Mindfulness Meditation May Reduce Low Back Pain

Posted by & filed under QV Medical Blog.

Mindfulness Meditation

 

People with chronic low back pain may benefit from meditating, a new study finds. The practice may reduce pain and make it easier for patients to carry out their daily activities, according to the findings.

In the study, a group of people with chronic low back pain participated in an eight-week program called mindfulness-based stress reduction, which involved using meditation to increase their awareness of the present moment, and their acceptance of difficult thoughts and feelings, including their pain.

 

What was discovered

About six months after the start of the study, the people who participated in the meditation program were more likely to experience at least a 30 percent improvement in their ability to carry out daily activities, compared with the people who received only standard treatments for low back pain, such as medication.

Those in the mindfulness meditation group were also more likely to report meaningful improvements in how much their back pain bothered them, compared with those in the standard treatment group, the study found. The findings remained similar a year after the start of the study.

The study suggests that mindfulness-based stress reduction (MBSR) “may be an effective treatment option for patients with chronic low back pain,” the researchers said. [7 Reasons You Should Meditate]

“We are excited about these results, because chronic low back pain is such a common problem and can be disabling and difficult to treat,” said study leader Daniel Cherkin, a senior investigator at Group Health Research Institute, a nonprofit health care organization in Seattle.

 

How the study was conducted

The new study involved 342 adults ages 20 to 70 who had low back pain that wasn’t attributable to another condition. On average, participants had experienced moderate back pain (rated as 6 out of 10 on a pain scale) for seven years, and said they had pain most days. About three-quarters of participants said they had used pain medication at least once in the past week to treat their back pain.

The researchers randomly assigned participants to one of three groups: One group received MBSR in addition to their usual treatment; another received cognitive behavioral therapy (or CBT, a type of talk therapy that is already recommended for people with low back pain) in addition to their usual treatment; and the third group that received only their usual treatment.

The participants answered questions about how their back pain limited their everyday activities (such as whether it prevented them from going to work, or standing for long periods of time), and how much their back pain bothered them.

After 26 weeks (18 weeks after the MBSR and CBT treatments had finished), about 60 percent of participants in both the MBSR group and the CBT group had experienced meaningful improvements on the survey of everyday activities, compared with just 44 percent in the usual care group. In addition, about 44 percent of participants in the MBSR group and the CBT group experienced meaningful improvements in their bothersomeness ratings, compared with just 27 percent in the usual-care group.

 

Conclusions

The results support those of previous studies, and Study leader Daniel Cherkin says, “I believe that there is (now) enough evidence…to say that MBSR is a reasonable treatment option,” Cherkin told Live Science. “It is relatively safe and may improve people’s life beyond just back pain,” Cherkin said.

The new findings “create a compelling argument for ensuring that an evidence-based health care system should provide access to affordable mind-body therapies,” says Dr. Madhav Goyal of Johns Hopkins University School of Medicine, writing about the wider implications of the findings in an editorial accompanying the study.  The results “indicate a considerable number of patients experienced clinically important relief of pain and disability.”

However, Cherkin noted that like all treatments for back pain, MBSR may not work for everyone. And more research is needed to see how long the effects last.

Original article on Live Science.

 

CSIRO diet turns diabetes management on its head

Posted by & filed under QV Medical Blog.

 

low carb diet

 

CSIRO researchers have developed a diet and exercise program to manage type 2 diabetes which they say reduces the need for medication by 40%.

The diet is based on findings from a recent NHMRC-funded study that effectively turns traditional thinking about diabetes management on its head. They have published a study that shows a very-low-carbohydrate diet coupled with high-unsaturated fat intake is the best bet for managing type 2 diabetes. This is in stark contrast to conventional thinking that such diets tend to elevate LDL cholesterol, a primary CVD risk target.

Published in the American Journal of Clinical Nutrition, the controversial study compares the effects of a very-low-carbohydrate diet with a high-carbohydrate, low fat diet on glycaemic control and cardiovascular disease risk factors.

