“Text Neck” and the issues it creates

Yoga for Posture Improvement: Hyperkyphosis Carries Similar Risks as Osteoporosis, Research Finds

By:

Eva Norlyk Smith, Ph.D., C-IAYT

If you’re over 40, or spend a lot of time hunched over your cell phone or computer, chances are that your posture is starting to look increasingly like the person in the image above.

We all know that poor posture isn’t flattering. However, in reality, posture affects our health and well-being in numerous ways. And one particular posture problem, has significant impact on our longterm health and wellbeing, and medical science is just starting to catch on to this fact.

Here is the one of the posture problems you rarely hear about, but which is well worth paying attention to:

We are talking about forward head posture and it’s more advanced relative, hyperkyphosis. You may have heard of the new concept of ‘text neck’– which is essentially forward head posture, where our head is forward of the center.  In its more advanced stages, forward head posture may develop into hyperkyphosis.

And, hyperkyphosis, as we shall see, is the precursor of pretty much any age-related condition you don’twant to have.

New Research Finds that Hyperkyphosis Presents Same Health Risks as Osteoporosis

What is hyperkyphosis and why should you care? In the last few decades, researchers have become increasingly interested in the health effects of a hyperkyphotic posture in older people. And, what they are discovering is pretty remarkable.

You’ve heard about osteoporosis and how important it is to prevent osteoporosis-related loss of bone mass to avoid fractures as you get older. But here’s what you probably haven’t heard: A slumped forward posture—if allowed to mature into the full-fledged hyperkyphosis of old age—puts you at risk for the exact same issues as osteoporosis.

Yes, you heard that right – hyperkyphosis is a risk factor for the same problems as osteoporosis, including greater risk for vertebral fractures, greater risk of falls and fall-related fractures. And, not only that—it is a contributing factor to a host of other health issues as well.

People with hyperkyphosis are more likely to have difficulty performing simple daily tasks like bathing and washing themselves. They are also more likely to fall and hurt themselves. And all of this, unfortunately, paves the road to the nursing home.

Hyperkyphosis has also been found to be a risk factor for fractures of the hip, leg, wrist, shoulder, and arm. The risk is greater the more hunched the back is. This risk is independent of bone mass density, which suggests that hyperkyphosisis a separate risk factor for suffering fractures, on par with osteoporosis.

It doesn’t stop there, however. When a person is constantly stooped forward, it puts tremendous pressure on the chest and lung cavity. This in turns restricts breathing capacity or creates shortness of breath. The breath is the source of vital, life-giving oxygen to all the cells of the body. In the elderly, shortness of breath leads to a host of health issues, including increased anxiety and depression, reduced happiness, and, again, reduced ability to undertake normal daily functions.

Some researchers claim that shortness of breath is a main factor of general health deterioration in elderly. Apart from making a person feel miserable, shortness of breath also undermines the body’s vital functions. The elderly who suffer from moderate to severe shortness of breath are more likely to die from cardiovascular or lung disease.

With all of this going on, it’s not a surprise that people with hyperkyphosis die earlier than their peers. Studies have shown that older men and women with a forward-hunched posture have higher death rates; in one study they had a 44 percent greater rate of mortality.

So why haven’t you heard about this before? Until recently, hyperkyphosis has been flying under the medical radar, because it was assumed that it was caused by osteoporosis. Doctors believed that it resulted from tiny fractures of the vertebrae, which in turn caused the spine to collapse forward into a dowager’s hump.

However, recent research shows that hyperkyphosis often develops without vertebral fractures. In fact, about two-thirds of older people with hyperkyphosis don’t have any fractures of the spine.

It’s really only in the last ten years or so that medical researchers have started to label hyperkyphosis as an independent medical condition. And while there’s a growing number of studies coming out on hyperkyphosis and its effects, it’s still not a condition we read about very much in the everyday media. Unlike osteoporosis, it’s not something that your doctor will check out for you when you go to your regular physical.

However,  there’s every bit as much reason to prevent hyperkyphosis as there is to prevent osteoporosis, because it has many of the same negative consequences on our long-term health.

Preventing Hyperkyphosis

You may be young or middle aged with no signs of osteoporosis or hyperkyphosis. So why should you worry about this issue at this point in your life? So why should you care?

Well, you should care because the body takes its shape over years. The foundation of hyperkyphosis and other posture problems is laid decades before it becomes a visible problem. So the time to focus on preventing hyperkyphosis is not when you’re 70 or 80 years old and have developed some degree of the condition.

It’s never too late to change your posture, but the older you get, the more you have to swim upstream. So the best time to improve your posture and prevent hyperkyphosis from developing is when you’re in your forties, fifties, and sixties. Hyperkyphosis isn’t an either or. It’s a subclinical condition long before it turns into a Dowager’s Hump.

Hyperkyphosis vs. Osteoporosis—Different Conditions, Similar Effects

The reason that we haven’t heard more about the health issues linked to hyperkyphosis is that has traditionally been thought to something that developed as a result of vertebral fractures caused by osteoporosis.

If you take a look at this picture, you’ll see the wedge fractures of the spine marked in red. Those are the kinds of fractures that people with osteoporosis are at risk for getting. You can imagine if one or two of the vertebrae collapsed forward like that with several wedge fractures, that it will cause the thoracic spine to cave in on itself and create a more collapsed, hyperkyphotic structure. So, treatment efforts generally have focused on preventing osteoporosis to avoid vertebral fractures and prevent the Dowager’s Hump of hyperkyphosis.

That really changed in 2004. In 2004, a groundbreaking study came out, which was the first to show that increased kyphosis does not necessarily result from vertebral fractures. In other  words, hyperkyphosis of the spine is not identical with osteoporotic fractures.

Another study, which looked at almost six hundred women between the ages of 47 to 92 over four years found that\ hyperkyphotic posture itself may be an important risk factor for fractures independent of low bone mass density or fracture history.

The increased risk of people in this study was 70% increased risk of future fracture (of any type) independent of age or prior fracture. The greater the hyperkyphosis, the greater the risk.

Why are people with hyperkyphosis at increased risk for fractures? Well, one reason is that they are more likely to lose their balance and fall. First of all, you can’t see very well and orient yourself to the environment very well if you’re constantly hunched over.

Also, the range of motion of the spine is severely reduced in people with hyperkyphosis. So if they fall, it’s harder to catch themselves, and they just kind of tumble over.

The other health consequence of hyperkyphosis is decreased mobility. People have more difficulty bathing and washing themselves. They have lower scores on what’s called the Timed Up and Go Test, which measures how quickly people get up from a chair, walk ten steps, go back, and sit down. This test is a very reliable predictor for general mobility in older people.

Wendy Katzman, a P.T. at UC SF, who is a leading researcher in this area, notes that this kind of decreased mobility is associated with advancing age, muscle weakness, low bone density, and a history of vertebral fractures. However, distinct from previous studies, she found that hyperkyphosis is a significant contributor to mobility impairment, independent of underlying low bone density and vertebral fractures that often are assumed to be causative factors of ill health. So again, hyperkyphosis has many of the same health consequences that we work so hard to prevent in people with osteoporosis, but no one is paying attention to this condition.

One of the issues of osteoporosis is that 25% of people who have a hip fracture end up in a nursing home within a couple of years. They lose mobility, and they become unable to take care of themselves. Here again, Wendy Katzman points out you have the same issue with hyperkyphosis and it really should be attended to in the same way as we are concerned about osteoporosis.

Why Is No One Paying Attention to the Health Risks Linked to Hyperkyphosis?

We spend a lot of money in our society on tests for low bone mass density and drugs to increase bone mass. But of course, the real risk of osteoporosis is not low bone mass. It is really fractures.

As recent studies show, hyperkyphosis is a separate risk factor for fracturess. However, so far, it has pretty much has been falling under the doctors’ radar. No one checks you for risk of developing hyperkyphosis when you go for your physical. But if older people with hyperkyphosis really are at a 70%  greater risk for fractures, this really is a health issue that should not be ignored.

There is growing awareness in society of the health issues linked to forward head posture and hyperkyphosis. However, the medical establishment has little to offer for the condition, both by way of prevention and treatmnet. So not surprisingly, there is growing interest in alternative approaches to improving posture, including yoga. Pilot studies have documented the benefits of yoga for hyperkyphosis, and this is an area of research that we can expect growing interest in in the future.

Do you have a daily practice?

The benefits of yoga are vast however, if you don’t practice they will elude you. Have you ever wanted a daily practice but just couldn’t get to the studio every day due to time constraints or cost? One of the best motivating factors I found was entering into a medical study.

In 2014 I joined a medical research study. At the time I was just thinking “how nobel it seemed to help advance medicine” but as it turned out it was so much more than that. I found my dedication to my practice heightened. Of course there were days here and there that I missed but having to record and keep track of my practice motivated me to practice. I  knew someone was going to look at my “score card”. The study I entered was Dr. Loren Fishman’s study on yoga and bone strength. He had people participating all over the world and the study spanned a 10 year period. We did the same 12 poses each day to see if there were changes in our bone density.

Bone density is measured with a Dexa scan, a very simple procedure usually done after you turn 50 and every two years afterwards. The two year span on the test is not because there is a lot of radiation exposure, on the contrary,  but because bone are slow to change. This study has since closed and it did show positive data on yoga increasing bone density. Dr. Loren Fishman has started a new study as of the fall of 2016. This new study will be measuring a little more closely the amount of time each pose is held  as well as the intensity level of each pose.

Would you like a nice well rounded and accessible yoga practice and motivation to practice on your own? Join the study. As we age we all will loose some bone mass, some of us more than others. Take part in your continuing health. Start a practice that can help keep your bones dense, can help with your strength and balance and can reduce stress. In 2017 I am offering workshops at several studios to introduce you to the 12 poses as well as explain the “whys” behind them. I also cover in the workshop safe range of motion for someone with bone loss. Yoga has exploded in America over the last several years. I believe it is accessible to everyone but not all poses are good for everyone. We must learn to practice with the bodies and conditions we have in this very moment and because of this I cover safe yoga for someone with bone loss. I am also doing follow-up classes after the workshops. If you are enrolled in the study you will need to practice with a certified Loren Fishman person 2x/month. This will help ensure the accuracy in the data for the study.

Maybe this is just what your yoga practice needs…or maybe it is just what your bones need?   Come help support a healthy aging process and lets do some yoga together. Contact Dr. Fishman at http://www.sciatica.org or myself for more information.

 

Yoga Therapy: The Newest Health Trend that Doctors are Paying Attention To

Wellness enthusiasts have long known the healing benefits of yoga. However, the popularity of this ancient practice is now growing among today’s mainstream, especially doctors. Today, there is a rise in doctor-prescribed yoga therapy, even among Western-trained doctors.

So what is yoga therapy? Why is it a growing trend? Will yoga therapy help patients feel better? Here is some insight.

What is Yoga Therapy? 

Yoga therapy involves a variety of practices that can help ease a natural process or improve a health condition. Some of the therapeutic tools that are used are breathing exercises, physical postures, guided imagery and meditation. Diet is also considered part of yoga therapy.

While regular yoga, depending on the type, can be fast-paced and physically demanding, yoga therapy serves as a safe, gentler alternative. It is led by yoga teachers who are specially trained to work with patients suffering from various health conditions. Just as each patient is different, the styles and formats of yoga therapy also differ greatly. They can vary from small therapeutic classes and one-on-one sessions to chair yoga in nursing homes and hospitals.

Yoga therapy takes a more holistic approach to healing, focusing on patients as a whole instead of just on their conditions. The practice simultaneously works on the body, mind, and spirit, strengthening the body’s different systems. These include the heart and cardiovascular system, muscles, the lungs, as well as the body’s nervous system.

Individuals may suffer from multiple conditions at once, so yoga therapy can be a multi-purpose form of healing. Yoga practices can simultaneously improve digestive system function, nurture psychological well-being, and enhance delivery of oxygen to the body’s tissues. Yoga also can assist the body to more effectively remove carcinogens, waste products and toxins.

Why Is It a Growing Trend?

Yoga therapy is still considered to be a new professional field. However, it is now recognized worldwide as a clinically viable treatment. There are established yoga therapy programs at major health care centers and clinics around the United States. It is increasingly being used regularly in health care facilities and hospitals. As more and more physicians see that yoga therapy helps their patients feel better, it is increasingly becoming a component of medical care.

For the last 12 years, the International Association of Yoga Therapists (IAYT), which has over 3,400 individual members from 48 countries, has worked hard to establish yoga as an esteemed and recognized therapy in the West. It has published an annual peer-reviewed medical journal, presented at academic research conferences, and received an NIH grant to create rigorous yoga therapy certification standards. It is now accrediting training programs and beginning to certify therapist graduates.

The IAYT database of yoga-therapy training programs has grown from five in 2003 to more than 130 schools worldwide today. These include 24 arduous multi-year programs that have been recently accredited by IAYT; there are an additional 20 still under review. As of 2015, most IAYT yoga-therapy practitioners work in hospital settings, while others work in outpatient clinics or physical therapy, oncology, or rehabilitation departments as well as in private practice.

Clinical research is partly responsible for the growing acceptance of yoga therapy in the health care sector. A growing body of research documents the proven benefits of yoga when using it to treat a wide range of health conditions, including anxiety, back pain, insomnia and depression. It is also proven to help reduce risk factors for hypertension and cardiovascular disease. Research also shows that yoga therapy has been successful in alleviating the side effects of cancer treatment. Some patients who have practiced yoga while undergoing radiation therapy have reported lower levels of fatigue, stress and a better quality of life.

Is Yoga Therapy Effective? 

Yoga therapy has been proven to be a particularly effective way to reduce stress. This is good news for most people in the West, who encounter high levels of stress on a daily basis. Stress has been known to cause or contribute to varying medical problems, ranging from irritable bowel syndrome, migraine headaches and potentially life-threatening conditions such as heart disease, diabetes and osteoporosis.

When combined with other types of health care, whether alternative or conventional, yoga therapy has proven to be particularly effective, especially in healing chronic ailments. For instance, studies show that in addition to reducing the side effects of chemotherapy and radiation treatments for cancer patients, yoga therapy can also enable faster recovery after bypass surgery. In clinical trials, many patients with high blood pressure, type II diabetes or asthma, who began practicing yoga regularly, were able to lower the lower the dosage of drugs they needed or eliminate some pills entirely. For patients, less medication means fewer side effects, not to mention, greater monetary savings.
The Future of Yoga Therapy

It will still take more time for the practitioners and patients to fully accept yoga therapy as a primary approach to their medical treatment. But even as a supplemental approach, yoga therapy is making great strides. The growing body of scientific research documenting its health benefits is great evidence that yoga therapy is here to stay.

I am pleased to be recognized by IAYT, International Association of Yoga Therapist as being certified…

C-IAYT

Your Brain and Bones

Interesting post from Yoga for Healthy Aging on how our brain talks to our bones and how the bones talk back to the brain. Is yoga in that loop? You bet, read on to see how.

