August 20th, 2007 by Dr. Val Jones in News
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There has been some recent buzz about the health risks of nail salon workers. Two studies suggest that constant exposure to nail product fumes might impact cognition in both nail salon workers and their unborn babies. Although the workers’ exposure is estimated at 1200 times that of the average American, it does make one wonder if any woman who frequents these places may be at some risk.
The first study involved neuropsychological testing of 33 female salon workers and comparing their results to 35 women matched controls. The researchers found that the salon workers did worse on tests of attention span and mental processing speed and their sense of smell was decreased. This study was too small and non-specific to tease out which chemicals might be the culprits, but the observations were concerning.
The second study involved cognitive testing of children born to 32 mothers who were exposed to organic solvents when they were in utero. Compared to a control group, the children (whose moms had been exposed to chemicals) performed more poorly on IQ tests and various other cognitive tests. Interestingly, the participants in this study were not nail salon workers – they held jobs ranging from funeral home embalming technicians to hair stylists, to dry cleaners.
The Environmental Protection Agency issued some guidelines for nail salons, and based on my experience I’d be surprised if salons adhere to even 1/3 of these guidelines on average. If you scroll to page 12 of the brochure, you’ll see that the EPA recommends wearing a “organic vapor cartridge respirator” which looks like something out of a HAZMAT video. I doubt that any nail salons provide these for their staff… and if they did, what would clients make of it?
And so I think these small studies raise an interesting question: how safe is it to be exposed to organic solvents at all? We need to do more research to tease out the exact risks of each individual chemical, and at which concentrations. As for me, I’d urge pregnant women to minimize their exposure wherever possible, and strongly consider avoiding salons that offer acrylic nail services. Until we know exactly how harmful these chemicals are – the best thing to do is to avoid them wherever possible. The potential for solvent-related cognitive decline is worrisome enough – but allergies and asthma exacerbations are far more common. For a full list of chemicals known to be harmful (and their side effects) please review the EPA brochure, pages 4-5.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 20th, 2007 by Dr. Val Jones in Opinion
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I returned from Trader Joe’s with several bags full of
organic produce and frozen goods today.
It cost me substantially more than it would have at a regular grocery
store, but I figured it was worth it since the food was probably of higher
quality. It also seemed that I might be
helping small farmers by purchasing goods there, which pleased me. And yet I had this nagging feeling that maybe
this was a marketing ploy… that the “experience” of Trader Joe’s was what I was
really buying.
Dr. Clark
directed me towards this interesting, if not controversial blog about organic foods. In it, the author explains the “real story”
behind Trader Joe’s:
Trader Joe’s is a
supermarket chain specializing in organic, vegetarian, and alternative foods
with hundreds of locations throughout the United
States, centered in organic-happy Southern
California. Shoppers appreciate its image of healthful food in a
small-business family atmosphere. Really? In 2005 alone, Trader Joe’s racked up
sales estimated at $4.5 billion. The company is owned by a family trust set up
by German billionaire Theo Albrecht, ranked the 22nd richest man in the world
by Forbes in 2004. He’s the co-founder and CEO of German multi-national ALDI,
with global revenue in grocery sales at $37 billion. According to Business
Week, the decade of the 1990’s saw Trader Joe’s increase its profits by 1000%.… Trader Joe’s customers are willing to pay
their premium prices to get that healthful image. But they should not kid
themselves that they’re striking a blow at big business and supporting the
little guy.
Ok, so maybe I’m not
helping the little guy. But isn’t it
healthier to eat organic food?
From Canada’s
Department of Agriculture (hat tip to Moof for finding this reference):
· Some studies have shown traces of pesticide
residues in both food sources, regardless of production method.
· Nutritional value of plants depends on
genetics, availability of water, amount of sunlight, maturity when picked, how
long it took to come to market and whether it was properly handled and
refrigerated. Numerous laboratory tests have not found any substantial
nutritional differences in organically and conventionally grown produce.
· In blind taste tests, consumers generally
cannot differentiate between organically and conventionally grown food.
· Organic produce is marketed as pure and
healthy. Conventionally produced goods are equally safe and nutritious due to
strict regulations and guidelines.
