunting boars and gathering berries.  Not a whole lot of job openings for these positions, however.

I consider myself very lucky because my job has me up and down, sitting and standing, bending and straightening, pretty much all day long (unless I happen to be doing a blog post at my computer, of course).

There has been no real clarity in studies over the years looking for factors that predispose to the development of back pain.  Nothing can be clearly identified in a pre-employment physical that would indicate that a worker is more likely to suffer injuries.

However, there has been a consistent pattern over the studies on workman’s compensation injuries; those who are not happy with their jobs or feel unempowered are more likely to suffer an injury.  Not that anyone is faking an injury because he or she does not like his or her job; rather, this reflects the complex interplay between the mind and the body when it comes to pain.

This particular study, however, seems able to add some insight.  In it, researchers looked at 2,161 men working in various occupations across France who were followed across 5 years.  Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey.  Five years later, in the second survey of these workers, they were asked about low back pain during the previous week.

Here’s what they found:

• 394 (30.0%) men had low back pain in the second survey.
• Frequent forward-only bending increased the risk of low back pain by 45%.
• Frequent forward-and-sideways bending increased the risk 213%.
• Driving industrial vehicles increased the risk 35%.
• Working more hours than officially planned increased risk 38%.
• Reported low support from supervisors increased risk 35%.

Notice that psychological factors showed up on this list again (low management support and working longer hours than planned).

There are other, general factors that play a role in low back pain.  Things like smoking and a sedentary lifestyle play a role in back pain, but these are easily modifiable.  If your occupation requires any of the behaviors or movements noted above, there is going to be a challenge.

The best you can do is manage your workstation, using back posture support devices when possible or lumbar support cushions if your job requires prolonged sitting or driving.  If you happen to own a company that uses team members who have to perform these repetitive movements, it might be well worth your while to invest in an ergonomic evaluation to see if any changes can be made to the workstation to minimize your team’s risk of low back pain.

 

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Calcium Supplements and Heart Disease

IS MY CALCIUM SUPPLEMENT GOING TO GIVE ME A HEART ATTACK??

It’s always funny the poor research that mainstream media picks up and the good stuff they don’t.

Here are a few things to consider. First, I usually don’t recommend calcium supplementation until someone becomes osteoporotic. At this point it becomes much, much more important to take calcium in order to protect the bones than worry about any additional increased risk to the heart.

Second, reading into the study, it appears that those with a higher dietary intake of calcium were at risk (my interpretation….more dairy intake), while those with lower levels of dietary intake were NOT affected by the calcium supplementation.

Further, we always have to look at the “how.” In this particular case, giving calcium without magnesium in a 2:1 ratio can cause a relative magnesium deficiency, which is NOT good for the heart….The higher quality calcium supplements all include magnesium.

Read More

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Simple Stroke Prevention with This supplement

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Any type of damage to the brain scares most people. Imagine a clot in your brain cutting off blood supply, killing brain cells that allow you to function.

While a survey of 100 people would likely yield all 100 of them voting to NOT damage his or her brain, it seems that most of these 100 people don’t opt to make lifestyle choices that will protect the brain.

Just in case this seems to be a little dramatic, I would point out that cardiovascular disease and stroke share almost identical risk factors.  In a recent blog article I pointed out that not a single person out of over 7,100 were living a lifestyle that included “Life’s Simple 7.”  These are simple lifestyle choices and yet not a single person in the study followed all seven.

Maybe lifestyle changes are just too darn hard to do.  All that exercise, eating right, getting sleep and maintaining an ideal body weight is just too much work.  And society just does not support a healthy lifestyle.

Aren’t there any simple approaches that can lower your risk of stroke?  Keep in mind that I have never been and never will be a “single supplement for a single condition” person.  Supplements should always be used as just one tool among a host of lifestyle changes designed to lower your risk of chronic disease.

That being said, sometimes supplements do show up in the medical literature demonstrating strong effects on preventing chronic disease.  This particular study is just such a situation.  In it, researchers looked at the ability of folic acid to lower the risk of stroke in a group of 20,702 patients with hypertension.

Patients were given either the high blood pressure drug enalapril or enalapril plus 800 mg folic acid.  Here’s what they found after the study was stopped early because the benefits were clear:

• 7% of those in the enalapril–folic acid group had a first stroke.
• 4% of those in the enalapril alone group had a first stroke.
• Overall, those taking the folic acid had a 21% lower risk of having a stroke.
• The benefit of taking folic acid was far stronger in those who started the study with lower levels of folate in the blood (<5.6 ng/mL). First stroke of 2.8% vs 4.6%, a reduction of 39%.

The results of this study managed to make it to the top of many of the medical websites despite that fact that the absolute numbers are very small (0.7% and 1.8% in the low blood folate patients).  We use the same excitement when we talk about statins and their ability to lower rates of heart attack.

One of the major differences here is that folic acid is a far safer and less expensive approach to protecting your health than the statin class of drugs.  Besides this, statin drugs don’t actually fix anything.  At all.  Folic acid, on the other hand, plays a role in blood vessel health by lowering homocysteine levels, a known irritant to the blood vessels.

The bottom line, however, is not to run out and buy a folic acid supplement.  Rather, a good quality multivitamin will contain a broad spectrum of high quality B vitamins including 800 mg of folic acid as well as vitamin B6 and B12 to make sure they all work well together.

One of my personal favorites is Pure Encapsulations’ Ultra Nutrient, which contains solid levels of folic acid and vitamin B12.

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Stress, Weight Gain and Depression; Are They Really Linked?

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Stress kills us.  Luckily, it is a slow process, dragged out over the course of decades resulting in a painfully slow death.

The process is not direct.  It’s not like you stress out after getting cut off in traffic and then drop dead before the next exit.  Acute stress is something our bodies were designed to handle and handle well.  It’s the chronic variety that our bodies do not know how to deal with.

Stress has been linked to many different chronic diseases, but top of the list is weight gain.  But how does this work?  Is it a direct effect?  This particular study addresses how stress effects our bodies’ response to fatty meals.

Specifically, researchers looked at 58 healthy women (38 breast cancer survivors and 20 control women) with an average age of 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal during two separate 9.5-hour admissions to a center for testing.

On each occasion, the women were asked about prior day stressors as assessed by the Daily Inventory of Stressful Events questionnaire.  Here’s what they found:

• Greater numbers of stressors were associated with lower postmeal Resting Energy Expenditures (they burned less calories after the meal with higher stress).
• More stress also led to less fat oxidation (less fat burning).
• More stress led to higher insulin after the meals (essentially more prediabetic).
• Interestingly, women with prior major depressive disorder had higher cortisol and higher fat oxidation.
• Women with a history of depression who had more stressors had a higher triglycerides after the meal.

These effects can be factored into a difference of 435 kJ less energy burned from depression factors that could add almost 11 pounds per year.  Cleary stress and depression, especially when mixed, play a role in the development of obesity and all the chronic diseases that go along with it.

Unfortunately, depression comes along with its own set of problems.  When you are in the throes of depression, making healthy choices is the last thing on the list.  Exercise and eating healthy just aren’t likely to happen.  And yet, these choices would help to curb obesity and chronic disease.

With anxiety and stress, on the other hand, making these healthy choices is not impeded by a lack of motivation, but rarely seem to happen.  If you experience anxiety or are prone to anxiety, understand that you every time you allow yourself to stress, every meal you eat over the next 24 hours will be a meal that increases your risk of becoming obese.

 

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Have a Skinny Friend? Maybe You Should Borrow Some of This

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Obesity and weight loss are complicated issues. It’s no longer about calories in versus calories out.

In a prior article I wrote about the contributions of environmental chemicals to obesity and diabetes.  And this contribution is not a small one.  You can read more about this relationship by clicking here.

Certainly the quality of the foods you eat, the calories and the amount of calories that you burn play a role.  You can’t sit on the couch and eat 4,000 calories a day and not expect to gain weight.  But what about the other extreme?  What if you watch your calories, watch the quality of your calories as well as exercise consistently using both aerobic and resistance training and still cannot get to your ideal weight?

That is the frustrating situation you may find yourself in, ultimately throwing up your hands and giving up.  And unfortunately, I can’t provide you with a direct, immediate answer.  The answer to maintaining an ideal weight is not an easy one.  It certainly requires attention to diet and exercise.

The harder factors to account for and change are the environmental ones I mentioned earlier.  I know that in our household we have moved to stainless steel pitchers for our tea, glass and stainless steel for our water bottles, glass for our cups, natural / fragrance free dish soaps, laundry soaps and cleaners as well as getting any other chemicals that we can identify out of our lives.  Not an easy task and we have to make some sacrifices as a family.

Talk about confusing.  I cannot tell you how many patients are unaware that drinking out of plastic water bottles can make them fat.  But what if the story got even MORE confusing?

Just what you wanted to hear.  But that’s exactly what this particular study does.  There has already been some hints from medical research that the bacteria in your gut can play a role in body fat.  Stress, artificial sweeteners and antibiotics have all been shown to disrupt the delicate balance of the bacteria in your gut towards obesity and diabetes.

The researchers in this study took it quite a bit further.  They took the bacteria in the gut of mice fed a high fat diet and transplanted this bacteria into mice who had basically had their guts wiped clean of bacteria so it was a clean slate.  Here’s what happened to the mice given the high fat diet bacteria:

• There were disruptions in exploratory, cognitive, and stereotypical behavior (there were actual behavioral changes in the mice).
• There were disruptions in markers of intestinal barrier function (aka leaky gut).
• The was increased circulating endotoxin (more toxins from the bacteria in the gut).
• There was increased lymphocyte expression of ionized calcium-binding adapter molecule 1, toll-like receptor 2, and toll-like receptor 4 (basically, the white blood cells were gearing up for a fight with something).
• There was increased inflammation in the brain as well as alterations in the blood flow within the brain.

