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Dr. Bartoszewski completes the 'Fix Your Own Back' course

fix-your-own-back-logo.png

This past weekend, Dr. Bartoszewski took a weekend continuing education course with Dr. Snell, regarding the evaluation and treatment of lumbar disc injuries.

If you've ever bent over to pick something up and got "stuck", have a history of sciatic pain down the back of your leg, pain rolling over in bed, getting in or out of a car or chair, or pain that's worse in the morning, you've more than likely experienced a disc injury at some point in your life.

Dr. Bartoszewski is able to evaluate your condition to determine if you are currently suffering from a lumbar disc injury.  The good news is that most disc issues do resolve with time and proper treatment.  To prevent these symptoms from coming back again and again, Dr. Bartoszewski is able to instruct you on specific movements you can do for pain relief and exercises to help strengthen your back and core, to prevent your low back pain from returning.

Dr. Bartoszewski actually experienced her own disc injury after moving to Portland.  Dr. Snell's rehab program got her moving and back to practicing and lifting in the gym after completion of the program!

Schedule your appointment at Stumptown Chiropractic today!

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Gardening without back pain

Gardening, like most other forms of yard work, is exercise!  The mistake many people make is starting to do yard work and gardening without warming up first and not knowing your limits.  Have you ever heard of the term, "weekend warrior"?  These are people that do excessive amounts of work around the house/play sports sporadically, without properly warming up, stretching, cooling down, with improper ergonomics, or continue to work through the pain, and then are in a great deal of pain by the time Monday comes along.

Gardening is a fun way to get outdoors and stay active without going to the gym.  Raking and carrying leaves is a great way to build endurance and strength, while pulling weeds and other tasks can help to maintain and improve flexibility.  Gardening is not only good for the body physically, but also mentally.  Getting outside to garden is a great way to de-stress from work, technology and other things that complicate life.

Gardening/Yard Work injuries can include traumatic injuries. Commonly from improper tool use and repetitive stress injuries (RSI) from repetitive work, many times due to improper form.

Common Repetitive Stress Injuries:

  • Back injuries from heavy lifting
  • Hands/arms/shoulder pain
  • Knee pain

 

ALWAYS-->

  • Warm up/Stretch BEFORE
  • Use a wheelbarrow/cart/friend to help carry heavy loads or make frequent trips if working alone
  • Lift with your hips, not your back
  • Alternate sides when raking, hoeing, etc.
  • Know your limits
  • Take frequent breaks
  • Pace yourself
  • Stay hydrated
  • Don't work through pain
  • Use long-handled tools to avoid kneeling, bending, or squatting
  • Alternate tasks in the garden/yard (kneeling work for 20 minutes, standing work for 20, etc.)
  • Cool down post gardening
  • Never bend and twist; always "square up" your hips and shoulders
  • Don't sit/lay down for extended periods post yard work.  Warm muscles are pliable and will mold to whatever position you cool down in; ie: a chair

To minimize injury

  • Foam tubing for garden tools
  • Dig weeds from a standing position (various alternatives available online)
  • Use long handed tools
  • Use the right size tool for you; smaller hands need smaller tools
  • Choose lightweight tools whenever possible
  • Stop working immediately if you think you injured yourself, don't continue to work!
  • Seek chiropractic treatment to address any muscular or joint pain; the sooner after injury, the better
  • A chiropractor can also suggest different ways to modify your positioning, specific to your injury and activity
  • Avoid laying on the couch/bed for prolonged periods after intense work/possibly injury
Tools with foam to cover the handles for decreased grip strain

Tools with foam to cover the handles for decreased grip strain

 

Sources: http://www.slideshare.net/ElisaMendelsohn/can-you-dig-it-the-ergonomics-of-gardening

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Sugar and Pain

Have you heard all of the news about sugar lately?  Some sources are even saying that sugar is far more harmful to our bodies than fat!   Whether you are in chronic or acute pain, sugar may play an important role in the inflammatory process, which may be contributing to your persistent symptoms.  Read on to find out more!

Excess sugar in the blood leads to a pathological process, called glycation. Glycation is the process of sugar molecules adhering to fascial proteins, causing stiffness and thickening (Cameron, 2014).  Robert Lustig, MD has become an anti-sugar advocate, exposing just how toxic sugar is.  See his presentation, "Sugar: The Bitter Truth" here.  Dr. Lustig has published several peer reviewed research articles regarding sugar and its connection to degenerative diseases.  Throughout his research, Dr. Lustig has concluded that about 75% of all diseases in America are in fact, preventable.  UCLA conducted a study on the impacts of fructose and high fructose corn syrup on the brain.   The professor of neurosurgery concluded that, "eating a high-fructose diet over the long term alters your brain's ability to learn and remember information" (Schmidt, 2012).  Based on the research study, he believes that "eating too much fructose could block insulin's ability to regulate how cells use and store sugar for the energy required for processing thoughts and emotions". 

Dr. Teitelbaum has written many books on chronic pain and is currently a medical director at a fibromyalgia center.  He notes that, “Sugar aggravates low blood sugar and adrenal problems, yeast (Candida) overgrowth, and nutritional deficiencies that worsen fibromyalgia,”.  He has seen patients experience a decrease in their pain, a sharper memory and more energy after coming off of sugar in as little as 10 days.

The Oxford Journal of Rheumatology performed a 2 year study, and found that 45% of patients had an increase in symptoms after consuming sweets and refined sugar.

Not only does sugar cause rapid spikes in blood sugar levels, release of cytokines (inflammatory messengers), and contributes to your risks of developing diabetes, it also attacks cells and tissues in the body.  The sugar and inflammation/chronic pain connection has been researched more and more over the past several years.  Many medical providers are advising all patients to reduce their sugar intake, now more than ever before.  White flour and other simple carbohydrates break down into sugar, so it is essential to eliminate/reduce actual sugar, along with white flour.  Chronic low grade inflammation, greatly contributes to atherosclerosis, strokes, memory loss, and more scary health conditions.

Common chronic conditions negatively affected by sugar:

  • fibromyalgia
  • arthritis
  • autoimmune conditions
  • leaky gut
  • adrenal fatigue
  • strokes
  • peripheral artery disease
  • irritable bowel disease (IBD)
  • arthritic conditions
  • colon cancer
  • diabetes
  • cataracts
  • poor memory
  • heart disease
  • osteoporosis

As you can see, sugar is not only costly to the human body, but also on the economy.  An estimated 40% of healthcare costs are due to excessive sugar intake (and this is probably a low estimate).  When you make the commitment to quit sugar for good, you will realize just how sweet today's foods are!  Sugar is addictive, don't get me wrong, but the more we consume, the more we crave it, like a drug.  There are several resources online that can help you to wean yourself off of sugar, and structured programs and books, such as the "21 Day Sugar Detox".  I remember seeing a baking tip years ago, that you could half the amount of sugar in any recipe and not notice a difference.  Since I've gone Paleo, I use honey or coconut sugar in recipes, but they usually only call for a few tablespoons, not multiple cups of refined white sugar!  After eliminating sugar and you taste sweet things that you used to crave constantly, you will realize just how sweet and sugar laden they were.

Consider going cold-turkey, signing up for a monthly sugar detox, or start tracking your daily meals, just to see how much sugar you are consuming!  Many products contain sugar, that you might not realize, such as: ketchup, salad dressings, yogurt, dried/dehydrated fruit, sauces, and more. 

If your pain is not going away with over the counter products or routine care, consider eliminating sugar from your diet!  Chiropractic and other holistic forms of healthcare can help to resolve musculoskeletal conditions with a proper assessment, diagnosis and treatment plan, but sugar may be hindering your progress and overall health and well being.  Remember, things labeled as "sugar free", are not necessarily better alternatives, if they contain harmful artificial sweeteners; always check the label and choose minimally processed foods.

 

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Do you have a Baker's Hump?

Are you a professional baker, chef or even a tattoo artist? Constantly looking down to chop or knead away?  You may start to develop, or already have, what is known as Dowager's Hump, or a "Baker's Hump", as it is sometimes known in the culinary industry.  Standing all day in a slouched posture can wreak havoc on your spine. 

A lot of recent news articles discuss the dangers of sitting at a desk all day and how detrimental it can be to one's health.  But, standing on your feet all day in a slouched posture, can be just as harmful, causing a myriad of acute and chronic symptoms.  I've also noticed similar conditions in tattoo artists.  While, one's job may require you to be in such a poor posture for long hours day in and day out, the long-term effects can be extremely frustrating. Read through the tips below and schedule an evaluation with a chiropractor today!

What Can You Do?

  • sit to chop/prepare foods if possible
  • raise/lower table heights so you don't have to bend or reach up; elbows relaxed at your sides is an ideal height to chop at
  • take regular stretching micro breaks before, during and after work
  • set a timer to take breaks if standing/sitting too long, every 10, 20 or 30 minutes
  • add a rubber floor mat to your work station; prolonged standing on hard/concrete surfaces can aggravate your symptoms and increase pain
  • wear supportive/comfortable shoes
  • stay hydrated; dehydrated muscles cause more pain and are more prone to injury
  • use a foot stool to alternate bending one leg as needed
  • make sure you square up your hips/shoulders when lifting heavy items; half kneel instead of squatting if necessary (the half kneeling position can also be helpful when plating items, etc.)
  • Get adjusted by a chiropractor as needed!
  • Strengthen back and gluteal muscles on a regular basis to help to counteract constant flexed/hunched posture

Image Sources: http://chefschool.ca/wp-content/uploads/2014/08/sous.jpg

http://www.baker.edu/site_media/244/m/

http://www.bakerchiropractic.org/wp-content/uploads/2013/10/Dowagers-Hump.jpg

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My First Paleo Thanksgiving

After being diagnosed with an autoimmune condition last year, this was my first gluten/dairy/soy/corn/peanut free Thanksgiving!  What that means? No boxed stuffing, canned cranberry, etc.  Everything will be made from scratch, and I think it will be even better tasting!

I got the smallest organic turkey I could find and planned ahead and found recipes beforehand.  My biggest fear was all of the extra time it would take to prepare freshly made fixings, but isn't that what the holidays are about? Taking the extra time to make a good tasting, healthy meal?  Things made from scratch always taste better, don't they? And they didn't take that long to prepare either!

The biggest changes were dairy free green bean casserole with freshly fried onions, homemade stuffing with gluten free bread, dairy/gluten/soy free pumpkin and apple pies, yams/mashed potatoes with ghee and coconut milk.  We'll see if my guests can taste the difference! 

Here's what I made! (Everything was so delicious, I forgot to take a picture of the fresh green bean casserole!).  Making the fresh mushroom soup with coconut milk was actually super quick and easy!

Freshly fried onions in coconut oil, homemade mushroom soup, gluten free homemade stuffing, organic turkey!

Freshly fried onions in coconut oil, homemade mushroom soup, gluten free homemade stuffing, organic turkey!

This is the one item that I purchased! A vegan apple pie from New Cascadia gluten free bakery in Portland!

This is the one item that I purchased! A vegan apple pie from New Cascadia gluten free bakery in Portland!

*Main image source: http://i.huffpost.com/gen/2303832/images/o-PALEO-THANKSGIVING-facebook.jpg
Fresh onions fried in coconut oil!

Fresh onions fried in coconut oil!

Crispy and delicious!

Crispy and delicious!

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Big Box Vitamins

Do you buy your vitamins in bulk to try to save money?  Bulk grocery stores like Costco and Sam's Club offer you huge bottles of vitamins at a great price, right!? Take a better look at the ingredients and you'll see why you could be wasting your hard earned cash!

If your goal of taking a daily vitamin is for improved health, choosing a pharmaceutical grade supplement is necessary.  If you're unknowingly ingesting food dyes, modified food starch, soy and more on a daily basis to improve your health, you must research the products that you are purchasing. Is it really worth the savings? You get what you pay for!  Maybe you're continuing to have gastrointestinal issues, breakouts, headaches, etc., and they may be from your vitamins ingredients.  If you check the labels on your food, also check the ones on your vitamins.

I'll compare popular vitamins I found at Costco this past weekend, show you the harmful ingredients, and a superior alternative that your body can actually use!  Synthetic vitamins often contain harmful chemicals and essential nutrients in inabsorbable forms.

While you can essentially get more "vitamins" for your dollar with the big box brands, that is because they are of lower quality, and use cheap preservatives, chemicals, dyes, etc., to bring the cost down.  For example, this is the same reason why real peanut/almond butters cost more than their cheaper alternatives, that have added sugars and hydrogenated oils.  Corn syrup is cheap, genetically modified, and easily added to foods, beverages and vitamins as a filler!

Kirkland Signature Wild Alaskan Fish Oil:

  • ~$.10 cents per capsule
  • Contains SOY (GMO)
  • Better option is Integrative Therapeutics Pure Omega HP; ~$.37 per capsule

  • Does not contain any of the following!

    • artificial coloring

    • artificial flavoring

    • corn

    • dairy products

    • gluten

    • preservatives

    • salt

    • soy

    • sugar

    • wheat

    • yeast

Nature Made Coenyzme Q 10:

  • ~$.25 cents per capsule
  • Contains artificial coloring, soy
  • Synthetic, chemically made.  Contains a different chemical other than the natural form
  • Better option is Integrative Therapeutics Vitaline CoQ10; ~$2.00 per capsule

  • Contains only the NATURAL form of CoEnzyme Q10 and is identical to the form produced by the human body

  • The natural form can cross the cell membrane and does increase serum CoQ10 levels
  • Does not contain any of the following!

    • artificial coloring

    • artificial flavoring

    • corn

    • dairy products

    • gluten

    • ingredients of animal origin

    • preservatives

    • salt

    • soy

    • wheat

    • yeast

Centrum Silver Women's 50+

  • ~$.08 cents per capsule
  • Contains modified corn starch, Red 40 Lake, hydrogenated palm oil, maltodextrin
  • Better option is Integrative Therapeutics Clinical Nutrients 45 Plus Women; ~$.19 per capsule

  • Does not contain any of the following!

    • artificial coloring

    • artificial flavoring

    • dairy products

    • gluten

    • preservatives

    • soy

    • sugar

    • wheat

    • yeast

 

*Main image source: http://sincitycrossfitsouth.com/wp-content/uploads/2015/09/Health-Benefits-of-Fish-Oil-For-Kids.jpg

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Cold and Flu Season: Boosting Your Immunity Naturally

In today's society we are used to going to the doctor only when we are sick (sick care), instead, we need to focus on preventative care. Do you want to mask symptoms or get the underlying problem fixed? Treating problems before they surface is more effective and cheaper. Boost your immune system year round with supplementation and chiropractic care to minimize sickness.  Eating healthy year round can help you stay a few steps ahead of illness.

Food as medicine

  • Onion: Red/Yellow; contain flavonols and quercetin, powerful antioxidants that help to decrease histamine release. Sulfur found in onions and garlic have anti-inflammatory properties which help to ease aches, pains and congestion caused by the cold/flu.
  • Garlic: Contains allicin, an antioxidant with anti-viral, anti-bacterial, anti-fungal capabilities. Helps to shorten and reduce cold symptoms. Allicin becomes active after being chopped/minced/crushed and is destroyed at high temperatures, so try to sprinkle freshly chopped garlic in soups, on pizza/pasta, etc. Allow garlic to "sit" for 10 minutes before ingesting to allow immune-boosting properties to become activated.
  • Echinacea: Fights inflammation, bacterial/viral infections; boosts the immune and lymphatic systems by stimulating white blood cells. It can help to reduce the duration of a cold by several days when taken at the first sign of symptoms.
  • Zinc lozenges: Decrease cold duration and helps to attack nose and throat viruses while boosting overall immunity. Take at the first sign of a cold for best results.
  • Goldenseal: Contains the anti-fungal phytochemical, Beribine, which fights infection/inflammation and helps to strengthen the immune system. It can be found in combination with Echinacea; alcohol-free varieties are best. (Note: not to be taken for extended periods of time; take as directed by your healthcare provider.)
  • Local honey: Boosts immunity by fighting viruses/bacteria. "In a Penn State University College of Medicine study, researchers found honey to be more effective than dextromethorphan (a cough suppressant) at reducing the frequency and severity of nighttime coughing" (Lissandrello, 2008). (Note: not for children under 12 months old.)
  • Ginger: Contains anti-inflammatory phenols, gingerols and shogaols to help relieve cold/flu aches. Ginger also helps to decrease fever, eliminate toxins and allows the body to sweat, without the harsh side effects of ibuprofen. Use in teas/meals; fresh is best.
  • Cayenne: Well known to help with joint pain, it also contains antiseptic properties to ease sore throats and decrease congestion by thinning mucus. (Note: not for nursing mothers or children under two years old.)
  • Astragalus: (Herb) promotes white blood cell production to fight infection.
  • Avoid sugar: Suppresses our immune systems and feeds bacteria.
  • Kiwi: High in vitamin C and can reduce the severity and duration of upper respiratory infections.
  • Siberian ginseng: A known adaptogen, allowing the body to restore balance and helps to strengthen the immune system.
  • Probiotics: Healthy bacteria for vital for our bodies; suggested dosage is 3-5 billion live organisms daily. (Yogurt only contains 100-200 million organisms and less effective strains, along with excessive amounts of sugar and additives).

Year-round health

Minimizing and eliminating sugar, processed foods, refined carbohydrates, dairy products, preservatives/artificial chemicals will help to decrease stress placed on our bodies. Eating more vegetables, fruits, and incorporating different vitamins/herbs/minerals/spices into your daily lives for overall health is essential. Seeing your chiropractor regularly to make sure your nervous system is functioning optimally is also important for overall wellness. Chiropractic adjustments help to reduce dysfunction and allow your body to heal itself.

Keeping your immune system running at its best will help to prevent sickness. Fueling your body with the nutrients it needs on a daily basis, not only when you are sick, will help with overall health. Taking a variety of herbs and vitamins at the first sign of sickness is important to help decrease the intensity and duration of colds. Getting sick a few times a year doesn't have to be the norm; think about boosting your immune system year round to minimize the not so inevitable common cold.

Sources
http://www.naturalnews.com
http://www.foods-healing-power.com/health-benefits-of-onions.html
http://www.google.com
http://health.slides.kaboose.com
http://www.naturalnews.com/037449_kiwifruit_common_cold_immunity.html
Kitchen Prescriptions Lissandrello, Maria Source:Vegetarian Times, Nov/Dec2008, Issue 363, p78-83, 6p
Prescription for nutritional healing by Phyllis A. Balch, CNC

*Main image source: http://www.oralanswers.com/wp-content/uploads/2010/10/teeth_getting_hurt_this_cold_and_flu_season.jpg

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Pumpkin Spice

Fall is here, and people are going crazy for their yearly "pumpkin" flavored drinks and treats.  Sadly, most don't contain real pumpkin, but artificial flavoring and tons of sugar to give you that "fall in a cup" flavor you crave every autumn.

Many people aren't fond of the "Food Babe", stating she has no educational background to question and enforce what goes into our food.  But, these ingredients speak for themselves.  I even stopped going to Starbucks recently when I found out that their coconut milk contains corn dextrin, and a long list of other ingredients, besides coconut milk. [Water, coconut cream, cane sugar, tricalcium phosphate, coconut water concentrate, natural flavors, sea salt, carrageenan, gellan gum, corn dextrin, xanthan gum, guar gum, vitamin A palmitate, vitamin d2. Ingredients in most legit coconut milk: Coconut milk, water.] Read more about Starbucks "coconut milk" here

For the 2015 season, Starbucks has claimed to eliminate the caramel coloring in its' pumpkin spice drinks and use real pumpkin.

Starbucks has a "My Starbucks Idea" site, where you can submit ideas to bring back old products or create new ones.  Here you can log in and vote to bring CLEAN almond/coconut milk to their stores!

I have not had a PSL in over a year, since I went dairy free after being diagnosed with Hashimoto's.  I have however, made my own at home using some of these delicious, natural recipes!

A better alternative to commercialized pumpkin spiced drinks:

You have the option to choose your own ingredients!  Fair-trade organic coffee, organic pumpkin, non-gmo spices, etc.

  • Choose your milk! (cashew, almond, coconut, hemp)
  • Add your choice of coffee or espresso
  • Add pumpkin puree
  • Add pumpkin pie spice
  • Add cinnamon
  • Add vanilla
  • Add maple syrup or coconut sugar to taste for added sweetness

 

Here are some links to recipes that I really enjoy and think you will too!

Pumpkin Spice Latte from Make It Paleo 2

Dairy Free Pumpkin Spice Latte

Dairy Free and Sugar Free Pumpkin Spice Coffee Creamer

Iced Pumpkin Thai Bubble Tea (With Dairy Free and Dye Free Directions)

 

 

 

*Main image source: http://www.pugetsound.edu/files/pages/pumpkinlatte-1.jpg

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Sitting Sucks!

I'm often asked by patients about what they can do to prevent acute or chronic back pain.  Moving every day is vital! Not just rolling out of bed, sitting in your car while driving to work, sitting 8-10 hours at work, then sitting again on your commute home, and sitting on the couch to watch TV before bed.  As a nation in general, we sit too much, hence the new "sitting is the new smoking" campaign.  Sitting diseases are a real thing.  We just aren't moving enough anymore. There's even a #sittingisthenewsmoking hashtag!

Sitting diseases are shown to reduce your life expectancy.

What are sitting diseases:

  • Type 2 diabetes
  • Cardiovascular disease
  • Breast and colon cancers

You also have an increased risk of:

  • Forward head posture
  • Forward rounded shoulders
  • Hyperlordosis
  • Thoracic hyperkyphosis
  • Tight psoas = low back pain
  • Deconditioned core and spinal musculature

Your chances of developing a sitting disease increases the more sedentary you are.

For more information, check out this article I wrote titled, 'Standing up for your Health' in 2012.


<div xmlns:cc="http://creativecommons.org/ns#" xmlns:dct="http://purl.org/dc/terms/" about="http://www.juststand.org/tabid/674/default.aspx"><span property="dct:title">Sitting Disease Infographic 1</span> (<a rel="cc:attributionURL" property="cc:attributionName" href="http://www.ergotron.com">Ergotron</a>) / <a rel="license" href="http://creativecommons.org/licenses/by/3.0/">CC BY 3.0</a></div>

<div xmlns:cc="http://creativecommons.org/ns#" xmlns:dct="http://purl.org/dc/terms/" about="http://www.juststand.org/tabid/674/default.aspx"><span property="dct:title">Sitting Disease Infographic 1</span> (<a rel="cc:attributionURL" property="cc:attributionName" href="http://www.ergotron.com">Ergotron</a>) / <a rel="license" href="http://creativecommons.org/licenses/by/3.0/">CC BY 3.0</a></div>

What Can You Do?

1. Change your desk!

Alternatives to traditional desks:

  • Standing desks
  • Treadmill desks
  • Half kneeling at your desk

Benefits:

  • Improved posture
  • Improved blood flow
  • Possible increase in productivity and energy levels
  • Burn more calories

2. Bike/Walk to work if at all possible.  If not daily, then try a few days per week

3. Set a timer to get up every 30 minutes to stretch and move around.  Many new activity trackers will alert you when you've been inactive for a certain period of time.

4. Get up during commercials at home to do chores or perform squats, jumping jacks, etc.

Next blog topic will cover stretches and specific exercises to keep your spinal muscles and joints healthy!

*Main image source: http://www.precisionnutrition.com/sitting-standing-walking-work

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Breast Cancer Awareness

October is also known as 'Breast Cancer Awareness' month.  Numerous companies campaign with "pink" products and ribbons to help support breast cancer awareness and research towards a cure.  Do you see a product with a pink logo or ribbon on it and automatically assume that it supports breast cancer?  Did you know that many products that claim to "support" breast cancer research and awareness, may actually increase your chances of developing cancer?

Such examples of products include:

  • energy drinks (that contain "natural and artificial flavors")
  • plastic polycarbonate water bottles containing bisphenol-A, more commonly known as BPA
  • cosmetics/perfumes (Red #5, violet #2, yellow #5, benzyl benzoate, etc.)
  • cleaning products
  • air fresheners
  • Yogurt 'Friends in the Fight' campaign (contains high amounts of sugar, modified corn starch, "natural flavor",  blue #1, yellow #5, etc.

*These items may not necessarily have any randomized control studies proving there is a 100% cause and effect relationship.  We do know that toxins in our food and environment may correlate with increased risks of developing cancer.  We also know that these synthetic chemicals added to our food provide no nutritional value, and increase the toxic load in our bodies.

(The U.K has banned food dyes and performed a randomized, double-blind, placebo-controlled study regarding behavioral disorders and Yellow #5 and #6.)

Many companies know that by putting a pink ribbon on their products, it will sell more products, as consumers automatically associate it with donations for breast cancer awareness/research.  But, how much of your purchase is actually donated?  Some companies may not donate any of their sales to the Susan G. Komen fund, despite the pink ribbon on their products.

Be sure to research companies before purchasing their product.  Consider making a donation directly to cancer research in the future, if you're unsure of the product safety.

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