Protecting Yourself From the Swine Flu

It looks like the whole country is going to be dealing with this new swine flu outbreak. So far there have been no cases reported in Iowa but it’s likely this will change in the next few weeks. While there’s no need to panic, this may be worse than anything we’ve dealt with for a number of years. Fortunately, there are some things we can do to protect ourselves and others.

  • Stay hydrated. Water is the best source of liquid, although unsweetened juice is fine too. Avoid caffeine drinks because caffeine increases stress hormones which knock down the immune system. You should get at least 2 quarts of water a day
  • Get adequate rest and sleep. Sleep deprivation severely weakens the immune system and makes you much more susceptible to infection. Depending on your physical type, you’ll need from 6 to 9 hours of sleep/night
  • Stress hormones depress the immune system. That’s why you want to avoid caffeine. In addition, try to reduce stress in your life. In addition to emotional stress there is also:
    • Thermal stress: extremes in temperature, especially when the temperature fluctuates rapidly like it has been lately. Listen to the weather report and try to dress appropriately
    • Chemical stress: Caffeine, refined sugar, food additives, cleaning and workplace chemicals are all in this category. Try to reduce or eliminate those you can. Ask me about nutrients and homeopathic remedies to help deal with those you can’t
    • Physical stress: poor working position, sleep deprivation, overworking, muscular and skeletal imbalances all contribute.
    • These all add up together to equal the magic stress number at which things start going wrong in your body
    • Incorporate some anti-stress activities in your life like
      • Moderate, aerobic exercise
      • Tai Chi
      • Yoga
      • Meditation. I’ll be writing a separate anti-stress breathing techniques that give some of the same benefits as medition
  • Wash your hands regularly, especially if you have been around anyone you think is sick or if you’re sick yourself. Definitely avoid touching your or anyone else’s face, mouth, nose, eyes with hands that may have the virus on them
  • Avoid sugar. A tablespoon of sugar inhibits the immune response by 40% for four hours. A can of pop contains 3 tablespoons of sugar.
  • Eat lots of fruits and especially vegetables. Fresh is best, followed by frozen. The more colorful the better. Deeply colored, fresh produce contain vitamins, minerals and phytonutrients that have been shown to fight infection and even cancer.
  • Shitake mushrooms have been shown to be big immune system boosters in many studies. They are available fresh, frozen and dried at most grocery stores these days.
  • There are a number of nutritional supplements that can build your immune system and help prevent infection
    • Vitamin C is a proven standby. I suggest 3000mg/day divided in at least 3 doses
    • Vitamin D has been found, in the last few years to be very important for immune function. One reason we are sicker during the Winter is that we don’t get significant vitamin D from the sun. The recent research in D has been very exciting. I plan to write a separate article for you just on D but for now here are some highlights
      • 10% of our genes depend on vitamin D to work properly
      • Vitamin D helps prevent several types of cancer, including skin cancers
      • You should get out in the sun with arms and legs bare for at least 10 min/day without sunblock, preferably between 10 AM and 2 PM
      • You should avoid getting burned. This, rather than just sun exposure may increase your chance of skin cancer
      • Some people don’t make vitamin D as effectively as others, especially as we get older. They will need vitamin D supplements and we all need them during the Winter, early Spring and late Fall. The best way to determine your best dose of D is a combination of a blood test that I can order for you and muscle testing.
    • Spriulina has been shown effective at reducing the reproduction of several viruses, including influenza. I suggest everyone take two 500mg tablets three times/day and increase to one every hour if you start getting sick.
    • Echinacea can be useful if you take it at the beginning of illness. It should not be used for prevention like spirulina because it becomes ineffective if taken for very long.
    • Boneset can be especially useful for the flu but, like echinacea, you should wait until you feel you are actually starting to get sick.
    • Zycam, available from the grocery store or drug store, is a zinc supplement you use in your nose that helps shorten colds and flus.
  • If/when we start getting swine flu cases nearby, it’s best to avoid situations where you might be crowded together with a lot of people. You also might want to carry a bandanna, silk scarf or surgical mask to wear over your mouth and nose.
  • If you get sick, stay home. I even suggest you wait to come to my office until you’re well. If you’re coughing or sneezing, cover your mouth with a handkerchief or tissue to avoid spread the virus around. Don’t touch other people, especially around their face until you’ve thoroughly washed your hands.
  • There are a number of treatments I can do that improve your ability to resist infection. The 1918 flu epidemic was probably the most dangerous and lethal flu in recent history. There were thousands of deaths. I’ve heard from several sources that people who were under regular chiropractic care during the epidemic did much better than average. One source claims that not one person under chiropractic care died of the flu. I’ll be tracking down the actual stats on that but I have many powerful tools for enhancing health and immune function that weren’t available in 1918. I suggest, if you want to optimize your immune system, that you come in to get checked at least once every two weeks until the present epidemic is past.

