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'Science' vs Squatting? (Zhang et al. 2004)



 
 
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Old April 18th 04, 08:36 PM
Todd Gastaldo
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Default 'Science' vs Squatting? (Zhang et al. 2004)

SCIENCE vs SQUATTING? (Zhang et al. 2004)

See the postscript.


SQUAT TO DELIVER?

PREGNANT WOMEN: You do NOT have to squat to allow your birth canal to OPEN
the "extra" up to 30%.

For simple instructions, see the very end of this post.

MDs are knowingly closing birth canals up to 30%. See PROOF at the very end
of this post.


IS SQUATTING FREE HIP OSTEOARTHRITIS PREVENTION?

"[Hip osteoarthritis in Chinese] was 80-90% less frequent than in white
persons in the US..."
--Nevitt et al. [2002; abstract below]

COULD squatting be free hip osteoarthritis prevention?

What a cool thought!

The KNEE osteoarthritis studies in China are interesting but they bother me
(see Zhang et al. 2004 discussion and abstracts below)...

WHY are scientists who are studying squatting failing to explicitly mention
The Great Squat Robbery - the West's robbery of the ability to rest the
spine while standing?

Incredibly, Western children are losing bony "squatting" facets
as they are robbed of an innate way to rest on their feet for hours in
virtually any terrain...

In 2001, Eve-Line Boule, chercheur associé at CÉPAM wrote:

"[S]quatting was a regular behavior used until the end of the Middle Ages,
and after this period a progressive decrease occurs..."
[Am J Phys Anthropol 2001 May;115(1):50-6]

I replied:

The Great Squat Robbery that started in the Middle Ages starts anew in
elementary schools every year!

See Sarah Key's huge balls (also: Kids can SQUAT
motionless for
hours)...
http://groups.yahoo.com/group/chiro-list/message/2084


COULD SQUATTING PREVENT LOW BACK PAIN?

It's nearly impossible to determine this but...

As I noted in my peer review of the first draft of the 1994 US Public Health
Service sponsored Acute Low Back Problems Guideline:

Making squatting an activity of daily living again would certainly increase
"flexibility," a distinct concern of the U.S. Department of Health and Human
Services, Public Health Service. Quoting from the PHS publication Healthy
People 2000:

"Flexibility describes the range of motion in a joint or sequence of joints.
Those with greater flexibility may have a lower risk of future back
injury...Joint movement through the full range of motion helps to improve
and maintain flexibility...

"...The performance of routine daily activities is particularly important to
maintaining functional independence and social integration in older adults.
Increasing public awareness of all of these potential benefits may help to
encourage the pursuit of activities that will promote...flexibility."
[Harrell JA, Artz LM, Files A, Baker D (eds.). Healthy people 2000: National
health promotion and disease prevention objectives. DHHS Pub. No.
(PHS)91-50212, 1991:100]


FOOTPRINTS ON THE TOILET SEAT

THRONE ("sitting-type") TOILETS IN CHINA

Chinese researchers Cai and You wrote in 1998:

"A field survey on the use of public toilets in Taipei reveals that almost
half of the subjects take a non-sitting posture while using the sitting-type
public toilets and 86% of the subjects agreed that the squatting-type public
toilets better satisfy sanitary requirements. An experiment was conducted to
determine relevant anthropometric data for a redesign of squatting-type
toilets. One of the variables studied was the effect of the footstep slope
on squatting comfort...The 15 degrees slope was found to be preferred..."
[Cai D, You M Appl Ergon 1998 Apr;29(2):147-53]

Hopefully the Chinese do not cave-in to Western chair-dwelling imperialism
and related obstetric crime - and I do mean obstetric crime. More on the
latter below.



SCOLIOSIS: LESS IN CHINA?

(DOES SQUATTING PREVENT SCOLIOSIS?)

Hoppenfeld wrote in 1967:

"Any postural habit which persists during the teenage period should be
regarded as a possible deforming force to the susceptible spine of the
adolescent." [Hoppenfeld S. Scoliosis: A manual of concept and treatment.
J.B. Lippincott Co. Phil, PA 1967:35]

A culture that forces chair-dwelling on children and fails to encourage
females to engage in physical activity is going to have a female
predominance of scoliosis...

According to Hoppenfeld [1967]:

"Adolescent idiopathic scoliosis is the most common type of scoliosis and
probably represents approximately 40 per cent of all cases of idiopathic
scoliosis. This curvature predominates in females in a ratio of 4 to 1, and
the curve is almost always right thoracic..."

Hmmmmm... The curve is almost always right thoracic...

Predominantly right-handed children might tend to similarly distort their
spines in chairs...

Hoppenfeld [1967] continues:

"During the growth spurt between the ages of 12 to 16, rapid progresssion is
known to occur. At the termination of growth the spine becomes stable, and
further progression of the spinal curve and deformity ceases...Definitive
closure of vertebral epiphyseal plates: Girls 14-15; Boys 16-17..."

Is this 4 to 1 female predominance still accurate?

Or have girls' sports and computer games narrowed the gap...

In China in one study there was only a "slight" prevalence in girls - among
the one
percent of 20,000 Beijing school children age 8-14 who reportedly evidenced
scoliosis...
[Chung Hua Liu Hsing Ping Hsueh Tsa Chih 1996 Jun;17(3):160-162]

A COVER-UP?

The knee osteoarthritis studies in China (see Zhang et al. 2004 discussion
in the postscript) seem strange to me...


Maybe the Holy See's "Big 'C'" - the Chair - is being "scientifically"
propped up like the other "Big 'C'" - American medicine's grisly most
frequent surgical behavior toward males?

Could it be that American MDs and PhDs are trying to retroactively
demonstrate "potential medical benefits" to The Great Squat Robbery *just*
like MDs are playing a "potential medical benefits" game to stay out of
prison and perpetuate routine infant circumcision^^^?

^^^American MDs got downright anti-Semitic in the late 80s. When I exposed
their phony "babies can't feel pain" neurology and called for an end to
their obvious mass child abuse - I also called for a religious exemption for
Jewish circumcision...

American MDs immediately came out in opposition to ALL religious
exemptions - and in favor of anonymity for PERPETRATORS of child abuse -
immediately after which the Calif. Med. Association ignored its own
Scientific Board and by voice vote instantly created "an effective public
health measure" out of "no medical inidications" routine infant
circumcision. (!)

See Difference between God and an MD?
http://health.groups.yahoo.com/group...t/message/2438

And then there is American medicine's grisly most frequent surgical behavior
toward FEMALES - it is sort of impossible to "scientifically" prop it up as
it involves MDs slicing vaginas en masse - surgically/FRAUDULENTLY inferring
they are doing everything possible to OPEN the birth canal - even as they
CLOSE the birth canal - up to 30%...

See Criminal medical CAM at Hawai'i's John A Burns School of Medicine
http://health.groups.yahoo.com/group...t/message/2256

And see: Helping baby open birth canal (Why obstetrics is criminal medical
CAM)...
http://health.groups.yahoo.com/group...t/message/2391

Interesting squatting quote from JAMA:

"[T]he original obstetric chair [was] squatting." [Holmes, RW discussing
Markoe JW. Posture in obstetrics. JAMA;
(Oct7)1916;67(15):1066]

This chair-dwelling culture is robbing its females of the original obstetric
chair.

LADIES: You do NOT have to squat to allow your birth canal to open the
"extra" up to 30%.

See the very end of this post.

Sincerely,

Todd

Dr. Gastaldo


PS Again HIPS: "[Hip osteoarthritis in Chinese] was 80-90% less frequent
than in white persons in the US..."
--Nevitt et al. [2002]

Maybe squatting DOES protect against hip osteoarthritis? It's an intriguing
thought...

But what's up with these studies of Chinese KNEES (abstracts below)?

According to Zhang et al. [2004]:

"Prolonged squatting is a strong risk factor for tibiofemoral knee OA among
elderly Chinese subjects in Beijing, and accounts for a substantial
proportion of the difference in prevalence of tibiofemoral OA between
Chinese subjects in Beijing and white subjects in Framingham."
[Zhang et al. Association of squatting with increased prevalence of
radiographic tibiofemoral knee osteoarthritis. ARTHRITIS & RHEUMATISM Vol.
50, No. 4, April 2004, pp 1187-1192]

WHOA! Not so fast...

If one reads the abstract closely, one finds that in Beijing Chinese women a
lifetime of squatting leads to only 10% more knee osteoarthritis seen on
x-ray than in white females in the US...

And Beijing Chinese men evidenced LESS knee osteoarthritis - 7% less -
relative to white males in the US...

LESS evidence of knee osteoarthritis in Beijing men - after a lifetime of
squatting!
"...the impact of squatting on the difference in prevalence of tibiofemoral
OA between the Chinese subjects from Beijing and the white subjects from
Framingham. After adjustment for age, the absolute prevalence of
tibiofemoral OA in the Chinese women was higher than in the white women, by
14.4%. However, with further adjustment for the time spent squatting at age
25, the difference in prevalence was reduced to 9.5%. Among the men, the
age-adjusted prevalence of tibiofemoral OA was only slightly lower in the
Chinese subjects compared with the white subjects, by 2.9%. However, after
adding the impact of squatting into the model, the difference became
greater, with the adjusted prevalence of tibiofemoral OA in the Chinese men
being 7.0% less than in the white men. (p. 1190)

PROLONGED squatting at age 25...

This was where the apparent knee-osteoarthritis-generating effect of
squatting exceeded "borderline" significance...

"...although our data showed that squatting at age 25 was associated with an
increased prevalence of tibiofemoral knee OA, the trend was of only
borderline statistical significance. The effect was mostly seen among
subjects with a history of prolonged squatting, but the percentage of
subjects who reported prolonged squatting was relatively small." (p. 1191)

I WONDER...

Are BEIJING Chinese 60-year-olds squatting like the rest of 60-year-old
Chinese in China? The study made this inference...
"Nonoccupational squatting is a common posture in daily living among Chinese
men and women...we recruited a random sample of men and women age [at least]
60 years from 4 central districts of Beijing, China. Subjects were
interviewed at their homes by trained health professional interviewers. We
administered a standardized questionnaire that focused on joint symptoms,
previous diagnoses of arthritis, and possible risk factors for OA. Subjects
were asked to recall how much time they spent squatting per day, on average,
at age 25 years, including squatting while using the toilet, talking,
cooking, eating, doing housework, washing clothes, and working." (p. 1888)

The study found a LOT of Beijing Chinese who thought that at age 25 they
squatted less than 30 min per day...Is this normal throughout China?

From p. 1190...a table showing minutes per day spent squatting at age 25 -
recollections 35 years later in Beijing Chinese men and women...

Men

0-29 212

30-59 229

60-119 215

120-179 51

[more than] 180 32

Women

0-29 146

30-59 189

60-119 442

120-179 230

[more than]180 70

QUESTION: How long do Beijing Chinese 60-year-olds squat TODAY at age 60+?
The study didn't say...

How many minutes per day do 60-year-olds squat throughout the rest of China?

A FLAW...

According to the April 2004 Zhang et al. study,

"In Western societies, squatting in occupational activities often occurs in
conjunction with other heavy labor. Any of these activities may increase the
risk of knee OA, thus confounding the relationship between squatting and
knee OA." (p. 1188)

I submit that in Western societies, many (most?) of those engaged "in
occupational activities" have LOST their innate prolonged squatting
ability...

They CAN'T squat. I emphasize the word PROLONGED here. Interestingly, no
one squatted in Gardosi et al.'s 1989 Lancet "randomised controlled trial of
squatting" - because (said Gardosi et al.) Westerners cannot squat for
prolonged periods.

SHORT periods of squatting (during contractions) suffice during birth:

See again: Sarah Key's huge balls (also: Kids can SQUAT
motionless for hours)...
http://groups.yahoo.com/group/chiro-list/message/2084

Western CHAIRDWELLERS are not likely squatting flat-footed when "deep
squatting" - or at the very least they are not squatting flat-footed **for
prolonged periods** while engaged "in occupational activities" - because
most simply CAN'T comfortably squat flat-footed for prolonged periods.

Zhang et al. assumed:

"[W]e assumed that all of the white subjects had squatted for fewer than 30
minutes each day at age 25. It is quite possible that some subjects in the
Framingham OA Study squatted for more than 30 minutes per day at age 25."
(p. 1191-2)

Yes, some Westerners still CAN squat flat-footed at age 25 - but I submit
that most do not do so for more than 30 minutes per day at age 25 for the
reasons given above.

I submit that *forced chairdwelling* is the problem:

In 1987, Newsweek reported that children can only sit still for 15 minutes
at a time in their chairs:

"Educators say that many five-year olds really can't handle a highly
academic program. They're still learning how to sit still for more than
15 minutes at a time." [Kantrowitz B, Wingert P. The big grind in
kindergarten. Newsweek (Aug10)1987. From Gastaldo's peer review of the
AHCPR-sponsored Low Back Guideline draft.]

The West does not want to give up its chairs...

The chair is a powerful symbol of power - both in language and practice.

The most powerful persons in organizations are termed "chairs"...

As alluded to above, the Pope is named after the chair he sits in (the Holy
See) and his corporate centers (Cathedrals) are named after the chairs
(Cathedra) they house...

The chair-dwelling West wishes to transfer this "ergonomics technology"
called the chair...

Gurr, Straker and Moore write:

"[i]f ergonomics technology transfer is based on the assumption that
ergonomics knowledge is culture free then ergonomics as a profession may be
guilty of hypocrisy. Sitting provides an excellent example of potentially
inappropriate technology transfer."
http://physiotherapy.curtin.edu.au/h...6CybTrans.html

Maybe there are PSYCHIATRIC/PSYCHOLOGIC benefits to squatting?

In 1944, psychiatrist EA Strecker, MD indirectly suggested there may be
psychiatric ramifications of our culture-wide loss of a fundamental human
range of motion...

"Are we not a crossroads in the path of our civilization when it would be
well for us to emulate that tribe of Amazon River natives who, from time to
time, interrupt their customary routine of activities and squat on the
ground? Neither persuasion nor threat serves to move them until an alloted
time has elapsed. They declare they are waiting for their 'souls to catch
up with their bodies...'" [E.A. Strecker, MD. 1944 Presidential Address
before the American Psychiatric Association. Am J Psychiatry. 1944;101:1-8]

Most Westerners cannot emulate Amazon river natives - they are ROBBED of
their innate ability to squat flat-footed for prolonged periods.

With an estimated 4.6% of "healthy" term babies suffering unexplained brain
bleeds...

BABIES probably derive psychiatric/psychologic benefits if mom squats **for
short periods** during delivery - to allow her birth canal to open an
"extra" up to 30% during contractions...

PREGNANT WOMEN: See the very end of this post for PROOF that OBs are
knowingly closing birth canals up to 30%...

LADIES - you do NOT have to squat to allow your birth canal to open the
"extra" up to 30%...

See below for instructions on how to allow your birth canal to open the
"extra" up to 30%...


SQUATTING ABSTRACTS....


Arthritis Rheum. 2002 Jul;46(7):1773-9. PubMed abstract

Very low prevalence of hip osteoarthritis among Chinese elderly in Beijing,
China, compared with whites in the United States: the Beijing osteoarthritis
study.

Nevitt MC, Xu L, Zhang Y, Lui LY, Yu W, Lane NE, Qin M, Hochberg MC,
Cummings SR, Felson DT.

Prevention Sciences, University of California, San Francisco, 94105, USA.


OBJECTIVE: To compare the prevalence of osteoarthritis (OA) of the hip among
elderly persons in China and the US. METHODS: We recruited a
population-based sample of 1,506 persons (82% of those enumerated) ages or
= 60 years living in Beijing, China. Subjects answered questions about joint
symptoms and underwent radiography of the pelvis. Radiographs of the Beijing
subjects were intermingled with hip radiographs of white women ages or =
65 years from the Study of Osteoporotic Fractures (SOF) and white men and
women ages 60-74 years from the First National Health and Nutrition
Examination Survey (NHANES-I) and were then interpreted. Radiographic hip OA
was defined as the presence of 1 of the following 3 findings in either hip:
minimum joint space of or = 1.5 mm, definite osteophytes and joint space
narrowing, or or = 3 radiographic features of OA. Symptomatic hip OA was
defined as both radiographic OA and hip pain. RESULTS: The crude prevalence
of radiographic hip OA in Chinese ages 60-89 years was 0.9% in women and
1.1% in men; it did not increase with age. Chinese women had a lower
age-standardized prevalence of radiographic hip OA compared with white women
in the SOF (age-standardized prevalence ratio 0.07) and the NHANES-I
(prevalence ratio 0.22). Chinese men had a lower prevalence of radiographic
hip OA compared with white men of the same age in the NHANES-I (prevalence
ratio 0.19). There were no cases of symptomatic hip OA in the Chinese men
and only 1 case in the Chinese women; 35 cases were expected in both sexes.
CONCLUSION: This is the first population-based study of hip OA in China to
use standardized radiographic methods and definitions. We found that hip OA
was 80-90% less frequent than in white persons in the US. Identification of
the genetic and environmental factors that underlie these differences may
help elucidate the etiology and prevention of hip OA.


Br J Rheumatol. 1996 Feb;35(2):146-9. PubMed abstract

Knee pain amongst the poor and affluent in Pakistan.

Gibson T, Hameed K, Kadir M, Sultana S, Fatima Z, Syed A.

Department of Medicine and Community Health Services, Aga Khan University
Hospital, Karachi, Pakistan.

The frequency of joint symptoms was determined amongst 2022 affluent and
2210 poor adults in Karachi, Pakistan. Joint pain was significantly (P =
0.025) more common amongst the affluent (6.6%) compared with the poor (5%)
and this was due to a significantly greater frequency of knee pain in the
richer community (3% vs 1.8%; P = 0.008). The prevalence increased with age
and was more common in females. Almost half were associated with varus
deformity, suggesting the presence of associated OA in a high proportion.
The overall frequency of knee pain seemed no greater than in series reported
from the West. Compared with age- and sex-matched controls, body weight was
significantly greater amongst those with knee pain, both amongst the
affluent (P = 0.005) and the poor (P = 0.02). Control subjects were heavier
in the affluent population, suggesting that the greater frequency of knee
symptoms in this community was due to their relative obesity. Knee bending
at prayer was most common amongst the affluent controls and may indicate
that religious observance also contributed to the problem in the richer
population. Squatting was a characteristic of the poor who had less knee
pain than the affluent. Knee flexing could not therefore be confidently
implicated. No relationship could be demonstrated between knee pain and
joint laxity.



Arthritis Rheum. 1987 Aug;30(8):914-8. PubMed abstract

The prevalence of knee osteoarthritis in the elderly. The Framingham
Osteoarthritis Study.

Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF.

To investigate the prevalence of osteoarthritis (OA) of the knee in elderly
subjects, we studied the Framingham Heart Study cohort, a population-based
group. During the eighteenth biennial examination, we evaluated the cohort
members for OA of the knee by use of medical history, physical examination,
and anteroposterior (standing) radiograph of the knees. Radiographs were
obtained on 1,424 of the 1,805 subjects (79%). Their ages ranged from 63-94
years (mean 73). Radiographs were read by a radiologist who specializes in
bone and joint radiology, and were graded 0-4 according to the scale
described by Kellgren and Lawrence. OA was defined as grade 2 changes
(definite osteophytes), or higher, in either knee. Radiographic evidence of
OA increased with age, from 27% in subjects younger than age 70, to 44% in
subjects age 80 or older. There was a slightly higher prevalence of
radiographic changes of OA in women than in men (34% versus 31%); however,
there was a significantly higher proportion of women with symptomatic
disease (11% of all women versus 7% of all men; P = 0.003). The
age-associated increase in OA was almost entirely the result of the marked
age-associated increase in the incidence of OA in the women studied. This
study extends current knowledge about OA of the knee to include elderly
subjects, and shows that the prevalence of knee OA increases with age
throughout the elderly years.


Arthritis Rheum. 2001 Sep;44(9):2065-71. PubMed abstract

Comparison of the prevalence of knee osteoarthritis between the elderly
Chinese population in Beijing and whites in the United States: The Beijing
Osteoarthritis Study.

Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, Lui LY, Felson DT.

Boston University School of Medicine, Massachusetts 02118, USA.

OBJECTIVE: To estimate the prevalence of radiographic and symptomatic knee
osteoarthritis (OA) in a population-based sample of elderly subjects in
Beijing, China and compare it with that reported in the Framingham
(Massachusetts) OA Study. METHODS: We recruited a sample of persons age or
= 60, using door-to-door enumeration in randomly selected neighborhoods in
Beijing. Subjects completed a home interview including questions on knee
symptoms and a hospital examination including knee radiographs obtained
during weight bearing. The protocol was identical to that used in the
Framingham OA Study. A reader read intermingled Beijing and Framingham Study
films to ensure high reliability. We defined a subject as having
radiographic knee OA when the Kellgren/Lawrence grade was or = 2 in at
least 1 knee. Symptomatic knee OA was recorded as present when knee pain was
reported and the symptomatic knee had radiographic OA. We estimated the
prevalence of these entities in elderly subjects in Beijing and compared it
with OA prevalence in Framingham, using an age-standardized prevalence
ratio. RESULTS: Of 2,180 age-eligible Beijing subjects contacted, knee
radiographs were obtained in 1,787 (82.0%). The prevalence of radiographic
knee OA was 42.8% in women and 21.5% in men. Symptomatic knee OA occurred in
15.0% of women and 5.6% of men. Compared with women of the same age in
Framingham, women in Beijing had a higher prevalence of radiographic knee OA
(prevalence ratio 1.45, 95% confidence interval 1.31-1.60) and of
symptomatic knee OA (prevalence ratio 1.43, 95% confidence interval
1.16-1.75). The prevalence of knee OA in Chinese men was similar to that in
their white US counterparts (for radiographic OA, prevalence ratio 0.90; for
symptomatic OA, prevalence ratio 1.02). CONCLUSION: Using identical methods
and definitions to evaluate the prevalence of OA across populations, we
found, surprisingly, that older Chinese women have a higher prevalence of
knee OA than women in Framingham, Massachusetts. The prevalence in men was
comparable. Possible explanations for these differences range from genetic
differences to heavy physical activity among Chinese.



Arthritis Rheum. 2002 May;46(5):1217-22. PubMed abstract

High prevalence of lateral knee osteoarthritis in Beijing Chinese compared
with Framingham Caucasian subjects.

Felson DT, Nevitt MC, Zhang Y, Aliabadi P, Baumer B, Gale D, Li W, Yu W, Xu
L.

Boston Medical Center, Boston, Massachusetts, USA.

OBJECTIVE: We recently reported that, despite their thinness, elderly
subjects in Beijing, China had an equal prevalence (in men) or higher
prevalence (in women) of both radiographic and symptomatic knee
osteoarthritis (OA) compared with that in the Framingham, Massachusetts
cohort of elderly subjects. Our objective was to evaluate whether Chinese
subjects might have more medial disease than do Caucasians, given a report
of varus alignment in the knee joints of Chinese elderly. METHODS: We
compared the prevalence of medial and lateral radiographic knee OA and
measured anatomic alignment in the knees of elderly subjects from the
Beijing and Framingham cohorts. Both studies recruited a random sample of
the population. The Beijing OA Study used the Framingham OA Study protocol
for radiographs. Anteroposterior weight-bearing films were read for Kellgren
and Lawrence (K/L) grade and joint space narrowing (JSN; 0-3 scale) in each
compartment. Medial disease was defined when radiographs showed a K/L grade
or=2 and medial JSN or=1, and lateral disease was assessed in a comparable

manner. Using knee-specific analyses, we compared the prevalence of medial
and lateral knee OA after adjusting for age, body mass index, and the
correlation between the 2 knees. Restricting the analyses to knees with JSN
or=2 and comparing the proportion of OA knees with medial disease and

lateral disease yielded similar results. We assessed alignment in knees from
100 persons without OA, measuring the angle subtended by the femoral and
tibial anatomic axes. RESULTS: We studied 1,781 Chinese subjects ages 60-88
years, and 1,084 Framingham subjects ages 63-93 years. Whereas medial OA was
less prevalent among the Beijing men, lateral OA was more than twice as
prevalent among the Beijing men and women, compared with that in the
Framingham elderly. For example, of all knees with radiographic OA, 28.5% of
Beijing women's knees had lateral OA versus 11% of Framingham women's knees
(P 0.001), and among men, 32.3% of Beijing men's knees versus 8.8% of
Framingham men's knees (P 0.001) had lateral OA. Alignment was more valgus
in the Beijing men than in the Framingham men (mean 4.5 degrees versus 2.7
degrees valgus, respectively; P 0.001), but no differences in alignment
were evident in the women. CONCLUSION: In this first attempt to compare the
characteristics of OA in different racial groups, we conclude that, opposite
to expectations, Chinese subjects have much more lateral OA than do
Caucasian subjects in the Framingham cohort, a predilection possibly
explained in the men by differences in anatomic alignment.



Arthritis Rheum. 2004 Apr;50(4):1187-92. PubMed abstract

Association of squatting with increased prevalence of radiographic
tibiofemoral knee osteoarthritis: The Beijing Osteoarthritis Study.

Zhang Y, Hunter DJ, Nevitt MC, Xu L, Niu J, Lui LY, Yu W, Aliabadi P, Felson
DT.

Boston University School of Medicine, Boston, Massachusetts.

OBJECTIVE: To examine the association between squatting, a common daily
posture in China, and the prevalence of radiographic osteoarthritis (OA) in
different knee compartments among Chinese subjects from Beijing, and to
estimate how much of the difference in prevalence of knee OA between Chinese
subjects in Beijing and white subjects in Framingham, Massachusetts is
accounted for by the impact of squatting. METHODS: We recruited a random
sample of Beijing residents age /=60 years. Subjects answered questions on
joint symptoms, and knee radiographs were obtained. Subjects were also asked
to recall the average amount of time spent squatting each day at age 25
years. Radiographic films (weight-bearing anteroposterior and skyline views)
were read for Kellgren/Lawrence (K/L) grade and individual radiographic
features. Medial disease was defined when radiographs showed a K/L grade of
/=2 at the tibiofemoral joint and a medial joint space narrowing score of
/=1, and lateral disease was assessed in a comparable manner in the lateral

compartments. We examined the association of squatting with the prevalence
of tibiofemoral OA as well as with the prevalence of patellofemoral knee OA,
while adjusting for age and other potential confounding factors. We used the
same approach to assess the relationship between squatting and tibiofemoral
OA in the medial compartment and in the lateral compartment. Finally, we
estimated the impact of squatting at age 25 on the difference in prevalence
of knee OA between Chinese subjects in Beijing and white subjects in the
Framingham OA Study. RESULTS: Squatting was very common among the Chinese
subjects: approximately 40% of men and approximately 68% of women reported
squatting /=1 hour per day at age 25. The prevalence of tibiofemoral OA
increased as the time spent squatting at age 25 increased in both the men
and the women. Compared with subjects who squatted 30 minutes per day at
age 25, the multivariable-adjusted prevalence odds ratios of tibiofemoral OA
were 1.1 for time spent squatting of 30-59 minutes/day, 1.0 for 60-119
minutes/day, 1.7 for 120-179 minutes/day, and 2.0 for /=120 minutes/day
among the men (P for trend = 0.074), and the respective odds ratios among
the women were 1.4, 1.3, 1.2, and 2.4 (P for trend = 0.077). A weaker
association with patellofemoral OA was found. Prolonged squatting in daily
life was more strongly associated with medial knee OA than with lateral
disease in the men, but had a similar effect on both knee compartments in
the women. After adjusting for the impact of squatting, the age-adjusted
difference in prevalence of tibiofemoral OA was reduced from an excess of
14.4% to 9.5% in the Chinese women, but the difference in prevalence of
tibiofemoral OA in the Chinese men increased after adjustment for age and
squatting, from 2.9% lower to 7.0% lower as compared with their white
counterparts. CONCLUSION: Prolonged squatting is a strong risk factor for
tibiofemoral knee OA among elderly Chinese subjects in Beijing, and accounts
for a substantial proportion of the difference in prevalence of tibiofemoral
OA between Chinese subjects in Beijing and white subjects in Framingham.


End SQUATTING ABSTRACTS....


PROOF that OBs are knowingly closing birth canals up to 30%...

According to the Merck Manual:

"When shoulder dystocia occurs...the mother's thighs are hyperflexed to
increase the diameter of the pelvic outlet..."
http://www.merck.com/mrkshared/mmanu...er253/253g.jsp

WHY are OBs and CNMwives (nurse midwives) waiting until the
head is
out and shoulders get stuck before giving the baby maximum pelvic outlet
diameter?

WHY are we letting OBs and CNMwives force babies' heads through birth canals
senselessly closed up to 30%?

For PROOF that OBs are knowingly closing birth canals up to 30%, scroll up a
little...

PREGNANT WOMEN: It is EASY for you to allow your birth canal to OPEN the
"extra" up
to 30%.
Just roll onto your side as you push your baby out - or deliver on
hands-and-knees, kneeling, standing, squatting, etc.

BEWARE though: Some MDs and MBs will let you "try" "alternative"
delivery positions but will move you back to dorsal or semisitting (close
your birth canal!) as you push your baby out!

Talk to your MD or MB about this TODAY. (For further details see the
"Criminal medical CAM" URLs above.)

MDs/MBs: If you must push or pull - and sometimes you must - first get the
woman off her sacrum - off her back/butt.

Thanks for reading, everyone.

Sincerely,

Todd

Dr. Gastaldo


Copied to the authors of the Zhang et al. [2004] study via Zhang and
co-authors - and others at Boston University Med School:

;
;
; ;

;






 




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