Food Allergy and Intolerance

Food allergies and intolerances are often misunderstood. Although many people have adverse reactions to certain foods, true food allergy—a reaction triggered by the immune system—is uncommon.

What is a food allergy?

Food allergies occur when the immune system has an abnormal response to an otherwise harmless food. Once the immune system mistakenly decides that a particular food is harmful, it creates specific antibodies to it. The next time you eat that food, the immune system releases neutralizing chemicals, including histamine, to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin and/or the cardiovascular system.

What is food intolerance?

A food intolerance is a digestive system response—not an immune system response. It occurs when something in a food irritates a person’s digestive system or when a person is unable to properly digest or break down the food—often due to a lack of a specific enzyme.

If you have a food allergy, eating even the smallest amount of the food may trigger a serious allergic reaction. But if you have a food intolerance, you can often eat small amounts of the food without a problem.

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Don't Take Arthritis Lying Down

Don't Take Arthritis Lying Down

Years ago, doctors hardly ever told rheumatoid arthritis patients to "go take a hike" or "go for a swim." Arthritis was considered an inherent part of the aging process and a signal to a patient that it's time to slow down. But not so anymore. Recent research and clinical findings show that there is much more to life for arthritis patients than the traditional recommendation of bed rest and drug therapy.

What Is Rheumatoid Arthritis?

The word "arthritis" means "joint inflammation" and is often used in reference to rheumatic diseases. Rheumatic diseases include more than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic arthritis, and many more. Rheumatoid arthritis is also a rheumatic diseases, affecting about 1 percent of the U.S. population (about 2.1 million people.)1 Although rheumatoid arthritis often begins in middle age and is more frequent in the older generation, it can also start at a young age.

Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints. Several features distinguish it from other kinds of arthritis:

• Tender, warm, and swollen joints.
• Fatigue, sometimes fever, and a general sense of not feeling well.
• Pain and stiffness lasts for more than 30 minutes after a long rest.
• The condition is symmetrical. If one hand is affected, the other one is, too.
• The wrist and finger joints closest to the hand are most frequently affected. Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected.
• The disease can last for years and can affect other parts of the body, not only the joints.2
Rheumatoid arthritis is highly individual. Some people suffer from mild arthritis that lasts from a few months to a few years and then goes away. Mild or moderate arthritis have periods of worsening symptoms (flares) and periods of remissions, when the patient feels better. People with severe arthritis feel pain most of the time. The pain lasts for many years and can cause serious joint damage and disability.

Should Arthritis Patients Exercise?

Exercise is critical in successful arthritis management. It helps maintain healthy and strong muscles, joint mobility, flexibility, endurance, and helps control weight. Rest, on the other hand, helps to decrease active joint inflammation, pain, and fatigue. For best results, arthritis patients need a good balance between the two: more rest during the active phase of arthritis, and more exercise during remission.2 During acute systematic flares or local joint flares, patients should put joints gently through their full range of motion once a day, with periods of rest. To see how much rest is best during flares, patients should talk to their health care providers.3

The following exercises are most frequently recommended for patients with arthritis:*

Type of Exercise Benefits Frequency of Exercise

Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day.

Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe.

Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.


* Adapted from Questions and Answers about Arthritis and Exercise.3

If patients experience
• Unusual or persistent fatigue,
• Increased weakness,
• Decreased range of motion,
• Increased joint swelling, or
• Pain that lasts more than one hour after exercising, they need to talk to their health care provider.3 Doctors of chiropractic will help arthritis patients develop or adjust their exercise programs to achieve maximum health benefits with minimal discomfort and will identify the activities that are off limits for this particular arthritis patient.

Nutrition for the Rheumatoid Arthritis Patient

Arthritis medications help suppress the immune system and slow the progression of the disease. But for those who prefer an alternative approach, nutrition may provide complementary support. Some evidence shows that nutrition can play a role in controlling the inflammation, and possibly also in slowing the progression of rheumatoid arthritis.

Some foods and nutritional supplements can be helpful in managing arthritis:

• Fatty-acid supplements: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma linolenic acid (GLA). Several studies point to the effectiveness of these fatty acid supplements in reducing joint pain and swelling, and lessening reliance on corticosteroids.4,5
• Deep-sea fish, such as salmon, tuna, herring, and halibut, are sources of EPA and DHA. GLA is found in very few food sources, such as black currants and borage seed.
• Turmeric, a spice that's used to make curry dishes, may also be helpful. A 95 percent curcuminoid extract has been shown to significantly inhibit the inflammatory cascade and provide relief of joint inflammation and pain.
• Ginger extract has been shown to be beneficial in terms of inflammation.
• Nettle leaf extract may inhibit some inflammatory pathways.
• A vegetarian or low-allergen diet can help with the management of rheumatoid arthritis as well.

The benefits and risks of most of these agents are being researched. Before taking any dietary supplement, especially if you are using medication to control your condition, consult with your health care provider.

What Can Your Doctor of Chiropractic Do?

If you suffer from rheumatoid arthritis, your doctor of chiropractic can help you plan an individualized exercise program that will:

• Help you restore the lost range of motion to your joints.
• Improve your flexibility and endurance.
• Increase your muscle tone and strength.

Doctors of chiropractic can also give you nutrition and supplementation advice that can be helpful in controlling and reducing joint inflammation.
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References
1. Questions and Answers about Arthritis and Rheumatic Diseases. National Institute of Arthritis and Musculoskeletal and Skin Diseases. February 2002. Available from http://www.niams.nih.gov/hi/topics/arthritis/artrheu.htm.
2. Handout on Health: Rheumatoid Arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Jan. 1998, revised Nov. 1999. Available from http://www.niams.nih.gov/hi/topics/arthritis/rahandout.htm.
3. Questions and Answers about Arthritis and Exercise. National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2001. Available from http://www.niams.nih.gov/hi/topics/arthritis/arthexfs.htm.
4. Fortin Paul R., et al. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. J Clin Epidemiol, Vol. 48, 1995, pp. 1379-90.
5. Navarro Elisabet, et al. Abnormal fatty acid pattern in rheumatoid arthritis - A rationale for treatment with marine and botanical lipids. J Rheum, Vol. 27, February 2000, pp. 298-303.

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Stability Balls

Stability balls, also known as exercise balls, Swiss balls, Physio balls, etc., are a low-cost versatile piece of equipment that can help improve core strength, facilitate flexibility exercises, and add variety to traditional fitness routines.

The exercise ball introduces an element of instability that isn’t available in a floor exercise. The body naturally and automatically responds to this instability by engaging the core muscles, both those in the abdominals and back and in the pelvic floor and hips. Over time, the core muscles strengthen, resulting in better posture, improved balance and enhanced athletic ability.

Choosing a stability ball
It’s important to buy the right size ball and maintain the proper air pressure. The firmer the ball, the more difficult the exercise will be. However, if you are overweight, an older adult, generally deconditioned, or just beginning a fitness routine, you may want to consider using a larger, softer ball. When sitting on the ball, make sure your hips are level—or just slightly higher than the knees.

Basic Exercises
Basic Abdominal Crunch: Lie on your back with your calves resting on the top of the ball. Curl your upper body, squeezing your abdominals and lifting your shoulders and upper back.

Body Ball Crunch: Lie on the ball with your back supported at the arch. Cross your arms behind your head or across your chest. Keep both feet on the floor. Curl your upper body, squeezing your abdominals and lifting your shoulders and upper back. Return to starting position. Do not pull on your head and neck.

Ball Pushups: Place the front of your knees and shins on the ball and your hands flat on the floor. Look down at the floor and lower your face to within a few inches of it, then push back up to the starting position. Increase the challenge by walking further out so that only your ankles are supported by the ball

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Key to Senior Fitness: Chiropractic Care and a Healthy Lifestyle

Over the hill at age 65? Ready for the rocker at 70? Not these days. Americans are living longer and making more of their later years. One key is exercise.

"Perhaps the most debilitating influence in people's health as they age is a sedentary life," said Dr. Richard Brassard, president of the American Chiropractic Association (ACA). "Exercise of some type is all but mandatory."

Otherwise, an individual may set him or herself up for broken bones, circulation problems caused by atrophying blood vessels, and a myriad of other physical problems associated with aging.

"Exercise, however, can improve a person's mobility, digestive processes and circulation. It can also reduce anxiety. Add proper nutrition and you have the makings of a naturally healthy lifestyle," said Dr. Brassard. "Following a healthy diet is another way of extending your golden years as long as possible."

Dr. Brassard and the ACA suggest the following tips to help seniors maintain a healthy lifestyle:

Walking

• Walking improves elasticity in blood vessels, which makes them less susceptible to formation of aneurysms or rupture.
• Start with one-third of a mile per day - one-sixth out and one-sixth back. (Measure the distance with your car.) Do that three days a week for a month, then double the distance, working gradually up to at least one mile a day, three days a week.
• Expect a little soreness in the thighs and calves for the first week or two. If you experience more than soreness, check with your chiropractor.

Stretching
• The average person should stretch to prevent the bowing or stoop caused by shortening of ligaments. A stoop can inhibit normal breathing.
• Stretch the groin muscles by sitting on the floor and bending one leg to the side and back as far as possible. Or sit Indian fashion on a cushion and watch television. A relaxed stretch is the goal.
• Stretch the back leg muscles by putting your hands on a wall, one foot flat on the floor behind you. Then lean into the wall. Or stand up straight and bend over. Or sit with one foot on an ottoman and bend forward.

Eating Right
• Make sure you have a properly balanced diet. If you take vitamins, take them with a meal. Drink 10 eight-ounce glasses of water a day to help keep the kidneys active, dilute and remove toxins from the body, and replace lost fluids. (Coffee, tea, soft drinks and alcohol are diuretics. Don't substitute them for water.)
Dr. Brassard suggests seeing your chiropractor regularly as well. "He or she has the expertise to help keep you in the mainstream of life."

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