No Time To Exercise
by Terry Grossman, M.D.

A recent study out of Heriot-Watt University in Edinburgh, Scotland showed that young men who exercised just four minutes a week had significantly lower levels of insulin.

After two weeks of this minimal amount of exercise, the researchers found a 23 percent improvement in how effectively their study subjects’ insulin cleared glucose (sugar) from their bloodstream. The positive benefits were found to last for 10 days after their last exercise session.

The United States currently spends over $2.5 trillion or more than $8000 per person each year on healthcare. Previous studies have found that poor eating habits and physical inactivity account for a significant portion of these expenses.

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Health Tourism
by Lolita Hanks, FNP-C

Health Tourism

Healthcare tourism describes the rapidly growing process of obtaining dental/medical (and cosmetic) procedures internationally – typically, in countries like Brazil, India, Cuba or the Philippines. The advantage is reduced costs for the patient. One site that assists travelers in seeking medical services abroad boasts that in India heart surgery costs only $8,000.00 versus $60,000.00 in the United States. The traveler is assured on various different global health tourism sites that the quality of care is quite good and on par with U.S. standards.

An article in the British medical journal, The Lancet, purported that international medical trade is big business. The researchers found that there was an abundance of opportunities that included efficiency, specialization as well as public sector cost savings. Healthcare is also being provided remotely via the telephone and/or teleconsulation. Foreign investors are putting their money in this market on an increasing scale as well. The researchers estimated that the global market for these services is $1 trillion annually.

People who utilize these services must pay in cash, as insurance typically does not reimburse for out-of-the-U.S. expenses. The authors expressed concern related to follow up, medical liability, privacy concerns and medical credentials. Interestingly, quality of care was not a problem in these other countries at the significantly reduced reimbursement rate. Despite the large amount of money spent in the U.S. on healthcare, the U.S. is ranked 15th globally by the World Health Organization; American life expectancy ranks 22nd in the world, and infant mortality ranks 39th. Food for thought….

Antioxidants for Chronic Pancreatitis
by Lolita Hanks, FNP-C

In New Delhi, India, a study was conducted on patients suffering from painful, chronic pancreatitis. The All India Institute of Medical Sciences reports that after 6 months, patients treated with antioxidants had significantly less pain than their placebo-treated counterparts. Missed work days, markers of oxidative stress and antioxidant serum status were also evaluated. The antioxidants consisted of daily doses of selenium, vitamins C and E (only alpha-tocopherol) and methionine, an amino acid. Those treated with the antioxidants reported a reduction in the number of days with pain was two times higher than the placebo group. Lost workdays were reduced by almost half: 1.5 days for those treated vs. 3.1 days for the untreated group. And one third of the antioxidant group reported being pain free in six months with only one in eight of the placebo group experiencing relief. Blood markers for inflammation were reduced as well.

Chronic pancreatitis can causes injury due to free radicals and chronic inflammation. Many alcoholics will suffer from pancreatitis but, for others the cause is unknown. Antioxidants are known for their role against inflammation and this study suggests this may be how antioxidants work in reducing symptoms of pancreatitis.

Inflammation can be the cause for pain and/or chronic disease in other tissues as well. Inflammation can be caused by direct trauma to the body’s tissues, toxicity, obesity, advancing age and/or nutrient deficiencies. Poor dietary and/or consumption habits can lead to inflammation as well, for example, smoking, excessive alcohol and/or caffeine intake and a diet high in sugar and processed foods.

Things that you can do to reduce inflammation include having a very limited or no sugar diet (less soda pop for sure!), increase your vegetable intake (especially green veggies), avoid alcohol, coffee, smoking, processed foods, and/or greasy, fried foods and food containing or cooked in trans fats.

Bhardwaj P (2009) A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology 136:149-159.

Motivation Key to Exercise Success
by Diane Henry, Fitness Director

There are millions of excuses not to exercise. Too busy, too tired, too bored, yet none of these are valid reasons. If you think you are alone, think again. You’re actually part of the growing majority of Americans who have crossed exercise off their “To do list.” In fact, more than 60% of American adults are not regularly active and 25% aren’t active at all according to the Surgeon General’s report on Physical Activity and Health.

