Full article below:
In the long run, encouraging a baby to finish the last ounce in their bottle might be doing more harm than good.

Though the calories soon burn off, a bad habit remains.

Brigham Young University sociology professors Ben Gibbs and Renata Forste found that clinical obesity at 24 months of age strongly traces back to infant feeding.

“If you are overweight at age two, it puts you on a trajectory where you are likely to be overweight into middle childhood and adolescence and as an adult,” said Forste. “That’s a big concern.”
The BYU researchers analyzed data from more than 8,000 families and found that babies predominantly fed formula were 2.5 times more likely to become obese toddlers than babies who were breastfed for the first six months.

But, the study authors argue, this pattern is not just about breastfeeding.

“There seems to be this cluster of infant feeding patterns that promote childhood obesity,” said Gibbs, lead author of the study that appears in Pediatric Obesity.

Putting babies to bed with a bottle increased the risk of childhood obesity by 36 percent. And introducing solid foods too soon – before four months of age – increased a child’s risk of obesity by 40 percent.

“Developing this pattern of needing to eat before you go to sleep, those kinds of things discourage children from monitoring their own eating patterns so they can self-regulate,” Forste said.

Forste said that the nature of breastfeeding lends itself to helping babies recognize when they feel full and should stop. But that same kind of skill can be developed by formula-fed infants.

“You can still do things even if you are bottle feeding to help your child learn to regulate their eating practices and develop healthy patterns,” Forste said. “When a child is full and pushes away, stop! Don’t encourage them to finish the whole bottle.”

Breastfeeding rates are lowest in poor and less educated families. Sally Findley, a public health professor at Columbia University, says the new BYU study shows that infant feeding practices are the primary reason that childhood obesity hits hardest below the poverty line.

“Bottle feeding somehow changes the feeding dynamic, and those who bottle feed, alone or mixed with some breastfeeding, are more likely to add cereal or sweeteners to their infant’s bottle at an early age, even before feeding cereal with a spoon,” said Findley.

The next project for Gibbs and Forste is to reevaluate the link between breastfeeding and cognitive development in childhood. Forste has previously published research about why women stop breastfeeding. You can listen her discuss that topic with The New York Times in this podcast.

“The health community is looking to the origins of the obesity epidemic, and more and more, scholars are looking toward early childhood,” Gibbs said. “I don’t think this is some nascent, unimportant time period. It’s very critical.”

A recent well designed study did just that.  They compared using an SSRI for depression(n=48) vs. using the SSRI in addition to acupuncture (one group manual acupuncture(n=54) and one group electroacupuncture(n=58).  The acupuncture groups were found to be associated with a significantly greater improvement in symptoms (69.8% and 69.6%, respectively), as compared to SSRI alone (41.7%). In the SSRI only group, 22.9% of patients required an increase in dose, as compared to 5.7% and 8.9% in the manual acupuncture and electro-acupuncture groups. They also had a 4 week followup after treatment to compare how the treatment groups were doing and the acupuncture group continued to show significant improvement.

The authors of the study concluded: “Our study indicates that acupuncture can accelerate the clinical response to selective serotonin reuptake inhibitors (SSRIs) and prevent the aggravation of depression.”

The fact is that eating cholesterol does little to increase the level of cholesterol in your system; saturated fats are a more likely culprit. But both cholesterol and saturated fats are necessary in the diet. Every cell in the body is made up of cholesterol and phospholipids — both abundant in egg yolk — as well as saturated fat, which keeps the cell from collapsing in on itself.

So the cholesterol naturally found in eggs is not a problem.  In fact, egg yolks are a great first food for a baby as they have an excellent fatty acid profile as well as abundant phosphatidylcholine for neuron and brain development.

It’s possible that cooking methods could be an issue.  The idea is that scrambling or frying the egg will create oxidized cholesterol (the unhealthy cholesterol),  although I could not find any evidence of this being true.  To be safe some suggest the best way to cook an egg is in the shell or poaching and that is what I do most of the time.

When selecting eggs, bear in mind that there is a big difference between the factory-farm egg yolks sold at Shaw’s and the egg yolks from a neighbor’s chicken.  Supposedly the cheaper store-bought eggs from large outfits have more oxidized cholesterol in the yolks because of the way the eggs are handled. Even comparing egg yolks from Shaw’s with something from Whole Foods — such as Country Hen or Vital Farms – one would appreciate a big difference in quality.  Egg yolks should be orange, and the standard grocery store ones are often a pale yellow at best.  If you have never had real eggs, the taste difference is also an eye opener.

Yours In Health

George Mandler

Licensed Acupuncturist
Licensed Dietitian
Certified Nutrition Specialist
Certified LEAP Therapist

It’s about a month into the New Year. Do you already wish you had a do-over for your New Year’s Resolutions?

If so, you’re in luck. You do.

February 10th is the Chinese lunar New Year. The celebration of the New Year, the Spring Festival, is China’s longest and most important holiday. Because it is based on a different calendar, it falls on a different date between January 21 and February 20 every year.

You can think of Spring Festival as Christmas and New Year all rolled into one. Just like our holiday season, it’s a time of celebration, visiting family and friends, giving gifts and preparing for the next year.

Chinese Lunar New Year: Spring Festival
In China, there are many New Year’s traditions during the 15-day Spring Festival. Many people clean their homes to sweep away the past year and usher in the next. Oftentimes family members travel home for a visit.

Children receive red envelopes, called hóngbo in Mandarin, filled with money from their relatives.

People hang red lanterns outside their homes to bring happiness and good luck. On Chinese New Year’s Eve families gather for a huge meal and enjoy “lucky” foods together. And, of course, there are fireworks.

The Chinese zodiac has 12 years in its cycle, each one represented by an animal; 2013 is the Year of the Snake. Astrologers say that people born in the Year of the Snake are wise but enigmatic. They are very intuitive and size up situations well, but say little.

Snakes are refined; they like to dress well and are usually financially secure. They are intense and passionate in relationships, but can become jealous and suspicious. Snakes prefer a calm, stress-free environment.

Recommit to Your New Year’s Resolutions
The Chinese do not traditionally make New Year’s Resolutions like we do in the west, however this is a good time to reflect on the goals you set a month ago. Are you keeping your New Year’s resolutions?

If you’re having trouble, maybe it’s time to take a lesson from the Snakes. Take a quiet moment and reflect on what is stopping you. Do you need to get serious? Do you need additional support? Are your goals genuine – do you want to do them or do you think you should do them? Why haven’t you kept your New Year’s Resolutions?

If your resolutions include improving your health in 2013, I can help you with that. Give me a call and we can arrange an appointment for anything from a tune-up to weight control to mood balancing.

If you need to make a deeper commitment to your resolutions, take a moment and think about what you need to do to keep them. Write down 3 easy action steps.

…and do them. Now.

Use the Chinese lunar New Year as a do-over. Commit to your New Year’s resolutions.

Gong Xi Fa Cái. Happy New Year.

There is a metabolic difference between simple and complex carbohydrates.  The simple ones become glucose soon after they are eaten.  The complex ones take longer to turn into sugar and are less apt to spike insulin and cause energy crashes down the line.  But that isn’t the only difference between the two.

Almost forty years ago scientists had an interest in the relationship of diet to health, specifically of sugar intake to immunity.   But their curiosity went past simple sugar to include carbohydrates other than glucose.  The cells that are the backbone of the immune system are supposed to kill, swallow, and dispose of alien bodies, including bacteria, viruses and cancer cells.  Scientists at Loma Linda University in California examined the activity of neutrophilic phagocytes (cells that dissolve the enemy) after subjects ingested glucose, fructose, sucrose, honey, or orange juice and found that “…all significantly decreased the capacity of neutrophils to engulf bacteria…”  (Sanchez, Reeser, et al. 1973)  Looking more closely, the researchers also discovered that the greatest effects occurred within the first two hours after eating, but “…the effects last for at least 5 hours.”  (Ibid.)  If there is any promise, it’s that the effects can be undone by fasting from added sugars for the next two or three days.