These are a few strategies for improving immune system strength and decreasing your chances of getting seriously ill. I’ve been delaying sending this out because I keep thinking of things to add. I’m going to post this now and send shorter messages for any additional tips that come to mind.

Let’s all work together to get through this.

Dr. Hogg

Healthy Shoes for Every Day Use

As you may know, I’m a big supporter of minimalist or “barefoot” shoes that let our feet work the way they were designed to. This also lets the rest of the body align correctly and improves the mechanical and neurological experience of walking, leading to better overall health. I wrote a series of short articles last year on this subject that you can read on our website at: http://www.drhogg.com/Health_Tips_and_Articles_Archive.php dated July 1 through July 12.

The last in the above series contains a review of various shoes that fit the minimalist criteria from inexpensive Converse and Keds to minimalist “Hitech” shoes from New Balance, Nike and Merrill.
A year later I like converse for knocking around, doing yard work etc. I like Merrill for more athletic activities and Terra Plano for exercise and dress shoes.

Karen and I just returned from shopping at TJ Max on 53rd and Utica Ridge next to HiVee. We found that they have women’s Merrill casual/dress flats for half price at $50! These are not athletic shoes. They’re made to replace flats with a barefoot alternative. We found off-white, light blue and fuscia colors. The off-white definitely can be worn in place of dress flats and the blue and fuscia shoes have attractive patterns on them like you’d expect from women’s causal shoes. Karen was delighted to buy the off-white and blue for the price she’d usually pay for one pair!

I’m hoping to see more examples of these types of healthy barefoot shoes creeping into mainstream stores and styles. After all, we spend most of our time in non-athletic activities. It’s nice to see some healthy shoes for everyday use!

Increasing Telomere Length

At the recent ICAK-USA (International College of Applied Kinesiology USA chapter) there were many cool new aproaches to improving our health. One of the most interesting presentations was on telomere research. Telomeres are the ends of our
chromosomes, a little of which are lost every time a cell divides. When the telomeres got too short, the cell stops dividing, becomes senescent, dies or sometimes becomes cancerous.

The good news is, there are ways, with lifestyle measures and techniques like NET (neuro-emotional technique) and others we use in the office that can slow the shortening of our telemeres and possibly even lengthen short ones. Studies on mice have shown that lengthening telomeres can actually *reverse* the aging process!

A lot of the approaches to improving telomere length involve healthy lifestyle choices (stress reduction, low glycemic index diet, proper exercise, increasing anti-oxidants) are those I’ve been talking to you about for years. In addition, many of the treatment approaches we use in the office also turn out to be likely telomere lengtheners!

I’ll be talking more about telomeres and how to keep them longer this Wednesday, June 6, 6:30 at our June Health Talk.
Here’s a link to some recent research on reversing aging in mice through telemere therapy
http://www.huffingtonpost.com/jay-williams-phd/telomeres-_b_837862.html

Hope to see you there!

Dangers of Proton Pump Inhibitors

I posted this on my office Facebook page but thought it was important
enough to post here too.

Did you know that taking proton pump inhibitors (PPI) like nexium,
prilosec and aciphex commonly prescribed for heartburn, acid reflux and
ulcers have a very dark side? They work by interfering with your normal
stomach secretions of hydrochloric acid (HCl). HCl is needed to digest
protein (for muscles, bones, hormones, immunoglobulins and virtually
every cell in the body), calcium and iron. PPIs interfere with digestion
and absorption of these vital nutrients as well as B12 which is needed
for nerve health and to prevent anemia.

PPIs are not meant for use longer than about two weeks but are often
used for a much longer time. This results in osteoporosis and increased
risk of hip, spine and wrist fracture. Additional problems include
anemia, increased risk of gut infection and certain types of pneumonia.

All this to treat a problem that can often be corrected by improving
function of the valve at the top of the stomach and keeping the HCl down
in the stomach where it belongs! Professional Applied Kinesiology has
effective treatments for doing just that. Let’s fix the cause rather
than treating symptoms and creating more problems!

For more on PPI dangers:
http://www.medicalnewstoday.com/articles/233272.php

Folates and Colorectal Cancer

I recently had a patient come in expressing concern about folate, a B
vitamin and colorectal cancer. A relative had told her that recent
research had suggested the connection. She was concerned because she
was taking a nutritional supplement I had recommended, 5-MTHF which is
what your body converts folate or folic acid into before it can be
used. A fairly large percentage of the population (about 40%) has a
genetic problem that interferes to a greater or lesser extent in this
important conversion.

I told my patient that’s I had not heard of a connection between
folate and colorectal cancer and would check it out. I asked her if
her relative had a reference for this study so I could see how the
study was conducted and what it really said. On her next visit she
brought me a page from the Mayo Clinic newsletter talking about the
study. There wasn’t a lot on information about the study in the
newsletter so I went to the Internet.

Here’s what I found out. The study 2006 Mayo was talking about was not
a well conducted study. It did not really link folate to and type of
cancer. All it did was to look at the incidence of colorectal cancer
from the time of U.S.mandatory folate fortification (1998) of things
like cereals and breads. In addition, the concern was for man-made
folate overwhelming the conversion to 5-MTHF and leaving lots of
folate floating around. Since 1998 the study found that there had been
an increase in colorectal cancer rates. There was no effort to look at
other possible causes of higher colorectal cancer rates, like other
dietary or lifestyle or environmental changes. This is sort of like
having a patient tell me that, after eating breakfast, they developed
severe low back pain. In might suspect that they had an adverse
reaction to something they ate for breakfast if I didn’t question them
further and find out that they spent the rest of the morning moving
rocks for a patio in their backyard!

There was a later study published in the July 2011 issue of
“Gastroenterology”. This study, involved around 100,000 participants
from 1999 to 2007. In that time there were 1023 cases of colorectal
cancer diagnosed. After looking at folate intake in the involved group
and crunching the numbers, the study found that there was *no*
evidence for increased rates of colorecta cancer with increased folate
intake. In fact the study found that folate intake from all sources
were associated with a 19 percent *reduction* in colorectal cancer
rates!

For more details and a link to the published study, visit the American
Cancer Society website or click on this link:

http://www.nutraingredients-usa.com/Research/No-evidence-for-folate-colorectal-cancer-risk-American-Cancer-Society

Considering all the known benefits of folate supplementation,
especially 5-MTHF supplementation including prevention of neural tube
defects in fetuses, anemia prevention, small intestine health, energy
production and serotonin (anti-depressoin) production, I’m more than a
little upset that a publication like the Mayo newsletter has been
spreading warnings about this important nutrient. Something to keep in
mind is that scientific studies are often flawed or slanted. It’s
important to look at how the studies were done and even who financed
them. Finally, if research results are valid, they will be backed up
in future studies. Most new information is not considered valid until
it has been reproduced in several subsequent and independent studies.

The bottom line: Folate and especially 5-MTHF has not been found to
actually cause colorectal cancer and may actually help to prevent it!

Antibiotics Can Do More Harm Than Good

A study published in the most recent Journal of The American Medical Association (JAMA) documented another area where antibiotics can do more harm than good.

“Researchers at Washington University’s med school worked with a bunch of primary care doctors around St. Louis to test whether an antibiotic was any better than a placebo for the treatment of run-of-the-mill sinus infections. Half the patients got amoxicillin and the rest got a sugar pill.

Almost all the 166 people got offered the other remedies to relieve symptoms, and most took advantage of a least some of them. That was true whether they got the antibiotic or not.”

The results were that there was *no difference* between the antibiotic and sugar pill groups! Researchers were not surprised that there was no difference at ten days since most sinus infections, whether viral or bacterial resolve themselves by ten days anyway. What did surprise the researchers was that there was also no change after three days when antibiotics would be expected to kick in!

Antibiotics have side effects, sometimes severe. Overuse of antibiotics is creating strains of “superbacteria” that aren’t killed by antibiotics. Unfortunately patients often go to their Medical doctors with sinus infections and ask to be given antibiotics. Too often their MDs will give antibiotics even though they know that about 98% of sinus infections are caused by viruses (for which antibiotics are useless) rather than bacteria.

The researchers are hoping this latest study will give Medical doctors some solid research to help convince their patients that antibiotics are not the right treatment for the vast majority of sinus infections.

You can read a recent NPR story on this research at:

http://www.npr.org/blogs/health/2012/02/14/146877772/got-a-sinus-infection-antibiotics-probably-wont-help

On the other hand, nasal rinsing (see my article “Wash your hands and……” available on the Hogg Chiropractic Center Facebook page or ask for a copy next time you come to the office) has been proven to both help prevent airborne viral infections and to speed recovery if you do get an infection. The bonus is that there are no side effects!

Weight Loss Strategies that Don’t Work

Now that the holidays are over, a lot of people are thinking about losing some weight for the New Year. The time for new years “resolutions” may be a bit past which means now is the time to get serious about changes you want to make!

I’ve been thinking about this topic for awhile now. I found myself procrastinating because I had a number of issues I wanted to address and kept waiting for enough free time to sit down and do it. Since this strategy didn’t seem to be working, I decided on a different one. I’ve decided to write a series of short articles rather than one big one.Flexibility in achieving a goal makes us more likely to actually get the job done!

Many people get discouraged in their weight normalization (I like this term better than “weight loss”) because they try things that just don’t work. Because of this, I thought I’d start my series by talking about approaches that I feel are either ineffective or downright harmful.

Let me start by saying that there is no “magic pill” that will help you achieve a healthy weight. I know that may be a disappointment 🙂 ! There are some nutrients such as vitamin D and chromium that, if you’re deficient, can make you more likely to gain weight. If you are not deficient, however, taking more of these nutrients will not help you normalize weight and may even cause toxicity!

There are also “diet pills” which are basically stimulants like caffeine and amphetamines that will temporarily increase calorie burning but are very damaging to your health. In addition, the results will only be temporary in most cases.

A truly effective weight normalization approach is one which will also result in improved energy, better mood, stronger immune system, improved cardiovascular health and help prevent blood sugar problems like type 2 diabetes. A successful approach is also one which will result in *long term* weight normalization. There are lots of approaches that can result in a weight loss of ten or twenty pounds. Unfortunately many of them yield only temporary improvement and often result in eventually gaining back more weight than originally lost!

One general rule of thumb is that the quicker we lose weight, the less likely we are to keep it off. Gradual weight loss of 1/2 to 2 pounds/week may not seem that exciting but, over a year, that adds up to 25 – 100 pounds that have stayed off! Rapid weight loss is also very stressful to our bodies. The gradual “slow and steady” approach is not only more successful, it’s much healthier.

One common weight loss method that has proven time and again to be unsuccessful is severe calorie restriction. This approach, which may involve calorie restrictions as severe as 500 calories/day, puts incredible stress on your system. Stress hormones go through the roof, including cortisol.

High cortisol levels are a primary culprit in accelerated aging, poor healing, high blood pressure, metabolic syndrome and type 2 diabetes as well as depressed estrogen, testosterone and impaired thyroid function. To add insult to injury, the “spare tire” pattern of weight gain around the waist is a classic high cortisol symptom.

Our bodies have a fantastic ability to adapt to harsh conditions. The body has a “famine mode” that it goes into when enough food is not available. In times past and in some parts of the world to this day, the “famine mode” enabled people to live through periods, like the end of Winter, when there just wasn’t enough food left.

To perform this vital function, your body metabolism and *calorie burning* slows down. This survival mechanism stays in effect even *after* you resume normal calorie consumption! As a result, although there may be initial weight loss, people on severe calorie restriction hit a point where they can’t lose any more. When they go to a *maintenance* level of calories they actually start gaining weight on a food intake that kept them level before!

This much has been know for many years but recent research indicates that your body’s reaction to low calorie diets is even worse than we knew. A study published in the October, 2011 issue of the New England Journal of Medicine found that the decreased rate of calorie burning lasted for more than a year. In addition, levels of hormones like insulin, leptin and ghrelin (an appetite stimulant) also remained altered after a year with the effect of *greatly increasing* appetite and hunger!

Not only do people who try to lose weight with severe calorie restriction diets start burning calories slower but they become much hungrier than they were before the “diet”. No wonder few people keep the weight off with this strategy and so many actually end up gaining even more than they originally lost!

So now we know what doesn’t work. In my next installment I’ll talk about weight normalization strategies that do work.

Flawed Multivitamin Study?

Some of our patients have expressed concern regarding a recent study that makes a (fairly weak) association between post-menopausal women who take multivitamins and increased death rate. The short article below from Thorne Research addresses several flaws in the study and talks about why we should be careful about drawing conclusions from this study.

Some highlights include the fact that people who have a serious health condition are more likely to start or increase multivitamin intake. For instance, the fact that someone started taking vitamins after learning they had a heart condition does not mean that the vitamins caused eventual heart attack. There also was no effort made in the study to learn what quality the vitamins were or what form they were in how they were manufactured ect. I have found that there is a big difference in quality from one vitamin company to another. I have found for instance that one form of calcium (calcium carbonate) may actually cause joint problems whereas something like calcium citrate will be beneficial.

On the other hand, iron and copper can be toxic, especially if taken over a long period. That’s why I have one multivitamin with iron and copper for younger women and another without for post menopausal women and men of all ages. When I do use an iron supplement, for people who show anemia on blood tests, I test for low dose, organically cheleated forms like found in spirulina first.

Lastly, the researchers themselves cautioned against making causative conclusions based on their study (eg concluding that multivitamins were causing more deaths).

I think the upshot is that statistical studies need to be taken with a grain of salt and need to be looked at from a number of angles. Also perhaps certain vitamins are not good for everyone, especially in high doses. This illustrated benefit of being able to muscle test for the best supplements for each individual and *unique* patient in my practice!

The whole article rebutting the study is below for those who want more information.

Dr Hogg

October 17, 2011
To Thorne Research’s valued medical practitioners and their patients:
A recent study, “Dietary Supplements and Mortality Rate in Older Women,” published in the Archives of Internal Medicine, 2011, Volume 171(18):1625-1633, has caused some concern among the public about the safety of dietary supplements. We have thoroughly reviewed this study and share the following analysis in order to help you better understand the study’s design and its findings, and to help allay any concerns you may have.

The Study’s Design
This study is an analysis of data gleaned from 38,772 postmenopausal Caucasian women enrolled in the then-ongoing Iowa Women’s Health Study. The data for the study is based on the responses obtained through a self-administered questionnaire initially distributed in 1986, with two follow-up questionnaires distributed over the next 18 years, in 1997 and 2004. The questionnaires inquired about lifestyle practices, food intake, dietary supplement use, weight, smoking status, hormone replacement therapy, and the presence of diabetes or heart disease.

Although study participants were asked about their intake of dietary supplements, the study did not report how much of any specific nutrient was consumed. Nor was information elicited from the women regarding the chemical form of the supplement (e.g., picolinate versus sulfate) or the quality of the supplements that were taken. Furthermore, although the women were asked whether they took a “multivitamin,” the study does not define this term; i.e., the mineral, vitamin, and botanical content of the study’s universal “multivitamin” cannot be determined.

Finally, no attempt was made to verify the accuracy of the answers provided in the questionnaires, nor were any of the participating women asked why they were taking supplements, and no attempt was made to determine the impact of taking-or not taking-supplements on any specific individual.
One possible flaw to consider. It is well known that when an individual is diagnosed with a serious disease, such as cardiovascular disease or cancer, beginning or increasing the use of dietary supplements occurs commonly. If the new or increased supplement use were reported on a questionnaire, and then subsequent mortality resulted because of the underlying disease, the situation
could very possibly exist such that the individual’s death, while properly attributed
to the disease, would also be “associated” with the use of a dietary supplement.
Such an erroneous scenario is a highly likely flaw in the study’s design.

The Study’s Findings
The results of the study’s analysis claim to show a slightly higher risk of all-cause
mortality associated with the use of multivitamins, iron, and copper. In weighing
the study’s findings, however, it must be emphasized that the Iowa Women’s
Health Study is a retrospective study of already collected data. It is not a
prospective, controlled intervention study, i.e., it is not a “clinical trial,” in which
participants would be given a specific dietary supplement or a placebo and then
followed closely over time to observe not only the specific outcomes but also the
factors possibly contributing to those outcomes.

As can only be surmised retrospectively, individual circumstances change over
time, and a significant number of the women participants likely either changed or
began new dietary supplement regimens over the course of the 18 years they
were studied. And since there was no direct contact with the participants outside
of the mailed questionnaires, general information surrounding individual deaths
had to be obtained from public records; it was not ascertained by direct medical
investigation.

With regard to iron and copper, it has been known for decades that both metals
can be potentially toxic, as exemplified by the multi-system disease states that
can result from hemochromatosis and Wilson’s disease, respectively. For this
reason, many postmenopausal women, like men, probably should not take an
iron supplement in the absence of anemia or a documented deficiency. At the
very least, iron and copper supplements should be taken concurrently with
antioxidants and/or antioxidant-rich foods to prevent a potential increase in
oxidative stress. Each of these circumstances points to the merits of dietary
supplements being recommended and overseen by medical professionals.

With regard to multivitamins, there is simply insufficient data that can be gleaned
from the study to make any serious conclusion about the impact of multivitamins
on mortality. This is due to the fact that there are literally thousands of different
combinations of vitamins, minerals, and botanicals that can be considered a
“multivitamin,” as well as a whole host of considerations such as quality, potency,
dosage, protocol, and indications for use, among others.

Practitioner and Patient Concerns
We believe there are serious flaws in the methodology, analysis, and findings on
which this study is based. Retrospective surveys such as this-in which people
are asked to recall years of dietary habits or supplement use-are notoriously
inaccurate. The only conclusion that can realistically be drawn is that a slight
statistical association was found based on a limited data set of questionable reliability-and a simple association does not reflect causation. The study’s authors do not disagree, stating the following in their commentary to the study: “It is not advisable to make a causal statement of excess risk based on these observational data…” We heartily agree with this advice.

When made by a quality manufacturer, when recommended by a knowledgeable health-care practitioner, and when taken for the appropriate indication, dietary supplements promote, enhance, support, and help maintain overall good health and well-being. The “results” of the recent study do not diminish this conclusion.

Alan Miller, ND Robert Rountree, MD
Director of Medical Education & Research Chief Medical Officer
Thorne Research, Inc.
For further commentary on this study:
The Alliance for Natural Health
The Council for Responsible Nutrition

Get Your Feet Turned On!

In my last post I talked about the need to gradually build up the strength in our feet and ankles if we want to switch to minimalist or “barefoot” styles of footwear. Highly supportive shoes and orthodics (arch/foot supports) deprive our foot and ankle muscles of exercise and cause them to atrophy if worn too much. By spending some time walking in bare or sock feet or wearing minimalist shoes, we work these muscles and give them a chance to strengthen up.

One of my patients recently brought it to my attention that this only works if the muscles are “turned on”. You may remember me talking about the “weak” muscles that show up on muscle testing. trying to exercise these “turned off” muscles is like trying to replace a light bulb when the dimmer switch is turned down in order to get more light! The muscles aren’t able to really exercise unless the we find the reason they are turned off and correct it.

Making sure the ankle and arch support muscles are turned on are always important not only for foot support but for structural alignment throughout the body. This is even more important during the transition to minimalist or barefoot styles.

Next time I see you, don’t forget to “get your feet turned on”!

Shoe Review

For the last few weeks I’ve been writing about my research and experimentation with minimalist or barefoot shoe and ambulation. I feel that there are some benefits to spending at least some time each day on our feet without heavy supportive shoes or orthodics. There will be at least one more post in this series that I’ll devote to a summary of the various benefits.

For some of us, myself included, a minimalist approach to footwear on a full-time basis may be beneficial. Since it’s not practical to go barefoot all the time (we may want to go to a restaurant sometime) a look at footwear that gives some or all of the barefoot benefits would be a good idea.

Within the context of this post I’m going to make a distinction between footwear that mimics the barefoot experience vs minimalist. In order to fit the “minimalist” definition, the shoe must be flexible throughout the sole and have a “rise” of no more than 7mm (about 1/4″). This seems to give many of the neurological benefits such as not interfering in normal gait muscle coordination.

I’m going to add some conditions to meet my definition of a “barefoot” shoe (please ignore the apparent contradiction of a “barefoot” shoe!). This is a shoe that will, basically, feel as much like walking barefoot as possible while still protecting your feet from stones, glass etc and win you admission to restaurants and other public places that require shoes.

A barefoot shoe has a heel that is on the same level as the ball of the foot without the small rise mentioned above. The sole is thin enough to allow you to feel the ground under your feet, all the nooks and crannies, almost as if you were barefoot. Most importantly, it has no cushioning in the heel. If you walk on a hard surface barefoot and land hard on your heel, it hurts! You should have the same experience in a “barefoot” shoe.

A barefoot shoe causes major changes in the way we walk and especially in the way we run. We’re forced to hit the ground with the mid-foot, take shorter steps and just brush the heel to the ground when walking. This engages your calf, abdominal and buttock muscles much more strongly than with “regular” shoes that allow you to land on your heels. One of the reasons that “barefoot” runners suffer fewer injuries is that they are running the way nature intended, engaging a whole series of shock absorber mechanisms that are bypassed with the modern athletic shoe and a heel-strike running style.

As you may remember, my first experiment with long-term use of minimalist footwear was with a martial art shoe (tiger claw shoes about $60) that I already had. These are sort of half way between minimalist and barefoot with a slight, 4mm rise, great flexibility and an uncomfortable heel strike on hard surfaces. They also have no arch support which forced my foot muscles to really work for the first time in decades. See my earlier post for the agonizing transition and my recommendation for starting with minimalist shoes.

My Tiger Claws are not really meant for outside wear and the sole was wearing down quickly on pavement. I also discovered that my left foot, which is a little bigger, was feeling cramped in the toe box especially when I walked very far using the increased flexion and toe push-off that’s needed for one type of barefoot gait.

After some checking around I found that most of the major athletic shoe companies were producing some kind of minimalist shoe. Since I’ve worn New Balance for years, I started with their “Minimus” line (around $100). There was no one locally who carried them so I ordered some online. I got two styles to try. Unfortunately, they were both too tight across the mid-foot. Many of these shoes are made to be worn without socks and that may have been the problem. Since I was looking for a shoe I could wear with socks, back they went.

The Vibram Five Finger shoe ($45-90) looks like a glove for your foot with a separate space for each toe. I’m not ready to wear something like this to the office but several of my patients think they’re great. This would probably be the ultimate “barefoot” shoe. They are available at several locations locally and on the internet. There have been some injuries reported, especially to the achilles tendon, from runners who didn’t go slow enough in their transition.

I found one place that sells the Merrel Trail Glove ($100 women, $110-120 men), a shoe that fits my definition of a barefoot shoe. Trade Home at Northpark Mall sells it and it should probably be called a foot mitten rather than a “glove”. It does “fit like a glove” though and is a bit snug if you’re not wearing thin socks. It can also be worn without socks. This is the shoe many of you have seen me wearing in the office for the past two weeks. It’s very comfortable, with plenty of room in the toe box. Of course the same transition period is needed no matter how comfortable the shoe is. The Trail Glove is very close to going barefoot. If you’re going to be walking over a lot of rocks, it may not give enough protection. The New Balance Minimus series has a somewhat thicker sole and a 4mm rise at the heel and may be more comfortable for some people.

Merrel also makes a “Mary Jane” style of minimalist/barefoot shoe for women ($99 at Trade Home). The women’s version of of the Trail Glove is called the Road Glove. Karen got one of each style and loves them as does Valerie (we got her a pair for mother’s day).

Terra Plana has a variety of minimalist and barefoot shoes from $110 to $175. Their barefoot models have a thinner sole than the Merrel Trail Glove so the same considerations when traveling over rocky terrain.

Nike has an interesting twist with their Nike Free line of running and walking shoes ($65-95). They have a much thicker sole than any of the other shoes I’ve talked about and achieve the needed flexibility by a series of grooves in the sole. I don’t think they qualify as “barefoot” because there’s too much padding in the sole but one of my colleagues likes them a lot.

So far I’ve talked about the medium to high end of the minimalist shoe line. There is also a low end that many of us are familiar with. Remember the old canvas “tennis” or “basketball” shoes we has as kids (speaking especially to “boomers” now)? Shoes like “Keds ($30-60), “Converse” (about $40) and
“PF Flyers” (about $50) are still around and qualify as minimalist. In fact several women patients have come in wearing Keds and I’ve complimented them on their “minimalist” shoes! There are several stores in the area that sell Keds for women but men will probably have to go online to find them. The official Keds site is the most expensive place to buy them and you can find Keds for about $20 less through other online retailers.

My daughter-in-law’s (that’s Valerie!) father introduced me to what may be the real low-end minimalist shoe. There’s a martial art shoe called the “Feyue” that is a lot like a canvas sneaker with a sole that’s good for wearing outside. I got a pair on Amazon for $15 plus shipping. They have a rounded sole that takes some getting used to and which, according to a review I read at: http://www.americanparkour.com/smf/index.php?topic=19437.0, should wear in pretty quickly. They have more room in the toe box that the converse shoes I tried. They’re not as comfortable as my Trail Gloves but I don’t want to wear the Trail Gloves for cutting grass and other yard work since the Trail Gloves are, for the moment, my “dress shoes”. For the price, you can’t really beat them but I suggest reading the above review before you buy.

This post has gone a bit longer than the previous ones. Can you tell I’ve been writing it in my head for the last two weeks? Hopefully this will give your some idea of where to look for minimalist/barefoot footwear across a good range of prices.