February 2020 Studio News

As many of you know, I took a sabbatical this year to London. 

 

I had time to reflect on all that I have been learning in the past few years about how movement is life, and how I might share it with you.

 

While on my trip, I went to the Netherlands to visit old friends. In Amsterdam, my friend Annemarie picked me up at Central Station in her canal boat. This charming, historic city, built on rivers and canals, has become less boat-friendly over the years, with fewer places to dock and tie the boat up.  As such, we had to climb over the fence and jump in the boat with our luggage. 

 

At 70 years of age, statuesque and strong, Annemarie was quite agile in this process.

e6d92883-30fd-442c-bce2-7d9f9908c966 (1).jpeg

Annemarie

 

She told me this story: 2 years ago she moved from her 3rd story canal-house where she walked to her gym, biked everywhere, and carried her groceries up the stairs each day; to a modern apartment building with an elevator, a garage, and all the living area on one level.

 

Her old gym was 30 minutes away, and she did not like the new one nearby. She no longer carried her groceries up the stairs of her old canal house, and she no longer walked to take care of her daily needs. She drove everywhere because it was easy. Within 6 months she developed knee and hip issues and Annemarie had to go to a physiotherapist. It took her 2 years to regain her physical confidence, but it is clearly back now, as I watched her jump in and out of the boat. Motion is lotion, I believe, and here was a great example.

 

I am interested in discovering the best ways to develop strength, agility, balance, and flexibility for the ultimate goal of dynamic aging. Balance and agility prevent accidents; strength and flexibility provide a platform for engagement in life, activity which increases our energy and optimism. This, in turn, feeds the brain.

 

I spent the last 4 years studying with Katy Bowman, of Nutritious Movement. 

 

Her interesting engineer’s mind is fascinated by movement, how we can move more, and ways to move more of our parts in everyday life.

 

IMG_4613.jpeg

Sitting in Annemarie’s new apartment.

 

This work has sent me on quite a journey. It’s part of why I moved from Valencia street to 18th street, as I wanted a more flexible space where my discoveries could instantly be shared and taught to each of my patients with ample tools.

 

At home, it prompted me to move my daily meals to a low floor sitting space and to use a floor desk as well. I discovered that getting up and down off the floor while serving dinner (more pepper? forgot the napkin?) is like a free home gym!

 

I gave up my car three years ago, and I walk everywhere now. 

 

I found that carrying my groceries home 1.3 miles was a good version of “The Farmer’s Carry” we used to do at CrossFit!

 

I learned that a way to reduce a dowager’s hump was hanging from monkey bars, so I installed them at my office.

 

In this time, I have seen my patients get confident with getting up and down with more ease,  get up from a chair without the assistance of their arms (and some from the floor!), and be able to walk up and down hills/stairs without knee pain. 

 

Feeling quite renewed, I am excited to share my learning with you. 

 

Complementing my 30 years as a Chiropractor, with an emphasis on hands-on treatment, my 4 years of Nutritious Movement study with Katy Bowman, has resulted in my certification as a Restorative Exercise Teacher.  This important milestone marries certification in MovNat, my Gokhale Method (Alignment) credentials, and level one coaching experiences with Kelly Starrett in Cross fit.

 

I am still a hands-on Chiropractor using Active Release and many traditional Chiropractic tools, but my skills have grown to include understanding and teaching the power of Restorative Movement.

 

What does this mean for you?

 

I want you to:

 

  • Feel ease in moving without difficulty.

  • Get up and down from the floor.

  • Walk a mile carrying your groceries or your kid without pain.

  • Develop your own personalized tools to make your joints and muscles feel better.

  • Age dynamically with boldness and grace.

 

Classes at my Studio:

 

I am offering classes starting in February and I have a schedule of compelling offerings by guest teachers as well.




 

From the Ground Up:  Foot Classes

 

Tuesday, February 11th at 2:00 PM

 

Saturday, February 22nd at 3:00 PM

 

Your foundation! Working with the feet is a great base for new exploration, starting from the ground up.

 

This one hour class will help those with issues concerning:

  • Feet

  • Bunions

  • Hips

  • Knees

 

Hands and Upper Body Classes

 

Tuesday, February 25th at 2:00 PM

 

This one hour class will help those with issues concerning:

  • Hands

  • Forearms

  • Shoulders

  • Neck

 

Bring your achy mouse hands, tight forearms, stiff shoulders, and text necks to learn the tools to loosen them up.

 

Balance:  The key to Safe Travels

 

Sunday, March 8th at 2:00 PM

 

Safety, stability, confidence. This is a great class for everyone but especially for those who are balance-challenged or feel concerned about falling.

 

Dynamic Aging:  Life is a Banquet 

 

This will be a twice a week class for 4 weeks. A comprehensive overview of the full complement of techniques to achieve vigor and health while aging and is designed to improve balance, self-reliance, mobility, and strength.

 

Flexibility:  Kin-Stretch Workshop

 

Tuesday, February 18th at 6 PM

 

I am also excited that Nat Viranond will offer a Kinstretch workshop. This fantastic mobility method will teach you how to control your joint range of motion. It’s an exciting new mobility tool that you can use at home as a daily practice, but it's easier to learn in person!

 

Gokhale Class

 

Sunday, February 9th at 10:00 AM

 

Charlene Hannibal will be in, teaching a Gokhale refresher course. Please contact Charlene directly to register at charhannibal@gmail.com

 

Please sign up on my Mind-body page for class and/or treatment:

https://mindbody.io/locations/dr-barbara-berkeley-dc

I look forward to seeing you soon!

 

Warmly,

Dr. Barbara Berkeley, D.C.

everything your dentist told you about treating cavities is outdated and untrue;

'No-drill' dentistry stops tooth decay
Date:
December 6, 2015
Source:
University of Sydney
Summary:
A new study has revealed that tooth decay (dental caries) can be stopped, reversed, and prevented without the need for the traditional 'fill and drill' approach that has dominated dental care for decades. The seven year study found that the need for fillings was reduced by 30 to 50 per cent through preventative oral care.

'No Drill' dentistry stops tooth decay, or everything they told you about cavities isn't true

'No-drill' dentistry stops tooth decay
Date:
December 6, 2015
Source:
University of Sydney
Summary:
A new study has revealed that tooth decay (dental caries) can be stopped, reversed, and prevented without the need for the traditional 'fill and drill' approach that has dominated dental care for decades. The seven year study found that the need for fillings was reduced by 30 to 50 per cent through preventative oral care.

How PT Exercises Heal Injured and Arthritic Tissue; Mechanotherapy!

Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair
Open Access
K M Khan, A Scott
+ Author Affiliations

University of British Columbia, Vancouver, Canada
Professor K M Khan, Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia, Vancouver, Canada; karim.khan@ubc.ca
Accepted 26 January 2009
Published Online First 24 February 2009
Abstract
Mechanotransduction is the physiological process where cells sense and respond to mechanical loads. This paper reclaims the term “mechanotherapy” and presents the current scientific knowledge underpinning how load may be used therapeutically to stimulate tissue repair and remodelling in tendon, muscle, cartilage and bone.

The purpose of this short article is to answer a frequently asked question “How precisely does exercise promote tissue healing?” This is a fundamental question for clinicians who prescribe exercise for tendinopathies, muscle tears, non-inflammatory arthropathies and even controlled loading after fractures. High-quality randomised controlled trials and systematic reviews show that various forms of exercise or movement prescription benefit patients with a wide range of musculoskeletal problems.1–4 But what happens at the tissue level to promote repair and remodelling of tendon, muscle, articular cartilage and bone?

The one-word answer is “mechanotransduction”, but rather than finishing there and limiting this paper to 95 words, we provide a short illustrated introduction to this remarkable, ubiquitous, non-neural, physiological process. We also re-introduce the term “mechanotherapy” to distinguish therapeutics (exercise prescription specifically to treat injuries) from the homeostatic role of mechanotransduction. Strictly speaking, mechanotransduction maintains normal musculoskeletal structures in the absence of injury. After first outlining the process of mechanotransduction, we provide well-known clinical therapeutic examples of mechanotherapy–turning movement into tissue healing.

WHAT IS MECHANOTRANSDUCTION

Exercise IS ADHD medication;

Exercise Is ADHD Medication

Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.

JAMES HAMBLINSEP 29 2014, 6:05 AM ET

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Electrophysiological plots representing brain processing
capacity and mental workload (P3 amplitude) during
cognitive tasks that require executive control in children
in the experiment and control groups. Red represents
the greatest amplitude, and blue the lowest.
(Hillman et al, Pediatrics/The Atlantic)

Mental exercises to build (or rebuild) attention span have shown promise recently as adjuncts or alternatives to amphetamines in addressing symptoms common to Attention Deficit Hyperactivity Disorder (ADHD). Building cognitive control, to be better able to focus on just one thing, or single-task, might involve regular practice with a specialized video game thatreinforces "top-down" cognitive modulation, as was the case in a popular paper in Nature last year. Cool but still notional. More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.

This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, "demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health." If it seems odd that this is something that still needs support, that's because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class.

The improvements in this case came in executive control, which consists of inhibition (resisting distraction, maintaining focus), working memory, and cognitive flexibility (switching between tasks). The images above show the brain activity in the group of kids who did the program as opposed to the group that didn't. It's the kind of difference that's so dramatic it's a little unsettling. The study only lasted nine months, but when you're only seven years old, nine months is a long time to be sitting in class with a blue head.

It may potentially be advisable to consider possibly implementing more exercise opportunities for kids.

Earlier this month, another study found that a 12-week exercise program improved math and reading test scores in all kids, but especially in those with signs of ADHD. (Executive functioning is impaired in ADHD, and tied to performance in math and reading.) Lead researcher Alan Smith, chair of the department of kinesiology at Michigan State, went out on no limb at all in a press statement at the time, saying, "Early studies suggest that physical activity can have a positive effect on children who suffer from ADHD."

Last year a very similar study in the Journal of Attention Disorders found that just 26 minutes of daily physical activity for eight weeks significantly allayed ADHD symptoms in grade-school kids. The modest conclusion of the study was that "physical activity shows promise for addressing ADHD symptoms in young children." The researchers went on to write that this finding should be "carefully explored with further studies."

Hip Hinging Prevents Osteoporosis Fractures

From Kate Lindeman at http://www.osteopenia3.com

Let's think about why we are concerned about bone density. After all there should be a reason for our concern, for our making changes in our daily routines.

Fundamentally the whole thing is about preventing fractures. I do not know about you but I had fractured a wrist and then an ankle all before anyone thought of suggesting a dexa scan. (From what I have read that is not too uncommon...or at least it was not some 20 years ago.) .

I keep working for strong bones because I do not want to fracture a hip - often a prelude to death within a year. .

No, this is not scare tactics day. I have always tried to be realistic when dealing with life. And realistically having osteopenia or osteoporosis leaves me at greater risk for fracture if I fall. .

OK...that is the key. "If I fall...". So for me, my fist focus has always been preventing fractures . If I do not bend forward from the waist or if I do not fall, I am far less likely to fracture a bone....no matter what else I am doing/not doing about my bone density. .

So again I share a few things:

1. Bending from the hips, not the waist. Not the usual way most people (other than ballet dancers) bend. Try this today. Stand. Keep your back straight. Now bend forward without losing that straight back. How far did you get? Could you pick something off the floor from that position? Could you load a dishwasher, take stuff from a clothes dryer? If not, get a stool and use it for those tasks. NEVER CURVE YOUR BACK when you bend and you are less likely to suffer a 'crush fracture' to your spine. .

2. As soon as you finish reading this newsletter, go into the kitchen and sit in a straight chair. (If you are reading this at the office you may already be in a straight chair - but you want one WITHOUT wheels.)

Now cross your arms in front of your chest and get up from the chair. Able to do it? Good. Do this at least twice a day for the rest of your life and you will have leg strength to prevent falls. .

