resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
June, 2007, Vol. 07, Issue 06
Glimpses of the Big Picture: Leptins
By Leon Chaitow, ND, DO
The topic covered in this article is relevant to practitioners of all disciplines, particularly those who are providing health care services to people who suffer from conditions as diverse as chronic inflammatory conditions, autoimmune diseases, neuropathic pain, obesity, diabetes, thyroid hormone resistance (e.g., unexplained hypothyroidism), many cardiovascular diseases, syndrome-X, food cravings ...and more. Before getting to the unlikely link that can connect these apparently unrelated diseases and conditions, a background setting is called for.
An image I like to use when explaining contextual issues in relation to health is that of an iceberg floating in the ocean. The visible portion of the iceberg - perhaps 20 percent of its total mass - simplistically can be seen to represent those aspects of the patient that we observe, palpate, assess, discuss and evaluate. These divinations result in a greater understanding of the unseen inner workings of the patient - equivalent to aspects of the unseen, underwater portion of the iceberg.
And then there is the ocean itself, in which the ice mountain floats. In relation to the iceberg, this would include elements such as the relative salinity, temperature and pH of the water, as well as the weather, currents and more. In relation to the patient, the context includes multiple influences - environmental; psychosocial, biochemical and biomechanical; past and present; intermittent and constant; acute and chronic - that affect the individual from cradle to grave.
The complexity of such interacting influences, overlaid on the person's genetic and acquired characteristics, as well as the symptoms being manifested, often seem too daunting to make sense of. Hence, the reductionist approaches of so much of health care, whereby modifications of single aspects of this confusing edifice are attempted in order to nudge it toward more normal function. This may be done via diet, medication, nutritional supplements or herbs, needles, manual treatment, exercise, hydrotherapy, better breathing or posture, homeopathy, and many other options. Any of these interventions might modify etiological features sufficiently to encourage the self-regulating functions and systems of the body toward better health.
Lifestyle changes might be suggested that appear to offer more fundamental health-enhancing possibilities. Here, treatment is not a feature, but rather the initiation of changes that aim to align the individual more closely with evolutionary imperatives - offering a chance for homeostatic functions to operate more efficiently. Such changes might involve reforming nutritional, exercise, sleep and other basic behavior patterns.
Many such changes are common sense. Practical lifestyle modifications have been demonstrated to lead to profound influences on well-being and health enhancement. These suggestions range from more exercise, adequate sleep, balanced/reformed dietary habits (avoiding or modulating intake of high-sugar, high-fat junk food and stimulants such as caffeine and alcohol), as well as better breathing and relaxation methods. Other simple choices also are now available, backed by solid scientific evidence; much of it relating to hormones produced by white adipose tissue (fat), such as leptin.
The Leptin Story
I am grateful to Judith DeLany, LMT, with whom I have happily co-authored three books, for drawing my attention to the rapidly-evolving area of leptin research and putting together a summary for use in one of our revisions. Credit for collating a great deal of the information outlined below belongs to her. Recent research points toward basic lifestyle changes that can have profound influences on the evolution of diseases. Due to space constraints, I will outline only some of the most pertinent information, with appropriate references that can be used to expand on the summary below:
A simple plan has been devised8 to help regain normal leptin levels and thereby, balance the hormonal cascade discussed above. Although this plan may not be ideal for every one, it is presented here for the majority who it is suggested should benefit from its use. The foundation of the plan contains five basic rules. Breaking any of the rules or guidelines (below) can lead to setbacks.
Rule 1: Never eat after dinner, not even a snack or glass of wine or juice. Allow 11-12 hours between dinner and breakfast. Generally, finish eating dinner at least three hours before bed. This rule is designed to allow leptin, melatonin, cortisol and other chemicals to balance during the night. Individuals with night-eating syndrome have abnormal hormonal patterns apparently associated with nocturnal eating.9
Rule 2: Eat three meals a day. Allow 5-6 hours between meals. Timing is crucial, so that insulin levels can drop, glucagon (produced by the liver) can rise, and fat metabolism can kick in. If this occurs a couple of hours before more food is eaten, fat stores can be utilized until the next food is eaten. Snacking between meals sends the insulin back up and fat stores remain untapped. Therefore, snacks are to be avoided. Protein and carbohydrate portions are the size of the palm of the hand and most vegetables can be eaten as desired. Peas, carrots and corn are taken in moderation.
Rule 3: Do not eat large meals. Eat slowly and, if overweight, always try to finish a meal when slightly less than full. Eating slowly allows time for hormonal signals to reach the brain before overeating occurs. Smaller meals allow for better digestion. Do not overstretch the stomach and reduction in overall caloric consumption can be achieved.
Rule 4: Eat a breakfast containing protein. This helps set the hormonal cycles for day and night. Compromising this can have hormonal effects during the day and into the night, disturbing sleep. Weigle, et al.,10 showed that an increase in dietary protein from 15 percent to 30 percent of energy produced significant weight loss, presumably "mediated by increased central nervous system leptin sensitivity."
Rule 5: Reduce the overall amount of carbohydrates eaten. Unless one already is on a low-carb plan, chances are that too many carbohydrates are routinely consumed. Regarding carbohydrate influences, Garg, et al.,11 note, "Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5 percent increase in plasma triglycerides and a similar increase in [very low-density lipoprotein]-cholesterol levels; it also reduced levels of HDL cholesterol by 11 percent."
This brief summary suggests that eating regular, balanced (low-sugar, for example) meals, including a protein breakfast; avoiding snacking between meals and reducing overall carbohydrate intake; and getting enough sleep can beneficially impact a huge range of diseases, including those that involve excessive inflammation.
If you or your clients are overweight, suffering from inflammatory conditions and/or any of the long list of conditions mentioned by researchers investigating leptin, these simple changes could offer a way of beneficially influencing health. When they do, this represents an example of contextual health care, as discussed at the start of this article.
Click here for more information about Leon Chaitow, ND, DO.
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