If you're pregnant or thinking of having a baby, you might want to take a look at some new research on the effects of plant estrogens, such as that found in soy, on a developing fetus.
According to Medical News Today1, a paper published in Biology of Reproduction2suggests that exposure to estrogenic chemicals in the womb or during childhood has the potential to negatively affect a woman's fertility as an adult.
This coincides with earlier research on neonatal effects of exposure to plant or environmental estrogens. In studies with mice, researchers found that causes of infertility included:
"The team now reports that neonatal exposure to genistein changes the level of immune response in the mouse oviduct, known as mucosal immune response. Some of the immune response genes were altered beginning from the time of genistein treatment, while others were altered much later, when the mouse was in early pregnancy.
Together, those changes led to harmfully altered immune responses and to compromised oviduct support for preimplantation embryo development, both of which would likely contribute to infertility."
Since human development of the reproductive tract continues through puberty, researchers believe that estrogenic chemical exposure to human females as a fetus, infant, child, and adolescent could have impacts on fertility. The authors suggested that minimizing the use of soy-based baby formula would be a step toward maintaining female reproductive health.
Earlier research has also found that the compound genistein impairs sperm as they swim toward the egg. Even tiny doses of the compound in the female tract could destroy sperm, which would impair your ability to conceive in the first place.
Do You Still Believe Soy is a Health Food?Soybeans contain compounds called phytoestrogens or isoflavones, which have been found to produce a variety of mild hormonal actions within the human body by mimicking the sex hormone estrogen. An increased risk of breast cancer is another potential hazard, especially if you're exposed to high amounts of estrogen-mimicking compounds from birth.
Making matters worse, unless you're buying USDA 100% Organic soy products, chances are you're consuming genetically engineered (GE) soy, or feeding it to your baby, and GE crops—soy in particular—has also been linked to serious fertility problems.Glyphosate, the active ingredient in Roundup, has similarly been implicated in causing miscarriages, and both conventional- and genetically engineered soy is typically treated with heavy doses of this herbicide.
All in all, the health hazards of unfermented soy products—particularly genetically engineered varieties—are so serious and numerous, I strongly suggest avoiding them altogether, whether you're planning a pregnancy or not. But clearly, it's of particular concern for pregnant women.
For an excellent summary of the many dangers of consuming unfermented soy, please see this previous article by The Weston A. Price Foundation.
Unfortunately, many Americans who are committed to healthy lifestyles have been hoodwinked and manipulated into believing that unfermented and processed soy products like soy milk, soy cheese, soy burgers and soy ice cream are good for them. This is a tragic case of shrewd marketing and outright lies, with the end result of producing large profits for the soy industry and impaired health for most who have been deceived into using unfermented soy long-term.
Why You Should Avoid Feeding Your Baby Soy Infant Formula. Nearly 20 percent of U.S. infants are now fed soy formula, but as demonstrated in the featured study, the estrogens in soy can cause serious long-term harm to your baby's sexual development and reproductive health. It's important to realize that feeding your baby soy formula is like giving her an estimated four to five birth control pills' worth of estrogen every day. Infants fed soy formula have up to 20,000 times the amount of estrogen in circulation as those fed other formulas!
A 1997 study in The Lancet3 found that infants who consume soy formulas were exposed to phytoestrogen levels that were 6-11 times higher, on a body weight basis, than in adults consuming soy foods. And when you consider the fact that drinking two glasses of soy milk a day for one month provides enough of these compounds to alter your menstrual cycle, I'm sure you can see what a massive problem soy formula can be.
Male infants are also adversely affected by phytoestrogens. Male babies undergo a testosterone surge during the first few months of life, when testosterone levels may be as high as those of an adult male.
During this period, baby boys are programmed to express male characteristics after puberty, not only in the development of their sexual organs and other masculinity traits, but also in setting patterns in the brain characteristic of male behavior. Flooding his system with female hormones during this time can have severe ramifications on his development, including potentially smaller testes and significantly reduced testosterone levels.
Today, about 15 percent of white girls and as much as 50 percent of African-Americans girls show signs of puberty, such as breast development and pubic hair, before the age of eight. Some girls are showing sexual development before the age of three! Such premature development of girls has been linked to the use of soy formula and exposure to other environmental estrogen-mimickers such as PCBs and DDE.
Soy Infant Formula May Reduce Your Baby's IQ aside from harmful endocrine disrupters, soy infant formula can also contain over 1,000 percent more aluminum than conventional milk-based formulas. Aluminum is a potent neurotoxin that has been implicated in the development of Alzheimer's disease and other brain disorders. According to a study in Pediatrics, the official journal of the American Academy of Pediatrics4:
"Aluminum is now being implicated as interfering with a variety of cellular and metabolic processes in the nervous system and in other tissues."
But that's not all. Many soy foods also have toxic levels of manganese. Soy formula contains up to 80 times more manganese than is found in human breast milk, and according to recent research, high concentrations of manganese can lead to brain damage in infants and altered behaviors in adolescents.5
I rarely talk about absolutes but this is one instant where I will say: I encourage you to NEVER give your child soy formula. (I guess the only exception would be if there was a catastrophe and soy formula was the only food source temporarily available to keep your baby alive.)
