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- FATIGUE AND FOOD SENSITIVITIES
In recent years, interest surrounding food sensitivities and their role in day-to-day well-being has increased. From gluten and dairy to soy and nuts, all one has to do is read the back of food labels or the finer details on the restaurant’s menus to see a wide range of potential food sensitivities. What seems most difficult for individuals suffering from suspected sensitivities is the identification of the attributing food, as reactions are often delayed and inconsistent. Part of the reason for the increase in food sensitivities may be contributed to the larger number of processed foods people consume today. In addition, many types of processed foods lack the nutrients the body needs for energy production and what little the body does get, is often used by the immune system to repair the damage and heal. As such, the body is not able to digest processed foods as effectively and efficiently. This can lead to a loss of energy, as well as other gastrointestinal problems. Symptoms of Food Sensitivities There are several signs you might have a food sensitivity including: • Feeling Lethargic • Problems Concentrating on Tasks • Aches and Pains in the Muscles and Joints • Headaches • Unexplained Rashes, Dermatitis, or Acne • Stomach and Intestinal Cramping and Pain • Excessive Gas • A Bloated Feeling Unlike food allergies, which present themselves almost immediately, food sensitivities can take much longer before exhibiting symptoms. In some cases, symptoms may not appear until a few days later, making it harder to narrow down the actual cause of the sensitivity, considering the amount of food a person consumes in a 48-hour period. Triggers for Food Sensitivities There are several common foods and food ingredients that have been associated with food sensitivities. These “trigger” foods can and do vary from one person to the next, but generally speaking, these foods are all inflammatory in nature, compromising the integrity of the gut lining and its ability to decipher between foods, chemicals, pathogens, and so on. • Preservatives Added to Processed Foods (Nitrates, MSG, Artificial Colours, Sulfites) • Certain Nuts • Gluten • Eggs • Soy • Dairy • Corn Identifying and Treating Food Sensitivities One of the more effective methods used to help identify food sensitivities is making changes to your diet. This begins by keeping a journal of the foods you are eating, energy levels, and other symptoms you experience afterwards. During this time, the more common food “triggers” are typically eliminated from the diet. After about a month, the common foods are reintroduced, one at a time over a short period of time. If a noticeable change in energy levels or other symptoms reemerge, then the food is most likely the cause. While the process can seem time-consuming, the primary benefit of taking this approach is to help people restore their energy and eliminate related symptoms. An alternative to this approach is food sensitivity testing. The results identify levels of inflammation in each individual food, helping to eliminate the guesswork in which foods may be provoking inflammation, and ultimately, your symptoms. It's important to recognize that while food sensitivity testing is very accurate, it is simply assessing inflammation resulting from individual foods, and results must be put into clinical context to evaluate if they are in fact attributing to your reported symptoms. It is also important to stress that there could be other factors at work beyond food sensitivities, so it is vital to ensure a qualified Naturopathic Doctor performs a full workup to rule out other potential causes. If you believe you have sensitivities to certain foods, book an appointment for a full health assessment with Dr. Courtney Holmberg, ND at her naturopathic clinic in Toronto by calling 647.351.7282 today!
- ALLERGIES | A NATURAL SURVIVAL GUIDE FOR ALLERGY SEASON
Allergy season. With the snow melting, it's fast approaching, and so are the dreaded symptoms of sneezing, congestion, itchy eyes/throat, and headaches... shall I go on? Those who suffer from seasonal allergies, understand me when I say it's near impossible to function on a day-to-day basis under the fog of these symptoms. Believe me, I know... I used to suffer from all of the above. The good news is, it doesn't have to be this way. Simply put, seasonal allergies are an overreaction of the immune system, and there's more we can do than just handing it a tissue. It's time to ditch the drowsy decongestants, for good. WHAT ARE ALLERGIES? An allergy, or hypersensitivity, develops when the immune system reacts to something in our environment that was once otherwise harmless but has now been flagged as problematic, or an "allergen". These reactions are acquired, meaning the first time you're exposed to it, you develop the antibodies, and the second time you're exposed, you experience the symptoms. Believe it or not, the symptoms of seasonal allergies, medically termed "allergic rhinitis", are a result of your immune system in action, and not the allergen itself. White blood cells over-actively release an antibody called IgE, as well as histamine, which both help the immune cells to rid of the allergen it deemed as harmful. WHY DO ALLERGIES HAPPEN? Allergies can usually be attributed to two factors - heredity, and the environment. Age, sex, race, and family history are correlated to the odds of developing allergies. The modifiable risk factor, however, seems to be our environment. Research shows children who are not breastfed, or who are not exposed to germs in early childhood have a higher incidence of allergy development, mostly because their immune systems never learnt to develop a balanced response. Top 5 SURVIVAL tips 1. STOP ALLERGIES BEFORE THEY START (NEW MOMS - this one is for you) Research confirms that the appropriate use of probiotics, particularly the strain of lactobacillus rhamnosus (both during pregnancy & in infancy) can influence and enhance the immune system response, and decrease the risk of atopy [1,2]. Furthermore, it's crucial for children to develop a healthy immune system. Breastfeeding passes along some of the immunoglobulins you've developed over the years - your breast milk is nature's best vaccine! And lastly, the hygiene hypothesis suggests that our world of sterility is harming our immune systems' ability to learn what's harmful and what's not. So let your kids eat dirt sometimes, don't smother them in hand sanitizer, and most of all, don't suppress mild fevers! Fevers are the body's way of creating an optimal environment for immune function, so instead, monitor, support with fluids, and ride them out! 2. PROBIOTICS Even in adulthood, probiotics have a powerful influence on our immune systems. Not only do they enhance immunity, but they have the ability to regulate it. While the research is still developing, a dysbiosis of gut bacteria has been linked to allergies, and certain probiotic strains have immunomodulatory effects in favour of suppressing overactivity and supporting balance [3]. Use a 10+ billion-count multistrain probiotic high is lactobacillus and bifidobacterium, especially in the 3 months leading up to allergy season. 3. VITAMIN C & BIOFLAVONOIDS Unlike the over-the-counter antihistamines that work to interfere with histamine after its produced, vitamin C actually works to PREVENT histamine production (bringing us closer to the root of the problem). To maximize the effects of Vitamin C, it's best taken with bioflavonoids, in divided doses throughout the day. And while these two ingredients are found actively in berries & other fruits, not in the amounts needed to have an effect. However, adding more bioflavonoids to the diet is always a great approach!! Dosage: 2000-6000 mg daily in divided doses. Too much vitamin C can cause loose stools, and should not be used at this dose if diabetic or pregnant. 4. QUERCETIN My favourite to-go for allergy season, Quercetin is the bioflavonoid found in onions that makes you tear up! Again, this compound works to actually prevent the white blood cells from producing histamine, but to you, it will work much like an antihistamine. Dosage: you generally require large daily doses to have an effect ~ 1000 mg 3 times/day, and it should be commenced before the season even starts. There are theories on temporary mega-dosing with Quercetin to cure allergies but talk to your Naturopath before trying this, as quercetin can have negative impacts on your kidneys if taken in high doses for long periods. 5. HOMEOPATHY There are some great and readily available homeopathic remedies out there for seasonal allergies, which are safe, non-drowsy alternatives to anti-histamines. Try Allium Cepa if you have very watery, irritating discharge running from the nose and feel better in the cool open air. Euphrasia is great if your eyes are irritated and won't stop watering. Nux Vomica helps with paroxysmal sneezing and lots of drainage from the nose, as well as itching in the ears. Gelsemium is great for extreme allergy sufferers who feel overwhelmingly fatigued and debilitated, with lots of discharge. And of course - don't forget to limit your exposure. Dust on and under surfaces often, eliminate animal hair, change the air filters and pillowcases/sheets often, use hypoallergenic bed-ware, and have the carpets replaced or deep clean them bi-annually. MOST IMPORTANTLY - look for household mold - it's a common cause of newly developed allergies. There you have it! Natural allergy treatments. I've done all of the above, and I'm happy to say that it not only relieved but resolved my seasonal allergies. If you've got questions on how to apply this for yourself, or want to know more about natural allergy treatment, comment below! REFERENCES: 1. Allergol Int. 2014 Dec;63(4):575-85. Epub 2014 Jul 25. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. 2. . Hauer, A. “[Probiotics in allergic diseases of childhood]” (article in German). MMW Fortschritte der Medizin 148, No. 35–36 (2006): 34–36. 3. Kramer MF, Heath MD. J Allergy (Cairo). 2014; Probiotics in the treatment of chronic rhinoconjunctivitis and chronic rhinosinusitis.
- DEPRESSION & INFLAMMATION | IT'S MORE THAN JUST A FEELING
"I've been feeling down lately", reports patient X. "It's becoming harder to get out of bed, I'm irritated by everyone around me, and I can't get a grasp on these negative thoughts. I know it's all in my head, but...". More often than not, the way we feel easily becomes isolated to a psychological state. Depressed or anxious feelings = a mental condition, even though the symptoms can often be very physical. But what if I were to tell you that that's not the whole story and that evidence suggests otherwise? We know that our hormones (and feelings, for that matter) are continuously creating a series of beautifully coordinated chemical reactions with the intent of communication within the body. And while these chemical reactions may produce very metaphysical feelings, I assure you, the process is very physical. Therefore, the way you feel isn't just all in your head, and believe it or not, there's a lot you can physically do to change it. Mild to moderate Depression and Generalized Anxiety Disorder (GAD) are the two most common mental-emotional conditions affecting today's population, with no signs of slowing down. While depressed and anxious feelings are a normal part of life struggles and downswings, prolonged engulfing sadness and relentless states of panic are not. Standards of care suggest treatment of these conditions begins with conservative psychological interventions such as cognitive behavioural therapy, stress reduction therapy, etc, before the prescription of medication. However, it's not uncommon for medications (termed "antidepressants") to be introduced as primary treatment for anyone experiencing symptoms of moderate to severe depression or anxiety, with the most common type being selective serotonin reuptake inhibitors (SSRIs). They've even become the leading treatment for menopause these days. Generally speaking, these medications work by modifying the signal pathway I mentioned earlier, increasing circulating levels of our "happy hormones"; serotonin, norepinephrine, and dopamine. So before "happy pills" become the new recommended drug of choice for everyone (and we're not far off), let's look at the facts... Two meta-analyses published in 2008 & 2010 concluded that SSRIs have little to no benefit over placebo in cases of mild to moderate depression. They do, however, bring side effects of weight gain, decrease libido, and believe it or not, increased suicide risk in children and adolescents. The benefits were significant for those with severe depression and GAD, although only about half (50%) respond to treatment. Is depression inflammatory? This is a new and very promising area of research with respect to mood disorders. A study completed in our own backyard, the CAMH Research Institute in Toronto, links a direct relationship between depression and inflammation. PET scan results conclude people experiencing depression have up to a 30% increased level of inflammation in the brain, with inflammation levels being most severe in patients experiencing the most severe depression. While the research is preliminary, and we still haven't really figured out the roles of "the chicken or the egg", the implications of treating inflammation in depression are promising. What research does conclude is that inflammation certainly plays a role in both the risk of development and progression of depression. Holistic Approaches BLOOD SUGAR Blood sugar spikes and drops affect insulin