Category Archives: Integrative Medicine

Shaoyun Li,1,* Yuefei Li,1,* Xiyan Xu,1 Jian Shao,2 Ruifeng Xie,3 Sheng Liu,1 Li Peng,1 Jin Wang,1 Kaixin Zhou,3 Huyi Feng1

1The Fifth Peoples Hospital of Chongqing, Chongqing, Peoples Republic of China; 2Guangzhou Laboratory, Guangzhou, Peoples Republic of China; 3Department of Life Sciences, University of Chinese Academy of Sciences, Beijing, Peoples Republic of China

Introduction: Simple non-invasive biomarker is urgently needed to detect the largely silent osteopenia in order to prevent osteoporosis-related fracture later in life. The accumulation of advanced glycation end products (AGEs) has been related to reduced bone density and osteoporotic fractures. Whether lens autofluorescence (LAF) based AGEs (LAF-AGEs) measurement could be used to assess the risk of osteopenia is aimed to investigate in this paper.Methods: Through routine health examination, 368 individuals under the age of 50 were enrolled. A dual-energy X-ray absorptiometry (DXA) device was used to measure bone mineral density (BMD) of the forearm and determine osteopenia. AGE levels were derived with LAF along with the other demographic and laboratory parameters. After deriving the age-adjusted AGE levels (AALs), a linear regression analysis and an ordered logistic regression analysis were applied to examine the associations between osteopenia and LAF-AGEs as well as AALs.Results: Negative correlations (Pearson r = 0.16, p Discussion: After reviewing the relevant studies, it is concluded that LAF-AGE is a more stable measure of long-term metabolic dysfunction than circulating AGE. LAF-AGEs are a valid, practical and non-invasive parameter for osteopenia risk evaluation. Further studies with longer follow-up will be helpful to clarify its effectiveness for osteoporosis risk assessment.

Keywords: lens autofluorescence, LAF, osteopenia, advanced glycation end products, AGEs, bone mineral density, T-scores

The prevalence of osteoporosis is 19.2% in people aged over 50 and increases to 65% for those over 65 in China.1 Osteopenia is the gradual loss in bone mineral density (BMD) prior to osteoporosis.2 Chronic osteopenia increases the risk of osteoporosis, fracture or stooped posture. Although early detection of osteopenia and intervention could reduce the risk for osteoporosis-related fracture later in life,3 the awareness rate of osteopenia is only 7% people in those aged over 50 and even lower in the young adults.1 This is largely due to the fact that osteopenia is asymptomatic and its diagnosis often relies on the hazardous X-ray scan.

Alternative biomarkers had been eagerly pursued to inform the early detection of osteopenia.4 Previous studies demonstrated that biochemical factors such as bone serum osteocalcin, alkaline phosphatase (ALP), and osteoprotegerin were associated with osteopenia.5,6 These biomarkers are useful to provide the early assessment of osteopenia and osteoporosis however they are invasive approaches and require laboratory to get the test results. On the other hand, efforts to combine multiple non-invasive measurements such as biceps brachii elasticity and percentage thigh muscle had been proven informative, but the clinical implementation had been severely hindered by its complexity.7 Simple non-invasive biomarkers of osteopenia are still on demand.

Advanced glycation end products (AGEs) include heterogeneous molecules that are nonenzymatically generated by glycation of proteins.8,9 Although distributed across multiple tissues, AGEs are well established to interact with proteins constituting extracellular matrix in bone to form covalent cross-links, damaging the bone properties. Since its distribution across tissues are correlated, AGEs from different compartments of the body had been examined for association with bone quality and fracture.7,8,10 Those from serum and urine were poorly associated due to the short half-life of AGEs related proteins in these tissues.7 Skin autofluorescence-based AGEs were also examined, but their association with bone strength was prone to confounding by renal function.11

Lens autofluorescence (LAF) measurement is a non-invasive technique for determining AGEs initially used for the evaluation of diabetes risk.12 This is largely driven by the fact that proteins in lens are long-lived and the uptake of glucose by lens is not regulated by insulin. Therefore, lens proteins are more likely to be carriers of glycosylation and the LAF-based AGEs (LAF-AGEs) levels are relatively stable. However, whether LAF-AGEs are associated with the risk of bone health and osteopenia is unknown.

In this study, we set out to examine the association between LAF-AGEs and osteopenia in a group of individuals under the age of 50, aiming to establish whether LAF-AGEs could inform early intervention of osteopenia to reduce its related risks later in life.

We recruited 773 adult participants from the Physical Examination Center of the Fifth Peoples Hospital of Chongqing between February and December 2019 while they took their annual physical check. Individuals were excluded if they were aged over 50 or suffer from crystal turbidity, or severe renal functional impairment, or diagnosed with osteoporosis. With the exclusion, 368 patients were selected in the study for the further analysis. In addition to the BMD test and the measurement of Lens Autofluorescence specific to this study, we also collected routine demographic and biochemistry measures such as age, sex, body mass index (BMI), serum creatinine and ALP. Both serum creatinine level and ALP were tested through a blood test where the amount of creatinine in blood and the amount of ALP were obtained. Estimated glomerular filtration rate (eGFR) was calculated by the chronic kidney disease epidemiology collaboration (CDK-EPI) equation.13 The study protocol was approved by the local appointed ethics committee and all participants gave their informed consent.

BMD was measured at the forearm with a dual-energy X-ray absorptiometry (DXA) device (SGY-I, TEDA Shenghong Medical Apparatus Co. Ltd., China). All scans were performed and verified by a trained technician who applied adjustments when necessary. The T-scores produced from each scan were used to identify participants with osteopenia or osteoporosis according the Manufacturer Instruction.14 Based on their T-scores, the participants were classified into five groups of normal (T-score 1), low level osteopenia (1.2 T-score < 1), medium level osteopenia (1.4 T-score < 1.2), high level osteopenia (2 T-score < 1.4) and osteoporosis (T-score < 2).

The AGEscan Lens Fluorescence Microscope (Sinocare Co. Ltd., China) was used to detect autofluorescence of lens. The equipment adopted the ClearPath DS-120 Lens Fluorescence Biomicroscope that had been most widely used in previous LAF studies.15,16 The system reported the ratio of green fluorescence to scattered light as the raw measurement of LAF-AGEs. The raw ratios were further adjusted by age and referenced against a normal population profile to derive four age-adjusted AGE levels (AALs):

Data was expressed as mean SD for continuous variables, and number of cases and percentage for categorical variables. Continuous variables were compared by the t or ANOVA test for normally distributed variables. Chi-Square test was used to compare categorical variables. The linear regression analyses were applied to examine whether T-scores were associated with LAF-AGEs as well as AALs. The co-impacts of the confounders, such as sex, BMI, eGFR and ALP were analyzed by the comparison between the values in two groups divided based on T-Scores. In addition, an ordered logistic regression analysis was applied to investigate whether the change of AALs between different levels affected impacts the different levels of osteopenia. p < 0.05 was considered statistically significant. Data processing was performed using Python (version 3.8.5) and statistical analyses were carried out using R (version 4.0.3).

After excluding individuals with existing osteoporosis (T-score < 2), the key characteristics of the remaining 368 participants in the study were summarized in Table 1. They were divided into the low osteopenia risk group (T-score 1.2) and the high osteopenia risk group (2 T-score < 1.2). In keeping with previous studies, individuals in the group with higher risk of osteopenia tend to be slimmer and older (both p < 0.001). No significant difference in ALP (p = 0.83) and eGFR (p = 0.13) was observed between the two groups. In addition, there was no significant gender ratio difference between the two osteopenia risk groups.

Table 1 Characteristics of the Participants

The joint distribution of osteopenia T-Scores and raw LAF-AGEs levels was plotted in Figure 1A. In a linear regression model, LAF-AGEs were significantly (Pearson r = 0.20, p < 0.001) and negatively correlated with T-Scores. As shown in Figure 1B, when LAF-AGEs were age standardized into AALs, there remained a significant (p = 0.025) negative correlation between AAL and T-score.

Figure 1 The correlation results: (A) Association between T-scores and LAF-AGEs; (B) association between T-scores and AALs.

In order to predict the transition between osteopenia severity levels with the LAF-AGEs, an ordered logistic regression model was employed with the AALs as the predicator and the leveled osteopenia diagnosis as the ordered outcome. This univariate analysis identified AAL was a factor for lower osteopenia level [p = 0.004, odds ratio (OR) = 1.28, 95% confident interval (CI) 1.081.51]. In the multivariate model with gender, BMI, eGFR and ALP as covariates, AAL remained a significant predictor [p = 0.02, OR = 1.22, 95% CI: 1.021.45].

In this cross-sectional study of 368 normal individuals under the age of 50, we showed an inverse association between LAF-AGE levels and osteopenia risk as measured by T-score. The age standardized LAF-AGE levels remained a statistically significant risk after adjusting for other known osteopenia risk factors.

The present investigation was set out to focus on the young adults. Abundant previous evidence had shown that people aged over 50 or menopausal women had increased risk of osteopenia.8,10,17 Yet the bone mass loss in young adults did not receive much attention with the osteopenia risk profile poorly defined.16 Early diagnosis and treatment of osteopenia for young people have been demonstrated to decrease fracture rates, improve life quality when they grow into elderly.18,19 Thus, we opted to extend existing knowledge by examining whether LAF-AGE could serve as a biomarker to inform early assessment of osteopenia.

AGEs are diverse compounds with tissue specific origin, reflecting the metabolic properties of multiple correlated tissues.17 The formation of covalant cross-links with collagen and other bone proteins which affect the mechanical properties of tissue and disturbs bone remodelling, deterioration and bone mass loss, underlying osteoporosis, is induced by the accumulation of AGEs within the bone. It is known that circulating AGEs plays a major role in the progression of osteopenia with a negative correlation of r = 0.26 to the T-score of lumbar spines.20 Here, we showed LAF-AGEs had a similar level of negative correlation (r = 0.16) with the T-scores of forearms. Thus, our study confirmed the LAF-AGEs, another form of AGEs existing in eyes, also had the inverse association with bone mass loss, raising the potential for osteopenia risk evaluation.

As with AGEs measured from other tissues, LAF-AGEs increase with natural aging. We then adopted the age standardized LAF-AGEs in this study to explore its association with T-score and osteopenia risk. The result of the ordinal logistic regression showed the transition between AALsalso resulted in a risk escalation of osteopenia, even after accounting for other known risk factors. Moreover, it has been shown that LAF-AGE is a more stable measure of long-term metabolic dysfunction than circulating AGE. Compared to skin measures of SAF-AGEs, it is less perturbed by short term physiological change which is relevant to the accumulating risk of osteopenia. Taken together, our results demonstrated LAF-AGEs as a valid and practical parameter for osteopenia risk evaluation, adding a non-invasive biomarker to the existing risk profile.

Our study references the bone mineral assessment at the forearm with the low radiation dose DXA which is commonly used in health care setting.21 In contrast, previous AGEs studies mostly measured bone mass at other body parts such as femoral neck and lumbar spine with higher accuracy.10,20 However, a recent study showed that BMD measured at different sites, including lumber, left hip and non-superiority forearm with DXA, were comparable in screening osteoporosis.22 Therefore, the association between LAF-AGEs and T-score observed in this study is likely to be a valid indicator of osteopenia risk.

The present study utilized a cross-sectional dataset and could only focus on the risk predication of osteopenia with LAF-AGEs. However, previous studies did suggest that skin measures of SAF-AGEs were associated with long-term outcomes of osteoporotic fractures and vertebral fractures in susceptible individuals.10,23 Given that LAF-AGEs and SAF-AGEs are significantly correlated,24 it would be reasonable for future studies to examine whether LAF-AGEs could serve as a valid indicator of fracture risk in longitudinal investigations of young cohort. On the other hand, this study used the BMD data measured by DXA at forearm which is widely in routine physical examinations. More analysis should be undertaken to explore whether and how strong the correlations are between LAF-AGEs and bone mass loss at other body sites such as lumbar spine and wards triangle. Further studies with longer follow-up will be helpful to establish whether LAF-AGEs could be used as a risk indicator of osteopenia and later osteoporosis.

In conclusion, this cross-sectional study of normal individuals under the age of 50 confirmed significant association between LAF-AGE levels and osteopenia. Together with other known risk of factors of osteopenia, the non-invasive and reliable measure of LAF-AGEs provides the possibility of more accurate risk profiling and early diagnosis of osteopenia.

Dr. Huyi Feng is a chief medical doctor in hepatobiliary surgery and the director of the Fifth Peoples Hospital of Chongqing. He received his MD in 1984 from West China Medical University and MMed in 2002 from Chongqing Medical University. He published 20 academic papers, had completed 9 research projects and is in charge of one on-going research project in medical science. He is the vice-chairman of Chongqing General Surgery Committee of Chinese Medical Association Integrative Medicine and a member of Chongqing Minimally Invasive Surgery Committee. He is also an editor of the journal Chongqing Medicine. He is expert in diagnosis and treatment of hepatobiliary and pancreatic diseases, especially in laparoscopic technique and laparoscopic cholecystectomy. His research interests include hepatobiliary and pancreatic diseases, endocrine system and advanced glycation end products.

Dr. Shaoyun Li is a data scientist working in the Big Data Laboratory of the Fifth Peoples Hospital of Chongqing. She received her PhD in computer science from De Montfort University in the UK in 2007. She has been working on the research and development in software engineering and data analysis for more than 20 years, especially focusing on medical science in the past 2 years. She has published more than 20 academic research papers in software engineering and medical science. Her current research interests include integration and analysis of medical data to discover the association between diseases and medication.

The electronic medical record data retrieved from the Fifth Peoples Hospital of Chongqing was anonymized for this study. Summary data that were used to support the findings of this study may be requested from the correspondent author.

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Fifth Peoples Hospital of Chongqing (protocol code: 2019CQSDWRMYYEC-003) on 10th March 2019.

We thank Sinocare Co. Ltd., China for providing the AGEscan Lens Fluorescence Microscope which was used to measure LAF-AGEs in our research.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

This research was funded by two National Key R&D Programs of China, grant numbers: 2018YFC2001003 and 2018YFC2001001.

The authors have declared that no competing interest exists.

1. National Health Commission of the Peoples Republic of China. Results of the first epidemiological survey of osteoporosis in China; 2018. Available from: http://www.nhc.gov.cn/wjw/xwdt/201810/d816a5c72f6b45e399a1e7214642cd47.shtml. Accessed August 26, 2022.

2. Varacallo M, Seaman TJ, Jandu JS, Pizzutillo P. Osteopenia. In: Statpearls. Treasure Island (FL): StatPearls Publishing; 2020.

3. Tucci JR. Importance of early diagnosis and treatment of osteoporosis to prevent fractures. Am J Manag Care. 2006;12:181190.

4. Kuo T-R, Chen C-H. Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives. Biomark Res. 2017;5:18. doi:10.1186/s40364-017-0097-4

5. Mekkawy ND, Elsaeed WF, Ahmed HS, Khaliel AM. Importance of serum osteocalcin as early biomarker for osteopenia in preterm neonates receiving total parenteral nutrition. Zagazig Univ Med J. 2019;28:497504.

6. Parveen B, Parveen A, Divya V. Biomarkers of osteoporosis: an update. endocrine. Metab Immune Disord Drug Targets. 2019;19:895912. doi:10.2174/1871530319666190204165207

7. Kida Y, Saito M, Shinohara A, Soshi S, Marumo K. Non-invasive skin autofluorescence, blood and urine assays of the advanced glycation end product (age) pentosidine as an indirect indicator of age content in human bone. BMC Musculoskelet Disord. 2019;20:627. doi:10.1186/s12891-019-3011-4

8. Tabara Y, Ikezoe T, Yamanaka M, et al. Advanced glycation end product accumulation is associated with low skeletal muscle mass, weak muscle strength, and reduced bone density: the nagahama study. J Gerontol: Med Sci. 2018;74:14461453. doi:10.1093/gerona/gly233

9. Steenbeke M, Bruyne SD, Aken EV, et al. Uv Fluorescence-based determination of urinary advanced glycation end products in patients with chronic kidney disease. Diagnostics. 2020;10:34. doi:10.3390/diagnostics10010034

10. Waqas K, Chen J, Koromani F, et al. Skin autofluorescence, a noninvasive biomarker for advanced glycation end-products, is associated with prevalent vertebral and major osteoporotic fractures: the Rotterdam study. J Bone Miner Res. 2020;35:19041913. doi:10.1002/jbmr.4096

11. Sim-Servat O, Planasa A, Ciudin A, Sim R, Hernndez C. Assessment of advanced glycation end-products as a biomarker of diabetic outcomes. Endocrinologa, Diabetes y Nutricin. 2018;65:540545. doi:10.1016/j.endien.2018.06.003

12. Cahn F, Burd J, Ignotz K, Mishra S. Measurement of lens autofluorescence can distinguish subjects with diabetes from those without. J Diabetes Sci Technol. 2014;8:4349. doi:10.1177/1932296813516955

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14. Teda Shenghong Medical Apparatus Co. Ltd. C. Manufacturer Instruction: sgy-I. 2010.

15. Burd J, Lum S, Cahn F, Ignotz K. Simultaneous noninvasive clinical measurement of lens autofluorescence and Rayleigh scattering using a fluorescence biomicroscope. J Diabetes Sci Technol. 2012;6:12511259. doi:10.1177/193229681200600603

16. Pehlivanolu S, Acar N, Albayrak S, Karakaya M, Ofluolu A. The assessment of autofluorescence of the crystalline lens in diabetic patients and healthy controls: can it be used as a screening test? Clin Ophthalmol. 2018;12:11631170. doi:10.2147/OPTH.S164960

17. Yamamoto M, Sugimoto T. Advanced glycation end products, diabetes, and bone strength. Curr Osteoporos Rep. 2016;14:320326. doi:10.1007/s11914-016-0332-1

18. Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Rev Endocr Metab Disord. 2011;11:237251. doi:10.1007/s11154-010-9154-0

19. Teng Z, Zhu Y, Yu X, et al. An analysis and systematic review of sarcopenia increasing osteopenia risk. PLoS One. 2021;16:114. doi:10.1371/journal.pone.0250437

20. Yang D-H, Chiang T-I, Chang I-C, Lin F-H, Wei -C-C, Cheng Y-W. Increased levels of circulating advanced glycation end-products in menopausal women with osteoporosis. Int J Med Sci. 2014;11:453460. doi:10.7150/ijms.8172

21. Augat P, Fuerst T, Genant H. Quantitative bone mineral assessment at the forearm: a review. Osteoporosis Internationa. 1998;8:299310. doi:10.1007/s001980050068

22. Wang Y, Zhang Z. Comparision forearm bone mineral density between lumbar spine and hip: a useful tool to screen osteoporsis in female patients with rheumatoid arthritis. Ann Rheum Dis. 2019;78:1634.

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24. Skrha J, Soupal J, Prazny M, Skrha J. Lens autofluorescence relates to skin autofluorescence but poorly to glycated haemoglobin in patients with diabetes. Diabetologia. 2015;58:560.

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tHE association between LAF-AGEs and osteopenia | MDER - Dove Medical Press

For young students, seeking reproductive health resources available in the area may be difficult to find.

Fosnight Center embraces the uniqueness of each individual in an effort to ensure all feel safe and welcome regardless of intersectional identities, said Casey Duncan, the director of administrative services for the Fosnight Center for sexual health in Asheville.

The director said the Fosnight Center provides inclusive healthcare for all bodies. The center covers gender affirming care, gynecology and urology services, sexual and integrative medicine and physical therapy.

At the Fosnight Center, we recognize the pieces and put them together to create an individualized treatment plan through a multidisciplinary team approach, Duncan said. You will have the opportunity to be evaluated by our medical providers, pelvic health physical therapist and sex therapist in order to look at the whole picture of your health concern.

The director said the sexual health center provides gender inclusive contraceptive care, gender affirming hormone therapies, STI testing and preventative care.

According to the CDC, before the overturning of Roe 65.3% of people born with a uterus were using contraceptives.

We pride ourselves on creating a safe space for all our patients and clients. Duncan said. We believe everyone deserves to love their body.

The Fosnight director said the center is passionate about reproductive freedom and bodily autonomy for all.

We are committed to cultivating an inclusive environment that benefits all our providers, staff, clients, patients and the community, Duncan said.

Duncan said the sexual health center accepts most commerical insurances and has self-pay discounts.

According to Planned Parenthood, after the overturn of Roe v. Wade on June 24, many Planned Parenthood centers were forced to close leavingmany low income young adults struggling to find affordable testing and sexual health clinics.

The staff understand the unique needs and challenges of being a college student, said Jay Cutspec, the director of Health and Counseling at UNC Asheville.

Cutspec said students receive basic reproductive care and services at UNCA comparable to a family physicians office.

We adapt our services to meet the unique needs of college students, Cutspec said. We have a diverse staff from a variety of backgrounds and experiences.

The health and counseling director said they advise students to make the Health and Counseling Center their first step. If they cannot provide specific services or have unmet needs, students will be referred to the most appropriate community provider.

The phone number for the Health and Counseling Center is (828)-251-6520.

We also understand that for many students, this may be the first time that they have to manage their own healthcare, Cutspec said. We try to educate them on how to manage the healthcare system.

Cutspec said the only charge for a visit to the Health and Counseling Center is for possible medication prescription or lab tests received during the visit.

The Menstrual Equity Club on UNCAs campus takes these matters into their own hands providing safer sex supplies, menstrual products and community health resources.

We have had the pleasure of partnering with organizations such as the Western North Carolina Aids Project and Planned Parenthood, said Samantha Mazze, a UNCA student studying psychology and co-president of the equity club.

Through these collaborations we have been able to provide the campus population with free HIV testing and guest speaker community health educators, Mazze said.

Mazze said the club members pride themselves on providing safe spaces for students to discuss reproductive justice, campus community needs and concerns.

The UNCA student said this was their third year being a part of the Menstrual Equity club.

The co-president said in the past year one of the biggest projects the club worked on was providing free menstrual products in all bathrooms on campus.

One of our goals for this next year is to make sure all students on campus have access to these essential supplies regardless of the bathroom they use, said Mazze.

Mazze said another project the club organizes is the packing party, a Halloween goodie bag filled with menstrual products, candies, stickers and more for students. The co-president said with events like packing parties the club donates supplies back to the community.

The UNCA student said the presence of organizations like the menstrual equity club are crucial because voices are not being heard.

We continue to see people of color and the LGBTQ+ community be consistently overlooked by our healthcare and justice systems, said Mazze.

Mazze said after their graduation they want to continue their efforts in reproductive health, and become a sex therapist.

The co-president said students wishing to get involved can follow the clubs instagram page @uncaforme or join the email list [emailprotected].

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UNCA and Asheville clinics priortize inclusive healthcare The Blue Banner - The Blue Banner

Sri Balaji Vidyapeeth (SBV) has launched an Institute of Salutogenesis and Complementary Medicine (ISCM) to better integrate ongoing complementary therapeutics and wellness medicine programmes for patients.

SBV has been providing complementary medicine services since 2007 in the form of music therapy interventions and yoga to target specific diseases, and in combination with modern medicine.

Both these services were subsequently established as centres - the Centre for Music Therapy Education & Research and the Centre for Yoga Therapy Education and Research.

Bhushan Patwardhan, chairman, executive committee, National Assessment and Accreditation Council (NAAC), and former vice-chairman, University Grants Commission (UGC), launched the facility at a function recently.

In his remarks, Dr. Patwardhan drew reference to the statistics provided by the World Health Organization (WHO) that nearly 80% of the global population utilises traditional, complementary and integrative medicine (TCIM).

Despite the rapid advances made in medical sciences and therapeutics, a mention must be made of the fact that several challenges do exist with reference to accessibility and affordability, he noted.

A holistic approach would involve the physical, mental, social and spiritual dimensions. In this regard, salutogenesis or wellness has been seamlessly integrated at SBV with the essential principles of complementary medicine and allopathy, he said.

Subhash Chandra Parija, SBV vice-chancellor, said that since the establishment of yoga and music therapy centres, an impressive volume of evidence had been generated through research publications in high-impact journals. Several thousands of people had benefited from outreach services.

On the academic front, several courses and programmes, including certificate, PG diploma, masters and doctoral programmes in music and yoga therapy, are being offered. It was in this context that a decision was made to upgrade the facilities into ISCM, with the aim of providing salutogenesis and wellness for all, Dr. Parija said.

N. Ananthakrishnan, Dean of Faculty, SBV, noted that yoga and music interventions would strive for promoting wellness when combined with standard healthcare. The concept of salutogenesis had been integrated into modern medicine, and this was an important contribution of SBV, especially during the post-pandemic period, he said.

Ananda Balayogi Bhavanani, Director, ISCM, said the upgradation of yoga and music therapy centres into ISCM would go a long way in promoting salutogenesis, besides addressing several disorders of lifestyle, metabolism and endocrine and nervous systems. A.R. Srinivasan, Registrar, SBV, Madanmohan Trakroo and Sumathy Sundar also participated in the event.

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Salutogenesis institute launched in Puducherry - The Hindu

Getting sick from COVID is bad enough, but for many it doesn't just end there. Millions will experience a long list of lingering symptomslike brain fog, fatigue, headaches, shortness of breath, neurological symptoms and GI issues for weeks, months and possibly years after the initial infection. According to the Centers for Disease Control and Prevention, "New data from the Household Pulse Survey show that more than 40% of adults in the United States reported having COVID-19 in the past, and nearly one in five of those (19%) are currently still having symptoms of "long COVID." Eat This, Not That! Health spoke with experts who explain how COVID affects the gut and signs you have Long COVID. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Raphael Kellman, MD, a Physician of Integrative and Functional Medicine tells us, "Research is showing that the COVID virus can actually impact and adversely affect the microbiome, which then results in inflammation in intestinal permeability, and a host of consequences that occur when the gastrointestinal wall becomes more permeable than it should be to toxins, environmental chemicals, and byproducts of bacterial metabolites. That can then cause a number of problems in the body, including inflammation and even oral immunity. A component of the effects of coronavirus is its impact on the microbiome and that's even if you don't have gastrointestinal symptoms. So that's why improving the microbiome is a very important component in the healing of COVID. Also, dealing with vaccines in vaccine injury assists with prevention and the treatment of long haul COVID."

Jacob Teitelbaum, M.D., Integrative Medicine Physician, Researcher and Bestselling Author From Fatigued to Fantastic! adds, "In some people, COVID likes to make a persistent home for itself in the gut lining. As the gut makes more brain and mood controlling neurotransmitters than the brain itself, This can trigger the persistent brain fog and anxiety frequently seen in long haulers."

Dr. Teitelbaum says, "It is not uncommon to see people come down with persistent diarrhea and sometimes nausea as part of their Long Covid."

Dr. Kellman adds, "Many people who've had no gastrointestinal symptoms before they got COVID have developed gastrointestinal symptoms. There's no doubt about it. Certainly, if one has an autoimmune gastrointestinal disease like Colitis or Crohn's disease, they're more susceptible to exacerbation. People who have had no gastrointestinal disease, symptom or problem at all developed GI and COVID related problems. They could persist for quite a while."

Dr. Teitelbaum explains, "Although the research has been done actually showing persistent parts of the Covid virus in the gut lining, these tests are not available outside of research settings. But they look very different on colonoscopy and biopsy. The main tipoff? That the gut symptoms started with a viral infection didn't go away."

Dr. Kellman states, "Well, first of all if someone had Crohn's before they would know. But if it's a new onset with Crohn's, you could get mucus and/or blood in the stool, same thing with Colitis. This is not as common with COVID, but there's a lot of crossovers because COVID can induce autoimmunity as well. So, it can be a trigger for Colitis and Crohn's disease. COVID could really cause many problems. It's a really difficult disease, as it has many weapons to it."

Dr. Teitelbaum shares, "In those that I treat, I begin with ivermectin 20 27 mg a day (depending on the person's weight) for five days along with Pepcid 20 to 40 mg twice a day. Interestingly, Pepcid has been shown to have marked immune and anti-COVID activities in a good number of studies. A recent Yale study also showed reactivation of the Epstein-Barr (Mono) Virus in people with Long Covid, and we have known for decades that Pepcid stimulates your immune system in ways that are helpful for this as well. In addition, Our recently published studies showed that a unique form of ginseng very high in rare ginsenosides resulted in 67% average increase in energy in post viral chronic fatigue syndrome."

According to Dr. Kellman, "There are absolutely things that can be done and it relates to restoring the microbiome. COVID can adversely affect the health of the microbiome. It reduces its diversity and it can absolutely reduce percentages of certain healthy bacteria in the gut and overgrowth of some other bacteria. So, number one, reestablishing some balance of the microbiome and helping it to endogenously become healthier so that it could flourish. A very important component of treatments is the use of both probiotics and prebiotics. Prebiotics are the nutrients that are used to help a healthy gut microbiome to proliferate and become more diversified. Probiotics that have immune modulating and anti-inflammatory effects,.are important to incorporate to assist with relief. When the microbiome is adversely affected by COVID, it can lead to an immunological flare up, even autoimmunity. So, you want to use the types of probiotics that tend to modulate and reduce the overactive immune expression."

Dr. Kellman lists the following GI symptoms that can happen with Long COVID:

"Persistent abdominal discomfort and cramps is certainly one possible sign that COVID has affected your gut.

Constipation and/or diarrhea is another sign, some people actually have alternating constipation and diarrhea post COVID.

Bloating is another symptom that I've seen.

When there's gastrointestinal symptoms, invariably, there are other systemic symptoms as well, such as brain fog and difficulty concentrating anxiety. It's rare that you'll see someone with long haul COVID and that they only have gastrointestinal symptoms. It's quite common that it's associated with problems in the brain as well, including anxiety, depression, brain fog, poor memory and difficulty concentrating, which is very common."

Dr. Teitelbaum shares, "The main symptoms of long Covid are fatigue, brain fog, achiness, and insomnia. Although you may have symptoms localized just to the gut, the onset after Covid and the association of these other symptoms suggests that possible long Covid needs to be addressed."

Dr. Teitelbaum tells us, "The more often one gets COVID, the more likely they are to have more severe illness. But in an otherwise young healthy and low risk population, the risk is still low. What is most important is to maintain optimal health and immune function. This can be as simple as taking a good daily multivitamin with zinc 15 mg, vitamin D 1000 units and other key nutrients. I recommend either the Energy Revitalization System vitamin powder or a combination of Clinical Essentials plus Virapro. Remember, 40% of people who get the virus have no symptoms whatsoever. And only about 20% of people in a household where somebody has the virus catches it. So simple measures such as a good multivitamin, getting your eight hours of sleep a day, and staying hydrated can make all the difference in the world."6254a4d1642c605c54bf1cab17d50f1e

Dr. Kellman explains, "It's most important for people to realize that long haul COVID is a big problem. Some studies show as high as 30% of people who've had COVID develop some form of long haul COVID and sometimes symptoms can start months later. So, it's very tricky to diagnose and sometimes people don't see the connection.

It's very elusive but it could have significant adverse consequences, not only in the fact that many people feel so terrible, but it could have detrimental effects on the brain and other organs. Causing persistent inflammation, which can then lead to a number of different problems, including coronary artery disease, neurological problems and neurological inflammation, which can then lead to neurodegenerative disorders and poor cognitive function. It's important to understand that number one, it needs to be diagnosed and identified and people need to be more aware of this possibility that their symptoms may be due to long haul COVID and not just say aging or "I'm just not feeling so good these days." Make the connection that if you've had COVID and you're having these symptoms, this definitely could be long haul COVID. In fact, some people have long haul COVID who had very mild symptoms with COVID. And then a few weeks or a month later they have long haul COVID symptoms such as brain fog, difficulty concentrating, anxiety, poor memory, and common fatigue among others." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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NAPLES, Fla., Aug. 29, 2022 (GLOBE NEWSWIRE) -- Lifestyle Healing Institute, a center for complementary and alternative medicine, treats illnesses with data-driven approaches delivered by a medical team with decades of experience. With new investments in its outdoor garden campus, LHI recently enhanced its holistic, integrative approach to healthcare.

LHI's improved campus includes gardens, nature paths for walking and bicycling, a swimming pool and badminton court, and outdoor spaces for meetings, lounging, meditation and prayer.

LHI founder Wyatt Palumbo said the treatment center has added the new features to enhance and improve patients' recovery process.

"It's like going to your primary care doctor or any specialist's office and having the ability to work with your doctors in both a clinical setting as well as in a real-world application," Palumbo said. "Patients have the ability to work in a clinical setting, and also in more of an everyday life setting, where they are able to ask questions and learn hands-on what works for them. They can directly apply lifestyle tools, new ways of life, and rediscover old ones."

The campus also allows caretakers such as spouses and other family members - the "silent warriors," Palumbo said - the opportunity to participate in both individual and group treatments to support their loved ones' healing and recovery process.

By blending scientifically validated diagnostics and therapies with the necessary lifestyle changes to support both the body and mind, LHI specializes in the treatment of chronic illness, including immune and infectious disease disorders like chronic Lyme disease, as well as chronic conditions involving pain, fatigue, brain fog, among others. Now patients with these everyday illnesses have the opportunity to work in both a traditional setting of a clinic and the real-world outdoor setting of what Palumbo calls the "pharm property."

"I haven't seen this kind of integrated treatment center short of payingtens of thousands of dollars or unless you have access to a large-scale hospital and university system," Palumbo said. "It's now available to the everyday patient locally and nationwide becoming the only Lyme disease treatment center of its kind."

All of LHI's therapies and facilities are integrated within one personalized treatment program with a multidisciplinary team of doctors and healthcare practitioners with more than 150 years of clinical and medical experience.

Each program includes utilization of the "pharm property," the outdoor space that spans about two acres andfunctions as a "real-world rehabilitation" for adults working towards healing, both one-on-one and in groups.

"We began by providing chronic Lyme treatment, addressing all the symptoms that accompany the disease," Palumbo said. "Treating those patients quickly showed us that this kind of facility better supports the whole person no matter the symptoms they had."

LHI has successfully treated more than 1,000 patients since its founding in 2014 with its holistic and integrative approach to traditional care, blending biochemical, emotional, psychological, and lifestyle therapies in both indoor and outdoor environments.

"We are hoping to redefine what primary care should look like," Palumbo said. "It's critical that we address each person's unique healing needs while keeping them engaged in the process, and investing in our natural campus ensures we can continue to do that."

To learn more, visit https://lifestylehealinginstitute.com.

About Lifestyle Healing InstituteLifestyle Healing Institute is a complementary and alternative treatment center specializing in chronic illness and overprescribed medications. Using a data-driven, holistic approach to healthcare, LHI's patented Baseline Therapy is delivered in one treatment program by a team of integrated doctors and healthcare professionals. To learn more, visitwww.lifestylehealinginstitute.com.

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Your immune system works hard to fight off forein invaders like infections and germs to keep you healthy and it never gets a break. It works around the clock everyday to protect you, so helping your immune system stay strong is vital to your overall well-being. So how can you help strengthen your immunity? Eat This, Not That! Health spoke with Dr. Michael Hirt, a Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California who shares what to know about your immune system, signs it's too weak and how to help boost it. As always, please speak with your physician for medical advice. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Hirt tells us, "You know exercise can make your heart stronger. You know puzzles can make your brain smarter. However, even after two years of pandemic health lessons, people are still puzzled as to how to reliably make their immune system stronger. Like your cardiovascular and nervous systems, the immune system is subject to the same lifestyle choices that affect the rest of your body. Eat too much sugar, drink too much liquor, shorten your sleep hours, and you should not be surprised that you are going to wake up with your heart pounding, brain fogged in, and the start of a sore throat. You are the sum of your choices, and a robust immune system is no exception to your cumulative health investments (or lack thereof)."

"The innate programming of your immune system is only to attack microbial threats and coordinate repairs ranging from skin scrapes to broken bones," says Dr. Hirt. "Under the influence of environmental toxins, intestinal imbalances (from diet and bacteria), and genetic tendencies, some parts of your immune system can go 'rogue' and attack the body it was sworn to only defend. This is called an auto-immune condition because the immune system is attacking parts of self like joints, skin, or internal organs. This is never supposed to happen, serves no evolutionary benefit, and requires major lifestyle changes, detoxification, and medical interventions to stop the attack and remove the triggers of self-attack. Without a coordinated healing effort, the immune system will likely continue to attack itself and require strong, immune-suppressive measures."

Dr. Hirt shares, "If you're thinking of trying to boost your immune system, consider how you would boost the effectiveness of your nation's defense forces. To have a stronger, more effective military, you would feed them healthy food, ensure they are well rested, avoid unnecessary stress, house them on clean bases, provide cutting edge equipment, and have plenty of munitions so they never run out of bullets and missiles. Same with your immune system. Eat the healthiest food you can, in the cleanest environment you can, under the least stress you can, having had the most restful sleep you can, and taking the best vitamins you can including zinc, vitamin C, and vitamin D. Just like our military, your immune system never gets to take a collective break from defending you from all threats, both foreign and domestic."

Dr. Hirt states, "Most adults get a cold or flu 2 3 times yearly. If you're calling in sick on a monthly basis, you could have a more significant immune deficiency that needs testing and treatments."

"When you cut your self, superficial wounds typically take seven days to heal," Dr. Hirt tells us. "If you are watching your skin take weeks to heal, then your immune system may be compromised."6254a4d1642c605c54bf1cab17d50f1e

According to Dr. Hirt, "When you get an upper respiratory infection, most people with healthy immune systems can fully recover in ten days. If your symptoms go on for most of the month, then there may be issues with the strength of your immune responsiveness."

"There are many reasons to be tired," Dr. Hirt says. "Many people are surprised to learn that one of them is a weak immune system, or low white blood cell count. If you are experiencing unusual fatigue, make sure your healthcare provider includes a screening test for your immune system."

Heather Newgen

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Sure Signs Your Immune System Isn't as Strong as it Should Be Eat This Not That - Eat This, Not That

Note: This article is a paid placement and does not necessarily reflect the views or opinions of Billy Penn at WHYY.

With the United States long at the forefront of medical breakthroughs, why do so many Americans still get sick with preventable illnesses?

Around 60% of adults in the U.S. have a chronic disease, according to the CDC, and over 40% have more than one.

The fast-growing field of integrative medicine looks to address that problem. Its practitioners are trained to consider the whole patient the person instead of just the symptoms or the disease. Its the driving philosophy behind the Marcus Institute of Integrative Health Jefferson Health in Philadelphia, where doctors just published a book with insights and tips on how you can use this thinking to further your own health.

Called Tapestry of Health: Weaving Wellness into Your Life through the New Science of Integrative Medicine (Kales Press), the book is by Marcus Institute founding director and CEO Daniel Monti, MD, and Medical Director Anthony Bazzan, MD.

It presents a step-by-step plan of evidence-based restorative approaches and emerging cutting-edge strategies. Its been well-received by readers, rocking a 4.4-star rating on Amazon, and by other experts in the field,

This book is so incredibly timely and important, writes Sara Gottfried, a doctor with four NYT best-sellers who provided the new books forward, because it helps you understand this new paradigm of health a massive shift that affects healthcare providers and patients alike,

As its currently structured, the authors say, the medical field suffers from an overemphasis on acute care, which is a reactionary approach. Under this model, when a person gets sick, medical care is sought and a standard treatment be it drugs or surgery is prescribed. Theres no doubt this approach has saved many lives. But it is not enough.

Heart disease, cancer, stroke, and diabetes are leading causes of death and disability in the U.S., accounting for the majority of the nations $4.1 trillion a year in health care costs.

In many cases, these illnesses are significantly exacerbated by key lifestyle risk factors. Some, such as tobacco use, are straightforward and easy to understand. Others, including the vital role of diet and specific nutrients, physical inactivity, and stress effects on immunity, are more complex.

In the case of immune resilience, the pandemic is a perfect example of how acute care medicine dominated the conversation.

Everyone understandably became very focused on the COVID-19 pathogen. However, what got lost was the state of the host i.e. people! For example, we know nutritional status affects the immune response to the virus, and that stress in general affects the immune system in very measurable ways. So while we very much needed an effective vaccine, we also needed tools to maximize immune wellness to maximize the host response to infection. That largely did not happen.

Some in medicine have begun to recognize the gap, which is why a new paradigm is emerging that integrates the best of modern medicine with proactive, holistic and preventive care.

Thomas Jefferson University is at the forefront of this movement. The Philly institution recently created the first-ever Department of Integrative Medicine & Nutritional Sciences at Sidney Kimmel Medical College. The new department includes the clinical programs of Jefferson Healths Marcus Institute of Integrative Health. These programs have introduced an approach to care that is a multifaceted partnership, connecting all aspects of well-being, including the physical, emotional, intellectual, spiritual, social, and nutritional.

To learn more about the book and other resources, visit the Tapestry of Health website.

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In a recently published report, Northwestern Health Sciences University (NWHSU) has identified seven domains of knowledge, skills, and behaviors that clinicians need to provide the best integrative care.

Integrative care has many elements. At NWHSU, the concept of integrative care extends beyond multi-disciplinary care, including team-based and holistic care, interprofessional collaboration, and partnerships between patients and communities. Integrative care also includes interdependent considerations such as genetics, social determinants of health, community support and resources, and beliefs and habits that influence health.

Domain 1, values, ethics, culture, and diversity: In integrative care, clinicians work with colleagues in other professions in a climate of mutual respect and shared values, with the recognition that there is diversity in and between disciplines as well as diversity in patient populations.

Values, ethics, culture, and diversity are the connective tissue of integrative care and a transdisciplinary approach to healthcare, says Michele Renee, DC, director of integrative care at NWHSU. "It is the shared mindset that unifies diverse paradigms of healing, creating a dynamic approach in which each point of view is honored and yet not sufficient in and of itself. We are also acknowledging the importance of social factors, from socio-economic status to religion to cultural norms, and professional diversity, from indigenous healing to mainstream medicine to complementary and integrative healthcare approaches. All these differences are important considerations in providing robust, multifaceted, and individualized approaches to care."

Domain 2, patient-centered care: Clinicians should seek out, integrate, and value contributions and engagement of the patient, family, and community in designing and providing care.

Patient-centered care acknowledges the pivotal role of patients in their care, Renee says. "Patient-centered care calls out the importance of acknowledging the bio-psycho-social-spiritual nature of whole person care. It is vital that healthcare providers are not doing to the patient, but rather with the patient. Our patients are active participants in care and the most important person in a healthcare team."

Domain 3, roles and responsibilities: Clinicians should use knowledge of their role and the role of other professions to identify and address the healthcare needs of patients, families, and communities.

"For team-based care to work, we must each understand the part we play, the unique skills others bring, and how we all fit into the larger picture. This is a dynamic process, created uniquely for each person we serve. These skills are essential to ensure care is complete and wraps around our patients and communities," Renee says.

Domain 4, interprofessional communication: Clinicians should be responsive and responsible in their communication with patients, families, communities, and other healthcare professionals, which helps establishing a team approach to health and the treatment of disease.

Communication is often where healthcare fails, so shared communication competencies are essential, Renee says. "This includes understanding ourselves, acknowledging biases, identifying and resolving conflict when it arises, and documenting care in a way that is universally understood. Multilayered communication is key to building trusting relationships."

Domain 5, team and teamwork: Clinicians should practice relationship-building values and embrace team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient-centered care that is safe, timely, efficient, effective, and equitable.

Patients and communities rely upon their healthcare teams knowing how to evaluate, plan, and deliver care, Renee says. "This involves designing and implementing evidence-informed systems that support effective teamwork, and creating accountability for each care team member to focus on all aspects of patient and population focused problem solving. Team-based care goes beyond what happens in the treatment room or hospital to include social determinants of health and health equity."

Domain 6, collaborative leadership: Clinicians should foster shared leadership and collaborative practice of care.

Healthcare professionals need to cultivate the skill of passing the baton as needed, Renee says. "One provider may be providing the primary intervention at one moment in time and complementary care at another. The needs of the patient change over time and the care team needs to be prepared to collaborate and share leadership accordingly, leaning on one another's unique insights and expertise as needed."

Domain 7, well-being and resilience: Clinicians need to recognize that the health of an individual has positive and negative effects on their ability to make change around them and adopt sustainable strategies to address challenges, while remaining committed to their sense of purpose.

Building a resilient healthcare system starts with the well-being of healthcare professionals, Renee says. "Health creation begins with prioritizing self-care, which in turn reduces burnout and improves job performance and satisfaction. Learning the skills to identify one's circle of influence, develop a growth mindset, and cultivate grit prepare providers to better support patients in their own health creation by putting the focus on well-being and resilience instead of disease management."

Christopher Cheney is the senior clinical care editor at HealthLeaders.

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While the ideal amount of water varies for each person depending on your geographic location, body type, and more, according to Dana Cohen, M.D., integrative medicine physician and co-author of Quench, you should aim to drink about half of your body weight in ounces of water each day to ensure youre staying adequately hydrated.

However, while it would take a lot to reach the point of "overhydrating," it is, in fact, possible to drink too much water. "In overhydration an excess of water dilutes the electrolyte concentrations in the blood, causing imbalance throughout the body's many systems," physician Catherine Waldrop, M.D., previously told mbg.

In fact, drinking too much water can even lead to an electrolyte imbalance called hyponatremia, that can have some fairly gnarly side effects on the body. "Mild hyponatremia is characterized by gastrointestinal tract symptoms, nausea, vomiting, loss of appetite," one study revealed. In short, hyponatremia is essentially low sodium in the blood.

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Can You Really Drink Too Much Water? We Investigated - mindbodygreen

One simple breathing technique that takes just over a minute to complete could help you fall asleep faster and get a better night's rest overall, according to experts.

The technique, known as 4-7-8 breathing, was developed by Dr. Andrew Weila trained medical doctor and founder of the Arizona Center for Integrative Medicine.

Weil developed the technique, which is based on breathing exercises found in yoga, for the purposes of managing stress and anxiety.

But experts told Newsweek the technique can also be useful for people who are having trouble sleeping.

Sleep is crucial to our physical and mental health, enabling our body to recover and wake up feeling refreshed.

But large portions of the population don't get sufficient sleep, have poor sleep quality, or have trouble falling asleep as a result of sleep disorders, medical conditions or mental health issues.

According to the American Sleep Association, 50 to 70 million adults in the United States have a sleep disorder, with insomnia being the most common one.

Around 10 percent of adults suffer from chronic insomnia, while many more suffer short-term issues. Meanwhile around 25 million U.S. adults have obstructive sleep apneaa sleep disorder characterized by repeated obstruction to the airway during sleep.

In addition, 35 percent of adults report getting less than seven hours of sleep during a typical 24-hour periodless than the minimum recommend amount.

"The 4-7-8 breath that I teach is the most powerful relaxation method that I've discovered," Weil said in a video demonstration of the technique. "It's very simple, requires no equipment, takes very little time, costs nothing."

This is how to practise the technique correctly:

The speed with which you do the technique is not necessarily important. What is important is maintaining the 4-7-8 ratio between the counts.

According to Weil, this is a technique that you have to practise regularlyat least twice a dayto benefit from fully.

"You can do it more frequently than twice a day but never more than four breath cycles at one time," Weil said in the video.

According to Weil, it may take four to six weeks before you notice any physiological changes from the practise.

Over time he said it could help to lower heart rate, lower blood pressure, improve digestion, improve circulation, and to help people fall asleep.

"It is the most effective anti-anxiety techniques that I've found," he said. "I've taught it to patients with the most extreme forms of panic disorder, who eventually brought that under control, just relying on this breathing technique."

According to Patrick McKeown, a leading international expert on breathing and sleep, and author of bestselling books like The Oxygen Advantage, changing our breathing can have a profound impact on our physical and mental states.

"With breathing exercises one can down-regulate and up-regulate, giving us control over how our minds and bodies react to external stimuli," McKeown told Newsweek. "For sleep, breathing and mental health, functional breathing is instrumental.

"Knowing what exercises to practise can be life changing as we learn to change states. It's not about taking the deep breath. It's much more than that!"

According to McKeown, how a person breathes during the day will influence our breathing patterns during sleep.

"If our breathing patterns mean we are breathing through the mouth, with a faster rate and from the upper chest, (rather than from the diaphragm) this will increase the risk of sleep issues including insomnia, snoring and sleep apnea."

McKeown said that for people with functional breathing who are able to slow down their respiratory rate to around three breaths per minutelike during 4-7-8 exerciseextended exhalation will help activate the bodies relaxation response.

"When the rest and digest response is activated, one feels sleepy and experience increased watery saliva in the mouth," he said. "Slowing breathing rate also enables a better gas exchange to take place from the lungs to the blood.

"Practising this breathing technique before going to bed will not only help people fall asleep but will noticeably improve quality of sleep and when practiced regularly, will lead to a better quality of life all around."

Michael Breus, a clinical psychologist who is a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine, told Newsweek he is a "huge fan" of the 4-7-8 breathing technique.

According to Breus, the technique lowers the heart rate to the point it needs to be at night when some is trying to fall asleep.

"I have adopted this method, as both a 'help you fall asleep' but more of a 'help you get back to sleep' method," Breus told Newsweek. "Most people do not know this metric, but in order to get to a state of unconsciousness you need a heart rate of 60 or below, to get there. So, when you wake up in the middle of the night and your anxiety is high because you looked at the clock, this can help you get back to sleep."

In addition, Breus said there is plenty of data to show that diaphragmatic breathing helps to lower anxiety, which has been linked to difficulties falling and staying asleep.

"Most people are what we call 'shallow breathers' meaning that they do not use their full lung capacity, unless during full-on physical activity," Breus said. "This type of breathing requires more breaths per minute to get the required volume of air to live. More breaths per minute equals increased heart rateand we know we need to get to 60, which is usually down from where people tend to sit naturally (unless you are an athlete)."

Breathing for four counts in will slowly fill the lungs, holding for seven enables oxygen exchange to the fullest, and breathing out for eight pushes all the excess carbon dioxide out of the lungs and allows more fresh, highly oxygenated air to enter the system, and so the heart does not have to work as hard, according to Breus. This leads to a lowering of the heart rate.

McKeown said it is important to note that not everyone will be able to practise 4-7-8 breathing.

"People with poor breathing already experience a breathlessness that we call 'air hunger'. Slowing down the respiratory rate to three breaths per minute will be impossible for them to practise. It could even cause a disruption to their breathing," he said.

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