In October 2012, a new clinical trial reported reduction of irritable bowel symptoms through the use of acupuncture. The researchers randomly assigned 116 subjects to receive 10 weekly individualized acupuncture sessions plus usual care, while the other 117 subjects continued with usual care alone. The investigators assessed the subjects for the IBS Symptom Severity Score every three months for 12 months.

The study  found that after three months, there was a statistically significant difference between the two groups, and revealed that acupuncture was associated with a reduced IBS Symptom Severity Score. The researchers determined that successful treatment—defined as a 50 point or greater reduction in the IBS Symptom Severity Score—was seen in 49 percent of the acupuncture group and 31 percent of the control group. Furthermore, the investigators found that this benefit largely persisted at six, nine and 12 months.

Their conclusion?

“Acupuncture for irritable bowel syndrome provided an additional benefit over usual care alone. The magnitude of the effect was sustained over the longer term. Acupuncture should be considered as a treatment option to be offered in primary care alongside other evidenced based treatments.”

Reference:

Macpherson H, et al. BMC Gastroenterol. 2012;1:150.

Additives used in the production of vaccines may include

1. suspending fluid (e.g. sterile water, saline, or fluids containing protein);
2. preservatives and stabilizers to help the vaccine remain unchanged (e.g. albumin, phenols, and glycine); and
3. adjuvants or enhancers to help the vaccine to be more effective.

Common substances found in vaccines include:

            Aluminum gels or salts of aluminum which are added as adjuvants to help the vaccine stimulate a better response. Adjuvants help promote an earlier, more potent response, and more persistent immune response to the vaccine. Under the age of 6 months there is no blood brain barrier enabling the aluminum to deposit in brain tissue.

           Antibiotics which are added to some vaccines to prevent the growth of germs (bacteria) during production and storage of the vaccine. No vaccine produced in the United States contains penicillin however everytime a child gets an antibiotic they compromise their gut health and by default their immune system. In addition overuse of antibiotics is creating antibiotic resistant bacteria that no antibiotic can kill.

          Egg protein is found in influenza and yellow fever vaccines, which are prepared using chicken eggs. Ordinarily, persons who are able to eat eggs or egg products safely can receive these vaccines. FOR THOSE WITH EGG ALLERGIES THESE VACCINES ARE NOT SAFE!

             Formaldehyde is used to inactivate bacterial products for toxoid vaccines, (these are vaccines that use an inactive bacterial toxin to produce immunity.) It is also used to kill unwanted viruses and bacteria that might contaminate the vaccine during production. Most formaldehyde is removed from the vaccine before it is packaged. Highly toxic to the nervous system, causing blindness, brain damage and seizures, this preservative may cross the blood/brain barrier exposing the brain to it’s toxicity in the very young. The U.S. Department of Health and Human Services openly admits that formaldehyde is a carcinogen

              Monosodium glutamate (MSG) and 2-phenoxy-ethanol which are used as stabilizers in a few vaccines to help the vaccine remain unchanged when the vaccine is exposed to heat, light, acidity, or humidity.

              Thimerosal is a mercury-containing preservative that is added to vials of vaccine that contain more than one dose to prevent contamination and growth of potentially harmful bacteria. Again, this mercury can cross the blood brain barrier of the very young.

From the CDC dated February 2012:

Vaccine Excipient & Media Summary Excipients Included in U.S. Vaccines, by Vaccine
This table includes not only vaccine ingredients (e.g., adjuvants and preservatives),
but also substances used during the manufacturing process, including vaccine-production media, that are removed from the final product and present only in trace quantities. In addition to the substances listed, most vaccines contain Sodium Chloride (table salt).

All reasonable efforts have been made to ensure the accuracy of this information, but manufacturers may change product contents before that information is reflected here. If in doubt, check the manufacturer’s package insert.
 
