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Monday, December 2, 2019

Radon Exposure and Cancer Risk: Warranted Caution or Unnecessary Hype?



Concern for a multitude of chemicals, environmental elements and toxic substances has been on the increase in recent years. Clearly, being surrounded by such influential components is not preferable, yet it remains to be proven that they are the primary cause of ill-health in our world. With that being said, there can be benefit to investigating the true effects of assumed toxins to determine whether or not they pose negative implications to health. 
Radon, a naturally-occurring radioactive gas found typically in rocks and soil, is produced when thorium and uranium radioactively decay.1 It is an odorless, colorless, inactive gas that does not chemically bond with other substances.1 With a half-life as long as 3.8 days, it has the potential of remaining in the air for an extended time.2  Radon has been the culprit of multiple claims suggesting its link to cancer, particularly for those exposed to it via occupational means (mining). As mentioned previously, however, it is important to review the evidence behind such hypotheses before engaging in great measures to eliminate exposure. Further, for the purposes of this analysis, focus will be given solely to indoor radon exposure rather than outdoor exposure experienced in situations such as underground mining.
In a nested case-control study, researchers in Finland examined the effect of indoor radon exposure and lung cancer risk, due to the conflicting outcomes observed in other studies.3 Study participants consisted of 517 case-control pairs in the matched analysis, and 1055 case subjects and 1544 control subjects  in the unmatched analysis.3 All participants lived within radon-exposed homes over a period of multiple years.3  Outcomes demonstrated that the odds ratio of lung cancer in the matched and unmatched analyses displayed no statistically significant indications for a heightened risk of lung cancer in relation to indoor radon concentration.3 Subsequently, researchers concluded that radon exposure did not appear to pose a causal threat to the incidence of lung cancer.3
In a French hospital-based case-control study, researchers looked at the connection between radon exposure and cancer risk.4 Four hundred eighty-six cases and 984 controls with radon measures in at least one dwelling were examined.4 Following adjustments for age, sex, region, cigarette smoking and occupational exposure, lung cancer risk was studied in relation to indoor radon exposure.4 Researchers concluded that a minimal increased lung cancer risk existed in relation to indoor radon exposure.4
A meta-analysis of 17 case-controlled studies was performed to determine the relationship between residential radon exposure and risk of lung cancer, based upon the exposure rate of 150 Bq/m3.5 Adjusted odds ratios with 95% confidence intervals (CI) in regard to lung cancer risk and concentration of radon exposure were extracted and quality of studies was examined.5 Authors noted that it was difficult to draw definitive conclusions based upon confounding variables, while also mentioning the caution that was taken to eliminate as many of these as possible to display accurate results.5 Further, authors stated that despite the inability to fully predict or assume direct association between residential radon exposure and lung cancer risk, a dose-response relationship was demonstrated in the review.5 Authors concluded that enough evidence was displayed to suggest the importance of developing strategies to reduce human exposure to radon.5
Researchers  in Germany performed two case-control studies during 1990-1997 and analyzed data from 2,963 lung cancer patients and 4,232 controls.6 Results demonstrated a linear dose-response relationship between the level of radon exposure and lung cancer in all subjects (smokers and never-smokers alike).6 Incidence of lung cancer among smokers with radon exposure showed even higher rates of lung cancer incidence.6 Researchers concluded that the risk for developing cancer as a result of radon exposure was significant.6
A New Jersey study was conducted amongst 433 female lung cancer cases compared to 402 control cases.7 After controlling for smoking and occupational histories, results showed a notable trend of increased risk of lung cancer in those exposed to residential radon.7 Though researchers acknowledged study limitations such as differences in housing construction and ventilation, age and socioeconomic status of participants and diet and lifestyle choices of those included, evidence remained that radon exposure posed a threat for many people in regard to cancer risk.7 Researchers concluded that though the study resulted in a positive correlation, limitations of the study should prompt further research, taking into account such variables before drawing firm conclusions.7
Based upon the preponderance of the evidence presented here, it appears that the risk associated with radon exposure is significant enough to pay attention to. Though future research is warranted in regard to confounding variables and study design, recommendations to limit radon exposure seem wise.
 References


