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Wednesday, December 29, 2010

Stone-age posture and diet : A facebook discussion


I am relatively new to FaceBook but am finding aspects of the interactions on the site fascinating and educational.

Today I posted the following:

“I came across this picture of a neanderthal guy on BBC's news site. It discussed new evidence that these people ate cooked vegetables. Clearly that was a necessity as their posture was awful. Look at those gothic shoulders! I bet he had headaches!”

I am copying some of the more interesting of the 30+ responses (some using pseudonyms) this attracted – as well as a few of the flip ones:


Gil Hedley said:

“Heck, that's my uncle!!”


Sallie Burge-Thurman observed (perhaps speaking with experience?) :

“No neck, squinty eyes, weather-beaten face, mustache that would keep any fly out, and hair everywhere but the belly and shoulder area.. must have rubbed off from all the potato vodka he drank…..falling down on one side all night long will do that to a guy”


I commented:

“To be serious for a moment....imagine this chap came into your office for an appointment and said -"I have this headache, and my neck's stiff, and I should mention my shoulders hurt like hell"
Is there any chance at all of more than symptomatic relief?
Can that dense mass of what used to be muscle ever be restored to elastic efficiency?
Could his crowded cervical joints realistically be mobilised?
We have all probably been faced with this immovable mass of fibrous gristle. So, where would you start?”


Michelle Doyle offered a serious thought:

“Yes, I have noticed how immobile this guy looks...could probably barely move to hunt, which is why they may be contributing Neanderthal extinction to over reliance on meat. Perhaps he was beyond help, unless given treatments early on. 'Movement is life'...which is probably what really lead to their extinction! But today, we can help people with posture and joint dysfunction.”


Pacific Rim Chiro offered specifics:

“Thoracic mobs/manipulation, SCM and Trap MET to start. Then I like to have my patient in a side lying position, mob the scapula in all directions and then using my hand in a knife edge and with the scapula passively pulled into retraction, try to work my hand up in under it, and then cup my hand slightly to create a little space, reduce adhesions etc.”


My daughter Sasha added her thoughts:

“But... they were designed like this weren't they? As far as I know, skeletal evidence has shown that their arms (shoulder & elbow joints) functioned very differently to ours, somewhat more like those of gorillas than of modern humans. Plus...... they used their arms much in the same way as gorillas - in addition to walking upright, though again. as far as I am aware there were anatomical differences. So are you sure that the picture we're looking at is one of pathology at all - because the whole design is different? Unless of course you do actually mean modern folks who actually do look like this! (yep, we've all seen them!)
And btw, they were very effective hunters.... used spears very well and could bring down mammoths when hunting in groups..... extinction ( I think) may well have more to do with brain evolution and climate than anything else.


Liz Baker commented:

“I have met many patient's in the chronic pain center where I work that could make this guy look better in comparison. These patients would fit your description, Leon. Dense mass, crowded joints, fibrous gristle, etc.”

I chipped in again:

If - as Sasha says - they were designed this way - they were destined to have stiff necks, jaws out of alignment, shoulders that were at a mechanical disadvantage (glenoid fossa protracted, putting stress onto rotator cuff muscles), ribs and thoracic cage crowded etc.

In other words their design was not conducive to the sort of activity they would have had to face in harsh environments....perhaps why only a few of their genes are still around?
If they moved around like gorillas do, they would probably have been better off than trying to walk upright.
As for meat eating Michelle...the BBC piece is about traces of cooked vegetable matter (now fossilised) being identified on teeth....so the diet was more varied than previously thought.”


Ed Lark offered cranial thoughts:

This is a great topic! It seems that their skulls also had an occipital bun. Goodness knows how strong their nuchal ligament was. I bet they had tremendous muscular support to hold their heads up! Now I want to look up cervical degradation ...amongst Neanderthals!
Is there a field called Paleo-Osteopathy?


Jason Erikson offered support for Gil’s remark about his uncle:

“A paleoanthropologist on the radio was saying that we now have DNA proof that Neanderthals mated with human ancestors. Up to 5% of the DNA of northern Europeans is of Neanderthal origin.”


