Issues

Will Non-GMO Foods Be Less Nutritious?

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The Unintended Consequences of the Proposed Non-GMO Labeling Laws

Author: Dr. Stephen Chaney

CerealPost Foods recently announced that their Grape Nuts cereal will be completely non-GMO. General Foods followed suit by announcing that their Original Cheerios will also be non-GMO. That’s good news, right?

Maybe, but it turns out that the new non-GMO Grape Nuts will no longer contain vitamins A, D, B12 or riboflavin, and the amount of riboflavin in a serving of Cheerios decreased from 25% of the daily recommended value (DV) to 2% of the DV.

The cereal manufacturers claim that their new cereals are more wholesome, but one nutrition expert said “The new products are arguably less healthy given their lower vitamin content.”

I’ve never been one to claim that throwing a few vitamins into a serving of cereal turns it into a nutrition powerhouse, but the decreased vitamin content of the new non-GMO cereals does raise a few questions.

  • Why were the vitamins removed?
  • Did it have anything to do with the cereals being non-GMO?
  • Does this mean that the non-GMO processed foods of the future will be less nutritious than the foods they replace?

The cereal manufacturers were mum when asked these questions, so we will need to rely on some scientific sleuthing and a bit of intuition to get the answers.

The Flaw in The Proposed Non-GMO Labeling Laws

I first discussed this topic a few months ago in a “Health Tips From The Professor” article titled “When is GMO Non-GMO?” I received a lot of irate comments from people who take every word on the non-GMO websites and videos as the gospel truth. (The professor has never been one to shy away from controversy when he sees claims that aren’t based on good science.)

However, I think my article was misunderstood by some of my readers, so let me review my conclusions briefly:

  • There are definitely environmental concerns around the widespread use of GM crops – especially those that allow heavy pesticide and herbicide usage.
  • There are potential health concerns related to the consumption of unprocessed GM foods and proteins derived from GM foods – although those heath concerns have been blown way out of proportion in the media.

If the proposed Non-GMO labeling laws stopped there, they would be scientifically justified. But they go one step further by requiring that processed foods labeled as non-GMO cannot contain any ingredient obtained from a GM source. There is no scientific justification for this.

  • Nutrients (sugars, oils & vitamins) derived from GM sources are chemically and biologically indistinguishable from those same nutrients derived from non-GMO sources.

The intentions of the proposed non-GMO labeling laws are good, but whenever you go beyond what good science supports there are often unintended consequences – such as the vitamin-depleted non-GMO cereals that the food manufacturers have just announced.

Will Non-GMO Foods Be Less Nutritious?

Non-GMOTo understand the answer to that question, let’s look at what probably happened to the vitamins in the non-GMO cereals.

In today’s world many vitamins are purified from genetically modified microorganisms – bacteria & yeast that have been modified to overproduce certain vitamins. In evaluating the significance of that statement, here are a few facts to consider:

1)     We have gotten vitamins from these sources for many years.

    • B vitamins have been obtained from yeast for at least a hundred years.
    • A significant portion of the vitamins we absorb on a daily basis are made by bacteria in our gut.

2)     The only difference today is that these microorganisms have been genetically modified to overproduce the vitamins.

3)     These are naturally sourced vitamins.

  • The microorganisms are the same ones that have provided these vitamins for generations.
  • The enzymes used by the microorganisms to make the vitamins are the same.

4)     There is no downside to the use of GM organisms as a source of natural vitamins.

    • There is no environmental risk from the use of these GM microorganisms. They don’t contain any dangerous genes that could wreak havoc if they escaped from the food processing plants.
    • Because the purified vitamins are indistinguishable from those obtained from non-GMO sources, there are also no health risks.

5)     The advantage of using these GM organisms is clear. It substantially lowers the cost of vitamins and allows them to be used in the mass market – for example, in popular breakfast cereals.

6)     Most food manufacturers can’t simply use non-GMO sourced vitamins and raise their prices.

    • A recent poll showed that 53% of Americans prefer non-GMO foods, but only 11% are willing to pay more for those foods

What Does the Future Hold?

Even though they are scientifically flawed, the proposed non-GMO labeling laws will probably become the law in several states in the near future. (Good science has never played much of a role in political decisions.)

Currently, there simply aren’t enough non-GMO vitamins available to supply the mass market – even if price were no concern. So, in the short term, many non-GMO processed foods are likely to be less nutritious than the foods they will replace – as we just saw with Grape Nuts and Cheerios.

However, most people feel that American ingenuity and the law of supply and demand will eventually result in a bigger supply of reasonable priced non-GMO vitamins. When that happens non-GMO processed foods will be just as nutritious as the older GM versions.

However, at this point nobody knows how long that will take.

The Bottom Line:

1)     There is a scientific basis for environmental and potential health concerns regarding genetically modified whole foods and the protein extracted from these foods.

2)     However, proposed non-GMO labeling laws would require that a processed food be labeled as genetically modified if it contains any nutrient purified from a genetically modified organism.

3)     There is no scientific justification for this requirement. Purified vitamins from GM and non-GM microorganisms are chemically and biologically indistinguishable. Furthermore, the GM microorganisms used to produce the vitamins pose no environmental or health risks.

4)     Non-GMO vitamins (vitamins prepared from non-GMO microorganisms) are currently in short supply and are very expensive compared to vitamins prepared from GM microorganisms.

5)     Consequently, the unintended consequence of these proposed non-GMO labeling laws will likely be that many of the new non-GMO processed foods will contain fewer vitamins and, therefore, will be less nutritious than the foods they replace – at least in the short term. The new non-GMO Grape Nuts and Cheerios may be just the tip of the iceberg.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are Toxic Chemicals Lowering Our IQ?

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Is Chemical Brain Drain A Pandemic?

 Author: Dr. Stephen Chaney

In a past issue of “Health Tips From the Professor” I examined the evidence suggesting that toxic chemicals in the home could cause childhood asthma. That is alarming because asthma can predispose individuals to other diseases and affects quality of life.

Confused ChildBut, what if that were only the tip of the iceberg? For example, a recent headline stated: “More Toxic Chemicals [In Our Environment] Are Damaging Children’s Brains”. If that headline is true, it’s downright scary.

The authors of this study suggested that toxic chemicals which are abundant in our environment can cause decreases in IQ and aggressive or hyperactive behavior in children – and that those changes may be permanent.