At the start of the twentieth century, Americans consumed only about five pounds of sugar a year.  By the fifties, that had grown to almost 110 pounds a year, and to more than 152 by the year 2000.  Corn sweeteners account for 85 of those pounds.
(USDA Economic Research Service, http://www.usda.gov/factbook/chapter2.pdf )  America’s sweet tooth increased 39% between 1950 and 2000 as the use of corn sweetener octupled.

Although the cited study is decades old, its message is contemporary. HFCS began replacing sugar in soft drinks in the 1980’s, after it was portrayed by marketers as a healthful replacement for demon sugar.  It didn’t hurt the industry that it cost less, either.  The biological effects of sugar and HFCS are the same, however.  Neither has any food value—no vitamins, protein, minerals, antioxidants, or fiber—but they do displace the more nutritious elements of one’s diet, and we tend to consume more than we need to maintain our weight, so we gain.

Even though the number of calories from the glucose in a slice of bread or other starch is the same as that from table sugar (half fructose and half glucose), they are metabolized differently and have different effects on the body.  While fructose is metabolized by the liver, glucose is metabolized by every cell in the body.  When fructose reaches the liver, especially in liquid form (as in soda), it overwhelms the organ and is almost immediately converted to fat.  (Taubes. 2011)

Innate immunity is that which occurs as part of your natural makeup and defends you against infection by other organisms.  Short-term hyperglycemia, which might come from a pint of vanilla, has been found to affect all the major components of the innate immune system and to impair its ability to combat infection.  Reduced neutrophil activity, but not necessarily reduced neutrophil numbers, is one of several reactions to high sugar intake.  (Turina. 2005)  Way back in the early 1900’s, researchers noted a relationship between glucose levels and infection frequency among diabetes sufferers, but it wasn’t until the 1940’s that scientists found that diabetics’ white cells were sluggish. (Challem. 1997)  More recent study has corroborated the diabetes-infection connection, agreeing that neutrophil phagocytosis is impaired when glucose control is less than adequate.  (Lin. 2006)  Impaired immune activity is not limited to those with diabetes.  As soon as glucose goes up, immune function goes down.

Some folks think they’re doing themselves a favor by using artificial sweeteners.  Once the brain is fooled into thinking a sweet has been swallowed, it directs the pancreas to make insulin to carry the “sugar” to the cells for energy.  After the insulin finds out it’s been cheated of real sugar, it tells the body to eat in order to get some, and that creates artificial hunger, which causes weight increase from overeating.   Even environmental scientists have a concern with fake sweeteners in that they appear in the public’s drinking water after use.  You can guess how that works. (Mawhinney. 2011)

Mineral deficiencies, especially prevalent in a fast-food world, contribute to immune dysfunction by inhibiting all aspects of the system, from immune cell adherence to antibody activity.  Paramount among minerals is magnesium, which is part of both the innate and acquired immune responses.  (Tam. 2003)  Epidemiological studies have connected magnesium intake to decreased incidence of respiratory infections, and intravenous administration has shown effective in treating asthma. (PDR. 2000)  But sugar pushes magnesium—and other minerals—out of the body.  (Milne. 2000)  This will compromise not only immune function, but also bone integrity.  (Tjäderhane. 1998)

Zinc has been touted for its ability to shorten the duration of the common cold.  Like magnesium, zinc levels decrease with age, and even tiny deficiencies can have a large effect on immune health, particularly in the function of the thymus gland, which makes the T-cells of the immune system.  Zinc supplementation improves immune response in both the young and the old.  (Haase. 2009)  (Bogden. 2004)  (Bondestam. 1985)  All the microminerals, in fact, are needed in minute amounts for optimal growth and development…and physiology.  Low intakes suppress immune function by affecting T-cell and antibody response. Thus begins a cycle whereby infection prevents uptake of the minerals that could prevent infection in the first place.  Adequate intakes of selenium, zinc, copper, iron plus vitamins B6, folate, C, D, A, and E have been found to counteract potential damage by reactive oxygen species and to enhance immune function.  (Wintergest. 2007)

Who would have viewed something as sweet as sugar as being so hostile? It taste great to eat but has a nasty habit of pushing everything else out.

This study discusses IgE immunoglobulins (one of the 5 types of immunoglobulins) that trigger release of inflammatory mediators (histamines, leukotrienes, interleukins) in the tissue (skin, nose, bronchial airway).  An IgE response is what I was taught to classify as an ‘allergy’.   The mediator release (histamines, leukotrienes, interleukins) from IgE are typically not seen in the blood, but rather the interstitial tissue compartments such as nose, skin and lungs.  This is experienced as swelling, rhinitis, or asthma.   With the MRT testing we are looking at other mechanisms such as IgG immunoglobulins that cause an inflammatory mediator release in the blood. When inflammatory mediators in the blood rise above an individualized threshold people can experience chronic symptoms that may take up to 3 days to appear.     True allergies (IgE) can usually be figured out as the reaction (skin hives, asthma, swelling) show up within 30 minutes after ingestion of the antigen.

Does that make sense?  People are confused by this.  What I call an ‘allergy’ is an IgE response.  It is almost immediate.  What I call ‘food hypersensitivity’ is a variety of mechanisms (IgG, IgA, complement, Cell mediated) and are often delayed responses causing chronic symptoms.  If you go to an allergist they will measure your blood levels of IgE to certain foods.    For ‘food hypersensitivities’ the only good test is one that measures the release of mediators in the blood.

This study showed that using a soap triggered a specific kind of exercise induced wheat allergy.  The soap in question used hydrolized wheat protein (HWP) as an ingredient.   The use of this soap seemed to trigger a sensitization to ingested wheat protein.  From the article:

“…After starting to use HWP-supplemented soap, patients were likely to be sensitized to HWP through the percutaneous and/or rhino-conjunctival route within 1 month to 5 years. Several patients had an immediate focal allergic reaction while washing their faces with the soap. Patients had systemic allergic symptoms when they were exposed to wheat products and subsequently exercised. In each of these patients, contact urticaria with soap preceded the food ingestion-induced reactions. The other patients directly developed generalized symptoms upon ingestion of wheat products. In some cases, allergies were triggered by mild exercise such as walking and bathing…”

What is most interesting to me is the ubiquitous use of wheat, corn, eggs, soy and dairy in all sorts of products that can touch our skin and can cause an unwanted immune response.   Can this be triggering unwanted immune responses?  Can this be one of the reasons these foods are common allergens?

So certainly do respect what is in your skin products as these can contribute to deleterious health effects.   Not only for allergens but also for toxins and the Environmental Working Group Skin Deep website is a great resource.)

Yours In Health,
George Mandler
Licensed Acupuncturist
Licensed Dietitian / Nutritionist

How could I be so sure we are saving so much?  One metric is simply based on people telling me they need surgery.  Back, knee, intestinal, hip etc.   Many times after a series of acupuncture treatments people feel remarkably better.   If they underwent surgery those procedure are often at minimum $15,000 per procedure. ( typically much more).   If people came to us before getting an expensive MRI the cost effectiveness would be even further realized.

Many people are not interested in taking medications with side effects. It seems more and more people are waking up to the fact that mediation for chronic conditions only treats symptoms and does little to help the underlying issue. Acupuncture is one of many great modalities that can help correct chronic conditions that Western medicine where western medicine has little answers except medication or surgery.  Those answers can be very costly.

The review just released below demonstrates the cost effectiveness of acupuncture to back up my claim.

Acupunct Med. 2012 Dec;30(4):273-85.
A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture.
Kim SY, Lee H, Chae Y, Park HJ, Lee H.
Abstract
OBJECTIVE: To summarise the evidence on the cost-effectiveness of acupuncture.

METHODS: We identified full economic evaluations such as cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA) alongside randomised controlled trials (RCTs) that assessed the consequences and costs of acupuncture for any medical condition. Eleven electronic databases were searched up to March 2011 without language restrictions. Eligible RCTs were assessed using the Cochrane criteria for risk of bias and a modified version of the checklist for economic evaluation. The general characteristics and the results of each economic analysis such as incremental cost-effectiveness ratios (ICERs) were extracted.

