Ice baths

Athletes from Andy Murray to Mo Farah swear by them, but they may subjecting themselves to unnecessary pain; a recent study has found that trendy ice baths were no better than cool-down exercises at reducing inflammation in muscles after exercise.

The theory of ice baths is that the cold water cuts muscle temperature and blood flow and this was thought to dampen inflammation and speed up the repair of muscles damaged by exercise, however, there is no human data which backs up this theory.

New research suggests the treatment may not be that scientific after all.

Published in the Journal of Physiology, the study concludes that the practice is no more effective than the old-fashioned approach – a low-intensity warm down.

The findings are likely to come as galling news for a swath of high-profile athletes who for years have devoted hours each week to shivering away at rock-bottom temperatures with the aim of recovering faster. For the study, participants completed regular sessions of tough leg exercises. After different exercise sessions they would either sit up to their waist for 10 minutes in 10-degree water, or they would perform a gentle warm down on an exercise bike. Researchers took muscle biopsies from the participants two hours, 24 hours and 48 hours after each trial, and examined the tissue for changes in the expression of genes and proteins that indicate inflammation, comparing the data between the two trials. These samples showed the gentle exercise to be just as good as the icy water at calming inflamed muscles.

The study also argues that reducing inflammation in muscle after injury impedes muscle repair, and states the notion that ‘the anti-inflammatory effects of cryotherapy such as icing or cold water immersion is beneficial for muscle repair’ has undermined sports medicine for many years. The authors suggest repair of skeletal muscle tissue following injury is a complex process involving interactions between inflammatory cells, satellite cells, fibroblasts and endothelial cells.

There are some draw backs to the study, however. The participant sample size used was small, meaning the data is not as reliable as if a greater number of subjects were used. It is also unknown whether these results would be replicable using differing standards of athlete – would an elite athlete have the same reaction as a recreational participant?

Although the new evidence is an interesting development, further research is required to validate the findings before saying whether it practically has a place in sport and exercise.

Bear in mind though that the therapeutic effects of applying cold to an injury is not what was studied here so keep using your ice pack for muscle strains and inflammation.

Sources: www.telegraph.co.uk; www.dailymail.co.uk


 Immunity Enhancing Supplements
1) Vitamin D – 5000 to 10,000 IU daily for most adults is safe and effective for the prevention of flus, colds, cancer and approximately 200 different diseases. No other supplemented nutrient has been as extensively studied as vitamin D. Thousands of studies support its use in higher than RDA doses. For the best source of information and documentation of all the benefits, visit http://www.vitamindcouncil.org
2) Omega-3 Fatty Acids – 4000 mg daily for most adults not only prevents heart disease but also powerfully boosts the immune system. Omega-3 is needed to help vitamin D work in an optimal manner and, in effect, helps prevent vitamin D deficiency. Omega-3 supplementation increases the activity of white cells that gobble up dangerous bacteria. Omega-3 also protects the lungs from colds, flus and other respiratory tract infections. No doubt you have heard of the benefits of taking cod liver oil during the winter months. Interestingly enough, the major active ingredients of cod liver oil that work their magic on the immune system are vitamin D, vitamin A  and omega-3 fatty acids.

3) Zinc – 30-50 mg daily is an effective preventive for all kinds of infections.  It is very easy to become zinc deficient and to test for it is very easy and inexpensive. . There is some evidence that using zinc lozenges can shorten the length of respiratory tract infections.
4) Vitamin A – 10,000 IU – another component of cod liver oil that plays a major role in preventing infections by influencing the activity of T and B lymphocytes (white cells). Vitamin A is a common component of many multivitamin supplements but some people just do not absorb enough of it from their diet because of unsuspected food allergies and insufficient secretion of pancreatic digestive enzymes. For most of these individuals, supplementing pancreatin (pancreatic enzymes) should help resolve the absorption issue.

5) Beta Glucans – The February, 2013 issue of the European Journal of Nutrition published the results of a clinical trial conducted in Germany which found a protective effect for beta-glucan derived from brewers’ yeast against the risk of acquiring the common cold, as well as a reduction in cold severity.

One hundred and sixty-two healthy men and women with recurring colds were randomized to receive 900 milligrams (1,3)-(1,6)-beta-glucan or a placebo daily for 16 weeks. Participants were instructed to document common cold episodes and rate their symptoms, which included headache, joint pain, sore throat, and feeling of lump in the throat and/or difficulty swallowing, hoarseness, cough, runny nose, nasal congestion, cold-related sleeping difficulties and fever. The subjects underwent examinations by a study investigator on the fifth day of each illness.

At the end of the trial, those who received beta-glucan had 25 percent fewer colds than the placebo group. Cold symptom scores were 15 percent lower on average, and cold-related sleep difficulties were significantly reduced by beta-glucan.

6) Vitamin C – 1000 mg or more daily has anti-viral and immune enhancing effects.  The only significant issue with the use of high dose vitamin C beyond the RDA levels is the diarrhoea side effect, using a buffered vitamin C such as Ester-C instead of ascorbic acid will prevent this from happening.

If you want to discuss what you should be taking on an individual basis, please call the clinic or speak to one of us the next time you are in.

