Empathy as Part of Integrative Health Dr. Erika D. Nelson

An integrative approach to health focuses on the goal of treating the mind, body and spirit all at the same time. In addition to conventional Western medicine, alternative or complementary therapies can play significant roles in maintaining health. These include everything from herbal remedies, acupuncture and massage to fitness, meditation and yoga. Scientific research is now investigating another important aspect of integrative health that centers on developing a more meaningful relationship between the patient and their practitioner.
I recently attended a presentation at the Scripps Natural Supplements conference given by Dr. David Rakel, M.D., Associate Professor and Medical Director of the University of Wisconsin Integrative Medicine Program. During his talk entitled “The Clinician as Intervention: Lessons for the Dietary Supplement Prescriber,” Dr. Rakel shared data from two recently published studies on treating the common cold, one looking at the effectiveness of Echinacea and the other the effectiveness of practitioner empathy.^1,2 In the first study, treating patients with self-reported colds with the widely used remedy Echinacea resulted in a shorter duration of one-half day and a 10% reduction in overall severity compared to placebo (neither improvement was significant; p>0.05).¹
CARE-ing Versus Standard Care
In the second study, patients with self-reported colds were randomized to either a “standard” practitioner-patient interaction, consisting of the basics such as relevant past medical history, a focused physical exam and diagnosis, or an “enhanced” practitioner-patient interaction in which physicians interacted according to the PEECE method: (P) Positive prognosis, (E) Empathy, (E) Empowerment, (C) Connection and (E) Education. Patients were then asked to assess their clinical encounter by filling out the Consultation and Relational Empathy (CARE) questionnaire.² The CARE questionnaire assesses ten areas of consultation, whether the clinician(s):

1. Made them feel at ease
2. Allowed them to “tell their story”
3. Really listened
4. Were interested in them as a whole person
5. Fully understood their concerns
6. Showed care and compassion
7. Were positive
8. Explained things clearly
9. Helped them take control
10. Helped create a plan of action

In this second study, the changes in cold severity and duration were not significantly different between the “standard” and “enhanced” interaction groups. However, patients who rated their clinical encounters with perfect CARE scores experienced a significant reduction in cold duration, by almost a full day, and a trend toward improved severity (16%) when compared to those who rated their encounters with less than perfect CARE scores. Together, the two studies suggest that when a patient with a cold experiences a truly empathetic interaction with their physician, their health tends to improve as much and perhaps more than if they were being treated with a well-known cold remedy.

A Spoonful of Empathy

While Dr. Rakel was speaking to an audience of primarily physicians, nurses and other healthcare professionals, I felt that the points he was making could be applicable for anyone interested in improving the health of others through an integrative approach. For me, the take-home message was this: the manner in which I introduce a dietary supplement to another person is extremely important. If I take the time to compassionately listen to and connect with the other person, keep a positive attitude and help that individual take control over his or her own health, the chance of that person having a beneficial experience can increase.
Maybe this isn’t a novel concept to you, but I was thrilled to learn about new, well-controlled scientific research supporting such a simple and cost-effective (read: FREE!) approach to integrative health. Here’s hoping that my next prescription reads, “Take two doses of empathy and call me in the morning!”
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¹B. Barrett et al., Echinacea for treating the common cold. Ann Intern Med. 2010; 153:769–777.
²D.P. Rakel et al., Practitioner empathy and the duration of the common cold. Fam Med. 2009; 41(7):494–501.
Dr. Nelson is a Research Scientist at Mannatech, Incorporated.

Nutritional Supplements and Athletic Performance

Nutritional Supplements and Athletic Performance

Dr. Stephen Boyd

In a departure from statements made in the past, the International Olympic Committee (IOC) now agrees that nutritional supplements can boost athletic performance. In the IOC Consensus Statement on Sports Nutrition 2010 issued from its head office in Lausanne, Switzerland, on October 27, 2010, the organization concedes that some supplements may enhance performance for some athletes. In the past, the IOC had warned athletes against using nutritional supplements.
While the statement did not comment on specific products, it did say, “..supplements that provide essential nutrients may be a short-term option when food intake or food choices are restricted due to travel or other factors” and that they should be “used in accordance with current evidence under the guidance of a well-informed professional.” The statement went on to say, “Athletes contemplating the use of supplements and sports foods should consider their efficacy, their cost, the risk to health and performance, and the potential for a positive doping test.” Of course, the Olympic Committee correctly was not suggesting that supplements replace a nutritious diet. The statement began by saying, “Diet significantly influences athletic performance. All athletes should adopt specific nutritional strategies before, during and after training and competition to maximize their mental and physical performance.”

Recommendations with More in Common?

What is interesting is that it would appear that the IOC is moving ever so slightly toward the recommendations of the Council for Responsible Nutrition (CRN) with respect to achieving optimal wellness. The three pillars of wellness according to the CRN are diet, appropriate supplementation and exercise. It goes without saying that optimal physical and athletic performance is related to optimal wellness, which in turn, is related to optimal nutritional intake. I would suggest that the “other factors” mentioned above in the IOC statement in support of appropriate supplementation include poor food choices, something that studies have shown to be prevalent in the majority of the population.
Other issues raised in the IOC statement are the possible risks involved in taking supplements. These include health and doping test risks. The statement also emphasizes that supplements should be used in accordance with current evidence. These issues raise important topics for discussion. How do you decide which supplements to choose based on concerns for safety and evidence of effectiveness? These issues are in fact investigated if nutritional supplements are studied in human clinical trials that follow current Good Clinical Practice (cGCP) guidelines. In following cGCP guidelines, clinical researchers must not only measure a product’s effectiveness, they must also investigate and document the product’s safety.
Athletes are ultimately responsible for any consequences associated with the supplements they choose in terms of regulations. The best first step they can take is to make sure the supplements they choose are not formulated to contain any substances banned by anti-doping agencies. Nutritional products that are formulated in this fashion are generally safe for use without fear of failing any sport doping test.
Mannatech’s clinical research program follows current Good Clinical Practices (cGCP) guidelines for documenting both product effectiveness and safety for general use. This is in keeping with Mannatech’s stated policy of using science to develop safe, natural and innovative dietary supplements. For more details, go to the website MannatechScience.org.
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Stephen Boyd, BS, MD, PhD, FRSM, is Senior Director of Medical Affairs for Mannatech, Incorporated.

Probiotic Research

Increase in Probiotic Research

Nutrition researchers have been paying attention, investigating a means to modulate GI tract function and support health. Probiotic research has recently become a hot topic, as can be seen in this chart showing an overview of studies published over the past five decades.

Mannatech has been in the forefront of developing supplements that support GI tract health.  Ambrotose^® complex, launched in 1996, was a prebiotic supplement ahead of its time.* Both Ambrotose complex and Advanced Ambrotose^® powder have been shown, in in vitro studies using human colonic bacteria, to exert positive prebiotic effects.*^(7,8) GI-ProBalance™ slimsticks were formulated to work together to enhance the effectiveness of Ambrotose products.*
Jane Ramberg is the Director of Product Science for Mannatech, Incorporated.
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Note: Probiotics are bacteria, taken orally, that are designed to colonize and support the health of the GI tract.
Prebiotics are oligosaccharides and polysaccharides that support the growth of healthy bacteria in the GI tract.
Reference List
1.   Simpson S, Ash C, Pennisi E, Travis J. The inner tube of life. The gut: inside out. Science 2005;307:1895–925.
2.   Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature 2010;464:59–65.
3.   Xu J, Gordon JI. Honor thy symbionts. Proc Nat Acad Sci USA 2003;100:10452–9.
4.   Dethlefsen L, Huse S, Sogin ML, Relman DA. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing. PLoS Biol 2008;6:e280.
5.   Turnbaugh PJ, Hamady M, Yatsunenko T, et al. A core gut microbiome in obese and lean twins. Nature 2008.
6.   Larsen N, Vogensen FK, van den Berg FW, et al. Gut Microbiota in Human Adults with Type 2 Diabetes Differs from Non-Diabetic Adults. PLoS ONE 2010;5:e9085.
7.   Sinnott RA, Ramberg J, Kirchner JM, et al. Utilization of arabinogalactan, aloe vera gel polysaccharides, and a mixed saccharide dietary supplement by human colonic bacteria in vitro. Int J Probiotics Prebiotics 2007;2:97–104.
8.   Marzorati M, Verhelst A, Luta G, et al. In vitro modulation of the human gastrointestinal microbial community by plant-derived polysaccharide-rich dietary supplements. Int J Food Microbiol 2010;139:168–76.

* This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

www.healthyscience.net

Gastrointestinal Research Is Becoming More than a Gut Feeling by Jane Ramberg

I have a gut feeling …www.healthyscience.net
… that many of us underestimate the important role our gastrointestinal tract plays in our overall health. If you have been following the literature, however, you will have noticed an explosion of scientific interest in this area—research made possible with the development of creative tools that can explore the inhospitable territory of our gut, our “inner tube of life.” ⁽¹⁾ Much of this research has focused on the 1,000 trillion microorganisms (primarily bacteria) that live there. Dubbed the “dark matter of life” by the renowned scientist E.O. Wilson, these microorganisms outnumber the cells of our bodies 10:1 and, as a group, their genes outnumber ours 100:1.⁽²⁾ They have been tough to study because they thrive in an environment that defies replication in the laboratory. So, scientists have resorted to genetic techniques to obtain their population “fingerprints.”
The emerging science is uncovering the exquisitely complex symbiotic (mutually beneficial) relationship that we share with these microorganisms.^(1,3) The benefit for them, of course, is a nice, warm, safe place to live! And what do we gain? We’re learning that these gut bacteria do a lot more than their long-acknowledged tasks of breaking down complex molecules that human enzymes can’t digest and producing biotin and vitamin K. Their functions are much more sophisticated: producing hormones that direct fat storage; regulating intestinal physiology, development and function; “training” the immune system, and preventing the growth of harmful, pathogenic bacteria. We’ve also learned that gut microbial ecosystems can be perturbed by antibiotics,⁽⁴⁾ associated with changes in body weight⁽⁵⁾ and correlated with blood glucose levels.(6)

Innovation—Real Food Technology® Solutions

A key to the ultimate success of social entrepreneurship is the creation of an innovative new technology for solving an existing global problem. As the lack of proper nutrition has become epidemic in both industrialized and developing countries, the supplementation of essential nutrients has become a critical strategy for protecting health.
Until recently, synthetically made vitamins and inorganic minerals have provided the only source for standardized levels of these essential nutrients. Synthetic vitamins are made from coal tar or petroleum; and due to their low cost they are the primary choice of manufacturers of both nutritional supplements and enriched foods. Inorganic minerals, either mined or by-products of a chemical process, also provide an inexpensive source for supplementation, but do not have the solubility of minerals found in food.

Fruits and vegetables make vitamins in their tissues and then bond them to various minerals, fats, polysaccharides, amino acids and other vital Phytochemicals to create what is called a food matrix. Minerals become more soluble in food and this matrix of nutrients provides the co-factors required by the body for the proper absorption and utilization of all essential nutrients. It has become clear that the human body was designed to obtain its nutritional requirements from food.
As a result, food based health products, such as “super” juices, have proliferated the market in recent years. On the surface they look like a good alternative to synthetically made supplements. Unfortunately, when scientifically analyzed, super juices have been shown to contain less than one percent of the recommended daily requirement of the most vitamins and minerals. This has left consumers the poor choice of standardized but synthetically made supplements, or non-standardized and nutritionally deficient food-based supplements. Major relief organizations around the world have had almost no alternative to inexpensive synthetic supplements or synthetically enriched grain-based cereals.

A Healthy Dose of Reality

Mannatech, Incorporated, the pioneers of Real Food Technology® Solutions has now developed a preferable new option to this challenge.
In 2007 Mannatech filed international patents on the nutrition industry’s first supplement to provide standardized and nutritionally effective levels of natural and plant-sourced vitamins, minerals and Phytochemicals, called PhytoMatrix®. To address the needs of the world’s most vulnerable children, Mannatech utilized this same patented technology to specially formulate PhytoBlend™ powder, a product made available exclusively to not-for-profit organizations fighting malnutrition in developing countries around the world.

Fruits/Veggies not as vitamin-rich as in the past, says new data

Fruits, Veggies Not as Vitamin-Rich as in Past, Says New Data

Larger Fruits and Vegetables Mean More Plentiful but Less Potent Bounty

By MEGAN CARPENTER March 1, 2006 — Fruits and veggies aren't what they used to be, new data suggests.

Of the 13 major nutrients found in fruits and vegetables, six have declined substantially, according to a study by Donald Davis, a biochemist at the University of Texas at Austin.
Using data from the U.S. Department of Agriculture, Davis concludes that recently grown crops have shown decreases of up to 38 percent in protein, calcium, vitamin C, phosphorous, iron and riboflavin when compared with produce from past decades.
What accounts for this negative trend? Like any other competitive industry, farmers' attempts to drive up profits have led them to use new techniques to increase production, Davis said. The faster-grown fruits don't have as much time to develop the nutrients.

"Farmers get paid by the weight of a crop, not by the amount of nutrients," Davis said. He called this the "dilution effect": As fruits and vegetables grown in the United States become larger and more plentiful, they provide fewer vitamins and minerals.

How Your Cholesterol Can Be Lowered with Plant Sterols

How Your Cholesterol Can Be Lowered with Plant Sterols

www.5min.com

Lowering cholesterol with plant sterols - Plant sterols are found naturally at low levels in everyday foods such as vegetable oils, nuts, seeds, grain products, fruits and vegetables, but it’s challenging to consume them in high enough quantities to see an impact on their cholesterol levels.