Adenovirus
sucrose, D-mannose, D-fructose, dextrose, potassium phosphate, plasdone
C, anhydrous lactose, micro crystalline cellulose, polacrilin potassium,
magnesium stearate, cellulose acetate phthalate, alcohol, acetone, castor
oil, FD&C Yellow #6 aluminum lake dye, human serum albumin, fetal
bovine serum, sodium bicarbonate, human-diploid fibroblast cell cultures
(WI-38), Dulbecco’s Modified Eagle’s Medium
March, 2011
Anthrax (Biothrax)
aluminum hydroxide, benzethonium chloride, formaldehyde, amino acids,
vitamins, inorganic salts and sugars
December, 2008
BCG (Tice)
glycerin, asparagine, citric acid, potassium phosphate, magnesium sulfate,
Iron ammonium citrate, lactose
February, 2009
DT (Sanofi)
aluminum potassium sulfate, peptone, bovine extract, formaldehyde,
thimerosal (trace), modified Mueller and Miller medium
December, 2005
DTaP (Daptacel)
aluminum phosphate, formaldehyde, glutaraldehyde, 2-Phenoxyethanol,
Stainer-Scholte medium, modified Mueller’s growth medium, modified
Mueller-Miller casamino acid medium (without beef heart infusion)
July, 2011
DTaP (Infanrix)
formaldehyde, glutaraldehyde, aluminum hydroxide, polysorbate 80,
Fenton medium (containing bovine extract), modified Latham medium
(derived from bovine casein), modified Stainer-Scholte liquid medium
November, 2011
DTaP (Tripedia)
sodium phosphate, peptone, bovine extract (U.S. sourced), formaldehyde,
ammonium sulfate, , aluminum potassium sulfate, thimerosal (trace),
gelatin, polysorbate 80 (Tween 80), modified Mueller and Miller medium,
modified Stainer-Scholte medium
December, 2005
DTaP-IPV (Kinrix)
formaldehyde, glutaraldehyde, aluminum hydroxide, Vero (monkey
kidney) cells, calf serum, lactalbumin hydrolysate, polysorbate 80,
neomycin sulfate, polymyxin B, Fenton medium (containing bovine
extract), modified Latham medium (derived from bovine casein),
modified Stainer-Scholte liquid medium
November, 2011
DTaP-HepB-IPV (Pediarix)
formaldehyde, gluteraldehyde, aluminum hydroxide, aluminum
phosphate, lactalbumin hydrolysate, polysorbate 80, neomycin sulfate,
polymyxin B, yeast protein, calf serum, Fenton medium (containing
bovine extract), modified Latham medium (derived from bovine casein),
modified Stainer-Scholte liquid medium, Vero (monkey kidney) cells
November, 2011
DTaP-IPV/Hib (Pentacel)
aluminum phosphate, polysorbate 80, formaldehyde, gutaraldehyde,
bovine serum albumin, 2-phenoxethanol, neomycin, polymyxin B sulfate,
Mueller’s Growth Medium, Mueller-Miller casamino acid medium
(without beef heart infusion), Stainer-Scholte medium (modified by the
addition of casamino acids and dimethyl-beta-cyclodextrin), MRC-5
(human diploid) cells, CMRL 1969 medium (supplemented with calf
serum).

July, 2011

 
Hib (ActHIB)
ammonium sulfate, formalin, sucrose, Modified Mueller and Miller
medium
May, 2009

Hib (Hiberix) formaldehyde, lactose. December, 2010 
Hib (PedvaxHIB) aluminum hydroxphosphate sulfate. December, 2010

Hib/Hep B (Comvax)
yeast (vaccine contains no detectable yeast DNA), nicotinamide adenine
dinucleotide, hemin chloride, soy peptone, dextrose, mineral salts, amino
acids, formaldehyde, potassium aluminum sulfate, amorphous aluminum
hydroxyphosphate sulfate, sodium borate
December, 2010
Hep A (Havrix)
aluminum hydroxide, amino acid supplement, polysorbate 20, formalin,
neomycin sulfate, MRC-5 cellular proteins
July, 2011
Hep A (Vaqta)
amorphous aluminum hydroxyphosphate sulfate, bovine albumin,
formaldehyde, neomycin, sodium borate, MRC-5 (human diploid) cells
December, 2010