1. Yoon JY, Lee JD, Joo SW, Kang DR. Indoor radon exposure and lung cancer: a review of ecological studies. Annals of Occupational and  Environmental Medicine. 2016;28:15. doi:10.1186/s40557-016-0098-z.
2. International Commission on Radiological Protection (ICRP) Protection against radon-222 at home and at work. A report of a task group of the International Commission on Radiological Protection. Ann ICRP. 1993;23(2):1–45. doi: 10.1016/0146-6453(93)90002-P.
3. Auvinen A, Mäkeläinen I, Hakama M, et al. Indoor radon exposure and risk of lung cancer: a nested case-control study in Finland. Journal of the National Cancer Institute. 1996;17;88(14):966-72.
4. Baysson H, Tirmarche M, Tymen G. Indoor radon and lung cancer in France. Epidemiology. 2004 Nov;15(6):709-16.
5. Pavia M, Bianco A, Pileggi C, Angelillo IF. Meta-analysis of residential exposure to radon gas and lung cancer. Bull World Health Organization. 2003;81(10):732–738.
6. Wichmann HE, Rosario AS, Heid IM, Kreuzer M, Heinrich J, Kreienbrock L. Increased lung cancer risk due to residential radon in a pooled and extended analysis of studies in Germany. Health Physics.  2005;88(1):71-9.
7. Schoenberg JB, Klotz JB, Wilcox HB, et al. Case-control study of residential radon and lung cancer among New Jersey women. Cancer Research. 1990; 50(20):6520-4.

