Thursday, July 28, 2016

The Mind-Gut Connection: How the Hidden Conversation Within Our Bodies Impacts Our Mood, Our Choices, and Our Overall Health


Combining cutting-edge neuroscience with the latest discoveries on the human microbiome, a practical guide in the tradition of The Second Brain, and The Good Gut that conclusively demonstrates the inextricable, biological link between mind and the digestive system.
We have all experienced the connection between our mind and our gut—the decision we made because it “felt right”; the butterflies in our stomach before a big meeting; the anxious stomach rumbling we get when we’re stressed out. While the dialogue between the gut and the brain has been recognized by ancient healing traditions, including Ayurvedic and Chinese medicine, Western medicine has  by and large failed to appreciate the complexity of how the brain, gut, and more recently, the gut microbiota—the microorganisms that live inside our digestive tract—communicate with one another. In The Mind-Gut Connection, Dr. Emeran Mayer, professor of medicine and executive director of the UCLA Center for Neurobiology of Stress, offers a revolutionary and provocative look at this developing science, teaching us how to harness the power of the mind-gut connection to take charge of our health and listen to the innate wisdom of our bodies.

The Mind-Gut Connection describes:

∙ Why consuming a predominantly plant-based diet is key for gut and brain health
∙ The importance of early childhood in gut-brain development, and what parents can do to help their children  thrive

The role of excessive stress and anxiety in GI ailments and cognitive disorders
How to “listen to your gut” and pay attention to the signals your body is sending you
∙ and much more.

Look inside a copy

Bike Fit: Optimise your bike position for high performance and injury avoidance


This practical guide, written by a leading BIKE FIT expert, takes you step-by-step through the BIKE FIT process – to ensure you maximise your cycling potential.

Do you suffer from lower back pain after a long weekend ride? Do your shoes wear out on one side more than the other? Are you experiencing numbness in your hands, or knee pain?

Phil Burt, Head Physiotherapist at British Cycling and Team Sky Consultant Physiotherapist, has worked with hundreds of cyclists to help them solve these and many other classic cycling niggles. In this book he outlines his methods to help you analyse your position and get the best from your bike. The right BIKE FIT can mean the difference between a good ride and a bad one, but a professional fit can cost more than you paid for your bike. The information is all here. Let Phil Burt guide you through your own BIKE FIT, to ensure your bike and body work in harmony.

Packed with useful diagrams, step by step diagnostics and case studies, this is the must-read for any cyclist keen to get a performance advantage.


A 30-Minute ‘Me’ Break Can Make You a Better Worker, Study Shows


Newswise — If there are crumbs on your desk from countless lunches spent responding to emails and attending to other job-related responsibilities, it may be time to clean up and take a step back.
New research suggests that detaching from work during a lunch break can boost energy and help you to better respond to the demands of the day.

That’s the message behind a new study that finds early-career doctors — and the rest of us — can be better at our jobs if we simply set aside as little as 30 minutes a day for some “me” time.
The alternative, the study finds, is a scenario in which the patient may suffer.

The study, conducted by University of Florida and University of Tennessee at Chattanooga researchers and published in Psychology, Health & Medicine Journal’s third issue in 2016, found that active recovery activities like exercising and volunteering can help employees recover quickly and respond better to their jobs’ demands.

Researchers focused on the work and rest patterns of 38 early-career physicians from a teaching hospital in the Southeast. Of the participants, 63.2 percent were male and the median age was 29. The typical physician can average an 80-hour work week, leaving little opportunity for leisure and sleep.
“Residents are a very unique population, the stressors that they engage with throughout the day are a lot more significant than those of the average American. Therefore, these moments of replenishment are that much more important,” said Nicole Cranley, the study’s lead researcher. Cranley did the research while a doctoral candidate in UF’s department of behavioral science and community health and is now a postdoctoral fellow at the University of North Carolina at Chapel Hill.

The study assessed the time early-career physicians spend at work versus the time they spent on sleep and leisure, their ability to detach from work during non-work hours and whether they engaged in active or passive recovery activities.

Physicians ranked activities they engaged in at home and at work for how draining or energy boosting they were.

The results showed that the time early-career physicians spent on work exceeded the time they spent on sleep and leisure activities combined — and although eating was the most highly ranked at-work activity, even lunch breaks were consumed by work.

“They grab things and go, or they are eating while they are in conference or listening to a lecture. There really isn’t that time when they are not doing something related to work,” Cranley said.
Researchers also found that the participants had trouble psychologically detaching from work and that they engaged in more passive forms of recovery in their non-work time. While passive recovery, like watching television, is not necessarily harmful, it also does not help to boost energy levels beyond the baseline like active recovery activities can.