Hep B (Energix-B)

aluminum hydroxide, yeast protein, phosphate buffers. October, 2011 

Hep B (Recombivax)
yeast protein, soy peptone, dextrose, amino acids, mineral salts, potassium
aluminum sulfate, amorphous aluminum hydroxyphosphate sulfate,
formaldehyde.
July, 2011
Hep A/Hep B (Twinrix)
formalin, yeast protein, aluminum phosphate, aluminum hydroxide, amino
acids, phosphate buffer, polysorbate 20, neomycin sulfate, MRC-5 human
diploid cells
November, 2011
Human Papillomavirus
(HPV) (Cerverix)
vitamins, amino acids, lipids, mineral salts, aluminum hydroxide, sodium
dihydrogen phosphate dehydrate, insect cell and viral protein..
July, 2011
Human Papillomavirus
(HPV) (Gardasil)
yeast protein, vitamins, amino acids, mineral salts, carbohydrates,
amorphous aluminum hydroxyphosphate sulfate, L-histidine, polysorbate
80, sodium borate.
March, 2011
Influenza (Afluria)
beta-propiolactone, thimerosol (multi-dose vials only), monobasic sodium
phosphate, dibasic sodium phosphate, monobasic potassium phosphate,
potassium chloride, calcium chloride, sodium taurodeoxycholate,
neomycin sulfate, polymyxin B, egg protein
November 2011
Influenza (Fluarix)
sodium deoxycholate, formaldehyde, octoxynol-10 (Triton X-100),
α-tocopheryl hydrogen succinate, polysorbate 80 (Tween 80),
hydrocortisone, gentamicin sulfate, ovalbumin
April, 2011
Influenza (Fluvirin)
nonylphenol ethoxylate, thimerosal (multidose vial–trace only in prefilled
syringe), polymyxin, neomycin, beta-propiolactone, egg proteins
May, 2011
Influenza (Flulaval)
thimerosal, α-tocopheryl hydrogen succinate, polysorbate 80,
formaldehyde, sodium deoxycholate, ovalbumin
December, 2011
Influenza (Fluzone:
Standard, High-Dose, &
Intradermal)
formaldehyde, octylphenol ethoxylate (Triton X-100), sodium phosphate,
gelatin (standard formulation only), thimerosal (multi-dose vial only) ,
egg protein
May, 2011
Influenza (FluMist)
ethylene diamine tetraacetic acid (EDTA), monosodium glutamate (msg),
hydrolyzed porcine gelatin, arginine, sucrose, dibasic potassium
phosphate, monobasic potassium phosphate, gentamicin sulfate, egg
protein
May, 2011
Japanese Encephalitis
(Ixiaro)
aluminum hydroxide, Vero cells, protamine sulfate, formaldehyde, bovine
serum albumin, sodium metabisulphite.
September, 2010
Meningococcal (MCV4-
Menactra)
formaldehyde, phosphate buffers, Mueller Hinton agar, Watson Scherp
media, Modified Mueller and Miller medium
November, 2011
Meningococcal (MCV4-
Menveo)
formaldehyde, amino acids, yeast extract, Franz complete medium March, 2011
Meningococcal (MPSV4-
Menomune)
thimerosal (multi-dose vial only), lactose, Mueller Hinton agar, Watson
Scherp media
January, 2009
MMR (MMR-II)
vitamins, amino acids, fetal bovine serum, sucrose, sodium phosphate,
glutamate, recombinant human albumin, neomycin, sorbitol, hydrolyzed
gelatin, chick embryo cell culture, WI-38 human diploid lung fibroblasts
December, 2010
MMRV (ProQuad)
sucrose, hydrolyzed gelatin, sorbitol, monosodium L-glutamate, sodium
phosphate dibasic, human albumin, sodium bicarbonate, potassium
phosphate monobasic, potassium chloride, potassium phosphate dibasic,
neomycin, bovine calf serum, chick embryo cell culture, WI-38 human
diploid lung fibroblasts, MRC-5 cells
August, 2011
Pneumococcal (PCV13 –
Prevnar 13)
casamino acids, yeast, ammonium sulfate, Polysorbate 80, succinate
buffer, aluminum phosphate
January, 2012

