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Bilateral Coordination: The Gateway to Successful Movement | Part 1

“You want me to do what?” says Susan when she hears the drill that I want her to complete during our exercise class. 

“You’ve gotta be kidding me! Where do you come up with these drills? You DO remember I have Parkinson’s Disease?” To which I smile and reply, “Yes, and you can do this, I promise!!” 

Susan rolls her eyes and jokingly replies, “Right, I guess we’ll just have to see about that, Colleen!”

“You can do this Susan,” I reply, “but it is going to require work, and I’ll be right here to help you.”

You may be thinking to yourself, what kind of drill is Colleen asking her client to perform? Could it be a 150lb deadlift? Maybe it’s a 5ft plyo-jump on one leg or possibly a 3 minute plank? Not even close! While the deadlift, jump and plank are all fantastic exercises, I’m asking Susan to do a lunge series with lateral arm lift series which incorporates Bilateral Coordination.

Bearfoot OT and Noémie von Kaenel, OTS share that bilateral coordination is the integration and sequencing of movement by using “two parts of the body together for motor activities”.

“To coordinate two-sided or bilateral movements, the brain needs to communicate between both its hemispheres through the corpus callosum which we will discuss later on. But it is important to note that this area of the brain develops at 20 weeks but connections between the two hemispheres strengthen and develop as a child develops . Bilateral coordination is also closely linked to the vestibular system (where your head is in space), posture, and balanced movements.”

For example: We all grew up challenging our friends to pat their head and rub their tummy at the same time. Then switch hand placement and repeat. Take a second and give it a try! Did you find one hand placement easier than the other? Now, imagine that you have Parkinson’s Disease (PD) and you’ve been given this challenge. You would probably tell me that it was tough on both sides. Why is that? 

Let’s take a few moments and discuss Parkinson’s Disease so you understand the challenge of Bilateral Coordination.

By definition, Parkinson’s Disease is a neurodegenerative disorder that affects predominantly dopamine-producing neurons in the Substantia Nigra (SN) (Latin for “Black Substance”, due to its darkened pigment in the brain). The substantia nigra contains the highest concentration of dopamine neurons. It is a part of the Basal Ganglia, an area responsible for motor control, motor learning, and procedural memory, such as learning how to tie your shoes. 

Substantia Nigra in Normal Brain vs. Parkinson’

Without the Substantia Nigra, the brain and body simply do not communicate as well, or at all depending on the stage of PD. To us, fitness professionals, we observe those living with Parkinson’s Disease displaying uncoordinated movements, loss of balance, poor gait, postural issues, visual tracking problems, rigidity, tremor, freezing, facial masking, inability to focus on a task or process information clearly, bradykinesia, hypophonia (volume of voice)… and as it pertains to Bilateral Coordination, the challenge to perform a drill with one side of the body such as the left arm while moving the right leg.  Now your wheels are turning and you are probably asking yourself…

Why Is Bilateral Coordination Important?  

Bilateral Coordination requires your small and large motor and visual-motor functioning to work together making it possible to accomplish ALL of your daily tasks! For example, in order to write your grocery list on a piece of paper, you need to hold the paper with one hand while writing the note at the same time. 

Proprioception or body awareness is another great reason to work on Bilateral Coordination. Throughout our entire life, we have the ability to know where our body is in time and space. For the person living with Parkinson’s Disease, this means a lower risk of falling, and believe me, that is crucial!

What Is The Scientific Explanation Of Bilateral Coordination?   

We learned in a previous article, “How a Thought Becomes an Action”, that motion in the brain is complicated and there are numerous steps to ensure that the motion in the brain is coordinated and precise. This all starts in the motor cortex, goes through the spine into motor neurons and muscles, and goes back into the brain to be fine-tuned by the basal ganglia (keep in mind this is where the substantia nigra resides). But now we’re adding onto this process by adding on even more coordinated movement in:

  • The premotor cortex
  • Supplementary motor area
  • The cerebellum
  • And the corpus callosum

Each one of these areas works in tandem with the movement pathways we discussed previously to produce bilateral movement and is the reason that I can type and you can read this paper right now. Let’s go over what each of these areas does, starting with the premotor cortex (Figure 1, below).

