Saturday, January 30, 2016

Look at how much weight you’re going to gain

Here's something to ponder as you consider whether to ditch that New Year's resolution to exercise more: Your 20s are your prime weight-gaining years,according to data from the CDC.
The charts above are approximations of typical lifetime weight gain, based onCDC data, which is reported in 10-year increments. The numbers come from the National Health and Nutritional Examination Survey, which involves medical examinations of thousands of men and women each year. The great thing about these numbers is that they're based on clinicians' examinations, not respondents' self-reports. So fibbing about your actual weight isn't an issue here.
Epidemiologists have observed that the average person typically puts on 1 to 2 pounds a year from early adulthood through middle age. The CDC's numbers show that much of the increase is concentrated in the 20s, for men and women.
The average man in his 20s weighs around 185 pounds, according to the CDC. But by his 30s, he's closer to 200 pounds. The average woman's weight goes from about 162 to 170 pounds over the same period. These increases are a little smaller than the 1 to 2 pounds per year you typically hear because of different methodology: The CDC makes national estimates based on a representative subset of the population, rather than studying the same individuals over time.
There are any number of factors at work here. As people leave school, they may be less likely to participate in sports. They take on jobs and sometimeslong commutes, which eat into time that could otherwise be spent exercising. Job-related time pressures make quick (and often calorie-dense) takeout meals more attractive than time-intensive home-cooked ones.
Then throw in marriage and kids for a whole different set of pressure on free time. Say you've got an hour free in the evening and you can spend it either by going to the gym or playing with your kids. Which one would you choose?
There is some good news: CDC's data suggest that your weight probably will not increase indefinitely. The rate of increase starts to slow in the 30s and 40s, and plateaus in your 50s.
After that, the average weight falls. The kids are out of the house and your career is hopefully in order, freeing up more time to take care of yourself.
But there are other factors at work at this end of the weight-age spectrum. Being overweight also carries increased risk of potentially fatal conditions, like heart disease and stroke. So across the population, some of the average post-50s weight loss may be due to people with unhealthy extra weight dying.
And as people get older, particularly into their 60s and 70s, weight loss may be a symptom of any number of age-related conditions: depression, gastrointestinal problems, cancer, etc.
One important caveat to remember is that we're talking about population-level averages here. Your individual likelihood of gaining or losing weight at any point in time is influenced by all of the things that make you a unique and special snowflake: your genetic makeup, your own workout regimen, your propensity for scarfing down Jalapeno Cheetos at lunch, etc.
Still, the average numbers give a sense of what a typical person can expect in their lifetime. So if you're in your 20s, before you ditch that exercise resolution, do the following thought experiment: Take your current weight, and add two pounds for every year until you hit age 50.
Then imagine what pants size that is.
More from Wonkblog:
Christopher Ingraham writes about politics, drug policy and all things data. He previously worked at the Brookings Institution and the Pew Research Center.
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Monday, January 25, 2016

The Real Reason You Get Sick After A Stressful Period Has Ended

It's called "the let-down effect."

 01/24/2016 10:06 am ET
  • Stacey ColinoU.S. News & World Report
Have you ever wondered how you manage to get through a particularly stressful period – whether it's an intense deadline at work, final exams in school or a spate of holiday houseguests – only to get sick after the stress has lifted?
It's not a fluke. It's a phenomenon that's often referred to as "the let-down effect," a pattern in which people come down with an illness or develop flare-ups of a chronic condition not during a concentrated period of stress but after it dissipates, explains psychologist Marc Schoen, an assistant clinical professor of medicine at the University of California–Los Angeles and the author of "When Relaxation Is Hazardous to Your Health."
Research has linked the let-down of perceived stress with an increase in flare-ups of pain and other ailments. One study found that people experience more panic attacks on the weekends, and a 2015 study from Taiwan found that holidays and Sundays have more emergency room admissions for peptic ulcers than weekdays do.
In a 2014 study, researchers from the Albert Einstein College of Medicine in New York had migraine sufferers track their symptoms and stress patterns in a three-month electronic diary; it turned out that participants' stress levels didn't impact migraine occurrence, but a decline in their perceived stress from one evening entry to the next entry was associated with increased migraine onset over the following six to 18 hours – evidence of what the researchers call a "let-down headache." The let-down effect can also happen with flare-ups of asthma, autoimmune diseases (like lupus and Crohn's disease), digestive problems and skin conditions (such as eczema and psoriasis), Schoen says.
It's long been known that stress can lead to illness but only recently has evidence emerged that some people tend to get sick after a pressure-packed period has ended. To understand how and why this can happen, it helps to review how stress affects the body.
During acute stress, the body releases key hormones – including glucocorticoids (like cortisol), catecholamines (like norepinephrine) and adrenaline – to prepare itself to fight or flee from danger and to trigger the immune system to step up certain types of surveillance. In the process, "glucocorticoids can reactivate latent viral infections such as herpes simplex 1 [which causes cold sores] and Epstein-Barr virus [which can trigger fatigue, fever, sore throat and swollen glands], for which symptoms are only obvious after a few days," explains behavioral neuroscientist Leah Pyter, an assistant professor of psychiatry at The Ohio State University Medical Center in Columbus. That's why the symptoms may appear after the stress lifts – say, over a weekend, on vacation or after an exam period.
Meanwhile, while you're under pressure, the rise in cortisol and other stress hormones can protect you against the perception of pain, which is helpful in the moment because it can help you reach safety in a dangerous situation without being hindered by pain, explains psychologist Dawn Buse, director of behavioral medicine at the Montefiore Headache Center and an associate professor of neurology at the Albert Einstein College of Medicine. "After a stressful period has passed, the body returns to a state of normality and many of the systems that were activated calm down," she says. "This includes a drop in cortisol as well as other stress hormones [which could] set the stage to initiate a migraine." Similarly, that post-stress drop in cortisol could trigger a flare-up of other forms of chronic pain, such as fibromyalgia and arthritis.
Another way the sudden decrease in pressure can set you up to crash and burn: "Emotional stress and physical stress kick up the same inflammatory response, which opens the door for illness or the let-down effect," Schoen explains. After either type of stress dies down, there's "a down-regulation of the immune system, a suppression of the immune response, [as a reaction] to the easing of stress." In addition, the surge-and-fall of stress hormones could knock down dopamine levels in the brain, which can trigger overeating and substance abuse as people (unconsciously) try to raise their dopamine levels so they can feel reward and pleasure again, Schoen explains.
One of the best ways to avoid the let-down effect is to prevent the strain from getting to you in the first place. You can do this by pacing yourself when you're under pressure, getting plenty of exercise and sleep, eating healthfully and taking time to decompress on a regular basis (with meditation, rhythmic breathing or other relaxation techniques), says Dr. Nieca Goldberg, medical director of the Joan H. Tisch Center for Women's Health at the NYU Langone Medical Center. "During a stressful period, have a plan that calls for breaks as you go through it" so that you're not revved up 24/7. Indeed, the body's "fight-or-flight response can be deactivated quite effectively through diaphragmatic breathing and guided visual imagery," Buse says. "Someone who has high levels of stress at work could simply take 30 seconds to focus on their breath between meetings and appointments and try to avoid the build-up of stress that could happen over the course of a day."
If it's too late for a pre-emptive approach, you can mitigate the let-down effect by helping your body de-stress slowly. "Just like you have a cool-down period after exercising, you want your body to have a tapering down of stress," Schoen explains. The key, he says, is "to keep your body slightly revved up to keep your immune system from downshifting abruptly" when the stress ends.
The best way to do this, Schoen says, is to seek the right intensity of physical and mental stimulation. For physical stimulation, "moderate exercise in quick bursts – such as jogging or walking stairs for five or six minutes at a time, several times a day – can help," Schoen says. For mental stimulation, do challenging math problems, crossword puzzles or computer games, or play chess under time pressure for 30 to 60 minutes at a time, he suggests. Do these activities for three days after a stressful period – "that's the critical window," Schoen says – and you'll improve your odds of emerging from the aftermath of stress feeling good, not sick.
The Let-Down Effect: Why You Might Feel Bad Right After The Pressure Is Off was originally published on U.S. News & World Report. 
Also on HuffPost:
7 Unexpected Signs of Stress

Wednesday, January 13, 2016

The probiotic effect: Analyzing a regimen that's ready to fight pathogenic biofilm

Analyzing a regimen that's ready to fight pathogenic biofilm
By Debbie Z. Sabatini, RDH
probiotic biofilm
Biofilm is the buzzword circulating the pages and airways of every health-related resource I stumble upon or subscribe to. Thousands and thousands of words are dedicated to defining what biofilm is, does, and why and how to treat it.
Those of us who keep up on biofilm are seeing more articles, products, and programs on surface disinfection, sterilization, and OSHA recommendations on biofilm in our water lines, and the importance of treating the inner surfaces of that toxic tube.
For the purpose of this article, we will focus on the toxic biofilm matrix that coats the structures of the teeth and gums. My goal for this article is that we change our conversations and the words we use among our patients and ourselves by not minimizing pathogenic biofilm and its damaging effects simply by calling it plaque.
Bacterial plaque biofilm is defined by the free dictionary as: (noun) a thick grouping of microorganisms that are very resistant to antibiotics and antimicrobial agents that live on the gingival tissues, teeth, and restorations, causing caries and periodontal diseases.
Actually, what I find perplexing is that the effects of the bacterial plaque biofilm, which are damaging and often irreversible, are the very things that are so undercommunicated to the patient.
What do you suppose the patient's response would be if we truthfully communicated the exact definition of pathogenic biofilm during the data collection portion of our risk assessment appointment? I believe it would finally put to rest the circulating fable that bacterial plaque accumulation is just from "not brushing or flossing enough." What would the reaction be if we changed the words we use to define the action or reaction of toxic biofilm to the patient's overall health?
Let's find the time to explain that the pathogenic biofilm that overpowers protective and preventive beneficial bacteria in our mouths eventually breaks down enamel by the release of lactic acid. Caries is an infection, a bacterial invasion of the tooth structure; it is not a cavity (a cavity is a hole caused by pathogenic biofilm releasing lactic acid). Pathogenic biofilm affecting the epithelial layer is a disease diagnosed as gingivitis; it is much more than bleeding gums. Let's explain that chronic biofilm exposure eats bone that supports natural teeth, a denture, partial, or an implant. This bacterial infection sadly has reached epidemic proportions, yet we still commonly refer to its generic term as periodontal disease.

Probiotics ready to fight

This is serious! The statistics of underdiagnosed and undertreated periodontal disease are staggering. Our dialogue and actions must adapt and lead us to applying personalized medicine protocols and identifying risks in long-term health or chronic illness to our clients-not to mention the added value and expertise we provide as a professional! Do you think if we articulated this position that patients would respond, "Honey, just clean my teeth"? I'm not naïve enough to say that some won't. We need to be resolved in our execution of therapy with them. Fortunately, in my experience, the majority of responses we receive is, "Why didn't someone tell me about this sooner? And how fast can we get rid of it?"
There are many forms of biofilm disruption protocols that offices try to integrate, too numerous to discuss in this article. What I do want to share, as I do in all of my seminars, is the "why" of the disease. Identifying specific species of pathogenic biofilm via noninvasive saliva testing is quick and painless. The more information you can get on the patient's specific inflammatory burden, the more predictable your treatment outcomes will become. It makes what we do medically necessary and our therapies measurably more beneficial.
So how does understanding biofilm and identifying the specific biofilm that affects tooth structure or epithelial tissue relate to probiotics? Simply put, our highly developed immune system is designed to be on guard and readily available to fight disease and safeguard itself against pathogenic biofilm. When the oral ecosystem is out of equilibrium, symptoms of inflammation, caries, and bleeding will ultimately present themselves. In identifying the imbalance, we can support its repair by selecting a supplemental product that repopulates beneficial probiotic levels found naturally in our immune system when we are healthy.
The term "probiotics" comes from Latin and Greek words literally meaning "for life." The World Health Organization's 2001 definition of probiotics is "the use of live microorganisms which, when administered in adequate amounts, confer a health benefit on the host." For those who have integrated dietary probiotics into their health regimen, it has recently been published that you may already be benefiting from the therapeutic potential and inhibition of periodontal pathogens, specificallyPorphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans.1This means there is a bidirectional effect on probiotics taken orally and oral care probiotics, which we will address now.

Science backs up products

Oral care probiotics are probiotics intended for the oral cavity to help maintain healthy oral flora. One of the most studied and accepted oral care probiotics is EvoraPro by Oragenics. While most probiotics are ingested orally, they are not intended to confer an oral benefit. EvoraPro's patented blend of probiotic strains (ProBiora3) naturally derive from the pockets of healthy mouths and are intended to impart an oral benefit. ProBiora3 is Streptococcus oralis (S. oralis KJ3) and Streptococcus uberis (S. uberis KJ2), which are both associated with gingival tissue health, as well as Streptococcus rattus (S. rattus JH145), which is specific to tooth health. These probiotic bacteria synergistically work as antagonists to undesirable oral bacteria associated with rampant caries, bad breath, and oral infections, all challenges dental health providers and patients face indiscriminately.
EvoraPro ideally should be taken orally every evening after normal oral hygiene routines are completed. Once activated via saliva (by chewing and swishing around the mouth, sucking on until dissolved, or crushing the tablet and placing in the mouth), ProBiora3 competes with the disease-causing pathogenic microorganisms for the same nutrient layer and space that proliferates below the gum line, deep down in the base of the pocket, and in and around the crevices of the tooth and occlusal surfaces.
In a 2009 human clinical study,2 the effects of daily usage of EvoraPro oral care probiotics over four weeks resulted in a decrease in the levels of Streptococcus mutans in 84% of the subjects tested. Across all subjects there was an average six-fold reduction, thus reducing the risk of a caries infection from moderate to low according to the CAMBRA index. Also documented was a greater than 300-fold decrease in the levels of Campylobacter rectus, a toxic gram-negative pathogenic bacterium found in patients with periodontal disease. A greater than 100-fold decrease response was also noted in Porphyromonas gingivalis among other oral pathogens within a month of use.
Imagine the impact of helping to maintain our patients' oral health by including EvoraPro as part of optimal long-term care. With the implementation of EvoraPro3 as part of the all-natural oral ecosystem hygiene protocol, we can now assist all patients in reestablishing and/or maintaining the delicate balance between oral microflora and the host to prevent the overcolonization of undesirable microorganisms that they sometimes cannot prevent on their own.
There are three other products available for the benefit of a balanced ecosystem. Sunstar provides GUM PerioBalance,3which contains two strains of Lactobacillus reuteri (Prodentis) that is derived from dairy and the human gut. When taken on a daily basis, it helps to balance the oral environment to promote healthy teeth and gums, reduce plaque, and fight bad breath.
Another product comes from BLIS Technologies. BLIS K12 is an advanced probiotic for oral and upper respiratory tract health. It is a specific and proprietary strain of S. salivarius able to help support fresh breath naturally while supporting immune system health as it relates to the mouth and upper respiratory tract.4 S. salivarius M18 also satisfies patients' desire for fresher breath, healthy teeth, and plaque reduction.
The last product is a toothpaste from Germany called Plidenta Pro-T-Action. It is a first-of-its-kind probiotic toothpaste. Pro-T-Action is a specific probiotic (Lacobacillus paracasei), which co-aggregates Streptococcus mutans and thus reduces caries-causing bacteria in the mouth.5
Please look at the manufacturer's labels and talk with your representatives when evaluating these six factors. Together you will determine the best product for your patient's condition.
In closing, bidirectional interactions between pathogenic biofilm and probiotics have a huge potential in playing an important role in the maintenance of oral health and general well-being. Including oral care probiotics will assist the patient to naturally and consistently improve oral health and maintain a balanced ecosystem easily, effectively, and consistently in between visits.
The key to maintaining oral health is to embrace its microbial ecosystem and its unique ability to thrive from exposure at birth until death. Now, with a better understanding of biofilm and probiotics, we can proactively impact the oral health of our patients and minimize the need for invasive dental or pharmacological oral care. RDH

Which oral care probiotic should you recommend?

In researching the best probiotic regimen for you and your clients, consider these six factors:
1. Price-This is often the first concern of the clinician in anticipation of explaining the investment in dispensable items to the client.
2. Purity-The fewer the additives, flavors, impurities, the better.
3. Potency-The total count of all bacteria in the probiotic. Potency is a measure of viable bacterial or fungal cells. It is often listed as CFU or colony forming units. Read the label; it often contains "live active cultures added." Taking and storing them according to manufacturer's recommendations will ensure the percent of live cultures will be maintained.
4. Expiration date-Probiotics are most effective when they are live. Some need to be stored in the refrigerator and have a short shelf life. Others have been manufactured and freeze-dried to maintain potency for a longer time period; this is called stability.
5. Strains-Most probiotics have a combination of effective strains, which enhance the bacteria to do a specific job.
6. Compliance-How do you think your patient will integrate oral care probiotics into the oral hygiene regimen? Taking an oral care probiotic is simple and inexpensive. I suggest my clients take it when I do-30 minutes after my home-care procedures, I allow it to dissolve in my mouth before I put my bruxism appliance in.

Debbie Z. Sabatini, RDH, is the founder of the OralED Institute. She has presented continuing education for a number of programs: oral-systemic health, oral abnormality screening techniques for cancer prevention, oral HPV, effective communication, and technologies for risk assessment. In 2015, Sabatini cofounded the All.Cancer.Prevention.Coalition (, a nonprofit whose purpose is to support a medley of cancer causes with its focus on early detection through education and screening events, as well as to comfort and support patients and families diagnosed with cancer.


1. van Essche M, Loozen G, Godts C, Boon N, Pauwels M, Quirynen M, Teughels W. Bacterial antagonism against periodontopathogens. J Periodontol. 2013;84(6):801-811. doi: 10.1902/jop.2012.120261. Epub 2012 Aug 16.
2. Journal of Applied Microbiology. 2009;107:682-690.


Thomas JG, Posey SP, Namsupak A. Probiotics: The link between beneficial oral bacteria and total health. Sherman Oaks, California. Health Point Press, 2009.