Reading The Research Regarding Supplements

By Mary Cissy Majebe, OMD

Each month I receive a newspaper entitled, Family Practice News. It refers to itself as “The Leading Independent Newspaper for the Family Physician.” I look through it as a way of keeping myself up to date with Western medicine, as well as with what the Western medical press may be reporting about alternative or complementary medicine. During the week of December 1, 2008, on page 32, the headline at the top of the page read:

“Prescribed Drugs, Supplements Tied To Liver Injury”

It went on to state: "Single prescription medication was the likely cause of the liver injury in 73% of cases. Multiple prescription medications or a combination of prescription medicine and dietary supplements were the cause in 18%. Single or multiple dietary supplements were the cause in the remaining 9%.”

Needless to say, I was distressed, so I sought out the research citation: “Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States.” Gastroenterology 2008: 136: 1924-1934. After reading this article, I had a much different picture.

The article’s headline listed both pharmaceuticals and supplements. However, of the total 300 patients in this study, 270 of these liver injuries were linked to either one or multiple pharmaceuticals. Only 30 of these liver injuries were linked to a supplement, and 2 of these 30 were linked to a pharmaceutical and a supplement. In other words, 90% of the liver injuries in this study are associated with pharmaceuticals and 10% to supplement usage. Of the 10% with liver injuries due to supplement usage, 65% of these were using supplements for weight loss and muscle building.

Furthermore, 73% (217 patients) of the liver injuries were due to pharmaceuticals, while 18% (55 patients) were linked to multiple pharmaceutical and supplement usage. Of these 55 patients, 2 of them used a supplement that was also listed as a probable causative agent, including Cell Tech, which is a muscle-building agent for body builders, and a Source of Life multivitamin supplement. For 53% of the 55 patients, they were using multiple pharmaceuticals. For 9% (28 patients), they were linked to supplements. Of these 28 patients, 19 were using supplements geared towards body building or weight loss.

All of the liver injuries that resulted in death (11% or 18 patients) were attributed to pharmaceuticals. No liver injuries in these 18 patients were attributed to supplements. Eight of the patients who were in this study received a transplant. One of these was attributed to an over-the-counter weight loss supplement, CVS Spectravite.

My concern with this type of reporting is that often, I, like many other health care professionals, only read the titles and highlights. Of the total 30 patients who were taking supplements, there were also no indications whether they had been prescribed to them by a Licensed Health Care Practitioner or a Trained and Educated Health Care Practitioner.

I find the article in Family Practice News to be reflective of the bias in the media and in allopathic research, which often highlights aspects of wholistic medicine, rather than focusing on the consequences of an over-medicated society. A point of interest is that all liver injuries due to Acetamenaphin were excluded from this study. I wonder how much smaller would the percentage have been for supplements, if all Liver injuries were included in this report.

Cooking With Chinese Herbs To Stay Healthy During The Winter Months

By Ann Wolman, L.Ac.

In Chinese Medicine, the winter is associated with the water element and with the energetic organ system of the Kidneys. It is the time of maximum yin. These are the cold, quiet, contemplative months. Kidney energy holds our deepest reserves and provides the basis for our constitutional strength. This is a perfect time of year to incorporate nourishing and warming medicinal herbs into your cooking.

Foods and herbs have flavors, temperatures and energetic qualities. The Kidneys are nourished by the flavor of salt and other astringents. The Kidneys benefit from cooling or warming foods depending upon an individual’s constitution, but generally speaking, the Kidneys prefer warm natured herbs and foods. Some foods that nourish Kidney Qi are root vegetables like potatoes, yams, parsnips, and small beans like kidney, aduki and black beans and seeds.

One of the best ways to utilize Chinese dietary and herbal therapy is to cook with Chinese herbs. You can put raw herbs into soups and stews. This is often done with herbs like gou qi zi (lycuim fruit), dang shen (codonopsis), fu Ling (Poria), ren shen (Ginseng) and da zao (Chinese Dates).

