The Prevention Series: Daily Steps to Good Health

magnoliaThis will be the first post in a series of posts about how to live a long, healthy life.  These basic guidelines are applicable for all of the decades.  Later on in this series, we will explore the common health concerns of the decades and discuss prevention strategies through diet, lifestyle, supplements and preventive exams.

DAILY STEPS TO GOOD HEALTH, FOR ALL AGES:

The guidelines below are meant to be helpful for most people throughout their lifetime. Some people with medical issues may need more tailored instructions to their condition.

  • Do not smoke or be around smoking: It is not too late to quit. Quitting now will still add years to your life, and improve your quality of life. Seek assistance with medication or counseling if needed.
  • Exercise regularly: 20-30 minutes a day, 4 days per week is a great goal.       It is not too late to start.       Find something you enjoy, or that brings you into social situations. Choose an activity that is safe yet challenging. The risk of getting hurt while exercising is lower than the downfalls of not exercising.
  • Eat a healthy diet: Diet philosophies are quite vast, and you may have a diet that you strongly believe in. Talk to a naturopathic physician about a diet that is right for you.       What has generally seen to be healthy and good for longevity is a mostly plant-based diet, with moderate animal products, moderate alcohol intake, and very minimal processed foods and sugar. I like to have my patients eat a cup of vegetables at each meal, and try to eat 2 vegetarian meals per day. Dark leafy greens should be a daily addition to meals. I also encourage eating protein, fat and fiber at every meal. Minimize charred and smoked foods. Consider a 12 hour fast every day (between dinner and breakfast).
    • Protein: meat, fish, eggs, dairy, nuts, seeds, legumes
    • Fat: meat, fish, eggs, dairy, nut s, seeds, coconut, avocado, olive oil
    • Fiber: vegetables, fruit, whole grains such as oats/quinoa/brown rice/millet (minimize grain products such as whole grain bread, pasta, etc).
  • Drink water: Generally, ½ of your body weight in ounces per day is recommended. (For example, if you weigh 150lbs you should be drinking 75oz of water daily).       Another glass of water is added for any alcoholic or caffeinated drinks.
  • Alcohol in moderation: Studies show that 1 glass of red wine daily can be beneficial for health. Consider that the body must process and discard alcohol and its byproducts, so heavier use can lead to health problems.
  • Avoid toxic chemicals: eat a diet of organic produce, organic free-range poultry and eggs, grass fed organic beef, wild seafood as much as possible.       Avoid processed and fast foods as much as possible. Use natural bath/beauty products and home cleaning products. Look at the website EWG.org (Environmental Working Group) to rate your products.
  • Participate in social activities: It is important to stay social and have relationships as we age. If you are in a partnership, continue to grow and change together and continue to experience new things together. It is important to maintain friendships and to continue making friends throughout your life. This helps with mental health, warding off depression and anxiety.
  • Appropriate supplements: For many people, a daily multivitamin is enough. This is important as we age and possibly have more limited absorption of nutrients from the gut. For those on medications, there may be other supplements that are important.       It is best to consult with a Naturopathic Physician for these concerns.
  • Immunizations: {Note- these are my personal opinions, which may be slightly different then the CDC recommendations}. Tdap/Dtap (tetanus, diphtheria and pertussis) vaccine is recommended every 10 years throughout life. This is especially important if you are caring for young children/babies.       Shingles vaccine is given once at age 60. The flu vaccine is recommended annually for all ages, but it can often be declined in healthy people. It is generally recommended for those over age 65 and for pregnant women, even in healthy individuals.
  • Weight management: Metabolism naturally slows after age 30, and many people find that they easily gain weight between ages 30-65. After age 65, many people start to lose weight again. This is partially from metabolism changes, but also can be related to absorption of nutrients in the gut. It is important to alter nutrition and diet during these years, to not become overweight or underweight. If you are experiencing weight gain or weight loss, seek the care of a physician, as it could be a sign of a treatable medical issue.

**Next Post in The Prevention Series: The 30’s- Common Medical Issues and Prevention Tips**

{Disclaimer: The information in this document is not meant to be personal medical advice and is for informational purposes only. For medical advice tailored to your needs, please schedule an appointment}

 

New Workshops Coming Up!

fruit veggie heart

Book now as space is limited!  Dr. Ward-Selinger and Dr. Herman are teaming up to present on these exciting topics.  Please reserve your space at www.sellwoodyoga.com

April Workshop:
Intro to Cleansing, $10 to reserve your space
In this workshop we will discuss the benefits of cleanses and and outline different protocols, as well as how to choose a program that’s right for you.  Dr. Kai and Dr. Lauren will provide tips for a safe and effective cleanse program, as well as ways to incorporate these healthy habits into your every day life.  Attendees will also receive a discount to use towards the group cleanse scheduled at Elixia Wellness Group in May 2014.
pollen

May Workshop:
Conquering Allergies, $10 to reserve your space
The incidence of food and skin allergies is steadily increasing. In this workshop we will discuss the causes and prevalence of environmental and dietary allergies.  Dr. Kai and Dr. Lauren will discuss how to limit your exposure to allergens and will discuss effective, natural allergy treatments that provide long term allergy control.

“Obamacare” from My Perspective

ACAThis post is more of an editorial than usual, so bear with me.

There aren’t many other topics lately that spark such a heated debate as the Affordable Care Act (ACA).  People love it and hate it, some think it’s socialist and some think it’s long overdue.  Some think it’s completely overboard and others think it is not nearly enough.  Some think it’s expensive others think it’s only a mere fraction of our actual healthcare costs.  Everyone is entitled to their own opinion, and no one can really expect us all to agree on whether it is right or wrong.  Surely we will not agree on what is “enough”, as the scale varies wildly from “provide nothing to nobody” to “provide everything for everybody”.  This post is only to provide an inside scoop from a Naturopathic Physician’s perspective.

ACCESS TO CARE: Since January 1st I have seen an influx of patients coming in to the clinic for general checkups or to take care of their known health problems.  Some of them have been without health insurance for years because they could not afford it. Patients with diabetes, high blood pressure, thyroid disease, psychiatric issues, and other conditions have been without medications, labwork and imaging for extended periods of time.  For those of you lucky enough not to have any chronic health conditions, let me stress how critical it is to get regular care.   Unmanaged health issues can result in heart attacks, blindness, pain, nerve problems, and much more.  It has been truly amazing to provide care to these patients who are so greatly in need.  I’ve also seen patients who have insurance for the first time in their lives, and are being diagnosed with serious conditions that they did not know they had.  The sooner we diagnose a problem and address the cause, the healthier they will be.  It is LONG overdue that everyone has equal access to healthcare.

ACCESS TO NATUROPATHIC MEDICINE: On a more political level, the ACA contains a clause which states that insurers cannot discriminate against medical providers who practice within their scope.  Therefore, medical providers will be reimbursed the same rate for similar services.  This is a huge step for Naturopathic Physicians who practice in primary and specialty care.  First of all, many insurance companies do not cover Naturopathic services, which excludes a large population from seeking our care. Second of all, if it is covered, often times the reimbursement rate is significantly lower than if the patient saw an MD (sometimes as low as 15% of the typical reimbursement rate for an MD visit).  Interestingly, Naturopathic visits are often twice as long and therefore much more in depth, and also involve much more counseling and education (such as dietary advice, supplementation, herbal medicines, exercises, physical treatments, etc).  This makes it extremely difficult to have a sustainable business.  Although much of the population does not know what Naturopathic Physicians do, and maybe wouldn’t choose to utilize our medicine, we deserve to be reimbursed at the same level for those who choose to use our services.  I take great pride in offering my patients safe, effective and thorough care, which should be reimbursed as such.

It has been truly inspiring and motivating to see so many people take charge of their health since January 1st.  I imagine that this year will continue to bring many new people to healthcare, and hopefully more people to Naturopathic Medicine.  I know the plan isn’t anywhere near perfect. I know that it is expensive.  But, if you have been fortunate enough to have access to healthcare and insurance your whole life (such as I have), you may not realize how life-changing the ACA is.  It has taken me seeing it through the eyes of my patients to realize this. I hope that sharing my side of things has helped others see the benefits of the ACA.

Here’s a great link about the ACA and Naturopathic Medicine: http://www.bastyr.edu/news/general-news-home-page/2013/01/health-care-reform-extends-reach-naturopathic-medicine

Sweeteners: the good, the bad and the ugly

Sugar

 

Let’s talk about sweeteners.  First of all, it deserves mentioning that the average American consumes 60-100 pounds of sugar per year (numbers vary according to the source).  This is a drastic increase over the past 200 years, from approximately 18 pounds per year. Obviously, humans like the taste of sugar.  It doesn’t take much extrapolation to associate the increase in sugar consumption with the increase in obesity and diabetes, among other health problems.  It’s also easy to assume that the increase in available processed foods and drinks have made this easier to attain.

Of course, no sweeteners are good for you in large quantities, but let’s minimize the harm.  I hope you already know that natural sweeteners are the only way to go.  Honey and maple syrup are the best, because they don’t need to be processed to be good.  They are naturally sweet and don’t require chemical modification.  They can be used in almost any recipe that calls for sugar (you may need to adapt the other liquid ingredients).  Other great sweeteners include fruit purees, dates and other dried fruits or juices.

Here’s a breakdown of the bad stuff:

White sugar is a highly processed product from sugar cane.  Brown sugar is just slightly less processed, containing more of the natural molasses.  Molasses is just what comes out of processing sugar cane to make white sugar (molasses actually has some nutritional benefits, unlike white and brown sugar which have miniscule to NO nutrition).  High fructose corn syrup (HFCS) is a chemical experiment that is 40-55% fructose (fruit is naturally 0-20% fructose).  It is known to be a major contributor to obesity- do not consume it.  Agave nectar is just as processed and bad for you as high fructose corn syrup.  It actually has more fructose than HFCS, at a whopping 55-90%!  If you own it, throw it away.

Artificial sweeteners like Splenda, NutraSweet, and Equal are chemicals that trick your taste buds into thinking that there is something useful like sugar coming down the tube. Therefore, your body gets all excited for it but then nothing comes of it.  Your gut and liver have to break down these strange chemicals and they don’t know what to do with them.  There have been many studies linking bladder cancer to these sweeteners.  Do NOT use them.

Stevia is a “natural” sweetener, but is rather processed to be in form that is useful.  Have you ever tasted it and noticed the strange aftertaste?  It’s the best out of the other processed sugars, but… Why?  Just use fruit, honey or maple syrup for those times that you want something sweet.

If you have ever tried to completely avoid sugar, you know how hard it is.  It is in products that you would never expect.  Also, taking it away creates a strong desire for it, just like an addiction.  Although it’s not easy to give up, once you do you will realize that you do not need it. You will also notice how excessively sweet everything is! You will be all the better for it.

 

{Disclaimer: this is not considered personal medical advice, and you should speak with a physician before making diet and lifestyle changes. I’m happy to be that physician; all you need to do is schedule an appointment with me}

How to get better sleep

Sleep is the arguably the most important part of the day, and it is also a huge struggle for so many people.  It has been shown that during sleep our bodies take time to repair damaged tissues and combat inflammation, as well as have a much needed break from digesting new food.  Without proper sleep, your body won’t have proper time to heal and repair.  People suffering with chronic pain, chronic fatigue, mood disorders, alzheimer’s, diabetes and other conditions would benefit greatly from this optimal time of healing.  It is also essential for athletes, whose activities could cause minor injuries or aches and pains.  It is in your best interest to do all that you can to control your sleep cycle.  Feeling rested with energy is such a fabulous way to start the day!

Here are some tips for how to get that snug-as-a-bug-in-a-rug, fulfilling sleep:

–   Go to bed and wake up at the same time every day.  This is optimal, and occasionally unattainable.  Do your best.

–   Sleep in a completely dark room (no cracks under the door, no glowing alarm clock, use light-blocking curtains)

–   Save the bedroom for sleeping and intimate activities only (no working or homework). On that note, do your best to make your room a sanctuary for sleep.  Make it clutter free, relaxing colors and sounds, comfortable temperature, etc.

–   No use of glowing electronics for 1 hour before bed (phone, tv, tablet, computer). The blue light stimulates your pineal gland, which tricks your body into thinking that it is not nighttime.

–   No eating within an hour of bedtime, and no caffeine after 12pm.  As stated above, sleep is  a time of digestive rest.  Unless you have a medical condition that requires otherwise, try to go to bed with a slight sensation of hunger (*weight loss tip!).

–   Avoid the excessive alcohol intake, especially before bedtime.  Alcohol raises your cortisol, which will keep you up at night.  If you do fall asleep, it will be less restful than if you didn’t have alcohol in your system.

–   Exercise or get some vigorous movement going within an hour of waking in the morning.  This gets your cortisol pumping, which is what should spike in the morning to get you out of bed.  By having a regular morning workout routine, you will encourage the cortisol burst to occur on its own before you even get up.  (*also a weight loss tip!)

–   If you cannot fall asleep after 30 minutes, get out of bed and read or do something relaxing for 30 minutes (don’t turn on the TV or computer!). Then try again.

If these tips do not help set your circadian rhythm within a few weeks, you may need a little help from our botanical, nutritional or pharmaceutical friends.  Commonly recommended supplements include melatonin, phosphatidyserine, chamomile, valerian, passionflower, kava kava, and hops.  These are all great and have their roles, but chronic use of some of these could have side effects.  Please consult a physician if you need help with choosing a sleep aid and the proper dosages.  Also, if you have an opposite sleep schedule (working nights and sleeping days), you are also a special situation and should seek a physician’s advice.  Did you know that working a swing/graveyard shift puts you at greater risk of many diseases?  It’s best to only work these hours for a limited time if possible.

Please contact me with any questions or comments. Happy sleeping!

5 Tips for Staying Healthy During the Holidays

1.   Keep to a healthy diet, but don’t obsess
-Don’t go to parties hungry! This will result in way too many appetizers and overfilling of the plate.  Have a healthy snack or smoothie before you go.
-Every meal should consist of half a plate of vegetables. This will keep your digestion moving and lower your calorie count.
-Indulge a little bit.  The holidays are about celebration, so go ahead and have a piece of grandma’s pumpkin pie.  But just one.  Consider prepping yourself with digestive enzymes or taking a teaspoon of apple cider vinegar before meals.

2.   Move your body EVERY DAY
-Keep to your exercise routine as much as possible.  The holidays are a time for exceptions, but don’t make this one of them.
-Get your family moving!  How about proposing a family walk after dinner? Or a touch football game in the park?  Or joining in on that local 5K run?
-If you can’t get anyone else to join you and you can’t get to the gym, do yourself a favor and do some fun exercises for 20 minutes in your home: burpees, situps, plank holds, jumping jacks, karate kicks, running the stairs, whatever you can think of!

3.       Solid sleep schedule
-Try to maintain a schedule of going to bed and waking up at the same time every day.  Optimally, this is from 10pm to 7am.  There will be blips, but make a conscious effort to make this happen!
-Too amped to sleep?  Limit caffeine to 1-2 cups BEFORE noon.  Don’t over-indulge on alcohol, and don’t drink later than an hour before bedtime.
-Exhausted in the morning? Get your cortisol pumping right away by getting in your daily movement!

4.       Mental health time
-This is very important.  Take time for yourself during the craziness.  Spend at least 15 minutes a day on yourself, whether that is meditating, taking a bath, praying, napping or simply walking.
-Take a moment to be thankful for all that you have, every day.  The holidays are a special time for reconnecting with friends and family, family traditions, letting go of grudges, and acknowledging the passing time.

5.       Natural immunity boosters
-Have an arsenal on hand.  Most people could benefit from taking a daily probiotic, vitamin D, and a multivitamin/mineral.  Brands I like: Integrative Therapeutics Probiotic Pearls, Genestra D-Mulsion 1000, and Innate Response One Daily Cap. {I have no financial affiliation with any of those products}.
-Contrast hydrotherapy: alternate hot and cold water in the shower (ex: 1 min hot, 10 sec cold, repeat 3 times).  Always end on cold.  This stimulates your circulation and causes your immune system to fire up.
-Wash your hands! Use soap and water to wash your hands several times per day, especially after being in public spaces and before eating.  No need for antimicrobial soaps, just regular soap is the best!

{Disclaimer: this is not considered personal medical advice, and you should speak with a physician before making diet and lifestyle changes. I’m happy to be that physician; all you need to do is schedule an appointment with me}

Diabetes and Blood Glucose Stabilization

Diabetes is a prevalent condition throughout the world, but is becoming much more so in the United States and other western countries.  The increase is partially attributed to better diagnostic methods, but unfortunately the “western lifestyle” is also to blame.  The CDC reports that 8.3% of the US population has diabetes, and almost 2 million adults are diagnosed every year.

There are several types of diabetes and blood glucose imbalances, outlined below.  Some people do not have a diagnosis of diabetes but are considered pre-diabetic, hyperglycemic, or hypoglycemic.  Much of the information below can be useful for any type of blood glucose disorder.

  • Type I diabetes is an autoimmune condition, often diagnosed in youth.  In a typically short period of time, the pancreas will stop making insulin and the patient must inject it.
  • Type II diabetes is generally more gradual and occurs in adulthood, and is often a result of diet and lifestyle factors. If caught early, it can sometimes be reversed or halted with treatment. Pre-diabetes is the very early stage of this disease.
  • Type 1.5 diabetes is a combination of the above two types.  It often begins in late childhood or adulthood, and has an autoimmune component as well as lifestyle component.
  • Glucose stabilization issues: this is a catch-all term to include hyperglycemia and hypoglycemia, episodes of low or high blood glucose.  These are often described symptomatically with dizziness, lightheadedness, low energy, fatigue, decreased athletic performance, and food cravings.  Although difficult to diagnose, diet and lifestyle changes can make dramatic improvements.

Tips for stabilizing your blood glucose:  Diet and lifestyle changes can be incredibly effective!

Physical activity: A mix of aerobic and resistance training is the most effective.  Studies have shown that high intensity interval training works well.  This type of exercise is quick, easy and doesn’t require any special equipment.  Plus, studies have shown that just 150 minutes of physical activity per week lowers the risk of diabetes (that’s only 22 minutes per day!).

Diet:  There are a ton of studies on what to eat and what not to eat with diabetes or blood glucose issues.  I’ve found that it’s not just what you eat, but how you eat that affects your blood glucose the most. These are the tips that I find are most successful for my patients:

  • Follow the anti-inflammatory diet guidelines as much as possible (see last post)
  • Protein, Fat and Fiber at EVERY MEAL!
  • Eat a small portion every 4 hours during the day
  • Do not eat at least an hour before bedtime
  • AVOID: high fructose corn syrup, trans fats, soda, energy drinks
  • MINIMIZE: baked goods, corn, alcohol, caffeine

Nutritional and botanical medicine:  Many individual nutrients have been studied rigorously and determined to be helpful with blood sugar stabilization.  Although most of these nutrients are part of a healthy daily diet, some are notched up to therapeutic doses.  Botanical therapies are used regularly in Naturopathic Medicine.  Discuss these with a physician before beginning;  to find healthy and safe doses tailored to you.

  • Chromium: improves insulin sensitivity, central obesity, and glucose control
  • Vitamin D: Supplementation improves insulin sensitivity and reduces inflammation
  • Magnesium: Deficiency independently associated with the development diabetes. Supplementation lowers fasting blood glucose
  • Botanical therapies: Curcumin/turmeric, fenugreek, bitter melon, berberine/Oregon grape are used to lower blood glucose.

{Disclaimer: this is not considered personal medical advice, and you should speak with a physician before making diet and lifestyle changes. I’m happy to be that physician; all you need to do is schedule an appointment with me}

References:
National Diabetes Fact Sheet.  CDC.  http://www.cdc.gov/diabetes/pubs/factsheet11.htm

The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Herman WH, Hoerger TJ, Brandle M, Hicks K, Sorensen S, Zhang P, Hamman RF, Ackermann RT, Engelgau MM, Ratner RE; Diabetes Prevention Program Research Group. Annals of Internal Medicine 2005 Mar 1;142(5):323-32.

Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes. Gillen JB,  Diabetes Obes Metab. 2012 Jun;14(6):575-7. doi: 10.1111/j.1463-1326.2012.01564.x.

Blood sugar and insulin stabilization. Pizzorno, J. Presentation from 11/2012.

What is the optimal diet?

This might be the hottest health question today, and for good reason.  The human race facing new and worrisome health statistics concerning cardiovascular disease, obesity, cancer, and autoimmune diseases.  These health concerns have been present for generations, but their likelihood is undoubtedly increasing.  The rise of these issues cannot be attributed to one single factor.  The changes to our food system (genetic engineering, pesticides, food importation), air/soil/water pollution, and public health practices are just some of the issues that may be contributing to the rise in these conditions.

So what can you do?  The best things you can do for yourself is to minimize your risk and exposure.  One way to do this is to abide by the Anti-Inflammatory Diet.  There are many versions of this diet, but I have compiled the most evidence-based version for you, below.  If you have any questions, comments or concerns, please contact me.  Other ways to minimize your risk include using responsible health and beauty products, aiding your body’s methods of detoxification, and maintaining a healthy home (future articles to come!).

{Disclaimer: this is not considered personal medical advice, and you should speak with a physician before beginning a new diet. I’m happy to be that physician, all you need to do is schedule an appointment with me}

Anti Inflammatory Diet HANDOUT