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Why Back Surgery Fails So Often

Researchers from Duke University show that back pain is usually caused by a person's immunity attacking the disc in the same way that it attacks invading germs, not by a broken disc pressing on a nerve (Arthritis & Rheumatism, July 2010). They found that people with back pain associated with damaged discs have high levels of Interleukin-17, produced by your immune lymphocytes and known to cause asthma, rheumatoid arthritis and other autoimmune diseases.

The natural history of back pain from "disc disease" usually starts after you hurt your back. You often appear to recover after several weeks or months of pain. However, the back pain can recur any time later, even many years after your original back problem.

The bones of your spine are separated by pads called discs . When you hurt your back, you can crack the outer layers of a disc, so the softer inner layers protrude through the cracks into the spinal canal. The softer inner layers of a disc normally are not exposed to the immune system. So the human immune system does not recognize it as self and attacks it in the same way that it attacks invading bacteria and viruses. The protruding inner portions of the disc then swell to press against nearby nerves to cause pain. This research implies that the immune reaction that attacks the protruding broken inner portion of the disc causes the disc to swell and press on nerves. The authors feel that the pain is not caused primarily by broken pieces of a disc pressing on nerves so it is incorrect to use the common term "slipped disc".

If this is true, future treatment for disc disease would be to inhibit the lymphocytes that make interleukin-17. This would allow the treatment to reduce pain without blocking the body's ability to prevent infections and tumors. Either way, surgery for "disc disease of the back" has among the highest failure rates of any surgery today.

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Dear Dr. Mirkin: Should people who do not have diabetes restrict foods that cause a high rise in blood sugar levels?

Yes! There is a significant increase in heart attacks in non-diabetic Caucasians and African Americans who ingest foods that cause a high rise in blood sugar (Annals of Epidemiology, July 7, 2010). Furthermore, one in three North Americans become diabetic, regardless of their country of origin. That means that you do not need to be diagnosed as diabetic to have high rises in blood sugar after eating refined carbohydrates.

When blood sugar levels rise too high, sugar sticks to the outer membranes of cells. Once there, sugar can not get off and is eventually converted to sorbitol that destroys the cell to cause all the know side effects of diabetes: heart attacks, strokes, blindness, deafness and so forth. Many experts feel that more than 70 percent of North Americans weigh more than they should because they eat or drink too much refined carbohydrates: sugar water (sugared soft drinks, fruit juices, any liquid sugar) and foods made from flour (bakery products and pastas).

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Why sitting shortens lives and causes heart attacks:

Researchers at the University of South Carolina found that men who spent more than 23 hours a week watching TV and sitting in their cars had a 64 percent greater chance of dying from heart attacks than those who sat for fewer than 12 hours a week (Medicine and Science in Sports and Exercise, May 2010).

Many of the men who suffered heart attacks also exercised regularly. Their exercise programs did not protect them from the heart attack-causing effects of sitting in cars or while they watched television. This month, a review of the world's literature shows that exercise may not protect you from the life- shortening effects of prolonged sitting (Exercise and Sports Sciences Reviews, July 2010), and many studies show that animals (rats and mice) that do not have exercise wheels in their cages develop insulin resistance, have higher blood fat levels, are fatter, and die earlier than those who have the exercise wheels.

Now we have to explain:

1) Why sitting causes premature death and heart attacks:
• Resting muscles require insulin and respond poorly to insulin in drawing sugar from the bloodstream.
• North Americans eat a lot of refined carbohydrates that cause a high rise in blood sugar.
• A high rise in blood sugar causes sugar to stick to cell membranes, which kills these cells to cause heart attacks, strokes, premature death and nerve damage.

2) How exercise prevents premature death and heart attacks:
• Contracting muscles prevent a high rise in blood sugar by pulling sugar from the bloodstream without needing insulin.

3) Why exercise does not protect many people who spend a lot of time sitting in one place:
• Contracting muscles draw sugar maximally from the bloodstream during exercise and for up to an hour after you finish and tapers until you lose all of its benefit at about 17 hours (Am J Clin Nutr. 2008 July; 88(1): 51-57; Am J Physiol Regul Integr Comp Physiol 1983;245(5):R684-R688; Journal of Applied Physiology, February 2010).
• While you sit, your resting muscles do not draw sugar effectively from the bloodstream and 17 hours after you finish exercising, you have lost this benefit of exercise.

4) Why intense exercise is more effective than more casual exercise in:
• Preventing and treating diabetes (Circulation, July 2008).
• Preventing heart attacks in obese people without weight loss (MSSE, Oct, 2006).
• Preventing heart attacks than exercising more frequently (MSSE, July, 1997).
• Reducing belly fat (MSSE, November 2008) (storing fat in your belly is a sign of inability to respond to insulin).
• Preventing premature death (Heart, May 2003).
• Preventing metabolic syndrome and heart attacks (Exercise and Sports Sciences Reviews, July 2009).
• Raising HDL (good) cholesterol (Journal of Strength and Conditioning Research, March 2009).

Further data to show that intense exercise is superior to casual exercise:
• The faster aged runners run, the lower their blood pressure, cholesterol, and blood sugar levels (MSSE, October 2008, Arch Int Med, 1999;159(8):882).
• High intensity interval training maximally improves every conceivable measure of heart function and heart strength. (Exercise and Sports Sciences Reviews, July 2009).

Caution: Intense exercise can cause heart attacks in people who already have blocked arteries.

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Recipe of the Week: Wild Rice Fruit Salad
Basic Wild Rice

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 21st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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