The Study Behind The Headlines

The paper that generated the headlines (Grandjean & Landrigan, The Lancet Neurology, 13: 330-338, 2014) was a review of the literature, not an actual clinical study.

Based on published clinical studies, the authors identified 12 chemicals commonly found in the environment as developmental neurotoxins (toxins that interfere with normal brain development) based. [If you would like to find out what those “Dirty Dozen” chemicals are and where they are found, click here.]

This finding compares with 6 developmental neurotoxins that they were able to identify in a similar study in 2006.

The authors were not claiming that the number or amount of toxic chemicals changed between 2006 and 2014. They were saying that science has advanced to the point where we can classify six more chemicals that have been in our environment for years as developmental neurotoxins.

Even more worrisome, the authors postulate that many more environmental neurotoxins remain undiscovered.

Are Toxic Chemicals Lowering Our IQ?

To answer that question, you need to look at some of the studies they cited in their review. For example:

  • Elevated blood lead levels in children are associated with as much as a 7 point decrease in IQ (Lamphear et al, Environmental Health Perspectives, 113: 894-899, 2005).
  • Elevated fluoride levels in drinking water are also associated with as much as a 7 point decrease in IQ (Choi et al, Environmental Health Perspectives, 120: 1362-1368, 2012).

The effects of many of the toxic chemicals on IQ were difficult to quantify, but the authors estimated that exposure of US children to just 3 of the chemicals (lead, methymercury and organophosphate pesticides) was sufficient to lower their average IQ by 1.6 points.

What Are The Potential Consequences?

The authors spoke of the environmental neurotoxins they identified as representing a “silent pandemic of a chemical brain drain” that could cost the US economy billions of dollars.

One of the blog posts I read on this topic summarized the consequences in a very graphic manner. It said:

If one child’s IQ is reduced by 5 points, it doesn’t appear to make a big difference.  For example, that child might be:

  • A little slower to learn
  • A little shorter of attention
  • A little less successful at tests and at work

That might result in $90,000 in lost lifetime earnings

However, if the average IQ of every child in the US were decreased by 5 points, the effect becomes significant:

  • Only half as many members of the next generation would be “intellectually gifted”.
  • Twice as many of the next generation would be “intellectually impaired”
  • Lost productivity could be in the billions

Of course, statements like that are a bit over the top. Drs. Grandjean and Landrigan did not claim that the net effect of the chemicals they identified was a 5 point drop in IQ. Nor did they claim that all US children were affected equally.

Still, it’s enough to make you think.

Are Toxic Chemicals Causing Behavior Problems?

Angry boy portraitThe authors cited numerous studies linking the chemical neurotoxins they identified to aggression and hyperactivity. But perhaps the most compelling reason to suspect that environmental chemicals may be affecting brain development is the spiraling incidence of developmental disorders such as autism and ADHD. For example:

  • Autism has increased by 78% since 2007 and now affects 1 of 88 eight year old children.
  • ADHD has increased by 43% since 2003 and now affects 11% of children age 4-17.

Some of this increase could be due to better diagnosis of these conditions, but nobody believes that all of it is due to improved diagnosis. The authors claim that much of this increase is likely due to environmental exposure to the kinds of developmental neurotoxins they identified.

Is The Science Solid?

This is a difficult area of research. You can’t do the gold standard double-blind, placebo-controlled clinical trial. Nobody in their right mind would give one group of children toxic chemicals and the other group a placebo.

The studies cited in this paper were mostly population studies. Basically this means that they compared children with exposure to certain toxic chemicals to a control group that was as similar as possible to the first group except that their exposure to the toxic chemicals was less.

The limitation of this kind of study is obvious. We are usually comparing children from different locations or of different backgrounds. We almost never know if we have controlled for all possible variables so that the groups are truly identical.

As a consequence it becomes important to ask how many studies come to the same conclusion. For some of the toxic chemicals, such as lead, methymercury and organophosphate pesticides, the weight of evidence is very strong. For some of the newer additions to their list of developmental neurotoxins, it is pretty clear that the chemicals have neurotoxic properties, but the significance of those effects on the developing human brain are hard to quantify at this point.

The Bottom Line:

1)     A recent review claims that there is a good scientific basis for classifying at least 12 environmental chemicals as developmental neurotoxins that are likely to reduce IQ and contribute to behavioral problems in US children. [If you would like to find out what those “Dirty Dozen” chemicals are and where they are found, click here.]

2)     The science behind the claims in this review is solid, but not iron-clad.

3)     However, there are times when we need to simply ask ourselves: “What if it were true?” The consequences of lowered IQ and developmental behavioral problems are so significant that it may not make sense to wait until we have unassailable scientific evidence before we act.

4)     We all need to be guardians of our personal environment. But, it is not easy. The “Dirty Dozen” chemicals identified in this study come from many sources:

  • Some are industrial pollutants. For those, we need lobby for better environmental regulation.
  • Some are persistent groundwater contaminants. For those we need to drink purified water whenever possible.
  • Some are insecticides and herbicides used in agriculture. For those we need to buy organic, locally grown produce when feasible.
  • Some are found in common household products and furnishings. For those we need to become educated label readers and use non-toxic products in our home whenever possible.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

The Dirty Dozen

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Environmental Toxins That Affect Brain Development

 Author: Dr. Stephen Chaney

 In a recent review, Drs. Grandjean and Landrigan (The Lancet Neurology, 13: 330-338, 2014) identified 12 toxic chemicals which are abundant in our environment and are developmental neurotoxins.

These are all chemicals that damage brain development. They can cause decreases in IQ and aggressive or hyperactive behavior in children – and that those changes may be permanent.

Let’s look at these developmental neurotoxins and where they are found.

The Dirty Dozen

In their review Grandjean & Landrigan identified 6 developmental neurotoxins that were known in 2006, and 6 more chemicals that have been confirmed to be developmental neurotoxins between 2006 and 2023.

Developmental Neurotoxins Known in 2006 and their sources:

  • Lead
    • Main Sources: paint, gasoline, solder and consumer products such as toys & jewelry
    • Current status: Lead has been banned in paint since 1978 and from gasoline since 1996. Millions of houses still contain lead paint. Other current sources are inexpensive toys and costume jewelry imported from China and other countries without tight regulations.
    • The EPA estimates that 1 million children in the US are affected by elevated lead levels.
  • Methylmercury
    • Main Sources: discharges into air & water from coal-burning power plants, mining, pulp & paper industries.
  • Polychorinated biphenyls (PCBs)
    • Main Sources: transformers and many commercial products
    • Current status: Banned in 1979, but continues to be a common environmental contaminant because this group of chemicals is very long-lived.
  • Arsenic:
    • Main Sources: extraction of metals from rock (smelting), algaecides, herbicides, pesticides and pressure-treated wood.
    • Current status: Pressure treated wood banned in 2003 for residential use. Still found in some playgrounds and older buildings.
  • Toluene:
    • Main Sources: gasoline. It is also a solvent for paints, paint thinners, spot removers, adhesives, antifreeze, & some consumer products like fingernail polish removers.
    • Current status: Common in consumer products. Read labels and make sure windows are open if you use.

Developmental Neurotoxins Identified Since 2006 and their sources:

  • Manganese
    • Main Sources: municipal wastewater discharge, emissions generated during alloy, steel & iron production, emissions from burning of fuel additives
  • Flouride
    • Main Sources: naturally elevated in groundwater in certain regions, added to municipal water supply, most bottled beverages and toothpaste.
    • The American Academy of Pediatrics has warned that children drinking fluoridated water, fluoridated beverages, using fluoridated toothpaste and receiving fluoride treatments for their teeth may be receiving excess fluoride.
  • Chlorpyrifos
    • Main Sources: insecticide
    • Current status: Banned for use in homes in 2001. Still one of the most widely used insecticides in agriculture.
  • DDT
    • Main Sources: insecticide
    • Current status: Banned for use in this country in 1972. DDT and its breakdown products still found in our water supply. DDT still in use in agriculture and insect control in some countries.
  • Trichloroethylene (TCE)
    • Main Sources: widely used in dry cleaning fabrics, the textile industry and metal degreasing
    • Current status: Found in groundwater due to discharge from factories and dry cleaners.
  • Polybrominated diphenyl ethers (PBDEs)
    • Main Sources: flame retardants – used in building materials, electronics, mattresses & household furniture, plastics, polyurethane foams & textiles.
    • Current status: Readily leached into the environment. Found in dust, water, food & human breast milk

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

Does Obesity Begin In Kindergarten?

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Is Obesity Caused By Bad Genes Or Bad Lifestyle?

 Author: Dr. Stephen Chaney

 In past issues of “Health Tips From the Professor” I have shared some common sense weight loss tips. But what if it is all for naught? What if there is nothing you can do about your weight?

Fat ChildYou may have seen the headlines suggesting that obesity in kindergarten is a very strong predictor of obesity later in life. If so, you are probably wondering what that means for your kids or grandkids – and what it means for you. You are probably asking questions like:

  • Should you be worrying about that your toddler’s baby fat?
  • What can you do as parents and grandparents to protect the ones you love from a lifetime of obesity and all of the health challenges that involves?
  • Is there anything you can do about overweight and obesity? Are some people just fated to be obese from childhood on?

What Does the Study Actually Show?

This was a very well done study. It followed 7738 children of all socioeconomic classes who were enrolled in kindergarten (mean age 5.6) in the US in 1998 and followed them through the 8th grade (mean age 14.1) (Cunningham et al, New England Journal of Medicine, 370: 403-411, 2014).

When the children entered kindergarten, 12.4% of them were obese, and another 14.9% of them were overweight. By the time they reached the 8th grade 20.8% were obese and 17% were overweight. Those results didn’t make the headlines. They are similar to many previous studies.

The results that made the headlines were:

  • Overweight 5 year olds were 4 times more likely to become obese by age 14 than normal weight 5 year olds.
  • 87% of obese 8th graders (14 year olds) had a body mass index above the 50th percentile in kindergarten, and 75% had a body mass index above the 70th percentile.
  • Only 13% of overweight 8th graders had been normal weight (<50th percentile) in kindergarten, and only 13% of the normal weight 8th graders had been overweight in kindergarten.

These results are fully consistent with earlier studies showing that overweight toddlers are likely to become overweight teens, and overweight teens are likely to become overweight adults. What was unique about this study (and generated the headlines) was the precision of the statistics.

Does Obesity Begin In Kindergarten?

The answer to that question is clearly yes. However, the more important question is what message we, as responsible health advocates, should be sharing with the general public. Let me break that down to some of the most important questions that you are probably asking.

Is Obesity Caused By Bad Genes Or Bad Lifestyle?

Bad GenesTaken on face value, the results of this study might seem to suggest that genetics is the primary cause of obesity. However, if that is the message we convey to the public, it is likely to simply fuel the perception that most overweight individuals are genetically destined to be obese. There is nothing they can do about it. So, why even bother trying?

However, the authors of the study also noted that the percentage of children aged 6 to 11 who are above the 95% percentile of weight has increased 4-fold between 1963 and 2000. Genetics does not change in a mere 37 years (37 generations maybe). That 4-fold increase in severe childhood obesity is clearly driven by lifestyle changes over the past 30 or 40 years.

While nobody knows the exact percentages, a reasonable interpretation of recent research in this area might be:

  • 10-15% of us are genetically destined to be obese. There is little we can do to change our weight, but a healthy lifestyle can significantly reduce our risk of disease.
  • 10-15% of us are genetically predestined to be lean no matter what we eat (Yes. Your suspicions are true). Once again, lifestyle has relatively little influence on our weight, but a healthy lifestyle can significantly reduce our risk of disease.
  • The other 70-80% of us are genetically predisposed to become obese if we adapt the typical American lifestyle. For most of us lifestyle choices can make a big difference in our weight as well as our health.

So the answer to this question is BOTH. For most of us, obesity is caused by bad genes AND bad lifestyle.

When Should We Intervene?

You probably already know that any extra fat cells we develop in childhood never go away. They are always with us, looking for those extra calories they can store as fat.

This study suggests that by the time we are in kindergarten, the die may already be cast. Those extra fat cells may have already developed.

And, for many people, the time to intervene may be even sooner. This study also showed that birth weight plays an important role as well. Children who weighed 9 pounds or more at birth were 2-fold more likely to be obese in kindergarten than children who weighed less than 9 pounds at birth.

Once again, a small percentage of overweight babies is due to genetics, but it is lifestyle choices during pregnancy that lead to the majority of overweight babies.

The authors of the study noted that most public health initiatives (school lunch programs, lifestyle education programs, etc.) are targeted at school aged children. The authors went on to say that by then it may be too late to have any significant effect on the incidence of obesity in our children.

They suggested that we need to place a stronger emphasis on influencing lifestyle changes that affect the weight of babies at birth and are likely to influence whether or not they become obese by the time they reach kindergarten.

That’s not the realm of public health policy. That’s our responsibility.

What Should We Do?

If You Are Pregnant:

  • The old adage “You are eating for two” was never true.
  • Aim for an extra 150 calories during the 1st trimester, 300 during the 2nd and 3rd trimesters (That’s 1 or 2 servings of healthy foods).
  • Aim for little or no weight gain during the 1st trimester and a total of 20-26 pounds during the last two trimesters (a bit less if you are overweight).

If You Have a Young Child Who Is Overweight:

  • Don’t restrict calories. Restricting calories can stunt growth and interfere with normal mental and physical development.
  • Encourage your kids to exercise rather than watching TV and playing video games. You may need to set the example, and that’s a good thing for you as well as for them.
  • Provide your kids with a healthy diet. For most kids, that means more fruits and vegetables and less sugary beverages, fruit juices, and processed snack foods. That may simply mean that you don’t bring those kinds of foods into your house. Again, that would probably be a good thing for everyone in the family.

I know some of you are saying “My kids won’t eat healthy stuff”. Let me give you my take on that.

When I was a kid, my mom had a pretty simple policy. If I didn’t like what she cooked, I didn’t have to eat it. I could simply wait until the next meal – when she would be serving the same kinds of healthy foods again.

I got the message pretty quick. It wasn’t eat healthy or eat junk food. It was eat healthy or go hungry. I decided early on that healthy was better than hungry.

Now, let me step down from my soapbox and summarize.

The Bottom Line:

1)     The latest research suggests that if a child is overweight by kindergarten, they are likely to be overweight for the rest of their lives. So if you want to spare your kids and grandkids  from a lifetime of obesity, you want to intervene early.

2)     A small percentage of those kids are destined to be obese no matter what they do. However, for the vast majority of them obesity can be prevented by a healthy lifestyle.

3)     If you are pregnant, don’t “eat for two”. That is terrible advice. If your pre-pregnancy weight is stable (neither increasing or decreasing), you only need to add a serving or two of healthy foods to your diet during pregnancy. Check with your doctor about the amount of weight gain that is right for you and follow their advice.

4)     If you have a young child who appears to be overweight, don’t restrict their calories. Instead, provide them with healthy food choices and encourage them to exercise.

5)     Finally, if you have been overweight since childhood, don’t despair. For most of us obesity is a combination of genetic predisposition and lifestyle choices. You can’t your genes, but you can change your lifestyle.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Fish Oil Really Snake Oil?

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Does Fish Oil Reduce Heart Disease Risk?

Author: Dr. Stephen Chaney

Fish OilOne of my readers recently sent me a video titled “Is Fish Oil Just Snake Oil?” and asked me to comment on it. The doctor who made the video claimed that the most recent studies had definitively shown that omega-3 fatty acids, whether from fish or fish oil, do not decrease the risk of heart attack, stroke or cardiovascular death. He went on to say that the case was closed. There was no point in even doing any more studies.

My reader, like many of you, was confused. Wasn’t it just a few years ago we were being told that clinical studies have shown that omega-3 fatty acids significantly reduce the risk of heart disease? Hadn’t major health organizations recommended omega-3 fatty acids as part of a heart health diet? What has changed?

The answer to the first two questions is a resounding YES, and “What has changed?” is THE story.  Let me explain.

Fish Oil And Heart Disease Risk In Healthy People

If we look at intervention studies in healthy people (what we scientists refer to as primary prevention studies) the results have been pretty uniform over the years. In a primary prevention setting, fish oil cannot be shown to significantly reduce the risk of heart disease (Rizos et al, JAMA, 308: 1024-1033, 2012).

That’s not unexpected because it is almost impossible to show that any intervention significantly reduces the risk of heart disease in healthy populations. For example, as I pointed out in recent Health Tips From the Professor (“Do Statins Really Work?” and “Can An Apple A Day Keep Statins Away?”) you can’t even show that statins significantly reduce heart attack risk in healthy populations.

If you can’t prove that statins reduce the risk of heart attacks in a healthy population, it should come as no surprise that you can’t prove that fish oil reduce heart attacks in a healthy population. To answer that question we need to look at whether fish oil reduces the risk of heart attacks in high risk populations.

Fish Oil And Heart Disease Risk In Sick People – The Early Studies

Most of the early  studies looking at the effect of fish oil in patients at high risk of cardiovascular disease (what we scientists refer to as secondary prevention studies) reported very positive results.

For example, the DART1 study (Burr et al, Lancet, 2: 757-761, 1989) and the US Physician’s Health Study (Albert et al, JAMA, 279: 23-28, 1998) reported a 29% decrease in total mortality and a 52% decrease in sudden deaths related to heart disease in patients consuming diets rich in omega-3 containing fish.

Even more striking was the GISSI-Prevenzione study (Marchioli et al, Lancet, 354: 447-455, 1999; Marchioli et al, Eur. Heart J, 21: 949-952, 2000; Marchioli et al, Circulation, 105: 1897-1903, 2002). This was a very robust and well designed study. It looked at the effect of a fish oil supplement providing 1 g/day of omega-3 fatty acids on the risk of a second heart attack in 11,323 patients who had survived a non-fatal heart attack within the last 3 months – a very high risk group.

The results were clear cut. Over the next 3.5 years supplementation with fish oil reduced overall death by 15% and sudden death due to heart disease by 30% compared to a placebo. And, if you looked at the first 4 months, when the risk of a second heart attack is highest, the fish oil supplement reduced the risk of overall death by 41% and sudden death by 53%.

The authors estimated that treating 1,000 heart attack patients with 1 g/day of fish oil would save 5.7 lives per year. That is almost identical to the 5.2 lives saved per 1,000 patients per year by the statin drug pravastatin in the LIPID trial (NEJM, 339: 1349-1357, 1998).

No wonder the American Heart Association said that patients “could consider fish oil supplementation for heart disease risk prevention.”

Fish Oil And Heart Disease Risk In Sick People – The Latest Studies

Heart Health StudyHowever, the most recent studies have been uniformly negative. For example, the ORIGIN trial (Bosch et al, NEJM, 367: 309-318, 2012) treated 12,536 patients who were considered at high risk of heart disease because of diabetes or pre-diabetes with either 1 g/day of fish oil or a placebo. This was also a robust, well designed study, and it found no effect of the fish oil supplement on either heart attacks or deaths due to heart disease.

Similarly, a recent meta-analysis looking at the combined effects of 14 randomized, double-blind, placebo-controlled trials in patients at high risk of heart disease found no significant effect of fish oil supplements on overall deaths, sudden death due to heart disease, heart attacks, congestive heart failure or stroke (Kwak et al, Arch. Int. Med., 172: 686-694, 2012).

No wonder you are confused by all of the conflicting studies. You must be wondering: “Is the American Heart Association wrong?” “Are fish oil supplements useless for reducing heart disease risk?”

What Has Changed Between The Early Studies & The Latest Studies?

When a trained scientist sees the outcome of well designed clinical studies change over time, he or she asks: “What has changed in the studies?” It turns out that a lot has changed.

1)     In the first place the criteria for people considered at risk for heart attack and stoke have changed dramatically. Not only has the definition of high cholesterol” been dramatically lowered, but cardiologists now treat people for heart disease if they have inflammation, elevated triglycerides, elevated blood pressure, diabetes, pre-diabetes or minor arrythmia.

For example, the GISSI-Prevenzione study recruited patients who had a heart attack within the past three months, while the ORIGIN study just looked at people who had diabetes or impaired blood sugar control. While both groups could be considered high risk, the patients in the earlier studies were at much higher risk for an imminent heart attack or stroke – thus making it much easier to detect a beneficial effect of omega-3 supplementation.

2)     Secondly, the standard of care for people considered at risk for heart disease has also changed dramatically. In the earlier studies patients were generally treated with one or two drugs – generally a beta-blockers and/or drug to lower blood pressure. In the more recent studies the patients generally receive at least 3 to 5 different medications – medications to lower cholesterol, lower blood pressure, lower triglycerides, reduce inflammation, reduce arrhythmia, reduce blood clotting, and medications to reduce the side effects of those medications.

Since those medications perform many of the beneficial effects of omega-3 fatty acids, it is perhaps no surprise that it is now very difficult to show any additional benefit of omega-3 fatty acids in patients on multiple medications.

The bottom line is that we are no longer asking the same question. The earlier studies were asking whether fish oil supplements reduce the risk of heart attacks or cardiovascular death in patients at high risk of heart disease. The more recent studies are asking whether fish oil supplements provide any additional benefits in a high risk population that is already on 3-5 medications to reduce their risk of heart disease.

However, the people who are writing the headlines you are reading (and the videos you are watching) are not making that distinction. They are pretending that nothing has changed in the way the studies are designed. They are telling you that the latest studies contradict the earlier studies when, in fact, they are measuring two different things.

Is Fish Oil Really Snake Oil?

Was the doctor who made the video “Is Fish Oil Just Snake Oil?” correct in saying that omega-3 fatty acids are ineffective at reducing the risk of heart disease? The answer is yes and no.

If you take the medical viewpoint that the proper way to treat anyone at the slightest risk of heart disease is with 3-5 medications – with all of their side effects, the answer seems to be pretty clear cut that adding fish oil to your regimen provides little additional benefit.

However, that is not the question that interests me. I’d like to know whether I can reduce my risk of heart attack and cardiovascular death by taking omega-3 fatty acids in place of those drugs – as the original studies have shown.

I’m sure many of my readers feel the same way.

The Bottom Line

  • Studies performed prior to 2000 have generally shown that fish oil supplements reduce the risk of a second heart attack in patients who have previously had a heart attack. One study even suggested that they were as effective as statin drugs at reducing heart attack risk in this population.
  • Recent studies have called into question the beneficial effects of fish oil supplements at reducing the risk of heart disease. However, these studies were performed with lower risk patients and the patients were on 3-5 medications to reduce their risk of heart attack or stroke.
  • The recent studies are no longer evaluating whether fish oil supplements can reduce the risk of heart disease. They are asking whether they have any additional beneficial effects for people taking multiple medications. That’s a totally different question.
  • So ignore the headlines saying that fish oil is snake oil. If you are content taking multiple medications to reduce your risk of heart disease, it is probably correct to say that omega-3 fatty acids provide little additional benefit.
  • However, if you are interested in a more holistic, drug-free approach to reducing your risk of heart disease, I still recommend omega-3 fatty acids as part of a heart healthy diet, as does the American Heart Association.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Stop Carpal Tunnel Syndrome Pain Naturally

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Five Stretches That Relieve the Symptoms of Carpal Tunnel Syndrome

Author: Julie Donnelly, LMT

Carpal Tunnel SyndromeHave you ever said in a half-joking voice, “I never felt these aches and pains before, I must be getting old?”  You aren’t getting old. You are just experiencing the results of repetitive strain injury to the muscles that you use every day.

When you use a muscle in the same manner over and over it eventually shortens.  However it is still attached to the same place and the now-shorter muscle pulls on the insertion point until it hurts.  The taut muscle can pull so hard that the joint can’t even move freely!

Perhaps you’ve been told that you have bursitis or tendonitis, when the only thing that’s happening is a muscle is pulling hard on a joint.  If the pain is in your wrist or you have numbness in your fingers you may even be told that you have carpal tunnel syndrome, and too often this will lead to unnecessary surgery or a long series of potentially dangerous drugs to stop the pain.

Whether the repetitive strain is caused by your job, your sport, or you simply overuse your hands by doing the same repetitive motion for hours at a time, hand and wrist pain can stop you short!  The pain of repetitive strain injuries can ruin the quality of your life.

Current Treatments for Hand and Wrist Pain and Numbness

Until now the initial treatments for hand and wrist pain and numbness were:

  • Wear a brace
  • Take anti-inflammatory drugs
  • Stop the repetitive motion, even if it is caused by your job
  • Go for hours of physical therapy

If unsuccessful you will be told that you need a surgical procedure that has a 50/50 chance of success and may have serious side effects. Those are not good odds, especially when it means that the negative result could have serious impact on your daily life and may even end your career!

The good news is that 95% of wrist pain and numb fingers is actually caused by tension and small knots in the muscles from your neck and shoulder, all the way down your arm and into your hand.  Release the tight muscles, and the pressure is removed from your nerve and your wrist.

Stop Carpal Tunnel Syndrome Pain Naturally

Five Exercises You Can Do At Home to Prevent Carpal Tunnel Syndrome

  1. Open your fingers up wide, really stretching out your hand and then rotate your wrists in large circles.  You will feel the stretch in your hands and your forearms.
  1. Stretch your forearm muscles by holding your arm straight out, putting your flat hand so it is pointing up, and then taking your opposite hand to pull it back.  Then reverse the movement by bending your wrist so your flat hand is pointing down and using your opposite hand to enhance the bend.
  1. Roll your shoulders in a circle going up and back.
  1. Lean your head back so you are looking at the ceiling, than slightly turn so your cheekbone is facing the ceiling.  Feel the stretch along the side of your neck.
  1. Pull your shoulders all the way down toward the floor while tilting your head to the side.  You’ll get an even better stretch by then slightly turning your head in several directions.

If you stretch your muscles frequently, you’ll be amazed at the relief you will feel.  Plus, you’ll have better flexibility and more strength.

The good news is that you can also learn how to self-treat each of the muscles that cause hand/wrist pain and numbness.  You have excellent options before even considering drugs that have potential dangerous side-effect, or surgery that causes scar tissue in your wrist.  It’s worthwhile to explore all of your options so you can get back to living your life to its fullest – without pain.

© Julie Donnelly 2013

Julie Donnelly, LMT is a recognized authority in repetitive strain and sports injuries, chronic pain, and carpal tunnel syndrome. Author of Carpal Tunnel Syndrome-What You Don’t Know CAN Hurt You and Treat Yourself to Pain-Free Living and a series of Stop Pain FAST! books that focus on separate conditions.

Julie is the developer of the breakthrough consumer product The Julstro Self Treatment System for Repetitive Strain Injuries of the Hand and Wrist. She lectures and teaches self-treatment workshops worldwide.

Visit: http://www.CarpalTunnelResults.com and http://www.julstro.com for more information about repetitive strain injuries.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Does An Apple A Day Keep Statins Away?

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The Latest On Diet And Heart Health

Author: Dr. Stephen Chaney

AppleIn a previous “Health Tips From the Professor” I talked about how difficult it has been to prove that statins significantly reduce the risk of heart attack or cardiovascular deaths in a low risk population group. Now let’s look at the other side of the coin – lifestyle change –and ask how effective lifestyle change is at reducing the risk of cardiovascular disease.

You’ve all heard the saying “An apple a day keeps the doctor away”. It dates back to Victorian England. It was the public health message of the day – much simpler and more concise than our current food guide plate.

A prominent British doctor and his research team recently decided to see how accurate that saying really was. But they took their study one step further. They compared the effectiveness of an apple a day versus a statin a day at reducing the risk of cardiovascular deaths (Briggs et al, British Medical Journal, 3013;347:f7267 doi: 10.1136/bmj.f7267).

The results of that comparison may surprise you.

Does An Apple A Day Keep Statins Away?

They used the data from the Cholesterol Treatment Trialist meta-analysis to estimate the effectiveness of statin drugs at reducing cardiovascular deaths. They used the data from the PRIME comparative risk assessment model to estimate the effectiveness of apple a day at reducing cardiovascular deaths.

They asked what would happen if each of them were the primary intervention for the entire British population over 50 who were not currently taking statin drugs (17.6 million people).

They assumed a 70% compliance rate for both interventions. In simple terms that means they assumed that 70% of the population would actually do what their doctors told them. (Patients must be more compliant in England than in the US).

The results were interesting. They estimated that:

  • Giving a statin drug each day to 17.6 million people would reduce the number of cardiovascular deaths by 9,400.
  • Giving an apple each day to the same 17.6 million people would reduce the number of cardiovascular deaths by 8,500 (not significantly different).

But when they looked at side effects and cost the two interventions were significantly different.

  • Giving a statin drug each day to 17.6 million people would also cause some significant side effects. The authors estimated that it would lead to:
    • 1,200 excess cases of severe muscle pain and weakness
    • 200 excess cases of rhabdomyolysis (muscle breakdown, which can lead to irreversible kidney failure)
    • 12,300 excess cases of diabetes
  • On the other hand, there are no known side effects to an apple a day.
  • The statin intervention would cost an estimated $295 million. In the case of apples, you would presumably be substituting a more healthy food for a less healthy food so there would be little or no net cost.

And the 70% compliance rate is probably wildly optimistic. Some experts have estimated that up to 50% of patients discontinue their statin medications within the first year because of side effects or cost.

Is There A Scientific Basis For Those Estimates?

Of course, we all know that the “apple a day…” saying was never meant to be taken literally. It was just a simple way of saying that a good diet will reduce the risk of disease.

It turns out that there was another major study on the effect of dietary fiber on reducing the risk of cardiovascular disease in the very same issue (Threapleton et al, British Medical Journal, 2013;347:f6879 doi: 10.1136/bmj.f6879). It was a meta-analysis that combined the data from 22 previously published studies.

This study showed:

  • For every 7 g/day increase in dietary fiber the risk of both heart attacks and cardiovascular disease decreases by 9% (7 grams of dietary fiber could come from one serving of whole grains plus one serving of beans or lentils or from two servings of fruits or vegetables).
  • For every 4g/day of fruit fiber (equivalent to one apple) the risk of heart attacks decreases by 8% and the risk of cardiovascular disease decreases by 4%.
  • The numbers are similar for every 4 g/day of vegetable fiber.

Another recent study showed that consumption of 75 g/day of dried apple (equivalent to two apples a day) lowered total cholesterol by 13% and LDL-cholesterol by 24% in post-menopausal women (Chai et al, J. Acad Nutr Diet, 112: 1158-1168, 2012). That’s comparable to the cholesterol reduction achieved with statin drugs.