References

  • Braly, J. Food Allergy Relief.  Contemporary Books, Illinois. 2000.
    • Piers Morgan Flu shot. http://www.naturalnews.com/038866_piers_morgan_flu_vaccines_sickness.html
    • Am J Clin Nutr. 2001 Dec;74(6):833-9.
    • Gill HS, Rutherfurd KJ, Cross ML, Gopal PK.
    • Heinerman, John.  Dr. Heinerman’s Encyclopedia of Anti-Aging Remedies.  Paramus: Prentice Hall, 1997; pp.85-86.
    • Rona, Zoltan P. Vitamin D, The Sunshine Vitamin. Tennessee, USA: Alive Books, 2010http://www.amazon.com/Vitamin-D-Sunshine-Zoltan-Rona/dp/0920470823
    • Rona, Zoltan. Childhood Illness and the Allergy Connection. Prima Publishing 1997.
    • Rona, Zoltan, P.  Natural Alternatives to Vaccination.  Vancouver: Alibe Books. 2000.

 


The non-compliance problem

The ultimate aim of any prescribed medical therapy is to achieve certain desired outcomes where the patient is concerned. These desired outcomes are part and parcel of the objectives in the management of the conditions. However, despite all the best intention and efforts on the part of the healthcare professionals, those outcomes might not be achievable if the patients are non-compliant. This shortfall may also have serious and detrimental effects from the perspective of disease management. Hence, therapeutic compliance has been a topic of clinical concern since the 1970s due to the widespread nature of non-compliance with therapy. Therapeutic compliance not only includes patient compliance with medication but also with diet, exercise, or life style changes.

To address the issue of therapeutic non-compliance, it is of first and foremost importance to have a clear and acceptable definition of compliance. In the Oxford dictionary, compliance is defined as the practice of obeying rules or requests made by people in authority (Oxford Advanced Learner’s Dictionary of Current English). In healthcare, the most commonly used definition of compliance is “patient’s behaviours (in terms of taking medication, following diets, or executing life style changes) coincide with healthcare providers’ recommendations for health and medical advice” (Sackett, 1976). Thus, therapeutic non-compliance occurs when an individual’s health-seeking or maintenance behaviour lacks congruence with the recommendations as prescribed by a healthcare provider.

It was estimated that the compliance rate of long-term therapies was between 40% and 50%. The rate of compliance for short-term therapy was much higher at between 70% and 80%, while the compliance with lifestyle changes was the lowest at 20%–30% (DiMatteo, 1995). For the management of diabetes, the rate of compliance among patients to diet changes varied from 25% to 65% (Rubin, 2005).

As previously mentioned, if the patients do not follow or adhere to the treatment plan faithfully, the intended beneficial effects of even the most carefully and scientifically-based treatment plan will not be realized.

In a study involving an exercise regimen, only 35% of patients adhered fully; 76% followed their prescribed regimen partly but not wholly (Sluijs et al., 1993). These programs were found to be more successful in supervised rather than home-based programs, however (McKelvie et al., 2002).

Many factors are thought to affect compliance. Psycho-social factors such as patient’s beliefs, attitude towards therapy and their motivation to the therapy are all important to consider. Since the 1990’s, research has focused more on the patient-provider relationship and patients’ beliefs about the therapies. For patients with chronic diseases, they would do their own cost-benefit analysis of therapy, either consciously or subconsciously. It means they weigh the benefits from compliance with therapy (i.e. controlling symptoms and preventing medical complications) against constraints on their daily lives and perceived risks of therapy such as side effects, time and effort involved (Donovan & Blake, 1992). Sometimes, they may have the wrong beliefs on the therapeutic intervention based on inadequate health knowledge or a negative relationship with the healthcare provider.

Whilst it is clear that more recent research needs to be completed on the subject, non-compliance, whatever the reasons, is a massive challenge and one which needs to be addressed by practitioners and patients if therapeutic interventions are to have their maximum desired effects.

 

References:

DiMatteo, M. R. (1995) Patient adherence to pharmacotherapy: the importance of effective communication. Formulary, 30, 596–8. 601–2, 605.

Donovan, J. L. & Blake, D. R. (1992) Patient non-compliance: deviance or reasoned decision-making? Soc Sci Med, 34, 507–13.

Jin, J., Sklar, G. E., Min Sen Oh, V., & Chuen Li, S. (2008). Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and Clinical Risk Management4(1), 269–286.

Martin, L. R., Williams, S. L., Haskard, K. B., & DiMatteo, M. R. (2005). The challenge of patient adherence. Therapeutics and Clinical Risk Management,1(3), 189–199.

McKelvie, R. S., Teo, K. K., Roberts, R., et al. (2002) Effects of exercise training in patients with heart failure: the exercise rehabilitation trial (exert) Am Heart J, 144, 23–30

Rubin, R. R. (2005) Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med, 118, 27s–34s.

Sackett, D. L. Introduction. In: Sackett, D. L. & Haynes, R. B. Compliance with therapeutic regimens.Baltimore: Johns Hopkins University Press; 1976. pp. 1–6.

Sluijs, E. M, Kok, G. J. & van der Zee, J. (1993) Correlates of exercise compliance in physical therapy. Phys Ther, 73, 771–82.