Pneumococcal (PPSV-23 –
Pneumovax)
phenol. October, 2011
Polio (IPV – Ipol)
2-phenoxyethanol, formaldehyde, neomycin, streptomycin, polymyxin B,
monkey kidney cells, Eagle MEM modified medium, calf serum protein
December, 2005
Rabies (Imovax) albumin, neomycin sulfate, phenol, MRC-5 human diploid cells December, 2005
Rabies (RabAvert)
β-propiolactone, potassium glutamate, chicken protein, ovalbumin,
neomycin, chlortetracycline, amphotericin B, human serum albumin,
polygeline (processed bovine 14 gelatin)
October, 2006
Rotavirus (RotaTeq)
sucrose, sodium citrate, sodium phosphate monobasic monohydrate,
sodium hydroxide, polysorbate 80, cell culture media, fetal bovine serum,
vero cells [DNA from porcine circoviruses (PCV) 1 and 2 has been
detected in RotaTeq. PCV-1 and PCV-2 are not known to cause disease in
humans.]
September, 2011
Rotavirus (Rotarix)
amino acids, dextran, , sorbitol, sucrose, calcium carbonate, xanthan,
Dulbecco’s Modified Eagle Medium (DMEM) [Porcine circovirus type 1
(PCV-1) is present in Rotarix. PCV-1 is not known to cause disease in
humans.]
February, 2011
Smallpox (Vaccinia –
ACAM2000)
human serum albumin, mannitol, neomycin, glycerin, polymyxin B,
phenol, Vero cells
August, 2007
Td (Decavac)
aluminum potassium sulfate, peptone, formaldehyde, thimerosal, bovine
muscle tissue (US sourced), Mueller and Miller medium,
March, 2011
Td (Tenivac)
aluminum phosphate, formaldehyde, modified Mueller-Miller casamino
acid medium without beef heart infusion
December, 2010

Td (Mass Biologics)
aluminum phosphate, formaldehyde, thimerosal (trace), ammonium
phosphate, modified Mueller’s media (containing bovine extracts)
February, 2011
Tdap (Adacel)
aluminum phosphate, formaldehyde, glutaraldehyde, 2-phenoxyethanol,
ammonium sulfate, Mueller’s growth medium, Mueller-Miller casamino
acid medium (without beef heart infusion)
December, 2010

Tdap (Boostrix) 
formaldehyde, glutaraldehyde, aluminum hydroxide, polysorbate 80
(Tween 80), Latham medium derived from bovine casein, Fenton medium
containing a bovine extract, Stainer-Scholte liquid medium
January, 2012
Typhoid (inactivated –
Typhim Vi)
hexadecyltrimethylammonium bromide, phenol, polydimethylsiloxane,
disodium phosphate, monosodium phosphate
December, 2005
Typhoid (oral – Ty21a)
yeast extract, casein, dextrose, galactose, sucrose, ascorbic acid, amino
acids
August, 2006
Varicella (Varivax)
sucrose, phosphate, glutamate, gelatin, monosodium L-glutamate, sodium
phosphate dibasic, potassium phosphate monobasic, potassium chloride,
sodium phosphate monobasic, EDTA, residual components of MRC-5
cells including DNA and protein, neomycin, fetal bovine serum, human
diploid cell cultures
August, 2011
Yellow Fever (YF-Vax) sorbitol, gelatin, egg protein January, 2010
Zoster (Shingles –
Zostavax)
sucrose, hydrolyzed porcine gelatin, monosodium L-glutamate, sodium
phosphate dibasic, potassium phosphate monobasic, neomycin, potassium
chloride, residual components of MRC-5 cells including DNA and
protein, bovine calf serum
June, 2011

 Cigarette smoking remains the leading cause of preventable illness and early death in the United States. Despite general declines in cigarette smoking, smoking persists among certain subpopulations, including persons with mental illness.

During 2009–2011, an annual average of 19.9% of adults aged over age18  had AMI (any mental illness); among these persons, 36.1% were current smokers, compared with 21.4 % among adults with no mental illness. Smoking prevalence among those with AMI was highest among men, adults under the age of 45 years, and those living below the poverty level and was lowest among college graduates. During 2009–2011, adults with AMI smoked 30.9% of all cigarettes smoked by adults.

The  percentage of cigarette smoking is high among adults with AMI, especially for younger adults, those with low levels of education, and those living below the poverty level; the prevalence varies by U.S. region. In Missouri, (the state with the lowest price for a pack of cigarettes), we have the 6th highest smoking prevalence in the country.

Increased awareness about the high prevalence of cigarette smoking among persons with mental illness is necessary if we plan to reduce smoking in this population.  Given that nicotin stimulates a temporary increase in serotonin,  serum serotonin levels should be checked the the smoker with AMI prior to their quitting to determine if 5HTP, a serotonin precursor, should be taken as a way to enable smoking cessation to occur more effectively. Given that persons with mental illness are at risk for multiple adverse behavioral and health outcomes, tobacco cessation will have substantial benefits, including a reduction in excess illness and early mortality attributed to tobacco use.

The health consequences of tobacco use include not only AMI but cardiovascular disease, multiple types of cancer, pulmonary disease, adverse reproductive outcomes, and the exacerbation of chronic health conditions (1) and causes approximately 443,000 premature deaths in the United States annually in addition to costing the United States $96 billion in direct medical expenses and $97 billion in lost productivity each year.*

AMI was defined as having a mental, behavioral, or emotional disorder, and did not include developmental and substance use disorders, in the past 12 months.

Current smoking was defined as smoking all or part of a cigarette within the 30 days preceding the interview. Among current smokers, daily smoking was defined as smoking every day in the past 30 days. Ever smoking was defined as adults who smoked at least 100 cigarettes in their lifetimes. The quit ratio was calculated as the percentage of adults who had ever smoked ≥100 cigarettes and who also reported no past month cigarette use. Current smoking was examined by age, race/ethnicity, education, poverty status, U.S. Census region, and year (≥18 years had AMI (Table 1). The prevalence of current smoking was 36.1% among persons with AMI and 21.4% among those without AMI (Table 2). The prevalence of adult smokers aged ≥18 years with AMI was 29.5%. Among current smokers, the average number of cigarettes smoked in the preceding month was higher among adults with AMI (331 cigarettes) compared with adults who did not have AMI (310) (p<.05).** Among all cigarettes smoked by adults aged ≥18 years, 30.9% were smoked by adults withAMI.** Among adults with AMI, the quit ratio was 34.7%, compared with 53.4% among adults who did not have AMI (p<0.05).

Prevalence of current smoking among adults with AMI was higher among men (39.6%) than women (33.8%). By age, prevalence was higher for those aged 18–24 years (41.6%) and 25–44 years (40.5%) than for those aged 45–64 years (33.5%) and ≥65 years (13.0%). By race/ethnicity, prevalence was lowest among Asians (20.6%) and highest among whites (37.7%) and respondents categorized as of Other race (40.0%).

Among adults age over the age of 25 with AMI, the prevalence of current smoking was lowest among college graduates (18.7%). By poverty status, prevalence was higher among adults living below the federal poverty level (47.9%) than among those at or above this level (33.3%).

erved in the West and the Northeast; by state, the lowest prevalence was observed in Utah. Prevalence was also low in Massachusetts and California, which have achieved successes in reducing smoking in the overall population through implementation of comprehensive tobacco control programs and population-based policy interventions (11). Moreover, Massachusetts substantially reduced smoking prevalence among Medicaid enrollees by establishing and heavily promoting comprehensive Medicaid coverage of evidence-based cessation treatments that minimized cost barriers to their access (12).

In addition to the high percentage of smoking among persons with AMI, data also indicate that this subpopulation smoke more cigarettes per month and are less likely to have stopped smoking, compared with persons without AMI. It is thought that this finding may be due to the fact that nicotine is a central nervous system stimulant with mood-altering effects, that may temporarily mask negative affect and symptoms associated with mental illness (3)and some research indicates that tobacco smoke can accelerate the metabolism of some mental health medications, reducing their effective blood levels (13) resulting in increased compensatory nicotine intake (13). It is also speculated that with over 80% of adult smokers smoked during adolescence including those with AMI and that factors that may predict dependence among teens include depressed mood (14); a making them more likely to smoke (15). The tobacco industry has marketed cigarettes to populations with AMI (16), suggesting that persons with AMI use nicotine to alleviate negative mood (i.e., self-medicate), Finally, persons with AMI are uniquely vulnerable. They often lack financial resources, face unstable, stressful living conditions, and have difficulty coping with symptoms of withdrawal; they also might lack health insurance, information on the health effects of smoking, and access to cessation treatments (4,17,18).

Acknowledgments

Sarra Hedden, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Devon S. Cribb, Jeremy D. Porter, Lauren K. Warren, RTI International, Research Triangle Park, North Carolina.

References

1. US Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2004. Available at http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2004/index.htm. Accessed November 9, 2012.
2. McClave A, Davis S, McKnight L, Dube SR. Smoking characteristics of adults with selected lifetime mental illnesses: results from the 2007 National Health Interview Survey. Am J Public Health 2010;100:2464–72.
3. Hall SM, Prochaska JJ. Treatment of smokers with co-occurring disorders: emphasis on integration in mental health and addiction treatment settings. Annu Rev Clin Psychol 2009;5:409–31.
4. Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health 2010;31:297–314.
5. Williams JM, Zimmerman MH, Steinberg ML, et al. A comprehensive model for mental health tobacco recovery in New Jersey. Adm Policy Ment Health 2011;38:368–83.
6. Hedden S, Gfroerer J, Barker P, et al. CBHSQ data review: comparison of NSDUH mental health data and methods with other data sources. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality; 2012.
7. CDC. Vital signs: current cigarette smoking among adults aged ≥18 years—United States, 2009. MMWR 2010;59;1135–40.
8. Substance Abuse and Mental Health Services Administration. Results from the 2010 national survey on drug use and health: summary of national findings: tobacco use. Available at http://www.samhsa.gov/data/nsduh/2k10nsduh/2k10results.htm#ch4. Accessed November 9, 2012.
9. Lasser K, Wesley BJ, Woolhandler S, Himmestein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA 2000;284:2606–10.
10. CDC. Best practices for comprehensive tobacco control programs—2007. Atlanta, GA: US Department of Health and Human Services, CDC; 2007. Available at http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm. Accessed November 9, 2012.
11. Mendez D, Warner KE. Setting a challenging yet realistic smoking prevalence target for Healthy People 2020: learning from the California experience. Am J Public Health 2008;98:556–9.
12. Land T, Warner D, Paskowsky M, et al. Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. PLoS One 2010;5:e9770.
13. Prochaska JJ. Smoking and mental illness—breaking the link. N Engl J Med 2011;365:196–8.
14. DiFranza JR, Savageau JA, Fletcher K, et al. Susceptibility to nicotine dependence: the Development and Assessment of Nicotine Dependence in Youth 2 study. Pediatrics 2007;120:e974–83.
15. Tercyak KP, Goldman P, Smith A, Audrain J. Interacting effects of depression and tobacco advertising receptivity on adolescent smoking. J Pediatric Psychol 2002;27:145–54.
16. Prochaska JJ, Hall SM, Bero LA. Tobacco use among individuals with schizophrenia: what role has the tobacco industry played? Schizophrenia Bull 2008;34:555–67.
17. American Legacy Foundation. A hidden epidemic: tobacco use and mental illness. Washington, D.C.: American Legacy Foundation, 2011.
18. Fagerstrom K, Aubin HJ. Management of smoking cessation in patients with psychiatric disorders. Curr Med Res Opin 2009;25:511–8.
19. Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M. The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 2009;11:12–24.
20. Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med 2003;37:268–77.
21. Caraballo RS, Yee SL, Gfroerer J, Mirza SA. Adult tobacco use among racial and ethnic groups living in the United States, 2002–2005. Prev Chronic Dis 2008;5(3):A78.
22. Druss BG, Zhao L, Von Esenwein S, Morrato EH, Marcus SC. Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Med Care 2011;49:599–604.

Pennsylvannia State University had 28 subjects eat an ounce (32 grams) of pistachios every day (one or two servings a day) for 30 days. Eating 2 servings a day lowered total cholesterol by 8 percent and lowered LDL cholesterol (bad cholesterol) by 12%

Two years later . .

They re-analyzed the original blood collected from these subjects and found the oxidized LDL (rancid fat – literally) in the blood and it was lowered too!

Cholesterol levels are risk markers for heart disease. High total cholesterol and high LDL levels raise  the risk of heart disease and atherosclerotic plaquing of blood vessels that cause them to block.  What we don’t hear about is that for cholesterol or LDL to cause blockage it needs to go rancid or oxidize. So while high cholesterol and high LDL’s are not good, high levels of oxidized LDL’s is really not good. The challenge therefore is lowering oxidzed levels of LDL’s more effectively. This explains why those on statin drugs don’t have a lower risk of heart disease statisistically.

Pistachio’s lower the amount of oxidized LDL.

It gets better. Some studies from California by a Dr Joan Sabate would suggest that walnuts and other nuts may do the same thing.  Don’t salt them or candy them or roast them. Just eat plain, raw nuts – two ounces a day. Substitute them for other less healthy snacks and your body will thank you!