Ravensara Travillian launched into analysis of Sasha’s earlier remarks….and went on with more insights:

“Hi, Sasha--I am a little bit confused by what you wrote.
You say: "they were designed like this weren't they?" which sounds like you are about to present an Intelligent Design creationism argument. But then you mention "brain evolution" which... sounds like just the opposite of a creationist argument. And your timeline and use of comparative anatomical evidence certainly does not sound like creationism. So I am not sure what you mean to say.
Would it be fair to reword your statement to say "they evolved like this in response to their environment, didn't they? As far as I know..."(then all the same as you originally wrote up to the following sentence). "So are you sure that the picture we're looking at is one of pathology at all - because the whole baseline is different?"
If I am correctly understanding what you intended to say, then I would agree that you have raised a very important point. Evolution is not the same as design; it doesn't plan in advance, and it doesn't produce optimal results. The results only have to be good enough to function in a particular niche in order to be successful there. Which I think reinforces your point, if I understand it correctly, that what we would call "pathology" comes from our looking at it from our modern context rather than from the point of view of the environment they themselves operated in.

Leon points out:
"If - as Sasha says - they were designed this way - they were destined to have stiff necks, jaws out of alignment, shoulders that were at a mechanical disadvantage (glenoid fossa protracted, putting stress onto rotator cuff muscles), ribs and thoracic cage crowded etc."

That is one of the classic critiques of Intelligent Design creationism--if we are supposed to believe there really is a designer, he/she/it is at best incompetent (knees, lower back, retina), and at worst, sadistic (surrounding the urethra with the prostate).
There was an amusing analysis of this in _Scientific American_ a couple of years back; you can see it at:

If humans really had been designed to avoid those flaws, you would expect us to look more like the improved versions illustrated in the article, which look (to me) more like hobbits.
"In other words their design was not conducive to the sort of activity they would have had to face in harsh environments....perhaps why only a few of their genes are still around?"
To avoid confusion, would it be ok to restate your first sentence as "their anatomy" rather than "their design"?
What you say is true, but it's equally true for us modern Homo sapiens as well. Neither of us lasts as long as we could, because our parts wear out prematurely, or poorly fit our environment in other ways. As you correctly point out, their environment was harsh, and they were poorly suited to it in the long run--but since their lifespan was ~30 or 40 years tops, the long run wasn't really an issue for them. They didn't have to be perfectly suited to their environment; they only had to be good enough to get by in their younger years.

If you think about what American football does to its players, it's similar in a way. It's harsh and damaging, and chews them up only to spit them out, physically used up, at the end of their careers. The only real difference is that the Neanderthals didn't have much longer to live afterwards. So what we, with our longer lifespans and more options would consider "pathology" might have simply been their baseline for normal.”


I responded to this:

Thanks for the detailed analysis Revensara
Clearly we are ill-designed for modern life/or poorly evolved - whichever suits you best.
Thankfully much of modern life has evolved/or been designed to match our inadequacies - so we (or most of us)... no longer have to sprint after antelopes to catch supper, but only need to hobble down to the store for whatever approximation of food we can afford.
But in truth - every now and then - I catch sight of a well designed and functioning body, the owner of which could probably chase antelope, leap over rivers and climb trees... and in those moments perhaps there is a glimpse of what we could be like - one in which a designer seems less improbable, and/or evolution seems to be on the right track.
For the most part however, both seem t have missed the mark.
Our neanderthal example seems to be just such a dead-end kid.


Elan Schacter observed:

“That artist missed some things we see that artists don't. Try this: ignore the head. On that body, where would you expect the head to be? I would expect it to be much more aligned.”


Laura Allen complained:

“My symptoms exactly and I've been hunched over the computer for so long I'm starting to resemble him.”


Stefan Chmelik moved back to the question of diet

“The Paleo diet seems to be the new trend, is there any evidence for it?”


I responded:

· Stefan, around 1985 I wrote a book "Stone Age Diet" based on current (at that time) research into paleolithic eating habits.

