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4 Surprising Things to Help Keep You Healthy

2012-02-07T09:34:17-08:00

Health recommendations are constantly changing. As scientists investigate new therapies and practices, the body of evidence supporting the use of complementary and alternative approaches to achieve optimal health and well-being is growing.

Mimi Guarneri, MD, a cardiologist and medical director of Scripps Center for Integrative Medicine, incorporates the latest findings in her heart care practice. Her prescriptions include interventions intended not only to heal the body, but also to mend the mind and soul. Here are four surprising things in her tool kit that you can easily incorporate in your healthy lifestyle plan.

Farmed and Wild Salmon
While seafood of any sort contains omega-3 oils that can benefit your heart, it turns out that not all fish are created equal. According to a study published in the Journal of Nutrition, your choice of wild vs. farmed salmon should be guided by your individual health concerns. Farmed salmon contains more heart-protective omega-3 oils, but it is also far more likely to be contaminated with concentrated environmental toxins. A middle-aged man with a high risk for heart disease will benefit more from farmed salmon, while young children, women of child-bearing age who are planning to conceive, and pregnant women are advised to reduce their exposure to contaminants by choosing wild salmon or other sources of fatty acids.
Meditation and Prayer
There is a growing body of evidence that mental and spiritual practices, including Judeo-Christian prayer, yoga, Zen, transcendental meditation and other relaxation techniques, are associated with quantifiable physical benefits including lower blood pressure, better blood lipid profiles, improved immune function, fewer stress hormones and better overall health outcomes. Research published in the journal American Psychologist looked at a wide variety of previously published studies on such practices and concluded that many were methodologically sound and presented evidence of efficacy. So whether you’re a believer or a skeptic, any regular activity that focuses and calms the mind may also help your body thrive.
Biofeedback
Dr. Guarneri has personally investigated and published papers on the effects of biofeedback on heart patients. In this technique, a therapist teaches you to control such measurements as blood pressure, heart rate, breathing, muscle tension, the skin’s temperature and ability to conduct electricity. While the mechanisms of biofeedback on health improvements are not fully understood, people who use this technique report symptom improvement from conditions such as anxiety, insomnia, tension and migraine headaches and urinary incontinence
Genetic Testing
One of the newest innovations in preventive medicine, genetic testing can reveal your inherited risk for a wide range of diseases and disorders like Alzheimer’s disease and obesity, as well as whether you process a dozen commonly used drugs differently than other people. Armed with individualized information, people who know they have an elevated risk for diabetes, for example, may be able to make proactive lifestyle choices that delay or even prevent the onset of the disease.

Learn more about integrative approaches to health

At the Scripps Center for Integrative Medicine, you can explore the latest evidence-based complementary and alternative therapies and practices for optimal health and well-being, including exercise, cooking classes and body-mind practices.

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Get Fit and Stay Trim

2012-02-13T12:41:45-08:00

If you’re determined to make this your year for better health and fitness, Scripps Health can make it easier, providing tips and tools to help you create a plan and get started on the road to success.

“Don’t center your fitness goals on a number on the scale,” says Lisa Carpenter, fitness manager, Scripps Center for Integrative Medicine. “Instead of focusing on weight loss, focus on healthy living. If you do, weight loss will come.”

For more fitness success

Set personal goals
“We recommend SMART goals (see below), which are specific, measurable, achievable and timely,” says Carpenter. For example, set a goal that 6 weeks from now, you’ll be able to swim 10 laps without stopping.

Focus on fun
Concentrate on activities you like or something new you’d like to try. Carpenter calls these “exciting” goals. If you like to hike, aim to hike a certain mountain or distance. “If you enjoy it, you’ll be successful,” she says. “Success breeds more success.”

Find a workout partner and get family and friends involved
“When you find like-minded people and incorporate a social component, you’re more committed,” Carpenter points out.

Schedule fitness like any other appointment
“Put it on your calendar, work your schedule around it and ask others to respect that,” she says.

