All Posts tagged chronic

Fructose Intolerance

Researchers have a new theory on why some kids get unexplained tummy aches.

In some people, the small intestine is unable to efficiently break down fructose (and sometimes other forms of sugar). This problem is sometimes referred to as fructose intolerance. The undigested fructose passes into the large intestine, where it is broken down by bacteria. A by-product of this process is the creation of carbon dioxide and hydrogen. These two gases build up in the intestine, causing bloating, gas, pain and diarrhea. In some cases, the problem can affect absorption of important nutrients, like calcium and iron.

Researchers estimate about 33 percent of Americans have some level of sensitivity to sugar, most commonly to fructose, but the symptoms are often vague. Some people with fructose intolerance can eat small amounts of the sugar and not have any problems, making diagnosis even trickier.

Daniel Lustig, M.D., Pediatric Gastroenterologist at Mary Bridge Children’s Health Center in Tacoma, WA, says patients with chronic digestive problems should have a physician’s evaluation to rule out other possible causes of the symptoms, like Celiac disease or Crohn’s disease. Once those conditions have been ruled out, he recommends a diagnostic tool called the breath hydrogen test.

A patient is given a dose of fructose. Then, periodically, he/she breathes into an air collection bag. The gases from the bag are retrieved and analyzed for the presence of hydrogen (one of the gases given off when fructose is broken down in the large intestine). Patients whose hydrogen levels exceed 20 points beyond a baseline reading are likely to be fructose intolerant.

Lustig explains the main treatment of fructose intolerance is avoidance of foods containing fructose. That includes fruits, fruit juices, sodas and processed foods and drinks with high fructose corn syrup. Since fructose is in so many foods, it can be tricky to find and hard to avoid.

Lustig recently performed a study to look at possible fructose intolerance in 245 children and adolescents (ages 2 to 18) with unexplained chronic abdominal pain, gas or bloating. The breath hydrogen test found that nearly 54 percent of the participants tested positive for fructose intolerance. Lustig says the problem appeared to be especially high among teen girls.

Those who were judged to be fructose intolerant were given advice on using a low-fructose diet. The investigators found that nearly 68 percent of those who followed the recommended diet had an improvement or resolution in their symptoms.

More

Almonds ward off diabetes, says study

Eating almonds could help prevent diabetes and heart disease, according to a study.

The research found incorporating the nuts into our diets may help treat type 2 diabetes, which accounts for 90 to 95 per cent of all cases.

As well as combating the condition, linked to obesity and physical inactivity, it could tackle cardiovascular disease, the report published in the Journal of the American College of Nutrition said.

Diabetes is one of the fastest growing diseases in the world, and sufferers have a shortage of insulin or a decreased ability to use the hormone that allows glucose (sugar) to enter cells and be converted to energy.

When diabetes is not controlled, glucose and fats remain in the blood and over time, damage vital organs.

The study found consuming a diet rich in almonds may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with pre-diabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be classified as diabetes.

Researchers looked at the effects of consuming an almond-enriched diet on 65 adults with pre-diabetes (48 women and 17 men) with an average age in the mid-50s.

The participants were split up, and the group on the almond-enriched diet showed greater improvements in insulin sensitivity and clinically significant reductions in LDL-cholesterol compared with the nut-free group.

Dr Michelle Wien, assistant research professor in nutrition at Loma Linda University's School of Public Health, said, “We have made great strides in chronic disease research from evidence of effective treatment to evidence of effective prevention.”

The principal researcher for the study, conducted at the University of Medicine and Dentistry of New Jersey, added, “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.”

An estimated 55 million people in Europe have been diagnosed with diabetes, and the figure is expected to rise to 66 million by 2030.

There is no known way to prevent type 1 diabetes, which may be autoimmune, genetic, or environmental. It accounts for five per cent of all cases. Type 2 diabetes most often occurs in people older than 40.

Around 60 million people in Europe have pre-diabetes. People with the condition have an increased risk of developing type 2 diabetes, heart disease and strokes.

Almonds are cholesterol-free and compared with other nuts, they are the highest in six essential nutrients – fibre, magnesium, protein, potassium, copper and vitamin E.

More

New test can predict complications from kidney disease

Cystatin C, a blood marker of kidney function, proved significantly more accurate than the standard blood marker, creatinine, in predicting serious complications of kidney disease, in a study by researchers at the San Francisco VA Medical Center and the University of California, San Francisco. Among adults who were identified as having chronic kidney disease by high creatinine levels, the researchers found that only patients who also had abnormally high levels of cystatin C were at high risk for death, cardiovascular disease, heart failure, or kidney failure. People with high creatinine but normal cystatin C levels had risks similar to those with normal creatinine levels.