These patterns of working without taking time to recover fully can lead to burnout.
“Burnout is a serious issue,” said Cranley, “It’s usually related to the fact that you’re not taking enough time for self-care or engaging in activities that help you gain back some of those resources.”
Higher levels of burnout, she said, lead to higher rates of poor-quality patient care.

“You can only effectively care for someone if you are in a good state of mind. You have to be in a good place to be able to give your all to someone else,” she said.

One way to replenish resources is engaging in active recovery activities outside of work, no matter how little time is available to engage in those activities.

“It doesn’t matter if you only have 45 minutes to go to the gym — you take those 45 minutes for yourself,” Cranley said.

She said the study’s findings provide the groundwork to improve physician self-care and medical education.

“It’s a very unique situation that residents are in because they are expected to have all of the answers, when oftentimes they don’t,” she said.

She said the goal of the research is to help medical schools and hospitals recognize the nature of the stressors that the early career physician population faces and equip them with skills to deal with stress and recognize signs of burnout in themselves.

“I think where we are missing the mark is in medical education — it is a culture issue and we need to reassure our health professionals that it’s okay to need self-care,” Cranley said. “Everybody’s valuable, everybody needs to take care of themselves sometimes. We can’t all be 100 percent all the time.”

Exercise ability in middle age may be one key to longer life


(Reuters Health) – Middle-aged men who have more endurance in exercise tests may end up living longer than their peers who struggle with physical activity, a Swedish study suggests.

Researchers gave about 650 men an exercise test in 1967 when they were 50 years old. They asked participants to push themselves to the limit and ranked results into three groups based on low, medium or high endurance.

Each bump up in the endurance rankings was associated with a 21 percent lower risk of death during 45 years of follow-up, after adjusting for factors like smoking, blood pressure and cholesterol levels.

“Low fitness in middle age was associated with increased risk for all-cause mortality for several decades,” lead study author Dr. Per Ladenvall of the University of Gothenburg in Sweden said by email.

To assess physical fitness in middle age, researchers used exercise tests and examined data on the maximum amount of oxygen participants’ bodies could use. Generally, people with higher fitness levels can use more oxygen than individuals who are out of shape.

Researchers started the study by looking at data on 792 men from a larger study designed to investigate risk factors for cardiovascular disease and mortality. Of those, only 656 were able to complete a maximum exercise test pushing themselves to the limit; the rest had a health condition that made this type of test unsafe.



ACSM, Walk with a Doc Program Announce Partnership


Newswise — INDIANAPOLIS— The American College of Sports Medicine (ACSM) announced a new partnership with the Walk with a Doc program today, forged to promote walking for better health. Walk with a Doc encourages healthy physical activity in people of all ages, because it can reverse the consequences of a sedentary lifestyle and improve the health and well-being of Americans.

ACSM is an international leader in promoting the benefits of exercise. “Walking is a safe, easy and effective way for all people to become healthier through physical activity,” said Jim Whitehead, ACSM’s EVP/CEO. “ACSM brings the expertise of 50,000 clinicians, researchers, educators and exercise professionals to this collaboration to team up with Walk with a Doc’s efforts to promote physical activity through walking.”

With close to 250 communities and thousands of doctors across the United States, Walk with a Doc sees the partnership with ACSM as a way to expand its impact as scores of additional communities stand to benefit from the collaboration. “With a doctor’s approval, walking is low impact and safe for people with orthopedic ailments, heart conditions and those who are more than 20 percent overweight,” said David Sabgir, MD, founder of Walk with a Doc. “Working with ACSM can help us meet our goals to help Americans become more active and meet national guidelines for physical activity.”

Walk with a Doc is following ACSM’s lead to answer the Surgeon General’s Call to Action on Walking and Walkable Communities, released in September 2015. The call to action recognizes the importance of physical activity for people of all ages and abilities and encourages Americans to be more physically active through walking and asks leaders to better support walking and walkability in their communities.

 Walk with a Doc will also be supporting ACSM’s signature program, Exercise is Medicine®, by promoting the EIM health care provider’s pledge to encourage patients to participate in regular physical activity to support their health.

New Treatment for Low Back Pain: Minimally Invasive Procedure Receives FDA Clearance


Newswise — It’s the most common reason people go to their doctors – back pain. According to the National Institutes of Health, 80 percent of adults will experience low back pain some time in their lives. In fact, chronic low back pain, lasting 12 weeks or longer, affects nearly one-third of the nation’s population.

Laura Donlon, 48, of Monroe had been dealing with low back pain for five years before she found out about a back pain study at Beaumont Hospital in Royal Oak, Michigan. The flight attendant says her pain was unbearable at times, especially when sitting. Seeking relief from her pain, caused by a degenerative disc, she contacted the orthopedic research team at Beaumont for details.

Treatments for low back pain range from noninvasive to invasive: physical therapy, pain medications to major surgery, such as spinal fusion. Now a minimally invasive, nerve ablating procedure, recently cleared by the Food and Drug Administration, may give some people with chronic low back pain a new treatment option.

