A Kilburn reader has written about rosehip tea. She recently started to drink this daily in the hope that the powerful antioxidants it contains will help her osteoarthritis. Is there, she wonders, any evidence to support the growing belief that rosehips are of use to alleviate arthritis?
British schoolchildren learn that Captain Cook kept sailors free of scurvy by providing limes. Without this serendipitous discovery, Australasia and the Pacific region might not have then been explored and exploited by the British.
Scandinavians teach history rather differently. They believe that the Vikings understood that rosehips enabled them to remain healthy — to help them to conquer and colonise parts of Europe far beyond Scotland, Yorkshire, East Anglia, Ireland and Normandy, the areas we were taught at school to associate with Viking invasions.
The Vikings in their longboats travelled to all parts of Europe, Russia and as far south as Budapest. Some Scandinavians believe that they also settled in other continents and crossed oceans as well as seas.
Swedish rosehip soup with cream is still a traditional Scandinavian dish and Danes enjoy rosehip marmalade with their morning coffee. Unfortunately, cooking them probably destroys most of the vitamin C and other antioxidants found in rosehips that would have kept the horned-helmeted Vikings fit enough to slaughter Norfolk farmers before seizing their land and women.
Rosehips during the Second World War were also part of every schoolchild’s life. Rosehip syrup was handed out to compensate for any lack of vitamins in the rationed diet, and school walks were enlivened by having to collect the hips of the dog rose that grew in the hedges. The dog rose, native to Britain and temperate areas of Europe, Asia and North Africa, is used to make the medicinal rosehip syrup or powder.
Rosehips contains vitamins C, A, B1 2 and 3, vitamin K and a wide variety of flavonoids, polyphenols, volatile oils and tannins. Two Scandinavians, Dr Kai Winther and Professor Arsalan Kharazmi, of the Copenhagen County Hospital, advocate the use of rosehip preparations. It occurred to Dr Winther, who has had a long career in cardiovascular disease research, that as rosehips had an antiinflammatory action this could help patients with heart disease as well as those with osteoarthritis, and he believes probably rheumatoid arthritis. The evidence is increasing that inflammation of the blood vessels is a highly relevant factor in heart disease. An indication of the ability of rosehips to reduce inflammation is its effect in lowering patients’ C-reactive protein levels, which are often raised in people with a tendency to heart disease, or confirmed heart disease.
Two recent studies, from Denmark and from Norway, have been published on the anti-inflammatory action in osteoarthritis of a standard rosehip powder produced from dog rosehips and seeds. In the Norwegian trial Litozin, the rosehip powder, was tested in a double-blind trial of 100 people with similar degrees of osteoarthritis. Those who had the rosehip powder developed better active movements of the hip, but passive movements remained comparable in both groups.
The Danish trial studied 100 people in a double-blind random trial. There was a significant reduction in pain and the consumption of painkillers in those taking rosehips for more than three weeks. Decreased disability and stiffness wasn’t generally significantly apparent until after three months of treatment. The anti-inflammatory action of rosehips is known to be independent of its vitamin C content.
A COUPLE from Suffolk are expecting a child next year. The wife, who has had problems in conceiving, is concerned that her child should have every opportunity in a delivery that will offer the baby the best chance of trouble-free health in infancy and beyond. She had planned to have an epidural block, but having read in the newspapers of the recent controversy that emanated from research published in the International Breast Feeding Journal, she now wonders if this is wise.
This journal’s report, which analysed the number of breast-feeders after an epidural, has inevitably been unable to cover all the factors that could influence these results. Reports of the research also failed to emphasise that the standard epidural block doesn’t usually contain either pethidine or fentanyl. Both drugs are opioid narcotics, but research indicated that there was a closer relationship between fentanyl and problems with breast-feeding than with pethidine.
The standard epidural anaesthesia given to produce a painless delivery, the objective of the procedure, comes from a continuous infusion of local anaesthetics through a catheter inserted in the gap between the second and third lumbar vertebrae. It is also possible to administer narcotics epidurally. Such problems as there have been after using narcotics during a delivery would apply by whatever route was used, but dose and timing would be important.
The objectives of doctors and midwives are that the delivery should be safe and painless and that the baby should be alert enough to be able to suck at the breast as soon as possible. These objectives are linked. There is no more common cause of failure in ensuring good maternal child bonding , or in inducing a poor suck reflex, than by allowing labour to continue for more than 12 or so hours. This is often followed by the baby taking a battering when delivered, thereby adding to the problems it has already suffered by enduring a long labour — factors more likely to produce long-lasting problems for a child than being a poor breast-feeder.
Pethidine is frequently given by mouth or intramuscular injection to relieve pain in the first stage of labour. Occasionally this causes some sleepiness and a poor sucking reflex, but its effects wear off within two days. At the age of 5 there is no difference detectable in either the physical or mental abilities between babies of mothers who had or not had epidurals. Similar trials at other ages confirms these findings. If pethidine or fentanyl is given epidurally it has been noted that the sooner the baby is delivered, preferably within an hour of the injection, the less likelihood there is of an effect on the baby’s behaviour in the first day or two.
Heavy doses of opioid narcotics may have a theoretical effect on lactation, as they alter the levels of the pituitary hormone prolactin that influences milk secretion, but not an effect comparable with a difficult delivery.
TOPIC OF THE WEEK
Read about sexually transmitted deseases in times2 tomorrow, and send any queries to Dr Stuttaford at www.timesonline.co.uk/talkingpoint His answers will appear online at 1pm on Wednesday.