It is also traditional to make congee, a kind of grain soup, with herbs. These congees are tasty, nutritious, and cost effective. They are particularly comforting on a cold winter morning. All of the herbal ingredients mentioned are available at the clinic and your practitioner can make more specific recommendations regarding those, which would be most beneficial for you.

Below are a couple of simple congee recipes.

Both of these congees can be varied based upon your taste, and as your practitioner recommends. You can use rice, millet, barley quinoa or amaranth as the base. Spices include cinnamon, bay leaf allspice, rosemary, ginger, nutmeg, cloves and fennel. Try walnuts, almonds or pumpkin seeds, and include different vegetables like sweet potato, pumpkin and squash. Experiment a little and enjoy.

If your practitioner suggests a more Kidney yin nourishing recipe, try the Mulberry Congee Recipe.

Basic Herbal Congee Recipe (warming)

½ cup white rice
8 cups vegetable or chicken stock (5 cups stock to 1 part grain if using a crock-pot)
10 grams astragalus root (huang qi)
6 grams codonopsis root (dang shen)
5 grams pueraria root (ge gen)
5 grams lotus seeds (lian zi)
8 shitake or black mushrooms, slivered
1 carrot, diced
1 strip seaweed

Place the astragalus in a bag or tie with string. Cover the codonopsis and pueraria with boiling water for 20 minutes, and then cut into ¼ inch lengths. Simmer all ingredients except carrot for 60 – 90 minutes, or cook overnight in a crock-pot on a low temperature setting. Add the carrot for the last 12 minutes. When done, remove astragalus and serve. This recipe can be varied using other grains like barley and warming herbs like fennel seed and dried ginger.

Mulberry Congee Recipe (cooling)

30 grams fresh mulberries
20 grams dry mulberries
20 grams dried lycium fruit (gou qi zi)
1 /2 cup walnuts
1 cup rice
4 – 7 cups water (7 cups water if using a crock-pot)

Cook mulberries and rice in water preferably overnight in a crock-pot on low setting. Add lycium fruit and walnuts. Serve warm each morning on an empty stomach.

It is even more important in the winter months to follow the basic principles of Chinese dietary therapy, as this will help to protect us from the bad effects of cold natured foods that tend to predominate the American diet. It is suggested that one avoid raw fruits and vegetables and cold or chilled foods and beverages (especially ice cream). Bon Appetit!

DAO YIN Exercises for Health

By Junie Norfleet, L.Ac.

In the book Daoist Health Preservation Exercises, it is reported that Dr. Tissot, a famous French doctor from the 18th century, said, "As far as the role of movement is concerned, it can almost replace any kind of medicine. But no medicine in the world can replace the role of movement."

For many years the Chinese culture has recognized the importance of using movement to maintain and support the health of the body. The type of movement that the Chinese culture uses is not the aerobic and weight lifting types of movement that are so much a part of the culture in the United States.

Dao Yin movements are gentle and yet very effective for moving the energy (qi) of the body to help maintain health or to help cure illness. Following are some Dao Yin exercises that will help to maintain a supple, energized body. (As with all exercise, do only what your body feels comfortable doing.)

1. Lie on your back. Relax. Notice where your breath is in your body. Put your hands on that area. Relax. Gently guide your breath to the lower body. Breathe into the lower body several times. Place one hand on the upper body and one hand on the lower body. Inhale into the lower body and hold the breath. While holding the breath, force the breath into the upper body and then back down to the lower body. "Pump" the breath between these two places until you can no longer hold your breath. Release the breath through the mouth. Repeat several times. Relax and notice where the breath is now.

2. Stretch both hands over your head and spread your legs so that your body looks like an "X." Relax. Now you are going to "crawl on your back." Stretch the right hand higher over your head, then stretch the left leg out; then the left hand higher and the right leg out. By letting the hips shift as you reach, a "crawling" motion will be created when you do it at a fairly rapid pace. Once you have done it several times, relax and notice what feels different in your body. Where is the breath?

