Research Roundup

By Lynn Miller, JD, CHC, CYT

AACP Recommends Mind-Body Approach for Lung Cancer

For the first time, the American College of Chest Physicians (AACP) has issued evidence-based guidelines that recommend mind-body modalities as part of a multimodality approach to reduce the anxiety, mood disturbances and chronic pain associated with lung cancer. Lung cancer continues to be the leading cause of cancer deaths in men and women in the United States, causing more deaths than the next four most common cancers combined: colon, breast, pancreas, and prostate.

Massage therapy is recommended for patients who are experiencing anxiety or pain, while acupuncture is recommended for patients experiencing fatique, dyspnea, chemo-induced neuropathy, or in cases where pain or nausea/ vomiting is poorly controlled. While certain supplements, including beta-carotene, Vitamins A and E and aspirin were recommended against in the prevention of lung cancer, the guidelines made headlines by also recommending against the use of chest X-rays and CT scans to screen for lung cancer, citing the lack of supporting evidence and the exposure of the patient to needless risk, both physically and psychologically.

Diagnosis and Management of Lung Cancer Executive Summary, CHEST. Sept 2007 supp, 132 /3

Physical Activity Prescription: Our Best Medicine

Reprinted, in part, from the following article which summarizes the state of science on physical activity for the overall prevention and treatment of common chronic diseases:

While it is clear that every one benefits from increased physical activity in any form, offering patients more specific instruction can help them better target individual goals. The FITT principle can be used as a simple tool to remind clinicians and patients to pay attention to the 4 key elements of physical activity: frequency, intensity, timing, and type. Exercise is a dose dependent activity: up to a point, the more one does, the more benefit one can expect.

Frequency is important when prioritizing activity for preventing chronic disease; everyone should accumulate a minimum of 150 minutes of moderate exercise per week. Intensity, as measured by heart rate, should be the priority when the focus of physical activity is weight loss or athletic performance. Counsel patients interested in weight loss to exercise to high intensities (65—76% of their maximal heart rate). Exercising timing is critical for people with diabetes to reduce the risks of hypoglycemia. To maximize compliance, you can match a specific type of exercise to an individual patient's goals….Types of exercise include aerobic, resistance training, balance training, and flexibility training.

Oberg, Erica. Physical Activity Prescription: Our Best Medicine, Integrative Medicine : A Clinician's journal , 2007:Vol 6, No. 5: 18-22    

Glycemic Control Improved by Meditation

Mindfulness-Based Stress Reduction (MBSR), a well studied method of meditation that has already been found to reduce stress-related symptoms in various patient populations, could also improve glycemic control among diabetics, according to a recent pilot study. The study, which was conducted at an academic health center, trained 11 non-insulin dependent patients, treated with hypoglycemic agents, in MSBR over the course of 8 weekly 150 minute sessions, plus a 7 hour weekend session and home practice. Subjects were taught to pay full attention to present-moment experience, choosing to respond skillfully, rather than react automatically to external events, thoughts, emotions or sensations as they arise. Compliance with home meditation practice was high, and one month after follow up, a statistically significant improvement in glycemic control (as indicated by levels of hemoglobin A1c) and a statistically significant reduction in mean arterial pressure were found. In addition, symptoms of depression, anxiety and general psychological distress decreased by 43 percent. There were no reported changes in medication, diet, weight or exercise that could account for the improved glycemic control. Since stress-mediated production of cortisol and other hormones increase blood glucose and insulin resistance, the researchers hypothesized that MSBR down-regulates an indvidual's psychological reactivity to stress triggers, which may in turn mitigate the physiological stress response.

Rosenzweig, Steven; Reibel, Diane, et al. Mindfulness-Based Stress Reduction is Associated with Improved Glycemic Control in Type 2 Diabetes Mellitus: A Pilot Study. Alternative Therapies, 2007, 13 (5) 36-38

Mediterranean Diet Prolongs Lives in Alzheimer's Patients

An observational/epidemiological study of 192 seniors diagnosed with Alzheimer's disease, conducted by neurologists at Columbia University Medical Center, found that those who adhered to the Mediterranean diet the closest, outlived those who had the lowest adherence by four years. Participants were rated on a scale of 0 to 9, and divided into blocks of high, moderate and low adherence. Compared with those in the low adherence group, mortality was reduced by 35% in the moderate group and by 73% in the highest adherence group. Even without adjusting for all potential covariates such as age, gender, ethnicity, education, smoking, the study found that for each additional point in the adherence score, the risk of death was reduced by 21 to 24%. Clinical trials and other studies have already shown that the Mediterranean diet is associated with lower risk for certain cancers, coronary heart disease, obesity, diabetes, dyslipidemia, and overall mortality. Although additional clinical trials are needed, a prior observational study at Columbia had previously shown that the diet could reduce the incidence of, or delay the onset of Alzheimer's disease, as well.

Scarmeas, Nikolaos, Neurology. 2007; 69:1084-1093.