Think vitamin D!

A majority of us are deficient in this important nutrient that prevents bone loss, fibroids and breast cancer!

BE CAREFUL of just buying an over the counter preparation! Consumer reports has listed a variety of Vitamin D products that have excessively high lead levels (exceed California proposition 65 lead limits for reproductive risk) including Caltrate, Citracal Maximum and Citracal Petites Calcium Citrate with D3, CVS, Equate, Kirkland (Costco), Oscal with extra D3, Schiff super calcium and Walgreens Calcium 600!

Another reason to pay a little more for a pharmaceutical grade product!!! We have a great liquid product with Vitamin D3 and K2 and . . . NO LEAD!

So we all know what we should eat but maybe,  just maybe, its the convenience of fast food or it just tastes good and this enables us to deviate from what we know we should be doing. When I mentioned diet in the title I didn’t mean dieting, I mean’t dietary choices (which, for some of you may be the same thing!)

It really is simple. A diet rich in lean meats (poultry,  fish), and that also includes eggs, raw nuts,  fruits and lots of vegetables with starches like rice, potatoes and sweet potatoes and that avoids processed foods, prepared lunch meats, refined flour, sugar and so much of the junk food that is part of our carb load helps.

Wheat and wheat products should be avoided as poor quality nutrition that creates inflammation in many.  Simple sugars and simple carbs (crackers/breads etc) which break down to simple sugars quickly raise insulin levels and raise blood sugar levels and raise your levels of inflammation.  Complex carbs like rolled oats are better.

High fructose corn syrup is in so many things – especially beverages – and it is a pro-inflammatory food that should be avoided. It is also know to accelerate the cross-linking of collagen fibres, so like smoking, high fructose corn syrup will age your skin prematurely in addition to leaving you achy all over.

We all know that we should perimeter shop the grocery store. The outside of the store is where virtually everything you need is – fruits/veggies/dairy/meat. You may need to pop down an aisle for whole grains, olive or flax oil or vinegar (make your own oil/vinegar dressing for those veggies – its healthier) and remember grill or broil meat, steam veggies. Try making it a happen for a few weeks. Your body will thank you!

Motor vehicle accidents are the leading cause of death among children in the United States and some literature would suggest that age and size appropriate car seats and booster seats would reduce serious and fatal injuries by almost 50%.

In 2008 968 children under the age of 14 died in accidents and about 168,000 were injured.

The CDC has stated that more than 618,000 childrent age 0 to 12 rode without child seat, booster seat or seat belt at least some of the time.

Here are the guidelines for your child:

Infants (birth to 12 months or 20 pounds) – use a rear facing infant/toddler convertible seat.

Toddlers (12 months to 47 months or 20 to 40 pounds) – use a forward facing infant/toddler convertible seat.

Young children (age 4 to 8 unless 4’8″ or more than 40 pounds) need a seat belt positioning booster seat

Only when a child of a height greater than 4’9″ can sit without a booster seat and have the shoulder strap fit across the chest while the lap belt is across the upper thighs can the child be considered ready for seatbelt only riding.

Any car after 2000 should have a special attachment that secures the tether strap found on more child/toddler/infant seats. If you are uncertain as to the proper installation of the seat in your car, your local fire department should have staff who will be able to assist you in the proper use of the seat.

Diagnoses of asthma are increasing, and currently it affects approximately 25 million Americans, which equals about one in 12 adults and one in 10 children.
The study subjects included 452 children three to six years of age. The parents of the children completed questionnaires regarding lifestyle, demographics and asthma symptoms. The parents also completed a three-day diet history for the children.

The investigators showed that the children with the highest intake of vitamin C had a 65 percent decrease in the likelihood of asthma compared to the children with the lowest intake. Similarly, the children with the highest vitamin E intake had a 68 percent decrease in the likelihood of asthma compared to the children with the lowest intake. Higher fruit intake was associated with a lower risk of asthma.

The study authors concluded, “These data suggest that children with high intakes of vitamins C and E may be associated with a reduced prevalence of asthma.”

Are you following the dietary guidelines of 7 to 9 servings of fruits and vegetables a day?