Keep a fitness diary
Recording progress can be especially helpful when starting a new fitness plan and it discourages you from making excuses.

Start a fitness plan and get guidance to reach your goals

Download (PDF, 713.6 KB) our SMART goals worksheet, fitness diary and sample fitness calendar.

To find a fitness professional who can help you set personal fitness goals and create safe workouts, call 1-800-SCRIPPS (1-800-727-4777).

How a Food Diary Could Help You Lose Weight

2012-02-13T12:43:59-08:00

Did you know that people who keep food journals lose more weight and keep more weight off in the long run? A food diary helps you confront the truth about how much, when and why you eat. Once armed with that information, you can start setting goals and making changes.

Cathy Garvey, registered dietitian at Scripps Center for Integrative Medicine, says this “bite it and write it” strategy can also be helpful to:

Control overeating
You are less likely to go for that second helping if you know you have to write it down.

Track progress
It can be motivating to look back and see that you are eating better today than you did weeks or months ago.

Connect eating to emotions
Certain feelings may trigger eating when you’re not even hungry. Only once you identify the causes can you start to do something about them.

Point out nutrition imbalances
Seeing food choices in black and white helps to uncover food and nutrient gaps you may have been neglecting.

Monitor eating patterns
Keeping tabs on your meals and snacks helps reveal things like that seven-hour gap between lunch and dinner, or the fact that you’re hungry only one hour after eating breakfast.

Garvey uses food diaries less as a calorie counter and more as a tool to help her clients work healthier foods into their meal plans.

Her mantra? “Once you are eating better, the weight loss (and health benefits) will follow.”

Start a food diary and get guidance

Download (PDF, 656.9 KB) our food diary worksheets.

Call 1-800-SCRIPPS (1-800-727-4777) to find a dietitian.

How to Lower Your Cholesterol Without a Prescription

2012-01-11T11:27:46-08:00

In November of 2011, Lipitor, the best selling drug in the history of pharmaceuticals went off patent, allowing a cheaper, generic version of the cholesterol-lowering drug to enter the market. The move made a popular medication more affordable for many Americans – but still not tolerable for some.

“We see quite a few patients who experience side effects from statins,” says Mimi Guarneri, MD, MD, cardiologist and medical director of Scripps Center for Integrative Medicine. “They are often looking for ways to reduce their dosage or get off the medication entirely.”

Statins can produce liver and muscle inflammation in some patients, which can result in abdominal distress, cramps, fatigue and achiness. Despite the discomfort of those side effects and others caused by the medication, the benefits of taking stains outweigh the risks for many patients. The drugs block a substance the body needs to make cholesterol. They may also help to reabsorb cholesterol that has accumulated in plaques on your artery walls, helping prevent further blockage in your blood vessels.

“The drugs can do a great job at lowering cholesterol, no doubt. But keep in mind, high cholesterol is only one of a number of risk factors for heart attack and stroke,” says Dr, Guarneri. “Cardiovascular disease is the end result of multiple factors. A pill alone won’t fix the problem.”

According to Dr. Guarneri, lifestyle changes are required to reduce your risk of heart disease, whether you take a statin or not. As the first line of intervention to lower “bad” cholesterol and improve heart health, she recommends the following dietary changes:

Cut the saturated fat
“Reduce your intake of butter, cheese, red meat and dark poultry. Those products are loaded with saturated fat, which raises cholesterol,” says Dr. Guarneri.
Eat more produce
“The closer you can get to being a vegetarian, the better,” she asserts. Eating fruits and vegetables won’t just help you keep your appetite in check. They have a protective effect against coronary heart disease.
Consume soluble fiber
Soluble fiber can help to remove artery-clogging LDL cholesterol from the body. Oat bran is a great source. Prunes, beans, barley, citrus fruits, apples, Brussels sprouts, apricots and broccoli all contain ample amounts too. “If you can’t fit those foods into your diet, you can also take soluble fiber in a pill or powder,” says Dr. Guarneri. “Just make sure you are incorporating it in some way.”
Add fatty fish to the menu
Certain types of fish are chock-full of omega-3 fatty acids, which can lower cholesterol and reduce blood pressure. High levels are found in salmon and sardines. “Aim to incorporate fish high in omega-3 fats into your diet two times a week,” she says. “Just be mindful about how you prepare it. Be sure to skip rich sauces that could be full of saturated fat.”

In addition to recommending changes to the menu, Dr. Guarneri often uses other evidence-based approaches to help her patients lower their cholesterol, including dietary supplements such as plant stanols, artichoke extract, niacin and red yeast rice. She also encourages her patients to exercise on a regular basis, and explore ways to reduce the amount of stress in their life.

“Chronic stress exposes your body to persistently elevated levels of stress hormones like cortisol, which can increase inflammation in the body and indirectly raise blood cholesterol levels,” says Dr, Guarneri. “To truly adopt a comprehensive program to reduce your risk of heart disease, it’s imperative that you find healthy ways to cope with stress.”

Next steps

If you have high cholesterol, have a thoughtful conversation with a doctor about your overall risk for cardiovascular disease. Develop a comprehensive heart disease prevention program that includes lifestyle changes.
To help make those changes stick, check out course offerings at Scripps Center for Integrative Medicine. From vegetarian cooking and yoga to meditation and music therapy, you’ll find classes and programs to help you heal mind, body and spirit.

Get a regular dose of health news and information from Scripps

How Yoga Helps Back Pain

2011-12-08T12:15:28-08:00

Low back pain is one of the most common reasons people visit the doctor – for obvious reasons. For some, the discomfort can be disabling, making it difficult to sleep or perform simple activities, like putting on shoes or picking up kids. It can also affect a career. In fact, low back pain is among the most frequent reasons for job-related disability and a leading contributor to missed work.

Historically, chronic lower back pain, which lasts more than three months, has been very difficult to treat. Now, a growing body of research is providing evidence that the condition can be alleviated using yoga.

The bottom line: stretching works

According to study findings published in the October issue of the Archives of Internal Medicine, weekly yoga or deep stretching classes were effective in reducing pain and improving mobility – yielding better results than simply following an at-home care plan. In addition to experiencing fewer symptoms and pain after following the exercise program, many people who attended the classes reported that they scaled back their medication usage.

“At the core of this study is the principle that individually-tailored exercise can be helpful. In many ways yoga has this built in, as it is done in a monitored setting where participants work to find positions that best address their needs,” says Robert Bonakdar, MD, director of pain management at Scripps Center for Integrative Medicine in La Jolla, California. “Additionally, yoga provides variable levels of attention to breath and relaxation, which is critical. Research has shown that low back pain can be associated with dysfunctional breathing patterns and/or stress-related muscle tension.”

Participants in the study experienced persistent, moderate back pain that was not the result of a specific medical condition. They attended weekly 75-minute exercise classes over a 12-week period, and supplemented the classes with 20-minute practice sessions at home, aided by CDs, DVDs or handouts. The classes emphasized basic postures and exercises that strengthened and stretched the low back and leg muscles.

“Basic yoga postures enhance hip flexibility, core strength and active spine rotation, all of which can be beneficial to a person with chronic back pain,” says Kathleen Blechertas, a physical therapist at Scripps Health in San Diego, California. After completing physical therapy, she and her colleagues typically recommend at-home and community exercise programs to patients.

Tips to keep in mind

Before embarking on an exercise program, patients should talk to their doctor or therapist about whether it is appropriate. Blechertas also recommends patients choose a class that starts with gentle stretches, and listen to their body for signs of increased pain and soreness.

Dr. Bonakdar stresses the importance of finding a good instructor. “When provided by a qualified teacher with appropriate attention to the participants’ movement needs, breath and relaxation, yoga can provide significant benefit for the pain with minimal downside,” he says.

