Natural Healing

Many restorative traditions being used today have ancient roots. The practice of yoga may be 5,000 years old, and the use of botanical remedies reaches back to the dawn of humankind.

Bend and Be Well

Modern medicine is embracing the ancient Indian discipline of yoga, which can help ease ailments ranging from back pain to heart disease

BY LESLEY ALDERMAN

HARD TO BELIEVE NOW, BUT YOGA WAS ONCE CONSIDERED heretical, even dangerous. As recently as a century ago, yogis in America were viewed with suspicion; some were actually thrown in jail. Today, though, most gyms offer it, many public schools teach it, and a growing number of doctors prescribe it. Yoga studios are as ubiquitous as Starbucks. It may have taken 5,000 years, but yoga has arrived.

Although yoga means “union” in Sanskrit, there are widely diverse ways to practice it. There’s gentle yoga and power yoga. Iyengar and Ashtanga. Short classes and long. But almost all offerings share core elements: challenging postures (asanas), focused breathing, self-acceptance. And no multitasking allowed. The poses challenge muscles, while yoga’s meditative character calms the mind. Altogether, yoga activates healthy processes (such as the rest-and-digest response) and deactivates less healthy ones (stress), bringing the body into better balance. Turns out this ancient Indian practice is a one-stop antidote to our modern, caffeinated culture. “Yoga is a systematic way to improve the function of everything in the body a little bit,” says Timothy McCall, author of Yoga as Medicine. “Keep up the practice, and those improvements tend to deepen over time.”

Some of those improvements, a growing body of research suggests, affect an array of particularly hard-to-treat medical problems, including depression, multiple sclerosis and osteoporosis. And that message is finally getting through. “M.D.s are increasingly comfortable recommending yoga for conditions ranging from lower-back pain to stress,” says Baxter Bell, a physician and therapeutic yoga instructor in Oakland, Calif.

Yoga may provide benefits for an array of hard-to-treat medical problems, including depression, multiple sclerosis, osteoporosis and even rheumatoid arthritis.

As we all know, chronic stress is no joke. Over time it can exacerbate or increase the risk of serious conditions including obesity, heart disease, diabetes, depression and gastrointestinal problems. “Unfortunately, stress is one condition our culture hasn’t found a good way to treat,” says Brent Bauer, director of the Mayo Clinic Integrative Medicine Program.

Luckily for our culture, another one has. Researchers at Ohio State University College of Medicine compared 25 novice yogis with 25 expert yogis (those who had been practicing at least twice a week for a year or more). The expert yogis had lower blood levels of interleukin-6, a marker of inflammation that often results from stress, which in turn contributes to heart disease and diabetes. In addition, IL-6 levels in the expert yogis increased less after they were subjected to stressors.

Mood disorders also seem to respond positively to yoga. While any number of medicines can boost mood and lower anxiety, too often it is difficult to come up with the right cocktail of drugs for particular patients. And the side effects can be deterring. Yoga, though, has been shown to have a Prozac-like effect on the brain. Researchers at Boston University School of Medicine, for example, monitored two groups of individuals for 12 weeks: one group walked for 60 minutes three times a week; the other spent the same amount of time doing yoga. The yoga group reported lower levels of anxiety and a greater improvement in mood. As mood rose, so did levels of GABA (gamma-amniobutyric acid), a neurotransmitter that helps promote a state of calm. (Low GABA levels, in contrast, are associated with depression and anxiety.) “Yoga may work in part by correcting imbalances in the autonomic nervous system caused by stress,” says one of the study’s authors, Chris Streeter, a Boston University School of Medicine psychiatrist.

A number of small studies have shown that yoga can reduce physical pain too, particularly back pain. One study compared three treatment options over a 12-week period: a weekly yoga class, a weekly stretching class and reading self-help books on back care. The yoga and stretching groups both improved significantly during and after the trial; these participants had less pain and were able to move more easily than the readers. The study’s authors concluded that because the two exercise groups had similar effects, yoga’s contribution to alleviating back pain was “largely attributable to the physical benefits of stretching and strengthening the muscles.”

Yet the findings, which were published in Archives of Internal Medicine, may not tell the whole story. “All the yoga subjects did the exact same moves,” notes Loren Fishman, the medical director of Manhattan Physical Medicine and Rehabilitation in New York. “In real life, patients with back pain would be given a series of poses tailored to their diagnosis. Someone with a herniated disc would be treated very differently from someone with spinal stenosis. So the results could be even better.”

Fishman brings up an interesting point. The many different versions of yoga provide an opportunity to customize therapy. So to optimize yoga’s benefits, patients should first consult a doctor to help pinpoint a class or style for their specific ailment. Although a general yoga class may help with problems like stress and depression, particular problems like arthritis may well require a more specialized class or customized routine.

In any case, most yoga will help keep the heart healthy by reducing stress levels and blood pressure. A study conducted at the University of Pennsylvania found that after completing a three-month yoga course, participants with hypertension had significantly lower blood pressure. And a review of 70 studies by the Center for the Study of Complementary and Alternative Therapies at the University of Virginia found that yoga may be instrumental in improving glucose tolerance and insulin sensitivity, cholesterol and triglyceride profiles, and blood pressure, all factors that contribute to cardiovascular problems. What’s more, yoga encourages heart-rate variability, which, perhaps counterintuitively, reduces heart-disease risk.

And while you are building heart health, you may be building bone strength as well. A 2009 study by Fishman found that just 10 minutes of yoga a day helped build bone mineral density in middle-aged subjects. How does yoga build bone? Bending and twisting stimulate osteocytes, the cells that make bone. Because yoga isn’t a traditional weight-bearing workout, however, it shouldn’t damage cartilage or lead to osteoarthritis, both common consequences of strength training.

Speaking of joint pain, rheumatoid arthritis is an autoimmune disease that causes painful inflammation of joints and surrounding tissues. Conventional treatments, including steroids, can have serious and unpleasant side effects such as heart problems and weight gain. Once again, preliminary research shows that yoga may be an appropriate alternative. An Indian study found that participants in a one-week yoga camp who practiced breathing exercises and yoga poses twice a day lowered their stress and anxiety levels and were able to perform basic tasks, including dressing and eating, more easily. What’s more, the subjects’ rheumatoid-factor levels, the most relevant marker of the disease, dropped. It was not clear why yoga helped reduce those levels, but the study’s lead author, Shirley Telles, head of the Indian Council of Medical Research Center for Advanced Research in Yoga and Neurophysiology, in Bangalore, theorizes that the carefully designed yoga program helped “correct the imbalance in the immune system.”

And a Mayo study found significant positive effects on its own employees after just six weeks of a yoga-based wellness program that included nutritional counseling and meditation. In particular, the participants displayed reductions in blood pressure and stress along with an increase in flexibility. What was especially encouraging to the researchers was that the participants attended class six days a week at 5:10 a.m. in the dead of winter, yet, according to Mayo’s Bauer, “we had to turn people away in droves.” That, more than anything else, he says, speaks to the interest that yoga is generating as people get increasingly concerned about contributing to their own wellness.

They’re making a good call. Yoga’s reach extends to most corners of the body, from the nervous system to the circulatory system to the immune system. But in the end, most of yoga’s advantages are a result of its overall calming influence. “Yoga is about learning to be where you are in this moment and not trying to be somewhere else or in some other body,” says Barbara Verrochi, a co-director of the Shala Yoga House, a New York studio. After a few months of yoga, there may be no other body you’d rather be in.

Just 10 minutes of yoga a day helps build bone mineral density in middle-aged subjects.

The Healing Power of Cannabis

Recent research shows that pot has promise in treating many ailments, including seizures, PTSD, nausea and especially pain

BY ALEXANDRA SIFFERLIN

WHEN DR. ORRIN DEVINSKY DECIDED HE WANTED to study whether cannabidiol—a compound from cannabis also known as CBD—could help people who suffer severe seizures, he didn’t realize just how difficult a feat it would be. Coming up with how the study would be conducted was the easiest part. Ultimately, the researchers would study whether taking CBD over a 14-week period could reduce seizure frequency in children and adolescents with Dravet syndrome—a rare and severe form of epilepsy.

After Devinsky, the director of the Comprehensive Epilepsy Center at NYU Langone Health, and his colleagues got approval for the research from NYU and the U.S. Food and Drug Administration, the team applied for approval from the U.S. Drug Enforcement Administration (DEA). “The DEA sent men with guns to my office to inspect,” recalls Devinsky. Whatever room the CBD was to be kept in needed to have a secure lock. Not only that, but the hospital itself had to have a special alarm system. The researchers had to keep the cannabis in a specific kind of safe that was so large that the university had to bring in engineers to ensure its weight wouldn’t cause it to cave into the floor. The DEA then returned to inspect the safe and the building’s security system one more time.

It may seem excessive, but all the regulatory hurdles that Devinsky and his team had to clear are standard when it comes to studying marijuana, which the federal government still considers an addictive and easy-to-abuse substance. “It’s a big deal every time the drug gets sent in,” says Devinsky.

So far, the results of Devinsky’s studies indicate that CBD is in fact an effective treatment. In a 2017 study published in the New England Journal of Medicine, the team reported that CBD reduced by 39% the number of seizures experienced by patients with Dravet syndrome. CBD, which does not contain the psychoactive attributes that induce a high, has been shown in studies to act as an anticonvulsant. “I think we’ve established that the drug works,” says Devinsky. “For some people the effects are superb, and some are mild to moderate.” Yet despite these results, the drug remains incredibly difficult to study. That’s because marijuana is still classified as a Schedule I drug in the United States.

Marijuana is still classified as a Schedule I drug in the United States. But some researchers who study the complex chemistry of cannabis argue that the label does not match the science.

Many researchers who study cannabis, including Devinsky, argue that the label does not match the science. Many of the compounds used in studies for therapeutic purposes do not contain THC, the compound in marijuana that gives people a high and that authorities may find objectionable. Part of what may make cannabis compounds effective medicine are the more than 60 cannabinoids they contain that interact with the body’s central nervous system and provide relief from a variety of conditions. “I think the Schedule I classification is insane and nonscientific,” says Devinsky. “We have so much data showing that CBD is not an addictive drug. It’s certainly safer than so many drugs that are not scheduled at all.” Such as alcohol, he points out.

In the U.S., 33 states and the District of Columbia have legalized marijuana for medical use, and patients are using cannabis-based products for a wide range of ailments, from seizures to PTSD to chronic pain. The growth of the medical-marijuana market and its legalization suggest a changing tide of social acceptance. “I think cannabis has gone from a plant that can produce compounds for spasms to a promise being realized,” says Devinsky.

But this transformation has not been seamless. Not all scientists can afford to do this research, which in addition to applying for approval requires special security systems, safes and other expensive protocols. Devinsky says his team still wants to know if CBD is helpful for other people with epilepsy and whether the types of compounds and oils that people are buying from state dispensaries are safe and effective. Unfortunately, that type of research is impossible under the current system.

