Is Vitamin D the "Missing Link" of Flu Prevention?

Vitamin D and Flu Prevention: Part 1

Influenza (the flu) is the poster-child of seasonal variability in an infectious disease. During "flu season" rates of influenza skyrocket, but in the warm, summer months the virus is seemingly dormant. I think that last bit does a particularly good job of beginning to elude to the commonly held beliefs surrounding the flu. Public officials tell us every year that this is going to be a bad year for the flu- perhaps the worst one yet. I think that most people conjure up an image of a virus that "attacks" every year, is defeated (fails to infect everyone), goes into hiding for the summer and makes itself bigger and better, and mounts an attack again the following year. It seems simple enough why people get sick- if you come into contact with enough germy people and if the virus is "bad" enough the virus will get you; it's only a matter of time. But what if the virus isn't the biggest variable in this equation- what if it's us?

There is a number of theories for what makes us more susceptible to infection in the winter. The start and end of the school year, the fall of absolute humidity in the winter months which dries out mucous membranes, seasonal patterns of behavior, temperature fluctuations, changes in viral transferability, and changes in host (human) immune function throughout the year all almost certainly play some role in influenza transmission [2]. Out of all of those reasons, however, one theory has risen above the rest in terms of answering unanswered questions (below) and promising research trials (to be discussed in Part 2).

Host (human) immune function is dependent on Vitamin D

Vitamin D is considered to be a hormone- a chemical that is made in one cell or gland (skin cells), released into the blood stream, and affects other cells in the body. Vitamin D is known to regulate at least 913 genes [3], including many that regulate immune function. Vitamin D is the major regulator of several antimicrobial peptides (AMPs) (you're body's in-house, broad spectrum antibiotics), namely cathelicidin and beta-defensin [3,4]. Among other functions, AMPs are known to protect the body's barrier surfaces (lungs, mouth and throat, gut) by creating a hostile antimicrobial shield [5]. This alone has tremendous implications in disease transferability! If the virus can not get past these barriers and get into the body it makes it tremendously difficult for it to make you sick. Vitamin D is also a key player in the innate immune system [3,5], which is the body's first, non-specific line of defense against pathogens. One way it does this is by enhancing TH3 cell function- T Helper cells that keep the rest of the immune system running smoothly. Fascinatingly, new research has shown that cells of the immune system and epithelium (barriers) are able to convert the non-active form of vitamin D into it's active metabolite [6]. This mechanism may further demonstrate the immune system's dependance on this modest little hormone.

Vitamin D as the "seasonal stimulus" answers many otherwise unanswerable questions about Influenza's odd behavior [5]

1. Why is Influenza both seasonal and ubiquitous (everywhere) and where is the virus between epidemics?
It is unlikely that the virus hides each summer and magically comes out in the winter. What's more likely is that the virus is around us (and in us) all year-round, but during times of enhanced immunity (sun exposure) we are able to fight it and remain asymptomatic.

2. Why are the epidemics so explosive?
As vitamin D levels begin to drop in the fall and winter months, so does our ability to fight infections. After a prolonged amount of time without sun exposure people's vitamin D levels will begin to fall, resulting in more and more people becoming increasingly more prone to infection. Once people's vitamin D levels drop below their tolerable threshold (which is most likely different from person to person), a subset of the population would find themselves suddenly susceptible to infection.

3. Why do epidemics end so abruptly?
It is likely that there is a sub-population of "good transmitters" within each population, which may be associated with each person's degree of Vitamin D deficiency. The depletion of this limited supply of good hosts most likely plays a large role in flu season's speedy resolution.

4. What explains the frequent coincidental timing of epidemics in countries with similar latitudes [5]? Why is the seasonal pattern of Influenza so weak or non-existent in equatorial regions [1]?
The peak of the last 25 epidemics in France and the USA occurred within a mean of four days of each other [5]. Similar latitudes likely follow a similar pattern (in both severity and seasonality) of impairments in innate immunity. This would also explain why regions closest to the equator experience fewer cases of influenza and seem to exhibit no pattern of seasonality [1].

5. Why is the serial interval so obscure?
The "serial interval" refers to the amount of time it takes for an infected person to make a well person sick. The serial interval has been shown for a number of other respiratory diseases, but has yet to be established for Influenza [5]. It appears that the presence of "good transmitters" among a population, who's infectious period is limited, makes this incredibly hard to measure for Influenza. The variation in Vitamin D status from one individual to another is likely one of many factors that seperates the "good transmitters" from the poor transmitters.

6. Why is the secondary attack rate so low?
For a  (supposedly) "highly contagious" virus such as Influenza, it's secondary attack rate is surprisingly low- about 15-20% at most, compared to 70% for measles and 58% for rhinovirus [5]. This is inconsistent with the idea that the virus sustains itself via regular sick-to-well transmission. The presence of a limited number of "good transmitters" as a result of vitamin D variation likely plays a role. Surely we've all known a person who always gets sick when there's a bug going around? It would be interesting to measure that person's vitamin D levels!

7. Why did epidemics in previous ages spread so rapidly, despite the lack of modern transportation?
"If Influenza were embedded in the population, only to erupt when impairments in innate immunity create a susceptible subpopulation, the disease would only give the appearance of spreading. Instead, it would appear in large segments of the population seasonally, and almost simultaneously, as long as good transmitters were available" [5].

8. Why are so few sickened by direct aerosol inoculation of influenza virus?
If the virus is highly infectious, one would expect most, if not all, people to fall ill when exposed to the virus. However, this is not the case. Even if the virus is sprayed directly into patient's eyes, nose and throat (I swear they really did this in 1918 and 1919) none of the volunteers became ill in any way. Other studies found similar results, where none or relatively few of the volunteers became sick after direct exposure to the virus. Once again, we must ask ourselves what makes one person susceptible and one person all but impervious to infection?

9. Why have influenza-related mortality and hospitalization rates significantly increased in the last three decades, despite profound increases in the rate of influenza vaccination?
Simply said, because vaccine manufacturers and researchers grossly overestimate the effectiveness of the flu vaccine every year. The flu vaccine lowers the incidence of the flu by 1.55%. If you want to know why I am so certain in saying so, please check out my previous blog posts on the flu vaccine here.

Check back soon for Part 2 of this series- I will be going over the current research on vitamin D as a means of preventing the flu.


Stay healthy out there, folks!

References:
[1] Juzeniene, Asta et al "The seasonality of pandemic and non-pandemic influenzas: the role of solar radiation and vitamin D" 2010 [PMID 21036090]
[2] Shaman, Jeffrey et al "Shortcomings of vitamin D-based model simulations of seasonal influenza" 2011 [PMID 3108988]
[3] Lang, PO "How important is vitamin D in preventing infections?" 2012 [PMID 23160915]
[4] Aranow, Cynthia et al "Vitamin D and the immune system" 2011 [PMID 3166406]
[5] Cannell, John et al "On the epidemiology of influenza" 2008 [PMID 2279112]
[6] Sundaram, Maria et al "Vitamin D and influenza" 2012 [PMID 3649720]

Why I'm Grateful for Smartphones

I fully admit to being a technology addict. I've had a love affair with Facebook for many years and am now starting to get really into Twitter, Google Plus, YouTube and (obviously) Blogging. I've had conversations with people who "don't get it" and have never been on Facebook before, and I'm sure I sound just as much like a martian to them as they do to me. I have also been a smartphone addict for a number of years and have had similar conversations with non-believers.

But beyond my love of all that has a microchip in it, I recently became exceptionally grateful for smartphones. Yes, those "unnecessary" phones that think they're computers. The very gadgets that make many in my parent's generation cringe when they see a 4 year old mindlessly thumbing her way through Facebook or Angry Birds when she should be paying attention to something else. Dear readers, these little gadgets have an important place in my heart.

My husband and I recently lost our beloved beagle Ralphy to cancer. We took him in to the vet because he started acting funny last week- he wasn't eating good for us and was a little more lethargic than usual. He had just recovered from a herniated disc in his neck, so we thought perhaps the steroids he had been on caused an ulcer. Five hours and a lot of testing later, the vet told us that the mass they saw on the X-ray was most likely a very malignant form of cancer and they had to remove his spleen. When they opened him up and removed the spleen they found several other masses on his liver and pancreas that they could not remove. When we got the phone call late that night we agreed with the vet- if we closed him up and let him wake up he would only be waking up to a very painful couple of weeks. Our baby didn't deserve that. We gave them the go-ahead to let him go that night. We had had him for one year and ten days and he was only six years old. Within a span of eleven hours we went from "just a quick run up to the vet" to "we think it's cancer" to "the humane thing to do is to let him go tonight".

Life is SO short, but the problem (and the blessing) is we don't really remember that until we lose someone close to us. It's probably a good thing that we're not fully aware of how short our time was here on Earth (go to 20:10). Maybe this is another case where ignorance is bliss. On the one hand, it makes these times in life tremendously painful. I feel like someone just came up and punched me in the face, heart and stomach all at once. But what about the alternative? If we had known that Ralphy's time with us was growing short what would we have done? The only thing we can hope to do is appreciate everyone and everything we have every single day and lead a life that brings ourselves and others joy.

Smartphones made this difficult time in our lives a little bit easier because they allowed (nay- encouraged) us to document every single thing that dog did this last year. In the old days if you saw something you wanted a picture of you'd have to run and find your camera, but not anymore. Why risk losing the photo op to go get your "real camera" when you can bust out your iPhone on the spot? We have hundreds of pictures of Ralphy doing absolutely nothing because we were constantly sending each other picture and video text messages of "our son". When I wasn't texting a picture to Mike I was posting pictures of Ralphy to Facebook and Twitter. Facebook is the new wallet full of awkward family photos- you don't need to have hard copy prints of every photo and then try to show them to everyone you know. Instead, upload them to Facebook or text them in real time. I can't tell you how many times I've talked to my mom on the phone and said "You wouldn't believe how cute Ralphy is being... Check your texts for pictures!"

If it wasn't for cameras, texting and social media on smartphones I guarantee we wouldn't have even 1/10th the number of pictures and videos of that precious dog as we do today. So yes, smartphones are unnecessary. But like so many things in life, sometimes you'd be surprised how one's definition of the word "necessary" can change in a matter of minutes.

In health,

The Pain Game Part 1: The Basics of Pain

As a chiropractor, it is not uncommon for people to come to my office in pain. We are a profession that has become well known for our non-surgical treatment of back and neck pain, and with good reason- chiropractic works marvelously for such problems. My mom has experienced this at least three different times when I've gotten rid of migraines on the spot with a cervical adjustment. But what about the cases that don't respond quite so quickly? What about chronic pain?

First, let's cover the basics of pain.

1. Pain is all in your head. Really.

Pain is not a sensory event, but a conscious one. There are receptors throughout the body that detect light, taste, smell, vibration, temperature, blood pressure, mechanical stress, muscle stretch, and tissue damage (nociception), but none actually sense pain. The nerves in our body can sense tissue damage and relay the information to our brain, but our perception and reaction to that information is what we have come to know as pain.

The easiest way to explain this concept is to use examples of pain and nociception that are independent of one another. A classic example of pain without nociception is phantom limb pain. We can't blame this type of pain on tissue damage since the nerves that would normally sense that tissue damage were removed along with the limb! Phantom pain is thought to be "learned pain"- a concept we will revisit later. Another example is pain that starts after a stroke. The body part that is perceived as being painful was never injured, but the neurons that represent that body part were damaged, resulting in the experience of pain. The key here is that the presence of pain does not necessarily indicate that the painful tissue is actually damaged- it simply means that the neurons in the brain that perceive/create the conscious event that we call pain have come to threshold. That doesn't make the pain any less real, but is a concept that will be important in a later blog post.

An example of nociception without (or with minimal) pain is when an athlete gets injured on the field but continues to play despite obvious injury. Other stimuli at that time (endorphins, distractions from the other team, teammates, coaches, and the roaring crowd, preconceived ideas of how much the injury should hurt) affected how the brain dealt with the nociceptive information it was receiving, and changed the pain it ultimately felt. This leads me to my next point...

2. A LOT of different things affect our perception of pain.

Pain is a lot more complex than we often give it credit for, undoubtedly because of how many different areas of the nervous system are involved. There are many, many levels of the nervous system where pain signals can start or the signals can become scrambled. Take the above scenario as an example. An athlete may not recognize the extent of the tissue damage and feel as much pain as we would expect for a number of reasons. The endorphins that bathe the athlete's nervous system during the game work on the brain stem in much the same way as morphine. An area of the brain stem called the periaqueductal gray then sends signals down to the spinal cord to inhibit nociceptive neurons. The sheer act of moving, which stimulates sensory nerves called mechanoreceptors, also inhibits nociceptive neurons in the spinal cord. Distractions from the crowd and teammates affect the frontal lobe's ability to focus enough to generate the perception of pain. The athlete's state of mind and mood affect the limbic system- the part of the brain that generates the emotional side of the pain experience. There are surely a multitude of other things that can influence such a scenario, but by now you get the idea.

3. There are two different types of pain- acute and chronic.

The mechanism behind acute pain is what people usually think causes all pain: tissue damage. Bodily damage can be caused by a number of things; a cut or a bruise, an invasive tumor, muscle soreness from a hard work out, sprain or strain, a burn, gangrene, or other physical injury. And while pain is never a pleasant experience, acute pain is incredibly useful- it serves as a warning. Without pain we wouldn't know when we are damaging our bodies and would surely wear them out very quickly. People with congenital insensitivity to pain typically lead short, injury-ridden lives for this reason. We need acute pain. It teaches us valuable lessons.

Generally, pain is said to be chronic when it has persisted for at least three months. Most often the initiating event is acute (injury), but the fact that the pain lingers for so long makes chronic pain completely different in it's pathology and therefore, treatment approach. Often chronic pain persists long after the tissues have healed and the body has otherwise recovered. This indicates that there is some level of neurological involvement- whether it be at the level of the brain, brianstem, spinal cord, peripheral nerves, or somewhere in between. Now, that's not to say that some cases of chronic pain are not directly due to downstream peripheral effects of old injuries. Perhaps an old ankle sprain just never really healed properly- the ligaments are now unstable or the muscle firing pattern has been altered. However, I would be one to argue that even in those cases there is some degree of neurological involvement that should not be (but often is) ignored. Sure, altered biomechanics sounds like a purely musculoskeletal problem, but the brain, cerebellum, and brain stem are always well aware and in control of everything that goes on in the body including what your muscles and tendons do.

4. There is no way to accurately measure pain.

Sure, we like to give the illusion that we can measure pain, but because pain is incredibly subjective it is also incredibly hard to quantify. In medical offices we like to use the visual analog (0-10) scale (VAS) which is an alright means of assessing someone's pain, but I think it's much more useful for tracking individual progress than anything else. As much as I may try, I have no way of knowing what a 9/10 pain feels like to you. I can, however, safely assume that I've made a pretty profound change in your symptoms if I figure out a way to bring that 9/10 down to a 3/10. The VAS is a game of comparing apples and oranges. If you compare apples to apples and oranges to oranges it has it's uses, but it still doesn't come close to telling you what the other person is going through.

5. Medications and Surgery don't fix the underlying problem*

Not only do medications not fix the problem, many of them do more harm than good. Morphine, hydrocodone, tramadol, vicodin and codeine are all opioids and work much like heroin or endorphins in the brain and brain stem. They work largely in the brain stem, firing pathways like the ones discussed before that inhibit nociceptive neurons. The problem is that while they are effective at getting rid of pain in the short term (or at least making you so sleepy you don't remember you have pain), they do nothing for the long term health of the brain- actually, quite the opposite! All of these drugs are highly addictive and often require more and more of the medication to produce the same effect because the body builds up a tolerance to them over time. Meanwhile, these drugs do nothing to improve the overall health of the brain, nor do they encourage the brain to relearn how to inhibit those pain pathways on it's own. The other major class of pain medications is COX inhibitor drugs such as celebrex and aspirin, which decrease inflammation. There is certainly theraputic value in decreasing inflammation, but there are many other ways to decrease inflammation in the body without drugs.

Surgery for chronic pain often involves cutting nerves that go to the painful body part. The problems with this approach are numerous, but the most important is that it's often not the body part causing the pain in chronic pain conditions- it's the brain and brain stem. Not only that, but such surgery usually has to be repeated every few months because the nerves grow back! And we wonder why healthcare is so expensive?

*This statement, as with most things in healthcare, is not absolute. If pain is caused by tissue damage- a broken bone, meniscus tear, tumor, etc then surgery will most likely fix the problem. In this case, I am referring to chronic pain, which is more often neurological in nature.

Stay tuned for my next post, Chronic pain- Why it's there and what you can do about it!

 In health,

Want to learn more about pain? Check out these videos:
Understand pain in less than 5 minutes
An excellent lecture about pain
A pretty good Ted Talk about pain (although I have a different treatment approach than he does)

The Moment We've All Been Waiting For!

It gives me great pleasure to announce the opening of my practice in Tempe, AZ earlier this month!

In my practice I will be focusing on  Functional Medicine [1] and Functional Neurology [2], the two topics I talk about here on the blog. If you or a loved one in the greater Phoenix area are unnecessarily suffering from a neurological or metabolic disorder such as those listed below, feel free to call my office at (480) 280-3943 to schedule a free ten minute consultation.

To check out my new website and learn more about my office, click here.

Conditions that often respond well to a Functional Medicine and Functional Neurology based approach include:

• Headaches
• Chronic constipation
• Chronic diarrhea
• Fibromyalgia
• Autism, ADD and ADHD
• Diabetes
• Thyroid problems
• Autoimmune diseases
• Chronic Pain

I evaluate the body through the use of  various lab testing- including blood, saliva and stool testing, as well as a neurological and full body exam. Only then, after I have a better understanding of the physiology at play, I am able to make recommendations about diet, lifestyle, supplements, neurological exercises, or medical referral.

That which get's measured gets understood. That which is understood gets effective care and monitoring.
That is the simplest possible way to explain how I practice.


Dr. DiNezza

[1] http://createanewbox.blogspot.com/2012/06/functional-medicine-new-box.html
[2] http://createanewbox.blogspot.com/2012/08/functional-neurology.html

http://www.drnicoledinezza.com/

Beware of Junk Science

The more I learn about health, the more I realize being healthy should be a no-brainer. Eat more vegetables. Move more. Laugh more. Put down that PopTart. But what about all the scads of conflicting information out there? Low fat, low carb, or low cal? Which of the thousands of antioxidants available should we be taking? Fish oils, resvertrol, goji berries, green tea? Is sunlight good because of the vitamin D, or bad because it increases our odds of skin cancer? Should we eat that egg yolk?

In many cases false information is propagated by one thing- money. I'm not saying that everyone with something to sell is trying to dupe you out of your money... I'm just saying they have something to sell you. As long as we remain objective and never stop asking questions, we will get along just fine in this free market economy, but it's always nice to have a little help to weed through information. Junk science is science (or something that seems scientific) that is produced or interpreted by those with special interests. For example, articles investigating the safety or efficacy of a drug that are being funded by the company that makes said drug. Can you say "conflict of interest"?

But I digress.

There is one particular experiment I have seen recently in the media and on the internet that I just couldn't resist debunking. On websites such as this one, authors say that you can test your vitamins by seeing whether or not they dissolve in water. While I will be the first to admit that most multivitamins sold in the stores are not only junk, but might actually be harming you [1], this is not a valid test by any means.

My favorite example of this lately is this popular commercial for a CoQ10 supplement, Qunol. The makers of this supplement boast that their product dissolves better in water than other CoQ10 supplements... but when did we decide that this was a good thing? Beyond the issues I outline below, CoQ10 is a fat soluble antioxidant, which means it should NOT be able to dissolve in water. The makers of this product are bragging about a quality in their product that is actually undesirable! That's marketing for you.

There is SO much more going on inside your body than in a cup of water it's exhausting to imagine listing them all, but for the sake of the article I will talk about just a few.

1. Stomach acid is extremely acidic- ranging in pH from 1.5 to 3.0 [2]. As we all know, acidic is extremely corrosive- apparently enough so to dissolve razor blades [4]! I should hope such a strong acid would be able to dissolve a pesky pill or two. While the above article did state that vinegar better mimics the stomach's acidic environment than water, vinegar is only moderately acidic with a pH of 4.25-5.0 [3]. Compared to the stomach's pH of about 2, even at it's strongest (we'll say 4.0) vinegar is 100 times weaker than stomach acid.

2. There's more stuff in the stomach than just acid. Even if you did dunk those pills in a vat of acid that is the same strength of stomach acid, you still couldn't hope to make up for all the other stuff in our guts. Digestive enzymes such as salivary amylase start working on your food the moment it enters your mouth and continually get added throughout the digestive process. Amylases, proteases, lipases, pepsinogen, intrinsic factor, mucous, bile salts, bicarbonate, and a plethora of gastric hormones are among the many, many things that get secreted as food moves through the digestive tract.

3. The digestive tract is a muscular tube. The juices that digest our food only make up a part of the whole digestive picture. The stomach is a big muscular bag and the rest of the digestive tract is one long muscular tube that is constantly pulling, pushing, squishing and mashing the ever-loving heck out of the food we eat. Last I checked, cups of water weren't capable of such things... even with the most vigorous of stirring.


The question we should be asking ourselves is not weather our pills can dissolve in a cup of water. Rather, once the pill (or food) is broken down will it be absorbed from the digestive tract and properly used in our body? If there is a leaky gut or inflammation afoot I would say the answer to both of those questions is a "no".

Take care and beware of junk science, dear readers


Nikki Cyr, D.C.


Resources
[1] http://createanewbox.blogspot.com/2012/11/metals-that-might-make-you-mental.html
[2] http://en.wikipedia.org/wiki/Gastric_acid
[3] http://en.wikipedia.org/wiki/Vinegar
[4] http://www.mnn.com/health/fitness-well-being/stories/infographic-28-odd-facts-about-the-human-body
[5] http://www.ehow.com/how_5641704_test-vitamins-home-dissolving-water.html

To Be or Not To Be "Sugar Free"

"Sugar free" seems like an easy enough thing to figure out. Sugar free foods are foods with no sugar in them, zero sugar, sugarless, if you will. But is that actually the case? In many instances, the answer is no.

For starters, let's look at how the USDA defines "sugar free". Technically, food manufacturers can say that their product has zero sugar if it contains 0.5 grams of sugar per serving or less [1]. The same is true of labels that boast claims of "cholesterol free", "calorie free", and "fat free". Certainly this is a negligible amount if you eat one serving, but what if you eat more than one serving? This tactic is commonly used when labeling junk food, foods which people are far more likely to consume more than one serving. Sure, two grams of sugar still isn't much if you eat four or more servings, but it's not what I would call "sugar free", either.

The other problem with processed foods that boast the sugar free label is that they are usually riddled with artificial sweeteners that are even worse for you than sugar. Aspartame consumption, for example, has been linked to numerous types of tumors. Add to that the fact that the ingestion of artificial sweeteners has been shown to increase sugar cravings, the exact opposite of what the average diet Coke drinker wants to do, and it just doesn't make sense to consume this stuff. On the other hand, low glycemic index (read: low glucose, high fructose) sweeteners such as high fructose corn syrup and agave nectar are technically low in the sugar that raises your blood sugar (glucose), but are preferentially stored as fat making them even worse for diabetics and people trying to lose weight than regular sugar. For more on these topics, please see my previous posts here.

 I don't think the Pillsbury dough boy will ever advertise something that is truly healthy...

However, my most recent pet-peeve has been the use of the term "sugar free" in various health food recipes such as this one. This recipe calls for bananas and honey, both of which have a pretty hefty amount of sugar in them [2].I see this type of thing all too often in paleo and vegan recipes- the use of maple syrup, honey, coconut crystals, dates, raisins, bananas, etc and yet they still call the recipe sugar free. I think what the author meant to say is that this fudge is refined sugar-free. Now, don't get me wrong, I make these types of recipes more frequently than I'd like to admit... I just think it's incorrect to call them sugar free. Actually, I made that fudge recipe this weekend and highly recommend it! Just don't go crazy and eat a lot of it because you think it's sugar free ; )


So where do we go from here? I think the best way to tackle this once and for all is to take a moment to define sugar. Hopefully if we know what sugar is we will know how to best avoid it.

Sugar
1. Table sugar, the white crystalline form of the disaccharide sucralose*.
2. The simplest form of carbohydrate, consisting of one, two or three carbon-based rings. Examples include glucose, fructose, and galactose (monosaccharides), as well as combinations of the three such as lactose (one glucose and one galactose) and sucrose* (one glucose and one fructose).

I hope this post has made you think of something you hadn't ever thought about before. Don't take anything at face value- even something as seeminly simple as the term "sugar free".



Nikki Cyr, D.C.



References
[1] http://www.fsis.usda.gov/pdf/labeling_requirements_guide.pdf
[2] http://nutritiondata.self.com/facts/fruits-and-fruit-juices/1846/2

Live and Lent Live

Ah, Lent. A season for sacrifice, for discipline. Each year thousands of Christians choose something to give up for forty days as they prepare for Easter. But have you ever noticed how many of these happen to be unhealthy habits? Chocolate, ice cream, soda, fast food and alcohol are among the things I have seen people give up for Lent.

In a weird way Lent is like New Years part two for Christians- with each holiday thousands of people give up an unhealthy habit each year. There are several key differences, however. New Years resolutions are intended to be permanent (although, sadly, many of them do not turn out that way). On the other hand, Lent is known to be a only temporary inconvenience. I think this creates a predictable, yearly yo-yo diet. Every year people give up something for Lent only to over-indulge and go back to their old, bad habits after the Easter finish line has come and gone. Yes, this almost always happens with New Year's resolutions, too, but at least the initial intention is for some degree of permanency.

Additionally, the motivation for Lent (sacrificing for something bigger than oneself, i.e. religion) is completely different than the motivation that drives New Year's resolutions. But that brings up an important question- why is it that we are able to buckle down and make a healthy choice for our religion, but not for our own health? I do not mean this to belittle the meaning of Lent, but I do think that there is nothing more important than taking care of our bodies. Arguably, without our bodies none of us would be able to worship the deities of our choosing, so shouldn't we regard our health with at least the same degree of importance as our religions?

My challenge to you, dear readers, is to not let Lent be yet another yo-yo diet. They say it takes 30 days to form a habit. So, since Lent is 40 days that means that if you can successfully make it through Lent you've already made it through the hardest part of kicking a bad habit! This year use Lent as a spring board into your new, healthy lifestyle, not just another fad diet.

Yours in health,

Nikki Cyr, D.C.