Women's Wellness Blog: 2010

After a glorious nights rest rocked to somnolence by the incoming waves rolling in a short distance from our window, the team arose to whiffs of Blue Mountain coffee, exclusive to Jamaica and rumored to be the richest and most flavorful in the world. The previous night we had made assignments for the day’s clinic and organized our makeshift pharmacy (sans our confiscated drugs) and now, with the sun lapping at the Caribbean waters, we were ready to venture into what was largely unexplored territory for most of us. Many on the team were health care workers from a variety of backgrounds, docs, dentist, nurses, physical therapist, yet few of us had been on a medical mission before, and none of us to the clinic assigned to us for the day. For me, and I dare say many of the team, this was not a leap of faith but a cliff-diving, no net, free fall of faith! We were there with no expectations other than to serve and it quickly became evident that we not only left our medicines at customs but we also checked our egos. This was no place for hubris of the “great American doctors here to save the world” mentality but an opportunity to stretch our limits and be flexible. In fact, Marla had preached early on in our team training that adapting to change was a necessity in Jamaica. Just like the weather, wait a few minutes and every situation will be a bit different. Ready, excited, apprehensive, and full of Ackee (the national fruit of Jamaica) we loaded our van to head to the Hampstead clinic.
To say the roads in Jamaica are a bit rough is like saying Lindsey Lohan may have a little drug problem. Our driver, Mrs.Betty the Invincible, had the stamina of Lance Armstrong, and possibly the booty to match because the pot holes we bounced through placed the same strain on her behind as did the Tour De France on Lance’s! We bounced, weaved, and dodged our way through crevices the size of New Zealand and arrived at Hampstead clinic, shaken and stirred, and began assembling our apparatus. The building itself looked like a saloon straight out of High Plains Drifter with a Jamaican twist. Everything was cinder block (the better to fight off hurricanes) and several of the rooms were without lights. But who needs lights when you have the warm Jamaican sunshine spreading its luminosity and heat throughout! Since I was dealing with the most intimate of patients, I garnished a 5 by 8 foot room with a privacy curtain and laid out my tools for the day. Medicine has become amazingly inundated with technology and this was never more apparent than here. We were reduced to basic diagnostic acumen with a minimum of tools other than our training and our wits. Chills ran down my spine as I realized that I would have to rely on just a history and cursory physical exam to provide care for these precious people. No CT scans, no sonograms, no blood chemistry, not even a quality assurance inspector was available. The thought of depending on basic skills was both exciting and disturbing. All first year medical students learn that nothing should supplant an accurate and detailed history, as the patient will tell you of their disease with a passion and detail like no other. It is the rare instance, except on TV, that requires an extensive diagnostic journey. Sometimes it takes planting yourself in unfamiliar soil to relearn lessons previously understood, like the utility of simplicity. For centuries medical men used more art than science, yet I dare say they were more effective healers than some of the academicians of today. Not to discount modern technology, but all healing begins with physical touch and emotional connection. Some of the most everlasting truths are the most basic, in medicine and in life. The good news written in scripture is one of uncomplicated simplicity...”for God so loved the world...” Like technology, theology is a useful tool, but not at the expense of the essence of the message. A stark, dimly lit room in a Jamaican jungle forced me to remember that healing is mostly about people connecting and caring.
The medical team saw approximately120 people that first day with the unstoppable dental wizard, Dr.Mike, pulling more teeth than the tooth fairy on crack. I was struck by the number of both young and old who were ravaged by chronic preventable illnesses such as diabetes and hypertension. These were lifestyle diseases, much as it is in the States, yet the lack of education and prevention was stark. It’s hard to explain to people that their choice of snacks and sustenance (in this case sugar cane) is killing them.
Assembled back at the hotel, we “debriefed” about the first day with our team leader and resident crazy person, Jesse. A helicopter EMT (that should tell you something right there!) Jesse and his tolerant and wise wife Allison (a family medicine doc) were the heart, soul, and drill sergeants for our expedition and blessed us with their wisdom, humor and knowledge of completely worthless Jamaican trivia. We felt good about the first day, in spite of the ongoing debacle with Jamaican customs regarding our confiscated stool softeners and other assorted dangerous drugs, and I was impressed by the teams willingness to roll with the punches. In fact, this group proved to be more flexible than a Chinese contortionist in meeting the challenges of the week. It was a lesson I desperately needed to learn, as I had entered the week with a corner on the anal-retentive market. I was the one who worried about not having anything to worry about, so learning to have faith and trust in God was like mastering Mandarin Chinese. Yet, through the example of Marla, Jesse, and Trevor (the Jeff Gordon of Jamaican bus drivers) I felt the worries melt away like butter on an iguana’s back in the midday sun. To serve is first to trust, and to trust is to leave your worries in the lap of the great physician.
Day number two found the team bouncing and bounding to the Rock River clinic. This remote site could have been the setting for a Jamaican “Deliverance” movie as it was about as isolated as a liberal at a Sarah Palin rally. As we pulled up to the hillside structure we were puzzled by the stillness. A the previous day’s clinic there were folks waiting for our arrival, some getting there as early as 3 hours before our scheduled start, so we expected the same reception on this day. We unloaded the bus to an eerie quiet, wondering if we had made a wrong turn at Haiti. Jesse and I climbed the hill and found one of the Ministry of Health nurses busily doing paperwork in the front office. Her look of surprise at seeing us spoke volumes as it soon became clear that she was not aware that we were coming to her clinic that day; more importantly, neither were any of the patients! Realizing this was simply another way of toying with my obsessive compulsive nature (remember, it’s always all about me) I thought about asking if any of the team members needed a Pap smear since it didn’t appear that I would be offering such services that day, but decided that might breach protocol. In another lesson in faith and trust, Jesse and Allison calmly (at least on the outside) asked the nurse if it was possible to get the word out that super docs were in town, and we were open for business. Remember, this is in an isolated Jamaica forest nowhereville, where they were fresh out of house phones, Internet, and planes that would fly over with banners telling you which bar had happy hours. In faith we unloaded the vans as if there were thousands waiting on us and prepared for the day. Within minutes it was if the forest opened up and brought forth people like a rabbit on fertility medicine. I learned that day that people in Jamaica still understand the power of community. News and needs travel fast and what one family knows is effectively communicated round about. I don’t pretend to know how the word got out so rapidly, and even more surprisingly how small children and old folks made it to the clinic so quickly, but they did in such a fashion that we saw well over a hundred patients before the day’s end. Mystery is often God’s way of staying anonymous.
On our way home that night we experienced what was to be the most powerful moment of the trip for some people. Trolling along precarious cliffside, semi-paved roads our bus slowed to a crawl at one particular juncture. I suspected that Trevor was stopping to execute one of his patented Jamaican history/culture/culinary demonstrations by harvesting a roadside fruit, slicing it with his ever present machete (that is a story in and of itself) and passing it through the bus to tickle the nose hairs and taste buds of the brave. However, this time there was no low hanging chocolate berries but a lone pedestrian that looked as if he had stepped off the film lot for “The Bob Marly Story.” Here was an old gentleman with dread locks to his waist and a beard to match trudging along this narrow, pock filled road. Trevor addressed him in Patois, the local dialect (a melodic mixture of French, English,and African) and welcomed him on board. He was heading down the road a bit and was most appreciative of the ride. His name was Jeremiah, “like in the Bible”, and Campbell, “like the soup, mon”. I must admit my prejudices were running wild as I surveyed Mr.Jeremiah, imagining him as both illiterate and detatched. Within minutes of his arrival I was proven hopelessly wrong on both accounts. After a brief explanation of the origin of his name, he broke out into a joyful rendition of “This is the Day That the Lord Has Made” and soon had the entire bus rocking in a spontaneous praise and worship that would have made TD Jakes proud. Get this picture in your mind’s eye. Here was a 70 something Jamaican Rastafarian look alike, poorer than any church mouse ever dreamed of being, obviously worn out from a long walk, leading a group of lily white Americans in shouts of joy to a Creator who made us all in His image. I have never witnessed a more spontaneous and sincere expression of joy in my life. Jeremiah was truly joyful, in spite of his poverty, his physical challenges, his lack of designer jeans, and no Internet access. C.S. Lewis wrote a book called “Surprised by Joy” in which he describes his unlikely conversion to Christianity. Watching and listening to Jeremiah, I was surprised by his joy and saw for a brief moment the origins of contentment. Jeremiah was the professor and we were all unwitting students in the hallowed halls of happiness university. Echos of Paul writing from prison bounced around in my head as he admonished his flock to be content in all situations. Mr. Campbell seemed to be living this truth. After a couple of songs Jeremiah spied his drop off point and thanked Trevor for his friendliness and then paused.
“Before I leave you, mon, can I pray for you all?”
“Of course,” we clamored. We bowed our heads and Jeremiah began a prayer that was straight from the mouth of God himself. He blessed us and our mission. He praised a God that would use us to bring healing to his people. He thanked God for his faith and his blessings, and he poured out his words of adoration like a saint filled with the Holy Ghost. His words were heartfelt and genuine and poured from his near toothless mouth with the force of a raging river. His eloquent, impassioned prayer humbled and honored us all and at amen tears flowed as free as the love he showed us in those few minutes. Jesus might not have taken the wheel on that bus like he did for Carrie Underwood, but he hitched a ride that day and we were the better for it.

