Hey, its just water

When we add words like “vitamin” or even the name of antioxidant containing fruit to the name of a drink, most of us would think it implies a certain healthfulness making it a better choice than plain old H2O or soft drinks.

Recently consumer advocates “Choice” challenged the claims made by the makers of “Vitaminwater” and the like, in a complaint to the ACC. The thrust of the claim was around the "explicit and implied" claims about its fruit content and nutritional benefits.

While the ACC sided with Coca-cola, the makers of Vitaminwater (the same company that tried, but failed to get away with a recent marketing campaign using a popular actress to say that the brown fizzy stuff isn’t bad for kid’s teeth or waistlines) in a backhanded way they accepted that the health claims were not as they seemed.

“The colour, taste and smell of one product, Vitaminwater, would cause any ordinary consumer to suspect the drink contained sugar, the commission stated in a letter to Choice.”

In other words, the ACC implied that the public is not gullible enough to be duped by health promotions implicit in the branding. Which makes me wonder why we even pretend to have fair advertising standards, if a company can be excused on the grounds that only a fool would accept their claims.

While Coca-cola has slipped through the net once more in Australia, the same product is currently the subject of a class action lawsuit in the USA regarding their nutritional claims.

The irony of the situation is both the ACC and Coca-Cola’s defense is based on the intelligence of a public who reads less and weighs more. The ACC suggested the mere smell and taste of the drink was enough to alert you to the lack of fruit and abundance of sugar. Coke on the other hand rests its case on their being sufficient nutritional information (in a smaller font) on the bottle, giving the consumer sufficient information as to the true kilojoule content.

The facts about enhanced waters

Fruit: Many of the fruity flavourings are not what they seem.

There is no actual kiwi fruit or strawberries in the drinks of these flavours.

In the cases where actual fruit products were present, the maximum any bottle any bottle contained was a mere 1% fruit juice.

Sugar: All products contained significant amounts of added sugar.

Coke’s Vitaminwater contains 6.5 teaspoons of sugar (per bottle).
Nutrient Water 7 teaspoons.
Smart Water 8 teaspoons.
A can of coke, by comparison, contains 10 teaspoons of sugar.

The take home message is don’t be conned, if it’s colourful and sweet it is not water. If you think your diet is inadequate, get some help to improve the way you eat and consider a short course of nutritional supplements at a medicinal dose to improve any real deficiency.

And when you are thirsty, drink water.

migraine headaches

Just as a heavy cold is not the flu, a bad headache is not necessarily a migraine.

More women (18%) than men (6%) are likely to have this type of chronic, episodic headache. The pain may be pulsating and one sided, with other symptoms such as vomiting, sensitivity to light and noise or visual disturbance (“aura”). In some cases it may mimic a transient ischaemic attack (TIA) with numbness on one side of the body, trouble speaking or reverting to a first language. In some cases a migraine may last up to 3 days (4-72 hours). Migraines often run in families.

Prodrome – some migraine sufferers notice certain symptoms occurring hours or days before an attack. These may include fatigue, mood swings, food cravings (often sugar or chocolate) or changes to bowel motions.

The aura – refers to some of the warning symptoms that a migraine is developing before the headache occurs. These symptoms include visual disturbance (often zig-zag shimmering lines), numbness or tingling in the body, difficulty speaking etc. Some people experience aura without a headache.

After the cessation of symptoms – most people feel wiped out for a day.

Causes: in the last few years more research into migraines is uncovering other possible physiological causes of these types of headaches. Previously, vascular (blood vessels) narrowing or dilation was thought to be the major problem but focus has widened to a variety of other neurological (nervous system) and even hormonal factors. Under current consideration are issues involving the trigeminal nerves and also serotonin levels. One theory is that serotonin levels drop, causing the trigeminal nerves to release a neuropeptide that causes dilatation and inflammation to the meninges that causes pain and a change of function.

Common Triggers

Musculo-skeletal problems especially affecting the neck, shoulders or temporomandibular joint (TMJ). Jaw clenching and teeth grinding are another symptom of imbalance in this part of your body.

Dehydration – yes 8 glasses of water a day seems like a lot but is what the average migraine sufferer need.

Caffeine – can affect hydration levels but also cause changes in the blood vessels. However a cup of coffee at the onset of an attack may be useful, don’t drink it at any other time.

Alcohol - especially red wine. However when this is due to a reaction to histamines, white wines matured in wooden barrels (eg an oaked chardonnay) may also trigger a reaction.

Sinus problems

Hormonal – puberty, peri-menstrual, OCP (pill) related, menopause and pregnancy are common migraine triggers. Note, oestrogen containing medication (HRT, the pill and other hormonal contraceptives) have not only been shown to cause migraines in some women but new research has suggested a link between women with migraines who use the pill and having an increased risk of having a stroke.

Withdrawal from pain or migraine specific medication (“rebound headache”).

Changes in weather, specifically barometric pressure swings can trigger some migraines.

Foods – being a co-factor are often an intolerance meaning you can sometimes get away with eating food and other times you can’t, which can make it difficult to track down initially. Topping the list of suspect foods are: chocolate, dairy (especially strong cheeses), oranges, tomatoes, food additives (especially tartrazine a yellow colouring). The only evidence based medicine proving a food trigger for migraine is monosodium glutamate (MSG) common to flavour boosters, as well as Chinese, Thai, Vietnamese and Japanese restaurant meals.

Stress – can be a player in its own right but also may increase muscular tension worsening neck and shoulder problems, cause you to change your eating and drinking patterns, or rob you of sleep.


Complementary medicine for migraines

Feverfew (Tanacetum) – is a commonly used herb for the prevention and treatment of migraine. Traditionally a leaf each day was eaten as a preventative (only consider this if your feverfew plant has been conclusively identified and not sprayed with any pesticides). Evidence based medicine (EBB) supporting its use is mixed. Meta-analysis shows “The majority (of trials) favor feverfew over placebo… Yet the clinical effectiveness of feverfew in the prevention of migraine has not been established beyond reasonable doubt.” (Interestingly, when EBB medicine is applied to most conventional treatments for a variety of conditions a similar caveat exists).

Chaste tree berry (Vitex agnus castus) is invaluable for hormonal triggers of migraines when a woman is not concurrently taking pharmaceutical oestrogens etc. Taken over 3-6 cycles chaste tree berry is very effective in treating all peri-menstrual related chronic conditions through its action as a ‘hormonal normaliser’.

St John's Wort (Hypericum) migraines have low serotonin levels in common with insomnia and depression. Theoretically, St John's Wort would be well indicated as long as you are not taking any of these drugs.

Other herbs used in migraine treatment would depend on the individual. Usually herbs for the nervous system (such as skullcap, passionflower or chamomile) are used in conjunction with liver or other digestive herbs depending on the person’s general heath.

NB: You might read about Butterbur (Petasites) as a herbal treatment for the migraines, however this herb is scheduled as a poison in Australia and is not recommended.

Aromatherapy: Cooling oils such as peppermint and lavender, applied to the back of the neck on a cold face washer can stop some migraines developing. Once company make a handy little roll on aromatherapy ‘stick’ suitable for migraines. (More on aromatherapy.)

Vitamin B2: very high doses, around 400 mg, of B2 have been investigated as a treatment for migraines. This is around 8-10 the amount found in some of the stronger OTC B-multivitamins on the market. As use of one B vitamin in high doses unbalanced by all the other B’s can cause deficiencies I would be hesitant to endorse this treatment at the current time. A daily multivitamin with at least 50 mg of B2 may be worth trying as part of a preventative program.

Magnesium: is a key nutrient for muscular tension. New research indicates a daily dose of up to 600mg of magnesium can reduce frequency and severity of attacks. NB: this is a very high dose and long term could disturb your calcium levels if calcium supplementation is not also used.

Coenzyme Q10 (CoQ10) a nutrient that has a strong affinity with the muscles and is often used for heart health is looking promising for a new role in migraine prevention. While sample sizes in the studies I have cited are very small, a daily dose of 150 mg of CoQ10 could reduce attacks by around 25%. Interestingly, cholesterol lowering drugs are known to reduce CoQ10 levels in the body, I’d strongly suggest any one with migraines who takes statin drugs to consider this as a supplement.

Acupuncture is endorsed by groups such as the British Medical Association as an effective treatment for migraines. In Victoria the practice of Traditional Chinese Medicine is regulated, so see a registered practitioner.

Remedial therapies: In my experience every migraine sufferer should look into assessment and treatment for back, neck or jaw problems. My preference is to see an osteopath but many other kinds of remedial therapists can be useful. See the recent show on muscles to learn more.


Lifestyle: There is a strong relationship between inadequate sleep and migraine attacks. Make 8 hours in bed a priority in how you organise your timetable. If you have trouble sleeping, read the notes from this show on insomnia. Sleep disturbance is often connected with stress. For stress management check out these links.

Regular, appropriate exercise which can be as simple as a daily walk for half an hour can relieve the build up of pressure in the muscles, help you sleep better and relieve tension. If you are “too busy” to find 30 minutes out of your day, that alone could be a key indication as to why you are prone to experience migraines.

Many of the women I see with migraines are busy at work and home, always putting other people first. Despite other symptoms suggesting they are tired or stressed they tend to ‘soldier on’ til a migraine hits, becoming so debilitated that they finally have to stop. Like many health issues, the first step to improving your health is to listen to your body.



Edvard Munch "The scream" - looks like a migraine to me

asthma

What is asthma?

With over 2 million Australians being diagnosed with asthma, including up to 1:4 children, we are living in one of the most allergy prone countries in the world.

Asthma is an inflammatory condition of the airways in the lungs. It may feel like a persistent, irritated cough, a tightness in the chest or a distinctive wheezing sound when trying to breathe. This may be caused by a change in air temperature, exercise, dust, pollens, cigarette smoke, a respiratory infection or a wide range of allergens. When triggered, this causes swelling, constriction and the production of thick, sticky mucus that makes breathing, especially exhaling air, very difficult. Most asthma attacks are well managed with preventative (eg: steroids) or acute (eg: Ventolin) drugs but sometimes an asthma attack can be fatal. Because of this, all practitioners take a diagnosis of asthma very seriously.

Can you treat asthma without drugs?

Firstly it is important to actually make sure that someone actually has asthma. This may sound strange but asthma is misdiagnosed in both children and adults at an alarming rate. In kids there has been a tendency to classify most prolonged coughs as asthma.

Associate Professor Colin Robertson from the Royal Children's Hospital Melbourne is also a spokesman for the National Asthma Council of Australia. He says he's spent more time undiagnosing asthma than diagnosing it over the past decade. “Throughout the quarter of last century, there was an amazing awareness campaign for improving the diagnosis of asthma, which has been incredibly effective, and perhaps a bit too effective, so that children with a wide range of respiratory symptoms are having the diagnosis of asthma and not all of them have it.” ABC ’7.30 Report’, 8.4.03

In adults as well as children, common conditions such as 'silent reflux’ (gastrointestinal oesophageal reflux or GORD/GERD) which often triggers coughing after food, coffee, exercising or lying down - may be more likely to be a culprit in a person with no past history or allergies. The cough does not significantly improve on asthma medication, nor develop into serious breathing problems.

With a clear diagnosis of asthma, it would be unusual for a naturopath to tell a client to cease their pharmaceutical drugs. Treatment is generally centred around – decreasing triggers, reducing mucus, improving breathing, increasing immunity and trying to decrease the incidence of respiratory infections.

Can foods cause asthma?

Asthma is typically seen initially in children with a family history of atopic allergies eg: eczema, asthma, hayfever, hives. Often they have a history of eczema or other skin rashes before developing respiratory problems. This may go away when they use topical steroid creams but later it is not unusual for some of these children to present with asthma. Some naturopaths believe that the eczema is the body’s way of trying to get the person to avoid an allergen and when this is dampened down or ‘cured’ with drugs it can express itself in a different way such as asthma or persistent rhinitis. While there is much debate as to whether foods like dairy products or wheat “cause” asthma or produce mucus in the respiratory system, in practice an appropriate low allergy diet does tend to provide good results.

In my experience, when all dairy foods (including ‘hidden’ dairy in some processed foods) are removed from the diet long term, it can improve most allergic respiratory conditions. While other triggers still abound – such as pollens and changes in air temperature, food is the one thing we can control most of all.

Other things we can’t always control that have been linked to developing asthma and other allergies include: caesarean birth, antibiotics in the first 6 months of life, being bottle rather than breast fed, air pollution, passive smoking or being overweight.

Nutrients for asthma

A number of studies have shown a connection between low nutrition, especially antioxidants such as Vitamins E, A and C and asthma. These nutrients tend to have anti-inflammatory actions, so too does fish oil. There is some evidence that magnesium may be implicated in asthma.

Try to avoid polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils that might contain trans-fatty acids and deep-fried foods, due to their ability to provoke inflammation. Use anti-inflammatory herbs like ginger and turmeric.

Typically, a low allergy diet for asthma is a good starting place. This is one without wheat, dairy, soy, corn (including high fructose corn syrup), eggs, nuts and all additives. Include alternative sources of calcium such as seeds (eg tahini), beans, and edible fish bones (eg: in canned salmon and sardines, also high in good oils). Ideally most food is cooked from scratch, as processed food even when it doesn’t contain suspected allergens, is low in nutrition. Increase the amounts of seasonal fruits and vegetables, grains such as quinoa, brown rice, oats and barley and other wholefoods like beans and lentils.

After 3-6 weeks, introduce a new food group, one at a time, each week and see if there is any worsening in the asthma. Record symptoms on a chart, peak flow readings and how often acute medication is needed.

Alternative treatments for asthma

Both Western and Chinese herbal medicines are frequently used for asthma. I use herbs like elecampane, hyssop and sundew to strengthen the lungs, as well as immune stimulants and nervous system tonics as required depending on the individual. Unfortunately in Australia some strong but effective herbs like lobelia and ephedra are no longer available to be prescribed by herbalists.

There are potentially issues with the contamination and adulteration of some Chinese medicines bought overseas or in Australia. These have included heavy metals or the inclusion of non-disclosed pharmaceutical drugs. This is less likely to occur if you are given raw herbs to decoct rather than pre-made tablets or powders.

Manual treatments – including osteopathy, chiropractic and remedial massage can often help if the diaphragm is tight of other musculo-skeletal problems are apparent.

Buteyko technique - has some of the most promising results for asthma management. This is a breathing technique that needs to be taught by a qualified instructor. I would thoroughly recommend every asthmatic to give it a go.

Appropriate exercise: There is a good reason why so many of our gold medal winning swimmers began their life as asthmatics. While exercise can be a trigger for asthma attacks, swimming is largely beneficial, though preferably in an outdoor, non-chlorinated pool. Yoga and chi-gong can also be useful.

Other common asthma triggers

Analgesic drugs, such as aspirin and nsaids, panadol is often a safer choice.

Cleaning products especially aerosol and spray based ones. White vinegar and bicarbonate of soda are effective cleaners and much safer for asthmatics.

Cockroaches mould and dust mites. This offers some solutions.

Cats and dogs are controversial. Though an obvious trigger for some, growing up in a home with pets, such as in this study looking at cats, can also reduce your chances of becoming an asthmatic. And here's a study in support of dogs.

Not taking your asthma seriously. While complementary therapies may reduce your need for medication, doing nothing and not having an action plan is a disaster waiting to happen.

As reminded by a caller on the show - check your heating. Gas heaters, especially those with a pilot light, can provoke asthma in some. Also clean out your ducted heating every year. It costs a little money but is worth it when you see the gunk pulled out of the ducts that you were breathing in.

Update: April 2009. "A low intake of vitamins A and C could raise the risk of asthma, a team which reviewed 40 studies carried out over the past 30 years has said.

A Nottingham University-led team found people with a low intake of vitamin C had a 12% increased risk of asthma, the Thorax journal reported.

For vitamin A the raised risk was less clear cut, the team said, but there was still a significant association." Read more