3. Lie on your back with your arms out to the sides as if the body is a cross. Pull the knees up and place the feet on the floor. Cross the right leg over the left leg so the knees cross. Inhale and let the weight of the right leg push the left leg to the left as far as it will go and release the breath. The head should naturally turn to the right. Let the left leg do the work of bringing both legs back up. Repeat this several times. As you repeat the exercise again, this time let the legs flop over to the left and release the breath rapidly. Repeat several times. Now lie on your back again. Notice what feels different in the body. Which leg feels longer, heavier? Where is the breath?

4. Repeat exercise 3, but cross the left leg over the right.

Doing these gentle exercises helps to lubricate the joints, stretch the sinews, move the qi, and relax the body. As you do these exercises more and more, you will begin to notice that you feel more centered and comfortable in your body, and that your body can stretch more each week. And remember, there is no medicine that can take the place of movement!

Setting a Good Example through Healthy Eating

By Rachel Nowakowski, L.Ac.

At Thanksgiving dinner, I noticed how some kids are willing to try new foods while others reject anything unfamiliar. Like adults, children develop a natural preference for what they eat most often and enjoy. One way to get kids to make healthy choices is by setting a good example. Because the childhood impulse to imitate is strong, you can encourage your child to eat nutritious foods by being a role model.

Spleen qi is responsible for transforming and transporting food essences and absorbing nutrients. In Chinese medicine theory, children are born with underdeveloped Spleen energy. Considering this theory, we must carefully introduce new foods to children. Overindulging in sweet foods will only lead to further Spleen qi deficiency. Because Spleen qi is associated with the sweet flavor, when it is out of balance, we usually crave sweet foods. (Perhaps this is why so many kids seem to be born with a sweet tooth!)

When your kids ask to taste what you're eating, it helps to have your plate filled with nutritious selections. But healthy eating is not just about what we eat, but also how we eat. Eating while under physical or emotional stress can be harmful to the digestion, even if we are eating a perfect diet. Do you eat while in a hurry? While standing up? While under stress? Stress negatively impacts Liver qi. When this excess energy overacts onto the Spleen, digestion will suffer.

We can teach our children healthy eating habits and take special care to protect Spleen qi if we:

Sit down to eat together. Studies show that children and teens, who eat frequent meals with their families, eat more fruits and vegetables (even dark green ones) and drink fewer soft drinks.

Knowing that dinner is served at about the same time every night and that the family will be sitting down together is comforting, which also enhances appetite and digestion.

Relax. Sitting and taking the time to eat slowly and digest helps Spleen qi to break down food properly. When we eat on the run or rush from the table after eating, it sends qi to other parts of the body when we need the qi in our stomachs for digesting. Taking time to give thanks and enjoy the company of your family and friends during meals also sets a good example for children.

Limit mealtime conversation to pleasant topics. Eating together provides time for your child to share what's on his/her mind. Make mealtime an enjoyable experience by avoiding upsetting topics while at the table.

Chew well. How many times have we heard this? Yet many of us tend to speed through meals, barely chewing our food. Digestion begins with chewing. Chinese medicine says the digestive qi works to break down food into a "100 degree soup". If we chew well, food gets broken down before it reaches the stomach and leaves less work for the digestive qi.

Avoid excess fluids while eating. Don't put out the digestive fire by drinking too many fluids. It is best to drink a little at the beginning and at the end of the meal. Not between each bite. Limiting drinks for kids will also keep them from getting full before they've eaten their vegetables!

Other tips to encourage healthy eating:

Get kids involved. Let them help with the grocery shopping. It's a great time for you to teach them about the nutritional values of different foods, and how to read food labels. Let your child help with dinner by washing or peeling the vegetables. Start a vegetable garden at home so your kids can eat what they grow!

Keep only healthy snacks around. Kids are bombarded by messages that counteract your best efforts. Between peer pressure and junk food advertisements, getting your child to eat well might seem like a lost cause. They may choose poorly when they are out of the house, but you can decide what is available to them at home.

Your children are looking to you for direction on how to eat well. Show them how and help your own health at the same time. Research shows that it takes the average child 8-10 presentations of a new food before he/she willingly accepts it. So don't give up.