In the meantime, research is continuing to show that medical cannabis has value. In January 2017, the National Academies of Sciences, Engineering and Medicine released a committee review of all research on the health impacts of cannabis since 1999. Its finding? Marijuana can bring about therapeutic effects for a number of ailments, especially pain.

And the drug looks promising for more than just pain. For adults with multiple-sclerosis-related muscle spasms, the researchers noted, there was substantial evidence that short-term use of man-made cannabinoid-based medications lessened symptoms. And for people with cancer, certain oral cannabinoids were effective at preventing chemotherapy-induced vomiting and nausea.

“No one has died from an overdose of cannabis,” says Donald Abrams, a professor of clinical medicine at the University of California, San Francisco, who has studied the health effects of marijuana and was on the committee that conducted the review. “There’s abundant evidence that it is a useful intervention for chronic pain, and we may see it’s useful in harm reduction.”

Cannabis’s potential in reducing pain has led some experts to recommend it as an alternative to addictive painkillers, such as opioids. Since 1999, overdose deaths in the U.S. involving opioids (prescription painkillers and heroin) have increased sixfold. A 2015 analysis published in the Journal of the American Medical Association reported a 30% or more reduction in pain from cannabinoids, compared with a placebo. Studies suggest that cannabinoids interact with receptors in pain centers in the brain and spinal cord and may have anti-inflammatory effects. States that have legalized medical marijuana have seen drops in opioid-related deaths.

What’s interesting is the effect that legal medical marijuana has on doctors’ prescriptions. In a 2016 report in the journal Health Affairs, W. David Bradford, the Busbee Chair in Public Policy in the Department of Public Administration and Policy at the University of Georgia, and his co-researcher and daughter Ashley C. Bradford looked at data on prescriptions filled by Medicare enrollees from 2010 to 2013 and found that older people who qualified for Medicare were, where appropriate, making use of medical pot. Not only that, they also found that when states legalized medical marijuana, prescriptions dropped significantly for painkillers and other drugs for which pot may be an alternative.

There’s evidence suggesting that elderly people may benefit from the drug. A 2018 study by Israeli researchers published in the European Journal of Internal Medicine found that using cannabis not only is safe for people over 65 but also may help symptoms of a variety of conditions. The study authors followed 2,736 people ages 65 and older who were using the drug to treat health problems (most were taking it for pain and cancer). The men and women filled out questionnaires about their experience six months after starting treatment: nearly 94% said their condition had improved, and the level of pain had decreased for most from around an 8 out of 10 to a 4. At six months, about 18% of the people in the study either had stopped taking painkillers or had reduced their dose.

The researchers write that “the therapeutic use of cannabis is safe and efficacious in the elderly population.” There were only a small number of reported side effects, and all were minor, including dizziness and dry mouth. “What we hope people take away from this is that when marijuana becomes available as a clinical option, physicians and patients together are reacting as if marijuana is medicine,” says Bradford.

As for Devinsky, he plans to continue his research. He argues that, as with any other drug, scientists need to fully understand marijuana’s efficacy and safety. “We are getting to the bottom of it,” he says. “But we are not there yet.”

Excerpted from TIME’s Marijuana: The Medical Movement. Available at retailers and on amazon.com.

While he was co-owner of the Northwest Patient Resource Center medical-marijuana dispensary, Jake Dimmock worked with flowering plants in a grow room in Seattle.

In states where medical marijuana is legal, doctors write fewer prescriptions for opioid pain medications.

The Facts About Weed

Rx History

1500 B.C. Earliest written reference to marijuana in Chinese pharmacopeia. The plant’s medicinal uses were also extolled in records from ancient India, Egypt, Persia, Greece and Rome.

1842 Irish physician William O’Shaughnessy’s clinical studies of cannabis find it to be an effective muscle relaxant and anticonvulsive.

1860 First U.S. government survey of the cannabis medical literature reports that the plant is helpful for pain, bronchitis, venereal disease and postpartum depression.

1915 Canadian physician Sir William Osler, often referred to as the “Father of Modern Medicine,” calls cannabis “the most satisfactory remedy” for migraines.

1996 California becomes the first state to legalize cannabis for medical purposes.

By the Numbers

94% of Americans favor legalization of medical marijuana.

23 conditions qualify for a medical- marijuana card in Pennsylvania.

92% of pediatric oncology providers surveyed in Illinois, Massachusetts and Washington said they would help children with cancer get medical marijuana.

$165 million was saved in Medicare prescriptions in 2013 by states that had legalized medical marijuana.

44% of patients with a severe type of epilepsy were helped by a marijuana-based drug called Epidiolex; the drug won FDA approval in 2018.

Under Study

Studies suggest that a compound in marijuana might slow the progression of Alzheimer’s. Other research is looking into whether marijuana might mitigate brain damage from stroke or concussions.

Marijuana is often used to treat PTSD, but not all experts feel that there is sufficient evidence to support its use for this condition. Further research is attempting to determine whether it works and, if so, how.

Studies in Israel show promising results in using cannabidiol to treat children with autism. Preliminary evidence suggests that it may help improve social interactions and reduce repetitive behaviors.

Plants with Benefits

Plants were the original medicines. Long before FDA-approved pharmaceuticals and synthetic vitamins, people relied on leaves, seeds and flowers as the best lines of defense against illness. Every culture had its favorites, and we can learn something from each. However, many have yet to be subjected to rigorous study, so we still don’t know how safe and effective they are, both in general and for each individual with his or her particular needs. Ancient claims are not the same as scientific proof. Before adding any herbal product to your routine, do your research about possible side effects and interactions it might have with prescription drugs. And consult your caregivers before taking the plunge.

Ayurvedic

Ayurveda, “the study of life,” is a Hindu system that dates to 300 B.C. Taking into account personality, pulse and habits, it is the original holistic approach. In India, Ayurveda is still practiced by 80% of the population, but its complexity and controversy (some of its herbs contain toxins) keep it outside the Western mainstream.

Ashwagandha

“That which has the smell of a horse” is said to offer the vitality and sexual energy of a stallion.

Gotu kola

This is used to revitalize nerves and brain cells—and thus supposedly to increase intelligence, memory and longevity.

Shatavari

Also known as asparagus root (no relation to the vegetable), it is used to treat fertility and menopause problems.

Amla

One of these walnut-size fruits has the vitamin C of 10 oranges.

Chinese

Another ancient holistic system that continues to evolve, Chinese medicine counts herbal remedies and acupuncture as primary elements. The herbs—more accurately “medicinals,” as they often include minerals and animal parts—are almost always used in combination.

Ginseng

One of the most popular of all herbs, it is said to boost energy, ward off mental decline and aid digestion.

Bupleurum

This herb is used for a variety of liver diseases, including cirrhosis and hepatitis.

Fo Ti

A restorative, this tonic herb is said to strengthen the lower back, darken gray hair, and nourish semen and blood.

Astragalus

Also known as yellow vetch, it purportedly bolsters the immune system. There are claims that it helps digestion and the lungs.

Native American

To the early indigenous populations of North and South America, plants, stones and animals provided as much healing information as any of today’s medical tomes. Their herbal remedies tended to be antimicrobial.

Goldenseal

Used as an antibiotic and to clear the GI tract of harmful yeast and bacteria, it may have anti-mucus properties as well. It’s not safe for children or pregnant or lactating women.

Saw palmetto

This small palm has a reputation for treating prostate problems, but studies yield conflicting results. It is also used for impotence and upper-respiratory problems.

Echinacea

An antibiotic, echinacea is said to activate white blood cells. It’s a popular treatment for the common cold, though studies have generally failed to confirm its effectiveness.

Chaparral

Claimed to offer antiviral, antifungal and antibacterial protections on top of an anti-inflammatory action, it can be dangerous, causing serious liver damage if not prepared properly.

European

Old World herbs have often served as a bridge between older, Eastern holistic traditions and the symptom-based approach of modern medicine. They are prescribed primarily as antidotes for the excesses of modern living.

St. John’s wort

It has been shown to treat mild depression, but this herb also interferes with some prescription drugs.

Celandine

This herb is used as an all-purpose liver remedy as well as a treatment for gout and insomnia.

Chamomile

Used to calm the nervous system and digestive tract, this well-known plant is popular as a tea.

Fennel

This aromatic is said to relieve intestinal bloating and gas, including in babies being breastfed.

Common Ground

Several broad-based herbs span most traditions, though they often have different names in different cultures.

Comfrey

Also called knitbone because of its reputation for healing fractures, it is for topical use only and can be toxic if taken internally.

Ginger

A digestive that dissolves mucus, this popular herb is used to treat nausea, vomiting and motion sickness.

Barberry

Said to dissolve kidney stones and relieve gout, the plant is considered a digestive by the Chinese.

Angelica

The Chinese variety (dong gui) is considered a first-line treatment for problems related to menstruation and pregnancy.

Nothing to Sneeze About

It’s true: global warming is making seasonal allergies worse than ever. Turns out some of the best weapons against this itchy future may be ancient ones

BY BRYAN WALSH

THE SPRING OF 2019 (LIKE MANY SPRINGS IN THE past 25 years) was a great one for fans of preternaturally warm weather and prematurely budding flowers. It was significantly less so for any of the roughly 40% of Americans who suffer from seasonal allergies. According to a report from the Environmental Protection Agency, warmer temperatures between 1995 and 2015 have lengthened the allergy season by up to three weeks by pushing oak and elm trees—two of the most notorious offenders for spring allergies—to sprout earlier in the year. And that meant millions of Americans found themselves sneezing and sniffling, blowing their noses and dabbing at watery eyes well ahead of schedule. As Alvin Sanico of Johns Hopkins Hospital says, “People were caught by surprise.”

Natural remedies may offer some relief from seasonal allergies. But such allergies, like the common cold, can only be managed; they are never really defeated.

Nature’s global-warming-induced practical joke is just the latest reminder of how tough allergies can be to control. The annual costs of asthma and allergic rhinitis in the U.S. are already estimated at $60 billion. On the day the antihistamine Allegra became available over the counter in 2012, manufacturers shipped more than 8 million pills. And now we can’t even predict when hay fever and its vexing relatives will come knocking? Something that is so common, so annoying and so unpredictable is bound to have desperate victims seeking relief wherever they believe they can find it. In fact, allergy sufferers have been quick to turn to alternative-medicine options in significant numbers—upwards of 1 in 4 of them, according to a 2011 study. But the question, as always, is: Are any of those treatments more than uncertain (as well as unregulated) hope in a bottle?

The short answer is yes, particularly if that answer includes “butterbur.” Butterbur is an herb whose roots were made into a remedy for headaches and inflammation by Native Americans. Today you can buy tablets of it over the counter. In a 2002 study published in the British Medical Journal, Swiss researchers showed that one tablet taken four times daily can be as effective as the popular antihistamine cetirizine (brand name Zyrtec) in controlling symptoms of hay fever, and without the drowsiness that’s often associated with this kind of allergy medicine. Another study found that butterbur worked as well as the antihistamine fexofenadine (Allegra) at relieving sneezing, congestion and itchy eyes.

Like conventional antihistamines, butterbur seems to block the effects of histamine and leukotrienes, those inflammatory chemicals that are activated by allergens and trigger the runny noses and watery eyes that every hay-fever sufferer dreads. Another substance, a natural antioxidant called quercetin, works in a similar way. Quercetin appears in some foods, like red apples, but it is also available in supplement form (a typical dose is 200 to 400 milligrams three times a day).

Other natural remedies that have been found to offer some relief include stinging nettle, which you can eat like spinach or consume in capsules or tea, and goldenseal, an herb with quite a memorable nickname: “king of the mucous membranes.” “King” may be a bit strong, but goldenseal does reduce inflammation and mucus production in the eyes, sinuses, nose and throat. Avoid it, though, if you have cardiovascular problems—berberine, one of the herb’s active ingredients, can disrupt heart rhythms. Pregnant or breastfeeding women also need to stay away from it, and infants given goldenseal have developed a rare but serious neurological condition known as kernicterus.

Girding against the seasonal onslaught of allergens isn’t just a matter of what you ingest. Hay-fever victims and other weed-pollen sufferers can benefit from what they don’t put into their bodies. Melons, cucumbers, bananas, chamomile and supplements that contain echinacea—a popular herbal treatment for colds and other respiratory infections—can often trigger the same allergic reactions that ragweed pollen does. In fact, echinacea is a member of the same botanical family as ragweed. What’s more, it is not even certain that echinacea does what it is supposed to do—prevent or alleviate colds.

It is a case study in the difficulty of establishing effectiveness in herbal remedies. Studies in 2005 and 2006 found no evidence that echinacea could prevent colds, but the latter study did turn up findings (albeit inconsistent ones) that echinacea might lessen a cold’s length and symptoms. A 2010 study that compared echinacea to a placebo and to no treatment at all found evidence that echinacea outperformed both when it came to reducing the duration of the common cold—but these benefits were too small to be considered statistically significant. In a 2014 review, however, researchers credited echinacea with “small preventative effects,” and a 2015 review gave echinacea a full-throated endorsement, concluding that it could reduce a person’s risk for colds by 35%. Whew!

Herbal medicines and dietary restrictions fall woefully short when your head is a cement block of congestion, though. Many clogged sufferers are inclined to head straight for a decongestant nasal spray or pill, but those can come with side effects like drowsiness, and they can even worsen symptoms if they’re used more than three days in a row. An old-time alternative, the neti pot, may be a better solution. Resembling a small plastic teapot and usually selling for around $10, the neti pot makes it easy to snort warm saline water, which irrigates the sinus cavities and shrinks the sinus walls, thus relieving congestion. Rinsing nasal passages with a saline-water solution can also flush out the tiny particles that trigger allergies, says Stephen Tilles, past president of the American College of Allergy, Asthma and Immunology. “This is dramatically effective for a lot of patients, and it’s a very reasonable, safe and well-tolerated option,” he says.

In fact, a study at the University of Michigan found that adults with chronic nasal and sinus problems who were treated with irrigation had better results over a two-month period than those on a conventional spray. It has reduced the need for steroid sprays in kids with allergies too. The FDA recommends always using distilled, sterilized or boiled water in neti pots, as tap water can contain microorganisms that are safe to swallow but can be dangerous in the nasal passages.

Common sense says the best allergy treatment, alternative or otherwise, would be to avoid whatever irritant causes the problem. Few doctors would counsel a hay-fever sufferer to take a stroll through a cloud of pollen. But you may have heard of an alternative treatment known as homeopathy, which is actually built on the theory that “like cures like”—that is, consuming a bit of a substance that causes disease in healthy people can cure that disease in the sick. Conventional practitioners regard homeopathy with a skeptical eye, and you can’t blame them. With the active ingredients in these remedies diluted to 1% or far less, it does seem a stretch to think they could have much of a medical effect. And few if any placebo-controlled studies have proved otherwise.

A more reasonable alternative is acupuncture. The ancient Chinese medical art is better known as a treatment for pain, as the piercing needles signal the brain to release morphine-like neurotransmitters known as endorphins. But endorphins may also help people with asthma or hay fever breathe easier. In a 2004 study published in the journal Pediatrics, school-age allergy sufferers who underwent a regular course of acupuncture had better symptom scores and more symptom-free days, both during treatment and afterward, than those given a placebo acupuncture therapy. (The placebo treatment involved the insertion of needles to much shallower depths than with actual acupuncture.) It’s notable that the kids in the study said they preferred oral medications to acupuncture—probably because not everyone is eager to be poked with needles. Also, aside from this one, studies that show a significant benefit against allergies from acupuncture are rare.

As people with allergies know all too well, a “significant benefit” is often too much to ask for. Like the common cold, seasonal allergies can only be managed; they are never really defeated. That was demoralizing enough before recent climatic realities ramped things up. Early springs surprise us now, but they’re likely to be routine before long, so seasonal allergies are almost certainly going to worsen. And premature discomfort is just the half of it: a study in the Proceedings of the National Academy of Sciences showed a strong link between increasing temperatures and a longer ragweed-pollen season.

But then, all the wet, red eyes staring at this page seem to say that this isn’t exactly news.

BUTTERBUR AND STINGING-NETTLE TEA: Butterbur works by inhibiting inflammatory compounds; stinging nettle, which is rich in vitamins and minerals, can be made into tea or eaten as a vegetable.

MELONS AND RAGWEED: Oral allergy syndrome can cause people with pollen allergies, such as those to ragweed, to also experience symptoms when eating certain raw fruits or vegetables, including melons.

Allergist’s Restaurant: A Dining Guide

Diet can make a difference for nearly everything that ails us, so why not allergies? Here are five healthy foods that have been shown to minimize the agony of seasonal sufferers

By Bryan Walsh

Nuts

A 2007 study found that children from the island of Crete who ate a Mediterranean diet—fresh fruits and vegetables, fish, olive oil, nuts—were less likely to develop allergy and asthma symptoms. Explaining the first four items is easy: studies show that a diet high in antioxidants (fruits, veggies, olive oil) and omega-3 fatty acids (fish) can ease seasonal allergy suffering. But what do nuts have to do with it? Well, they are rich in magnesium, which helps protect against the wheezing that accompanies asthma, and vitamin E, which boosts immunity and protects against free radicals, those floating molecules that cause inflammation. The study offers support for the idea that the protective effects of the foods we eat may be especially apparent in children because their growing airways may be vulnerable to stress. Food for thought: 80% of the kids ate fresh fruit and 70% ate fresh vegetables at least twice a day.

Fish

Omega-3 fatty acids in seafood have natural anti-inflammatory effects that boost the immune system—which is helpful, given that allergies occur when your immune system is out of whack. In a study of expectant moms, researchers found that those who ate fish during pregnancy reduced the risk that their children would develop asthma or allergic diseases. The kids whose moms ate fish once a week or more were less likely to have eczema than children of mothers who never ate fish. Not a fan of fish? Try omega-3 and algae supplements or fish oil to boost your defenses.

Apples

In the Crete diet study on nuts, researchers also found that people whose diets included apples as a staple had greater protection against both allergies and asthma. Apples are rich in quercetin, a flavonoid with anti-inflammatory properties. But don’t peel them—much of the benefit comes from the skin, which is also packed with antioxidants called polyphenols that help prevent cell damage. Another study found that pregnant women who ate apples reduced their children’s risk of developing asthma. Kids whose moms ate the most apples during pregnancy were the least likely to report wheezing or to have asthma.

Grapes

The skin of red grapes is high in antioxidants and resveratrol, another anti-inflammatory compound. Reducing inflammation throughout the body can go a long way toward lowering the impact of allergies. It also helps reduce the risk of heart disease and other cardiovascular problems, which have been connected to inflammation. Stick with red grapes, though. Green, purple, white, blush . . . no other color is as rich in either antioxidants or resveratrol.

Tomatoes

Whether you eat them fresh or in sauce or paste, tomatoes are high in vitamin C, and studies say that can help build tolerance against asthma and respiratory problems. Vitamin C is an immune-system booster and a natural antihistamine, but it also suppresses swelling. Plus, tomatoes contain lycopene, another antioxidant compound. A study from the University of Tel Aviv found that men who added 30 milligrams of lycopene to their daily diet improved their ability to fight off asthma attacks by 45%. In another study, Spanish children who consumed more than 40 grams of fruity veggies a day—including eggplant, cucumber and zucchini—were much less likely to suffer from childhood asthma than those who ate less.

Let Nature Heal

A walk in the park will boost your health. It can make you happier too

BY JAMIE DUCHARME

SPENDING TIME OUTDOORS, ESPECIALLY IN GREEN spaces, is an effective way to improve your health and happiness. It’s been shown to lower stress, blood pressure and heart rate while encouraging physical activity and buoying mood and mental health. Some research even suggests that green space is associated with a lower risk of developing psychiatric disorders.

A recent study published in the International Journal of Environmental Health Research adds to the evidence and shows how little time it takes to get the benefits of being outside. Spending just 30 minutes in a park—even if you don’t exercise while you’re there—is enough to improve well-being, according to the research.

For the study, researchers surveyed 94 adults who visited one of three urban parks near Birmingham, Ala., over the summer and fall. They were given fitness trackers to measure physical activity but were not told what to do in the park or how long to stay. Each person also answered questions about their life satisfaction and mood—which were used to calculate a score of subjective well-being before and after their park visit.

The average park visit lasted 32 minutes, and even though just 30% of people engaged in physical activity while there, well-being scores rose during the park visit in 60% of people. For a substantial number of people in the study, simply being in green space seemed to be enough to spark a change, says study co-author Hon Yuen, director of research in the occupational-therapy department at the University of Alabama at Birmingham.

“Some people may go to the park and just enjoy nature. It’s not that they have to be rigorous in terms of exercise,” Yuen says. “You relax and reduce stress, and then you feel more happy.” And that’s certainly not to diminish the value of more strenuous exercise. Health professionals are unanimous in advocating for physical activity that gets your heart pumping faster. There is also plenty of research that comes to the conclusion that while exercising is good for mental health, exercising outside is even better.

It is for all of these reasons that the medical community is increasingly viewing green space as a great place where their patients can reap physical and mental health benefits. Some physicians, like Robert Zarr, a pediatrician in Washington, D.C., are even writing prescriptions for it. These “nature prescriptions”—therapies that are redeemable only outdoors, in the fresh air of a local park—advise patients to spend an hour each week playing tennis, for instance, or exploring all the soccer fields near their home. The scrips are recorded in his patients’ electronic health records.“There’s a paradigm shift in the way we think about parks: not just as a place for recreation, but literally as a prescription, a place to improve your health,” says Zarr, who writes up to 10 park prescriptions per day. In 2017 he founded Park Rx America to make it easier for health professionals to write park prescriptions for people of all ages, particularly those with obesity, mental-health issues or chronic conditions like hypertension and Type 2 diabetes.

By writing nature prescriptions—alongside pharmaceutical prescriptions, when necessary—physicians are encouraging their patients to get outdoors and take advantage of what many view to be free medicine. The specificity that comes with framing these recommendations as prescriptions, Zarr says, motivates his patients to actually do them. “It’s something to look forward to and to try to feel successful about,” he says.

In 2018, NHS Shetland, a government-run hospital system in Scotland, began allowing doctors at 10 medical practices to write nature prescriptions that promote outdoor activities as a routine part of patient care. And in recent years, organizations with the goal of getting people outside for their health have proliferated in the U.S. The National Park Service’s Healthy Parks Healthy People program promotes parks as a “powerful health prevention strategy” locally and nationally. Walk with a Doc, which sponsors free physician-led community walks, is now in 48 states (and 29 countries), and Park Rx, which has studied and tracked park-prescription programs since 2013, says these are now in at least 34 states and Washington, D.C. Even mental-health professionals are going green. A growing number of “ecotherapy” counselors conduct sessions outdoors to combine the benefits of therapy and nature.

Plus, these unusual prescriptions are the prettiest you’ll ever fill—a fact that Betty Sun, program manager at the Institute at the Golden Gate, which runs Park Rx, says encourages people to actually do them. “With social media and Instagram, when you see your friends going out to beautiful places, you want to go too,” Sun says. “It’s about making a positive choice in your life rather than a punitive choice—like ‘You’re sick; take a pill.’ It just seems so much more supportive.”

Doctors are writing their patients “nature prescriptions” to promote outdoor activities.

Will Any Green Space Do?

Quality matters. So do your goals

By Abigail Abrams

The social function of green spaces may matter more than size.

Taking the nature cure can sometimes feel like a tall order. Not everyone has the means to stroll on stunning beaches or hike to awe-inspiring views of mountain valleys. The good news is that neither is necessary. At least, not exactly. Studies suggest that nearly any green space can boost your well-being, as long as it meets certain criteria.

The quality of the green space seems to matters more than the quantity. In one recent study in the journal BMC Public Health, researchers found no significant link between the amount of green space in an individual’s local area and their mental well-being. Merely having vegetation doesn’t guarantee a positive experience, explains study author Victoria Houlden, at the University of Warwick in England.

Although Houlden’s study used census units to measure how much green space people had access to, individuals don’t stick to government-assigned districts in real life. They may frequent a park near their office or go out of their way to play sports in a neighboring town. “The relationship between green space and mental well-being is more complicated than an arbitrary sense of boundary,” Houlden says.

In another recent study, a group of researchers in the Netherlands found that people who think of their local green spaces as more accessible and usable felt more satisfied with their neighborhood, regardless of the amount of green space they had. But they also reported better mental health and more emotional attachment to local greenery when they had higher-quality green spaces.

So what makes a green space high-quality—and therefore more healthful? Some research has linked health effects to specific types of green spaces—broadleaf woods, parks that feature water and areas with significant biodiversity, for example. Aesthetic factors can be important.

But that’s not the last word. Andrew Lee, a public-health researcher at the University of Sheffield in England who has conducted large reviews of green-space research, says the functionality of parks is paramount for making people feel happy. “If it’s a social space, where people meet together and chat and go on walks, that kind of social contact and interaction builds social networks,” Lee says. “That’s probably where the real impact is coming from that gives people a sense of well-being.” On the other hand, if a green space is difficult to get to, has poor lighting or is not clean, it may be seen as unsafe or inaccessible and probably wouldn’t boost a visitor’s mood, explains Lee.

People may also experience the benefits of green spaces in unique ways, says Sarah Bell, a lecturer at the University of Exeter’s European Centre for Environment and Human Health. “It doesn’t necessarily come naturally to people,” Bell says of nature appreciation. Sudden health changes, the end of a job or something that causes a high level of stress can make nature more important to people, she says.

The secret to using nature as a mood booster in these situations, Bell says, is to find activities in a green space that match your own individual preferences, personality and goals.

Kids on Alternative Medicine

Adults seek out alternative treatments for many reasons, including the health and well-being of their children, especially when there are few other options

BY KATHRYN SATTERFIELD

I GREW UP IN A FAMILY THAT EMBRACED CONVENTIONAL medicine, getting vaccinations on time, attending all appointments on schedule and following doctors’ orders closely. That began to change when my first son was born. On his third day of life, doctors at Yale New Haven Hospital saw physical anomalies that indicated he could have issues and ordered genetic testing. Six months later, they told us he had 150 or so extra genes on his 15th chromosome. They also noted that, upon reviewing the literature, they could find only a handful of similar cases. We were dealing with an unknown syndrome. The kindly but ill-prepared geneticist couldn’t say what this meant for our son, only that he would be mildly to severely delayed. “What can we do?” I cried. “Go home and love your baby,” he said.

Several months later, our pediatrician, who specialized in neonatal-perinatal medicine, patted my hand when I expressed concerns about my son’s seemingly incurable congestion and resulting asthmatic episodes, and the subsequent prescriptions for steroids. “You have enough to worry about,” he’d tell me. Conventional medicine wasn’t giving me any answers. Thus began an ongoing journey to treat my son with alternative options. Throughout the years, I’ve tried craniosacral therapy. Hippotherapy. Swim therapy. Speech and occupational therapies, which he continues today. Nutritional supplements. Essential oils. I applied for a service dog, hoping she would keep him calmer. And yet I haven’t turned my back on modern medicine. I vaccinate him on a modified schedule. He has an inhaler and nebulizer for the asthma. Both he and his younger brother have regular checkups, take antibiotics when they have an infection and get a flu shot every fall.

Though my son’s primary diagnosis itself may be unique, incorporating alternative medicine into his care is not. A recent survey by the National Center for Complementary and Integrative Health (NCCIH) revealed that approximately 12% of children ages 4 to 17 had been given some form of complementary health product or practice in the previous year. In children living with chronic illness, including asthma, ADHD and migraines, the number increased to more than 50%. Among the most common treatments were herbal medicines and probiotics, osteopathic or chiropractic manipulation, and yoga, tai chi or qigong.

Interest in the field of pediatric integrative medicine has increased as parents and physicians seek out options when treating children with chronic illness; there is the desire to reduce frequency and duration of pediatric prescription medication use, and there’s a need for more effective approaches to preventive health in children. The NCCIH’s mission, after all, applies to children as well as adults.

But what does this look like in practice? At St. Jude Children’s Research Hospital in Memphis, Tenn., researchers are exploring the use of virtual reality as a “distraction technique” for children and teens suffering from the painful episodes of sickle cell disease. As part of an ongoing study, the hospital has partnered with the Methodist Comprehensive Sickle Cell Center to study the use of immersive virtual-reality sessions—exploring an ocean habitat while swimming alongside tropical fish, friendly seals and dolphins, for example—as a complement to the pain meds. While receiving IV medications, patients enter an interactive 360-degree underwater world where they can launch multicolored bubbles at passing marine life and other objects such as treasure chests. It is an opportunity, explains Doralina Anghelescu, director of the hospital’s pain-management service, for St. Jude to “be on the front line and be a champion for this new concept of integrative medicine.”

Treatments don’t need to be high-tech to make a difference. At Nationwide Children’s Hospital in Columbus, Ohio, the behavioral-health group has developed a complementary treatment for patients struggling with anxiety. For 90 minutes a week for six weeks, “skill building” sessions teach children sensory-based and mindfulness-based activities including mindful movement. Each session ends with a guided meditation. “I’m a licensed professional clinical counselor, but I’m also a yoga instructor, so I combined forces,” says Gina McDowell, a behavioral-health clinical educator who developed the program. Most of the participants also met weekly with their assigned therapist or psychiatrist; some were on medication. “A lot of these kids had been discharged from a hospitalization. So we used it in conjunction with other treatment and found that combining all those things together has the best results,” McDowell says.

The program draws not only from yoga but also from various techniques based on sensory check-ins. “It helps establish the mind-body connection and grounding,” she says. “What we have found is that a lot of kids with anxiety or emotional dysregulation do very well with sensory activities. It helps calm everything down. It doesn’t necessarily fix the problem, but it helps them regulate enough to a point that they can get through it.” They are also given homework to consistently practice the techniques throughout the week, while they are calm and not in crisis. The goal is to make it their “new norm.” As McDowell notes, “We have kids that have said, ‘I was at school and was in a large crowd and started to panic, but I was able to use deep breathing or pull out a sensory item that was really helpful to me.’ They’ve figured out beforehand what works, and then they can use it in the moment.”

The program has produced measurable results. Kids reported a 24% reduction in anxiety, and parents reported a 29% reduction in their child’s anxiety upon completion of the group sessions. “We’ve really found that mindfulness is so beneficial no matter what we’re dealing with, no matter the diagnosis—even physical diagnoses,” McDowell says.

In 2017, the American Academy of Pediatrics (AAP) updated its statement on complementary medicine. The organization noted that “consumer interest in and use of complementary therapies has outpaced training options in pediatric integrative medicine, leaving pediatricians with a desire for more training and familiarity with resources.” For example, a 2012 survey of academic pediatric training programs revealed that only 16 of 143 programs reported having an integrative-medicine program. In response to this gap, conventional pediatric residency training is being expanded to include pediatric integrative medicine. One example is the Pediatric Integrative Medicine in Residency program through the University of Arizona. Other teaching initiatives are underway in medical schools affiliated with the Academic Consortium for Integrative Medicine and Health.

“It’s important for conventionally trained doctors to have an understanding,” says Joy Weydert, of the AAP’s Section on Integrative Medicine. “Rather than say [to parents], ‘That’s stupid’—which some doctors do—they can say, ‘Tell me more about your experience with that.’ They can at least learn from their patients’ experiences, which may be helpful to another family.” Too often, says Weydert, there is too little exchange of information and families seek complementary treatments only as a “last-ditch effort” after they have exhausted all conventional approaches. “I saw this so frequently.”

Though interest among physicians continues to grow, Weydert still sees resistance. After all, medicine is a scientific field that demands hard evidence from clinical trials. “Little by little as physicians we’re starting to do the research to show the effectiveness” of natural remedies, she says.

Weydert would like to see conventional physicians working alongside their patients to come up with solutions to health problems when there seems to be none. This requires time—listening to their story, getting a diet history, asking what they’ve already tried—and an open mind. Is the child getting enough vitamins and minerals? How does the child’s gut function?

Alternative medicine—especially when it is for kids—should be a collaboration. Parents know their children best, says Weydert, but “pediatricians may have knowledge about potential interactions between dietary supplements and the child’s condition or medications. The pediatrician may also have access to clinical studies that support the safety and efficacy for these natural [treatments] so that they can be used with confidence.”

By listening and asking questions and taking into account a wide range of factors, Weydert, while she was in clinical practice, was able to help families who had long been searching for help. When a dietary change or other action finally made a difference, explains Weydert, “they would ask, ‘Why aren’t there more physicians like you out there?’ ” For Weydert, the answer is clear, and so is the solution: “So what I’m trying to do is reach the doctors who can reach them.”

Immersive virtual-reality and relaxation techniques are being used to help ease pain.