Thursday, July 31, 2014

Chiropractic for Kids: More and more children are receiving chiropractic care

Chiropractic for Kids: More and more children are receiving chiropractic care and there's a good reason why: chiropractic provides safe, natural treatment for a number of conditions while promoting wellness.

Multiple studies point to the safety of chiropractic for kids. In a 2012 survey of European chiropractors, fewer than 1% of children experienced side effects from chiropractic treatments, and those side effects were all mild.1

This confirms the results of three other studies in which no serious side effects were reported in pediatric patients receiving chiropractic treatment. Research suggests that chiropractic can safely relieve musculoskeletal pain in children. In a 2003 study, 62% of pediatric patients had substantial reductions in back pain after receiving chiropractic adjustments.3

Treatment of musculoskeletal conditions continues to be the number one reason why children receive chiropractic care. But chiropractic does more than treat conditions, it can help children improve their health through wellness care. In a 2009 survey, one of the primary reasons why parents took their child to see a chiropractor was for wellness care.4

Current research shows that chiropractic can reduce blood pressure, heart rate, and stress hormones, release endorphins, and boost the immune system. Whether you're hoping to ease your child's pain or improve their health, chiropractic can help.  

1. Marchland A. Chiropractic care of children from birth to adolescence and classification of reported conditions: an Internet cross-sectional survey of 956 European chiropractors. Journal of Manipulative and Physiological Therapeutics 2012; 35 (5):372-380.
2. Humpheys BK. Possible adverse events in children treated by manual therapy: a review. Chiropr Osteopat. 2010;18: doi:  10.1186/1746-1340-18-12.
3. Hayden Ja, Mior SA, Verhoef MJ. Evaluation of chiropractic management of pediatric patients with low back pain: a prospective cohort study. J Manipulative Physiol Ther. 2003 ;26(1):1-8.

4. Alcantara J, Ohm J, Kunz D. The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network. Explore NY 2009; 5(5): 290-5.

Wednesday, July 30, 2014

Infant Colic and Chiropractic Care

Infant Colic and Chiropractic Care

New parents could fill a book with the advice they receive on how to cure a colicky baby. But moms and dads don’t need to rely on drug therapies or old wives’ tales to experience the peace of a happy baby. Here are three reasons parents should consider chiropractic care for colicky infants:

Research shows chiropractic care for colic works. A Danish study found that spinal manipulation was better at reducing colic symptoms than the commonly-prescribed drug simethicone. After two weeks of treatment, infants who received chiropractic care cried for two hours less each day while the simethicone-taking infants cried just one hour less each day.

Another study of 316 colicky infants found that more than 90 percent of those who had chiropractic treatment showed fewer symptoms. Parents of study participants reported their children experienced relief, on average, after only three treatments. Chiropractic benefits continue long after the colic disappears.

A published study of more than 200 babies in England found that children who received spinal manipulations for colic were reaping benefits as long as three years after the treatment ended. Parents reported their children were more than twice as likely to fall asleep in less than 20 minutes compared with children who had received no chiropractic care. In addition, the kids who had undergone chiropractic treatment were more than twice as likely to sleep through the night. Chiropractic care is safe. Even though an infant’s spine is remarkably flexible and strong, a chiropractor will apply a light touch, often using no more than the tips of the fingers to make the adjustment.

Several reviews of pediatric chiropractic care have demonstrated its safety in children. Spinal manipulations produce far fewer side effects than conventional therapies, including drugs used for pain relief.

Klougart N, Nilsson N, Jacobsen J: Infantile colic treated by chiropractors: a prospective study of 316 cases. JMPT, August 1989, Vol 12;4.

Lucassen P. Infantile colic. Clin Evid (Online). July 2007. pii0309 (

Miller J, Lane Phillips H. Long-Term Effects of Infant Colic: A Survey Comparison of Chiropractic Treatment and Nontreatment Groups. Journal of Manipulative and Physiological Therapeutics – October 2009 (32:8, 635-638).

Asthma and Chiropractic

Asthma and Chiropractic 

If you or someone you love lives with asthma, you know how it impacts daily living. Asthmatic patients learn to rely on inhalers and other medications to manage their condition, however, chiropractic care can offer a drug-free way that, in combination with traditional medical therapy, can help alleviate asthma and its symptoms. 

What does the spine have to do with breathing? According to researchers, brain-spine communication is critical for normal immune and respiratory function. When a qualified chiropractor makes spinal adjustments, he or she will open the message pathways that create a healthier respiratory system. An increasing body of research suggests that spinal manipulations can be an effective treatment for asthma: 

A 2010 review of eight published studies found that some asthma patients receiving chiropractic care reported a higher quality of life. 

A 2002 study noted that asthma patients who received spinal manipulation reported an improvement in symptoms, as well as lower levels of depression and anxiety. Additional testing showed that the patients had lower levels of the stress-inducing hormone cortisol after the treatments. 

Researchers at Northwestern Health Sciences University found that asthma patients who were given three months of chiropractic care reported less-severe symptoms and increased quality of life. The patients who received spinal manipulations also reported fewer uses of their emergency inhalers. Remember that asthma is a serious condition, and you should always consult your primary-care doctor before discontinuing medications. 

Also make sure your primary care physician is aware of any complementary care you receive with a chiropractor or other provider. Chiropractic care has the potential to reduce the number of attacks you suffer. If you live with asthma, consider adding chiropractic care to your treatment program.


Bronfort G, Evans RL, Kubic P, Filkin P. Chronic pediatric asthma and chiropractic spinal manipulation: A prospective clinical series and randomized clinical pilot study. Journal of Manipulative Physiological Therapeutics. 2002 Oct;25(8):540-1. 

Hondras MA, Linde K, Jones AP. Manual therapy for asthma. Cochrane Database of Systematic Reviews. 2002;(4):CD001002. 

Kaminskiyj A, Frazier M, Johnstone K, Gleberzon BJ. Chiropractic care for patients with asthma: A systematic review of the literature. The Journal of the Canadian Chiropractic Association. 2010 Mar;54(1):24-32.

Friday, July 18, 2014

Sunblocks and Sunscreens: Year-Round Advice for Parents

Sunblocks and Sunscreens: Year-Round Advice for Parents

By Claudia Anrig, DC
With an unusually hot summer winding down, many parents have been diligently covering their children with sunblocks and sunscreens for the past several months, believing it is best for their children.
But how effective are these products at protecting them from the damaging rays of the sun? And just as important, how safe are the products themselves?
The History of Sun Protection Factor (SPF)
The concept of the "Sun Protection Factor" or "SPF," originally credited to Franz Greiter, supposedly helped determine which sunblock or sunscreen would be best for use based on a measurement of effectiveness when applied at an even rate of 2 milligrams per square centimeter of skin. Controversy still exists over the accuracy of this rating system and whether the rate of application truly represents actual use.1-2 With the more widespread use of sunscreens came the development of waterproof and sweatproof products, and eventually the claim that sunblocks and sunscreens are the ultimate protection against skin cancer.3
kid with sunscreen - Copyright – Stock Photo / Register MarkWhile many sunscreens now offer "broad-spectrum" protection against both UV-A and UV-B rays, that wasn't always the case. The original idea to block the UV-B rays that cause sunburn may have been a sound one, but as with most chemical options, it failed to consider the consequences. While sunscreens and sunblocks protected the skin from being burned by UV-B rays, they did not block UV-A rays, which penetrate the skin more deeply and actually cause melanoma.
Moreover, with all sunscreens, but particularly those with higher SPF, the sensation of being burned is stunted, typically resulting in a longer amount of sun exposure, which means more exposure to the harmful UV-A rays that cause melanoma. And to top it off, sunscreens and sunblocks do not allow the body to absorb the sun's rays and produce vitamin D.4
Chemical Concerns
Created to block out the UV-B ray or ultraviolet radiation that causes sunburn, sunscreens were originally designed solely to protect the skin from being burned utilizing different chemicals. These chemicals include oxybenzone, methyl anthranilate, titanium dioxide and zinc oxide, among others.5 Chemicals approved for use within the European Union and other parts of the world that have not been tested include but are not limited to: 4-methylbenzylidene camphor, Tinosorb M and S, Uvasorb HEB and isopentenyl-4-methoxycinnamate.6
Adverse health effects have been associated with some synthetic compounds in sunscreen, and in 2007 the Centers for Disease Control and Prevention (CDC) reported a concern regarding oxybenzone (benzophenone-3). There were two studies, the first of which "detected the chemicals in greater than 95% of the 2000 Americans tested,"7 while the second revealed that mothers with high levels of oxybenzone were more likely to give birth to underweight babies.8
Vitamin D and Sunshine
The most powerful and natural vitamin D is produced by the body when in direct sunlight, preferably the noonday sun, for about 10-20 minutes a day or until the skin begins to turn a very light pink. Despite the hype about the sun's rays being dangerous and cancer-causing, the fact is that we cannot be healthy without regulated and regular doses of natural direct sunlight.9
While vitamin D supplements do exist, it's important to differentiate between D2 and D3 forms. The weaker variant is called D2. The most powerful form is D3, and it is this variant that is produced by the body when exposed to sunlight and has been found to be a natural cancer preventative. In 2007, a study published in the American Journal of Clinical Nutrition found that vitamin D cut the risk of several types of cancer by as much as 60 percent, but it's important to understand they were using a natural supplement of vitamin D3, which is available in stand-alone dietary supplements.10
Additionally, a 2009 U.K. study reported that "mothers given ten times the usual dose of vitamin D during pregnancy had their risk of premature birth reduced by half and had fewer small babies."8
Internationally recognized research scientist and vitamin D expert, Dr. William Grant, has said that about 2,000-4,000 IU a day of vitamin D can help reduce cancer risk by up to 50 percent. He has also determined that up to 30 percent of all annual cancer deaths could be prevented with higher levels of vitamin D. That equates to 2 million less deaths worldwide and 200,000 less in the U.S. alone.11
Calculate the Recommended Amount of Sun Exposure
Scientists at the Norwegian Institute for Air Research have devised a calculator12 that will estimate how many minutes of exposure you need for your skin to produce 25 mcg (the equivalent of 1,000 International Units) of vitamin D. It is not written for U.S. cities, so you'll need to to find the latitude and longitude of your city and enter the numbers manually. The easiest way may be to simply Google "altitude of [your town]." Remember to convert it to kilometers. One kilometer is about 3,300 feet.
If your latitude is 39 S, enter -39. If your longitude is 76 W, enter -76. You'll also need to enter the time of day you are going out in the sun, expressed as UTC (Greenwich Mean Time).13 The calculator uses a 24-hour clock, so hours from 1 p.m. to midnight are expressed as 13 to 24.
The calculator also wants to know the thickness of the ozone layer. I suggest just setting this one to medium. Be sure to click the radio button next to the entries. They are often not automatically selected when you fill in the values. Keep in mind that the exposure times given are considered enough to maintain healthy vitamin D status. If you are starting out with a vitamin D deficiency, you might need more.
Exposure Wisdom
In 2002, 50 percent of all cancers in the United States were skin cancers. That works out to approximately 1.1 million cases of diagnosed skin cancer in one year. Considering the prevalence of sunscreen "awareness campaigns" over the past 50 years, it's safe to assume that many of those 1.1 million people were wearing sunblock or sunscreen. So, it's equally safe to assume that sunscreen is not the ultimate protection against skin cancer.11
Rather than having parents apply chemicals to their children, we should advocate limiting sun exposure to spans of 10-20 minutes at a time. When limits cannot be set, be sure parents and their children wear loose-fitting, light-colored clothing, as lighter-colored fabrics will reflect the sun's rays instead of absorbing them. Also, hats with a wide brim will protect both the face and the back of the neck. When swimming, always have children wear a thin, light-colored T-shirt over their swimsuits. This will protect their shoulders and chest from overexposure to the sun, as these are the areas most likely to burn when in water.
  1. "Protecting Your Skin: The History of Sunscreen."
  2. How OTC Sunscreens Are Formulated. Letter from Edward Kavanaugh, president of The Cosmetic, Toiletry and Fragrance Association, to Dr. Debra Bowen, deputy director of the FDA Office of Drug Evaluation, Sept. 11,
  3. Pekkanen J. "Summer Sun Can Kill; The Sun Does to Your Skin What Cigarettes Do to Your Lungs." Chicago Sun-Times, July 17, 1987.
  4. "How Supermodel Gisele Bundchen 'Infuriated Cancer Experts.'", April 22, 2011.
  5. Information on sunblock. University of California, San Francisco, School of Medicine; Department of
  6. Chemicals in sunscreen as approved by the European Union. Council Directive, 1976.
  7. Holder E. "CDC Finds 97 Percent of Americans Contaminated by Sunscreens.", April 11, 2008.
  8. Gillie O. "Vitamin D 'May Cut Premature Birth Risk and Protect Newborn Babies." The Sunday Times, Oct. 10, 2009.
  9. "Vitamin a Cancer Fighter? D Supplement Cuts Risk of Disease in New Study." Albany Times Union, 2007.
  10. "When Should You Go Out in the Sun?", Sept. 4, 2008.
  11. "Sunblock Can Actually Increase Your Cancer Risk.", July 2, 2003.
  12. Calculated Ultraviolet Exposure Levels for a Healthy Vitamin D Status. Norwegian Institute for Air Research, 2005.
  13. You can convert your time into Greenwich Mean Time by going

Evaluating Prenatal and Pediatric Automobile Injuries

Evaluating Prenatal and Pediatric Automobile Injuries

By Claudia Anrig, DC
Often in a family practice, one of your patients or an entire family is in an automobile accident and you are sought out to provide care for their soft-tissue injuries. Depending on the severity of the collision and individual complaints, each of the occupants may need to be treated differently.
This is a brief introduction and overview of chiropractic care for the prenatal and pediatric patient following a collision injury. Be aware that these patients may require care by other specialists, but I the following is not a narrative or advice on co-management of the injured individual.
The Prenatal Patient
Prior to your consultation, request that all accident reports and examinations by other providers be forwarded in advance for your review. The first point for consideration is the prenatal patient's stage of pregnancy and the immediate care offered as a result. For instance, if the occupant is in her first trimester, it was probably recommended that she go to her OB for an evaluation; whereas if she is in her second or third trimester and/or the driver of the vehicle, especially if she were close to the steering wheel at the time of the crash, the airbag deployed and/or if she felt abdominal trauma from the seatbelt, she may have first gone to the emergency room and followed up with her OB once released.
There are several questions you might consider asking the pregnant patient about what happened during the collision (after asking these, pose the traditional personal-injury questions):
  • How was the seatbelt used?
  • What position was your body in at the time of the collision?
  • What position was your body in when the car came to rest?
  • Did the airbag engage and where was the point of strongest contact?
  • Did you experience bruising from the airbag or seatbelt?
  • What was reported by your OB?
auto injuries - Copyright – Stock Photo / Register MarkNote that increased levels of the hormonerelaxin may have caused increased ligament laxity in the prenatal patient, which may cause a more symptomatic picture. For example, if the patient's arms were on the steering wheel, she may have an increase of cervical and thoracic instability. If her right leg were extended out on the pedal (gas or brake), her pelvis may have been in rotation upon impact.
A comprehensive chiropractic, orthopedic and neurological examination to document the nature of the injury and provide more recommendations for an appropriate treatment plan is required. The examination must include enough procedures that would allow you to write a comprehensive report for an OB or attorney if they are co-managing the case.
Regarding radiographing the cervical spine of the pregnant patient, the doctor must determine if taking this series (within their practice or referring out to an X-ray facility) is warranted due to the clinical findings of the examination. All precautions (lead shielding) are mandatory and the doctor must always weigh the benefits versus risks of radiographing with shielding, and discuss this with the patient and possibly other health care providers involved with her care.
The Pediatric Patient
In the United States in 2011, more than 650 children under the age of 12 died and 148,000 were injured in motor-vehicle accidents,1 while in 2012, more than 2,000 teenagers (ages 13-19) were killed.2 As described by Murphy3 in his chapter in Pediatric Chiropractic2nd Edition, there are many contributing factors to the injury of a pediatric patient involved in a collision. Anthropometric and positioning variables include head size, pelvic height, anterior-superior iliac crest and the center of gravity, to name a few.
The pediatric population may be one of the most underserved when it comes to post-automobile-collision treatment. Many children are deemed "normal" because they "were in a car seat" or "have no apparent symptoms" (e.g., no headaches or neck pain), so parents and those in the medical field may inadvertently not be aware that the child could have soft-tissue injuries warranting a musculoskeletal exam.
In my clinical experience with infants and young children, I have often seen what I call the "silent signals"– subtle but notable abnormal functions reported by the parents. Some of these signals include positional discomfort (putting the infant or a toddler in a certain positions causes discomfort), night terrors, picky eating, bowel disruption (usually constipation), and being clingy, anxious and/or unable to focus in the classroom. If a parent is not sure if their child has been injured, one can always rule it in or out by performing an exam.
Consultation questions to include with your traditional questions (ask the parents of the pediatric child or the child, if old enough to communicate clearly) include the following:
  • What type of restraint system was used in the vehicle?
  • What position was the child in before and after the injury?
  • Was there crying, confusion, signs of pain or discomfort after the accident?
  • What other symptoms besides neck, back pain or headaches is the child experiencing?
Your exam of the infant to age 5 child should include static and motion palpation, ROM, and orthopedic and neurological examination. Take X-rays (or refer out for radiological exam) if X-rays are warranted. For patients ages 5 and older, I suggest the above, but I would include selective X-ray views.
Re-examinations of the pediatric patient are recommended every 30 days or 12 visits. Parents should be asked during the examination and each treatment visit, about their child's overall quality of life since the accident, including sleep, digestion, elimination, behavior, etc. Also inquire as to any activities the child has been unable to do – or been limited in doing – post-accident.
The Child Advocate: If Not You, Then Who?
It should be noted that the insurance community is not embracing the legitimacy of soft-tissue injuries in the pediatric population. I have found that it requires extensive documentation, having the parents involved with their pediatrician, sending out periodic update reports to the child's other doctor(s), and sometimes the involvement of an attorney (one willing to accept a case even if it appears to be minor and who believes in advocating for the right of the child to receive necessary and appropriate care). In some cases, I have even provided the insurer with a copy of Pediatric Chiropractic so they can review Dr. Murphy's chapter.
Sadly, some of our colleagues have earned us a bad rap (and thus the challenges from the insurance industry) when it comes to the care of individuals with car injuries, but that small percentage should not cause the majority of us to think twice about caring for the pregnant or pediatric population. It would be unethical to selectively eliminate certain population groups (pediatric, special need, etc.) access to appropriate care via chiropractic.
I encourage our profession to advocate for the child patient and the mother of the unborn child in the event of an automobile collision. Perform the necessary examinations and document your findings to provide appropriate care for this important patient group.
  1. Child Passenger Safety: Fact Sheet. Centers for Disease Control and Prevention.
  2. Teen Driver Car Accident Statistics - 2012. Law firm of Edgar Snyder and Associates.
  3. Murphy D. Children in Motor Vehicle Collisions. In Pediatric Chiropractic, 2nd Edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2012.

The pediatric examination may vary due to the nature of the injury, but the following chapters of Pediatric Chiropractic, 2nd Edition, may prove useful in helping guide a comprehensive exam: Chapter 6 – the prenatal patient and neurological examinations for the neonate; chapters 9, 11-12 – neurological examinations; chapter 13 – orthopedics; chapter 4 – diagnostic Imaging; and chapters 5, 28-34 – techniques for spinal and cranial examination.

Spinal Hygiene and Safety, Part One

Spinal Hygiene and Safety, Part One

By Claudia Anrig, DC
Spinal hygiene and safety may be a new concept for chiropractors, but if you have a family practice, this should become a part of your daily routine for parents and children. Dentistry has promoted its concept of dental hygiene for decades. 
The habits of Americans have been altered by dentistry, from purchasing fluoride toothpaste to the niche products for baby-boomer concerns for tartar control and gingivitis. Flossing has become a daily ritual for the masses, and parents wouldn't imagine giving their infant a night-time bottle. All these behaviors have become conditioned because dentists took the time to teach their patients about dental hygiene.
Chiropractors have a similar opportunity to share ideas and behaviors that would enhance the recovery of the patient or improve their lifestyle. In a family practice, the chiropractor examines the spine of the child as a routine. It is during these visits that the doctor should take time to share his or her knowledge to the child and parent.
Start your spinal hygiene and safety awareness with new parents. Advise parents that approximately 50 percent of all infants are accidentally dropped in their first year of life. That's an alarming figure, and occurs most commonly when the infant is on a changing table, bed or couch. Recommend to parents to never leave their child unattended on the couch or bed (even if it's for 30 seconds to answer the telephone), and teach them to change their infant on the floor (which is ergonomically better for the adult spine) to reduce the risk of spinal trauma.
Changing diapers may also place undue stress on the thoracic spine. Raising the infant's legs with one hand to place the diaper underneath can cause repetitive stress to the spinal joints. Commonly, a vertebral subluxation in this region may contribute to the disorder of the colic or stomach reflux.
The use of baby walkers appears to be on the rise again since manufacturers have addressed some of the previous safety concerns. Unfortunately, the alterations do not improve placing early stress on the lumbopelvic area and lower limbs. Baby jumpers are a joy for infants who like to be upright and in motion, but the repetitive bouncing stress can be unhealthy on joints that are not yet developed to bear weight.
Baby bouncers (a cloth carrier on string suspension) that the infant can use to rock themselves are often placed on a kitchen counter or dining room table rather than the floor. The added height can become a problem if the child creates enough momentum and springs off the counter, usually striking their skull.
The portable high chair that is attached to the end of the breakfast table is another hazard. Poor attachment to the table or a heavy infant who strongly rocks the chair can propel the infant backward, risking a fall to a hard surface.
Public awareness has changed consumer habits by alerting automobile drivers with airbags to avoid placing infant carriers and children in the front seat. However, many parents unknowingly endanger child passengers with other unsafe procedures. For example, most infant car seat manufacturers recommend that car seats not be reused if they have been involved in a car accident. Parents should be made aware that many manufacturers will replace or reduce the cost of replacement of the car seat if you return it. Many companies have a policy to review their products after an accident.
Early this past March, the National Highway Traffic Safety Administration (NHTSA) and the Consumer Product Safety Commission (CPSC) announced a massive recall of 800,000 "Evenflo On My Way Home" infant car seat/carriers. It appears that the product meets the crash standards inside the car, but there is no mandatory safety standard for using the seats outside of the car. Both agencies have reported injuries that have occurred because buttons on either side of the seat that are used to latch and adjust the carrying handle can unexpectedly release, causing the seat to flip forward.
Skull fractures, concussions and bruises have been the most commonly reported injuries. Those who have this product with model numbers #207 and #497 can call the Evenflo hotline for a free kit to correct this problem. Their phone number is (800) 203-2138.
For those family chiropractors who treat children in automobile accidents, take note. The federal standard for car seats is that the product must be designed to prevent serious injury in 30 mph crashes. Unfortunately, many insurance companies and even IME chiropractors will defend a position that children in car seats cannot be injured in crashes.
Another safety issue for the car is the proper use of seatbelts for children. The shoulder harness should not cross the neck of the occupant or be worn under the armpit of the child. Several companies manufacture a device that will lower the shoulder harness to the comfort and safety level for the smaller child.
Dr. Carol Phillips, a pediatric chiropractic authority, has discovered that often the infant carrier (which is made from molded plastic) has a large indent or hole approximately at the sacral region. From her clinical experience, she has noted that this can cause sacral strain, causing subluxation. Dr. Phillips recommends that the chiropractor inspect the carrier and, if this problem does exist, inform the parent to have a piece of foam to fill the space.
Part two will discuss the spinal hygiene and safety for the older child. For a copy of the USA Today article regarding the infant car seat recall, contact the ICPA at 1-800-670-KIDS (5437).
Claudia Anrig, DC
Clovis, California 

Monday, July 7, 2014

13 Ways to Boost Your Testosterone

13 Ways to Boost Your Testosterone

If you want to boost your natural testosterone levels, it helps to know all the best strategies — both in and out of the gym.
By Steven Stiefel; Photography by Robert Reiff / Jason Breeze / Gregory James; Models: Brian Yersky & Nancy Tremblay
Testosterone is the quintessential male hormone for building muscle mass. Having normal levels of testosterone is also crucial for a myriad of other benefits, including well-being, enhanced energy, increased libido and, potentially, improved athletic performance. Every guy should be seeking to maximize his T levels, even if muscle building isn’t his primary goal. Guys should be especially focused on boosting testosterone if they’re trying to add muscle mass.
This is especially true as you age. “The older you are, the more likely you are to have lower testosterone levels. Natural levels begin to decline for most men in their late 20s to early 30s, and these drops become even more precipitous as you advance in age,” says Gary Kehoe, CEO of Dreamspan Product Innovation, and formulator for numerous pharmaceutical companies.
Of course, once you go well above the normal range — about 300–1000 ng/dl — then you run the risk of blowback. Above this point, excess testosterone can convert to estrogen, leading to conditions such as gynecomastia (male breast growth), baldness and growth of body hair. Extremely high levels of testosterone are uncommon in natural bodybuilders, but occur frequently in those who use performance-enhancing drugs such as anabolic steroids.
On the other hand, you may be able to enhance muscle building and other positive benefits of testosterone, even if you’re in the middle of the normal range, by boosting your endogenous levels. If your test levels aren’t already maxed out due to natural production or performance-enhancing aids, then you can increase your natural testosterone production by including the following exercise, nutrition, supplementation and lifestyle strategies into your daily life.

Boost Testosterone with Exercise

You probably aren’t surprised to hear that having more muscle mass helps keep testosterone levels high. However, it’s hard to untangle which is the cause and which is the effect because high T and increased muscle go hand in hand. “Training to build muscle mass elevates testosterone, and elevated testosterone helps build muscle mass,” Kehoe says. Just make sure you don’t get too much of a good thing. When you overdo it with weights, you go past the point where you’re elevating testosterone levels. Instead, you boost stressful cortisol levels, which can reduce your muscle mass and testosterone levels. To maximize testosterone levels, include the following exercise strategies.
1) Train smart with weights.
Weight training stimulates muscle growth by tearing down muscle tissue, requiring your body to repair it. Weight training also elevates testosterone levels in the period right after you leave the gym — you may even notice this, as many men experience increased energy and libido at this time of day. Research has demonstrated that compound (multijoint) moves using heavier weights for fewer reps boosts testosterone more than other weight-and-rep schemes, Kehoe says.
>> Take action: Keep your hardcore weight-training sessions to 4–5 per week, and try to finish your workouts in 60–75 minutes. Emphasize sets where you max out at 5–8 reps, and reduce your rest periods to about two minutes between sets to include more sets in a shorter time span.
2) Keep your cardio moderate.
You want to include cardio in your training regimen for heart health and to control bodyfat. But you don’t want to perform so much that you reverse muscle gains. You may have noticed that marathoners often have very little muscle mass up top. That’s because upper-body muscle is just extra baggage that works against distance running. Overtraining your cardio can also have a detrimental effect on your muscle mass and, potentially, your testosterone levels as well.
>> Take action: Perform moderately paced cardio such as an easy jog or fast-paced walk on a treadmill. Keep sessions to no longer than 30–45 minutes, and perform no more than about four a week, especially during phases when you’re trying to add muscle mass. Bodybuilders can perform more cardio during contest phases where they’re trying to shed more bodyfat ¾just be aware that T levels may be affected.

Boost Testosterone with Nutrition

Certain dietary adjustments help you naturally boost your testosterone levels, especially in concert with the other strategies included in this article. Some foods help boost testosterone while others may suppress it, so knowing the difference is key. Implement the following dietary strategies to make sure that your food choices are boosting your testosterone levels to maximize muscle gains.
3) Consume plenty of protein.
You already know that you need protein to build muscle mass, but you may not know that consuming protein also helps boost testosterone levels. “Supplemental forms of protein such as whey or egg hydrolysates are associated with higher levels of testosterone.” Kehoe adds that diets high in protein compared to carbs have a beneficial effect on the liver and kidneys, and overall levels of testosterone. In addition to consuming supplements, also emphasize whole-food forms of protein, including dairy, eggs and meat forms such as lean beef, poultry and pork.
>> Take action: Consume at least 1 gram of protein for each pound of your bodyweight every day, and strive to get in about 30% of your total calories from protein each day. This means that a bodybuilder who consumes 4,000 calories a day should consume up to 400 grams of protein (1,200 calories) per day, well above 1 gram per pound, and more than 2 per pound for bodybuilders under 200 pounds.
4) Consume cruciferous vegetables.
You already know that vegetables are crucial for optimal health and muscle growth, but you may not know that certain vegetables may also help boost testosterone levels. “Research has shown that consuming a diet rich in cruciferous vegetables such as broccoli, cabbage, brussels sprouts, collards, watercress, kale, kohlrabi, mustard greens and bok choy may help boost testosterone levels.” Kehoe says that this is due to the phytonutrients they contain, including indoles, which help suppress estrogen.
>> Take action: Emphasize these foods in your nutrition program, striving to get at least one serving a day of cruciferous vegetables. A mix is always better than relying on one and excluding all the others, but choose those that you like best, as you’ll be more likely to consume them regularly.
5) Eat plenty of fats.
Fats such as omega-3s are important for a well-rounded healthy diet, but saturated fats, which are considered “unhealthy” by some, still have advantages, especially for bodybuilders seeking to increase testosterone levels and muscle mass. “These [saturated] fats provide the raw materials your body needs to produce hormones such as testosterone,” Kehoe says.
>> Take action: Consume 10% of your daily calories in the form of saturated fats. A bodybuilder who consumes 4,000 calories a day can consume 400 calories from saturated fats or about 45 grams per day. In addition, target 10% of your daily calories from unsaturated fat sources such as oils (olive and canola) and fatty fish (salmon) for 400 calories or 45 grams of unsaturated fats. In total, dietary fat should constitute 20% of your total caloric intake, or 800 calories (90 grams of fat).
6) Avoid alcohol.
While it’s true that small amounts of alcohol (1–2 drinks per day) may improve heart health, large amounts of alcohol consumed in binges or regularly may suppress testosterone levels. This is because too much alcohol can promote inflammation and testosterone degradation. “During the time when elevated levels of alcohol are present in the blood, production of testosterone may be impaired,” Kehoe says.
>> Take action: Keep alcohol consumption to no more than 1–2 drinks per day, enough for the health benefits without the disadvantage of severely impacting T levels.

Boost Testosterone with Supplements

Many companies have put out products that boost testosterone levels. These products often contain multiple ingredients — some literally contain more than a dozen different individual supplements that help boost testosterone through different mechanisms. Here are four of the most potent for you to seek out as stand-alones or to look for in your multiple-ingredient testosterone product.
7) Choose a testosterone product that includes cordyceps.
Cordyceps is a fungus that grows on caterpillars. Not the tastiest sounding delicacy to partake of, but this supplement, found in many testosterone boosters, not only increases testosterone levels, but also enhances energy. “Cordyceps boosts blood flow, lowers your heart rate and improves oxygen uptake,” Kehoe says. “Another benefit of cordyceps is that it attaches to the same receptor sites as caffeine.” Taking cordyceps may lead to less dependence on caffeine for energy.
>> Take action: You have two options: 1) getting in 3–9 grams of the mushrooms themselves, or 2) Take a product with 300–450 milligrams of cordyceps in its standardized extract form.
8) Try tribulus terrestris.
This is another well-studied testosterone booster that you can find as a stand-alone or in many multiple-ingredient T boosters. Supplemental tribulus terrestris comes from an herb that grows in North America and Asia, and it’s been used as a libido booster for centuries. “Tribulus terrestris stimulates your pituitary gland, releasing more luteinizing hormone, which stimulates testosterone production,” Kehoe says. The active ingredient is protodioscin, a saponin.
>> Take action: To maximize testosterone results look for products that deliver 500–2000 milligrams of furostanolic saponins per day. Whether you’re buying a stand-alone or multi-ingredient product, look for those that contain 80% total saponins and 40% protodioscin. For best results, take 2–3 doses per day, including one an hour before workouts. Take a break from all saponin products, cycling on for eight weeks, and then off for 2–4 weeks.
9) Look for Fenugreek.
Another great testosterone-boosting supplement is fenugreek, an herb from Southern Europe and Western Asia. As with the others on this list, it boosts libido and raises testosterone levels. Another advantage is that fenugreek also increases insulin release, which can help increase muscle mass after weight training. “Your body sends fenugreek through your liver so that it can balance and regulate it,” Kehoe says. This is different from many pharmaceutical forms of testosterone, which are absorbed into the body.
>> Take action: Look for products that contain 500–600 milligrams of fenugreek extract and follow label information.
10) Go with ginseng.
Ginseng is a root that’s frequently consumed in Asian foods and beverages, but it’s also a powerful nutrient that drives many healthful physiological functions. Included in the list is an increase in libido and testosterone. Ginseng directly stimulates the central nervous system and gonadal tissues, and can help facilitate erections in males. Ginseng also contains ginsenosides that increase the conversion of arginine to nitric oxide, which helps build muscle mass.
>> Take action: Look for products that provide 40–50 milligrams of ginseng extract, and take two doses per day.

Lifestyle Strategies for Increased Testosterone

One of the least understood elements of bodybuilding is the importance of your lifestyle and its impact upon the recovery and growth processes. If you bombard your body with weights every day, you’ll end up overtrained. And, if you ignore the importance of rest and recovery on the growth process, you’ll have a similar result even if your gym time isn’t excessive. Implement the following lifestyle strategies to help keep your testosterone levels high.
11) Get plenty of sleep.
Sleep not only promotes recovery from training, but it helps keep critical muscle-building hormones such as growth hormones and testosterone high. When you’re well rested, you not only have more energy, but you have higher hormone levels for better muscle-building results.
>> Take action: Get at least 7–8 hours of sleep per night, striving for the high end on days when you train harder such as when doing legs or back.
12) Schedule days off from the gym.
You’ve probably already figured out from the previous tips that you need to take a break from the gym to maximize your testosterone levels. If you’re weight training 4-5 days a week, then you aren’t lifting on the others. This scheme of work and recovery is key to maximizing testosterone.
>> Take action: Frequently, on non-workout days it’s a good idea to give your body a full day of recovery with no weights, cardio or any other stressful forms of activity. Plan at least one of these every week, Kehoe suggests. You can throw in other recovery strategies such as massage or acupuncture on rest days, which may further help boost testosterone levels by encouraging more efficient recovery.
13) Have sex regularly.
This is another chicken-and-egg scenario. “When you have sex more often, you help keep testosterone levels high,” Kehoe says. “When you have higher testosterone levels, you tend to have 3/4 or at least want — sex more often.” So, it turns out that old wives’ tale of avoiding sex before athletic performance isn’t necessarily a good idea.
>> Take action: With a partner or alone, frequent ejaculation boosts testosterone levels, which in turn works your endocrine system, helping to keep it primed. We’ll leave it up to you to determine how much action you can take.

Wednesday, July 2, 2014

Food and Addiction: The Dopamine Made Me Do It

Food and Addiction: The Dopamine Made Me Do It
by Pamela Peeke, MD, MPH, FACP

Research is uncovering a link between our lifestyle, our genes, and a means to overcome the unhealthy connection between food and addiction.

Two human behaviors explain why we’re still here: engaging in sex and consuming food. Both are inextricably linked by dopamine, the neurotransmitter associated with reward and pleasure. It’s what motivates us to read all three volumes of Fifty Shades of Grey or to inhale a plate of mom’s homemade oatmeal raisin cookies. To date, procreative activities have maintained their primal prerogative without too much deviation from nature’s blueprint. Food production and consumption, on the other hand, have fallen prey to psychosocial, cultural and environmental factors that increase our collective girth and make us more vulnerable to disease.

Researchers have recently uncovered a critical clue to help explain this problem—a link between food and addiction.

The Dopamine Connection
“I can’t get off the stuff.” “I need a hit.” “I’ve got to detox.” “Withdrawal is hell.” Fitness, nutrition and health professionals have heard this kind of addiction vernacular for years. However, we’re not talking about drugs, alcohol or cigarettes—this is about food. The big culprits are the hyperpalatables—sugary, starchy, fatty and salty foods. Is there a relationship between food and addiction? Can food products hijack the reward system in much the same way as drugs? Yes, according to newly published data and a growing chorus of scientists.

Central to this burgeoning research is the role of dopamine, the neurotransmitter that
• signals when rewards are present;
• motivates us to seek rewards;
• promotes exploring and learning about rewards; and
• maintains awareness about reward-related cues.

Cocaine and heroin target and hijack this reward system. So do appetite-controlling hormones, leading a growing number of researchers to consider obesity from the standpoint of addiction neuroscience (Dagher 2012).

Dopamine is actually dispersed throughout the brain. Ninety percent of the dopamine neurons in the ventral
tegmental area (VTA) become stimulated when we’re about to eat. The VTA reaches out to the rest of the brain via countless axons to stimulate dopamine secretion in several brain regions, including the mesolimbic and mesocortical dopamine systems. The mesolimbic system reaches into the nucleus accumbens (the site of reward, pleasure and addiction), the amygdala (where emotions are processed and remembered) and the hippocampus (a site that converts short-term memory to long-term memory) (Volkow & Wise 2005). In an effort to understand whether certain foods exert the same kind of addictive effect on the reward system as drugs, scientists have turned their attention to the reward centers in normal and overweight humans.

Leading the charge is Nora Volkow, MD, director of the National Institute on Drug Abuse. In 2001, Volkow and her team used PET scans and radioactive chemicals that bind to dopamine receptors (Wang et al. 2001). Their research revealed that obese people had far fewer dopamine receptors in the brain’s striatum, or reward center, and therefore had to eat more to experience the same reward, or “high,” as average-weighted individuals.

Did these people already have fewer receptors—predisposing them to weight gain—or did they once have a normal number of receptors, which through repeated exposure was down-regulated? The answer is both. Animal studies have shown profound down regulation of D2 receptors (dopamine receptors subtype 2) after overconsumption of a hyperpalatable junk food diet (Avena, Bocarsly & Hoebel 2012). Swiss researchers using lab rats discovered that it wasn’t weight gain per se that caused the decrease in receptors, but rather the specific consumption of hyperpalatable foods versus normal rat chow (Alsio et al. 2010).  Volkow then delved into the craving, or “wanting,” question. When people were exposed to their favorite foods but
were not allowed to eat them, a tidal wave of dopamine surged through the striatum (Volkow 2002). They said they “hungered” for their food fixes, yet they weren’t hungry at all. This is similar to what occurs in the brains of drug abusers after they watch a video of people using cocaine—or receiving any cue that hearkens back to an addictive pleasure.

Anticipation and Satisfaction
Animal studies have helped us understand this addictive cycle of anticipation and reward. When rats are given free access to a mix of the typical hyperpalatable foods available to humans—chocolate, cheesecake, bacon, sausage and other fat and processed products—the rat’s brain structure changes the same way it would if cocaine were ingested. Yale University researchers used functional MRI (fMRI) studies to prove that both lean and obese women who demonstrate addictive behavior around food show the same pattern of neural activity as a chronic drug abuser: very high levels of anticipation of their drug of choice—in this case, a chocolate milk shake—but very low levels of satisfaction after consumption (Gearhardt et al. 2011).

How does the addiction develop? Think of a river during a flood. The water charges over the banks, taking down trees and houses along the way. Something similar happens when dopamine continually floods the brain. The pathway between the VTA and the nucleus accumbens repeatedly floods with dopamine. This results in a down regulation of the total number of dopamine D2 receptors, including those in the limbic system, the site of motivation and emotions. Consequently, greater quantities of hyperpalatables are required to elicit the same level of reward. This launches a vicious cycle: increased ingestion leads only to further down regulation and a relentless, insatiable appetite.

As the D2 receptor population decreases, there is a profound change in the ability of critical brain structures to communicate effectively. In 2008, Volkow and her team found that obese people who have fewer dopamine receptors also have less activity in the prefrontal cortex (Volkow 2008). The prefrontal cortex (PFC) is responsible for handling “executive” functions—including planning, organizing, making choices and being creative—as well as for reining in impulsivity, impatience and irritability. This constitutes double trouble for the food addict. Not only is it necessary to eat more food to experience normal reward and pleasure, but it’s much more difficult to stop after the first bite. This is why stressing “moderation” to a food addict is a moot point.

Hyperpalatables = Heroin?
Is sugar as addictive as heroin or cocaine? Could that cupcake with the mile-high frosting act like crack to a
susceptible brain? Animal studies reveal that hyperpalatable diets, and sweet ones in particular, are more
rewarding—and potentially more addictive—than intravenous cocaine and heroin (Ahmed 2012).

