Karuparthy Column

Management of Chronic Pain

(Continued from last month)

Integrative approach of Yoga therapy for chronic pain

Integrative approach of Yoga therapy for chronic pain is very important in the present confusion of so many claims from so many techniques, styles, individualized yoga names, e.g., Maharishi’s TM, Bikram Yoga etc.  Each one of these are great techniques of yoga.  However, in the holistic treatment of a patient, these  techniques should be integrated into the essence of the treatment specifically tailored to each patient.  Otherwise, it would be a violation of the fundamental aspect of the treatment of the patient in the whole.  In fact the Yoga therapeutics are also needed to be integrated with the broad Vedic sciences and fundamental principles of Ayurveda.

Integrative Approach of Yoga Therapy (IAYT), standardized by Vivekananda Yoga Anusandhana Samsthana (VYASA) - the world’s largest institute engaged in scientific study of Yoga- located in Bangalore, India, is the best integration of the principles of Yoga therapeutics tailored to each patient. This integration takes into consideration of all the components of yoga from the fundamental principle of “Pancha Kosha” theory from the ancient text “Vashishta Gita”

Pancha Kosha means five sheaths that are part and parcel of every existence including humans. Even though translation of these words into English conveys  imperfect meaning, these sheaths and corresponding yoga techniques are given below for convenience of the reader. The goal is to integrate all aspects of the practices to holistic approach of yoga. 

Annamaya Kosha	Food Sheath	Asanas or postures & diet and others
Pranamaya Kosha	Life force sheath	Pranayama or Yogic breathing
Manomaya Kosha	Mind sheath	Meditation
Vijnanamaya Kosha	Intellect sheath	Discourse on yoga concepts
Anandamaya Kosha	Ego sheath	Ego surrender techniques of yoga to access universal energy

Integration of the yoga as above and tailoring of the innumerable subtypes of techniques according to each individual (dosha prakruthi & vikruthi of Ayurveda) is the true integration to get the maximum benefits.  
(to be continued)

KV, June 2003
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Vegetarian Diet is Better
Vegetarian diet can be a healthier alternative to standard meat-based eating styles for all age groups. In a joint statement, published in the June issue of the Journal of the American Dietetic Association, the American Dietetic Association (ADA) and Dietitians of Canada (DC) say: It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate and provide health benefits in the prevention and treatment of certain diseases. The statement reaffirms and updates ADA's position on vegetarian diets. It details the most current science regarding key nutrients and how to obtain them through a vegetarian diet. Numerous health benefits are also cited such as lower intakes of saturated fat and cholesterol and higher intakes of carbohydrates, fiber, magnesium, potassium, folate and antioxidants such as vitamins C and E.

Vegetarians have been reported to have healthier body weight than non-vegetarians, as well as lower rates of death from heart disease, lower blood cholesterol levels and lower rates of high blood pressure, type 2 diabetes and prostate and colon cancer.  Planning a healthy vegetarian diet doesn't need to be complicatd. Just as with a meat-based diet, the key to ensuring the body meets all its nutritional needs is to choose a wide variety of foods. Approximately 4 percent of Canadian adults and nearly 3 percent of adults in the United States follow vegetarian diets and interest is on the rise, according to the ADA/DC statement. Many restaurants and caterers routinely offer vegetarian meals. Substantial growth in sales of foods attractive to vegetarians has occurred in recent years.

The complete position paper is available on the Journal of the American Dietetic Association's Web site at www.adajournal.org and on the Dietitians of Canada Web site at http://www.dietitians.ca/news/highlights_positions.html. The authors of the joint position statement have developed a Vegetarian Food Guide modeled after the United States Department of Agriculture's Food Guide Pyramid and the Canada's Food Guide to Healthy Eating. The guide is also published in the June issue of the Journal of the American Dietetic Association. 

Food Pyramid from Harvard Medical School for Healthy Life

(Note that according to this pyramid, for healthy life, fish, poultry and eggs may be zero (0) servings and meat and butter should be sparingly used (i.e., don't use). Diary can be substituted by calcium supplements. Fish can be substituted by flax.)

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Control Hypertension with Food
High blood pressure, called hypertension, is a silent killer and affects more than 50 million Americans. The prevalence of high blood pressure increases with age and is often related to lifestyle habits. Most doctors recommend that patients try to restore a healthy blood pressure level by first making lifestyle changes. Here are some natural ways to prevent or reduce high blood pressure:

• Add more fruits, vegetables and low-fat dairy products to your plate. Eat one additional fruit or vegetable with every meal. Shrink the size of your daily meat intake to six ounces or less, and designate at least two dinners a week as meat-free.  Vegetarian diet is better.
  
• Shed excess pounds. There's a direct link between being overweight and having high blood pressure. The more overweight you are, the greater the risk. Start by making small changes. Cut 200 to 300 calories from your diet each day — about the equivalent of saying "no" to two chocolate chip cookies.
• Exercise. First, get the green light from your physician. Then, slowly introduce aerobic exercise into your life, increasing the time and intensity at a pace that feels right, aiming for at least a 30-minute workout most days of the week.
• Decrease salt intake. High salt intake is linked to high blood pressure. You should consume no more than 2,000 milligrams of sodium per day (about one teaspoon of salt). The average American consumes twice that, often through canned soups, frozen dinners, soy sauce, pickles, olives and processed cheeses, which are loaded with sodium. Read food labels and select reduced-sodium products.
• Avoid alcohol consumption. Alcohol elevates blood pressure. Avoid it. If you drink, drink no more than one 12-ounce beer, one 5-ounce glass of wine or one swallow (1.5 ounces) of 80-proof whiskey if you’re a woman. 
• Stop smoking. Not only will this help keep your blood pressure in line, you'll also diminish your risk of cancer and cardiovascular diseases.

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See Also Preventing Cancer With Food

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Stroke Reduction in Asian Immigrants

A two-year study compared 134 Chinese immigrant stroke patients with 132 Chinese immigrants who had not suffered stroke. Half were men and their average age was 74. Modifying lifestyle and diet reduced stroke incidence among Chinese immigrants to the United States, according to the study presented at the American Heart Association's Second Asia Pacific Scientific Form.  The preliminary results show that changes in diet, exercise and job status after immigration reduced stroke risk in the control group.  People in the control group were more likely to reduce the salt and sugar intake in their diet once they immigrated to the United States. In China, the food is very salty. Salt often is used as a preservative for fish and meat.
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High Cholesterol in Children
Three- and four-year-old children who have high cholesterol levels are likely to have high cholesterol levels later in childhood, which is a concern because elevated cholesterol levels that appear early in life tend to persist to adulthood, researchers report at the American Heart Association's Second Asia Pacific Scientific Forum.  The researchers measured the children's total cholesterol levels at enrollment, as well as their levels of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), and levels of triglycerides. Children with the highest levels of cholesterol when they were 3 and 4 years old tended to be those with the highest levels five years later. Specifically, for those with cholesterol levels in the top 10 percent in preschool, more than half (57 percent) continued to have cholesterol levels in the top 10 percent. Children with "high normal" cholesterol levels in preschool, with total cholesterol levels measuring on average 164 milligrams per deciliter at ages 3 and 4, were five times more likely to have high cholesterol levels when they were 8 years old.  Good eating habits and restricting fat and cholesterol to lower heart disease risk need to begin early in life, Strobino says. Autopsy studies in children have found that precursors of coronary heart disease, such as fatty streaks and lesions in the arteries, are associated with cholesterol and other fats in the blood. Preventing coronary heart disease can begin as early as 3 and 4 years of age, by identifying those at risk, and close observation and possibly intervention. It is during these years that primary prevention may be most effective.
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Healthy Diet Cuts Costs
With 20 percent of the U.S. population estimated to be 65 years or older by the year 2030, the potential to contain health care costs by implementing healthy lifestyles and healthy eating habits earlier in life has important implications for future health care expenditures. Research reported at the American Heart Association's Second Asia Pacific Scientific Forum looked at eating behavior in midlife and found that high intake of fruits and vegetables translates to lower health care costs later. Previous studies have shown that adopting a healthy diet and reducing risk factors such as smoking and lack of exercise early in life can help protect against long-term risk of death from coronary heart disease, stroke and cancer. Few studies have described the economic consequences of these risk factors. The findings suggest that high intake of fruits and vegetables reflects healthy eating habits and in middle age has beneficial impact not only on future health but also on health care costs in older age. They also support current dietary guidelines, which advocate consumption of five or more servings of fruits and vegetables per day, much higher levels than those consumed in the average American diet.  Lifestyle modification and statin therapy can slow or even reduce calcium deposits in the coronary arteries of patients without symptoms but at risk for coronary artery disease who still have no symptoms, according to another study presented at the American Heart Association's Second Asia Pacific Scientific Forum.
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Early Puberty and Risk of Cancer
For women genetically predisposed to get the disease, the rush of hormones of puberty may result in breast cancer later in life, according to a study of twins from the University of Southern California at Los Angeles that appears in June 5th New England Journal of Medicine.  The study suggests early puberty may trigger the development of breast cancer in women who are already at unusually high risk because of their genetic makeup.  A women's risk of breast cancer is believed to be linked to her lifelong exposure to the sex hormone estrogen, with slight increases for those who start menstruating early, reach menopause late, never have children or have them late.  For identical twins with cancer, the first twin to reach puberty was five times more likely to get the disease first. The link was even stronger when menstruation began early, before the age of 12. The implications of the study are worrisome given the gradual decline in the age of puberty in the United States and the rise in childhood obesity. Body fat can stimulate hormones and there's even more impetus to try to reverse this epidemic of obesity in children.
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Mother's Care
The way a mother cares for her baby can determine how stressed out the child will be as an adult because her nurturing can permanently change the way the infant's genes operate, new studies on rats suggest.  The studies, presented on June 8th at a Conference on the Fetal and Infant Origins of Adult Disease, found that baby rats who were licked by their mothers a lot turned out to be less anxious and fearful as adults and produced lower levels of stress hormones than those who were groomed less.  The scientists found that the mothers' licking caused the baby's brain to crank up a gene involved in soothing the body in stressful situations. Several human studies have found an association between a mother's nurturing and the future mental health of her children.
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Mothers Pregnant with Boys Eat More
Women pregnant with boys tend to eat about 10 percent more calories a day than those carrying girls but don't gain more weight, new research indicates. The study, published 1st week of June in the British Medical Journal, explains why newborn boys are heavier than girls and suggests that signals between the fetus and the mother drive the appetite during pregnancy. Boys are on the average 3.5 ounces heavier at birth than girls. The study by researchers from the Harvard School of Public Health and the Karolinska Institute in Stockholm, Sweden, is the first to examine whether that difference could be due to the mother eating more. The scientists assessed the diets of 244 American women one week before they came to the hospital for a routine prenatal checkup at 27 weeks of pregnancy. All the women later gave birth to normal-weight babies at full term.  The results indicate that male fetuses may be more vulnerable than female ones to problems linked to fetal nutrition.
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Night Shift and Colorectal Cancer
Nurses who worked the night shift at least three times a month for 15 years or more were 35% more likely to develop that type of cancer than nurses who never worked nights, according to a Harvard University report in the Journal of the National Cancer Institute. The finding, from the ongoing Nurses Health Study, is the first to link night-shift work with a higher risk of colorectal cancer. The disease is expected to kill 57,100 Americans this year, the American Cancer Society says. Other research, including a 2001 report out of the Nurses Health Study, has suggested that working rotating night shifts raises women's risk of breast cancer.
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Alcoholism
Chronic alcoholism damages parts of the brain used in learning and memory, but giving rats an antioxidant protected them from the damage, according to researchers working in the United States and Spain. The findings are reported in June 3rd online issue of Proceedings of the National Academy of Science. Antioxidants are chemicals that inhibit the oxidation of a substance to which they are added. Oxidation can stress or damage cells. Alcohol also kills liver cells, and the researchers knew that this can be reduced with the use of antioxidants.
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RU-486
RU-486, the chemical used to induce abortions, may extend the life of brain cells.  The cells normally undergo a programmed cell death in culture. But when RU-486 was added to the culture, the life of the cells was extended. The team said the finding may lead to future treatments for brain-damaging diseases. The findings are reported in June 3rd online issue of Proceedings of the National Academy of Science.
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Cigarette Smoking
In a sample of 17,353 adults, cigarette smoking was associated with elevated levels of C-reactive protein, fibrinogen, and homocysteine, three recently identified risk factors for heart disease, according to American College of Physicians.  Current smokers had higher levels of the three risk factors than former smokers, as did those who smoked more cigarettes daily. It is possible that these risk factors are partly responsible for the effect of smoking on the risk of heart disease.

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Worship Shade
Worship shade - that's the message from the dermatologists. Cover up. Bathe in sunscreen. Remember as you head out to beach parties and barbecues that sun exposure is dangerous.  Every year, more than 1 million Americans are diagnosed with skin cancer, the most common type of cancer in the U.S. Of even greater concern to dermatologists is that incidents continue to rise. Since sun damage is cumulative, prevention efforts need to start with children. Most of the damage, anywhere from 50 percent to 80 percent, occurs by the age of 18.   The problem is people think they can dab on a little sunscreen and then tan away. However, sunscreen only slows but does not prevent damage to the skin. And most people use only a quarter of the amount of sunscreen needed to receive the protection stated on the bottle.  

Here are some tips and products to help protect you and your family from the ravages of the sun:

Sunscreen: The first line of defense against the sun. Greaseless formulas, spray-on products, even a convenient SPF 30 wipe called Spwipes (www.spwipes.com) take the mess out of applying sunscreen. Children should use sunscreen with an SPF 30 or higher. Look for products that also contain zinc oxide, titanium dioxide or avobenzone (also called Parsol 1789). These protect against the sun's UVA rays thought to trigger melanoma, the most deadly skin cancer. Most other sunscreen ingredients absorb UVB rays, which are responsible for sunburn and less serious skin cancers. Apply sunscreen 15 to 20 minutes before going out into the sun to allow the cream to bind to the skin, use an ounce of sunscreen per application and reapply every two hours. For everyday use, an increasing number of moisturizers, such as Neutrogena Healthy Defense (www.neutrogena.com), contain SPF 30 or higher sunscreen. Use these in addition to sunscreen, not in place of them.

Clothing: Doctors recommend covering up as much skin as possible. Wear lightweight long-sleeve shirts with collars and pants. And don't forget a wide-brimmed hat or legionnaire's cap - the kind with a flap over the neck. Sunscreen should be applied to any areas not covered by clothing. Dermatologists say avoiding the sun is the most important tactic in the effort to prevent skin cancer. Ultraviolet rays are most intense between the hours of 10 a.m. and 4 p.m. Specialized fabrics are now available to block almost all of the sun's ultraviolet rays. Mail-order catalogs include Sun Precautions ([800] 882-7860, www.sunprecautions.com) and Coolibar ([800] 926-6509, www.coolibar. com). Rit Sun Guard (www. ritsunguard.com) laundry additive washes SPF 30 sun protection into regular clothing. Treatments last for about 20 washings.

Eyeglasses and sunglasses: A recent study found that only 6 percent of people knew that the sun's rays can harm the eyes. The American Academy of Ophthalmology suggests looking for labels that promise 99 percent to 100 percent protection from ultraviolet rays, both UV-A and UV-B. Sunglasses should wrap to your temples to keep UV rays from entering from the sides. While polarized sunglasses cut down on glare, consumers should still check to make sure the glasses offer full UV protection. Sun exposure can damage the eyes by causing the outer layers to degenerate. Wearing sunglasses also protects the eyelids from skin cancer. The lower eyelid is more prone to skin cancer. Any tumors found there should be caught as early as possible to minimize the reconstruction proces. Transitions Optical ([800] 848-1506, www.transitions.com), among others, makes prescription lenses that automatically darken when exposed to ultraviolet light. Similarly, FeatherWates SPF, available at LensCrafters optical stores (www. lenscrafters.com), are prescription sunglasses that reduce the sun's damaging rays.

Lip protection: Lips are a common site for skin cancer, in part because people often miss them when applying sunscreen. Lip balms with sun protection, such as Blistex Ultra Protection (www.blistex.com), have been associated with a decrease in lip cancers.

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Mammograms for Men
Breast cancer is rare in men, but a higher percentage men diagnosed with the disease die of it because it is usually discovered at a later stage. Researchers believe that 1,500 men will be diagnosed with breast cancer this year and roughly 400 of them will die of it. The disease is more likely in men older than 50 and black men are more likely than white men to succumb to it. Former Sen. Edward Brooke, 83, a black U.S. senator, was diagnosed with breast cancer in September. He is encouraging men to perform self-examinations and advocating that insurance companies cover male mammograms. After his wife, Anne, discovered a lump on the right side of his chest, he underwent a double mastectomy and is currently free of the cancer.  
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Diabetes Warning 

Diabetes leads to a host of problems, including blindness, kidney failure, amputation and heart disease, and diabetics are getting younger and younger. Diabetes is a disease caused largely by obesity and lack of exercise.  Including undiagnosed cases, CDC authorities believe about 17 million Americans, nearly 6 percent of the U.S. population, have diabetes today. One in three U.S. children born in 2000 will become diabetic unless many more people start eating less and exercising more, CDC warns. Nearly half of black and Hispanic children are likely to develop the disease. Some 45 million to 50 million U.S. residents could have diabetes by 2050.   From the mid-1960s to the mid-'90s, the number of cases tripled, hitting 11 million in 2000, and is expected to rise an additional 165 percent by 2050, to 29 million, an earlier CDC study by Narayan and others found. Overall, 39 percent of the girls who now are healthy 2 1/2- to 3-year-olds and 33 percent of the boys are likely to develop diabetes. For Hispanic children, 53 percent of the girls and 45 percent of the boys,  about 49 percent and 40 percent for black girls and boys, and 31 percent and 27 percent for white girls and boys.  Globally, the World Health Organization has estimated that by 2025, the number of people with diabetes worldwide will more than double, from 140 million to 300 million. They estimated that by 2025 in India, there would be close to 6% of the country's population with diabetes, i.e., 60 million.  Type 2 diabetes can be prevented or delayed by losing weight, exercising and following a sensible diet.  Dr. K.M. Venkat Narayan, M.D., the Centers for Disease Control and Prevention (CDC)'s chief of diabetes epidemiology and others of the CDC presented these projections during the annual Scientific Sessions of the American Diabetes Association. Scientists from the National Institutes of Health (NIH) said this huge increase is preventable, if people will control their weight, exercise regularly and eat healthy foods. More information is available at www.ndep.nih.gov.
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Males Won't Perish, After all!
Males are different from females because of the Y chromosome, which is best known for supplying the biological signal that makes males rather than females. The body's other chromosomes are inherited in pairs, with one member coming from the mother and the other from the father. That pairing allows them to swap corresponding pieces of themselves, a mechanism that lets the species get rid of damaged genes. But the Y chromosome comes by itself from the father. It can't trade appreciable amounts of DNA with its partner, the X chromosome that comes from the mother, so it can't get rid of damaged genes and can't fix its genes in the usual way.  Some scientists have suggested that it might disappear millions of years from now because it can't eliminate genetic defects in the usual way, and broken genes tend to erode away over the long haul.  A report by scientists at the Whitehead and the Washington University School of Medicine in St. Louis that appeared in June 19th issue of the journal Nature suggests that the Y chromosome makes extensive use of a process called gene conversion to repair itself. The chromosome carries backup copies of its important genes, and it can use one copy to fix a flaw in the other.  During this process of repairs sometimes the Y chromosome makes mistakes resulting in deletion of stretches of DNA. Such deletions are a recognized cause of male infertility, occuring in one in every two thousand males.                                                                                                                                                                                                              Contents

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Use It or Lose It
The brain is like any other muscle, use it or lose it. That's the growing conclusion of research that shows fogged memory and slowed wit are not inevitable consequences of getting old, and there are steps people can take to protect their brains. Mental exercise is crucial. Benefits start when parents read to tots and depend heavily on education.  Scientists say it's never too late to start jogging the gray matter. Other researchers have discovered evidence that mental activity may guard against dementia. An absorbing book or a challenging crossword puzzle may keep your mind more than busy. It may keep it healthy, too, according to a 21-year study, of mental breakdown in old age, led by Albert Einstein College of Medicine in New York City and published in June 19th New England Journal of Medicine.. The study adds to the evidence that stimulating the mind can ward off Alzheimer's disease and other dementia, much as physical exercise can keep the body fit. Read, read and read and do crossword puzzles. Pull out the chessboard or Scrabble. Learn a foreign language or a new hobby. Do anything that stimulates the brain to think.  Cut back on TV.  When you watch television, your brain goes into neutral  But physical health is important, too. A healthy brain needs lots of oxygen pumped through healthy arteries. High-fat diets increased the risk seven times, a Case Western study found.  That means exercising and eating right, the very things that prevent heart disease and diabetes, help the brain, too.                                                                          Contents

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Effect of Separation on Children
Children of divorced parents who are separated from one parent due to the custodial or non-custodial parent moving beyond an hour’s drive from the other parent are significantly less well off on many child mental and physical health measures compared to those children whose parents don’t relocate after divorce, according to a study that appeared in the June issue of the American Psychological Association’s (APA) Journal of Family Psychology, a special issue on linkages between family psychology and the law. It is the first study to provide direct evidence of the effect of relocation on children after divorce.

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Fish Feel Pain

Fish feel pain, say scientists in Britain in a breakthrough study.  Laboratory tests in which bee venom and acetic acid was injected into the lips of rainbow trout, suggested that fish have feelings, including stress and pain in the form of "trout trauma". The research was carried out by the researchers at the University of Edinburgh and Roslin Institute and published by the August Royal Society in London.

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Children Could Be Saved in Poor Countries
About 6 million of the 10 million children in poor countries who die each year before their fifth birthday could be saved by low-tech preventive measures or a few cheap and proven medical treatments, according to a series of new studies published in the Lancet, the European medical journal. More than 10 percent of the deaths could be prevented if women in poor countries fed their infants breast milk and nothing else for six months. About 7 percent of deaths could be prevented if children in malaria-prone regions slept under insecticide-treated mosquito nets. Zinc supplements given weekly could save about 500,000 children now dying of diarrhea and pneumonia. Inexpensive generic antibiotics could save an additional 600,000, the research predicted.

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