The researchers also found that a small but important segment of the study population was missed by creatinine but identified by cystatin C as being at significant risk of serious complications, according to lead author Carmen A. Peralta, MD, MAS, an SFVAMC researcher and an assistant professor of medicine in residence in the division of nephrology at UCSF.

The study of 11,909 participants appears online on December 16, 2010, in the JASN Express section of the Journal of the American Society of Nephrology. The authors analyzed patient data from two prospective studies: the Multi-Ethnic Study of Atherosclerosis and the Cardiovascular Health Study, both sponsored by the National Heart, Lung, and Blood Institute.

Principal investigator Michael G. Shlipak, MD, MPH, chief of general internal medicine at SFVAMC, said that the current study highlights a potential clinical use for cystatin C as a method for confirming a diagnosis of chronic kidney disease. Shlipak has been a leader among physicians in identifying cystatin C as an alternative, accurate, and reliable marker of kidney function.

Both cystatin C and creatinine are substances made in the body and filtered by the kidneys. High levels of the substances in the blood indicate that the kidneys are losing the ability to filter them, and thus are losing function. However, explained Peralta, creatinine is a byproduct made in muscles, so it is affected by what you eat and especially by how much muscle you have. Thus, a bodybuilder with healthy kidneys might have an elevated creatinine level because of high muscle mass, whereas a frail elderly person might have normal or even low levels of creatinine, but in fact this persons kidneys are not working well – its just that theres not much creatinine because theres not much muscle.

In contrast, cystatin C is a protein made in cells throughout the body. In studies so far, it does not seem to be that affected by age or muscle mass or diet, said Shlipak, who is also a professor in residence of medicine and epidemiology and biostatistics at UCSF.

Shlipak proposes that cystatin C, which can cost as little as $17 per test, be added as a method for confirming or staging chronic kidney disease in guidelines that are currently being formulated by nephrologists. Its vital that we have an accurate diagnostic test, because kidney disease does not show symptoms until its too late, when your kidneys have almost failed completely, he said. Being missed by creatinine is an important limitation in our current method of diagnosing kidney disease, said Peralta. Yet, she adds, being falsely identified with kidney disease through inaccurate test results can be disastrous as well. There is fear and psychological stress, particularly in communities of color, where people have a lot of friends and family members who are on dialysis, she noted. You can also be subjected to unnecessary and expensive tests and medications.

More

Almonds can fight diabetes

Here is another reason to make the tasty almonds a part of your daily diet. The humble tidbit nuts that combine tons of essential nutrients in one delicious package are an effective weapon in fighting type 2 diabetes and cardiovascular diseases, claims a new study. According to researchers, almonds added to the diet have a favorable effect on blood cholesterol levels and insulin sensitivity, two vital risk factors that can trigger diabetes and heart problems.

Lead author of the study, Dr. Michelle Wien, Assistant Research Professor in Nutrition at Loma Linda University’s School of Public Health stated, “We have made great strides in chronic disease research from evidence of effective treatment to evidence of effective prevention. “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.”

In a bid to assess the impact of almond enriched diet as a prescription for physical wellness, the researchers conducted a study. The focus of the study was to analyze the effect of the humble nut on the progression of type 2 diabetes and cardiovascular disease. The investigators enrolled a group of 65 adults comprising 48 women and 17 men with pre-diabetes in their mid-50s. The study subjects were split into two groups. As a part of the study, one group was assigned to almonds while the second formed the control group. The control group followed a diet recommended by the American Diabetes Association (ADA).The group assigned to almonds conformed to a similar diet but also added 20 percent calories from almonds. All the participants were asked to consume the same amount of calories from carbohydrate-containing foods, such as pasta, bread, and rice. However, those consuming the almond-enriched diet reported a lower intake of carbohydrate-containing food items.

After a period of 16 weeks, the investigators compared the insulin and cholesterol levels of both the groups. It was noticed that people consuming almond-enriched diet exhibited marked improvement in their insulin sensitivity and a dramatic reduction in LDL cholesterol as opposed to those eating the nut-free regular diet.

The study was conducted at the University of Medicine and Dentistry of New Jersey. The findings of the research are published in the ‘Journal of the American College of Nutrition

More

Chocolate reduces effect of Chronic Fatigue Syndrome

Chocolate reduces effect of Chronic Fatigue Syndrome

Researchers from the University of Hull and the Hull York Medical School have found dark chocolate has a significant effect on reducing the symptoms of Chronic Fatigue Syndrome (CFS). The research, published in Nutrition Journal, found that polyphenol rich chocolate eases the condition, with subjects noting significant improvements to their well-being. Chocolate is known to increase neurotransmitters like phenyl ethylamine, serotonin, and anandamide in the brain, but this is the first time that polyphenol rich chocolate in people with CFS has been studied.

darkchocolate1_v_340h

Above: Professor Steve Atkin.

Subjects with CFS having severe fatigue of at least 10 out of 11 on Chalder Fatigue Scale were enrolled on the pilot study. Participants were given one of two types of chocolate, one with a high cocoa content and the other without.

Over an eight week period the volunteers consumed one type of chocolate followed by a two week wash out period and then another eight weeks of eating the other variety. The dark chocolate contained 85% cocoa solids with the alternative containing none. Each individual bar weighed 15g with each volunteer expected to eat three per day, and also told not to consume more or make changes to their diet.

Researchers also noted the weight of subject did not significantly alter despite consuming an extra 245 calories per day for two months.

Professor Steve Atkin who led the study says: “The significance of the results is particularly surprising because of the small number of subjects in the study. A further study is needed to see what the effects would be on a larger group of people, but this is potentially very encouraging news for those who suffer from Chronic Fatigue Syndrome.”

This latest finding follows recent research also carried out at the University of Hull and the Hull York Medical School where dark chocolate was found to help reduce the risk of heart attacks in people with Type 2 diabetes by increasing the amount of good cholesterol in the blood stream.

More

Immune system important in fight against stomach cancer

The team looked at how NK cells (natural killer cells – a type of immune cell) reacted to Helicobacter pylori. These cells are an important part of the immune system as they can both recognise and kill cells that are infected by viruses and bacteria as well as tumour cells.

“We found that a special type of NK cells was active against the stomach ulcer bacterium,” says Åsa Lindgren. “These NK cells produced cytokines, which are the immune system's signal substances and act as a defence against the intruder.”

The researchers' results suggest that NK cells can play an important role in the immune defence against Helicobacter pylori. Previous research has also shown that a high proportion of NK cells in tumour tissue has contributed to a better prognosis and longer survival for patients with stomach cancer, as these cells help to eliminate the tumour cells.

The researchers therefore believe that activation of the NK cells can play a key role in stopping tumours from developing, and that reduced NK-cell activity can increase the risk of cancer developing. Åsa Lindgren hopes that these findings can be used to develop new ways of diagnosing and treating stomach cancer.

“This would make it possible to diagnose stomach cancer at an early stage, which, in turn, could mean a better prognosis for the patients.”

More

Meditation reduces the emotional impact of pain

The study, to be published in the journal Pain, found that particular areas of the brain were less active as meditators anticipated pain, as induced by a laser device. Those with longer meditation experience (up to 35 years) showed the least anticipation of the laser pain.

Dr Brown, who is based in the University's School of Translational Medicine, found that people who meditate also showed unusual activity during anticipation of pain in part of the prefrontal cortex, a brain region known to be involved in controlling attention and thought processes when potential threats are perceived.

He said: “The results of the study confirm how we suspected meditation might affect the brain. Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse.”

Dr Brown said the findings should encourage further research into how the brain is changed by meditation practice. He said: “Although we found that meditators anticipate pain less and find pain less unpleasant, it's not clear precisely how meditation changes brain function over time to produce these effects.

“However, the importance of developing new treatments for chronic pain is clear: 40% of people who suffer from chronic pain report inadequate management of their pain problem.”

In the UK, more than 10 million adults consult their GP each year with arthritis and related conditions. The estimated annual direct cost of these conditions to health and social services is £5.7 billion.

Study co-author Professor Anthony Jones said: “One might argue that if a therapy works, then why should we care how it works? But it may be surprising to learn that the mechanisms of action of many current therapies are largely unknown, a fact that hinders the development of new treatments. Understanding how meditation works would help improve this method of treatment and help in the development of new therapies.

“There may also be some types of patient with chronic pain who benefit more from meditation-based therapies than others. If we can find out the mechanism of action of meditation for reducing pain, we may be able to screen patients in the future for deficiencies in that mechanism, allowing us to target the treatment to those people.

More

General Information

Definition

Chronic Fatigue Syndrome (CFS) was originally defined in 1988 when the Center for Disease Control (CDC) in the US brought together a number of researchers who had been investigating a strange syndrome characterized by overwhelming fatigue. This definition however was reviewed by a panel of international experts in 1994 and subsequently revised.

CFS is very difficult to diagnose because the main symptom of fatigue is present in so many other illnesses. However, once other illnesses have been ruled out through laboratory tests and physical examination, a diagnosis of CFS may be given if the following criteria are met:

Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e., not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social, or personal activities.The concurrent occurrence of four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern, or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours. These symptoms must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue.

The full text of the revised definition can be found at the CDC website: http://www.cdc.gov/ncidod/diseases/cfs/about/definition/index.htm

Symptoms and General Information

Obviously, as is implied by the various names, fatigue is the major symptom in CFS. People often have the misconception that this is the only symptom and hence they assume that sufferers simply like to complain about the normal tiredness that everyone experiences after a day at work etc. CFS is actually much more than fatigue, and the fatigue experienced is a lot more severe than simple tiredness. The following is a list of the major symptoms of CFS.

  • Fatigue
    • Exercise Intolerance
    • Severe Malaise
    • Muscle and Joint Aches
    • Cognitive Dysfunction
    • Chronic Headache
    • Balance Disturbance
    • Recurrent Sore Throat
    • Mood and Sleep Disturbances
    • Abdominal Pain/Digestive Disturbances
    • Sensitivity to Light and/or Sound
    • Visual Disturbances
    • Skin Sensitivity

Possible Causes

The cause, or causes of ME/CFS are still not clear. There are a number of theories that have been proposed, the main ones propose the following factors as the cause or causes of the illness:

  • Viral Infection
  • Mycoplasma Infection
  • Immune or Endocrine Dysfunction
  • Autonomic Nervous System Dysfunction
  • Environmental Toxins
  • Genetic Factors
  • Candida Overgrowth
  • Gut Dysbiosis
  • Heavy Metal Sensitivity
  • Emotional Stress or Trauma

There may be a large number of abnormalities in multiple body systems in CFS patients. These abnormalities centre around the nervous, endocrine and immune systems and the way these interact with each other. Although these abnormalities have been identified it is still unclear which are causes and which are effects. New research will hopefully shed more light on this but until then doctors who are seeing the best results with patients seem to be those who take a multifactorial approach and try to correct as many of the abnormalities discussed as they possibly can, using currently available treatments.

More

Medicare Allied Health Initiative

While most private health funds provide rebates for visits to APDs, some patients may be eligible for a Medicare rebate instead.

The Medicare Allied Health Initiative allows chronically ill people being managed by their GP under the Enhanced Primary Care (EPC) Program access to Medicare rebates for ADP services. Eligible patients are those with a chronic condition, defined as one that is likely to be present for at least 6 months. This includes, but is not limited to, asthma, cancer, cardiovascular disease and diabetes. General practitioners must be managing the patient through the GP Management Plan (GPMP) and the need must be identified as part of a Team Care Arrangement (TCA). (Please note these are not the only criteria for Medicare eligibility for a GPMP, TCA and referral.) The dietitian must provide a service that is directly related to the management of the patient’s chronic condition. General practitioners must then fill out the EPC Program Referral Form for Allied Health Services under Medicare for the rebate to be possible. The Medicare rebate is currently $48.95 per service with out-of-pocket expenses counting toward the extended Medicare safety net. Patients are given a maximum of five allied health visits per calendar year.

Medicare rebates are now also payable for group services for patients with type 2 diabetes, on referral from a GP. Contact Medicare for further information about eligibility, requirements, rebates and referral forms.

More

How your Medical Practice can benefit

Nastaran’s individually-designed client plans:

  • Provide early diagnosis of nutrition-related health problems
  • Facilitate better management of chronic conditions through diet and lifestyle change
  • Lead to fewer nutrition-related secondary complications such as neuropathies from diabetes
  • Dispel myths regarding fad diets
  • Teach patients how to take personal responsibility for their own health status
  • Raise awareness regarding nutrition-related problems like high cholesterol, diabetes and hypertension

Placement in Practitioner’s Office

Some practitioners would prefer their patients receive all medical services in their own offices. Nastaran is available for scheduled placement in your office to meet with patients you believe would benefit from professional nutrition services. From once a month, to once a week, Nastaran can accommodate your office and patient needs.

Lunch & Learn

Recognizing how quickly nutritional information changes, Nastaran offers free lunchtime programs in your office, specifically tailored to your patient base and staffing needs.

Topics include:

  • Eating for thyroid disorder
  • Celiac disease
  • Chronic fatigue
  • Supplement protocols
  • Diabetes care and prevention
  • General Nutrition
  • Pediatric Nutrition

Please contact Nastaran directly with any questions regarding any of our services.

More