All of these changes from something as simple as changing the bacteria in the gut.  Some would say this is just a mouse study and has no relevance.  That argument is a little weak when you look at the human studies previously mentioned that have found relationships between bacteria in the gut and obesity.  Then when you consider the reports of weight gain in patients who has undergone fecal transplants for C. diff infections this study becomes even more important.

The take home message is that the bacteria in your gut plays a strong role in your weight.  The stress you experience, the foods you eat, your exercise and the drugs you take in (from anti-inflammatories and steroids down to antibiotics) all have an influence on your gut bacterial populations.  Think on that when you decide to adopt a behavior that is known to negatively affect the bacteria in the gut.

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Childhood Obesity Statistics: Contributions of a Forgotten Chemical

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Calories in, calories out.  Seems to be a simple enough equation for weight loss or maintenance.  Or, at least it used to be.

Make sure your son or daughter stays active.  Throw out any Kellogg’s breakfast cereals and keep them away from fruit juice.  These recommendations are simple enough and makes sense for keeping the rising obesity tide in children at bay.

But somewhere along the process the equation changed.

When you took math class, you were dealing with numbers you understood and could work with.  But what if the equation your teacher put in front of you had numbers that weren’t even on the page?  Makes absolutely no sense, right?

But when it comes to health, this is exactly what is happening.  As society and manufacturing have progressed we have introduced chemicals into the environment that can have a very strong impact on your risk of chronic disease.  It’s no longer about watching the calories you eat and making sure you stay active.  The equation now contains chemicals in the environment that are affecting your health.  And not in a good way.

Many are aware of the more common chemicals like bisphenol A (BPA) in plastic water bottles, thermal register receipts and soda cans.  Teflon in non-stick cookware.  Flame retardants in your clothing, mattress and furniture.

But if in casual conversation I asked your thoughts about dichlorodiphenyldichloroethylene I’m pretty sure you’d give me a blank look and steer the conversation to politics.  Unless, of course, you’re a biochemist for DuPont.

If instead I asked you if you had ever heard of DDT used as a insecticide in farming, that glossy look in your eyes would disappear and you’d become more and more animated as you recall the damage this chemical did to animals in the environment and how it was banned from use in the US in 1972.

The rest of the world was a little slow to catch on.  DDT was banned worldwide during the Stockholm Convention on Persistent Organic Pollutants (POPs) on May 21, 2002, going into effect in 2004.  Over a decade ago.  Little did we know just how tough it was for Mother Nature to degrade and get rid of DDT.

With this in mind, if you knew that dichlorodiphenyldichloroethylene was a breakdown product of DDT, things would make a little more sense.  And your cause for concern would go up.

Here in the US, 40+ years after DDT was banned, almost all of us have breakdown products of DDT that can be found in our blood.  Scary.

The DDT ban is not so new in Europe and given how long it takes for DDT to clear from the environment it’s hard to imagine that this is not having an effect on our kid’s health.

As if this wasn’t enough to worry about, phthalates are incredibly common in our lives.  That “new shower curtain smell” or the new car smell likely indicates that phthalates are present.  Many “fragrances” have phthalates embedded within them.  Think about how many household items you use on a daily basis that have a scent to them.  It’s likely that phthalates are at work.

All of these environmental chemicals have been shown to contribute to chronic disease.  Top of the list is obesity.  But just how much do these chemicals contribute?  Just a little?  A lot?

This is the exact question posed in this particular study.  In it, a panel of researchers used models to estimate the potential that dichlorodiphenyldichloroethylene, BPA, phthalates and other chemicals were contributing to childhood obesity.  Then they went further, determining the costs related to healthcare expenditures due to these chemicals.  Here’s what they found:

• The panel identified a 40% to 69% chance that dichlorodiphenyldichloroethylene caused 1555 cases of overweight at age 10 (in 2010) with associated costs of $36.7 million.
• There was a 20% to 39% chance that dichlorodiphenyldichloroethylene caused 28,200 cases of adult diabetes with associated costs of $12.5 billion.
• The panel also identified a 40% to 69% chance that phthalate exposure caused 53,900 cases of obesity in older women and $232 billion in associated costs.
• Phthalate exposure had a 40% to 69% chance of causing 20,500 new cases of diabetes in older women with $907 million in associated costs.
• Prenatal bisphenol A exposure had a 20% to 69% chance of causing 42,400 cases of childhood obesity with associated lifetime costs of $2.16 billion.

These are estimates, but they are based on what it known about how much these chemicals contribute to poor health.  Unless you take these chemicals into account for the equation of your good health, the solution won’t balance.

In everything you do, you need to pay attention to the chemicals you may be exposed to and do your best to avoid them whenever possible.

 

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