Friday, November 18, 2011

Eating Organic Realistically!

There are so many reasons to eat organic:  you know you aren't getting or supporting the use of pesticides, your food is richer in nutrients (and flavor), and you are making a choice to support your health with food.    Excellent!

Now ...  how is this going to fit into your everyday life?  Are organic products easily available?  And are they local?  Do you need to drive all over town? And how much is this really going to cost?  Hmm, is this still going to be feasible?

In an ideal world, we'd all be able to pull up to the local farmer's market and fill our pantries.  Better yet, our local supermarket would stock all the local and organic products. In some cities this is  easy enough, there are lots of local farms but in other areas organic shopping is a huge struggle.  So what are your options?

1) Check out Farmer's markets. Bear in mind that not every stall will have organic certification, but many will be working toward it and all are local. You'll have the option to ask questions and get to know your farmers.  This is also true for local butchers and fishmongers.  You may have to travel more to find these shops but you'll get to know the people and your food.

2) Look into Organic Food Delivery Services.  Most major centres have companies that provide weekly food bin deliveries to your home.  The bins are stocked with fresh fruits and veggies and some have connections to local meats, eggs and dairy.  For links to food delivery services in BC have a look at FarmFolk/CityFolk.

3) Make smart choices.  If its just not possible to go completely organic, look at buying organic for those foods that are most affected by pesticide use and conventional for those that are safer.  Look back to the Environmental Working Group website to find out which foods to focus on.  Here is a link to this year's Dirty Dozen (buy these organic) and the Clean 15 (ok to go conventional).   And of course, these guys have an app so you can check this on the go.

Enjoy, your tasty foods and enjoy getting to know your local producers! And as always, feel free to email me with comments or questions.  Happy shopping!

Monday, October 31, 2011

Cookus Interruptus: A laugh for while you cook.

I should be more careful when looking for nutrition blogs.  I found "Cookus Interruptus" a video blog by Cynthia Lair, and got stuck watching the videos for an hour!  Not only was I taking notes about the recipes, by the end of the first video I was hooked by the humor and storyline. 

The genius behind the blog, Cynthia Lair, is an Associate Professor for Bastyr University's School of Nutrition and Exercise Science and the Culinary Curriculum Director for their new Culinary Arts Degree program.  Cookus Interuptus' mission is to blend entertainment with whole foods nutrition education.  Their story line centers around "Cynthia", a fresh local organic nutrition educator  and cookbook author.  She lives with her husband of 25 years, Steve.  The economic downturn has her daughter, grandson and Steve's dad all living in the home.  So without a steady stream of income and many more hungry bodies, Cynthia agreed to do a web cooking show in her home, her very busy home.   Family life proceeds as usual during shooting, sometimes Steve, Jane, Ward or Darrell pitch in but mostly they interrupt and Cythia saves the world, one recipe at a time.  

Have a look, but just be warned, it will be hard to stop watching.  Now, excuse me, there is a red soup recipe I'd like to hear about.

Tuesday, October 18, 2011

Alliance for Natural Health comment on the AMA's article about Multivitamin use.

A well phrased comment on the recent journal article about Multivitamin use. It is a good reminder to look at sweeping claims with a critical eye and to make your own conclusions.  Click below to see the commentary.

Shame on AMA’s Archives of Internal Medicine

Wednesday, October 12, 2011

Helpful hits about how to negotiate a safe and fun Halloween!

I've talked before about two fantastic magazines (The Autism File and Living Without).  This month, both have articles discussing how to make Halloween fun, safe and stress-free of families dealing with Autism Spectrum Disorder and/or special diets.

Living Without's article focuses on tips for keeping Halloween and Trick or Treating fun but avoiding all the potential pit falls associated with food sensitivities.  Listed among their suggestion, I also recommend setting up a trading post for doing a treat exchange and or buy-back.  This allows kids to trade for safe goodies or to cash in their loot for coins.  At the end of the night you may even offer to exchange the whole lot for a new toy or gift card to their favorite book or toy store.   Follow this link to see the full article:  Grapevine: Trick or Treat! Seven ideas for a safe and happy Halloween

The ghostly season also brings lots of unexpected treats and baked goods at schools and daycares.  Consider a friendly reminder to teachers about your child's restrictions and an offer to bring in safe treats when needed.  Coaching your child to avoid those treats, and rewarding with special prizes can go along way to helping them stick to their diets.

The Autism File has extra strategies for kids that might struggle with the Halloween environment. It has ideas for how to manage the tactile concerns with costumes and the extra stresses of door to door visits.  For that article follow: Top 10 Strategies “To Ensure Halloween is Healthy and Stress-Free for your Family” from Autism File Readers

Happy Halloween to all the little goblins and ghosts!

Thursday, September 15, 2011

Eat your way to a healthy immune system: Kid friendly herbs

Immune support is a big topic in our clinic in the fall.  "What can I do to keep my whole family healthy as the weather turns and the kids go back to school?"  Below are my best two tips for the family's immune support. Yumm!  And enjoy your healthy family.