Have the kids help with this fun and yummy recipe:

Butternut Squash Fries. Peel and remove seeds from squash. Cut into long, 1/2-inch wide strips. Drizzle with olive oil. Sprinkle with sea salt. Toss the fries to make sure they are evenly coated. Spread fries on a baking sheet. Bake 30-45 minutes, turning to ensure they are crispy on all sides. Enjoy!

Ensuring the Safety of Chinese Herbs

By Mary Cissy Majebe, L.Ac.

Due to the arrival of toxic toys and foods from China into the United States, I would like to address the safety of Chinese herbal medicines for our patients. I will share information with you about how herb producers and manufacturers in the United States have been working to ensure the safety of Chinese herbal products.

First of all, for more than ten years, herbal manufacturers and Chinese medicine practitioners have taken steps towards ensuring a safe supply of Chinese herbal products. Aware of potential issues, Licensed Acupuncturists and herbal companies in the U.S. had already begun instituting procedures to ensure that herbal medicines were safe. This was done well before the recent crisis involving toys and foods from China, and the FDA’s new regulations for dietary ingredients, nutritional supplements and herbal medications.

Secondly, herbal companies in the U.S. carry product liability, which means they must have Certificates of Analysis for each herb product they offer for purchase. This verifies the identity of the herbs in order to prevent misidentification. This process also involves testing to assess any heavy metal toxicity or bacterial contamination.

Asia Natural is the primary company that supplies the Chinese Acupuncture Clinic with the herbs used for making teas. We have worked with this company for more than 20 years, and I have personally visited them in Berkley, California, where I was given a tour of their facilities. I left the factory reassured that the company was doing an excellent job supervising the growing of the herbs in China and following the testing guidelines for herbal products.

In June of 2007, the FDA published its final regulations. Called FDA cGMP, these standards require that each herb importer and manufacturer have documentation attesting to the identity and purity of the herbs it has imported into the U.S. from China. All raw herbs entering the U.S. must meet specifications, which include testing for active ingredients, heavy metals and bacterial contamination. These regulations are to be implemented June 25, 2009 or June 25, 2010.

Likewise, regulations have been published in China requiring cultivators to follow certain practices that minimize pesticide use and residues. In July 2001, China adopted the "Green Trade Standards of Importing and Exporting Medicinal Plants and Preparations." These standards provide for testing of organochloride pesticides, as well as heavy metals, bacteria and aflatoxin. Although pesticides of various types are used in growing some portion of Chinese herbs, detectable levels of pesticide contamination cannot be found.

In conclusion, thanks to a safety net of regulations from the U.S. and China, as well as the conscientious oversight and testing of American herbal companies, I feel comfortable trusting the herbal products available to our patients at the Chinese Acupuncture Clinic.

Supporting Childbirth With Acupuncture

By Joshua Herr, L.Ac.

A documentary on the state of childbirth in the United States was released this year. “The Business of Being Born” was produced by Ricki Lake and directed by Abby Epstein. In 2006, CNN reported, “The US has the second worst newborn death rate in the developed world.” In all other countries, midwives attend 70-80% of births. In 2003, midwives attended approximately 8% of births in the United States.

The rate of cesarean section has increased as a result of the majority of births occurring in hospitals instead of birthing centers or homes. The pharmaceutical pitocin is often used in the hospital to speed the process of labor by increasing the strength and frequency of contractions. This induction of labor can be too soon or too strong for the mother or child and lead to cesarean as the next intervention. To help prevent this cascade of events, choose a care provider who induces labor only for medical reasons.

In 1998, the journal Gynecologic and Obstetrics Investigation published a study titled, “Influence of Acupuncture on Duration of Labor.” Beginning at week 36 of pregnancy, they gave 4 treatments once per week with acupuncture. The comparison group consisted of women who delivered closely before or after the women who were receiving acupuncture.

What they found was that the acupuncture group had a significantly shorter time of first stage of labor, which they defined as 3-cm dilation to full dilation. The average time of the first stage of labor for the acupuncture group was 196 minutes, which is a little over 3 hours. The average time of the first stage of labor in the group that did not receive acupuncture was 300 minutes, which is a little over 5 hours. There was no change in the duration of the second stage of labor, full dilation to delivery. This study suggests that acupuncture is useful in preparation for childbirth and can shorten Stage l of the laboring process.

We are grateful for many of the advancements in science and technology that have saved the lives of premature babies and mothers of high-risk pregnancies. However, the advancements in scientific knowledge do not replace the inherit knowing of the woman’s body.

Midwives recognize this inherit ability of the mother and know how to encourage it emotionally and spiritually during the process of labor. They are also trained on how to assess the need for medical intervention to ensure that the mother and newborn are not in danger during the birth process.

In Germany, many midwives are trained to perform acupuncture in the context of pregnancy and childbirth, because they recognize the benefits.

The practitioners at CAC are well equipped to work with pregnant patients and have many resources to offer including relieving pain during pregnancy, labor induction, assisting with turning a breech baby, and late stage acupuncture for preparation for child birth.

Sugar, Sugar Everywhere. Not Sure What To Eat?

By Rachel Nowakowski, L.Ac.

Eliminating sugar from the diet isn’t easy. The U.S. Department of Agriculture estimates that the per capita consumption of sugar is 44.2 lbs per year! Sweetened items on special occasions and in moderation can make life a little more fun, but there are alternatives to refined white sugar and high fructose corn syrup.

In Chinese Medicine, the sweet flavor is associated with the Spleen energy. The Spleen energy benefits from a small amount of the sweet flavor, as found in whole grains and vegetables. In large quantities, sweet foods weaken the Spleen, impeding the digestive function and causing dampness to accumulate in the body. Just because something is “naturally sweetened” does not necessarily mean it is any better for you. As a general rule: the less sweet, the better. When we read labels on natural food products, we see a variety of different sweeteners.

Here are a few:

Grain Malts like rice syrup, barley malt, and amasake are mildly sweet and do not cause a rapid rise in blood sugar. These sweeteners are considered to be among the healthiest sweeteners in the natural food industry.

Stevia is an all-natural substance derived from the leaves of a South American shrub. It has virtually no calories, doesn't raise blood sugar levels, and does not appear to have the same dampness-producing quality of other sweeteners when used in moderation. But because it is considered to be 300 times sweeter than sugar, an overconsumption can lead to Spleen weakness.

Molasses is a thick syrup by-product from the processing of the sugarcane or sugar beet. Black Strap Molasses contains significant amounts of vitamins and minerals and is the least sweet of the varieties. It is considered a Blood tonic because of its high iron content.

Honey is as sweet as sugar. Research has found that honey enhances growth of specific strains of Bifidobacteria, beneficial bacteria in the colon. Honey neutralizes toxins, activates the Lung and Spleen meridians, and nourishes Yin.

Sugar Alcohols (Mannitol, Sorbitol, Xylitol) are derived from the fibers of fruits and vegetables. Excess consumption can have a laxative effect and may produce gas, which implies that they do impact on the Spleen qi.

Many people turn to artificial sweeteners in an attempt to cut sugar from their diet. But what are they really made of? Aspartame (NutraSweet, Equal) breaks down in the body and converts to formaldehyde! Saccharin (Sweet n’ Low) is a petroleum-based compound, which was temporarily banned in 1977 when a study suggested saccharine caused bladder cancer. Sucralose (Splenda) is chlorinated and other chlorinated substances are known to contain pesticides. With these sweeteners, you may get more than just a little sweetness.

With all the options readily available to us, why not go for more natural, less sweet foods? The best source of sweetness is whole foods, chewed well to bring out their natural flavors.

Baked Apples

2 red apples, cored
1 tablespoon butter
1 tablespoon maple syrup or honey
1/8 teaspoon ground cinnamon
1/8 teaspoon ground ginger
1/2 teaspoon lemon juice
1/4 teaspoon vanilla extract
1 tablespoon coarsely chopped walnuts

1. Preheat oven to 350 degrees. Place apples in a baking dish.

2. In a small saucepan over medium heat, combine all other ingredients.

3. Bring to a boil, and drizzle equally over apples.

4. Cover with foil, and bake for 20 minutes. Remove cover, and continue to bake for 10 minutes, or until apples are tender. Serve warm.