Diet and lifestyle in the management of reflux.

The First line of defense against heartburn/acid reflux should be lifestyle and diet modification and not drugs. It is also a good idea to investigate if your body is trying to tell you that you have a food intolerance or sensitivity. Is your body crying for a change? Is it crying for a certain digestive enzyme? You will not know the answer to this if your first decision is to take a drug to suppress the symptom.

There are many reasons for reflux and therefore one can explore many different options. I believe that many do not wish to change their diet and lifestyle and therefore opt to take medications. Many do so without knowing/caring about the long term cascade of negative effects this can have on your body.

Please speak to a health care professional if you have been using PPI's and antacids for a long period of time,  as this is not beneficial to your longterm health...

Proton Pump Inhibitors vs Diet in the Management of Reflux

Most clinicians know that patients who present with complaints and symptoms indicative of gastroesophageal reflux diseases (GERD) can be amongst the most challenging to diagnose since they mimic so many other conditions and, are often the most difficult to effectively treat. Symptoms indicating reflux diseases are also increasingly more commonly being diagnosed  in the clinician’s office and often directly attributed to the weakness of the gastroesophageal juncture (EGJ) which begins at the terminal end of the esophagus and beginning of the cardiac orifice of the stomach. Obesity and increased abdominal (belly) fat can cause pressure on the stomach and lead to hiatal hernia; the herniation can cause acid backflow. The EGJ serves as a physical barrier to all reflux fluids (acid, bile, pepsin etc). It’s interesting to note that are also more than one type of reflux disease:

• Gastroesophageal reflux (GERD)
  • Where the gastric contents in the stomach reflux back into the esophagus in causing typical symptoms of heartburn and/or acid regurgitation
• Non-erosive reflux disease (NERD)
  •  Characterized by reflux-related symptoms; these patients are often less responsive to PPI therapy
• Extra esophageal disease (EER) which includes respiratory or  laryngopharyngeal reflux
  • Often the result of the rapid transit of gastric contents to the esophagus, and up into the larynx, bronchi, lungs, etc

Treating GERD, according to association recommendations, should involve a stepwise approach with lifestyle modification (including weight loss) and exercise as the first step. Subsequent use of pharmacologic agents such as antacids, proton pump inhibitors (PPIs) or surgical treatment may be considered only if lifestyle modification over the course of several weeks is not successful. The goals of GERD treatment are to control symptoms, to heal esophagitis, and to prevent recurrent esophagitis or other complications. Unfortunately, too often the clinician starts the patient with pharmacological interventions and this can lead to unintended and unwanted complications later on including increased risk for C. difficile infections (CDI) which was outlined in a prior article on this site.

A recent, small, retrospective study undertaken by researchers from New York Medical College assessed the efficacy of totally dietary approach to manage reflux—specifically laryngopharyngeal reflux—in  two cohorts of patients at a New York hospital from 2010 to 2015. One cohort of 85 patients were managed with proton pump inhibitors (PPIs) plus standard reflux precautions; the other cohort of 99 patients were treated with alkaline water (pH >8.0) and a plant-based, Mediterranean-style diet plus standard reflux precautions.

Results showed after 6 weeks, 63% of the diet group and 54% of the PPI group had achieved a clinically meaningful improvement in a reflux symptom score. Additionally, the diet group had a significantly greater mean reduction in the score than did the PPI group (40% vs. 27% reduction).

Why is this Clinically Relevant?

• Reflux diseases are an increasingly common clinical finding in adults today and linked to numerous conditions including increased weight and lack of activity
• First line of therapy in managing reflux disease is lifestyle modification and exercise
  • Most clinicians and patients opt for PPIs
    • Often they are unaware of long term consequences of PPI use
  • The results of this small study support the use of plant based, Mediterranean diet as a first line management consideration in the management of reflux conditions
    • Particularly laryngopharyngeal reflux
  • This 6 week study demonstrated compared to PPIs, dietary modification is more effective at improving reflux symptoms
  • Clinicians should consider step wise approach to managing reflux diseases by first encouraging lifestyle modification and exercise before pharmacologic interventions

Link:http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2652893

Related article: http://healthcareinstituteforclinicalnutrition.com/clinical-tools/maintaining-healthy-bmi-reduces-gerd-and-subsequent-acid-suppressing-medication-side-effects-including-c-difficile-infections/

Other links: https://www.nytimes.com/2017/09/07/well/live/laryngopharyngeal-reflux-diet-ppis.html

The message of pain is all about healing...

The Message of Pain

BY MADISYN TAYLOR Both emotional and physical pain are messages that we need to stop and pay attention. When we feel pain, our first impulse is often to eradicate it with medication. This is an understandable response, but sometimes in our hurry to get rid of pain, we forget that it is the body's way of letting us know that it needs our attention. A headache can inform us that we're hungry or stressed just as a sore throat might be telling us that we need to rest our voice. If we override these messages instead of respond to them, we risk worsening our condition. In addition, we create a feeling of disconnectedness between our minds and our bodies. Physical pain is not the only kind of pain that lets us know our attention is needed. Emotional pain provides us with valuable information about the state of our psyche, letting us know that we have been affected by something and that we would do well to focus our awareness inward. Just as we tend to a cut on our arm by cleaning and bandaging it, we treat a broken heart by surrounding ourselves with love and support. In both cases, if we listen to our pain we will know what to do to heal ourselves. It's natural to want to resist pain, but once we understand that it is here to give us valuable information, we can relax a bit more, and take a moment to listen before we reach for medication. Sometimes this is enough to noticeably reduce the pain, because its message has been heard. Perhaps we seek to medicate pain because we fear that if we don't, it will never go away. It can be empowering to realize that, at least some of the time, it is just a matter of listening and responding. The next time you feel pain, either physical or emotional, you might want to try listening to your own intuition about how to relieve your pain. Maybe taking a few deep breaths will put an end to that headache. Perhaps writing in your journal about hurt feelings will ease your heart. Ultimately, the message of pain is all about healing.

Fluoride and reduced IQ

We all wish to do what is right for our health and the health of our children. Recent researchers claim the adverse affects of fluoride on unborn children. We, including our children on earth and in utero, are exposed to so many different chemicals every day. It is not surprising that we are getting sicker and sicker and kids are developing more and more sensitivities. A little body can only handle a certain amount of toxic onslaught before their bodies become overwhelmed and more and more sensitive.

Association Reported Between Fluoride and Reduced IQ

A mother's exposure to fluoride during pregnancy could lower the intelligence of her children, researchers say.

Following a group of Mexican children from the time of their mother's pregnancy to early adolescence, an international team of researchers found an association between high fluoride levels in the mothers' urine and reduced scores on the children's cognitive tests.

Contrary to the claims of fluoride activists, however, the study does not seal the case against fluoride, said first author Morteza Bashash, PhD, an assistant professor of public health at the University of Toronto in Canada.

Published September 19, 2017 in Environmental Health Perspectives, the study adds significantly to the body of data on fluoride's effects because it followed a relatively large group for more than a decade, Dr Bashash said. "This kind of birth cohort study is considered a gold standard to determine what happened over time that eventually leads to some sort of outcome.”

Studies in rodents have shown that fluoride can alter their cognition and behavior, and researchers in China have found an association between human intelligence quotient (IQ) deficits and exposure to high levels of fluoride in water, as reported in a National Research Council review.

To probe this association further, Dr Bashash and colleagues examined data from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project, a longitudinal study designed to explore the effects of toxins in Mexican children.

Two cohorts from the ELEMENT study comprised 997 mothers recruited from hospitals serving populations with low or moderate incomes from 1997 to 2001.

The women were all in at least their 14th week of gestation at the time of recruitment; planned to stay in the Mexico City area for at least 5 years; did not report a history of psychiatric disorders, high-risk pregnancies, or gestational diabetes or current use of daily alcohol, illegal drugs, or continuous prescription drugs; and were not diagnosed with preeclampsia, renal disease, circulatory diseases, hypertension, and seizures during the index pregnancy. For the current analysis, the researchers excluded mothers younger than 18 years, those without adequate urine samples, and those whose fluoride concentrations were extreme outliers.

When the children reached 4 years of age, they took the McCarthy Scales of Children's Abilities test. Between ages 6 and 12 years, they took the Wechsler Abbreviated Scale of Intelligence test.

The researchers were able to obtain 287 mother–child pairs with data for the McCarthy test and 211 with data for the Wechsler test. On both tests, an average score is between 85 and 115, with a higher score indicating better performance.

The researchers found a significant correlation between General Cognitive Index (GCI), as measured by the McCarthy test, and IQ, as measured by the Wechsler test (Spearman r = 0.55; P < .01).

They found that for every increase of 0.5 mg/L in fluoride in the mother's urine, the children's GCIs changed by a mean score of −3.76 (95% confidence interval [CI], −6.32 to −1.19).

Likewise, every increase of 0.5 mg/L in the mother's urinary fluoride was associated with a change of −2.37 in IQ (95% CI, −4.45 to −0.29).

The association remained after the researchers adjusted for child-related factors (gestational age and weight at birth, sex, being the first child, and age at outcome measurement) and maternal factors (smoking history, marital status, age at delivery, IQ, education, and cohort). The adjustments changed the decrease per 0.5 mg/L of maternal urinary fluoride in GCI to −3.15 (95% CI, −5:42 to −0:87) and changed the decrease in IQ to −2.50 (95% CI, −4.12 to −0:59).

For a subset of children with data available on socioeconomic status, maternal bone lead, and blood mercury, the researchers controlled for these variables as well and found that the association between maternal urinary fluoride and GCI and IQ did not change substantially.

The researchers found that GCI decreased with each increase in maternal urinary fluoride in a linear relationship. But the decrease in IQ only began at 0.8 mg fluoride per liter of maternal urine.

When they focused their analysis on fluoride in the children's urine, they found no significant association with the prenatal concentration of fluoride in the mothers' urine.

In addition, they found no statistically significant association between fluoride in the children's urine and their IQ. (The authors did not report on a relationship of children's urinary fluoride and GCI.)

The results justify further research, Dr Bashash said. He would like to follow the children to look for cognitive associations with fluoride as they get older, and he would like to look for other adverse events. Some colleagues are analyzing data on sexual maturation, he said.

However, whether enough evidence has accumulated to make policy recommendations, he could not say. "Decision making in medicine and public policy requires some sort of compromise and measurement of the risk and benefit," he said. "There is a big argument. We know that fluoride has some beneficial effect in preventing caries. We show that there is a potential that it has some negative impact, too. Our piece of work gives the opportunity to help policymakers to make an informed decision.”

Others were less hesitant. In a press release, the antifluoride group the Fluoride Action Network wrote that the study "confirms" that fluoride is harmful to the fetal brain.

Philippe Grandjean, MD, PhD, adjunct professor of environmental health at Harvard University in Cambridge, Massachusetts, did not go quite that far, but said it adds to the evidence for rethinking fluoridation. "I think the study is a red flag," he told Medscape Medical News. "And when you take it into consideration with the Chinese studies, I think the time is way overdue for a broad-scale reevaluation of fluoride exposure.” Other methods of preventing dental caries might be more effective, making fluoridated water obsolete, he suggested.

This study was supported by the National Institutes of Health, the National Institute of Environmental Health Sciences/the US Environmental Protection Agency, and the National Institute of Public Health/Ministry of Health of Mexico. The authors, Dr Tomar, and Dr Grandjean have disclosed no relevant financial relationships. 

Environ Health Perspect. 2017;125(9):097017.

Artificial sweeteners and higher risk to diabetes.

This may shed some light on the obesity and high rate of diabetes that we are experiencing. The  diet industry is a huge reason for the over consumption of artificial sweeteners and the biggest scam on our health and wellbeing. Avoiding added sugars in our food would be a much healthier option. I will share this study with you and let you decide what is the best choice!

Artificial Sweeteners Alter Gut Response to Glucose

LISBON, PORTUGAL — Habitual consumption of artificial sweeteners commonly found in diet drinks alters the gut's response to glucose — affecting absorption, glycemic response, and response of gut glucagonlike peptide 1 (GLP-1) — results of a small, first-in-human study in healthy volunteers indicate.

The findings were presented here at the European Association for the Study of Diabetes (EASD) 2016 Annual Meeting. 

High levels of artificial-sweetener consumption could therefore predispose people to development of type 2 diabetes, lead researcher Richard Young, MD, from the Adelaide Medical School, University of Adelaide, Australia, hypothesized.

"Two-week diet supplementation with artificial sweeteners augments glucose absorption, glycemic response to glucose, and attenuates the GLP-1 response," said Dr Young, reporting the main results of the study.

"This means that, according to the findings from this trial…artificial sweeteners [may] limit the amount of glucose that can access more distal portions of the gut and reduce glucose exposure to distal cells that release GLP-1."

Artificial Sweeteners Compared With Placebo in Healthy Subjects

"The relationship between sugar-sweetened beverages and type 2 diabetes has prompted policy changes, including the introduction of taxes on these beverages to try to reduce intake," Dr Young pointed out.

As an alternative, artificial sweeteners are used in so-called "diet" sodas and some foodstuffs, but there is ongoing controversy over whether these cause more harm than good.

Previous work by Dr Young's group has shown that switching from sugar to noncaloric-artificial-sweetened (NAS) beverages does not predict a lower risk of type 2 diabetes.

In fact, the association between NAS beverages and type 2 diabetes risk is similar to that seen with sugar-sweetened beverages, even after adjustment for adiposity and energy intake (often those with prediabetes reach for NAS as an alternative to sugar), he said.

Until this study, it was unknown whether NAS alters glucose absorption in humans, and if so, whether this adversely affects postprandial glycemic control.

Healthy volunteers were recruited and the researchers assessed the effects of diet supplementation with combined NAS (such as sucralose and acesulfame-K, often found in diet beverages) for 2 weeks in a double-blind, randomized parallel-group clinical study.

Initially, 60 subjects were screened and those who were high habitual consumers of sweeteners were excluded. Participants had a mean age of 27 years, a body mass index of 24 kg/m², and 14 were men. After an overnight fast, participants underwent an endoscopy incorporating a 30-minute intraduodenal glucose infusion (30 g/150 mL, 3 kcal/min, including 3 g of the glucose analogue 3-omethyl glucose [3-OMG]) and biopsy collection before and immediately after the intervention.

The scientists assessed the effects on glucose absorption, glycemic responses to intraduodenal glucose infusion, insulin production, and gut hormones, including glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 and GLP-2.

Taken in the form of capsules, three times daily before meals, blinded participants received either the combined NAS (n = 17), equivalent to drinking 1.2 to 1.5 L of diet beverage per day or an inactive placebo (n = 16).

Assessments were performed after participants had taken the NAS capsules or placebo for 2 weeks. At this time, subjects had their response to glucose tested, examining glucose absorption, plasma glucose, and levels of insulin and gut peptides.

Glucose Absorption and Glycemic Response Increased With Sweeteners

With respect to glucose absorption, the two groups showed similar absorption patterns at study start in response to enteral glucose.

But "after 2 weeks of NAS supplementation, there was increased glucose absorption that was significant at 90 to 120 minutes [after start of glucose consumption]. We showed that sweeteners do augment the uptake of glucose," reported Dr Young. There was a 20% difference between glucose absorption in the placebo and NAS-supplemented group (P ≤ .05).

The two groups had similar prestudy glycemic responses to enteral glucose, but NAS supplementation increased plasma glucose levels by 24% compared with placebo (P < .05).

For GLP-1, which acts to limit the rise in blood glucose after meals, the two groups were once again well-matched in response to enteral glucose prior to NAS supplementation.

But after the 2 weeks of supplementation, "the subjects who consumed sweeteners had a lower risk of GLP-1 response to enteral glucose," reported Dr Young. "Those individuals who received supplementation showed a 34% attenuated GLP-1 response (P < .05) compared with placebo.

"This response possibly reflects reduced glucose exposure to more distally located L-cells," he added.

The GLP-2, GIP, and insulin responses to enteral glucose were similar between participants on artificial sweeteners and placebo groups, although GLP-2 and insulin were lower 40 and 60 mins after the glucose challenge, respectively, in the NAS group (37% for both vs baseline, P ≤ .05).

Findings Provide Impetus for Larger Studies in This Area

The findings highlight "the potential for these responses in habitual consumers of artificial sweeteners and support the concept that artificial sweeteners could reduce the body's control of blood sugar levels, exaggerating postmeal glucose levels, which could predispose them to developing type 2 diabetes," Dr Young remarked.

He also noted that the results provided an impetus to perform larger studies and look at the mechanisms responsible. "We are doing this by looking at cells collected in this study as well as looking at the microbiome," he said, with a view to the next steps in his work.

Commenting on the results, session attendee Viktor Jörgens, MD, former executive director of EASD, from Dusseldorf, Germany, said it was a "brilliant study."

He remarked, "Because less glucose goes to the L cells, these cells make less GLP-1, and this is the reason these individuals have less insulin and higher glucose. I believe this study has enough power to say that this is indeed the mechanism, and it works this way."

Dr Young has declared no relevant financial relationships. 

European Association for the Study of Diabetes (EASD) 2016 Annual Meeting. September 14, 2017, Lisbon, Portugal. Abstract 193

Words have power to heal or to hurt...

Our words have the power to heal us or hurt us and others. How we communicate with ourselves can and usually is related to old patterns learned over time and thus we have the power as conscious being to pay attention and shift those vibrations to attract a better healthier life...

Here is an piece by Madison Taylor that once again hits home for me....

Healing Past Hurt

BY MADISYN TAYLOR We can create positive change by choosing not to use these words and phrases as we come across them in our vocabulary. There are many troubling phrases in our language that we use without considering their full meaning simply because they have been accepted into common knowledge. Even as our ideals progress, our language maintains some phrases from our past that no longer serve us, for example: Boys don't cry; good child; boys will be boys; problem child; illegitimate child; and many more. While these phrases may be used without harmful intent, they are inherently negative. Children can be especially sensitive to such phrases, which may stay with them their whole lives, adversely affecting their self-image and wounding their self-esteem. We can create positive change by choosing not to use these words and phrases as we come across them in our vocabulary. It is challenging to examine our habits in terms of the words we use to express ourselves, but it is also exciting. Language is an area where we can exercise our free will, creating positive change in the world around us by simply choosing carefully the words we use. It may seem like a small thing, but our words have a rippling effect, like a stone thrown in a pond. People naturally pick up on the way other people speak, consciously or unconsciously changing the way they speak in response. We don't need to actively try to influence people; it happens without our even thinking about it. All we have to do is choose to be more conscious ourselves, putting to rest words and phrases that are outmoded, insensitive, or harmful. We can also exercise our creativity by creating new phrases that carry positive and loving energy to replace the old ones. You may already have some ideas about phrases you'd like to transition out of your language, and now that you're thinking about it you may come across many more. As you consciously decide not to use these phrases, you may feel lighter and more joyful, knowing that you have chosen to drop baggage that was handed down to you from a less conscious time. As you do so, you elevate the language for future generations who would no doubt thank you if they could.

Sound Healing....

I love this Article by Madison Taylor on sound healing....Everything I wish to say and share in a short succinct manor......ENJOY! Sound Healing

BY MADISYN TAYLOR When the vibrations of our physical and spiritual bodies are out of harmony it can cause disease. Everything in the universe is in a constant state of vibration, including our bodies. Sound is vibration that can be translated by the delicate structures of our inner ear, but it moves more than just those tiny receptors. It is part of the spectrum of energy vibrations that affect us on the mental, physical, and spiritual levels. Long ago shamans recognized the power of sound when they first used chants and drumming to heal people. In ancient Egypt, Greece, and India, the use of sound and music for healing was a highly developed sacred science. Sonic vibration has been one way of experiencing the energy of the universe for much of humanity's history. When the vibrations of our physical and spiritual bodies are out of harmony it can cause disease. Sound healing gently massages the molecules back into the right places, clearing blockages and restoring harmony. Ancient healing systems such as Chinese medicine and Indian Ayurveda associate specific musical notes with subtle-energy systems of the body, such as in yoga where particular notes of music correspond to each of the seven chakras. In Tibet, priests have long used bells and bowls over and around the body to tune and clear the energy centers. Chimes and tuning forks are other tools that have been used to heal not only the body but the energy in a room as well. Knowing that sound has the power to heal, we should also try to remember that sounds from modern life can have a negative affect. Choosing silence over discord may help us maintain a state of equilibrium. As we seek soothing and harmonizing sounds to surround us, we may be doing more than creating a balm for the noise of the world. We may actually be performing an act of self-healing that connects us with one of the most basic vibrations of the universe.

Random acts of kindness

Today I have heard the message of kindness twice...

Kindness to ourselves can and is sometimes the hardest. It is said that loving oneself is selfish even narcissistic but that is not true. Narcissists do not love themselves.
Loving yourself is imperative to be able to love others. Even saying, "Oh, I really love myself when I do that" makes you cringe a little doesn't it. Yet, it is easy to say that about another.

The absence of love is fear and fear wrecks havoc within your life and body. Good health depends on you to start allowing more love in. Allowing more light into your life. Do not fear the darkness, just allow it and then bring in more light. This will dispel the fear/darkness and help you see clearly. It will also raise the frequency within your cells which in turn heals.

I am encouraged by the words of Anita Moorjani and Matt Kahn to do random acts of kindness for others, but most of all to do a random act of kindness for myself. Why? so that I can send a clear message to the Universe that I matter, and that I am just as important as all the others I am kind to.

I will heed the message I have so clearly received and start by performing random acts of kindness every day. And like the little kids do when handing out treats...."one for you and one for me."