Yogaforhealthyaging.blogspot.com

The Bone-Brain Connection

Posted: 17 Aug 2016 04:15 AM PDT

by Ram

Red Hills and Bones by George O’Keeffe
When we talk about bones and/or joints, we are referring to the body’s skeletal system. The skeletal system is comprises of all the bones and joints in the body provides structural support and serves as a storehouse for calcium and phosphate. Different kinds of cells, proteins, and minerals make up the skeletal system to act as a scaffold by providing support and protection to the softer tissues of the body and also attachment points for muscles to allow movements at the joints. Up until now it was assumed that the skeletal system was an inert calcified structure that only provided structural framework to prevent the body from collapsing. But thanks to some recent groundbreaking work (see The contribution of bone to whole-organism physiology), we now know that there’s more to the bones than just the support structure.
Endocrine organs secrete hormones directly into the blood stream to be carried to distant target organs. Examples of endocrine organs include the hypothalamus, pituitary, thyroid, parathyroid, adrenals, pineal body, and the reproductive organs (ovaries and testes). Recent research studies now point to the skeleton as an endocrine organ that secretes the endocrine hormone osteocalcin. Osteocalcin, which is found at high concentrations in the skeleton, was thought to be primarily involved in bone-building, bone mineralization, and maintaining calcium ion levels. Researchers now believe that osteocalcin acts as a hormone and travels to distant organs including the pancreas to release more insulin, to the adipose tissue to stimulate the release of another hormone adiponectin, which also regulates insulin levels, and the testes for testosterone production. Thus, the bone has now emerged as a genuine endocrine gland (see The “soft” side of the bone: unveiling its endocrine functions). 
Additionally, work by Gerard Karsenty, at the department of genetics and development at Columbia University Medical Center, reveals that osteocalcin has wide-ranging effects on liver, muscle, and, guess what, the brain as well (see Maternal and offspring pools of osteocalcin influence brain development and functions). Working with mice that had been engineered to lack osteocalcin, Karsenty noticed that while their skeletons appeared essentially normal, the mice appeared too docile, less rebellious, anxious, depressed, and displayed memory issues, suggesting that the bone via its hormone osteocalcin plays a direct role in memory and moods. When Karsenty infused these mice with osteocalcin, their moods improved and their performance on memory tests became normal. Furthermore, Karsenty also discovered that osteocalcin from pregnant mother mice crossed the placenta barrier and triggered the development and architecture of the mouse fetus’s brain. Simply put, bones communicated with the neurons and shaped the brain even before birth. This entire concept of bone-brain axis was least surprising to me because in Ayurveda, we are taught that the nervous system (brain and spinal cord—Majja Dhatu) arises from the precursor skeletal tissue (Asthi Dhatu). So as a researcher I was happy with the evidence-based research supporting this concept. 
So what might the bone-brain communication mean for human health? We know that as we age, our skeletal system degenerates as reflected in the reduction of bone mass. Additionally, aging also brings with it memory and cognitive loss and emotional turbulence. While all these changes were considered to be separate and independent effects of old age, taking into account Karsenty’s tantalizing work, it appears that these age-associated degenerative events in the physical body, emotional imbalance, and memory losses may actually be related and interconnected, and osteocalcin may be one of the molecules cementing these processes. 
Now I am sure you must be curious to know if we need to start taking osteocalcin to protect ourselves from age-associated skeletal degeneration or memory and cognitive decline. Remember, these kinds of questions can create false hopes, so before you sprint to the nearest pharmacy for a dose of synthetic osteocalcin, think of another attractive and natural alternative route to boost the bone-brain connection. Research studies show that the best thing to do to strengthen the bone and prevent age-related cognitive decline is exercise. Physical exercise helps partly because it works to maintain and strengthen the bones, which make more osteocalcin that in turn helps preserve memory and mood. And for us yogis, there is some exciting news as well. A recent research study showed that yoga increases bone turnover and triggers increased production of osteocalcin, which may help in the preserving bone mineral density (see Effects of Yoga on Bone Metabolism in Postmenopausal Women). While the authors of this study did not examine cognitive changes in these human subjects, I am guessing that given the ground-breaking studies by Gerard Karsenty, the osteocalcin production from the yoga regimen may help reverse cognitive changes.
Thus, it appears that all the regions of the body are more closely networked and interconnected than most people think, and the brain cannot be delineated or excluded from the body (see Your Brain is More Than That Thing in Your Skull). Additionally, the above-mentioned studies also suggest that the concept of unidirectional information flow from the brain to the periphery is incorrect, and it appears that peripheral organs also talk to the brain, making the information flow bidirectional (brian-body-brain). In addition to the different areas of the body communicating to the brain, we now also have a better understanding of how the bone talks to the brain and fosters its development, and how yoga can strengthen the bone-brain nexus. Let’s just say that an additional path to the brain starts from the bone!

Essential Oils

Essential Oils are an alternative to keeping some of the pharmaceuticals out of the water supply. Essential oils have been around for hundreds of years. Plants have a unique way of protecting themselves from the environment they live in. Utilizing some of those protective properties scientist have been able to extract from plants oils that retain these properties. From the most basic of things like a cut to sometimes much more complex conditions essential oils helps your body come back into balance.

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Here is a visual of a before and after shot after using Frankincense for just one month on a persistent skin rash that would not go away with other conventional methods…

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Drugs in the Water

health.harvard.edu

Drugs in the water
Harvard Health Letter

Pharmaceutical pollution doesn’t seem to be harming humans yet, but disturbing clues from aquatic life suggest now is the time for preventive action.

Although maybe not as tasty as an ice-cold gulp from a mountain spring, the water that flows through most American kitchen faucets is generally clean, clear, and safe. Approximately 170,000 public water systems are monitored for nearly 80 harmful substances. The prohibited nasties include bacteria, viruses, pesticides, petroleum products, strong acids, and some metals.

But water quality experts and environmental advocates are increasingly concerned about another kind of water pollution: chemicals from prescription drugs and over-the-counter medications that get into lakes, rivers, and streams. Water also gets contaminated by perfume, cologne, skin lotions, and sunscreens that wash off people’s skin.

At this point, there’s really no evidence of pharmaceutical and personal care products in the water harming people, but studies are showing adverse effects on aquatic life.

Drug take-back programs, which allow people to drop off their unused medications at central locations, serve two purposes. They keep unused drugs out of the water and prevent diversion of drugs, mainly the opioid painkillers, for recreation and illegal purposes.

Another step in the right direction is new guidelines from the federal Environmental Protection Agency (EPA) that discourage hospitals and nursing homes from flushing unused drugs down the drain or toilet. Guidelines for individuals also discourage flushing most, but not all, unused drugs. The question now is whether these and other efforts will be enough to keep the chemicals out of the water at a time when the use of pharmaceuticals and personal care products continues to grow at a rapid rate.

The sources

Reliable figures are hard to come by, but it’s a safe assumption that we, as consumers, are responsible for a hefty percentage of the pharmaceutical and personal care products that wind up in lakes, rivers, and streams. The typical American medicine cabinet is full of unused and expired drugs, only a fraction of which get disposed of properly. Data collected from a medication collection program in California in 2007 suggest that about half of all medications — both prescription and over-the-counter — are discarded. That’s probably a high-end estimate, but even if the real proportion is lower, there’s a lot of unused medication that can potentially get into the water.

Chemicals also get into the water from the drugs we use. Our bodies metabolize only a fraction of most drugs we swallow. Most of the remainder is excreted in urine or feces (some is sweated out) and therefore gets into wastewater. An increasing number of medications are applied as creams or lotions, and the unabsorbed portions of those medications can contribute to the pollution problem when they get washed off. It’s been calculated, for example, that one man’s use of testosterone cream can wind up putting as much of the hormone into the water as the natural excretions from 300 men.

Health care institutions are another source of pharmaceutical water pollution. Hospitals are probably less of a problem than nursing homes because they typically have on-site pharmacies with arrangements in place to return unused drugs to manufacturers for credit or disposal. Nursing homes, though, have often been guilty of flushing medications down the toilet or drain after a patient dies or is transferred to another facility. Typically, they don’t have the same kind of return arrangements as hospitals. And the rules for getting rid of opioid painkillers, which make disposal down the drain an acceptable option, have inadvertently encouraged some nursing homes to dispose of all their leftover medications that way.

Drug manufacturing also results in some pharmaceutical pollution, although some factories are bigger problem than others. For example, a U.S. Geological Survey study found contamination levels downstream from two drug manufacturing plants in New York State that were 10 to 1,000 times higher than those at comparable facilities around the country.

Agriculture is another major source. The two trillion pounds of animal waste generated by large-scale poultry and livestock operations in this country is laced with hormones and antibiotics fed to animals to make them grow faster and to keep them from getting sick. Inevitably, some of those hormones and antibiotics leach into groundwater or get into waterways.

illustration of garbage dump and sewage treatment plant

How bad is the problem?

A study conducted by the U.S. Geological Survey in 1999 and 2000 found measurable amounts of one or more medications in 80% of the water samples drawn from a network of 139 streams in 30 states. The drugs identified included a witches’ brew of antibiotics, antidepressants, blood thinners, heart medications (ACE inhibitors, calcium-channel blockers, digoxin), hormones (estrogen, progesterone, testosterone), and painkillers. Scores of studies have been done since. Other drugs that have been found include caffeine (which, of course, comes from many other sources besides medications); carbamazepine, an antiseizure drug; fibrates, which improve cholesterol levels; and some fragrance chemicals (galaxolide and tonalide).

Sewage treatment plants are not currently designed to remove pharmaceuticals from water. Nor are the facilities that treat water to make it drinkable. Yet a certain amount of pharmaceutical contamination is removed when water gets treated for other purposes. For example, some research shows that conventional treatment methods result in a 90% decrease in the amount of ibuprofen and naproxen in the water discharged from sewage treatment plants. On the other hand, treatment doesn’t seem to have much effect on the levels of drugs such as carbamazepine and diclofenac (a pain reliever).

Some aspects of sewage treatment may remove pharmaceuticals from the water, but as a result, concentrations in sludge increase. Some of that sludge is used as fertilizer, so the pharmaceuticals are getting into the environment in another way.

Drinking-water treatment may also get rid of some pharmaceutical contamination. Chlorine is used to kill bacteria and other pathogens, but it also seems to degrade or remove acetaminophen, codeine, and the antibiotic sulfathiazole. A 2007 study of one drinking-water plant found that conventional treatment methods reduced the concentrations of several important medications (acetaminophen, carbamazepine) by 75%.

Still, there’s really not much question that some pharmaceutical pollution persists and does wind up in the water we drink. In 2008, the Associated Press published a series of investigative articles about pharmaceutical contamination in drinking water. The journalists uncovered test results that showed the water supplies for 24 major metropolitan areas had detectable levels of pharmaceuticals. Scientists from the Southern Nevada Water Authority and other organizations reported results in 2010 from a study analyzing drinking water from 19 treatment plants. Their tests found antidepressants, antipsychotics, antibiotics, beta blockers, and tranquilizers, although only in trace amounts and far below levels thought to have an effect on humans.

It’s possible that there’s a cumulative effect on people from even tiny amounts of these and other pharmaceuticals in drinking water, but this hasn’t been proven. And perhaps vulnerable populations (pregnant women, people with disabilities) are affected, although that’s also unproven.

Effects on fish and wildlife

In contrast to the uncertainty about human health effects, there’s quite a bit of evidence for pharmaceuticals in the water affecting aquatic life, particularly fish. Numerous studies have shown that estrogen and chemicals that behave like it have a feminizing effect on male fish and can alter female-to-male ratios. Sources of estrogen include birth control pills and postmenopausal hormone treatments, as well as the estrogen that women produce naturally and excrete. Intersex fish — creatures with both male and female sex characteristics — have been found in heavily polluted sections of the Potomac River. Studies of fish upstream and downstream of wastewater treatment plants have found more female and intersex fish downstream from the plants, presumably because of the higher estrogen levels in the downstream water. Other research has uncovered popular antidepressant medications concentrated in the brain tissue of fish downstream from wastewater treatment plants.

4 ways to reduce your pharmaceutical footprint

Limit bulk purchases. Volume discounts make the price attractive, but big bottles of unused pills create an opportunity for medications to end up in the water.

Use drug take-back programs. A federal law went into effect in 2010 that makes it easier for those programs to be organized at a local level, so you may see one in your community. The federal Drug Enforcement Agency has held two national drug take-back days and is likely to organize some more.

Do not flush unused medicines or pour them down the drain. This is the very least you can do. But the FDA advises that certain powerful narcotic pain medications should be flushed because of concerns about accidental overdose or illicit use unless you can find a drug take-back program that will accept them. We’ve posted a list of the narcotics on our Web site at http://www.health.harvard.edu/healthextra.

Be careful about how you throw medications into the trash. Medications thrown into the trash end up being incinerated or buried in landfills, which is preferable to flushing them or pouring them down the drain. If you put them in the trash, remove them from the packaging, crush them, and seal them in a plastic bag with some water. You’re supposed to add sawdust, cat litter, coffee grounds, or some other unappealing material to the bag. That isn’t for environmental reasons, but to cut down on the chances that a child or animal might eat the contents. You should also be careful to peel off any identifying information from containers of prescription medicine.

What is being done

There are several things we can do as individuals to limit pharmaceutical water pollution (see “4 ways to reduce your pharmaceutical footprint”).

On a larger scale, the EPA has taken a four-pronged approach that involves public education, stepped-up monitoring of water supplies, partnerships with health care facilities and agribusinesses to reduce waste, and eventually, perhaps, new regulations. As an introductory step toward possible regulation, the EPA has added 10 pharmaceutical compounds — one antibiotic and nine hormones — to its watch list of potentially harmful contaminants that warrant greater investigation.

The Natural Resources Defense Council, an environmental group, has called on drug manufacturers to design “eco-friendly” drugs that are absorbed by the body more efficiently or will break down in the environment after they’re excreted. The organization has also asked companies to implement techniques to limit bioactive waste generated in their manufacturing processes.

love yourself…

“Being preoccupied with our self-image is like coming upon a tree                                                of singing birds while wearing earplugs”      – Pema Chodron

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…so love yourself… you are beautiful both inside and out

Boost and stimulate your digestion

Drinking a cup of warm lemon water first thing in the morning helps to stimulate your digestion and elimination. It is alkaline to your system which is helpful to keep your system more alkaline than acidic for your bone health. The lemon juice is high in Vit.C and is an antioxidant which aid your liver in it’s functions. In Tiffany Cruikshank’s book Optimal Health for a Vibrant Life she has a recipe I have been loving.

Try it out.

  • Juice of half of a lemon
  • 1 Tbls of Apple Cider Vinegar
  • 1 tsp of Honey ( I use less)
  • Pinch of Cayenne
  • cup of warm water

Drink it 30 minutes before your meal.

Brawn and Brains

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Brawn and Brains

149

GETTY IMAGES
By GRETCHEN REYNOLDS
NOVEMBER 18, 2015
Sturdy legs could mean healthy brains, according to a new study of British twins.

As I frequently have written in this column, exercise may cause robust improvements in brain health and slow age-related declines in memory and thinking. Study after study has shown correlations between physical activity, muscular health and mental acuity, even among people who are quite old.

But these studies have limitations and one of them is that some people may be luckier than others. They may have been born to have a more robust brain than someone else. Their genes and early home environment might have influenced their brain health as much as or more than their exercise habits. Their genes and early home environment also might have influenced those exercise habits, as well as how their bodies and brains responded to exercise.

In other words, genes and environment can seriously confound experimental results.

That problem makes twins so valuable for scientific purposes. (Full disclosure, I am a twin, although not an identical one.) Twins typically share the same early home environment and many of the same genes, and if they are identical, all their genes are the same.

So if one twin’s body, brain and thinking abilities begin to differ substantially over the years from the other’s, the cause is less likely to be solely genetic or the early environment, and more likely to be attributable to lifestyle, including exercise habits.

It was that possibility that recently prompted Claire Steves, a senior lecturer in twin research at King’s College London, to consider twins and their thighs.

Muscular power, especially in the legs — which are the largest muscles in the body — is widely accepted as a marker of healthy aging. Older people with relatively powerful leg muscles get around better than those with weak legs. They also tend to have sharper minds, studies show.

But whether people’s lifestyles, and in particular their exercise habits, had provided them with good legs and minds, or whether they had won the genetic lottery, remained unclear.

So for the new study, which was published this month in Gerontology, Dr. Steves and her colleagues turned to the TwinUK registry, which includes health and fitness data for thousands of British twins.

The scientists pulled records for 162 healthy, middle-aged, female twin pairs, some of whom were identical and some not.

The scientists looked for twins who, 10 years previously, had completed extensive computerized examinations of their memory and thinking abilities, as well as assessments of their metabolic health and leg-muscle power, which measure muscles’ force and speed.

The scientists focused on the twins’ muscles rather than their exercise habits largely because the power measures were objective, unlike people’s notoriously unreliable recollections of how much they have worked out. (There was a correlation, though, between more self-reported exercise and sturdier legs.)

The scientists then asked the twins to visit a laboratory and repeat the cognitive tests.

Twenty of the identical twin pairs also completed brain-imaging scans.

Then the researchers compared leg power 10 years earlier with changes in brain function over the same time period.

They found that of the 324 twins, those who had had the sturdiest legs a decade ago showed the least fall-off in thinking skills, even when the scientists controlled for such factors as fatty diets, high blood pressure and shaky blood-sugar control.

The differences in thinking skills were particularly striking within twin pairs. If one twin had been more powerful than the other 10 years before, she tended to be a much better thinker now.

In fact, on average, a muscularly powerful twin now performed about 18 percent better on memory and other cognitive tests than her weaker sister.

Similarly, in the brain imaging of the identical twins, if one genetically identical twin had had sturdier legs than the other at the start of the study, she now displayed significantly more brain volume and fewer “empty spaces in the brain” than her weaker sister, Dr. Steves said.

Over all, among both the identical and fraternal twins, fitter legs were strongly linked, 10 years later, to fitter brains.

Of course, this study involved only a single snapshot of the brain health of middle-aged female twins. The scientists did not directly study the effects of exercise on the women’s brains, or look at changes in muscular health over the 10 years and whether that affected how well the twins could think.

The study also was not designed to uncover how muscle power builds brainpower, Dr. Steves pointed out, although she said she suspects that working muscles release biochemicals that travel to the brain and affect cellular health there. And the sturdier the muscles, the more of these chemicals they create.

More experiments obviously are needed, however, to understand these mechanisms.

For now, she said, the results imply that whatever your genetic make-up, building muscles can strengthen your mind, and should your legs currently be spindly, you might want to consider walking, running, standing or dancing more often.

“I was quite surprised by the strength of the findings,” Dr. Steves said, “because to be honest, I am someone who has always in the past prioritized work of the mind over work of the body. This study brings home to me that the brain needs exercise to keep fit.”