Maintaining Muscle When You’re Sick or Injured: Why It Matters and How to Do It

Muscle loss is accelerated in response to serious illness or injury, and that can have a direct impact on your recovery, which is why maintaining muscle mass when you’re sick is so very important. Essential amino acids can help reverse muscle loss associated with illness, injury, or high stress levels, and help accelerate recovery.

It is unfortunately true that, at some point in our lives, most of us will have to deal with a major health issue. This may be surgery, serious illness such as pneumonia, or chronic disease such as kidney disease. Muscle loss is accelerated under such conditions, which can have a direct impact on your recovery. In this article, I’ll first explain the biological processes that contribute to accelerated muscle loss and why it’s so vital to counteract those. Then I’ll equip you with evidence-based good advice on maintaining muscle when you’re sick, a key piece of which is to focus on obtaining a steady supply of essential amino acids to help reverse muscle loss and accelerate your recovery.

The Importance of Maintaining Muscle When You’re Sick or Injured

The consequences of muscle loss as a result of serious injury or illness can be severe and immediate. Muscle mass can be a direct contributor to survival during times of critical illness and can significantly contribute to the speed and extent of recovery. When we age, we lose muscle slowly and gradually. However, battling a serious illness or injury can result in rapid weight loss—a significant portion of which may come from the loss of muscle tissue rather than body fat. This deterioration of muscle mass occurs so quickly that consequences can be evident in a matter of days or weeks.

Understanding the Catabolic State

In technical terms, the biological mechanisms that result in rapid muscle loss can be referred to collectively as a catabolic state. This state itself can be seen as a subcomponent of the body’s overall physiological response to intense stress. Regardless of the underlying cause of that stress (i.e., cancer, injury, surgery, etc.), the body’s response features certain common aspects.

In a catabolic state, you not only lose an increased percentage of your muscle mass in a shorter period of time, but you also experience decreased appetite as well as metabolic changes, such as reduced sensitivity to the action of the hormone insulin, that intensify the associated adverse outcomes. The loss of appetite results in decreased nutritional intake at a time when demand for dietary nutrients, particularly protein, is increased.

Interestingly, regardless of the clinical condition that causes the stress response, changes in muscle protein metabolism are basically the same. Therefore, the body’s response to stress and the effects of the catabolic state can be discussed generally without the need to specify what instigated them.

Muscle Protein Metabolism in a Catabolic State

The rapid loss of muscle protein that transpires during a catabolic state reflects an imbalance between the rates of muscle protein synthesis and muscle protein breakdown. This imbalance has less to do with changes to muscle synthesis (muscle growth) and instead stems from a large increase in the rate of muscle protein breakdown. You can see in the figure below how different illnesses affect a similar increase in muscle protein breakdown.

Maintaining muscle when you're sick

Certain physiological states, such as illness, cause the rate of muscle protein breakdown to accelerate. This, in turn, releases a flood of essential amino acids into the muscle cells to stimulate muscle protein synthesis. The message sent by the availability of essential amino acids is to amp up muscle growth to attempt to keep pace with muscle loss. However, the increased synthesis is still not enough to balance the dramatic increase in breakdown. The net result is a large increase in the loss of muscle mass because muscle protein synthesis just can’t match the speed of muscle protein breakdown.

While free amino acids released during muscle protein breakdown can be reincorporated during muscle protein synthesis, that process is further stimulated only marginally (or not at all) by nutritional intake. The catabolic state suppresses appetite so much that it is hard to eat enough food, and even when you do force down food or rely on traditional protein shakes and meal replacement beverages, you see little or no beneficial response. Food doesn’t have much of a beneficial effect due to the abundance of essential amino acids already available. Accelerated protein breakdown has freed so many essential amino acids for protein synthesis that the rate of synthesis is already close to maximal.

Furthermore, the catabolic state causes severe anabolic resistance, which means eating dietary protein doesn’t increase muscle protein synthesis in times of injury and stress as it does in times of optimal health. The body absorbs essential amino acids from intact protein slowly and the extent of the increase in essential amino acids is not particularly large. Therefore, dietary protein is essentially rendered ineffective in stimulating protein synthesis because consuming it doesn’t induce enough of a change in essential amino acid concentrations in the muscle.

Activating Muscle Building In a Catabolic State

In order for muscle protein synthesis to be further increased in the stress response, there must be an activation of the intracellular molecules involved in initiating protein synthesis. The central factor in this process is an initiation factor of protein synthesis called mTOR.

New evidence indicates that the most effective way to activate mTOR is to fortify your body with an essential amino acid supplement formulated with a high proportion of leucine. The leucine stimulates mTOR activity, and the available essential amino acids serve as precursors for newly synthesized protein. If enough essential amino acids are consumed, concentrations will rise high enough to inhibit muscle protein breakdown as well. The combination of activating mTOR and stimulating protein synthesis while inhibiting protein breakdown improves the net balance between protein synthesis and breakdown.

To synthesize the most important and actionable point: supplementing with a mixture of free essential amino acids high in leucine can slow the net loss of muscle protein, whereas consuming intact protein in a meal or a meal replacement beverage is ineffective during physiological stress.

Why Inactivity Exacerbates Muscle Loss

Illness, injury, and surgery bring about inactivity. If you are ill or injured enough to be admitted to the intensive care unit, you will almost certainly be confined to bed. Those over 65 years old may find themselves confined to their beds during hospital stays even when they are capable of walking due to concerns with stability and risk of a fall.

After surgery, you are likely to be physically limited until incisions are healed and you show some degree of recovery. This is particularly true after orthopedic surgery. Even illnesses that don’t require hospitalization take a serious toll on the body and health care practitioners advise pausing your exercise program until you have fully recuperated.

Hopefully, you have made sleep a priority during times of health. Your body needs high-quality rest to recover between training sessions and maximize the strength and fitness gains you hope to achieve with your hard work. Short-changing your rest periods will hold you back. This holds particularly true when you’re sick or injured. Not only do sleep and rest enhance immune function, but physical activity can also suppress it. Plus, if you’ve fallen victim to flu season or a respiratory infection, heading back to the gym too soon means you’re likely to infect your fellow gym-goers. And while injuries are not contagious, returning to your usual exercise program too soon increases the likelihood that the original injury will not heal properly, which often necessitates further time off in order to make a full recovery.

Scientific Studies on Inactivity and Muscle Loss

For all these reasons, the metabolic effects involved in muscle loss that I explained above are usually coupled with the catabolic impact of inactivity.

A series of studies sponsored by the National Aeronautics and Space Agency (NASA) showed how inactivity amplifies the catabolic response to stress. Spaceflight offers a perfect model for experimentation. The lack of gravity during spaceflight reduces the physical work of movement drastically, and muscle loss during space flight can be severe.

NASA has used strict bed rest as a model for the effects of zero gravity during space flight. Bed rest studies have been done on young, healthy subjects and older subjects. As you might expect, inactivity produces the opposite effects of exercise. Muscle mass and strength are reduced, and the rate of deterioration is faster in older individuals.

By itself, inactivity is detrimental to muscle mass and function. When coupled with the physiological stress response to illness or injury, inactivity accelerates muscle loss.

Studies have shown that the use of amino acids can, once again, effectively counterbalance the processes that result in the loss of muscle mass. Consumption of a balanced essential amino acid mixture (15-gram doses) throughout bed rest slowed the loss of muscle mass and strength in both young and older subjects as illustrated in the figure below.

Further confirmation of the role essential amino acids play in maintaining muscle mass comes from a blinded study of a large number of patients in which a carefully formulated blend of amino acids was shown to speed recovery from hip or knee replacement, procedures which inevitably involve a significant limitation in activity.

How to Maintain Muscle During Acute Crises and Ongoing Recovery

The acute period of the catabolic state can be considered the most severe phase. The word “acute” implies a short time, but in fact, this phase can last for months in some cases, such as for individuals with cancer. During the acute phase, body weight and muscle mass are rapidly lost. Decreased appetite complicates the metabolic response.

Essential amino acid supplements are uniquely suited for the acute phase because they can be formulated to elicit a stimulation of muscle protein synthesis, even in the state of anabolic resistance. Given that your appetite is flagging, many find it preferable to consume the necessary essential amino acids in supplement form because of the small volume in which an effective dose can be delivered.

The recovery phase still presents metabolic challenges, as many of the responses in the acute phase are slow to heal in the recovery phase. For these reasons, an essential amino acid supplement should be used as a supportive aid during the recovery phase. Essential amino acid intake is crucial to avoid replacing lost muscle with fat.

The specific goals for recovery and strategies for achieving those goals will vary from person to person, however, the following pieces of advice apply almost universally for everyone seeking to preserve muscle in the wake of sickness or injury.

Maintaining muscle when you're sick

1. Fuel the Healing Process

As discussed, the catabolic state decreases appetite. You may also find that nutrient-poor comfort food such as ice cream holds the most appeal. While there’s no shame in indulging (in moderation, of course), be sure to provide your immune system with the nutrients it needs to carry out the healing process.

If you’re in the habit of targeting your caloric intake in accordance with your weight-training regimen, for instance, you should err on the side of generosity when calculating your maintenance caloric intake. It’s more likely that you will undershoot your nutrient goals, catalyzing further muscle loss. If you do overshoot and gain a little fat, chances are your weight will even out once you start training again.

Given that you’ll likely be working with lower appetite levels, it can be helpful to divide your overall caloric intake into six smaller meals spread throughout the day.

2. Prioritize Protein Intake

While dietary protein intake does not get utilized as effectively when your body is coping with injury or illness, that does not mean you should neglect to consume an appropriate quantity of protein.

As a general rule, you should aim to take in approximately 1 to 1.5 grams of protein per pound of lean body mass. This will help to prevent excess muscle protein breakdown.

According to a study published in the American Journal of Clinical Nutritionwhen critically ill patients in hypermetabolic and catabolic states consumed higher quantities of protein they had positive nitrogen balances. Those with lower protein intakes, however, had continued negative nitrogen balances and continued to experience muscle protein catabolism.

Work with the constraints of your appetite and seek out easy-to-eat, easy-to-digest sources of protein, such as cottage cheese, yogurt, and omelettes.

3. Avoid Simple Carbohydrates

Though it can be tempting to base your diet on white toast with cinnamon and sugar, that type of meal plan will compromise muscle mass maintenance and encourage your body to store any calories not used for essential functions as fat.

If you are going to eat a carbohydrate-heavy meal, timing matters. Plan to consume your simple carbohydrates early in the day when your muscle cells are primed to store calories as glycogen.

4. Liberalize Fats

Per the American Journal of Clinical Nutrition study cited earlier, your body can use fats more effectively than it can carbohydrates while in a catabolic state.

While an increased carbohydrate intake was associated with lipogenesis (fat formation) and decreased fat oxidation (fat burning), the reverse proved to be true for an increased fat intake.

Furthermore, fatty acids form a crucial element of cell membranes, which your immune system will be rapidly generating as you navigate the recovery process. Ensure your immune response can produce all the new cells it needs (in particular, white blood cells) by providing it with a steady supply of healthy fats. A good goal would be to take in 30% of your total daily caloric intake from high-quality, omega-3-rich fatty foods.

5. Hydrate, Hydrate, Hydrate

It bears repeating. Our bodies constantly lose fluids, and when you consider increased mucus production, fevers, rapid generation of new cells, and so on, you can easily see how your hydration needs increase when your health has been compromised.

It’s incredibly unlikely you will over-hydrate. According to some experts, a gallon of water is the minimum you should consume during an acute health crisis. And it should go without saying that you should continue to drink plenty of water as you move from the crisis to recovery phase.

Autoimmune Diseases: When the Body Attacks Itself

Autoimmune diseases are relatively common in the United States. Autoimmune disease does not refer to one particular disease but rather a group of diseases that all stem from the body’s immune system misfiring or malfunctioning. Let’s answer some of the most common autoimmune-related questions.

Autoimmune diseases are relatively common in the United States. The American Autoimmune Related Diseases Association reports that 50 million Americans have some form of autoimmune disease. Of those 50 million Americans, 75% are women.

Let’s answer some of the most common autoimmune-related questions:

  1. What exactly is an autoimmune disease?
  2. What are the most common autoimmune diseases?
  3. Why do autoimmune diseases affect women so much more frequently than men?

What Is Autoimmune Disease?

Autoimmune disease does not refer to one particular disease but rather a group of diseases, or autoimmune disorders, that all stem from the body’s immune system misfiring or malfunctioning.

The body’s immune system is comprised of white blood cells that produce antibodies. These antibodies are the body’s defense system against everything from common colds and sinus infections to shingles, pneumonia, and cancer. The immune system’s job is to produce these white blood cells and antibodies so they can protect the body from illness and help it heal from injury.

But sometimes, the immune system confuses healthy cells and tissue for foreign cells and germs. When this happens, the immune system produces autoantibodies that may attack the body’s own tissues, organs, cells, joints, and muscles, although the body’s connective tissues (skin, muscle, and joints) are the most vulnerable to attack. So, a simple definition of an autoimmune disorder is a disease in which the immune system attacks the body.

Autoimmune diseases take many forms. They are often systemic, meaning they attack numerous parts of the body. An example is rheumatoid arthritis, which attacks multiple joints and the surrounding tissue. An autoimmune disease may also focus on one main part of the body, such as Graves’ disease, which attacks the thyroid. Autoimmune diseases may develop at any age but often start at a young age or in middle age.

What Causes Autoimmune Diseases?

Doctors know that autoimmune diseases are brought on by the body’s immune system misfiring and launching missiles at healthy cells. But they do not know what causes this autoimmune response to begin. Several risk factors are thought to contribute to one’s risk for developing an autoimmune condition.

Race

Some autoimmune diseases, such as lupus, are more frequently diagnosed in Hispanic and African-American people. Overall, African American, Latino, and American Indian ethnic groups tend to be at a higher risk for autoimmune conditions.

Genetics

Autoimmune diseases do have a hereditary link. Often, several members of the same family are found to have an autoimmune disease, even though they may not all have the same disease. For example, it is possible for three different members of the same family to each have an autoimmune disease for a total of three different autoimmune diseases in one family. Each of the three family members would likely have something written in his or her genetic code that made them develop an autoimmune disease, even though the autoimmune response may manifest as a different disease in each person.

Environmental Factors

Some doctors believe that environment plays a critical role in the onset of autoimmune diseases. A 2016 study published in Cellular and Molecular Life Sciences and a 2004 study published in the European Journal of Endocrinology highlighted key environmental factors such as diet, smoking, radiation exposure, and bacterial or viral infections that are thought to contribute to the development of certain autoimmune diseases, including thyroid diseases and multiple sclerosis.

Some people may develop more than one autoimmune disease. A study published in Maedica A Journal of Clinical Medicine revealed that about 25% of autoimmune patients tend to have one or more additional autoimmune diseases. If a patient develops three or more autoimmune diseases, it is known as multiple autoimmune syndrome, or MAS.

Autoimmune Diseases: When the Body Attacks Itself

Symptom Triggers

Regardless of the genetic or environmental factors that may cause a person to develop an autoimmune disease, there are certain triggers that may bring about the initial onset of symptoms. These triggers may also induce a flare of symptoms, even if the disease has been in a state of remission for some time. Common triggers of autoimmune activity and symptoms include:

  • Stress—thought by some to be the number one cause of symptom flares
  • Allergens
  • A diet high in inflammatory foods like sugar, sodium, and alcohol
  • Infection
  • Injury
  • Environmental factors such as exposure to chemicals

Women vs. Men

For years, doctors and scientists have been trying to figure out why autoimmune diseases are more prevalent in women than in men. While no one knows the exact reason, various studies lean toward a genetic predisposition and environmental factors.

A study published in the journal Emerging Infectious Diseases suggests that infections may play a role, as women have been shown to have an increased immune response over men when it comes to severe infection. Researchers believe that when women face a serious infection or illness the elevated response from their immune systems may be a triggering factor in the development of autoimmune diseases, though further research is needed to confirm this.

Other studies suggest a link between autoimmune diseases and sex chromosomes. A 2015 study published in Frontiers in Genetics suggests that, because women have two X chromosomes while men have only one X and one Y chromosome, the additional X chromosome in women may play a part as to why women develop autoimmune diseases more frequently than men do.

Despite many studies and theories as to why autoimmune diseases develop more often in women than in men, the short answer is that no one quite knows for sure yet.

Symptoms of Autoimmune Disease

According to the American Autoimmune Related Diseases Association, there are over 100 different types of autoimmune diseases. Many autoimmune diseases present with similar symptoms.

More specific symptoms will be found when looking into different diseases. For example, lupus may present with a butterfly-shaped rash across the face and joint pain, and Graves’ disease may present with unexplained weight loss and a goiter, or enlarged thyroid, that can be seen and felt when swallowing. Psoriasis shows up as scaly, silvery plaques on the skin due to the immune system’s overproduction of T-cells.

With some diseases, a patient may experience periods of remission, in which the symptoms go away. When the symptoms return, the patient is considered to be having an active flare.

Diagnosing Autoimmune Diseases

Diagnosing an autoimmune disease can be very difficult. Many autoimmune diseases present with similar symptoms and most do not have a single definitive test that will provide a simple positive or negative result. The American Autoimmune Related Diseases Association states that the average autoimmune patient spends over 3 years seeking a correct diagnosis and will see 4 different doctors during that time.

Diagnosing an autoimmune disease often consists of running a variety of tests and ruling out certain conditions to try to narrow things down. If a doctor suspects a patient’s symptoms are from an autoimmune disease, he or she will typically order a series of blood tests. Common blood tests used for diagnosing autoimmune diseases include:

  • Antinuclear antibody test (ANA): An ANA test is a blood test that checks for autoantibodies. If a patient has a positive ANA test, it doesn’t necessarily mean he or she has an autoimmune disease, but it does let the doctor know that an autoimmune disease shouldn’t be ruled out.
  • Inflammation test: Some autoimmune diseases, such as rheumatoid arthritis, cause chronic inflammation throughout the body. If a patient’s inflammatory markers are high, it helps point the doctor toward an inflammatory disease.
  • Organ function tests: Some autoimmune diseases, such as Graves’ disease or lupus, target specific organs like the thyroid or kidneys. So most health care providers want to see how well a patient’s organs are functioning. If there is any indication that a specific organ is not working properly, then the doctor may be able to narrow down the list of possible diseases.

In addition to blood tests, a doctor may order images such as X-rays, sonograms, or MRIs. X-rays and sonograms may be able to show damage from a condition like rheumatoid arthritis. MRIs can be useful in diagnosing multiple sclerosis, as the disease typically causes lesions on the brain and spinal cord. A colonoscopy may be used to diagnose or rule out inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.

Types of Autoimmune Disease

The American Autoimmune Related Diseases Association lists over 100 different autoimmune diseases. Here are just a few of the most common.

  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Celiac disease
  • Pernicious anemia
  • Psoriasis and psoriatic arthritis
  • Inflammatory bowel disease
  • Hashimoto’s disease
  • Autoimmune Addison’s disease
  • Sjogren’s disease
  • Type 1 diabetes
  • Graves’ disease
  • Guillain-Barre syndrome
  • Autoimmune hepatitis
  • Myasthenia gravis
  • Multiple sclerosis

Autoimmune Diseases: When the Body Attacks Itself

Autoimmune Diseases Treatment

Treating autoimmune diseases can be a tricky business as not all patients will respond to the same treatments and some autoimmune diseases may be more aggressive in some patients than in others. The type of treatment a doctor recommends will depend upon the type of autoimmune disease he or she thinks is present. Treatments usually consist of a variety of medications including:

  • Pain relievers
  • Anti-inflammatories
  • Immunosuppressant drugs

From there it gets more specific. For instance, type 1 diabetes patients require insulin injections to regulate blood sugar, and people with underactive thyroid are prescribed thyroid hormone replacement to restore thyroid hormone levels.

In some cases, surgery may be required depending upon the disease, its impact on the body, and the overall health of the patient. For example, sometimes lupus patients will need to undergo a kidney transplant or Graves’ disease patients may need a partial or total thyroidectomy. These are usually done in cases in which the disease was caught in a late stage and much damage had already occurred or the patient did not respond well to medications and treatments and so the disease continued to progress and cause damage.

Depending upon the disease, some patients may also find relief in alternative therapies such as:

  • Acupuncture
  • Reiki
  • Massage therapy
  • Chiropractic care
  • Meditation and mindfulness

Any treatment plan should first be discussed with a physician to ensure it is safe for the particular autoimmune disease that has been diagnosed. Most autoimmune diseases are chronic and last a lifetime. While patients can achieve periods of remission, autoimmune diseases are unpredictable and can flare up at any time.

Breast Ultrasound: Should It Replace My Annual Mammogram?

A healthy debate exists over the methods used for breast cancer screening as well as the optimal frequency of screenings. While mammograms remain the most commonly recommended option, interest in the use of breast ultrasound as a screening test continues to grow.

Since the American Cancer Society first recommended mammograms in 1976, they have reigned as the primary test used for breast cancer screening. Millions of women receive an annual mammogram as part of a concentrated effort to increase early detection of breast cancer. Health care practitioners agree that early detection leads to better outcomes, in part because it allows for treatment using less invasive therapies. However, a healthy debate exists over the methods used for breast cancer screening as well as the optimal frequency of screenings. While mammograms remain the most commonly recommended option, interest in the use of breast ultrasound as a screening test continues to grow.

In this article, we’ll discuss the differences between the two types of imaging tests to help you understand the benefits and drawbacks of each method.

What Is a Mammogram?

Most of us have heard the word mammogram before, and know that it’s a breast cancer screening test. Unless you’ve had a mammogram yourself, however, you may not know exactly what the procedure entails.

The simplest explanation of a mammogram is that it’s a low-dose X-ray examination of the breasts. During a mammogram, you stand facing a special X-ray machine while a radiologic technician places each of your breasts in turn between an X-ray plate and a plastic plate. The X-ray machine then presses the plates together to flatten the breast, spreading out the tissue so a clearer image can be created when the X-ray is transmitted. The sensation is certainly not a comfortable one—many report feeling pinched or squeezed. However, this discomfort only lasts a few seconds.

Typically, two pictures will be taken of each breast, one from the side and one from above. The images—recorded either on X-ray film or on a computer—are called mammograms. A radiologist examines those images to look for changes in breast tissue that could indicate cancer. The whole mammogram process typically takes 20 minutes from the moment you enter the room until you leave.

Mammograms can be used as a part of routine screening for women who have no concerns about their breasts or for women worried about symptoms like changes to the size or shape of a breast, lumps that can be felt in breast tissue, nipple discharge, or pain. While many breast changes turn out to be benign, only a doctor can conclusively determine that.

According to the Office on Women’s Health, a division of the U.S. Department of Health and Human Services,  high-quality mammograms are “the most effective way to detect breast cancer early. Finding breast cancer early greatly improves a woman’s chances for successful treatment.”

The Limits of Mammograms

While mammograms are promoted by health institutions as the most effective method for early detection of breast cancer available at this time, they do have drawbacks.

The Office on Women’s Health lists the following limitations for the efficacy and use of mammograms:

  • False negatives: While this does not happen often, in some cases, mammogram images may indicate that all is well when cancer is actually present. According to the American Cancer Society, screening mammograms fail to find breast cancer in about 20% of all recorded cases. This is more common among younger women than older women, largely because of differences in breast tissue (more on that later).
  • False positivesIn certain instances, a mammogram result may make it appear that cancer is present when it is not. This can lead to unneeded worry and follow-up tests. Per the American Cancer Society, about 50% of women who receive annual mammograms over a 10-year period will receive at least one false positive. Having past mammogram results available for comparison dramatically decreases false positives, again, by around 50%. False positives happen at higher rates for young women, women who have had breast biopsies, women with family histories of breast cancer, and women taking estrogen.
  • Exposure to radiation: As is true of dental X-rays and other routine X-rays, mammograms expose us to small doses of radiation. This carries a very low risk of harm, though the accumulation of repeated X-rays over the course of a lifetime may slightly elevate your risk of developing cancer. It’s a good idea to speak with your doctor about the need for any type of X-ray, how to shield parts of your body not in the X-ray picture, and any possibility that you might be pregnant.
  • Increased likelihood of unnecessary interventions: Because mammograms can detect small breast lumps, masses, and calcifications, they may alert you to the presence of changes in your breast tissue that do not yet require treatment or may never require treatment. However, once those changes have been spotted, many do feel the need to intervene.

How Breast Density and Breast Implants Influence Mammogram Results

There are two types of breast tissue: fatty breast tissue and dense breast tissue. Mammograms are highly reliable when it comes to detecting changes in fatty breast tissue, but less so when it comes to dense breast tissue.

Fatty breast tissue appears black or gray on a mammogram while cancerous masses or calcium buildups appear white. This makes it fairly easy for a radiologist to spot cancer in fatty breast tissue. Dense breast tissue, however, is much thicker than fatty breast tissue and appears white on a mammogram just like cancer does. As a result, a radiologist may miss cancerous masses that are surrounded by similar-looking dense breast tissue.

According to the Susan G. Komen Foundation, 40-50% of U.S. women ages 40-74 have dense breast tissue, and these women are 4 to 5 times more likely to get breast cancer than women with mostly fatty breast tissue. For these individuals, it can be extremely valuable to use other breast cancer screening tests instead of or in addition to mammograms.

Mammograms can also be less effective for those with breast implants. Individuals who had reconstructive surgery including implants after a mastectomy should consult their doctor about the necessity of mammograms. In most cases, mammograms are still considered the most effective breast cancer screening test for those with breast implants who have not had mastectomies.

If you have breast implants, you should mention this when scheduling a mammogram so you can be paired with a technician and radiologist experienced in X-raying patients with implants. The reason for this is that implants can hide some breast tissue, so the technician will need to gently lift the breast tissue away from the implant and create additional images.

General Guidelines for Mammograms

Different organizations offer varying guidelines for both the age at which routine mammogram screening should begin as well as the ideal frequency of screenings.

The latest guidelines issued by the United States Preventative Services Task Force (USPSTF) recommends that women between the ages of 50 and 74 schedule mammograms every 2 years. This recommendation mirrors those of most European countries, but differs from those of other U.S.-based organizations.

For instance, both the American College of Radiology as well as the Society of Breast Imaging currently advise that women should schedule annual mammograms beginning at the age of 40. Meanwhile, the American Cancer Society holds that women between 45 and 54 years of age should schedule annual mammograms, then space that out to a mammogram every 2 years from the age of 55 onward.

The goal behind the more conservative recommendations in terms of the age at which screening should begin as well as frequency of screening is to reduce the rate of false positives, which some evidence shows increases among younger women as well as women who receive annual screenings.

What Is Breast Ultrasound?

The American Cancer Society describes breast ultrasound as a useful method for examining some types of breast changes, particularly lumps that can be felt during a physical exam but not identified on a mammogram or changes in the breasts of women with dense breast tissue.

Breast ultrasound can also be an advantageous next step after a mammogram to gather more information about breast changes, since ultrasound can distinguish between fluid-filled cysts—which tend not to be cancerous—and solid masses—which usually require additional testing such as biopsies to determine whether or not they’re cancerous.

Breast ultrasound uses high-frequency sound waves to create images of the interior of each breast. A trained ultrasound technician, typically a sonographer, first physically examines the breasts. If the purpose of the ultrasound is to gather more information about an identified change, such as a lump, they will also ask questions about when the change was first detected, whether you’ve noticed any other symptoms, and so on. Next, the sonographer will apply clear gel to the breast, which improves the ability of the high-frequency sound waves to move through the breast tissue, and gently move a wand-like device called a transducer over the breast.

As the sound waves emitted by the device bounce off body tissues, they create echoes that form ultrasound images on a computer screen in real time. A breast ultrasound typically lasts between 15 and 30 minutes, and while you will feel some pressure as the device moves across the surface of each breast, it will likely be painless unless your breasts themselves are tender at the time.