“In 25 years of practicing orthopedics, this is the most important clinical study I’ve ever done,” said Jeffrey Fischgrund, chairman, Orthopedics, Beaumont Hospital, Royal Oak and principal investigator of the FDA-approved Relievant SMART trial. “The system is proven to be safe and effective in clinical trials. It is much less invasive than typical surgical procedures to treat low back pain.”
A spine expert and orthopedic surgeon, Dr. Fischgrund helped design the research study. Research teams in the United States and Germany recruited 225 participants, with 150 receiving the minimally invasive, ablation treatment and 75 receiving the placebo.

Donlon was told she met the trial criteria and enrolled in the study. In December 2014, she had an outpatient spine procedure by Beaumont physicians. Because she did not know if she received the minimally invasive trial procedure or a placebo, she had to guess based upon results.
“After the procedure, I went home and within 24 hours I could touch my toes,” said Donlon, a running enthusiast and marathon competitor. “That’s when I figured I had the study procedure. Within 48 hours, I was back to work.” One year later, the research team confirmed what she suspected; she had undergone the nerve ablation treatment.

The treatment uses radio frequency energy to disable the targeted-nerve responsible for low back pain. Under local anesthesia with mild sedation, through a small opening in the patient’s back, an access tube is inserted into a specific bony structure of the spine, called a vertebral body. Radio frequency energy is transmitted through the device, creating heat, which disables the nerve. The access tube is then removed. The minimally invasive, implant-free procedure takes less than one hour.

“This is a new way to treat back pain. This type of treatment has never been done before,” said Dr. Fischgrund. “It’s revolutionary, compared to more traditional therapies; the odds of success are much greater.”

Patients eligible for this new procedure typically are candidates for more invasive back surgery or take strong pain medications, like opioids. Those research participants that had the radio frequency ablation procedure noticed significant improvement in their back pain within two weeks of surgery.
The nerve ablation procedure and technology was developed by Relievant Medsystems Inc., a California-based medical device company.

Nineteen months after Donlon’s minimally invasive nerve ablation treatment, she said, “Today, I have no back issues. I’m pain free. In fact, since my procedure, the pain has not recurred. I’m extremely grateful for the care and treatment I’ve received through my participation in the lower back pain study.”

For more information on this procedure and to be notified when it is available at Beaumont Hospital, Royal Oak, visit:

Friday, July 22, 2016

BMJ: Exercise as effective as surgery for middle aged patients with knee damage


Exercise therapy is as effective as surgery for middle aged patients with a common type of knee injury known as meniscal tear (damage to the rubbery discs that cushion the knee joint), finds a study in The BMJ this week.

The researchers suggest that supervised exercise therapy should be considered as a treatment option for middle aged patients with this type of knee damage.

Every year, an estimated two million people worldwide undergo knee arthroscopy (keyhole surgery to relieve pain and improve movement) at a cost of several billion US dollars. Yet current evidence suggests that arthroscopic knee surgery offers little benefit for most patients.

So researchers based in Denmark and Norway carried out a randomised controlled trial to compare exercise therapy alone with arthroscopic surgery alone in middle aged patients with degenerative meniscal tears.

A randomised controlled trial is one of the best ways for determining whether an intervention actually has the desired effect.

They identified 140 adults (average age 50 years) with degenerative meniscal tears, verified by MRI scan, at two public hospitals and two physiotherapy clinics in Norway. Almost all (96%) participants had no definitive x-ray evidence of osteoarthritis.

Half of the patients received a supervised exercise programme over 12 weeks (2-3 sessions each week) and half received arthroscopic surgery followed by simple daily exercises to perform at home.
Thigh muscle strength was assessed at three months and patient reported knee function was recorded at two years.

No clinically relevant difference was found between the two groups for outcomes such as pain, function in sport and recreation, and knee related quality of life. At three months, muscle strength had improved in the exercise group.

No serious adverse events occurred in either group during the two-year follow-up. Thirteen (19%) of participants in the exercise group crossed over to surgery during the follow-up period, with no additional benefit.

“Supervised exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term,” say the authors. “Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no radiographic evidence of osteoarthritis to consider supervised structured exercise therapy as a treatment option.”
How did this situation – widespread practice without supporting evidence of even moderate quality – come about, ask two experts in a linked editorial? “Essentially, good evidence has been widely ignored,” say Teppo J√§rvinen at the University of Helsinki and Gordon Guyatt at McMaster University in Canada.

“In a world of increasing awareness of constrained resources and epidemic medical waste, what we should not do is allow the orthopaedic community, hospital administrators, healthcare providers, and funders to ignore the results of rigorous trials and continue widespread use of procedures for which there has never been compelling evidence,” they conclude.