Archive for May 20th, 2018

Americans and Europeans are abandoning parenthood at an alarming rate, profoundly changing the nature of our societies, our politics and our cultures.

Last year, women in the U.S. had children at the lowest rate ever recorded. There were just 60.2 births for every 1,000 girls and women ages 15 to 44 in our country. As a result, there were fewer births in America last year – 3.85 million babies – than at any time since 1987. This was a 2 percent drop from 2016.

In addition, those having the most children are least able to pay for their upbringing. American women became mothers last year at rates that were inversely proportional to family income. The birth rate was almost 50 percent higher for those with less than $10,000 in family income than for those with family incomes of $200,000 or more.

There are many wonderful mothers in impoverished families. And a good income is no guarantee of good parenting. But in general, children being raised in very low-income families will struggle, while children being raised in middle- and upper-income families will do better without relying on taxpayers to finance their upbringing.

The lack of commitment of middle-class and wealthy Americans to having and parenting their own children goes hand in hand with our elite’s casual approach to other issues – in particular, mass immigration.

The notion that we can simply import foreigners to make up for the child-rearing job we have refused to do ourselves completely ignores the cultural, civic and economic impacts of immigration – as well as the impacts to ourselves when we bring in foreign adults as a substitute for raising our own children.

While I would be the last person to insist that large families like ours be the American model, an America where only the poorest have large families and most people choose to have small families – or no children at all – is not economically or culturally sustainable.

While selective immigration in conjunction with a naturally growing population and economy can be a healthy phenomenon, using immigration as a substitute for having enough of our own children leads us down an  easy and comfortable but ultimately perilous route without precedent in American history.

People having fewer or no children at all may seem at first blush to be simply making a personal choice, of consequence only to themselves. However, this decision is actually one with profound political implications.

No matter where on Earth a person lives, parenthood is a lifelong investment. The willingness to make that investment is a critical indicator and determinant of a person’s political viewpoint.

In the U.S., parents with more children are embracing a more traditional lifestyle and also are more likely to vote Republican. In the 2016 presidential election, Donald Trump won all 10 of the states with the highest fertility rates – as well as 16 of 17 states with the highest fertility rates. And the bottom 10 states in fertility were all carried by Hillary Clinton.

The most family-friendly element of the tax cuts Congress approved and President Trump signed into law was increasing the child tax credit from $2,000 from $1,000 (where it had been stuck since 2003) and substantially raising the phase-out threshold from $110,000 in family income to $400,000. It’s a change that puts real money in the pockets of taxpaying American families.

Still, even under the new tax regime, the fertility of women of childbearing age in households paying no federal income taxes is almost 25 percent higher than the fertility of those paying income taxes. To say this demographic trend is incompatible with the long-term viability of a welfare state is understating matters considerably.

But for all the challenges we face in the U.S., the problem is far worse in Europe, where the current attitude was summarized in a recent report by Population Europe titled  “No Kids, No Problem!”

European women of child-bearing age had an average of 1.56 children each over their lifetimes – far fewer than the 2.1 necessary to even keep their population stable. The comparable figure in the U.S. is 1.76 children per woman. And both the numbers in the U.S. and in Europe would be far worse were it not for higher immigrant fertility.

In Europe, it’s not just that they are having fewer children – more and more people aren’t having any children at all.

The Europeans who are declining to become parents are only following the example of their leaders. Of the six founding members of the European Union (Germany, France, Italy, Belgium, Luxembourg and the Netherlands) today only one of them (Belgium) is led by someone who has had children.

Britain and the European Commission are also headed by childless leaders. Amazingly, these eight core leaders of modern Europe have a total of only two children among them.

Contrast this demographic collapse to the situation of the leaders of this same group of countries in 1951, when they founded what became the European Union. At that time, the eight leaders of these countries had 32 children.

If you wanted to summarize the forthcoming demographic and cultural collapse of Europe in one statistic, the decline in children among Europe’s core leaders from 32 to 2 in a little more than a generation would be an ideal place to start.

At an individual level, each of today’s European leaders may have had compelling or even tragic reasons for not becoming a parent – perhaps at great personal sorrow. Yet while we cannot judge any one particular situation, we can almost certainly say that such a dramatic pattern is not coincidental. Nor is it harmless.

In both Europe and the U.S., the decline in motherhood – and the increased decline in the number of men accepting the responsibilities of fatherhood (40 percent of births in the U.S and Europe  occur out of wedlock) are indicative of a materialistic, pleasure-seeking, live-for-today ethos. This attitude minimizes or denies the obligations we have toward future generations.

It is a sign of our crisis of parenthood that to even raise such issues publicly is uncomfortable. Certainly, maximum childbearing is not an outcome we seek – countries with the world’s highest fertility rates are mired in poverty and face many challenges. But with so many of the West’s citizens and leaders abandoning parenthood and responsibility, some response is needed.

I say all this not as an academic observer but as the father of five young children, with a wife who works part-time at night. We have taken no paid maternity or paternity leaves and utilized only very limited outside child care. So I know from my personal experience every day the sort of social, emotional and financial sacrifices that parenting requires.

While I would be the last person to insist that large families like ours be the American model, an America where only the poorest have large families and most people choose to have small families – or no children at all – is not economically or culturally sustainable.

In his book, “The Disappearance of Childhood,” the late cultural critic Neil Postman wrote: “Children are the living messages we send to a time we will not see.”

We need to keep sending those messages, not just because it is our responsibility or because of the profound love and joy children bring into our lives, but because we realize that a society that abandons parenthood is a society that forfeits its future.


Read Full Post »

Photo: Ainsley Joseph

Vitiligo seems like a hidden disease with limited awareness, but for the over 200,000 patients in the United States (and almost 2 percent internationally) who suffer from vitiligo, the lack of knowledge and information can be frustrating. Vitiligo is a condition in which the skin loses pigment, resulting in patches of lighter or white skin spreading diffusely throughout the body. While the cause is debated and treatment options continue to develop, managing vitiligo can have both physical and psychological repercussions. Recently, though, models with vitiligo have been featured prominently in marketing campaigns—including Amy Deanna, starring in a foundation campaign with CoverGirl—to raise awareness of the skin condition in a more positive light.

Vitiligo causes.

For most of the population, however, vitiligo is currently perceived as an abnormal skin condition in which the skin starts to lose melanin, the pigment that essentially gives skin its trademark color. The way it works is that melanocytes—cells that create melanin—in the skin die off, no longer protecting the skin from harmful UVA and UVB rays. A vitiligo patient may suffer from patches of depigmented or white skin anywhere, including visible areas like the face and hands. Premature graying of hair and discoloration of mucus membranes are also telltale signs of vitiligo.

There is uncertainty around the causes of vitiligo, although there is a known genetic component. Recent studies show that changes in the genes that regulate glutathione, a potent antioxidant, play a role in vitiligo. Vitiligo is historically thought to be an autoimmune disorder, or a condition where the immune system reacts on itself.

I have had the opportunity to work with many patients with vitiligo over the years in my integrative medical practice. Many of these patients present with patches of depigmented white skin in prominent areas of their face, hands, back, or legs. As we work on the chemistry of vitiligo, or the “why” of this disease, the psychological implications can be equally devastating. Many vitiligo patients become self-conscious about the visibility of this disease, retreating from social occasions or trying to find ways to camouflage their appearance. For the majority of vitiligo patients, the disease began in childhood, spreading through the years. But thanks to efforts being made on Instagram, mainstream beauty advertising campaigns, and the buzzy skin positivity conversation—it’s starting to get better.

Vitiligo treatment.

Currently the treatment for vitiligo focuses on using sunscreen to cover up areas where the skin has depigmented; phototherapy with UVB or UVA light, typically done in a clinic setting; or in some extreme cases, depigmentation, where the “normal” skin is depigmented to match the white patches. Additionally, dermatologists recommend a one-month trial of topical corticosteroids to stop the depigmentation or the spread of vitiligo, or use of a topical vitamin D cream (Dovonex).

Psoralens are also used in combination with UVA and UVB therapy, slowly returning pigment to the skin over six to 12 months. Psoralensare light-sensitive compounds that work to absorb UV radiation, essentially acting like UV light.

Vitiligo cure?

Photo: Pablo Anton

These treatments have some success in treating vitiligo but often work best to control the spread, if desired, and to work on self-confidence rather than full reversal of this disease. More cutting-edge treatments include using pseudocatalase, an enzyme that helps repigment the skin. A drug that mimics the melanocyte-stimulating hormone, MSH, is also being used more frequently in the treatment of vitiligo.

While these treatments offer patients options, rethinking vitiligo opens additional avenues for treatment. Like many autoimmune diseases, vitiligo is a manifestation of an immune system disorder, triggered by any of a number of factors. Thinking about vitiligo from the inside out expands the toolbox with which to approach this disease.

Natural vitiligo treatment.

There are increasing reports that vitiligo can be caused by a trifecta of multiple factors: genetics, exposure to chemicals, oxidative stress, viral triggers, and stress. I have also seen hormone imbalances trigger vitiligo in practice. Approaching vitiligo with this whole-systems approach may ultimately be of more benefit than a single-treatment approach. Managing inflammation, oxidative stress, your toxic load, your immune system, and even hormone balance can influence the spread of this disease.

Vitiligo and inflammation.

Inflammation begins in the gut, so following a diet that reduces inflammation is important in the management of all autoimmune diseases, including vitiligo. Lowering gluten and dairy intake while limiting sugar are central tenets of this diet. Increasing healthy fats, including omega-3 and omega-9 fats, further helps to lower the inflammatory load.

Oxidative stress is caused by natural wear and tear, environmental toxins, or stress. It is the process where the body begins to produce more free radicals, damaging and changing our DNA. A diet high in antioxidants from brightly colored fruits and vegetables can prevent oxidative stress. Oxidative stress and melanocyte survival may be influenced by glutathione, the antioxidant released when greens are blended or juiced.

Vitiligo and thyroid function.

In practice, I have also seen vitiligo connected to imbalances in thyroid function. Optimizing hormone balance, which I discuss in my mindbodygreen class on hormone balance, and thyroid function can be helpful as well. Lastly, understanding your toxic load and the role of toxins in the expression of vitiligo is an evolving field. Taking steps to minimize exposure to environmental toxins in household products, personal body care, cosmetics, and food is important.

A number of herbal products and natural products have been recommended for treatment of vitiligo with varying levels of success. In ayurveda, herbal formulas that mimic the activity of psoralens are often used to treat vitiligo. The herbs Katuki and Bakuchi show psoralen and antioxidant activity respectively, repigmenting the skin. Turmeric has been used as well for skin repigmentation. Many of these herbs and natural products are used both topically and internally.

Replacing B vitamins and silica have shown some promise in the treatment of vitiligo while Ginkgo biloba has been shown to have anti-inflammatory effects and to be useful in treating vitiligo. The recommended dose is 120 milligrams per day. In Chinese medicine, the plant Psoralea cordyfolia is a natural source of psoralens. The seeds were used in combination with other herbs to repigment the skin.

Vitiligo and stress.

Stress management is also a factor in vitiligo. Some studies point to the use of St. John’s wort in controlling stress and helping to manage depression and anxiety.

As treatment options continue to evolve, understanding the complexities of vitiligo is critical to its resolution. From focused treatment options to underlying causes, shifting thinking about vitiligo to a whole-systems approach can bring greater success at repigmentation and prevention. Helping patients and family members through the psychological and self-esteem issues associated with vitiligo should also be a priority.


Read Full Post »

Photo: Darren Muir

Despite what conventional medicine may tell you, autoimmunity is not a black-and-white issue. Instead, there’s what I call “the autoimmune spectrum,” and how much inflammation you have determines where you fall on that spectrum. I coined this term back when I first began writing about autoimmunity, and now it’s become the established term in functional medicine to explain how autoimmune conditions develop and, more importantly, how to reverse them.

I myself struggled with autoimmunity during my second year as a medical student. Despite experiencing rapid weight loss, tremors, a racing heart, and a number of other frightening symptoms, my doctor brushed it off as “medical school stress.” However, I knew my body and was certain that something wasn’t right, and so I insisted on a complete work-up and lab testing. Sure enough, I was not going crazy: I had Graves’ disease. Graves’ disease is a condition in which the thyroid overperforms. It enlarges to up to twice its normal size, producing all the symptoms I had been suffering from: racing heart, tremors, muscle weakness, disturbed sleep, and excessive weight loss.

The treatments conventional medicine offered for Graves’ were almost as scary as the disease itself, and after a brief stint with the drug propylthiouracil (PTU), which caused me to develop toxic hepatitis, I resorted to radioactive thyroid ablation and a lifetime of supplemental thyroid hormone. I only wish I had known then what I know now—that having an autoimmune disease does not mean you are destined to a life of painful symptoms and harsh medications.

The good news is that by reducing inflammation, you CAN work your way down the autoimmune spectrum and reverse your condition! By understanding the factors that are contributing to your inflammation, you can get to the root cause of your autoimmunity and start leading your best life.

Autoimmunity: your immune system gone rogue

Autoimmune disease is a disease of the immune system. Aside from the nervous system, the immune system is the body’s most complex system, made up of your digestive system, skin, tonsils, bone marrow, lymph nodes, spleen, and the thin skin on the inside of your nose, throat, and genitals. All of these tissues, organs, and cells work together to keep your entire body healthy.

Under our current medical system, autoimmune diseases are not recognized as diseases of the immune system as a whole; rather, they are treated as diseases of particular organs. However, when you have autoimmunity, it means that somewhere along the way your immune system went rogue and began attacking your own tissues. It could be your thyroid under attack, your intestines, your skin, your brain, your pancreas, or another organ. No matter what part of your body is under siege, the underlying problem is within your immune system. In order to treat, prevent, and reverse your autoimmune disease, you’ll need to get your immune system back under control.

Inflammation and the autoimmune spectrum.

So what caused your immune system to go rogue in the first place? One word: inflammation. And unfortunately, nearly everyone has at least some inflammation thanks to our modern lifestyles. The five factors that I’ve identified in my patients that contribute to chronic inflammation are diet, leaky gut, toxin exposure, infections, and chronic stress—or a combination of these factors.

For many people, diet is their primary source of inflammation. Gluten and dairy are two of the most inflammatory foods, along with corn, soy, grains, and legumes. Even those of us with a clean diet are exposed to thousands of environmental toxins that contribute to inflammation every day in the form of plastics; pesticides, herbicides, and hormones in our food; heavy metal exposure from fish and dental fillings; and air and water pollution—the list goes on.

Family history can also affect where you fall on the spectrum. The more relatives you have with an autoimmune condition, the higher your risk is, especially when it’s a first-degree relative such as a parent or sibling. Even so, genetics account for only about 25 percent of the chance you’ll develop an autoimmune disorder. The remaining 75 percent of the picture is environmental and, therefore, up to you. I find that an incredibly empowering statistic.

Once you figure out where you fall on the spectrum, you can assess your risk for developing autoimmunity. Or if you’ve already been diagnosed with an autoimmune disease, take the proper steps to reduce inflammatory factors in your life to work your way back down the spectrum.

At the low end of the autoimmune spectrum are those of you who are only moderately inflamed. You may get occasional symptoms such as acne, digestive issues, and fatigue, although these tend to come and go, and you haven’t begun to show signs of illness.

Toward the middle of the spectrum are those of you who experience symptoms of chronic inflammation that have not yet turned into full-blown autoimmune disorders. These symptoms might include joint pain, obesity, allergies, muscle aches, fatigue, and digestive issues. Although you don’t have an autoimmune condition at this point, you are at significant risk to develop one if you don’t address your inflammation.

Finally, at the high end of the spectrum are those who can officially be diagnosed with an autoimmune disease. While conventional doctors would have you believe that you need to be on medications for life or take other drastic measures to control your autoimmunity, there are simple lifestyle changes you can adopt to live a long, healthy, and symptom-free life.


Read Full Post »

%d bloggers like this: