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National Database Could Be ‘Game Changer’ in MS, Parkinson’s Research

Funds have been approved for a national health database designed to keep track of people living with neurological conditions.
This could mean better research opportunities to help those living with Parkinson’s disease and multiple sclerosis.

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Funds have been approved for a national health database designed to keep track of people living with neurological conditions.

This could mean better research opportunities to help those living with Parkinson’s disease and multiple sclerosis.

Late last month, President Donald Trump signed into law the Labor, Health and Human Services, Education, and Defense omnibus spending bill.

This measure provides funding to the Centers for Disease Control and Prevention (CDC) for the National Neurological Conditions Surveillance System, which was authorized by the 21st Century Cures Act in 2016.

“[This] is important for research,” said Dr. Jaime Imitola, the director of the progressive multiple sclerosis multidisciplinary clinic and translational research program at The Ohio State University Wexner Medical Center.

Imitola explained that databases are important as they allow for many large research efforts to be done from a variety of different places.

“But, the most important aspect of databases is how to harmonize all of them,” he said.

“Within a health database lies central known patient information, identifiers, analyzed data that could be awesome,” Imitola told Healthline, “but the question is how to coordinate the data, how it is handled, and who has access.”

 

How the databases help

Countries around the world are using national health databases for research in multiple sclerosis (MS).

These MS registries are helpful for studying diseases and their symptoms in large populations.

They are also useful in monitoring the long-term outcome of disease-modifying therapies.

Proponents say the systems help improve the understanding of and knowledge about MS.

In addition, they can assist the government and relevant parties to make informed decisions about MS.

In 2013, the Swiss MS Society decided to initiate and fund the Swiss Multiple Sclerosis Registry.

Other national databases include the Danish Multiple Sclerosis Registry, the Norwegian Multiple Sclerosis Registry and Biobank, the Italian Multiple Sclerosis Database Network, the NARCOMS Registry for Multiple Sclerosis, and the Multiple Sclerosis Registry in Germany.

“There is emerging idea that you need more people to do more things,” Imitola said.

In 2001, the Sylvia Lawry Centre for Multiple Sclerosis Research started the world’s largest database of patient information. It includes more than 20,000 patients and the equivalent of more than 81,000 patient years. It continues to grow.

“The other spectrum to consider is the heterogeneity, or uniqueness, of one’s MS,” suggested Imitola.

The ailment is considered a snowflake disease in which no two people with MS present with the exact same symptoms.

“In order to look at the diversity of those living with MS within the landscape of the disease, we need lots of people,” said Imitola. “Then we can look at the individual person for treatment for their MS.”

Another growing area of research is in patient reported outcomes.

“These studies too could use more people,” said Imitola.

 

How important is it?

Some consider the new database a game changer.

“Funding for the Surveillance System is a culmination of over a decade of work by the Society, our partners at The Michael J. Fox Foundation, and the neurologic community,” Bari Talente, executive vice president for advocacy at the National Multiple Sclerosis Society, said in a statement. “This new National Neurological Conditions Surveillance System will provide important demographic data on neurologic conditions like MS and give us a better understanding of their impact on Americans.”

The authorization and funding of the system have been longtime priorities for both the National MS Society and the Michael J. Fox Foundation.

“Establishing a national data collection system is a game changer for researchers working on scientific breakthroughs and for families impacted by a neurological condition,” Ted Thompson, JD, senior vice president of public policy at The Michael J. Fox Foundation, said in a statement. “Our hope is that the critical insights gathered from this demographic information can illuminate new pathways toward cures for the millions who live with conditions like multiple sclerosis and Parkinson’s disease.”

“Having a database for any condition is helpful in terms of collecting epidemiologic and demographic data that can help drive research questions and clinical care,” Dr. Barbara Giesser, professor of clinical neurology at the David Geffen School of Medicine at the University of California Los Angeles and clinical director of the UCLA MS program, told Healthline.

Candidates for the database may be concerned about privacy.

In the United States, patients are protected under the HIPAA Privacy Rule. But, as more health information is stored on computers, this may cause a risk in security.

Editor’s note: Caroline Craven is a patient expert living with MS. Her award-winning blog is GirlwithMS.com. She can also be found on Twitter and Instagram.

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General Health

High Heel Arm

Focusing on whole-person care, Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to consider how environmental and lifestyle factors impact your health. With advanced knowledge of the musculoskeletal system, DOs also believe that the body performs better when it is in proper alignment. By partnering with their patients to help them get healthy and stay well, they can help them avoid injuries and pain from high heels.

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You can help prevent injuries and pain from high heels by regularly stretching the plantar fascia and calves.

If you’re among the many who can’t—or won’t—say no to stylish but uncomfortable high heels, Sajid A. Surve, DO, knows all about your pain.

Dr. Surve, co-director of the Texas Center for Performing Arts Health and an associate professor at the University of North Texas Health Science Center Texas College of Osteopathic Medicine, helps dancers and other frequent heel wearers counteract the head-to-toe toll high heels take on the body. He treats high heel pain daily, taking a whole person approach to help performers avoid long-term harm.

Focusing on whole-person care, Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to consider how environmental and lifestyle factors impact your health. With advanced knowledge of the musculoskeletal system, DOs also believe that the body performs better when it is in proper alignment. By partnering with their patients to help them get healthy and stay well, they can help them avoid injuries and pain from high heels.

“From an osteopathic perspective, we’re looking for the body to be centered from head to toe. High heels put the foot at an angle and pull muscles and joints out of alignment, so the effects aren’t limited to the feet,” Dr. Surve explained. “It’s not unusual for people who spend lots of time in high heels to have low back, neck and shoulder pain because the shoes disrupt the natural form of the body.”

Structurally, the plantar fascia in the foot is connected to the calf muscle, which in turn connects to the hamstring. The hamstrings attach to the pelvis and low back, which is why wearing high heels can make your back ache along with your feet. Also, walking on the balls of your feet will shift your center of gravity forward, forcing you to arch your back when you stand and further contributing to back pain.
The high heel stretch

Regular stretching of the plantar fascia and calves will loosen hamstrings and work to alleviate back pain from your high heels. Dr. Surve recommends stretching before and after long periods in heels and sneaking in some foot work during breaks in your day.

Try this stretching routine during your next break:

  1. Lay a book with a one-inch spine on the floor.
  2. While standing, place the ball of your right foot on the book and rest your heel on the ground.
  3. Bend forward at the waist and try to grab the toes on the book. (If you need to bend your knees a little, that’s OK).
  4. Hold for 30 seconds.
  5. Switch feet. Repeat two to three times.
  6. Gradually increase the height of the book by 1-inch increments per week to a maximum of 3 inches.

It’s also important to understand that the slope of the shoe is more important than heel height when it comes to comfort, Dr. Surve notes. Look for a platform sole to decrease the angle between the heel and the ball of the foot, so your weight can be more distributed across the entire foot. A thicker heel also spreads your weight more evenly and decreases the risk of spraining your ankle.

Also, avoid narrow toe boxes that squeeze toes. Narrow, pointy high heels are the perfect storm for foot pain, according to Dr. Surve. Ideally, a pointed shoe will narrow after the toe box to give the illusion of length while providing ample space for your foot.

Finally, high heels should fit snugly and hold the foot firmly in place. High heels that are slightly loose cause your foot to slide back and forth. That friction is the culprit behind blisters, bleeding feet and ripped toenails, according to Dr. Surve.

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Health News

Here’s How the Mediterranean Diet May Reduce Your Breast Cancer Risk

Like your gut, the breast has a microbiome, and a new study shows it can be directly influenced by what you eat.

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Like your gut, the breast has a microbiome, and a new study shows it can be directly influenced by what you eat.

Breast glands have a microbiome.

And, like the gut microbiome, it can be affected by diet, according to researchers at Wake Forest School of Medicine in North Carolina.

“Microbiome” refers to a variety of living organisms, such as bacteria and fungi, that populate our bodies. This ecosystem is essential to good health.

“We were surprised that diet directly influenced microbiome outside of the intestinal tract in sites such as the mammary gland,” the study’s lead author, Katherine Cook, PhD, said in a press release.

The researchers say that shifting the breast microbiome through diet may reduce the risk of developing breast cancer.

The scientists used female monkeys to see how diet affects breast tissue. They fed one group a high-fat Western diet and another group a Mediterranean diet, which is plant based.

After 2 1/2 years, which is about the same as 8 years for humans, the two groups had significant differences in bacteria in their breast tissue.

The Mediterranean diet group had 10 times more mammary gland Lactobacillus. These bacteria have been shown to slow growth in breast tumors. Also, cancerous breast tumors have lower Lactobacillus abundance than noncancerous breast tumors.

The Mediterranean diet group also had more bile acid metabolites, which the researchers say may reduce the risk of breast cancer.

Study authors acknowledge the research is still in the early stages.

Because microbiomes vary according to where a person lives, they say future studies will involve primates from different regions.

Other studies are also underway to see if fish oil or probiotic supplements can affect microbiomes in mammary glands.

Details of the research are published in Cell Reports.

 

The role of diet in breast cancer

Dr. Janie Grumley is a breast surgical oncologist, director of the Margie Petersen Breast Center at Providence Saint John’s Health Center, and associate professor of surgery at John Wayne Cancer Institute in California.

“I love these studies because they help encourage patients to be aware of diet,” she told Healthline.

But breast cancer prevention isn’t that simple.

Women in the United States have a 1 in 8 lifetime risk of developing breast cancer.

Some breast cancer risk factors, such as genetics and age, are beyond a person’s control.

“Studies are really important, but you have to be careful how you interpret the conclusions. It’s not one thing, but a combination of things. Age is a huge factor for breast cancer,” said Grumley.

And breast cancer isn’t a single disease.

“What makes cancer research so interesting and challenging is that you’re trying to attack a very wide range of diseases. There are many different kinds of breast cancer,” she explained.

And many things can affect development of breast cancer.

“Diet may be one small portion of that. I don’t want patients to think if they adopt a diet like this they won’t get breast cancer. You can adopt these diet habits and it may reduce risk, but that doesn’t mean you don’t have to screen or you’ll never have breast cancer,” cautioned Grumley.

She tells her patients to keep things simple.

“A healthy diet, exercise, and moderate alcohol intake are all factors we have control of to reduce the risk of breast cancer,” said Grumley.

She added, “Weight control is important. We know that obese women are at higher risk.”

Grumley advises patients to get their nutrients through a healthy, natural diet. When you do that, large amounts of vitamin supplements aren’t necessary.

She also emphasizes the need for moderation in how much you eat.

“We can pick apart these diets, but I sometimes wonder if what’s wrong is volume. If you sit down for a meal in Europe, they don’t give ginormous portions and expect you to eat it all. Here, what they serve you can feed a family of four,” said Grumley. “And if olive oil is good, you shouldn’t just pour it on everything or eat a jar of olives.”

Moderation is key, both for general health and for lowering the risk of breast cancer.

Grumley said her patients work with a nutritionist.

“It’s really enlightening to have a patient do a food diary to see how much they’re eating. Keeping track helps them reflect and realize maybe they could be doing better,” she said.

Transitioning to a Mediterranean diet

Samantha Lyles, an Illinois-based registered dietitian, told Healthline, “The Mediterranean diet is more focused on plants and whole grains.”

“Contrast that with the Western diet, which is full of white breads, refined grains, and processed and prepackaged foods,” she continued.

Whenever possible, choose fresh over processed foods, she advises.

“When you’re trying to decide if something is plant based or processed, ask if it looks like something you would find in nature. You won’t find Fruit Loops sitting in a field,” explained Lyles.

A few simple dietary changes can go a long way.

“For example, instead of a prepackaged breakfast bar, have a nut mix. Look for foods that don’t have added sodium and sugar,” she said.

Lyles also recommends substituting high-starch foods like corn and potatoes with other vegetables.

“Fresh is best. But if you have to, frozen or canned vegetables are OK.”

The typical Western diet includes a lot of fatty red meat, which can contribute to inflammation. The Mediterranean diet limits red meat in favor of more fish and poultry.

“The Mediterranean diet contains more omega-3 fatty acids, which are anti-inflammatory. Consuming fish such as salmon, plus nuts and healthy oils, lowers your risk of cancer and other illnesses,” said Lyles.

“Think about how much red meat and pork you consume in a week. Keep it down to once or twice a week and have chicken and fish more often,” she suggested.

“Less red meat and dairy can help lower cholesterol, triglycerides, and blood pressure. Also, the Mediterranean diet is typically lower in salt and sodium than the Western diet. That helps control blood pressure.”

Lyles suggests replacing white bread with whole-wheat bread. But that can be tricky.

“It’s important to know that wheat bread and honey wheat bread are not the same as whole-grain wheat bread. They’re just white bread in disguise. Look for 100 percent whole wheat, not enriched flour,” she said.

Eating out can make things even trickier.

But you can still make a few healthier tweaks.

“When ordering salad in a restaurant, choose oil- and vinegar-based dressings rather than creamy ones, like ranch. Olive oil has healthy fats and is a huge component of the Mediterranean diet. It helps control inflammation. And look for options other than potatoes. Instead of fries, ask for a side salad or see if you can substitute a fresh vegetable or fruit,” she explained.

Lyles said the typical American diet is filled with processed and prepackaged foods meant to make our lives easier — but they’re not good for overall health. So, every time you swap these things out for fresh vegetables or fruit, it’s a step in the right direction.

“Everything else will fall into place from there,” she said.

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