While both diets achieved substantial weight loss and reduced HbA1c and fasting glucose after a year, the low-carb diet achieved greater improvements in the lipid profile, blood glucose stability and reductions in diabetes medication requirements.

“Compared with the high-carb diet, the low-carb diet achieved greater reductions in diabetes medications and enhanced improvements in diurnal blood glucose stability and the lipid profile,” write the CSIRO researchers led by Associate Professor Grant Brinkworth.

Dr Brinkworth describes the results as “groundbreaking”. And he says the ensuing CSIRO diet and exercise program have been life-changing” for many people. “Health professionals have been divided over the best dietary approach for managing type 2 diabetes and the ongoing uncertainty is a hotly debated topic among clinicians and researchers,” he says.

“The most amazing benefit of the low carbohydrate diet was the reduction in the patient’s medication levels, which was more than double the amount than the volunteers following the lifestyle program with the high-carbohydrate diet plan.”

The research suggests traditional dietary approaches for managing type 2 diabetes are outdated, Dr Brinkworth says. “We really need to review the current dietary guidelines if we are serious about using the latest scientific evidence to reduce the impact of the disease.”

 

Full results in journal article from The American Journal of Clinical Nutrition

Original article from Endocrinology

Women visit their GP more than men. Here’s why.

Posted by & filed under QV Medical Blog.

Doctor and female patient talking

 

Women go to the doctor more often than men, particularly in their reproductive years, between the ages of 15 and 44. This difference is partly due to management of gynaecological and reproductive issues.  Because of the frequency of visits, and the sensitive nature of many of these, it’s important a woman has a good relationship with her general practitioner.

 

Why women go to the doctor

In a recent study, we found about 12% of problems managed for women of all ages in primary care concerned their reproductive or genital system.

Australian women visited a GP on average nearly seven times a year in 2013-14. For men, this figure was just under five times. Among those between 15 and 24, 83% of women – but only 68% of men – saw a GP at least once in any given year.  The frequency and type of these problems varied across age groups.

Throughout their lives, women experience different health issues. For instance, about 20% of women of childbearing age experience heavy bleeding during menstruation, and 15% have chronic pelvic pain. These numbers drop in older age groups.

Our study showed in the decade between 2004 and 2014, female-specific problems accounted for a quarter of all problems managed by GPs for women in childbearing years. This fell to only 10% of problems managed for those between 45 and 64 years, and 3% for those 65 and over.

Across all adult age groups, gynaecological check-ups involving pap smears were common. Other female-specific problems managed by GPs aligned with the life stages: pregnancy and contraception in younger women, menstrual problems and menopause in the middle and older age groups.

We found the most common problem managed overall for women between the ages of 15 and 64 was depression.

The most commonly prescribed medications were contraceptives and antidepressants.

Across all age groups, women were more likely to have depression than men and this was reflected in higher management by GPs.

For women 65 years and over, depression dropped down the list of problems, overtaken by a number of physical conditions. Pelvic floor disorders, such as urinary and faecal incontinence, affect about 50% of women aged 80 and older.

There are various theories about why women have higher depression rates. Environmental and biological influences, such as hormones, have been implicated, but studies on this aren’t conclusive.

 

Relationship with a GP

Some women feel embarrassed talking about female-specific issues, even with a health professional. One study showed only 32% of women aged 45 and over who had urinary incontinence actually mentioned this to their GP.

This is why having a regular GP is important. Studies show continuity of care in primary care is associated with better health outcomes.

Reassuringly, our study found women between 25 and 44 were more likely to attend a regular practice than men in the same age group. Across all age groups, more than 90% of women said they had a regular GP practice.

This is likely because they need repeated cervical cancer screening (pap smears) and contraceptive prescriptions, and management of chronic diseases in later years.

We hope future changes to cervical cancer screening (to replace two-yearly Pap smears with a five-yearly HPV test) and the push towards long-term contraception, despite their benefits, will not affect the relationship between women and their GP.

 

This article was originally published on The Conversation. Read the original article.

Research confirms two new key health risk factors

Posted by & filed under QV Medical Blog.

Man sitting at desk
While smoking and alcohol have long been recognised as king and queen of the ‘deadly lifestyle habits’ list, research has recently confirmed two more additional culprits.

According to a recent study published in PLOS Medicine, prolonged sitting and unhealthy sleeping patterns now feature in the top six risk factors associated with premature death in older Australians, alongside tobacco, alcohol, poor diet and physical inactivity.  And as many as one-quarter of Australians are considered ‘at risk’ when it comes to sedentary behaviour (sitting for longer than 7 hours per day).

Where many may have previously assumed that a couple hours on the tennis court per week could absolve you from the risks of long hours spent sitting at a desk or on the couch, the recent study in PLOS medicine appears to dispel that belief.  It suggests adequate threshold levels physical activity alone are not enough to ensure low risk – it’s about considering a person’s overall patterns (hours spent sitting vs. standing / activity vs. inactivity).

Could you benefit from sitting less?  In office environments many are turning to standing desks and adjustable workstations.  There’s also some anecdotal evidence that suggests standing desks increase productivity.

standing desk

 

Activity-based risk categories

You are considered ‘at risk’ if you;

  • Sleeping patterns = are getting less than 7 hours or more than 9 hours per night
  • Physical activity = are getting less than 150 mins (2.5 hours) of moderate-vigorous activity per week
  • Sedentary behaviour = are sitting for more than 7 hours per day

Ticking one of these boxes, while not ideal, isn’t necessarily panic stations in itself.  A key take-away from the research seems to be that risk factors are most detrimental when experienced in groups.  The evidence shows combinations involving physical inactivity, prolonged sitting, and/or long sleep duration; and combinations involving smoking and high alcohol (more than 14 drinks per week) are the most strongly associated with all-cause mortality.

Researchers estimate in examining the data that one-third of the person-years lost due to death could have been avoided if all the 230,000 people had had a risk score of zero.

View the full study in PLOS Medicine.

 

Gluten and Coeliac Disease: A quick introduction

Posted by & filed under QV Medical Blog.

Lady feeding bread to birds

 

Going gluten-free is almost a byword for alternative health food choices these days – we can thank the likes of Miley Cyrus and mainstream mass media for the glorification of the gluten free diet to ‘fad’ status. But for those with Coeliac disease, avoiding gluten-containing foods is not just a lifestyle option; it’s the only way to steer clear of a potentially wide range of debilitating medical conditions.

So, what is gluten? It’s the protein found in the endosperm of seeds surrounding the fertilised embryo. Or, ahem… for those preferring a less confronting description; it’s a ‘protein composite’ found in wheat, barley, rye (and to a lesser extent in related grains such as kamut, spelt and oats).

Gluten comes from Latin, meaning ‘glue’, and it provides dough with its elastic consistency. It is one of the most complex proteins consumed by humans, making it somewhat difficult for the body to absorb. Not everyone has a problem with it however, and reactions to gluten are very much individual. Some will have no problem scoffing a couple large pizzas by themselves (although we don’t advise that), and for others, a single crouton is enough to put them in the foetal position.

Those who have trouble digesting gluten may be described as having a gluten sensitivity or intolerance, but this is not to be confused with genuine Coeliac disease, which affects around 1% of the population. Coeliac disease is an auto-immune condition in which the body’s immune system attacks the hair-like villi that line the wall of the intestines, and effects can be quite uncomfortable.

Villi are responsible for the absorption of nutrients into the bloodstream, and damage to them restricts the ability of essential nutrients and vitamins to be utilised by the body. Immediate physical symptoms may include bloating, nausea, diarrhoea, abdominal pain, and fatigue; however if left untreated, Coeliacs may face more serious consequences in the longer-term.

The only treatment for Coeliac disease is to follow a life-long gluten-free diet. Avoiding gluten means more than giving up traditional breads, cereals, pasta, pizza, and beer. Gluten also lurks in many other products, including soy sauce, some foods made with “natural flavourings,” some vitamin and mineral supplements, and is used as a thickening agent in some curries and sauces. This makes dietary-diligence a top priority for Coeliacs.

In years gone by, being a Coeliac could be hard work. Asking a waiter about gluten free options was akin to asking them whether shellfish have feelings, or to succinctly explain quantum physics. It would undoubtedly catch them completely off-guard, and typically be followed by a long blank stare. One might spend the next five minutes explaining themselves, and anxiously waiting as they went to ask the head chef – hoping, praying, that they understood you.

Luckily, following a gluten free diet is much easier than it used to be. Awareness and labelling standards have come a long way, and options are plentiful. Most menus are clearly marked, and there’s virtually a smorgasbord of choices – even gluten-free breads, cakes and pastas. They can taste darn good, too. Food manufacturers are increasingly finding and new and innovative ways to substitute gluten without sacrificing flavour and texture.

If you think gluten is an issue for you, it’s best to visit your GP. There are fairly straightforward tests available these days, administrable by your doctor, which can determine whether or not you have Coeliac disease. If you find that you are part of the 1%, a gluten free life will certainly be an adjustment, but it’s not all bad news. There are a multitude of products, resources and support-structures out there to help you make the switch, and make informed choices about your diet.

For more information, pay a visit to Coeliac Australia.  Think you may have coeliac disease? Take this quiz.

Preventable cancers: Avoiding the 6 biggest risk factors

Posted by & filed under QV Medical Blog.

Excessive red meat - one of the biggest risk factors for cancers in the Australian population

 

AT LEAST one-third of cancers in Australia – 37,000 cases annually, are preventable.

A recent study published in the Australian and New Zealand Journal of public health helps isolate behaviours most likely to have an impact on our cancer risk.  And some may surprise you.

Smoking, UV radiation, body weight, alcohol consumption, red and processed meats, and not getting enough fresh fruit and vegetables are the top correlated factors, accounting for around 90% of preventable cancers in Australia, according to the study.

Unsurprisingly, tobacco tops the list. But what may be news to many (including GPs) is the range of cancers correlated to tobacco smoke. The link between lung, mouth and throat cancers has been well established. The effects of cigarettes are far reaching however, with data indicating substantial rates of cancers of the stomach, liver and pancreas attributed to tobacco smoke.

Somewhat more surprising however, and one cancer exposure factor that often flies under the radar, is the consumption of red and processed meats. Excessive consumption of red meat was likely causal for 16% of colon cancers and 23% of rectal cancers, say the authors of the study.

“We tend to have [meat] two or three times a day – which is probably not necessary,” says Cancer Council CEO, Professor Sanchia Aranda. “I think we’ve been sold a line about needing more protein in our diet and meat being the easiest source to get that.”

“When we buy a steak at the butcher it is probably at least two, if not three, times the size that we actually need to have at a sitting,” says Professor Aranda.  “So the recommendation would be about 100g three times a week. It’s about having your plate with just a small amount of meat on it and more vegetables – particularly green leafy ones.”

Without ruining the enjoyment of the odd steak here and there, but it would seem obvious to consider BBQ culture in Australia as a contributing factor. Australians are some of the biggest consumers of meat in the world, consuming around 111kg of meat per person (approx. 43kg chicken, 33kg beef, 25kg pork, 9kg lamb) – second only to the USA.

Other diet factors included acknowledged in the study include some better known ones such as getting enough fruit, vegetables and fibre in our diets – all of which increase our body’s ability to fight back against cancer cells.

“People are confused about fad diets and mixed health messages, but the evidence is clear that a diet rich in vegetables, fruit and whole grains, with other foods consumed in moderation, will cut your ­cancer risk,” says Professor Aranda.  “Now we can back that advice with data on cancer case numbers, to emphasise why we urge people to adopt a cancer-smart lifestyle.”

Skin cancers are another very important one in Australia’s arid, UV-exposed climate. One way to reduce your risk is to download the free Sunsmart app – this smartphone application shows you when the UV rays are at dangerous levels, and when you should slip, slop, slap.

Don’t underestimate your ability to limit your cancer risk.  For a holistic, personalised cancer risk assessment, check out the FREE Cancer Council Australia quiz.