Step 1:  Clean your hands often! This is the best protection against catching and spreading illness.  Wash before you eat and before touching your eyes, nose or mouth either soap and water or a hand sanitizer after touching anything that a sick person has touched (such as dishes, towels, clothes, and trash).  Teach kids to wash well and rub their hands with soap and water for at least 15 seconds (long enough to sing a song).

Step 2:  Immune boosting with food.  Try incorporating one or more of these nutrient packed foods into your family's meals.   These are safe for kids and for pregnant or nursing women.


Immune Support Soup
1 large onion, chopped
3 cloves of garlic, minced
2 Tbsp olive oil
4-5 sticks of Astragalus sticks
1 cup celery, chopped
1 cup green beans chopped
2 cups carrots or other root veggies chopped
2 large potatoes chopped
4 dried or 2 fresh shiitake 
Basil, Parley, Tarragon, Oregon, Thyme and herbs to taste
1 pound of tofu cut to bite size
1-2 Tbsp miso
1 cup high fiber/whole wheat pasta 
8 cups water
Mix in large soup pot and simmer for 20 minutes.  Freezes well.  Immune modulating herbs, fiber, vitamin, mineral, and electrolyte support, as well as direct antiviral and bacterial spices.

Okanagan Veggie Butter
4 cups of grated carrot or carrot pulp from a juicer
4 Tbsp fresh parsley or 2 Tbsp dried parsley
1/2 cup of flax seed oil
3 Tbsp butter
4 Tbsp. ground sesame or hemp seeds
1 tsp sage
1/4 tsp thyme
1/2 tsp each of oregano and basil
2 cloves of minced garlic
1/2 tsp sea salt (optional)

Mix all your ingredients in a food processor until well blended. Keeps refrigerated for about a week.  High in immune boosting beta carotene and antiviral/antibacterial herbs.

Yumm!  Enjoy your healthy family.

Thank you to Dr Cathy Carlson Rink for her recipes!
Reference:  Non-Obstetrical Complaints in Obstetrical Patients: Primary Care for Pregnant Patients by Cathy Carlson Rink, ND, RM.  NWNPC.  Friday, May 6, 2011.

Friday, August 19, 2011

Treats for the GFCF and Special Diets in Victoria

Having safe treats for birthdays and holidays is always a challenge for those on Special Diets - let's be honest most of us aren't Master Bakers!  However, now there is another great option with Cupcake Heaven up in Sidney.  Aside from baking terribly tasty and funky treats, they are willing to cater to many diet requests, including Gluten-free baking.   Not only that, they try to make sure those goodies are just as decadent and naughty as the original.

It's definitely worth the short drive but make sure you've called to pre-order; regular stock does sell out and specialty cupcakes are made to order.

Mmm!  What a happy find!



Monday, August 8, 2011

Resources for Autism Spectrum and Special Diets

I'd like to take a quick break from hormones to point out two fantastic magazines: Living Without and The Autism File.  Living Without focuses on support and ideas for those with Special Diets, with extra tips for those starting a Gluten and/or Casein Free diet.  The Autism File is a newer North American Publication with articles spanning many aspects of ASD life and families.

I am grateful for both for providing comprehensive and well-researched information and for maintaining fantastic websites.  For any families working with diet restrictions, have a look at Living Without for their archived recipes.

Enjoy!

Tuesday, July 12, 2011

Let's talk about hormones! Part 3: Estrogen and Progesterone

If you've been reading the "Let's talk about hormones!" series, you'll have seen that the hormone system is rather incredible with its complexity, control and elegance.  We tend to think about things in very simple terms, that one hormone does one thing, and increasing or decreasing the hormone level directly controls that one thing. However, as we've discussed, hormone systems have target roles and then they affect lots of different processes to achieve that role, with many many different checks and balances along the way.

The classic "female" hormones, Estrogen and Progesterone, are prime examples of this complexity. At the most basic level Estrogen and Progesterone levels cycle in a specific way to control the menstrual cycle and ovulation.  But on a grander level, Estrogen and Progesterone supports most aspects of fertility and pregnancy.  Estrogen levels are controlled by the brain and, when its levels peak, it signals for ovulation. In situations that aren't ideal for pregnancy (high stress, or low body fat), the body downregulates Estrogen, effectively shutting down ovulation and preventing pregnancy.  During a pregnancy, the caloric needs greatly increase, both to support the mother's needs but also those of a growing fetus and so Estrogen also affects storage of fats into the lower tummy, hips, breasts and thighs.   Estrogen affects cholesterol and insulin resistance, supports vaginal secretions and uterine lining thickness, and has a positive effect on emotional and physical arousal.  Along with progesterone, estrogen prevents excess calcium and bone loss.

