Stomach pH is a Chesterton’s Fence: beware of tearing it down

Stomach pH is a Chesterton’s Fence: beware of tearing it down

G.K. Chesterton described a scenario like this:

There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence or gate erected across a road. The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”

In other words, beware of tearing down structures until you fully understand their benefit.

Chesterton’s Fence can also be thought of as the Precautionary Principle. Not following this principle led to scientific practices like frontal lobotomies or removing the entire large intestine because doctors didn’t understand the benefits of these structures or the consequences of removing them.

A narrow range of focus, i.e., this organ is causing a problem, or we don’t know why it’s here, led to drastic action that resulted in unforeseen, disastrous consequences.

I believe that such is the case with our stomach acid.

The stomach is essentially a lined bag filled with acid. Stomach pH is from 1.5 to 3.5, acidic enough to burn a hole in your shoe. However, the mucus layer of the stomach protects it from being destroyed by the acid. The acid in the stomach helps dissolve and digest the food chewed up by the teeth and swallowed.

Stomach pH is needed for breaking down proteins. Stomach acid also plays a role in absorbing minerals such as calcium, zinc, manganese, magnesium, copper, phosphorus and iron. It activates intrinsic factor, which is needed for B12 absorption in the small intestine.

Stomach acid regulates the rate of gastric emptying, preventing acid reflux.

Fast-forward to a condition called gastric esophageal reflux disease, or GERD. GERD affects about 20% of Western countries, characterized by high esophageal pH and reflux of the stomach acid and stomach contents into the esophagus. While the stomach is designed to handle a shallow pH environment, the esophagus is not. A doorway called the lower esophageal sphincter, or LES, keeps stomach contents where they should be–in the stomach.

In GERD, the tone of the LES is weak, resulting in a backflow of stomach contents. This can damage the esophagus, causing heartburn, pain, bad breath, coughing and even problems like ear pain, sore throat, and mucus in the throat. Silent reflux occurs when these symptoms occur without burning.

The symptoms occur from the stomach’s acidic contents irritating the more delicate tissues of the esophagus. So, rather than treat the root problem, i.e., the reflux, drugs like proton pump inhibitors (PPIs), H2 blockers, and buffers like Tums are recommended to reduce the stomach’s acidity.

Essentially, with GERD, we are tearing down Chesterton’s Fence to pave a road without taking even a moment to consider why the fence might be there in the first place.

About 12% of people are prescribed PPIs. They are given for GERD, gastritis, and IBS symptoms like bloating and stomach pain. Most of my patients are prescribed them for virtually any stomach complaint. PPIs, it seems, are the hammers wielded by many GPs, and so every digestive concern must look like a nail. Most people are put on them inevitably, without a plan to end the use and address the root cause of symptoms, which in most GERD cases are low LES tone.

PPIs raise stomach pH, disrupting stomach function. This causes issues with mineral absorption and protein digestion. Their use results in B12, vitamin C, calcium, iron, and magnesium deficiencies. Many of these deficiencies, like magnesium deficiency, can’t be tested and therefore might show up sub-clinically in tight muscles, headaches, painful periods, disrupted sleep and anxiety, and constipation. Therefore they fly under the radar of most primary care doctors.

No one connects someone’s heartburn medication with their recent onset of muscle tightness and anxiety.

Many of my patients report difficulties digesting meat and feeling bloated and tired after eating, particularly when consuming a protein-rich meal. They conclude that the meat isn’t good for them. The problem, however, is not meat but that stomach acid that is too diluted to break down the protein in their meal, leading to gas and bloating as the larger protein fragments enter the small intestine.

Many digestive problems result from this malabsorption and deficiency in stomach acid, not too much. Zinc is required for stomach acid production, and one of the best sources of zinc is red meat (zinc is notoriously lacking from plant foods). I have recently been prescribing lots of digestive enzymes and zinc to work my patients’ digestive gears.

Therefore, beware of tearing down a fence without understanding why it’s there. Stomach acid is essential for digesting our food, and regulating blood sugar and building muscle mass through protein digestion.

It is necessary for mineral absorption and B12 digestion. Our stomachs were designed to contain an extremely low pH. They evolved over millennia to do this. Stomach acid is low for a reason. It’s highly unlikely that our bodies made a mistake when it comes to stomach acid.

Therefore, beware of messing with it.

Consider that our bodies know what they’re doing. Consider the importance of finding and treating the actual root cause, not one factor that, if mitigated, can suppress symptoms while causing a host of other problems.

Don’t block your stomach acid.

As Hippocrates said, “All disease begins in the gut.”

It is the boundary between us and the outside world, the border where our body carefully navigates what can come in and nourish us and what should stay outside of us: our fence. Beware of tearing it down.

References:

Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/

Daniels B, Pearson SA, Buckley NA, Bruno C, Zoega H. Long-term use of proton-pump inhibitors: whole-of-population patterns in Australia 2013-2016. Therap Adv Gastroenterol. 2020;13:1756284820913743. Published 2020 Mar 19. doi:10.1177/1756284820913743

Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013;4(3):125-133. doi:10.1177/2042098613482484

Informed Consent: Your Right to Bodily Autonomy

Informed Consent: Your Right to Bodily Autonomy

“The right to determine what shall or shall not be done with one’s own body, and to be free from non-consensual medical treatment is a right deeply rooted in Canadian common law. The right underlines the doctrine of informed consent.

“With very limited exceptions (such emergency use or incapacity), every person’s body is considered inviolate and accordingly every competent adult has the right to be free from unwanted medical treatment.

“The fact that serious risks or consequences may result from a refusal of medical treatment does not vititate the right of medical self-determination.

“The doctrine of informed consent ensures the freedom of individuals to make choices about their medical care. It is the patient, not the physician (or others) who ultimately must decide if treatment–any treatment–is to be administered.” Justice Robbins of the Ontario Court of Appeal.

I deeply believe that the key to optimal health is taking full responsibility and accepting all personal power for one’s own health. This may involve doing research, educating oneself, or assembling a team of trusted health professionals, with you, the patient at the centre.

We have a busy and overloaded healthcare system and even well-meaning professionals can find themselves hurriedly having a conversation in which they are not properly informing patients of the risks and benefits, or alternatives to treatment that they are recommending. I have had patients hurriedly scheduling for surgeries they weren’t sure they wanted, or pressured into hysterectomies or long-term treatments whose risks they didn’t understand.

I have also had patients make perplexing choices in the name of their own care–choices I didn’t necessarily agree with, such as forgoing conventional cancer treatments or further testing or screening.

However, it is the duty of the healthcare provider to provide advice. And it is the right of every patient to accept or reject that advice.

In light of recent, disturbing events, I have started posting some facts on Canadian law and Informed Consent only to be met with surprise–many people are not aware of their rights to refuse medical treatment, to be informed of the risks, and to be allowed to make a choice free of pressure or coercion.

Despite it being deeply enshrined in Canadian law, many patients are not aware of their right to full bodily integrity, autonomy, and choice.

Since 1980, the Supreme Court of Canada made it the right of every patient to be given full informed consent before any medical procedure such as taking blood, giving an injection or vaccination, performing a physical examination, exposing the patient to radiation, and so on.

“The underlying principle is the right of a patient to decide what, if anything, should be done with his body.” Is quote from the famous Supreme Court case of Hopp v. Lepp.

Every health professional under the Regulated Health Professions Act, including naturopathic doctors has a duty to uphold informed consent. We are well versed in it. We are required to uphold it, document it, and maintain it with every patient we see.

Our naturopathic guidelines on consent state, “The ability to direct one’s own health care needs and treatment is vital to an individual’s personal dignity and autonomy. A key component of dignity and autonomy is choice. Regulated health professionals hold a position of trust and power with respect to their patients and can often exercise influence over a patient; however, decision-making power must always rest with the patient.”

In 1996 Ontario passed the Health Care Consent Act, a legal framework for documenting, communicating, establishing and maintaining informed consent in all healthcare settings.

Informed consent is required before all treatment can be administered. Treatment includes: “anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment, plan of treatment or community treatment plan.”

Informed consent must be present in 4 key areas:

  1. The consent must relate to the treatment.
  2. The consent must be informed.
  3. The consent must be given voluntarily, i.e.: made by the patient, and under no coercion, pressure, or duress.
  4. The consent must not be obtained through misrepresentation or fraud.

In order to obtain your full informed consent, you must be given the following information:

  1. The nature of the treatment.
  2. The expected benefits of the treatment.
  3. The material risks of the treatment, no matter how small, especially if one of the risks of side effects is death. The risks should not be minimized for the purpose of influencing your decision-making. The risks should be in relation to your health history. For example, if you suffer from cardiovascular disease, you should be made aware of the the risk of blood clots or myocarditis. It should also be disclosed if certain risks remain unknown.
  4. The material side effects of the treatment. Again, these side effects should be explicitly stated, no matter how small, and if long-term side effects are unknown, that should be stated.
  5. Alternative courses of action.
  6. The likely consequences of not having the treatment. These consequences should not be exaggerated and must be related to the particular patient at hand. What is the actual risk of the patient not receiving the treatment?

Consent cannot be given in a state of duress or coercion. Healthcare providers must be aware that they hold a position of authority and may maintain a power imbalance. They must not misrepresent the benefits of the treatment, and they must disclose any conflict of interest.

Healthcare providers must ensure that patients are not acting under the pressures of someone else, such as an employer, government agency or family member, and are making this decision on their own.

Finally,

The Informed Consent Guide for Canadian Physicians states, “Patients must always be free to consent to or refuse treatment, and be free of any suggestion of duress or coercion. Consent obtained under any suggestion of compulsion either by the actions or words of the physician or others may be no consent at all and therefore may be successfully repudiated. In this context physicians must keep clearly in mind there may be circumstances when the initiative to consult a physician was not the patient’s but was rather that of a third party, a friend, an employer, or even a police officer.

“Under such circumstances, the physician may be well aware that the paitent is only very reluctantly following the course of action suggested or insisted upon by a third person. Then, physicians should be more than usually careful to assure themselves that patients are in full agreement with what has been suggested, that there has been no coercion and that the will of other persons has not been imposed on the patient”.

It is your body and it is your choice. You always have the right to do what’s best for you. True, empowered health cannot come from a place of coercion or pressure.

Know that you always have a choice–your doctor has a duty to inform you of your choice, as well as the information necessary for you to make the right choice for you, regardless of what is happening in the media or in politics.

Informed consent is your right and it’s the law.

I Treat Stories

I Treat Stories

“I don’t believe in diseases anymore, I treat stories.

“…No other medical system in the world ever believed in diseases. They all treat everybody as if, you know it’s whether it’s the ancestors or meridians–it’s none of this rheumatoid arthritis, strep throat kind of thing. That’s just this construct that we kind of… made up.”

– Dr. Thomas Cowan, MD

Dr. Cowan is admittedly a (deliciously) controversial figure. His statement, I’m sure, is controversial. But that’s why it intrigues me.

In naturopathic medicine, one of our core philosophies, with which I adhere very strongly, is “treat the person, not the disease”.

And, in the words of Sir William Osler, MD, “It is much more important to know what sort of person has a disease, than to know what sort of disease a person has”.

And, I guess it’s relevant to ask, what is disease in the first place?

I see disease as an non-hard end point, a state that our biological body enters into. On the continuum between perfect health (which may be an abstract and theoretical construct) and death, disease I believe is near the far end of the spectrum.

Disease happens when the body’s proteins, cells, tissues, or organs begin to malfunction in a way that threatens our survival and disrupts our ability to function in the world. For example, a collection of cells grows into a tumour, or the immune system attacks the pancreas and causes type I diabetes.

But, of course there is always more to the story.

What causes disease?

I have heard biological disease boiled down to two main causes: nutrient deficiencies and toxicities. And, I’m not sure how strongly I agree with this, but on a certain level I find this idea important to consider.

However, it is definitely not how Western Medicine views the cause of disease!

Diseases, as they are defined, seem to be biological (as opposed to mental or emotional). They have clinical signs and symptoms, certain blood test results, or imaging findings, and they can be observed looking at cells under a microscope.

Medical textbooks have lists of diseases. Medicine is largely about memorizing the characteristics of these diseases, differentiating one from another, diagnosing them, and prescribing the treatment for them.

As a naturopathic doctor, I see a myriad of patients who don’t have a “disease”, even though they feel awful and are having difficulty functioning. These patients seem to be moving along the disease spectrum, but their doctors are unable to diagnose them with anything concrete–they have not yet crossed the threshold between “feeling off” and “disease”.

Their blood tests are “normal” (supposedly), their imaging (x-rays, MRIs, ultrasounds, etc.) are negative or inconclusive, and their symptoms don’t point to any of the diseases in the medical school textbooks.

And yet they feel terrible.

And now they feel invalidated.

Often they are told, “You haven’t crossed the disease threshold yet, but once you reach the point where you’re feeling terrible and our tests pick it up too, come back and we’ll have a drug for you”.

Obviously not in so many words, but often that is the implication.

Our narrow paradigm of disease fails to account for true health.

Even the World Health Organization states that health is not the mere absence of disease.

So if someone does not have health (according to their own personal definition, values, dreams, goals, and responsibilities), but they don’t have disease, what do they have?

They have a story.

And I don’t mean that what they’re dealing with is psychological or mental or emotional instead, and that their issues are just “all in their head”. Many many times these imbalances are very biological, having a physical location in the body.

Subclinical hypothyroidism, insulin resistance, nutrient deficiencies, chronic HPA axis dysfunction, and intestinal dysbiosis are all examples of this. In these cases we can use physical testing, and physical signs to help us identify these patterns.

An aside: I believe the categories of biological, mental, environmental, and emotional, are false.

Can we have minds without biology? Can we have emotions without minds or physical bodies? How do we even interface with an environment out there if we don’t have a body or self in here?

Aren’t they all connected?

Ok, back to the flow of this piece:

Your story matters.