Because breast ultrasounds do not use radiation, they are the safest option for women who are not good candidates for screening tests that involve radiation, like mammograms. If you are pregnant or trying to become pregnant, for instance, you should avoid exposure to radiation.

Breast ultrasound can also be an advisable breast cancer screening measure for women with dense breast tissue. Because cancerous masses appear black on an ultrasound, as opposed to white on a mammogram, ultrasound can be a more reliable means of locating breast cancer in dense breast tissue.

The Limitations of Breast Ultrasound

Common consensus among health care providers at this time is that the limitations of breast ultrasound disqualify it as a screening test in most instances. Those limitations include:

  • Limited imaging capacity: The hand-held devices typically used for breast ultrasounds cannot take a comprehensive image of the entire breast. They also cannot take images of areas deep inside the breast, so while they can be used to detect and evaluate superficial lumps, deeper abnormalities may be missed. Ultrasound images also fail to capture architectural distortions and asymmetries.
  • Inaccurate diagnostic images: The increased specificity of ultrasound images which makes them advantageous as a screening tool for women with dense breast tissue also increases the likelihood that inaccurate diagnostic images will be produced. A great diversity exists both among ultrasound images of healthy breast tissue and pathological lesions, due to factors such as the age of the patient, hormone levels, and previous breast surgery, trauma, or radiotherapy. This can make it challenging to differentiate between benign variations and changes that indicate cancer.
  • Inability to detect microcalcifications: Early detection of breast cancer often results from the discovery of microcalcifications, tiny deposits of calcium that commonly appear in the tissue surrounding a tumor. Microcalcifications do not register on breast ultrasound, meaning a diagnosis could be delayed.
  • Impact of technician skill: The skill and experience of a sonographer can significantly impact the results. Human error can cause lesions to be overlooked or images to be misinterpreted.
  • False positives and false negatives: While mammograms can also deliver false positives, this happens at a higher rate with ultrasounds when they are conducted along with mammograms. As discussed previously, a false positive can lead to more tests, including invasive breast biopsies. This can send health care costs and anxiety levels soaring. Ultrasounds can also turn up false negatives, though this is less of a concern.

When to Consider Automated Whole Breast Ultrasound

By this point, it has hopefully become clear that neither mammograms nor breast ultrasound using a hand-held transducer are foolproof. Automated whole breast ultrasound is an option that some believe can be more reliable.

Concerns about the dangers of inadequate breast cancer screenings led board-certified diagnostic radiologist Dr. Kevin Kelly of the Breast Ultrasound Center in Pasadena, California to patent SonoCine automated whole breast ultrasound in 1999. According to Dr. Kelly, automated whole breast ultrasound eliminates some of the disadvantages associated with conventional breast ultrasound screenings, such as the inability to create a comprehensive image of each breast and the errors introduced by sonographers.

Automated whole breast ultrasound slowly scans the entire breast, capturing images that include the underarm area, the lymph nodes, the sides of the breasts, and the areas above and below each breast. The procedure captures thousands of pictures of the breast that are then played back like a movie for the radiologist to review. As with traditional breast ultrasound screenings, automated whole breast ultrasound is typically recommended as a secondary screening measure for women with dense breast tissue or breast implants. Again, as with hand-held breast ultrasound screening, the procedure typically takes about 30 minutes to complete and, in the absence of breast tenderness, does not cause pain.

Dr. Kelly is an advocate of breast health education and wants women to understand their breast type, risk factors, and options when it comes to breast cancer screening and diagnostics. He has given a Tedx Talk in which he highlighted the dangers of inadequate breast cancer screenings and the importance of making ultrasound procedures like AWBUS the standard in care.

As of 2012, the FDA has approved the use of automated whole breast ultrasound as a secondary breast cancer screening test, but not as a replacement for an annual screening mammogram.

Breast Ultrasound: Should It Replace My Annual Mammogram?

Breast Ultrasound vs. Mammogram: Which Is Best?

A study published in the Journal of the National Cancer Institute, a peer-reviewed journal that’s internationally acclaimed as the source for the most up-to-date information from the fields of cancer research and treatment, directly compared the efficacy of breast ultrasounds and mammograms. The lead author, Dr. Wendie A. Berg, concluded that: “Where mammography is available, ultrasound should be seen as a supplemental test for women with dense breasts who do not meet high-risk criteria for screening MRI and for high-risk women with dense breasts who are unable to tolerate MRI.”

Other experts agree. Sharon L. Koehler, an assistant professor of breast surgical oncology in the Department of Clinical Specialties at the New York Institute of Technology College of Osteopathic Medicine, believes mammography is the best primary screening test for most women, since the results are less dependent on the operator and the images show calcifications, architectural distortions, and asymmetries in addition to masses.

However, because hand-held ultrasounds are more portable and less expensive than the machines needed for mammograms, an emerging consensus among medical practitioners holds that they can be a crucial screening tool in developing countries. “As long as we are aware of ultrasound’s limitations, in countries where mammogram is not available, ultrasound is a good option,” Dr. Lusi Tumyan, City of Hope assistant clinical professor and section chief of breast imaging in the Department of Radiology, said in an interview.

According to Dr. Kelly of the automated whole breast ultrasound, approximately 50% of American women have dense breast tissue, and 70% of all breast cancers occur in dense breasts. Dr. Kelly has stated that one of the biggest misconceptions currently surrounding breast cancer screenings is that mammograms are believed to be fully able to find cancer whenever it’s in the breast, but this is not necessarily true. Dr. Kelly has stated that 50% of cancers in dense breasts are felt before they’re seen on a mammogram. According to Dr. Kelly, mammograms work well, but unfortunately, they don’t work often.

Another common misconception about mammograms that Dr. Kelly has observed is the belief that mammograms usually find cancers when they’re small. But Dr. Kelly has stated that this is not true. The average size of breast cancer when it is detected by mammogram is 17 mm. The ideal size for treatment of cancer is between 5-10 mm. While mammograms often find cancer once it’s past the ideal treatment stage, the AWBUS can find 5 mm invasive breast cancer. The AWBUS is far more accurate in detecting breast cancer in women with dense breast tissue and implants, and in clinical trials was 300% more accurate than mammograms at detecting small invasive breast cancers. The earlier cancer is discovered, the more likely that it can be monitored and treated, eliminating extreme and traumatic treatments like chemotherapy and mastectomies and saving tens of thousands of lives in the U.S. every year.

However, Dr. Melanie Royce, an oncologist who specializes in breast cancer, finds it frustrating when people try to equate mammograms and breast ultrasound. “One is not better than the other, they are complementary” said Royce, the director of the breast cancer multidisciplinary team at the University of New Mexico Comprehensive Cancer Center. “They are complementary. They should be seen as such and used as such rather than one as a substitute for the other. At least this is the case where both are widely available.”

At this time, neither breast ultrasound using a hand-held transducer nor automated whole breast ultrasound have been proven or approved as a substitute for a mammogram.

This means that while breast ultrasound may be covered by insurance, patients should be sure to verify that prior to scheduling an appointment. The out-of-pocket cost of a breast ultrasound ranges between $150-500 for an exam using a hand-held transducer and $160-400 for automated whole breast ultrasound. Routine screening of both breasts typically costs more than the use of ultrasound as a follow-up test to examine breast abnormalities in a particular area of concern.

An additional hurdle patients interested in automated whole breast ultrasound may encounter is availability. At this time, it’s less common for facilities to use this technology. If you believe automated whole breast ultrasound could be the best screening test for you, it could be worthwhile to mention it to your primary care physician or OB-GYN.

It’s important to note, too, that both mammograms and ultrasounds can only suggest the possibility of cancer. In order for a definitive diagnosis to be made, a biopsy that removes a tissue sample for examination under a microscope must be carried out.

Ultimately, experts agree that no single screening test can be declared superior for all women in all instances. The best option for patients would be to have a balanced discussion with a health care provider about their individual risk factors and the pros and cons of available screening technologies.

 

Amino Acids for Hair Loss

If you’re noticing more hair loss than normal and witnessing visible thinning of your hair, then you could be dealing with an imbalance of hormones, low thyroid, too much testosterone, or a nutritional deficiency, such as too little protein or iron. If nutritional deficiencies are at play, amino acids for hair loss are an effective and natural first line of defense.

We lose anywhere from 50 to 100 strands of hair a day, so there’s no need to be alarmed by clumps of hair in the shower drain or loose hairs on the carpet. But if you’re noticing more hair loss than normal and witnessing hair thinning, then you could be dealing with an imbalance of hormones, low thyroid, too much testosterone, or a nutritional deficiency, such as too little protein or iron. If nutritional deficiencies are at play, amino acids for hair loss are an effective and natural first line of defense. After all, amino acids are the building blocks of protein, and protein is needed to grow tissue cells, including the cells that make up your hair.

Lysine and Iron for Hair Loss

Iron deficiency is the number one nutritional deficiency in the world. If your hair loss is caused by a lack of iron, there’s a chance that you may also be low in the essential amino acid lysine. Studies link hair loss to low levels of both iron and lysine. A 2002 study published in Clinical and Experimental Dermatology showed that when female participants supplemented with iron and lysine, hair loss decreased, but when subjects supplemented with just iron, hair loss stayed the same. Researchers note that patience is required, as the benefits of iron and lysine supplementation for hair loss may take a few months to be noticeable.

Lysine is one of nine essential amino acids that your body cannot make on its own. In addition to supporting the body’s uptake of iron, it also plays a role in zinc uptake. Low levels of zinc have been linked to pattern baldness, which accounts for 95% of hair loss in men and affects 45% of women. Lysine also helps to build collagen, a protein component of hair.

Complete proteins such as red meat, poultry, pork, eggs, cheese, cod, sardines, soybeans, nuts, legumes, and brewer’s yeast are rich in lysine. If you’re on a low-protein or vegan diet you may be at risk for not just iron and lysine deficiency, but a possible protein deficiency overall. Being deficient in even just one amino acid could accelerate hair loss. If you think you might be protein deficient, start by following the Recommended Dietary Allowance (RDA) for protein: 0.36 grams of protein for every pound of body weight.

Amino Acids for Healthy Hair Growth

Healthy hair depends on two amino-acid-built proteins: keratin and collagen.

Ninety percent of every strand of hair on your head is made of a tough, fibrous protein called keratin. Keratin is formed from long chains of amino acids that allow your hair to bend, twist, and turn without breaking, lending strength and elasticity to hair.

Collagen is another building block of hair. A 2016 study from Japanese researchers linked hair loss to decreased collagen near hair follicle stem cells beneath the scalp. Eating protein-rich foods and taking essential amino acid supplements can support the health of your hair by helping your body produce more keratin and collagen.

The 4 amino acids that help boost keratin hair growth are:

  • Cysteine
  • Lysine
  • Arginine
  • Methionine

The 4 amino acids that help increase collagen production are:

  • Lysine
  • Methionine
  • Glycine
  • Proline

But amino acids don’t stop there. They also help form red blood cells that carry oxygen and nutrients to hair cells. Healthy hair depends on these nutrients.

We’ve already seen how lysine can help protect against hair loss, but let’s take a look at other key amino acids for hair loss in more detail.

Arginine

Beyond producing keratin for healthy hair, arginine (or L-arginine) can help put a stop to hair loss in several ways. It’s an excellent immune enhancer, and as such provides a shield against disease-related hair loss.

Arginine is best known for boosting nitric oxide levels in the body. Nitric oxide is a vasodilator that relaxes blood vessels and opens up the potassium channels of cells, thereby improving blood flow throughout the body. By increasing nitric oxide, arginine supports optimal circulation and reinforces blood supply to the hair root, which helps boost hair growth.

Arginine has also demonstrated effectiveness as a topical agent that can help protect hair from bleaching and coloring treatments. When researchers replaced part of the ammonia in a coloring agent with arginine, hair did not sustain as much damage.

Arginine is not an essential amino acid, which means the body can make it on its own, but during times of stress or injury, arginine may become a conditionally essential amino acid (not enough arginine is being produced to meet all demands and dietary support may be called for). Arginine is abundant in dairy, fish, poultry, beef, sesame seeds, chickpeas, oatmeal, soybeans, granola, pumpkin seed, sunflower seeds, and nuts.

Cysteine

Cysteine is a nonessential amino acid that makes up a quarter of keratin. Several studies indicate that cysteine supplementation can help decrease hair loss in men and women with androgenic alopecia (pattern baldness/hair loss).

Cysteine also helps produce a very potent antioxidant called glutathione, which can help protect hair follicles from oxidative stress. Topical cysteine is considered a safe treatment for straightening hair.

To ensure adequate cysteine intake, eat dairy, pork, poultry, legumes, broccoli, Brussels sprouts, and grains. Taking a supplement of L-cysteine or N-acetyl cysteine can induce vomiting and other symptoms of gastric distress. Cysteine is produced from the essential amino acid methionine, and adequate methionine intake generally ensures a sufficient amount of cysteine.

Methionine

Methionine is an important amino acid necessary for the production of keratin and procollagen—the precursor of collagen. It lends structure and strength to your hair and helps to prevent hair loss by building a sulfurous network of chains.

Researchers presented the results of a study examining the efficacy of methionine as a hair loss treatment at a dermatological congress in Florence in 2006. Scientists divided 30 people into two groups. The control group took a placebo and the variable group supplemented with an amino acid preparation containing methionine and vitamin B complex. After 6 months, those supplementing with methionine had 10% more hair regrowth than participants taking the placebo. Other studies show that methionine may help slow hair thinning and greying.

Unlike arginine and cysteine, methionine is an essential amino acid that you must get from the foods you eat and the amino acid supplements you take. Methionine amino acid-rich foods include:

  • Eggs
  • Fish
  • Seeds
  • Leafy greens
  • Broccoli
  • Zucchini
  • Squash
  • Nuts, especially Brazil nuts

Glycine and Proline

Glycine impacts hair health because it’s central to collagen production, as is proline, which also plays a key role in cartilage production. Both are nonessential amino acids that you can find in fish, meat, dairy products, soybeans, spinach, cabbage, beans, kale, banana, kiwi, legumes, broccoli, spinach, and soybeans.

Tyrosine

In addition to thinning hair and hair loss, the color of hair might also take a hit due to stress or adrenal, thyroid, or pituitary gland dysfunction. This is where the amino acid tyrosine can come to our aid.

Tyrosine helps form melanin, which imparts color to our skin and hair. By keeping tyrosine levels adequate in the body, we can help stabilize the body’s production of melanin. Food sources of melanin include pumpkin seed, lima beans, dairy and soy products, almonds, and fish.

Important Hair-Loss Nutrients

Healthy hair depends on a nutritive diet full of vitamins, minerals, and antioxidants. In addition to amino acids for hair loss, the following nutrients help keep hair in lustrous condition.

  • Vitamin A supports sebum production to keep hair follicles lubricated.
  • Vitamin C is a key nutrient in collagen synthesis for strong hair.
  • Iron, silica, and zinc encourage new hair growth and protect against hair loss.
  • Vitamins E, B5, B6, B12, and folic acid improve blood circulation for better nutrient delivery to hair follicles.
  • Essential fatty acids such as omega-3 contribute to hair health by promoting circulation and cell growth.

If you are deficient in any of these nutrients or an amino acid, hair is likely to feel dry and brittle and a supplement program may be in order. However, it’s important not to take hair loss supplements that target a specific nutrient if you are not deficient in that nutrient, as too much of a vitamin, such as too much vitamin A or C, can actually cause hair loss. A complete and balanced essential amino acid supplement, however, does not carry that same risk.

If you’re noticing more hair loss than normal and witnessing visible thinning of your hair, then you could be dealing with an imbalance of hormones, low thyroid, too much testosterone, or a nutritional deficiency, such as too little protein or iron. If nutritional deficiencies are at play, amino acids for hair loss are an effective and natural first line of defense.

The Rationale for Choosing Natural Ways to Lower Cholesterol Over Prescription Drugs

Cholesterol is perhaps the most misunderstood nutrient of all. Let’s get clear on what cholesterol is, how it works in the body, and useful strategies for optimizing your cholesterol levels.

Cholesterol is perhaps the most misunderstood nutrient of all. To many of us, it functions essentially as a bogeyman, hence the plethora of articles out there promising to provide you with the most effective natural ways to lower cholesterol.

It’s understandable how it got cast in that role. After all, the statistics can be overwhelming. For instance, the Centers for Disease Control and Prevention (CDC) lists the following alarming facts about cholesterol:

  • High blood cholesterol significantly increases your risk of heart disease, the leading cause of death in America.
  • 71 million American adults—or 33.5% of the population—have high levels of low-density lipoprotein (LDL, colloquially known as the “bad” kind of cholesterol).
  • Only 1 out of every 3 adults with high LDL cholesterol has that serious health condition under control.
  • Because high cholesterol itself, separate from the chronic diseases it can instigate, has no symptoms, many people are unaware that their cholesterol levels are too high.
  • By lowering your cholesterol levels, you can reduce your risk of facing serious consequences stemming from heart disease, such as suffering a heart attack, undergoing heart bypass surgery or angioplasty, or even dying from heart disease.

After reviewing those sobering facts, you may be wishing you could magically remove all the cholesterol from your body. If you could achieve that, however, you would soon regret it. Cholesterol actually carries out a number of vital functions inside the body, such as helping to keep the walls of your cells flexible and facilitating the production of several hormones.

Before diving into my recommendations on truly useful strategies for optimizing your cholesterol levels, let’s get clear on what cholesterol is, how it works in the body, and the connection between dietary cholesterol and blood cholesterol.

What Is Cholesterol?

Cholesterol, in the simplest terms, is a waxy, fatty substance made by the liver. As touched on above, your body needs some cholesterol for certain key functions. When it begins to accumulate, however, it can cause problems.

Cholesterol belongs to a category of particles called blood lipids. In fact, cholesterol is the best-known blood lipid. While the term “blood lipids” technically refers to fat particles circulating in the bloodstream, it’s conventionally used to refer to particles in the blood that are combinations of lipids and protein, like cholesterol.

The Basics of High-Density Lipoprotein, Low-Density Lipoprotein, and Very Low-Density Lipoprotein

Because cholesterol is a combination of lipid and protein, cholesterol-containing particles in the blood are called lipoproteins. These include high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoproteins (VLDL). The other primary type of fat in the blood are triglycerides, so named because they form when three fatty acid molecules hook together.

Each type of lipoprotein affects your health in different ways. Excess quantities of low-density lipoprotein, for example, can build up on the walls of your blood vessels, resulting in clogged arteries, strokes, heart attacks, and even kidney failure. High-density lipoprotein, however, actually clears away cholesterol deposits from blood vessel walls, thereby lowering your risk of the same set of adverse health outcomes.

So, when we talk about finding ways to lower cholesterol, the precise target of those strategies is low-density lipoprotein, not high-density lipoprotein.

The liver is the main site of fatty acid and cholesterol production. Fatty acids produced in the liver link together to form triglycerides. While triglycerides and cholesterol are made in the liver, the liver is not equipped to store much of either. Consequently, they are packaged with proteins and secreted into the blood as very-low-density lipoproteins (VLDL).

VLDL molecules serve as the primary transporters of fat from the liver to the peripheral fat stores. As VLDL circulates in the blood, it deposits fatty acids and cholesterol in your adipose tissue—otherwise known as body fat.

I should briefly note here that not all the triglycerides produced by the liver are excreted as VLDL—some can be secreted in the form of triglycerides directly into the blood. This is another way that fatty acids are transferred from the liver to adipose tissue for storage.

Adipose tissue is the proper storage site for triglycerides. A larger amount of fat can be stored in adipose tissue. Under normal conditions, fat can be stored in adipose tissue without any adverse impact on overall health, though an excessive amount of triglyceride storage factors into obesity.

The triglycerides in the VLDL molecules are taken up by the adipose tissue thanks to a protein called lipoprotein lipase. This enzyme is not completely effective, though, resulting in incomplete clearance of the VLDL by the adipose tissue. The fat that remains in the blood becomes low-density lipoproteins (LDL), which circulate back to the liver where they are either cleared from the blood or taken up by other cells in the body. This is the main route by which cholesterol is delivered to the tissues of the body.

A special receptor on the membranes of the liver and other tissues plays a key role in taking up the cholesterol from LDL molecules. If the cholesterol in LDL is taken up by the liver, it is then metabolized and eliminated from the body. Conversely, cholesterol taken up by other tissues can remain and disrupt normal bodily functions.

I previously mentioned that low-density lipoprotein has earned itself the infamous nickname “bad” cholesterol. As you may already know, or be able to intuit, that makes high-density lipoprotein (HDL) the “good”cholesterol, in large part because it clears LDL from the blood.

HDL cholesterol, also released by the liver, carries unabsorbed, un-utilized cholesterol back to the liver in a process called reverse cholesterol transport. This keeps your arteries free from cholesterol accumulation, which in turn reduces your risk of heart disease and stroke.

The more HDL in your bloodstream relative to LDL, the more rapidly cholesterol will be cleared by the liver, broken down, and excreted. When evaluating your cholesterol levels, doctors commonly test for and give serious weight to your LDL:HDL ratio.

Cholesterol is perhaps the most misunderstood nutrient of all. Sure, the stats are overwhelming, but let’s take the “scare” out of the statistics and really get clear on what cholesterol is, how it works in the body, and the most natural ways to lower cholesterol levels to optimal.

The Role of Cholesterol in the Body

During a physical exam, it is routine to have the concentrations of these blood lipids measured, and if the values are out of the normal range, treatment options are recommended. This gives us the very distinct feeling that the blood lipids are all bad.

Normal values for blood lipids are as follows:

  • LDL < 100 mg/dl
  • HDL ≥ 40 mg/dl
  • Triglycerides < 150 mg/ml

While elevated levels of some of the blood lipids are indeed associated with bad health outcomes, let’s first consider some of the beneficial roles of blood lipids.

Cholesterol plays many roles in the body, including helping the body produce certain hormones, vitamin D, and enzymes that help you digest food. Cell membranes are largely made up of lipids. Problems arise, however, when you have high cholesterol levels, high triglyceride levels, or both. Excess is never a good thing.

How Excess Cholesterol Harms Your Health

LDL, as previously touched on, has the reputation of being the worst of the blood lipids. The cholesterol in LDL can accumulate and form plaques that stiffen your arteries. This condition is called atherosclerosis.

Cholesterol-rich plaques can clog the arteries, leaving less room for blood to circulate. Plaques can also rupture, which causes platelets to come to the site of rupture and form blood clots. If the clot is big enough, it can block blood flow. If this happens in a vessel supplying blood to the heart, it will cause a heart attack, and if it happens in a vessel supplying blood to the brain, it will cause a stroke.

Triglycerides are also a risk factor for atherosclerosis and, therefore, heart attack and stroke. Recently physicians have been paying even more attention to an elevated triglyceride level because that is one of the underlying factors that leads to metabolic syndrome. Triglyceride accumulation in the liver, specifically, has been shown to drive the progression of metabolic syndrome, which is itself a precursor to diabetes. This means the diagnosis and treatment of metabolic syndrome is critical to diabetes prevention.

Conventional Strategies to Lower LDL Cholesterol and Triglyceride Levels

A class of drug called statins are widely prescribed to lower LDL cholesterol levels. While statins are usually effective in doing so, they come with side effects—most commonly, muscle pain. The side effects of statins can be particularly pronounced in older individuals. In some cases, that muscle pain can be alleviated by switching to a different type of statin, or by taking a dietary supplement called Coenzyme Q10, or CoQ10. One of the side effects of statins is CoQ10 depletion, and given that CoQ10 contributes to the body’s energy production system, it can be quite worthwhile to reestablish healthy levels.

There are other medications to help lower LDL levels, including cholesterol absorption inhibitors, fibrates, and niacin. Again, all these drugs commonly come with adverse side effects. The cholesterol absorption inhibitors that block fat absorption can lead to diarrhea, fibrates can impair normal liver function (again, especially in older individuals), and niacin can cause itching and flushing.

Keep in mind that while these medications may help lower cholesterol, they usually do not affect triglyceride levels. Fibrates are the most effective prescription medication to lower triglycerides, but adverse effects on the liver limit the use of these drugs.

Plus, of those medications, only fibrates have been shown to effectively lower triglycerides, and their adverse effects on the liver limit their use.

Thus, though there are several prescription drug options shown to effectively lower LDL cholesterol levels, most do not address high levels of triglycerides. That, in combination with the numerous potential side effects associated with those medications, inspires many to seek out more natural ways to lower cholesterol.

The Link Between Your Diet and Lifestyle Choices and Your Blood Cholesterol Levels

The cholesterol myth is still holding strong: that you can lower cholesterol by cutting out cholesterol in the diet. This is a fallacy. Cholesterol in the blood is produced in the liver, not absorbed from digested food.

Though food manufacturers continue to shill low-cholesterol products, the truth is that dietary cholesterol has a fairly small impact on the amount of cholesterol circulating in the body. One reason for that is your liver’s ability to modulate how much cholesterol it produces in response to how much cholesterol your diet contains. If you’re taking in more cholesterol from the foods you eat, your liver scales back cholesterol production accordingly.

Take eggs, for example, which have long been scapegoated as unhealthily high in cholesterol. According to a study published in the European Journal of Nutrition, study participants randomly assigned to increase their dietary cholesterol intake by adding two eggs to their daily diet did not experience increases to their total cholesterol or lipoprotein levels compared to participants following diets with fewer high-cholesterol foods.

No wonder then that the most recent dietary guidelines from the U.S. Department of Agriculture give the green light to eating eggs, cholesterol-rich yolks and all. Feel free to enjoy whole-egg omelettes, with no side of guilt needed.

Although dietary cholesterol does not substantially influence your cholesterol levels, other foods in your diet do affect them—both for the good and the bad. Certain behaviors, such as smoking or the amount of physical activity you get, can also have an influence.

Read on to learn about the lifestyle changes that can increase your good HDL cholesterol levels while lowering your bad LDL cholesterol and triglyceride levels.

10 Natural Ways to Lower LDL Cholesterol and Triglyceride Levels

Certain dietary and lifestyle behaviors are associated with lowering cholesterol, but it should be noted that some of these are merely associations, and association does not prove cause and effect. Studies showing a significant effect of certain changes in diet or behavior may be occurring at the same time as other changes that are actually responsible for the observed response. So, let’s stick to approaches that have a physiological rational, if not a scientifically proven mechanism of action.

Cholesterol is perhaps the most misunderstood nutrient of all. Sure, the stats are overwhelming, but let’s take the “scare” out of the statistics and really get clear on what cholesterol is, how it works in the body, and the most natural ways to lower cholesterol levels to optimal.

1. Up Your Physical Activity

When it comes to improving your heart health, few lifestyle changes can be as impactful as increasing your physical activity. Strong evidence shows that exercise can optimize cholesterol levels, both by decreasing damaging LDL cholesterol as well as increasing healthful HDL cholesterol.

According to one 12-week study, a program that combined aerobic and resistance exercise successfully reduced LDL cholesterol. Participants spent 3 days weekly engaging in a variety of aerobic activities, including walking, jumping jacks, resistance-band training, and Korean dance.

Research indicates that exercise can increase HDL cholesterol too. A review of multiple published investigations indicate that both aerobic exercise and resistance training of varying volumes and intensities can beneficially impact all different types of cholesterol.

The review found that 30 minutes of exercise carried out 5 days a week can optimize cholesterol levels and lower your risk of heart disease.

The authors found that the ideal threshold for aerobic activity is to raise the heart rate to approximately 75% of its maximum. When your heart rate reaches 85% of its maximum, you both increase your HDL and decrease your LDL.

For resistance training, you should strive to hit at least 50% of your maximum exertion, though even a lower intensity effort can decrease LDL. As your exertion level increases, you begin positively impacting your HDL. By increasing the number of sets and repetitions you carry out, you maximize the benefits you experience.

2. Consider Weight Loss

Solid evidence shows that losing weight can decrease the amount of cholesterol your liver generates.

A study published in the American Journal of Clinical Nutrition showed that one mechanism by which weight loss decreases cholesterol production is by increasing the absorption of cholesterol from the food participants ate. Over the course of the study, participants levels of HDL cholesterol increased and participants’ risk of heart disease dropped.

A similar study conducted by the American Heart Association that looked specifically at the use of a diet found that weight loss can also decrease LDL cholesterol levels, which may have an even more direct effect on heart health.

3. Increase Monounsaturated Fat Intake

From a certain angle, it might seem logical to reduce overall fat intake in order to support the dual goals of losing weight and optimizing cholesterol levels. However, at least one study found that when participants followed a low-fat diet, HDL levels dropped along with LDL levels.

By contrast, it appears that adhering to a diet high in monounsaturated fat can cut LDL levels while leaving HDL levels intact or even increasing them. One study compared the effect of a diet high in monounsaturated fat to that of a diet low in saturated fat, and found that the diet that prioritized monounsaturated fat increased HDL levels by 12%.

As opposed to saturated fats, unsaturated fats have at least one double chemical bond that changes the way they are used in the body. Monounsaturated fats have only one double bond.

Valuable dietary sources of monounsaturated fats include:

  • Olives and olive oil
  • Avocados and avocado oil
  • Tree nuts including almonds, walnuts, pecans, hazelnuts, and  cashews
  • Cooking oils made from plants, such as sesame and sunflower oil

4. Avoid Trans Fats

In order to make unsaturated fats more stable, which then increases the shelf life of products that contain them, manufacturers use a process known as hydrogenation.

This results in fats that are not fully saturated, but remain solid at room temperature. It’s common to find trans fats in products such as spreads, pastries, and cookies, since they result in a more desirable texture than unsaturated, liquid oils do.

The effects these partially hydrogenated trans fats have on the human body, however, are far from desirable. Not only do they increase total cholesterol and LDL cholesterol, but they also decrease HDL cholesterol—in some cases, by up to 20%.

One study estimated that trans fat intake may account for 8% of heart disease deaths worldwide, while another predicted that by restricting the use of trans fats, heart disease deaths could be reduced by 4.5%.

While food companies are required to disclose the presence of trans fats in their products, they are allowed to round down when the amount of trans fat per serving is under 0.5 grams. As a result, some foods feature labels proclaiming that they contain 0 grams of trans fat per serving when, in fact, they do contain trans fats.

Outsmart manufacturers by reading the ingredients list in addition to the nutrition facts. If you see partially hydrogenated oil, or a similar phrase, the product in question contains trans fats and should be avoided.

5. Boost Omega-3 Fatty Acid Intake

Omega-3 fatty acids are a particularly heart-healthy, cholesterol-lowering kind of polyunsaturated fat.

Research shows that due to their multiple double bonds, polyunsaturated fats function differently inside the body than saturated fats do. It appears they can lower levels of LDL cholesterol, consequently lowering your risk of heart disease too.

Multiple studies indicate that prioritizing your intake of polyunsaturated fats while cutting back on saturated fats can decrease your LDL and total cholesterol levels. This benefits your overall health by reducing your risk of coronary artery disease, metabolic syndrome, and type 2 diabetes.

Good sources of omega-3 fatty acids include:

  • Fatty fish such as salmon, sardines, herring, and bluefin or albacore tuna
  • Scallops and mussels
  • Seeds and tree nuts
  • Eggs

6. Eat More Soluble Fiber

Humans can’t digest soluble fiber, yet it’s still important to include it in our diets. The probiotics that live in our intestines thrive off soluble fiber, and these industrious little bacteria can clear out both LDL and VLDL cholesterol from the bloodstream.

Studies have primarily focused on the use of soluble fiber supplements as well as foods fortified with added soluble fiber. According to one, taking 3 grams of soluble fiber each day over the course of 12 weeks led to an 18% drop in LDL cholesterol levels.

When researchers looked more generally at the health benefits of fiber, they linked an increased intake of fiber-rich grains and cereals to a longer lifespan. One study that surveyed over 350,000 adults found that those eating the most fiber were between 15% and 20% less likely to die during the course of the 14-year study.

Key sources of soluble fiber include:

  • Beans, peas, and lentils
  • Apricots, nectarines, and pears
  • Oats and whole grains
  • Psyllium supplements

7. Stop Smoking

As you are likely aware, one of the many negative ways smoking impacts your health is by elevating your risk of heart disease.

One reason for this is that smoking changes the way the body metabolizes cholesterol. Tobacco tar damages the immune cells, rendering them unable to remove cholesterol from blood vessel walls so it can be transported back to the liver. Experts believe that, due to these dysfunctional immune cells, smokers develop clogged arteries faster than non-smokers do.

The good news is, the damage appears to be reversible. Smoking cessation, with or without the use of transdermal nicotine patches, can undo the harmful effects of tobacco tar and return immune cells to full, cholesterol-removing capacity.

8. Drink Alcohol Moderately

As is true of cholesterol itself, the right amount of alcohol can improve your health, but if the balance skews too far, the effects can be quite detrimental.

Thanks to the ethanol it contains, alcoholic drinks can raise your HDL cholesterol levels, which as I have stated previously, lowers your risk of heart disease.

One study compared the effects of 24 grams of white wine to an equal quantity of white grape juice. The wine improved HDL levels by 5%.

Separate findings indicate that alcohol can also beneficially impact reverse cholesterol transport, which decreases the likelihood of clogged arteries as well as heart disease. The standard recommendation is no more than two drinks per day for men and one drink per day for women.

9. Add Plant Sterols and Stanols to Your Diet

Plant stanols and sterols are, in essence, the plant versions of cholesterol. They resemble the cholesterol produced by human livers, but because of certain differences in their chemistry, they do not accumulate on the walls of blood vessels.

In fact, they actually lower total cholesterol levels. When the body absorbs plant sterols, they replace the absorption of human cholesterol.

While research indicates plant sterols and stanols can lower LDL cholesterol levels—by between 15% and 20%—it remains to be seen whether those benefits lower a person’s risk of heart disease.

Some of the top sources of plant stanols and sterols include:

  • Wheat germ and wheat bran
  • Peanuts
  • Almonds
  • Brussels sprouts

10. Try Science-Backed Supplements

Both fish oil and psyllium fiber have been shown to optimize cholesterol levels and enhance heart health, while CoQ10 shows clear promise in its effect on cholesterol levels though its long-term benefits have yet to be fully mapped.

Last but certainly not least, exciting new findings reveal that consuming essential amino acids in the form of a nutritional supplement can lower liver and blood triglycerides as well as total cholesterol, LDL cholesterol, and VLDL cholesterol, whether taken alone or with plant stanols and sterols.

Fish Oil

Given the focus on fish in the section on omega-3 fatty acids, the source of fish oil’s influence on cholesterol levels should come as no surprise: the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

Researchers have found that taking fish oil can decrease the total amount of cholesterol present in the blood, increase HDL cholesterol levels, reduce your risk of heart disease, and prolong your overall life expectancy.

Psyllium Fiber

There’s no question that the supplemental form of soluble fiber can reduce both total cholesterol and LDL cholesterol.

Studies show that the daily use of a psyllium fiber supplement can lower cholesterol levels by between 5% and 10%.

Coenzyme Q10

As touched on previously, coenzyme Q10, or CoQ10, assists with the cellular production of energy. Though the body can produce its own CoQ10, deficiencies can arise. And even in the absence of a deficiency, it can be beneficial to supplement with CoQ10.

Multiple studies show that taking a CoQ10 supplement can reduce total cholesterol levels. Plus, it seems increasing your CoQ10 intake can help treat heart failure.

Essential Amino Acids

Essential amino acids (EAAs) are the only required dietary macronutrient. They are involved as key components of all proteins in the body and play various physiological roles. EAAs are in all forms of dietary protein, so regardless of the nature of your diet, you consume at least some EAAs.

EAAs stimulate the synthesis of proteins involved in transporting lipids from the liver to peripheral fat, as well as the protein required for the clearance of fatty acids into adipose tissue for storage. Dose response studies have not been done, but successful reduction of blood and liver lipids was achieved with two doses of 11 grams of EAAs twice per day.

The great advantage of EAA supplements is that they are natural, and essential, components of our regular diet and pose no known risks of adverse responses. Not only can they impart beneficial effects by themselves on blood and liver lipids, but they can also boost the effectiveness of statins. In addition to the positive influence EAAs have on blood lipids, they also have proven benefits for muscle health and physical function.

Cholesterol is perhaps the most misunderstood nutrient of all. Sure, the stats are overwhelming, but let’s take the “scare” out of the statistics and really get clear on what cholesterol is, how it works in the body, and the most natural ways to lower cholesterol levels to optimal.

Osteopenia Treatment: Let’s Exercise Those Bones!

Roughly 33 million people over age 50 in the United States have low bone density of the hip. About 4 in 10 Caucasian females, as well as a growing number of Asian and Hispanic women, in the U.S. will suffer a bone fracture from age 50 for the remainder of their lives. Each year, approximately 1.5 million people fall victim to bone fractures due to low bone density.

These are some of the startling statistics that illustrate the severity of bone disease, and health experts predict the problem will get worse. As more people are living longer, it is estimated that by 2020 one in two Americans over 50 will be at risk of developing osteoporosis of the hip, and a larger percentage of the aging population will likely develop low bone mass density (BMD) in other skeletal areas.

What Is Osteopenia?

Osteopenia measures as a lower bone density than is normal, but it is not a disease. It is the precursor to the bone disease osteoporosis, which signals a progression of bone weakness that may result in severe bone fractures. It is important to note that not everyone who has osteopenia will develop osteoporosis. Partaking in proper exercise and eating a sound diet are just a few steps you can take to keep bones healthy and prevent lower bone density before it progresses.

Osteopenia Causes

The amount of bone mineral in the bones determines bone mineral density. The lower your bone mineral density, the higher your risk of suffering bone fractures while engaging in normal daily activities.

A bone mineral density T-score between -1.0 and -2.5 defines osteopenia. For the average person, bone density usually peaks from ages 30 to 35. Not everyone is affected by the potential for bone loss in the same way, however. The rate at which you begin losing bone mass as you age depends on several natural factors in addition to other variables.

Caucasian and Asian females tend to lose more bone mass as they age than other groups, but all aging adults are at risk. Both males over age 50 with lower testosterone levels and postmenopausal women over age 50 with lower estrogen levels are at high risk for developing osteopenia. It is estimated that 35% of postmenopausal women develop osteoporosis.

Broken bones are the primary manifestation of osteoporosis bone disease among the elderly. Common bones that break are of the spine vertebrae, hip, and forearm. Bones may become so weakened to the point where they may break even without minor stress.  

Depending on how strong your bones are early in life, you may not develop osteopenia at all or you may lose bone mass earlier and at a faster rate than you can build new bone. The denser your bones are at youth, the less likely you will develop osteopenia. Circumstances, like heavy alcohol consumption, current or prior illness, or use of certain anticonvulsant medications like phenytoin, can increase the risk for osteopenia.

While age, gender, and ethnicity are prime causal variables to consider, here are some other osteopenia risk factors:

Lifestyle causes for osteopenia:
  • Lack of exercise
  • Poor diet and vitamin deficiencies (e.g., vitamin D, vitamin K, and calcium)
  • Cigarette smoking
  • Heavy alcohol consumption
  • Poor exposure to sunlight
Compromising conditions that aggravate osteopenia:
  • Prior cancer treatments (e.g., chemotherapy or radiation)
  • A family history of bone disorders, such as osteoporosis, Paget’s disease, or osteomalacia
  • Removal of ovaries
  • Early menopause
  • Atopic dermatitis
  • Kidney disease
  • Celiac disease
  • Chronic obstructive pulmonary disease (COPD)
  • Thyroid disorders (e.g., hyperthyroidism)
  • Cushing syndrome
  • History of eating disorders (e.g., anorexia or bulimia)

Osteopenia Treatment

Since there are no symptoms for or pain due to low bone mass per se, it is a good idea to seek medical attention for proper osteopenia diagnosis, especially if one or more risk factors applies to you. A recurrence of minor bone fractures or clean bone breaks from minor stress are indicators that you should consider taking a bone density test, which is dual-energy X-ray absorptiometry that computes bone mass levels at the hip bone region.

Treating osteopenia so that it does not progress is crucial and entails a high level of consistency. Ignoring this condition may engender fairly unpleasant consequences, including an inability to participate in normal activities, severe bone fractures, chronic pain, or disfigurement from compacted bones, such as a spine vertebrae collapse that leads to hunchback. You can prevent accelerated bone loss by making healthy lifestyle choices. Many at-risk individuals suffer worsening bone loss due to neglect, so it is important to be consistent with your bone loss prevention plan and follow the osteopenia treatment options below.

Exercise

A 2018 report published in the Journal Physical Activity and Health confirms that adults engaged in sports early in life have higher bone density than nonactive adults. This is especially true for women. But simply engaging in physical activity is not enough for osteopenia sufferers. At-risk individuals may experience bone injuries from vigorous activities and learn of their low bone mass status as a result.

Taking on the correct exercises at the appropriate intensity levels is very important. Osteopenia exercises should be weight-bearing with light-to-moderate intensity. These include training with resistance bands, tennis, running, walking, tai chi, climbing stairs, dancing, and yoga. If you have low bone density, be especially cautious of spine and hip movements. Always consult your doctor before taking on a new exercise regimen.

Osteopenia weight-bearing exercises:
  • Resistance bands
  • Tennis
  • Running
  • Walking
  • Tai Chi
  • Climbing stairs
  • Dancing
  • Yoga

Diet

An effective osteopenia diet should address vitamin deficiencies that induce bone loss.

Bone-nurturing essential vitamins and minerals include iron, phosphorus, vitamin D, vitamin K, vitamin C, calcium, and magnesium. Meat, seafood, spinach, and beans are good sources of iron. Leafy-green vegetables, including kale, collard greens, and mustard greens, are a go-to source for vitamin K. Vitamin C is abundant in pineapples, mangoes, papaya, and berries—like strawberries, blueberries, and blackberries.