Progesterone is more of a pregnancy hormone, and it is primarily produced by the egg released at ovulation and then by the placenta during pregnancy.  It affects the body by loosening joints, and altering other hormone functions and body systems for the optimal conditions for growing a baby and preventing a miscarriage.  Progesterone also works in balance with Estrogen, sensitizing the body to Estrogen but also protecting against its effects.  This protects the uterus from cancer growth, improving cholesterol profiles and protecting against the insulin effects.  Progesterone is also helpful for mood support and for helping with sleep disturbances.  These hormones fluctuate dramatically during the cycle and increase even further during pregnancy.  A key point is that the Estrogen and Progesterone levels are kept carefully balanced together and with Testosterone (especially in later life). When those ratios are out of balance, then you may see a variety of symptoms from libido changes, hair loss, or fatigue, to heavy menstruation and migraines.

As usual, we chat about testing to evaluate the hormones.  We can test these hormones with saliva tests or blood tests.  Both choices have their merits and difficulties.  Dr George Gillson MD,  the President and Medical Director of Rocky Mountain Analytical Labs, talks about our testing methodology as being woefully primitive for such a wonderfully complex system. He says "Trying to figure out what is going on inside the cell from blood, urine or saliva tests is like trying to read a newspaper on the sidewalk, from the 15th floor".  After discussion with my patients, I usually choose to order a panel of saliva tests, even knowing they aren't the most accurate, because they do give me enough clinical information to make good choices about treatment options.

In the next post, we'll talk a little about some of the common female hormonal complaints and basic naturopathic therapies.  As always, please feel free to email me or post a comment if you have any questions or topics you'd like to see in the future.

Thursday, June 23, 2011

Let's talk about hormones! Part 2: Growth Hormone

So in the last post we talked a bit about Thyroid hormone and its function in the body.  This time, let's get into a hormone that's a little less well known but that plays an interesting role in anti-aging (among other things).  Human Growth Hormone (HGH) is a very complex hormone and we probably don't even know half of its functions.  We do know that it is a key factor in regulating growth in childhood and adolescence and but our understanding has expanded to it functions in healthy aging and tissue repair.

At the most basic level Growth Hormone influences how the body use fuel and how it grows and repairs, especially on the cellular level. If we think about HGH's primary goal is tissue growth and repair, then its effects on metabolism make a little more sense.  HGH signals to cells to take in more nutrients and also to make more energy sources available in the blood.  It increases the cells uptake of protein, which is key  for bone and cartilage production.  It also increases the release of fatty acids from adipose (fat) stores, so that those fats can be broken down and used as fuel.    HGH increases the liver's production of glucose as well as increasing insulin resistance, basically increasing overall blood sugar.  So much so that HGH could even be called a diabetic-like hormone.  Not only that, it signals for a release of ghrelin, which stimulates appetite!  No wonder teenager boys eat as much as they do. (1)

Its pretty obvious why HGH would be important for childhood growth and HGH does decrease about 14% with each passing decade.  Unfortunately, this decrease contributes to many complaints that we associate with aging.  These include: loss of muscle mass, strength and stamina, papery skin changes, poor circulation and depressed mood. (2).  In addition, we also suspect HGH plays a role in Fibromyalgia.  HGH output follows a daily rhythm, with its biggest output in the first few hours of sleep.  The current theory for Fibromyalgia is that there is sleep disturbance (usually stress or some type of injury), which decreases the HGH output. This  prevents the body from doing its daily repair and will perpetuate the body pain.

We can easily blood levels of HGH,  but this doesn't give us very usable information.  HGH varies so much during the day, that a single sample doesn't tell us anything about the overall picture.  Some labs will measure IGF-1, which is a different hormone but it rises and falls with overall HGH levels and ends up being a reasonable reflection of HGH levels.  Unfortunately, not all labs will test IGF-1 levels and it does end up being a slightly pricey test. (1).

So how to support HGH levels:  Direct hormone supplementation isn't usually recommended outside of some genetic growth disorders, so for antiaging and fibromyalgia we need to support it indirectly.  Exercise and Sleep are essential factors for supporting HGH production.  So the first and most important step is to address sleep concerns, with sleep hygiene and possibly relaxant/sedative herbs (passionflower and valerian) or other most direct supplementation support like melatonin or 5HTP.  Your Naturopathic Physician may also suggest specific herbs or amino acid formulas that will specifically increase HGH production and these should only be done with the supervision of a qualified and licensed professional. (1).

Good luck and keep an eye out for the next posting that will discuss Estrogen and Progesterone.  As always, please feel free to leave a comment or email if you have any questions or topics you'd like to see discussed.

References:
1) Lecture by Pamela Jeanne, ND.  HOrmonal Milieu in the Aging Process: A Naturopathic Perspective.  NW Naturopathic Physicians Conference. May 2011. Vancouver, BC.

2) Medscape: http://emedicine.medscape.com/article/120767-overview

Wednesday, June 1, 2011

Let's talk about hormones! Part 1: The Thyroid

Hormones are a common theme in Naturopathic Medicine.  Many people come in with complaints that can be linked back to hormone imbalances.  As such, support around those hormones can have benefits in a number of different areas.

In this posting, I'll cover some basic information about Thyroid : its biology, the functions of thyroid hormones and the symptoms of dysfunction.  I'll also chat a little about treatment options.  In future postings, I'll touch on Growth Hormone, Estrogen and Progesterone and Testosterone.

The thyroid gland sits in front of the windpipe just below the Adam's apple.  The brain releases two chemincals called TRH and TSH.  TRH is released from an area called the hypothalamus, which then signals for the release of TSH from the pituitary.  TSH tells the thyroid to release two chemicals called T3 and T4.  Higher levels of T4 cause the pituitary to decrease its production of TSH, which acts as a control mechanism for the thyroid.

T3 and T4 are very basic molecules with one amino acid, called Tyrosine and 3 or 4 Iodine molecules.  For such simple hormones, these two are really active in the body.  They control overall metabolic rate, including how the body burns carbohydrates, proteins and fats as well as growth and development.  Thyroid hormone also helps to regulate adrenal hormones and gonadal hormones (ie. estrogen/testosterone).   T3 is extremely active, so the body cleverly protects itself by producing mostly T4 (about 80% of thyroid hormone is T4) and then converting T4 to T3 in the tissues as needed.  Unfortunately, there are many factors that can prevent the body from producing Thyroid hormone but also from converting the less active T4 into T3.  Perchlorates (which are chemicals released from airplane fuel), fluoride and a diet low in iodine decrease the production of T4 and T3.  Stress, fasting and mineral deficiencies will affect the conversion of  T4 to T3.  There are also autoimmune conditions that can either decrease or increase thyroid function.  Adrenal hormones also interact with thyroid balance and often this needed to be addressed along with the thyroid.

So what are symptoms of thyroid dysfunction?  Low thyroid often shows as cold body temperature, dry skin, hair and nails, constipation, joint tenderness, fatigue and depression.  High thyroid is less common but a little more risky with elevated heart rate, sweating, peeling nails, weight loss and eye symptoms.

Thyroid testing is most commonly done by testing TSH.  Unfortunately, as this is the brain hormone, it is an indirect marker of function and can be a little slower to show problems.  The lab reference range for normal thyroid is also very broad, because it is supposed to show overt disease.  But many people feel unwell and like they have low thyroid function with "normal" results.  This is called subclinical hypothyroidism.  Testing TSH as well as T3 and T4 and antibody levels gives a much more complete and helpful picture of function.  Unfortunately, in BC General Practice MD's are limited to testing TSH for screening and T3 and T4 only if defects come up.  Naturopathic Physicians in BC can order the full panel but this need to be paid out of pocket.

There are many treatments for thyroid function.  Generally, I suggest starting off with nutritional support with low dose iodine, selenium and or L-tyrosine before getting into anything more hefty.  From there we can discuss homeopathics or herbal support to increase thyroid function.  If needed, prescriptions can be good choices.  T4 alone as Synthroid is the most common prescription but many people do better with a little bit of T3 support too.  Prescription thyroid extracts (as USP thryoid, or Armour thyroid) from bovine or porcine sources with natural T4 and T3 can be good alternatives.

If you suspect thyroid dysfunction consider chatting with your GP or Naturopathic Physician for testing and treatment.  Don't hesitate to ask for the full panel of testing or for a change in your prescription if you aren't noticing improvements.

Please stay tuned for upcoming posts on Growth Hormone and Gonadal Hormones.  As always, please feel free to email or comment with questions or ideas for topics.

* Thank you for the use of the thyroid pathway image from http://www.women-health-info.com/236-Thyroid-hormones.html.

Wednesday, May 18, 2011

I've got Food Sensitivies... So Now What's the Plan?

So you've done your food sensitivity testing, and you know you have foods you react to.. So now what?  Your practitioner will likely have recommendations for you based on your complaints but my usual suggestions are to avoid your most reactive foods and rotate through the milder sensitivities.

Its important to remember that food sensitivities and environmental allergies are additive and will accumulate.  Symptoms will show us when you hit a threshold.  Moderately or strongly reactive foods will hit your threshold even when eaten in really small amounts, and so should be avoided.   Whereas mildly reactive foods will be fine as long as you eat them in small or infrequent amounts or in rotation.  The Rotation Diet is fairly simple but does require some organization.  And I often recommend some form of Rotation Diet when testing shows multiple mild reactions.  In this diet, we try to cycle through the various sensitivities.  For example if dairy, chicken, halibut and salmon are all in the list of mild reactions, then I suggest we try to cycle through them and limit each to no more than twice a week.   So a week's menu may include:  Mac n'cheese on Monday, Baked Chicken Tuesday, Breaded Halibut Wednesday, Lasagna on Thursday, BBQ'd Salmon Friday, and Chicken Strips on Saturday.   Obviously, the Rotation diet gets a little more complex if there are fruits, veggies or grains on the list too.  But the basics are still the same.  Try to limit your sensitive foods at each meal and give yourself a few days between each introduction of a specific food.  This helps to give the body time to clear out the reaction from each food so that you don't hit your threshold.

Sometimes we have a food sensitivity result where there are just so many reactions that its not realistic to avoid them all or even to rotate through.  In this case,  the digestive tract is so inflamed and reactive that it needs to be healed up first.  So I suggest just focusing on avoiding the most severe reactions and using supplements (like digestive enzymes, probiotics and others) to support, calm and heal the gut.

Finally, the important question is "Do I have to do this forever??".  No, you don't have to avoid your entire list forever.  Most people need to be quite diligent for 6 months or so and then can experiment with introducing some of their foods.  Some of the key sensitivities (like soy or dairy) may remain and you may need to avoid them always, or you may find that you can now have them in small amounts.  But you will likely find that with avoidance and rotation your reactions have settled down and your digestive tract has healed such that you no longer have a sensitivity to most of your list.  Please be aware that this is not true of food allergies - these should never be reintroduced without consulting a physician.

As always, please let me know if you have any comments, tips for a Rotation Diet or topic suggestions.

Monday, May 2, 2011

Naturopathic Medicine and Biomedical Therapies in Autism and ADHD


Naturopathic Medicine focuses on finding underlying causes or triggers for illness and optimizing overall health. It is a perfect fit for families looking for support for Autism Spectrum and Attention Deficit and Hyperactivity Disorder.   Some Naturopathic Physicians use a Biomedical approach for supporting the two conditions.  Biomedical therapies are defined as science-based therapies that look at optimizing the biology of the individual patient to improve the symptoms of Autism.  This is done in three ways:  assessing nutrient deficiencies, removing any interfering or triggering factors, and optimizing body systems (such as the digestive or immune system).  These three areas are targeted based on each patient’s specific circumstances, symptoms and lab results.

Perhaps we have a child diagnosed with Autism, whose biggest challenges are with language skills and unpredictable outbursts. We also find out he has difficult digestion and is very limited in his diet.  Since he’s eating limited foods, he’s probably quite nutritionally deficient.  Many nutrient deficiencies (B vitamins, amino acids and essential fatty acids) impact brain functioning, cognition and learning. 

We often try a special diet to eliminate reactive and inflammatory foods that are causing his pain and gassiness.  Many kids will express tummy pain or discomfort with restlessness and unpredictable stereotypic or aggressive behaviours.   

To help guide our treatment plan, we may choose to do specific testing to investigate various aspects of his digestion and nutritional status.  The testing, along with his symptoms and goals will dictate our treatment course.   This evolving plan often uses a combination of special diets, nutrient and supplement support, and sometimes pharmaceutical prescriptions. 

Naturopathic and Biomedical therapies are not cookie-cutter, but rather they are specific to the family and to the child.  This approach complements applied behavioural, speech and occupational therapies, as they help to reduce distractions and improve cognitive and learning functions.

More information about Biomedical Therapies is available at www.autism.com and to find a Naturopathic Physician in BC see www.bcna.ca.

Wednesday, April 13, 2011

How to sneak supplements or medications into kids?

Every child will need to take medications or supplements at some time and its not a secret that kids are picky about what they consume.  It's not always feasible to find yummy liquids or chewable forms of all of those products and let's be honest.. kids can be very good at not taking stuff.  And so I get lots and lots of phone calls asking for ideas about how about how to reliably administer supplements and medications to their sensitive kids. 

First for medications:  I usually try to chat with a compounding pharmacist before prescribing meds to kids.  There are often liquid suspensions that are slightly modified with taste in mind. We can make sure that the preparation is specific to a child's needs (ie. GFCF or colorant free) and all compounding pharmacies have the ability to make the medications into more kid-friendly forms like lollipops.  

Supplements require a little more creativity.  Below is a list of suggestions compiled by many saavy parents.  A little trial and error is required to find the balance for each child and supplement.  For example: Chocolate hides bitter tastes nicely,  sour hides well in fruit or yogurt, minerals are often a little salty and can hide in savory foods or sweet ones, and B vitamins hide well in tangy foods like tomato or peanut butter.

Try to:
  • mix into juices (lemonade, orange, grape and pear juices are good starts)
  • mix into V-8 splash
  • mix into yogurt, applesauce or pudding
  • mix in fruit sorbets
  • mix in chocolate syrup
  • mix in nut butters (cashew, peanut or almond)
  • add to a fruit smoothy or protein shake
  • mix in honey, maple syrup or jam
  • make popsicles with supplements or freeze in ice cube trays with toothpicks for smaller bites
  • hide doses in rice-crispy treats
  • mix in ketchup and put on french fries
  • hide in baby-food
  • add heat-stable products in cooked scrambled eggs or cooked spaghetti sauce, or pancake batter
  • Sprinkle on toast or waffles before adding butter or coconut oil and jam
I'd welcome any other suggestions and good luck!