Fig. 1 The neural pathway from stimulus sensation to movement response.

  • The premotor cortex is more involved in the planning of movement rather than the execution is important for bilateral coordination in movements even as simple as walking. 
    • When walking, the premotor cortex would be important for planning the gait length required to keep our balance, the speed, and overall how the movement is going to go so we don’t crumple or trip over our own feet (to some extent anyway…)
  • The supplementary motor area (SMA) is also involved in planning movement, but in a different way. 
    • The SMA is planning for movements both ipsilaterally (scientific jargon for same-side), and contralaterally (scientific jargon for different-side).
      • While the premotor cortex is planning for what muscles have to move to do the actual action, the SMA is controlling which sides are going to go first to maintain balance and what makes the most sense given the environment we would be walking in.
  • The cerebellum is less involved in conscious movement but is extremely involved in coordination and balance, which is needed for performing tasks bilaterally. 
    • When walking, we need our brain to fine-tune the balancing and counterbalancing errors (such as arm swing), which happens in the cerebellum. Think of the cerebellum like an editor. The movement keeps happening, and each time it keeps getting better and easier because of the error calculations the cerebellum makes.
  • The corpus callosum, which works in tandem with the rest of the cortex to send signals to the different halves of the brain. 
    • What happens on one side doesn’t always translate to the other side, which is where the corpus callosum comes in. Each side has its own control mechanisms for the opposite side of the body (talk about contralateral). The corpus callosum is the phone line that connects these two hemispheres so they can talk to each other and get the messages for both sides of the body into a beautifully coordinated orchestra of neuronal firing and muscle movements.

So given these four areas of the brain, along with the rest of the movement pathway, there are numerous elements here contributing to sensory integration, planning of movement, checkpoints for these movement executions, and a miscommunication playing out on both sides of the brain. This means that there are a lot of alternate pathways in case anything goes wrong. However, pathways can deteriorate over time, and problems can arise. Which brings us to PD, and the issues that may happen in bilateral coordination as the disease progresses.

How Does Bilateral Coordination falter in the PD brain?

There’s a lot of different attributes to movements like walking –  a complicated movement with a number of variables:

  • First, you have to start walking.
    • Because it requires a lot of input all at once, it’s hard for the brain to do subconsciously, especially for someone who has PD. similar to revving a car for the first time after stopping at a red light.
  • Then you have sensory cues.
    • These can be challenges like incline or decline, which determines how much effort you need to stay upright, stay up to speed, and how much force you need to put into your step to keep up with gravity (like a driver constantly paying attention to the road).
  • Once you start walking, your brain can put less effort into what researchers call “steady-state walking”, where your legs follow the same instructions repeatedly, similar to coasting on a highway (2).
  • Next, we get to turning, where walking requires more input such as:
    • Balancing on one leg while pivoting the other
    • Slowing down, and speeding back up again (all while navigating those sensory cues, mind you), which is where a lot of the times this bilateral coordination seems to freeze up in PD, hence the clinical symptom called freezing of gait (FOG).
    • Thinking again of the car analogy, this is akin to having to slow down and turn the wheel the proper amount so you don’t hit the curb but you make it to the proper lane, speeding back up again.

With all those steps, anything that goes wrong will hurt the body’s ability to keep steady and coordinate larger and smaller movements on both sides. We also need to take into consideration that we all have a dominant side in normal movement that is easier to control. Evidence suggests the dominant side is worse in PD, perhaps due to brain asymmetry, meaning anything involving that side is most likely going to be slower and more uncoordinated, such as balancing on your dominant side or having to pivot on your dominant foot (1,2). Again, comparing it to a car running, if you have a bad steering wheel, your turns are going to be a little rough and you might end up swerving more or less on target. Or you need new adjustments or wheel bearings that make your balance and steadiness just a little bit better (speaking from personal experience). These parts make a car drive smoothly, as the neural circuits involved in the basal ganglia — along with all the new motor regions I mentioned–interact as one unit to make the walking as coordinated as possible.

This type of movement is also affected by our favorite neurotransmitter: dopamine. As we know, dopamine affects the basal ganglia, which has a conversation with all of the different areas we’ve talked about, such as the supplementary motor area, which is important for coordinating movements. We have seen in past research that taking dopaminergic medication has positively affected Phase Coordination Index (PCI), which measures bilateral coordination by looking at footsteps and foot switching (4). What does this mean exactly? Taking dopaminergic medications creates a more balanced movement, most likely by increasing basal ganglia activity, which thus increases the conversation between this and other movement areas needed for bilateral movement.

We also know that exercise is great for PD! Not only has this been seen in PD-specific fitness classes, but in research as well! Taking medications that increase dopamine uptake can mitigate some of these falters in movement and can create a more efficient signaling cascade, but it can only do so much. The other part of strengthening these pathways comes from exercise that can lead to better balance, smoother motion, and greater bilateral coordination! We’ve seen in some research studies on physical therapy techniques that auditory and visual cues, premeditated/thoughtful movements, and most importantly repeated balance drills can decrease FOG episodes, which could be attributed to a lack of bilateral coordination (3).

And what incorporates all of those? Exercise classes! In Part 2, we discuss Steps To Incorporating Bilateral Coordination Into Your Exercise Program.

Become a Parkinson’s Disease Fitness Specialist!

Check out Colleen’s online course on MedFit Classroom….


Co-Written by Colleen Bridges, M.Ed, NSCA-CPT and Renee Rouleau.

Colleen Bridges is the author of MedFit Classroom’s Parkinson’s Disease Fitness Specialist course. Renee Rouleau is a PhD student at the Jacobs School of Biomedical Sciences, University at Buffalo.


References

  1. van der Hoorn, A., Bartels, A. L., Leenders, K. L., & de Jong, B. M. (2011). Handedness and dominant side of symptoms in Parkinson’s disease. Parkinsonism & Related Disorders, 17(1), 58-60. https://doi.org/https://doi.org/10.1016/j.parkreldis.2010.10.002
  2. Plotnik, M., & Hausdorff, J. M.. (2008). The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson’s disease. Movement Disorders, 23(S2), S444–S450. https://doi.org/10.1002/mds.21984
  3. Rutz, D. G., & Benninger, D. H.. (2020). Physical Therapy for Freezing of Gait and Gait Impairments in Parkinson Disease: A Systematic Review. PM&R, 12(11), 1140–1156. https://doi.org/10.1002/pmrj.12337
  4. Son, M., Han, S. H., Lyoo, C. H., Lim, J. A., Jeon, J., Hong, K.-B., & Park, H.. (2021). The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson’s disease using inertial sensor. Npj Parkinson’s Disease, 7(1). https://doi.org/10.1038/s41531-021-00186-7
  5. Kramer P., & Hinojosa, J., (2010). Frames of Reference for Pediatric Occupational Therapy: 3rd Edition. Baltimore, Maryland: Lippincott Williams & Wilkins
  6. Magalhães, L.C., Koomar, J.A., Cermal, S.A. (1989, July) Bilateral Motor Coordination in 5- to 9-year old children: a pilot study. The American Journal of Occupational Therapy. Volume 43 Number 7.
  7. Piek, J.P., Dyck, M.J., Nieman, A., Anderson, M., Hay, D., Smith, L.M., McCoy, M., Hallmayer, J., (2003) The relationship between motor coordination, executive functioning and attention in school-aged children. Archives of clinical neuropsychology. Elsevier’s Ltd. doi:10.1016/j.acn.2003.12.007
  8. Roeber, B.J., Gunnar, M.R. and Pollak, S.D. (2014), Early deprivation impairs the development of balance and bilateral coordination. Dev Psychobiol, 56: 1110-1118. https://doi.org/10.1002/dev.21159
  9. Rutkowska, I., Lieberman, L. J., Bednarczuk, G., Molik, B., Kaźmierska-Kowalewska, K., Marszałek, J., & Gómez-Ruano, M.-Á. (2016). Bilateral Coordination of Children who are Blind. Perceptual and Motor Skills, 122(2), 595–609. https://doi.org/10.1177/0031512516636527
  10. Schmidt, M., Egger, F., & Conzelmann, A. (2015). Delayed Positive Effects of an Acute Bout of Coordinative Exercise on Children’s Attention. Perceptual and Motor Skills, 121(2), 431–446. https://doi.org/10.2466/22.06.PMS.121c22x1
  11. Tseng, Y., & Scholz, J. P. (2005). Unilateral vs. bilateral coordination of circle-drawing tasks. Acta Psychologica, 120(2), 172-198.
Success

Foundations of Wellness and Lifestyle Coaching

Having a foundation in coaching skills equips fitness professionals and wellness professionals to help their clients succeed at lifestyle improvement. 

MedFit Classroom’s upcoming course will provide you with a thorough overview that enables you to be much more coach-like in your work with clients.  

In the Foundations of Wellness Coaching course, authored by Dr. Michael Arloski, you’ll…

  • Learn how to help your clients go well beyond just goal setting and make use of behavioral change methodologies that create real progress.  
  • Gain the skills needed to help clients mobilize their motivation to make positive lifestyle changes and accomplish goals they never thought possible.  
  • Become proficient in having The Wellness Coaching Conversation, a conversation that demonstrates understanding while eliciting and empowering the client to choose an active role in their own health. 
  • Through the use of select coaching skills training videos and demonstrations you’ll learn about the use of Active Listening Skills and Powerful Questions to help your clients assess their own wellness and develop a Wellness Plan for growth and change.
  • Gain accountability and support skills that ensure progress towards lasting lifestyle improvement. 
  • Explore the use wellness and health coaching models and how they can be implemented in your setting.  

This course is ideal for the fitness or wellness professional looking to either integrate the skills and methods of coaching into their own professional work, or to serve as an introduction to the path of learning how to become a health and wellness coach.

Dr. Arloski is a pioneering architect of the field of health and wellness coaching.  He and his company, Real Balance Global Wellness, have trained thousands of health and wellness coaches worldwide.  His book, Wellness Coaching for Lasing Lifestyle Change is a foundational book of the field, and his new book Masterful Health and Wellness Coaching: Deepening Your Craft takes the field to a new depth.  

Creatine

Creatine: The athlete’s supplement of choice can boost anyone’s fitness plan and health goals

Long trusted by athletes and bodybuilders to help improve athletic performance, the muscle strength supplement creatine remains either unknown or shrouded in myth among the wider population.  But increasingly creatine is being recognized by the medical community for the benefits it can bring beyond just athletic performance.  From assisting in injury recovery to helping reduce the risk of falls in the elderly, creatine is a natural, safe, and effective tool all of us can use…

senior-couple-walking

Five Ways to Build Immunity

A strong and healthy immune response can mitigate the effects of an infection. Boosting your immune system is the key to fending off illness when you get it or maybe avoiding it together. The best approach to maintain your immune system is to adopt a healthy lifestyle. 

While bolstering your immunity is easier said than done, several dietary and lifestyle changes may strengthen your body’s natural defenses and help you fight harmful pathogens or disease-causing organisms. Some of them are below.

Sleep In

Yes! Lack of sleep can make you sick. Sleep deprivation is linked to a higher susceptibility to sickness. During sleep, the immune system releases cytokines, some of which help promote sleep. Cytokines are also needed to fight against infection, inflammation and ward off stress. Sleep deprivation leads to a reduction in antibodies and cells necessary to fight infection. According to Mayo Clinic, adults should aim to get seven or more hours of sleep each night, while teens need 8–10 hours and younger children and infants up to 14 hours. Keeping a stable sleep schedule, making your bedroom comfortable and free of disruptions, following a relaxing pre-bed routine, and building healthy habits during the day can all contribute to excellent sleep hygiene.

Consume Whole Foods

A healthy diet gives your body the essential nutrients to fight off germs. Whole plant foods like fruits, vegetables, nuts, seeds, and legumes are rich in micro-nutrients and antioxidants. There is a wealth of evidence that suggests that what we eat matters. The antioxidants in plants can help decrease inflammation by battling free radicals. The fiber consumed from plant foods increases your gut microbiome. A robust gut microbiome is essential for a stronger immune system.

Don’t Be Afraid of Healthy Fats

It is vital to consume healthy fats to receive positive advantages for our immune health. Healthy fats help reduce inflammation and fight infections.  Many plant-based foods are rich in fatty acids, linoleic, and alpha-linolenic acid, with an optimal omega-3/omega-6 ratio. Some examples include; hemp seeds, walnuts, chia seeds, dark leafy greens, spinach, arugula, and romaine. Eating healthy fats will provide the body with the energy and essential fatty acids to optimize immune function. 

Get in Moderate Exercise

It’s true that exercise increases your immunity to certain illnesses. Research shows that frequent exercise reduces systemic inflammatory activity and improves aspects of immune function, leading to alterations in an aging immune system’s classical biomarkers. Examples of exercise include 30-minutes a day of brisk walking, hiking, a dance class, and cycling. So, wherever you are, get moving now.

Reduce Stress

According to the Mayo Clinic, the stress hormone cortisol can subdue your immune system. While it might be impractical to let go of stress completely, managing stress in a healthy way is possible. Creating some white space in your day and meditating can help with stress. Meditation lowers your heart rate and blood pressure and reduces anxiety. Watching a funny show or just laughing with friends and family is a great way to relieve stress. 

Our bodies are regularly exposed to invaders and toxins like mutated cells, bacteria, and viruses. We can make changes in our lifestyle to toughen our immune system. Including exercise, consuming a healthy diet, meditating, and practicing good sleep hygiene can go a long way to protect us from illnesses and strengthen our immune system. It might seem a lot to do right off the bat but making small changes can go a long way. Keep adding these lifestyle changes to your routine until they become a habit. Soon you will have a robust immune system to guard you against diseases.


Aesha is the founder and head coach at Tone and Strengthen. She holds a Master’s in Exercise Science from Concordia University and has earned multiple credentials from the National Academy of Sports Medicine, Athletics and Fitness Association of America, and other NCCA accredited fitness associations. Aesha is a Master Instructor for MadDogg Athletics, Spinning® program and offers FREE workouts and healthy lifestyle tips on the Tone and Strengthen’s IG page

kettlebell-sneakers

The Three R’s: Reset. Reload. Reinforce.

Before you can begin checking the boxes off above a baseline needs to be established. What is the best way to set a baseline that isn’t time-consuming? A Physical Therapist can test physical capacity, but will that give them the total picture? What if you are a health care provider such as a Massage Practitioner or a Chiropractor, or a doctor of an individual who wants to start an exercise program? How do you set-up a baseline of indicators to capture dysfunction at the level of the movement pattern, not just muscles/tissues that are weak or injured?

The quickest and easiest way I know of is a Functional Movement Screening and a Movement Assessment Screening. It is a ranking and grading system to measure asymmetries. If there is a pain in any of the movement patterns the activity is stopped and a referral is made. As a Functional Movement Specialist, I can do the movement screening with a printed report and corrective strategy exercises to reinforce quality movement patterns. This establishes a baseline to work from and retesting is done periodically.

The way this effective approach works: Each box needs to be checked off before you move to the next box.

The meaning of the three Rs is…

Reset

When a patient/client goes into a Physical Therapist for treatment, or Massage Practitioner for manual manipulation of muscles/tissues, or Chiropractor for a muscular skeletal adjustment. After the procedure the next step is usually, rest, ice, maybe some stretches and to review or start an exercise program. Ok, if this is the standard procedure followed, what is missing from this picture?

Reinforce

This next step is where I as a Fitness Trainer am highly effective, first with myself and now others. I took my twisted muscular-skeletal frame from a seat belt injury and started retraining the correct movement patterns by reinforcement. It takes about 7,000 repetitions of a movement pattern before it becomes spontaneous. What do I mean by reinforce? Reinforce means you either go back to what you were doing with the same faulty movement pattern and setting yourself up for needing another reset, instead of going in for a maintenance appointment. Keeping the cycle of dysfunction and asymmetries going that lead to dysfunction, pain and injury.

Reload

A combination of corrective exercises and conditioning work, such as using supersets to establish better hip hinging and then doing deadlifts, and then maybe add some kettlebell swings.

Reload the frame with the right resistance that maintains the right movement pattern exercises. I use a wide variety of tools based on the client’s needs and preferences.

Reset, reinforce and reload can be applied to both rehabilitation and exercise. In rehabilitation, Physical Therapist/Health Care Provider is working with pain and dysfunction. Exercise professionals work with dysfunction by setting up a baseline and reinforce correctives and conditioning to help prepare the individuals to return to a full active life.

I have successfully retrained my body after a seat belt injury that caused asymmetry imbalances, and now successfully use these remedial corrective strategies with my clients. I give my clients enough practice to learn how to move efficiently, and believe in open communication, taking after hour calls and making home visits.

Move well, move often, stay fit, live!


The Kettlebell Lady – Leanne Wylet, BA, ACE -NCCA, specializes in Orthopedic Exercise, Functional Movement, Hard Style/High Intensity Kettlebell Fitness, Silver Sneakers FLEX & Tai Chi Instructor works with the aging population. She has come back from a seat built injury that left her disabled and two major illnesses; her body is now restored. Taking the skills she’s developed, plus academic training, she works with individuals in all walks of life from youth to those in their golden years. Visit her website, kettlebelllady.com

high-fiber-foods

How fiber-rich foods protect against breast cancer

Breast cancer —  two words that strike fear in every woman.  The good news is women can help lessen their risk.  One important defense is to consume a high-fiber diet.

A 2011 meta-analysis of 10 scientific studies found that higher fiber intake is associated with lower risk of breast cancer.1 In 2012, another meta-analysis of 16 studies came to the same conclusion.2 In the Nurses’ Health Study, higher fiber intake during childhood and adolescence was linked to a decrease in the risk of breast cancer in adulthood.3

How fiber impacts breast cancer risk

Given that animal products, refined grains, sugars and oils contain little or no fiber, fiber intake is a marker for greater intake of natural plant foods, many of which are known to have a variety of anti-cancer phytochemicals. Some breast cancer protective substances that have already been discovered include isothiocyanates from cruciferous vegetables4, organosulfur compounds from onions and garlic,5 aromatase inhibitors from mushrooms,6 flavonoids from berries,7,8 lignans from flax, chia and sesame seeds,9 and inositol pentakisphosphate (an angiogenesis inhibitor) from beans.10

Influence of fiber, glucose, insulin on breast cancer

High-fiber foods help to slow emptying of the stomach and absorption of sugars, which decreases the after-meal elevation in glucose. This is meaningful because elevated glucose levels lead to elevated insulin levels, which can send pro-cancer growth signals throughout the body, for example via insulin-like growth factor 1 (IGF-1).11 As such, high dietary glycemic index and glycemic load (characteristic of refined grains and processed foods) are associated with an increase in breast cancer risk.12-14  Accordingly, a study on Korean women found that higher white rice intake was associated with higher breast cancer risk.15

Fiber, estrogen, and breast cancer

Increased exposure to estrogen is known to increase breast cancer risk.16-18 A woman may be exposed to estrogen via her ovaries’ own production, estrogen production by excess fat tissue, or environmental sources such as endocrine-disrupting chemicals (like BPA, a chemical added to many consumer products). Fiber can reduce circulating estrogen levels, thereby reducing breast cancer risk, because it helps to remove excess estrogen from the body via the digestive tract. Fiber binds up estrogen in the digestive tract, accelerates its removal, and prevents it from being reabsorbed into the body.19-21

In addition, soluble fiber (as shown in studies using prunes and flaxseed) seems to alter estrogen metabolism so that a less dangerous form of estrogen is produced, whereas insoluble fiber (wheat bran) did not have the same effect. 22,23  For this reason, beans, oats, chia seeds and flaxseeds may provide some extra protection due to their high soluble fiber content.

Foods rich in fiber

Although most people probably just associate whole grains with fiber, beans contain more fiber than whole grains, and vegetables and fruits (and some seeds) contain comparable amounts – here are a few examples:

  • 1 cup cooked quinoa – 5 grams fiber
  • 1 cup cooked brown rice – 4 grams fiber
  • 1 cup cooked kidney beans – 11 grams fiber
  • 1 cup cooked broccoli – 6 grams fiber
  • 1 cup blueberries – 4 grams fiber
  • 1 tablespoon chia seeds – 6 grams fiber

Overall benefits of fiber: promotes weight loss and digestive health

Fiber, by definition, is resistant to digestion in the human small intestine. This means that during the digestive process, fiber arrives at the large intestine still intact. Fiber takes up space in the stomach but does not provide absorbable calories, and it also slows the emptying of the stomach.24 These properties of fiber make meals more satiating, slow the rise in blood glucose after eating and promote weight loss. In the colon, fiber adds bulk and accelerates movement, factors that are beneficial for colon health. Soluble fiber (primarily from legumes and oats) is effective at removing cholesterol via the digestive tract, resulting in lower blood cholesterol levels. Some types of fiber are fermented by intestinal bacteria. The fermentation products, short-chain fatty acids (SCFA) such as butyrate and propionate, have anti-cancer effects in the colon and also serve as energy sources for colonic cells. These SCFA are also thought to contribute to promoting insulin sensitivity and a healthy weight.25,26

Fermentable fiber also acts as a prebiotic in the colon, promoting the growth of beneficial bacteria. Fiber intake is associated with a multitude of health benefits, including healthy blood pressure levels and reduced risk of diabetes, heart disease and some cancers.24,27

Importance of choosing high-fiber and high-nutrient foods

Yes, fiber itself has some breast cancer-protective properties, like limiting glycemic effects of foods and assisting in estrogen removal, but we get optimal protection when we focus on foods that are both rich in fiber and rich in micronutrients and phytochemicals.

G-BOMBS contain fiber along with numerous anti-cancer phytochemicals, however, green (cruciferous) vegetables, mushrooms, flax and chia seeds in particular contain anti-estrogenic substances in addition to fiber, making them more effective breast cancer fighters than whole grains. Remember, beans are higher in fiber (and resistant starch) and lower in glycemic load than whole grains, making beans a better carbohydrate choice.

A Nutritarian diet is designed to include a full portfolio of the most protective foods to prevent cancer and slow the aging process.  Advances in nutritional science make winning the war against cancer a reality in our lifetime.

Originally printed on DrFuhrman.com. Reprinted with permission.

👉👉Get $10 off $150 or more on Dr. Fuhrman’s website. Use coupon LS10OFF150.


Joel Fuhrman, MD is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 7 New York Times bestselling books, including his most recent book, “Eat to Live”. Visit his website, DrFuhrman.com.

 

References:
  1. Dong JY, He K, Wang P, et al. Dietary fiber intake and risk of breast cancer: a meta-analysis of prospective cohort studies. Am J Clin Nutr 2011.
  2. Aune D, Chan DS, Greenwood DC, et al. Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 2012.
  3. Farvid MS, Eliassen AH, Cho E, et al. Dietary Fiber Intake in Young Adults and Breast Cancer Risk. Pediatrics 2016, 137:1-11.
  4. Liu X, Lv K. Cruciferous vegetables intake is inversely associated with risk of breast cancer: A meta-analysis. Breast 2012.
  5. Powolny A, Singh S. Multitargeted prevention and therapy of cancer by diallyl trisulfide and related Allium vegetable-derived organosulfur compounds. Cancer Lett 2008, 269:305-314.
  6. Chen S, Oh SR, Phung S, et al. Anti-aromatase activity of phytochemicals in white button mushrooms (Agaricus bisporus). Cancer Res 2006, 66:12026-12034.
  7. Stoner GD. Foodstuffs for preventing cancer: the preclinical and clinical development of berries. Cancer Prev Res (Phila) 2009, 2:187-194.
  8. Kristo AS, Klimis-Zacas D, Sikalidis AK. Protective Role of Dietary Berries in Cancer. Antioxidants (Basel) 2016, 5.
  9. Bergman Jungestrom M, Thompson LU, Dabrosin C. Flaxseed and its lignans inhibit estradiol-induced growth, angiogenesis, and secretion of vascular endothelial growth factor in human breast cancer xenografts in vivo. Clin Cancer Res 2007, 13:1061-1067.
  10. Maffucci T, Piccolo E, Cumashi A, et al. Inhibition of the phosphatidylinositol 3-kinase/Akt pathway by inositol pentakisphosphate results in antiangiogenic and antitumor effects. Cancer Res 2005, 65:8339-8349.
  11. Gallagher EJ, LeRoith D. The proliferating role of insulin and insulin-like growth factors in cancer. Trends Endocrinol Metab 2010, 21:610-618.
  12. Dong JY, Qin LQ. Dietary glycemic index, glycemic load, and risk of breast cancer: meta-analysis of prospective cohort studies. Breast Cancer Res Treat 2011, 126:287-294.
  13. Romieu I, Ferrari P, Rinaldi S, et al. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2012, 96:345-355.
  14. Sieri S, Pala V, Brighenti F, et al. High glycemic diet and breast cancer occurrence in the Italian EPIC cohort. Nutrition, metabolism, and cardiovascular diseases : NMCD 2012.
  15. Yun SH, Kim K, Nam SJ, et al. The association of carbohydrate intake, glycemic load, glycemic index, and selected rice foods with breast cancer risk: a case-control study in South Korea. Asia Pac J Clin Nutr 2010, 19:383-392.
  16. Hankinson SE, Eliassen AH. Endogenous estrogen, testosterone and progesterone levels in relation to breast cancer risk. J Steroid Biochem Mol Biol 2007, 106:24-30.
  17. Pike MC, Pearce CL, Wu AH. Prevention of cancers of the breast, endometrium and ovary. Oncogene 2004, 23:6379-6391.
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wine-glasses

