I recently had an emotional experience that most women can relate to, although not too happily during some times of the month. I cried, laughed, sighed, and got angry-- in a matter of a two hour span. Thankfully, this wasn't related to a hormonal shift, but rather my virtual transportation into Julie Robert's world on the big screen. That's right ladies; I saw the latest film, "Eat, Pray, Love".  (Ok, men, stay with me here, it will give you some insight into the inner workings of the women you love, including your sisters, nieces, and mom).

The movie portrayed a stereotypical relationship-addicted female who ends up finding her true self through a one year excursion to re-igniting pleasure in Italy, finding peace and faith in India, and balance in Bali. I know, many of you are thinking, "I'd be able to find pleasure, peace, faith and balance if I could get away for a year and travel the world too."  In fact, many of you may have heard me make reference to an all expense Sandals Resort get-away as a cure?  I'm not joking when I say this. See, here's the deal, you don't have to travel the world; although it can helpful, in order to find what is already inside your body-the most powerful chemical producing factory that affects your health.

Our body releases an inordinate amount of chemical mediators to run our functions daily. In fact, it is estimated that number of one form of enzymes, protein kinases which are involved in biochemical pathways to signal changes in gene expression, protein activity, and various biological responses, is 518, about 1.7% of all known human genes. This is only one class of enzymes that make up your body! There are many others. Furthermore, your cells are exposed and interact with dozens of substances everyday including nutrients, sex and stress hormones, inflammatory mediators, and neurotransmitters.

How does this subject relate to Naturopathic and Functional Medicine, and what happened to Dr. Sarah's long list of references (don't worry, scroll down)? The more time I spend with people, and the more I study the effects of stress, the more I am convinced that stress is not just a contributor to many disease processes or symptomology, but also triggers and potentiates various issues.

According to last year's gallup poll, the percentage of Americans experiencing happiness without significant worry declined slightly from an average of 48.2% in 2008 to 47.4% in 2009. Furthermore, the inverse increased, meaning more Americans are stressed and less happy. What does this entail?

We know that obesity is at an all-time high. Stress has been shown to contribute to insulin resistance, the precursor of diabetes and a major contributor to weight gain. Stress causes an increase in catecholamines, such as adrenaline, which prolong the effects of the stress hormone cortisol, down-regulating hormonal response and affect the emotional center of the brain, leading to mood disorders.

According to webmd, depression can contribute to various physical symptoms from low libido to insomnia. Furthermore, "Major depression may directly damage the part of the brain associated with learning and memory via inflammation or the release of stress hormones."  This can lead to the snippy, irritable, impatient, angry road rager who has a higher risk of cardiovascular disease and high blood pressure.

Furthermore, we know that chronic stimulation of the stress response, down-regulates the immune system, making you more susceptible to infection, affects the digestive processes by affecting absorption and toxin removal, and can cause weight gain! (Remember the non-stressful eating paradigm of the French)?

So, back to my take on the movie....women and men are affected by stress and emotions differently, and for women who have more hormonal pathways at play, mood ups and down can be overwhelming at times of stress. Still, it's vital for us to be aware of how stress affects us and use tools to modulate its effect.

I like to incorporate EFT, emotional freedom technique, deep breathing, and self-care practices in my protocols with my patients. However, the most important thing about stress to keep in mind, that this film summarized well, is that when our problem rests manly in our perception, and we lose our perspective, it's important to come back to center and realize that ultimately, we hold the key to our own choices for health, including emotional, and spiritual.        

 

References:

Jones, D. Textbook of Functional Medicine. 2005. WA. IFM

Witters, D. http://www.gallup.com/poll/124904/americans-less-happy-stressed-2009.aspx. January 2010.

Wales. Diabetic Medicine. Volume 12 (2):109-112. Published Online: 30 Jul 2009.

Hudson, T & Bush, B. The Role of Cortisol in Sleep. NMJ June 2010.

Webmd

http://www.webmd.com/depression/how-depression-affects-your-body?ecd=wnl_dep_052110

http://www.webmd.com/depression/news/20100706/late-depression-linked-alzheimers?page=2

Horm Behav. 2010 Mar;57(3):276-83. Epub 2010 Jan 4. PMID: 20045413 

 

 

 

 Ok, now, after all that sweating over trying to make a decision on which technique to choose (see my previous blog), your poor brain is fried. So, now you are trying to decide what your next move (pun intended) should be to alleviate this annoying brain fog. (Darn information overload!)

Pausing between your racing thoughts, you remember your last consult with Dr. Sarah, "Are you eating protein, carbs, and fats together to balance your blood sugar? That will help with everything, you know. See, high blood sugar raises insulin, and insulin modulates cortisol, blah, blah, blah..... affect your hormones and weight." Ok, you didn't get it completely the first time with those scientific pathways, but you got the idea.

So, feeling pretty proud of yourself, you walk at a fast pace (holding your pulse, of course), to the refrigerator and smiling, pull out your organic, PLAIN (ughh), Stonyfield yogurt. You put a scoop of organic almond butter in it, and top it off with a fresh handful of organic berries. Then, you sit at your computer content. To top off your excitement, you find that Dr. LoBisco's latest blog was just posted. Imagine your feeling of serendipity when you read the following:

Great news for helping the brain! As most of you are aware, a healthy diet and healthy mind go together. A recent article from Science Daily reports how the polyphenolics in berries can help make your brain new and shiny!

In the new research, Poulose and Joseph focused on another reason why nerve function declines with aging. It involves a reduction in the brain's natural house-cleaning process. Cells called microglia are the housekeepers. In a process called autophagy, they remove and recycle biochemical debris that otherwise would interfere with brain function.

"But in aging, microglia fail to do their work, and debris builds up," Poulose explained. "In addition, the microglia become over-activated and actually begin to damage healthy cells in the brain. Our research suggests that the polyphenolics in berries have a rescuing effect. They seem to restore the normal housekeeping function. These findings are the first to show these effects of berries."

Poulose said the study provides further evidence to eat foods rich in polyphenolics. Although berries and walnuts are rich sources, many other fruits and vegetables contain these chemicals ― especially those with deep red, orange, or blue colors. Those colors come from pigments termed anthocyanins that are good antioxidants. He emphasized the importance of consuming the whole fruit, which contains the full range of hundreds of healthful chemicals. Frozen berries, which are available year round, also are excellent sources of polyphenolics, he added.

Another reason for the powerful effects of berries on the brain could be due to their ability to act as antioxidants, which in turn regulates inflammation and blood sugar. In fact, resveratrol, an antioxidant compound found in many berries, was shown to increase cerebral blood flow, according to the American Journal of Nutrition:

Results: Resveratrol administration resulted in dose-dependent increases in cerebral blood flow during task performance, as indexed by total concentrations of hemoglobin. There was also an increase in deoxyhemoglobin after both doses of resveratrol, which suggested enhanced oxygen extraction, that became apparent toward the end of the 45-min absorption phase and was sustained throughout task performance. Cognitive function was not affected. Resveratrol metabolites were present in plasma throughout the cognitive task period.

Conclusion: These results showed that single doses of orally administered resveratrol can modulate cerebral blood flow variables.

How does this relate to blood sugar? Well, according to Vitalchoice, "The Greek scientists also noted the well-established fact that higher intakes of food-borne antioxidants are linked to lower markers of inflammation. Furthermore, in the same article, it is reported that:

Recent studies suggested that oxidative stress - that is, excessive free radical production - appears to promote diabetes. Pancreatic cells, which produce insulin, are particularly susceptible to free radicals due to their low levels of antioxidant enzymes.

By damaging the mitochondria (energy centers) of pancreatic beta cells, oxidative stress can kill these critical cells, thereby blunting insulin secretion and allowing blood sugar levels to stay chronically high.

.....So, now you're feeling pretty good about yourself, or at least you're not hiding when you walk in front of a mirror. Satisfied with your snack, content with your "workout", and ready to relax, you do your deep breathing exercise and looking forward to another helpful blog which further portrays just how much you already know!

References:

Science Daily: http://www.sciencedaily.com/releases/2010/08/100823142927.htm?osadcampaign=PRFFF082710&leadsource=PRFFF082710

Webmd: http://www.webmd.com/healthy-aging/news/20100823/berries-may-slow-mental-decline-from-aging?ecd=wnl_hrt_083110

Am J Clin Nutr (March 31, 2010). doi:10.3945/ajcn.2009.28641

Vital Choice: http://newsletter.vitalchoice.com/e_article001687290.cfm?x=bgDM4hs,b1h0JlRD

 

I've written in the past of the many important benefits of exercise. Exercise plays a pivotal role in brain health, mood balance, stress relief, heart health, weight control, blood sugar balance, and joint health.  

Here's the simple fact: almost everyone knows that diet and exercise increase longevity and aid in overall health, yet very few people actually adapt these practices that encourages the body's innate healing response (see my website for the latest research on food constituents and health).

I think one of the main reasons for this discrepancy of knowledge and follow through is that people are already stretched for time and trying to figure out the correct exercise for you can become a headache waiting to happen--I mean it's information overload, people! 

Sigh... all these "trends" in exercise. First in the 80s, it's Jane Fonda, high tops, big hair, and sweat bands. In the 90s, were told that's not enough and we start to inch our way into the intimidating weight bearing machine exercises, which look like contraptions derived from outer-space! Then, in the age of technology,  who can keep up....it's burst training and bare foot, it's walking and yoga, it's running a marathon then falling down with joint pain, it's.......ughhh!!!

If you weren't stressed out already, boy would you be by the time you get to the gym and start to analyze the scene. You try to determine if you should hit the pool (good for the joints, right?), join the kick boxing class vs. spinning class, or push that muscle head out of the way for the thigh cruncher and....didn't your naturopath say to do some burst training and to burn fat with weight lifting, and isn't the pool filled with toxic chlorine that kills your thyroid??!!

You haven't even taken a step, and your heart rate has already gone through the roof. Your heads spinning enough to make you turn around, sweat bands and all, and stomp out the gym door (of course you're measuring that your heart rate doesn't exceed maximum fat burning capacity as you do this!).

Furthermore, now, not only do you have to worry about what to do, but what to do after. Exercise, can increase oxidative stress, according to some studies , and by now you are sweating from your venture forth and forgot to remember  to take your gogi berry juice and alpha lipoic acid after you've burst trained. Great, now your muscles are eating themselves, you're hungry and irritable and were you supposed to drink that whey pro before or after?? Do you add the fat and peanut into the shake or where you supposed to just do strict carbs to increase insulin resistance sensitivty, or was that protein?  What increased fat burning vs. weight gain....AUGGGHHHHHHHHHHHHHHHH. 

Then, this whole thing with adrenal stress! You consider yourself definitely burned out, so you are advised now to do gentle stretching and breathing exercises to get rid of that pot belly insulin resistance stomach, when what you really want to do is grab your running shoes and sprint around the block pushing away any innocent bystander who happens to get in your way!!

Ok, ok, enough with the detailed description. Here's where your trusty Naturopathic Doctor and Integrative Medical Specialist comes in. Good news. It's about bio-individuality, what works for you, what your body is signaling, and the results you're getting!

Recent research has showed that even light activity aids in overall health:

CONCLUSION: Being physically active reduces the risk of all-cause mortality. The largest benefit was found from moving from no activity to low levels of activity, but even at high levels of activity benefits accrue from additional activity.

So, at least move your buns around the block, maybe throw in a few sprints, and then run (maintaining your fat burning threshold heart rate) to your nearest integrative practitioner that can help you decode your body's signals, bio-chemistry, and what is optimal for you...if that doesn't cause more stress....which increases weight....which.....

Hope I made you smile!!

In health,
Dr. Sarah J

 

References:

Proceedings of the Society for Experimental Biology and Medicine. Volume 222, Number 3 Pp. 283-292.

International Journal of Epidemology. http://www.ncbi.nlm.nih.gov/pubmed?term=%22International+journal+of+epidemiology%22%5BJour%5D+AND+2010%5Bpdat%5D+AND+Woodcock%5Bauthor%5D&cmd=detailssearch

Science Daily:http://www.sciencedaily.com/releases/2010/07/100723112713.htm

 

 

 

Weight loss, a hardy topic. No pun intended. Recently, vitalchoice published an article regarding the intake of omega 3s vs. omega 6s on weight loss. In a one woman's self-inflicted trial, the theory that high omega 3 intake is related to healthy weight and high omega 6 intake causes weight gain, was put to the test. For one month, Susan Allport replaced her usual omega 3 rich diet to a more omega 6 containing one. This one-women-experiment was based on the following theory:

Omega-3s and omega-6s compete for positions in our cells, as scientists have known since the 1950s, such that anyone consuming a diet too rich in omega-6s (and that would be me) would have fewer omega-3s in all of her tissues - no matter if she continued to eat fish.  

Americans consume 10 times as many omega-6s as they do omega-3s, according to the Agricultural Research Service. And it is that imbalance - not the amount of fish we eat--that is causing us to be deficient in omega-3s, the scientists who study these fats realize. A healthy balance is on the order of 4:1.

What did this experiment entail? In Susan's words:

To the casual observer, the foods in my experimental diet would look just like my normal fare: lots of whole grains, nut butters, vegetables, fruits, lean meats, fish, and salads. But they would differ in a small way that I, and a growing number of scientists, know to be very important: the fats I would cook with; the oils I would dress my salads with would be vegetable (or seed) oils that are very rich in omega-6s, oils such as safflower, sunflower, corn, and soybean oil, oils that constitute most of the added fats in the American food supply.

 

AND....the results..... 

Yes, my weight was almost the same, but what weight I had gained - 5.6 ounces or just under half a pound - was almost entirely fat and in my abdominal area, as the follow-up body scan showed - exactly as I had experienced it. Just as interesting, and the cause, perhaps, of this gain, was that my resting metabolic rate had fallen, by an intriguing five percent. This drop was within the day-to-day variation for this test (6.2%), but it was in the direction predicted by the diet and the magnitude to explain my small gain in weight. 

Final conclusion....

High omega 6 intake is related to inflammatory fat, the very kind that has been linked to various chronic diseases. 

Other studies show the connection between high omega 6s and weight gain. Gaining weight on omega 6s was reported in an article from the Journal of Lipid Research as follows:

The prevalence of obesity has steadily increased over the last few decades. During this time, populations of industrialized countries have been exposed to diets rich in fat with a high content of linoleic acid and a low content of alpha-linolenic acid compared with recommended intake. To assess the contribution of dietary fatty acids, male and female mice fed a high-fat diet (35% energy as fat, linoleic acid: alpha-linolenic acid ratio of 28) were mated randomly and maintained after breeding on the same diet for successive generations. Offspring showed, over four generations, a gradual enhancement in fat mass due to combined hyperplasia and hypertrophy with no change in food intake. Transgenerational alterations in adipokine levels were accompanied by hyperinsulinemia. Gene expression analyses of the stromal vascular fraction of adipose tissue, over generations, revealed discrete and steady changes in certain important players, such as CSF3 and Nocturnin. Thus, under conditions of genome stability and with no change in the regimen over four generations, we show that a Western-like fat diet induces a gradual fat mass enhancement, in accordance with the increasing prevalence of obesity observed in humans.

Translation:

It's more than calories in verses calories out! Food is information and how we respond is not doomed to the "slow down of metabolism as we age", but rather how we use food to communicate to our body. Here enters the science of epigenetics and nutrigenomics....and...Functional Medicine.

In fact, an abstract from the British Journal of Nutrition reports the following:

The prevalence of obesity is reaching epidemic proportions in many industrialized countries. There is growing evidence that, even if the trigger of this epidemic is found in changes in the environment, genes are interacting with the environment to cause weight gain. Studies of twins reared apart indicate that approximately two-thirds of the variability in BMI is attributed to genetic factors. From prospective studies in Pima Indians we can ascribe 12 % of the variability in BMI to metabolic rate, 5 % to fat oxidation, and another probable 10 % to the level of spontaneous physical activity. These data indicate that at least 40 % of the variability in BMI is related to genetic factors involved in the regulation of food intake and/or volitional activity. This indicates that the most likely successful therapy for obesity may target pathways of the regulation of food intake. Similarly, an environment favoring engagement in physical activity should be promoted.

Here's my question: is it really the omega 6s or bio-individuality and epigenomics? (Remember Bruce Lipton's connection the fatty cell membrane and the "brain" of the cell?) 

After doing functional testing and following results with the blood type diet, I've seen plenty of thin people who eat twice as much as their overweight counterparts.

Our society is becoming obsessed with finding the "perfect diet", and I have to say, as a Naturopathic Doctor, I too have made the same mistake, with myself and my patients. BUT, now, with what I've learned through experience and studying various nutritional theories, I'm happy to report that long term weight loss is not about the "perfect diet", cutting this and cutting that, restricting this, and adding that...it's more than that, and easier! It's about finding what works for you, and feeding your body healthy communication signals! 

I've blogged in the past about epigenetics, the power of the mind, and nutrigenomics. I'm now applying this in my clinical practice and the results are exciting.... I may have to write a book!

What does this mean? Most people know what's good for them to eat; they've just been trained out of it. Emotional eating is a big issue, and biochemical imbalances play a role too. Therefore, all of these factors must be part of the consideration for weight loss.

What is the take home message of the above studies for me? These individuals tested found their optimal diet for optimal weight. The use of functional tests can show what would best serve the body, and the use of integrative, holistic, body-mind medicine will do the rest!

References:

Allport, S. Vitalchoice Newsletter. August 12, 2010. http://newsletter.vitalchoice.com/e_article001842884.cfm?x=bhg1DV3,b1h0JlRD

Nutr Rev. 2010 May;68(5):280-9. PMID: 20500789

ScientificWorldJournal. 2010 May 4;10:818-31. PMID: 20454764 

Journal of Lipid Research, Vol. 51, 2352-2361, August 2010
Copyright © 2010 by American Society for Biochemistry and Molecular Biology.http://www.jlr.org/cgi/content/abstract/51/8/2352?maxtoshow=&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT 

British Journal of Nutrition (2000), 83:S17-S20 Cambridge University PressCopyright © The Nutrition Society 2000. doi:10.1017/S0007114500000908

 

 

According to C. Norman Shealy, M.D., Ph.D. the five essentials for health includes the following:

1. Positive attitude

2. Body Mass Index 18-24

3. 5 servings' fruits or veggies daily, MINIMUM

4. No smoking

5. Exercise- 30 minutes, 5 days a week

Accordingly, only 3% of Americans have all these habits and if adopted average life expectancy would increase from 78 to 100!  

As Hippocrates states:

o  If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health

Why aren't Americans taking better care of themselves? My belief is that we are living in an age of information overload and human doings, rather than embracing inspiration and human beings.

According to the 2009 Gallup poll:

The percentage of Americans experiencing a lot of happiness or enjoyment without a lot of stress or worry declined slightly from an average of 48.2% in 2008 to 47.4% in 2009...

Conversely, the percentage of Americans experiencing a lot of stress or worry but not a lot of happiness or enjoyment increased by about the same amount.

See, our fast paced lifestyles has led us to stop taking care of our souls needs and turned our attention to how to produce outcomes. It's a tough balance. I know this for myself. What this means is the old cure-all-one -magic- bullet- pill, won't work. That's because stress and lifestyle factors affect everyone differently. This cure- all-magic -bullet may actually throw you more off balance if it's not what you need!

As the father of medicine was also quoted to have said:

o  Everything in excess is opposed to nature.  

o  Extreme remedies are very appropriate for extreme diseases

I'd like to add, that when the body is chronically in a state of imbalance, it takes a lot to get it to a new set point. That's why it's so important to let someone help you decipher what is right for your individual needs. Asking for help until one has learned to tune in and trust their own wisdom again is necessary when there is so much we are up against us that prevent us to tuning in for ourselves!

Today, there's more toxins, more stress, more food manipulation, and what seems like less time. What does this mean for me, as an Integrative Practitioner? It is not just choosing the right supplement and adjusting symptoms to create a healing response. It is working with the client to teach habits that not only reverse the progression of disease but prevent future issues.  It also means  applying the knowledge that supplements not properly used could potentially harm the body. Using objective measures such as labs and reviewing symptom response questionnaires is essential to make sure the body is safely getting what it needs.

I have always been a strong proponent in bio-individuality in medicine. Most cases that have come to me, through my Naturopathic training, I am able to tune into specific causes of the dis-eases and suggest an individualized protocol. Conventional lab testing, through the client's primary care physician, case histories, and symptom analysis, provided an excellent framework, and in most cases are usually enough to ignite a change for the better.

Right now, I'm currently going through training for functional medicine. I have learned a lot through testing different individuals. This is a new, more in depth approach for me and my clients. By studying what is going on at the cellular level, I am able to determine what processes are dysfunctional before they can be labeled as diseases. It is quite exciting and definitely prevenative! Furthermore, the testing allows me to move beyond organ dysfunction and into bio-individuality regarding what supplements are best for each patient.

When a client is stuck, or just wants more information on optimal, specific recommendations, this is a tool that can analyze the breakdown in the cellular mechanics and assess what nutrients are needed to maintain longevity and health!

Hooray for more efficient tools to optimize health! If you want to learn more about functional medicine and how it stops the game of supplement roulette, please check the Institute of Functional Medicine at www.functionalmedicine.org, my name will be posted after I complete the certification in September.

 

 

 

 

This 20 minute video is very eye-opening on the politics and science behind artificial sweeteners. Like anything, "tis the dose that is the poison." Many of you are aware that I do work with neurotransmitters in my practice; therefore, the topic of consumption of artificial amino acids which affect your brain chemicals, grabs my attention. My concern is how these "excitotoxins" are affecting health, not just physically, but emotionally, where disease can be perpetuated (see my past articles on stress and disease).

The two amino acids that make up nutrasweet/equal aka aspartame, cause an increase in excititary signals to the brain. This can downregulate other calming neurotransmitters and even deplete hormones. (For example, phenalyanine, one component, is a precursor to catecholamines and thyroid hormone.)

Not only can artificial sweeteners affect biochemistry, they can also cause harmful side effects. Here is a link to my website which lists some published research documentation on the side effect of these exicto-toxins.

Therefore, my advice is to use stevia or xylitol. Both are beneficial to health, blood sugar, and bones and are very safe. For that sugar craving, sip on 2 oz of braggs apple ciear vinegar in 8 oz water, 2 T of xylitol, and 3 drops of lemon essential oil, as bitters decrease sweet cravings. If you don't like it that bitter, you can always adjust the vinegar portion. Either way, protect your brain and your health, by avoiding these products whenever possible.

Here's to a sweet, natural, life! :)

 

It's the buzz word for all the magic pills and potions. When unchecked, it's the underlying mechanism for most chronic diseases and the reason why long-term stress contributes to so many of them. Know what it is? It's inflammation. This means that your chronic red, hot, joint could be signaling an underlying process that is spreading throughout your whole body. How?

A recent article in July's Integrative Practitioner by Lise Alschuler, ND, FABNO sheds light on how inflammation contributes to the other symptoms that seem to pop up more with your chronic joint pain (fatigue, digestive disturbances, ect.):

Chronic inflammation is a complex prolonged internal response to a tissue insult. This response involves the immune and endocrine systems.  The initial tissue insult results in a massive release of powerful chemical messenger molecules (cytokines, enzymes, interleukins and prostaglandins). These chemicals stimulate specific activities such as blood vessel growth and also bind to cellular membrane receptors and create cell division and anti-apoptotic signals. A powerful mediator of these reactions is nuclear factor kappa  B (NF-kB). NF-kB engages the inflammatory response, stimulates cell division, alters immunity and decreases apoptosis.

Huh, Dr. Sarah? In English- an inflammatory response triggers a massive release of chemicals that can enter the body systemically. If your body doesn't have the resistance to put out the fire, these mediators could damage various organs, tissues, and cause changes in our DNA structure (cancer).

How do we control inflammation? What could prevent our resistance and cause low immunity? Stress is a big factor, along with many other environmental and lifestyle choices. The stress mechanism signals a whole array of events from inflammatory mediators, blood sugar deregulation, hormonal imbalances, changes in digestive processes and circulatory functions.

According to the American Institute of Stress, stress contributes to 70-90% visits to primary care doctors and the American Psychological Association reports the following:

More than half of working adults-and 47 percent of all Americans-say they are concerned with the amount of stress in their lives, according to a new telephone survey conducted...Moreover, the survey finds that people experiencing stress are more likely to report hypertension, anxiety, depression or obesity.

Here is a review on some of these conditions associated with chronic inflammation (and probably linked to stress):

The American Heart Association- Heart Disease

C-reactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It's been suggested that testing CRP levels in the blood may be an additional way to assess cardiovascular disease risk. A more sensitive CRP test, called a highly sensitive C-reactive protein (hs-CRP) assay, is available to determine heart disease risk.

Circulation Journal

A role for inflammation has been well established over the past decade or more in describing the artherogenic process.

Neurobiology Aging Journal [abstract] - Alzheimer's disease

Thus, animal models and clinical studies, although still in their infancy, strongly suggest that AD inflammation significantly contributes to AD pathogenesis. By better understanding AD inflammatory and immunoregulatory processes, it should be possible to develop anti-inflammatory approaches that may not cure AD but will likely help slow the progression or delay the onset of this devastating disorder

 

Nature Journal [abstract] - Cancer

Recent data have expanded the concept that inflammation is a critical component of tumour progression. Many cancers arise from sites of infection, chronic irritation and inflammation. It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival and migration. In addition, tumour cells have co-opted some of the signaling molecules of the innate immune system, such as selectins, chemokines and their receptors for invasion, migration and metastasis. These insights are fostering new anti-inflammatory therapeutic approaches to cancer development.

 

European Journal of Endocrinology [abstract]-Metabolic Syndrome & Hormonal Effects

Low testosterone and SHBG levels were strongly associated not only with components of the metabolic syndrome, but also with the metabolic syndrome itself, independently of body mass index. Furthermore, sex hormones were associated with inflammation and body iron stores. Even in the absence of late-stage consequences such as diabetes and cardiovascular disease, subtle derangements in sex hormones are present in the metabolic syndrome, and may contribute to its pathogenesis.

 

So, my beautiful patients, you now know why the mind-body approach is so important. It's not so much the event, but our perception and reaction that contribute to stress. So what do we do about this? Here are some simple tips to quench inflammation and calm the stress response:

1.      Eat real, whole, organic, unprocessed foods.

2.      Exercise in a way that is enjoyable for you

3.      Drink plenty of filtered water to dilute toxins

4.      Take a good multivitamin (see my webpage on supplement quality) and any lacking nutrients in your diet.

5.      Supplement your many colorful vegetables with spices which down-regulate inflammatory mediators.

6.      Most importantly, breathe and find relaxation therapies that work for you, such as yoga, deep breathing, or google techniques from the heartmath institute.

7.      Get sleep

 

 

References:
AHA. http://www.americanheart.org/presenter.jhtml?identifier=4648

Circulation. http://circ.ahajournals.org/cgi/content/full/107/3/499

Neurobiology and Aging. PMID: 108586

Nature. 2002. http://www.ncbi.nlm.nih.gov/pubmed/12490959

America's No. 1 Health Problem. American Institute of Stress. http://www.stress.org/americas.htm.

Brain and Cognition. Volume 65, Issue 3, December 2007, Pages 209-237

The American Psychological Association. Stressed out Nation. http://www.apa.org/monitor/apr06/nation.aspx

European Journal of Endocrinology. 2003.  http://www.eje-online.org/cgi/content/abstract/149/6/601

 

Literally....approximately 12% of Americans suffers from migraines, and about 20-40% experience insomnia. Recently, a connection between headaches and sleep has been revealed, making yet another reason, (besides brain health, memory, longevity) to get some shut-eye.

 

Many people who are interested in Health Care Reform and Integrative Medicine are familiar with Gary Null's  publication, Death By Medicine, a compilation of various studies on the state of healthcare statistics in the US. This publication, which cites references for estimated costs, death rates, and unnecessary medical events, concludes the alarming statement that American medicine causes more harm than good.

For example, the article listed the following conditions with their estimated rates of mortality:

Adverse Drug Reaction
Medical error  
Bedsores  
Nosocomial Infection
Malnutrition  
Outpatients
Unnecessary Procedures
Surgery-related
Total 7,841,360  

The conclusion was, "Our estimated 10-year total of 7.8 million iatrogenic deaths is more than all the casualties from all the wars fought by the US throughout its entire history." Yikes.

A June 2010 report by the Commonwealth Fund echoed this disconcerting news on the state of  US healthcare. The Commonwealth Fund is a private organization advocating for a "high performance health care system providing better access, improved quality, and greater efficiency."  The Fund supports independent research on health care issues and grants to improve health care quality, access, and an international program in health policy.

The 34 page report released in June 2010 read:

EXECUTIVE SUMMARY
The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from the most recent three Commonwealth Fund surveys of patients and primary care physicians about medical practices and views of their countries' health systems (2007-2009), confirms findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the most recent (2008) U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.

Among the seven nations studied--Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States--the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by the U.K. and Australia. The 2010 edition includes data from the seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.

The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014.

Key Findings were listed for quality of care, access ( we ranked bottom three), efficiency (last place), equity (last place), and quality of life (last place).

Depressing news, isn't it? Or is it? Despite some of the negative press around doctors and health care, I never cease to be amazed at the absolute dedication and brilliance across all forms of specialties in medicine and the doctor's dedication to do what is best for the patient.

As a Naturopathic Doctor and Integrative Medical Specialist, I admit the obvious difference in my viewpoint on how to treat certain conditions and the importance of treating the cause, but I still hold the upmost respect for the diagnostics and skills of doctors as a whole. Most Physicians got into the profession of medicine to help people, not to hurt them. That we are not doing well with results, allows us room to make change and the answer is now here at the forefront-integration! This is where integrative medicine, functional medicine, and naturopathic medicine shine. Instead of using the acute care model to treat chronic disease, focus is on lifestyle and diet modifications, epigenetics, and nutrigenomics, supplementation, and mind-body techniques to prevent high cost pathology to begin with.

Here's my thoughts: with these dreary statistics, maybe lack of access in the past was a self-protective mechanism? Why create more access to a broken down system that isn't producing results?

With statistics and dis-satisfaction of the current state of healthcare,  the day is coming when the focus on prevention, integration, and use of the most evidence based and clinically effective treatments (be them natural or synthetic) will be the norm.

In fact, the CDC even states the following about the leading cause of death, cardiovascular disease, "A healthy diet and lifestyle are the best weapons you have to fight heart disease. Many people make it harder than it is."

Furthermore, various journals are reporting the same conclusion:

Ford ES, Bergmann MM, Kroger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-1362.

Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-952.

INTERPRETATION: Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.

And, natural products with lower toxicity are being studied more and more. For example, the following was reported on breast cancer and the use of fish oil in a recent article from vitalchoice.

So the results of a very large epidemiological study from Seattle's Fred Hutchinson Cancer Research Center are making headlines worldwide.
 
In short, the study showed that women who took fish oil regularly were 32 percent less likely to develop breast cancer over a six-year period (Brasky TM et al. 2010).

The Seattle team surveyed 35,016 postmenopausal women between the ages of 50 and 76, who were taking part in the Hutchinson Center's Vitamins and Lifestyle (VITAL) study.
 
The goal was to compare the women's breast health over the six year study period to their intake of non-vitamin, non-mineral "specialty" supplements.

The nearly one-third reduction in breast cancer diagnoses among fish oil users came almost entirely from a reduction in common ductal tumors ... there was no drop in the fish oil users' risk of the far less frequent lobular tumors.
 
Invasive lobular carcinomas make up a small portion of all breast cancers. The most common type of breast cancer - ductal carcinoma - begins in the breast ducts.

Further references:

Science news:

Free abstract:

Environ Health Perspect. 2000 Sep;108(9):895-900.
Identification of phthalate esters in the serum of young Puerto Rican girls with premature breast development.

In summary, one must look at what is not working in order to take inventory and sort out what is. Rather than the "throw the baby out with the bath water approach," how about let's work with the best skilled team, using everything we have and empowering people to health rather than fighting disease! The new model will also embrace a new mindset!

I try to encompass this vision everyday by empowering my clients to be their own best doctor and giving them information from both sides of medicine; conventional and integrative. I don't believe there has to be a choide. The answer isn't ALL in integrative medicine or ALL in conventional medicine, but in what's best for the patient. As one of my mentors always said, "I don't fall in love with the theory of medicine, I fall in love with the patient." Amen to that!

The Power of Anti-oxidants

I was fortunate enough to spend a lot of my time with my family and friends on the 4th. It was a great time. My very first mentor, who is an integrative chiropractor, was a wonderful surprise addition to the family gathering. I was reminded about the power of anti-oxidants when my cousin had asked me how to treat a certain allergic/chemical sensitivity skin reaction. Immediately, my mind jump started into biochemical pathways, the importance of liver detoxification and modulating phase two reactions, cleaning the diet up of triggering immune mediators such as sugar and gluten, balancing the inflammatory response with omega fatty acids, addressing blood sugar imbalances which trigger skin issues, making sure you support the body with antioxidants, etc


Well, my cousin is 14. His eyes began to glaze over as I began to discuss the liver pathways and I stopped before I headed into phase II detoxification and glutathione. This kid wanted a simple solution and quick fix. My mentor came to my rescue. He giggled as he witnessed my working brain and placed his hand on my shoulder.

"Well, with chemical sensitivities, you want to aid the body with anti-oxidants." Snap. I was jolted back into the reality of how best to treat the patient at the moment they present to you!

Although it's true that eventually people will need to address all the above areas as the route cause of what is occurring in order, my cousin is a teenage boy!

 

Using integrative and functional medicine in my practice, I've learned the importance of honoring the process of healing. For example, the steps to healing will be different for each person. For my cousin, a relatively young male, anti-oxidants and a basic supporting protocol would be the first step. The next step, once the body is supported and the symptom is addressed, it would be time to honor the healing response and work on preventing chronic disease later on. This is especially important for my younger patients. If someone at a young age is presenting with a chronic symptom, it is very important to make sure that the underlying mechanism and contributing factors are addressed so that it won't progress to something more intense down the line.

Although most people wait until the disease has progressed to do preventative work, it's important to note that for every year a disease exists, it takes 1-3 months to heal. The younger one starts, the more quickly it can be corrected and more intensive protocols down the road can be prevented.

Therefore, my lesson for the day was this-keep things simple first and takes baby steps in order to grow more healthy and strong. As I'm writing this, my beautiful baby niece just smiled in approval.

Here's some additional benefits of anti-oxidants from some of recent research- from skin to weight loss to blood sugar regulation:

 
Weight Loss and Antioxidants:

The researchers randomly assigned the subjects to one of four treatment groups. All groups ate a low-calorie, Mediterranean-type diet averaging 1,500 calories daily, containing only 25 percent from protein foods, with the rest made up of low-glycemic-index carbohydrates (carbs that do not raise blood sugar levels quickly or greatly, such as whole grains). Group A only ate this kind of diet, and group B ate the same diet plus took the drug metformin. For groups C and D, the researchers prescribed a diet enriched in antioxidant, with a calculated intake, 800 to 1,000 milligrams a day, coming from fruits and vegetables, but group D also took metformin.

Despite similar weight loss in all the groups, only the two groups receiving the antioxidant diet (groups C and D) had a significant decrease in insulin resistance, the authors reported. Group D had the best improvement in insulin resistance on some measures of insulin response to an oral glucose tolerance test, according to the abstract.

 

My comment:

Of course, with weight loss you release toxins, and your body knows this. It needs support so it will work better with release!


Antioxidants: In fish?

Abstract

Omega-3 (ω3) fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), protect against cardiovascular disease. Despite these benefits, concern remains that ω3 fatty acids may increase lipid peroxidation. It has previously been shown that urinary F2-isoprostanes (F2-IsoPs) were reduced following ω3 fatty acid supplementation in humans. It is now determined whether EPA or DHA supplementation affects plasma F2-IsoPs. In two 6-week placebo-controlled interventions, Study A: overweight, dyslipidaemic men; and Study B: treated-hypertensive Type 2 diabetic, patients were randomized to 4 g daily EPA, DHA. Post-intervention plasma F2-IsoPs were significantly reduced by EPA (24% in Study A, 19% in Study B) and by DHA (14% in Study A, 23% in Study B) relative to the olive oil group. The fall in plasma F2-IsoPs was not altered in analyses that corrected for changes in plasma arachidonic acid, which was reduced with EPA and DHA supplementation. Neither F3- nor F4-IsoPs were observed in plasma in both studies. These results show that in humans, EPA and DHA reduce in vivo oxidant stress as measured in human plasma and urine.

 

Chart of Antioxidants:

Oils and Species trump food, the power of the golgi.