Health facts — Current health updates

by  Dr. Nicholas Warner — 

If you suffer from mild to moderate depression, try engaging in some type of physical activity. You will experience a wide range of benefits in a short amount of time.

This article reports on the effects of exercise on depression, the affect of bed rest on low back pain, and caffeine and chronic daily headaches.

Exercise may help reduce depression

A 1997 study found that mild to moderate major depressive disorder (MDD) ranked second behind heart disease in terms of years of life lost due to premature death or disability. National estimates indicate that fewer than one-fourth of individuals with MDD seek treatment, and only one in 10 receives adequate treatment. A recent study was designed to test whether exercise is beneficial in treating mild to moderate MDD, and to determine the dose-response relationship of exercise and reduction in depressive symptoms.

Eighty adults diagnosed with mild to moderate MDD were randomly distributed to one of four aerobic exercise treatment groups that varied with respect to total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and frequency (three days/week or five days/week), or to a placebo control group that participated in flexibility exercises three days a week. The outcome was determined by the score on the 17-item Hamilton Rating Scale for Depression (HRSD).

After 12 weeks, the group expending 17.5 kcal/kg/week (consistent with public health recommendations) had the lowest scores, while the placebo control group had the highest scores. The authors concluded that “aerobic exercise in the amount recommended by public health consensus recommendations was effective in treating mild to moderate MDD. The amount of exercise that is less than half of these recommendations was not effective.”

If you suffer from mild to moderate depression, try engaging in some type of physical activity. You will experience a wide range of benefits in a short amount of time, including elevated mood, increased stamina and improved overall health.

Reference: Dunn, A.L., Trivedi, M.H., Kampert, J.B., et al. “Exercise treatment for depression. Efficacy and dose response.” American Journal of Preventive Medicine 2005;28(1):1-8.

Bed rest: Unadvisable for low back pain

Considerable evidence in the past decade has shown that bed rest has not necessarily benefited patients suffering from low back pain (LBP). A recent review by the Cochrane Collaboration Back Review Group analyzed all randomized studies through March 2003, yielding two new trials that compare advice for patients with LBP: rest in bed versus advice to stay active. In total, six trials compared bed rest with staying active for the management of LBP.

Results found that bed rest was clearly less effective than staying active for patients with acute simple LBP. High-quality evidence shows small but consistent differences in favor of staying active for decreasing pain and improving functional status at three- to four-week and 12-week follow-up points, respectively. Additionally, in patients with acute simple LBP, evidence shows that bed rest actually increases the length of sick leave in the first 12 weeks, compared to remaining active. For patients with sciatica, studies proved that bed rest has little or no effect on pain and functional status, compared to staying active at three to four weeks and 12 weeks.

All in all, it appears that LBP sufferers should not look to bed rest to help decrease their recovery time or stave off pain. If you suffer from LBP, talk to your doctor of chiropractic about an appropriate treatment plan that includes staying active.

Reference: Hagen, K.B., Jamtvedt, G, Hilde, G, Winnem, M.F. “The updated Cochrane Review of bed rest for low back pain and sciatica.” Spine, March 1, 2005;30(5):542-46.

Caffeine increases chronic daily headache risk

Before your reach for your next cup-o’-joe, you might want to consider the consequences of excessive caffeine consumption. The addictive nature of caffeine has been shown to cause withdrawal headache, which may contribute to the development of chronic daily headache (CDH), or headache occurring at least 15 days per month.

To confirm such a hypothesis, researchers recruited population cases and control subjects from three U.S. metropolitan areas as part of a study designed to address caffeine’s potential involvement in CDH. Control subjects reported two to 104 headache days annually (average: 30 days), while population cases reported 180 or more headache days per year (average: 260 days). Current and past caffeine consumption was assessed by way of self-report.

The results showed that high caffeine exposure (defined as falling into the upper quartile of dietary consumption, or using a caffeine-containing over-the-counter medication as a headache treatment) was associated with onset of CDH. Approximately one-fourth of case subjects reported taking some sort of pain medication daily for headache in the previous three months.

According to the authors, “high medicinal or dietary caffeine consumption at the time of CDH onset (e.g., pre-CDH consumption) was a modest risk factor for CDH onset. Secondary analyses revealed that pre-CDH caffeine consumption might be an initiating factor in a subset of CDH sufferers, with the high-risk groups being women and those younger than age 40.”

Still need a morning pick-me-up, but want to wean yourself from caffeine? Try green tea, which contains less caffeine than coffee and has been shown to have many health benefits, including antioxidant and anti-cancer properties.

Reference: Scher, A.I., Stewart, W.F., Lipton, R.B. “Caffeine as a risk factor for chronic daily headache. A population-based study.” Neurology, Dec. 14, 2004;63(11):2022-27.

Dr. Nicholas Warner is a certified massage therapist and a doctor of chiropractic with Wellness in Motion, LLC in Phoenix, Ariz. He has been an instructor at Los Angeles College of Chiropractic. 602-863-4252.

Reprinted from AzNetNews, Volume 24, Number 3, June/July 2005.