The Benefits of Breast Feeding, and Healthier AlternativesOne of the best gifts you can give your child is to start out their life with a sound nutritional foundation, and the best way from a health perspective to do this is by breastfeeding if you can. In fact, statistics show a clear correlation between feeding infants artificial formula and increased infant mortality within the first year.
It's important to realize that there are at least 400 nutrients in breast milk that are NOT found in formula. Of course, the healthier a mom's diet is, the healthier her breast milk will be, too. While any amount of breastfeeding is better than none at all, it is clearly to your advantage, and best for your baby's health, to breastfeed exclusively for at least the first 6 months. Then, at the age of 6 or 9 months, you can begin to supplement with solid foods (while still continuing to breastfeed as well).
As you can see from the chart below, breast milk, and animal milk are far superior to commercially available infant formulas. What exactly does your baby stand to gain by being breastfed?
There are benefits to mom, too. The main ones are a reduced risk of chronic diseases like cancer, a faster return to your pre-pregnancy weight, and increased bonding between you and your baby.
There are circumstances and medical conditions that can prevent a woman from breastfeeding, however the majority of women are able to breastfeed successfully. If you need help, contact a lactation consultant in your area for tips and support. You can also visit La Leche League, which is a phenomenal resource for breastfeeding moms. If for some reason you're not able to breastfeed, or you have adopted a baby, your next best option is to make a healthy infant formula using raw milk. You can find homemade formula recipes here.
(Time.com) -- "Don't get sick in July."
This is a common refrain in teaching hospitals. It's driven by the academic calendar: July is when the new interns — fresh out of medical school — start work. It's also when the senior trainees, the residents and fellows, graduate to supervisory, self-managed patient care roles.
In other words, it's when everyone is most inexperienced. The worry is that this inexperience leads to mistakes.
But what is less clear is how a doctor's experience influences the quality of their care. On its face, it makes sense that the longer a doctor practices, the more expertise she gains — which means better care for you.
But, in reality, it's not that simple.
Say, for instance, your doctor tells you: "In my experience, this antibiotic works great for sinus infections." Fair enough. It may also be completely true from your doctor's perspective: When she has prescribed antibiotics in the past for sinus infections, patients got better. But statements like this make us cringe, for two reasons.
First, as it turns out, antibiotics don't actually work for most sinus infections. In a large study published in the Journal of the American Medical Association earlier this year, people with sinusitis were randomly assigned to take antibiotics or a placebo. People treated with antibiotics did no better than those who got the sugar pill. The reason that bacteria-killing antibiotics don't help when you have sinusitis is because the infection is almost always caused by a virus.
The second — and perhaps more cringe-worthy — part is the summoning of the phrase "in my experience" as the major reason to prescribe the drug.
In the case of sinus infections and antibiotics, doctors' experiences (and those of patients) support the wrong decision. Here's why: The natural course of most sinus infections is to resolve on their own over time. People tend to go to the doctor — and get their antibiotics — when they are at their sickest. So they and their doctors falsely attribute their improvement to the antibiotic pills. Here, experience gets in the way of the right medical decision, which is to avoid antibiotics in the first place.
Time.com: What the affordable care act means if you are...
So let's get back to the July effect and the inexperienced, error-prone interns.
On one hand, some studies suggest that the July effect is a myth: A recent study examining 10 years of data on patients undergoing neurosurgery showed that July was no more dangerous than other months. On the other hand, reports have found that July patients do indeed fare worse: In a study of patients undergoing surgery for spine-related cancer, July patients were more than twice as likely to have a surgical complication and 81% more likely to die, compared with August or June patients.
A recent systematic review of all the research done on the topic concluded that many of the studies showing no July effect had small sample sizes and were not rigorously done, but the bigger and better investigations leaned toward finding that July is truly a more dangerous month in teaching hospitals.
So is medical experience good or bad?
Well, in most cases, your doctor's experience is very helpful, allowing her to pick up on a very subtle symptom early in a disease process, for instance, or to determine the right treatment when your condition falls outside of what is taught in textbooks.
And for many medical treatments — especially the highly technical ones — there's a direct correlation between physician experience (the number of procedures she's performed) and your outcome (whether the procedure works).
In a variety of situations, though, experience can backfire, and the reason is simple psychology. Doctors are human too, and they fall prey to tricks of the mind — like thinking that an ineffective treatment really works (ahem, antibiotics for sinus infections).
In fact, entire fields of research are devoted to understanding why these errors of thought occur. They spring from so-called cognitive biases and false heuristics: mental shortcuts that can mislead even highly educated, well-seasoned practitioners into making the wrong decisions.
Time.com: Simple design: What health care can learn from the TV remote control
Here are four key cognitive biases that trick even the smartest physicians:
Anchoring bias, which causes doctors to lock onto a diagnosis early and disregard new and conflicting information. For example, a patient may be diagnosed with a quickly fatal cancer, but then ends up trying various (ineffective) herbal remedies and lives for 30 more years. Instead of considering whether the initial diagnosis was incorrect, the patient — and maybe even the doctor — may falsely assume that the herbal remedies cured the cancer.
Availability bias, when clinicians tend to think that the patient they are treating today has the same condition as the patient they treated last week. Imagine your doctor saw a rare, life-threatening illness last week that presented with a common symptom, such as belly pain. Today, you're in the doctor's office for belly pain, and your doctor may be unjustifiably concerned that you too have that rare life-threatening disease just because she's still thinking about it.
Confirmation bias, which causes doctors to believe evidence when it supports their pre-conceived opinion, while ignoring evidence that contradicts it. For example, let's say your doctor is pretty certain that you have an infection and orders a test to confirm the suspicion. The test is negative for infection, but she treats you for it anyway because she doesn't believe the test results; meanwhile, she disregards clues that point to another, correct diagnosis.
Commission bias, when doctors err on the side of doing something — like ordering a prostate biopsy — as opposed to watchful waiting because it seems that doing something is better than a doing nothing.
As you can imagine, the effects of these biases can be significant, particularly if it leads to the wrong treatment or a wrong diagnosis. In the case of antibiotics for sinusitis, for instance, the negative impacts of overtreatment include the promotion of drug-resistant superbugs, higher medical spending and rare but sometimes serious allergic reactions to antibiotics.
So when does experience help and when does it get the way?
That's a tough question because there are clearly many benefits to having a highly experienced doctor, such as technically proficiency and knowing the pitfalls of various treatments. Conversely, there may actually be some intangible benefits to having a less experienced doctor: She may have a more up-to-date education, boundless energy and perhaps less susceptibility to cognitive biases developed by years of thinking and practicing the same way.
Time.com: Should your doctor be napping on the job?
The key here lies in the evidence. The data show that certain procedures have a clear volume-outcome relationship — that is, the more experience a doctor or hospital has, the better their outcomes.
These procedures include: open-heart surgery, hernia repairs, obstetrics and trauma care. Note that many of the areas where the volume-outcome relationship exists involve technical expertise. As Malcolm Gladwell so popularly noted in his book "Outliers," Andre Agassi got good at tennis through 10,000 hours of practice. The same principle holds with doctors who perform medical procedures.
The flip side involves certain medical situations in which medical evidence trumps experience, such as using routine mammograms to screen for breast cancer in women under 50, prescribing anti-arrhythmia medications for heart rhythm disturbances after heart attack, or adhering to super-tight glucose control in diabetics.
In all these cases, as new evidence emerged refuting the benefits of what had once been considered standard care, both doctors and patients were shocked into re-thinking treatment decisions. Here, what seemed to make sense from years of experience turned out to be wrong.
So what can you do as a patient to receive the best care? Well, maybe nothing if you get admitted on an emergent basis to a teaching hospital during July. But one thing you should always do is ask a lot of questions. It may not always be possible to determine that your doctor has fallen victim to an unconscious thinking trap or that she's practicing outdated medicine. But asking questions does force your doctor to think and justify decisions about your care.
Secondly, become an informed patient: Try to learn as much as you can about your medical issues and what trusted sources recommend as the "right" approach. Even 15 years ago, it was rare for a patient to crack open a medical textbook to question a treatment decision. Now, online resources such as MedlinePlus, provide both up-to-date and easy-to-understand explanations of complex medical care. A good summary of evidence-based medicine can also be found at the Agency for Healthcare Research and Quality's website.
Time.com: Googling symptoms helps patients and doctors
To be clear, an experienced doctor may provide the best care in the world for you or your loved one. But for some decisions, you'd be better off if she didn't use that experience as the only reason to choose a medicine or test. Experience may make the mechanics of a medical procedure smoother and more efficient, but it can also make medical decision-making messy, and sometimes plain wrong.
Meisel is an assistant professor of emergency medicine at the Perelman School of Medicine and medical editor of the LDI Health Economist, both at the University of Pennsylvania. Follow him on Twitter at @zacharymeisel.
Pines is the director of the Center for Health Care Quality and an associate professor of emergency medicine at George Washington University. Follow him on Twitter at @DrJessePines.
This article originally appeared on Time.com:
The 'July effect' revisited: Why experienced doctors may not deliver the best medical care
Back Pain Facts & Statistic
sAlthough chiropractors care for more than just back pain, many patients visit chiropractors looking for relief from this pervasive condition. In fact, 31 million Americans experience low-back pain at any given time.1
A few interesting facts about back pain:
The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.
Manipulation as a Treatment for Back Problems
Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today's growing emphasis on treatment and cost effectiveness, manipulation is receiving more widespread attention.
Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5
In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research—a federal government research organization—recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6
The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how chiropractic manipulation may help you, contact a Doctor of Chiropractic in your area. Search our online database of ACA members to find a doctor of chiropractic near you.
Tips to Prevent Back Pain
1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.
2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
3. This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville,
4. In Vallfors B, previously cited.
5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.
6. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
Back in Line BLOG
Drs. Nate, CJ, and Hannah will take turns sharing information they stumble across from certain research, publications, or may just post a quick healthy tidbit to keep you motivated to leading a happier, healthier lifestyle!