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From the Townsend Letter
October 2008

Comprehensive Lifestyle Intervention Improves Hair and Skin Status and Mental and Physical Functioning
by Gary Null, PhD, and Martin Feldman, MD

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Fruits, Vegetables, Antioxidants, and Phytochemicals
Bazzano LA, He J, Ogden LG, et al. Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr. 2002;76(1):93-9.

Bazzano LA, Serdula MK, Liu S. Dietary intake of fruits and vegetables and risk of cardiovascular disease. Curr Atheroscler Rep. 2003 Nov;5(6):492-9.

Cao G, Booth SL, Sadowski JA, Prior RL. Increases in human plasma antioxidant capacity after consumption of controlled diets high in fruit and vegetables. Am J Clin Nutr. 1998;68(5):1081-7.

Chu YF, Sun J, Wu X, Liu RH. Antioxidant and antiproliferative activities of common vegetables. J Agric Food Chem. 2002;50(23):6910-6.

Craig WJ. Phytochemicals: guardians of our health. J Am Diet Assoc. 1997;97(10 Suppl 2):S199-204. Review.

Ding EL, Mozaffarian D. Optimal dietary habits for the prevention of stroke. Semin Neurol. 2006;26(1):11-23.

Galli RL, Shukitt-Hale B, Youdim KA, Joseph JA. Fruit polyphenolics and brain aging: nutritional interventions targeting age-related neuronal and behavioral deficits. Ann N Y Acad Sci. 2002;959:128-32. Review.

Genkinger JM, Platz EA, Hoffman SC, et al. Fruit, vegetable, and antioxidant intake and all-cause, cancer, and cardiovascular disease mortality in a community-dwelling population in Washington County, Maryland. Am J Epidemiol. 2004;160(12):1223-33.

Heber D. Vegetables, fruits and phytoestrogens in the prevention of diseases.
J Postgrad Med. 2004 Apr-Jun;50(2):145-9.

Holick CN, Michaud DS, Stolzenberg-Solomon R, et al. Dietary carotenoids, serum beta-carotene, and retinol and risk of lung cancer in the alpha-tocopherol, beta-carotene cohort study. Am J Epidemiol. 2002;156(6):536-47.

Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288(20):2569-78.

John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: A randomised controlled trial. Lancet. 2002;359(9322):1969-74.

Joseph JA, Shukitt-Hale B, Casadesus G. Reversing the deleterious effects of aging on neuronal communication and behavior: beneficial properties of fruit polyphenolic compounds. Am J Clin Nutr. 2005;81(1 Suppl):313S-316S. Review.

Joseph JA, Denisova NA, Bielinski D, et al. Oxidative stress protection and vulnerability in aging: putative nutritional implications for intervention. Mech Ageing Dev. 2000;116(2-3):141-53. Review.

Joseph JA, Shukitt-Hale B, Denisova NA, et al. Reversals of age-related declines in neuronal signal transduction, cognitive, and motor behavioral deficits with blueberry, spinach, or strawberry dietary supplementation. J Neurosci. 1999;19(18):8114-21.

Joshipura KJ, Ascherio A, Manson JE, et al. Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA. 1999;282(13):1233-9.

Kelemen LE, Cerhan JR, Lim U, et al. Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: A National Cancer Institute-Surveillance, Epidemiology, and End Results population-based case-control study. Am J Clin Nutr. 2006;83(6):1401-10.

Larsson SC, Bergkvist L, Wolk A. Fruit and vegetable consumption and incidence of gastric cancer: A prospective study. Cancer Epidemiol Biomarkers Prev. 2006;15(10):1998-2001.

Liu RH. Potential synergy of phytochemicals in cancer prevention: Mechanism of action. J Nutr. 2004 ;134(12 Suppl):3479S-3485S.

Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. Am J Clin Nutr. 2003;78(3 Suppl):517S-520S.

Peterson S, Lampe JW, Bammler TK, et al. Apiaceous vegetable constituents inhibit human cytochrome P-450 1A2 (hCYP1A2) activity and hCYP1A2-mediated mutagenicity of aflatoxin B(1). Food Chem Toxicol. 2006;44(9):1474-84. Epub 2006 Apr 27.

Romieu I, Trenga C. Diet and obstructive lung diseases. Epidemiol Rev. 2001;23(2):268-87.

Steinmetz KA, Potter JD. Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc. 1996;96(10):1027-39.

Stevenson DE, Hurst RD. Polyphenolic phytochemicals – just antioxidants or much more? Cell Mol Life Sci. 2007 Aug 30; [Epub ahead of print].

Stoewsand GS. Bioactive organosulfur phytochemicals in Brassica oleracea vegetables--a review. Food Chem Toxicol. 1995;33(6):537-43.

Sun J, Chu YF, Wu X, Liu RH. Antioxidant and antiproliferative activities of common
fruits. J Agric Food Chem. 2002; 50(25):7449-54.

Wang Y, Chang CF, Chou J, et al. Dietary supplementation with blueberries, spinach, or spirulina reduces ischemic brain damage. Exp Neurol. 2005;193(1):75-84.

Meat Consumption
Chao A, Thun MJ, Connell CJ, et al. Meat consumption and risk of colorectal cancer. JAMA. 2005;293(2):172-82.

Fung TT, Schulze M, Manson JE, et al. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med. 2004; 164(20):2235-2240.

Larsson SC, Bergkvist L, Wolk A. Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women. Int J Cancer. 2006;119(4):915-9.

Lewis S. An opinion on the global impact of meat consumption, Am J Clin Nutr 1994;59:1099S–1102S.

Michaud DS, Augustsson K, Rimm EB, et al. A prospective study on intake of animal products and risk of prostate cancer. Cancer Causes Control. 2001;12(6):557-67.

Norat T, Bingham S, Ferrari P, et al. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition. J Natl Cancer Inst. 2005;97(12):906-16.

Pattison DJ, Symmons DP, Lunt M, et al. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption. Arthritis Rheum. 2004; 50(12):3804-3812.

Singh PN, Fraser GE. Dietary risk factors for colon cancer in a low-risk population.
Am J Epidemiol. 1998;148(8):761-74.

Snowdon DA, Phillips RL, Fraser GE. Meat consumption and fatal ischemic heart disease. Prev Med. 1984;13(5):490-500.

Nutrition and DNA Damage and Repair
Recent studies have investigated the effect of nutrients on the repair of DNA damage.

Astley SB, Elliott RM, Archer DB, et al. Evidence that dietary supplementation with carotenoids and carotenoid-rich foods modulates the DNA damage: Repair balance in human lymphocytes. Br J Nutr. 2004; 91(1):63-72.

Chakraborty S, Roy M, Bhattacharya RK. Prevention and repair of DNA damage by selected phytochemicals as measured by single cell gel electrophoresis. J Environ Pathol Toxicol Oncol. 2004; 23(3):215-226.

Collins AR, Harrington V, Drew J, Melvin R. Nutritional modulation of DNA repair in a human intervention study. Carcinogenesis. 2003; 24(3):511-515.

Djuric Z, Depper JB, Uhley V, et al. Oxidative DNA damage levels in blood from women at high risk for breast cancer are associated with dietary intakes of meats, vegetables, and fruits. J Am Diet Assoc. 1998; 98(5):524-8.

Moller P, Loft S. Interventions with antioxidants and nutrients in relation to oxidative DNA damage and repair. Mutat Res. 2004; 551(1-2):79-89.

Pool-Zobel BL, Bub A, Liegibel UM, et al. Mechanisms by which vegetable consumption reduces genetic damage in humans. Cancer Epidemiol Biomarkers Prev. 1998; 7(10):891-899.

Tyson J, Mathers JC. Dietary and genetic modulation of DNA repair in healthy human adults. Proc Nutr Soc. 2007;66(1):42-51.

Weisel T, Baum M, Eisenbrand G, Deitrich H, Will F, et al. An anthocyanin/polyphenolic-rich fruit juice reduces oxidative DNA damage and increases glutathione level in healthy probands. Biotechnol J. 2006; 1(4):388-97.

Many studies have documented the positive aspects of supplementing the diet with vitamins, herbs, and other nutritional substances such as enzymes, coenzymes, and minerals.

Baliga MS, Katiyar SK. Chemoprevention of photocarcinogenesis by selected dietary botanicals. Photochem Photobiol Sci. 2006;5(2):243-53. Epub 2005 Aug 12.

Bhatia N, Agarwal C, Agarwal R. Differential responses of skin cancer-chemopreventive agents silibinin, quercetin, and epigallocatechin 3-gallate on mitogenic signaling and cell cycle regulators in human epidermoid carcinoma A431 cells. Nutr Cancer. 2001;39(2):292-9.

Cauffield JS, Forbes HJ. Dietary supplements used in the treatment of depression, anxiety, and sleep disorders. J Clin Psychopharmacol. 2000;20(6):680-4.

Fugh-Berman A, Cott JM. Dietary supplements and natural products as psychotherapeutic agents. Psychosom Med. 1999;61(5):712-28.

Galan P, Preziosi P, Monget AL, et al. Effects of trace element and/or vitamin supplementation on vitamin and mineral status, free radical metabolism and immunological markers in elderly long term-hospitalized subjects. Geriatric Network MIN. VIT. AOX. Int J Vitam Nutr Res. 1997;67(6):450-60.

Girodon F, Blache D, Monget AL, et al. Effect of a two-year supplementation with low doses of antioxidant vitamins and/or minerals in elderly subjects on levels of nutrients and antioxidant defense parameters. J Am Coll Nutr. 1997;16(4):357-65.

Kapadia GJ, Azuine MA, Tokuda H, et al. Inhibitory effect of herbal remedies on 12-O-tetradecanoylphorbol-13-acetate-promoted Epstein-Barr virus early antigen activation. Pharmacol Res. 2002;45(3):213-20.

Malvy DJ, Favier A, Faure H, et al. Effect of two years' supplementation with natural antioxidants on vitamin and trace element status biomarkers: preliminary data of the SU.VI.MAX study. Cancer Detect Prev. 2001;25(5):479-85.

Monget AL, Richard MJ, Cournot MP, et al. Effect of 6 month supplementation with different combinations of an association of antioxidant nutrients on biochemical parameters and markers of the antioxidant defence system in the elderly. The Geriatrie/Min.Vit.Aox Network. Eur J Clin Nutr. 1996;50(7):443-9.

Olmedilla B, Granado F, Southon S, et al. A European multicentre, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene: analysis of serum responses. Clin Sci (Lond). 2002;102(4):447-56.

O'Mahony R, Al-Khtheeri H, Weerasekera D, et al. Bactericidal and anti-adhesive properties of culinary and medicinal plants against Helicobacter pylori. World J Gastroenterol. 2005;11(47):7499-507.

Preziosi P, Galan P, Herbeth B, et al. Effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, on biochemical indicators and markers of the antioxidant system in adult subjects. J Am Coll Nutr. 1998;17(3):244-9.

Rabovsky A, Cuomo J, Eich N. Measurement of plasma antioxidant reserve after supplementation with various antioxidants in healthy subjects. Clin Chim Acta. 2006; [Epub ahead of print]

Wolters M, Hermann S, Hahn A. Effects of 6-month multivitamin supplementation on serum concentrations of alpha-tocopherol, beta-carotene, and vitamin C in healthy elderly women. Int J Vitam Nutr Res. 2004;74(2):161-8.

Engaging in regular aerobic and resistance exercise has been shown to positively affect endorphins, enhance digestion, and decrease weight, blood pressure, pulse, low density lipoproteins, and triglycerides. Studies have not focused on the effects of exercise on hair and skin.

Annesi JJ. Moderating effects of physical self-appraisal on relations of weight with energy changes for obese women initiating a supported exercise and nutrition information program. Psychol Rep. 2006;99(3):925-9.

Archie SM, Goldberg JO, Akhtar-Danesh N, et al. Psychotic disorders, eating habits, and physical activity: Who is ready for lifestyle changes? Psychiatr Serv. 2007;58(2):233-9.

Barnett A, Smith B, Lord SR, et al. Community-based group exercise improves balance and reduces falls in at-risk older people: A randomised controlled trial. Age Ageing. 2003;32(4):407-14.