This is the first part of a series documenting my recent mission trip to Jamaica.

“I’m sorry sir, but without the correct paperwork you have to leave the bags here.”

The sweat began trickling down my temple as the Jamaican sun burst from around a cloud and both my temperature and my anger rose. I had just landed in the Montego Bay airport with four bags of medications destined for the rural parish of St.Mary, and it wasn’t going like I had planned. I was bolstered by a team of docs, nurses, and normal folks from my church who had committed to a week in rural Jamaica delivering basic medical care to the poorest of the poor. Prior to departure we had painstakingly assembled reams of paper work and government forms to assure a smooth transition through customs, but fate sometimes slaps you up side the head with a wet squirrel and I found myself negotiating with a polite but insistent clerk at the customs desk. Apparently the threat of a hurricane had freed the government to take a three day holiday and the persons responsible for stamping the forms for our passage had opted for a long weekend of Red Stripe beer and jerk chicken instead of clearing our medicines. With all the charm of a rabid badger I tried to convince the Jamaican official that I was not a drug lord recently released from lockup but a simple gynecologist from a sleepy southern town. I suspect she was convinced that impounding a vertically challenged southern doctor’s medicines would earn her brownie points with the local bureaucracy, so she persisted in her confiscatory activities and forcefully informed me that I best move on unless I wanted to spend a night in the local jail explaining my dilemma to Rasta Joe. Not wanting to test the hospitality of Jamaican jails, I relented and reluctantly completed the process to get my personal bags through the gate.

The bus ride to our hotel revealed a contrast of cultures. Decrepit hovels were interspersed with five star luxury resorts. The irrepressible beauty of the countryside was pockmarked with unfinished cinder block construction, and goats and dogs roamed freely as if they belonged on the roads and the vehicles were the intruders. Two hours after leaving Sanger International Airport we arrived at the Galina Breeze, our home for the next week. This oasis in the midst of hopelessness serves as the home base for the American Caribbean Experience, or ACE to those in the know. ACE is an amazing ministry run by the Energizer Bunny incarnate Marla Fitzwater, who for more than twenty years has been serving the people of St.Mary’s Parish, the most impoverished area of the island. Through a number of enterprises, ACE integrates into the community and puts hands and feet to the Gospel message of “Just as you have done for the least of these, you have done for me.” ACE sponsors medical clinics (which is why I was there at this particular time), micro-businesses, schools, and even a soccer team in its ongoing mission to minister to the body, mind, and souls of the Jamaican people. And what an amazing people these are; the town folk of Port Maria. In spite of devastating poverty, many of these precious souls have a joy for living and a desire to seek God in all they do. Theirs is a constant struggle against disease, violence, drugs, and poverty; yet they are some of the most appreciative, kind, and friendly people on earth.

The spiritual guide for our trip was Rev.Scott, a veteran of numerous mission trips and the proud owner of the best beard of the whole group. Rev. Scott is the kind of guy that can be comfortable in any situation. Whether it’s building a cinder block wall or preaching a sermon, he has a quiet presence that both soothes and inspires. He’s just a doggone nice guy to be around, and let’s face it, you can’t say that about all preachers. I have met some ministers who could brighten up a room by just leaving it! Rev. Scott not only challenged you in your spiritual walk but also helped you find the path. ACE is a Christian based ministry and our medical team was firmly entrenched in Christian outreach so it followed that any spiritual needs of either the team or the patients would be channeled to Scott. I seriously considered sending him an acutely menopausal woman claiming she was possessed by a hot flash demon, but thought better of it as I suspect Peter or Paul would have had trouble with this woman. As it turned out she needed estrogen not an exorcism. It must get trying for a minister to always be the one everyone looks towards when a group asks for blessings or prayers. I suspect just one time Scott would love to blurt out,”Doesn’t anyone remember Now I lay me down to sleep. Just say that for goodness sake!!” But Scott is much to gracious for such outbursts and his calming presence reminded me of the eye of a storm. He took a diverse group of folks and effectively related spiritual truths that applied to us all and left us with a sense of purpose anew. I did sit near him in the singing church though, and let me say clapping to the beat is not his spiritual gift. In spite of his lack of rhythm, Rev.Scott not only gave us spiritual comfort, but he showed us by his actions what a man devoted to the church should be.

Speaking of the singing church, on Sunday before the first clinic day we loaded up the bus and rode 30 minutes to Ocho Rios, the closest “big town” to where we were. Many of you Bermuda shorts wearing, flower shirted, black socks with sandals crowd will recognize Ocho Rios as a frequent stop on various cruise lines. It is like a flea market on steroids. If you need a giant wooden phallic symbol, pirated Frank Sinatra albums, counterfeit Blue Mountain coffee, or dread locks wigs...this is your place. A carnival atmosphere is punctuated with smells of jerk chicken and Red Stripe beer, sidewalk speakers blaring kettle drum Jamaican Reggae, and hawkers eager to show you the closest ATM. We were able to bypass this circus (at least for the moment) and walk upstairs to a nondescript building in the downtown. The minute we began to ascend the stairs we heard chest pounding bass backbeats emanating from the second floor. Welcome to The Church of the Rock. Reverend Roland was presiding and the faint of heart best stay outside. A 5 member band and three back up singers were praising God and a tower of speakers assured you that no one needed a hearing aid. All this was in a space about the size of a large elementary school classroom. The sermon series was on marriage, and up front was a visual aid that said it all. A man mannequin and a woman mannequin were dressed in their wedding best, smiling under a traditional Jamaican marriage arch, complete with flowers and petals at their feet. Seeing that it was a man and a woman, I correctly surmised that this was not going to be a sermon about tolerance and Billy’s two dads. Indeed, when the praising stopped and the preaching began, Reverend Roland delivered one of the most eloquent, humorous, and theologically challenging orations I have ever heard. At the completion of the service, after a bit more praising and a bit more worshiping, we all came out of the Church of the Rock knowing that it was truly built on a firm foundation. This church was an oasis in a spiritual desert. Although Jamaica is a predominately Christian enclave, the area we were in was strongly influenced by Rastafarianism and Islam. The Church on the Rock preached Biblical truths and practical applications that obviously spoke to the local folks...and us. There could have been no better way to initiate us to these remarkable people and our reason for being there.