Wednesday, November 27, 2019

Acupuncture for the Treatment of Tinnitus



Acupuncture for the Treatment of Tinnitus
Tinnitus, the perception of noise or ringing in the ears, is a prevalent problem in the United States, affecting approximately 45 million Americans each year.1,2 Though tinnitus is not considered a disease on its own, it is a significant symptom stemming from some kind of underlying condition.3 Root causes of tinnitus range from age-related hearing loss to ear injury or circulatory disorder.1 Further, tinnitus can appear in those with structural lesions or those with conditions such as Meniere’s disease and multiple sclerosis.3 Pulsatile and non-pulsatile tinnitus are two ways to classify the problem, though many subtypes are frequently identified in the literature (somatic, neurological, objective, subjective). Pulsatile tinnitus involves the sensation of a rhythmic sound that resembles a heartbeat, swooshing or whooshing not externally sourced.4,5 This form of tinnitus is often caused by sounds such as personal pulse, vascular problems or changes in the ear canal.5 By comparison, non-pulsatile tinnitus is attributed to problems with the nerves involved with hearing and may be experienced in one or both ears.5 This form of tinnitus is oftentimes described as originating inside the head.5
Determining the cause of tinnitus, regardless of type, is of key importance in the terms of treatment. Clearly, if the underlying problem can be addressed and rectified or improved, the associated symptoms may be alleviated or improved as well. However, finding effective treatments for tinnitus have been challenging to date.3
Acupuncture, originating in ancient China, has been used for thousands of years to treat a variety of conditions. Due to its efficacious outcomes in treating multiple maladies, it seems appropriate to examine its usefulness when applied to those suffering from tinnitus. Research surrounding this topic is abundant, yet simultaneously inconsistent with many studies demonstrating efficacy and some  presenting its lack of usefulness.
In a review of 40 research studies, the efficacy of acupuncture as a treatment for tinnitus was examined.6 Eight different types of acupuncture were analyzed, some of which were tested in conjunction with additional interventions such as supplementary medicine.6  A total of 3657 subjects were included across the 40 studies.6 Researchers concluded that all eight methods of acupuncture were effective in the treatment of neurological tinnitus (tinnitus caused by disease such as Meniere's disease).6 
Similarly, a  2019 study was performed to determine the usefulness of acupuncture as a treatment choice for patients suffering from tinnitus.7 One hundred seven tinnitus patients were examined over the course of 17-24 acupuncture treatments.7 Researchers concluded that patients experienced improvement in their tinnitus condition following the course of treatment.7
A clinical observation study was performed to determine the difference in outcome between acupuncture combined with the intake of an herbal formula compared with the intake of the same herbal formula alone.8 Sixty patients were randomized into two groups - a combined therapy group and an herbal formula only group and treatment was administered according to a specific regimen for a total of six weeks.8 Tinnitus severity score and tinnitus handicap inventory were used to determine clinical effects of the treatments over the course of the study.8 Results showed an efficacy rate of 93.3% in the combined therapy group when compared to the 67.9% efficacy rate in the herbal formula only group.8 Researchers concluded that acupuncture used in conjunction with an herbal formula provided improvement for tinnitus patients.8
 A randomized clinical trial of 50 participants tested the effectiveness of acupuncture on tinnitus when compared to no treatment.9 Subjects were divided into equal groups and were evaluated for five weeks.9 Results showed a statistically significant effect between groups, leading researchers to conclude the efficacy of acupuncture to reduce tinnitus intensity and improve the quality of life of the tinnitus patients.9
In a  systematic review of literature, tinnitus and the effect of acupuncture as a treatment modality was studied.10 Six randomized controlled studies were examined and results showed positive effect in two unblinded studies and no significant effect in four blinded studies.10 Researchers concluded: “The belief that acupuncture is a specifically effective treatment for chronic tinnitus is not based on the evidence of rigorous randomized controlled trials. Further research on this subject seems to be warranted but should be conducted according to the highest methodological standards.”10
            An additional study demonstrated the ineffective nature of acupuncture on tinnitus patients.11 The randomized, single-blind, placebo-controlled study followed 50 patients suffering from the condition and divided participants into a manual acupuncture group, an electrical acupuncture group and a placebo group.11 Researchers studied frequency of tinnitus, tinnitus intensity, and reduction of life quality among patients over the course of the study.11 Patients were evaluated before treatment, following six sessions of treatment and one month following the completion of treatment.11 Results demonstrated no statistically significant effect of either form of acupuncture.11 Despite the lack of statistically significant improvements, researchers noted relative advantages of electrical acupuncture when compared to the other two groups.11


From the preponderance of the evidence, it appears that acupuncture holds a distinct amount of possibility in terms of an effective treatment modality for those suffering from tinnitus. There are several factors to acknowledge in regard to the studies reviewed, including small sample sizes and relatively brief treatment periods. However, it is important to note that though the evidence for the efficacy of acupuncture as a treatment option is perhaps not overwhelming, it does not include extensive risk. Therefore, it likely would be wise to consider acupuncture as a treatment option for those suffering from tinnitus, particularly if other therapies have not yielded results or have created negative side effects.


 References

1.Mayo Clinic. Tinnitus. Available at: https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156. Accessibility verified November 24, 2019.
2.American Tinnitus Association. Understanding the Facts: Demographics. Available at: https://www.ata.org/understanding-facts/demographics. Accessibility verified November 24, 2019.
3.Naderinabi B, Soltanipour S, Nemati S, Saberi A, Parastesh S. Acupuncture for chronic nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018;9(1):38–45. doi:10.22088/cjim.9.1.38
4.Department of Radiology and Biomedical Imaging. Pulsatile Tinnitus Clinic. Available at: https://radiology.ucsf.edu/pulsatile-tinnitus. Accessibility verified November 24, 2019.
5.My Health Alberta. Ringing in the ears (tinnitus). Available at: https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tinit. Accessibility verified November 24, 2019.
6. Pang P, Shi Y, Xu H, et al. Acupuncture methods put to the test for a tinnitus study: A Bayesian analysis. Complementary Therapies in Medicine. 2019; 42:205-213.
7. Lin TY, Yang SW, Lee YS, et al. Analysis of Factors Influencing the Efficiency of Acupuncture in Tinnitus Patients. Evid Based Complement Alternat Med. 2019;2019:1318639. Published 2019 May 26. doi:10.1155/2019/1318639.
8. Chen S, Tan X, Fei L, Xiang X. Clinical observation on idiopathic tinnitus treated with acupuncture, buzhong yiqi tang and cizhu wan. Zhongguo Zhen Jiu. 2018;38(4):369-73. doi: 10.13703/j.0255-2930.2018.04.007.
9. Doi MY, Tano SS, Schultz AR, Borges R, Marchiori LL. Effectiveness of acupuncture therapy as treatment for tinnitus: a randomized controlled trial. Braz J Otorhinolaryngol. 2016;82(4):458-65. doi: 10.1016/j.bjorl.2016.04.002.
10. Park J, White AR, Ernst E. Efficacy of Acupuncture as a Treatment for Tinnitus: A Systematic Review. Arch Otolaryngol Head Neck Surg. 2000;126(4):489–492. doi:https://doi.org/10.1001/archotol.126.4.489.
11.Wang K, Bugge J, Bugge S. A randomised, placebo-controlled trial of manual and electrical acupuncture for the treatment of tinnitus. Complement Ther Med. 2010;18(6):249-55. doi: 10.1016/j.ctim.2010.09.005.

Sunday, November 10, 2019

Protein Needs in Compromised Populations Part II



HIV Patients
In a randomized, double-blind, multicenter trial of 59 HIV positive subjects, researchers studied the effect of high protein whey supplementation when compared to a matched isocaloric control supplement without added protein for patients with a history of weight loss (a typical and potentially dangerous factor for HIV positive patients).7 Following the 12-week study, researchers concluded that there was no observed difference in regard to increased energy intake or changes in weight/lean body mass.7 However, researchers stated that CD4 lymphocytes (white blood cells responsible for fighting bacteria, viruses and germs) did increase in the protein group, a potential benefit according to the authors.7 However, researchers also stated that gastrointestinal symptoms were more commonly reported in the high protein whey  group.7 It is important to note that this study was supported by the whey supplement company, drawing into question the validity of accurate findings.7
A 1999 three-arm randomized controlled trial of 536 HIV patients with CD4 counts below 200 looked at the impact of nutrients on the prevention of weight loss over a four-month period.8 Researchers  studied the implementation of three nutritional regimens to determine their effect on the prevention of weight loss in patients.8 Therapies consisted of a  500 kcal daily of caloric supplement with peptides and medium-chain triglycerides plus a multivitamin and mineral supplement, 500 kcal of a caloric supplement with whole protein and long-chain triglycerides plus a multivitamin and mineral supplement, and a multivitamin and mineral supplement only.8 At the conclusion of the four-month study, researchers concluded that no differences were observed (including the increased protein group), stating that caloric supplements did not provide a viable treatment modality for this population.8
In a 2003 study of 467 weight-stable HIV-infected men with CD4 counts lower than 200 were observed in regard to protein intake and body composition variables, including body cell mass (the depletion of which is a predictor of disease progression and death).9 Researchers concluded that increased protein intake was related to increased body cell mass, suggesting efficacy in the use of protein to boost health variables in HIV patients.9
Researchers in a 2006 study of children suffering from rapidly-progressing AIDS, examined the effect of  a whey protein supplement in regard to erythrocyte glutathione concentration, T lymphocyte counts and occurrence of additional infections.10 In the prospective double-blind clinical trial, 18 HIV-infected children undergoing antiretroviral therapy were followed for four months.10 The subjects were divided into three groups and given whey protein, maltodextrin or placebo, followed by an evaluation of erythrocyte glutathione concentration, T lymphocyte counts and occurrence of additional infections.10 Results demonstrated  that in the whey protein group, erythrocyte glutathione levels increased and co-infection occurrence decreased, while T lymphocytes remained unchanged when compared to the control group (placebo).10  Researchers concluded that the inclusion of a whey protein supplement was advisable for this population.10
Summary of Findings and Limitations
Though this brief review may appear to point to the overall benefits of increased protein intake and health-compromised people groups, it is important to note the existence of study limitations. Several of the studies reviewed involved very small sample sizes. Though this fact does not necessarily fully discount the findings, it does give reason to be cautious when evaluating the efficacy of information. Many of the studies reviewed also examined multiple factors combined with increased protein intake, making the definitive factor of efficacy more difficult to deduce. Further, as mentioned previously, one of the studies presented was funded by the maker of the protein supplement used in the study, thus giving reason to again be mindful of the bias potential. Length of the studies is also a factor to consider due to the fact that the relevance of data was not studied extensively in terms of long-term outcomes. Oftentimes interventions appear positive in the short-term but neutral or negative in the long-term. Further, though some benefit was shown in some of the presented studies, it is important to note that reduction in wound size or increased levels of CD4 levels for example, does not necessarily imply positive health outcomes for the individual overall. Symptom management, symptom reduction and more acceptable biomarkers do not always suggest optimal health, a point of key importance when evaluating treatment modalities.
Risks
It is always important to examine the level of risk associated with any type of intervention, even if the added measure appears to be harmless. Though protein is a necessary nutrient, an increase of consumption does not come without risk. Consuming large amounts of protein carries with it a significant amount of risk such as increased risk of cancer, diabetes and overall mortality.11 Eating a high protein diet also creates excessive strain on the kidneys, causing complications such as the formation of kidney stones and other kidney-related health issues.13 In addition, the inclusion of high protein supplements made from dairy products carries with it a considerable amount of risk due to the detrimental effects of dairy consumption. Higher mortality rates, cancer, fracture risk and heart disease can all be linked to the consumption of dairy, a fact that should give significant pause to the recommendation to increase the consumption of it, particularly in immune-compromised populations.,14, 15, 16
Conclusions and Future Research Opportunities
As reviewed above, some evidence appears to exist in regard to increased protein intake. However, study limitations exist and multiple risks exist to the implementation of increased protein intake. Additional research into alternative methods of improvement that do not involve increased protein intake would be wise to conduct, in addition to a more extensive evaluation of the risk-benefit ratio of protein intervention and the detrimental effects of engaging in such measures.

References
7. Sattler FR, Rajicic N, Mulligan K, et al. Evaluation of high-protein supplementation in weight-stable HIV-positive subjects with a history of weight loss: a randomized, double-blind, multicenter trial. American Journal of Clinical Nutrition. 2008;88(5):1313–1321. doi:10.3945/ajcn.2006.23583
8. Gibert CL, Wheeler DA, Collins G, et al. Terry Beirn Community Programs for Clinical Research on AIDS: randomized, controlled trial of caloric supplements in HIV infection. Journal of Acquired Immune Deficiency Syndrome. 1999;22:253–259. 
9. Williams SB, Bartsch G, Muurahainen N, et al. Protein intake is positively associated with body cell mass in weight-stable HIV-infected men. Journal of Nutrition. 2003; 133(4): 1143-1146.
10. Moreno YF,  Sgarbieri VC, da Silva MN, Toro AADC, Vilela MMS. Features of whey protein concentrate supplementation in children with rapidly progressive HIV infection. Journal of Tropical Pediatrics. 2006; 52(1): 34–38.
11. Levine ME, Suarez JA, Brandhorst S, et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell Metabolism. 2014;19(3):407–417. 
12.  Fontana L, Klein S, O Holloszy J, Long-term low-protein, low-calorie diet and endurance exercise modulate metabolic factors associated with cancer risk. American Journal of Clinical Nutrition. 2006; 84(6):1456–1462.
13. Robertson W, Heyburn P, Peacock M, Hanes F, Swaminathan R. The effect of high animal protein intake on the risk of calcium stone-formation in the urinary tract. Clinical Science. 1979; 57(3):285-288.
14. Michaëlsson K, Wolk A, Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. British Medical Journal.  2014; 349 :6015.
15. Aune D, Rosenblatt DAN, Chan DSM, et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. American Journal of Clinical Nutrition. 2015;101:87-117.  
             16. Chen M, Li Y, Sun Q, et al. Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults.                 American Journal of Clinical Nutrition. 2016;104(5):1209–1217. 

Sunday, November 3, 2019

Protein Needs in Compromised Populations Part I



There does not appear to be much debate when discussing the importance of nutrition on patients suffering from wounds and burns and likewise with people who are HIV positive. More specifically, increased intake of protein is often posed as the essential nutrient for such patients. However, as is always the case, it is of paramount importance to examine the scientific findings of such claims before making the assumption that the recommendations are sound. For the purposes of this paper, a brief review of the literature concerning the afore-mentioned populations in relation to protein intake will be presented.
Wound and Burn Healing
According to an article published in the British Journal of Nursing, author Linda Russell reported that protein deficiency poses many detriments to the healing process such as reduction in collagen formation.1 Further, Russell commented that high exudate loss has the potential to deplete protein stores by 100 grams per day, thus indicating the need for heightened intake of protein.1 It should be noted that in addition to increased protein intake, the author encouraged a comprehensive evaluation of nutrition overall, stating that a holistic approach to nutrient load is vital to wound healing.1
A 2014 review of the literature looked at the necessity of nutrition, including the subset of protein, in relation to wound healing.2 Researchers stated that increased  protein needs were noted as a result of protein loss due to large surface area of unhealed wounds, wound exudates, chronic wound sites, and losses in lean body mass.2, 3 Further, researchers stated that in order to experience wound healing, protein losses must be accounted for and replaced by increased intake of protein.2 Once again, it is noteworthy to mention that the authors recommend a comprehensive overview of nutrition and possible supplementation of various sources to enhance wound healing, rather than solely relying upon increased protein intake.
In a 1993 study of 28 malnourished patients with truncal pressure ulcers, researchers examined the effect of protein on wound healing.3 Patients were divided into two groups, one receiving 24% protein (high intake) and the other receiving 14% protein (moderately high intake).3 Researchers observed a decrease in wound surface area in the higher protein group but not the moderate protein group.3 Higher caloric intake was also noted as a contributing factor to the reduction in wound surface area in the higher protein group.3 Though the researchers concluded that high protein diets may improve wound healing, it is important to point out the uniqueness of the population studied (malnourished nursing home patients) and not automatically apply the findings to the general population.
A 2009 review of the literature studied the connection between nutrition and wound healing and confirmed conclusions previously mentioned. Authors stated, based upon their review,  that protein is a vital component to wound and burn healing.4 Skin regrowth, according to the review, is dependent upon cell proliferation and protein synthesis, both of which require increased protein consumption.4 In addition, researchers concluded that rapid protein initiation was vital in preventing protein malnourishment in patients.4 Researchers not only recommended protein intake increase but also the inclusion of anabolic hormones to heighten the body’s response to protein4  Of key importance would be an additional review of the data concerning risks involved with this type of supplementation,  a suggestion not examined in the current article.
A literature review in the Indian Journal of Critical Care Medicine examined the importance of hydration and nutritional intake in relation to pressure ulcers.5 Researchers noted that though hydration is of key importance to the regeneration of skin, nutrition is equally imperative to the wound healing process.5 Protein, along with a multitude of other nutrients, was recommended  as essential to the process of wound healing, stating that protein was the most important macronutrient involved in the repair of tissues.5
In a 2014 Cochrane Review, researchers studied a variety of factors in regard to wound healing, including increased protein intake.6 Outcome results showed a lack of efficacy in regard to the incorporation of increased protein and wound healing.6 Furthermore, out of the fourteen studies reviewed, authors concluded that nutritional supplements overall showed no benefit to wound healing (with the questionable exception of arginine which showed possible but not convincing efficacy).6


References


1. Russell, L. The importance of patients' nutritional status in wound healing. British Journal               of Nursing. 2013; 10(1): 44-49.
2. Molnar JA, Underdown MJ, Clark WA. Nutrition and chronic wounds. Advanced Wound                  Care (New Rochelle). 2014;3(11):663–681.
3. Breslow RA, Hallfrisch J, Guy DG, Crawley B, Goldberg AP. The importance of dietary                 protein in healing pressure ulcers. Journal of the American Geriatric Society. 1993; 41(4):                   357-362.
4. Demling RH. Nutrition, anabolism, and the wound healing process: an overview. Eplasty.                2009;9:e9.
5. Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z. Pressure                    ulcer and nutrition. Indian Journal of Critical Care Medicine. 2018;22(4):283–289. 
6. Langer  G, Fink  A. Nutritional interventions for preventing and treating pressure ulcers.                  Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.:CD003216. 
DOI:  10.1002/14651858.CD003216.pub2.





Monday, September 23, 2019

A New Take on Breast Cancer Awareness Month...

October is Breast Cancer Awareness Month, and it is discouraging to see misguided the “celebration” is – there are pink M&Ms, pink buckets of fried chicken, and of course the constant reminder that the best way to reduce your risk of breast cancer is to have mammograms.
This year, we have a constructive alternative. Healthy on Purpose is partnering with Wellness Forum Health and the Physicians Committee for Responsible Medicine (PCRM) to promote a different awareness campaign designed to educate women and show them how to really reduce their risk of breast cancer.
Women will be asked to sign a pledge card with 4 commitments:
  • Choose plant-based foods
  • Exercise regularly
  • Limit alcohol
  • Maintain a healthy weight
Those who sign the pledge through Healthy on Purpose and Wellness Forum Health will receive a $100 coupon good toward one of our online educational programs, and also have access to a free lecture on breast health. We will be donating $25 to PCRM and the wonderful work this organization does for every coupon redeemed by November 15.
This promotion starts October 1. If you would like to sign a pledge and/or help by asking women to sign the pledge, please send an email to kylea.rorabaugh@gmail.com

Sunday, January 20, 2019

about me

My name is Kylea and I am a mom and wife with a passion for maintaining a vibrant and intentional lifestyle and sharing what I have learned with others. I am also a Licensed Professional Counselor, crazy about research, and am always looking for new ways to learn. This blog is intended to showcase key components of what it means to live a life that is healthy on purpose.

Saturday, January 5, 2019

New Healthy on Purpose Offer


Healthy on Purpose is offering free memberships to Wellness Forum Health, a wellness company specializing in Informed Medical Decision-Making and with whom Healthy on Purpose is affiliated. This provides a great way to begin the process of intentionally pursuing optimal health. 

Free Membership Lets You Get to Know Us Better!

Includes:
·       Weekly newsletter with articles about health (emailed Monday)
·       Weekly video clips packed with information about important health issues (emailed on Tuesday and Thursday)
·       Free workshop allowing you to sample excerpts from our programming
·       5 free articles from the Health Briefs Library
·       5 free recipes
·       One free appointment to help you develop a plan of action for achieving optimal personal health, learning more about health-related issues that interest you, and/or professional development

Joining is simple –
just fill out the form below and email to kylea.rorabaugh@gmail.com

Note: memberships will not be processed unless all information is provided


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