Unscrambling the egg enigma

I’m confused. When I was young I was told that I should eat only three eggs a week. Now they say I can eat one egg everyday if I want. What’s the real score? – D.S., Muntinlupa City

If you’re still not clear about whether it’s a good idea to eat eggs, that’s not surprising: The research isn’t too clear, either. A new analysis from a team of eminent cholesterol researchers sheds light on the egg issue.

Dutch scientists analyzed the combined results of 17 clinical trials on eggs and cholesterol levels. They focused on the ratio of total HDL cholesterol, which appears to be strongly correlated with coronary risk. The results indicated that eating an egg a day would increase the ratio by an amount that in theory would raise heart attack risk by two percent.

That’s not much – which may help explain why several observational studies of egg consumption have failed to detect any increased risk. Certainly, eggs raise cholesterol levels considerably less than foods high in saturated fat, such as fatty meat and dairy products. Eggs raise the "bad" LDL cholesterol less in people who consume little saturated fat than in those who consume a lot.

People whose heart risk and cholesterol levels aren’t elevated – particularly if their saturated fat intake is low – can almost surely eat an egg a day without worry. But others should eat probably less than one egg yolk (which contains the cholesterol) per day or, if their risk or cholesterol levels are specially high, avoid egg yolks almost entirely.

* * * A Pain In The Back

What exactly do chiropractors do? Can they really help with problems like back pain? – W.C., Pasig City

There are currently about 60,000 chiropractors in the United States and I know of at least three practicing in the Philippines. People go to them more than any other type of "complementary and alternative" medical practitioner. The mainstream of chiropractic focuses on spinal manipulation or moving the bones of the spine to bring them into proper "alignment" and relieve pain.

According to a review in the February 5, 2002 issue of the Annals of Internal Medicine, there have been at least 43 clinical trials of chiropractic for lower back pain. Most found that manipulation worked better than the various techniques it was compared to. Four out of 11 trials for neck pain were positive, although seven found no strong evidence one way or the other.

As a whole, the evidence supporting chiropractic for back and neck pain is marginal and open to interpretation. Still, a large number of people continue to use chiropractors and the evidence to date suggests that spinal manipulation rarely causes harm (although people with severe osteoporosis may be at higher risk of fractures). But as far as the scientific backing for spinal manipulation, only larger and more decisive studies can settle it.

* * * Creatine Use In The PBA

I am a well known professional basketball player so please do not put my initials when you publish this letter. I have teammates who use creatine to improve their fitness and performance. Does it really build strength and endurance?

Creatine, consisting of three amino acids, is naturally produced by the body. Most creatine is held in skeletal muscles. Some are converted into phosphocreatine, which makes energy available to the muscles for short bursts of physical activity. The kidneys, liver, and pancreas make one to two grams of creatine per day.

Creatine is used by many professional athletes to increase their strength and build muscle mass. A number of PBA players have consulted me on its use. Some older adults have also used it in the hopes of increasing muscle strength and mass.

Most studies to date have used a "loading" dose of 20 to 25 grams of creatine per day for five days, followed by a "maintenance" dose of two to five grams per day. A daily dose of three grams per day for 28 days may produce the same results.

The studies to date suggest that, in athletes, creatine supplementation may enhance strength in short bursts for certain forms of exercise – weight lifting and bicycle sprinting, for example. But as a whole, studies have been small and the results mixed, with some showing a possible effect and others showing no effect. Typically, people gain 1.1 to 3.5 pounds of lean body weight from taking creatine, although this is mostly due to water retention rather than a gain in actual muscle mass.

Creatine does not appear to be dangerous in healthy people when used at appropriate doses. Because the kidneys remove excess creatine, concerns have been raised whether creatine supplementation could impair kidney function. There have been reports of kidney failure or malfunction associated with creatine use, but it’s unclear whether creatine was actually the cause. Ultimately, the risks of long term creatine supplementation are unknown.

Despite all the research, it’s not clear who can benefit from creatine and at what dose. Some experts advise that people with kidney problems, people at risk of kidney failure (diabetics and the elderly), or people taking medications with possible adverse effects on the kidneys (such as ACE inhibitors, cyclosporin or non-steroidal anti-inflammatory drugs), should not use creatine. The U. S. Food and Drug Administration (FDA) recommends that consumers consult a physician before using creatine. If you end up taking creatine, make sure you drink lots of water with it to prevent dehydration.

* * * Can Cellulite Be Removed?

I have cellulite in my thighs. Is there anything I can apply on my legs or take orally to get rid of it? – J.O., Cebu City

You may call it "cellulite" or "adipose tissue" or just "fat." Actually it is just fat – technically, there’s no such thing as cellulite. Whatever you call it, no woman wants it – that bumpy, waffled, dimpled skin in areas where fat is deposited. Women are more prone to cellulite than men, not only because women have thinner skin and less even fat distribution under the skin, but also because they tend to accumulate fat around their hips and thighs. When fat cells increase in number, the accumulation stretches the connective tissue and the fat bulges, causing the overlying skin to take the waffled appearance. Most women have some degree of cellulite. Nothing completely gets rid of it.

This hasn’t kept cellulite removal from becoming a full-fledged industry. In stores, you’ll find creams of all kinds, including many with seaweed, white willow bark, herbs, anti-wrinkle chemicals, caffeine, and other ingredients. There is no evidence that anything you apply on your skin can "fight" cellulite. Health clubs and spas offer seaweed wraps, vibrators, massage, and aromatherapy – to name a few treatments for it. You can even buy a pantyhose that supposedly will reduce cellulite.

There are supplements that claim to help you lose weight and body fat. One such is Cellasene, a mix of ginkgo biloba, sweet clover, seaweed, and other ingredients, none of which would eliminate fat. The daily dose contains five times the RDA for iodine, on amount that could cause thyroid problems. The U. S. FDA has filed suit against Rexall Sundown for making false and unsubstantiated claims about this product.

And then there’s Endermologie. This cellulite treatment can be administered only by an M. D. and involves a massage with a high powered device that looks like a vacuum cleaner. You may need 14 to 21 sessions. It may temporarily improve appearance, but basically it is a costly gimmick.

There is no such thing as spot reducing. No product or treatment on the market will eliminate cellulite. If you are overweight, diet and exercise can help you lose weight and improve your appearance. If you are not overweight but still worry about cellulite, remember that the gaunt, taut young female body so admired in our time is not admired by everybody. As the Cellasene ads exhort, you should fight cellulite "from the inside" – but from the inside of your head. Older skin, maybe with a few bumps in it, can be beautiful, too. Fuller, rounder figures were once thought beautiful. Think of the women painted by Rubens or Rembrandt – or the Venus de Milo. Buy an art book, rather than an expensive cream that’s sure to fail.