Consume dairy products like milk, yogurt, and cheese for calcium. The dark leafy-green vegetables spinach and kale offer a considerable amount of calcium as well. Almonds, dark chocolate, whole grains, and artichokes supply magnesium for healthy bones. Consider taking vitamin and mineral supplements if you are concerned that your dietary intake of these nutrients is not sufficient.

Wheat-based foods tend to contain generous amounts of bone beneficial vitamins, like iron and magnesium. However, those at risk for osteopenia who suffer celiac disease—a gluten allergy that damages the small intestine—should avoid gluten whenever possible. A 2017 study published in the Indian Journal of Pediatrics highlights a strong correlation between gluten consumption and low bone mineral density in children newly diagnosed and already diagnosed with celiac disease.

Essential bone nutrients:
  • Iron
  • Phosphorus
  • Vitamin D
  • Vitamin K
  • Vitamin C
  • Calcium
  • Magnesium

Sunlight

Your body produces vitamin D in response to sunlight exposure. Vitamin D regulates calcium function and sustains adequate phosphorus levels in the body—two functions that are crucial for maintaining strong bones. Aim to get at least 15 to 20 minutes of direct sun exposure on your bare skin daily.

Pharmaceuticals

Speak with your health practitioner about treatment options for osteopenia. If you have osteopenia or have a family history of low bone mass, certain medications may help protect bones and prevent bone loss. Medications, such as Fosamax, Reclast, and Boniva, are often prescribed to prevent bone fractures and increase bone mass.

Oxidative Stress and Bone Loss

The journal Therapeutics and Clinical Risk Management published a recent 2018 study that implicates oxidative stress as a “fundamental mechanism in the decline of bone mass.” Oxidation occurs as a result of metabolic activity in the body. The reactive oxygen that the body produces causes damage to cells, mitochondria, and DNA. Chronic stress levels, a poor diet, cigarette smoking, and pollution are just a few things that aggravate oxidative stress.

Adhere to a sound diet full of antioxidants (e.g., vitamin C and vitamin E) and void of processed foods, sugars, toxins, and preservatives. The body produces the powerful antioxidant glutathione which is comprised of the amino acids glycine, glutamate, and cysteine. Consuming tomatoes, peaches, spinach, and walnuts promotes glutathione synthesis in the body.

Cultivate a Positive Attitude for Greater Longevity

You want longevity. A life of happiness and vigor. We can relate. Read on to discover how the power of positive thinking can help you achieve the happiness, vigor, and longevity you desire.

You want longevity. A life of happiness and vigor. We can relate. Because, really, who wouldn’t want these things? The problem is that the many ups and downs of life can make these goals seem like little more than pipe dreams. But what if we told you that living a longer, more vibrant life could be achieved—in great measure—by simply cultivating a positive attitude? And what if we told you that more and more research is suggesting that this is anything but a pipe dream?

Interested? Then read on to discover how the power of positive thinking can help you achieve the happiness, vigor, and longevity you desire.

Attitude Is Everything

You already have the power to starve your negative experiences of too much attention. Because it’s your mental attitude that determines whether negative thoughts from these experiences snowball into something worse. In other words, if bad things are destined to happen—after all, it’s just a natural part of the human experience—you can control how you respond.

Consider the concept of locus of control.

This phrase, taken from personality psychology, refers to the degree to which we believe we have control over our own lives.

A study in the Review of European Studies measured the impact of locus of control on the level of subjective well-being of study participants. Researchers found that a significant relationship exists between an individual’s locus of control expectancy—or expectation of being in control—and their level of happiness.

Specifically, they found that people with high levels of self-confidence and belief in their ability to create positive change feel more contented in their daily lives. But they also found that a balanced approach was important too. It appears that people experience less happiness when they hold on too tightly to control, lack trust in others, and can’t accept that bad situations are a natural part of life.

Recognizing that you have ultimate control over your attitude and outlook doesn’t just help you feel better overall. By consistently practicing positive thinking, you may be able to live a longer life as well.

The Science of Longevity

Studies of centenarians have found that the power of positive thinking is not just a tired cliché. On the contrary, a positive attitude may just be the best way to ensure a long life.

For example, the annual 100@100 surveys conducted by UnitedHealthcare have consistently found that looking on the bright side and maintaining a positive state of mind are essential to a long and happy life. In fact, the 2015 survey of 100 people over the age of 100 found that:

  • 61% view themselves as “very positive” people
  • 84% think laughing and having a sense of humor are important to healthy aging

What’s more, centenarians rank having a positive attitude (25%) as more critical to overall good health than both eating a healthy diet (21%) and getting regular exercise (10%). Finally—and this may seem a bit counterintuitive—almost half of all respondents said that maintaining a positive attitude gets easier with age.

In addition, a study out of Yale University found that people with a positive view of aging live an average of 7-1/2 years longer than those with more negative attitudes.

So how do you resist negative feelings and keep the positive thoughts flowing? While there’s no one-size-fits-all answer, there are some practical steps you can take that will help you develop and maintain a more positive outlook.

Cultivate a Positive Attitude for Greater Longevity

Developing a Positive Attitude

Becoming a more positive person doesn’t have to be an exercise in futility. Like most things in life, all it takes is a little commitment to personal development and some old-fashioned hard work.

So in this proactive spirit, we now offer up some practical steps you can take to cultivate a positive attitude and increase your longevity.

Drop Dead Weight

It’s difficult to be positive when negative people and situations are weighing you down. So dump them! Well, unless it’s a close relative or life event you can’t avoid, in which case, might we suggest you just do your best to guard your time and maintain perspective. Whatever you can do to limit the time you spend giving energy to the people and situations that only drag you down will not only reduce stress but will also add to your happiness.

Honor Yourself

Dropping dead weight becomes much easier when you begin to honor yourself. Far from coming from a place of selfishness, honoring yourself means respecting and loving yourself enough to do what’s right for your highest good. When you learn to do that, the dead weight in your life will naturally begin to fall away, and you’ll attract the people and situations that contribute to a healthier and happier life.

Practice Gratitude

Let’s be honest. Most of us tend to take things for granted. It doesn’t matter if it’s the greatest job, the closest family, or the best health, we rarely take a moment to be thankful for what we have. So whether it’s a once-in-a-lifetime vacation or simply a beautiful wildflower that catches your eye, take a moment to stop and really appreciate it.

Use Affirmations

Positive affirmations can be a useful tool for encouraging more positive behaviors. By repeating a chosen set of positive words several times throughout the day, you can reprogram self-sabotaging thoughts. What makes this approach so user-friendly (and effective) is both its simplicity and the ease of molding the technique to suit your individual preference. After all, since you’re saying your affirmations in front of an audience of one, there’s no need to dress them up. Just focus on the changes you want to see in your life, compose a few succinct phrases that are easy to remember and worded as if the change has already taken place (such as I have… or I am…), and repeat as often as you like. The more you practice this simple technique—and believe in what you’re saying—the more positive your life will be.

Get a Hobby

In an ongoing study from the University of California Irvine Institute for Memory Impairments and Neurological Disorders (UCI MIND), researchers have discovered that people who spend at least 2 hours a day engaged in a hobby are 21% less likely to die early. So if you already have a hobby, keep at it. And if you’ve always wanted one but didn’t think you had the time, indulge yourself. You may just be adding years to your life and added enjoyment to your years.

Have Fun! 

Just like having a hobby, finding time to have fun is a must for longevity. After all, when you’re having fun, you’re living in the present moment—a place where regrets regarding the past and worries for the future don’t exist. What’s more, having fun releases powerful feel-good brain chemicals like dopamine and serotonin. So what are you waiting for? Get out there and have some fun!

Get a Pet

Few things keep you more present-focused and positive than having a pet. And there’s actually data to prove it. In a study conducted by the American Psychological Association of people who had pets and those who didn’t, it was found that people with pets had greater levels of physical and psychological well-being—including improved self-esteem—than their counterparts without pets.

Practice Mindfulness

When you practice mindfulness—the nonjudgmental awareness of your thoughts, internal sensations, surroundings, etc.—whether by engaging in meditation or by simply enjoy a relaxing, thoughtful walk in the woods, you’re focused on the present moment and fully engaged with life. And just like having fun, mindfulness pulls you away from negative emotions like regret and worry and brings a sense of connectedness that can improve your overall well-being.

No matter how old you are, practicing just a few of these techniques on a daily basis can help train your brain to look at life in a more positive way. And as we’ve seen, cultivating a positive attitude may just be the key to a long and fulfilling life.

How Can I Boost My Immune System? Amino Acids and Immune Function

Proper nutrition is a must for a strong immune system. Immune-boosting vitamins like zinc, copper, B vitamins, and iron are some of the key micronutrients that help keep immune function running at full strength. In fact, many multivitamins are marketed as “immune system boosters.” The most important nutrient for optimal immune function, however, may be protein. If you’re interested in optimizing the way your immune system responds to threats, however, it’s vital that you understand the connection between amino acids and immune function.

Studies of malnourished children in developing countries have demonstrated the strong link between protein intake and immunocompetence, or the ability to fight off infection and disease. Most components of the immune system defense arsenal are proteins, so it’s only logical that in order to have an immune system that operates at peak capacity, the building blocks for these proteins, amino acids, must be in plentiful supply.

Before delving into the relationship between amino acids and immune function, let’s take a moment to review some basics about the immune system itself.

Understanding the Inner Workings of the Immune System

Chances are, you have a basic grasp of the role of the immune system: it prevents you from getting sick. To get a bit more precise, a well-functioning immune system protects the body from the threat posed by infectious agents such as bacteria, viruses, fungi, parasites, and other noxious invaders.

All the cells of the immune system originate in the bone marrow, whether they go on to circulate through the bloodstream, disperse to other locations throughout the body, or develop into the lymphoid organs: the thymus, spleen, and lymph nodes.

The immune system has what can be thought of as two different modes: innate immunity and acquired immunity (also called specific or adaptive immunity). Both modes involve the same collection of immune cells described above, but it’s important to differentiate between the two.

The Innate Immune System

Innate immunity functions as the the first line of defense against infectious agents. Its primary purpose is to prevent those pathogens from entering the body, and, if they do manage to enter, swiftly disposing of them. Often, this involves an inflammatory response in which compounds called prostaglandins cause blood vessels to dilate so that blood flow to the infected area can increase.

The innate immune system also relies on physical barriers and blood-borne defenders such as cytokines and a type of white blood cell called leukocytes. Phagocytes, the most abundant of the many types of leukocytes, specialize in physically engulfing infectious organisms, a process known as phagocytosis, then destroying them using naturally generated toxic chemicals, such as superoxide radicals or hydrogen peroxide. Natural killer cells, another key element of the innate immune response, use a similar process to destroy pathogens.

The central difference between innate immunity and acquired immunity is that the innate immune system has no memory and does not alter its response based on prior exposure to a specific pathogen. The innate immune system takes on invaders first, but the acquired immune system is both more powerful and more flexible.

The Acquired Immune System

The acquired immune response relies on cells called lymphocytes, specifically B cells and T cells, each of which responds specifically to a single pathogen. Lymphocytes remain active for some time after they first detect a threat, which allows for the development of immunological memory. This lays the foundation for a fortified, more effective immune response when facing off against a pathogen it has encountered before.

Infectious invaders carry with them substances known as antigens. Lymphocytes recognize pathogens based on these antigens. B lymphocytes carry antibodies on their surfaces that bond to the antigens on invaders to form an antigen-antibody complex. Once the B cell processes this complex, it displays certain proteins which attract matching helper T cells that release chemicals called lymphokines. The lymphokines, in turn, signal the B cells to release a flood of antibodies into the bloodstream where they then bind to invaders, marking them for phagocytosis or destroying them on the spot. This is known as the humoral immune response.

Some infection agents, viruses in particular, enter directly into the cells of the human body, thus escaping detection by the antibodies B cells release into the bloodstream. The acquired immune system deals with these via a process called cell-mediated immunity. T lymphocytes confer this immunity. Infected cells signal to T lymphocytes by expressing peptide fragments derived from the invader in conjunction with proteins called the major histocompatibility complex (MHC) on their surface.

The acquired and innate immune systems communicate via cell-to-cell contact as well as the use of chemical messengers, chiefly cytokines. When everything works as it should, the systems carry out different tasks while working closely together.

The Relationship Between Dietary Protein and Immune System Health

Both the innate and acquired immune system need soluble substances found in the blood and other bodily fluids. According to a study done by the Institute for Quality and Efficiency in Health Care (IQWiG) in Cologne, Germany, “These are mainly proteins like enzymes, antibodies and short amino acid chains.”

Proteins are of particular importance to the complement system, a part of the immune system made up of a group of proteins found in the blood that are critical in the defense against infection. Producing these specialized cells and proteins requires an abundant supply of amino acids, some of which must come from the diet. When the immune system can’t keep up with the production of these molecules, we become vulnerable to many health problems and diseases.

While very few people in the United States are “protein-malnourished,” many people may not be consuming enough high-quality proteins to obtain the amount of essential amino acids needed for optimal nutrition.

Dietary protein is broken down to provide amino acids. Essential amino acids are those that cannot be made by the body and therefore must be obtained from the diet. Nonessential amino acids can be synthesized in the body. However, under conditions of stress when the immune system is challenged, the body cannot keep up with the demand for certain amino acids so they are considered conditionally essential in that dietary sources are required to meet the demand.

How Amino Acids Can Improve Immune Function


As touched on previously, dietary protein deficiencies have long been known to impede immune function. Over the last decade and a half, scientists have begun to investigate the cellular and molecular mechanisms underlying the influence of protein on the immune system.

One of the most thorough inquiries into the link between amino acids and immune function, published by the British Journal of Nutrition, noted that recent studies show amino acids play several important roles in immune responses. They:

  • Regulate the activation of T lymphocytes, B lymphocytes, natural killer cells, and macrophages
  • Manage cellular redox state
  • Modulate gene expression and lymphocyte proliferation
  • Orchestrate the production of antibodies, cytokines, and other cytotoxic substances

The article, authored by Drs. Peng Li, Yu-Long Yin, Defa Li, Sung Woo Kim, and Guoyao Wu, gives a comprehensive look at the evidence supporting the beneficial effects of dietary supplementation of amino acids on immune function. It appears that functional amino acids and sulfur amino acids in particular can enhance immune status.

Like all other cells, the cells that make up the immune system require energy. In fact, when immune system cells are challenged by a pathogen or disease, they require lots of energy in a hurry.

Mitochondria are the engines of cells and produce the energy needed to support all cellular functions. Balanced mixtures of essential amino acids have been shown to increase mitochondrial number and function. Studies show that when essential amino acids are consumed, they stimulate the production of mitochondrial proteins (a process called mitochondrial protein synthesis) including the production of enzymes that contribute to immune system functions. Amino acids help improve mitochondrial function by increasing the available number of enzymes involved in energy production.

If essential amino acid concentrations fall below the appropriate level, the number of mitochondria and their ability to work at full capacity is compromised. This energy shortage limits the ability of the immune system to keep producing all the cells needed to fight off the threat presented by pathogens and disease.

Beyond serving as the fuel source to build up and support the defense system arsenal, mitochondria also get directly involved in killing off infected cells and helping to coordinate signals and messages sent out by the immune system. Nutrients that support mitochondria, therefore, help to improve immune function.

The authors of the British Journal of Nutrition study cited earlier also state that advances in our comprehension of amino acid metabolism in leucocytes will likely prove critical to the development of effective methods for preventing and treating diseases linked to immunodeficiency. They concluded that amino acids “hold great promise in improving health and preventing infectious diseases.”

Here are eight amino acids shown to have powerful benefits for immune function.

How Can I Boost My Immune System? Amino Acids and Immune Function

1. Alanine

Though alanine is a nonessential amino acid, it can become essential under certain circumstances. Vast concentrations of alanine can be found in muscle tissue. When the body detects an excess of alanine, it uses a process called catabolism to break it down into glucose and use it as energy. Alanine has also been shown to contribute significantly to immune cell function.

Per the British Journal of Nutrition article cited previously, the primary influence of alanine on immune function has to do with its role as a precursor for glucose, a key energy substrate of leucocytes. Evidence shows that supplementing with alanine can prevent immune cell apoptosis (cell death), enhance immune cell growth, and augment antibody production in B-lymphocytehybridoma.

Researchers have yet to identify the underlying mechanism for alanine’s beneficial effects but believe it may have to do with the inhibition of protein degradation in immunocytes.

2. Arginine

Our bodies require a plentiful supply of arginine, specifically L-arginine (if you would like, you can learn more about the difference between L- and D- amino acids here), for white blood cell proliferation and functionality. These cells need certain structures on their surface in order to recognize diseased or damaged cells, and arginine is involved in the formation of the molecules that serve this purpose.

Arginine is also involved in wound repair, and its availability is important for the production of nitric oxide (NO) through nitric oxide synthase. NO plays an important role in regulating the dilation of blood vessels, which decreases blood pressure by making it easier for blood to flow. Increased blood flow to an injured area of the body is important because it helps to deliver immune cells along with extra oxygen and nutrients needed to repair the damage.

NO is also important in the activation of inflammation as part of the immune response. Macrophages and a number of other immune system cells, including inflammatory cytokines, can actually make NO, which they then use to neutralize infectious organisms.

While increased availability of arginine can lead to higher levels of NO metabolites, the best way way to elevate arginine levels may be supplementing with citrulline, rather than arginine. The amino acid citrulline helps elevate arginine levels inside the cell, thereby boosting NO.

Both increased dietary L-arginine intake as well as arginine supplementation can majorly enhance immune function.

3. Glutamine

The amino acid glutamine (L-glutamine) plays a significant central role in maintaining immune function. The effects of glutamine include helping to create and mobilize white blood cells and aiding in phagocytosis. These processes are influenced by glutamine availability and may run inefficiently if glutamine concentrations drop too low.

Immune system cells use glutamine at a high rate, particularly in stressful situations like sepsis, injury, burns, surgery, and endurance exercise. In each of these conditions, the immune system is often suppressed. Glutamine supplementation has been shown to be valuable in maintaining immune function in these circumstances.

4. Glutathione

Glutathione, an antioxidant made of three amino acids, is produced endogenously within the human body. Antioxidants work by donating electrons to free radicals, which neutralizes them before they can cause harm. In addition to its antioxidant properties, glutathione is an important anti-inflammatory compound that can eliminate toxins. It is present in all cells and is believed to help prevent cancer.

Located in the mitochondria of the cell, glutathione is responsible for getting rid of the free radicals that occur naturally from energy-producing reactions in the cell. It does this by protecting vital parts of the cells from the destructive effects of reactive oxygen species (ROS), a chemical species that includes free radicals as well as heavy metals, peroxides, and lipid peroxides.

In the liver, glutathione binds to and neutralizes toxins by converting them to compounds that can be safely excreted from the body. Glutathione is recycled to some extent, but when free radicals, inflammation, and toxin levels are high, available glutathione levels decrease.

There are nutritional strategies to overcome this deficit but what would seem to be the most obvious, a glutathione supplement, is not the most efficient or effective. The reason is that glutathione is a small protein (called a peptide) made up of three amino acids: cysteine, glycine, and glutamate. If taken orally, the stomach does what it does to proteins, which is to digest it down to its component amino acids such that glutathione itself is not absorbed intact.

Increasing blood levels of the three component amino acids is a starting point to encourage glutathione synthesis. Glycine and glutamate are nonessential amino acids and usually present in good supply. Cysteine is considered semi-essential because it can be produced in the body, but it needs methionine, an essential amino acid, as a starting point.

Boosting cysteine in the cell is not an easy task. High doses of supplemental cysteine or its precursor methionine can be toxic or result in homocysteinemia, which is related to early development of heart and blood vessel disease.

Because of its unique chemical structure, N-acetyl-cysteine (NAC) can effectively increase cysteine levels in the cell. NAC is used for treating asthma and in the emergency room to reverse acetaminophen (Tylenol) poisoning. However, NAC is a medicine and therefore presents the potential for side effects including nasal irritation, vomiting, and development of a rash, among other problems.

Glutathione and its constituent amino acids are naturally present in many foods, in particular cruciferous vegetables as well as a variety of meat and dairy products. Whey protein is especially rich in cysteine and overall is a very good source of all essential amino acids. These dietary sources at a minimum provide the building blocks for glutathione synthesis.

A balanced essential amino acid supplement containing methionine is an effective approach for improving immune function and glutathione levels since the methionine can be converted to cysteine in the cell, ensuring that intracellular concentrations of cysteine are plentiful.

Glutathione can be replenished more successfully when other vitamins for immune system health, such as vitamins C and E, are available in good supply, as well as folate, B vitamins, and zinc, all of which act as cofactors in the synthesis of glutathione.

5. Isoleucine

Isoleucine, one of the branched-chain amino acids, can be found in many cells of the immune system, such as lymphocytes, eosinophils, and neutrophils.

Researchers have studied the uptake of isoleucine and the other BCAAs by a B cell line through the cell cycle and found that the pattern of uptake for all three is the same.

Decreasing concentrations of isoleucine and the other BCAAs can significantly impair immune cell production, but increasing them has not been shown to result in significant changes. In other words, the focus of supplementation with isoleucine and the other BCAAs should be on preventing a deficiency more than creating a surplus.

6. Taurine

Taurine, a conditionally essential amino acid, can be found throughout the body. It is the single most abundant free amino acid making up many key body parts, from your retinas to your heart to your skeletal muscles. Concentrations of taurine become especially dense leukocytes, a type of white blood cell, where they top out 50 mM.

Taurine offers particular benefits for wound healing. Studies have shown it has impressive tissue-protective capacities, perhaps because it reacts with hypochlorous acid (HOCl) to taurine chloramine, an oxidant derivative with greater stability and lesser toxicity than taurine itself. Researchers have found that taurine chloramine exerts an impressive regulatory influence over the immune system.

Evidence has shown that taurine chloramine can decrease production of pro-inflammatory mediators in white blood cells. It appears to do this by activating NFkappaB, a protein complex that relays signals related to the production of inflammatory cytokines.

7. Threonine

Threonine, an essential amino acid, is a vital component of healthy immune function. The thymus gland uses threonine to produce T lymphocytes, which then fight off infections.

Without an adequate supply of threonine, the body cannot produce enough T lymphocytes to protect the body from disease and injury.

8. Valine

Valine, another branched-chain amino acid, also makes integral contributions to immune system function. It seems to bring the immune system into balance, both enhancing the immune responses that protect us from infectious agents and reducing inappropriate immune responses such as chronic inflammation and autoimmune conditions.

Amino Acids and Immune Function: Final Takeaways

A strong immune system is the key to staying healthy, and the key to a strong immune system is proper nutrition with nutrient-dense foods and high-quality proteins and amino acids.

While specific amino acids have been shown to be particularly useful when it comes to enhancing immune function, the British Journal of Nutrition article explains that care must be taken when supplementing due to “the negative impact of imbalance and antagonism among amino acids.”

In simple terms, taking a well-formulated essential amino acid supplement will likely result in greater benefits for immune function than the use of a single amino acid supplement would. The effective use of amino acid supplements for immune support will consider the biochemistry and physiology of amino acids, their roles in immune responses, the nutritional and pathological states of individuals and expected treatment outcomes.

Types of Arthritis: Causes, Symptoms, Testing and Treatment

Managing arthritis pain requires an understanding of the mechanisms behind arthritis, as well as the different types of arthritis, of which there are more than 100. We’re covering the most common arthritis conditions and offering suggestions for treatments.

While arthritis often comes with age (as is the case with osteoarthritis), sometimes it can be caused by an autoimmune disorder or other disease-causing pathogens inside the body. Rheumatoid arthritis, for example, is the result of immune system dysfunction. It can attack a person early in life.

What is the immune system doing to cause arthritis? The immune system begins to produce antibodies to fight off what it perceives as disease. In doing so, it attacks the rubbery cushion around a person’s joints. This cushion is known as cartilage.

In more common types of arthritis such as osteoarthritis, cartilage simply becomes worn out due to normal wear and tear and aging.

In some cases, osteoarthritis and rheumatoid arthritis both can be present in the same joint. Athletes who have sustained injuries often deal with multiple forms of arthritis. Infection from an injury can complicate arthritis.

Just the thought of bone-on-bone can be painful to many. Bone-on-bone causes joints to swell and even become deformed. Often, people with arthritis lose mobility and suffer from greatly diminished quality of life. Sometimes surgery becomes necessary.

But there are ways to manage arthritis pain once you understand the different types of arthritis, of which there are more than 100. In this article, we cover the most common.

Types of Arthritis: Cause, Symptoms, Testing and Treatment

Osteoarthritis

Osteoarthritis affects almost 30 million Americans. It is the most common form of arthritis, occurring naturally in people as they age. Certain jobs also may result in people developing osteoarthritis in certain joints.

Osteoarthritis is the result of cartilage deteriorating through wear and tear. A world-class runner may develop osteoarthritis in the knees, for example. Any job or activity that involves doing the same thing over and over can result in wear and tear on cartilage that protects a specific joint or joints.

Testing and Treatment for Osteoarthritis

Pain and swelling in the joints, as well as decreased range of motion, make arthritis pretty easy to spot. Doctors can confirm a diagnosis with X-rays or, in rare circumstances, MRI scans.

Besides taking nonsteroidal anti-inflammatory drugs (NSAIDS such as aspirin and ibuprofen) to help combat joint inflammation, many people living active lives with arthritis use nutritional supplements. Glucosamine and chondroitin are especially popular (these are compounds that make up bone cartilage). Doctors and clinical studies disagree though on whether these compounds actually work. They have been determined safe and well tolerated.

A large, 2010 multi-site study called GAIT showed that people taking glucosamine and chondroitin alone or in combination with prescription medication fared about the same as those taking prescription medication alone. However, in the same study, people with knee pain specifically tended to fare a bit better on glucosamine and chondroitin than those without.

Fish oil supplements are a popular choice for people suffering from osteoarthritis. A 2010 meta-analysis “found that fish oil significantly decreased joint tenderness and stiffness in (rheumatoid arthritis) patients and reduced or eliminated NSAID use,”according to The Arthritis Foundation. “Preliminary studies indicate it may have a similar effect on osteoarthritis.”

Over-the-counter topicals and creams also provide fast and easy pain relief.

Inflammatory Arthritis

Rheumatoid arthritis and psoriatic arthritis are the most common types of arthritis caused by inflammation. In addition to autoimmune disorders and genetics playing a role, researchers believe “infectious agents, stress, cigarette smoke and hormones” may also contribute to symptoms.

Other types of inflammatory arthritis include juvenile arthritis, of which the most common type is juvenile idiopathic arthritis (JIA), and spondylarthropathies. All are discussed in more detail below.

The Arthritis Foundation stresses the importance of self-care for people who live with types of inflammatory arthritis.

“Self-management involves understanding and following the treatment prescribed by doctors and other health care providers,” the foundation explains on its website. “But it also involves making lifestyle choices and addressing both the physical and emotional effects of having a rheumatic disease like inflammatory arthritis. Self-management encompasses the choices made each day to live well and stay healthy.”

These choices may include the foods you eat, where you live and how much you exercise, and other best practices for wellness while living with a chronic condition.

Rheumatoid Arthritis

Rheumatoid arthritis (RA), like some other forms of arthritis, tends to target a specific gender. Three-fourths of the 1.3 million Americans with rheumatoid arthritis are women.

Unlike osteoarthritis, rheumatoid arthritis and other forms of arthritis caused by autoimmune disorders affect young people. Rheumatoid arthritis can begin at any age, but often women are around 40 at the onset.

Rheumatoid arthritis can be debilitating when not properly managed. This is the type of arthritis known for causing “stiff joints” in the morning. Some people have a very difficult time getting moving each day.

Rheumatoid arthritis tends to target multiple joints. Morning stiffness doesn’t go away after half an hour or so. Weight loss, fever, fatigue, and weakness also are symptoms of rheumatoid arthritis.

Scientists still don’t know why the immune system attacks healthy cartilage in people with rheumatoid arthritis. The damaging antibodies can cause long-term damage, but treatment options have come a long way.

Rheumatoid arthritis actually can be coaxed into “remission,”according to the American College of Rheumatology. “No single treatment works for all patients. Many people with RA must change their treatment at least once during their lifetime.”

Damage caused by arthritis is irreversible, and there is no cure, so it’s important to catch chronic conditions like rheumatoid arthritis early.

Testing and Treatment for Rheumatoid Arthritis

Doctors can check you for rheumatoid arthritis by taking blood tests or X-rays, though X-rays do not always catch early rheumatoid arthritis. They look for anemia, a “rheumatoid factor” or antibody, protein, or other biomarker (clues in your blood that show you have the disease).

Expensive treatments known as “biologics” have been created to treat debilitating forms of arthritis not caused by normal wear and tear. These revolutionary new medications actually are proteins that are made from genes. This genetic material convinces the immune system to leave your healthy cartilage alone and to stop creating painful and damaging inflammation.

A class of drugs known as DMARDs (disease-modifying anti-rheumatic drugs) also can be used. These are given by pill or by injection into a muscle. These drugs reduce pain and help prevent joint damage.

For people who suffer from rheumatoid arthritis, it is important to understand signs of a flare-up. Over time, patients learn what foods or activities aggravate their disease and cause a flare-up.

Carefully choosing which foods you eat when living with a chronic condition like rheumatoid arthritis is essential. Making healthy lifestyle choices, keeping stress to a minimum, and getting plenty of sleep also is important.

Psoriatic Arthritis

Psoriatic arthritis is characterized by painful swelling of the joints in the hands and feet. It often follows an outbreak of psoriasis, a skin condition. Enthesitis occurs when the connective tissue where ligaments and tendons connect to bones become inflamed, and typically accompanies psoriatic arthritis, as well as ankylosing spondylitis and juvenile idiopathic arthritis.

Until the beginning of the new millennium, few therapies existed for people suffering from psoriatic arthritis. That has changed with the development of biologics.

Testing and Treatment for Psoriatic Arthritis

“Early diagnosis is important, since people who present late do not fare as well,” Italian researchers wrote in the journal F1000 Research. “There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop (psoriatic arthritis), and several screening tools have been developed.

“It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of (psoriatic arthritis), and several targets have been identified for therapeutic interventions.”

It also is important to keep conditions that can exacerbate psoriatic arthritis at bay. These conditions include obesity, diabetes, depression, osteoporosis, and many others. These comorbid conditions often can be managed effectively with diet and exercise.

“The expectation is that, in the future, (psoriatic arthritis) patients will be treated early and more aggressively and that there will not be significant progression of joint damage,” the researchers reported.

Systemic lupus erythematosus

Lupus is a chronic inflammatory disease that occurs when your body mistakes its own tissues and organs as invaders and begins attacking them. This autoimmune disease causes pain, fatigue, skin rashes, inflammation and its associated redness and swelling, and can severely harm internal organs including the lungs, heart, joints, kidneys, and nervous system.

Testing and Treatment for Lupus

Because lupus mimics the symptoms of several other chronic illnesses, it can be difficult to diagnose. Your health care provider will likely order a combination of blood and urine tests, as well as imaging tests and possibly a biopsy.

The most common medications used to treat lupus include:

  • NSAIDs
  • Antimalarial drugs
  • Corticosteroids
  • Immunosuppressants
  • Biologics

Gout

Gout is a type of inflammatory arthritis that occurs when uric acid crystals build up in the synovial tissues, such as the hands, feet, big toe, or elbows. It’s characterized by a sudden, sharp pain in the affected joint that can decrease mobility and accompany redness and swelling. Left untreated, gout can have serious ramifications on your lungs and kidneys.

Testing and Treatment for Gout

Apart from conducting a medical exam and history intake, the doctor will test your uric acid levels with a blood test. X-rays and MRI scans can check for bone, joint, and tissue damage, which will determine treatment protocol.

The aim of treatment is to reduce uric acid levels with medications such as colchicine and allopurniol, and to reduce inflammation with anti-inflammatory over-the-counter or prescription drugs.

To help prevent future gout attacks, reduce consumption of foods high in purine, such as red meat, organ meat, seafood, and alcohol.

Spondylarthropathies

Think of spondyloarthritis as “spider arthritis.” It may be a fitting reminder because like a spider, spondyloarthritis is a bit menacing. It also has many ways of attacking the body. This rare form of arthritis usually affects young men and boys in their teens and twenties.

Spondyloarthritis comes in different forms, or spondylorarthopathies. The most common is ankylosing spondyloarthritis. This type is hereditary, and researchers have begun to map which genes are involved. HLA-B27 is one.

The geographic distribution of ankylosing spondylitis is distinct. You find it most often in Alaska, but also among Native Americans in the Western United States.

Many people who suffer from spondyloarthritis report low back pain. Some have problems with hands or feet. Ankylosing spondylitis is particularly brutal and can result in deformities. Bones are chiseled away, making movement of the shoulders and hips difficult. Ankylosing spondyloarthritis often results in the need for spinal fusion surgery or joint replacement.

Another form of spondyloarthritis, enteropathic, is associated with autoimmune diseases of the bowel.

Testing and Treatment for Spondyloarthritis

Tests exist to find known genes causing spondyloarthritis. However, presence of a gene does not mean a person will develop the disease.

X-rays and other tests can be used to determine if there are changes in the spine. An MRI can pick up more subtle nuances that could result in earlier detection.

Like other forms of arthritis caused by autoimmune disease, biologics often are used to treat spondyloarthritis when over-the-counter pain relievers don’t do the trick.

Juvenile Arthritis

Juvenile arthritis simply refers to arthritis in children. Children usually have arthritis because of autoimmune disorders.

It is important especially for children to remain active to stave off joint pain and inflammation. Children also need to be encouraged to stay active, so they can maintain lives that are as normal as possible.

Testing and Treatment for Juvenile Arthritis

Juvenile arthritis can be confirmed by blood tests and imaging scans. Treatments include the same medications as those available to adults, including DMARDs, biologics, NSAIDs, and corticosteroids.

In addition to the specific treatment recommendations for the different types of arthritis covered, physical therapy and physical activity can help reduce associated arthritis pain by strengthening joints, increasing mobility, reducing joint stiffness, and increasing range of motion. To find out how amino acids can help treat arthritis and its symptoms, read this article.

The Most  Detrimental Side Effect of Bed Rest? Muscle Loss

Bed rest causes muscle loss, reduced leg strength, and decreased muscle fiber function. Bed rest also induces a variety of metabolic problems, including insulin resistance and increased fat within muscle cells. Learn how essential amino acids can help prevent muscle loss during bed rest.

If you are feeling sick, one of the first things you usually do to take care of yourself is go to bed. With more serious conditions, bed rest is almost inevitable. Sound reasoning supports this type of short-term inactivity for the purpose of facilitating recuperation, however, during bed rest, muscle loss occurs at a rapid rate, particularly among older adults.

In this article, I will explain the purpose of bed rest, why bed rest produces such pronounced muscle loss, and how to avoid that unwanted and deleterious side effect.

The Rationale Behind Bed Rest

References to the curative properties of bed rest, which has also historically been referred to as a rest-cure, can be found in some of the earliest medical writings. In the 19th century, the idea of taking to bed was a culturally acceptable method of treating both physical and mental afflictions.

Typically, bed rest refers to the prescription to remain in bed despite having the physical capacity to leave the bed, rather than being confined to bed because of a health impairment that physically prevents one from leaving it.

The practice of bed rest, particularly extended periods of bed rest and bed rest during pregnancy, has become increasingly controversial in recent decades. Some in the medical profession began to suspect that the effects of inactivity itself, and consequent muscle loss, can compound the problems caused by the pathological condition that spurred the decision to  prescribe bed rest. Researchers have now compiled compelling data on the adverse side effects of physical inactivity, such as muscle atrophy.

Per a seminal 1999 systematic review published in The Lancet, bed rest should be viewed as “a potentially harmful treatment,” especially when used for the management of medical conditions that do not prevent a patient from engaging in weight-bearing activity. After analyzing a number of bed rest studies—specifically, randomized controlled trials that compared bed rest to early mobilization protocols for medical conditions and procedures—that enrolled a combined total of 5,777 patients, the authors concluded that bed rest did not improve outcomes and in some cases, worsened them. The authors did note the necessity of further research to make a complete determination of the benefits and harms associated with the use of bed rest as a treatment.

At this time, many health care professionals still routinely use bed rest as part of a management plan. In an intensive care unit, virtually all patients will spend their stays in bed. In hospitals across the United States, it’s common practice to enforce bed rest for elderly patients to reduce the risk of injuries and complications caused by falls. And though orthopedic surgery itself may not require bed rest, a serious orthopedic problem usually results in at least a short period of inactivity, both before surgery and during recovery.

Understanding the Effects of Inactivity

Our understanding of the effects of inactivity on muscle mass and function initially stem from the space program. Even though astronauts may be quite busy in space, the absence of gravity in effect creates a condition of inactivity. This is because on earth our actions are working against gravity, but the resistance caused by gravity is missing in the gravity-free environment of space. This results in a rapid loss of muscle mass as well as loss of strength during space flight.

Astronauts returning from the early space flights had lost so much muscle function that it was not unusual for them to have difficulty walking and carrying out other activities of daily living. There was concern that the loss of muscle mass and strength would limit the ability to perform more prolonged flights in space. Consequently, NASA began sponsoring a series of studies to identify the reasons for the muscle mass loss and whole-body muscle weakness that developed during space flights and to develop effective countermeasures.

It was not practical for researchers on earth to study the effects of weightlessness, so a model was needed. Complete bed rest causes the same kind of muscle loss and strength declines as astronauts experienced in space. The NASA program, therefore, focused on bed rest. The results of those studies have not only identified effective countermeasures to be used in space flight, but have also given us insights into the broader issue of the effects of weeks of bed rest in clinical settings.

How Bed Rest Produces Muscle Loss

Due to a reduced rate of muscle protein synthesis, bed rest causes a loss of lean body mass (particularly skeletal muscle from the lower extremities), and decreased muscle fiber function. Bed rest also induces a variety of metabolic problems, including insulin resistance and increased fat within muscle cells.

If you know about the changes in muscle mass and function that occur with aging, the responses to bed rest will sound familiar. Bed rest can be looked at as accelerated aging—all of the same aspects of deterioration of physical function that we see with aging also occur with bed rest, but at an even faster pace.

Bed rest for older patients can be particularly problematic. Older individuals lost as much muscle tissue and function in just 10 days of bed rest as younger individuals lost in 30 days, as evidenced by a study my research team and I conducted which was subsequently published in JAMA: the Journal of the American Medical Association.

Stress Compounds the Problems Caused by Bed Rest

People usually have a good reason for taking to complete bed rest. This means that in most cases, the negative consequences of a stressful condition are layered on top of the damaging effects of bed rest.

The combined effect of stress and bed rest has been examined experimentally by infusing study participants with doses of the stress hormone cortisol throughout bed rest. While stressful clinical conditions induce many responses, an increase in cortisol is common to virtually all clinical conditions.

Clinical trials have revealed that the infusion of cortisol triples the rate of muscle loss during bed rest. This indicates an interactive effect between bed rest and stress such that bed rest amplifies the catabolic response to stress.

Preventing Muscle Loss During Bed Rest

The most obvious countermeasure for inactivity is, simply, to be active. This is why patients are often encouraged to resume physical activity—typically, beginning in a supervised, physical therapy setting—as soon as possible after surgery or serious illness.

However, in many cases bed rest is not a choice, but goes along with the clinical condition. It is, therefore, necessary to look at dietary options that will amplify the beneficial effects of activity and also work in the absence of activity.

The requirement for dietary protein to curtail muscle loss during bed rest is significantly greater than when a person’s activity level is normal. However, adding sufficient protein to the diet to eliminate the loss of skeletal muscle mass due to inactivity is usually impractical.

During space flight, an increase in the protein content of the diet is limited by constraints on weight and food preparation. For bed-rest-restricted patients, a loss of appetite usually accompanies the catabolic response to the clinical condition. Consequently, we need to focus on a nutritional approach that provides greater benefit per gram consumed than dietary protein does.

Using Essential Amino Acids to Curtail Muscle Loss During Bed Rest

Essential amino acids (EAAs) are the dietary amino acids that are not produced in the body but are needed for the synthesis of all proteins in the body, including muscle protein. EAAs constitute about 30-45% of dietary proteins and are the “active components” of the protein.

Consuming EAAs stimulates muscle protein synthesis. When taken daily throughout bed rest, EAAs lessen the loss of lean mass and physical strength. We discovered that the improvement in muscle strength with EAAs is in part due to an improvement in the functional capacity of the individual muscle fibers. Strikingly, the deterioration in physical function as a result of 10 days of bed rest in older individuals was completely reversed with EAA supplementation.

EAA supplementation offers a compact delivery system of the most potent stimuli of muscle protein synthesis. When taken in conjunction with exercise the effects of EAAs are amplified, but when inactivity is dictated by a clinical condition EAA supplementation still is an effective approach to minimizing the loss in muscle mass and function that would otherwise occur.

What Everyone Should Know About Bed Rest and Muscle Loss

Bed rest has been used to facilitate recuperation from illness or injury for centuries. In the modern era, however, it has become apparent that bed rest can produce unwanted side effects—namely, significant muscle loss. Despite the downside of bed rest, it remains a common feature in many health care settings.

Older adults are both particularly likely to be prescribed bed rest and particularly susceptible to the detrimental side effects of bed rest, which include changes to muscle protein synthesis and muscle fiber function as well as insulin resistance and increased fat within muscle cells. Stress aggravates the negative impact of bed rest.

When bed rest is, in fact, necessary, the best way to minimize muscle loss is to increase protein intake. Doing so through diet alone tends to be impractical, though. In a majority of cases, essential amino acids prove to be a better alternative. My own research as well as studies carried out by other experts show that essential amino acids can stimulate muscle protein synthesis and lessen the loss of lean body mass and muscle strength during bed rest.

Essential Amino Acids Can Prevent-Muscle Loss During Bed Rest