RESULTS:Of 17 included studies, nine were CUAs that measured quality-adjusted life years (QALYs) and eight were CEAs that assessed effectiveness of acupuncture based on improvements in clinical symptoms. All CUAs showed that acupuncture with or without usual care was cost-effective compared with waiting list control or usual care alone, with ICERs ranging from €3011/QALY (dysmenorrhoea) to €22 298/QALY (allergic rhinitis) in German studies, and from £3855/QALY (osteoarthritis) to £9951/QALY (headache) in UK studies. In the CEAs, acupuncture was beneficial at a relatively low cost in six European and Asian studies. All CUAs were well-designed with a low risk of bias, but this was not the case for CEAs.

CONCLUSIONS: Overall, this review demonstrates the cost-effectiveness of acupuncture. Despite such promising results, any generalisation of these results needs to be made with caution given the diversity of diseases and the different status of acupuncture in the various countries.

Of course a small percentage of pregnancies require modern medical intervention in the forms of medications and potential surgeries.  Modern medicine has saved countless pregnant women and  newborn lives.  But I don’t agree with the unnecessary overuse of strong medicines or procedures that have little clinical evidence of safety and potential deleterious side effects when safer options are available.

For example women given SSRIs to ‘prevent’ postpartum depression (PPD)  may cause language development delays in their child. The underlying causes of PPD are hardly addressed and drugs are prescribed as an easy solution.  Underlying PPD is often inflammatory mediators expressed in response to food hypersensitivities or an underlying endocrine dysfunction.  This is where modern medicine fails women as  the undesirable ‘side effects’ from prescription medications (the quick fix of a symptom) misses the root of the issue.  Sure the strong medication may fix the symptom, but often an undesirable effect (‘side effect) also shows up somewhere else.

Another example of a condition when there is medication overuse is Pregnancy Induced Hypertension (PIH).   Certainly hypertension during pregnancy can have some serious consequences for the baby and mother.  However even the slightest increase in blood pressure can sometimes trigger a script for a prescription anti-hypertensive drug without consideration as to why the blood pressure may be elevated.   These drugs have recently come under question as to their safety during pregnancy.   The aforementioned article states: “The drugs prescribed included ACE inhibitors and angiotensin receptor blockers — both of which have been shown in studies to have harmful side effects during pregnancy.” There are much safer and healthier options available, as PIH is a symptom of an underlying imbalance.   Correct the underlying imbalance and blood pressure is reduced.  I’ve had many patients reduce their hypertension without taking prescription medication.

One solution is that exercise before and during pregnancy helps reduce hypertension in laboratory rats. Now it makes sense that exercise can help reduce hypertension across the board.  But it is a lot easier for a rat to spin on a wheel in third trimester (when PIH is the worst) than a pregnant woman to get out and exercise, as many times exercise can trigger Braxton-Hicks contractions with uncomfortable uterine tightening.  So the exercise option is not always viable later in pregnancy.  However exercise before getting pregnant and during pregnancy does appear to have an inverse relationship to blood pressure levels.

I have found acupuncture to be very effective at controlling PIH.   Acupuncture can offer a very calming the nervous system and an individualized needle prescription based on the woman’s presentation can have excellent results in reducing blood pressure.  Typically at least 4-6 acupuncture treatments are needed two times per week, but then once it gets under control a weekly acupuncture treatment should keep it stable.

Another pregnancy complication that can often be better treated with more complementary treatments is pre-term labor.   It is accepted that inflammatory mediators are the cause of pre-term labor.   One of the  most common ways we create inflammation is to eat foods that cause hypersensitivities reaction.   The hypersensitivities cause an immune response and a release of inflammatory mediators which cause many women to have a high load of oxidative stress.    Given the almost miraculous changes I see in some people that do an individualized food sensitivity low inflammatory  diet I am confident that in the not too distant future we may find that proper dietary changes during pregnancy may help prevent pre-term labor in those at risk.

There are many things a woman can do before getting pregnant and in early pregnancy to reduce changes of medical intervention.   If conditions do develop then alternative care such as acupuncture, diet and safe for pregnancy herbal formulas are often a better bet than standard care which uses medications that contribute to undesirable side effects.

Yours In Health,

George Mandler

Licensed Acupuncturist

Licensed Nutritionist / Dietitian

There can be many reasons why someone is not sleeping well. The typical patterns I see when someone complains of a not sleeping well or ‘insomnia’ is either:

• A person cannot fall asleep.   Either their head is spinning with thoughts (“monkey mind”  心猿)  or they just feel wired and jittery.
• A person wakes up after a few hours of sleep.  Often around 2 am for about 1-2 hours.
• A person wakes up early in the morning feeling they haven’t had enough sleep, but cannot fall back asleep. (even though it is 4:00am).

Some sleep issues can stem from endocrine system and blood sugar dysregulation.  Some can be caused by anemia.  Some may stem from circumstantial life situations one is currently experiencing and causing a ‘Heart’ disturbance.  Certainly the sleep disorder is not from an Ambien deficiency.

Acupuncture is an amazing modality to treat any sleep disturbances and my first choice.   Many times people come to me for complaints other than sleep, but then report that whenever they receive acupuncture then they sleep great.

Two studies were just released to determine the efficacy of acupuncture for sleep disturbances.  One study compared Ambien to acupuncture and found that they both significantly improved sleep.  The ‘side effects’ of acupuncture are considerably more beneficial than the side effects of Ambien.

The other study looked at the efficacy of points on the lateral occiput called Anmian (“Peaceful Sleep”) and if they improve sleep quality vs just using body meridian points.  Researchers found that the addition of these occiput acupuncture points significantly improved sleep quality over meridian points alone.

Do consider acupuncture and Chinese Medicine for the treatment of sleep disorders before resorting to medications. Your body will appreciate you for it.

Yours In Health,

George Mandler

Licensed Acupuncturist

Licensed Dietitian

Stow & Cambridge, MA

Here we have a meta analysis that looked at raw data from over 2 dozen studies and it showed that acupuncture is an effective treatment for back pain.  However the anti-alternative medicine folks are quick to pounce on the fact that real acupuncture over sham acupuncture only had about a 10% improvement in chronic pain scores.  In other words it wasn’t statistically significant.   The 5 senses only folks then claim acupuncture is just a placebo effect, which is a ridiculous argument in of itself for a few reasons:

1. The sham group in this case is not ‘sham’, as in receiving no treatment.   “Sham” absolutely can trigger a physiological response.  As any acupuncturists will tell you the mere puncturing of the skin in needles at random points can bring about positive change in some.   Yes you don’t need to hit exact points in some people as they may respond to almost anything.
2. Of course there is a ‘placebo’ effect in acupuncture treatments.  How can there not be?   The patient/practitioner relationship plays a significant role as shown by Ted Kaptchuk. But what is the ‘placebo effect’?    It is the mind bringing about a healing response.    If the goal is to make people feel better than that is a treatment!  Who cares how one gets there as long as they feel better.
3. If it is just a placebo effect then how does one explain the numerous reports of improvement of health for animals?

The authors also eliminated two RCTs that strongly favored acupuncture because of bias concerns, therefore if these were included the results would have been even more pronounced showing the efficacy of acupuncture for chronic pain.   But to me the real point of the study was that acupuncture was better than the care that would typically be received.   Acupuncture is certainly much less expensive than the medications and surgeries that people in chronic pain endure.   Therefore acupuncture is an effective solution for reducing healthcare costs.

An interesting study would be to split a population of chronic pain patients where one group receives acupuncture and the other group receives standard of care and follow these two groups over a 5 year period.   I would expect that acupuncture would prove to be more cost effective and show better outcomes.    A study such as this is much more useful than a study that tries the impossible task to make a placebo of an acupuncture treatment.   There is no such thing as ‘placebo’ acupuncture.

There were several good write-ups about this meta-analysis article.  Click here for one from Medpages. (http://www.medpagetoday.com/PrimaryCare/AlternativeMedicine/34673)

Yours In Health,

George Mandler

Licensed Acupuncturist

Licensed Nutritionist/Dietitian