Stay motivated

Regular stretching and strengthening of the back and leg muscles can alleviate chronic low back pain symptoms. However, you have to be persistent about following the exercise regimen. Here are a few tips to help you stay on track:

Find a class to attend on a regular basis.
Having something booked on your calendar increase the chances that you’ll go.
Find a partner to go with you.
Accountability is key. Find a friend to do the classes and exercises with you. Yoga and stretching are beneficial for most people.
Keep an exercise log.
Keep track of how often you attend class and practice at home, which exercises you do, and other details. A log will provide you an extra measure of accountability. You’ll also be able to see your progress, which is motivating.

Find help for low back pain

If you’re looking for a doctor, physical therapy or exercise class for low back pain, call 1-800-SCRIPPS (1-800-727-4777) to speak to a member of our call center.

Get a regular dose of health news and information from Scripps

Military to Implement Integrative Medicine for Comprehensive Pain Management

2011-07-12T09:53:12-07:00

Washington − Senior military medical leadership met with The Bravewell Collaborative and renowned scientists and physicians to discuss improving pain management for warriors and veterans through the use of integrative medicine. This meeting was part of the Army’s effort to provide “a standardized DoD and VHA vision and approach to pain management to optimize the care for warriors and their families.”

The 2009 Army Pain Management Task Force (PMTF) report called for building best practices for the continuum of acute and chronic care based on a “holistic, multidisciplinary, integrative approach to care.” The Army Comprehensive Pain Management Campaign Plan Symposium is an important step in implementing the PMTF recommendations.

“This is a unique, historic moment to capitalize on what we know works to effectively treat pain,” said Army Surgeon General Lt. Gen. Eric B. Schoomaker, MD, PhD. “It marks the beginning of a cultural shift in how health care is practiced in the military.”

Symposium participants reviewed the latest science in pain management and how integrative interventions can not only help improve pain management but also advance the over all health and “mission readiness” of the DoD and VHA, which is vital to the safety of our nation.

“We have an extraordinary generation in the military right now,” Schoomaker noted. “Today’s wounded warriors do not want to be defined by their injuries.” They want to live fully and in some cases, they want to return to active duty.

It is estimated that millions of our nation’s warriors and veterans live with chronic pain and research shows that pain reduces quality of life, work and relationships. Integrative strategies, such as those presented by leadership from the Allina Health System in Minnesota and the Scripps Center for Integrative Medicine in California, have been shown in clinical research to reduce pain scores by as much 50 percent.

Brig. Gen. Richard Thomas, the assistant Surgeon General (Force Projection), noted that many medical advances have come through wartime medicine, such as the development of the yellow fever vaccine by Walter Reed and the discovery by Dr. R. Adams Cowley of the golden hour in emergency medicine, the time period following traumatic injury during which if proper treatment is administered, lives can be saved. “Many innovations in military medicine have changed American health care,” said Col. Kevin Galloway, Chief of Staff for the Army Pain Management Task Force, “…and we are approaching the tremendous need for improvement in pain management with this same spirit.”

“Integrative medicine is a system of care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health,” explained Christy Mack, President of The Bravewell Collaborative. “The nine integrative medicine centers in the Bravewell Clinical Network have been developing successful models of integrative care for the past nine years and we are pleased to be able to share these with the military and the VHA.”

Schoomaker tasked the leadership in the room with developing a sustainable, economically viable system of integrative care for pain. “We need to ensure we have the healthiest military in the world,” he said.

For more information about the Army Pain Management Task Force, please visit: http://www.armymedicine.army.mil/prr/pain_management.html.

For more information about The Bravewell Collaborative, see www.bravewell.org.

Media Contact: Sharon Reis
Email: sreis@gymr.com
Phone: 202.745.5103

The Dr. Oz Show Discusses Alternative Medicine; Scripps Physician Weighs In

2011-04-27T12:53:07-07:00

Many doctors claim alternative medicine practices are junk science and may even be dangerous. On a recent episode of The Dr. Oz Show, Dr. Oz explored all sides of this debate, adding his own perspective on alternative remedies. The physicians held an open discussion about vitamins, herbs and supplements; massage and acupuncture therapies; and mind and body therapies such as meditation and breathing exercises.

As a guest of the show, Scripps physician Mimi Guarneri, MD, identified several integrative medicine therapies she recommends for her patients. This evidence-based discipline blends conventional Western medical perspectives and treatments with a whole person approach that emphasizes mind and body wellness.

Dr. Guarneri is founder and medical director of the Scripps Center for Integrative Medicine and is board certified in cardiology, internal medicine, nuclear medicine and holistic medicine.

Watch the videos:
Part 1
Part 2
Part 3

As seen on The Dr. Oz Show April 26, 2011.

Help for Headaches: Tools to Treat and Prevent Pain

2011-02-28T15:01:01-08:00

By Robert Bonakdar, MD, Scripps Health

Recently, an entertainment reporter made headlines for her garbled, confused speech during a live broadcast. While many people guessed that she had suffered a stroke on the air, it turned out that her speech problems were a side effect of a severe migraine headache.

While such extreme symptoms may be unusual, many headache sufferers can relate. Headaches affect 90 percent of people, and can range from mild discomfort to debilitating pain. The pain can feel like throbbing, stabbing, pressure or a dull ache. It can last from a few hours to a few days. Severe headaches can also be accompanied by speech or vision problems, nausea, muscle aches and insomnia.

The fact that there are so many types of headaches makes them a difficult beast to treat. Often, we have the most success by taking a comprehensive integrative approach with multiple tools. This often means receiving consultation and overview of available preventive and acute strategies. These discussions can help to best determine what approaches, including lifestyle change, medications, diet and supplements, physical and mind-body therapies, as well as procedures such as acupuncture or various injections, may be most appropriate for your particular circumstance.

The first step is to determine what type of headache you are having and what may be causing it. Tension-type headaches, for example, may be the result of tight muscles caused by too many hours at the computer. Migraine headaches may be triggered by foods, strong odors, changes in the weather, bright lights and hormonal fluctuations. Being overweight can increase headache duration and intensity. Stress can be a culprit in all types of headaches.

Diet is a very common trigger. Alcohol (especially red wine), foods with monosodium glutamate (MSG), excessive caffeine, preserved meats with nitrates and nitrites, and foods that contain tyramine (such as aged cheeses) are among the common triggers. Skipped meals and dehydration can bring on headaches as well. In cases where diet is a factor, we have patients meet with a nutritionist to identify triggers and develop a diet plan that avoids or minimizes them. Also, studies have shown that up to a third of patients who have frequent headaches may be low in certain nutrients, such as magnesium, riboflavin, and CoQ10. Since it may be difficult to compensate for these low levels through diet alone, w may recommend supplements as well.

Paradoxically, exercise can help some types of headaches and trigger others. A lack of exercise can contribute to headaches in some patients; many find that cardiac exercise that gets the blood flowing can help relieve headache pain by increasing blood flow and oxygen to the brain. For others, however, a rapid change in heart rate or blood flow can set off a migraine. In these cases, we help people learn to exercise correctly to obtain the health benefits without triggering headache. For example, patients may ride stationary bicycles while we guide them through slowly increasing their heart rate, maintaining it at a safe rate, and then slowly cooling down.

Sleep is another very important factor. Too little or too much sleep can trigger headaches, as can disruptions to your usual sleep schedule or hormonal changes that affect sleep. Ideally, we like to see patients obtain at least seven hours of sleep. Often, meeting with a sleep therapist can help improve your sleep habits and get much-needed rest to prevent headaches.

In addition, several complementary therapies can help. Extensive studies have found that acupuncture treats and can prevent frequent migraine and tension headache; a series of eight to 12 sessions lasting twenty to thirty minutes each provided headache relief that may last for several months following treatment.

Biofeedback is another highly effective treatment. Patients learn to identify and recognize potential triggers such as muscle tension, shallow breathing and stress; at that point, they can initiate breathing exercises or other relaxation techniques that they have learned to prevent a full-blown headache. Biofeedback can be very empowering; patients learn the techniques over four weeks and have these valuable tools for the rest of their lives.

Because some studies have found that over 90 percent of headaches have some type of muscle knots and soreness in the soft tissue, known as trigger points, we often collaborate with physical therapists to use techniques such as myofascial release, massage, and cranial sacral therapy to reduce tension and improve range of motion of the neck and upper back. Yoga can also be a marvelous tool to retrain the muscles in a mindful and relaxed environment with the goal, similar to biofeedback, of noticing and preventing patterns that contribute to headache. Lastly, various techniques, including trigger point, occipital nerve and botox injections that reduce muscle and nerve abnormalities associated with headache, can also provide relief.

There is no one “best” solution to headache pain; what works for one patient may not work for another. Often, a combination of these therapies is the most effective plan to relieve and prevent headaches.

Join Robert Bonakdar, MD, and Christy Jackson, MD, to learn about effective conventional and complementary treatment options for headache relief on Tuesday, March 8 at 7 pm at the Scripps Center for Integrative Medicine. There is no charge; please call 1-800-SCRIPPS to register.

Media Contact: Lisa Ohmstede
E-mail: ohmstede.lisa@scrippshealth.org
Phone: 858-626-7142

Heart Healthy Tips from Scripps

2011-02-25T14:56:20-08:00

Heart disease is the number one killer of women in the U.S., but it’s largely preventable. Mimi Guarneri, MD, medical director of Scripps Center for Integrative Medicine, was featured on KSWB to discuss ways women can reduce their risk of developing heart disease including weight management, a healthy diet and stress reduction.

Watch the video

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
E-mail: ohmstede.lisa@scrippshealth.org

Tips for Using Dietary Supplements to Manage Pain

2011-02-10T13:35:58-08:00

Certain supplements can help to improve all types of pain. The problem, says Robert Bonakdar, MD, director of integrative pain management at Scripps Center for Integrative Medicine, is that many people are looking for a single supplement to cure all that pains them.

“Very often, the reason why supplements don’t work is because people are looking for that magic bullet,” Dr. Bonakdar says. “Supplement therapy has to be highly individualized. There’s not one absolute perfect supplement for pain.”

Dr. Bonakdar says before selecting the appropriate supplements for patients, he will not only consider their medical condition, but also its underlying causes. For example, muscle-induced low back pain may be treated differently than back pain from a spinal condition.

You should talk to your doctor before taking any supplements. In some cases, blood tests are necessary to determine whether too much or too little of a certain nutrient is causing your pain, Dr. Bonakdar says.

However, in general, certain supplements have been shown to combat certain types of pain.

Inflammatory pain
Conditions such as rheumatoid arthritis, and lupus respond well to omega-3 fish oil. In fact, one study found that omega-3 supplements had the same effect as ibuprofen in reducing arthritic pain.

Headaches
Chronic headaches may be caused by deficiencies in nutrients such as magnesium, B vitamins (riboflavin) and coenzyme Q10. A blood test can help pinpoint whether your body is lacking vital nutrients.

Joint pain
Vitamin D and zinc supplements have been shown to improve hip and knee pain. Antioxidants such as vitamin A, lutein and lycopene, which are also found naturally in many foods, may have benefits for joint health.

All-over pain
While few supplements have been found effective for conditions such as fibromyalgia, dietary changes can make a difference. Gluten sensitivity may be behind many types of widespread pain, and spices such as ginger and turmeric have anti-inflammatory properties.