Urban Chiropractic

Post-COVID Exercise Intolerance Associated with Capillary Alterations and Immune Dysregulations in Skeletal Muscles

Post-COVID exercise intolerance, a condition experienced by some individuals after recovering from COVID-19, is increasingly drawing attention from the medical and scientific communities. This condition is characterized by a diminished capacity to engage in physical activities that were previously manageable, leading to a significant reduction in overall quality of life. The underlying mechanisms of this phenomenon are multifaceted, involving complex interactions between capillary alterations and immune dysregulations in skeletal muscles.

Understanding Post-COVID Exercise Intolerance

COVID-19, caused by the SARS-CoV-2 virus, primarily affects the respiratory system but also has systemic impacts. Even after recovery from the acute phase of the infection, some individuals experience lingering symptoms, known as ‘Long COVID’ or ‘Post-Acute Sequelae of SARS-CoV-2 infection (PASC)’. One of the manifestations of Long COVID is exercise intolerance, which is not only limited to respiratory distress but also involves the musculoskeletal system.

Capillary Alterations in Skeletal Muscles

One of the critical factors contributing to post-COVID exercise intolerance is the alteration in capillary function within skeletal muscles. Capillaries, the smallest blood vessels in the body, are crucial for delivering oxygen and nutrients to muscle tissues and removing waste products. During exercise, the demand for oxygen and nutrients in muscles increases exponentially, necessitating an efficient capillary response.

In individuals with post-COVID exercise intolerance, these capillaries may be functionally impaired. This impairment could be due to direct viral damage, inflammation, or thrombosis (blood clots), all of which have been observed in COVID-19 patients. The endothelial cells lining the capillaries can be directly infected by the virus, leading to endotheliitis, an inflammation of the endothelium. This inflammation can reduce capillary dilation and impair blood flow, leading to decreased oxygen and nutrient delivery during exercise.

Immune Dysregulation and Skeletal Muscle Function

Another aspect of post-COVID exercise intolerance is immune dysregulation. COVID-19 triggers a robust immune response, which in some cases becomes dysregulated, leading to a state of chronic inflammation. This prolonged inflammatory response can affect skeletal muscles.

Cytokines, small proteins released by immune cells, play a significant role in this process. During and after COVID-19 infection, levels of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) are often elevated. These cytokines can directly impact muscle function by promoting catabolism (breakdown of muscle tissue) and inhibiting anabolism (muscle building). Additionally, chronic inflammation can lead to muscle fatigue and reduced exercise capacity.

The Interplay of Capillary and Immune Alterations

The relationship between capillary alterations and immune dysregulations in the context of post-COVID exercise intolerance is complex. Impaired capillary function can lead to reduced oxygenation of muscle tissues, exacerbating the effects of immune-mediated inflammation. Conversely, the inflammatory milieu can further damage capillaries and impair their function.

Implications and Future Directions

The implications of these findings are significant for the management of post-COVID patients. Rehabilitation strategies need to consider not only respiratory recovery but also the restoration of muscle function and capillary health. This might involve tailored exercise programs, anti-inflammatory treatments, and perhaps interventions aimed at improving microvascular health.

Further research is crucial to unravel the detailed mechanisms of capillary and immune alterations in post-COVID exercise intolerance. Understanding these mechanisms will aid in the development of targeted therapies to alleviate these symptoms and improve the quality of life for those affected.

Conclusion

Post-COVID exercise intolerance is a complex condition involving capillary alterations and immune dysregulations in skeletal muscles. It highlights the need for a holistic approach in treating Long COVID patients, addressing not just the respiratory symptoms but also the systemic impacts of the disease. As our understanding of this condition evolves, so too will our strategies for managing and mitigating its effects on the lives of those recovering from COVID-19.

Healthy Foods That Can Prevent Kidney Stones

Kidney stones are a common health issue that affects many people worldwide. These stones are hard mineral and salt deposits that form inside the kidneys, and they can be quite painful when passed. The good news is that diet plays a significant role in preventing kidney stones. Consuming certain health foods can lower the risk of developing them.

Firstly, it’s essential to understand the primary types of kidney stones, as this can influence dietary choices. Calcium oxalate stones are the most common, and although it may seem counterintuitive, maintaining a diet with normal calcium levels is crucial. Foods high in calcium such as dairy products, kale, and broccoli, should not be eliminated from the diet. Instead, the focus should be on reducing the intake of oxalate-rich foods like spinach, beets, and chocolate. However, when consuming foods with oxalates, pairing them with calcium-rich foods can be beneficial, as calcium can bind with oxalate in the intestines, reducing the risk of stones.

Hydration is another key factor in preventing kidney stones. Drinking plenty of fluids, especially water, helps to dilute the substances in urine that lead to stones. An easy way to check for proper hydration is by looking at the color of the urine – it should be light and clear. Besides water, lemonade and orange juice are also beneficial because they contain citrate, which can prevent stone formation.

Reducing salt intake is also important. A high-salt diet increases the amount of calcium in urine, which can lead to the development of kidney stones. Processed foods are typically high in salt, so it’s better to choose fresh, whole foods when possible. Seasoning foods with herbs and spices instead of salt can also help reduce overall sodium intake.

Another dietary consideration is the consumption of animal protein. Foods like red meat, poultry, eggs, and seafood can increase the risk of kidney stones. This is because they increase the amount of uric acid in the body and can lead to the formation of stones. It’s not necessary to completely avoid these foods, but moderation is key. Plant-based proteins such as lentils, chickpeas, and quinoa are good alternatives.

A lesser-known preventive measure involves incorporating citrus fruits into the diet. Citrus fruits like lemons, oranges, and grapefruits contain citric acid, which is beneficial for preventing stone formation. Citric acid can bind with calcium in the urine, reducing the risk of stones. A simple way to add more citrus to the diet is by squeezing lemon or lime juice into water.

In addition to these specific foods, overall dietary patterns are important. A diet rich in fruits and vegetables can help prevent kidney stones. Fruits and vegetables are high in fiber, magnesium, and potassium, all of which are beneficial for preventing stone formation. They also help in maintaining a healthy weight, which is another factor in reducing the risk of kidney stones.

It’s also beneficial to limit the intake of foods high in oxalates if you are prone to forming calcium oxalate stones. While foods like nuts, tea, and chocolate are generally healthy, they are high in oxalates, which can contribute to kidney stone formation in susceptible individuals.

Lastly, it’s important to consult with a healthcare provider before making any significant dietary changes, especially for those with a history of kidney stones. A healthcare provider can offer personalized advice based on the type of stones and individual health needs.

In conclusion, preventing kidney stones through diet involves a balanced approach. It includes staying well-hydrated, reducing salt and animal protein intake, eating calcium-rich foods in moderation, and incorporating citrus fruits and a variety of fruits and vegetables into the diet. By making these dietary adjustments, the risk of developing kidney stones can be significantly reduced, leading to better kidney health and overall well-being.

The Health Benefits of Cottage Cheese

Cottage cheese, a fresh cheese curd product with a mild flavor, is a highly nutritious and versatile dairy item that has been gaining popularity due to its numerous health benefits. One of the primary benefits of cottage cheese is its high protein content. Rich in casein, a slow-digesting dairy protein, cottage cheese provides a steady release of amino acids, making it an excellent option for muscle repair and growth. This feature is particularly beneficial for athletes and those engaged in regular physical activity. Moreover, the high protein content contributes to a feeling of fullness, which can aid in weight management by reducing the likelihood of overeating.

In addition to protein, cottage cheese is an excellent source of many vital nutrients. It is rich in B vitamins, particularly B12, which is essential for brain health and the maintenance of the nervous system. It also contains calcium, crucial for bone health. Regular consumption of calcium-rich foods like cottage cheese can help prevent osteoporosis and bone fractures. Another significant mineral present in cottage cheese is phosphorus, which works in tandem with calcium to strengthen bones and teeth.

Cottage cheese is also beneficial for heart health. It contains a considerable amount of potassium, which can help in maintaining blood pressure levels. Potassium aids in balancing out the effects of sodium and helps in the relaxation of blood vessels, reducing the risk of hypertension. While cottage cheese can be high in sodium, low-sodium varieties are available, making it a heart-friendly option.

For individuals with diabetes, cottage cheese is a smart dietary choice due to its low carbohydrate content. This characteristic helps in maintaining stable blood sugar levels, making it a suitable option for those managing diabetes or those who are at risk. Additionally, the presence of magnesium in cottage cheese plays a role in carbohydrate metabolism, further aiding in blood sugar control.

Digestive health is another area where cottage cheese shines. It contains probiotics, beneficial bacteria that can aid in maintaining a healthy gut microbiome. Regular consumption of foods rich in probiotics, like cottage cheese, can promote digestive health and can help in preventing gastrointestinal issues such as constipation and bloating.

Cottage cheese is also a valuable dietary inclusion for those looking to improve their skin health. It is rich in selenium, an antioxidant that helps protect the skin from free radical damage and inflammation. This nutrient can also aid in maintaining skin elasticity and reducing the appearance of fine lines and wrinkles.

Moreover, cottage cheese can be an integral part of a weight loss or weight management diet. Its high protein content, combined with a relatively low calorie count, makes it a satisfying food that can help reduce overall calorie intake. This aspect, along with its nutrient density, makes cottage cheese an excellent choice for those trying to lose weight without compromising on nutritional quality.

In summary, cottage cheese is a nutrient-dense food offering a multitude of health benefits. Its high protein content supports muscle repair and growth, and aids in weight management. Rich in vital nutrients like B vitamins, calcium, phosphorus, and magnesium, it contributes to bone health, heart health, and blood sugar control. The presence of probiotics promotes digestive health, while selenium supports skin health. As a versatile and easily incorporated food into various diets, cottage cheese is an excellent choice for anyone looking to enhance their overall health and well-being.

The Effects of Cold Weather on Back Pain

Cold weather significantly impacts back pain, a common condition among many people. Understanding this relationship is crucial for managing and preventing discomfort during colder months. The effects of cold weather on back pain encompass various aspects, including physiological responses, exacerbation of existing conditions, and lifestyle changes.

Physiologically, cold weather leads to increased muscle tension as muscles contract more to conserve heat. This results in stiffness and pain, particularly in the back and neck, with muscles becoming less flexible and more prone to injury. The cold also causes blood vessels to constrict, reducing blood flow and slowing down the healing process in the back. Moreover, nerves may become more sensitive in the cold, heightening pain perception, especially in conditions like sciatica.

Existing conditions such as arthritis, which often affects the spine and back, can worsen in cold weather. The drop in barometric pressure accompanying colder climates can expand tissues and increase joint pain, exacerbating back discomfort. Previous back injuries may also become more sensitive to weather changes, leading to increased pain.

Lifestyle changes during cold weather also play a significant role. Reduced physical activity leads to muscle weakness, particularly in core and back muscles, critical for spinal support. Lack of exercise contributes to weight gain, putting additional strain on the back. Moreover, heavy winter clothing and boots can alter walking and standing patterns, leading to poor posture and additional strain on the back.

To manage cold weather back pain, several strategies can be employed. Keeping the back and muscles warm is essential, using clothing layers and heating pads to maintain muscle flexibility. Regular exercise, especially activities strengthening core and back muscles, is crucial. Paying attention to posture, even when wearing heavy winter clothing, and ensuring ergonomic setups at home and work can prevent additional strain. Over-the-counter pain relievers, massage therapy, and acupuncture are useful for pain management, but it’s important to consult healthcare professionals before starting any new treatment. Vitamin D supplementation might be beneficial due to reduced sunlight in winter, leading to vitamin D deficiency linked to increased pain sensitivity. Additionally, staying hydrated is important, as dehydration can exacerbate muscle stiffness.

In conclusion, the effects of cold weather on back pain are influenced by a combination of physiological changes, exacerbation of existing conditions, and lifestyle shifts. By adopting appropriate strategies like staying warm, maintaining physical activity, and practicing good posture, individuals can mitigate these effects. However, consulting healthcare professionals for personalized advice and treatment is always advisable.

Foods that Help You Lower Your Cholesterol

Foods that help lower cholesterol play a crucial role in maintaining heart health and overall well-being. Cholesterol, a waxy substance found in your blood, is essential for building healthy cells. However, high levels of cholesterol can increase the risk of heart disease. This is where diet becomes important, as certain foods can help reduce cholesterol levels.

Oats are a great starting point. A simple change like starting your day with a bowl of oatmeal or oat-based cereal can make a significant difference. Oats contain a type of soluble fiber known as beta-glucan. This fiber helps reduce the absorption of cholesterol into your bloodstream. Including oats in your diet can lower LDL (low-density lipoprotein) or “bad” cholesterol, which is a significant contributor to heart disease.

Another powerful food in the fight against high cholesterol is fish, particularly fatty fish like salmon, mackerel, and sardines. These fish are rich in omega-3 fatty acids, known for their heart-health benefits. Omega-3s help reduce triglycerides in the bloodstream and also slow down the growth rate of atherosclerotic plaque, which can clog arteries. Incorporating fish into your diet a couple of times a week can be beneficial, especially when it replaces sources of saturated fats, like red meat.

Nuts, especially almonds, walnuts, and pistachios, are also beneficial for lowering cholesterol. Nuts contain monounsaturated fats, which are heart-healthy. They also have fiber, which can help lower your LDL cholesterol. Eating a handful of nuts every day can have a positive effect on your heart health. However, nuts are high in calories, so it’s important to eat them in moderation.

Vegetables are an integral part of a cholesterol-lowering diet. They’re high in soluble fiber, which helps lower cholesterol levels. Dark leafy greens, like spinach and kale, contain lutein and other carotenoids, which are associated with a reduced risk of heart disease. Vegetables also have a low calorie-density, meaning you can eat large servings without consuming too many calories, helping in weight management, which is crucial for maintaining healthy cholesterol levels.

Beans are another excellent source of soluble fiber. They also take a while for the body to digest, meaning you feel full for longer after a meal. This is beneficial for weight management. Beans are versatile and can be included in a variety of dishes, making them an easy addition to your diet.

Avocados are a nutrient-dense fruit that can help lower LDL cholesterol. They’re a rich source of monounsaturated fats and fiber, both of which are known for their heart health benefits. Including avocados in your diet can lead to an improvement in your overall cholesterol profile.

Whole grains, like brown rice, barley, and whole wheat, contain more soluble fiber than refined grains. Including more whole grains in your diet can help lower total cholesterol and LDL cholesterol.

Fruits, particularly those high in fiber like apples, grapes, strawberries, and citrus fruits, can also contribute to cholesterol reduction. These fruits are rich in pectin, a type of soluble fiber that lowers LDL cholesterol.

Soy foods, such as tofu and soy milk, can also help lower LDL cholesterol. Studies have shown that consuming soy protein in place of animal protein can lead to a modest reduction in cholesterol levels.

Lastly, dark chocolate and cocoa can also play a role in lowering cholesterol. They contain flavonoids, antioxidants that help lower LDL levels. However, it’s important to choose dark chocolate with a high percentage of cocoa and consume it in moderation due to its high calorie and sugar content.

In conclusion, incorporating a variety of these cholesterol-lowering foods into your diet can significantly impact your overall heart health. It’s also important to remember that lifestyle changes, including regular exercise, not smoking, and maintaining a healthy weight, work in conjunction with a healthy diet to lower cholesterol levels. By making these dietary changes, you can reduce your risk of heart disease and improve your overall health.

Tirzepatide for Weight Loss: Current Status

Tirzepatide is a medication used to treat type 2 diabetes. Sold under the brand name Mounjaro, tirzepatide activates receptors for the glucagon-like-peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) hormones, which are involved in the control of blood sugar.¹ Patients who receive tirzepatide experience a drop in their hemoglobin A1C level, a common measure of average blood sugar levels. Tirzepatide has also demonstrated great potential as a weight loss drug.

Studies have shown that drugs which interact with the GLP-1 and GIP receptors could help treat obesity, owing to the effects that these receptors’ hormones have on brain signaling and the buildup of adipose tissue.² These results motivated researchers to conduct a clinical trial in which individuals with obesity would be administered varying amounts of tirzepatide once a week, with some participants receiving a placebo. The results of the trial, which was called SURMOUNT-1, were published in July 2022 in The New England Journal of Medicine.³

Tirzepatide, the researchers found, has remarkable ability as a weight loss drug. Over the course of the 72-week trial, participants who received a 5-mg dose of tirzepatide experienced a 15% decrease in body weight, those receiving a 10-mg dose saw a 19.5% drop in weight, and the 15-mg group had a 20.9% decrease in body weight, on average. Participants in the placebo group only saw a weight reduction of 3.1%. The mean reduction in total body fat mass across the tirzepatide groups was 33.8%.

The more moderate success of previous weight loss drugs is the context behind the excitement surrounding tirzepatide. Traditionally, a 5% or greater reduction in body weight has been the threshold for regarding an intervention as clinically significant.⁴ Weight-loss medications currently approved by the FDA have typical weight loss reductions between 3 and 8.6%.⁵ The next most effective weight-loss drug, semaglutide, led to a 15% reduction in weight loss in a trial similar to SURMOUNT-1.⁶ Remarkably, weight loss reduction percentages from tirzepatide approach those of bariatric surgery, which typically decreases weight by 25-30% within 1 to 2 years following surgery.⁷

Whereas SURMOUNT-1 was conducted in people without type-2 diabetes, SURMOUNT-2, a more recent clinical trial whose results were published in August 2023,⁸ sought to evaluate the weight-loss abilities of tirzepatide in people with type-2 diabetes. In this trial, participants who received 15-mg injections of tirzepatide had, on average, weight reductions of 14.7%. Though this is significantly lower than the 15-mg group in SURMOUNT-1, the authors of SURMOUNT-2 note that such a magnitude of weight reduction has previously only been seen in people without type-2 diabetes. Additionally, factors such as physical function improved significantly in the tirzepatide group, while risk factors like blood pressure and triglyceride and cholesterol levels decreased. These changes together can contribute to reduced cardiovascular disease over time. The safety profile of tirzepatide was favorable in both SURMOUNT-1 and SURMOUNT-2.

Tirzepatide is expected to skyrocket in popularity once it receives FDA approval, with some predicting it will become the best-selling drug of all time.⁹ Further iterations of the SURMOUNT trials are currently underway, one of which is directly comparing tirzepatide against semaglutide.¹⁰ Semaglutide itself has exploded in popularity recently, but data accumulates from real-world use, its side effects are becoming more apparent. It is clear that tirzepatide has the potential to considerably help patients with weight loss; additional research will make clear what advantages and disadvantages it may have.

References

1. Office of the Commissioner. FDA Approves Novel, Dual-Targeted Treatment for Type 2 Diabetes. FDA https://www.fda.gov/news-events/press-announcements/fda-approves-novel-dual-targeted-treatment-type-2-diabetes (2022).

2. Samms, R. J., Coghlan, M. P. & Sloop, K. W. How May GIP Enhance the Therapeutic Efficacy of GLP-1? Trends Endocrinol. Metab. TEM 31, 410–421 (2020), DOI: 10.1016/j.tem.2020.02.006

3. Jastreboff, A. M. et al. Tirzepatide Once Weekly for the Treatment of Obesity. N. Engl. J. Med. 387, 205–216 (2022), DOI: 10.1056/NEJMoa2206038

4. Ryan, D. H. & Yockey, S. R. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr. Obes. Rep. 6, 187–194 (2017), DOI: 10.1007/s13679-017-0262-y

5. American Diabetes Association. 8. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 43, S89–S97 (2020), DOI: 10.2337/dc20-S008

6. W, John P. H. et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N. Engl. J. Med. 384, (2021), DOI: 10.1056/NEJMoa2032183

7. Aminian, A. et al. Association of Bariatric Surgery With Major Adverse Liver and Cardiovascular Outcomes in Patients With Biopsy-Proven Nonalcoholic Steatohepatitis. JAMA 326, (2021), DOI: 10.1001/jama.2021.19569

8. Garvey, W. T. et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. The Lancet 402, 613–626 (2023), DOI: 10.1016/S0140-6736(23)01200-X

9. A new weight loss drug could become the best-selling drug of all time. Who can afford it? NBC News. https://www.nbcnews.com/health/health-news/weight-loss-drug-affordability-rcna60422 (2023).

10. A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight With Weight Related Comorbidities – Full Text View – ClinicalTrials.gov. https://classic.clinicaltrials.gov/ct2/show/NCT05822830.

Carbohydrate Content of Fruits and Vegetables

Along with vitamins, minerals, and antioxidants, fruits and vegetables contain carbohydrates, biomolecules that consist of carbon, hydrogen, and oxygen atoms. It is recommended that 55-60% of one’s daily caloric intake consist of carbohydrates. [1] Understanding the carbohydrate content of different fruits and vegetables is crucial for managing health, as they are main energy source in the human diet but can lead to complications if consumed in excess.

Carbohydrates exist in two primary categories: simple and complex. Simple carbohydratesare composed of one or two sugar molecules. The most common simple sugar is glucose; fruits contain simple sugars such as fructose, while milk and dairy products contain lactose. These sugars are digested and absorbed quickly, leading to rapid spikes in blood sugar levels. High consumption of simple carbohydrates can lead to alteration of the gut [2] – which in turn may cause inflammation – as well as an increased risk for diabetes, heart disease, and high cholesterol.

Complex carbohydrates consist of long chains of sugar molecules. Starches, found in foods like grains and legumes, are complex carbohydrates. They take longer to break down and therefore have a more gradual impact on blood sugar. Fibers are complex carbohydrates the body cannot digest, and they help stabilize blood sugar levels and contribute to a feeling of fullness, potentially making calorie intake easier to control. [3]

Fruits contain varying amounts of carbohydrates, primarily in the form of simple sugars. A medium-sized apple, for example, contains around 25 grams of carbohydrates, while an average banana has about 27 grams of carbohydrates. [4] Berries like strawberries, blueberries, and raspberries are relatively low in carbohydrates: a cup of strawberries, for example, contains roughly 11 grams of carbohydrates.4 While there is no inherent difference between natural and added sugars, such as those found in a candy bar, it’s worth emphasizing that fruits provide antioxidants, fiber, and other nutrients, while foods rich in added sugars often contain little nutritional value.

Vegetables tend to be lower in carbohydrate content compared to fruits, making them a preferred choice for those aiming to manage their carb intake. One cup of cooked broccoli, for example, contains about six grams of carbohydrates, while a cup of raw spinach has only about one gram of carbohydrates.4 Interestingly, steaming and boiling certain root vegetables can increase their dietary fiber content, as shown in a recent study. [5]

Another important concept to consider when evaluating the carbohydrate content of fruits and vegetables and their impact on blood sugar levels is the glycemic index (GI) and glycemic load (GL). GI measures how quickly a food can raise blood sugar levels. Foods with a high GI (70 or more) are rapidly absorbed and can cause spikes in blood sugar, while low-GI foods (55 or less) are absorbed more slowly. GL is a newer metric that considers GI along with the amount of carbohydrates per serving and provides a more accurate picture of how a food impacts blood sugar. [6] Watermelon, for example, has a high GI because it contains natural sugars, but its GL is relatively low because it’s mostly water. This means that while it can raise blood sugar, the effect is less significant compared to some other high-GI foods.

References

1. Krauss, R. M. et al. Dietary Guidelines for Healthy American Adults. Circulation 94, 1795–1800 (1996), DOI: 10.1161/01.cir.94.7.1795

2. Clemente-Suárez, V. J. et al. The Burden of Carbohydrates in Health and Disease. Nutrients 14, 3809 (2022), DOI: 10.3390/nu14183809

3. National Research Council (US) Subcommittee on the Tenth Edition of the Recommended Dietary Allowances in Recommended Dietary Allowances: 10th Edition (National Academies Press (US), 1989), DOI: 10.17226/1349

4. United States Department of Agriculture, FoodData Central. https://fdc.nal.usda.gov/fdc-app.html#/food-details/171688/nutrients.

5. Andersson, J. et al. Comparison of steaming and boiling of root vegetables for enhancing carbohydrate content and sensory profile. J. Food Eng. 312, 110754 (2022), https://doi.org/10.1016/j.jfoodeng.2021.110754

6. Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships | European Journal of Clinical Nutrition. https://www.nature.com/articles/1602942, https://doi.org/10.1038/sj.ejcn.1602942

Aflotoxins Harmful Effects and What Foods They are Found In

Aflatoxins, produced primarily by Aspergillus flavus and Aspergillus parasiticus molds, are highly toxic compounds that pose severe health risks to humans and animals, leading to diseases such as liver cancer. These toxins are secondary metabolites of certain fungi, with several types including Aflatoxin B1, B2, G1, G2, M1, and M2, among which Aflatoxin B1 is the most prevalent and toxic. They are chemically stable and can survive processing treatments.

Aflatoxins frequently contaminate crops like maize, peanuts, cottonseed, and tree nuts, especially under warm and humid conditions. They are also found in milk and dairy products when animals consume contaminated feed. As potent carcinogens, aflatoxins are linked to liver cancer in humans. Chronic exposure can lead to aflatoxicosis, causing liver damage, jaundice, and potentially liver failure. In children, it can stunt growth and delay development, while acute high-dose exposure can be immediately lethal.

The presence of aflatoxins in animal feed, when consumed by livestock, can lead to liver damage and reduced productivity in these animals. This also results in aflatoxins being present in animal products like milk, eggs, and meat, which is a significant health risk to humans. Economically, the presence of aflatoxins in crops can cause substantial financial losses in agriculture-dependent economies and create trade barriers due to stringent regulations on aflatoxin levels in imported foods.

To protect consumers, many countries enforce maximum levels for aflatoxins in food and feed, with international standards set by the Codex Alimentarius Commission. Regular monitoring for aflatoxin contamination is vital, employing methods such as chromatography and immunoassays, with technological advancements making detection more rapid and sensitive.

Prevention of aflatoxin contamination involves controlling mold growth through agricultural practices like crop rotation, proper irrigation, and pest control, as well as post-harvest measures like adequate drying and storage. Research is ongoing in understanding the biology of aflatoxin-producing molds and developing resistant crop varieties. Biotechnological approaches, such as genetic modification and biocontrol agents, are emerging as promising solutions.

Public health initiatives focus on educating the public about aflatoxin risks and promoting safe food handling and storage practices, particularly in developing countries, which is crucial for minimizing exposure to these toxins. In summary, aflatoxins represent a major threat to public health and the economy, necessitating comprehensive efforts in monitoring, regulation, research, education, and public health initiatives to mitigate their effects and ensure food safety.

Medical Gaslighting

Medical gaslighting is a concerning phenomenon in the healthcare sector where patients’ symptoms and concerns are dismissed or trivialized by healthcare professionals. This often leads to misdiagnosis, delayed treatment, or even no treatment, impacting patient health and trust in the medical system significantly.

At its core, medical gaslighting involves healthcare providers, whether consciously or unconsciously, invalidating or downplaying patients’ symptoms. This could be as overt as suggesting that symptoms are imagined or as subtle as attributing them to psychological factors without thorough investigation. The impact on patients is profound, potentially leading to the worsening of untreated conditions, mental health issues due to persistent invalidation, and a general mistrust of the medical system. In extreme cases, it can result in severe health consequences or death due to undiagnosed conditions.

Certain groups are more susceptible to medical gaslighting. Women, particularly those suffering from chronic pain conditions, often report not being taken seriously. Similarly, minorities, people from lower socioeconomic backgrounds, and members of the LGBTQ+ community face biases that can lead to their health concerns being overlooked or wrongly attributed to stereotypes.

The issue is highlighted through numerous case studies. Patients with conditions like fibromyalgia or endometriosis often recount years of pain being dismissed before receiving a correct diagnosis. Stories from racial minorities and LGBTQ+ individuals reveal a pattern of their health concerns being ignored or misattributed.

The root causes of medical gaslighting are complex, including systemic issues such as time constraints in consultations, lack of training in rare diseases, and unconscious biases in healthcare professionals. The culture within the medical profession, which sometimes values empirical data over patient testimony, also contributes to this problem.

Healthcare providers play a crucial role in addressing medical gaslighting. This involves acknowledging its existence, engaging in active listening, showing empathy, and undergoing continuous education on rare diseases, mental health, and diversity. Empowering patients is also key, which involves educating them about their rights, encouraging them to speak up, and advising them to seek second opinions if they feel dismissed. Patient advocacy groups are instrumental in this effort.

Medical gaslighting raises ethical and legal concerns. Ethically, it violates the principles of beneficence and non-maleficence in medicine. Legally, it can lead to malpractice lawsuits if the dismissal of symptoms results in harm to the patient. Beyond individual patients, it undermines public trust in the healthcare system and can lead to increased healthcare costs due to delayed diagnoses and treatments.

Addressing medical gaslighting requires systemic changes in healthcare, including better patient-provider communication, more inclusive medical training, and a shift in medical culture to value patient experiences. Research into patient experiences and outcomes can provide insights into the prevalence and impact of medical gaslighting, guiding future improvements in healthcare practices.

Chiropractic Neural Mobilization for Diabetic Neuropathy

Chiropractic Neural Mobilization (CNM) is an emerging approach in the management of diabetic neuropathy, a common complication of diabetes characterized by nerve damage, particularly in the extremities. This condition can lead to symptoms such as numbness, pain, and weakness in the feet and hands. Traditional treatments for diabetic neuropathy have focused on controlling blood sugar levels and medication for pain relief. However, CNM offers a complementary and alternative approach that focuses on the mechanical and functional aspects of the nervous system.

Understanding Diabetic Neuropathy

Diabetic neuropathy arises primarily due to prolonged exposure to high blood sugar levels, which damages nerves and impairs blood flow, essential for nerve health. The most common form is peripheral neuropathy, affecting the extremities. Symptoms can range from mild to severe and can significantly impact the quality of life.

Chiropractic Neural Mobilization: An Overview

CNM is a therapeutic approach that combines the principles of chiropractic care with specific techniques aimed at mobilizing the nervous system. This approach is grounded in the understanding that the nervous system is not just a static network of nerves but a dynamic system that requires movement and flexibility for optimal function. CNM techniques include gentle manipulations and stretches designed to relieve nerve entrapments and improve nerve gliding, which can be impaired in diabetic neuropathy.

Mechanism of Action

The underlying theory of CNM is that by improving nerve mobility and reducing nerve entrapment, it can alleviate the symptoms associated with diabetic neuropathy. Nerve mobilization techniques aim to restore the natural movement of nerves within their surrounding tissues, thus reducing tension and improving blood flow. This can lead to a reduction in pain and improvement in nerve function.

Clinical Application of CNM for Diabetic Neuropathy

In clinical settings, CNM is tailored to the individual needs of patients with diabetic neuropathy. The chiropractor assesses the patient’s condition, focusing on areas where nerve entrapment or reduced mobility is suspected. Treatment involves gentle manipulative techniques and stretches, targeting the affected nerves. This approach is often integrated with other therapeutic strategies, such as lifestyle modifications and exercises, to enhance overall effectiveness.

Research and Evidence

Research into CNM as a treatment for diabetic neuropathy is still in its early stages. However, preliminary studies and anecdotal evidence suggest that patients may experience improvements in symptoms like pain, numbness, and overall nerve function. Ongoing research is needed to establish the efficacy and safety of CNM in this context and to understand the mechanisms behind its potential benefits.

Advantages and Considerations

One of the primary advantages of CNM is its non-invasive nature, making it a safe option for many patients who may not tolerate certain medications or invasive treatments. It also addresses the mechanical aspects of neuropathy, which are often overlooked in standard diabetic care. However, patients considering CNM should consult with their healthcare provider, as it should complement rather than replace conventional diabetes management strategies.

Conclusion

Chiropractic Neural Mobilization represents a novel approach in the management of diabetic neuropathy, focusing on the mechanical and functional rehabilitation of the nervous system. While promising, it is important for patients and practitioners to approach this treatment as part of a comprehensive care plan for diabetes and its complications. As research in this area evolves, CNM may become a more integral part of neuropathy management, offering a new avenue of relief for those suffering from this challenging condition.