Thursday, January 3, 2019

How to have a safe Halloween

Alcohol is embedded in our society, and it is difficult to be in a public space without seeing a reference to alcohol or being offered a drink. Alcohol is broken down in the liver by an enzyme called alcohol dehydrogenase. People with a variant in this enzyme have issues with metabolizing alcohol and can develop total body flushing or reddening of the skin.

Alcohol consumption has been associated with pregnancy defects, liver disease, pancreatitis, high blood pressure, coronary artery disease, stroke, cancer, addiction issues, and physical injury (trauma to self/others with acute intoxication). The health benefits of alcohol may be up for debate. However, moderate alcohol consumption may have some beneficial effects, which was appreciated in 1992 based on the observation that populations in France had high dietary intake of saturated fats, but a relatively low incidence of cardiovascular disease. This phenomenon was labeled as the “French paradox,” and has been thought to be due in part to the consumption of red wine.
Quit your wine-ing?

Alcohol has long been associated with the development of headache, with about one-third of patients with migraine noting alcohol as a trigger. Based on this association, population studies show that patients with migraine tend to drink alcohol less often than people without migraine. Wine in particular is an alcoholic beverage that has been linked to headaches dating back to antiquity, when Celsius (25 B.C.–50 A.D.) described head pain after drinking wine. Despite this commonly held belief, there is very little scientific evidence to support the belief that wine is a more common trigger of headaches than other forms of alcohol.

The studies that have been conducted suggest that red wine, but not white and sparkling wines, trigger headache independent of how much a person drinks in less than 30% of people. Lower quality wines may cause headaches due to the presence of molecules known as phenolic flavonoid radicals, which may interfere with serotonin, a signaling molecule in the brain involved in migraines. In one study, the odds of a person citing red wine as a trigger of headache were over three times greater than the odds of indicating beer as a headache trigger. In some studies, it was observed that spirits and sparkling wines were associated with migraines significantly more frequently than other alcoholic beverages.
Here is the advice of one wine expert

I turned to Barb Gustafson, a sommelier (certified wine professional) for some insight on the qualities of wine that might be associated with headache.

(Barb works at Paul Mathew Vineyards — and yes, there is actually a winemaker in California that bears a name spelled identically to my own, but there is no relation.)  “Legumes” sounds like such a fancy word.  Let’s clarify that we’re talking about beans, folks. Beans, lentils, peas, chickpeas, it’s all good… and good for you.  Legumes are amazingly nutritious, high in protein and fiber, low in fat, and low in glycemic load.
Legumes for heart health

Scientific studies have definitively linked a diet high in legumes with a lower risk of developing obesity, diabetes, high blood pressure, high cholesterol, heart disease, or strokes. As a matter of fact, eating legumes every day can effectively treat these diseases in people who already have them. In one randomized controlled clinical study of over 100 people with type 2 diabetes, consuming at least one cup of legumes (beans, chickpeas, or lentils) every day for three months was associated with significant decreases in body weight (2.7 kilograms, about 6 pounds); waist circumference (a 1.4 centimeter decrease); blood sugar (a 0.5% decrease in HbA1c); cholesterol (an 8-point decrease in LDL, measured in mg/dl); and blood pressure (a 4.5-point decrease in systolic and a 3.1-point decrease in diastolic blood pressures, measured in mm Hg). All of these improvements are impressive! We’re talking about beans, not medicines with all those side effects, right? Right: you can check out the entire study here.

Similar findings have been reported from other studies. An analysis of eight randomized controlled clinical trials including data from over 550 participants with a wide variety of medical problems found that participants who consumed about a cup of legumes every day for 10 weeks had a significant decrease in systolic blood pressure (average 2.25 points). In another study, researchers combined data from ten randomized controlled trials representing over 250 participants who had been prescribed legumes every day for at least three weeks. The legumes varied: pinto beans, chickpeas, baked beans, lentils, and peas in amounts ranging from 1/2 cup to 2 cups. None of the participants was taking cholesterol-lowering medication, and yet the legume diets resulted in an average 8-point decrease in LDL cholesterol (that’s the low-density lipoprotein, the “bad” cholesterol). This is better than many people can achieve with pills! You can check out this study here.
How can beans have all of these benefits?

Legumes are high in fiber, specifically viscous soluble fiber, which not only slows their absorption in the small intestine, but also binds up certain molecules having to do with cholesterol. This makes legumes very low in glycemic index and load, meaning they result in lower blood sugars and less insulin released after eating them. This fiber also lowers cholesterol levels.

But wait — there’s more: not only are legumes high in fiber, they are also high in protein, making them very filling and satisfying, so people tend to eat less of other things. And they contain plenty of potassium, magnesium, folate, and other plant nutrients that are associated with lower blood pressure and improved cardiovascular health.

Despite all of this good evidence, people in the United States tend not to eat a lot of legumes. Given how healthy and economical beans, lentils, chickpeas, and peas are, we aim to help with some suggestions: A highly effective psychotherapy called cognitive behavioral therapy (CBT) focuses on how our thoughts, beliefs, and attitudes can affect our feelings and behavior. Traditional CBT treatment usually requires weekly 30- to 60-minute sessions over 12 to 20 weeks. A faster option now emerging is intensive CBT (I-CBT), which employs much longer sessions concentrated into a month, week, or weekend — or sometimes a single eight-hour session.

CBT helps people learn tools to reframe different types of thinking, such as black-and-white thinking (I can’t do anything right) and emotional reasoning (I feel you dislike me, so it must be true) and other potentially harmful thought patterns that fuel mental health problems and undermine relationships, work, and daily life. Once learned, the coping strategies taught during CBT or I-CBT sessions can help people deal with a variety of problems throughout life.
Can intensive CBT help people with anxiety, depression, and other issues?

I-CBT has been used to treat many people suffering from mood and anxiety disorders, trauma-related disorders, and other issues. Some programs treat children or teens who have mild autism spectrum disorder (mild ASD), selective mutism, or prenatal alcohol exposure, or who are struggling with school refusal.

There are I-CBT programs that focus in specific areas, such as:

    attention deficit hyperactivity disorder (ADHD)
    anxiety disorders, including agoraphobia, generalized anxiety disorder (GAD), social anxiety, specific phobias, panic attacks and panic disorder, and separation anxiety
    obsessive-compulsive disorder (OCD)
    post-traumatic stress disorder (PTSD), sexual trauma, and traumatic brain injury (TBI).

Is intensive CBT effective?

Research on effectiveness — or whether or not I-CBT works — is relatively new. Studies suggest it is effective for treating OCD. Children and adults who have this condition make similar, long-lasting gains with traditional or intensive CBT. It’s also effective for treating panic disorder in teens, anxiety symptoms in children with mild autism spectrum disorder, and severe mood disorders.

Additionally, fewer people drop out of treatment with I-CBT compared with traditional CBT.
Who might benefit from the short time span?

People with full-time jobs who find it difficult to take time off during the work week for weekly appointments might be able to commit to a weekend of intensive treatment. Teenagers busy with academics and activities during the school year may benefit from intensive sessions for a week during the summer. Families juggling multiple schedules can benefit from I-CBT because it allows them to focus on treatment without feeling their time is split among several other commitments. And people who live in areas without easy access to mental health services or specialists may be able to travel for a weekend for intensive treatment.

I-CBT may also help people who have tried traditional CBT, but have not found it feasible or successful. Alternatively, I-CBT sessions may introduce people to this form of psychotherapy, and its benefits, thus serving as a catalyst for traditional CBT treatment.
What are the drawbacks?

Most importantly, the effectiveness of I-CBT is still being evaluated. Intensive treatment requires specialized therapists who are trained to deliver I-CBT. It may not be possible to find a well-qualified program or therapist nearby, which would add to the cost and time commitment of treatment. Most insurance companies do not cover intensive treatments such as I-CBT, so it can be expensive.

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