The Bottom Line

  • If you have not previously had a heart attack and are at relatively low risk, something as simple as adding an apple a day (in place of less healthy foods) may just as effective as statin drugs at reducing your risk of cardiovascular death without the side effects and cost of the drugs.
  • This is not really new information. For years both the American Heart Association and the National Institutes of Health have recommended that Therapeutic Lifestyle Changes (weight loss, healthy diet and exercise) should be tried BEFORE drug treatment to reduce the risk of heart disease.
  • So if you want to avoid statins, tell your doctor that you are willing to make the needed lifestyle changes to reduce your risk of heart disease and stick with it. Lifestyle changes are hard, but clinical studies clearly show they can often be just as effective as drug therapy, without the cost and side effects.
  • Don’t misunderstand me. I’m not advocating avoiding statin drugs if they are absolutely necessary. If you have had a heart attack or are at high risk of heart disease, it is clear that statins can save lives. Even here I would recommend talking with your physician about incorporating therapeutic lifestyle change into your regimen. It may allow them to minimize the dose, and therefore the side effects, of the statin drugs.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

The Fundamentals of Stretching

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When, Why & How To Stretch

Author: Kai Fusser, MS

StretchingEverybody knows (even non-athletes) that stretching can be beneficial for physical performance.

But there is a lot of misinformation and confusion on why, when, what and how to stretch. Also, many confuse stretching with a warm up and vice versa.

A warm up is exactly what it says, warming up your body, the muscles, through dynamic movements. It is the increased blood flow that warms up your muscle. Stretching on the other hand is either static or performed very slowly, which is just the opposite of a warm up.

When Should You Stretch?

 One issue is that the muscles don’t like to be stretched when they are cold. They will hardly be able to be “stretched” or lengthened as they are not supple and don’t like to “let go”. Therefore, the stretch is being transferred to the ligaments and tendons, and that’s not what we want.

So I recommend only stretching if your muscles are really warmed up, ideally after a workout or some physical activity. By the way, there is no evidence that stretching will prevent injury before physical activity, yet plenty of evidence that a warm up will.

Why Should You Stretch?

So why should we stretch? It’s to prevent your muscles from tightening after hard physical activity and giving the muscles the signal to let go which is controlled by your nervous system.

I do not recommend to use stretching alone to improve flexibility or range of motion. Stretching alone will not strengthen the muscles as there is no stabilizing of the joints required. This is better achieved through full range of motion exercises that involve a load on the muscles by using weight or resistance.

The Fundamentals Of Stretching

There are many different ways to stretch – from completely static (holding) to PNF (short term tension then letting go). I suggest you try different ways and see what feels best.

I prefer stretching against a rubber band, i.e. attached to a solid object and leaning against it or pulling the extended leg towards the chest with a rubber band. Rubber bands will “dampen” the pull on the muscles and can help with a more progressive and controlled stretch.

So stretch! Just know when and why.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Does Leucine Trigger Muscle Growth?

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What Does The Perfect Post-Workout Protein Shake Look Like?

Author: Dr. Stephen Chaney

 Post-Workout Protein ShakeIf you work out on a regular basis and read any of the “muscle magazines”, you’ve seen the ads. “Explode Your Muscles.” “Double Your Gains.” They all claim to have the perfect post-workout protein shake, backed by science. They all sound so tempting, but you know that some of them have to be scams.

I told you about some of the sports supplements to avoid in a previous “Health Tips From the Professor”. In this issue, I’m going to ask “What does the perfect post-workout protein shake look like?”

For years athletes have been using protein beverages containing branched chain amino acids after their workouts to maximize muscle gain and recovery. There was some science behind that practice, but the major questions were unanswered. Nobody really knew:

  • How much protein is optimal?
  • What kind of protein is optimal?
  • What amount of branched chain amino acids is optimal?
  • Are some branched chain amino acids more important than others?
  • Does the optimal amount of branched chain amino acids depend on the amount of protein?

As a consequence, after workout protein supplements were all over the map in terms of protein source, protein amount, branched amino acid amount and type of branched chain amino acids. Fortunately, recent research has clarified many of these questions.

How Much And What Kind Of Protein Do You Need?

  • Recent research has shown that the optimal protein intake for maximizing muscle gain post workout is 15-20 gm for young adults (Katsanos et al, Am J Clin Nutr 82: 1065-1073, 2005; Moore et al, Am J Clin Nutr, 89: 161-168, 2009) and 20-25 gm for older adults (Symons et al, Am J Clin Nutr 86: 451-456, 2007).
  • More protein isn’t necessarily better. The effect of protein intake on post workout muscle gain maxes out at around 25 gm for young adults and 30 gm for older adults (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009).
  • Whey protein is the best choice for enhancing muscle gain immediately after a workout. Other protein sources (soy, casein, chicken) are better choices for sustaining muscle gain over the next few hours.

Does Leucine Trigger Muscle Growth?

  • It turns out that leucine is the only branched chain amino acid that actually stimulates muscle protein synthesis (Am J Physiol Endocrinol Metab 291: E381-E387, 2006). And protein is what gives muscles their strength and their bulk.
  • Recent research has shown that 2-3 gm of leucine (2 gm for young adults; 3 gm for older adults) is sufficient to maximize post workout muscle gain if protein levels are adequate (Am J Physiol Endocrinol Metab 291: E381-E387, 2006).

Unanswered Questions About Optimizing Muscle Gain Post-Workout

  •  Do the other branched chain amino acids play a supporting role, or is leucine alone sufficient to drive post-workout muscle gain?
  • Can leucine still help maximize post-workout muscle gain if protein intake is inadequate? If so, how much leucine is needed?

Does Leucine Enhancement Improve Low Protein Shakes?

Lrg Extension ExercisesA recent study (Churchward-Venne et al, Am J Clin Nutr, 99: 276-286, 2014) seems to answer those two questions. The authors compared the effect of 5 protein-amino acid combinations on muscle protein synthesis in 40 young men (~21 years old) following unilateral knee-extensor resistance exercise. The protein shakes contained:

  • 25 gm of whey protein, which naturally contains 3 gm of leucine (high protein)
  • 6.25 gm of whey protein, which naturally contains 0.76 gm of leucine (low protein)
  • 6.25 gm of whey protein with 3 gm of leucine (low protein, low leucine)
  • 6.25 gm of whey protein with 5 gm of leucine (low protein, high leucine)
  • 6.25 gm of whey protein with 5 gm of leucine + added isoleucine and valine (the other branched chain amino acids). (low protein, branched chain amino acids).

The results were clear cut:

  • The high protein shake (25 gm of protein) was far superior to the low protein shake (6.25 gm of protein) at enhancing post workout protein synthesis. This is consistent with numerous other published clinical reports.
  • Adding 3 gm of leucine to the low protein shake had no effect on post-workout protein synthesis, but 5 gm of added leucine made the low protein shake just as effective as the high protein shake at supporting post-workout protein synthesis.

In short, leucine can improve the effectiveness of a low protein shake, but you need more leucine than if you chose the high protein shake to begin with.

  • Adding extra branched chain amino acids actually suppressed the effectiveness of leucine at enhancing post-workout protein synthesis. These data suggest:
    • Leucine probably is the major amino acid responsible for the muscle gain reported in many of the previous studies with branched chain amino acids.
    • If the other branched chain amino acids play a supporting role in the muscle gain, the quantities that occur naturally in the protein are probably enough. Adding more may actually reduce the effectiveness of leucine at stimulating muscle gain.

While this is a single study, it is consist with numerous other recent clinical studies. It simply helps clarify whether leucine can increase the effectiveness of a low protein supplement. It also clarifies the role of branched chain amino acids.

Also, while this study focused on protein synthesis, numerous other studies have shown that optimizing post-workout protein and leucine intake results in greater muscle gain (for example, Westcott et al., Fitness Management, May 2008)

The Bottom Line

Research on post-workout nutrition to optimize muscle gain from the workouts has come a long way in recent years. It is now actually possible to make rational choices about the best protein supplements and foods to support your workouts.

  • If you are a young adult (17-30), you should aim for 15-20 gm of protein and about 2 gm of leucine after your workout.
  • If you are an older adult (50+), you should aim for 20-25 gm of protein and 3 gm of leucine after your workout.
  • If you are in between you are on your own. Studies haven’t yet been done in your age group, but it’s reasonable to assume that you should aim for somewhere between the extremes.
  • If you are getting the recommended amounts of whey protein, the leucine level will also be optimal. If you are using other protein sources you may want to choose ones with added leucine.
  • The research cited above shows that you can make a low protein supplement effective by adding lots of leucine, but that’s going to require artificial flavors and sweeteners to cover up the taste of that much leucine. I would recommend choosing one that provided adequate protein to begin with.
  • While the research in this area is still somewhat fluid, I would avoid protein supplements with added branched chain amino acids other than leucine. If the paper I cited above is correct you probably get all of the other branched chain amino acids you need from your protein and adding more may actually interfere with the effect of leucine on muscle gain.
  • I’d pretty much forget all the other “magic ingredients” in post-workout supplements. If you’re a novice there is some evidence that arginine and HMB may be of benefit, but if you have been working out for more than 6 months, the evidence is mixed at best. As for the rest, the clinical studies are all over the map. There’s no convincing evidence that they work.
  • Whey protein is the best choice for enhancing muscle gain immediately after your workout. Soy and casein are better choices for sustaining muscle gain over the next few hours. If you’re looking at meat protein, chicken is a particularly good choice. Four ounces of chicken will provide the protein and leucine you need to sustain muscle gain for several hours.
  • Even if you are not working out, recent research on dietary protein and leucine has important implications for your health. In a recent “Health Tips From the Professor” I shared research showing that optimizing protein and leucine intake helps to increase muscle retention and maximize fat loss when you are losing weight.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

What Is Ergonomics?

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How Do You minimize Workplace Injuries?

Author: Dr. Pierre DuBois

 woman at deskYou’re not doing anything stressful at work. You’re just sitting at your desk in front of a computer screen all day. Yet you come home every night with a backache, headache or sore wrist.

If this describes you, your doctor or chiropractor has probably told you that you need to improve your workplace ergonomics. That’s easy for them to say, but what is ergonomics and how do you improve it?

What Is Ergonomics?

The term ergonomics stems from the Greek words ergon (work) and nomos (laws). According to the US Occupational Safety and Health Administration (OSHA), ergonomics is defined as “the science of fitting workplace conditions and job demands to the capabilities of the working population.”

Good ergonomics in the workplace is key to maintaining our body’s proper health and function, and it can have a major effect on the quality of our work.

Ergonomics involves the physical stressors in our workplace as well as related environmental factors. For example, physical stressors are any activities that put strain on the bones, joints and muscles. These can involve things such as performing repetitive motions, vibrations, working in awkward positions and actions using excessive force.

Environmental factors that contribute to bad ergonomics include loud noise, bad indoor air quality and improper lighting.

Why Is Workplace Ergonomics Important?

Bad ergonomics can increase the risk of injury to the musculoskeletal system, causing conditions such as carpal tunnel syndrome, tendonitis and neck and back pain, as well as creating a range of other health problems, including sick building syndrome, eyestrain and hearing loss.

However, there are steps you can take to improve your workplace ergonomics that can help reduce health risks.

How Can You Improve Workplace Ergonomics?

Cumulative trauma disorders, such as carpal tunnel syndrome and tendonitis, are caused by repetitive motions such as typing. To prevent this, set up your computer workstation in a way that allows your hands and wrists to be in as neutral a position as possible.

When sitting at your desk, your chair should be at a height where your eyes are level with the top of your computer screen, and your arms are at a 45-degree angle for typing. Ensure that your wrists are not angled up or down or to the left or right.

If your desk is too high to keep your forearms straight, raise the height of your chair and use a footrest to keep your feet from dangling. Your chair should be at a height where your feet are flat on the floor or on a footrest, while keeping your knees just slightly higher than the level of the seat.

The chair should provide some light support to your lower back (use a pillow, if necessary) while allowing you to move freely. The arms of the chair should support your lower arms while letting your upper arms remain close to your torso.

To reduce eyestrain, adjust ambient lighting to diminish glare and adjust the brightness and contrast until your eyes are comfortable reading. If you are working in a noisy area, use earplugs or headphones that cut ambient sound (but not set loud enough to damage your hearing!).

Good ergonomics also involves taking frequent breaks. Move around, get some fresh air and focus your eyes on things at varying distances.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor