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Description: In This Issue: To Sleep or Not to Sleep, Cardiovascular Health, Alternate Delivery, and Bone, Joint & Muscle Health

Don t miss a single issue of NP in 2017...go online to renew your free subscription today JanFeb17 HE January February 2017 AL THE VIS TH IN IT U BO CAR TEG S A OT E S RA T H Y TIV 1 MP E 01 OS 8 IU M A VRM Media Publication Go to davinci for info about this advertiser Go to americasfinest for info about this advertiser TABLE OF CONTENTS January February 2017 VOLUME 6 NO. 1 17 24 28 FEATURES 17 Preserving Heart Health Fear of heart issues remains prominent among adults many of whom don t know how to caretake their cardio system. COLUMNS 4 Editor s Note 28 Supplement Science 8 Practitioner Corner 27 Product Focus Alternate Delivery 22 To Sleep or Not to Sleep Sleepless nights can be triggered by countless factors but by confronting the issue head on practitioners are able to gain a better understanding of what causes them. DEPARTMENTS 13 Health Industry News 16 INM Update 30 Practitioner Chat 32 Natural Health Studies 34 Natural Marketplace 35 Conferences & Events 36 Media Corner 36 Advertiser Index 24 The Root of the Problem After determining the root cause of their patients bone joint and muscle care issues natural health practitioners have a wide array of products and therapies to choose from. Visit FreeProductInfo for FREE Product Information or Samples from All Natural Practitioner Advertisers FREE Subscription (Print Digital or BOTH) FREE E-newsletter Visit Copyright 2017. Natural Practitioner (ISSN 2331-2580) Volume 6 Number 1 January February 2017. Natural Practitioner is published monthly (except for bimonthly January February March April June July and September October) by VRM Media 431 Cranbury Road Suite C East Brunswick NJ 08816 USA Phone (732) 432-9600 Fax (732) 432-9288. All rights reserved including the right to reproduce in whole or in part. Not responsible for unsolicited material. Opinions expressed in by-lined articles or advertisements are not necessarily those of Natural Practitioner or its owners. Publisher is not liable for advertiser product claims or representations. Advertisers assume total responsibility for the contents of their advertisements. No portion of this magazine is intended to diagnose treat cure or prevent any disease. Printed in U.S.A. Basic annual subscription rate is 50.00. POSTMASTER Send address changes to Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246. Subscription Customer Service Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs Back Issues & Single Copies For order information contact (732) 432-9600 or info December issue is 25.00. All other issues are 10.00 each. 2 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to livon for info about this advertiser EDITOR S NOTE New Year New Beginnings appy New Year dear Natural Practitioner (NP) readers. I hope the holidays were both relaxing and enjoyable for all of you. The new year is a time for new beginnings and adventures. The start of the year is a time for many to create and stick to a New Year s resolution or two. While those of you who made resolutions are trying to implement them (my gym is currently overflowing with what my personal trainer calls the resolution crowd ) the NP staff s New Year s resolution was to begin the year with new content--and I am happy to say that we have already fulfilled it. You may recall that we added the Supplement Science (see page 28) column in 2016 and 2017 is no different as we are introducing new content both online and in the print issues. First the Institute of Natural Medicine (INM) will be featured in each print issue of the magazine speaking directly to NP readers about topics that concern you and your patients. A not-for-profit organization dedicated to advancing natural medicine the purpose of the INM is to increase awareness broaden the public s access and encourage research of natural medicine and therapies. The first update about chronic disease H and INM s children s health initiative can be found on page 16. In addition to the INM updates NP has debuted its first blog which can be found on the magazine s homepage. Written by Gene Bruno MS MHS dean of academics for Huntington College of Health Sciences who also pens the aforementioned Supplement Science column the blog will be updated monthly. Bruno s first blog entry entitled Lutein & Zeaxanthin for Cognitive Function A New Use for Eye Antioxidants is ready for viewing at Lastly we are happy to announce that Serena Goldstein ND has joined NP s Editorial Advisory Board. Dr. Goldstein is a naturopathic doctor in New York NY specializing in hormonal health concerns such as menses menopause libido and inability to lose weight. Each member of the NP Editorial Advisory Board is present in key editorial throughout the year and authors an annual article for the Practitioner Corner column that highlights their expertise and professional experiences. In addition board members lend their perspective on trends and topics that will be covered in future issues. You can find Dr. Goldstein s first Practitioner Corner article on page 8. We hope you enjoy the new content offerings. Here s to a happy healthy and successful 2017 PUBLISHER DANIEL MCSWEENEY EDITORIAL DIRECTOR DanM ASSOCIATE PUBLISHER RUSS FIELDS RussF ADVERTISING GARY PFAFF SALES MANAGER GaryP EDITOR-IN-CHIEF SHARI BARBANEL ShariB ASSOCIATE EDITOR NICHOLAS SARACENO NicoS CONTRIBUTING EDITOR JANET POVEROMO JanetP ART DIRECTOR ROBERT CERTO PRODUCTION MANAGER RobertC PRODUCTION ASSISTANT BRYAN ZAK GRAPHIC ARTIST BryanZ CIRCULATION MANAGER ROSIE BRODSKY Rosie PHONE FAX E-MAIL WEBSITE PRESIDENT VRM MEDIA 431 Cranbury Road Ste. C East Brunswick NJ 08816 (732) 432-9600 (732) 432-9288 info DANIEL MCSWEENEY DanM MISSION STATEMENT Natural Practitioner magazine provides alternative complementary and integrative health care professionals information about natural products market trends industry news health research and other content designed to benefit their practices and improve their business results. Subscription Customer Service To order a subscription or manage your account please contact us at Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs Back Issues See the Table of Contents page for price and order information. Connect With Us vitaminretailer vitaminretailermagazine company vrm-media vitaminretailermagazine vrm_media 4 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to kyowa for info about this advertiser Meet Natural Practitioner s Editorial Advisory Board Shailinder Sodhi ND Growing up near the Himalayas Dr. Shailinder Sodhi developed an early interest in ayurvedic plants and herbs and received his BAMS (bachelor in ayurvedic medicine and surgery) degree from Dayanand Ayurvedic College in Jalandhar India in 1985. In 1993 he received a naturopathic medicine degree from Bastyr University as well as a degree in diagnostic ultrasound from Bellevue College. Dr. Sodhi practices naturopathic medicine along with his wife Dr. Anju Sodhi and his brother Dr. Virender Sodhi at the Ayurvedic and Naturopathic Medical Clinic in Bellevue WA which he established in 1989. In addition Dr. Sodhi serves as president of Ayush Herbs Inc. a manufacturer of high-quality ayurvedic herbal formulas is an adjunct faculty member at Bastyr and has been published in several natural health magazines. In its search to provide readers with insight and perspective that will help them build and better their practices Natural Practitioner has culled together an Editorial Advisory Board of authoritative practitioners willing to do just that. You will see our Board members present in key editorial as well as each authoring their own column Practitioner Corner throughout the year that highlights their expertise and professional experiences. They will also lend us their perspective on trends and topics that Natural Practitioner will be covering in issues to come. Natural Practitioner s Editorial Advisory Board is comprised of Holly Lucille ND Dr. Holly Lucille is a nationally recognized licensed naturopathic physician lecturer educator and author of Creating and Maintaining Balance A Women s Guide to Safe Natural Hormone Health. Her private practice Healing From Within Healthcare focuses on comprehensive naturopathic medicine and individualized care. Outside of her practice Dr. Lucille holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation. She is the past president of the California Naturopathic Doctors Association where she spearheaded a lobbying effort to have naturopathic doctors licensed in the state of California. A graduate from the Southwest College of Naturopathic Medicine Dr. Lucilles commitment to naturopathic medicine has been recognized with the Daphne Blayden Award and more recently the SCNM Legacy Award. Amber Lynn Vitale BA LMT CN Amber Lynn Vitale BA LMT CN majored in economics with postgraduate work in medical sciences and additional certifications in bodywork ayurveda and holistic nutrition. Her journey in the healing arts developed richly as she worked for years in practices with integrative physicians acupuncturists chiropractors and nurses. Ultimately she developed an integrated modality of ayurvedic medicine yoga advanced bodywork and integrative nutrition. Vitale uses her 19 years of experience in integrative medical practices to educate on the consumer mindset and to distill these wisdoms into digestible information bytes. In 2014 she joined the Garden of Life team as their Northeast regional educator. Adam Killpartrick DC Dr. Adam Killpartrick earned his degree from Palmer College of Chiropractic in Davenport IA. His primary practice focus has been a synergistic blend of NUCCA (upper cervical chiropractic) with Cranial Release Technique for which he has attained lead instructor status. Dr. Killpartrick furthered his education in clinical nutrition functional diagnostics and lifestyle medicine and has since successfully integrated this blend of specialized chiropractic care and functional medicine into his New Hampshire private practice. This practical experience led him to clinical consulting for numerous nutritional supplement companies. He is currently the chief scientific officer for DaVinci Laboratories. Jared M. Skowron ND Dr. Jared M. Skowron is a national expert in natural medicine for children. Author of the best-selling 100 Natural Remedies For Your Child his lifes work is dedicated to the optimal health of children. A faculty member at University of Bridgeport and founder of their Pediatric & Autism Clinic Dr. Skowron has helped thousands of children fulfill their optimal potential. He is vice president of the Pediatric Association of Naturopathic Physicians and his expertise is in pediatrics autism ADHD and acute and chronic EENT conditions. Jacob Teitelbaum MD A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally and does phone consultations with CFS fibromyalgia patients worldwide. He is the author of the popular iPhone application Cures A-Z and author of the best-selling book From Fatigued to Fantastic (3rd revised edition Avery Penguin Group) and Pain Free 1-2-3--A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW (Fairwinds Press 2010). Dr. Teitelbaum does frequent media appearances including Good Morning America CNN Fox News Channel the Dr. Oz Show and Oprah & Friends. Isaac Eliaz MD MS LAc Dr. Isaac Eliaz is a recognized expert in the field of integrative medicine since the early 1980s with a specific focus on cancer immune health detoxification and mind-body medicine. He is a respected formulator clinician researcher author and educator. As part of his commitment to the advancement of integrative medicine Dr. Eliaz partners with leading research institutes and has co-authored numerous peer-reviewed papers on innovative therapies for immune enhancement heavy metal toxicity and cancer prevention and treatment. He is founder and medical director of Amitabha Medical Clinic and Healing Center in Santa Rosa CA where he and his team of practitioners pioneer individualized treatments for cancer and chronic illness. Serena Goldstein ND Serena Goldstein ND is a naturopathic doctor in New York NY specializing in hormonal health concerns such as menses menopause libido and inability to lose weight. She graduated cum laude double majored in psychology and biology from Barrett Honors College at Arizona State University and received her Naturopathic Doctorate from National University of Natural Medicine in Portland OR. She has been published in numerous health and wellness resources such as MindBodyGreen GreenMedInfo and Better Nutrition and appeared on multiple radio shows. Dr. Goldstein also gives talks as in most recently the American Cancer Society. Dr. Goldstein is in her own practice and volunteers at the NYUHospital Poison Control Center. 6 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to probioticsinternational for info about this advertiser PRACTITIONER CORNER Hormones & the Heart Why This Relationship is Not Monogamous By Serena Goldstein ND C hronic conditions exhibited in current day reflect the impact of epigenetics a very imbalanced interaction how lifestyle (95 percent) and genetics (5 percent) affect disease development. Coronary heart disease (CHD) the number one cause of death in the United States which encompasses a spectrum of conditions such as high blood pressure coronary artery disease high cholesterol and an irregular heart rate or rhythm can gradually advance over weeks years or decades. The multiple risk factors mostly from our lifestyle involved in the development of heart disease has also contributed to other conditions seemingly unrelated to the cardiovascular system like hormone imbalances gastrointestinal concerns and other endocrine disorders. We cannot alter our age race or biological sex but we can address the complex interaction of how our mind and body work through adapting a healthier lifestyle that can improve our heart health amongst many other conditions and serve as prevention. The main risk factors for CHD are high blood pressure high cholesterol diabetes and cigarette smoking and independently contribute to approximately 80 to 90 percent of patients with the diagnosis.1 The most prevalent type of CHD is coronary artery disease (CAD) the leading risk factor for arrhythmias and the most common cause of mortality in the developed world. CAD is the buildup of various types of plaques that lodge in arteries can be stable or unstable with the latter potentially leading to a greater chance of rupture or getting lodged in arterial walls and may result in a heart attack or stroke.2 However the main conditions and scenario (smoking) that increase the risk of CHD does not provide immunity from other risk factors or other diseases states. Perhaps too much sugar from diet or stress which can raise cholesterol and increase the chance of plaque deposit or may narrow space that reduces the amount of blood pumped so the heart has to work harder to improve circulation. Excessive sugar in the bloodstream can also damage all vessels (including compromising the release of nitric oxide that lets blood vessels expand to manage blood pressure) and potentially reduce organ function as a result. Furthermore elevated blood pressure and stress are some of the risk factors for arrhythmias which can result in congestive heart failure stroke and sudden death. Our body encompasses millions of signals and networks destined with the possibility to overlap and affect how we function. The endocrine system is responsible for reproduction metabolism mood cell and tissue function sexual function growth and development. If there s too much or too little a feedback mechanism will signal the glands to produce or inhibit production of the desired hormones. Reproductive hormones (e.g. estrogen testosterone progesterone) play a pivotal role in various aspects of cardiovascular health and but still may only be a part of the reason of someone s risk for development or poor outcome. Estrogen is produced in both genders but to a lesser extent in men and its role in heart disease includes reduced risk of heart disease by increasing the high density lipoprotein (HDL) cholesterol (good) reducing low density lipoprotein (LDL) cholesterol (bad) promoting clots that help stop bleeding and relaxing blood vessels. Testosterone is also produced in both genders more so in men and helps protect against heart disease by lowering the risks of high blood pressure 8 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to daiwa for info about this advertiser PRACTITIONER CORNER and heart attack decreasing the stickiness of platelets (less chance of blood clot) and decreasing LDL cholesterol. Progesterone too is present in both yet naturally higher in women is known to promote overall relaxation and can aid in reducing blood pressure prevent blood vessel constriction and protective of arterial function.3 Harmonizing gastrointestinal bacterial health is very important to mitigating unwanted cardiovascular outcomes or diseases as our four pounds of gut flora can include unwanted strains. Bacteria produce trimethylamine (TMA) in the presence of dietary choline (e.g. eggs red meat milk liver) and L-carnitine (e.g. red meat) which gets converted into TMA N-oxide (TMAO) in the liver. TMAO is associated with an increased risk of atherosclerosis elevated cholesterol blood sugar issues worse prognosis in heart failure and a major cardiac event (MI stroke or death).4 On the other hand choline and L-carnitine are extremely beneficial nutrients so while there s potential contribution it s not a direct cause and effect. Increased incidence of heart disease-related-concerns have also been attributed to reduced thyroid function a main player in metabolism. Therefore an underactive thyroid can lead to low blood pressure and lessen the heart s ability to contract and move blood throughout the body impair blood vessel relaxation and impede clearance of plaques that can increase risk of high cholesterol. Conversely an overactive thyroid has it s own concerns as it can speed up heart rate and metabolism to place someone at risk for atrial fibrillation and potential heart failure.5 Cortisol our stress hormone and member of the endocrine system (like reproductive hormones and thyroid) may disrupt many or all of these functions even ones not mentioned yet required for survival. It is produced by adrenal glands which also controls our salt water balance (aldosterone) and contributes to the quantity of reproductive hormones especially in postmenopausal women when they become the main source. Unfortunately in current times we tend to carry constant emotional and physical stress so our body generates more cortisol to simply run from a bear (primal times) and then reduces resources devoted to digestion and reproduction because those are not as critical to survival. Therefore chronic stress can compromise digestion and nutrient absorption affect mood by altering gut bacteria s serotonin production (our happy hormone) weaken thyroid capacity affect sleep by reducing melatonin (made from serotonin and varies inversely with cortisol) and lead to imbalanced hormones by prioritizing cortisol production from the cholesterol molecule instead of the other path to make reproductive hormones. The interplay of how organ systems outside the cardiovascular system play a role in heart disease development is a testimony of why treatment requires a multifaceted approach both in choice of therapies and the concerns addressed. Moreover it s imperative to tailor therapies that account for why the individual is in this diseased state as two people could have the same diagnosis but different etiologies. Healing begins with optimizing lifestyle through a foundation of a nutrient-dense diet (account for food allergies and personal dietary preferences) smoking cessation (if applicable) Go to womensinternational for info about this advertiser 10 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 daily exercise and regular movement proper quality and length of sleep and stress management. A diet rich in healthy fats like olive oil nuts avocado fish poultry beans grains and a rainbow of vegetables plus regular physical activity have been demonstrated to help mitigate present disease and reduce risk of deleterious outcomes.6 More specifically ground flaxseeds are rich in fiber to help feed beneficial gut bacteria promote healthy bowel movements and optimize metabolism of cholesterol and hormones. Dark leafy greens and cruciferous vegetables contain crucial vitamins and minerals essential to general health and best even lightly cooked as raw may lessen thyroid function (yet better to choose raw than an unhealthy food). Mindfulness meditation (bringing awareness to a moment) has been shown to reduce symptoms of anxiety and depression perceived stress blood pressure and weight in people with CHD.7 Yoga further adds to these benefits with reduced cholesterol and improved blood plasma glucose.8 Supplementation should be to supplement not replace a healthy lifestyle and customized to the individual. However favorable choices for most include a high quality B-complex (L-MTHFR instead of folic acid or folate) fish oil and CoQ10. B vitamins are involved in more than 300 reactions such as reducing LDL and raising HDL lowering homocysteine (known heart disease risk factor) and aiding in hormone production. Fish oil is an overall potent antiinflammatory and CoQ10 is an important factor in mitochondrial function ( powerhouse of the cell) as our heart is the hardest working muscle in the body. Please discuss with your health professional any nutrients herbs or other supplements taken especially if taking pharmaceuticals as there is potential for interaction. Pharmaceuticals may also have their place but have potential risks and side effects such as how statins (reduce cholesterol) can lower testosterone raise blood sugar numbers and cause muscle pain--yet there s still a question of whether it helps prevent CHD. Additionally hormone replacement therapy (HRT) may be considered to reduce risk of CHD as it adds in a single or combination of hormones that can improve many aspects of cardiovascular health. HRT is commonly given to women with peri- or menopausal concerns like hot flashes osteoporosis prevention and insomnia while men of similar age may have decreased energy or libido and labs show low testosterone. Numerous studies demonstrated how estrogen or estrogen and progesterone hormone replacement therapy (HRT) might provide symptomatic relief for women but results are dismal in its protection against heart disease if any.9 Conversely testosterone replacement for men did have protective benefits but did not change or worsen a women s risk of heart disease (Huang et al. 2014 Kelly & Jones 2013).10 11 The complexity of how chronic disease develops lies in the blend of one s physiology emotional health lifestyle and individual past and family history and is further complicated because it s not the same ratio in each person. The current paradigm shift in medicine interconnects these factors to prioritize therapies while providing education inspiration and guidance specific to the person not just the diagnosis to get to the root cause of disease. Even nature created this very beneficial cardiovascular herb called Go to emerson for info about this advertiser 11 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 PRACTITIONER CORNER Crataegus monogyna (Hawthorne) that serves as a natural beta blocker to lower blood pressure and support overall emotional health and exemplifies an integrative approach to care that truly encompasses the mind-body connection. cle 195543. 7 Parswani M.J. Sharma M.P. & Iyengar S.S. (2013). Minfulness-based stress reduction program in coronary heart disease a randomized control trial. International Journal of Yoga. 6(2) 111-117. http article.asp issn 09736131 year 2013 volume 6 issue 2 spage 111 epage 117 aulast parswani. 8 Bijlani R.L. et al. (2005). A brief but comprehensive lifestyle education program based on yoga reduces risk factors for cardiovascular disease and diabetes mellitus. The Journal of Alternative and Complementary Medicine. 11(2) 267-274. http doi abs 10.1089 acm.200 5.11.267. 9 Hormone therapy and heart disease. Committee Opinion No. 565. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013 121 1407 10. resources-and-publications committee-opinions committee-on-gynecologic-practice hormone-therapy-and-heart-disease ismobileset false. 10 Huang G. et al. (2014). Testosterone doseresponse relationships with cardiovascular risk markers in androgen-deficient women A randomized placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism. 99 7. http doi full 10.1210 jc.20134160. 11 Kelly D.M. & Jones T.H. (2013). Testosterone a vascular hormone in health and disease. Journal of Endocrinology. 217(3) R47-R71. http content 217 3 R47.full. References 1 Khot U.N. et al. (2003). Prevalence of conventional risk factors in patients with coronary heart disease. Journal of the American Medical Association. 290(7) 898-904. http journals jama fullarticle 197133. 2 Ashley EA Niebauer J. Cardiology Explained. London Remedica 2004. Chapter 5 Coronary artery disease. books NBK2216 . 3 Barbagalla M. et al. (2001). Vascular effects of progesterone. Role of cellular calcium regulation. Hypertension. 37 142-147. http content 37 1 142.full. 4 Tang W.H. & Hazen S.L. (2014). The contributory role of gut microbiota in cardiovascular disease. The Journal of Clinical Investigation. 124(10) 42044211. pmc articles PMC4215189 . 5 Klein I. & Danzi S. (2007). Thyroid disease and the heart. Circulation. 116 1725-1735. http content 116 15 1725.full. 6 Hu F.B. & Willett W.C. (2002). Optimal diets for prevention of coronary heart disease. Clinical Cardiology. 288(20) 2569-2578. http journals jama fullarti- Serena Goldstein ND is a naturopathic doctor in New York NY specializing in hormonal health concerns such as menses menopause libido and inability to lose weight. She graduated cum laude double majored in psychology and biology from Barrett Honors College at Arizona State University and received her Naturopathic Doctorate from National University of Natural Medicine in Portland OR. She has been published in numerous health and wellness resources such as MindBodyGreen GreenMedInfo and Better Nutrition and appeared on multiple radio shows. Dr. Goldstein also gives talks as in most recently the American Cancer Society. Dr. Serena is in her own practice and volunteers at the NYU-Hospital Poison Control Center. Go to emerson for info about this advertiser 12 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 HEALTH INDUSTRY NEWS Natural Partners Broadens Its Wellness Portfolio to Include Acupuncture Needles and Supplies N atural Partners Inc. (Scottsdale AZ) has broadened its portfolio to include acupuncture products and traditional oriental medicine supplies. Catering to the diverse needs of their clients Natural Partners now provides an even more convenient way for health care practitioners to supply their practice and patients with professional-grade supplements and wellness products. Traditional oriental medicine has been practiced globally for thousands of years and is a growing complementary therapy in the United States. Practitioners use acupuncture acupressure and other ancient methods to address a variety of ailments from acute pain to stress and anxiety. By offering acupuncture needles and supplies Natural Partners demonstrates its continued support of integrative practitioners by providing easier access to high-quality products used in the delivery of care to its patients. This is an exciting time for Natural Partners as we expand our portfolio to better meet the needs of our practitioners said Joyce Ito vice president marketing and business development at Natural Partners. Acupuncture is a growing practice among integrative medical professionals and we are privileged to be a trusted resource in this marketplace. Five premium practitioner-respected brands including Shunli SMC Energy Flo Peace and MTP have been added to Natural Partners extensive portfolio of existing Chinese herbs. Through their customary rigorous vetting process Natural Partners selected acupuncture needle and supply brands that met their strict quality standards. For more information visit Dr. Serena Goldstein Joins Natural Practitioner Advisory Board FTC Issues Enforcement Policy Statement on Marketing Claims for Homeopathic Drugs he Federal Trade Commission (FTC) has announced a new Enforcement Policy Statement on Marketing Claims for Over-the-Counter (OTC) Homeopathic Drugs. An FTC workshop held last year to examine how such drugs are marketed to consumers informed the policy statement. The FTC also released its staff report on the workshop which summarizes the panel presentations and related public comments in addition to describing consumer research commissioned by the FTC. The policy statement explains that the FTC will hold efficacy and safety claims for OTC homeopathic drugs to the same standard as other products making similar claims. That is companies must have competent and reliable scientific evidence for health-related claims including claims that a product can treat specific conditions. The statement describes the type of scientific evidence that the Commission requires of companies making such claims for their products. For the vast majority of OTC homeopathic drugs the policy statement notes the case for efficacy is based solely on traditional homeopathic theories and there are no valid studies using current scientific methods showing the product s efficacy. As such the marketing claims for these products are likely misleading in violation of the FTC Act. However the policy statement also notes the FTC has long recognized that S erena Goldstein ND has recently joined Natural Practitioner s Editorial Advisory Board. Dr. Goldstein a naturopathic doctor in New York NY specializing in Serena hormonal health concerns Goldstein such as menses menopause libido and inability to lose weight. Dr. Goldstein graduated cum laude double majored in psychology and biology from Barrett Honors College at Arizona State University and received her Naturopathic Doctorate from National University of Natural Medicine in Portland OR. She has been published in numerous health and wellness resources like MindBodyGreen GreenMedInfo and Better Nutrition and appeared on multiple radio shows. She also gives talks as in most recently the American Cancer Society. Dr. Goldstein is in her own practice and volunteers at NYU-Hospital Poison Control Center. Each member of the Natural Practitioner Editorial Advisory Board is present in key editorial throughout the year and annually authors an article for the Practitioner Corner column that highlights their expertise and professional experiences. In addition board members lend their perspective on trends and topics that will be covered in future issues. T marketing claims may include additional explanatory information to prevent the claims from being misleading. Accordingly it recognizes that an OTC homeopathic drug claim that is not substantiated by competent and reliable scientific evidence might not be deceptive if the advertisement or label where it appears effectively communicates that 1) there is no scientific evidence that the product works and 2) the product s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts. The policy statement notes that any such disclosures should stand out and be in close proximity to the product s efficacy message and might need to be incorporated into that message. It also warns marketers not to undercut a disclosure with additional positive statements or consumer endorsements reinforcing a product s efficacy. The statement warns that the FTC will carefully scrutinize the net impression of OTC homeopathic marketing claims and that if an ad conveys more substantiation than a marketer has it will violate the FTC Act. The Commission vote approving the enforcement policy statement and issuance of the staff report on the Homeopathic Medicine & Advertising Workshop was 3-0. For more information visit JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 13 HEALTH INDUSTRY NEWS Marketers of Blood-pressure App Settle FTC Charges Regarding Accuracy of Readings T he marketers of a mobile app designed to measure blood pressure have agreed to settle Federal Trade Commission (FTC) charges that they deceived consumers with claims that their Instant Blood Pressure (IBP) app was as accurate as a traditional blood pressure cuff. In addition the Commission alleged that the owner provided a positive review of the app rating it five stars in the app stores without disclosing his connection to the company. Under the terms of the FTC settlement Aura Labs Inc. doing business as AuraLife and AuraWare and its founder and coowner Ryan Archdeacon are barred from making such unsupported claims in the future and must disclose any material connections between Aura and people who endorse its products. For someone with high blood pressure who relies on accurate readings this deception can actually be hazardous said Jessica Rich director of the FTC s Bureau of Consumer Protection. While the Commission encourages the development of new technologies health-related claims should not go beyond the scientific evidence available to support them. According to the FTC s complaint Aura sold the IBP app through Google Play and Apple s App Store for between 3.99 and 4.99. Between June 2014 and June 2015 sales of the app totaled more than 600 000 according to the agency. In marketing the app Aura and Archdeacon claimed that it could be used to replace around-the-arm cuffs and would be just as accurate as the traditional device the FTC charged. In reality however blood pressure readings reported by the IBP app were significantly less accurate than those taken with a traditional blood pressure cuff. To use the company s IBP app users put their right index finger over the phone s rear camera lens and held the base of the phone over their heart. The Commission charged defendants with violating the FTC Act. The stipulated federal court order prohibits the defendants from making the deceptive claims alleged in the complaint. It also prohibits them from making any claims about the health benefits of any product or device without the scientific evidence to support the claims. It imposes a judgment of 595 945.27 which is suspended based on the defendants inability to pay. The full amount will become due however it they are later found to have misrepresented their financial condition. The Commission vote authorizing the staff to file the complaint and stipulated order was 3-0. The FTC filed the complaint and order in the U.S. District Court for the Central District of California and the order has now been signed by the judge. For more information visit Zing Bars Announces Winners of First Annual Nutrition Grants T he dietitians behind Zing Bars (Seattle WA) have announced the recipients of the 2016 Zing Nutrition Grants. The purpose of the grants is to support registered dietitians in launching or growing their nutrition businesses or bringing new nutrition products or services to market. The company received more than 60 entries and introduced the winning entrepreneurs at the recent annual Academy of Nutrition and Dietetics Food and Nutrition Conference & Expo (FNCE) in Boston MA. The three winners are Jodi Danen RDN and owner of Create Kids Club who was awarded 1 000 to bring her childhood nutrition education club s products and services to life. Her first project with Create Kids Club is the launch of Lunch Bites lunch box cards. These cards get kids laughing and learning at lunch with positive sayings acts of kindness recipes jokes and fun food facts. All are food and nutritionthemed. Danen is launching Lunch Bites this month to lunch boxes across the world and intends to use grant funding toward printing distribution and marketing costs. Rebecca Bitzer MS RDN LD CEDRD and owner of Rebecca Bitzer & Associates has been awarded 500 to help fund her plan to train new dietitians on establishing a private practice. She has been in private practice for nearly 30 years and employs eight RDNs. She aims to use grant funds to increase the success and business-savvy of future private practice RDNs by distributing training materials and conducting business-focused training sessions with dietetics students and interns in the Washington D.C.-metro area. Mascha Davis MPH RDN owner of Nomadista Nutrition. Davis was awarded 500 to help fund the creation of her ebook debunking nutrition myths and conveying what it means to truly eat healthily and sustainably. She will enlighten on how to make an impact on our food systems both locally and globally. Davis has spent the past five years working in humanitarian aid mostly in Africa with a focus on the treatment and prevention of childhood malnutrition. As four practicing dietitians we created Zing Bars and launched our company because we couldn t find a nutrition science-based bar on the market that met the needs of our patients. Now with the growth of Zing Bars into markets across the country we wanted to give back and support the entrepreneurial initiatives of other dietitians who are trying to close the awareness gap in better nutrition and build their businesses noted Zing Bars Co-founder and CEO David Ingalls. For more information visit 14 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Forever Health and APS Pharmacy Announce Marketing Alliance orever Health (Fort Lauderdale FL) and APS Pharmacy (Palm Harbor FL) have jointly announced the creation of a marketing alliance to create more awareness among their customers about health and wellness matters and to help educate the public about how to take greater control of their health. Forever Health is a vetted resource for prospective patients to connect with qualified integrative health practitioners who specialize in age-management environmental medicine preventive medicine and bioidentical hormone replacement therapy (BHRT). Patients can locate practitioners in their geographic area free of charge by visiting the Forever Health Practitioner Network at F APS is a compounding pharmacy specializing in treatments for hormone replacement therapy (HRT) environmental medicine urology and workers compensation. APS Pharmacy s philosophy is that medicine is not a one-size-fits-all matter. The pharmacy creates safe reliable and affordable medicines to meet the specific needs of the individual patient. Our collaboration with APS generates win-win-win situations that offer value to both partnering companies and to our Forever Health practitioners and customers said Rey Searles vice president of marketing for Forever Health. And the best part is that ultimately our customers the consumer and health professional network win as they are introduced to Forever Health branded dietary supplements initiatives new products and features and a host of other health-related services including blood testing designed to encourage and build loyalty Searles continued. The strategic goal of our partnership is to find new potential customers where our companies and brands don t compete added Jaime Rios president and owner of APS Pharmacy. Forever Health opens new distribution channels for us to reach these new potential customers who may not be aware of the APS Pharmacy brand. Forever Health is a partner that can help the APS Pharmacy brand sustain continuous growth. For more information visit or Diabetes Prevention Missing Essential Component According to Behavioral Expert oughly 30 million people in the U.S.--9.3 percent of the total population--are currently living with diabetes. Lou Ryan founder of SelfHelpWorks is urging programs that work to prevent diabetes to include cognitive behavioral training (CBT). CBT helps to support the changing emotional needs of diabetics and those who suffer from pre-diabetes alike. These needs often go unmet by many programs and that can lead to additional problems with the health condition. CBT is an effective method for getting rid of unhealthy habits that most people find too tough to give up for any length of time said Ryan. Good examples are smoking or snacking on sugary or starchy foods. These can literally kill a diabetic over time. The goal of most programs is to help stop diabetes and that won t happen without ending the unhealthy habits. Knowing you need to stop is very different from actually stopping--that s where cognitive behavioral training comes in Ryan noted. It s highly effective in breaking what we call the emotional trained response that keeps people tied to their cigarettes or unhealthy foods. CBT is the process of ending the patterns that result in emotional dependency on unwanted behaviors. It works to replace them with rational responses and healthier patterns. CBT can help change the mindset which may lead to a more lasting shift. Ryan said The emotional impact of diabetes can be devastating . . . It s critical to have effective emotional tools and strategies for getting back on top. For more information visit THE GO TO RESOURCE FOR ALTERNATIVE & INTEGRATIVE HEALTHCARE PROFESSIONALS R NP s Upcoming Issue Highlights March April 3 6 17 ad closing 4 17 17 ad closing 6 1 17 ad closing Immune Support Cognitive Health CAM Innovations Women s Health Weight Management AANP Show Issue May June July Our 2017 Media Planner Is Available At 2017-Media-Planner Contact One of Our Ad Specialists Today Russ Fields at 732-432-9600 ext. 102 e-Mail RussF Gary Pfaff at 732-432-9600 ext. 103 e-Mail GaryP NATURAL PRACTITIONER JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM 15 INM UPDATE Leading Industry Organization Speaks Directly to Natural Practitioner Readers Naturally Well Decreasing Chronic Disease One Fourth Grader at a Time. By Michelle Simon PhD ND President INM e know chronic disease is an increasing burden on our society our health care system and our families. This year for the first time since 1996 the life expectancy of Americans declined.1 This is a departure from the trend in other Western nations who continue to see a lengthening in life expectancy. The U.S. ranks 31st in life expectancy according to the WHO (World Health Organization) which is just behind Costa Rica just ahead of Cuba2... and falling. The debate over what has caused this trend reversal is a rich one with many theories. What people desire I suspect is not debate and confusion but guidance. What can they do to live a long healthy and productive life I propose examining one strategy diet. Dietary choices are a strong determinant of health. Overexposure to environmental toxins through our food system can disrupt our metabolism and make us more predisposed to diabetes.3 For example a study published in the Lancet found a correlation between insulin resistance (a precursor to diabetes) and persistent organic pollutants (POPs) in the blood.4 BPA an additive in many plastics and found in the liners of canned goods can increase the risk of diabetes and cause weight gain.5 6 The importance of dietary choices is paramount. How does one choose well when education largely comes from consumer media We at the Institute for Natural Medicine (INM) have created a pilot program to begin to address this overwhelming need. And we are targeting fourth graders. W of but do not have access to the benefits of naturopathic medicine. This community like many others is particularly hard hit with chronic diseases such as diabetes and heart disease. These conditions are largely preventable and treatable with diet and lifestyle measures. During the 12-week afterschool program kids learn about healthy eating and cooking nutrition gardening sustainability and lifelong wellness habits. Research about children in the fourth fifth and sixth grades shows that learning during this time period is particularly influential on lifelong choices. A motivated fourth grader is a change agent in their family and their family s health. By partnering with a local community-based organization like the YMCA our intent is to refine the model and replicate it in at risk communities across the country. Incorporating a local naturopathic doctor to teach these specialized classes is one of the major strategies to fulfill our vision of bringing in naturopathic doctors or naturopathic medicine residents (graduating naturopathic doctors) to community-based organizations or schools working directly with students and their families to teach and model healthy living habits. We are excited to announce that INM has secured funding to bring this program to the Phoneix AZ metro area in 2017 The Institute of Natural Medicine (INM) Just over 20 years ago a leadership core of naturopathic doctors established INM as a not-for-profit organization dedicated to advancing natural medicine. The purpose of the INM is to increase awareness broaden the public s access and encourage research of natural medicine and therapies. Among its milestones the INM counts the launch of the Association of Accredited Naturopathic Medical Colleges as an independent organization leading California s efforts to obtain licensure for naturopathic physicians and funding graduating naturopathic medical students in studies that advance the profession. The INM has joined forces with the American Association of Naturopathic Physicians serving as its charitable arm to deepen access to naturopathic care public education and research. Dr. Michelle Simon is a licensed naturopathic physician clinician educator and leader in many organizations dedicated to improving the quality and delivery of healthcare. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill. Dr. Simon serves as president of the Institute for Natural Medicine (INM) treasurer of the American Association of Naturopathic Physicians (AANP) and a director of the Naturopathic Physicians Research Institute (NPRI). Dr. Simon served nine years on the Washington State Health Technology Clinical Committee which is part of the Health Technology Assessment Program (HTA) that examines the scientific evidentiary basis for efficacy safety and cost effectiveness of health care technologies. Dr. Simon has served as an Ambassador to the Academy of Integrative Health and Medicine (AIHM) an international inter-professional organization that educates and trains clinicians in integrative health and medicine and as an invited participant for health care economics at Summit on Integrative Medicine and the Health of the Public at the Institute for Medicine (IOM) in 2009. Dr. Simon also serves on the Advisory Board for Natural Partners Inc. For more information contact msimon Naturally Well--A Children s Health Initiative of the INM Through a collaborative grant initiative with the West San Gabriel Valley YMCA and the Food as Medicine Institute (FAMI) INM is delivering an ND-led afterschool program. This pilot program focuses on preventative medicine to establish early habits for lifelong health in children and their families in at risk communities of the West San Gabriel Valley CA. We are targeting communities like this one which are culturally supportive 1 nchs products databriefs db267.htm 2 mediacentre news releases 2016 health-inequalities-persist en 3 Hyman M. Systems biology toxins obesity and functional medicine. Altern Ther Health Med. 2007 13(2) S134-S139. Spiegel K Leproult R Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999 354 1435-1439. 4 Jones OA Maguire ML Griffin n JL. Environmental pollution and diabetes a neglected association. Lancet. 2008 371(9609) 287-288. 5 Todd Hagobian Allison Smouse Mikaela Streeter Chloe Wurst Andrew Schaffner Suzanne Phelan. Randomized Intervention Trial to Decrease Bisphenol A Urine Concentrations in Women Pilot Study. Journal of Women s Health 2016 DOI 10.1089 jwh.2016.5746 6 Lang IA Galloway TS Scarlett A et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008 300(11) 1303-1310. References 16 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Fear of heart issues remains prominent among adults many of whom don t know how to caretake their cardio system. By Lisa Schofield A lthough most people think of the romantic heart during February ruminating about one s physical heart also tends to be common this month. Unfortunately during the snowy month of February fatal heart attacks rise in the brittle cold weather while exerting one s self in activities such as shoveling snow. Heart disease and fatal heart attacks have been in the spotlight recently during the holiday season when the entertainment industry lost icons such as television actor Alan Thicke pop musician George Michael and film actress and author Carrie Fisher. In this modern age all three individuals are considered too young to die--and many middle-aged Americans who held the trio in high esteem have been shocked and wondering just where they stand cardiovascular wise. And many may be turning to natural practitioners to help discover where they stand and how they can improve cardiovascular status. A number of clients patients may also be holding onto older notions of what affects and influences the health of their hearts and cardiovascular systems. For example according to Jonny Bowden PhD CNS The Nutrition Myth Buster the biggest shift in the nutrition arena is a growing realization about the roles of fats and sugar in heart disease. I ve been arguing for a decade that fat has been wrongly demonized he asserted. Dr. Bowden pointed to several significant meta-analyses that have absolved saturated fat of a causative role in heart disease--e.g. American Journal of Clinical Nutrition (Siri-Tarino 2010) and the Annals of Internal Medicine (Chodhury 2014). Sugar is being shown via research to be a major dietary instigator in the development and progression of heart disease. This is a pretty seismic shift in our understanding of the real demons in the diet he commented. Further a December 12 2016 scientific press release from the Houston Methodist DeBakey Heart and Vascular Center via the JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 17 American Heart Association described how many women may miss signs of heart trouble thinking that some symptoms are simply anxiety or indigestion. According to Karla Kurrelmeyer MD a cardiologist at the center stress can cause symptoms of a heart attack in women that aren t as obvious as heart attack symptoms in men. These include sweating nausea vomiting and dizziness (flu-like symptoms) indigestion fullness and tightness in throat area tachycardia extreme weakness anxiety and shortness of breath and pressure heaviness or pain in the arm chest and below the breastbone in the middle of the back. And there are other studies and recent theories that your peers find worthwhile to discuss with their clients patients who are concerned about their cardiovascular status. A majority of clients patients will immediately want to discuss cholesterol levels as most people believe that unfavorable levels of cholesterol is the main (and sometimes only) culprit of heart disease. However said Raphael Kellman MD founder of the Kellman Center for Functional and Integrative Medicine Cardiovascular health is not just about lowering cholesterol or raising good cholesterol that s old medicine. There are several other important factors that need to be considered he stated. Endothelial function--and dysfunction--is key here as the most important functional characteristic of arteries is elasticity. Inflammation affects nitric oxide which keeps endothelial tissue pliable and therefore controlling or lessening the inflammatory response is important for overall cardiovascular health. In the body the ability to accommodate changes allows for adaptability that maintains health Dr. Kellman elucidated. Once rigidity sets in disease takes hold. Likewise the way vessels heal when damaged is also critical. There are different pathways in the cardiovascular toolkit to correct the nicks and damage to vessels. In inflammatory states genes turn on and off leading to the repair vessels in ways more likely to cause atherosclerosis and dyslipidemia. Now we know Apo A and B and particle sizes are critical. If there is inflammation then there will be more atherosclerosis. Additionally said Dr. Kellman heart dis- ease also is affected by bacteria. There are approximately 10 times more bacteria in the human body than cells and 150 times more DNA. This genetic component is truly what determines health and impacts cardiovascular disease he said. The body uses bacteria to coordinate genes to turn the inflammatory process on or off and while genes are fixed so to speak the great genetic diversity of the microbiome is where freedom lies to heal cardiovascular disease he added. Microbiome medicine Dr. Kellman described works on healing the gut and bacteria which in turn helps strengthen the body to realign to achieve homeostasis and resilience helping to repair insulin resistance and lower inflammation among other benefits. These bacteria produce butyrate a biochemical that also helps lessen inflammation and insulin resistance. The microbiome is our greatest ally he attested. the causes of heart disease. They are not and they never were he declared. And our single-minded myopic concentration on lowering cholesterol has caused us to take our eye off the ball when it comes to identifying and fixing the real culprits in heart disease dietary sugar inflammation oxidative damage and stress. The focus on lowering cholesterol in the blood and fat in the diet led to the craziest nutritional experiment in history--the low-fat high processed carbohydrate diet--which in my opinion is largely responsible for epidemic explosions in diabetes heart disease obesity and Alzheimer s. As these myths are busted and new causes or contributors to poor cardiovascular status are found your peers are relying on specific tests to reveal status or presence of causative factors of potentially devastating cardiovascular conditions and creating sound protocols to preserve or improve cardiovascular functioning. It makes sense that low functioning thyroid plays a role in CVD (cardiovascular disease)--if the vessels can t function and the patient s body can t produce antioxidants increased inflammation will result. If we overlook the hidden world of the microbiome and proper thyroid function we put the patient at risk. --Raphael Kellman Founder Kellman Center Testing The cardiovascular care program at Kellman Center for Functional and Integrative Medicine noted Dr. Kellman always begins with improving overall function of the entire body and includes deep testing to find areas that may be weak and contributing to the underlying issues. Testing he reminded should be well rounded to check inflammation biomarkers such as CRP (c-reactive protein) TNF-a (tumor necrosis factor-alpha) interleukins IL1 IL6 IL8 IL10 and homocysteine as well as glucose and insulin dysregulation. Lipid panels should also include a check for particle size. The routine thyroid test simply is not enough to catch many cases of low thyroid so we include a full panel to check TSH free and total T3 free and total T4 RT3 thyroid antibodies plus a TRH stimulation test and secondary markers including cholesterol and alpha beta carotene. A third area of testing for cardiovascular status that Dr. Kellman feels is necessary includes a full exploration into bacterial health this may include breath testing for overgrowth blood testing for LPS urinalysis to check bacterial metabolite markers and a stool assay to show the balance of bacteria look for parasites and yeasts plus check functional markers including SIgA and butyrate. As a nutritionist Dr. Bowden said he recommends a cholesterol particle test which functional medical physicians tend to perform. He agrees with Dr. Kellman noting that thyroid (not just the TSH test also free T4 and T3) is very important to test as well. Further he recommends testing for the following all hormones including testosterone (for both sexes) estradiol DHEA Finally he added the thyroid is often the most overlooked factor that impacts cardiovascular status. In the medical field routine testing is abysmal he declared. Low thyroid increases homocysteine slows the methylation pathway raises cholesterol and contributes to insulin resistance. It makes sense that low functioning thyroid plays a role in CVD (cardiovascular disease)--if the vessels can t function and the patient s body can t produce antioxidants increased inflammation will result. If we overlook the hidden world of the microbiome and proper thyroid function we put the patient at risk. Dr. Bowden believes that the American medical community has wasted not only millions of dollars but has placed millions of lives in cardiovascular jeopardy by collectively focusing on cholesterol and saturated fat as 18 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to natreon for info about this advertiser triglycerides which are underappreciated as a risk factor fasting glucose and also fasting insulin and homocysteine the hs-CRP test. Lp(a). And maybe even a CIMT test (carotid inter-medial thickness) which is a pretty direct measurement of what s going on in the arteries. And of course blood pressure. Many of my colleagues also like to do an adrenal panel of some kind. Natural practitioners can easily recommend a free test --the triglyceride HDL ratio--that clients patients can do at home said Dr. Bowden. Look at their recent blood test and divide triglycerides by HDL. If that number is 2 or less he or she is in good shape risk wise as that number is a surrogate for many things including insulin resistance. Also weight measurement is indicative of status. There are fewer health risks for women with a waist of 35 inches or under and for men with a waist size of 40 inches or under he said. functional by the toxins in cigarette smoke. Aparna Kalidindi PharmD BCPS technical sales and marketing manager for New Jersey-based Natreon Inc. agreed stating that cigarette smoking is not only a major cardio-pulmonary disease risk factor--it is also known to adversely affect other organs in the body. It is one of the major sources of free radical production and these free radicals contribute to many complications including cardiovascular disease she said. The company s key cardiovascular product Capros may help protect the heart in smokers by decreasing the production of free radicals and improving antioxidant status. Capros has an ORACFN value of 47 110 moles TE g which is significantly higher than most other superfruits she said. In addition Capros significantly improves endothelial function improves the lipid profile (significantly increases HDL lowers LDL lowers total cholesterol and lowers triglycerides) and lowers hsCRP levels by greater than 50 percent. Be a Quitter The recent new year has brought with it a refrain of every new year for decades--folks dedicated to smoking cessation to prevent heart disease. Unfortunately many people who quit start again. But there are quite a few who remain successful former smokers. Your clients patients who smoke may need some more enlightenment as to why abandoning so-called cancer sticks (or in this case heart attack sticks ) is a very wise idea. According to Dr. Kellman smoking greatly increases the amount of free radical exposure to the body and cells as well as increases inflammation. As a practitioner he emphasized It is never too late to quit smoking Cigarette smoking added Dr. Bowden causes about one in five deaths. Beyond significantly increasing risk for lung cancer and emphysema (and COPD) it also happens to exponentially increase the risk for heart disease. Toxins and chemicals in the smoke interfere with cellular health and metabolism constrict the vascular system and increase blood pressure he explained. And when one stops smoking those things begin to reverse. The cells can start to breathe again and carry on basic metabolic processes without interference. The mitochondria are no longer overwhelmed and rendered dys- Crominex3 has been clinically shown to be efficacious for those who are type 2 diabetic and pre-diabetic (metabolic syndrome) notably in the support of healthy endothelial function HDL nitric oxide and glutathione levels and reduction of total cholesterol LDL VLDL HbA1C and triglycerides. Arjuna Heart is a cardio-specific supplement from Washington-based Ayush Herbs. Arjuna Heart said Jared Paulson MTCM sales and education manager is a simple combination of the herbs arjuna and inula with CoQ10 vitamins and minerals. Arjuna Heart benefits cardiovascular health by strengthening the heart as a cardiotonic promoting oxygenation and calming the sympathetic nervous system. In addition it improves the elasticity of blood vessels and increases the sensitivity of baroreceptors allowing the blood vessels to maintain heathy blood pressure levels within a normal range. These herbs have long been used in both ayurvedic (Indian) and Chinese medicine to support health and longevity. Of course there are omega-3 EFAs vitamin K2 bergamot oligomeric proanthoycanidins vitamin E (tocopherols and tocotrienols) phytosterols and more--all natural substances that have attractive human clinicals showing cardiovascular benefit. After thorough testing and consultation with your client patient you can recommend the most suitable supplement and lifestyle program to ensure his or her (heart)beat goes on. The biggest shift in nutrition is a growing realization about the roles of fats and sugar in heart disease. Sugar has been shown to be a major dietary instigator in the development and progression of heart disease. In women stress can cause symptoms of a heart attack that aren t as obvious as heart attack symptoms in men. Endothelial dysfunction has been found to be characteristic in cases of heart disease. The thyroid is often the most overlooked factor that impacts cardiovascular status. The routine thyroid test is not enough to catch many cases of low thyroid. Under oxidative stress most antioxidants become inactive. Healthy Take Aways FDA (U.S. Food and Drug Association) GRAS (generally recognized as safe)-affirmed Capros which can be formulated in dietary supplements and functional foods beverages is a pro-oxidation free cascading antioxidant. Under oxidative stress most antioxidants become inactive whereas Capros utilizes a multilevel cascade of antioxidant compounds resulting in a prolongation of its antioxidant capabilities Kalidindi explained. Natreon s Crominex3 described Kalidindi is a trivalent chromium supplement prepared by complexing chromium chloride with two natural products Phyllanthus emblica (Capros) and Shilajit (PrimaVie) which minimizes the conversion of trivalent chromium to toxic hexavalent chromium. Crominex3 has shown significant anti-hyperlipidemic and anti-inflammatory activities in type 2 diabetic patients as well as pre-diabetics. Also she noted FOR MORE INFORMATION Ayush Herbs Natreon 20 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Go to mitoq for info about this advertiser Sleepless nights can be triggered by countless factors but by confronting the issue head on practitioners are able to gain a better understanding of what causes them. By Nicholas Saraceno A s the old saying goes time flies when you re having fun (or sleeping for that matter). Unfortunately for some this is not always the case. According to the American Sleep Association (ASA) 50 to 70 million adults in the United States have some sort of sleep disorder. These disorders can range from dyssomnias to parasomnias. Often times this inability to rest results in sleepless nights. Although there are a plethora of causes linked to difficulty sleeping integrative practitioners are able to pinpoint the most popular ones while finding potential solutions. Causes & Common Conditions As previously mentioned the causes that influence the lack of sleep are numerous but doctors and experts alike have been able to narrow these down to ones backed by science such as brain function which could be the root of the problem. There are cycles of sleep rapid eye movement (REM) and non-rapid eye movement (non-REM) said Jeremy A. Holt associate director of Ajinomoto North America s health services section in New Jersey. REM is typically 25 percent of the sleep period. Non-REM is divided into four stages. Stage One is the period between being awake and falling asleep. Stage Two is the onset of sleep and becoming disengaged from your surroundings. Stages Three and Four are the deepest and most restorative sleep where muscles are relaxed blood pressure drops and breathing becomes slower. A restless sleeper will wake up while transitioning between these stages. Once the body wakes it doesn t return to the stage it awoke from--it must go back to Stage One. Continually waking during the night and not reaching Stages Three and Four is what causes poor sleep quality. However lack of sleep can also stem from gender-related issues that interfere with the REM process. Gina Besteman RPh is the director of compounding and dispensing at the Women s International Pharmacy in Wisconsin a compounding pharmacy that provides high-quality bioidentical hormone therapies. One of the more common symptoms of peri-menopause and menopause that patients complain of is difficulty sleeping. There is a significant amount of research1 showing how hormones affect sleep she noted. Progesterone affects GABA receptors which are responsible for non-REM sleep the deepest of the sleep stages. Progesterone also affects breathing. It s been shown to be a respiratory stimulant and has been used to treat mild obstructive sleep apnea. Estrogen s role in sleep appears to be more complicated than that of progesterone. Estrogen is involved in breaking down norepinephrine serotonin and acetylcholine in the body. Estrogen has been shown to decrease the amount of time it takes to fall asleep decrease the number of awakenings after sleep occurs and increase total sleep time. Low estrogen levels may lead to hot flashes which can also affect sleep. Perimenopause refers to the menopausal transition normally occurring in a women s 40s sometimes mid-30s ( Dr. Besteman also cited that if there is a disruption in cortisol the stress hormone produced by the adrenal glands and melatonin the hormone responsible for sleep and wakefulness manufactured by the brain s pineal gland these could be contributors to the issue. 22 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 As a result different sleep conditions affect different societal demographics. According to Svetlana Kogan MD an integrative doctor in New York NY and author of Diet Slave No More individuals affected by difficulty sleeping can be broken up into three categories. Young people have over stimulated nervous systems due to cell phones video games computers TV and other electronic gadgets she said. Older people (ages 35-60) are having difficulty sleeping due to all of the above plus the stress of having to balance family children and work. Much older people (over 60) have physiologic issues during sleep that cause them to wake up many times during the night (urinary incontinence or frequency sleep apnea insomnia pain syndromes). Overall people who live in big cities sleep much less than the rest of the country. This could be due to overstimulation of the nervous system work stress and lack of time spent outdoors (that is less oxygen to the brain). Solutions to Better Sleep After hearing of patients difficulty sleeping the next question is what exactly can practitioners recommend to their patients to help combat these issues A great starting point would be in the mineral magnesium which notably has a calming effect to it. Magnesium is an essential electrolyte and is known as the anti-stress mineral and is a natural sleep aid mentioned Carolyn Dean MD ND advisory board member of the Nutritional Magnesium Association. Numerous studies2-5 have shown its effectiveness in reducing stress levels as well as helping with deeper more restful sleep. This mineral has been depleted from our soils and foods due to modern farming methods and food processing. More than 75 percent of Americans do not get their recommended daily allowance of this mineral which is a co-factor in 700-800 enzyme reactions in the body. A magnesium deficiency can magnify stress because serotonin the feel good brain chemical that is boosted artificially by some medications depends on magnesium for its production and function. Not all forms of magnesium are easily absorbed by the body. Magnesium citrate powder is a highly absorbable form that can be mixed with hot or cold water and sipped at work or at home throughout the day. As another option Boiron USA a Pennsylvania-based manufacturer of homeopathic medicine offers Quietude dissolvable tablets that help target lack of sleep without the effects that come with it. Christophe Merville DPharm director of education and pharmacy development at the company explained how exactly the medication is effective. Quietude temporary relieves sleeplessness restless sleep and occasional awakening without grogginess or risk of dependency he said. The biggest advantage of this sleep aid is that it doesn t knock you out. It may sound funny for a sleep medicine to be nondrowsy and non-doping but this means you won t have that groggy hangover effect the next day like you re still in a fog which is typical with sleep aids that mask the problem by sedating you. Instead Quietude helps an overactive mind calm down. It s perfect for when your head hits the pillow but you keep going over that to-do list or replaying the day s events. If you ve had a particularly exciting day--whether it s from good or bad news--prepare for bed by taking Quietude once in the early evening and then again at bedtime. A common trend among those struggling with sleeplessness is the fact that the body especially the brain is operating at full capacity even during the late evening hours when it should be resting. Glycine an amino acid found in Ajinomoto s Glysom is able to affect the body accordingly. Glycine is a naturally occurring amino acid that induces sleep by resetting the body s internal clock and reducing the core body temperature said Holt. It signals the body to relax and prepare for a better sleep cycle improving the body s sleep architecture. Taking Glysom together with melatonin provides a combo effect--the melatonin helps you fall asleep the Glysom keeps you asleep. State of the Market Being that difficulty sleeping is an ongoing issue there are positive strides being made in the market precisely in terms of both traditional and natural medications respectively. In fact a major contributor to traditional medicine s success is the severity of the conditions that it treats. Insomnia is recognized as the fourth most prominent health issue just behind stress said Dr. Dean. The projections for sleep aids for 2018 are approximately 732 million with a 27 percent category growth rate. The recognized drawbacks are sideeffects and addictive nature of these medications. Moreover as Dr. Kogan stated the sales are unprecedentedly high--especially those of generic sleep meds as they are cheaper. On the other hand natural sleep medication has continuously garnered attention partly due to individuals that are popular in the public eye. Awareness of the importance of sleep and getting proper sleep is growing and with high profile celebrity deaths (Michael Jackson Prince) related to sleep issues consumers are searching for and demanding natural alternatives to otherwise harmful side-effect ridden medications added Dr. Dean. As a result being that pros and cons lie in (Continued on page 31) Body Pillow Therapy An all-natural method of physical therapy during sleep. he world is finally waking up to healing their bodies during sleep. Pam Blumenthal the creator of the all-natural head and body dual-pillow sleep system called Body Pillow Therapy contends that setting your body up (when you go to bed) with the natural kapok-filled Curvy Head Pillow and Body Pillow Therapy Body Pillow will give your whole body a stable supportive environment for restorative rest as well as injury recovery. Body Pillow Therapy is a new concept in maintaining proper posture for comfort and healing during rest and recovery from injury. Specially positioning oneself with the therapeutic head and body pillow allows the body to achieve a state of profound comfort and relaxation for healthy rest and the promotion of healing. There are various positions that physical thera- T pists have found helpful for specific injuries. More information on the therapeutic positions can be found on the company s website Created in 1988 the Original All-Natural Body Pillow Therapy Body Pillow was the very first body pillow on the market. Soon after its creation it was discovered by physical therapists as a special positioning tool to help with patients rest and recovery. As the company evolved they paired a special curvy head pillow along with the original body pillow and thus the Body Pillow Therapy Sleep Set was born. The Body Pillow Therapy Sleep Set provides total body comfort and healthy posture from head to toe. For more information visit JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 23 After determining the root cause of their patients bone joint and muscle care issues natural health practitioners have a wide array of products and therapies to choose from. By Karen Morse MPH T raditional methods for treating bone joint and muscular health conditions have taken a backseat to the booming industry of natural medicine. Often consumers who used to reach for pharmaceutical and over-the-counter products are now having success with vitamins minerals and other natural remedies meeting the majority of their health care needs. After determining the root cause of their patients bone joint and muscle care issues natural health practitioners have a wide array of products and therapies to choose from. The prevalence of bone joint and muscular disorders in the United States has risen over the past several decades. Age is a risk factor as are a number of lifestyle factors including nutrition exercise smoking and alcohol use. According to the Centers for Disease Control & Prevention (CDC) over 52 million Americans had been diagnosed with some form of arthritis said Ross Pelton RPh PhD CCN the scientific director for Essential Formulas Incorporated in Texas. However by 2040 the number of U.S. adults projected to have doctor-diagnosed arthritis will rise to 78 million. Osteoarthritis also referred to as degenerative joint disease is the most common form of arthritis according to the CDC. They estimate that osteoarthritis affects approximately 26.9 million adults in the United States up from 21 million in 1990 and these numbers are increasing. Skeletal muscle system disorders are numerous and most patients present symptoms of weakness cramping stiffness and painful spasms according to the National Institutes of Health (NIH). A big part of that is due to an aging population and muscle and joint issues simply come with the territory as these structures break down said Cheryl Myers Wisconsin-based Euromedica s chief of education and scientific affairs. A 2012 survey found that back pain arthritis and other muscle joint and bone disorders affect more than 1.7 billion people around the world. And since bone and joint disorders are reported to affect about half of all people age 50 and above there s a strong chance that this will be an ongoing concern for decades. Younger customers are also important drivers in this category. There are many younger people who are very active in the outdoors organized traditional sports and in many other exercise regimens that have become especially popular in recent years including parkour mud runs and Crossfit training Myers stated. Dr. Serena Goldstein a naturopathic doctor who practices in New York NY and sits on Natural Practitioner s Editorial Advisory Board explained that the causes of bone joint and muscle disorders can have various etiologies since each structure is made up of different material. Wear and tear or overusing the same motion poor posture prolonged immobilization or a more traumatic incident may result in a sprain fracture or break she explained. She also highlighted the importance of considering other organ systems that could contribute to bone joint and muscular health disorders. The faster metabolism caused by hyperthyroidism for example could break down bone. Osteoporosis and hyperparathyroidism are other examples of disease conditions that affect the bones. Myers agreed. There are many things that contribute to disorders high levels of 24 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 activity low intakes of bone and musclebuilding nutrients genetic predisposition aging or a combination of all of the above she stated. If you re active and younger you may start to notice some of the issues early on. If you have a fairly moderate level of activity in your life it may take a few years but eventually you ll want some extra support for your joints muscles and bones. That s why an integrative approach is so ideal it matches an individual with treatment and a regimen that best suits their whole life and person. Taking a good medical history from the patient can really help practitioners identify sources of pain added Dr. Goldstein. which natural medicines use clinicallystudied ingredients and not only address the problems at hand but provide a lot of other overall benefits as well. That s a far cry from the one-track style of most prescription and over-the-counter drugs she emphasized. for stabilizing osteoporosis and osteopenia and helping with other bone health issues as well. Natural Anti-inflammatories For muscular tension and cramping Patient One MediNutritionals based in New York offers MuscleCare an herbal blend including valerian root white willow and passion flower that help to relieve the pain associated with tight and tense muscles. Valerian root is used as a sedative and muscle relaxant aiding relaxation and promoting a restful sleep. Passion flower increases the levels of gamma-amino butyric acid (GABA) in the brain which results in a state of relaxation. White willow bark contains a compound known as salicin a pain reliever similar to aspirin. It is responsible for the pain-relieving and antiinflammatory effects of MuscleCare. MuscleCare also includes essential electrolytes--magnesium calcium and potassium--to ensure proper functioning of the muscles and nervous system. MuscleCare is so popular that we added two sizes and now offer it in a 90- 180- and a 30-capsule travel size said Kathy McIntee of Patient One. Euromedica offers two powerful herbal formulas for practitioners to offer their patients who suffer from joint pain and mobility issues. Curaphen Extra Strength is a professional pain formula with four ingredients including clinically tested curcumin (BCM-95) blended with turmeric oils for Bone Joint and Muscle Health Supplements Vitamins and Minerals For bone health Dr. Goldstein recommended supplements with combinations of vitamins and minerals such as calcium vitamins D and K phosphorus silica and magnesium to balance the nutrients that make up healthy bones. Vitamin C is very important for joint and muscle health as it helps with healing and integrity she said. Bone-Sil from Euromedica supports healthy bone structure and density according to the company. In a special process the silica used in Bone-Sil is extracted while still attached to the bioflavonoids from the silica plant that supports its activity in the body. The silica in Bone-Sil was shown to increase absorption of calcium into the bone by an average of 50 percent Myers explained. A randomized double-blind placebocontrolled study over 12 months revealed that Bone-Sil supported bone health and strength in women. Organic silica also has positive effects on the formation of collagen too which is a major component of living bone tissue Myers acknowledged. That s why silica-- provided in the right form--is so valuable Approaches to Treatment After identifying the root cause of the bone joint or muscle condition the practitioner can then consider and select the best treatment options. If the disorder is caused by another organ system then the approach should focus on maximizing therapies to encompass the physiological systems that contribute to their discomfort explained Dr. Goldstein. Since the practitioner s goal is to make the patient feel better diet and lifestyle should be examined before recommending supplements. Supplements are literally to supplement not replace an unhealthy lifestyle she pointed out. In addition to oral supplementation topical creams and ointments using herbs and homeopathic medicines should be considered. Dr. Goldstein advised that these are great to promote healing and pain relief for patients as they can be applied directly to the affected area. The knowledge and ability to consider their multiple risk factors (e.g. genetics musculoskeletal health food allergies emotions) helps guide therapies to continue addressing the root cause as two people with the same condition may experience different types of pain she stated. Continuously asking why and having the knowledge of conventional and natural medicine allows us to broaden our scope of considering diagnosis beyond just pain. In the past decade consumers have become more informed and involved in decisions about their health seeking natural products as solutions. The need however is not so much for the supplements themselves as they now saturate the shelves but the information around the quality as the internet can overwhelm most people with information Dr. Goldstein said. Myers agreed. In a very real sense practitioners have the inside scoop about Gut Health and Rheumatoid Arthritis ccording to a 2016 study gut bacteria may be able to predict susceptibility to rheumatoid arthritis an autoimmune disorder affecting more than 1.5 million Americans that causes painful swelling in the joints. Veena Taneja PhD an immunologist at Mayo Clinic s Center for Individualized Medicine and her team identified intestinal bacteria as a possible cause of the disease indicating that tests for specific gut bacteria could help health professionals predict and prevent the onset of rheumatoid arthritis. Additionally the research could provide data to provide more effective treatments for those who already have the disease. A study published in Arthritis and A Rheumatology compared a group of arthritis-susceptible mice treated with the bacterium Prevotella histicola to a group that was not given treatment. The study found that mice treated with the bacterium had fewer and less severe symptoms and fewer inflammatory conditions associated with rheumatoid arthritis than those who didn t receive treatment. While no human trials have taken place the mice s immune systems and arthritis mimic that of humans which is promising for future human studies. In a press release study co-author Joseph Murray MD a Mayo Clinic gastroenterologist said since this bacterium is a part of healthy human gut treatment is less likely to have side effects. JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 25 Symphytum x uplandicum NYMAN which is completely free of pyrrolizidine alkaloids (PAs)--compounds that may be toxic to the liver. Traumaplant is soothing safe and speedy said Myers. It treats injuries of all kinds including open wounds and knee and ankle sprains. Probiotics Results from recent studies link probiotics to more than just better gut health. Probiotics are linked to brain chemistry weight management and even better bone health. A healthy microbiome reduces inflammation and at the same time produces nutrients that are required for bone health and also regulates digestion and absorption of nutrients required for bone joint and muscle health said Essential Formula s Pelton. A 2003 study with male and female subjects between the ages of 20 and 70 found that a lactic acidic bacteria product known as OM-X improved bone health by raising bone mineral content and improving bone mineral density. Essential Formulas offers Dr. Ohhira s Probiotics Professional Formula a balance of probiotic bacteria prebiotic foods and postbiotic metabolites great for creating a healthy microbiome to enhance bone health. Under the brand name Reg Activ Essential Formulas markets additional specialized probiotics that boost levels of the antioxidant glutathione. Since glutathione is the master antioxidant explained Pelton boosting glutathione levels could conceivably reduce the inflammation and related free radical activity in bone joint and muscle diseases. enhanced absorption and blood retention. It s the perfect recommendation for anyone who simply has occasional muscle pain or someone who suffers from ongoing issues related to range of motion or other chronic conditions said Myers. The formulation also contains boswellia an Indian medicinal plant known to reduce pain as well as DLPA which helps prevent the breakdown of enkephalins a natural pain-killing substance found in the brain. Additionally shared Myers this formula includes nattokinase an enzyme from fermented soybean that increases circulation and enables the other ingredients to even more effectively reach the areas in the body where they are needed the most. ArthoMed is another joint and spine health formula from Euromedica. In addition to the curcumin and boswellia offered in Curaphen Extra Strength Arthomed contains two other herbal ingredients--devil s claw and amla. Devil s claw can help practitioners relieve patients arthritis inflammation and protect joints and cartilage for greater mobility stated Myers. In a clinical study devil s claw relieved hip pain by 54 percent and knee pain by 38 percent in only eight weeks. The devil s claw extract in ArthoMed is a specialized concentrated extract standardized to provide the key compounds harpagosides and shown to reduce COX-2 activity by 31 percent. Amla also referred to as Indian gooseberry also exhibits antiinflammatory activity that can help protect both collage and cartilage. ArthoMed is a great choice for anyone with range-of-motion issues who may be finding their mobility and flexibility declining Myers added. It can really help rebuild the ease that people feel they are missing due to age or repeated motion. For muscular pain and inflammation Euromedica also offers a topical comfrey formula called Traumaplant Comfrey Cream. This soothing cream uses a special variety of the comfrey herb known as patients to take supplements isn t enough Pelton warned. Follow through and compliance are much better if patients understand how various products work and why they are important he maintained. Dr. Goldstein stressed the importance of keeping the patient s big picture in mind understanding what they are presenting with and why the pain may be present. Further if someone is not improving she stated continue to question why or consider another organ system or structure their environment a mental emotional component and refer to other professionals as needed. References Antony B. et al. A pilot cross-over study to evaluate human oral bioavailability of BCM-95 CG (BiocurcumaxTM) a novel bioenhanced preparation of curcumin. Indian Journal of Pharmaceutical Sciences 70.4 (2008) 445. A double-blind placebo-controlled randomized study of the effect of Trica-Sil on several biochemical markers of the bone remodeling. CERN (Lorient France) 2005. Data unpublished. Barna M Kucera A Hladicova M et al. Wound healing effects of a Symphytum herb extract cream (Symphytum x uplandicum NYMAN) Results of a randomized controlled double-blind study. Wien Med Wochenschr. 2007 157 569-574. Kawakami M Ohhira I et al. The Influence of Lactic Acid Bacteria (OM-X) on Bone Structure. Journal of Applied Nutrition Vol. 53(1) 2003. Marietta Eric V. et al. Suppression of Inflammatory Arthritis by Human GutDerived Prevotella histicola in Humanized Mice. Arthritis & Rheumatology 68.12 (2016) 2878-2888. The Practitioner Market One of the strengths that practitioners have is they understand the ramifications of the overuse of painkillers--over-thecounter or prescription explained Myers. They know (as do many patients) that the side effects of painkillers along with the epidemic of addiction to some of the most over-prescribed drugs is simply not a workable solution. Practitioners can have a large beneficial impact on reducing the incidence of bone joint and muscle diseases by educating patients about the importance of a healthy diet regular exercise and the appropriate use of supplements that reduce inflammation and promote the development of overall health added Pelton. Just telling Muscle joint and bone disorders affect more than 1.7 billion people worldwide. The Centers for Disease Control reported that more than 52 million Americans have some form of arthritis. Osteoarthritis the most common form of arthritis currently affects approximately 26.9 million adults in the United States. Studies suggest that probiotic supplements can improve bone mineral content and bone mineral density. A balanced diet and regular exercise are important lifestyle factors for healthy bones joints and muscles. Healthy Take Aways FOR MORE INFORMATION Essential Formulas Inc. Euromedica Patient One 26 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 PRODUCT FOCUS Innovating With Alternate Delivery ith 2017 just getting underway the start of a new year can often signify change. In the medical world this can be interpreted in several ways such as the manner in which medications and or supplements are presented to their patients. W By Nicholas Saraceno From powders to liquids and even vapors manufacturers have developed innovative products to keep up with the ever-changing 21st century. The variety surrounding delivery methods provides people with additional options outside of the traditional pill that may be more suitable to their needs. Below is a collection of products that practitioners and medical professionals can recommend to their patients. Ashwagandha Drops Ayush Ashwagandha Drops are fullspectrum standardized organic extract cultivated on company-owned farms in India s prime growing region. Ayush Herbs based in Washington uses an extraction technique that allows the company to create a true full-spectrum extract. Ashwagandha the most revered herb of India is an adaptogen making the body more resistant to stressors. In addition it is an immune modulator that benefits energy levels. Ashwagandha is an excellent herb for cognitive health that has a calming effect allowing one to relax focus and retain information. While both men and women can take ashwagandha it has particular benefits for men promoting healthy testosterone levels. A 2-oz. bottle has a suggested price of 21. For more information call (800) 925-1371 or visit Arnica montana Arnica montana (which is Latin for the Mountain Daisy) relieves muscle pain stiffness swelling from injuries and bruises. From Pennsylvania-based Boiron Arnica montana is safe to use at the first sign of muscle pain it does not interact with other medications. Try it for neck back shoulder and leg muscle pain stiffness and swelling from injuries and bruising. Available in Boiron s innovated dispenser that holds approximately 80 pellets (suggested price 7) Arnica comes in various dilution levels such as 6C and 30C for local or systemic treatments. For more information call (610) 325-8321 or visit GastroOne Natural Calm You need magnesium for hundreds of activities in the human body yet nearly 70 percent of Americans don t get the minimum daily requirements of this vital mineral. Natural Calm by Texas-based Natural Vitality is the best-selling magnesium supplement in the natural market for over a decade according to the company. The easily absorbable anti-stress non-GMO (genetically modified organism) powdered drink mix also supports heart bone health better sleep natural energy production and lots more (suggested price 23.95 8 oz. 40.95 16 oz.). It is available in a variety of delicious organic flavors and now in a topical cream and bath providing optimal transdermal magnesium absorption. Natural Calm Plus Calcium is available as well. For more information call (866) 806-7650 or visit New York-based Patient One offers GastroOne which supplies comprehensive support for gastrointestinal (GI) health and function. GastroOne combines more than 10 synergistic science-backed natural ingredients known for their beneficial effect on GI tract health L-glutamine N-acetyl-D-glucosamine (NAG) deglycrrhizinated licorice extract (DGL) aloe vera slippery elm marshmallow root fenugreek mucin methysulfonylmethane (MSM) chamomile ginger quercetin fiberaid and zinc Lcarnosine. An ideal formula to soothe gastrointestinal discomfort while strengthening and promoting healing of the GI tract lining GastroOne is presented in a pleasant natural strawberry flavored powder that can be mixed with water or preferred beverage. A 7.05oz. container (30 servings) is valued at 53.75. For more information call (877) 723-0777 or visit Hevert Trauma Roll-On Hevert Trauma Roll-On from Colorado-based Hevert Pharmaceuticals is a homeopathic topical pain relieving gel that provides gentle relief from minor aches and pains with the power of arnica. This includes muscle pain and stiffness along with bruising and swelling. The 1.7-fl.-oz. bottle has a suggested price of 19.98. For more information call (855) 387-6466 or visit (Continued on page 31) JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 27 SUPPLEMENTSCIENCE Does Calcium Supplementation Coronary Artery Calcification By Gene Bruno MS MHS Huntington College of Health Sciences alcium intake and its relationship with coronary artery calcification (CAC) was examined in a recently published article by Anderson et al. in the Journal of the American Heart Association.1 The study looked at 5 448 adults who were free of cardiovascular disease at the onset of the study and their calcium intake over a period of 10 years. After 10 years CAC was measured in 2 742 of the original participants. The results were that high total calcium intake was associated with a decreased risk of atherosclerosis over the long-term. However an additional controversial finding in the study was that calcium supplement use (as opposed to dietary calcium intake) was associated with an increased risk of CAC--which could be a problem since CAC is associated with an increased risk of cardiovascular disease. So what does this mean Should everyone stop taking calcium supplements To answer this question let s Cause C take a closer look at this study. Epidemiological Not Clinical First of all the Anderson et al. study was epidemiological not clinical. Epidemiological studies show relationships but do not establish cause and effect as would be the case with a clinical study. Consequently the Anderson et al. study in no way established that calcium supplementation was in fact a risk factor for developing CAC. increased risk of CAC. At first glance these results might seem counter-intuitive to the study conclusions that calcium supplementation increase CAC risk. However it may actually suggest something else not noted in the study--namely that those getting the most calcium from diet and supplements may also be getting higher levels of other nutrients as well. Other Nutrients Vitamins D and K2 So why would the increased intake of other nutrients be significant Because other nutrients play key roles in the way that calcium is metabolized and where it is delivered in the body. One nutrient that is critical for calcium absorption and metabolism is vitamin D. In fact another recent study found that those with CAC were 3.31 times more likely to be vitamin D deficient. However the researchers in the study wrote Our study did not control for vitamin D intake or seasonal ultraviolet exposure of skin. Calcium Intake Levels Secondly the study categorized calcium intake into five intake levels looking at total calcium intake (food supplements) and intake from supplements specifically. Those with the lowest intake of calcium from diet (306 mg day) and supplements (91 mg day) were at highest risk for CAC while those with the highest intake of calcium from diet (1 280 mg day) and supplements (1 223 mg day) had no 28 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Likewise clinical research2 has shown that a high intake of vitamin K2 (as MK-7 180 mcg day) is associated with reduced arterial calcification reduced arterial stiffness and a reduced incidence of coronary heart disease. Again the Anderson et al. study did not control for vitamin K2 intake. compared to the lower dose group. The researchers concluded that in this study higher levels of calcium supplementation were not associated with an increased risk of coronary atherosclerosis as measured by the CAC score. 400-1 400 mg Calcium Not Associated With CAC The final point was made by Anderson et al. within the text of the study which stated Our results suggest that a wide range of calcium intakes between 400 and 1 400 mg day are not associated with CAC over a period of 10 years. Consequently the daily use of supplements providing up to 1 400 mg of calcium per day should not be a cause for concern. Certainly this is well within the tolerable upper intake level for calcium (2 500 mg day for adults 19-50 2 000 mg day for adults 51 ) established by the Food and Nutrition Board of the Institute of Medicine.3 Consequently the daily use of supplements providing up to 1 400 mg of calcium per day should not be a cause for concern. Another epidemiological study5 looking at the relationship between calcium intake and CAC was published in 2012. Participants included 690 women and 588 men and examined calcium intake (from diet and supplements) over a period of four years. The results were that the study did not find a relationship between high calcium intake and increases CAC--and this was true for both dietary calcium and calcium supplement use. The researchers concluded The evidence is not sufficient to modify current recommendations for calcium intake to protect skeletal health with respect to vascular calcification risk. Perhaps most interesting was the results of a randomized clinical trial published in a medical journal in 2010 (remember epidemiological studies show relationships while clinical studies show cause and effect).6 This study compared CAC scores after trial completion between postmenopausal women randomized to calcium vitamin D supplementation (1 000 mg of elemental calcium 400 IU vitamin D daily) and women randomized to placebo. The results showed that CAC measurements were similar in women randomized to calcium D supplemen- tation and those receiving placebo. In fact the average score was 91.6 for women receiving calcium D and 100.5 for women receiving placebo. The researchers concluded that doses of calcium D used in this study did not seem to alter coronary artery calcified plaque burden among postmenopausal women. Conclusion Don t stop using your calcium supplement. Rather make sure your diet and supplements provides a broad range of other nutrients as well. Personally I would recommend getting 2 000 IU day of vitamin D3 and 180 mcg day of vitamin K2 as MK-7. References 1 Anderson JJB Kruszka B Delaney JAC et al. Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults 10-Year Follow-up of the MultiEthnic Study of Atherosclerosis (MESA). J Am Heart Assoc. 2016 5 e003815. 2 Maresz K Bruno EJ. Vitamin K2 An Essential Protector for Cardiovascular Health. Agro Food Industry Hi Tech. 2015 26(5) 21-24. 3 Food and Nutrition Board Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington D.C. The National Academies Press 2011. 4 Geraldino-Pardilla L Dhaduvai S Giles JT Bathon JM. Lack of association of oral calcium supplementation with coronary artery calcification in rheumatoid arthritis. Arthritis Rheumatol. 2015 Jun 67(6) 1465-73. 5 Samelson EJ Booth SL Fox CS Tucker KL Wang TJ Hoffmann U Cupples LA O Donnell CJ Kiel DP. Calcium intake is not associated with increased coronary artery calcification the Framingham Study. Am J Clin Nutr. 2012 Dec 96(6) 1274-80. 6 Manson JE Allison MA Carr JJ Langer RD Cochrane BB Hendrix SL Hsia J Hunt JR Lewis CE Margolis KL Robinson JG Rodabough RJ Thomas AM Women s Health Initiative and Women s Health Initiative-Coronary Artery Calcium Study Investigators. Calcium vitamin D supplementation and coronary artery calcification in the Women s Health Initiative. Menopause. 2010 Jul 17(4) 683-91. Other Research on Supplemental Calcium and CAC When examining the results of any new controversial study I always like to consider the results of similar previous studies. One such epidemiological study4 was published last year in a medical journal. Geraldino-Pardilla et al. conducted a three-year (39 months) study of 145 patients with rheumatoid arthritis without known cardiovascular disease (CVD). CAC was measured in the beginning at just under two years and at 39 months. A CAC score of under 100 was considered desirable since CAC 100 has been shown to be a strong predictor of future CVD. Among the patients studied 28 percent were taking 1 000 mg day of supplemental calcium. Results showed that a CAC score of 100 units was seen in 30 percent of the patients at the beginning of the study and 34 percent at the end of the study. What was interesting however is that beginning CAC scores of 100 units were significantly less frequent in patients receiving the higher dosage (1 000 mg day) of supplemental calcium than in those receiving the lower dosage ( 1 000 mg day) Similarly at the end of the study CAC scores of 100 units were still less frequent in the higher supplemental calcium dose group Gene Bruno MS MHS the dean of academics for Huntington College of Health Sciences is a nutritionist herbalist writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals has researched and formulated natural products for dozens of dietary supplement companies and has written articles on nutrition herbal medicine nutraceuticals and integrative health issues for trade consumer magazines and peerreviewed publications. He can be reached at gbruno JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 29 PRACTITIONER CHAT WITH SHARI BARBANEL N Nada Milosavljevic MD JD E-mail nada Website ada Milosavljevic JD MD is a faculty member at Harvard Medical School founder of the Integrative Health Program at Massachusetts General Hospital and the first MD Certified Tea Specialist (CTS) in the United States. She is also the founder of Sage Tonic and author of the book Holistic Health for Adolescents. Prior to her medical career she practiced law with a specialty in intellectual property. She lives in Boston and has a private practice in Newton MA. to provide a wide-ranging platform--a guided menu of approaches--that would introduce positive holistic therapies in the form of multisensory stimuli. This platform would then prime the brain to support reactions of decreased pain increased relaxation and healing. Using the senses as the pathway to mental health therapy has three distinct advantages 1. the senses are foundational not just to our well-being but also to our being our sense of self 2. sensory stimuli affect us every day--we need to learn how to channel these stimuli to make us feel better not worse and 3. the senses are easy to access requiring little or no technological gadgets or highly skilled expertise to leverage. Adolescents are undergoing rapid change which includes social pressures mounting responsibilities and uncertain self-identity. Behavioral and emotional problems are not uncommon during this period of the life span and educating adolescents about the sensory aspects of their bodies can help them learn self-regulation. From a neurological standpoint as we interact and engage in daily activities our bodies are continuously inundated with stimuli. The integration of these stimuli and our brain s interpretation of this information is what allows our bodies to react and respond to the environment. Reactions can include the release of neurotransmitters in the brain a cascade of hormones and inflammatory reactions to name a few. Choosing the kind of sensory stimuli our brains have to interpret can help rewire and recondition the brain to create a healthier sensory environment. Everyone faces stress at some point but what is the difference between how an adolescent and adult deals with stress found that in general adolescents are much more susceptible to feeling stress than their parents or grandparents. The trends suggest as we might suspect that the perspective gained from age and experience may be crucial in helping individuals cope with stressors as they age. There is evidence that as people age they focus less on negative emotions and savor positive aspects of life. How important is sleep for adolescents If they aren t getting enough or quality sleep what can be done to improve it Sleep is supremely important to mental and physical health. One indication of sleep s role in optimal human functioning is suggested by how active the brain is during sleep. The changes in brain metabolism and neurological activity that occurs during sleep exceeds those which occur during most waking periods. Sleep helps stabilize and preserve functionally synaptic networks and dreaming can be seen as another means of adapting to the environment. Sleep-deprived adolescents are being deprived of tools that could enable them to adapt to new circumstances. Herbal teas like chamomile and lemon balm aromatherapy using lavender acupuncture meditation regular vigorous exercise and also specific yoga poses can be used alone or in combination to improve sleep length and quality. Q To address the interest and need for evidence-based integrative treatment options. The book provides holistic and natural tools for self-care to augment current approaches for common health conditions. These treatments offer simple and accessible tools added options and possibilities to educate and empower adolescents with the hope for real improvement to their lives. What is a multisensory therapeutic approach How do different sense therapies work together to help adolescents face various the types of challenges in life Our bodies possess a powerful innate capacity to promote healing when provided with the appropriate intervention. Stimulating our sensory pathways with positive signals can influence our response to pain immunity the stress response circadian rhythms and illness. Knowing this a logical approach to calming the excited or depressed adolescent brain is to find a path through the senses that can influence the brain in a positive way. One powerful remedy is Q A Why did you decide to write Holistic Health for Adolescents A Q A Q A In some longitudinal studies of stress in the United States it s been Low mood is a minor form of depression. The two conditions share many of the same symptoms but low mood can be dealt with more easily and turned back relatively quickly. Reduced school performance withdrawal from friends and activities difficulty sleeping and changes in eating habits are among the signs and symptoms Q A What is low mood What effect does it have on adolescents 30 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 of low mood in adolescents. These changes can have a negative impact on mental and physical well-being and may lead to bad coping mechanisms and negative thinking patterns. Preventative measures drawn from integrative medicine can stop many cases of low mood from spiraling down into depression. What impact can yoga and meditation have on improving a teen s focus and concentration Regular yoga and or meditation sessions and relaxation techniques can help children relax and learn discipline to help them manage symptoms of attention deficits. Alone or in combination with dietary changes massage therapy acupressure music therapy and essential oils these therapies can calm anxiety and improve concentration. Do you think these sensory tools you ve laid out throughout the book can help people not just during adoles- A cence but also throughout the rest of their lives How These approaches work. They don t cure everything of course but they have a positive impact. Being cost effective and versatile means the techniques can be used by a wide variety of people in many different settings. If learned in adolescence and substituted for less-healthy coping mechanisms these therapies can be long-term components of good mental and physical health. A Q Q (Continued from page 23) both forms of medication practitioners must fairly provide both options to their patients. Research There are endless questions surrounding sleep such as what in fact is the best solution to a good night s sleep and how one gets to that point. Progress has been made in this regard and to further enhance this progress practitioners are thinking out of the box with their interest in research. I am interested in researching auto-hypnosis and sleep--specifically how teaching patients self-hypnosis techniques can help them fall asleep easier noted Dr. Kogan. In fact she is quite fond of this delivery method as it take more of a holistic approach to medicine. Self-hypnosis (which I admire) is the least popular method because it s an acquired skill that needs to be rehearsed many times over until it becomes a lifestyle she mentioned. Teaching patients self-hypnosis is my favorite modality because it empowers patients to tap into their own inner resources instead of depending on pills. Although the medical world may not have received all the answers it has been looking for thus far one idea is for sure good sleep is king. There is a much greater understanding of the overall physiological and emotional role sleep plays on a body s health said Holt. Polysomnographic studies have proven that there is no substitute for good sleep. If a body is deficient in vitamin C a supplement will help adjust that. The same cannot be said of sleep deficiency. Lack of sleep affects the whole body including metabolism. That s why good sleep is so important for weight loss. These Uses have not been evaluated by the Food and Drug Administration. and-chronic-stress 4 magnesiumdeficiency-induces-anxiety 5 J Res Med Sci. 2012 Dec 17(12) 1161-9. The effect of magnesium supplementation on primary insomnia in elderly A double-blind placebo-controlled clinical trial. Abbasi B1 Kimiagar M Sadeghniiat K Shirazi MM Hedayati M Rashidkhani B. According to the American Sleep Association (ASA) 50 to 70 million adults in the United States have some sort of sleep disorder. One of the more common symptoms of peri-menopause and menopause that patients complain of is difficulty sleeping. There is a significant amount of research showing how hormones affect sleep. The projections for sleep aids for 2018 are approximately 732 million with a 27 percent category growth rate. Healthy Take Aways FOR MORE INFORMATION Ajionomoto North America Inc. Boiron USA Natural Vitality Svetlana Kogan MD (212) 580-0900 Women s International Pharmacy References 1 Eichling Philip S. MD Evaluating and Treating Menopausal Sleep Problems. Menopause Management. Sept Oct 2002. 2 magnesiumintake-and-stress-reduction 3 magnesium- PRODUCT FOCUS (Continued from page 27) Herbal Vapors In ayurveda there is a tradition of smoking herbs called Dhum Pan which is smoking therapeutic herbs. This makes sense because the lungs are the quickest path to the bloodstream skipping digestion. Rebel Herbs (from Indiana-based NuAxon Bioscience Inc.) patent-pending herbal vapors use the pure CO2 extracts from therapeutic herbs grown on its certified organic farms in India. The device which is available for 95.99 (includes two cartridges a battery and charger) offers a 29.99 refillable single cartridge heats the extracts to a temperature below combustion and vaporizes the extracts. This delivers the therapeutic benefits to the lungs and then directly to the blood stream giving effects within minutes. The vapors contain no propylene glycol vegetable glycerin or synthetic additives or solvents. For more information call (812) 762-4400 or visit JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 31 NATURAL HEALTH STUDIES Reducing Salt Intake May Help Protect Kidney Patients Heart and Kidney Health N ew research indicates that reducing sodium intake may provide kidney and heart benefits for patients with chronic kidney disease (CKD). The findings appear in the Journal of the American Society of Nephrology (JASN). Urinary excretion of proteins including albumin is a hallmark of CKD. Therapies that reduce such albuminuria can slow kidney function decline and also have beneficial effects on the heart and blood vessels. Unfortunately currently available therapies do not eliminate albuminuria in many patients leaving these individuals with what is known as residual albuminuria. A team led by Martin de Borst MD PhD (University Medical Center Groningen in The Netherlands) studied two interventions that have demonstrated potential for reducing residual albuminuria dietary sodium restriction and a drug (paricalcitol) that activates the vitamin D receptor. In a randomized trial that included 45 patients with CKD each intervention was added to an optimized conventional treatment regimen during four eight-week periods. The investigators found that dietary sodium restriction led to a significant reduction of residual albuminuria and blood pressure whereas paricalcitol had no significant effect on these measures. The combination of paricalcitol and a low sodium diet however resulted in the lowest albuminuria levels. What we found was that sodium restriction provided a relatively large beneficial effect whereas the effect of paricalcitol was small. Thus the impact of the combined intervention was largely due to the protective effect of sodium restriction said Dr. de Borst. Most people consume twice as much sodium as the 2 grams per day recommended by the World Health Association. In our study patients consumed on average 4 grams of sodium per day which is well in line with global trends in sodium consumption among CKD patients said Dr. de Borst. Interestingly following our intervention aimed at reduced sodium intake patients consumed 2.5 grams per day which is still above the recommended level. This moderate restriction resulted in a strong reduction in albuminuria and blood pressure indicating that even a moderate reduction in sodium intake may provide serious health benefits. (Source Journal of the American Society of Nephrology--November 2016) A Handful of Nuts a Day Cuts the Risk of a Wide Range of Diseases large analysis of current research shows that people who eat at least 20 g of nuts a day have a lower risk of heart disease cancer and other diseases. The analysis of all current studies on nut consumption and disease risk has revealed that 20 g a day--equivalent to a handful-- can cut people s risk of coronary heart disease by nearly 30 percent their risk of cancer by 15 percent and their risk of premature death by 22 percent. An average of at least 20 g of nut consumption was also associated with a reduced risk of dying from respiratory disease by about a half and diabetes by nearly 40 percent although the researchers note that there is less data about these diseases in relation to nut consumption. The study led by researchers from Imperial College London and the Norwegian University of Science and Technology is published in the journal BMC Medicine. The research team analyzed 29 published studies from around the world that involved up to 819 000 participants including more than 12 000 cases of coronary heart disease 9 000 cases of stroke 18 000 cases of cardio- A vascular disease and cancer and more than 85 000 deaths. While there was some variation between the populations that were studied such as between men and women people living in different regions or people with different risk factors the researchers found that nut consumption was associated with a reduction in disease risk across most of them. Study co-author Dagfinn Aune from the School of Public Health at Imperial said In nutritional studies so far much of the research has been on the big killers such as heart diseases stroke and cancer but now we re starting to see data for other diseases. We found a consistent reduction in risk across many different diseases which is a strong indication that there is a real underlying relationship between nut consumption and different health outcomes. It s quite a substantial effect for such a small amount of food. The study included all kinds of tree nuts such as hazel nuts and walnuts and also peanuts--which are actually legumes. The results were in general similar whether total nut intake tree nuts or peanuts were analyzed. What makes nuts so potentially beneficial said Aune is their nutritional value Nuts and peanuts are high in fiber magnesium and polyunsaturated fats--nutrients that are beneficial for cutting cardiovascular disease risk and which can reduce cholesterol levels. Some nuts particularly walnuts and pecan nuts are also high in antioxidants which can fight oxidative stress and possibly reduce cancer risk. Even though nuts are quite high in fat they are also high in fiber and protein and there is some evidence that suggests nuts might actually reduce your risk of obesity over time. The study also found that if people consumed on average more than 20 g of nuts per day there was little evidence of further improvement in health outcomes. (Source BMC Medicine--December 2016) 32 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 Vitamin D Status in Newborns and Risk of MS in Later Life B abies born with low levels of vitamin D may be more likely to develop multiple sclerosis (MS) later in life than babies with higher levels of vitamin D according to a study published in the online issue of Neurology. More research is needed to confirm these results but our results may provide important information to the ongoing debate about vitamin D for pregnant women said study author Nete Munk Nielsen MD MSc PhD of the State Serum Institute in Copenhagen Denmark. In Denmark dried blood spots samples from newborn screening tests are stored in the Danish National Biobank. Researchers identified everyone in Denmark who was born since April 30 1981 had onset of MS by 2012 and whose dried blood spots samples were included in the biobank. The blood from those 521 people was then com- pared to that of 972 people of the same sex and birthday who did not have MS. In this study newborns with levels of vitamin D less than 30 nanomoles per liter (nmol L) were considered born with deficient levels. Levels of 30 to less than 50 nmol L were considered insufficient and levels higher than or equal to 50 nmol L were considered sufficient. The study participants were divided into five groups based on vitamin D level with the bottom group having levels of less than 21 nmol L and the top group with levels higher than or equal to 49 nmol L. There were 136 people with MS and 193 people without MS in the bottom group. In the top group there were 89 people with MS and 198 people without the disease. Those in the top group appeared to be 47 percent less likely to develop MS later in life than those in the bottom group. Nielsen emphasizes that the study does not prove that increasing vitamin D levels reduces the risk of MS. The study has several limitations. Dried blood spots samples were only available for vitamin D analysis for 67 percent of people with MS born during the time period. Vitamin D levels were based on one measurement. Study participants were 30 years old or younger so the study does not include people who developed MS at an older age. In addition the Danish population is predominantly white so the results may not be generalizable to other populations. Furthermore it cannot be excluded that this apparent beneficial effect could be mediated through other factors in later life such as vitamin D levels in which case a possible maternal vitamin D supplementation would not reduce the MS risk in the offspring. (Source Neurology--November 2016) Higher BMI in Adolescence May Affect Cognitive Function in Midlife S cientists at the Hebrew University of Jerusalem have found that higher body mass index (BMI) if it begins in adolescence can affect cognitive function in midlife. However the effect appears to be restricted to adults who had lower socioeconomic position as children. Overweight and obesity in adolescents have increased substantially in recent decades and today affect a third of the adolescent population in some developed countries. While the dangers posed by high adult BMI on cognitive function in later life have been documented the association of adolescent BMI with cognitive function in midlife has not yet been reported. To shed light on this issue scientists at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine set out to determine the association between cumulative life course burden of high-ranked BMI and cognitive function in midlife. The research which appears in the Journal of Alzheimer s Disease was led by Professor Jeremy Kark from the Braun School in the Hebrew University of Jerusalem s Faculty of Medicine working with colleagues in Israel and the United States. The researchers used weight and height data from 507 individuals tracked from over 33 years starting at age 17. The participants completed a computerized cognitive assessment at ages 48-52 and their socioeconomic position was assessed by multiple methods. Using mixed models the researchers calculated the life-course burden of BMI from age 17 to midlife and used multiple regression to assess associations of BMI and height with global cognition and its five component domains. In this population-based study of a Jerusalem cohort followed longitudinally from adolescence for over 33 years we found that higher BMI in late adolescence and the long-term cumulative burden of BMI predicted poorer cognitive function later in life. Importantly this study shows that an impact of obesity on cognitive function in midlife may already begin in adolescence independently of changes in BMI over the adult life course said the paper s senior author Professor Jeremy Kark of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine. Our results also show that taller stature was associated with better global cognitive function independent of childhood and adult socioeconomic position and that height increase in late adolescence reflecting late growth conferred a protective effect but among women only added Irit CohenManheim doctoral candidate at the Braun School and lead author. The researchers pointed out that while socioeconomic position may have a particularly important role in the trajectory of a per- son s lifetime cognitive function it has rarely been adequately taken into account. To the best of our knowledge the association between BMI and cognition as a function of childhood and adult socioeconomic position has not been previously reported. Childhood household socioeconomic position appears to strongly modify the association between adolescent BMI and poorer cognition in midlife the inverse association being restricted to low childhood socioeconomic position said Kark. Our results are consistent with the hypothesis that childhood living conditions as reflected also by height influence cognitive function later in life however our study is unique in showing that an adverse association of higher BMI with cognitive function appears to begin in adolescence and that it appears to be restricted to adults with lower childhood socioeconomic position said Kark. Evidence for the association between impaired cognitive function in midlife and subsequent dementia supports the clinical relevance of our results. Findings of the relation of BMI in adolescence with poorer midlife cognitive status particularly in light of the ongoing epidemic of childhood obesity require confirmation concluded CohenManheim. (Source Journal of Alzheimer s Disease-- December 2016) JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 33 NATURAL MARKETPLACE NATURAL MARKETPLACE PROVIDES INFORMATION ABOUT NEW PRODUCTS AVAILABLE TO THE NATURAL HEALTH CARE INDUSTRY. ALL STATEMENTS CLAIMS AND PRODUCT INFORMATION ARE PROVIDED BY THE MANUFACTURER. NATURAL PRACTITIONER DOES NOT ENDORSE ANY PRODUCTS INCLUDED IN NATURAL MARKETPLACE OR ATTEMPT TO CORROBORATE ANY CLAIMS MADE BY THE MANUFACTURER. To have a new product included in Natural Marketplace please send a press release and photograph to Natural Practitioner by email to ShariB Vitamin C-1000 with Citrus Bioflavonoids FARMINGDALE NY--Patient One Vitamin C by MediNutritionals Research LLC supplies 1 000 mg of all-natural C-lipid metabolites along with 200 mg of citrus bioflavonoids. As vitamin C is a water-soluble vitamin that the body does not make or store Patient One s formula uses a special delivery system that allows the vitamin C to be more rapidly absorbed and retained by the body. Lipid metabolites are fat-soluble compounds that increase vitamin C s function in the body. Bioflavonoids polyphenolic compounds found in plants such as vitamin C-rich citrus fruit are included in Patient One s proprietary formulation to complement the activities of vitamin C. Ninety tablets which are equivalent to 90 servings are available for a suggested price of 23.90. For more information call (877) 723-0777 or visit StressRX TULSA OK--StressRX by Unhealthy Anonymous Inc. offers the body immediate help for stress management. It s the ideal solution to provide your body with what it needs when it needs it for a balanced and stress-free lifestyle. Without disrupting normal biological functions it manages and adapts to the body s stress response as it changes throughout the day. From external stresses like polluted air and poor food choices to internal stresses like anxiety brain fog and fatigue the body s adaptogens provide what the body needs when it needs it. Teaming up with Jordan Rubin leading industry formulator and founder of Garden of Life this proprietary adaptogenic formula was created from safe and time-tested herbal ingredients used over the past 1 000 years and blended for maximum efficacy and results. A bottle of 60 capsules is valued at 37.99. For more information call (918) 521-2777 or visit 34 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2017 CONFERENCES AND EVENTS February 8-12 14th Annual Natural Supplements An Evidence Based Update San Diego CA The conference will take place at the Paradise Resort & Spa in San Diego CA. Speakers will include Robert Alan Bonakdar MD FAAFP ABIHM Mimi Guarneri MD FACC ABIHM and Rauni Prittinen King MIH RN HNB-BC CHTP I among others. Course highlights include three days of evidence-based educational courses presented by leading experts full day interactive workshops to fine tune clinical applications prevention and treatment of cardiovascular disease for primary care providers and opportunities to interact with faculty and fellow attendees to established a network of like-minded professionals. For more information visit naturalsupplements. February 18-19 GPL University Practitioner Workshops Scottsdale AZ Held at the Courtyard Scottsdale Salt River practitioners will learn how to better integrate specialty diagnostic testing into their practices for greater patient health outcomes. This workshop will review organic acids testing genetic testing and toxic chemical testing. For more information visit February 22-25 Integrative Healthcare Symposium New York NY This clinically relevant evidence-based medical conference program is designed to educate inspire and engage integrative practitioners and those interested in learning more about alternative and complimentary approaches to heath care. Speakers at this year s event include Robert Rountree MD coauthor of five books on integrative and nutritional medicine and medical editor for a national periodical Deborah McElligott DNP ANPBC AHN-BC HWNC-BC CDE and adult and holistic nurse practitioner and many more. For more information visit annual-conference. March 25-26 Integrative Therapies for Anxiety & Depression San Diego CA This event will provide a two-day intensive workshop for mental health practitioners wanting to learn hands-on how to transition into a truly integrative psychiatry practice. For more information visit workshops. April 7-9 Southwest Conference in Botanical Medicine Tempe AZ This year s conference offers a large variety of presentations from plant identification to new insight into commonplace and undervalued herbs. Lectures include Eyes Ears Nose and Throat Demonstration Preparing and Applying EENT Preparations Neurohacking Cognitive and Performance Enhancing Therapies and much more. The conference includes a Friday Intensive on Botanicals for Immuno-inflammation with emphasis on Cardiovascular Disease and Cancer with Lise Alschuler ND. Other experts in attendance include Jill Stansbury ND Jason Miller Mimi Kamp David Winston and more. Discounted registration is available until March 1. For more information visit May 4-7 12th Annual NANP Conference & Expo Portland OR Gain cutting-edge holistic nutrition knowledge and interventions and learn how to leverage your unique abilities in today s health care landscape. Earn continuing education units and even get certified. For more information visit June 2-5 Medicines from the Earth Herb Symposium Black Mountain NC The Medicines from the Earth Herb Symposium begins with an Ethnobotanical and Native Plant Field Study with David Winston and a preconference intensive on June 2 with Kenneth Proefrock ND titled Immuno-psychiatry--A New Paradigm for Mental Health. Other experts include Donald Yance and Kathleen Maier among others. The topics covered at the symposium will range from neuroinflammation to botanical medicine in oncology putting together the pieces and building a comprehensive protocol as well as plant walks medicine-making demonstrations and panel discussions. Early bird registration is now open. For more information visit June 30-July 2 4th International Congress on Naturopathic Medicine (ICNM) London England The International Congress on Naturopathic Medicine is a non-for-profit international and professional organization which began with the mission of providing high quality continuing education for health care professionals dedicated to patient care all over the world. This year s theme is Global Patient Care Restoring Health Naturally. Speakers include Ryan Bradley ND MPH naturopathic doctor assistant director at Helfgott Research Institute associate professor at National University of Natural Medicine s School of Research and Graduate Studies and Susan Arentz PhD BHSc(Hons) Adv Dip Naturopathy lecturer at Endeavour College of Natural Health among others. Registration is now open. For more information visit Don t miss a single issue of NP in 2017... go online to renew your free subscription today JanFeb17 JANUARY FEBRUARY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 35 MEDIACORNER App PatientRounds PatientRounds for iPad a cloud-based encrypted HIPAA compliant Electronic Medical Records for health care professionals has been officially launched in the iTunes store. With a simplified and elegant user interface that doctors are already familiar with PatientRounds provides an easy efficient and secure access to patients medical history and vital information anytime and everywhere. PatientRounds has a host of features that make creating storing and accessing patient information simple streamlined and effective. The main features include creating and managing patient s information allergies history and diagnosis monitor review and write patients results review and write accurate and safer medication create view and edit progress notes and orders and log patients communication. The templates and customized phrases will allow completing notes in a very efficient manner reducing errors and repetition of routine tasks and allowing physicians to spend more quality time with patients said Angeles Baquerizo founder of PatientRounds. This revolutionary medical tool also enables doctors to share patient charts with other health professionals allowing the transfer of patient care between health care providers facilitating the coordination of care and ultimately improving the quality of patient care. The ability to access update and maintain patient records by different health care providers will allow better-coordinated patient care. With PatientRounds patients can avoid repeating tests when visiting different MDs said Baquerizo. A secure and robust cloud-based platform with capabilities for data storage back-up and disaster recovery will ensure data integrity. PatientRounds is available for the iPad in the iTunes store. For more information visit App Better Habits Available now the Better Habits app offers a unique process built from the ground up based on the latest studies of behavioral psychology and habit formation. Better Habits uses your own effort to leverage motivation. Get hooked and watch as daily actions that were once impossible become effortless and automatic. Better your habits better your life. Better Habits is not a goal-setting stat-tracking or coach-networking app. It s a tool that is laser-targeted on forming habits that last. Forty-five percent of all daily behavior is habit. Changing those habits can be incredibly difficult and many of us unfortunately never succeed in doing so. It is possible to change one s core habits and many Better Habits users already have. The process is built from the ground up based on the latest most comprehensive studies of habit formation and behavioral psychology. The company taps into user s natural pain pleasure triggers. They are rewarded for performance with visual-anchored progress. When they fail to perform they lose portions of that progress. Rather than a static black and white all or nothing answer the company offers a sophisticated living algorithm that is backed by science and flexible to fit everyone. The app is deceptively simple and its users are stunned at why--and how well--it works. Behind its elegant surface and easy interaction is a union of serious study and complex technology that gently guides its user along the path to success. Better Habits is just the beginning. 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