Newsletter SEPTEMBER / OCTOBER 2007

Article
Natural Knee Pain Relief

Research Review
Acne Associated with Dairy Products

Ask the Doc
GMP Supplement Certification

Recipes of the Month
Mango Avocado Spring Rolls
Spicy Peanut Dipping Sauce

Quote:
“Worry does not empty tomorrow of its sorrow, it empties today of its strength.”
Corrie Ten Boom

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Natural Knee Pain Relief
By Sarah Cimperman, ND

Knee pain is an increasingly common cause of dysfunction and disability. Diagnosis is critical and certain symptoms require immediate medical care, such as numbness, fever, deformity, inability to bend or bear weight on the limb, and excessive bruising, bleeding or swelling. But when knee pain is minor, natural therapies are often good alternatives or adjuncts to conventional treatment. Exercise, nutritional supplements, botanical medicines, and hydrotherapy can relieve pain, reduce inflammation, and speed healing.

Acute Care

The standard prescription for acute knee pain known as “RICE,” an acronym for rest, ice, compression, and elevation. Resting prevents further injury while and ice, compression, and elevation reduce blood flow to the area, limiting swelling and bleeding. Ice also has a numbing effect and helps to relieve pain. It should be applied for ten to twenty minutes every one to two hours as needed.

Physical Activity

Although rest is critical at the time of injury, physical activity actually promotes tissue growth and repair once injuries start to heal. A study in German recently examined the impact of exercise on recovery from knee surgery. Researchers followed 118 patients who underwent surgery to replace damaged areas of knee cartilage with cartilage cells taken from a non-weight bearing part of the joint. Post-surgically, patients who engaged in sports at least once per week showed significantly improved knee function and cartilage repair (evaluated by MRI) compared to those who exercised only one to three times per month or not at all. Results were apparent after six months and active patients continued to improve during the three years of follow-up. Doctors concluded that patients recovering from knee surgery should engage in sports several times per week for at least two years after their operation, excluding high-impact activities and those that require pivoting, like basketball, football, soccer, and tennis.

Exercise not only stimulates healing of injured tissues, it helps to prevent future injury by strengthening muscles and bones surrounding vulnerable joints and improving flexibility. Stronger tissues and a greater range of motion allow forces to be distributed more evenly across the knee, minimizing stress on the joint. Exercise also helps overweight individuals lose weight, reducing pressure on knee joints. The best activities are low-impact sports such as cycling, walking, weight lifting, swimming, and other aqua-exercise.

Supplemental Support

Glucosamine and chondroitin are structural components of cartilage in joints. They are naturally produced by the body and supplements are derived from animal cartilage (chondroitin) and shellfish (glucosamine). Several randomized clinical trials support their effectiveness in relieving knee pain and there are no significant side effects in individuals without shellfish allergies. Chondroitin is related to heparin, so it should not be used with anticoagulant medications because it can increase the risk of bleeding.

Several herbs have anti-inflammatory effects and can be used to relieve knee pain as well. These include boswelia, ginger, devil’s claw, tumeric, and bromelain, an enzyme extracted from the pineapple plant. These herbs have a long history of traditional use and in vitro and animal studies have demonstrated their anti-inflammatory effects. Although they are non-toxic and well tolerated, interactions and allergic reactions are possible. Always talk to your doctor before taking any new medicines. She or he can recommend the best dosage and identify any potential interactions with other medications you are taking.

Hydrotherapy

The therapeutic use of hot and cold water, known as hydrotherapy, can also provide long-term support after acute inflammation subsides. Hot water dilates blood vessels on the surface of the skin and cold water constricts them. When hot and cold applications are alternately applied, circulation to the area is increased, bringing white blood cells and nutrients needed to stop tissue damage, destroy any foreign elements, remove waste materials, and rebuild tissues.