Alcohol and Your Health – Cheers! or Not?

Depending with whom you speak, alcohol can be a villain or it can be a hero. We have long known that alcohol can help reduce the stress of everyday life, and even relaxes our most tightly wound friends and associates. Recent data also suggests that fairly regular alcohol ingestion is actually good for your heart.

This is probably one of the reasons that many European countries, where wine is a normal part of everyday life, have significantly lower rates of heart disease despite relatively high-fat diets. The protective effects may come from substances called flavonoids and also antioxidants that are found in alcohol, especially wine. It also can increase HDL levels (the good cholesterol) and lower the risk of blood clots by slightly “thinning” your blood (anti-platelet effect). Red wine also has resveratrol, a compound that has been shown to possibly reduce lung damage in patients with chronic bronchitis and emphysema, by lowering levels of interleukin 8, a chemical that causes lung inflammation. It has also been touted to have life extension (i.e. longevity) and disease-fighting capabilities but more research is needed.

Too bad it’s not that easy, i.e. “drink to your heart’s content.” There is a dark side. Even the American Heart Association cautions people NOT to start drinking if they do not already drink alcohol. For many, alcohol can be deadly. It can be a cellular toxin, with brain cells and liver cells particularly susceptible. Alcoholism is a serious disease, with some predisposed from a genetic standpoint. For them, there is no safe amount. It is also never safe or recommended during pregnancy because of the harm it can cause to the developing baby. Alcohol can be dangerous for those with certain medical conditions such as diabetes and liver ailments and also has been implicated in the development of certain cancers. Also many alcoholic beverages pack a significant amount of calories which contribute to obesity risk and much of the obesity epidemic.

Alcohol also kills when mixed with driving. I believe we will see tighter restrictions regarding the legality of drinking and driving especially in terms of acceptable blood-alcohol content. Recent scientific data suggests that we actually loose coordination as well as other important motor and cognitive skills essential for safe driving, even while we are within the legal limits of blood alcohol levels. The National Highway Traffic Safety Administration, in conjunction with The University of Iowa, is doing research on driving under the influence using a three ton, $81 million DUI simulator. This simulator puts the drunk driver in “real life” road situations using high resolution 3-D images, and monitors reaction times and other motorist behaviors. Hopefully studies like this will help provide safer guidelines for us. I am fairly certain that study will have no trouble finding volunteers. There are even commercially available simulators (drunk driving and texting while driving) for educational purposes.

Being an orthopedic surgeon, who has spent plenty of time in the ER, I can state without hesitation that impaired driving kills, and kills many, dramatically changing lives (even innocent ones), be it alcohol, marijuana, or other drugs. Ditto for cell phone distracted driving. All preventable.

So, what is the right answer for you in terms of alcohol? The key, like so many other things in life, is balance and moderation. Weighing risks with rewards and being responsible, not only to yourself, but to those around you.

Poison or potion? It is up to you. Remember, moderation is the key. Check with your doctor to see if there is a place for alcohol in your path to better health.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.


Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA