Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial.

BACKGROUND: Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas. OBJECTIVE: To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise. STUDY DESIGN: Randomized controlled crossover trial with balanced allocations. SETTING: Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ±â€¯9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 oC ±â€¯SEM 0.12 oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 oC ±â€¯SEM 0.12 oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ±â€¯SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ±â€¯SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions. CONCLUSIONS: These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.

Acute effects of dietary plant nutrients on transcriptome profiles: evidence from human studies.

The health benefits of long-term dietary plant ingestion are well-established. However, literature on acute nutritional challenges is very limited. This study aimed to identify available evidence on transcriptomics responses to acute ingestion of plants or plant extracts and identify signature gene profiles that may serve as biomarkers of health status. We systematically searched electronic databases and extracted information based-on inclusion criteria such as human clinical studies, single plant-based nutrients and outcomes reported on acute transcriptome responses. A total of 11 studies reported on acute intake of plant dietary interventions. Four studies investigating natural oil extracts with three reporting on whole plants and two studies on natural plant-derived extracts. Gene expression was found to be associated with immune response (7 studies), inflammation (9 studies), metabolism (8 studies), cellular processes and cancer. The finding of this systematic review suggests that acute ingestion may significantly impact diverse physiological and pathological pathways including inflammatory, immune, cancer and oxidative stress pathways. Transcriptomics approach is proven to be an effective strategy in discovery of these anticipated mechanisms. Further studies are now required to validate and continue exploring the short-term health impact of dietary plants and their bioactive phytochemicals on gene expression and function.

A hot topic for health: Results of the Global Sauna Survey.

OBJECTIVE: Sauna-bathing is an ancient tradition that is gaining popularity across the world as a wellness tool. There is a growing body of medical evidence supporting the role of saunas, or whole-body thermotherapy, as a form of treatment for a range of health issues. However, the demographics, motivations and experiences of current sauna bathers have not yet been explored on a global scale. This study is designed to explore these themes. DESIGN: An online 71-item questionnaire compiling information on the individual characteristics, sauna-related habits and perceived health and wellness experiences of regular sauna bathers was conducted from October 2016 to October 2017. The validated 'SF-12' quality of life scoring tool was incorporated into the questionnaire to measure physical and mental indicators of well-being. RESULTS: Of 572 logins recorded, 482 valid responses were generated. Both men (51.3%) and women (48.7%) were represented, and respondents were predominantly well-educated (81.8%), non-smoking (90.6%), regularly-exercising (78.8%) individuals of normal-to-overweight status (87.1%) who sauna-bathed approximately 1-2 times per week. The key reasons indicated by respondents for sauna-bathing included relaxation/stress reduction, pain relief and socializing. Nearly a third of respondents reported medical conditions and of this subset, those with back/musculoskeletal pain and mental issues cited the greatest improvements in their conditions with sauna-bathing. Of all respondents, 83.5% reported sleep benefits after sauna use. Analysis of well-being scores after stratifying respondents into three groups by sauna-bathing frequency (group I: <5 times per month; group II: 5-15 times per month; group III: >15 times per month) revealed group II respondents had slightly higher mental well-being scores (Kruskal-Wallis testing: H = 6.603 > ꭔ2 of 5.991, p = 0.0368, df = 2 with post hoc analysis using Mann-Whitney U test: p = 0.016) as compared to respondents who were sauna-bathing less frequently (group I). No respective differences were detected between the physical well-being scores of any of the three groups. Adverse reactions to sauna-bathing were recorded as mostly minor (93.1%), including primarily symptoms of dizziness, dehydration and headache. However, there were two reports (0.3%) of chest pain and eye irritation requiring hospitalization. CONCLUSIONS: This cross-sectional study documents that sauna-bathing participants, particularly those from Finland, Australia and the United States, are motivated to use saunas predominantly for relaxation, reporting health benefits especially around mental well-being and sleep, with relatively few adverse effects. While these results reinforce some of the known health benefits of sauna bathing, they indicate that further research and better dissemination of existing evidence is needed to fully develop the sauna's potential as a therapeutic intervention.

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial.

OBJECTIVES: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. DESIGN: A pragmatic, multicentre, randomised, assessor-blinded, equivalence and non-inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10-point verbal numerical rating scale (VNRS) of at least 4. MAIN OUTCOME MEASURES: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. RESULTS: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non-inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention-to-treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between-group differences. CONCLUSION: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

Working Up a Good Sweat - The Challenges of Standardising Sweat Collection for Metabolomics Analysis.

INTRODUCTION: Human sweat is a complex biofluid of interest to diverse scientific fields. Metabolomics analysis of sweat promises to improve screening, diagnosis and self-monitoring of numerous conditions through new applications and greater personalisation of medical interventions. Before these applications can be fully developed, existing methods for the collection, handling, processing and storage of human sweat need to be revised. This review presents a cross-disciplinary overview of the origins, composition, physical characteristics and functional roles of human sweat, and explores the factors involved in standardising sweat collection for metabolomics analysis. METHODS: A literature review of human sweat analysis over the past 10 years (2006-2016) was performed to identify studies with metabolomics or similarly applicable 'omics' analysis. These studies were reviewed with attention to sweat induction and sampling techniques, timing of sweat collection, sweat storage conditions, laboratory derivation, processing and analytical platforms. RESULTS: Comparative analysis of 20 studies revealed numerous factors that can significantly impact the validity, reliability and reproducibility of sweat analysis including: anatomical site of sweat sampling, skin integrity and preparation; temperature and humidity at the sweat collection sites; timing and nature of sweat collection; metabolic quenching; transport and storage; qualitative and quantitative measurements of the skin microbiota at sweat collection sites; and individual variables such as diet, emotional state, metabolic conditions, pharmaceutical, recreational drug and supplement use. CONCLUSION: Further development of standard operating protocols for human sweat collection can open the way for sweat metabolomics to significantly add to our understanding of human physiology in health and disease.

The Clinical Efficacy and Safety of Tulsi in Humans: A Systematic Review of the Literature.

Tulsi, also known as holy basil, is indigenous to the Indian continent and highly revered for its medicinal uses within the Ayurvedic and Siddha medical systems. Many in vitro, animal and human studies attest to tulsi having multiple therapeutic actions including adaptogenic, antimicrobial, anti-inflammatory, cardioprotective, and immunomodulatory effects, yet to date there are no systematic reviews of human research on tulsi's clinical efficacy and safety. We conducted a comprehensive literature review of human studies that reported on a clinical outcome after ingestion of tulsi. We searched for studies published in books, theses, conference proceedings, and electronic databases including Cochrane Library, Google Scholar, Embase, Medline, PubMed, Science Direct, and Indian Medical databases. A total of 24 studies were identified that reported therapeutic effects on metabolic disorders, cardiovascular disease, immunity, and neurocognition. All studies reported favourable clinical outcomes with no studies reporting any significant adverse events. The reviewed studies reinforce traditional uses and suggest tulsi is an effective treatment for lifestyle-related chronic diseases including diabetes, metabolic syndrome, and psychological stress. Further studies are required to explore mechanisms of action, clarify the dosage and dose form, and determine the populations most likely to benefit from tulsi's therapeutic effects.

Do Wellness Tourists Get Well? An Observational Study of Multiple Dimensions of Health and Well-Being After a Week-Long Retreat.

BACKGROUND: Wellness retreats use many complementary and alternative therapies within a holistic residential setting, yet few studies have evaluated the effect of retreat experiences on multiple dimensions of health and well-being, and no published studies have reported health outcomes in wellness tourists. OBJECTIVES: To assess the effect of a week-long wellness-retreat experience in wellness tourists. DESIGN: A longitudinal observational study with outcomes assessed upon arrival and departure and 6 weeks after the retreat. SETTING: A rural health retreat in Queensland, Australia. INTERVENTIONS: A holistic, 1-week, residential, retreat experience that included many educational, therapeutic, and leisure activities and an organic, mostly plant-based diet. OUTCOME MEASURES: Multiple outcome measures were performed upon arrival and departure and 6 weeks after the retreat. These included anthropometric measures, urinary pesticide metabolites, a food and health symptom questionnaire, the Five Factor Wellness Inventory, the General Self Efficacy questionnaire, the Pittsburgh Insomnia Rating Scale, the Depression Anxiety Stress Scale, the Profile of Mood States, and the Cogstate cognitive function test battery. RESULTS: Statistically significant improvements (p < 0.05) were seen in almost all measures (n = 37) after 1 week and were sustained at 6 weeks (n = 17). There were statistically significant improvements (p < 0.001) in all anthropometric measures after 1 week, with reductions in abdominal girth (2.7 cm), weight (1.6 kg), and average systolic and diastolic pressure (-16.1 mmHg and -9.3 mmHg, respectively). Statistically significant improvements (p < 0.05) were also seen in psychological and health symptom measures. Urinary pesticide metabolites were detected in pooled urine samples before the retreat and were undetectable after the retreat. CONCLUSION: Retreat experiences can lead to substantial improvements in multiple dimensions of health and well-being that are maintained for 6 weeks. Further research that includes objective biomarkers and economic measures in different populations is required to determine the mechanisms of these effects and assess the value and relevance of retreat experiences to clinicians and health insurers.

Environmental Chemical Assessment in Clinical Practice: Unveiling the Elephant in the Room.

A growing body of evidence suggests chemicals present in air, water, soil, food, building materials and household products are toxicants that contribute to the many chronic diseases typically seen in routine medical practice. Yet, despite calls from numerous organisations to provide clinicians with more training and awareness in environmental health, there are multiple barriers to the clinical assessment of toxic environmental exposures. Recent developments in the fields of systems biology, innovative breakthroughs in biomedical research encompassing the "-omics" fields, and advances in mobile sensing, peer-to-peer networks and big data, provide tools that future clinicians can use to assess environmental chemical exposures in their patients. There is also a need for concerted action at all levels, including actions by individual patients, clinicians, medical educators, regulators, government and non-government organisations, corporations and the wider civil society, to understand the "exposome" and minimise the extent of toxic exposures on current and future generations. Clinical environmental chemical risk assessment may provide a bridge between multiple disciplines that uses new technologies to herald in a new era in personalised medicine that unites clinicians, patients and civil society in the quest to understand and master the links between the environment and human health.

Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial.

OBJECTIVE: To evaluate the effectiveness of a phytotherapeutic intervention comprising a combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus (Chaste tree/berry) in the management of menopausal symptoms. DESIGN: A double-blind, randomized, placebo-controlled, parallel trial was performed over 16 weeks in 100 eligible late-perimenopausal or postmenopausal women experiencing hot flushes and other menopausal symptoms. Herbal combination therapy or placebo tablets were administered twice daily. The primary endpoint was hot flush episodes. Secondary endpoints included Greene Climacteric Scale scores, Hamilton Depression Inventory scores, and Utian Quality of Life Scale scores. RESULTS: Ninety-three women completed the study. Data analysis on an intent-to-treat basis found no significant differences between the two groups for any of the endpoints. Analyses performed at interim data time points revealed no significant differences at week 4, 8, or 12 for daily weighted flushes or scores on the Greene Climacteric Scale or Hamilton Depression Inventory. However, significant improvements across the treatment phase were observed in both the placebo and active treatment groups for these endpoints. No significant change was found for either group on quality of life. CONCLUSION: The herbal combination of H. perforatum and V. agnus-castus was not found to be superior to placebo for the treatment of menopausal symptoms. The herbal combination was well tolerated with no significant adverse events noted in the short term. Robust findings from quality studies such as this are important for informing the community, healthcare providers, and regulatory authorities.

The integration of complementary therapies in Australian general practice: results of a national survey.

METHODS: Australian general practitioners' (GPs) attitudes toward and use of a range of complementary therapies (CTs) were determined through a self-administered postal survey sent to a random sample of 2000 Australian GPs. The survey canvassed GPs' opinions as to the harmfulness and effectiveness of CTs; current levels of training and interest in further training; personal use of, and use in practice of, CTs; referrals to CT; practitioners; appropriateness for GPs to practice and for government regulation; perceived patient demand and the need for undergraduate education. RESULTS: The response rate was 33.2%. Based on GPs' responses, complementary therapies could be classified into: nonmedicinal and nonmanipulative therapies, such as acupuncture, massage, meditation, yoga, and hypnosis, that were seen to be highly effective and safe; medicinal and manipulative therapies, including chiropractic, Chinese herbal medicine, osteopathy, herbal medicine, vitamin and mineral therapy, naturopathy, and homeopathy, which more GPs considered potentially harmful than potentially effective; and esoteric therapies, such as spiritual healing, aromatherapy, and reflexology, which were seen to be relatively safe yet also relatively ineffective. The risks of CTs were seen to mainly arise from incorrect, inadequate, or delayed diagnoses and interactions between complementary medications and pharmaceuticals, rather than the specific risks of the therapies themselves. CONCLUSIONS: Nonmedicinal therapies along with chiropractic are widely accepted in Australia and can be considered mainstream. GPs are open to training in complementary therapies, and better communication between patients and GPs about use of CTs is required to minimize the risk of adverse events. There is also a need to prioritize and provide funding for further research into the potential adverse events from these therapies and other therapies currently lacking an evidence base.

CAM practitioners and "regular" doctors: is integration possible?

Integrated clinics have already been established in response to community demand. The growing evidence base for complementary and alternative medicine (CAM) and its widespread community use compels doctors to understand complementary therapies and to refer patients to CAM practitioners where appropriate. Most general practitioners have patients with chronic illness who could benefit from the services of CAM practitioners, and virtually all CAM practitioners have patients who require access to mainstream diagnosis and therapy. Collaboration requires shared respect and trust, and education. Dangers of not integrating care include delaying or depriving patients of safe and effective management, and the potential for harmful interactions. Integration is currently being supported by government initiatives such as the new MedicarePlus package, as well as by initiatives from organisations such as the Australian Medical Association, the Royal Australian College of General Practitioners and the Australasian Integrative Medicine Association.

Characteristics of Victorian general practitioners who practise complementary therapies.

BACKGROUND: To compare the characteristics of Victorian general practitioners who practise and do not practise complementary therapies. METHOD: A self administered postal survey sent to 800 Victorian GPs. RESULTS: The response rate was 64%. There were no statistically significant differences between complementary therapy practitioners and nonpractitioners in the number of patients seen per week, urban versus rural location, solo versus group practice or Fellowship of the Royal Australian College of General Practitioners. In some complementary therapies, practising GPs tended to be male, full time and older. DISCUSSION: Victorian GPs who practise complementary therapies are on the whole not from the fringes of the medical community. The reasons why GPs include complementary therapies in their practice cannot be answered by this study.