Exercise is a great way to lose weight and stay healthy, but all those benefits won’t matter if you’re not getting your exercise done. The most important part of exercising is sticking with your program. We all know how easy it is to put off exercise, especially if you have a busy life, but here are five ways to keep yourself motivated:

1. Track Your Progress – Make a wall chart and track how many calories you’ve burned by walking, jogging, running or any other activity you participate in. (see link below) Keep track of how many calories you’ve eaten and how many calories you’ve burned. At the end of the month, see how often you have stuck to your plan. You’ll be motivated to keep going.

2. Reward Yourself - Once you’ve reached a milestone on your chart, reward yourself with a non food reward. Treat yourself to some new music to exercise to. Treat yourself to new exercise clothes or a new pair of exercise shoes. Enjoy a movie. If you reward yourself with something that matters to you, you will make the effort to work out more.

3. Give Yourself a Break - If you have missed a day due to illness, or busy schedule, don’t beat yourself up about it. Punishing yourself each time you make a mistake with your exercise program has no benefit and eventually you may end up getting rid of your program entirely. Just plan to make up for a missing session on another day.

4. Mix Up Your Exercise Routine - One of the main reasons people stop exercising is out of boredom. Even your favorite work out can get boring after a while. You need to have variety to keep you interested and working out. Change up your workout often. One day do weight training, one day aerobics, ball training, swimming… you get the idea. There are also many benefits to this besides staying motivated. Over time, your body gets used to the same repetitive movements and figures out ways to make the exercise easier. By introducing different types of movement, you’ll keep your body guessing and get more from your work out.

5. Workout with Friends or Family - Exercise for some is a lot more enjoyable when you do it as a group. The best way to stay motivated is to work out with someone. You can motivate each other to keep going and it’s not as easy to miss your work out when someone is holding you accountable.

Excuses provide an easy way to avoid exercising. The faster you work towards eliminating those excuses, the closer you will be to living a healthier, more active life. Eventually exercise won’t be a chore, it will be the reward your body’s been craving.

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Chronic Fatigue Sufferers More Likely to Have Suffered Childhood Abuse
by Lolita Hanks, FNP-C

A study done in Atlanta, Georgia demonstrated that people plagued with chronic fatigue syndrome (CFS) as adults were more likely to have history of child abuse and/or neglect than the control group. Those who had suffered from emotional neglect were 3.5% more likely to have CFS as an adult. According to Medpage Today article online January 5, 2008, ”Childhood trauma was also associated with decreased salivary cortisol concentrations after awakening compared with controls, indicating neuroendocrine dysfunction, which is a feature of chronic fatigue.”

Women tend to have CFS disproportionably to men. For every 100,000 people, 373 women are diagnosed with CFS but only 83 men. Women also tend to handle stress differently from men. They tend to be more vocal while men keep stress to themselves. Men who suffer from CFS have similar cortisol levels as men who do not have CFS.

The fight or flight response may be to blame. The response is useful when we are in a life endangering situation but, in the case of chronic stress, especially from a young age (an environment that an abused child would living in) it results in dysfunction of the hypothalamic-pituitary-adrenal axis. When we are stressed or scared, our body releases the hormones, cortisol and epinephrine, which result in an increase in blood pressure, heart rate and blood sugar. When this occurs over a prolonged time period, the body is unable to respond to stressful events as cortisol is depleted. Many people with CFS will also have a peak in cortisol at night which can cause insomnia, exacerbating their fatigue.

The hormone oxytocin is released from the pituitary gland during sexual encounters and in response to stress, and in women during labor and during breastfeeding.. Oxytocin encourages people to bond to their mate and their children. It may also reduce feelings of anxiety. Oxytocin is released during other situations such as interacting with a pet. One study showed that women had a significantly higher release of oxytocin than men in response to petting their dogs. When under stress, oxytocin can reduce the release of cortisol, this may be why women have lower cortisol levels than men, when both have the same chronic illness.