If you could not do it, start practicing. Do it every day - I often do it at the end of breakfast. In the beginning you may need to sit forward a bit...or rock forward as you rise. Keep the table or something in front of you so you can catch yourself if you being to tip. .

Keep at it. Soon you will be able to rise from anything WITHOUT USING YOUR HANDS. And being able to do this means you are much more likely to recover your balance 'if you tip a bit' and so are less likely to fall. No falls means less chance you will break a hip.

Gifts

If your children or friends read ads, they may be tempted to buy you a big chair with a lever on the side to help you get out of it. DO NOT LET THEM DO THIS. (Bring it up in a conversation now - explain how dangerous these are to older persons because they encourage weakness etc.

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If you really want to impress them (or yourself) reread the material on the web about the program in Japanese homes for the aged. Persons so debilitated that they were in wheel chairs all day were able to get out of those chairs...some began using walkers and some were able to even leave their walkers behind. Why? They began light exercise programs....lifting one pound weights...lifting legs...and eventually doing that with light weights around their ankles (Don't have ankle weights? Make one by adding dried beans to an old stocking and tie it around your ankles and lift while watching TV.)

Really so much is in our grasp

I do not know about you but I have never had a physician suggest that I practice getting up from a chair without using my hands.

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I have never had anyone suggest I make or buy a weight vest (By the way the company that makes hyper vest said they are having a sale this month - the link is here.

http://www.osteopenia3.com/Weight-vest.html

.

I have never had a physician show me how to bend from the hips and not round my back.

And then there is practicing balance - simple things - on the web site at http://www.osteopenia3.com/osteopenia-exercises.html

YOU can do these at home or any time you are standing in line..it helps if there is a shopping cart or wall nearby so you have something to grab if you begin to topple. (Yes!)

REMEMBER - THESE ARE FIRST STEPS to preventing fractures. Yes, there is medication and there are supplements - just as there is fire insurance for my home. But not playing with matches while reading my morning paper seems like a more basic step to prevent a house fire. Prevention is most important and for us, preventing falls should be #1.

Ending

OK. I am not usually so strong with recommendations.

. I hope this newsletter has charged you up to start or continue your fracture prevention steps. Even 5 minutes day can make all the difference. PLEASE PLEASE JUST DO IT.

love,

Kate

 

 

Probiotics may help women shed pounds

Featured Research

from universities, journals, and other organizations

Certain probiotics could help women lose weight, study finds

Date:

January 28, 2014

Source:

Université Laval

Summary:

Certain probiotics could help women lose weight and keep it off, according to a recent study. Studies have already demonstrated that the intestinal flora of obese individuals differs from that of thin people. That difference may be due to the fact that a diet high in fat and low in fiber promotes certain bacteria at the expense of others. Researchers tried to determine if the consumption of probiotics could help reset the balance of the intestinal microbiota in favor of bacteria that promote a healthy weight.

 

Certain probiotics could help women lose weight and keep it off, according to a recent study published in the British Journal of Nutrition by a team of researchers headed by Université Laval Professor Angelo Tremblay.

 

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Studies have already demonstrated that the intestinal flora of obese individuals differs from that of thin people. That difference may be due to the fact that a diet high in fat and low in fiber promotes certain bacteria at the expense of others. Professor Tremblay and his team tried to determine if the consumption of probiotics could help reset the balance of the intestinal microbiota in favor of bacteria that promote a healthy weight.

To test their hypothesis, researchers recruited 125 overweight men and women. The subjects underwent a 12-week weight-loss diet, followed by a 12-week period aimed at maintaining body weight. Throughout the entire study, half the participants swallowed 2 pills daily containing probiotics from the Lactobacillus rhamnosus family, while the other half received a placebo.

After the 12-week diet period, researchers observed an average weight loss of 4.4 kg in women in the probiotic group and 2.6 kg in the placebo group. However, no differences in weight loss were observed among males in the two groups. "We don't know why the probiotics didn't have any effect on men. It may be a question of dosage, or the study period may have been too short," says Professor Tremblay, who is also the Canada Research Chair in Environment and Energy Balance.

After the 12-week maintenance period, the weight of the women in the placebo group had remained stable but the probiotic group had continued to lose weight, for a total of 5.2 kg per person. In short, women consuming probiotics lost twice as much weight over the 24-week period of the study. Researchers also noted a drop in the appetite-regulating hormone leptin in this group, as well as a lower overall concentration of the intestinal bacteria related to obesity.

According to Angelo Tremblay, probiotics may act by altering the permeability of the intestinal wall. By keeping certain proinflammatory molecules from entering the bloodstream, they might help preventing the chain reaction that leads to glucose intolerance, type 2 diabetes, and obesity.

The Lactobacillus rhamnosus strain used in this study belongs to Nestlé, which uses it in certain yogurts it makes for the European market, but Professor Tremblay believes that the probiotics found in dairy products in North America could have a similar effect to the Nestlé strain. He stresses, however, that the benefits of these bacteria are more likely to be observed in a favorable nutritional context that promotes low fat and adequate fiber intake.

probiotics reduce incidence of colic

Original Investigation | January 13, 2014JOURNAL CLUB

Prophylactic Use of a Probiotic in the Prevention of Colic, Regurgitation, and Functional ConstipationA Randomized Clinical Trial FREE ONLINE FIRST

Flavia Indrio, MD1; Antonio Di Mauro, MD1; Giuseppe Riezzo, MD2; Elisa Civardi, MD3; Cristina Intini, MD4; Luigi Corvaglia, MD5; Elisa Ballardini, MD6; Massimo Bisceglia, MD7; Mauro Cinquetti, MD8; Emanuela Brazzoduro, MD9; Antonio Del Vecchio, MD10; Silvio Tafuri, MD, PhD11; Ruggiero Francavilla, MD, PhD1

[+] Author Affiliations

JAMA Pediatr. Published online January 13, 2014. doi:10.1001/jamapediatrics.2013.4367

Text Size: A A A

Article

Figures

Tables

References

Comments

ABSTRACT

ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSION | ARTICLE INFORMATION | REFERENCES

Importance  Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life and are often responsible for hospitalization, feeding changes, use of drugs, parental anxiety, and loss of parental working days with relevant social consequences.

Objective  To investigate whether oral supplementation with Lactobacillus reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns and thereby reduce the socioeconomic impact of these conditions.

Design  A prospective, multicenter, double-masked, placebo-controlled randomized clinical trial was performed on term newborns (age <1 week) born at 9 different neonatal units in Italy between September 1, 2010, and October 30, 2012.

Setting  Parents were asked to record in a structured diary the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days.

Participants  In total, 589 infants were randomly allocated to receive L reuteri DSM 17938 or placebo daily for 90 days.

Interventions  Prophylactic use of probiotic.

Main Outcomes and Measures  Reduction of daily crying time, regurgitation, and constipation during the first 3 months of life. Cost-benefit analysis of the probiotic supplementation.

Results  At 3 months of age, the mean duration of crying time (38 vs 71 minutes; P < .01), the mean number of regurgitations per day (2.9 vs 4.6; P < .01), and the mean number of evacuations per day (4.2 vs 3.6; P < .01) for the L reuteri DSM 17938 and placebo groups, respectively, were significantly different. The use of L reuteri DSM 17938 resulted in an estimated mean savings per patient of €88 (US $118.71) for the family and an additional €104 (US $140.30) for the community.

Conclusions and Relevance  Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition.

Trial Registration  clinicaltrials.gov Identifier: NCT01235884

20 minutes of yoga improve brain function

 

J Phys Act Health. 2013 May;10(4):488-95. Epub 2012 Jul 9.

The acute effects of yoga on executive function.

Gothe NPontifex MBHillman CMcAuley E.

Source

Dept of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL, USA.

Abstract

BACKGROUND:

Despite an increase in the prevalence of yoga exercise, research focusing on the relationship between yoga exercise and cognition is limited. The purpose of this study was to examine the effects of an acute yoga exercise session, relative to aerobic exercise, on cognitive performance.

METHODS:

A repeated measures design was employed where 30 female college-aged participants (Mean age = 20.07, SD = 1.95) completed 3 counterbalanced testing sessions: a yoga exercise session, an aerobic exercise session, and a baseline assessment. The flanker and n-back tasks were used to measure cognitive performance.

RESULTS:

Results showed that cognitive performance after the yoga exercise bout was significantly superior (ie, shorter reaction times, increased accuracy) as compared with the aerobic and baseline conditions for both inhibition and working memory tasks. The aerobic and baseline performance was not significantly different, contradicting some of the previous findings in the acute aerobic exercise and cognition literature.

CONCLUSION:

These findings are discussed relative to the need to explore the effects of other nontraditional modes of exercise such as yoga on cognition and the importance of time elapsed between the cessation of the exercise bout and the initiation of cognitive assessments in improving task performance.

PMID:

 

22820158

 

Vitamin D slows MS progression

MS: Slow Progression With Vitamin D?
Published: Jan 20, 2014 | Updated: Jan 21, 2014

By John Gever, Deputy Managing Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
save|AA

Action Points
Patients with relatively high vitamin D levels in the year after a first multiple sclerosis-like attack showed, over the next 4 years, markedly lower levels of MS disease activity and disability progression than those with lower levels.
Note that the study does not prove that vitamin D levels were directly causative of the clinical and MRI results, or that patients would benefit from vitamin D supplements.
Patients with relatively high vitamin D levels in the year after a first multiple sclerosis-like attack showed, over the next 4 years, markedly lower levels of MS disease activity and disability progression than those with lower levels, researchers found.

Each 20 ng/mL increment in serum levels of 25-hydroxyvitamin D (25-OH-D), the active metabolite of vitamin D, averaged during the first 12 months of participation in a clinical trial of interferon-beta (Betaseron) was associated with nearly 60% lower rates of new MRI lesions and clinical relapses (both P<0.05) during subsequent follow-up relative to those with smaller or no increases in 25-OH-D levels, according to Alberto Ascherio, MD, DrPH, of Harvard School of Public Health, and colleagues.

Higher 25-OH-D levels shortly after the initial clinical attack were also associated with significantly smaller T2 lesion volumes later on, and there was a trend toward less brain atrophy as well, the researchers reported online in JAMA Neurology. Disability as measured by the Expanded Disability Status Score (EDSS) was lower in those with high 25-OH-D levels at the trial's 5-year mark as well (mean difference 0.17 points, P=0.004).

Ascherio and colleagues noted that treatment assignments in the randomized immediate-versus-delayed therapy trial were not associated with 25-OH-D levels -- in other words, 25-OH-D was not simply a marker of interferon-beta response.

Some of the results had been presented last year at the European Committee for Treatment and Research in Multiple Sclerosis meeting.

Lawrence Steinman, MD, of Stanford University in Palo Alto, Calif., who was not involved in the study, told MedPage Today that it was of "great importance" and that it supported a causal relation between higher vitamin D levels and reduced MS disease activity.

"Epidemiologists are notoriously reluctant to give a 'cause and effect' conclusion, but a reasonable experimentalist could attribute a cause and effect relationship," Steinman said in an email.

"Simply stated, I am willing to support that if your vitamin D levels are high, early on in MS, your disease activity will be reduced. The cause and effect association is based on the known immune suppressive properties of vitamin D on the major pro-inflammatory pathways."

In particular, he said, vitamin D regulates expression of interleukin-17, "one of the key mediators of MS."

The double-blind trial, called BENEFIT, was conducted in the early 2000s to test the effects of interferon-beta on patients' progression from clinically isolated syndrome to clinically definite MS. Participants who had had a single MS-like attack were randomized 5:3 to either interferon-beta or placebo 2 years, followed by open-label treatment with interferon-beta for all participants choosing to continue.