Alternating hydrotherapy can be done daily or as needed after activity. To perform the treatment, you will need two towels, tongs, a container of ice water, and a microwave or a large pot of simmering water. Place one towel in ice water. If using a microwave, wet the other towel, ring it out well, and heat it until hot. If using a pot of water, bring it to a simmer, remove it from the heat and add the towel. Exercise caution with the hot towel and use tongs to extract it from the pot or microwave, letting steam evaporate for a few seconds until the towel is cool enough to handle. Wrap it around the knee, taking care not to burn skin, and leave it in place for 3 minutes. Wring out the cold towel and apply it to the knee for 30 seconds. Repeat these steps for two additional cycles, reheating the hot towel and returning the cold towel to the ice water as needed.

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Acne Associated with Dairy Products

Harvard researchers studied the association between acne and dairy products in more than 47,000 women who participated in the Nurses Health Study II. After adjusting for age, body mass index and energy intake, they found a positive correlation between acne and consumption of milk, cottage cheese and cream cheese. Women who had ate these dairy products in high school were more likely to have been diagnosed with severe teenage acne. The researchers hypothesized that hormones in the milk were likely the cause.

To reduce the risk of acne and other conditions, avoid dairy or consume only products from pastured, organically fed cows, goats or sheep.

Dept of nutrition, Harvard school of public health. High school dietary dairy intake and teenage acne. Journal of the American Academy of Dermatology, 52(2):207-14, Feb 2005.

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Ask the Doctor: GMP Certification

Know can I know which supplement brands are better than others?
Sullivan
Jersey City, NJ

When selecting supplements, look for these four things:

• Expiration date
• Batch number
• Name and address of the manufacturer
• GMP Certification

The National Nutritional Foods Association (NNFA) outlines Good Manufacturing Practices (GMP) regarding the design, manufacture, packaging, and labeling of dietary supplements sold in the United States. Companies that are GMP compliant monitor themselves and those that are GMP certified are monitored by outside auditors.

GMP certification ensures that supplements contain what they are labeled to contain, but it doesn’t ensure that manufacturers start with the highest quality raw ingredients or test them in clinical trials. It is always a good idea to ask these questions of manufacturers before you buy their supplements or ask your naturopathic doctor for recommendations.

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Mango Avocado Spring Rolls

For vegan rolls, add strips of sautéed tempeh or red bell pepper in place of the chicken. Seafood lovers can substitute cooked shrimp if they wish.
Extra-virgin olive oil
Sea salt and pepper
1 free-range, organic chicken breast
1 mango, peeled and thinly sliced
1 avocado, peeled and thinly sliced
1 cup chopped cilantro leaves
4 spring roll wrappers (rice paper sheets)

Warm olive oil over medium heat and sprinkle chicken breast with salt and pepper. Sauté chicken until lightly browned on both sides and thoroughly cooked (juices should run clear). Cool and quarter the chicken, then thinly slice each quarter into strips.

Warm one inch of water, until simmering, in a skillet large enough to accommodate the spring roll wrappers. Turn off the heat and add one wrapper, soaking until soft, about 30 seconds to one minute. Remove the wrapper from the warm water and lay flat on a ceramic plate. Place a quarter of the chicken slices in the middle of the wrapper, along with a quarter of each of the mango slices, avocado slices and cilantro leaves. Fold one edge of the wrapper over the filling, then fold in the sides and roll it up. Place the roll seam-side down and repeat with the other wrappers and fillings.

Serve with Spicy Peanut Dipping Sauce.

Makes 4 rolls.

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Spicy Peanut Dipping Sauce

Cashew butter, sunflower seed butter or tahini can be substituted for the peanut butter.

1 ½ cup natural peanut butter
¼ cup hot water
2 tbsp tamari
4 tbsp rice vinegar
2 tbsp minced fresh ginger
1 clove garlic, pressed
¼ tsp cayenne pepper, or to taste
¼ tsp sesame oil

Stir together the nut butter and hot water until well combined, then add the remaining ingredients. Combine again until the mixture is smooth and consistent. Taste and adjust seasoning if necessary.

Serve with spring rolls.

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