· There's good evidence that they were healthy unless oevrtaken by clubs, tigers or bears etc, BUT

· They had lots of exercise

· They ate at dawn and around sunset (read up on effect of timing of eating, Leptin behaviour & syndrome X)

· They slept at night (read up on Leptin again)

· They ate LOTS of green vegetables (not cultivated, but gathered) as well as seeds, nuts, fruit etc

· The meat they ate was lean

· Many lived by oceans and rivers and fish was a major part of the diet
If we could approximate that pattern then having a physique like a gorilla might not matter.....”


Sasha woke up and replied to Ravensara:

“Ravensara - I was certainly not referring to intelligent design/creationist terms- my use of "designed" was entirely figurative. I'll admit my wording was sloppy (but it was 5am this end!), and also in Europe (or at least in my immediate... environment) the creationist-evolutionary debate is a non-issue, so apologies for any confusion.
You are correct that my point was in fact that I think the question is starting from a mistaken premise: clearly they functioned effectively, and even though they died out when they did, they were still highly successful for almost 200000 years. Homo Sapiens hasn't been around for as long as that, so we don't actually know whether our "design" (figuratively meant!) is any more effective than theirs, and since we left Nature behind centuries ago, perhaps we will never know.
Any number of factors could have contributed to the demise of the Neanderthals, though I think that brain capacity/evolution in contrast (and perhaps competition) with Cro Magnon man may well have been a major factor (abstract thought, innovation, complex reqasoning, etc). But I really don't see how we can talk about this as a pathological posture if this is the build that served them best in their natural environment. Many animals are paradoxical with notoriously inefficient systems of one type or another, yet somehow, they survive and continue to exist and function quite nicely.
Would he have had neck pain? Not if the whole skeletal and muscular setup is different to ours,so that even though the position of the head looks out of alignment in comparison to a modern human - perhaps what we consider "normal" would have been entirely unnatural to him. Skeletal studies necessary?”

“PS, as some of you know, I'm actually a bit of an interloper on this thread, since my area is not bodywork at all, but the Humanities.

Being Leon's daughter however, I've been weaned on a good number of these concepts (and it's his own faul...t for explaining what he did as he went along and being a great teacher to boot!) But given that I've gone off in a different direction, my use of language tends to be more figurative in nature.

Just explaining as I won't pretend to be able to get into the fine detail of anatomical issues, but as I have done quite a bit of reading into prehistoric culture fairly recently, that is why I have an objection to the assumption that this was anything other than a reasonably effective anatomical structure for this particular creature at this particular point in evolution - particularly as it's unlikely that this would have been why they died out.”


Ravensara returned to the fray:

No worries, Sasha--I quite understand the 5 AM thing, and I also live in England, where creationism isn't really an issue, although it's a huge problem in the States. And I have to confess that we biologists add to the confusion whenever we use "design", "purpose", or "body plan" as a shorthand. As convenient as it is, I really think it generates more confusion among non-biologists than it's worth.

From the way your argument was proceeding, it didn't sound like you were taking the creationist position overall, so the word was a little jarring. But you cleared up that confusion nicely.
My favourite example of your point is the use of the terms "obese" or "obesity" in reference to bears. Certainly, they (mostly) have higher BMIs than humans do--but is the term "obese" appropriate? To decide that, we would first have to decide whether "obese" means pathological or not, and how it relates to "normal", which is a whole other discussion right there.
Your overall point about applying human standards of health and illness to other species is well-taken, and can be the basis for some fascinating discussion.
Interloper? To the contrary, some of the best discussions are the interdisciplinary ones.

Leon's point is well-taken:
"If we could approximate that pattern then having a physique like a gorilla might not matter....."
Being young and having lots of physical reserves to draw upon, and maintaining that pattern as long as possible can compensate for a multitude of what would otherwise be problems. :)


Eric Beard was also worried about the accuracy of the picture:

“I too wonder about this accuracy of the artist's rendering. I also have enjoyed Sasha's comments. If this person were to walk in to me me today it would take some serious time and $ on his part to start to get "straightened out". I question what sort of permanent changes could even be made. His continued habits outside of the bodywork sessions would be entertaining to hear about. How did he get this way? Nature? Nurture? or both?”


Charles Smith was clearly pro these ancestors (of some of us)

“Has anyone here ever tried to work flint into anything? It is not such a simple task. A heightened sense of smell would have been a requirement. Just foraging and hunting to survive took far more intelligence than we know. This guys head forward posture screams cervical, neck and upper body issues. Hunting mastadons and other large game is both dangerous and physically demanding. All sorts of joint and alignment pain from stalking, exertion or hard blows in assaulting the beasts. They ate whatever they could find in a area between forested and tundra conditions. There is no reason to assume that they only ate meat but probably learned as much from animals as each other. I an animal can eat it and live (particularly small) then a human might also. Russian soldiers actually ate grass rather than give up when under siege as late as WWII. Food from sources not usually tapped often means survival.”


Ferguson John returned to less serious (for some) matters:

“The San Francisco 49er's need a new head coach. Maybe we will see more of this guy.”

Which was responded to by


Charles Smith:

“How about a line backer? Stocky and low to the ground just right for tripping up other linemen.”

"The They Died out Suddenly Theory is in question. A skeleton that had all of the characteristics was found that dates a few thousand years later than the commonly accepted die out date. Interbreeding is most likely the case. The Hittites of Eurasia were highly successful in their empire yet none of Hittite blood is present today as a separate race. Men meet, fight and interbreed as their mode of operation."


….end of day’s play…which reminds me, today England beat Australia in Melbourne (cricket) – actually gave them a lesson to remember.


HAPPY NEW YEAR

Sunday, December 19, 2010

The Greatvine project - offering advice at a distance...and the problems of offering advice at a distance








A couple of years ago I was contacted and asked to become an 'expert' on a new website project - Greatvine.com


The idea was simple but innovative.
Greatvine was recruiting a wide range of 'experts' in a plethora of areas of interest.
Each expert would have a dedicated page to which they could upload articles and information sheets, that could either be downloaded by visitors at no cost, or for a modest fee (determined by the expert).
There would also be a system whereby experts could be contacted by phone - (for a fee set by the expert, per minute) - at prearranged times.
The process had teething problems but these have now been overcome, and the site is operational, with hundreds of experts (areas range from health & wellbeing, to finance, parenting, writing and more, with thousands of articles available to download.

The site carries this particular notification about my presence on Greatvine:

Leon would be pleased to advise individuals on any questions involving osteopathy, naturopathic medicine, soft-tissue manipulation, complementary and alternative medicine, chronic pelvic pain disorders, fibromyalgia or chronic fatigue syndrome.

My contact details for Greatvine are: www.greatvine.com/leon-chaitow and my advice line number (UK only) is 0906 194 9628
This is only 'active' when I switch on my 'availability' button on the site, signifying that I can receive calls to its dedicated number that finds me anywhere in the world. It's easy to see whether I'm available to chat, as a thumbnail picture appears on the right of the home-page under a heading "Experts Available Now"
At present that 'available' button is not switched on much of the time, as I have a variety of writing and editing deadlines to meet.....but given a few spare hours, I will activate it to test out just how many people are interested in actually contacting me for advice ---- at a cost. ----- as distinct from the many who ask for advice for free.

Advice at a distance....?
When I placed the Greatvine information on my Facebook page, I almost instantly started receiving emails asking for health advice - something I actively discourage on my website - www.leonchaitow.com- as there is no way that meaningful, responsible, specific advice can be offered via that medium.
And even offering general advice, and referral information, requires a greater awareness of the individual's background than can be easily gleaned by email correspondence!

One such email, that arrived yesterday, detailed a truly heart-rending catalog of chronic health problems.
I am copying the non-personal sections of my response - see below - as it represents a summary of the philosophical approach I adopt when considering complex chronic health issues (whether at a distance, or in person) - and I hope it is of some interest:?


Thank you for your detailed summary of your history and current health problems One thing I've learned in trying to advise people with complex problems is to avoid trying to 'fix' anything. The way to best deal with complexity is through a lens that evaluates three possible intervention approaches - built on a foundational recognition that self-regulation/homeostasis is constantly operating, and that the most effective role of health intervention is to provide that inbuilt feature (self-regulation) with the best possible chance of manifesting, without creating additional adaptation demands.
An additional lens requires an appreciation of both inherited and acquired features within the orbits of the biochemical, biomechanical and psychosocial aspects of the individuals makeup.


The first way
of trying to reduce complexity via simple initiatives, lies in establishing, as best possible, whether functional improvement can be achieved - possibly not in the most obvious or affected areas/system/tissues.
For example in many cases, by focusing on breathing function (possibly, not certainly - as this is an example only).
Other broadly influential areas that always require consideration, and sometimes modification, are nutrition, sleep, posture, exercise and mento-emotional balance.

Functional improvement in all and any of these areas can permeate into improved clinical presentations, even though they may not immediately be recognisable as being part of the etiology.


Secondly
, there is a need to focus on what obstacles there may be to enhanced function/symptom reduction, that might be modified or modulated.
The idea of removal of obstacles to recovery/improvement, works on the principle that health issues represent failed or failing adaptation (based on Selye's General Adaptation Syndrome concepts) - which calls for attention to whatever adaptive demands can be minimised i.e. 'reduce the load'.

Thirdly
, there is the strategy that aims at easing symptoms, without adding to the adaptive load.
This is in contrast to methods that:
a/ try to fix something and/or
b/ impose a new set of adaptive demands, that actually make matters worse
This highlights the fallacy of an 'ideal structural state' which some manual practitioners attempt to restore. There are probably as many people who have multiple structural anomalies (as compared to text-book ideals), and yet who have no symptoms whatever, as there are individuals who are text-book ideal - but with multiple symptoms.! Symptom relief is a reasonable approach, when the first and second objectives, listed above, are not achievable (i.e. enhance function and reduce the adaptive load), or are only marginally successful. Easing of symptoms, even though underlying features are unaltered, can contribute significantly to well-being.

So, with that philosophical (but I believe extremely practical) background, my particular advice for people seeking help for complex health conditions (where regular health-care fails) is to broaden perspectives in seeking help. - by paying attention to diet, exercise, sleep, breathing, stress management etc. It also pays to seek professional advice that evaluates the whole complex story, rather than small pieces of it.
Osteopathic and naturopathic (and TCM) practitioners tend towards looking at the big picture, rather than at the obvious.

My best wishes for 2011

Wednesday, December 1, 2010

The Vitamin D Scandal





This post is almost entirely pasted from the latest newsletter from the Vitamin D Council

It is in response to frank distortions of the truth by a quasi-U.S. Governmental agency - the Food & Nutrition Board, acting on behalf of the Institute of Medicine.

Please read Dr John Cannell's words - and weep for the unborn millions who will suffer as a result of this failure to tell the truth.

Subscribe to the Newsletter by writing to: newsletter@vitamindcouncil.org

Today, the FNB has failed millions...

3:00 PM PST November 30, 2010
After 13 year of silence, the quasi governmental agency, the Institute of Medicine's (IOM) Food and Nutrition Board (FNB), today recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman. While that 400 IU/day dose is close to adequate for infants, 600 IU/day in pregnant women will do nothing to help the three childhood epidemics most closely associated with gestational and early childhood vitamin D deficiencies: asthma, auto-immune disorders, and, as recently reported in the largest pediatric journal in the world, autism. Professor Bruce Hollis of the Medical University of South Carolina has shown pregnant and lactating women need at least 5,000 IU/day, not 600.

The FNB also reported that vitamin D toxicity might occur at an intake of 10,000 IU/day (250 micrograms/day), although they could produce no reproducible evidence that 10,000 IU/day has ever caused toxicity in humans and only one poorly conducted study indicating 20,000 IU/day may cause mild elevations in serum calcium, but not clinical toxicity.

Viewed with different measure, this FNB report recommends that an infant should take 10 micrograms/day (400 IU) and a pregnant woman 15 micrograms/day (600 IU). As a single, 30 minute dose of summer sunshine gives adults more than 10,000 IU (250 micrograms), the FNB is apparently also warning that natural vitamin D input - as occurred from the sun before the widespread use of sunscreen - is dangerous. That is, the FNB is implying that God does not know what she is doing.

Disturbingly, this FNB committee focused on bone health, just like they did 14 years ago. They ignored the thousands of studies from the last ten years that showed higher doses of vitamin D helps: heart health, brain health, breast health, prostate health, pancreatic health, muscle health, nerve health, eye health, immune health, colon health, liver health, mood health, skin health, and especially fetal health. Tens of millions of pregnant women and their breast-feeding infants are severely vitamin D deficient, resulting in a great increase in the medieval disease, rickets. The FNB report seems to reason that if so many pregnant women have low vitamin D blood levels then it must be OK because such low levels are so common. However, such circular logic simply represents the cave man existence (never exposed to the light of the sun) of most modern-day pregnant women.

Hence, if you want to optimize your vitamin D levels - not just optimize the bone effect - supplementing is crucial. But it is almost impossible to significantly raise your vitamin D levels when supplementing at only 600 IU/day (15 micrograms). Pregnant women taking 400 IU/day have the same blood levels as pregnant women not taking vitamin D; that is, 400 IU is a meaninglessly small dose for pregnant women. Even taking 2,000 IU/day of vitamin D will only increase the vitamin D levels of most pregnant women by about 10 points, depending mainly on their weight. Professor Bruce Hollis has shown that 2,000 IU/day does not raise vitamin D to healthy or natural levels in either pregnant or lactating women. Therefore supplementing with higher amounts - like 5000 IU/day - is crucial for those women who want their fetus to enjoy optimal vitamin D levels, and the future health benefits that go along with it.

For example, taking only two of the hundreds of recently published studies: Professor Urashima and colleagues in Japan, gave 1,200 IU/day of vitamin D3 for six months to Japanese 10-year-olds in a randomized controlled trial. They found vitamin D dramatically reduced the incidence of influenza A as well as the episodes of asthma attacks in the treated kids while the placebo group was not so fortunate. If Dr. Urashima had followed the newest FNB recommendations, it is unlikely that 400 IU/day treatment arm would have done much of anything and some of the treated young teenagers may have come to serious harm without the vitamin D. Likewise, a randomized controlled prevention trial of adults by Professor Joan Lappe and colleagues at Creighton University, which showed dramatic improvements in the health of internal organs, used more than twice the FNB's new adult recommendations.

Finally, the FNB committee consulted with 14 vitamin D experts and – after reading these 14 different reports – the FNB decided to suppress their reports. Many of these 14 consultants are either famous vitamin D researchers, like Professor Robert Heaney at Creighton or, as in the case of Professor Walter Willett at Harvard, the single best-known nutritionist in the world. So, the FNB will not tell us what Professors Heaney and Willett thought of their new report? Why not?

Today, the Vitamin D Council directed our attorney to file a federal Freedom of Information (FOI) request to the IOM's FNB for the release of these 14 reports.

Most of my friends, hundreds of patients, and thousands of readers of the Vitamin D Council newsletter (not to mention myself), have been taking 5,000 IU/day for up to eight years. Not only have they reported no significant side-effects, indeed, they have reported greatly improved health in multiple organ systems. My advice, especially for pregnant women: continue taking 5,000 IU/day until your 25(OH)D is between 50-80 ng/mL (the vitamin D blood levels obtained by humans who live and work in the sun and the mid-point of the current reference ranges at all American laboratories). Gestational vitamin D deficiency is not only associated with rickets, but a significantly increased risk of neonatal pneumonia, a doubled risk for preeclampsia, a tripled risk for gestational diabetes, and a quadrupled risk for primary cesarean section.

Today, the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. Let us hope the FNB will comply with the spirit of "transparency" by quickly responding to our Freedom of Information request
John Cannell, MD
The Vitamin D Council