In a recent
article in the Chicago Tribune, raw foods were not found to be as healthy
as initially suspected. The natural
sprouted plant enzymes that are supposed to be really good for you are actually
destroyed by stomach acid and never absorbed in the body. A raw food diet lacks Vitamin B12, which can
cause dangerous deficiencies.
A study by the Center for Global Food Issues found that
although organic foods make up about 1 percent of America’s diet, they also account
for about 8 percent of confirmed E. coli cases.
For a long list of organic food contaminations, check out the Canada Free Press.
What about hormones
given to animals to increase milk production or bulk them up?
In theory, this is the most concerning and potentially
convincing reason to preferentially select organic meats. I could imagine that eating animals pumped
with hormones could have a negative impact on humans – though the research I
found from the WHO and Cornell
University did not support my initial fears. They write:
Studies indicate that
if correct treatment and slaughter procedures are followed, the levels of these
hormones may be slightly higher in the treated animal’s meat or milk, but are
still within the normal range of natural variation known to occur in untreated
animals.
FDA scientists have
concluded that eating foods with slightly higher levels of rbGH would not
affect human health. This is because the amount of rbGH that is in milk or milk
products as a result of treatment of the animals is insignificant compared to
the amount of growth hormone that is naturally produced by our bodies. Also,
rbGH is a protein hormone and is digested into smaller fragments (peptides and
amino acids) when eaten. The rbGH hormone used on dairy cattle is effective in
promoting growth in cows, but does not work in humans. Scientists know that
rbGH is not recognized as a hormone by human cells.
Well, isn’t organic
farming better for the environment?
The Canadian Department of Agriculture states that organic
farming methods lead to increased soil erosion, lower crop yields (which
require more acres to produce the same amount of food), and require more
pesticides. Although regular farming
methods use different pesticides than the organic variety, neither types of
pesticides are particularly safe for humans.
Organic pesticides such as
rotenone may be a risk factor for developing Parkinson’s Disease – though
more research is needed to fully elucidate this risk.
So should you go
organic?
If you enjoy the flavor or the food quality of certain
produce (and don’t care about price) then purchase it gladly. Make sure you wash it well (organic or not)
and peel the skin if you have any doubts about remaining pesticides. Buy food directly from local farmers when you
can, support free range farming (it’s so much kinder to the animals), and don’t
believe the hype about organic foods automatically being healthier or more
nutritious for you.
Conclusions: organic food is not necessarily more
nutritious, it still may contain harmful pesticides, it is more likely to
contain harmful bacteria, there’s no convincing evidence to suggest that
hormones or antibiotics given to cattle have a negative impact on meat eaters,
and one thing’s for certain: organic food costs at least 20% more than
non-organic.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 14th, 2007 by Dr. Val Jones in Expert Interviews
4 Comments »
In a recent study conducted by the Agency for Healthcare Research and Quality (AHRQ), it was argued that better primary care could prevent 4 million hospitalizations per year. This staggering potential savings – on the order of tens of billions of dollars – seems like a good place to start in reducing some of the burden on the healthcare system (and reducing unnecessary pain and suffering). I interviewed Dr. Joe Scherger, Clinical Professor of Family & Preventive Medicine at the University of California, San Diego School of Medicine (UCSD) and member of the Institute of Medicine, to get his take on the importance of prevention in reducing health costs.
Dr. Val: What do the AHRQ
statistics tell us about the role of primary care in reducing healthcare
costs?
Volumes!
Primary care works with the
patient early in the course of illness, maybe even before it has developed, such
as with prehypertension and prediabetes. Primary care focused on prevention
with patients keeps people healthier and out of the
hospital.
Dr. Val: What can individual
Americans do to reduce their likelihood of having to be admitted to the
hospital?
Prevention begins with the individual,
not the physician. 60% of disease is related to lifestyle. Bad habits such as
smoking, overeating, not being physically fit, and stress underlie most common
chronic diseases. If Americans choose to be healthy and work at it, we would
save tremendously in medical expenses.
Dr. Val: Are there other studies
to suggest that having a medical home (with a PCP) can improve
health?
The medical home concept is new and lacks
studies, but the work of Barbara Starfield and others have confirmed the
importance of primary care and having a continuity relationship with a primary
care physician. The more primary is available, the healthier the population.
The opposite is true with specialty care.
Dr. Val: Why did the
“gatekeeper” movement (promoted by HMOs) fail, and what is the current role of
the family physician in the healthcare system?
The
“gatekeeper” role failed because it restricted patient choice. Patients need to
be in control of the health care, which is what patient-centered care is all
about. HMOs put the health insurance plan in charge, something which was hated
by patients and their physicians.
Dr. Val: In your work with the
IOM (specifically in Closing the Quality Chasm) did the role of primary care and
preventive medicine come up? If so, what did the IOM think that PCPs would
contribute to quality improvement in healthcare? Did they discuss (perhaps
tangentially) the cost issue (how to reduce costs by increasing preventive
measures?)
Just before the IOM Quality Reports
came out, the IOM did a major report on the importance of primary care. The
importance of primary care and prevention are central to improved quality. In
the “Chasm Report”, the focus was more on the patients taking greater charge of
their health care, and the realization that primary care is a team effort, and
not just a role for physicians. The reduction in costs comes from making health
care more accessible (not dependent on visits) through health information
technology and the internet. Preventing disease, and treating it early when it
comes, are the keys to quality and cost reduction. Revolution Health is a
vehicle for this, consistent with the vision of the “Chasm Report.”
Dr. Val: How can patients be sure that they’re getting the best primary care?
First take charge of your
own primary care. The traditional patient-physician relationship was, “Yes
doctor”, “Whatever you say doctor”. Your care would be limited by the knowledge
and recall (on the spot) of your doctor.
Much better is a “shared care” relationship with your primary care
physician and team. After all, the care is about you. Be informed. Make your
own decisions realizing that the physician and care team are advisors, coaches
in your care. You may agree with them, or disagree and do it your way. By
having your own personal health record and being connected to resources like
Revolution Health, you are empowered to get the care you want and need.
Finally, choose your primary care wisely. Not just anybody will do. Your
primary care physician is as important a choice as your close friends. You need
to like and trust this person. Have a great primary care physician who knows
you and cares about you and your health care is in real good shape. But, no
matter how good she or he is, you still must take responsibility for your care.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 10th, 2007 by Dr. Val Jones in News
3 Comments »
I rarely get too excited about mouse studies, but this one is pretty amazing. Researchers at my alma mater have discovered that osteoblasts (cells that create bone) secrete a certain protein that affects the health of the pancreas. The protein (osteocalcin) stimulates the pancreas to create more insulin-secreting beta cells. When people don’t secrete enough insulin, the result is often type 2 diabetes. So a healthy pancreas with a good insulin secreting capacity is critical to regulating blood sugar.
The researchers also discovered that mice who were bred to have no osteocalcin gene had abnormal amounts of fat in their bodies. So this means that bones may have something to do with energy metabolism and weight gain.
Of course it’s too early to speculate on the implications of all this (what’s true for mice is not necessarily true for humans – but I’m going to anyway). Since bone cells (osteoblasts) are sensitive to gravity, and increase their activity with weight bearing, this could explain why exercise (especially weight lifting) is important in weight loss. The new ACSM guidelines recommend weight training as part of a healthy exercise regimen, and the underlying mechanism for this may be that bone cells rev up metabolism and insulin secreting capacity in response to weight lifting.
So, if you want to lose weight – make sure you stimulate those bone cells with some good weight bearing exercises. They may just help to reduce your risk of type 2 diabetes as well!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 31st, 2007 by Dr. Val Jones in News
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Thanks to ED nurse Ian Miller who brought this research study to my attention: lidocaine jelly can substantially reduce the pain of having a Foley catheter inserted into the urethra – for both men and women. And yet the jelly is not always used for women. Many nurses, PAs and physicians erroneously believe that only men benefit from the numbing gel because they have longer urethras. But new research suggests that women benefit substantially from this pain reducing gel. What amazes me is that it took this long to research the issue – imagine all the women who could have had a more comfortable experience with this process. So ladies, if you (or your mom) need a bladder catheterization for any reason, be sure to ask for lidocaine jelly.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