Signs, Symptoms and Associated Conditions

Although the severity of symptoms may vary from patient to patient, the most common symptoms of celiac disease include weight loss, fatigue, chronic diarrhea, cramps, bloating, irritability and anemia. While weight loss is the most common symptom,  weight gain and constipation can also by symptoms in some. Other patients experience no intestinal symptoms and only complain of weight loss or fatigue. A wide variety of symptoms can include mouth ulcers, bone pain, Vitamin B12, Vitamin K and Vitamin D deficiency, nausea, vomiting, peripheral neuropathy,  and dermatitis herpetiformis, an itchy rash with bumps and blisters.

Diagnostic Methods

Although small-bowel biopsy is usually required to confirm the diagnosis, blood tests are now available to detect the presence of celiac disease testing for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). As there is often a family link to the disease, family members of celiac patients should undergo this blood test to see if they have a low-grade or symptom-free version of a celiac condition.If these tests are negative and a biopsy is negative, a patient may still be wheat sensitive and IgG4 testing can identify patients in the sensitivity spectrum.

Hidden Gluten in Common Foods and Dietary Management

Gluten in flour helps bread and other baked goods bind and prevent crumbling making gluten an attractive addition to many processed and packaged foods. Consequently, celiac patients and gluten sensitive patients need to read the labels of all packaged and processed foods to ensure they are gluten-free. This is especially true for soups, luncheon meats and sausages.

Attention to food labels is vital, as the only truly effective treatment for celiac disease is to maintain a strict gluten-free diet for life. If celiac disease is diagnosed early and treated with a gluten-free diet, the damaged tissues can heal and the risk of developing many of the long-term complications of this disease, including osteoporosis, neuropathy, lymphoma, and infertility, may be reduced.

The Benefits of B Vitamins

A 2009 study published in the World Journal of Gastroenterology showed that celiac disease patients commonly have suboptimal nutritional status of certain B vitamins (folic acid, vitamin B₆, vitamin B₁₂). As these vitamins are required to keep homocysteine in a safe range, many celiac patients have high blood levels of homocysteine, which increases their risk for heart disease, stroke and other vascular complications.²

Homocysteine is a chemical made in all body cells which, if left unchecked, diffuses into the bloodstream and causes damage to the blood vessel wall – setting the stage for plaque development, with resulting increased risk for heart attack, stroke and other vascular problems. Some reports suggest that at least 10 percent of all heart attacks in the U.S. each year are attributable to high homocysteine levels.^3-4

The body relies on vitamin B₆, folic acid and vitamin B₁₂ to recycle homocysteine back to methionine or serine within our cells. This keeps homocysteine blood levels in the ideal range. Thus, even marginal deficiencies in these B vitamins can result in higher homocysteine levels, with resulting increased risk of vascular disease.^3-4

Celiac patients have damage to the absorptive lining of the intestinal tract and thus do not absorb many nutrients, including B vitamins, as well as patients with normal intestinal health. In the 2009 study, researchers gave a subgroup of celiac disease patients a B-vitamin supplement (including vitamin B₆, folic acid and vitamin B₁₂), only to discover that their blood homocysteinelevels declined into the normal and safer range.

As celiac patients are known to be prone to high homocysteine levels, they should pay heed to the findings of this study from the standpoint of helping to reduce risk of heart attack and stroke – an important factor in the long-term management of their health.¹

In my view, this study emphasizes the need for celiac patients to take a high-potency multivitamin / mineral that includes a B-50 complex. A supplement of this nature would also help to improve their nutritional status of all important micronutrients (vitamins and minerals), and reduce the risk of premature vascular disease by helping to keep homocysteine within the desired range (under 6.3 micromoles per liter). To maximize bioavailability of B vitamins and minimze gastric distress from B-vitamin supplementation we use either liquid nutrition or whole food nutrition to supply necessary nutrients based on the clinical needs of our patients.

References

1. Food and Nutrition: Celiac Disease – Food Allergies and Intolerances. Health Canada.
2. Hadithi M, Mulder CJJ, Stam F, et al. Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease. World Jrnl Gastroent, 2009;15(8):955-60.
3. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA, 1995;274:1049-57.
4. Kang SS, Wong PW, Malinow MR. Hyperhomocyst(e)inemia as a risk factor for occlusive vascular disease. Ann Rev Nutr, 1992;12:279-98.