Bussmann JB, Garssen MP, van Doorn PA, Stam HJ. Analysing the favourable effects of physical exercise: relationships between physical fitness, fatigue and functioning in Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy. J Rehabil Med. 2007;39(2):121-5.

Chu NF, Stampfer MJ, Spiegelman D, et al. Dietary and lifestyle factors in relation to plasma leptin concentrations among normal weight and overweight men. Int J Obes Relat Metab Disord. 2001;25(1):106-14.

Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: A randomized controlled trial. JAMA. 2007;297(19):2081-91.

Conn VS, Hafdahl AR, Mehr DR, et al. Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia. 2007;50(5):913-21. Epub 2007 Mar 7.

Costanza MC, Beer-Borst S, Morabia A. Achieving energy balance at the population level through increases in physical activity. Am J Public Health. 2007;97(3):520-5. Epub 2007 Jan 31.

Engelke K, Kemmler W, Lauber D, et al. Exercise maintains bone density at spine and hip EFOPS: a 3-year longitudinal study in early postmenopausal women. Osteoporos Int. 2006;17(1):133-42. Epub 2005 Aug 12.

Eversden L, Maggs F, Nightingale P, Jobanputra P. A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC Musculoskelet Disord. 2007;8:23.

Henwood TR, Taaffe DR. Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training. Gerontology. 2005;51(2):108-15.

Hu G, Lakka TA, Kilpelainen TO, Tuomilehto J. Epidemiological studies of exercise in diabetes prevention. Appl Physiol Nutr Metab. 2007;32(3):583-95.

Huonker M, Schmidt-Trucksass A, Heiss HW, Keul J. [Effects of physical training and age-induced structural and functional changes in cardiovascular system and skeletal muscles] Z Gerontol Geriatr. 2002;35(2):151-6. Review. German.

Kamel HK. Postmenopausal osteoporosis: etiology, current diagnostic strategies, and nonprescription interventions. J Manag Care Pharm. 2006;12(6 Suppl A):S4-9; quiz S26-8.

Karvinen KH, Courneya KS, North S, Venner P. Associations between exercise and quality of life in bladder cancer survivors: a population-based study. Cancer Epidemiol Biomarkers Prev. 2007;16(5):984-90.

Kelley GA, Kelley KS, Tran ZV. Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials. Prev Med. 2004; 38(5):651-61.

Kelley GA, Kelley KS, Tran ZV. Aerobic exercise and lipids and lipoproteins in women: a meta-analysis of randomized controlled trials. J Womens Health. (Larchmt) 2004; 13(10): 1148-64.

Kemmler W, Engelke K, von Stengel S, et al. Long-term four-year exercise has a positive effect on menopausal risk factors: The Erlangen Fitness Osteoporosis Prevention Study. J Strength Cond Res. 2007;21(1):232-9.

Kietrys DM, Galper JS, Verno V. Effects of at-work exercises on computer operators. Work. 2007;28(1):67-75.

Konstantinovic L, Devecerski G, Petronic I, et al. [Quality of life in patients with subacute low back pain treated with physiotherapy rehabilitation] Med Pregl 2006;59 Suppl 1:35-9. Serbian.

Lavie CJ, Milani RV. Disparate effects of improving aerobic exercise capacity and quality of life after cardiac rehabilitation in young and elderly coronary patients. J Cardiopulm Rehabil. 2000;20(4):235-40.

Lee IM. Dose-response relation between physical activity and fitness: even a little is good; more is better. JAMA. 2007;297(19):2137-9.

Lim KC, Kayser-Jones JS, Waters C, Yoo G. Aging, health, and physical activity in Korean Americans. Geriatr Nurs. 2007;28(2):112-9.

Mackey M, Maher CG, Wong T, Collins K. Study protocol: the effects of work-site exercise on the physical fitness and work-ability of older workers. BMC Musculoskelet Disord. 2007;8:9.

Malin A, Matthews CE, Shu XO, et al. Energy balance and breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2005;14(6):1496-501.

Manson JE, Hu FB, Rich-Edwards JW, Colditz GA, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med. 1999;341(9):650-658.

Marshall P, Al-Timman J, Riley R, et al. Randomized controlled trial of home-based exercise training to evaluate cardiac functional gains. Clin Sci (Lond). 2001;101(5):477-83.

Mier N, Medina AA, Ory MG. Mexican Americans with type 2 diabetes: perspectives on definitions, motivators, and programs of physical activity. Prev Chronic Dis. 2007;4(2):A24. Epub 2007 Mar 15.

Mildestvedt T, Meland E. Examining the "Matthew Effect" on the motivation and ability to make lifestyle changes in 217 heart rehabilitation patients. Scand J Public Health. 2007;35(2):140-7.

Miszko TA, Cress ME, Slade JM, et al. Effect of strength and power training on physical function in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2003;58(2):171-5.

Monnier-Benoit P, Groslambert A, Rouillon JD. Effects of steady-state exercise on perceived pain: Comparison of sedentary students and cyclists. Percept Mot Skills. 2006;103(3):659-66.

Mutrie N, Campbell AM, Whyte F, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ. 2007;334(7592):517. Epub 2007 Feb 16.

Nakken KO. Physical exercise in outpatients with epilepsy. Epilepsia. 1999;40(5):643-51.

Netreba AI, Popov DV, Liubaeva EV, et al. [Physiological effects of using the low intensity strength training without relaxation in single-joint and multi-joint movements] Ross Fiziol Zh Im I M Sechenova. 2007;93(1):27-38. Russian.

Niederdeppe J, Levy AG. Fatalistic beliefs about cancer prevention and three prevention behaviors. Cancer Epidemiol Biomarkers Prev. 2007;16(5):998-1003.

Ohta M, Takigami C, Ikeda M. Effect of lifestyle modification program implemented in the community on workers' job satisfaction. Ind Health. 2007;45(1):49-55.

Ransdell LB, Taylor A, Oakland D, et al. Daughters and mothers exercising together: effects of home- and community-based programs. Med Sci Sports Exerc. 2003;35(2):286-96.

Regensteiner JG, Steiner JF, Hiatt WR. Exercise training improves functional status in patients with peripheral arterial disease. J Vasc Surg. 1996;23(1):104-15.

Richards SC, Scott DL. Prescribed exercise in people with fibromyalgia: parallel group randomised controlled trial. BMJ. 2002;325(7357):185.

Rolland Y, Pillard F, Klapouszczak A, Reynish E, et al. Exercise program for nursing home residents with Alzheimer's disease: A 1-year randomized, controlled trial. J Am Geriatr Soc. 2007;55(2):158-65.

Ryan AS, Treuth MS, Hunter GR, Elahi D. Resistive training maintains bone mineral density in postmenopausal women. Calcif Tissue Int .1998;62(4):295-9.

Sarkar U, Ali S, Whooley MA. Self-efficacy and health status in patients with coronary heart disease: Findings from the heart and soul study. Psychosom Med. 2007; [Epub ahead of print]

Slaven L, Lee C. Mood and symptom reporting among middle-aged women: the relationship between menopausal status, hormone replacement therapy, and exercise participation. Health Psychol. 1997;16(3):203-8.

Ulrich CM, Georgiou CC, Gillis DE, et al. Lifetime physical activity is associated with bone mineral density in premenopausal women. J Womens Health. 1999;8(3):365-75.

Urponen H, Vuori I, Hasan J, Partinen M. Self-evaluations of factors promoting and disturbing sleep: An epidemiological survey in Finland. Soc Sci Med. 1988;26(4):443-50.

Wijndaele K, Duvigneaud N, Matton L, et al. Muscular strength, aerobic fitness, and metabolic syndrome risk in Flemish adults. Med Sci Sports Exerc 2007;39(2):233-40.

Stress Management and Relaxation
Over the past 50 years people have de-stressed with techniques such as Tai Chi, qi gong, meditation, prayer, yoga, and journal writing. All of these methods have produced beneficial results, including a decrease in blood pressure, but the research has not focused specifically on hair and skin effects.

Tai Chi
Brown DR, Wang Y, Ward A, et al. Chronic psychological effects of exercise and exercise plus cognitive strategies. Med Sci Sports Exerc. 1995;27(5):765-75.

Chen KM, Snyder M, Krichbaum K. Facilitators and barriers to elders' practice of t'ai chi. A mind-body, low-intensity exercise. J Holist Nurs. 2001;19(3):238-55.

Chen KM, Lin JN, Lin HS, et al. The effects of a Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults living in long-term care facilities: A single group design with multiple time points. Int J Nurs Stud. 2007; [Epub ahead of print]

Faber MJ, Bosscher RJ, Chin A Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabi.l 2006;87(7):885-96.

Kressig RW, Beauchet O, Tharicharu J. [T'ai chi in the elderly: Practical aspects] Rev Med Suisse Romande. 2003;123(11):671-5. Review. French.

Kuramoto AM. Therapeutic benefits of Tai Chi exercise: Research review. WMJ. 2006;105(7):42-6. Review.

Lu WA, Kuo CD. Comparison of the effects of Tai Chi Chuan and Wai Tan Kung exercises on autonomic nervous system modulation and on hemodynamics in elder adults. Am J Chin Med. 2006;34(6):959-68.

Wang YT, Taylor L, Pearl M, Chang LS. Effects of Tai Chi exercise on physical and mental health of college students. Am J Chin Med. 2004;32(3):453-9.

Zwick D, Rochelle A, Choksi A, Domowicz J. Evaluation and treatment of balance in the elderly: A review of the efficacy of the Berg Balance Test and Tai Chi Quan. NeuroRehabilitation. 2000;15(1):49-56.

Qi gong
Arch JJ, Craske MG. Mechanisms of mindfulness: emotion regulation following a focused breathing induction. Behav Res Ther. 2006;44(12):1849-58. Epub 2006 Feb 7.

Bach JR. New approaches in the rehabilitation of the traumatic high level quadriplegic. Am J Phys Med Rehabil. 1991;70(1):13-9.

Cline EC, Davis R, Burkard JF. Vocal cord dysfunction: a case report. AANA J. 2006;74(5):375-8.

Jouper J, Hassmen P, Johansson M. Qigong exercise with concentration predicts increased health. Am J Chin Med. 2006;34(6):949-57.

Lee MS, Lim HJ, Lee MS. Impact of qigong exercise on self-efficacy and other cognitive perceptual variables in patients with essential hypertension. J Altern Complement Med. 2004;10(4):675-80.

Lee MS, Ryu H, Song J, Moon SR. Effects of Qi-training (Qigong) on forearm blood gas concentrations. Int J Neurosci. 2004;114(11):1503-10.

Li M, Chen K, Mo Z. Use of qigong therapy in the detoxification of heroin addicts. Altern Ther Health Med. 2002;8(1):50-4, 56-9.

Olsen MF, Lonroth H, Bake B. Effects of breathing exercises on breathing patterns in obese and non-obese subjects. Clin Physiol. 1999;19(3):251-7.

Omura Y. Special sunrise and sunset solar energy stored papers and their clinical applications for intractable pain, circulatory disturbances and cancer: comparison of beneficial effects between Special Solar Energy Stored Paper and Qigong Energy Stored Paper. Acupunct Electrother Res. 2004;29(1-2):1-42.

Schmekel B, Smith HJ. The diagnostic capacity of forced oscillation and forced expiration techniques in identifying asthma by isocapnic hyperpnoea of cold air. Eur Respir J. 1997;10(10):2243-9.

van Dixhoorn J, Duivenvoorden HJ, Staal HA, Pool J. Physical training and relaxation therapy in cardiac rehabilitation assessed through a composite criterion for training outcome. Am Heart J. 1989;118(3):545-52.

Westerdahl E, Lindmark B, Eriksson T, et al. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128(5):3482-8.

Winkler G, Zifko U, Nader A, et al. Dose-dependent effects of inspiratory muscle training in neuromuscular disorders. Muscle Nerve. 2000;23(8):1257-60.

Wu WH, Bandilla E, Ciccone DS, et al. Effects of qigong on late-stage complex regional pain syndrome. Altern Ther Health Med. 1999;5(1):45-54.

Bradley BW, McCanne TR. Autonomic responses to stress: the effects of progressive relaxation, the relaxation response, and expectancy of relief. Biofeedback Self Regul. 1981;6(2):235-51.

Canter PH, Ernst E. The cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials. Wien Klin Wochenschr. 2003;115(21-22):758-66.

Cunningham C, Brown S, Kaski JC. Effects of transcendental meditation on symptoms and electrocardiographic changes in patients with cardiac syndrome X. Am J Cardiol. 2000;85(5):653-5, A10.

Davidson RJ, Kabat-Zinn J, Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65(4):564-70.

Delmonte MM. Physiological responses during meditation and rest. Biofeedback Self. Regul 1984;9(2):181-200.

Delmonte MM. Effects of expectancy on physiological responsivity in novice meditators. Biol Psychol. 1985;21(2):107-21.

Deshmukh VD. Neuroscience of meditation. ScientificWorldJournal. 2006;6:2239-53.

Dhalla S, Chan KJ, Montaner JS, Hogg RS. Complementary and alternative medicine use in British Columbia--a survey of HIV positive people on antiretroviral therapy. Complement Ther Clin Pract. 2006;12(4):242-8. Epub 2006 Jul 10.

Ditto B, Eclache M, Goldman N. Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Ann Behav Med. 2006;32(3):227-34.

Doraiswamy PM, Xiong GL. Does meditation enhance cognition and brain longevity? Ann N Y Acad Sci. 2007 Sep 28; [Epub ahead of print].

Fehr TG. [Therapeutically relevant effects by transcendental meditation?] Psychother Psychosom Med Psychol. 1996;46(5):178-88. German.

Harte JL, Eifert GH, Smith R. The effects of running and meditation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biol Psychol. 1995;40(3):251-65.

Majumdar M, Grossman P, Dietz-Waschkowski B, et al. Does mindfulness meditation contribute to health? Outcome evaluation of a German sample. J Altern Complement Med. 2002;8(6):719-30; discussion 731-5.

Severtsen B, Bruya MA. Effects of meditation and aerobic exercise on EEG patterns. J Neurosci Nurs. 1986;18(4):206-10.

Singh BS. Ventilatory response to CO2. II. Studies in neurotic psychiatric patients and practitioners of transcendental meditation. Psychosom Med. 1984;46(4):347-62.

Wachholtz AB, Pargament KI. Is spirituality a critical ingredient of meditation? Comparing the effects of spiritual meditation, secular meditation, and relaxation on spiritual, psychological, cardiac, and pain outcomes. J Behav Med. 2005;28(4):369-84.

Walton KG, Schneider RH, Nidich S. Review of controlled research on the transcendental meditation program and cardiovascular disease. Risk factors, morbidity, and mortality. Cardiol Rev. 2004;12(5):262-266.

Yuille JC, Sereda L. Positive effects of meditation: a limited generalization? J Appl Psychol. 1980;65(3):333-40. No abstract available.

Stress Management
Kondwani KA, Lollis CM. Is there a role for stress management in reducing hypertension in African Americans? Ethn Dis. 2001; 11(4):788-792.

Taylor DN. Effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in HIV positive men. Psychol Rep. 1995;76(2):451-7.

Vocks S, Ockenfels M, Jurgensen R, et al. Blood pressure reactivity can be reduced by a cognitive behavior stress management program. Int J Behav Med. 2004; 11(2):63-70.

Healing Touch/Therapeutic Touch
Engle VF, Graney MJ. Biobehavioral effects of therapeutic touch. J Nurs Scholarsh. 2000;32(3):287-93.

Ai AL, Tice TN, Peterson C, Huang B. Prayers, spiritual support, and positive attitudes in coping with the September 11 national crisis. J Pers. 2005;73(3):763-91.

Craig C, Weinert C, Walton J, Derwinski-Robinson B. Spirituality, chronic illness, and rural life. J Holist Nurs. 2006;24(1):27-35.

Fitchett G, Murphy PE, Kim J, et al. Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. Int J Psychiatry Med. 2004;34(2):179-96.

Harris WS, Gowda M, Kolb JW, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Arch Intern Med. 1999 Oct 25;159(19):2273-8. Erratum in: Arch Intern Med. 2000;160(12):1878.

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Many self-actualization exercises, such as conscious living and applying positive thoughts and emotional principles to everyday choices, have been popular since the 1960s. Studies of this process have not focused on hair and skin effects.

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