This is why it takes me 90 minutes to get started with a new patient.

It’s why I recommend symptom and lifestyle habit tracking: so that we can start to pay attention.

It’s why I’m curious and combine ancient philosophies, research (because yes, research is useful, there’s no doubt–we should be testing out our hypotheses), and my own intuition and skills for pattern-recognition, and my matching my felt-sense of what might be going on for a patient with their felt sense of what they feel is going on for them.

Attunement.

I write about stories a lot. And I don’t mean “story” in a woo way, like you talk about your problems and they go away.

No. What I mean is that you are an individual with a unique perspective and a body that is interconnected but also uniquely experienced. And my goal is to get a sense of what it’s like to be you. What your current experience is like. What “feeling like something’s wrong” feels like. What “getting better” feels like.

And all of that information is located within story.

Your body tells us a story too. The story shows up in your emotions, in your physical sensations, in your behaviours (that might be performed automatically or unconsciously), in your thoughts, in your energy, and in the palpation of your body.

No two cases of rheumatoid arthritis are the same. They may have similar presentations in some ways (enough to fit the category in the medical textbooks), but the two cases of rheumatoid arthritis in two separate people differ in more way than they are the same.

And that is important.

We’re so used to 15 minute insurance-covered visits where we’re given a quick diagnosis and a simple solution. We’re conditioned to believe that that’s all there is to health and that the doctors and scientists and researchers know pretty much everything there is to know about the human body and human experience.

And that if we don’t know about something, it means that it doesn’t exist.

When we’re told “nothing is wrong” we are taught to accept it. And perhaps conclude that something is wrong with us instead.

When we’re told that we have something wrong and the solution is in a pill, we are taught to accept that too. And perhaps conclude that something is wrong with our bodies.

But, you know what a story does?

It connects the dots.

It locates a relevant beginning, and weaves together the characters, themes, plot lines, conflicts, heroes, and myths that captivate us and teach us about the world.

A story combines your indigestion, mental health, microbiome, and your childhood trauma.

A story tells me about your shame, your skin inflammation, your anxiety, and your divorce.

Maybe you don’t have a disease, even if you’ve been given a diagnosis.

Maybe you have a story instead.

What do you think about that?

Preventive Medicine: 9 Root Causes of Disease

Preventive Medicine: 9 Root Causes of Disease

I often get emails like this, “Dear Doctor, please tell me your favourite natural cure for anxiety”, to which I often reply:

Dear, Anxiety,

Imagine you are a gardener, tending to your garden. You are a skilled gardener: you tend lovingly to your plants every day and you care deeply for their welfare.

You are the perfect gardener in every way, except for one: for some reason you don’t know anything about soil.

No one has ever taught you about the damp, dark soot that envelopes the roots of your beloved plants, kindly offering to them its protection, water, and nutrients.

You are a gardener, but are innocently oblivious to the fact that soil must be nurtured by millions of microbes, and that nutrients in the soil must be replenished. You have no idea that the other plants sharing the soil with your garden form a complex network of give and take, depositing nutrients into it, while greedily sucking others away.

Now, as this soil-ignorant gardener, imagine your surprise when, despite your care and attention, the plants in your garden wither and die, bearing no flowers or fruit.

Imagine your frustration when your efforts to prop up tired stems fail. You apply water and fertilizer to buds, leaves and stems. You stand by, powerless, as your garden dies.

Notice the weeds taking over your garden, which you lop off at their stems, unaware that their roots reside deep inside the earth.

When the weeds pop up again and again, you slash at them, burn them, and you curse the skies.

“Why me?”

Why you, indeed.

You are unaware of root gardening, soil gardening, just as many of us are unaware of root medicine—soil medicine.

You see, Anxiety, there are many natural remedies that can help.

However, tossing natural pills at twitching nerves, imbalanced blood sugar, unregulated stress responses, and various nutrient deficiencies, might be as naive a practice as spray painting your roses while they wilt in sandy earth, beneath their red paint.

It might be akin to prescribing anxiety medication or a shot of vodka to calm your trembling mind; you might feel better for a time, propped up with good intentions, before collapsing in the dry soil encasing you.

With no one to tend to your roots you eventually crumple, anxiety still rampant.

“Why me?” You curse the skies.

Rather than asking, “Why me?” it might help to simply start asking, “Why?”

While it is important to understand the “What” of your condition—What disease is present? What is the best natural cure for anxiety?—naturopathic doctors are far more interested in the “Why”.

As Dr. Mark Hyman, functional medical doctor, asks:

Why are your symptoms occurring?

Why now?

And why in this way?

Naturopathic doctors prescribe natural remedies for conditions such as anxiety, it’s true. However, naturopathic medicine is a medicine that first tends to the soil.

Naturopathic doctors first look for and addresses the roots of symptoms, working with the relationships that exist between you and your body, your food, the people in your life, your society, your environment—your soil.

Healing involves taking a complete inventory of all the factors in your life that influence your mental, physical, and emotional wellness. It requires looking at the air, water, sunlight, nutrients, stressors, hormones, chemicals, microbes, thoughts and emotions that our cells bathe in each day.

Healing means looking closely at the soil that surrounds us. It requires asking, What are the roots that this condition stems from? And, What soil buries these roots? Does it nourish me?

Do I nourish it?

The causes of disease can be interconnected and complex. Very often, however, there are common root networks from which many modern-day chronic health conditions arise.

Starving Gut Bacteria.

It was Hippocrates, the father of medicine, who first proclaimed that “All disease begins in the gut.”

Our digestive systems are long, hollow tubes that extend from mouth to anus, and serve as our body’s connection to the outside world. What enters our digestive system does not fully become the body until the cells that line that digestive tract deem these nutrients worthy of entering.

Along their 9 metre-long, 50-hour journey, these nutrients are processed by digestive enzymes, broken down by trillions of beneficial bacteria, and sorted out by the immune cells that guard entrance to our vulnerable bodies.

Our immune cells make the judgement call between what sustains us, and what has that potential to kill us. For this reason, about 70% of our immune system is located along our digestive tract.

Our gut bacteria, containing an estimated 30 trillion cells, outnumber the cells in our body 3 to 1. Science has only just begun to write the love story between these tiny cells and our bodies. These bacteria are responsible for aiding in the digestion of our food, producing essential nutrients, such as B vitamins and fat-soluble vitamins, and keeping our intestines healthy.

However, this love story can turn tragic when these little romantics are not properly fed or nurtured, or when antagonists enter the story in the form of pathogenic bacteria or yeast.

Our microbiome may impact our health in various ways.

Studies are emerging showing that obese people have different gut profiles than those who are normal weight. Our gut bacteria have a role in producing the hormones that regulate hunger, mood, stress, circadian rhythms, metabolism, and inflammation. They regulate our immune system, playing a role in soothing autoimmune conditions, and improving our ability to fight off infections and cancer.

Psychological and physical stress, inflammation, medication use, and a diet consisting of processed food, can all conspire to negatively affect the health of our gut. This can lead to a plethora of diseases: mood disorders, psychiatric illness, insulin resistance, cardiovascular disease, chronic pain and inflammation, obesity, hormonal issues, such as endometriosis, autoimmune disease, and, of course, chronic digestive concerns such as IBS, among others.

As Hippocrates long knew, one doesn’t have to dig for long to uncover an unhappy gut microbiome as one of the primary roots of disease.

Our gut has the power to nurture us, to provide us with the fuel that keeps our mood bright and our energy high. However, if we fail it, out gut also has the power to plague our cells with chronic inflammation and disease.

To be fully healthy, we must tend to our gut like a careful gardener tends to her soil.

This involves eating a diet rich in fermented foods, like kefir, and dietary fibre, like leeks, Jerusalem artichokes, and black beans. It also means, consuming flavonoid-rich foods like green tea, and cocoa, and consuming a colourful tapestry of various fruits and vegetables.

Healing our gut requires avoiding foods it doesn’t like. These may include foods that feed pathogenic bacteria, mount an immune response, kill our good bacteria, trigger inflammation, or simply those processed foods that fail to nurture us.

To heal ourselves, first we must feed out gut.

Confused Circadian Rhythms.

For hundreds of thousands of years, all of humanity rose, hunted, ate, fasted, and slept according to the sun’s rhythms.  

To align us with nature, our bodies contain internal clocks, a central one located in brain, the suprachiasmatic nucleus, which is susceptible to light from the sun, and peripheral clocks located in the liver and pancreas, which respond to our eating patterns.

Our gut bacteria also respond to and influence our body’s clocks. 

However, the invention of electricity, night shifts, and 24-hour convenience stores, means that our bodies can no longer rely on the outside world to guide our waking and sleeping patterns. This can confuse our circadian rhythms, leading to digestive issues, insomnia, daytime fatigue, mood disorders, and problems with metabolism, appetite, and blood-sugar regulation.

Dr. Satchin Panda, PhD, a researcher at the Salk Institute in California, found that mice who ate a poor diet experienced altered circadian rhythms. However, he found that when these mice were fed the same diet in accordance with their natural rhythms, they weighed less, had lower incidences of diabetes and cardiovascular disease, had better cognitive health, and lived longer.

These findings indicate that perhaps it is not what we eat but when that may impact our health.

Perhaps it is that an unnatural diet disconnects us from nature, or that this disconnection tempts us to choose non-nutritive foods, but the research by Dr. Panda and his team reveals the importance of aligning our daily routines with our bodies’ natural rhythms in order to experience optimal health.

According to Dr. Panda’s findings, this involves eating during an 8 to 12-hour window, perhaps having breakfast at 7am and finishing dinner early, or simply avoiding nighttime snacking.

For many of us, this may involve making the effort to keep our sleep schedules consistent, even on weekends.

For most of us, it involves avoiding exposure to electronics (which emit circadian-confusing blue light) after the sun goes down, and exposing our eyes to natural sunlight as soon after waking as possible.

Nature Deficit Disorder.

Nature Deficit Disorder is a phrase, coined by Richard Louv, in the 2005 book, Last Child in the Woods.

According to Louv, a variety of childhood problems, especially mental health diagnoses like ADHD, are a direct result of our society’s tendency to increasingly alienate children from nature.

With most of humanity living in cities, nature has become a place we visit, rather than what immerses us. However much modernization might remove us from nature, our bodies, as well as the food, air, water, sunlight, and natural settings they require to thrive, are products of nature, and cannot be separated from it.

A Japanese practice called Shinrin-Yoku, or “Forest Bathing”, developed in the 1980’s to attempt to reconnect modern people with the healing benefits of spending time in a natural setting. There is an immediate reduction in stress hormones, blood pressure, and heart rate when people immerse themselves in natural environments, such as a forest. 

Whether we like it or not, our roots need soil. It is possible that the components of this soil are too complex to manufacture. When we try to live without soil, essential elements that nourish us, and the various relationship between these elements are left out.

When we remove ourselves from nature, or ignore it fully, we become like gardeners oblivious to the deep dependency their plants have on the soil that enshrouds them.  

Connecting with nature by spending time outside, retraining our circadian rhythms, connecting with our food sources, and consuming natural, whole foods, may be essential for balancing our minds, emotions, and physical bodies.

A Lack of Key Building Blocks.

Our bodies are like complex machines that need a variety of macro and micronutrients, which provide us with the fuel, building blocks, vitamins and minerals that we need to function.

As I child, I would play with Lego, putting together complex structures according to the blueprints in the box. When I discovered that a piece was missing, I would fret. It meant that my masterpiece would no longer look right, or work. If I was lucky, I might find a similar piece to replace it, but it wouldn’t be the same.

After looking long and hard for it, sometimes the missing piece would turn up. I’d locate it under the carpet, my brother’s bottom, or lodged in a dark corner of the box. Often our bodies don’t get that lucky.

Nutrients like vitamin B12, perhaps, or a specific essential amino acid, or a mineral like magnesium, help our body perform essential steps in its various biochemical pathways.

These pathways follow our innate blueprint for health. They dictate how we eat, sleep, breathe, and create and use energy. They control how our bones and hair grow. They control our mood and hormones. They form our immune systems. These pathways run us.

Our bodies carry out the complicated instructions in our DNA to will us into existence using the ingredients supplied from food. If our bodies are missing one or several of these ingredients—a vitamin or mineral—an important bodily task simply won’t get done.

Dr. Bruce Ames, PhD, theorized that when nutrient levels are suboptimal, the body triages what it has to cove tasks essential to our immediate survival, while compromising other jobs that are important, but less dire.

For example, a body may have enough vitamin C to repair wounds or keep the teeth in our mouths—warding off obvious signs of scurvy, a disease that results from severe vitamin C deficiency. However, it may not have enough to protect us from the free radicals generated in and outside of our bodies. This deficiency may eventually lead to chronic inflammation, and even cancer, years later.

According to Dr. Ames’ Triage Theory, mild to moderate nutrient deficiencies may manifest later in life, as diseases that arise from the deprivation of the building blocks needed to thrive.

In North America, despite an overconsumption of calories, nutrient deficiencies are surprisingly common.

25-50% of people don’t get enough iron, which is important for the transport of oxygen, the synthesis of neurotransmitters, and for proper thyroid function.

One third of the world’s population is deficient in iodine, which affects thyroid health and fertility.

Up to 82% of North Americans are vitamin D deficient. Vitamin D regulates the expression of over 1000 genes in the body, including those involved in mood regulation, bone health, immunity, and cancer prevention.

Vitamin B12 is commonly deficient in the elderly, vegans and vegetarians. It is important for lowering inflammation, creating mood-regulating neurotransmitters, and supporting nervous system health. Deficiency in vitamin B12 can result in fatigue. Severe deficiency can lead to irreversible nerve damage, dementia, and even seizures.

Magnesium is an essential mineral involved in over 300 chemical reactions, including mood and hormone pathways. Over 40% of North Americans do not consume enough magnesium, which is found in leafy green vegetables.

Our bodies have requirements for fats, which make up our brain mass and the backbone of our sex hormones, and protein, which makes up our enzymes, neurotransmitters and the structure of our body: bones, skin, hair, nails, and connective tissue.

Our gut microbiota require fibre.

Our cells need antioxidants to help protect us from the free radical damage from our own cells’ metabolism and our exposure to environmental toxins.

We certainly are what we eat, which means we can be magnificent structures with every piece in place, thriving with abundance and energy.

Despite reasonably good intentions, we can also suffer from nutrient scarcity, forced to triage essential nutrients to keep us from keeling over, while our immune health, mood, and overall vitality slowly erode.

A Body on Fire: Chronic Inflammation.

When we injure ourselves—banging a knee against the sharp edge of the coffee table, or slashing a thumb with a paring knife—our immune systems rally to the scene.

Our immune cells protect us against invaders that might take advantage of the broken skin to infect us. They mount an inflammatory response, with symptoms of pain, heat, redness, and swelling, in order to heal us. They recruit proteins to the scene to stop blood loss; they seal our skin back up, leaving behind only a small white scar—a clumsiness souvenir.

Our inflammatory response is truly amazing.

One the danger has been dealt with, the immune response is trained to turn off. However, when exposed to a stressor, bacteria, or toxin, for prolonged periods, our immune system may have trouble quieting. Chronic issues can contribute to chronic inflammation.

Scientists argue that an inflammatory response gone rogue may be the source of most chronic diseases, from heart disease, cancer, and diabetes, to schizophrenia and major depressive disorder. 

The gut is often the source of chronic inflammation as it hosts about 70% of the immune system. When we eat something that our immune system doesn’t like, an inflammatory response is triggered. This can cause digestive issues such as inflammatory bowel disease, celiac disease, and the more common irritable bowel syndrome. It can also lead to more widespread issues like chronic pain, arthritis, migraines, and even mood disorders like Bipolar.

Ensuring optimal gut health through nurturing the gut microbiome, and eating a clean diet free of food sensitivities, is essential for keeping the body’s levels of inflammation low.

Constant Fighting and Fleeing.

Like inflammation, our stress response is essential to our survival.

When facing a predatory animal, our body is flooded with stress hormones that aim to remove us from the danger: either through fighting, fleeing, or freezing. Our stress response is affectionately called our “Fight or Flight” response.

However, like inflammation, problems arise when our stress response refuses to turn off. Traffic, exams, fights with in-laws, and other modern-day struggles, can be constant predators that keep us in a chronically stressed-out state.

Chronic stress has major implications for our health: it can affect the gut, damage our microbiome, alter our circadian rhythms, mess with mood and hormones, and contribute to chronic inflammation. Stress gets in the way of our ability to care for ourselves: it isolates us, encourages us to consume unhealthy foods, and buffer our emotions through food, alcohol, work, and drugs.

We also know that stress has a role in the development of virtually every disease. Like chronic inflammation, it has been found to contribute to chronic anxiety, depression, digestive concerns, weight gain, headaches, heart disease, insomnia, chronic pain, and problems with concentration and memory, among others.  

Discomfort with Discomfort.

To assess its impact on health, it helps to determine between two key types of stress: distress, the chronic wear and tear of traffic, disease, and deadlines, and eustress.

Eustress is beneficial stress—the short-lived discomfort of intense exercise, the euphoric agony of emotional vulnerability, or the bitter nutrients of green vegetables—that makes the body more resilient to hardship.

Whenever I feel discomfort, I try to remember the ducks.

Several years ago, on a particularly frigid winter day, I was walking my dog. Bundled against the cold wind, we strolled along the semi-frozen lake, past tree branches beautifully preserved in glass cases of ice. Icebergs floated on the lake. So did a group of ducks, bobbing peacefully in the icy waters.

With nothing to protect their thin flippers from the sub-zero temperatures, they couldn’t have felt comfortable. There couldn’t have been even a part of them that felt warm, cozy, or fed.

There was no fire for them to retreat to, no dinner waiting for them at home, no slippers to stuff frozen, wet flippers into. This was it. The ducks were here, outside with us, withstanding the temperatures of the icy lake. A part of them must have been suffering. And yet, they were surviving.

Far from surviving, the ducks looked down-right content.

I think of the ducks and I think of the resilience of nature.

We humans are resilient too. Like the ducks, our bodies have survived temperature extremes. Our ancestors withstood famine, intense heat, biting cold, terrible injury, and the constant threat of attack and infection, for millenia. You were born a link on an unbroken chain of survivors, extending 10,000 generations long.

Our bodies have been honed, over these hundreds of thousands of years, to survive, even thrive, during the horrendous conditions that plagued most of our evolutionary history.

Investigations into the human genome have revealed genes that get turned on in periods of eustress: bursts of extreme heat or cold, fasting, and high-intensity exercise. When our body encounters one of these stressors, it activates a hormetic response to overcome the stress. Often the response is greater than what is needed to neutralize the threat, resulting in a net benefit for our bodies.

These protective genes create new brain cells, boost mitochrondria function, lower inflammation, clear out damaged cells, boost the creation of stem cells, repair DNA, and create powerful antioxidants. Our bodies are flooded with hormones that increase our sense of well-being.

It’s like the old adage, “What doesn’t kill you makes you stronger.”

Our bodies were made for discomfort. In fact, we have entire genetic pathways waiting to kick in and heal us as soon as they experience hardship.

There are a growing number of studies on the healing power of small troubles. Fasting may have a role in treating autoimmune diseases, decreasing the signs of aging, and as an adjunct therapy for cancer; sauna therapy boosts detoxification and may prevent dementia; cryotherapy, or exposure to extreme cold, has the potential to heal arthritis and autoimmunity; and High Intensity Interval Training has been shown to boost cardiovascular health more than moderate-intensity exercise.

Plants may benefit us through flavonoids, which, rather than serving as nutrients, act as small toxins that boost these hormetic pathways, encouraging the body to make loads of its own, powerful antioxidants to combat these tiny toxins.

Mindfully embracing discomfort—the bitter taste of plants, the chilly night air, the deep growling hunger that occurs between meals—may be essential for letting our bodies express their full healing potential.

Not Minding Our Minds.

Our ability to withstand powerful emotions may have healing benefits.

Many of us avoid painful feelings, allowing them to fester within us. We buffer them with excess food, or drugs, leading to addictions. Mindfulness can help us learn to be with the discomfort of the emotions, thoughts and physical sensations that arise in the body as inevitable side effects of being alive.

Research has shown that mindfulness can help decrease rumination, and prevent depressive relapse. It also helps lower perceived stress. How we perceive the stressors in our lives can lower the damaging effects they have on us. Research shows that those who view their life stressors as challenges to overcome have lower stress hormone activation, and experience greater life satisfaction.

According to Cognitive Behaviour Therapy (CBT), our thoughts create our emotions. Becoming more aware of our thoughts, through CBT or mindfulness, allows us to identify which thoughts may be limiting us or exacerbating our reactions to stressful situations.

When we learn to observe our thoughts, we create some distance from them. We become less likely to see the dismal thoughts in our minds as absolute truths.

Practicing mindful meditation, CBT, or cultivating positive thoughts, such as engaging in a daily gratitude practice, may improve our resilience to chronic stress.

Inattention.

According to Stephen Cope, yoga teacher and author of The Great Work of Your Life, “You love what you know deeply. Get to know yourself deeply”. We get to know things deeply by paying attention to them.

Georgia O’Keefe’s admiration for flowers, or Monet’s adoration of landscapes, is apparent to anyone who sees their work. In order to commit images to canvas, the artists gets to know their subject matter deeply. Their art celebrates what they took the time to pay attention to, and eventually came to love. 

As a naturopathic doctor, I believe that healing begins with attention. When we become aware of our bodies, we begin to know them deeply. Awareness allows us to respond to symptoms lovingly, the way a mother learns to skillfully attend to her baby’s distinct cries.

When I first meet a new patient, the first thing I have them do is start to pay attention.

We become curious about their symptoms, their food intake, their sleep patterns, their habits and routines, the physical sensations of their emotions, the thoughts that run through their heads.

Through paying attention, with non-judgmental curiosity, my patients start to understand their bodies in new ways. They learn how certain foods feel in their bodies, how certain sleep habits affect their energy levels the next day, and how specific thoughts contribute to their feelings.

Once we begin to open up this dialogue with our bodies, it becomes impossible not to answer them with love. It becomes hard not to eat, sleep, and move in ways that convey self-respect.

A gardener who pays deep attention cannot ignore the obvious—her plants have roots, embedded in soil. The gardener quickly learns, through careful observation, that the health of this soil is vital to the health of her plants.

And so, back to the original question, “What is your favourite natural cure for anxiety?”

My favourite remedy isn’t a bottle of pills we reach for, it’s a question we reach for from within:

“What do I need to heal?”

After asking the question, we wait.

We wait for the answer to emerge from some primal place within, just as a gardener waits for new buds to rise out of the mysterious depths of the dark, nutritious soil.

 

When Your Doctor Says, “You’re Fine!”

When Your Doctor Says, “You’re Fine!”

I hear this a lot:

“I followed X, Y, Z (controversial) diet, and my doctor said my blood is fine!”

Firstly, what do we think doctors are testing our blood for? Most standard blood tests look at cholesterol, check for anemia, and to see if our kidneys are failing or not.

If you’re lucky, your doctor might test your iron levels, B12, and thyroid function (using one hormone measure, TSH, which often fails to pick up cases of under-active, or autoimmune, thyroid).

Your doctor is likely not looking at inflammation levels, vitamin levels, hormone levels, insulin resistance, or delving into the nuances of your cholesterol levels. Standard blood tests do not provide a comprehensive analysis of your health status. Rather, they rule out the presence of serious disease.

Your blood tests are “fine” because the markers that might actually be negatively (or positively) impacted by your diet and lifestyle are simply not tested for.

Secondly, let’s challenge the notion of “fine”.

For most practitioners, “fine” means, “You don’t qualify for a diagnosis of X disease, which would justify the prescription of Y medication.”

I meet a lot of patients whose B12 levels aren’t “fine”, or whose thyroid levels are certainly not “fine”.

Sure, they are not deficient to the point where they have dementia (from low B12), or where they need thyroid hormone replacement medication, but their bodies are not working optimally.

If we dig a bit below the surface, we find that they are insulin resistant, they have elevated anti-thyroid antibodies, their B12 and iron levels are suboptimal, or their ovaries are not making progesterone.

Someone with these lab markers may not get a disease diagnosis from their medical doctor, and they may not need medication yet, but they’re not “fine”.

Oftentimes your blood tests are fine for decades—until they’re not fine.

This is a classic problem for those who are diagnosed with diabetes. I believe that for many patients, if we had done some exploration of their symptoms and blood 15 to 20 years earlier, we could have detected insulin resistance simmering below the surface of the conventional lab tests. (https://www.ncbi.nlm.nih.gov/pubmed/16627374)

Perhaps we could have prevented their diabetes, and subsequent cellular and metabolic damage, altogether.

I love it when we can do more in-depth lab testing based on your individual signs, symptoms, and risk factors. We take a full inventory of your lifestyle and health history and really dive into the nitty-gritty when it comes to preventing the diseases that your doctor looks for when ordering lab tests.

With the right approach, we might be able to keep those lab tests looking “fine”.

Feeling Tired? Try These 15 Ways to Beat Fatigue

Feeling Tired? Try These 15 Ways to Beat Fatigue

Like many people I see, Sandra was experiencing debilitating exhaustion.

Completing her PhD, she was working all day and collapsing on the couch at 8 pm.

She stopped going out in the evening. She ceased spending time with friends, engaging in activities outside of her studies, exercising, and having sex.

Her motivation and zest for life were at all-time lows.

Her marriage, and her life, were being sidelined in the service of her fatigue.

Her family doctor met her complaints with a defeated shrug. “You’re just getting older,” he offered by way of explanation.

Sandra was 27.

My patient is not alone. At least 20% of patients approach their family doctors complaining of fatigue.

24% of North American adults report feeling fatigued for more than two weeks, unable to find a cause. 

Additionally, one third of adolescents report feeling tired most days.

Surely these teens are not just “getting older”.

Lack of energy is a problem that can arise from any body system. Fatigue can be an early warning sign that something has been thrown off balance.

I frequently see fatigue in patients suffering from hormone imbalances, including suboptimal thyroid function, insulin resistance, and low estrogen, progesterone, or testosterone. But also in chronic stress, depression, and anxiety.

Fatigue is often connected to mental health conditions, digestive issues, lifestyle imbalances, chronic inflammation, chronic stress, and lack of restful sleep. It’s no wonder, then, that most of the people I work with experience some level of low energy.

Conversely, I see improvement in energy as one of the first signs that someone is moving towards more robust health. Some of the first signs of healing are a clear mind, bright mood, and vibrant, buoyant energy.

There are a few steps you and your naturopathic doctor can take to identify and remove the cause of fatigue, while optimizing your health and energy levels.

  1. Differentiate between sleepiness and fatigue.

It is important to determine if low energy is fatigue or sleepiness.

Sleepiness is characterized by the tendency to fall asleep when engaging in non-stimulating activities like reading, watching TV, sitting in a meeting, commuting, or lying down.

Sleepiness:

  • Is often improved by exercise, at least in the short-term
  • Is improved with rest

Fatigue is characterized by a lack of energy, both physical and mental. Fatigue is often worsened by exertion.

Those who are fatigued:

  • Suffer from mental exhaustion
  • Experience muscle weakness
  • Have poor endurance
  • Typically feel worse after physical exercise and take longer to recover
  • Don’t feel restored after sleeping or napping
  • Might experience ease in initiating activities but progressively experience more weakness as they continue them (e.g.: engaging in social activities, movement, working, etc.)

To determine between sleepiness and fatigue, your naturopathic doctor will ask you a series of questions about the nature of your low energy.

2. Assess sleep.

Assessing and optimizing sleep is essential for beginning to treat all low energy and, in particular, sleepiness.

Assessing sleep involves looking at a variety of factors such as:

  • Bedtime and waking time
  • Sleep onset: how long it takes
  • Sleep routine and sleep hygiene habits
  • Sleep duration: how many times you wake up, how quickly you can fall back asleep after waking
  • Causes of interrupted sleep such as sleep apnea, chronic pain, frequent urination, children/pets/partners, etc.
  • Nap frequency and length
  • Ability to wake up in the morning
  • Perceived sleep quality: do you wake feeling rested?
  • The use of sleep aids
  • Exercise routines, how close to bedtime you eat or exercise.

And so on.

Using a sleep app or undergoing a sleep study are two additional tools for assessing the quality and duration of your sleep cycles that may be useful.

3. Address sleep issues.

Whether the cause of fatigue is sleepiness or not, restful sleep is essential to restoring our energy levels. Optimizing sleep is an important foundational treatment for all health conditions.

Restorative sleep regulates hormones and balances the stress response, called the hypothalamic-pituitary-adrenal axis (HPA axis). It improves cell repair, digestion, memory, and detoxification.

Mental and emotional stress, artificial light, blood sugar dysregulation, inflammation, and hormone imbalances can interfere with sleep.

To address issues with sleep, it is important to:

  • Maintain a strict sleep schedule. This means keeping bedtime and waking time consistent, even on weekends.
  • Practice good sleep hygiene by avoiding electronics at least an hour before bedtime, using blue light-blocking glasses if necessary, and keeping the bedroom as dark as possible.
  • Avoid stimulating activities like exercise in the hours before bed.
  • Keep the bedroom cool and dark.
  • Reserve the bed and bedroom for sleep and sex only.
  • Balance circadian rhythms by exposing your eyes to sunlight immediately upon waking and eating protein in the morning.

In addition to sleep hygiene and balancing circadian rhythms, sleep aids can be helpful. I start my patients with melatonin, a non-addictive antioxidant, to reset the sleep cycle and help with obtaining deeper, more restorative sleep.

It is important to take melatonin in a prolonged-release form a few hours before bedtime and to use it in addition to a dedicated sleep routine.

  1. Determine whether the fatigue is secondary to an underlying medical condition.

Secondary fatigue is defined as low energy, lasting from 1 to 6 months, that is caused by an underlying health condition or medication.

With your medical or naturopathic doctor, be sure to rule out any issues with your immune system, kidneys, nervous system, liver, and heart, and to assess the side effects of any medications you’re taking.

Ruling out chronic infections, pregnancy, anemia, and cancer may be necessary, depending on other signs and symptoms that are present, your individual risk factors, and family history.

While the vast majority of fatigue is not caused by a serious health condition, ruling out more serious causes is an essential part of the diagnostic process.

Remember that this is not a job for Dr. Google! Because fatigue is a sign that something in the body is not functioning optimally, it can be implicated in virtually every health condition, alarmingly serious ones, but also more benign conditions as well.

Taking into account your entire health history, risk factors and particular symptoms, as well as assessing blood work is a complex job that a regulated health professional can assist you with.

  1. Get blood work done.

Assessing blood work is necessary for ruling out common causes of fatigue.

Blood tests are used to rule out anemia, infections, suboptimal iron, B12, and folate levels, under-functioning thyroid, inflammation, insulin resistance, and hormonal imbalances.

To evaluate the cause of fatigue, your doctor will look at:

  • A complete blood count (CBC) that looks at your red and white blood cells.
  • inflammatory markers like ESR and hs-CRP
  • TSH, to assess thyroid function, and occasionally free thyroid hormones and thyroid antibodies, if further investigation is indicated
  • B12, iron and folate
  • Other tests such as fasting insulin, fasting blood glucose, liver enzymes, and hormones like estradiol, testosterone, estrone, LH, FSH, and progesterone, depending on the health history and the constellation of symptoms.

Your doctor may take further measures to assess your heart and lungs, or to rule out chronic infections.

6. Identify physiologic fatigue, or burnout.

Once sleepiness and any underlying health conditions have been ruled out, your doctor may determine whether you have physiologic fatigue.

Physiologic fatigue, also commonly called “burnout” or “adrenal fatigue”, is the result of an imbalance in sleep, exercise, nutrition intake, and rest.

It is by far the most common category of prolonged fatigue that I see in my practice. Two thirds of those experiencing fatigue for two weeks or longer are experiencing this type of fatigue. 

Feeling a lack of motivation, low mood, and increased feelings of boredom and lethargy are characteristics of this kind of fatigue.

Physiologic fatigue can be confused with depression, leading to a diagnosis and subsequent antidepressant prescription, which may fail to uncover and address contributing lifestyle factors.

To tell if you might be experiencing physiologic fatigue, or burnout, see if you answer yes to any of the following questions, adopted from the Maslach Burnout Inventory

  • I feel emotionally drained at the end of the day.
  • I feel frustrated with my job.
  • I feel I’m working too hard.
  • I feel fatigued when I have to face another day.
  • I have a hard time getting up in the morning on weekdays.
  • I feel less sympathetic and more impatient towards others.
  • I am more irritable and short-tempered with colleagues, my family, my kids.
  • I feel overwhelmed.
  • I have more work than I can reasonably do.
  • I feel rundown.
  • I have no one to talk to.

Fortunately, there are many solutions to improving low energy and mood caused by burnout.

  1. Balance the HPA Axis

Balancing the stress response, otherwise known as the Hypothalamus-Pituitary-Adrenal (or HPA) axis, is an important component of treating physiologic fatigue.

Our HPA axis becomes activated in the morning when the hormone cortisol is released from the adrenal glands. Cortisol suppresses inflammation and gives us the motivated, focussed energy to go about our day.

Towards the end of the day, cortisol levels naturally fall. In the evening, cortisol is at its lowest, and melatonin, our sleep hormone, rises.

Those with HPA dysfunction have an imbalance in this healthy cortisol curve.

They commonly experience sluggishness in the mornings, a crash in the afternoon (around 2 to 4 pm), and restless sleep, often waking up at 2 to 4 am as a result of nighttime cortisol spikes and an impairment in melatonin release.

These individuals often experience cravings for salt and sugar. They may have low blood pressure and feelings of weakness.

It is common for those experiencing burnout to get sick when they finally take a break or experience prolonged healing time from common infections, likes colds and flu.

They may suffer from inflammatory conditions like chronic migraines, muscular tension, and report feeling depressed or anxious.

In this case, balancing the HPA axis is a treatment priority.

Treatment involves:

  • HPA axis balancing through adaptogenic herbs
  • Optimizing adrenal nutrient levels
  • Regulating blood sugar
  • Improving circadian rhythms
  • Reducing workload and perceived stress through addressing perfectionism, practicing setting boundaries, and developing mindfulness, among other skills.
  • Improving sleep
  • Engaging in regular, scheduled exercise
  • Reducing inflammation, improving digestion, or regulating hormones
  • Being proactive about mental health and emotional wellness
  • Improving self-care and stress resilience

Cognitive Behaviour Therapy can be used to teach healthy coping skills while balancing sleep and stress. Studies show it can be more effective than medication for the depression and anxiety related to physiologic fatigue.

Of course, from a holistic perspective, the above strategies are the foundations for improving general health and wellness for all fatigue-related conditions, regardless of whether the fatigue is due to sleepiness, secondary fatigue, physiologic fatigue, or chronic fatigue syndrome.

  1. Talk to your naturopathic doctor about adaptogenic herbs.

Adaptogenic herbs are an important natural tool for improving mood and energy.

Adaptogens help the body “adapt” to stress. They up-regulate genes involved in boosting the body’s natural stress resilience.

They also balance the cortisol curve, and protect the brain from the effects of stress.

Because of this, adaptogens not only improve energy and mental and physical endurance, they also improve attention and concentration, immune system function, and mental work capacity.

They can treat depression and anxiety, and regulate circadian rhythms.

Common adaptogens are withania (or ashwaghanda), rhodiola, holy basil, the ginsengs, like Siberian gingseng (or eleuthrococcus), schizandra, liquorice, and maca, among others.

My two favourite adaptogens are ashwaghanda and rhodiola, however your naturopathic doctor can work with you to pick the best herbal combination for your individualized needs.

9. Rule out Chronic Fatigue Syndrome.

Chronic fatigue syndrome (CFS) is characterized by fatigue that lasts 6 months or longer, is not improved by exercise and rest, is not related to an imbalance in lifestyle, and is not caused by a primary health condition.

Those with CFS often have signs of an activated immune system such as enlarged lymph nodes, a low-grade fever, or a sore, inflamed throat. Sufferers may experience generalized weakness and pain.

CFS can be an extremely debilitating condition that results in a 50% reduction of daily functioning.

The cause of CFS is not known, however balancing HPA axis function, improving nutrient status, reducing inflammation, healing the gut, reducing toxic burden, boosting mitochondrial functioning, and promoting self-care are all useful treatment strategies.

  1. Rule out food sensitivities.

Research may suggest that fatigue, including CFS, may be caused by food sensitivities. IBS and food intolerance are also linked to fatigue of various types.

Our gut is the seat of the immune system, sampling foreign substances from the external environment and activating an immune response, if it finds any of those substances pose a threat to the health of the body.

If our immune system comes into contact with something doesn’t like, even if that something is a benign food substance, an inflammatory reaction can be triggered. Chronic inflammation can exacerbate fatigue.

To test for food sensitivities, your naturopathic doctor will either order a blood test, or recommend an elimination diet where suspicious food is removed from the diet, the gut is healed, and foods are later reintroduced.

Common foods to eliminate are gluten, dairy, sugar, eggs and soy. Stricter Autoimmune Paleo diets involve the removal of all dairy, eggs, grains, legumes, and nuts.

  1. Mind your mitochondria.

Our mitochondria are the “powerhouses” of the cell, responsible for making ATP, our body’s energy currency, out of the carbs, protein, and fats from our food.

Research has shown a link between mitochondrial dysfunction and chronic fatigue.

The mitochondria need a variety of different nutrients to function optimally. These nutrients include B vitamins, magnesium, Coenzyme Q10, and certain amino acids.

When the mitochondria are unable to produce sufficient ATP, fatigue may result. Similarly, a problem with antioxidant production can result in the buildup of reactive oxygen and nitrogen species, otherwise termed “free radicals”, in the mitochondria.

Free radicals can trigger inflammation and immune system activation in the entire body, causing us to feel ill and fatigued.

B vitamins are also important for a process called “methylation” which is essential for energy and hormone production, immune function, detoxification, mitochondrial function, and DNA repair.

  1. Balance your blood sugar.

Insulin resistance, hypoglycaemia, type II diabetes, and metabolic syndrome are all common conditions that reflect the body’s inability to regulate blood sugar.

All of these conditions can cause frequent energy crashes, fatigue after eating, brain fog, and lethargy.

Even those free of the above conditions may still struggle with blood sugar imbalances. Signs of blood sugar dysregulation are craving sweets, feeling hungry less than 3 hours after a meal, getting “hangry”, feeling weak and dizzy if missing meals, waking at night, and snacking at night.

Balancing blood sugar by eating enough fibre, fat and protein at every meal is essential to maintaining the endurance to get through the day.

Your naturopathic doctor can help you come up with a diet plan that keeps your blood sugar balanced and your energy levels stable throughout the day.

  1. Support your immune function and eradicate chronic infections.

Chronic infections can result in prolonged activation of the immune system, resulting in chronic fatigue.

Viral infections, like mononucleosis and Epstein Barr, and gut bacteria imbalances, such as SIBO, C. Difficile, and candida overgrowth can be implicated in chronic fatigue.

Supporting the immune system with herbs, balancing the HPA axis, and using natural remedies to eradicate the infection are all courses of action you may take with your naturopathic doctor to eradicate infectious causes of fatigue.

  1. Uncover and treat hormone imbalances.

Our hormones, the messengers of the body, regulate how our cells talk to each other.

Hormones are responsible for blood sugar control, the stress response, ovulation and fertility, sex drive, metabolism, and, of course, energy production and utilization.

It is possible that those who suffer from low energy have an imbalance in the hormones cortisol, insulin, estrogen, progesterone, DHEA, testosterone, or thyroid hormones. Directly addressing hormones is then the main treatment goal for improving energy.

Uncovering other signs of hormonal imbalance, such as the presence of PCOS, endometriosis, or symptoms of hypothyroidism, as well as ordering blood tests, can help reveal if an imbalance in hormones is the main cause of your fatigue.

  1. Encourage detoxification.

Our body has the powerful ability to process and eliminate the 500 chemicals and toxic substances we come into contact with daily, as well as the hormone metabolites and immune complexes produced as a result of normal metabolic functioning.

Our livers, kidneys, colon, and skin regularly filter hundreds of harmful substances from our bodies. This process happens naturally without the aid of outside support.

However, it is possible that an increased toxic burden on the body paired with a sluggish liver and digestive system, can increase the body’s overall toxic load.

Toxic overload can contribute to fatigue by increasing inflammation and immune system activation, as well as impairing energy production pathways, and disrupting hormonal function.

Reducing contact with harmful toxins, while supporting kidney, liver and colon function can help restore optimal energy and health.

Treating fatigue first involves developing a relationship with your healthcare provider: finding someone who takes your concerns seriously.

Conducting a thorough assessment of blood, lifestyle factors, sleep, hormones, and digestion, and as many other factors as possible, is essential to uncovering the cause of fatigue.

Treatment involves removing obstacles to healing, supporting energy production, balancing lifestyle, and using herbs to boost energy and stress resilience.

When we consider fatigue as an important sign that something in our body is functioning sub-optimally, we can use our energy levels are important indicators for health.

13 Ways to Self-Care

13 Ways to Self-Care

Humour me for a moment. Take a moment to imagine your “happy place”—the place you feel most at home. Where are you? What are you doing? Who is there with you?

What are the sights, sounds, smells, tastes, and sensations that fill the air and tickle your skin? What are the internal bodily sensations you notice when you find yourself here, in this place? What emotions do you feel?

I’ll venture some guesses: you feel calm, at peace, safe, energized, connected, and integrated. If you turn your attention to your breathing you probably notice that it’s slow, deep, restorative. That head cloud of frenzied thoughts and worries that you tend to spend your time in might have cleared. Your sense of “self” has probably moved out of your head and into your body.

Maybe, through doing this short exercise, you’ve come home to yourself, even just a little.

1) Understand what “self-care” means.

A friend recently shared a Collegehumor video with me depicting three women in a nail salon, bragging about what horrible things they’ve done, from eating 13 glazed donuts in a single sitting, to “enslaving the entire office”, in the name of their own self-care. Because, according to the video, “You can be terrible if you call it ‘Self-care’”.

Humorous? Perhaps. An accurate depiction of self-care? Well, no.

I asked followers of my Facebook page to tell me what the phrase “Self-Care” means to them. They enthusiastically replied:

  • “Silence. No social media, or anything electronic.”
  • “Floating in water—buoyant, effortless.”
  • “Being kind and gentle to myself.”
  • “Meditation and time to oneself.”
  • “Eating healthy foods.”
  • “Respecting your body.”
  • “Epsom salt baths.”
  • “Peace.”
  • “Rest.”
  • “Hygge.” (a Danish word that is roughly translated as “warm and cozy”)
  • “Yoga.”
  • “Commitment.”
  • “Masturbation.” (There’s one in every crowd.)

In essence, their responses boiled down to, “Self-care is feeling good, taking care of myself, and taking care of my body, by engaging in activities that feel nourishing while reducing external stress and overwhelm.”

Put even more simply, self-care is the act of practicing self-compassion, whatever that might look like to you.

2) Understand the impacts of stress.

The relationship between self-care and stress is important. According to The American Institute of Stress, about 75% of us have significant physical and psychological stress in our lives.

This stress takes a toll; it produces physical, mental and emotional symptoms, sending us into emergency rooms with panic attacks, and drugstores with prescriptions for pain, anxiety, or anti-hypertensive medications.

Stress lands us in doctor’s offices, pouring over junky magazines waiting to discuss our latest health complaint—digestive issues, mental health issues, fatigue, autoimmune disease, metabolic syndrome, chronic pain, weight gain, and so on.

Our bodies have a built-in stress response to save our lives when triggered by a life-threatening danger. Now, this fight-flight-freeze mechanism is chronically set off by the abundant stressors in our modern era—traffic, deadlines, relationship woes, artificial lighting, and in-laws.

When our body encounters a stressor, one of the hormones it releases is cortisol.

Cortisol affects every system in the body; it elevates blood sugar, heart rate, and blood pressure. It suppresses the immune system, redistributes fat, shrinks certain areas of our brain involved in learning and emotional regulation, causes painful muscle contraction, impairs digestion, and affects our sleep.

Managing stress involves two main goals: lowering external stressors, and managing internal perceived stress by boosting our physical, mental, and emotional resilience. Self-care is our armour against the internal and external stress we put up with daily.

3) Make a list of your nourishing and depleting daily activities.

Let’s try an exercise from Mindfulness-Based Cognitive Therapy. Write down a list of routine activities in your typical day: hauling yourself out of bed, brushing your teeth, eating breakfast, sitting in traffic, working, exercising, making dinner, and so on.

Decide if each activity is nourishing, depleting, or neutral. In other words, does this activity fill your cup or drain it?

For instance, I find that breakfast is nourishing, but less so when I scroll through Facebook feeds or answer emails while eating it. Coffee immediately feels nourishing to me but, hours later, caffeine-fuelled and wired, I often feel more depleted than if I had opted for an herbal tea, or hydrating water instead.

4) Find out what brings you pleasure or mastery.

To get a deeper understanding of your day, determine if the activities that nourish you provide you with pleasure, mastery, or both.

Pleasurable activities feel good in our bodies, and minds when we do them. They bring us positive emotions like safety, calm, peace, happiness, joy, excitement, gratitude, and awe. Sleeping, eating, laughing with friends, cuddling with my dog, and consuming art, are all activities that give me pleasure.

Activities of mastery give us a sense of accomplishment and achievement. We feel that we are developing ourselves and moving closer towards an important goal. When we engage in activities that give us a sense of mastery, we experience our lives to be rich in meaning. Checking things off a to-do list gives me a sense of accomplishment. So does making strides at work, and taking a course, or studying. 

5) Make some changes to your list.

Oftentimes, patients recoil in horror when they realize that their lists contain only depleting and neutral activities. There are no activities in their day that nourish them: either through pleasure or self-development. I ask them:

  • Are there any depleting activities that you can stop doing?
  • Are there more nourishing activities that you can start doing?
  • How can you make a depleting activity feel more nourishing?

Self-care and self-compassion are the agents through which we answer these questions.

6) Set healthy boundaries.

Before we can reduce the invasion of depleting activities in our lives, we must learn to prioritize our needs. Many of us put others’ needs first. We ignore the advice of every flight attendant—we put on everyone else’s oxygen mask before our own. Before long, we run out of air.

In order to nourish ourselves, we need to learn to create healthy boundaries around our energy and time; we need to say “no.” Author Cheryl Strayed writes, “No is golden. No is the kind of power the good witch wields… [It involves] making an informed decision about an important event in your life in which you put yourself and your needs and your desires front and centre.” When we say no to the people, activities, commitments, and responsibilities that drain us, we say “yes” to ourselves.

Think of your list of depleting, nourishing and neutral activities. What activities, if you could just say “no” to them, would bring you immense relief? What would saying no to those activities allow you to say yes to instead?

7) Recognize perceived stress.

Whether or not external events elicit a stress response in our body depends on our perception. Stressful events are woven into how harmful and uncontrollable we perceive them to be, rather than their intrinsic capacity to cause us harm.

Our perception of stress can be influenced by biochemical factors, such as our levels of neurotransmitters, and hormones. It can also be influenced by our mindset, our capacity for resilience, and how far into burnout we’ve begun to drift.

Lowering our perception of stress requires that we practice the skill of mindfulness: being aware of how external situations affect our thoughts, emotions, body sensations, and behaviours. It also requires that we pay attention to our internal physiology: our hormones and circadian rhythms, and inflammation levels, to support our body’s physical capacity to deal with stress.

8) Practice Mindfulness.

A tarot reader friend of mine once said, “It is impossible to be healthy in this day and age without mindfulness.” She was probably right.

Mindfulness helps us lower our perception of stress. It is the act of bringing attention to the present moment, intentionally, without judgement. Through mindfulness we can be intentional about our behaviours: how often we exercise and what it feels like, what certain foods feel like in our bodies, and what activities we engage in.

Mindfulness also allow us to parse out our overwhelmed, worried, personalizing, catastrophizing, black-and-white, future-telling, and negative, thoughts from our body sensations and emotions. We realize that our thoughts are just that—thoughts. Thinking something doesn’t necessarily make it so.

Research shows that mindful meditation strengthens the connections between the rational brain and the emotional brain. It helps us develop awareness of our moment to moment experience. It connects us to our bodies and our emotional states.

There are many different mindfulness techniques. You can do sitting meditations, standing meditations, and walking meditations. You can do mindful yoga. You can wash the dishes mindfully.

However, the simplest way to begin a mindful practice is to sit or lie down in a comfortable position, with an relaxed and alert posture, and focus on the experience of breathing.

Focussing on the breath helps us practice bringing our awareness to the present moment. As we learn to ride the waves of our breathing, we eventually learn to ride the waves of stress that sometimes lap gently at our floating bodies, and other times rock us to our core.

With mindfulness we can begin to relax our resistance to the waves. As Jon Kabat Zinn says, “You can’t stop the waves, but you can learn to surf.” Mindfulness is the surfboard that carries you.

9) Practice self-soothing.

Self-soothing helps us regulate our emotions in the presence of external stressors. Dialectical Behaviour Therapy teaches self-soothing as a means of returning to the “Window of Tolerance”.

When we’re in the Window of Tolerance we’re not in fight, flight or freeze. We aren’t depleted, disconnected and dissociated. We feel relaxed and safe, but also alert and focussed. We are present, in control of our bodies. Self-soothing allows us to enter the window of tolerance by boosting the hormone oxytocin, which helps us feel calm, nurtured, and connected.

To boost oxytocin:

  • Lie or sit in a comfortable position, place your hands on your chest and breathe slowly and deeply.
  • Connect deeply with a trusted other: a person in your life, a pet, or an entity (God, your higher self, a deceased loved one, etc.).
  • Use body weights or heavy blankets on your body.
  • Recite believable affirmations of self-love.
  • Ask someone you trust for a hug.
  • Boost pleasure through engaging the senses: listen to soothing music, savour delicious food, look at beautiful images, touch soft fabrics, and use aromatherapy and calming essential oils, like lavender.

Poet Mary Oliver tells us, “You do not have to be good… You only have to let the soft animal of your body love what it loves.”

Self-soothing requires practicing mindful awareness to recognize if you’re slipping outside your Window of Tolerance. It also involves implementing nourishing rituals that “the soft animal of your body” loves, to release oxytocin, and return to feelings of calm.

10) Balance blood sugar to balance your mood.  

Our blood sugar is complexly intertwined with our other hormones, like insulin and cortisol, but also our neurotransmitters, like serotonin, epinephrine and dopamine, which influence our mood.

More than 1 in 3 American adults has pre-diabetes. This indicates an impairment in our body’s ability to control blood sugar, which throws mood and hormones off balance.

One of the main life-saving actions of the body’s stress response is to regulate glucose in the blood. Fluctuations in blood sugar can trigger cortisol and stress hormone release. Stressful events can also wreak havoc on our body’s ability to control blood sugar.  Regulating blood sugar, therefore becomes a priority for managing our body’s internal stress cues.

To balance blood sugar:

  • Eat a full 20 to 30 g serving of protein and healthy fat at each meal.
  • Eat a large, protein-rich breakfast that contains at least 200 calories’ worth of healthy fats: 1 avocado, a handful of nuts or seeds, coconut oil, full fat yogurt or kefir, 3 eggs, etc., within an hour of waking.
  • Eat snacks that contain 10-15 g of protein. A great snack for balancing blood sugar is a 1/4 cup of pepitas, or raw pumpkin seeds. Rich in protein, fibre and healthy fats, they also contain zinc and magnesium, two important minerals for balancing mood and supporting stress hormones.
  • Ensure that every meal contains gut-loving fibre: eat 2-3 cups of vegetables at every meal.
  • Avoid refined sugars and flours wherever possible.
  • Experiment with Time-Restricted Feeding, leaving at least 12 hours of the day open where you consume only water and herbal teas, to give the digestive system a rest. For example, if you have breakfast at 7am, finish your dinner by 7pm, to allow 12 hours of fasting every night.

11) Calm your stress response through healing your circadian rhythms.

The body’s stress response is tightly connected to our circadian rhythms. Cortisol, the stress hormone, follows a predictable daily pattern, rising within an hour of waking in the morning, and then falling throughout the day. Low cortisol levels at night coincide with the rise in melatonin, our sleep hormone.

Morning fatigue, afternoon crashes, and waking at night, all point to a flattened or altered stress response that has negatively impacted our body’s circadian rhythms. Sleep is also the greatest reset for the stress response. We build up our metabolic reserve and internal stress resilience every night when we rest.

To heal your circadian rhythms:

  • Expose yourself to bright, natural daylight soon after waking.
  • Eat a large, fat and protein-rich breakfast within an hour of waking.
  • Avoid exercising too close to bedtime.
  • Keep blood sugar stable.
  • Practice sleep hygiene: keep your bedroom dark and cool, and reserve your bed for sleep and sex.
  • Avoid blue light after 7 to 8 pm. Wear blue light-blocking glasses, use a blue light-blocking app on your devices, such as F.Lux, or simply avoid all electronics in the evening, switching to paper instead.
  • Try to get to bed before midnight, as the deepest sleep occurs around 2 am.
  • Talk to your naturopathic doctor or natural healthcare professional about melatonin supplementation or other natural remedies to help reset your sleep cycle.

12) Manage Inflammation and nurture your microbiome.

Cortisol, the stress hormone, is an important anti-inflammatory. High levels of inflammation have been associated with mental health conditions like depression and anxiety.

Keeping inflammation levels low not only reduces our need for stress-hormone-signalling, but keeps us healthy. Most chronic conditions, like cardiovascular disease and diabetes, are associated with inflammation.

To keep inflammation levels low:

  • Eat a variety of anti-inflammatory colourful fruits and vegetables.
  • Avoid processed oils like soy and corn oil, whose omega 6 fatty acids are known to contribute to inflammation.
  • Eat healthy fats from avocados, fish, coconut, olives, nuts, seeds and grass-fed animals.
  • Avoid processed foods and fried foods wherever possible.
  • Nurture your gut health by eating lots of fibre, and consuming fermented foods, like kefir and sauerkraut.

Our gut is the seat of the immune system. Keeping it healthy is a powerful preventive measure for keeping inflammation levels low. Our gut bacteria also play a role in our mood and stress-hormone regulation. Therefore, keeping them healthy and happy is essential for boosting our internal resilience against external stressors.

13) Recognize that balance doesn’t exist.

None of us are born cool and collected. Those of us who seem to “have it together” are simply quick to respond to life’s tendency to fall apart. Balance doesn’t exist; as soon as we feel like we have the details our lives lined up, a sharp gust of wind sends them tumbling in all directions. Therefore prioritizing self-care becomes an ever-evolving balancing act that we must commit ourselves to through nurturing our internal resilience.

A poem by Kelly Diels says it best, “when your love knocks you down or your weak ankles trip you up, stop worrying about balancing—‘cuz you’re not — and bounce.”

And bounce.

The Do’s and Don’ts of Human Nutrition

The Do’s and Don’ts of Human Nutrition

ÏÏAround the same time that the American Heart Association published a paper warning the public that coconut oil contained saturated fat, supposedly leading to heart disease, Netflix released the vegan documentary What the Health, which declared diabetes to be a disease of fat buildup in the blood, among other completely unscientific claims.

It was no wonder that my inbox and social media were bombarded with comments from confused patients, family members and friends; their attempts at healthy eating were being called into question by this onslaught of confusing contradiction.

“But I’ve been adding coconut oil to my morning smoothies!” one person wrote.

“I’ve switched to a plant-based diet!” another triumphantly declared. She was currently seeing me for treatment for her long-standing anemia.

Don’t: Freak Out

It seems like every new nutrition-focused Yahoo! News article lifts the protective rock of certainty off the health-conscious, sending us scuttling frantically for cover like newly exposed garden grubs.

You can hardly blame us. As someone who studies health and nutrition for a living, even I find myself caught up in this health claim game of ping-pong. How could one claim be true if the complete opposite claim was being made? Was coconut oil the devil incarnate, or the next belly-fat blasting super food? Do vegan diets cure diabetes or cause it?

I take my eyes off the ping pong ball and stop to massage my neck.

Do: Understand the Power of Food

If there is one right diet for humans, then we certainly haven’t found it through modern-day nutritional research. One of the problems with finding a standardized “perfect” human diet is that humans are not gerbils: our food serves various functions.

A good diet fuels the body, prevents disease and promotes health, but also provides us with a source of pleasure, soothes emotional pain, gives us something to look forward to, serves as a reward (for ourselves, our loved ones, our children), takes centre stage during celebrations, supports social cohesion, and encourages meeting attendance, or blood donations.

Food allows us to wallow in the luxury of our senses, or to commune with the Divine. Eating and making food serve as hobbies, creative outlets, and so on.

Food holds a sacred place in virtually every human culture.

As a naturopathic doctor, I use food as a medicine; the food we eat has the power to reverse disease and promote health.

With conditions like cardiovascular disease, type II diabetes, and mental health conditions, on the rise, it becomes imperative that we make an effort to understand the health impact of our food choices.

Understanding the Do’s and Don’t’s of Nutrition can help us harness the power of food to heal the body and prevent disease.

Do: Be Critical of Nutrition Research

Nutritional research, while essential for separating the gluten-filled wheat from the chaff, is flawed in many regards.

Because well-controlled, long-term clinical trials on compliant humans are nearly impossible to do, much of the nutritional information we rely on comes from epidemiological studies, which establish relationships between two isolated variables, such as a food and a health outcome (red meat consumption and colon cancer incidence, for example).

When evaluating these studies it is important not to confuse correlation with causation. This is what happened in the 1950’s, when Ancel Keys published his famous Seven Countries Study that claimed to link saturated fat intake and coronary artery disease.

Keys’ findings led us to toss out our delicious bacon and egg breakfasts in lieu of spending the next 60 years munching fat-free yogurt and sugary cereal.

Keys assumed that because saturated fat, dietary cholesterol, and heart disease were linked (in the seven countries he included data for) that the relationship was causal. However, we know from current research that this is not true—correlation does not equal causation.

Other things that correlate with an increased incidence of heart disease are paying tax in Sweden and owning multiple TV sets. While paying taxes may certainly give you chest pain, avoiding them will probably not reduce your heart disease risk.

Nutrition researchers attempt to account for as many relevant lifestyle variables as possible, but there are many that they miss.

For example, studies may record whether the participants smoked, drank, or exercised, but important variables such as the status of their gut microbiome, or how they season their meat, are often left out. This can be problematic—when we fail to include everything, we’re bound to miss something.

While nutritional research is essential for understanding how food interacts in our bodies, we certainly need to take most studies with a grain of salt (which a new study shows has no impact on your blood pressure).

Do: Pay Attention to What Healthy Traditional Societies Ate

Speaking of salt, any human nutrition article wouldn’t be worth its weight in it without mentioning the work or Dr. Weston A. Price. Dr. Price was a Canadian dentist who lived at the turn of the 20th century, when food was becoming more industrialized.

Suspecting that the increase in tooth decay he was noting in his child patients was diet-related, Price set out on a 10-year journey in the 1930’s to find the “perfect diet” by analyzing what traditional human societies ate.

He studied populations in remote Swiss villages, in the Americas, African tribes, Australia and New Zealand, and the Melanesian and Polynesian South Sea Islanders. Dr. Price took meticulous notes, food samples for analysis, and many pictures, all of which he published in his book Nutrition and Physical Degeneration.

While many of the populations he studied had also begun to experience the creeping influence of an industrialized food economy, others had still managed to retain their native diets. Due to globalization and its effects on traditional communities, this type of study could never be done today.

Price found some of the populations exhibited incredible characteristics of robust health. They had decay-free, straight white teeth, flawless facial and jaw structures indicating healthy bones, and no diseases; cancer and autoimmune conditions were virtually nonexistent across generations in these populations.

Price noticed that, while the healthy populations’ diets consisted of a variety of foods and macronutrients, they all had very important commonalities.

Don’t: Consume Processed Foods:

First of all, Dr. Price found that the healthiest populations somehow managed to avoid the flood of industrial food products. They refrained from eating refined flours, sugars, food additives, and vegetable oils, and stuck to their native diets of meat, eggs, dairy, fish, fruits, and vegetables.

He noted that, once processed foods started to creep into a population’s diet, dental decay and degenerative diseases, such as cancers, tended to quickly follow.

Don’t: Eat Anything Your Grandmother Wouldn’t Recognize

Michael Pollen, author of The Omnivore’s Dilemma, reminds us of some simple food rules, such as his famous “Eat food. Not too much. Mostly plants.”

In his book, Pollen clearly differentiates between “food”, i.e.: something your grandmother would recognize, and something “made from a plant, not in one”, and “edible food-like products”, which tend to increasingly populate our grocery stores, kitchen cupboards, and bodies.

Refined sugars and vegetable oils have increased exponentially in the average diet in the past few decades. So have metabolic degenerative diseases such as cancer, diabetes, and heart disease.

It seems that the entire food industry, from the way grocery stores are set up, to the way that foods are marketed to consumers, to the promotion of a culture of snacking, is built around encouraging the consumption of processed, “edible food-like products” rather than real foods.

The book The Dorito Effect outlines how the food industry engineers processed foods to contain taste, textures and chemicals that override our body’s hunger and satiation signals in order to monopolize our cravings, leading us to overeat.

Steering clear of these packaged, processed and over-produced food-like products is essential for promoting health.

Do: Eat Whole Foods

Stick with consuming what Michael Pollen classifies as “food”: whole substances that come from plants and animals, that resemble how they are found in nature, and that usually exist in the periphery of the grocery store.

Prepare foods at home as much as possible. Avoid foods in packages that contain more than 5 ingredients, especially if the ingredients listed are unpronounceable, or something your average 5th grader wouldn’t recognize.

As early on as the 1930’s, Dr. Weston A. Price was already noting an increase in tooth decay and jaw malformation in children who were consuming the industrialized processed foods that were beginning to enter the North American diet.

Since then our consumption of processed foods, refined sugars, vegetable oils and flours has increased, and so have our incidences of chronic, lifestyle-related diseases.

Therefore: Eat Food. Not too much. Mostly plants (and animals).

Do: Consume Animal Products

Dr. Price found that every population he studied consumed some form of high-nutrient animal product. While some populations were vegetarian, consuming raw dairy products, none were vegan.

Every healthy population consumed some combination of fish, organ meats, insects, eggs and dairy from pastured animals. All animals consumed were obtained from nature and ate their natural diet; cows ate grass and poultry ate grass, grubs, and worms.

They consumed the entire animal, favouring nutrient-rich organs over muscle meat: liver was highly valued. They used bones to make gelatin, which provides a source of bone, skin and connective-tissue-building collagen.

Obtaining enough organ meats, fish, egg yolks and grass-fed beef and dairy allowed the healthiest populations to achieve ten times the dietary intake of the fat-soluble vitamins A, E, D and K than the typical North American.

Do: Consume Fat

The healthiest populations that Price studied consumed anywhere from 30 to 80 percent of their total calories from fat. Most of these fats were saturated, obtained from animal sources, and heart-healthy monounsaturated fatty acids, obtained from foods such as olives, avocados, and macadamia nuts. Only 4% of the fat they consumed came from the polyunsaturated fats that are found in vegetable oils, nuts, seeds, processed grains and legumes (like corn and soy), and fish.

Vilified for years in North America, fat is essential to the human diet: it builds our brains, nervous systems, hormones, and cell membranes. Fat is a fuel source for our brains. It aids our bodies in blood sugar regulation and the absorption of essential nutrients.

Contrary to what we’ve been told for the last few decades, a low-fat diet, rather than a high-fat one, is associated with increased risk of mortality.

A 2017 Lancet study that observed the diets and disease risk of 135,000 people found that total fat intake, including saturated fat, was not associated with any increase in cardiovascular disease or mortality. The study also found that when saturated fat intake increased the risk of stroke decreased.

Don’t: Consume Vegetable Oils

Polyunsaturated fats, or PUFAS, exist as omega 6 (found in processed vegetable oils like corn, soy or canola oil) and omega 3 fatty acids (found in fish, nuts and seeds).

Healthy human populations generally obtained a 1 to 1 ratio of omega 6 to omega 3 fatty acids. The increase in cheap vegetable oils in our diets has brought our inflammatory omega 6 fatty acid levels up substantially, to a ratio of 10 to 1. With this increase we see a rise in inflammatory health conditions: arthritis, diabetes, obesity, cardiovascular disease, mental health conditions, and autoimmune disease.

Vegetable oils like canola, corn and soya oil require intense chemical processing and are very unstable, becoming rancid quickly. Their high omega 6 content promotes inflammation.

Avoid these oils whenever possible by avoiding store-bought salad dressings, packaged foods, restaurant foods, and fried foods. Instead, cook from home whenever possible using the healthier oils from olives, coconut, and avocado, or using butter and ghee.

Do: Consume Fermented Foods

Our microbiome, the universe of trillions of bacteria that live inside our digestive tracts, has become the subject du jour of intense medical research. The health of our guts has been associated with virtually every disease, from our mental health to our risk of inflammatory, degenerative diseases, to our circadian rhythms and stress responses.

It is no wonder, then, that Weston A. Price, found in the 1930’s what modern science is now confirming: the healthiest human populations regularly consumed fermented foods, like kefir, that were rich in healthy probiotics.

These populations also soaked, fermented and sprouted their grains, seeds and legumes to neutralize their lectins and phytates. Lectins present in grains and legumes can cause inflammation and autoimmune reactions, while phytates act as anti-nutrients, preventing absorption of minerals in the digestive tract.

Fermentation supports the health of our gut bacteria and aids in the digestion of various foods.

Do: Personalize Your Diet

While the work of Weston A. Price and intuitive wisdom—avoid fake foods wherever possible—can serve us in our eating choices, there was a significant amount of variability among the foods consumed in healthy human diets.

How do we know what foods will help us thrive personally?

Eran Segal, in his popular Ted Talk, presents a variety of blood sugar responses to different types of carbohydrate-rich food.

When we eat food high in carbohydrates, our blood glucose levels rise as those carbs are broken down into simple sugars in the digestive tract and then absorbed. Constantly spiking blood sugar levels, when done repeatedly over time, is a recipe for fat-gain and increasing our risk of type II diabetes.

Segal and his team found that some foods, like bananas or white rice, caused a marked increase in blood sugar levels when some study participants ate them, while foods like cookies and ice cream had no effect, slowly raising blood glucose levels rather than dramatically spiking them.

There were other study participants, however, who experienced the opposite effect: a marked spike in blood sugar in response to sugary foods, like ice cream, and a more gradual increase (consistent with healthier blood-glucose control) in response to rice and cereal grains.

Segal found that an individual has a personalized blood sugar response to certain foods, which can be predicted by their genetics and microbiome, among other factors.

Segal’s team concluded that dietary guidelines are not one-size-fits-all. Each individual may have a specific set of foods on which they thrive.

Do: Find Your Perfect Diet

So, how do we find our perfect personalized diet?

Life coach, Brooke Castillo, of the Life Coach School Podcast has some useful guidelines. Castillo suggests four questions to ask yourself when eating a specific food to find out if that food is right for you:

1) Does this food taste good to me?

2) Does this food feel good in my body?

3) How is this food acting in my body?

4) Is this food helping me get me the health results that I want?

Do: Eat Food You Like

As a naturopathic doctor, I know: it doesn’t matter how good a particular food may be, if my patient doesn’t like it, he or she won’t eat it.

Finding the perfect diet for us involves eating a variety of unprocessed foods that provide us with fuel and that we look forward to eating. However, it can take a while to learn what real food tastes like if our palates have been manipulated by the chemically-enhanced flavours of processed foods.

Ayurveda, a 6000-year old medicine from India, identifies 6 tastes: sweet, sour, salty, spicy, astringent and pungent; a healthy diet consists of all 6 tastes.

The Standard American Diet contains mostly sweet taste, with some salty and sour (alcohol) added to the mix. Being relatively rare in nature, the human palate evolved to prefer these tastes over others (such as bitter taste, which is abundant in antioxidant-rich plants).

In order to balance our diets, we may need to make an effort to consume more bitter or astringent foods from micronutrient-rich leafy green vegetables. Training ourselves to appreciate a variety of tastes may be important for finding a diet that fuels us while also bringing us pleasure.

Do: Pay Attention to How Foods Feel in Your Body

If Eran Segal’s study subjects had had experience practicing mindful eating and body awareness, I wonder how many of them would have already known whether their bodies could better tolerate white rice or ice cream.

If they had been paying attention to their body’s cues, it’s possible that they already knew that white rice spiked their blood sugar, causing symptoms of shakiness, dizziness, brain fog and lethargy, or increased hunger and sugar cravings.

Whenever I see a new patient, I have him or her record their food intake for two weeks along with any symptoms experienced in their bodies. This exercise almost always proves useful in a variety of ways. Patients notice that certain foods make them feel bloated and lethargic, or cause headaches, while other foods reduce their cravings and provide them with level energy.

Paying attention to how our body feels immediately after eating or in the hours following, can provide us with invaluable information about the specific effects certain foods have on us.

Do: Consider Working With a Professional

To answer Brooke Castillo’s 3rd guideline question “How is this food acting in my body?” you may need to work with someone who understands nutritional biochemistry and physiology.

For example, you may love cheese and it may feel good in your body immediately after you eat it.

However, unbeknownst to you, cheese may be causing a delayed food sensitivity reaction that produces symptoms many hours to days later and contributes to your symptoms of hormone imbalance. Cheese may be encouraging mucus production, contributing to your chronic sinus congestion.

The way different foods interact with our hormones and immune systems may not be apparent immediately after we ingest them. The effects may be delayed or slowly accumulate over time. Gaining a professional’s view on the impact a food has on our complex bodily systems, including our personalized genetics and gut microbiome, can help us understand whether that food has a place in our ideal diet.

A professional combines his or her knowledge of the body with your knowledge of your own body, your health history, and blood tests, to help you identify which foods might not be right for you.

Do: Eat Food that Supports Your Health Goals

As Hippocrates once said, “Let food be thy medicine.” As a naturopathic doctor, I believe that nutrition has an important place in disease prevention and healing. Each bite of food we take can have the effect of moving us toward health or away from illness.

Our nutritional requirements will differ depending on our health goals. A 71-year old woman undergoing chemotherapy and radiation for stage 2 lung cancer will be eating a very different diet than her 24-year old bodybuilding grandson. A 42-year old woman who has polycystic ovaries and hopes to get pregnant in the next year will also have completely different dietary requirements and health goals.  

You might love the food you eat. It might feel great in your body; you’re eating unprocessed, whole foods you prepare at home. However, you’re not feeling as amazing as you feel you should. Perhaps you feel tired, or struggle to lose weight. You might suffer from depression, diabetes, or daily digestive symptoms.

Depending on your health goals, a healthcare professional can work with you to find the ultimate nutrition do’s and don’ts for your body.

Do: Have Courage

Dipping our toes into the deep pool of human nutrition can be a daunting, yet essential act. Our dietary habits have the power to deeply influence our health. In the words of Ann Wigmore, “The food you eat can either be the safest and most powerful form of medicine, or the slowest form of poison.”

Removing processed foods from our kitchens, eating whole foods, cooking at home, eating enough of the right types of fats, developing awareness of how foods feel in our bodies, and considering working with a professional to help us reach our health goals through diet and lifestyle changes, can have a powerful impact on the quality of our lives.

Eat Less, Live Longer: The Therapeutic Benefits of Fasting

Eat Less, Live Longer: The Therapeutic Benefits of Fasting

In the past I used to suffer from “hanger”, feeling hungry and irritable if going more than a few hours without food. Now my body is adapted to fasting, going prolonged periods without food—and I feel all-the better for it.

When I was a kid, no one ever had to convince me to finish my dinner. Perpetually “hangry” (hungry and angry), I was the Tasmanian devil of snacking, vacuuming up whatever food substances crossed my path, leaving wrappers and crumbs in my wake. “Never get between Talia and her food,” my brother facetiously coined when, like a voracious bull, I would bully my way into the kitchen to fix myself an emergent after-school snack. From the moment I was born, it seems, going more than two hours without eating was a physical impossibility. “I’m sick with hunger,” I would complain whenever my blood sugar levels dipped.

Now I sit here writing this article, in my adult incarnation, comfortably having abstained from eating for more than 14 hours. Whereas before I couldn’t go more than 2 hours without some kind of sugary snack, my body is now adapted to thriving during prolonged periods without food—and I feel all-the better for it.

“Eat a snack every 2-3 hours to keep blood sugar stable and lose weight,” dieticians and nutritionists often advise . However, as we dig into the disease prevention, anti-aging and weight management research, we learn that there may be benefits to going without food for prolonged periods.

We humans spent much of our evolutionary history hunting and gathering with extended periods of food scarcity. Our bodies adapted to survive through, and perhaps even thrive and depend on, periodic fasts. We now live in a society that enjoys food abundance: with 24-hour convenience stores and fast food restaurants at our disposal, we rarely go hungry. This recent lifestyle change may contribute to the increase in the diseases of excess that afflict modern bodies.

Ancient healing systems like Ayurvedic medicine and Traditional Chinese Medicine have long recognized the benefits of fasting for purifying and healing the body. Today, a body of research is accumulating that suggests that fasting may help treat diseases like multiple sclerosis and cancer, reduce the risk of chronic metabolic diseases, such as diabetes, battle dementia and cardiovascular disease, and reverse the effects of aging, helping us live longer.

What Happens During Fasting: 

Human physiology fluctuates between two modes: the fasted and the fed state. After eating, a hormone called insulin rises in response to the intake of dietary carbohydrates and, to a lesser extent, protein. Insulin allows glucose to enter cells where it can be used for energy. Insulin encourages the storage of body fat and glycogen—a molecule stored in the muscles and liver that can be broken down quickly for energy. Insulin is an anabolic hormone that promotes tissue building and growth.

Our bodies are in the fed state, or postprandial state, for up to 4 hours following a meal, when blood sugar and insulin levels rise and the body begins to store food energy. 4-6 hours after eating, our bodies enter the post-absorptive state. Insulin and blood sugar levels fall, and blood sugar is maintained through the breakdown of liver and muscle glycogen. At the 10-12 hour mark post-meal, the body enters the fasting state. At this stage, glycogen stores have been depleted and blood glucose is maintained through a process called gluconeogenesis: glucose is created from fat, lactate and protein. In the fasting state, the body taps into fat stores to create ketone bodies, which are used for fuel.

Approximately 24-48 hours after a meal, the body enters a state called autophagy (or self-eating). The body breaks down old, damaged cells into their proteins and reuses them to build new cells or for fuel, through gluconeogenesis. Autophagy has gained the attention of researchers who recognize its benefits for managing inflammation, slowing the effects of aging, and treating various chronic diseases, such as autoimmune disease and cancer—more on this later!

Fasting to Treat Cancer:

Valter Longo, PhD, at the Longevity Institute at the University of Southern California, examined the effects of 2 to 4-day fasts on patients with cancer who were undergoing chemotherapy. The study found that several days of fasting improved the efficacy of chemotherapy, while reducing its side effects, protecting healthy, non-cancerous cells. Healthy cells responded to the periods of food restriction by shutting down, protecting them from the toxicity of the chemotherapy. Cancer cells don’t have such a response, leaving them susceptible to the chemotherapy. “Cancer cells are dumb cells,” says Dr. Longo.

The fasting period not only improved the effects of cancer treatments, it stimulated the regeneration of the immune system through the creation of progenitor stem cells. Fasting cleared out damaged immune cells and cancer cells through autophagy and new cells were regenerated upon re-feeding. Dr. Longo and his team found that up to 40% of the immune system is rebuilt in mice after a fasting and re-feeding cycle.

Fasting Mimicking Diets:

Recognizing the difficulty in going 3 days without food, Dr. Longo developed a 5-day “Fasting Mimicking Diet” that allows for the consumption of about 700-1000 calories per day in the form of small snacks. The Fasting Mimicking Diet is low enough in calories, protein and carbohydrates to mimic the physiological conditions and benefits of fasting like autophagy, ketone body production, beneficial stress response, and cancer cell starvation.

Mice given the Fasting Mimicking Diet (FMD) lost 30% of their body weight through the breakdown of body fat and clearing away of old, damaged cells. When the mice were re-fed, their blood, brain and bone cells were rebuilt. The mice who underwent the Fasting Mimicking Diet had rejuvenated immune systems, decreased incidences of cancer, reduced body fat, improved cognitive performance, decreased inflammation, and increased lifespans.

Fasting to Treat Autoimmunity:

Research in mice showed promising results in using the Fasting Mimicking Diet to treat multiple sclerosis, a debilitating autoimmune condition that attacks the nervous system. When following the diet, immune cells that were attacking the brain and spinal cord were destroyed. Upon re-feeding, new progenitor stem cells were created that repopulated the immune systems of the affected mice, and aided in repairing the damage to the brain and spinal cord. The Fasting Mimicking Diet resulted in a 20% reduction in autoimmunity in mice with multiple sclerosis.

A study that examines the effects of the Fasting Mimicking Diet on humans with Crohn’s Disease, an autoimmune disease the affects the digestive system, are currently underway.

Fasting to Reverse Aging:

Autophagy, the process of removed and recycling old and damaged cells, is a new area of research for reversing the effects of aging. Autophagy alleviates the body burden of senescent cells that have stopped dividing but are still robbing the body of essential nutrients and energy.

When cells become senescent, they release inflammatory mediators, which can damage neighbouring cells and cause inflammation and disease. Cellular senescence is thought to be one of the primary mechanisms by which we age. As we age, more cells become senescent, causing age-related inflammation. A study found that inflammation is the primary factor that drives the aging process, damaging DNA and contributing to various diseases, such as cardiovascular disease, diabetes, arthritis, cancer, and autoimmunity.

The process of fasting and re-feeding stimulates the production of new, healthy progenitor stem cells in the immune system. Mice and human volunteers who underwent cycles of the Fasting Mimicking Diet had decreased numbers of myeloid cells, the inflammatory immune cells that become more numerous as we age, and increased numbers of cytotoxic T cells, which protect the body against viruses and cancer.

Fasting promotes longevity through its inhibition of Insulin-like Growth Factor -1 (IGF-1), a growth factor that promotes cellular growth, and prevents the death of senescent cells. Growth factors are important for growing babies and children, developing fetuses, boosting muscle, and growing new brain cells. However, growth factors like IGF-1 are negatively associated with longevity because of their potential to stimulate the growth of cancer and prevent autophagy. Mice whose growth factor-dependent genes were removed, or “knocked out”, lived 40-50% longer and suffered from less diseases as they aged. IGF-1 is stimulated by protein and carbohydrate intake; it is elevated in the fed state and inhibited when fasting.

Healthy humans who underwent cycles of the Fasting Mimicking Diet had lower risk factors that were associated with cardiovascular disease and diabetes, such as lowered blood pressure, reduced CRP (a marker of inflammation in the blood), and reduced fasting blood glucose levels. These markers remained improved even after the subjects returned to a normal diet, which indicates that fasting may help reduce the risk of chronic diseases, such as diabetes and heart disease, promoting health longevity and increased lifespan.

Fasting for Energy and Resilience to Stress:

Hormesis is the process in which the body’s response to a stressor like the slightly toxic flavonoids in plants, intense exercise, or extreme temperatures, benefits the body as a whole. Hormesis is one of the reasons that exercise and green leafy vegetables are so good for us; they impose minor stressors on the body, boosting its healing properties, and improving resilience.

Fasting, in addition to other positive stressors, up-regulates a stress-response gene called FOX03. When FOX03 is activated, it produces proteins that reduce inflammation, increase anti-oxidant production, repair DNA, and increase cellular energy production through the creation of new mitochondria. Humans with a more active version of the FOX03 gene have an almost 300% chance of living to be over 100 years old.

Fasting also promotes a process called mitophagy. Similar to autophagy, mitophagy involves removing and recycling damaged mitochondria that are no longer able to effectively produce energy. Through activation of the FOX03 gene, more mitochondria are created to replace the old, improving energy production. The creation of new mitochondria only occurs in response to exercise, extreme temperatures, and periods of fasting.

Fasting for Weight Loss:

It doesn’t take a researcher to figure out an obvious truth about fasting: when you don’t eat, you lose weight. Dr. Jason Fung, MD, a Toronto-based nephrologist, prescribes fasting to his obese and diabetic patients. In his book, The Obesity Code, Dr. Fung discusses how the old paradigm of restricting calories for weight loss—eating 1500 calories a day while burning 2000, for example—is out-dated and ineffective for keeping weight off longterm. Dr. Fung argues that fat storage and breakdown are not the result of a simple calories in minus calories out equation, but the performance of a hormonal orchestra conducted by insulin. Insulin stores fat and glycogen, while inhibiting the release of fat breakdown. The body only begins to tap into its glycogen and fat stores when insulin drops during the post-absorptive and fasting phases after a meal. Once it depletes its glycogen stores, the body burns fat as its main source of fuel as long as insulin levels remain low.

According to Dr. Fung, fasting is superior to caloric restriction diets because it keeps insulin levels low for long enough to allow the body to deplete its glycogen stores and tap into fat. Fasting also releases surges of growth hormone, which prevents muscle loss, and norepinephrine, which boosts energy and feelings of well-being. Unlike caloric restriction diets, studies have shown that metabolism increases during and after fasting, preventing weight regain. Dr. Fung argues that fasting can spare muscle, boost metabolism, increase energy, and increase feelings of well-being, making it an effective tool for lasting weight loss.

Ways to Fast: 

While the health benefits may be numerous, fasting isn’t easy. The first time I tried a prolonged fast, all I could think about was food. Food was everywhere and the people around me seemed to be eating all the time. My body, accustomed to being constantly fed, wasn’t too happy with the sudden metabolic switch I was demanding from it. Many of our metabolisms have been trained to run on dietary carbohydrate and glycogen as their primary fuel sources, making the first few hours to days of fasting a challenge. However, there are many ways to ease into the practice of fasting. You can obtain Dr. Valter Longo’s Fasting Mimicking Diet kit from a healthcare provider through ProLon, or practice small intermittent fasts, such as Time-Restricted Feeding.

Time-Restricted Feeding: 

A researcher at the Salk Institute in Califoronia, Dr. Sachin Panda, PhD, found that restricting eating time had amazing health benefits in mice. Mice were fed an unhealthy diet of lard and sugar. The mice, as you might expect, had shorter lifespans and a variety of health problems: diabetes, obesity, and heart disease. However—and this part is miraculous—when Dr. Panda and his team restricted the time the mice were fed the exact same crappy diet to 12 hours (instead of allowing them to eat whenever they wanted), none of the negative health benefits occurred; the Time-Restricted Fed mice were 70% leaner, lived longer and were free from diabetes or heart disease.

Further investigation revealed that restricting feeding time to 8-12 hours a day, resulted in mice that had less body fat, improved muscle mass, decreased inflammation, increased cardiovascular function, increased mitochondrial function, higher levels of ketone body production, increased cellular repair processes and anti-oxidant production, and increased aerobic endurance. It was when the mice ate, not what they ate, that conferred these health benefits.

North Americans, on average, eat on a 15-hour clock. We seem to eat constantly, stopping only to sleep. To study the effect of Time-Restricted Feeding on humans, Dr. Panda had human participants restrict their food intake to 12 hours a day; if the volunteers had their first sip of coffee at 7 am, they were told to cease all food intake by 7pm. After the completion of the 16-week study, the volunteers lost 3-5% of their body fat without making a conscious change to their diets. The participants reported sleeping better and feeling more energized in the morning. They noted that their overall calorie consumption decreased by about 20% without effort.

Research into Time-Restricted Feeding indicates that allotting at least 12 hours a day to fasting boosts the body’s repair mechanisms, improves digestive function and motility, provides time for the body to switch to ketone body production (which tends to happen 10-12 hours after a meal), improves blood sugar control, regulates appetite, and enhances stress resilience. Taking a break from eating allows the body to invest its energy into repair, rather than digestion. The best part about Dr. Sachin Panda’s research is its simplicity; to obtain all of the benefits, simply avoid after-dinner snacks!

Intermittent Fasting: 

Similar to Time-Restricted Feeding, Intermittent Fasting plays with the ratio of fasted to fed hours. Proponents of Intermittent Fasting refrain from eating from 12 to 23 hours within a 24-hour period. A common ratio of fasted to fed time is 16 to 8 hours: fasting for 16 hours a day and eating within an 8-hour window. For example, if breakfast is at 8am, then those following a 16:8 intermittent fast stop eating by 4pm in the afternoon.

Alternate Daily Fasting or the 5:2 Diet: 

Studies with mice and human subjects found that alternating daily food intake, or following a 23:1 fast (having just one meal a day) every second day, was effective for weight loss. The protocol is beautifully simple: every second day either fast completely or indulge in only one meal. While people tend to eat more on their “fed” days, they don’t seem to make up the calories that are lost on the fasting days, resulting in an overall reduction in calories and weight loss.

Water Fasts:

It’s estimated that we need to fast for at least 36 hours to get the autophagy benefits, which makes water fasting a powerful therapeutic and anti-aging practice. Water fasting is simple: withstand extended periods, usually 3 to 5 days, but often longer, only consuming water.

The longest recorded water fast was 382 days, performed in 1973 by a 27-year old male who weighed 456 lbs. During the months he fasted, the 27-year old consumed only water and a multivitamin and, according to the study published on him, experienced “no ill-effects”. While water fasts can have amazing therapeutic benefits, it is advised that they be medically supervised.

Ketogenic Diets: 

Ketogenic diets are high-fat diets that restrict carbohydrates and limit protein, and can mimic the low-insulin conditions of fasting. Because carbohydrates and protein are restricted, the body is forced to turn dietary fat into ketone bodies, which it can use for energy.

Ketone bodies, especially beta-hydroxybutyrate, produced from either dietary or body fat, have important therapeutic uses. They provide more energy for the brain than glucose, which can have benefits for memory, mood, concentration and cognitive performance. Ketogenic diets have been recommended for treatment-resistant epilepsy, and diseases associated with cognitive decline like Alzeimer’s and Parkinson’s. More recently ketogenic diets have been recommended for mental health conditions, such as depression and anxiety.

Ketone bodies also help cells resist oxidative stress, preventing cellular damage, which makes ketogenic diets of interest to cancer researchers because or their ability to starve cancer cells of protein and carbohydrates, while fuelling healthy cells.

Ketogenic diets can deliver many of the benefits of fasting because of the low-insulin, low growth factor conditions they induce. When a person becomes “keto-adapted”, able to burn ketone bodies efficiently for fuel, the transition to fasting is easy. For this reason, ketogenic diets and fasting often go hand-in-hand.

Cautions:

While fasting can deliver many health benefits, it can impose a temporary stress on the body for those who haven’t adapted to ketosis or prolonged periods without food. Therefore, it’s important to fast under the supervision of a medical professional, especially if deciding to embark on an extended fast.

Before deciding to fast, the individual’s energy levels and vitality, health status, hormone regulation (those who are taking insulin should practice extreme caution when fasting), age, health history, and health goals, should all be considered. A woman of fertility age will have different health goals than a 72-year old woman with type II diabetes. The former may want to preserve body fat and promote fertility and ovulation, while the latter may want to reduce her insulin and growth factor levels, and lose weight in order to promote health longevity.

Fasting may not be appropriate for everyone. For example, those who are underweight, pregnant, breastfeeding or suffering from an eating disorder should not fast. Fasting in women of reproductive age has the potential to produce hormonal imbalances such as hypothalamic amenorrhea (irregular or absent menstrual cycle). Fasting can exacerbate or cause dysregulation in stress hormones, particularly cortisol, known as “adrenal fatigue”, and potentially effect thyroid function, as a result of the body’s starvation response. Fasting while under the pressure of chronic mental and emotional stress is probably not a good idea. Working with a professional and listening to your body are key elements to doing fasting right.

However, when used correctly, it can be a simple, free, powerful therapeutic tool for healing the body, treating chronic disease, and promoting longevity.

 

 

Contrast Showers for Immunity, Inflammation, Mood, Pain and Weight Loss

I talk about contrast showers for boosting immunity, lowering inflammation, mood, pain and weight loss.

Hello everyone, my name is Dr. Talia Marcheggiani, I’m a naturopathic doctor and today I’m going to talk about hot and cold contrast showers. As naturopathic doctors, one of our modalities is hydrotherapy. Hydrotherapy comes from naturopathic medicine’s roots, using hot and cold water to make changes to circulation, hormonal functioning and immune functioning. I’m going to talk about some of the science behind hot and cold contrast showers.

This is something I recommend to my patients to increase their immune activation, decrease autoimmunity, improve mood and hormonal functioning, as well as increase circulation and there’s some evidence that it might help with weight loss as well.

So, firstly, things like exercise and hot and cold therapies induce a little bit of stress. There’s two kinds of stress: distress, which is sort of that chronic, cortisol-fuelled stress that a lot of people come in with, in a state of burnout that’s causing things like inflammation, and mental-emotional illness, and autoimmune issues, and dysbiosis, and then there’s something called eustress, which is more like exercise, cold therapy: short, small bursts of stress that actually up-regulate proteins and genes in our body to combat stress. These genes are involved in DNA repair, increase antioxidant synthesis, and the antioxidants that our body makes are far more powerful than the ones that you’re going to get from food or supplements.

So, by upregulating these genes, we can protect ourselves from cancer, neurodegenerative disease, and other chronic diseases. It’s really powerful stuff, this is called a “Hormetic” response, hormesis, where small stressors mount bigger responses by the body than is needed to deal with those stressors and overall we’re better off; there’s this net beneficial effect. This is one of the proposed mechanisms for some of the antioxidants or flavonoids in green leafy vegetables. It’s not that they provide us with antioxidants, it’s that they encourage our body to make antioxidants due to the small, toxic load that they present to us. And so there’s some evidence that getting short bursts, or longer bursts of cold, very cold, will increase a hormone called norepinephrine. Norepinephrine is involved in depression and mood. Norepinephrine is a catecholamine and it increases the sympathetic nervous system, which is that fight or flight nervous system. When boosted in small amounts, it can actually elevate mood and so a lot of anti-depressant medications also induce, or inhibit the reuptake of norepinephrine. So these are called SNRIs and they include things like Venlafaxine and Cymbalta. So there’s some evidence that norepinephrine increases 2-3 times after only 20 seconds of immersion in cold water. There’s a connection between norepinephrine lowering pain and inflammation and increasing metabolism and there’s some anecdotal evidence and one study, at least, was done to show that cold immersion therapy actually decreased symptoms of depression.

There’s also these things called hot and cold shock proteins, heat shock proteins and cold shock proteins. So, for example, one is called RBM3, which is a cold shock protein, and these proteins can actually help increase longevity and they can actually help decrease incidences of neurodegenerative diseases and neurodegeneration, so something like Alzeimer’s disease or Parkinson’s disease, which can help us with health longevity, so staying healthier into our later years.

We know that inflammation is one of the drivers of the aging process. Probably the primary driver of the aging process, and one of the main factors in chronic, debilitating disease, and, especially in my focus, mental health, there’s more and more researching coming out that inflammation, low levels of inflammation in the brain, is the main cause of mental health conditions, such as depression, and anxiety, bipolar disorder, OCD, ADHD. There’s these low levels of inflammation that contribute to the symptoms of low mood and by increasing norepinephrine, through small bursts of cold and increasing those cold shock proteins, we’re actually able to combat these mental health conditions. Norepinephrine decreases inflammation by decreasing a cytokine called TNF-a that is known to increase inflammation in the body and in the brain. TNF-a can cross the blood brain barrier and it can inhibit serotonin synthesis and it can actually also increase neuro-inflammation, causing symptoms of mental health disorders.

There’s some studies that cryotherapy, for rheumatoid arthritis actually decreased pain significantly. And there’s also some studies that being in cold water, that cold shock, can actually increase the immune system activation. It’s good to increase our immune system activation if our immune cells are behaving properly. If our immune cells are attacking ourselves, then we want to decrease the immune response. But having higher levels of lymphocytes, especially cytotoxic T lympthocytes that are involved in killing cancer cells, is a very positive thing and that’s been shown to increase in people that underwent cryotherapy, or really acute, short exposure to intense cold.

There’s also an ability to lose weight when exposed to cold, over the long term. There’s a man called Ray Cronise who lost over 80 lbs by just habitually exposing himself to mildly cold temperatures. And one of the mechanisms for this weight loss is through non-shivering thermogenesis, in which the cells in the mitochondria uncouple proteins that make energy and they dedicate all the stored energy in fat to making heat. Kind of like cutting your bike chain. So instead of biking, you’re not moving forward, but you’re generating energy and you’re generating heat. And so our body will do this when it’s slightly cold that it can increase heat. Our body is always striving to maintain constant temperature, between 1 or 2 degrees. This process is regulated by norepinephrine, which rises acutely as soon as we’re exposed to just a few seconds of cold. This can be 40-50 degree water. And then I already mentioned that short, cold exposure can increase the production of antioxidants. Our mitochondria are constantly creating reactive oxygen species and reactive nitrogen species. This is just a product of normal cell metabolism. These become toxic, though and damage DNA if our body doesn’t also produce anti-oxidants to clear out those reactive oxygen species and reactive nitrogen species. The cold induces a little bit of a stress that increases our metabolism that increases the reactive oxygen and nitrogen species in our mitochondria and therefore our body is incited to up-regulate the enzymes that create those powerful anti-oxidants that I talked about that are far more powerful than the ones that you can get from food: vegetables, fruits, vitamin C supplement. A couple of these enzymes are glutathione reductase and superoxide dismutase, which are very powerful to our cells.

There’s some evidence that hot and cold therapy can increase muscle mass, can increase muscular strength and aerobic endurance. So this is great for athletes post-workout to lower inflammation and improve muscle regensis. And then, it can also increase something called mitochondrial biogenesis, which is the production, or the replication of more mitochondria in the tissues, especially the muscle tissue. So our body will increase the mitochondria content, the mitochondrial mass, in muscle tissue under certain conditions. These conditions are mainly fasting, exercise, and hot and cold shock.

So, what I’ll recommend to my patients, somebody who’s suffering from low immunity, so they’re getting frequent colds and flus, or maybe autoimmunity, or maybe just general inflammation and pain, brain fog sluggishness adrenal fatigue, that kind of sluggish lethargy from depression. So it’s more the sluggish depression, I’ll recommend hot and cold showers.

So what you do is, in your shower, either during your shower, during your regular cleaning routine, or after your shower is done, and you’ve already washed your hair and everything, you’re going to turn the water on to a reasonably hot temperature, so not so hot that it’s scalding, and you’re going to leave that hot water on for 30 seconds to 1 minute. When that’s done, you’re going to turn the shower to as cold as you can tolerate. So with my patients I often coach them to start with a lukewarm temperature before going whole hog and doing cold. And this is just to coax the body into that stress response that we want, that short, quick stress response that’s going to do all those good things: up-regulate anti-oxidant production, increase norepinephrine, decrease inflammation, increase mitochondria synthesis, burn fat. So you’re going to try and make it as cold as possible, for 20 to 30 seconds, and then you’re going to cycle back and forth at least 5 to 10 times, always end on cold, and then, when you’re done, towel off and keep warm.

There’s some evidence that doing this before bed can actually increase REM sleep and help you sleep more soundly without waking up in the middle of the night. We all know that a good sound sleep is going to set the tone for the next day and your energy for the next day. And then there’s also some evidence that doing this in the morning can increase your energy and alertness throughout the day, so it’s almost like this same practice at different times of day impacts our circadian rhythms differently and can give us more of what we want: either more profound sleep or more daytime energy.

So, that was hot and cold showers, my name is Dr. Talia Marcheggiani and you can check out my website at taliand.com or contact me at connect@taliand.com . A lot of this research came from Dr. Rhonda Patrick at foundmyfitness.com .

 

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