As part of the study, blood samples were collected at baseline and at 6, 12, and 24 months into the study. Patients were followed for 5 years after study entry with brain MRI scans and clinical exams.

A total of 465 patients (out of 468 enrolled) had at least one measurement of 25-OH-D, including 417 with two or more and 303 with analyzable samples from all four collections. Ascherio and colleagues restricted some analyses to participants with 25-OH-D measurements at the 6-month as well as baseline time points, which would provide a check on seasonal variations in vitamin D levels (which are affected by sun exposure).

During the 5 years of follow-up, about 80% of patients converted to definite MS by the relatively expansive 2001 McDonald criteria, and 47% converted according to more rigorous standards set by Poser et al.

Just over half of patients had "low" 25-OH-D levels, defined as an average of the three first-year measurements below 20 ng/mL. Patients with average first-year levels of 20 ng/mL or higher were classed as "high."

By year five, the following were seen in the "low" versus "high" groups, after adjusting for age, sex, treatment assignment, follow-up duration, and baseline T2 lesion volume:

Mean cumulative new active MRI lesions: 12.5 low versus 8.5 high (P=0.002)
Mean percent increase in T2 lesion volume: 93% low versus 22% high (P=0.008)
Mean percent decrease in brain volume: 2.4% low versus 1.8% high (P=0.005)
For each 20-ng/mL increment in first-year 25-OH-D levels, adjusted relative risks from study month 12 to the 5-year evaluation were as follows:

New active lesions: 0.43 (95% CI 0.26-0.70)
Clinical relapse: 0.43 (95% CI 0.20-0.92)
Ascherio and colleagues also found that each 20 ng/mL increment in the first-year average of 25-OH-D predicted a 25% smaller T2 lesion volume (95% CI 14%-34%).

There was a trend toward lower EDSS score with each 20-ng/mL increment in 25-OH-D (-0.18 points per increment, P=0.19), but first-year averages classed as "high" were significantly associated with lower scores relative to the group classed as "low," the researchers found.

They stopped short of concluding that vitamin D levels were directly causative of the clinical and MRI results, or that patients would benefit from vitamin D supplements. They did, however, venture to say that "low vitamin D was not a consequence of the disease process but rather its predictor."

Steinman told MedPage Today that "there are always alternative explanations" in studies of this type. Still, he suggested that the results probably do indicate some type of causation and perhaps even a result of vitamin D supplementation.

"I might wonder if these data might explain the progressive decrease in relapse rate in the placebo arm of clinical trials of MS over the past decade. Maybe more and more individuals are aware of vitamin D, and that they are taking vitamin D supplements, thus lowering the relapse rate in placebo arms of trials."

Small randomized trials of supplements have been conducted in MS patients with mostly negative results. Nevertheless, Steinman said he recommends them to his patients and to healthy people as well.

aerobic exercise improves 'executive function'

 

WATCH more videos

 

Over the course of the season, we’ll roll out dozens of new videos each month. See a sampling on the “Secret Life” homepage.

The Science of Smart: “A Surprising Way To Improve Executive Function”

Posted by Annie Murphy Paul | 13 March 2013

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Chances are you’ve recently heard or read about the importance of “executive function”—the set of higher-order mental skills that allow us to plan and organize, make considered decisions, manage our time and focus our attention. (The famous “marshmallow experiment” was all about executive function.) No matter how smart or talented we—or our kids or our employees—are, not much will get done well without these key capacities.Aerobic exercise can grease the wheels of executive brain function.

The problem is that researchers don’t yet know much about how to strengthen executive functioning. A review from cognitive scientist Daniel Willingham reports that certain parental behaviors—”meaningful praise, affection, sensitivity to the child’s needs, and encouragement,” along with intellectual stimulation, support for autonomy, and well-structured and consistent rules—can help kids develop robust executive function skills over the long run. Shorter-term interventions, such as the school-based program Tools of the Mind, have shown mixed or disappointing results, and computerized “brain training” exercises have generally failed to show that improvements in executive function produced by such exercises transfer to real-life tasks.

There is one surprising but well-supported way to improve executive function in both children and adults, however: aerobic exercise. A just-published review of the relevant research, appearing in the journal Psychonomic Bulletin and Review, concludes that “ample evidence indicates that regular engagement in aerobic exercise can provide a simple means for healthy people to optimize a range of executive functions.” Drawing on that article, here are some of the benefits of exercise for executive function, as found in three different populations:

School-aged children. Studies of kids have found that regular aerobic exercise can expand their working memory—the capacity that allows us to mentally manipulate facts and ideas to solve problems—as well as improve their selective attention and their ability to inhibit disruptive impulses. Regular exercise and overall physical fitness have been linked to academic achievement, as well as to success on specific tasks like safely crossing a busy street while talking on a cell phone (note to concerned readers: the street in the experiment was virtual).

Young adults. Executive functioning reaches its peak levels in young adults, and yet it can be improved still further with aerobic exercise. Studies on young adults find that those who exercise regularly post quicker reaction times, give more accurate responses, and are more effective at detecting errors when they engage in fast-paced tasks in the lab.

Older adults. Research on older adults has found that regular aerobic exercise can boost the executive functions that typically deteriorate with age, including the ability to pay focused attention, to switch among tasks, and to hold multiple items in working memory. One such study assigned older adults to three one-hour sessions of exercise a week for six months, scanning participants’ brains before and after the six-month period; the scans showed “significant increases in gray and white matter volumes” in areas of the brain associated with executive control. (A group of older adults who engaged in strength and flexibility training for the same six months showed no such brain growth.) Abstracts of all the studies cited are available here.

(Want to read past issues of The Brilliant Report? You’ll find them here.

head forward posture leads to disabilty in seniors

this study shows that as the forwad angle of the head increase, the need for care increases. In other words, your stooped over posture means someone else will need to help you wipe your butt,dress yourself,and get in and out of a chair.

Is there a bigger motivator than this to improve your posture now?

Web address:
     http://www.sciencedaily.com/releases/2013/04/
     130408184724.htm

Posture Provides Clue for Future Disability

Apr. 8, 2013 — The shape of an individual's spinal column may predict his or her risk for nursing home admission or need of home assistance in old age, according to a new article published online in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences.

A team of researchers based in Japan discovered that the trunk angle of inclination -- the angle between the true vertical and a straight line from the first thoracic vertebra to the first sacral vertebra (view image) -- is associated with becoming dependent on help for activities of daily living (ADL). These activities include such basic self-care tasks as bathing, feeding, toileting, maintaining continence, dressing, and transferring in or out of a bed or chair.

"Spinal posture changes with age, but accumulated evidence shows that good spinal posture is important in allowed the aged to maintain independent lives," the authors state.

The research team's data were sourced from 804 participants in the Kurabuchi Study, a community-based prospective cohort study of residents aged 65 years or older in Kurabuchi Town, approximately 62 miles (100 kilometers) north of Tokyo.

The test subjects' spinal posture was measured with a spinal mouse, which is a computer-assisted noninvasive device for measuring spinal shape. The device is guided along the midline of the spine, starting at the spinous process and finishing at the top of the anal crease.

Of the four spinal measurements taken by the device, only trunk angle of inclination was associated with future dependence in ADL -- defined by the researchers as either admission to a nursing home or need of home assistance after a 4.5 year follow-up period. At that time, 15.7 percent became dependent in ADL, 7.6 percent died, and 0.7 percent moved out of the town. The group was 58 percent female.

The subjects in the highest quartiles, who had the greatest angle of spinal inclination, were 3.47 times more likely to become dependent in ADL than those in the lowest quartiles (the group with the least spinal inclination), even after adjusting covariates such as age, sex, back pain, and stiffness.

The authors' research was supported by a grant in aid from the Japanese Ministry of Health, Labor, and Welfare. The article in which their work appeared is titled "Spinal Posture in the Sagittal Plane Is Associated with Future Dependence in Activities of Daily Living: A Community-Based Cohort Study of Older Adults in Japan."