What about withdrawal from the hyperpalatables in comparison to drugs? Substance abuse researchers note that the brain adaptations that result from regularly eating foods that layer salt, fat and sweet flavors are likely to be more difficult to change than those from cocaine or alcohol because the food-related adaptations involve many more neural pathways. Almost all of the dopamine neurons in the VTA are activated in response to food cues (Wang & Tsien 2011).

An fMRI study found that among women who tested higher for food addiction, just thinking about drinking a
chocolate milk shake stimulated greater activation in the anterior cingulate cortex, medial orbitofrontal cortex and amygdala, all areas of the brain involved in emotion, anticipation and decision making (Gearhardt et al. 2011). Rats who received highly palatable food for only 2 weeks showed a decrease in gene expression for enkephalin, a natural painkiller in the nucleus accumbens. The same changes were found in the brains of chronic morphine or heroin addicts (Kelley et al. 2003).

Lab rats with unlimited access to a high-fat, high-carbohydrate diet almost eat themselves to death. They’ll
voluntarily walk across an electrified plate and endure painful shocks in order to get their junk food hit. In one study, when rats had access to high-fat, high-carbohydrate food for only 1 hour a day, they consumed 65% of their daily calories in one sitting, continuously gorging until the food was removed. However, when the food disappeared they didn’t simply shrug their rodent shoulders and turn back to regular chow. Instead, they withdrew and curled up into a fetal position, soothing themselves with nervous hand-wringing, and becoming excessively twitchy and easily startled. They were hungry for their fix. Without it, they ended up with “the shakes” (Johnson & Kenny 2010).

Lab rats will quickly develop a tolerance for sugar, eagerly quadrupling their daily sugar consumption in 1 week. If the sugar’s taken away, the hunger for their fix is relentless and leads to withdrawal symptoms. They’ll start fighting with other rats, shaking and getting angry. Once the rats become addicted to sugar, they are far more eager to gobble up amphetamines, alcohol and cocaine in huge quantities—and they become almost instantly addicted to those substances as well. When given the choice between sugar, cocaine and alcohol, those cross-addicted rats will always choose—you guessed it—sugar (Johnson & Kenny 2010).

In humans, there’s clear evidence that habitual consumption of calorie-dense hyperpalatables elicits changes in brain responses that mirror those that occur during drug addiction. And akin to drugs, these same foods are implicated in cravings and in the perception of loss of control (Pelchat 2002). Speaking of cravings, 95% of the foods humans most crave are, not surprisingly, calorie-dense. Why do we favor calorie-dense foods? It’s about survival. When food was scarce, ingesting calorie-dense foods gave us our optimal chance of surviving. That is not the case today.

The Role of Epigenetics
When researchers from the Washington University School of Medicine in St. Louis first did a study of almost 40,000 people in the early 1990s, addictive genes appeared to have no impact on body weight. People were just as likely to be obese whether they came from a family with addiction or not. But when scientists did a follow-up study of 40,000 other people in 2001 and 2002, the picture was very different. Subjects were 30%–40% more likely to be obese if they had addiction in the family. For women, the chance was 50% greater (Finucane et al. 2011).

This upsurge in obesity was not caused by evolutionary changes to the genome. The basic genetic makeup of humanity cannot change that quickly. No, this explosive weight gain was caused by changes to the environment that switch on individual genes. Enter the exciting, newly emerging science of epigenetics (for more on epigenetics, read “Our Dynamic DNA,” by Charlie Hoolihan, in the May 2012 issue of IDEA Fitness Journal).

Epigenetics (epi meaning “around” and genetics referring to the study of genes) helps us understand how any
environmental cue—person, place or thing—can influence how our genes are expressed. If you live and participate in an active social community, with plenty of fresh food and opportunities for exercise, the genes that control your weight operate as nature intended, and you can more easily enjoy a fit and healthy body.

Conversely, here’s a scenario in which gene expression is constantly altered to the detriment of the individual. For example, take someone who starts the day in fight-or-flight overdrive: an argument with a spouse, running out the door, skipping breakfast, driving the 30-mile commute to work, getting to work hungry, dealing with a micromanaging boss and spending hours sitting glued to a computer screen. Levels of acetylcholine and cortisol, stress hormones that trigger fat storage and cravings, go through the roof. To anesthetize the pain of a stressed daily existence, it’s easy to habitually reach for “fixes,” which are often conveniently available at the office vending machine or at drive-throughs. This constant dependence on hyperpalatables not only thickens waistlines and changes brain structures; it also takes its toll on genes, changing their expression to one that supports overeating and addiction. This further reinforces the cycle (Peeke 2012).

What’s the solution? If altering genetic expression facilitates food addiction, can we reverse this messaging to promote healing and recovery? Epigeneticists believe this is possible.

Think of the genome as a book, filled with genes that make up its sentences, paragraphs and chapters. The pages of that book are filled with annotations. Some pages are bookmarked or dog-eared; others are stapled together and inaccessible. The annotations in your genetic book take the form of certain chemicals and molecules that attach themselves to the genes. Because they sit, in a sense, on top of the genome, this collection of annotations is called the epigenome.

Most cells in your body contain the entire genome; a cell in your heart contains not only the genes for a heart cell but also the genes for a liver cell, a nerve cell, a skin cell and every other kind of cell. Yet that heart cell ignores all instructions that aren’t heart cell–related. The epigenome switches certain genes off and certain genes on.

All this switching is the work of special proteins called histones that surround each gene. Histones are genetic referees, scanning every action and choice you make and switching the messages that individual genes deliver to the rest of the body. Eat junk food and your genetic “speech” or expression changes, resulting in a cascade of biological changes, including increased inflammatory processes. Eat an apple and histones order a gene to start a different cascade, resulting in improved immune function. The goals are for histones to script the healthiest messages possible and to maintain happy histones throughout life.

Epigenetics in Action: Agouti Mice
Once born, you cannot alter your genes. What’s exciting about the epigenome is that it adds possibilities. You can change genetic expression, proving that DNA is not destiny. Lifestyle choices powerfully influence genetic expression—and most important, they are passed on to children.

A striking example of this occurs in a breed of lab mouse called agouti. These mice have a unique gene—the agouti gene—that causes them to become obese and also gives them yellow fur. The mice are at high risk for developing heart disease, diabetes and cancer. Scientists have observed that among female agouti mice who have exactly the same genes, one mouse can produce obese pups with the characteristic yellow fur, while the other mother produces pups with brown fur that grow up slim.

How is this possible, and why does it matter? The answer is epigenetics. In one mouse, the agouti gene has been switched off, and so the yellow fur and obesity don’t develop in her pups. The gene is marked “do not read” because a specific molecule, called a methyl group, has been attached to it. The process is called methylation. Researchers simply supplemented this obese, yellow-furred mother’s diet with methyl donors such as vitamin B12, choline, betaine and folic acid or genistein, a phytoestrogen food in soy products. The mouse pups of this agouti mother fed the methylated food were born lean, with brown fur and at no risk for disease (Dolinoy et al. 2007).

This was a groundbreaking experiment and officially established the food–gene connection; it also helped mark the birth of epigenetics.

The Road to Recovery: An Integrative Mind-Body Approach
By harnessing the power of epigenetics, it is possible to rein in impulsivity, strengthen PFC function and recover from food addiction for a lifetime. Here are simple, proactive steps to achieve detoxification and sustainable recovery, adapted from The Hunger Fix: The Three-Stage Detox and Recovery Plan for Overeating and Food Addiction (Rodale 2012).

Stress can have a significant impact on PFC function. Studies using fMRI have shown that simply reducing stress can enhance functioning and return it to levels of nonstressed people (Brandon et al. 2010). That’s why radical stress reduction remains a top priority. Meditation is a central focus of successful addiction recovery.

Transcendental Meditation (TM) has been shown to significantly augment PFC function (Hooper 2011). When people engage in regular meditation, they release up to 65% more dopamine in the ventral striatum (Kjaer et al. 2002). One study found that these higher levels of dopamine, along with the continued practice of meditation, reduced people’s impulsiveness (Kjaer et al. 2002).  Meditation also helps prevent relapse. An fMRI study done at the University of California in San Francisco found that people who were least likely to relapse in alcoholic abstinence programs had greater brain volume and thicker cortices. They had a much easier time sticking with their sobriety. When they did fall off the wagon, they experienced less severe relapses (Durazzo et al. 2011).

Another study found that after an 8-week program, previous Mindfulness-Based Stress Reduction (MBSR) novices showed significant gains in brain size, with the most gray matter growing in the posterior cingulate cortex, the temporoparietal junction and the cerebellum. These are brain regions that help us learn and remember, stay calm, critically evaluate our thoughts and understand other people’s perspectives (H√∂lzel et al. 2011).

The bottom line. The mind plays a crucial role in reclaiming a hijacked reward system and sustaining recovery from food addiction. A strong, well-trained PFC has a better chance of helping an individual remain vigilant, make the right choices, steer clear of hyperpalatables and select fresh, whole, life-promoting foods instead.

Mouth The agouti mouse paradigm carries over to humans. The goal is to choose foods that promote health through optimal gene expression. Following are two examples to illustrate how to apply epigenetics through nutrition.

Choline figures prominently in attention and prefrontal cortex function. Studies on rats have shown that
supplementing with dietary choline can increase the nerve growth factor in the PFC, improving memory and
precision, helping reduce aging deficits and even aiding in recovery from early PFC injury (Sandstrom, Loy & Williams 2002; Tees 1999). Acetylcholine is also credited with strengthening synapses—the connections between neurons—particularly when we’re learning and using our short-term memory (Rasmusson 2000). Although our bodies generate choline, we need food sources to maintain adequate levels.

Omega-3s are used by the brain to form 60% of its fat-based cell structure. These fatty acids ensure that cell membranes will be flexible enough to letcin other nutrients. One study (Davis et al. 2010) found that rats fed a diet low in omega-3s had 20% lower levels of the omega-3 docosahexaenoic acid (DHA), which researchers found significantly reduced the density of the D2 dopamine receptors in the ventral striatal section of the brain—an area closely associated with impulsivity.

Another study found that supplementing with fish oil increased serotonin receptor activation and Brain Derived Neurotropic Factor (BDNF) production (Vines 2012). BDNF is a protein that stimulates new neuron growth in the hippocampus, which scientists believe helps improve memory and decrease anxiety and depression.

Perhaps the best way to test how omega-3s can influence our ability to calm down and focus is to look at 8- to 10-year-old boys. One placebo-controlled fMRI study found that supplementing with DHA for 8 weeks increased activity in the boys’ dorsolateral PFC significantly more than taking the placebo. The study also found a “dose response”—the more DHA the boys took, the higher their ability to concentrate, the greater the activity in their PFCs and the faster their reaction times (McNamara et al. 2010).

The bottom line. With every mouthful, an individual alters genetic expression. The stronger the PFC, the more likely the choice will be an apple and not a Twinkie®.

Regular physical activity increases the body’s production of BDNF. This, in turn, can lead to higher PFC functioning. One study in the journal Health Psychology found that kids aged 7–11 who had done more vigorous exercise—40 minutes or more, five times a week, for 3 months—had a net gain of 3.8 additional IQ points. MRIs showed that the kids’ PFC—where decision making, planning, social awareness and complex thought take place—was growing, presumably strengthening their executive function abilities (Davis et al. 2011).  Exercise is the best healthy fix because it directly regenerates D2-like dopamine receptors—similar to those linked with food addiction—in the brain, helping to rebuild the damage of past addiction and prevent it in the future (MacRae et al. 1987). And it doesn’t require a gym membership, an elliptical trainer or a set of barbells. It simply requires increasing activities of daily living. In fact, it’s been shown that a 5-minute walk around the block or 30 jumping jacks reduces the intensity of withdrawal symptoms.

One Vanderbilt University study found that 10 (30-minute) sessions of moderate treadmill walking over 2 weeks was enough to cut addicts’ marijuana smoking in half, even though the addicts were not asked to cut down and had, in fact, explicitly said they didn’t want to. Participants cut their original intake by a third even after the study was over (Buchowski et al. 2011).

Researchers believe that exercise altered the reward circuits in the brain to the point where treadmill walking took the place of cannabis. Movement became self-reinforcing, leading the addicts to need less pot to get the same high. Exercise also decreased their cravings, compulsiveness and emotional ups and downs, as well as their desperate focus on marijuana (Buchowski et al. 2011).

Most studies have found that walking is king. Indeed, one randomized controlled fMRI study published in the Proceedings of the National Academy of Sciences found that after a year of taking 40-minute walks three times a week, sedentary older adults grew their hippocampi by 2%—reversing their brains’ aging process by almost 2 years. Those who remained sedentary saw their brains shrink by almost the same amount (Erickson et al. 2011).

The bottom line. Regular physical activity facilitates neurogenesis, augments PFC function and significantly aids in relapse prevention and sustained recovery from addiction.

Beyond Food Addiction
Research on food and addiction is rapidly gathering momentum. World-class scientists are scrutinizing the
relationship between the foods we consume and their profound epigenetic effects on our mental and physical
health. Kelly Brownell, PhD, director of Yale University’s Rudd Center for Food Policy & Obesity, notes: “Whether food and addiction is a viable concept is scarcely in question. . . . Food can act on the brain as an addictive substance. Certain constituents of food, sugar in particular, may hijack the brain and override will, judgment and personal responsibility. . . . The addictive impact of food may be a contributor to the global health crises created by obesity and diabetes” (Brownell & Gold 2012).

The situation goes further than food and addiction. It’s imperative that we carefully examine the living and working environment that enables overeating and addictive behaviors. What are the persons, places, things and psychosocial stresses that foster our continued overconsumption of calorie-dense hyperpalatable foods? This is required homework that must be done to fully appreciate how to reverse this troubling trend, facilitate long-term recovery and promote a healthier lifestyle for a lifetime.