release, which affects cortisol, and ultimately our ability to cope with stress. It's very important to eat whole food meals and on a regular schedule. Refined sugar is a known pro-inflammatory substance, and is added to all processed foods on the shelves. SOLUTION: Fibrous foods and protein help to offset glucose levels, so make sure there's protein and leafy greens at every meal. OMEGA 3's Fish oil - specifically the EPA component - has been shown to be an effective way of managing mood and depression. Omega 3 fatty acids actually shunt the body away from producing inflammation, which is why they've been coined as anti-inflammatory. To receive mood benefits from fish oil, evidence suggests you need a fish oil with a minimum of 60% EPA content, as lower ratios are ineffective SOLUTION: supplement capsulated fish oil daily with a 3:1 ratio of EPA: DHA, and a minimum of 1000 mg EPA per day VITAMIN D It's important to differentiate between depression and seasonal affective disorder (SAD). Decreased amounts of sunlight during winter months (and the natural tendency to hibernate from the cold - especially this year) lower our natural production of vitamin D, and have shown to have effects on our mood. During winter months, vitamin D supplementation can offset this drop. Vitamin D also supports our immune system, which is an added benefit. SOLUTION: minimum 4000 IU of vitamin D during winter months, in a fat-soluble solution (liquid, NOT capsules) ADDRESS THE GUT While the science behind it is still not well understood, the state of our gut plays a critical role in how we feel. Not only does the gut have its own nervous system, but 75% of the body's happy hormone, serotonin, is produced there. Nearly 80% of those suffering from irritable bowel syndrome experience anxiety and/or depression. One study even showed a connection between probiotics and improved stress response. SOLUTION: ensure healthy & regular bowel movements, ask your Naturopath if you need good probiotics, and reduce gut inflammation by avoiding dairy, gluten, and processed/refined foods. References: 1. www.NICE.org.uk 2. Hammad TA (2004-08-116). "Review and evaluation of clinical data. Relationship between psychiatric drugs and pediatric suicidal behavior" (PDF). FDA. pp. 42; 115. 3. Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT (February 2008). "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration" 4. Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J (January 2010). "Antidepressant Drug Effects and Depression Severity" 5. CAMH new release: New biological evidence reveals link between brain inflammation and major depression 6. Philip Rouchotas MSc, ND. What You Need to Know About Fats, The Good, the Bad, and the Ugly.
- THE PURSUIT OF BALANCE: 8 WAYS TO A STRESSLESS LIFESTYLE
If you're like me, just the word "STRESS" brings on the urgent need to take a slow, deep breath in. Few are foreign to the concept of stress and its impact on our health, but how many of us actually know what the stress response really is... or why we even have one? Furthermore, it may surprise you that we have more control over our state of "stress" than originally thought. Let's see if we can change our perception of the dreaded topic, and learn some great, actionable ways to manage it. Let's talk about "stress" Stress, by definition, is felt as strain or pressure, and perceived as something threatening. Depending on where you are in your life, the thought of good grades, finances, children, promotions, deadlines, health, etc may bring on that feeling. Now think of vacation, relaxation, your happy place, a good night's sleep, seeing your child smile, etc... Believe it or not, your body is releasing some of the same hormones in both of these situations. The important thing to recognize from this is our perception of what our "stressors" are, and how we're responding to them. So what is STRESS? The stress response stems from an adaptive strategy our body developed for temporary periods of danger to ensure our survival. Simply put... see Sabertooth Tiger -> recognize danger -> activate stress response -> run away quickly (or fight if you're nuts) Basically, what's happening is our sensory organs (ears and eyes) recognize the threat, which sends a signal to our brain (the hypothalamus, specifically), which interprets the response and decides what to do about it. In situations of danger, as seen above, a cascade of hormones is released, with the intention to activate our adrenals. The adrenals pump out the hormones epinephrine (adrenaline), norepinephrine, and cortisol, all with the intention to prepare our body to run faster or fight harder for our survival. We'll call this situation "acute stress". So why am I boring you with this... The important thing to recognize is this response is designed to prepare us physically for situations of life or death - situations that occur far less often these days (I haven't seen a Sabertooth tiger lately, anyways) However, the stress response is still active, but for different reasons. Today's Stress Today we experience a much different kind of stress - more like the one I mentioned initially (work, school, home, etc). Instead of this stress being "acute" or temporary, it tends to be of lower intensity and of longer duration. Nowadays, you can't simply run from the problem, if you get what I'm saying. We'll call this "chronic stress". So what does this mean for our health? An acute stress response is great - it's what our bodies use to perform at our best in sports or endurance activities, it focuses our mind for big presentations, and it allows us to hammer the gas pedal quickly when the other car comes out of nowhere. But chronic stress is a problem. Much like the engine in a car, our adrenal glands have a threshold of performance. And if you keep pressing down that gas pedal, you're eventually going to run out of gas. The same happens with your adrenals. Chronic stress leads to a constant output of these hormones, which in turn uses up a lot of the body's vitamins, minerals, and cofactors to make them until we eventually run dry. Furthermore, constant exposure to these hormones can have some negative effects long-term. Believe it or not, stress is linked to 99% of all chronic conditions. The most common effects of prolonged stress include: High blood pressure & blood sugar Skin conditions, Pain, Frequent colds and flus, allergies Inability to lose weight or weight gain, Hormonal imbalances & infertility, Anxiety & depression, Difficulty sleeping, Premature Aging/ Accelerated Aging How do I know if I'm stressed? Besides listening to the clinical presentation of stress (see below), there is a way to actually determine what is happening with your adrenal glands. It's called 4-point cortisol testing - basically, 4 salivary measurements throughout the day quantifying the level of cortisol you're releasing. When plotted onto a graph and compared to normal cortisol levels, we get a qualitative measure of adrenal function. Generally speaking, there are 3 stages the adrenal glands undergo when dealing with chronic stress. The Alarm phase: This is when you're starting to press down on that gas pedal and speeding more than you should - your demands for cortisol are high and your adrenals are responding. This state is reversible. The Resistant phase: You're speeding constantly and the engine is reeving - your adrenals are overworking and cortisol is chronically elevated all day. Your adrenals are no longer adapting. The Exhaustion phase: You've run out of gas, the engine has crashed. Your adrenals are no longer mounting a physiological response to the brain's demands. You're "burnt out". Symptomatically, you might be experiencing: Alarm and Resistance Stage: Irritability Feeling "tired but wired" Difficulty sleeping Anxiety High blood pressure Thyroid dysfunction Weight gain Exhaustion Phase: Fatigue -> feeling “burnt out" Waking unrested, "could sleep forever" Infections & allergies Exhaustion after exercise Depression Low sex drive Blood pressure drops SO, What can I do about Stress? 1. Measure your cortisol via 4 saliva samples. Getting an objective measure of how your adrenals are performing throughout the day takes the guesswork out of diagnosing your phase of dysfunction and allows for the most management of your state of stress. 2. Exercise Moderate-intensity exercise improves your mood (by releasing feel-good hormones), helps the body manage blood sugar levels, and actually has shown to be a form of meditation if movements are repetitive (jogging, biking, swimming, etc). But be careful, too much exercise can worsen the demand on your adrenals - so listen to your body. If you feel burnt out after exercise, you're working too hard. 3. Sleep hygiene Your adrenals ideally need 8 hours of restful sleep to "recharge". Cortisol naturally drops at sundown, when your melatonin (sleep hormone) takes over the circadian rhythm, so its important to wind down when it gets dark outside. 1 hour before bed, dim the lights, turn off the screens, and clear the mind. Light actually stimulates cortisol release, and screens of electronics like laptops, televisions, iPads, etc actually have been shown to disrupt sleep patterns. Even a stressful crime novel can boost your cortisol. The bed is for sleep and intercity period. Practicing good sleep hygiene can improve sleep quality by up to 40%! 4. Nutrients & Herbs We also need to think about adrenal hormone production and what nutrients are involved, specifically vitamin C, CoQ10, B vitamins, magnesium, calcium, and selenium. They are all important cofactors in helping the adrenal glands function and get depleted quickly when they are working in overdrive. Typically in later stages of adrenal dysfunction, these nutrients will need to be supplemented at higher doses than what's accessible from food. Adaptogenic herbs are also great ways to support the adrenals. Some herbs like rhodiola and magnolia help bring down cortisol levels, while others like panax ginseng, eleutherococcus and ashwaganda help improve the body's energy levels and resistance to stress. Nutrients and herbs must be used correctly, as some should only be used in certain phases of adrenal dysfunction. It can be risky to self-prescribe, so talk to your Naturopath about which supplements are best for you. There are some great formulas out there compounding these ingredients together in one capsule. 5. Diet What you eat has a profound effect on your stress levels. More specifically - sugars and caffeine. Sugar causes our blood sugar levels to spike, which induces an insulin spike, which loads our cells with glucose and causes us to release cortisol to return those blood sugar levels back to normal. Moral of the story - avoid insulin spikes. Replace white bread and pasta with complex carbs like carrots, potatoes, beans, and grains like quinoa or brown rice. Skip on dessert. Usually, those who are stressed feel burnt out and require coffee to get them through the day. Caffeine causes cortisol spiking, which has a negative impact if your cortisol is already too high. Replace the coffee with something like green tea, which contains theanine that helps the brain respond to stress naturally. 6. Meditation People shy away from the concept, but it's remarkable what meditation can do for our stress response, especially mindfulness-based stress reduction techniques - mindful meditation + body scans + yoga postures. Researchers at Harvard Medical School confirmed that meditation actually induces what we call a RELAXATION RESPONSE, which counter-effects the fight-or-flight response. Studies confirmed that moving into a meditative state changed oxygen consumption, decreased blood pressure, and even decreased levels of stress hormones. Grounding. Studies show that making direct contact (without the non-conductive soles of our shoes) with the earth's magnetic pull can actually regulate cortisol levels, and other hormones such as melatonin, estrogen, and serotonin. During the summer months, walk outside barefoot in the grass for ~5 mins/day. If you can't get outside and want to benefit right away, you can buy grounding mats to place under your bed at night or desk during the day that have been shown to have the exact same effect. How cool is that? 7. Acupressure My favourite acupressure point for relaxation is called LI 4 - it's located between your thumb and index finger, in the meaty tissue of your palm. When you press down on it, you should feel an uncomfortable achy sensation. It's great for acute feelings of stress, headaches, or any tension felt in the head or neck area. Hold it for 1 minute, on both sides. This point is not to be used during pregnancy. 8. Perception Probably my favourite approach to managing stress is in our perception of what stress means. If you haven't seen this TedTalk ... go watch it. Now. Dr. MacGonigal points out shocking statistics on stress levels and life expectancy. People who experience large amounts of stress had a 43% increased risk of death, but… this was only true for those people who BELIEVED stress was harmful to their health. Those who did not believe stress was bad actually had no increase in the risk of death. Furthermore ... and this is my favourite part... rethinking our stress response as HELPFUL actually changes the body's response to mimic the same response shown in moments of joy and courage. Today's stress isn't changing us down and trying to eat us for dinner (although some are probably thinking "have you met my boss?"). Today's stress is what we perceive to be true and fear of what that might mean. Change fear of the future into the presence of the moment. Thank the body for preparing you. Practice mindfulness.
- TO BREAK, OR BREAK UP WITH, BREAD
Unless you've been living under a rock, I'm sure you've come across the ingredient every product is labelling free of and every consumer is trying to avoid gluten. One of the most common questions I'm asked with regard to dietary changes in practice is "should I be gluten-free too?" Stats say roughly 29% of households now have a family member who eats gluten-free, and the "Gluten Free" label has become the top 5th label claim since 2011. But when asked, less than a third of respondents (including those who claimed to be gluten-free) actually knew what gluten was and where it was found. So... what is it? Why is it bad for us? And what's with all the hype anyways? There are a number of articles circling the web on either side of the gluten fence. I'm not here to persuade you but to inform you, so listen closely. First off... what is gluten? Gluten, by definition, is a family of proteins, made up of gliadin and glutenin that give bread its elasticity, or ability to rise. The family that seems to be problematic in today's diet is found in wheat, barley and rye. Dr. Tom O'Bryan, a certified gluten practitioner in the US, discusses the reason for its "toxicity". He states that although not everyone may show symptoms of sickness from eating gluten, the human body does not produce intestinal enzymes to break down the gliadin component of the protein [1]. For someone with celiac disease, this is a serious problem. Their immune system produces an anaphylactic response when exposed to the gluten protein (even in minute amounts)... much like someone would with a bee allergy, but in their gut. These people often carry a gene that predisposes them to this condition, and a gluten-free diet is absolutely essential for them. The interesting fact is that there has been a 4 fold (or 400x) increase in the incidence of celiac disease over the past 50 years [1]. That leaves us with the question... Why is gluten suddenly a problem? Although wheat hasn't changed, and has been cultivated now for roughly 10000 years, its been only in the last 500 years that the actual content of gluten in wheat-based foods has gone up [2]. This is because gluten helps breads rise and holds food together, making for better texture, and is therefore actually added to foods already containing gluten. It can also be found in cosmetics, hair products, and household cleaners. It's important to note that although only 3% of those with the celiac gene actually develop celiac disease, roughly 30% of the population carries the gene. So why isn't everyone developing celiac? Tom O'Bryan states this is due to the concept of loss of oral tolerance - meaning overexposure and weakened gut health due to environmental factors may be the key to the expression of this gene [3] Can we test for it? The short response would be yes. Without boring you with the details, blood samples can test for antibodies to the gluten components to see if your body is mounting an immune response to them, but the gold-standard testing for diagnosing celiac disease is an intestinal biopsy, looking for destruction of the brush border, or "microvilli" of the gut lining. HOWEVER... it's very important to understand that lab testing is not the gavel of medicine. Clinical symptoms are just as, if not more important, than lab values. Now, science says these tests are very accurate at determining celiac disease - but only in those with full-blown villous atrophy, or complete destruction of the brush border. If the lab tests included all stages of symptoms, the stats drop to roughly 27-32% efficacy [4.5]. This means that, in this case in particular, the testing is really only conclusive for those with COMPLETE microvilli destruction, not partial or moderate states. Therefore, although people are symptomatic, they're experiencing false negatives with testing, and are deemed "non-celiac". This leads us to the topic causing the most controversy... Non-Celiac Gluten Insensitivity Have I lost you yet? So you've tested negative for celiac disease. Or in some cases, your blood tests are positive, but the biopsy is negative (for further info on this, check out this article). But you're experiencing symptoms. How can this be explained? A condition called "NON-CELIAC GLUTEN SENSITIVITY", or NCGS - is a condition that the medical community is slowly including as a clinical diagnosis. Basically, your biopsy does meet the criteria for celiac disease, but you're still mounting an immune response to gluten. While it's still largely misunderstood, there's research that attributes this phenomenon to "leaky gut syndrome", which is basically inflammation in the gut that develops from the environmental exposures that allow substances to pass between the cells instead of through. So now your immune system is reacting to the gluten you're intaking in a systemic inflammatory way, much like you're body would react to a bacteria or virus coming through the gut. This inflammation is not localized to the gut, as these antibodies cycle through your body, causing a number of indirect symptoms. such as bloating and gas, joint pain, skin conditions, mental fog/depression, fatigue, etc. This is where we see cross-linking between other immune conditions, such as Hashimoto's Thyroiditis (hypothyroidism), Inflammatory bowel disease, Systemic Lupus, Inflammatory skin conditions, etc. Some of the symptoms: the Journal of Attention Disorder (2004) published a study showing people with ADHD also reported the following list of symptoms, all of which improved with a gluten-free diet: 87% bloating 83% abdominal pain 31% sores in the mouth 68% lack of wellbeing 64% fatigue 54% headache 39% anxiety 31% joint or mm pain So is a gluten-free diet healthier? Again, the short response would be maybe. IF DONE PROPERLY. Since gluten-free has become so widely recognized as a healthier way of eating, many food companies have followed the trend of creating gluten-free alternatives. Now, just because something is labelled "gluten-free" does not mean this alternative is healthier for you - most cereals, bread, and snack foods are loaded with high fructose corn syrup to make up for the loss of gluten, which comes with a whole new bag of problems. What can I do? 1. eat NATURALLY gluten-free items If you've chosen to avoid gluten, also choose to avoid the alternatives. Corn and rice-based products are gluten-free but skip on the bread, cereal, and snack alternatives. Choose whole foods, increase produce and protein (grass-fed as opposed to grain), and up your omega 3s (flax, walnuts, fish, etc) to offset the more inflammatory omega 6s that come from grains. Choose items such as quinoa, rice, millet, or buckwheat for your grains. Cook with almond or coconut flour. Search the web for gluten-free blogs (they're everywhere). If you've got to have your bread fixed, find a great local gluten-free bakery you can trust. 2. do some further reading There is so much on this topic that I haven't even touched on. There's research on the theory that gluten sensitivity is correlated to Alzheimer's and Dementia, as well as a number of other neurological conditions. Although quite opinionated, these books are user-friendly resources to find out more: - The Grain Brain, David Perlmutter, MD - The Wheat Belly, Dr. William Davis, MD 3. address your gut Leaky gut syndrome is a consequence of lifestyle and environment. Many things cause inflammation in our enterocytes, leading to food allergies and systemic symptoms. Your naturopath can run a food allergy test, or IgG test to find out if you're having an immune-mediated response to any of the foods you're consuming - not just gluten. Learn more about FOOD ALLERGY TESTING HERE >> Furthermore, if any of these symptoms sound like something you're experiencing, see if naturopathy can help by booking your naturopathic consult HERE >> References: Celiac Disease on the Rise. Mayo Clinic: http://www.mayo.edu/research/discoverys-edge/celiac-disease-rise US perspective on gluten related disease. Clinical and Experimental Gastroenterology. http://cdn.thedr.com/wp-content/uploads/2014/11/US-perspective-on-gluten-related-diseases-Leonard-2014.pdf Meresse B., , Ripoche J., Heyman M., Cerf-Bensussan N., Celiac disease: from oral tolerance to intestinal inflammation, autoimmunity and lymphomagenesis, Nature Vol 2 No 1, JANUARY 2009 Abrams JA, Diamond B, Rotterdam H, Green PH. Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy, Dig Dis Sci. 2004 Apr;49(4):546-50 Tursi A., Seronegative Coeliac Disease: a Clinical Challenge. BMJ 26 April, 2005.
- THE BONE-BREAKING FACTS ABOUT MILK
For generations now, we have all been told that we must get our daily fix of cow's milk in order to get our required dose of calcium and build ourselves some strong bones. The 15$ billion-dollar Canadian Dairy Industry's marketing campaigns work hard to teach the public that if you're not drinking enough milk, you're not looking out for your own health. And while there's no excusing the truth that calcium is a key mineral in the makeup of your bones and that milk is a rich source of it, it gets a little more complicated than that. What most of us don't know is that milk itself may not be the best food source for our bodies to utilize all that calcium. In fact, it may be working against you... first things first... Let us start by pointing out an obvious fact - we are the only species known to drink milk past infancy, and more importantly, it's not even our own milk. The fat-filled, hormone-rich, mineral-dense cocktail a mother cow produces is intended to take her roughly 65 lb infant calf to a whopping 700 lbs in just under a year. That ratio in comparison to human development seems a little off to me... That infant then grows to a healthy size, develops dentition, and takes on solid food, leaving the milk behind. Yet we as North Americans never seem to really outgrow milk, and I say North Americans because there are numerous cultures around the world that have never tasted a drop of bovine syrup and have lived healthy ever after. Furthermore, there's a concern with the drug called rBST (recombinant bovine growth hormone) used to increase the milk yield from cattle. And much like the name suggests, growth hormone leads to the proliferation of cells in the body. Unfortunately, cancer cells from ovarian, breast, and prostate cancer are very receptive to this hormone, causing them to grow and spread at an alarming rate. Now the plus side is, no dairy cows within Canada are approved for the use of this hormone. However, that's not to say that Canada does not import dairy products from the US. In 2011, more than 102 million kilograms of dairy products were imported into Canada from the US, all of which were not rBST free. So if you've just got to have some of that creamy white nectar, look for this emblem on the packaging to ensure it's 100% Canadian. the sour facts... To summarize what's out there, plenty of older research supports the fact that calcium prevents bone loss, and milk is rich in calcium. Studies looking at fracture incidence in North American women conclude that a lower intake of milk in adolescence has an increased risk of fracture later on in life (1). However, according to the authors of the Save Our Bones program, the vast amount of research is often misinterpreted, with the underlying truth being that very little evidence actually shows a positive relationship between calcium and bone health, with an almost non-existent relationship between milk and bone health. A famous Harvard study in the late 90s followed a large group of women for 12 years, and concluded that drinking milk once or more daily actually increased fracture risk compared to those women who only drank milk once per week (2). An excerpt from the study: "These data do not support the hypothesis that higher consumption of milk or other food sources of calcium by adult women protects against hip or forearm fractures.” Furthermore, when you dig into the demographics, data shows that the countries that consume the most amount of milk actually have the highest incidences of osteoporosis and loss of bone mass. How is that so, when milk saves our bones? On the same subject line, similar results are seen regarding calcium when you compare African tribes who consume less than 350 mg of calcium a day and almost zero incidences of broken bones with the Eskimo tribes who survive on fish bones loaded with calcium and have one of the highest incidences of osteoporosis in the world (3). That being said, I think it's also very important to recognize other factors involved here, as the lower incidence populations also have higher amounts of vitamin D exposure and greater amounts of daily exercise - hint hint. what the dairy industry doesn't tell us... There's some evidence out there to suggest that milk may increase the risks of certain types of cancer for both men and women. The sugar in milk, called galactose, which is digested to the well-known allergenic sugar, lactose, may have some effects on ovarian cancer risk. While not all studies suggest this, one Harvard study pooled results of multiple trials to conclude that with a high intake of lactose (unspecific to which type of dairy it came from) there was a modestly higher risk of ovarian cancer. It's not to be ignored that this may actually correlate more so to the hormonal compositions of today's milk, as ovarian cancer is hormone sensitive. With regards to males, a prospective study suggests men who consume high amounts of calcium (nearly 2000 mg/day or 3 cups of milk) may have anywhere between 39% to almost double the increased risk of developing fatal prostate cancer than those who consume low amounts (4,5). the take-home message... #1 substitute Scrap the belief that milk is needed to breed strong bones. Theres some fantastic alternatives out there that do the trick, and aren't squeezed from a cow's udder. Almond and Coconut milk are very tasty, they make for a delicious latte, and they can replace milk in any recipe (my favourite brand is Silk, as it contains no carageenan - a stabilizing agent linked to endocrine problems). Coconut yogurt is a delicious alternative. Stick to goat-based cheeses to avoid lactose. #2 balance What's important to know is that milk actually contains some ingredients, protein is the most prominent, that can have acidifying effects on our bodies. The problem lies in the fact that our body maintains an ideal pH to function properly, and the only way to neutralize acid is to add an alkaline substance or base. And where are the most basic minerals stored in our bodies? You guessed it - our bones. Now I haven't come across any HARD evidence to say this happens in humans, but mouse trials support this hypothesis. Offset things that acidify your body with the most basic, mineral-rich food group known to man, VEGETABLES! Mom did know best. Ditch the coffee (I know, I was devastated too), alcohol, sugar, cheeses and animal proteins for some mineral-dense, alkalinizing items like Spinach, Sprouts, Cucumber, Apples, Zucchini, and so on. #3 don't leave anyone out Vitamin D, vitamin K (found in dark leafy greens), magnesium, and phosphorus are ALL just as essential to bone health as the ever-popular calcium. Leaving one out throws off the whole matrix. Again, vegetables are the best sources of all these nutrients, as well as some healthy, safe, sun exposure. Evidence shows that a little daylight (up to 15 mins/day) actually increases vitamin D serum levels more effectively than supplementing with it. In the winter months, however, 2000-4000 mg/day of liquid (in a fat solution) vitamin D may be an easier option. And let's not forget the role of exercise - particularly the weight-bearing kind. There's no question that increased stresses on the bones from weight-bearing activity leads to a better, stronger, and thicker depositing of minerals into that beautiful white matrix. Park your car at the end of the parking lot and carry your groceries. Walk around the house with the baby, or puppy, or your husband if you have to, in your arms. Engage in some fun interval training, using your own body weight as the resistance. Get out and move. And most of all, don't stress if you haven't been drinking your milk... you may have done yourself a favour.
- SO YOU'RE A NATURAL-PATH, RIGHT?
the art behind the science If you're unfamiliar with Naturopathic medicine, or even simply how it's pronounced, don't feel disheartened... you’re not alone. It’s a question I get asked day in and day out, and a tough question to answer at that. You see, Naturopathy doesn't fit as easily into a categorical box as some might hope, primarily because the term itself serves as an umbrella for what is practiced beneath it. If you're looking to understand the criteria of a Naturopathic medical education, the modalities used, or how it compares to an allopathic curriculum, the AANM does a lovely job of breaking it down for you. Rest assured, your ND is well-educated in both the holistic and allopathic sides of medicine. However, the part I hope to emphasize is not the structure of the curriculum or the hours of clinical experience, but more so the beauty of the way in which it is practiced - the art of Naturopathy. The best analogy I like to give is to imagine a toolbox. While the hammer might be the chiropractor, adjusting our structural misalignments, or the electrical tape being the family doctor, mending our symptoms, or even the measuring tape being the nutritionist, quantifying the amounts from what we are made, it is best to look at Naturopathy as the toolbox itself. You see, it isn’t so much a defined medicine, focusing on single complaints, with sole modalities, or on one realm of health... but rather an overarching style of medicine, treating overlapping conditions, with multiple modalities, on the physical, mental, and emotional realms of health. And while every therapy applied (be it botanical medicine, nutritional supplementation, or even an acupuncture protocol) is researched for efficacy and cross-referenced with pharmaceutical modalities until the cows come home, the art is in the application and the combination of these therapies, and how - much like a painting - no two treatment plans are ever the same. Now, being both a patient and practitioner of Naturopathy myself, I've experienced this - shall we call it, style - from both angles. I can still recall the moments (not once, but twice) that I fell in love with natural medicine - first as a patient when I recognized that I was not merely a cookie who fit into a mould of what the medical system had planned for me, and secondly as a practitioner, when I realized the paintbrush was now in my hand. After conventional medicine had identified my symptoms, completed all its diagnostic tests, and ultimately run its course, my Naturopath went the step further to educate me on treatment options and lifestyle changes I could make to address the cause of why it all happened in the first place. And therein lies the beauty of the two realms of medicine working hand in hand - but that there is a whole topic all its own. I later fell in love all over again, when I began my clinical internship. Over the three years of long class hours, overwhelming amounts of dry theory, and endless late nights of cramming combined with un-naturopathic choices, I can now admit I had lost a feel for the art. My right-sided brain had shrivelled into the organic, sugar-free, sun-dried raisins I found myself consuming to fuel the days that had blurred into weeks. It wasn't until after the first few weeks of my clinical internship that my new non-textbook, multidimensional patients and acquired medical detective skills reminded me that not only did I love the art of this medicine, but that I was "in love" with it. So now that we've covered the common question of what, we must address what comes next - why? Can’t anyone buy nutraceuticals, or simply ask the guy behind the health food store counter what they need? Of course, they can. But much to Dr. Oz's failure, not every natural health product or home remedy is for everyone. The simple statement "drink more water" could kill a patient with congestive heart failure. And more importantly, not all health products meet therapeutic standards. A recent and widely recognized editorial published in Annuals of Internal Medicine blatantly concluded that vitamins and minerals were a waste of money. However, Dr. Alan Gaby, MD an expert in nutritional medicine, wrote a thoroughly researched response highlighting the importance of choosing the right products, with effective dosages and free of additives. So again, we come back to the art of individualized treatment, the importance of educated choices, and the use of treatments to best address the underlying cause above ameliorating symptoms. Naturopathy in a nutshell. But then again, that's just my take on things.
- WHY FATS DON'T MAKE YOU FAT
Whether or not you're new to the coconut oil craze, or you've been soaking your skin with it for years, there is no doubt you've made the right choice by hopping onboard. Despite the fact that this natural, drupe-based oil received unwarranted flak for a number of years for being a saturated fat, the jury is out... and we were wrong. And although it lacks a few extra double bonds, this oil has many - if not more - health benefits than a number of the other unsaturated vegetable oils that sit in most pantries today. But the best part… theres evidence to prove it. So without further ado, heres why… first things first… a lesson on fatty acids Generally speaking, fatty acids are long molecules found in both vegetable and animal products that are used by the body to create lubrication for our joints, insulation for our nerves, protective cushioning for our organs, and ultimately make up the outer membrane of every single cell in our body. By now, I'm sure you've begun to appreciate their importance. The key to remember about any fat is the types, quantities, and lengths of the fatty acids it contains. To explain, there are both saturated fatty acids (SFA), which lack double bonds (like coconut oil) and are therefore solid at room temperature, and unsaturated fatty acids, which contain double bonds (like our omega oils) and are liquid at room temperature. For a long time, if was believed that saturated fats were bad for our health, but that myth is debunked below. In the food industry, there exists a third form known as hydrogenated fatty acids, which basically means the unsaturated fat has been given a few extra hydrogen atoms to make it more stable at room temperature. However, in doing so, the break down of this product creates trans fats, which are not found in nature and are unrecognizable to our bodies, therefore ending up places they shouldn't - like the walls of our arteries. the myth about saturated fat A meta-analysis done by the American Journal of Clinical Nutrition concluded that we've had it wrong for years - saturated fats are evidently harmless, and there is "no significant evidence that dietary saturated fat is associated with increased risk of Coronary Heart Disease or Cardiovascular Disease". Furthermore, another study from the AJCN showed that replacing SFA with unsaturated fatty acids had no effect on the fluidity or stiffness of arterial walls. Now this doesn't mean that everyone at risk for heart disease should go liberally divulging on animals fats and cheese, as there is an importance to the type of saturated fat consumed, and of course in moderation. That importance is in it's length. Coconut oil is set apart from other fatty acids because it is made up predominantly (~70%) of medium-chain fatty acids, which are absorbed directly into the digestive tract and sent straight to the liver, and unlike animal and dairy products, they do not require bile salts for breakdown. Coconut oil is therefore a direct source of energy - remember this for later. To top it all off, a saturated fat like coconut oil tolerates high temperatures much better than most unsaturated fats like corn, sunflower, or olive oil, and that is due to it's higher smoke point. The smoke point of an oil is the temperature at which the oil begins to break apart, producing byproducts and free radicals that can be dangerous to the body. Most unrefined oils on the shelves (depending on their quality) have a smoke point ranging from 250 - 320°F, whereas coconut oil ranges upwards of 350°F. Therefore, the use of coconut oil decreases the risk of free radical damage from cooking. why we should all ditch the carbs for fat While every cell in the body burns glucose (the breakdown product of all carbohydrates), the heart and skeletal muscle in particular prefer fatty acids, as it is a greater source of energy production, and doesn't require insulin to do so. This point is very important, as so much of the population today experiences insulin resistance (the first step to type II diabetes) due to the overburden of insulin our body experiences from all the sugar we consume. FUN FACT: 4 g of sugar on a food label = 1 tsp of white sugar… think about it next time you read the side of a box. Moreover, the foods we eat and the sources they come from have effects on the way in which our body handles our hormones. Firstly, high amounts of sugar increases insulin, which counters cortisol, leading to more fat storage in the abdomen and less breakdown. Now for the importance of those medium-chain fatty acids I mentioned. One study shows that the thermic effects of medium-chain fatty acids in coconut oil are greater than long-chain fatty acids of equal calorie content, suggesting an important take home message: a calorie is not a calorie. There isfurther evidence to suggest that increasing medium-chain fatty acids in the diet can increase your body's energy expenditure by 5%, which averages an extra 120 calories burnt per day. The ketone bodies that are produced from coconut oil's metabolism is also shown to have appetite reducing effects, meaning less calories consumed throughout the day. So yes, it is too good to be true … sugar = fat storage, and fat = weight loss. other fabulous facts about coconut oil FOR YOUR SKIN and HAIR: it has an SPF of 10 (blocking ~20% of the suns rays), making it not only incredibly hydrating to the skin and hair, but protective. Furthermore, coconut oil is made up of ~ 60% lauric acid, a natural antiviral, antibacterial, and antifungal, making it a great topical treatment for infected wounds or fungal infections like tinea. Don't forget, it works the same way internally, for preventing things like candida. FOR YOUR BRAIN: we all know fatty acids are essential for brain function and development, but medium-chain fatty acids specifically are turned into ketones by the body, which some studies have shown to have therapeutic effects in conditions such as epilepsy and Alzheimer's. Something to consider... FOR YOUR CHOLESTEROL: studies show coconut oil increases levels of HDL (the "good" cholesterol) and lowers oxidative damage of LDL (the type that clogs our arteries when exposed to oxidative damage). FOR YOUR DIGESTION: because it requires no energy for breakdown or transportation across the intestines, people who suffer from IBS or Crohn's may benefit from the ease of coconut oil's absorption. More remarkably, those who suffer from gallstones or bile duct conditions will not be affects by coconut oil, as this fat requires no bile salts for emulsification. Hooray! FOR YOUR HEALTH: fat soluble substances, like vitamin A, D, E, and K, and minerals like calcium are all more readably absorbed when taken with coconut oil. Your mood, your bones, and your immune system will love you for it. REMEMBER: like any oil, coconut oil varies in quality. When choosing a brand, go for UNREFINED and VIRGIN forms (meanly those lovely medium-chain fatty acids haven't been destroyed in the making). My favourite so far - Carrington Farm's cold-pressed, organic coconut oil, found at Costco for a fantastic price (~17$ for a tub that will last you months).