Copper and wrinkles

I assume that you, like me, do not wake up looking your best.  So here's interesting news from Korea via Prevention Magazine in cooperation with Bergdorf Goodman. 


That which keeps our skin firm and fresh are two proteins--collagen and elastin--and a substance called hyaluronic acid.  Collagen gives structure to the skin and promotes the foundation in which elastin provides elasticity (e.g. the ability to spring back to smoothness after being smushed all night against the pillow) while hyaluronic acid cushions and moisturizes.  Sun exposure, smoking, dry air, pollution, facial expressions, and sleep positions along with aging hasten the loss of these three substances and the progression of lines to wrinkles to furrows and folds.


Apparently copper oxide can be absorbed by intact skin wherein it facilitates the process of making these structural proteins and stabilizes them within the sub-surface structure.  Korean dermatologists took these copper characteristics and ran with them, theorizing that sleeping on pillowcases made of copper-saturated fibers could reduce wrinkles(1).  61 volunteers were recruited to snooze perchance to lose their bags and sags. They were graded and measured by 'expert graders' as well as with an objective skin wrinkle measuring device called the 3D Image Analysis GFM PRIMOS.


A significant decrease in crow's feet as well as in 3 'roughness parameters' was both observed and measured at 4 and 8 weeks into the study in the copper-pillowcase group but not in the usual bed linen controls.  That translates into shallower wrinkles and better overall appearance! An earlier study (2) noted these same improvements after a mere 2 weeks of nighttime copper exposure.


So here's where BergdorfGoodman.com comes in.  You can order a coppery pillowcase for $60.  I was so-so on the prospect after reading the news in Prevention and somewhat more interested now that I've read the study.  It does seem like the perfect 'milestone' birthday gift, but I'm unsure if I'm ready to buy one myself.  Let me know if you give it a try!
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1) Baek, JH et al.  Reduction of facial wrinkles depth by sleeping on copper oxide containing pillowcases. http://www.ncbi.nlm.nih.gov/pubmed/22938003
2) Borkow, G et al. Improvement of facial skin characteristics using copper oxide containing pillowcases. http://www.ncbi.nlm.nih.gov/pubmed/19467028

Small thigh circumference and cardiac risk

Here's a new take on body build and health! We are all familiar with the apple/pear thing in that those who carry their weight around the waist in an apple-ish silhouette are at greater risk of heart disease than those whose excess pounds hang on their hips. These Danish researchers took the measurements one level lower(1); here's what they found:

Professor Berit Heitmann and company from Copenhagen's Research Unit for Dietary Studies took tape measure to thigh on over 2800 legs still attached to as many Danes, then followed the group for 12+ years checking out incidence of heart disease and death. Pipe cleaner thighs that fell short of 60 cm. (23.6 in.) in circumference were an independent risk marker for both unfortunate endpoints.

So what's the problem with skinny thighs? Two of our biggest muscles are contained therein, namely the quadriceps and the hamstrings. A loss of muscle mass could be a marker for inactivity or chronic disease such as COPD that prevents exercise. In fact, a Canadian study found that loss of mid-thigh muscle mass as measured by CT scanning was a better predictor of mortality in chronic pulmonary patients than a low body mass (both indicative of the wasting associated with lung disease).(2) Less muscle mass is also known to predispose to insulin resistance and type 2 diabetes as demonstrated by the elevated fasting blood sugars and cases of diabetes that we unexpectedly see in scrawny old ladies.

So should we be measuring thighs along with waistlines, blood pressures, and pulse rates (and also asking about physical activity, sleep habits, diet histories and domestic violence in the leftover minutes of annual physicals)? Says Australian epidemiologist Dr. Ian Scott in an editorial accompanying the Danish study: "Will this association help clinicians predict risk in individual patients more accurately than they already do using readily accessible and validated risk calculators? The answer is — we do not know."

I, for one, shall pass for now.
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(1) Heitmann, BL et al. Thigh circumference and risk of heart disease and premature death: prospective cohort study. BMJ. 2009 Sep 3;339:b3292. doi: 10.1136/bmj.b3292.
(2) Marquis, K et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002 Sep 15;166(6):809-13.

Pedometer-based walking intervention

I love these names--if I recommend pedometers, and I do, then I am conducting pedometer-based walking interventions. Visions of two wild-eyed pedometer experts swooping unannounced into your workplace, grabbing you one arm apiece, and carrying you out to the parking lot where they install a pedometer on your waistband and drag you screaming, half-walking/half-kicking around the parking lot until you hit 10,000 steps.

Anyway, scientists from the Dept. of Family Medicine conducted a meta-analysis of PBWI's which means that they not only searched six electronic databases for weight loss outcomes in nine different studies that compared the pedometered with the pedometerless to see who lost the most weight, but they also contacted real-life pedometer experts just in from field interventions to interpret the results. Their conclusion?

Pedometer-based walking programs result in a modest amount of weight loss. Longer programs lead to more weight loss than shorter programs.

I trust the experts were pleased.

Ergonomic snow shovels

Wendy did a recent blogo-riff on snow shovels. Must be a Canadian thing as Jean had a thing or two to say on the subject last winter. More than likely it's a consideration for those of us middle-aged and beyond, and it just popped on my radar screen and lumbar spine this past week here in Denver.

Ergonomics is the study of people at work, and the science of fitting equipment and work place to worker to optimize performance and minimize injury. "Your online guide to ergonomic snow shovel" says it all:

The gardens, or lawns are covered with snows and the road is also covered with snow that piles up to any feet. The snowfall creates a lot of inconvenience and we wish that the days of snowfall are numbered...The act of removing snow is also back breaking work and many people go to the doctor to rid themselves of the ailment they have got on them during snow shoveling. The snow shovel is an important tool and it becomes very important during the days of snow. ...There is a lot of research going into the making of these snow shovels and the result is different types of snow shovels.

Well, I got a back pain on me when I used our new snow shovel on the first snow this season. My husband, noting that plastic rimmed shovels break easily, bought a metal-edged scoop. Cold metal on wet concrete is an ergonomic no-no. The characteristics of an ergonomically correct snow shovel have been described in exacting terms: plastic blade, 16 1/2" x 14 1/2" with a 42" adjustable shaft for a short person such as I've become, no steel-reinforced edges (note to husband!), and an angular shaft. And ergonomically correct snow shovel reviews are fun to read:

With a shovel like this, the user can thankfully proclaim "Who needs a snowblower?" Of course, snowblowers might make the job of clearing snow easier, but they are expensive, noisy, smelly, and can cause numbness in the hands. The ergonomic shovel will allow the operator to breathe clean air and experience healthy physical exercise. The chances for injury will be reduced as will the snow in the driveways and on the sidewalks of America.

But oh Wendy and Jean, wouldn't you wuv a SnoWovel Wheeled Snow Shovel as pictured above?

Unipedal standing

Less scholarly, perhaps, to just call it standing on one foot. Unipedal or onefooted, these Japanese orthopedists wondered if a daily balancing act might make old people less prone to pitch to earth and break their hips(1).

During their six month study, they divvied a pack of old folks at high risk of falling into two groups. The test subjects stood on one foot, then the other, one minute per side for three sessions each day. The other group just stood their ground in the usual manner.

Dr. Sakamoto previously calculated the load-bearing effects of stork-like posturing on the femoral head(2) or that part of the hip bone connected to the pelvic bone. This area is susceptible to loss of bone density and fracture when an old person goes to ground. He concluded that unipedal standing placed a load equivalent to 2.75 times the body weight on the involved femoral head, and one minute of time spent doing so was the equivalent of 53 minutes of walking with respect to benefits to bone density.

Let's see, one minute per side x 3 sessions per day equals six minutes of balancing acts vs. 318 minutes of walking. Well, how would you rather spend your discretionary time?

Alas, either six months is not long enough to determine the benefits of unipedal standing on old Japanese fogies, or you can't fool Mother Nature. At the end, there was a sort of significant decrease in falls in the test group compared to controls, and only one hip fracture in both groups.

I don't know whether I'm going to do this or not. Maybe if I could wear my Yoga Toes while balancing and thus do all my weird self-trials at once.
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(1)Sakamoto, K et al. Effects of unipedal standing balance exercise on the prevention of falls and hip fracture among clinically defined high-risk elderly individuals: a randomized controlled trial. J Orthop Sci. 2006 Oct;11(5):467-72.
(2)Sakamoto, K. Effects of unipedal standing balance exercise on the prevention of falls and hip fracture. Clin Calcium. 2006 Dec;16(12):2027-32.

Thanks to Jacob Schor, ND and his always excellent newsletter for calling my attention to these articles. You can subscribe at denvernaturopathic.com.

Stiff feet and Yoga Toes

Twenty-six bones in the feet, and all 26 of my Mom's moved as one. Zero flexibility in her old feet, and I'm here to tell you that was no small part of her mobility challenges.

As so many aging children of elderly parents do, I kept close watch on the physical changes my parents endured through the years with an eye towards my future. And I decided as I followed Mom down many a hallway, I do NOT want wood for feet.

No surprise that my arches had already fallen, they did so painfully about 8 years ago. As I researched this stiff foot thing, I discovered the too many toes sign and posterior tibial tendon dysfunction. I went to an orthopedic specialist in feet who assured me that while I had the first, I did not have the second. That's all I got from him for my $45 copay, but a little reassurance is always helpful. For quite a bit more, I bought Good Feet arch supports which resulted in 2 of the most painful months of walking I've ever experienced.

But now, color me green with 'range-of-motion' envy. I had a patient in recently with the most flexible forefeet I've ever seen. She could wave bye-bye with those toes in great sweeping motions so freely mobile her digits. And her secret? "Oh no," says she, "I didn't always have such clever feet. I owe it all to Yoga Toes.


Shoot, I had to get me a pair of those Yoga Toes. The picture on Amazon is inscrutable--they're actually clear plastic toe separators (and no longer available on Amazon!). When I put them on at work, my medical assistant declared them the very thing for painting your nails without smudging them.

Will they restore range of motion to my tired dogs? I'll keep you posted.

Hemorrhoids and spicy foods

Are you a PLWH? Chances are good that you are as about 50% of adult persons are indeed living with hemorrhoids. Does the thought of spicy in (like, say, red hot chili peppers) leading to hot out (now I don't have to explain that, do I?) make your hemorrhoids cringe? Rest easy and indulge; research* indicates your hemorrhoids are not a risk from your spicy excesses.

Italian researchers, about 50% of whom doubtless had hemorrhoids, randomized 50 adults with big-time 'rhoids to receive two blue capsules at two different meals either packed with red hot chili pepper powder or placebo powder with no kick at all. They prepared the real deal capsules with the amount of spice needed to achieve "spicy enough" status (as defined by the Association of Teachers of Italian Cuisine) if the contents had been added to a normal dish rather than the colons of the test subjects.

One week, half the group popped hot and the other half downed not. The following week, the capsule allocation was reversed. On a visual scale of 0 to 10 (can you picture the visuals here?), the subjects were asked to rate the situation down under with respect to bleeding, swelling, itching, and burning before and after.

The results? Spice in is not a problem at the end of the line.
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*Altomare DF, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial. Dis Colon Rectum. 2006 Jul;49(7):1018-23.

Fall prevention

My friend Anita has suggested a mantra for growing older (nofallingnofallingnofalling). Having spent more than a little time trailing after an extraordinarily shaky old lady, I do not believe that this mantra has the proper rhythm to keep an old person upright. I found that singing "The Hokey Pokey" with gentle taps to the appropriate foot had just the rhythm for easy ambulation.

Dr. Frederick Carrick of the Carrick Institute searched for music to stay upright by, registering one clinical trail with the NIH under the title "Fall Prevention in a Geriatric Nursing Home Setting Using the Music of Nolwenn Leroy."* Who then is Nolwenn Leroy?

She is a 25 year old French pop star who's shuffle along music can be found at Nolwenn Sings for the Unsteady. While Dr. Carrick found her tuneskys superior to other musicians including Mozart for modulating the gait of walkers walking with walkers, I don't get it. I'd sooner do the Hokey Pokey myself.
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*"Music to stand bolt upright to."