There are some things a dad just shouldn’t do. Now this is not going to be some sexist, misogynistic diatribe about why men should only eat meat and watch football and women should bake pies and pump out kids like a Krispy Kreme assembly line. What I mean is that in the course of everyday life, dads need to exercise restraint and good judgment which, in turn, benefits the entire family. It’s like in those old National Geographic films where the unsuspecting Gazelle wanders close to the watering hole and gets his head eaten by the lurking alligator. “Yes Marlin, watch as the normally cautious creature simply wants to have a drink and...Oh! Heavens to Betsy! Did you see how agile that gator was? Just lopped off that head in one manly snap! Yep, that Gazelle is having a bad day!” Sometimes all us dads want to do is get a drink of water and Bam! Off with our heads! Let me give you an example.
Not long ago I was minding my own business relaxing in our kitchen with a manly cup of dark roast java, and my two daughters were discussing whatever daughters discuss (in my usual manly stupor I had no idea of the topic), yet I detected a somewhat disrespectful tone to the conversation. I was brought up in a house where showing disrespect to anyone, anytime was tantamount to committing a war crime, so I have this “disrespect” radar that can sense such activity even if my mind is focused on other things like a Glen Beck rant. I sensed this tone in their conversation so I commented that I thought they could discuss boys or clothes or global warming with a bit more congeniality. Mistake! As soon as the words came out of my mouth they both turned to me and like the aforementioned Gazelle, Snap! Off with my head! A sure fire way to cure your teenagers from arguing is to instantly give them a common enemy. Never mind the fact that all the women in my household are on a synchronous hormone pattern that would make a Swiss watch maker envious. So not only had I intervened in a conversation in which I was not welcomed or needed, I had done it at a time when the alligator in each was in its most ravenous state. There are some discussions that dads just need to stay out of, and I have been rendered headless many times to validate that conclusion.
Dads don’t need to do the wash. I can hear the NOW supporters bristling in their “I Am Woman” tee shirts but hear me out on this one. I do believe in a division of labor around the house. In today’s society almost 70% of women work outside the home, so it is only fair that the responsibilities be divided from those according to their ability to those according to their need. (Where have I heard that before?) For example, I love getting the dishes out of the dishwasher. I imagine each time I am doing this that the items I am placing on the shelves are new (even if they are the same ones we have had since 1991). This somewhat delusional game makes emptying the dishwasher fun as it seems like I have a big Christmas package that I get to unwrap every night. On the other hand, my wife , who is mysteriously grounded in reality, hates doing this chore, mainly because she sees it for what it really is, a drudgery akin to working an assembly line checking bananas for bruises. So the fact that she despises this and I adore it makes it easy to understand who empties the dishwasher at our house. Don’t get me started about getting the kids to do such a thing. That would be like trying to get Barney to go straight...a battle not worth fighting at this point. So why, you ask pensively, should dads not do the wash? I guess I should clarify my statement somewhat by saying that dads with teenage daughters shouldn’t do the wash. There are things you discover in folding clothes that you were not meant to know. The other day I was sorting and folding a load of wash (yes ladies, my wife married a jewel!), and I came across a piece of fabric that confused me. It was close to Halloween and for all the world it looked like an eye patch. I tried placing it on my head in the right position and the triangular, stripped fabric barely covered my eye. During my investigation my wife walked in the room and gave me one of those “What in the name of fabric softener are you doing” looks. I asked her who was going to be the pirate for Halloween and, knowing my propensity for delusion, she just laughed and said no one that she knew, and then she calmly asked me why I was wearing my youngest daughter’s underwear on my head. Jerking the minuscule swath of cloth off my head I look incredulously at the nearly non-existent fabric and shook my head in an attempt to grasp that this microscopic snippet was used for anything besides a blanket for a baby hummingbird. Once my wife gained her composure and I voiced my fatherly objections, we agreed that maybe I should go back to emptying the dishwasher.
Dads should not dress themselves, especially if they are older like myself. We have a propensity for wearing such atrocious items as high water pants, dad jeans, and wife beater shirts. If you don’t know what these fashion items are then you certainly don’t want to adorn your form by yourself as you are probably wearing all of them. If your sole goal in life is to embarrass your children and humiliate your wife, go ahead and pick out your wardrobe everyday and you will most likely accomplish this task. Most dads get excited when we see a sale on jeans at Target or find a stash of ties for a dollar at a garage sale. Wise up guys, they are on sale for a dollar for a reason as most of these ties were rejected by Goodwill! Not everyone needs another salmon colored tie with a swordfish the size of New Jersey on it. ( I have three).
I have what I call my “bringing sexy back” line of clothing for the middle aged dad. It can be one or a combination of items that can illicit nausea and uncontrolled laughter from anyone within viewing distance. There are the “Richard Simmons” workout shorts and shirt. I got these from a clearance sale (first red flag) and the shorts look like hot pants from the 80s and the shirt is mesh see through. The first time I wore these to go exercise, my family, once they stop seizing from laughing so hard, threatened to move to California if I ever wore them in public. Then there are my black “compression socks”. Now these are legitimate tools for recovery after a long race, they just happen to look like support hose. So picture, if you dare, a middle aged man in black support stockings up to his knees, plastic like gym shorts, and a Boston Marathon tee shirt and you can see why my family wants me on house arrest.
I love being a dad, but I have learned that there are just some things we have to avoid if we want to excel at it.

As another birthday steamrolls over my consciousness, I find myself searching for that Holy Grail of anti-aging solutions that has proven so elusive. A quick survey of my current understanding of the ant-aging literature revealed that this whole body of work is misnamed. There is no such thing as not aging! It happens! We are all captives of time and space and no matter what we do or say, we will get older. A better goal is learning how to age well. Live long and healthy, then crash and burn for a brief time! I love the term "compressed senescence" because it encapsulates what I perceive as the real goal we all strive for; that is living life in a state of good health and vigor and when it is time, and there will come a time, having a rapid decline. I would much prefer to live to a vigorous ninety and die at ninety one than live to ninety five and be dependent and sickly for the ten years prior. In that vein let me expound on a few things that may help both you and me achieve that goal.

If you have read anything from me in the past you know that I feel exercise is the fountain of youth. A 30-45 minute daily routine that gets your heart rate up and your body moving is quite possibly the best thing you can do to keep healthy longer. A close second is diet. What we eat really does determine what we become. My simple rules are; eat balanced meals, whole foods as close to how God made them as possible, eat mostly plants, low sugar, low fat, high fiber, and generally less than you have been. If you follow those two things you are ahead of about 90% of the population and well on the road to a healthy longevity.

I am often asked about vitamins and supplements and their role in living a long healthy life. The simple answer is that if we eat right you don't really need anything additional...but honestly, who eats right all the time. Reality dictates that we benefit from a basic multivitamin. Don't fall for the hype of slick markerters that say their vitamin is far superior to the their guys. Most of the products from reputable companies provide what you need.

The only additional supplement that I almost universally recommend is the Omega 3 Fatty Acids. I think the data is overwhelming that an abundance of these substances in either your diet or supplements can reduce inflammation, oxidative stress, and free radical formation, all which have been associated with more rapid aging and disease. Honestly I know of very few folks who wouldn't benefit from a healthy dose of Omega 3s. Here there is a difference in the quality of the product. Numerous studies show that some fish oil capsules (a great source of omega 3 fatty acids) either contain minimal omega 3s or an improper balance of the various types. Quality and dose does matter greatly when considering the scientific data on the benefits of these substances. I recommend a proprietary brand of Omega 3s called Omega XL. It has stood rigorous independent evaluation and has shown to be consistent in dosage and effectiveness. The company that manufactures it, Great Health Works, has a long history in the supplement world and is well respected for the quality and integrity of its manufacturing process. I take it, and so does my family. That's the best endorsement I can give!

Live Well!

I have been doing some research into the literature on omega 3 fatty acids and attention deficit disorder in kids. The literature is pretty clear that this is a metabolic/genetic/environmental/structural problem that runs the gamut as far as presentation of symptoms. Neuroscientists largely agree that there probably is a nutritional component also, with ADD kids almost always showing below normal serum levels of essential fatty acids. A few studies (see below) have suggested that supplementation with Omega 3 PUFAs may improve behavior in some kids with this disorder. I will continue to search the literature for reliable information on this topic. I suspect many of you are already aware of this, but I just wanted you to know this is another area of interest on my part. I have attached the abstracts of several relevant studies with the important conclusions highlighted and the sites on PubMed where they can be found. Let me know if this stuff is helpful. I will be addressing this in next months blog posting and newsletter.

Ron Eaker,M.D.

http://www.ajcn.org/cgi/content/abstract/71/1/327S

American Journal of Clinical Nutrition, Vol. 71, No. 1, 327S-330S
Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder1,2
John R Burgess, Laura Stevens, Wen Zhang and Louise Peck
From the Department of Foods and Nutrition, Purdue University, West Lafayette, IN.
Attention-deficit hyperactivity disorder (ADHD) is the diagnosis used to describe children who are inattentive, impulsive, and hyperactive. ADHD is a widespread condition that is of public health concern. In most children with ADHD the cause is unknown, but is thought to be biological and multifactorial. Several previous studies indicated that some physical symptoms reported in ADHD are similar to symptoms observed in essential fatty acid (EFA) deficiency in animals and humans deprived of EFAs. We reported previously that a subgroup of ADHD subjects reporting many symptoms indicative of EFA deficiency (L-ADHD) had significantly lower proportions of plasma arachidonic acid and docosahexaenoic acid than did ADHD subjects with few such symptoms or control subjects. In another study using contrast analysis of the plasma polar lipid data, subjects with lower compositions of total n–3 fatty acids had significantly more behavioral problems, temper tantrums, and learning, health, and sleep problems than did those with high proportions of n–3 fatty acids. The reasons for the lower proportions of long-chain polyunsaturated fatty acids (LCPUFAs) in these children are not clear; however, factors involving fatty acid intake, conversion of EFAs to LCPUFA products, and enhanced metabolism are discussed. The relation between LCPUFA status and the behavior problems that the children exhibited is also unclear. We are currently testing this relation in a double-blind, placebo-controlled intervention in a population of children with clinically diagnosed ADHD who exhibit symptoms of EFA deficiency.

http://www.ncbi.nlm.nih.gov/pubmed/16962757

Omega-3 fatty acid status in attention-deficit/hyperactivity disorder.
Antalis CJ, Stevens LJ, Campbell M, Pazdro R, Ericson K, Burgess JR.
Department of Foods and Nutrition, West Lafayette IN 47909-2059, USA.
Abstract
Lower levels of long-chain polyunsaturated fatty acids, particularly omega-3 fatty acids, in blood have repeatedly been associated with a variety of behavioral disorders including attention-deficit/hyperactivity disorder (ADHD). The exact nature of this relationship is not yet clear. We have studied children with ADHD who exhibited skin and thirst symptoms classically associated with essential fatty acid (EFA) deficiency, altered plasma and red blood cell fatty acid profiles, and dietary intake patterns that do not differ significantly from controls. This led us to focus on a potential metabolic insufficiency as the cause for the altered fatty acid phenotype. Here we review previous work and present new data expanding our observations into the young adult population. The frequency of thirst and skin symptoms was greater in newly diagnosed individuals with ADHD (n = 35) versus control individuals without behavioral problems (n = 112) drawn from the Purdue student population. A follow up case-control study with participants willing to provide a blood sample, a urine sample, a questionnaire about their general health, and dietary intake records was conducted with balancing based on gender, age, body mass index, smoking and ethnicity. A number of biochemical measures were analyzed including status markers for several nutrients and antioxidants, markers of oxidative stress, inflammation markers, and fatty acid profiles in the blood. The proportion of omega-3 fatty acids was found to be significantly lower in plasma phospholipids and erythrocytes in the ADHD group versus controls whereas saturated fatty acid proportions were higher. Intake of saturated fat was 30% higher in the ADHD group, but intake of all other nutrients was not different. Surprisingly, no evidence of elevated oxidative stress was found based on analysis of blood and urine samples. Indeed, serum ferritin, magnesium, and ascorbate concentrations were higher in the ADHD group, but iron, zinc, and vitamin B6 were not different. Our brief survey of biochemical and nutritional parameters did not give us any insight into the etiology of lower omega-3 fatty acids, but considering the consistency of the observation in multiple ADHD populations continued research in this field is encouraged.

http://www.ncbi.nlm.nih.gov/pubmed/17629918

Nutr J. 2007 Jul 13;6:16.
Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder.
Sorgi PJ, Hallowell EM, Hutchins HL, Sears B.
Hallowell Center, Sudbury, MA 01776, USA.
Abstract
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most common neurological condition in children. This pilot study evaluated the effects of high-dose eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the isolated plasma phospholipids and behavior in children with ADHD (primarily inattentive subtype and combined subtype). METHODS: Nine children were initially supplemented with 16.2 g EPA/DHA concentrates per day. The dosage was adjusted dependent on the ratio of arachidonic acid (AA) to EPA in the isolated plasma phospholipids at four weeks to reach a level normally found in the Japanese population. RESULTS: At the end of the eight-week study, supplementation resulted in significant increases in EPA and DHA, as well as a significant reduction in the AA:EPA ratio (20.78 +/- 5.26 to 5.95 +/- 7.35, p < 0.01). A psychiatrist (blind to supplement compliance or dosage modifications) reported significant improvements in behavior (inattention, hyperactivity, oppositional/defiant behavior, and conduct disorder). There was also a significant correlation between the reduction in the AA:EPA ratio and global severity of illness scores. CONCLUSION: The findings of this small pilot study suggest supplementation with high-dose EPA/DHA concentrates may improve behavior in children with ADHD.

http://www.ncbi.nlm.nih.gov/pubmed/18072818

Altern Med Rev. 2007 Sep;12(3):207-27.
Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids.
Kidd PM.
University of California, Berkeley, California, USA.
Abstract
The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are orthomolecular, conditionally essential nutrients that enhance quality of life and lower the risk of premature death. They function exclusively via cell membranes, in which they are anchored by phospholipid molecules. DHA is proven essential to pre- and postnatal brain development, whereas EPA seems more influential on behavior and mood. Both DHA and EPA generate neuroprotective metabolites. In double-blind, randomized, controlled trials, DHA and EPA combinations have been shown to benefit attention deficit/hyperactivity disorder (AD/HD), autism, dyspraxia, dyslexia, and aggression. For the affective disorders, meta-analyses confirm benefits in major depressive disorder (MDD) and bipolar disorder, with promising results in schizophrenia and initial benefit for borderline personality disorder. Accelerated cognitive decline and mild cognitive impairment (MCI) correlate with lowered tissue levels of DHA/EPA, and supplementation has improved cognitive function. Huntington disease has responded to EPA. Omega-3 phospholipid supplements that combine DHA/EPA and phospholipids into the same molecule have shown marked promise in early clinical trials. Phosphatidylserine with DHA/EPA attached (Omega-3 PS) has been shown to alleviate AD/HD symptoms. Krill omega-3 phospholipids, containing mostly phosphatidylcholine (PC) with DHA/EPA attached, markedly outperformed conventional fish oil DHA/EPA triglycerides in double-blind trials for premenstrual syndrome/dysmenorrhea and for normalizing blood lipid profiles. Krill omega-3 phospholipids demonstrated anti-inflammatory activity, lowering C-reactive protein (CRP) levels in a double-blind trial. Utilizing DHA and EPA together with phospholipids and membrane antioxidants to achieve a triple cell membrane synergy may further diversify their currently wide range of clinical applications.

http://www.ncbi.nlm.nih.gov/pubmed/16188207

Reprod Nutr Dev. 2005 Sep-Oct;45(5):549-58.
Effect of randomized supplementation with high dose olive, flax or fish oil on serum phospholipid fatty acid levels in adults with attention deficit hyperactivity disorder.
Young GS, Conquer JA, Thomas R.
Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ontario N1G 5B6, Canada.
Abstract
Dietary intake of omega-3 fatty acids has been positively correlated with cardiovascular and neuropsychiatric health in several studies. The high seafood intake by the Japanese and Greenland Inuit has resulted in low ratios of the omega-6 fatty acid arachidonic acid (AA, 20:4n-6) to eicosapentaenoic acid (EPA, 20:5n-3), with the Japanese showing AA:EPA ratios of approximately 1.7 and the Greenland Eskimos showing ratios of approximately 0.14. It was the objective of this study to determine the effect of supplementation with high doses (60 g) of flax and fish oils on the blood phospholipid (PL) fatty acid status, and AA/EPA ratio of individuals with Attention Deficit Hyperactivity Disorder (ADHD), commonly associated with decreased blood omega-3 fatty acid levels. Thirty adults with ADHD were randomized to 12 weeks of supplementation with olive oil (< 1% omega-3 fatty acids), flax oil (source of alpha-linolenic acid; 18:3n-3; alpha-LNA) or fish oil (source of EPA and docosahexaenoic acid; 22:6n-3; DHA). Serum PL fatty acid levels were determined at baseline and at 12 weeks. Flax oil supplementation resulted in an increase in alpha-LNA and a slight decrease in the ratio of AA/EPA, while fish oil supplementation resulted in increases in EPA, DHA and total omega-3 fatty acids and a decrease in the AA/EPA ratio to values seen in the Japanese population. These data suggest that in order to increase levels of EPA and DHA in adults with ADHD, and decrease the AA/EPA ratio to levels seen in high fish consuming populations, high dose fish oil may be preferable to high dose flax oil. Future study is warranted to determine whether correction of low levels of long-chain omega-3 fatty acids is of therapeutic benefit in this population.

http://www.ncbi.nlm.nih.gov/pubmed/19436468

Paediatr Child Health. 2009 Feb;14(2):89-98.
Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study.
Bélanger SA, Vanasse M, Spahis S, Sylvestre MP, Lippé S, L'heureux F, Ghadirian P, Vanasse CM, Levy E.
Department of Pediatrics, CHU Ste-Justine, Montréal, Québec.
Abstract
BACKGROUND: Although several clinical trials have evaluated the impact of n-3 polyunsaturated fatty acid (PUFA) on patients with attention-deficit hyperactivity disorder (ADHD), changes in plasma PUFA composition were not always assessed following n-3 supplementation. Furthermore, no reports are available on the efficacy of n-3 PUFA in Canadian youth with ADHD. OBJECTIVES: To determine fatty acid (FA) composition, and the efficacy and safety of n-3 PUFA supplementation on ADHD clinical symptoms in French Canadian primary school children. PATIENTS AND METHODS: The Strengths and Weaknesses in ADHD and Normal Behaviors (SWAN) and Conners' questionnaires were used to assess changes in ADHD symptoms in 37 children (only 26 children completed the study from zero to 16 weeks). They were divided into two groups (A and B), and participated in a 16-week, double-blind, one-way, crossover randomized study. In the first phase, group A received the n-3 PUFA supplement and group B received n-6 PUFA (sunflower oil) as a placebo. During the second phase, group B received the active n-3 PUFA supplement that was continued in group A. FA composition and lipid profile were assessed during the phases of the study. RESULTS: FA differences between groups were observed in the 26 patients. Supplementation with n-3 PUFA resulted in significant increases in eicosapentaenoic and docosahexaenoic acids in group A, while group B was enriched with alpha-linolenic, gamma-linolenic and homo-gamma-linolenic acids. The n-3 PUFA supplement was tolerated without any adverse effects. A statistically significant improvement in symptoms was noted based on the parent version of the Conners' questionnaire from baseline to the end of phase 1, and this amelioration continued from phases 1 to 2, although the latter changes from phases 1 and 2 were not statistically significant in any of the subscales except for the subscale measuring inattention in group B. The improvement was greater in patients from group A in phase 1 and in patients from group B in phase 2. A subgroup of eight patients (four in each group) displayed a statistically significant clinical improvement following the administration of the n-3 PUFA supplement, particularly for the inattention and global Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, total Conners' subscales. CONCLUSIONS: A subgroup of children with ADHD who used n-3 PUFA supplements achieved and maintained symptom control. The data of the present study also supported n-3 PUFA safety and tolerability, but limited changes were noted in the FA profile in French Canadians with ADHD.

http://www.ncbi.nlm.nih.gov/pubmed/14669965

Lipids. 2003 Oct;38(10):1007-21.
EFA supplementation in children with inattention, hyperactivity, and other disruptive behaviors.
Stevens L, Zhang W, Peck L, Kuczek T, Grevstad N, Mahon A, Zentall SS, Arnold LE, Burgess JR.
Department of Foods & Nutrition, Purdue University, West Lafayette, Indiana 47907, USA.
Abstract
This pilot study evaluated the effects of supplementation with PUFA on blood FA composition and behavior in children with Attention-Deficit/Hyperactivity Disorder (AD/HD)-like symptoms also reporting thirst and skin problems. Fifty children were randomized to treatment groups receiving either a PUFA supplement providing a daily dose of 480 mg DHA, 80 mg EPA, 40 mg arachidonic acid (AA), 96 mg GLA, and 24 mg alpha-tocopheryl acetate, or an olive oil placebo for 4 mon of double-blind parallel treatment. Supplementation with the PUFA led to a substantial increase in the proportions of EPA, DHA, and alpha-tocopherol in the plasma phospholipids and red blood cell (RBC) total lipids, but an increase was noted in the plasma phospholipid proportions of 18:3n-3 with olive oil as well. Significant improvements in multiple outcomes (as rated by parents) were noted in both groups, but a clear benefit from PUFA supplementation for all behaviors characteristic of AD/HD was not observed. For most outcomes, improvement of the PUFA group was consistently nominally better than that of the olive oil group; but the treatment difference was significant, by secondary intent-to-treat analysis, on only 2 out of 16 outcome measures: conduct problems rated by parents (-42.7 vs. -9.9%, n = 47, P = 0.05), and attention symptoms rated by teachers (-14.8 vs. +3.4%, n = 47, P = 0.03). PUFA supplementation led to a greater number of participants showing improvement in oppositional defiant behavior from a clinical to a nonclinical range compared with olive oil supplementation (8 out of 12 vs. 3 out of 11, n = 33, P = 0.02). Also, significant correlations were observed when comparing the magnitude of change between increasing proportions of EPA in the RBC and decreasing disruptive behavior as assessed by the Abbreviated Symptom Questionnaire (ASQ) for parents (r = -0.38, n = 31, P < 0.05), and for EPA and DHA in the RBC and the teachers' Disruptive Behavior Disorders (DBD) Rating Scale for Attention (r = -0.49, n = 24, P < 0.05). Interestingly, significant correlations were observed between the magnitude of increase in alpha-tocopherol concentrations in the RBC and a decrease in scores for all four subscales of the teachers' DBD (Hyperactivity, r = -0.45; Attention, r= -0.60; Conduct, r = -0.41; Oppositional/Defiant Disorder, r = -0.54; n = 24, P < 0.05) as well as the ASQ for teachers (r = -0.51, n = 24, P < 0.05). Thus, the results of this pilot study suggest the need for further research with both n-3 FA and vitamin E in children with behavioral disorders.

http://www.ncbi.nlm.nih.gov/pubmed/20491709
Acta Paediatr. 2010 May 19.
EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD.
Gustafsson PA, Birberg-Thornberg U, Duchén K, Landgren M, Malmberg K, Pelling H, Strandvik B, Karlsson T.
.Department of Child Psychiatry, Linköping University, Linköping, Sweden.
Abstract
Abstract Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners' Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. Results: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners' total score. In oppositional children (n = 48), CTRS total score improved >/=25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), >/=25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved >/=25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). Conclusion: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.

http://www.ncbi.nlm.nih.gov/pubmed/20424008

J Atten Disord. 2010 Apr 27. [Epub ahead of print]
The Impact of Polyunsaturated Fatty Acids in Reducing Child Attention Deficit and Hyperactivity Disorders.
Transler C, Eilander A, Mitchell S, van de Meer N.
Sensation, Perception and Behavior Department.
Abstract
Objectives: To review the impact of polyunsaturated fatty acids (PUFA) in reducing ADHD symptoms in children. Methods: Peer-reviewed experimental literature published from 1980 to Mai 2009 is consulted (Psychinfo, Medline, and resulting reference lists). Results: Placebo-controlled studies with ADHD or hyperactive children show no effects on behaviors or cognition when only n- 6 (omega-6) PUFA, only docosahexaenoic acid (DHA), or n-6 and n-3 (omega-3) short-chain PUFA are supplemented. Yet three out of four studies suggest that a combination of long-chain n-3 and n-6 fatty acids (DHA, eicosapentaenoic acid [EPA], and gamma-linolenic acid [GLA]) supplemented daily for 3 to 4 months could lead to a reduction in ADHD symptomatology. Results on cognitive outcomes are inconsistent. Conclusions: Evidence is too limited to reach definitive conclusions but suggests that research on the impact of long-chain PUFA (n-3 and n-6) should continue with special focus on individual differences (genetic and fatty acid markers), mechanisms (brain imaging), and new enhanced methods of systematic observations of behaviors.

http://www.ncbi.nlm.nih.gov/pubmed/20146180

Tijdschr Psychiatr. 2010;52(2):89-97.
Omega-3 and omega-6 fatty acids in the treatment of children and adolescents with ADHD
Aben A, Danckaerts M.
Abstract
Background There is a growing trend towards the use of alternative forms of treatment for attention deficit hyperactivity disorder (adhd), such as the food supplements omega-3 and omega-6 fatty acids. AIM: To study biochemical aspects, important hypotheses regarding the role of these fatty acids in brain development, the mode of operation and research results concerning the effectiveness of treating adhd with these supplements. METHOD: A Medline search was performed using the Mesh-term 'fatty acids' and the search terms 'omega-3 and omega-6 fatty acids' and 'attention deficit hyperactivity disorder'. results Some rct's (randomised controlled trails) involving children with adhd didn't show any improvement after treatment with omega-3 and omega-6 fatty acids. Some other rct's, however, did show a reduction in adhd symptoms and learning difficulties, but the children concerned had not been officially diagnosed with adhd. A recent rct showed a substantial reduction in adhd symptoms in children with the inattentive type of adhd and in children with adhd and comorbid problems. CONCLUSION: There are indications that there is a theoretical rationale for the effectiveness of fatty acids in the treatment of adhd; research is ongoing. At the moment, however, treatment of adhd with omega-3 and omega-6 fatty acids is not recommended because it does not qualify as being evidence-based.

http://www.ncbi.nlm.nih.gov/pubmed/18448859

J Atten Disord. 2009 Mar;12(5):394-401. Epub 2008 Apr 30.
Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents.
Johnson M, Ostlund S, Fransson G, Kadesjö B, Gillberg C.
Department of Child and Adolescent Psychiatry, Göteborg University, Göteborg, Sweden. mats.k.johnson@vgregion.se
Abstract
OBJECTIVE: The aim of the study was to assess omega 3/6 fatty acids (eye q) in attention deficit hyperactivity disorder (ADHD). METHOD: The study included a randomized, 3-month, omega 3/6 placebo-controlled, one-way crossover trial with 75 children and adolescents (8-18 years), followed by 3 months with omega 3/6 for all. Investigator-rated ADHD Rating Scale-IV and Clinical Global Impression (CGI) scale were outcome measures. RESULTS: A majority did not respond to omega 3/6 treatment. However, a subgroup of 26% responded with more than 25% reduction of ADHD symptoms and a drop of CGI scores to the near-normal range. After 6 months, 47% of all showed such improvement. Responders tended to have ADHD inattentive subtype and comorbid neurodevelopmental disorders. CONCLUSION: A subgroup of children and adolescents with ADHD, characterized by inattention and associated neurodevelopmental disorders, treated with omega 3/6 fatty acids for 6 months responded with meaningful reduction of ADHD symptoms.

http://www.ncbi.nlm.nih.gov/pubmed/18622940

Z Kinder Jugendpsychiatr Psychother. 2008 Mar;36(2):109-16.
The treatment of Attention-Deficit/Hyperactivity Disorders with polyunsaturated fatty acids - an effective treatment alternative?
[Article in German]
Frölich J, Döpfner M.
Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln. Praxis-dr-froelich@t-online.de
Abstract
OBJECTIVES: Both omega-3 and omega-6 long-chain polyunsaturated fatty acids (PUFA) have a substantial impact on human brain development and function. However, in western industrial countries omega-3 LC-PUFA in particular are often lacking in diets. Increasing evidence indicates that LC-PUFA imbalance or deficiencies may be associated with Attention Deficit/Hyperactivity Disorder (ADHD) through involvement in the dopaminergic corico-striatal metabolism. Preliminary study result suggest that dietary supplementation with LC-PUFA might be effective in the treatment of ADHD. METHODS: This review summarizes the knowledge in terms of a hypothesized pathogenetic relationship between fatty acid metabolism and ADHD and discusses the possible clinical benefit of a primary or combined treatment with LC-PUFA. RESULTS: Actually it is unclear whether a deficit in intake or metabolism of LC-PUFA may play a major role in the pathogenesis of ADHD. Moreover treatment studies yielded conflicting results. A combination of Omega-3 and Omega-6 - fatty acids might attenuate the symptoms of ADHD significantly, thus making this dietary intake useful. CONCLUSIONS: Considerable research has to be done in the future to identify ideal therapeutic combinations and dosages of various fatty acids, and to develop reliable ways of defining those individuals to benefit from this treatment access.

For additional info on a great product that concentrates Omega 3 fatty acids go to www.OmegaXL.com.

Some folks say there is a fine line between ambition and obsession. My wife insists that I cross that line all too often. I have decided to try a new challenge this fall and she is convinced I am either deluded or just plain senile. I like to think I am simply not acting my age. I have decided to do a half marathon marathon. I know on the surface that sounds a bit confusing and you may be agreeing with my bride at this point, or simply thinking I didn’t proofread this well and am repeating myself; but I intend to run four half marathons in four successive weekends in October. So indeed it is a marathon of half marathons. Of course you may be thinking, as does she,”You nut, you are 52 years old and you wear black socks with sandals. You have no business running that number of long races in a short period of time.” She has a point, but I think it can and should be done for a variety of reasons. Allow me to eloquently explain why.

First, I agree with my bride that I am a bit obsessed. Over the past 10 years I have made a careful study of healthy lifestyle habits, not only for myself but for my patients, and I have concluded that exercise is the true fountain of youth. There is no single thing a person can do that will more comprehensively prolong the quality of life and reduce morbidity and mortality as a 30-45 minute daily aerobic session. I have preached exhaustively that this doesn’t have to be training for a marathon, wind sprints until you throw up, or bench pressing 300 pounds. Just walking at a brisk pace and throwing in some hills will achieve remarkable results for weight management, disease prevention, and mental health. Those of you already practicing this and yet finding you are still gaining weight or not improving fitness need to fool your body. Years ago there was a commercial on TV that had the tag line,”It’s not nice to fool mother nature”. In this case that’s exactly what you want to do. If you’re in a rut as far as weight for example, you simply have to change your regimen a bit to jump start the gains. If I run 5 miles every day soon my body adapts to that and I no longer see the dramatic benefits I once did. I fool my body by altering my exercise and my weight improves and I get fitter. Instead of always running I cross train 2 days a week by lifting weights or cycling. The variation keeps things interesting and leads to additional benefits. My wife has recently introduced me to cycling (not menstrual cycling you understand ... a gyn joke there) and since I have been bike riding on my non running days, I have seen my running improve. The take home here is to first: start exercising, and second: if you are already exercising, vary your activity for the greatest benefits.

Second, I find that if I have a goal I tend to be more productive and focused. That applies to everything from exercise to work. A study done at Harvard (someYankee school up north) a few years ago concluded that those individuals who had written goals tended to be higher achievers in all aspects of their lives. I know for myself that if I have a race, or in this case a series of races, that I am planning for, then I am much more motivated to train and stay focused. It’s a lot easier to get up at 5:45 AM for a long run when you know there is a specific goal you want to achieve. That doesn’t mean you have to sign up for the next 5K in your town. Your goal can simply be to lose 10 pounds or to reduce stress. Whatever the reason, find a specific goal for your exercise and write it down. Include a timeline and signposts along the way to measure your progress. Make it both fun and achievable, and reward yourself as you successfully complete the milestones.

Third, I am running this half marathon marathon with the proper tools. By that I mean I am using the supplements, gadgets, and gizmos that are available to both make it fun and keep me healthy. I have told you in previous communications of my love affair with a product called OmegaXL. It is a concentrated dose of omega 3 fatty acids which act as both an anti inflammatory agent and an anti oxidant. In exercise, or just walking around, your body produces an enormous amount of metabolic products called free radicals. These are not college kids holding protest signs, but chemicals that can have a destructive effect on joints, tissues, and other organs. The anti oxidants in OmegaXL act like little Pac men going around in the bloodstream gobbling up the nasty little free radicals thus both preventing things like muscle fatigue and arthritic pain and creating an environment where the body functions more efficiently.

Fourth, I’m running to set an example for my kids. One of the greatest legacies I can leave is that of a healthy lifestyle. My kids are no different from most. They tend to do the opposite of what their parents do or say, but I’m hoping that one day when they visit me in the nursing home they will tell me of the latest race they completed with their kids. I take solace in knowing that I laid the foundation while they were growing up. The example we set as parents has more of an impact than we often realize. Your teens may be committed couch potatoes now but as they get a bit older, I trust they will remember the things you taught them about exercise and nutrition.

“There is evidence from multiple studies supporting intake of recommended amounts of DHA and EPA in the form of dietary fish or fish oil supplements lowers triglycerides, reduces the risk of death, heart attack, dangerous abnormal heart rhythms, and strokes in people with known cardiovascular disease, slows the buildup of atherosclerotic plaques ("hardening of the arteries"), and lowers blood pressure slightly.”
Mayo Clinic

So begins the entry on omega 3 fatty acids on the Mayo Clinic website. A little deeper digging reveals the following report from the journal Current Atherosclerotic Reports:

“Clinically important anti-inflammatory effects in man are further suggested by trials demonstrating benefits of n-3 fatty acids in rheumatoid arthritis, psoriasis, asthma, and inflammatory bowel disorders. Given the evidence relating progression of atherosclerosis to chronic inflammation, the n-3 fatty acids may play an important role via modulation of the inflammatory processes.”

Now granted I am not as bright as some government community organizers, but I can pick up on something valuable when it slams me in the face. The only logical conclusions from these and literally hundreds of additional studies is that ingesting the proper amount of these little fatty acids is good for you on a number of levels. In this world of “pharmaceuticals:bad - naturals:good” we should all be embracing tools available to us to extend lives and reduce morbidity.

I have said on numerous occasions that exercise is the fountain of youth. I still believe it is the single most advantageous activity a person can undertake to promote health. Exercise will do more for you physically and mentally than anything else out there, yet it takes you actually doing it for there to be any benefit. Likewise, proper nutrition is another big piece of the health puzzle. I am not telling you something you don’t already know. In fact I preached this for the length of an entire book in Fat Proof Your Family. So if we all know the importance of exercise and nutrition, why don’t we practice it? Psychologists, doctors, multi level marketers, and the biggest losers have all pondered this question and come up lacking. I wont tease you into thinking I have the answer either. My libertarian instincts lead me to simply say, the data is there and it is up to each individual to do with it what they may.

So why did I start this rant off with the benefits of omega 3 fatty acids and then swerve into a rave on lack of discipline and initiative? Simply to show that, thanks to modern research, there are things you can do that don’t involve treadmills or tofu that can enhance your health. I am a critical consumer when it comes to supplements and “natural” remedies. However, I do embrace those approaches when the science supports them and there are few of these over the counter products that have as much scientific and clinical validation as the omega 3s. Most of you know that these substances are abundant in cold water fish (tuna, salmon etc.) and many soybean products, flaxseed, and walnuts. As with most nutrient benefits, they are most realized when consumed in their natural state, i.e. fresh from the ocean or the ground; yet, in many cases this is not practical or cost efficient. This is one of the few areas where supplements in pill or capsule form are still as effective (and in some cases more effective) than the natural occurring nutrient. As I have mentioned before, I am a fan of the supplement OmegaXL, as my research of the literature confirms this product contains one of the greatest concentrations of the types of omega 3 fatty acids that are beneficial to humans. In addition, there are numerous studies using this actual product (which is very important) that show the anti inflammatory benefits are product specific.

The conclusion to all this for each of us; exercise daily, consume fewer calories, and take supplements that have been proven to have a benefit.

For more information go to: www.omegaxl.com

When we think of inflammation most of us envision the reddened swollen toe of the gout sufferer or the hot tender knee of the weekend warrior. Indeed these devilish conditions are a direct result of inflammation, yet this natural process impacts much more than over used appendages. For example, many people don’t associate inflammation with heart disease, yet research is conclusive that the inflammatory response is partly responsible for the artery clogging plaques that lead to chest pain and heart attacks.

Let’s take a brief repose to review what happens in a typical inflammatory response. I promise to not make your eyes bleed by using eight syllable medical jargon, but a basic understanding is critical in knowing how reducing inflammation can promote long term health and wellness.

Inflammation is basically a response of tissue to any type of insult. I don’t mean the liver retaliates against the heart for hurting its feelings. I’m not talking about that kind of insult, but more as something that causes an injury like infection, trauma, lack of nutrients (like a decreased blood supply), or intense heat or cold. This life saving cascade is responsible for both protection and healing and is characterized by the production of chemicals that have a multitude of effects on the injured tissue. This is a good thing, right? Yes it is…in most cases. However, if the inflammatory response is not limited or becomes chronic, problems arise; kind of like when your in-laws come to visit. A typical inflammatory reaction leads to redness and swelling in the surrounding tissue often accompanied by tenderness. That is why anti-inflammatory drugs like ibuprofen and naproxen are some of the most popular medications consumed by folks. None of us like pain, except the guy wearing the leather pants and carrying a whip, and the meds medicate the ouch by reducing the inflammation. Most of the time the body will stop the inflammation on its own, but in our “I want it yesterday” society sooner is always better than later. The real problem with inflammation is when it stakes its claim more permanently. Certain conditions like arthritis and auto-immune disorders stimulate “inflammation gone wild” and set up environments where pain and tissue destruction becomes more long lasting. We can also see this inflammatory tsunami from poor dietary choices, chronic couch potato-hood, and smoking.

The more we learn about the inflammatory response the more we discover the wide ranging impact it has on multiple tissues and organ systems. I mentioned earlier that clogging up the heart pipes is linked to inflammation. The cells that line the blood vessels like wallpaper are called endothelial cells and they can get irritated and inflamed by fats and other nasties in your diet. This sets off a whole cascade of events that leads to the gunking up of the artery and soon, Poof!, you get chest pain while chasing squirrels from your rutabaga garden. Doctors now use some simple blood tests that analyze your total body’s state of inflammation (called inflammatory markers), and they can predict your chance of getting a heart attack. There also seems to be a connection between chronic inflammation, Alzheimer’s disease, and certain cancers. I don’t claim to be as smart as Barak Obama, but it would make sense to me then that reducing the inflammatory response (especially the chronic kind) would be a very good thing, and science, in fact, agrees.

So how do we make the response to inflammation a happy face and not a sad face? The obvious answer would be to take a daily dose of anti-inflammatories with the same gusto that a wino sloshes down a quart of Ripple. But often the obvious response is the wrong answer, as it is in this case. Yes, taking an aspirin (the mother of all anti-inflammatories) a day has been associated with a number of benefits, and I will not dispute that some are helped from this, but there is a better way. In fact there are a number of better ways. One such healthy approach is to eat what I call an anti-inflammatory diet. By that I mean hog down on almost any fruit or vegetable you can get your little meat-stained hands on. Most fruits and vegetables contain substances such as omega three fatty acids that have a natural anti inflammatory effect. These substances swim around in the bloodstream and act like little vacuum cleaners sucking up bad stuff that would otherwise make you forget where you left your keys or who that chubby person standing next to you in the picture on the mantle is. Eat whole foods that are as close to the way God made them; the more processed the less beneficial. A good rule of thumb about eating is that if you can get it from a window without ever leaving your car, it’s probably not good for combating inflammation. Decrease your consumption of white flour products and sugar then double up on whole grains and nuts. Boycott saturated fats, like those found in most red meats and oils, and instead ingest polyunsaturated fats from cold water fish (salmon, tuna) and use olive oil. Drink enough water to drown a camel and eat fiber like it is banana cream pie.

Everyone would agree that the ideal source of anti-oxidants are whole foods, but the reality is that most of us don’t follow a consistently healthy diet think that chocolate is one of the four main food groups. Therefore supplements can be of great benefit, especially with the content of the Standard American Diet (SAD). You must be a critical consumer when assessing vitamins and supplements as there is shelf after shelf of expensive garbage in every grocery store and pharmacy in the country. These products are not regulated by any government agency (yet) so you have to rely on the integrity of the manufacturer, and just let me say that is a bit like trusting the IRS to be compassionate. As a marathon runner and a physician I have both a personal and professional interest in natural anti inflammatories that are effective and have minimal side effects, so I have done my due diligence in researching what is out there. I believe I have come upon a product that satisfies both my scientific cynicism and my personal requirements. I would have never thought that one of the most powerful anti-oxidant, anti-inflammatory substances commercially available was extracted from the New Zealand Green Lipped mussel (I’m not kidding!).

Omega XL is a concentrated powerhouse of omega 3 fatty acids that has stood the rigor of numerous double blind studies and shown to be a stupendous reliever of pain, muscle soreness, and irritation secondary to both acute and chronic inflammation. Of course the most important test was the highly touted “Eaker study” which consisted of a 51 year old middle of the pack marathoning gynecologist and his use of Omega XL while training and recovering from his last 4 marathons. Needless to say I wouldn’t even be mentioning this product if I hadn’t had great results from its use myself. In 21 years of medical practice I have never endorsed a specific product, but my own experience and the bountiful, credible studies convinced me that Omega XL is the real deal. To give you some perspective, most people understand the benefits of fish oil supplements, well, a recent study from Australia showed that Omega XL was 200 times more powerful in reducing the inflammatory changes of arthritis than standard fish oil extracts. And that’s just the beginning of the remarkable wealth of literature that has documented this product’s benefits.

I won’t bore you with my own sordid tales of marathon agony, but let it suffice to say that for years I would struggle for days, sometimes weeks, after a marathon to recover from muscle soreness and weakness. Once I started Omega XL I found I recovered from training runs quicker and therefore was able to not only run more marathons in a shorter period of time, but also run them faster than I had ten years earlier! My wife doesn’t share my enthusiasm as she says this new found vigor has only fueled my obsession with running and further kept me from my household chores. My kids love it as it gets me out of the house more often and at greater intervals so I bug them less about their homework.

The bottom line in the war against the ravages of acute and chronic inflammation is to eat well, exercise, get adequate rest, and use supplements wisely. For my money (and for my knees) Omega XL is a vital part of that regimen.

To find out more go to www.OmegaXL.com

At age fifty-one I ran my 17th marathon faster than I had run a decade earlier, and I owe it to a rare sea mollusk from New Zealand! I am no elite athlete. I am just an average Joe who enjoys distance running, but I, like most runners, thought I would get slower with age.
I began running marathons at age 37 with a trip to San Francisco and a race raising money for the Leukemia and Lymphoma Society. It was a glorious event but I hobbled around like a crippled old man for weeks afterwards. For the next decade I could average one, occasionally two, marathons a year. It literally took so much out of me that I couldn’t properly train and recover for any more than that
At age 50 I decided to challenge my “mature status” by training and completing three races in a year. By this time I had become fairly well educated about nutrition, effort, and the limits of my own ability. I still struggled with post run soreness and delayed recovery. As apart of my research ( I am a type “A” physician) I discovered the critical role of antioxidants and anti-inflammatory mechanisms in healing and recovery.
Most exercise generates chemicals and changes in the body that promote inflammation. This is a conundrum as stress pushes the body to adapt and become more fit, yet it also leads to soreness, muscle fatigue, and joint pain. As a physician biased towards natural mechanisms for reducing the effect of inflammation, I did extensive research into natural anti inflammatory tools for both my own benefit and that of my patients, as I had observed the same set of problems in their lives.
It was in the midst of this research that I came across a product called Omega XL. Omega 3 fatty acids are nature’s anti-inflammatory medicines, and I discovered that Omega XL contained the highest concentration and bioavailability of omega 3 fatty acids than any other product I could find. This little capsule derived from the green lipped mussel of New Zealand was thoroughly researched, and there was a voluminous literature published by independent investigators about its benefits. However, I wanted to see if it worked for me. Two months prior to my first “post 50” marathon I began taking Omega XL, careful to not alter any other aspect of my training such as diet and mileage as to properly asses the effect of this product. What I discovered confirmed the research; I recovered quicker and had less post-run soreness and discomfort. I didn’t measure all the inflammatory markers that were collected and followed in the research papers, but I knew how I felt and it supported the claims of the product. For me the biggest difference was how I felt after a training run or a race.
Prior to using Omega XL, I was hobbled and in agony after a marathon, unable to run or train for 2-3 weeks. Recently, however, after running the recent Albany Marathon I was back on the roads three days later looking forward to my next race. I initially thought that this recovery was just a fluke. Maybe I had trained harder or rested more, so I continued the Omega XL through my training and running of the North Carolina Marathon a few months later. Again, I was amazed at not only my time in the race but by my post race recovery.
Understand that I am a skeptic and not given to endorse any product on a whim, but here was a product that had both credible research and my own experience to support its value. Currently I am a few months from running in the 114th Boston Marathon. Not only has my training been injury free but my seasonal allergies have abated! (an unsuspected anti-inflammatory benefit)
You don’t have to train for a marathon to reap the benefits of Omega XL. Anyone who suffers from inflammatory conditions such as asthma, arthritis, back and joint pain, and even heart disease may potentially benefit from this anti-oxidant powerhouse.
I will continue to take Omega XL and will encourage my patients to do likewise.

Two roads diverged in a wood, and I- I took the one less traveled
by,and that has made all the difference.
Robert Frost

It began innocently enough, but in the end would have been grounds for divorce in twenty two states! I was speaking at a conference at a beautiful lake side resort and was hoping to get in a run before my morning presentation. The hotel was magnificently situated on hundreds of wooded acres with two golf courses cut from the fabric of the landscape. My wife had accompanied me on this trip as she knew of the splendor of the location and wanted to drink it in for herself. We don't normally run together as our schedules and biorhythms rarely coincide, but on this early October morning we had both the opportunity and motivation to venture out side by side. I had measured the distance from the entrance of the property to the hotel and had mapped out a simple 5 mile route for the occasion. It was a brisk morning, enough for a long sleeve shirt and gloves, and we stretched and warmed up by the first tee. It was too early for the golfers so we speculated that a run on the golf course was not out of the question if we wanted to "live on the wild side". About that time I spotted a jogging path lying parallel to the first hole and suggested we follow that instead. Susan agreed, so I started my Garmin 405 watch and off we went.

The first few miles were surprisingly hilly and we easily broke into a cool sweat. We kept a slow pace because of the topography and enjoyed the scenery. Three deer ran across our path onto the golf course ahead and with their abundant numbers, the squirrels looked like they were having a convention of their own. I had planned our departure to allow for about an hour run to get me safely back to the hotel in time to shower and prepare for my talk.

After going about a half hour I noticed that the color coordinated trail markers had changed from their original yellow color to black. I remember taking a few turns and forks, but thinking this was a simple circular route, I didn't pay much attention to the details. I mentioned this change to Susan and she didn't seem too concerned so we ventured on. After another mile it became clear that we were not going in a circle but were in fact traveling farther and farther from our home base. I have the sense of direction of a cross eyed pelican and Susan is not much better, so we soon realized that we were lost and about 5 miles from whence we started. We were obviously in a golf course neighborhood, but at 7 AM and dressed in black tights I was not about to knock on any doors and ask directions. We did the only logical thing we could think of and started to retrace our path in hopes of rediscovering the way home.

Mistake! As I said I could get lost in a mall parking lot so depending on me to follow the bread crumbs home is like a blind person following Google Maps. At this point two concerns were percolating in my brain, first, would I make it back in time for my talk, and second, would my wife kill me for turning our 5 mile fun jog into a 10 mile juggernaut?

I tell this tale to illustrate the universal law of unintended consequences. I started out with a plan in mind and ended up with my wife asking a passing motorist for the name of a good divorce attorney. President Obama's health care debacle reeks of unintended consequences. Regardless of the moral high ground and good intentions of universal coverage, it cannot and will not arrive without unforeseen and unintended consequences. Herein lies the dilemma; we won't know many of those effects until after years into the change.

The HIPPA laws passed by congress are a perfect example. They were intended for a noble purpose, protecting the privacy of the patient; however they have morphed into regulations that make nuclear facilities look tolerant and paper work that has singlehandedly deforested the Amazon basin. Be prepared for some form of restrictions (i.e. rationing) tax hikes (there is no other way to pay for it all), lower quality care (dumbing down just like in the public schools), and more fraud (unscrupulous doctors and executives unwilling to give up the house in the Hamptons). The system is indeed in need of repair, but to strap us all with a complete overhaul is like buying a new car when all you need is a lube job. Let's look at real reform like prevention, tort reform, portability, non exclusion clauses, and free deep fried candy bars on a stick for everyone. Okay, maybe we can leave off the candy bars, but we need a heavy dose of common sense so step number one is, in the words of Shakespeare, "let's kill all the lawyers." (and politicians, I might add)

Oh by the way, I did make it back in time from the run to give my presentation and my wife has not filed for divorce, so far.

A Prevent Defense
With the health reform debate blazing forward with the speed of a pregnant turtle, it seems only right to mercilessly show the political hacks where they have fallen off the bus. I know that sounds a bit presumptuous but trust me, I’m a doctor and I don’t just play one on TV.
First, what Washington is gobbling up then spewing out is not health care reform but heath coverage and insurance reform. No sane individual debates the merit of health care for all; it’s how that is achieved that befuddles the legislators, many of whom cannot find their way out of a wet prescription bag. Having Washington revamp the health care industry is akin to having the Chemistry department at your local community college write education policy for the nation; it’s just not what they do.
The key to real health care reform is not in legislation but in prevention. And you can’t legislate prevention! True honest to goodness prevention begins with the individual, and, in the case of kids, the family. Before we explore some practical tips for family disease prevention allow me to make the distinction between prevention and early detection. Pap smears, mammograms, and colonoscopies are techniques for early detection, not prevention. The disease already exists when these tools are utilized. They are incredibly useful and important tests and I strongly recommend their use, but don’t be under the misconception that getting a regular Pap smear will prevent cervical dysplasia and that yearly mammograms will keep breast cancer at bay. True prevention is designed to prevent or delay the onset of disease, not find it earlier once it exists. If we are to truly reform health care in this country it must begin with every family taking responsibility for prevention.
Let’s examine some methods of prevention especially suited for the family.
1) Get your kids vaccinated. If you are one of those wild-eyed, Jenny McCarthy worshiping, whack jobs that thinks childhood immunizations cause autism or any other disease, then you may already be too far gone. Not only is there no credible scientific evidence that vaccines cause autism, but not vaccinating your kids leaves them, and those around them, vulnerable to known diseases that can kill them! Measles, rubella, influenza, pertussis, and encephalitis still exist and still have serious consequences.
2) Insist on at least 30-60 minutes of physical activity for your child every day. This is an absolute minimum, and you can’t rely on the school gym program to meet this need. The average teenager spends 17 minutes actively moving in an hour long physical education class! Put a lock on the computer, blow up the TV, pour molasses in the back of the Xbox, and buy your kid a nice pair of running shoes. Childhood obesity is one of the top health problems in the country and the cure for obesity is exercise.
3) Teach good dental hygiene. We don’t often think about this as a public health issue, but many good health habits are taught early and this is one that will pay lifelong dividends. Dentists report that more and more kids (and adults) are foregoing routine check ups and preventive care due to economic concerns. Have a few less Grande Mocha Latte espressos and get your child’s teeth cleaned on a regular basis.

Now a few tips for the adults. Remember, you set the tone for the family. What you do often becomes the norm for everyone else.
4) Let’s get this out of the way right up front: eat healthy and exercise! There, I said it, you heard it, so do it! Enough said.
5) Wear seat belts. If you don’t know by now that buckling up saves more lives than Bruce Willis in Die Hard II then you have been living in a cave in Afghanistan. We all freak about the H1N1 virus that has killed 1000 people so far this year, but forget that not wearing seat belts kills an average of 5500 persons and injures 132,000 every year!
6) Join a church. Now before you write me hurtful and angry emails telling me that I am an ignorant, fundamentalist, Southern fried religious nut, hear me out. A study from Harvard (that close minded, Bible thumping bastion of evangelism) concluded that people who belonged to a religious community (i.e. church) had not only lower incidences of hypertension, diabetes, and senile dementia than their non church going brethren, but they also had longer lives on average. I am not advocating populating the pews just to live longer and healthier, but what a great side effect! In fact many studies show that people who regularly attend church tend to practice fewer risky health behaviors, are more emotionally stable, and have a greater sense of purpose.
7) Go back to school. This should convince you that I have gone completely bonkers. The reality is that people who keep their mind engaged in some meaningful activity have fewer risks for Alzheimer’s disease, senile dementia, and even some forms of cancer! Granted, this doesn’t mean you have to become a freshman at your local college, but staying mentally challenged through reading, working puzzles, journaling or a thousand other activities of the mind can be as healthy as jogging a mile a day.
You want health care reform? Start today by practicing family prevention

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Ron Eaker

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