Tuesday, March 29, 2011

Food Sensitivity Testing - let's talk about your options!

So as promised in the last posting, today I'll give you a little more information about testing for Food Sensitivities.  And just to backtrack a little .. food sensitivities happen when the body reacts to proteins in specific foods and the immune system is activated by those proteins in much the same way as it is activated by proteins on bacteria.  A reaction is mounted by the immune system and can cause inflammation both at the gut level but also systemically.  Because of the complexity of the immune reaction, food sensitivities are often one of the key triggers for many different complaints.  I almost always think about them when dealing with three key complaints including: skin conditions like eczema or psoriasis, GI upset including anything from heartburn to diarrhea, and behavior difficulties in kids (ADHD, temper or Autism Spectrum Disorder).  And  many people with autoimmune disorders and arthritis or migraine benefit from knowing if there are any food triggers aggravating their symptoms.

So we know its important to check for food sensitivities but how do you do it?  There are three different testing choices available to identify food sensitivities. Please note, that food sensitivities are very different from food allergies and the following testing methods are not adequate to diagnose food allergies. The gold standard is an Elimination and Challenge test.  In this case, we limit the diet to a very restricted set of hypo-allergenic foods (usually foods that are outside the normal diet) for a good period of time (usually 3-6 weeks).  The goal is to allow the body a chance to heal up as we take away any provoking foods.  Then we slowly add one food type at a time and gauge for reactions.  For example, we might do our elimination for 3 weeks and eat only lamb, pear and brown rice, then introduce dairy products for a few days while we watch for skin or tummy symptoms.   This type of diet needs a lot of planning and commitment and, because it is so limited, it should not be done without the supervision of a qualified practitioner.  And it should be mentioned that challenging with foods can cause quite a pronounced reaction and should be done exceptionally carefully with asthma or autoimmune conditions.

The next type of testing is called EAV testing, which is also known as Biomeridian or VEGA testing.  This testing evaluates the energy in specific acupuncture meridians and how that energy reacts when challenged with foods.   It sounds a little odd but is really very effective for many complaints.  The advantage to this is  that it can be done quickly and in-office and is non invasive.  It does require that the patient be able to sit relatively still for a period of time, so it can be difficult with younger kids or kids with restlessness/hyperactivity.  On the down-side, the testing isn't well accepted by conventional medical practitioners and so isn't my first choice when we are also working with an allergist or other specialist.

The last type of testing and the only one that can allow us some information about food allergies is called ELISA testing.  ELISA testing is a specific testing procedure that measures how much (if any) of an antibody (immune) reaction there is to specific food proteins.  There are many lab companies in North America that offer this testing and they have widely variable pricing and reliability of their tests.  Most have different food lists available that can be chosen specific for the patient's needs (ie. vegetarian panels or specific testing for food allergies).  This testing does require a blood sample, but depending on the type of tests, it is either with an arm drawn sample or more commonly a dried blood spot taken using a finger stick.  Most kids find the finger prick quick and easy, enough that they don't complain.. at least not much.  I find this to be the best choice for most people as the company I use has excellent pricing and turn-around time and has a choice for an expanded panel with many extra spices and foods.  In addition, ELISA testing is a common procedure and one that is being used by conventional allergists to explore food allergies.  So as a testing method, it is one that conventional physicians can identify with.

For patients coming into my office, I always suggest we discuss your complaints and talk about the testing options to figure out which, if any, is the best choice.  This might depend on your financial situation, time goals and the condition itself.  Most Naturopathic Physicians have done a good investigation into the testing options available in your area and can give you good guidance.  To find a Naturopathic Physician in Canada go to http://www.cand.ca/index.php?findnd&L=0 to find one in the US try http://www.naturopathic.org/AF_MemberDirectory.asp?version=1  .

Tuesday, March 15, 2011

Gluten Sensitivity, its not just a myth!

Finally, some research has illustrated what so many of us knew:  Even with a negative celiac test it is still possible to have a dramatic sensitivity to gluten proteins.

Have a quick look at this article from the Wall Street Journal "Clues to Gluten Sensitivity" from March 15th, 2011 publication by Melinda Beck.

Lisa Rayburn felt dizzy, bloated and exhausted. Wynn Avocette suffered migraines and body aches. Stephanie Meade's 4-year-old daughter had constipation and threw temper tantrums.

All three tested negative for celiac disease, a severe intolerance to gluten, a protein found in wheat and other grains. But after their doctors ruled out other causes, all three adults did their own research and cut gluten—and saw the symptoms subside.

A new study in the journal BMC Medicine may shed some light on why. It shows gluten can set off a distinct reaction in the intestines and the immune system, even in people who don't have celiac disease.

"For the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease," says lead author Alessio Fasano, medical director of the University of Maryland's Center for Celiac Research. (Click here for the full article).

There are testing options available to confirm a gluten sensitivity.  They include an elimination and challenge, EAV testing or antibody tests (IgG and IgA).   In the next blog, we'll discuss these three options and the differences between them.



Thursday, March 10, 2011

Holey Protein Bagels, Batman!

If I had to name my top nutrition tip it would be to focus on protein throughout the day.  Not low fat or low sodium, probiotic foods or alkaline diets. No, for most of the people I see day to day, definitely protein.  While the other diet suggestions are key in some circumstances, the average person has a busy stressful day and most of us (yes me too!) are so rushed with meals.  Breakfast (if it happens) is a banana and toast or maybe just coffee as you rush the kids to school.  Lunch is soup or a salad, as we escape work for a few minutes.  Then dinner is the bigger focus, but really when you get home and get the kids organized who wants to cook something elaborate? Evenings? Yes, this is when we snack. This is when the cookies call to us from the cupboards and the treats look so inviting.  After all, that was a really long day!

And that was a really good day!  There were three solid meals, nutritious even!  Maybe a little snacking but well deserved.  But that's a pretty healthy diet.  True enough.. except for the protein. The problem is that we ask ourselves to be "on" and alert all day, ready to meet any challenge at work or to tackle any kid emergency at any moment.  And by maintaining that level of stress, we need our adrenal glands to produce cortisol at a slighly higher level throughout the day.   After a while of producing that slightly higher level of cortisol, our adrenals just run out of steam a little.  Nothing horrible, but just a little and enough that the body conserves its cortisol production.  At the end of the day, the normal energy slow down may turn into an energy crash.  You might notice that is takes longer to get going in the morning and, perhaps, little more irritability and moodiness? 

Ok, and what does that have to do with eating?  Cortisol also has influences on metabolism, weight distribution and, most important, blood sugar control. After longer periods of stress many (especially women) notice that they start to store weight right on their bellies, they may crave sugar and have trouble skipping meals.   Keeping a focus on protein at every meal and every snack helps to keep blood sugar stable.  And that removes one big stress to the adrenals and decreases the amount of cortisol we need to keep up our energy.  It doesn't have to be much protein either.  Adding some nuts to a snack, or switching to a higher protein bread  for sandwiches or toast can make a huge difference for overall energy and sugar cravings. Check out SilverHills bagels, they have an astounding 15g of protein each!  An easy option for lunches is to plan to keep leftovers from every dinner.  Our Magnificent meat loaf  makes a great lunch for adults and kids.  Adding a handful of beans to pasta dishes or a stirfry is a fantastic and inexpensive choice and can be pureed for the picky kids.  So, planning to have a little protein at every meal and supporting the body with small snacks with a little protein is the best start for overall fatigue and stress management.

Stay tuned for more health tips and please feel free to email if you have any questions you'd like to see answered here.

~ Dr Kellie

Wednesday, February 23, 2011

Victoria Autism Resource Fair, March 5th 10-4 at the Ambrosia Centre on Fisgard St.

Come join Dr Kellie and a variety of other providers for the Greater Victoria Autism Resource Fair.  This fair hopes to provide parents and professionals with an opportunity to learn about the wide variety of autism services and products available in the Greater Victoria area.

There will be several speakers presenting on many different topics including Art and Play therapies.  Dr Kellie will be doing a Brief Introduction to Biomedical Interventions with Dr Marianne Trevorrow, ND at 1:45.

There will be door prizes and some amazing silent auction items including gift certificates for restaurants, spas, clothing, hair salons and many items from local businesses and several exhibitor.

Admission is FREE and children are welcome!  In fact, there will be a small children's area where you can try out some therapy toys and a face painting station.

We hope to see you there and please stop by our table to say Hi!

~ Dr Kellie

Monday, February 14, 2011

How to Manage Special Diets on Holidays? Plan for treats!

Special Diets can be extremely helpful for a number of conditions and complaints.  Anything from acne to Autism Spectrum Disorders often benefit from Special Diets, which might limit food sensitivities or completely avoid specific foods like Gluten and Casein.  And there is nothing more exciting than having a parent or patient return to the office now that they've done planning and cooking and tell me they now know the foods they are avoiding really were a problem.  They really know that if those foods sneak in then the symptoms come back, their tummy feels gross or their child is doing their Tasmanian Devil imitation.  Then comes the big question..  "but Dr Kellie, I know we need to stick to this but its Valentine's Day and Grandma always has treats for the kids on Valentine's Day!".

So how do you manage a Special Diet on holidays?  Because there really is nothing worse and nothing that's going to make us hate our food challenges more than feeling left out or deprived.  The answer.. planning.  Yes, that's pretty much the answer for every question diet related and its especially true here.  Knowing that there is a treat-worthy holiday coming up and planning for a happier alternative is the best course. 

For Kids:
Parents may want to send out an emails out to other parents asking for a heads-up about birthday cupcakes so that a Special Diet friendly option can be send from home.  And sometimes giving the teacher a small supply of kid-friendly treats for the days when you may have had no warning.   For holidays when treats come in bulk (you know when there are bags and baskets involved) I suggest the Exchange Policy.   Kids love to trade in candy or chocolate for a much desired toy or game or even a special family outing.

For Us Adults:
Again, plan for holidays.  We'd love to think that our will-power has super-strength but in the face of treats everywhere its not hard to give in and then feel rotten for having done so.  Consider keeping the house and your desk drawer stocked with a few friendly treats.  Perhaps, do a little bargain with yourself.  "Self, I know that you love those creamy Easter eggs.  This year, let's make a deal to choose a better treat and reward myself with an indulgent pedicure.

We all hate to feel like we can't have those lovely treats, especially when people around us are and when they are offering.  Having a plan and something to indulge yourself or your family with will make all the difference.

Happy Valentine's Day and please feel free to email if you have any questions you'd like to see answered in a future Post.
~~ Dr Kellie

Tuesday, February 8, 2011

Magnificent Meatloaf Makes Meals Easier

I think almost everyone would agree that good nutrition is the foundation for great health.  And let's be honest.. most of us could use a fine tuning when it comes to eating a healthy diet.   However, our lives are busy and there is only so much time and energy available in the day.  I like cooking, but I know that at the end of my day the last thing I want to do is to chop veggies and whip up an elaborate meal.  My solution is to pack (aka hide) as much nutritional punch into easy meals as possible, and if its ready by the time I get home.. even better!

I've adapted this recipe from one in a fantastic cookbook called "300 slow cooker favorites"  by Donna-Marie Pye and Robert Rose Inc publishing.  This is a great cookbook for those that are just starting off with the slow-cooker and one of my favorites.

Magnificent Meatloaf and more.
Serves 4-6 people.

Ingredients:
1 lb of extra lean ground beef or bison
1 lb of ground turkey
4 green onions (chopped)
1/2 package of fresh chopped spinach (approx 150g)
1/4 cup fresh chopped cilantro or basil
3/4 cups of rolled or Scottish oats (or fine dry breadcrumbs)
1/2 cup of Parmesan cheese
1/4 tsp (depending on taste) Chili paste
2 eggs slightly beaten
2 tsp sea salt
1/2 tsp fennel seeds
1/4 tsp fresh ground pepper

Extras:
For an extra fiber boost add 1/2-1 cup of canned pinto or black beans.
For extra vitamins any veggie can be finely chopped and added.  My favorite is 1/2 cup of finely chopped beets.
For those that like a sweet topping or dip try an organic tomato soup instead of ketchup.

Gently grease the bottom of the slow cooker with olive oil or cover in tin foil (with edges above the rim if you'd like to be able to remove the meatloaf).

In a large bowl, combine the meats and mix well.  In a seperate bowl, combine and mix the remaining ingriedients.  Add to the meat and mix again.  Press evenly into your slow cooker cookware and tuck tinfoil ends under the lid.

Cover and cook on Low for 6-8 hours or High for 4-6 hours or until a meat thermometer inserted into the middle of the loaf reads 170F.  Serve sprinkled with more cheese, cilantro or tomato soup. 

This dish is tasty as is but is also perfect for hiding extra veggies and fiber.  Adding extra fennel, chili paste or Parmesan tailors the flavor to your family's preferences.  Pair it with baked sweet potato, or roast veggies and you have a great and easy meal.

Monday, February 7, 2011

Welcome to the blog

Well.. I've heard about Naturopathic Medicine but I have some questions?

Why see a Naturopathic Physician?  

Most often people choose to see a Naturopathic Physician because they want a little more control over their conditions.  Maybe just a chance to take the time to talk about everything that's going on.  Perhaps, they'd like a little more information about their lab testing or treatment options and how to take steps before they need conventional interventions.  Most patients want the opportunity to be looked at as a whole being and and to have the cause of their complaints identified and addressed rather than just having the symptoms addressed.


How are Naturopathic Doctors trained?

BC requires licensing of all Naturopathic Physicians, which requires that they complete a minimum of 3 years of pre-medical undergraduate training and a 4 year post-graduate training at an accredited naturopathic medical school. Training includes over 3000 classroom hours in basic and conventional clinical sciences as well as nutrition, counseling, and botanical medicine and roughly 2000 hours of Clinic experience in Physical Medicine, Counseling and General Medicine. ND’s also must complete standard North American exams in all the basic and clinical sciences as well as a practical skills exam.

 

I’ve heard all Naturopathic Physicians make you stop Dairy and Sugar!

Many people have sensitivities to dairy and sugar and would benefit from avoiding them – maybe most of us would, but a treatment plan has to be specific to you and your life and what will be effective for you. No plan will work if it’s too difficult to follow.  An appointment with a Naturopathic Physician will give you enough time to create a plan together, and one that will be appropriate manageable and effective.