Chiropractic + Naturopathic Doctor • February 2016 • Roundup

Breaking a major bone may increase risk of widespread chronic body pain in later life, a new study has found.

Researchers at the Medical Research Council Lifecourse Epidemiology Unit (MRC LEU), University of Southampton in the U.K., found that men and women who had a spine fracture, and women who had a hip fracture were more than twice as likely to experience long-term widespread pain as those who had not had a fracture.

“The causes of chronic widespread pain are poorly characterised, and this study is the first to demonstrate an association with past fracture. If confirmed in further studies, these findings might help us to reduce the burden of chronic pain following such fractures,” said lead researcher Nicholas Harvey, professor of rheumatology and clinical epidemiology.

The study, published in Archives of Osteoporosis, used the UK Biobank cohort of 500,000 adults aged between 40 and 69 years old, to investigate associations between a past history of fracture affecting upper and lower limb, spine or hip, and the presence of chronic widespread body pain. The researchers considered possible effects of a wide range of further factors, including participant diet, lifestyle and body build, and, importantly, measures of psychological health.

They found that the risk of chronic widespread body pain was increased if participants reported having a past fracture, especially spine and hip fractures.

Harvey added, “Chronic widespread pain is common, and leads to substantial health related problems and disability.

Past studies have demonstrated an increased risk of chronic widespread pain following traumatic events, but none have directly linked to skeletal fractures.”

According to professor Cyrus Cooper, director of the MRC Lifecourse Epidemiology Unit at the University of Southampton, the findings will be built upon in further analyses that capitalise on the genetic and intensive musculoskeletal phenotyping components of the study.

A recently published study found that eating less fiber, more saturated fat and more sugar is associated with lighter, less restorative, and more disrupted sleep.

Results show that greater fiber intake, on the other hand, predicted more time spent in the stage of deep, slow wave sleep. In contrast, a higher percentage of energy from saturated fat predicted less slow wave sleep. Greater sugar intake also was associated with more arousals from sleep, according to the study.

“Our main finding was that diet quality influenced sleep quality,” said principal investigator Marie-Pierre St-Onge, assistant professor in the department of medicine and Institute of Human Nutrition at Columbia University Medical Center in New York.

“It was most surprising that a single day of greater fat intake and lower fiber could influence sleep parameters.”

Study results are published in the January 2016 issue of the Journal of Clinical Sleep Medicine.

“This study emphasizes the fact that diet and sleep are interwoven in the fabric of a healthy lifestyle,” said American Academy of Sleep Medicine president Dr. Nathaniel Watson, who was not involved in the study.

“For optimal health it is important to make lifestyle choices that promote healthy sleep, such as eating a nutritious diet and exercising regularly.”

The study also found that participants fell asleep faster after eating fixed meals provided by a nutritionist, which were lower in saturated fat and higher in protein, than self-selected meals. It took participants an average of 29 minutes to fall asleep after consuming foods and beverages of their choice, but only 17 minutes to fall asleep after eating controlled meals.

“The finding that diet can influence sleep has tremendous health implications, given the increasing recognition of the role of sleep in the development of chronic disorders, such as hypertension, diabetes and cardiovascular disease,” said St- Onge.

The randomized, crossover study involved 26 adults – 13 men and 13 women – who had a normal weight and an average age of 35 years old.

During five nights in a sleep lab, participants spent nine hours in bed from 10 p.m. to 7 a.m., sleeping for seven hours and 35 minutes on average per night. Objective sleep data were gathered nightly by polysomnograhy. Sleep data were analyzed from the third night, after three days of controlled feeding, and the fifth night, after one day of ad libitum food intake.

According to the authors, the study suggests that diet- based recommendations might be used to improve sleep in those with poor sleep quality. However, future studies are needed to evaluate this relationship.

The study was supported by grants from the U.S. National Institutes of Health, including a grant from the National Center for Advancing Translational Sciences.

A Calgary-based think-tank says the provinces seem to be ill-prepared for the country’s aging population, and the financial challenges that will bring.

Colin Craig of the Manning Centre says for the last five years, the federal government has been looking at the situation and the long-term financial impact, but provincial governments don’t seem to be doing the same.

He says the Manning Centre asked each province what was being done and none had any information, including Saskatchewan.

Craig says an aging population is one of the most significant issues facing Canada over the next several decades.

A policy paper by the Manning Centre recommends that each province analyze its long-term finances and share money-saving ideas.

Craig pointed to the Saskatchewan government partnering with a private company to manage hospital linens for a savings of around $93 million as a positive step.

Craig says each provincial government should also begin regular projections of their finances over 10, 20 and 30-year periods so they can predict the financial challenges ahead of time.

If nothing is done, Craig believes taxes will have to go up substantially and services will have to be cut.

If you’re serious about spreading cheer in the New Year, consider passing along more specific advice from a psychologist who studies the science of happiness at Washington University in St. Louis. There is no secret to happiness, but there is a science to it, says Tim Bono, a psychology lecturer in arts and sciences who teaches courses on happiness at the university.

1. Get outside and move around. Research confirms that a few minutes walking around in nature can boost both mood and energy levels. Exercise is key to psychological health because it releases the brain’s “feel good” chemicals.

2. Reach out and connect. People with high-quality relationships are not only happier, they’re also healthier. They recover from illnesses more quickly, live longer and enjoy more enriched lives.

Sites like Facebook often exaggerate how much better off others are compared with how we might feel about ourselves at the moment. Bono’s research on college students shows more time spent on social media usually is associated with less self-esteem, optimism and motivation while leaving people feeling less socially connected to others.

4. Spend less time on email. Adults who check email only “in chunks” at designated times during the day — instead of checking and responding to messages continuously — are significantly less stressed and less distracted throughout the day. And they’re still just as accomplished with their work.

5. Get more happiness for your money. Studies show little connection between wealth and happiness, but there are two ways to get more bang for your happiness buck: buy experiences instead of things, and spend your money on others. The enjoyment one gets from an experience, like a nice dinner or weekend getaway, will far outweigh and outlast the happiness from adding another possession. A different study found adults given $20 to spend were happier when they spent the money on someone else.

6. Carve out time to be happy, then give it away. People dream of finding an extra 30 minutes to do something nice for themselves, but using that time to help someone else is more rewarding and actually leaves us feeling less pressed for time. Doing a good deed empowers us to tackle the next project, helps us feel more in control of our lives and leads to higher levels of happiness and satisfaction.

7. Delay the positive, dispatch the negative. Anticipation itself is pleasurable and looking forward to an enjoyable experience can make it that much sweeter. Wait a couple of days before seeing a new movie, plan your big vacation for later in the summer and take time to savor each bite of dessert. On the flip side, get negative tasks out of the way as quickly as possible.

8. Enjoy the ride. People who focus more on process than outcome tend to remain motivated in the face of setbacks. This “growth mindset” helps people stay energized because it celebrates rewards that come from the work itself. Focusing only on the end outcome can lead to premature burnout if things don’t go well.

9. Embrace failure. How we think about failure determines whether it makes us happy or sad. People who overcome adversity do better in life because they learn to cope with challenges. As IBM CEO Thomas Watson once said, “If you want to increase your success rate, double your failure rate.”

10. Sweet dreams. Get a full night’s sleep on a regular basis. Our brains are doing a lot of important work while we sleep, including strengthening neural circuits that both consolidate memories from the previous day and help us regulate our moods when we are awake. Sleep deprivation can lead to cognitive impairment similar to that of intoxication, and often is the prelude to an ill-tempered day.

Former deputy Progressive Conservative leader Christine Elliott has been appointed Ontario’s first patient ombudsman.

Elliott will deal with complaints from patients and their families who have trouble navigating the health care system after she officially takes the post on July 1, 2016.

She will also issue annual reports on the government’s programs such as trying to shift the emphasis from hospitals to home and community-based care.

However, unlike the auditor general, privacy commissioner and provincial ombudsman, the patient ombudsman won’t be an independent officer of the legislature and will instead report to the minister of health.

Elliott, who had been the Tories’ health critic before she resigned last summer after losing the PC leadership race to Patrick Brown, calls the new position “a dream job.”

She says as patient ombudsman she will respond to unresolved complaints about hospitals, community care access centres and local health integration networks.

Elliott is the widow of former federal and Ontario finance minister Jim Flaherty.

A concussion bill named for a 17-year-old girl who died after being injured while playing high school rugby was introduced in the Ontario legislature with rare all-party support.

Rowan Stringer had been accepted to the University of Ottawa’s nursing program, but never got to attend, as she died in 2013 from multiple concussions. She was a nurturing person who would have wanted her memory to be used to help other children, said her mother, Kathleen.

“It’s almost impossible to describe losing a child,” she said. “I would never want another family to have to experience this again and I would be just devastated to find out that another child in Canada dies from second impact syndrome.”

A 2014 study from Toronto’s York University and the Institute for Clinical Evaluative Sciences found the number of children and youth treated for concussions in Ontario has risen significantly. Between 2003 and 2011, almost 89,000 pediatric concussions were treated in either an emergency department or a physician’s office. The rate of concussions jumped to 754 from 466 per 100,000 for boys, and to 440 from 208 per 100,000 for girls.

Rowan’s Law would establish a committee to get the recommendations that came out of the coroner’s inquest into her death implemented within a year. Those recommendations include establishing guidelines to ensure a child is removed from play if a concussion is suspected and that they not return to play until a medical clearance is issued.

Lisa MacLeod, who represents the Ottawa-area riding where the Stringers live, said Rowan’s Law would be Canada’s first concussion law. The bill was co-sponsored by Liberal John Fraser and New Democrat Catherine Fife.

Rowan’s father, Gord Stringer, said his daughter was a person who brought people together, so this is the way she would want action to happen.

“This isn’t a political issue, it’s a health and safety issue,” he said. “It’s for kids. It doesn’t need a political stripe on it.”

A previous attempt at concussion legislation was left on the table in the fall of 2012, not long before Rowan died.

Experts recommend active individuals who participate in higher impact activities may need to maintain higher vitamin D levels, reports The Journal of Foot & Ankle Surgery.

Investigators tested the serum concentration of 25(OH) D, which is used to determine vitamin D status, in patients with confirmed stress fractures.

“By assessing the average serum vitamin D concentrations of people with stress fractures and comparing these with the current guidelines, we wanted to encourage a discussion regarding whether a higher concentration of serum vitamin D should be recommended for active individuals,” explained lead investigator Jason R. Miller, fellowship director of the Pennsylvania Intensive Lower Extremity Fellowship.

The investigators reviewed the medical records of patients who experienced lower extremity pain, with a suspected stress fracture, over a threeyear period from August 2011 to July 2014. All patients had x-rays of the affected extremity and were then sent for magnetic resonance imaging (MRI) if no acute fracture had been seen, yet concern for the presence of a stress fracture remained based on the physical examination findings. Musculoskeletal radiologists independently reviewed all the MRI scans, and the investigators then confirmed the diagnosis of a stress fracture after a review of the images.

The serum vitamin D level was recorded within three months of diagnosis for 53 (42. 74 per cent) of these patients. Using the standards recommended by the Vitamin D Council (sufficient range 40 to 80 ng/mL), more than 80 per cent of these patients would have been classified as having insufficient or deficient vitamin D levels. According to the standards set by the Endocrine Society (sufficient range 30 to 100 ng/mL), over 50 per cent had insufficient levels.

“Based on these findings, we recommend a serum vitamin D level of at least 40 ng/ mL to protect against stress fractures, especially for active individuals who enjoy participating in higher impact activities,” explained Miller.

“However, vitamin D is not the sole predictor of a stress fracture and we recommend that individuals who regularly exercise or enjoy participating in higher impact activities should be advised on proper and gradual training regimens to reduce the risk of developing a stress fracture,” he concluded.