Q: I hear advertisements on the radio all the time promoting male enhancement products. What’s in the products?

A: There are a lot of these products. They are available without a prescription and promoted as “all natural.”

It’s hard to say what’s in a particular product without reading the label. But even reading the label — if there is one — may not give you a true picture.

Some of the products, the U.S. Food and Drug Administration has found, actually contain the same or similar ingredients as what’s in the prescription drugs Viagra, Cialis and Levitra sold to treat erectile dysfunction.

Siobhan DeLancey, a spokeswoman for the FDA, explained the agency’s authority over dietary supplements. By law, the agency does not have the authority to evaluate dietary supplements for safety or effectiveness, she said.

The law states that manufacturers of these products bear the responsibility for marketing a safe product.

“Nothing is said about effectiveness. They cannot make a drug claim. They cannot claim to treat erectile dysfunction,” DeLancey explained.

“They can make what are called structure/function claims,” she said. “Those are things like ‘support sexual health.’ Or ‘helps you maintain a vibrant sex life.’ Things that are really kind of unmeasurable or in the eye of the beholder. Unfortunately, there are a number of people who have found this loophole in the law. What we have found is they are importing products and marketing them as dietary supplements, but they actually contain drugs.”

They contain the actual drugs used in the prescription products or an analog, which has a slight chemical difference.

“They can contain it at wildly higher doses. We have seen up to seven times higher,” DeLancey said. “The bitter irony here is that people who have been to their doctor to get a prescription for the approved products have been turned down because they have a heart problem, they take nitrates for chest pain, things that are on the warning labels for those prescription products.

“So these people who don’t qualify to get the prescription, they see this thing that is marketed as the safe, herbal alternative that actually contains a drug. They take it and, sadly, we know there are many people who suffer heart attacks or strokes or other side effects.”

Until this year, the FDA did not have mandatory recall authority, so it relied on voluntary recalls, essentially asking manufacturers to take a product off the market.

The problem is tracking down a responsible party. Some FDA warning letters are addressed to websites.

“In a lot of cases, these products don’t have any manufacturer name. They don’t have any identifying information on where they came from,” DeLancey said.

Even then, she said, a product may be removed only to resurface with a new name and new label. By Tammie Smith, Richmond Times Dispatch

You have likely heard about a recent study, involving roughly 40,000 women over the age of 60, in which daily use of a multivitamin — and several other nutrient supplements — was associated with a higher rate of death. Along with the mix of shock, consternation, and disappointment is the very practical question: could a multivitamin kill you?

Almost certainly not! The current study — like others before it that have hinted at much the same association — is absolutely NOT cause for panic. For each such study, there is another showing no real harm. That vial of (now menacing) multivitamins in your medicine cabinet doesn’t mean you need to fast track the preparation of your will and testament.

For starters, the study now making headlines, and the similar studies preceding it, are observational. A large group of people is simply followed and assessed over time, and the associations between what they do, and what happens to them, are analyzed.

In the current case, routine use of a multivitamin was associated with roughly a 2 percent greater chance of dying over a 20-year span for women over age 60. So, for starters, a 2 percent increased risk of dying over 20 years is not exactly cause for panic — especially when one considers that dying in our early 80s is not entirely unexpected or untimely.

But even more important, these women were not assigned to a multivitamin or placebo; they made up their own minds. Some chose to take nutrient supplements, some did not. How did these two groups differ? Like all good observational studies, this one attempted to account for obvious differences — in education, income, smoking status, general dietary pattern, and so on — but the only honest answer is: we don’t know! We can’t possibly know all the ways women who opt to take nutrient supplements differ from those who don’t. (That, by the way, is why randomized trials can be so important; they reliably correct for this limitation of observational studies.)

So, for instance: What if women more concerned about a family history of chronic disease were the ones to take supplements? What if women who were less confident in their ability to eat fruits and vegetables daily were the ones to take supplements? What if women who were just more anxious and pessimistic about their health were the ones to take supplements? Independent of all other factors, pessimism increases mortality, and optimism decreases it.

We don’t know that any of these “what ifs” was true; but if any one of these, or another like them, was true, it might be the reason for the (minimally) higher death rate among supplement users, rather than the supplements per se.

But, the fact of the matter is that several large studies now suggest possible harm attached to the use of multivitamins and certain other supplements (including some B vitamins, and iron). Since we never had any clear evidence of benefit from multivitamin use, and since the “at least it couldn’t hurt” rationale for using multis as an insurance policy is clearly not valid — the day of the conventional multinutrient supplement is over. I used to take a multi, and no longer do; I used to recommend them to patients, and no longer do.

How could a mix of nutrients known to be essential cause harm? When we extract nutrients from their context in food, we are “guessing” about preparation, dose and combination. Errors in any of these could lead to trouble.

Imagine, for example, that you had all the essential construction material you needed to build a house — but in the wrong proportion. Too many roofing shingles, but too little lumber. Or perhaps the beams were too short for the dimensions of the roof. We use nutrients to build cells and proteins and hormones every day, and having the right “stuff” but in the wrong form or supply could make a mess of things.

Or, consider a musical analogy. You love a jazz ensemble, a rock band and a symphony orchestra. Imagine the sax player from the one, the guitarist from the other, and the cellist from the third each playing her own music, all at the same time. Noise! Lovely on their own, a mess when combined badly.

This could be the case with how we have approached nutrient supplementation. Frankly, I don’t know for sure — nobody does — but the potential for real, if modest, harm is plausible.

So what do we do now?

For one thing, we should recall that all along, the best-case scenario was “supplement,” not substitute. There is no substitute for eating well, and that deserves our dedicated commitment.

At this point, unless you are likely to have a serious deficiency in overall nutrient intake — or unless you have a specific indication for taking a multivitamin, such as pregnancy or the intent of pregnancy — use of a multivitamin seems ill advised. You need a good reason to do it; “what the heck” is no longer sufficient.

Judicious use of select supplements still makes sense. We have convincing evidence of known or likely benefit from supplemental omega-3 oils and vitamin D for most men and women, and calcium for most women. For the most part, other supplements should be used for a specific reason, and with input from someone with genuine expertise. As an example, B12 supplementation is warranted for most vegans, and for all older adults with pernicious anemia. Let’s not toss out the baby with the bathwater!

Another intriguing consideration is the use of whole food-based supplements (for example). Such products are “humble” in the sense that they don’t presume to know how to combine nutrients — they let nature do it. They simply compress the nutrients from healthful foods into pill form so that those who don’t eat quite as they should — including children — can fill in the gaps. We need more science to prove the benefits of such supplements, but the approach makes sense to me, and may prove to be the new-age answer to the multivitamin/mineral supplement.

Independent of other factors, a multivitamin is very, very unlikely to kill anyone. If there is risk attached to the use of such supplements, it is very small. But there may be some risk — and there is no reliable indication of benefit.

That’s really all we need to know to conclude: it’s probably time for us to kill the multivitamin. Huffington Post

The cost of laparoscopic surgery for inguinal hernia can be brought down substantially if the synthetic mesh that is imported now can be manufactured in the country, Director of Gem Hospital C. Palanivelu told presspersons here on Friday on the sidelines of “EndoHernia 2011” conference.

Expensive

“An inguinal laparoscopic surgery is very expensive. This is because the mesh used in the surgery itself can cost anywhere between Rs.25,000 and Rs.60,000,” he said.

“The synthetic mesh is imported from France and the U.S. I wish our Government simplifies licensing procedures and ensures we have companies manufacturing meshes in India.”

Along with Consultant Surgeon of Royal Infirmary of Edinburgh Steve Nixon and national president-elect of Association of Physicians of India A. Muruganathan, Dr. Palanivelu explained the causes and symptoms of hernia and the difference between laparoscopic and open surgeries.

“Hernia and appendicitis are two very common medical conditions affecting people of all age groups,” said Dr. Palanivelu. “Hernia might be caused due to weakness of abdominal muscles. Lifting weights or playing sports can also be risk factors in the persons with this condition.”

Hernia, a condition in which an organ in the abdomen protrudes through a layer of tissue, can be inguinal, femoral, hiatal, incisional and umbilical.

Dr. Palanivelu pointed out that the most common type of hernia is inguinal hernia. “We carry out about seven laparoscopic hernia surgeries a day. Out of these, 60 per cent are inguinal.” He went on to add, “Obesity is one of the major reasons for hernia among Indians. When there is a lot of fat in the abdominal region, the strength of the stomach muscles decreases, resulting in hernia.”

Dr.Nixon said hernia could be partly caused by genetic factors. “A person might produce weaker collagen, because he might be genetically predisposed to do that. This leads to weak abdominal muscles, and subsequently hernia.”

Explaining strangulated hernia, Dr. Muruganathan said “When one does not approach the doctor after spotting a bulge (which indicates hernia) it could lead to a condition called strangulation.” Blood supply is cut off to the hernia, thereby leading to complications.\

Dr. Palanivelu stressed the importance of laparoscopic hernia repair, subsequently. “In open hernia surgery, a large cut has to be made and the hernia has to be pushed back to its place, and suturing has to be done. The patient might take at least two months to recover from the surgery. Whereas in laparoscopy, only a small incision needs to be done and the patient can start working on the day after the surgery.” However, in India, only two to three per cent of hernia surgeries being done are laparoscopic. The Hindu

The pleas and presentations came on the first day of a two-day hearing at which Genentech, the manufacturer of Avastin, is getting a chance to try to persuade the F.D.A. to reverse its decision made in December to revoke the drug’s approval for advanced breast cancer.

The proceedings emphasized a conflict that has bedeviled pharmaceutical regulation and other efforts to control the practice of medicine — one between cold statistics from clinical trials about overall populations and the often emotional experiences of individual patients who say a therapy has, or might, work for them.

About a dozen women with breast cancer, some tearful, told the F.D.A. that while Avastin did not show a big benefit over all in clinical trials, the medicine did help some women substantially and should be left available for that reason.

“Despite the potential side effects from Avastin, metastatic breast cancer has only one — death,” Priscilla Howard, who said Avastin had controlled her cancer for 32 months, told the committee presiding over the hearing. “I want every available weapon in my arsenal as I fight this devastating disease.”

Avastin received so-called accelerated approval for metastatic breast cancer in 2008 under a system intended to allow drugs for serious diseases to get to market more rapidly, subject to later studies to confirm they really work.

The F.D.A. said that those subsequent studies had not confirmed that Avastin was safe and effective. With five randomized trials of Avastin now having been completed, the F.D.A. said, no trial had shown that Avastin prolonged life or improved the quality of life. And no trial showed that the drug delayed the progression of tumors to the same extent as the one trial that led to the drug’s approval.

“All we are asking for here is one trial that shows clinical benefit,” said Dr. Richard Pazdur, the head of the agency’s cancer drug division.

F.D.A. officials said that data from trials had not shown even a small subset of women receiving Avastin living substantially longer than those in the control group, raising doubts about whether there are “super responders” who derive great benefit from the drug.

“We’re just not seeing that population,” said Dr. Patricia Keegan, an official in the agency’s cancer drug division.

Even if the approval is revoked, Avastin would remain on the market as a treatment for other types of cancer, so doctors could use it off-label to treat breast cancer. However, insurers would be less likely to pay for the drug, which Genentech says costs a typical breast cancer patient $88,000 a year.

Women with breast cancer testifying at the hearing feared the drug would become out of reach for them and other cancer patients. Husbands, doctors and some patient advocates also spoke in favor. Each speech in favor of retaining Avastin’s approval was met by applause.

“Make no mistake, this hearing is a death trial, not of Avastin but of these women who rely on Avastin to stay alive,” said Terry Kalley, of Troy, Mich., whose wife, Arlene, is being treated with Avastin.

Mr. Kalley also helped organize a demonstration by women and their families that took place just outside the F.D.A. campus in Silver Spring, Md., where the hearing was held.

Representatives of advocacy groups for patients with ovarian, kidney and colon cancer and melanoma also spoke in favor of retaining the breast cancer approval, saying, among other things, that revocation could discourage drug development.

But defying the mood in the room, representatives of four breast cancer advocacy groups testified in favor of the F.D.A.’s proposal to withdraw the approval.

“What use is there for a drug which in this population has more toxicities, some very serious, than the previous standard of care?” said Helen Schiff of Share, a breast and ovarian cancer support group.

Ms. Schiff said that for every woman who testified Tuesday in favor of Avastin, there were others who were not helped by the drug or had even been hurt by side effects like brain hemorrhages.

“Those people don’t come to testify,” she said.

Christine Brunswick, representing the National Breast Cancer Coalition, said: “The F.D.A.’s decision on Avastin must be based on scientific evidence from well-done trials and cannot be based on any one individual story, no matter how compelling.”

These remarks were met by derision. “I am completely disgusted to have to follow somebody like that,” said Kim Jewett, a breast cancer patient and representative of mylifeline.org, a cancer support group, who spoke directly after Ms. Brunswick.

Genentech, which is owned by Roche, will present its case on Wednesday. Later that day, the advisory committee will vote on its recommendations for the F.D.A. commissioner, Dr. Margaret A. Hamburg, who will make the decision at some future time. By Andrew Pollack, Herald Tribune

“A negative effect on bone health that may increase the risk of fractures is an important consideration for people considering bariatric surgery and those who have undergone bariatric surgery,” said Kelly Nakamura, a medical student at Mayo Clinic College of Medicine in Rochester, Minnesota, and study’s lead author.

Nakamura reported the final analysis of research presented two years ago in a small subset of the 258 patients included in this study.

This full analysis showed that patients who had bariatric surgery have 2.3 times the chance of fractures compared with the general population, as opposed to the 1.8-fold increased risk found initially.

Patients who had bariatric surgery had an increased risk of a fracture at nearly all skeletal sites studied, according to the researchers.

The chance of breaking a foot or hand was especially high—about three times what would be expected, said Nakamura.

Patients underwent bariatric surgery at Mayo Clinic Rochester between 1985 and 2004, with 94 percent of patients having a gastric bypass.

A total of 79 patients had 132 fractures during an average follow-up of nine years. On average, they experienced their first fracture about six years after surgery, noted the researchers.

These findings will be presented Tuesday at The Endocrine Society’s 93rd Annual Meeting in Boston. DNA India

Acetic acid is formed only by the Acetobacter family of bacteria. These bacteria are found everywhere in food, water, and soil and is naturally produced as fruits spoil. In humans and other primates, acetic acid is a component of the female vagina, where it serves as an antibacterial.

The acetic acid content of vinegar will determine its use and varies according to the fruit or grain used to start with. Rice wine vinegar is quite mild with a low acid level making it a good choice for salad dressings. On the other end of the scale is distilled white vinegar which is highly acidic and suitable for making pickles. All other vinegars fall in between.

Malic acid, in particular, is the main digestive acid found in apple cider vinegar as well as in our own body cells. It has many health benefits, including boosting immunity, maintaining good oral health, reducing the risk of toxic heavy metals, and promoting good skin tone. Its most significant contribution is the ability to stimulate the metabolism and increase energy production.

Apple Cider Vinegar Nutrition

Apple cider vinegar is a concentration of acids, flavonoids, polyphenols, pectin, enzymes, minerals, and amino acids that form during fermentation. Scientists have found about 90 different substances in apple cider vinegar, including 13 kinds of carbolic acids, 4 aldehydes, 20 ketones, 18 types of alcohols, 8 ethyl acetates and much more.

Nutrients include:

* Acids – acetic, isobutyric, lactic, malic, and propionic

* Amino acids – the number and amount depends on its source with some having antioxidant properties.

* Beta-carotene – helps prevent cancer and protects the body against damage caused by exposure to toxic chemicals

* Boron – is found abundantly in fresh apples. It is a key mineral that assists other bone-building minerals also found in apple cider vinegar like calcium, magnesium, and phosphorus.

* Enzymes – are built from protein molecules and have many duties in the body. Those suffering from indigestion, gas, or bloating lack the essential digestive enzymes needed to digest food properly. Fresh apples are loaded with enzymes, which increase as vinegar is made. This is why it is important to buy apple cider vinegar with the mother. That way you know the precious enzymes and nutrients have not been destroyed in processing.

* Magesium – is needed for bone health as well as for proper muscle function, including the heart where it can strengthen the beat and help normalize blood pressure.

* Pectin – is a soluble fibre that can absorb water, toxins, and cholesterol in the digestive tract. Apple cider vinegar contains valuable pectin from the apples and will go a long way in improving heart health and regularity.

* Potassium – is stripped from processed foods and replaced by sodium. To make matters worse, caffeine and sugar take what little is left in the diet because both act as diuretics, flushing valuable nutrients out of the body. Apple cider vinegar is an excellent source of potassium, giving roughly 100 mg per 3.5 ounces.

* Tannins – are released from the crushed cells of the apple. Tannins are the red-gold plant chemicals that give plants and various fruits and vegetables their astringency. They are effective antioxidants that help to prevent spoilage.

* Other – During both fermentation processes, many new plant chemicals are formed. As yet, many remain unidentified and no doubt will add to apple cider vinegar’s growing list of health-giving substances.

Apple Cider Vinegar Benefits

* TONIC – 1-2 tsp apple cider vinegar in 1 glass filtered water. Drink before or during meals 3 times a day.

* Acne – Mix 2 tablespoons apple cider vinegar with a cup of water and dab on blemishes several times a day. This will help dry them out and curb infection. You can follow this treatment with a little aloe vera gel to help prevent scarring.

* Aging – Premature aging can be a sign of an inefficient digestive process. Drinking a little apple cider vinegar before each meal can help improve digestion. Taking the TONIC on a regular basis will improve digestion and metabolism, resulting in better skin tone, less joint pain, improved memory, and a trimmer figure.

* Allergies – Regular use of apple cider vinegar helps strengthen the immune system and improve metabolism.

* Arthritis – Although there is no definitive research on this, many arthritics attest to its effectiveness. Dosages vary from taking 2 teaspoons a day to 10 with water after a meal until the pain subsides. Arthritis is often aggravated by food allergies. The most common culprits are nightshade vegetables (potatoes, tomatoes, peppers, eggplant, and tobacco), wheat, dairy, corn, and citrus. By eliminating one at a time, people can find out which one may be affecting them.

* Asthma – Sipping a glass of water containing a tablespoon or more of apple cider vinegar often helps.

* Athlete’s foot – Soak the feet twice a day in half water and half apple cider vinegar. Applying the vinegar directly to the affected areas several times a day also works well.

* Bladder – Patricia Bragg recommends this healing and cleansing drink to help overcome bladder and kidney infections: 2 tbsp. cornsilk to 1 quart distilled water or marshmallow herbal tea. Drink 1 cup 3 times a day, adding ½ tsp apple cider vinegar and 1 tsp buckwheat honey each time. Adding a little apple cider vinegar to organic, non-sweetened cranberry juice also works well.

* Bleeding – Vinegar has long been used to treat wounds and stop bleeding. It is believed that the adrenaline-like effect of apple cider vinegar helps to coagulate the blood. A cottonball soaked in apple cider vinegar and placed in the bleeding nostril is more effective than a plain cottonball.

* Blood pressure – Take the TONIC to gain the benefits of the potassium in the apple cider vinegar. Potassium helps balance the body and lower the blood pressure.

* Bones – Apple cider vinegar contains minerals (magnesium, manganese, and silicon) which contribute to good bone health. It also contains the trace mineral boron which supports the metabolism of calcium and magnesium. Several good quality calcium and magnesium manufacturers are recognizing this and adding the mineral to their supplements. Boron also helps elevate levels of the hormones estrogen and testosterone which help keep bones strong.

* Bruises – Dissolve and warm 1 tsp salt in ½ cup apple cider vinegar. Apply as a compress to the affected area.

* Burns – Use apple cider vinegar full strength to any burn, including sunburns.

* Cancer – Apple cider vinegar contains a number of substances that can help protect against cancer, including beta carotene and pectin that help fight against free radicals. One interesting study published in Lancet was done by researchers at Johns Hopkins University and at the University of Zimbabwe. Nurse midwives screened more than 11,000 women for cervical cancer, using both acetic acid (the prime ingredient in apple cider vinegar) and the traditional pap smear. They found that the vinegar test picked up more precancerous or cancerous cells than the pap smear.

* Cancer sores – Rinse the mouth with 1 tsp apple cider vinegar in 1 glass of water several times a day.

* Candida – As a douche for vaginal yeast infections, mix 2 tbsp apple cider vinegar and 1 quart warm water and use twice a day until the burning and itching stop. Adding 1 cup of the vinegar to bath water also brings relief and toning the skin and helps to heal other skin problems.

* Cataracts – Studies have shown that diets high in fat and salt increase the risk for cataracts. Since apple cider vinegar helps metabolize proteins which, in turn, improve fat metabolism, it should be added to the diet to lower the risk of cataracts. Not only that but apple cider vinegar also includes the antioxidants (beta-carotene, C, and E) known to fight against the free radicals formed in the body that contribute to cataracts.

* Chicken pox – The discomfort of the itching pox can be relieved by applying apple cider vinegar full strength to the affected areas and by adding 1 cup to a warm bath.

* Cholesterol – Taking the TONIC is an effective way of adding pectin to the diet. Pectin is a soluble fibre which absorbs fats and cholesterol and removes them from the body. The vinegar also contains amino acids which neutralize harmful LDL cholesterol.

* Cold sores – Cold sore pain and duration can be lessened by applying apple cider vinegar full-strength to the sores several times a day.

* Colds – During a cold, the body is more alkaline. Therefore, taking the TONIC several times a day at the onset of a cold can help raise the acidity level to kill off the harmful viruses and boost the body’s immune system. Nasal congestion can be relieved by adding apple cider vinegar to a steaming bowl of water and inhaling the vapors. This will not only open the passages but the vinegar will help kill the viruses or bacteria causing the problem.

* Constipation – Constipation is caused by a poor diet and a reduction in digestive acids that deminish with age. Along with improving the diet by adding more fibre, apple cider vinegar taken with meals can also help with regularity.

* Corns – Soak feet in a warm bath containing ½ cup apple cider vinegar. Rub the corns with a pumice stone and apple vinegar full strength. Cover with a bandage overnight. Apply the vinegar and a bandage again in the morning. Repeat until the corn has dissolved.

* Coughs – One of the oldest home remedies is honey and lemon juice, but using apple cider vinegar instead of lemon juice also works well.

* Cramps – Muscle cramps can be an imbalance of nutrients in the body, especially vitamin E, potassium, calcium, or magnesium. Taking apple cider vinegar daily will help supply as well as metabolize these nutrients from other sources.

* Cuts and abrasions – Applying apple cider vinegar to superficial wounds is an age-old practice. It will not only cut down on the risk of infection; but it will also speed the rate of healing.

* Dandruff – Use apple cider vinegar full strength on the scalp to destroy the bacteria or fungus that is causing the problem. Apply to the scalp, rub in, and leave on for half an hour before shampooing the hair.

* Deoderant – A good diet and regular cleansing will go a long way in reducing body odor; but for added protection, dip a cloth in apple cider vinegar and wipe underarms with it.

* Depression – Although depression can range from the mild to the severe, it is a serious metabolic disorder. Apple cider vinegar can help cleanse the body by stimulating the liver to get rid of toxins that might be contributing to the problem. It also helps metabolize the proteins needed to influence production of seratonin.

* Diaper rash – Apply half apple cider vinegar and half water to a diaper rash or any other type of rash. It also tones the skin.

* Diarrhea – Taking the daily TONIC can help get rid of the micro-organism causing the problem and improve digestion that might also be a contributing factor. Some people resort to over-the-counter use of Kaopectate. The “pectate” part is simply pectin. Much cheaper and more natural versions can be found in fruits and vegetables and of course, apple cider vinegar. Persistent diarrhea, however, requires medical attention.

* Digestion – As mentioned many times, apple cider vinegar improves digestion especially in metabolizing proteins. It enhances the action of hydrochloric acid (HCL – which deminishes with age) and digestive enzymes. Digestion begins in the mouth where the apple cider vinegar stimulates the acid receptors on the tongue to produce saliva that begins the breakdown of carbohydrates. Taking apple cider vinegar and water before each meal can help improve the digestive process.

* Dizziness – An alkaline environment can produce dizziness and a number of other conditions. Some people have obtained relief from dizziness by taking the TONIC on a regular basis.

* Earaches – While waiting for antibiotics to work, should one be needed, put some apple cider vinegar on a cotton ball and place in the ear. This can help kill off any microbe that might be causing the problem as well as relieving pain.

* Eczema – Use half apple cider vinegar and half water to relieve the itching and dryness.

* Fatigue – The amino acids in the apple cider vinegar can help neutralize the build-up of lactic acid in the bloodstream that occurs after exercise and stress. It is also thought that regular use of the TONIC can help prevent fatigue.

* Fever – There is an age-old remedy of wrapping the calves with towels that have been soaked in 1 part apple cider vinegar and 3 parts water. This seems to have helped reduce fevers. Resoak and reapply as the towels dry out and until the fever is reduced, all the while keeping the patient warm, of course.

* Flatulence – Stomach gas is a sign of poor digestion, often caused by the incomplete digestion of carbohydrates. Sipping the TONIC before meals can help relieve the problem.

* Food poisoning – Traveling to other countries often brings on digestive upsets. Traveling with liquids can cause other problems. However, apple cider vinegar is available in capsules. Taking them every time you eat can help avoid digestive problems and kill any microbes that cause food poisoning.

* Gall bladder – Apple cider vinegar can be an integral part of what is called a gall bladder flush. There are many variations to this flush, which is taken over a period of 2 to 3 days followed by drinking straight olive oil. However, this should only be attempted if small gallstones are present and even then, should be supervised by a health care professional. Consuming apple cider vinegar on a regular basis can help avoid gallstones altogether.

* Gums – Bleeding gums are often relieved by using the TONIC as a mouth rinse. The action of the vinegar dissolves plaque and fight oral infections. It can also dissolve tooth enamel, so swish well with water after a vinegar rinse.

* Hair – Add ¼ cup apple cider vinegar to 1 quart warm water and use as a final rinse or for loosening tangles. It will restore lustre and shine to dull, lifeless hair. The mixture will also help fight scalp conditions like dryness, itchiness, and flaking, especially if caused by a fungus. For hair colouring: If using a vegetable-based hair dye or henna, rinsing with apple cider vinegar holds the colour longer. In addition, rinsing the hair with apple cider vinegar before a colouring or perm process will remove any residue from shampoos and make the dye or perm take a better hold.

* Headaches – Headaches are often the result of the body being too alkaline. The fastest way to gain relief is to try a little apple cider aromatherapy by breathing in the fumes of simmered water and apple cider vinegar. Adding the vinegar to a vapourizer can also help.

* Head lice – Over-the-counter head lice preparations are very toxic and often are not as effective as more natural approaches. Try rinsing the hair with full strength apple cider vinegar. Do not wash out. Wrap in a scarf and leave until the next shampoo. Do this for 2 or 3 days in order to kill all the adult lice. Then for the next few days, examine each strand of hair in the sunlight for eggs. Use a nit-comb or fingernails to remove these. Wash your hands and clean your fingernails thoroughly afterwards. Use apple cider vinegar regularly on your hair to keep the scalp free of pests and other infections.

* Heartburn – Ironically, heartburn results from too little hydrochloric acid rather than too much. Taking antacids only compounds the problem. Regular use of apple cider vinegar can help eliminate the problem as it properly breaks down fats and proteins and stimulates digestive enzymes to improve the whole digestive process.

* Heatstroke – This can happen when not enough fluids are consumed, causing the body to overheat. Apple cider vinegar can quickly restore electrolytes and other minerals lost during sweating. In fact, an age-old remedy called switchel was served to exhausted workers. It consisted of combining 2 tablespoons of apple cider vinegar, 1 ½ tablespoons of blackstrap molasses, and 2 cups boiling water poured over ice.

* Hemorrhoids – Apply full strength apple cider vinegar to the hemorrhoid to promote shrinking and a reduction in the itch and pain. Regular internal use can help with the digestion that precludes the onset of hemorrhoids.

* Hiccups – There are so many remedies for hiccups that adding apple cider vinegar should come as no surprise. Sipping a glass of warm TONIC sometimes helps.

* Hives – Make a paste of equal parts apple cider vinegar and cornstarch and apply to the hives or rash to help calm the itching. This also works for jock itch and other rashes.

* Impetigo – Impetigo is a very contagious bacterial infection (staph or strep) often seen in young children. Applying apple cider vinegar to the lesions every 3 hours should help halt the spread and dry up the areas.

* Iron absorption – Apple cider vinegar can help improve the absorption of iron, a mineral that carries oxygen to the cells and holds it there, thus preventing iron deficiency anemia. The acetic acid found in apple cider vinegar helps release iron from food. The more iron that is absorbed, the more oxygen will be in the blood cells and the more energy a person will have.

* Insect bites and stings – Apply full strength apple cider vinegar to reduce pain and/or itching.

* Insomnia – A glass of apple cider vinegar TONIC with a little honey before bed often helps. The carbohydrates in the vinegar and honey will activate serotonin, a brain chemical that promotes relaxation.

* Kidneys – Pyelitis (Pyelonephritis) is an inflammation of a kidney. Some doctors have used the apple cider tonic with good results. However, always check with your own health care professional.

* Leg cramps – Regular intake of TONIC can help absorb calcium and magnesium. A lack of these minerals often contributes to leg cramps, especially at night.

* Liver function – Apple cider vinegar has long been used as a detoxifying agent. To promote good liver function, add an additional 1 tablespoon of apple cider vinegar to your daily TONIC. This will increase the breakdown of fats and proteins from foods that tax the liver.

* Night sweats – Whether night sweats are the result of an illness or menopause, drinking a glass of TONIC in the morning can help rebalance the hormones and help the body remove toxins through the perspiration.

* Pets – Apple cider vinegar works very well on animals, as well as on humans.

o Putting a little in their water dish helps keep their digestive tract healthy, deters fleas and ticks, and gives them a shiny coat.

o Swabbing their ears with diluted apple cider vinegar keeps them free from itching.

o Skin conditions are relieved by adding apple cider vinegar to their bath.

o Using the vingegar instead of tomato juice can help relieve the smell after a run-in with a skunk, as well as being healthy for their coats; shampoo as usual after the treatment. Horses can develop intestinal stones (enteroliths) that can cause blockages. Veterinary researchers at University of California Davis recommend 1-2 cups of apple cider vinegar daily in their water to prevent these stones from forming. In addition, by pouring the vinegar over the feed, flies stay away.

* Poison ivy, oak, sumac, nettles – Mix equal parts of cider vinegar and water and apply directly to the area. By keeping this mixture in a spray bottle in the fridge, the coolness will also help bring more relief.

* Salt replacement – Apple cider vinegar can be used to replace salt, which can be a flavor enhancer for fat. In other words, eating too much salt can cause a person to increase fat consumption. Adding apple cider vinegar to protein foods, including beans, can go a long way in enhancing flavour and be a much healthier substitute for salt.

* Shingles – This is a painful condition of the nerves caused by a herpes virus. Applying apple cider vinegar full strength to the areas 6 or 8 times a day can help the itching and burning. Taking apple cider vinegar internally can help speed healing as well.

* Sinusitis – Drinking a glass of apple cider vinegar TONIC can balance the body’s pH level since sinusitis is sometimes caused by the body being too alkaline. Inhaling the fumes from hot apple cider vinegar and water can also help destroy any virus or bacteria that might also be the cause of an infection.

* Sore throat – Gargling with apple cider vinegar TONIC helps relieve a sore throat – but do not swallow the gargle since you do not want to swallow any microbes that might be the cause. Apple cider vinegar can reduce any swelling and increase the flow of mucus. This is also a good preventative if there is to be much stress placed on the throat, as singing or public speaking.

* Swimmer’s ear – Combining the drying effects of alcohol with the disinfecting properties of apple cider vinegar can help reduce the itching and pain. You can use 3 to 4 drops in the ear after swimming or showering.

* Teeth – Daily rinsing with TONIC can help maintain good oral hygiene and fight bacteria that cause tooth decay and gum disease. However, be sure to rinse well with water afterwards as vinegar can damage tooth enamel in time.

* Tinnitus – Tinnitus is an annoying condition with any number of causes. Daily consumption of TONIC helps improve mineral balance and circulation, both of which can have a positive effect.

* Ulcers – Apple cider vinegar has been used to help keep stomach ulcers from forming.

* Varicose veins – A number of apple cider authorities recommend soaking a compress in the vinegar and wrapping it around the legs twice a day for a month. The legs should be kept elevated for about ½ hour before removing the compress. Drinking the TONIC before or with meals, along with the soaks, helps as well.

* Warts – Combine 1 part salt with 4 parts apple cider vinegar and apply several times a day to the wart until it disappears.

* Weight loss – Although fat is necessary for the body to function, most people eat too much of the wrong kinds. Appetite increases as daylight decreases. So does the craving for fat, which is the body’s main line of defence against the cold of winter and possible food shortage. The body uses protein for fuel and carbohydrates for instant energy, but it is fat that provides the resources for long-term energy.

Fat insulates vital organs (heart, liver, lungs, and kidneys) as well as keeping the body temperature regulated. It is also involved in certain chemical reactions in the body involving enzymes, hormones, and fat-soluble vitamins (A, D, E, and K).

Another responsibility added to fat is its role in a healthy nervous system. When fat is combined with phosphorus, lecithin is created. Lecithin plays an important role in the formation of neurotransmitters – chemicals needed for proper functioning of the brain which, in turn, controls such things as appetite, mood, and the ability to learn and remember.

Essential fatty acids are essential because they must come from the diet. Manufacturers remove the omega-3 fatty acids to lengthen shelf life. This means omega-6 fatty acids are all we get in most foods. The omegas work in opposition to each other; and by getting too much of one and not enough of the other, health problems result. For example, omega-6s increase blood pressure, blood clotting, and cell proliferation. Omega-3 fatty acids do the exact opposite and, without it, heart problems, diabetes, and cancers – just to name a few – increase.

So, what has all this got to do with apple cider vinegar and weight loss? Well, I am glad you asked. Apple cider vinegar helps with gradual weight loss. Fad diets encourage rapid weight loss – which is never permanent. This is how.

The acids in apple cider vinegar help to improve the digestion of protein. Protein helps to construct some of our hormones, especially the growth hormone which is instrumental in breaking down fat cells. By increasing the acid in the stomach before a meal begins, the chances for proper digestion of protein also increases. All too often people think they have too much acid because they have heartburn and take an antacid when, in fact, the exact opposite is true. The stomach is too alkaline and pours out more acid to compensate, but antacids are taken instead and the whole viscious cycle begins again.

Proper digestion of protein will also improve carbohydrate conversion and, ultimately, insulin production. Apple cider vinegar starts a process by first raising the metabolism, which increases the body’s ability to utilize proteins for insulin formation. This ultimately improves the transformation of the amino acid tryptophan into serotonin, which is a natural mood elevator and tranquilizer. In addition, because apple cider vinegar stimulates and improves digestion, it can reduce the amount of time fats remain in the digestive tract all the while allowing enough time for other nutrients to be absorbed. By Sanjay Babu, Kashmir Observer

According to the Massey University Sleep Wake Centre 37 per cent of New Zealand adults aged 30 to 60 are sleep-deprived and 25 per cent of adults aged 20 to 60 have insomnia. A number of studies have shown that proper selection of a pillow can significantly reduce neck pain and improve quality of sleep[1]. Chiropractors believe that more education around pillow and bed selection could help reduce these numbers.

‘People rarely give much thought to the pillows that they use, focusing almost entirely on the bed. However, if the neck is not supported properly when sleeping it can cause a whole range of problems from neck pain to upper and lower back discomfort, headaches, shoulder and arm pain and restlessness,’ explains Dr. Hayden Thomas, chiropractor and spokesman for the New Zealand Chiropractors’ Association.

A new study by researchers at the University of Warwick Medical School, UK, shows that people who are unable to get a sleep of at least six hours a day are at an increased risk of suffering a heart attack or stroke. The researchers found that those who slept for less than six hours a day had a nearly 50 percent more risk of suffering a heart attack and 15 percent more at risk of a heart stroke[2].

Fortunately, there are a number of things that can be done to ensure an unsuitable pillow is not going to get in the way of getting a healthy night’s sleep.

‘It is important to choose a pillow that is of a shape and material that suits your sleeping position,’ advises Dr. Thomas. ‘For example, a side sleeper will need something that cradles and contours the neck, providing an even surface, whereas a back sleeper will require a medium support pillow that will support the natural curvature of the upper spine, providing support under the head, neck and shoulders. If you are in any doubt, get in touch with a suitably qualified health professional as they will be more than happy to point you in the right direction.’

‘One of the other mistakes people make is that they keep the same old pillow for years,’ adds Dr. Thomas. ‘They do wear out and need to be replaced eventually, just like your bed. As a general rule, a feather pillow should last around eight years, a down pillow five years and a man made filling from six months to two years. The best way to check whether it is time to get a new feather or down pillow is to lay it on a hard surface, fold it in half and squeeze out the air. Release the pillow. If it unfolds and returns to its original position, it has enough support. An overused pillow will stay folded.

‘To test a polyester pillow, fold it in half in the same way and place an object weighing about ten ounces or 280 grams on top. If it unfolds itself and dislodges the object, it has plenty of use left in it. If it remains folded then it won’t be adequately supporting your head and really should be replaced.’

‘Today the choice is vast’ says Dr Thomas ‘There are now pillows on the market made from specially contoured memory foam, natural latex and even a water-filled pillow which has been shown very effective for neck pain suffers and improving sleep quality.’1 These newer designs and materials may offer an advantage for some people giving greater support and usually last far longer than loose filled pillows, however they can be a significant initial investment.

One technique involves a portable bioprinter that could be carried to wounded soldiers on the battlefield where it would scan the injury, take cells from the patient and print a section of compatible skin.

Another uses a three-dimensional printer combining donor cells, biofriendly gel and other materials to build cartilage.

The 3-D printer was shown at work, building a prototype of an ear during a half-hour demonstration at a Washington science conference.

Hod Lipson of Cornell University in New York said it worked much like an ink-jet printer.

“It spits out plastic to gradually build an object layer by layer… after a couple of hours you end up with a real physical object that you can hold in your hand,” he said.

“Just imagine — if you could take cells from a donor, culture them, put them into an ink and recreate an implant that is alive and made of the original cells from the donor — how useful that would be in terms of avoiding rejection,” said Lipson.

“That is where we are going. Let’s see how far we can go.”

Studies using the technology in animals have shown promise, particularly with printed cartilage, which is relatively simple in its construction and is tough so it can withstand the rigors of printing.

“There are very severe limitations,” Lipson said. “We are right now limited to cells… that can handle being printed.”

Scientist James Yoo of Wake Forest University in North Carolina said his team’s approach to printing skin has shown positive results in repairing skin in mouse and pig models.

“One approach is to directly deploy cells to the wound site and the other approach is to build a tissue construct outside the body and transfer it into the body,” said Yoo.

The technology works in part via a scanner that takes a measure of the affected area and identifies the depth and extent of the injury, informing the bioprinter of how many layers of cells need to be made.

Both scientists said the advances were still in their early stages and required more research and refinement before they are ready for human patients.

“One of the challenges that we will eventually face is like anything else, when you are trying to transfer the technology into the body, how can we create and connect those tissues?” said Yoo.

“Whatever you put in the body has to be connected with the body’s blood vessels, blood supply and oxygen.” PhysOrg

The Scientific Advisory Committee on Nutrition (SACN) was asked by the Department of Health to review dietary advice on meat consumption as a source of iron.

In a draft report published in June 2009 the committee of independent experts said lower consumption of red and processed meat would probably reduce the risk of colorectal cancer.

The committee said: “Although the evidence is not conclusive, as a precaution, it may be advisable for intakes of red and processed meat not to increase above the current average (70g/day) and for high consumers of red and processed meat (100g/day or more) to reduce their intakes.”

A daily total of 70g is equivalent to about three rashers of bacon.

The Sunday Telegraph said the full report, to be published within days, was expected to echo the committee’s draft report.

A Department of Health spokeswoman said: “The DH committee of independent experts on nutrition will shortly publish their final report on iron and health.”

The World Cancer Research Fund already recommends people limit their intake of red meat, including pork, beef, lamb and goat, to 500g a week.

The fund also advises consumers to avoid too much processed meat, including hot dogs, ham, bacon and some sausages and burgers. London Evening Standard

Flavonoids are found in plants and fruits and are also known collectively as vitamin P and citrin. They can also be found in berry fruits, chocolate, and citrus fruits such as grapefruit.

The study involved 49,281 men and 80,336 women. Researchers gave participants questionnaires and used a database to calculate intake amount of flavonoids. They then analyzed the association between flavonoid intakes and risk of developing Parkinson’s disease. They also analyzed consumption of five major sources of foods rich in flavonoids: tea, berries, apples, red wine and oranges or orange juice. The participants were followed for 20 to 22 years.

During that time, 805 people developed Parkinson’s disease. In men, the top 20 percent who consumed the most flavonoids were about 40 percent less likely to develop Parkinson’s disease than the bottom 20 percent of male participants who consumed the least amount of flavonoids. In women, there was no relationship between overall flavonoid consumption and developing Parkinson’s disease. However, when sub-classes of flavonoids were examined, regular consumption of anthocyanins, which are mainly obtained from berries, were found to be associated with a lower risk of Parkinson’s disease in both men and women.

“This is the first study in humans to examine the association between flavonoids and risk of developing Parkinson’s disease,” said study author Xiang Gao, MD, PhD, with the Harvard School of Public Health in Boston. “Our findings suggest that flavonoids, specifically a group called anthocyanins, may have neuroprotective effects. If confirmed, flavonoids may be a natural and healthy way to reduce your risk of developing Parkinson’s disease.” PhysOrg