Category Archives: Food Intolerance

Why… Why… Why?

The patient reported on her first visit having leg symptoms of an achy nature that has been persistent for more than a year. She could not recall a specific event that initially seemed to cause the problem, nor could she recall anything that aggravated the leg symptoms. She advised me she experiences the leg achiness daily and it’sbeginning to affect her ability to work. She indicated have been seen by her medical doctor with no relief of her achiness. She reported being referred for a neurological consult for further evaluation. She relayed that the neurologist was unable to find a reason for her symptoms. She indicated that she had heard chiropractic care could help with her problem and made an appointment with my clinic.

I relayed to the patient that I believed chiropractic manipulation should be the first step in her care to help alleviate any nerve irritation that may be causing or contributing to her leg problems. In addition, we began soft tissue work on the leg musculature to help relax tight muscles and alleviate any trigger points that could be causing the symptoms. After explaining to the patient my treatment plan, she agreed to it and we began care. In her case, I wanted to see some type of improvement in her symptoms within the initial two-week period. Although she indicated her back and neck had more mobility after a few weeks of care, she reported having no relief of her leg achiness. I began to think what else could we do to help her. I asked myself what could be the underlying cause of her symptoms. Using the philosophy of functional medicine I reviewed her file. Based on her case and financial situation I asked her to do one thing and go on a gluten free diet then return a few times over the next six weeks to see how she was doing.

I am going to take a moment to mention a method of approaching health and disease referred to as functional medicine. The focus of functional medicine is to look for the root cause of symptoms by looking at the way key body systems function. Finding imbalances in key body systems and then working towards correcting them is at the center of functional medicine. Although this way of approaching medicine is growing in popularity, it is currently considered an alternative approach to allopathic care. Naturopaths, chiropractors and some medical doctors use functional medicine to look for the root cause of symptoms. They often use different types of laboratory work to look for the underlying cause of problems.   It can be a powerful tool to help patients since treatment often involves healthy lifestyle changes as well as other remedies to bring systems back into balance.

Ok, back to our patient.

I remember not hearing from her for about three months. She returned to my office indicating that her leg achiness was 100% gone. She reported that the only thing different she did since her last visit was the gluten free diet plan I had asked her to strictly adhere too. She reported the diet change was tough at first, but became easier as she began to progressively feel better.

I wanted to tell this story to help illustrate a direct cause effect relationship may be missed if we do not continue looking for a reason behind symptoms. Sometimes it can be one thing that drives symptoms. Of course, it is not always this easy. Finding the underlying problem will most likely take patience on the part of the patient and the doctor. I could have stopped trying to figure out the problem after manipulation failed this patient. However, it is as one of my mentors, Dr. William Timmons, N.D. always used to say, “you always have to ask why?….why?….why?… to get to the underlying cause”. Dr. Timmons did not like to treat the symptom by masking over it with various herbs and other modalities. He would instead strive to look for the cause. Then he would treat the cause not the symptom. As practitioners we must always ask ourselves why is the patient experiencing these problems. Functional medicine is one approach to health that helps practitioners find answers by asking why… why… why? This time, it was intolerance to gluten.  To see how gluten intolerance could be associated with symptoms such as leg achiness, read my post; Could this one thing be making you sick?

As always, you should consult with your health care professional for any health concerns. Because your health affects everything you do and everyone you know, I encourage my readers continue to educate themselves as much as possible on their own well-being.

Yours in Health,

Sean Ripp, D.C.

Should you start here?

This post is written by one of the most commited professionals I have ever worked with in the areas of natural and functional medicine, Eric Wood, MA, NMD. I talked with Dr. Wood about creating information that would help people feel better by reducing stress on the mind and body. This post is the result. Although this article is a large time commitment, I am convinced if you incorporate this information into your life, it will place you on the path to improving the way you feel. You may want to print this out for future reference. Dr. Wood is a board certified, licensed naturopathic doctor and is a graduate of the Canadian College of Naturopathic Medicine in Toronto, Canada where he completed specialty rotations in HIV/AIDs care, sports medicine, and cancer.  He received additional training at Harvard University’s Benson Henry Institute for Mind Body Medicine, completed a fellowship through the International Lyme and Associated Diseases Society’s Physician training program and volunteered and observed at notable integrative cancer treatment centers while in school including the Cancer Treatment Centers of America, the Issels Clinic, and Medicor (Canada).  Since graduation, he has worked with some of the leading supplement companies in integrative medicine including Neuroscience Inc. and Life Extension, where he served as a staff physician specializing in integrative oncology and infectious disease and has practiced naturopathic medicine in both Minnesota and Florida, where he founded his healthcare consulting company, Visionary Health and Wellness.  At Neuroscience, he served as one of two physicians on staff advising doctors across the country on balancing their patients’ neurotransmitter levels through targeted amino acid and vitamin protocols.  Currently,  he is an associate professor with the Mind Body Medical University of Los Angeles, associate professor of Nutrition studies at Hawthorn University (Whitethorn, CA) and is a NEI certified Neuro-Endocrine immune specialist (through Neuroscience) and has recently become the Medical Director of a new anti-aging virtual medicine clinic based in Florida, Beyond Biology (www.beyond-biology.com).  Additionally, he has completed additional training in advanced European detoxification techniques, German/Swiss Biological Medicine, Food as Medicine, HCG weight loss and more.   As a medical writer, he has written for a number of physicians and conference presenters, supplement and personal care companies.  He is also a member of the Oncology Association of Naturopathic Physicians and was previously a certified personal trainer while in medical school in Canada.

Yours in Health,

Sean Ripp, D.C.

A must read for anyone interested in improving the way they feel.

A wise sage once said, “Without health, you have no wealth.”  In today’s health-deficient society, there has perhaps never been a time when this has been more common.  With obesity at all time highs, millions of prescriptions filled yearly for depression, and the first generation of children expected to have shorter life expectancies than their parents, we are a society in considerable trouble (Olshansky et al,  2005).  For too long has the focus of the healthcare system been on waiting until problems of significant magnitude arise and then medicating the symptoms.  This, of course, never truly addresses underlying causes OR looks at contributing lifestyle factors that may be playing critical roles in the development and promotion of such ills.  On the bright side, research has begun substantiating much of what natural medicine traditions have emphasized for centuries:  the importance of diet, sleep, exercise, detoxification, and stress management.  We now have the ability to not only suppose a benefit of why eating an apple is healthful, but can discuss the physiological reasons why it indeed is, in so many ways.   This program is geared towards this very thing—discussing the rationale AND specific steps for implementing a wellness oriented lifestyle to give you more of what you wanthealth, vitality, energy, and a sense of wellbeing—in your day to day existence!  Thankfully, this does not necessarily need to be an expensive undertaking to reap significant benefits from but rather more just a ‘committed’ undertaking of putting suggestions into regular habit.

To give a useful analogy, I liken one’s ‘foundations of health’ to a model of a four legged stool.  Each leg could represent a particularly important aspect of ‘foundational health promoting practices.’  One could arguably add more “legs” to the stool to be more complete, but for basic understanding, the four-legged model really does work just fine.  I would encourage you to begin thinking of each leg to represent one of the 4 following areas:

1)      Sleep and general ‘downtime’/’recovery’ time:  this means time actually spent asleep and also time engaged in restful activities such as meditation, deep breathing, or to a lesser extent relaxing in your favorite chair or sofa

2)      Diet: This includes EVERYTHING you consume—all foods, all liquids, all prescriptions, supplements, etc.  You are the totality of what you consume as our body is being constantly remodeled on a daily basis.

3)      Exercise:  This includes ‘formal exercise’ such as running, lifting weights, swimming, etc. but also, to a less intense extent, activities such as raking, gardening, some forms of yoga, and household chores.

4)      Stress Management:  This is of course linked to all of these other areas and may include incorporating some of these other areas as ‘stress buffers’ but it may also encompass other things such as massage therapy, acupuncture, an activity you enjoy doing that relaxes you, reframing, physical and emotional detoxification regimens, and more.

Arguably, with the pace of life and the demands of day to day life so considerable nowadays, attending to all of these areas for individuals should really be mandatory, should they wish to support and maintain their health and energy into middle age and beyond.  Unfortunately, ‘Youth’ really will not get us too far anymore due to these demands, as many people in their early thirties (or even earlier in some cases) are already suffering from adrenal fatigue/exhaustion and in some cases, premature hormonal decline.   So, on that note, lets delve into exploring what you can do, without breaking the bank, to improve your health and the ‘wealth’ of your life in each of these important areas!!

SLEEP

Never have Americans ever been as sleep deprived as they are today.  In 1900, the typical American averaged 9 hours of sleep nightly (www.sciencedaily.com).  This number has plummeted to approximately 6.3 hours according to recent studies (Lauderdale et al, 2006).  Unfortunately, many studies suggest our bodies are really designed to do better typically with 7-9 hrs nightly, on average (www.mercola.com ).  Thus, the chronic shortage of 1-2.5 hrs/nightly for most people of sleeping leads to a host of potential problems including:

1)      Suppressed immunity

2)      Impaired cognitive function due to drowsiness and lessened alertness

3)      Accelerated aging

4)      Greater risk of obesity, cancer, and many degenerative illnesses

5)      Lowered energy

6)      Greater risk of depression    AND MANY OTHER ISSUES!

In a time where the choices for entertainment, employment, travel, and personal freedoms are at perhaps an all-time high, it is perhaps not a surprise that individuals literally are working and stimulating themselves into early decline and dysfunction.  That said, mindfulness is perhaps our greatest tool in turning this issue around—that is, being purposeful, methodical creators of our day to day schedules and learning to judiciously reserve precious time for adequate sleep and recovery.

But for many people, the problem goes deeper than that.  One may have good intentions indeed of getting good sleep and may strive to get to bed and get their 7-9 hrs a night.  What happens however when you can’t fall asleep or you continue to wake up at night and struggle with restless sleep quality?  There certainly are pharmaceutical options that may assist in this, but thankfully we have many other options both lifestyle-wise and supplement wise to support healthier sleep cycles and more restful , quality sleep.

The Importance of Good Sleep Hygiene:

‘Sleep hygiene’ may be a new phrase or conceptual way of thinking for many to think about their sleep supporting habits, but just like ‘oral hygiene’ where you take particular steps to support good teeth and gums, it is important for us to think of it this way, because as we know, good sleep doesn’t always magically happen throughout one’s life.  However, our regular practices and habits can greatly increase the likelihood that it will and that is where the hygiene (i.e. ‘your active health promoting practices’) comes in to play.  Some notable areas to attend to when addressing your sleep hygiene include:

1)      The timing of your bed time.  Chinese medicine teachings suggest that for optimal resetting of hormones, adrenal recharging and supporting detoxification (most of which happens when we sleep) we need to be WELL asleep before 11pm.  That means for most people aiming for a bedtime of 10pm or even 9:30pm would be ideal.  Most of our melatonin production happens between 1am-3am, so if we are a perpetually ‘late-to-bedder’, we are literally short-circuiting our restorative processes to our own detriment (Reiter et al, 1995).

2)      The importance of absolute darkness.  Studies have shown that cortisol levels will rise with just the light coming from a small alarm clock or nightlight, so we must do our utmost to minimize our exposure to these in our bedroom (Figueiro, M et al, 2010).  We need to remember that for almost all of humanity’s existence, we have been wed to the cycles of the moon and sun and our bodies are very much still in tune with this—i.e. we sleep when its dark and we wake with the light.  Our bodies are sensitively tuned systems and thus when we have multiple lights, whether clock radios, stereos, computers, street lights, etc. shining in or lighting up our bedroom, we are not allowing our body to truly relax and allow cortisol levels to bottom out (as they should at night, for a more restful sleep experience).  So, make sure to turn off your computers and other electronic devices in the bedroom (or better yet, move them out of the bedroom), turn the clock radio away from your view, and have blackout shades and good blinds or curtains to completely block external street lights.  Another good suggestion is an eye pillow/face mask to block light on the eyes/face.   Research also suggests that blue/green lights are more disruptive to melatonin levels, so if you must have some light in the bedroom as a clock radio or something, preferably choose one with red colored lights (although these may also still artificially stimulate cortisol too) (Figueiro, M. et al, 2010).  Lastly, minimizing the electronic appliances in your room will also minimize your exposure to EMF (electro-magnetic frequencies), which some studies suggest are disruptive to sleep and may have a whole array of deleterious health effects.

3)      The importance of cool.   Our bodies typically prefer cooler temperatures to sleep and actually in order to sleep, the body must typically drop in temperature by several tenths of a degree (www.insomnia-free.com)!  Thus if you are sleeping in an overheated room, it makes it much more difficult for one to get to sleep.  So, in addition to saving money on heating costs, make sure to turn down your thermostat by several degrees at night for a better night’s sleep.  Too constricting or warm bedtime clothing also can exacerbate over-heating during the night, so also remember to dress to ensure your personal comfort for the whole night.

4)      The importance of avoiding pre-bed over-stimulation.  This relates in part to too much visual (light) stimulation but also related to too much mental stimulation.  This can involving watching TV, doing computer work, doing personal finances or anything else that stimulates, worries, or excites you into a more sympathetic (i.e. fight/flight mode) state.  Before bed, we want to do things that encourage minimal wakefulness, such as washing up for bed, deep breathing or simple meditation exercises, that ‘wind us down’ and prepare us for sleeping.

 

 

                                 COMMON SLEEP IMPEDIMENTS AND SLEEP-INFLUENCING PROBLEMS

A)     The importance of screening for Sleep Apnea!   An increasing concern with age, this problem now is estimated to affect over 18 million Americans and up to 24 percent of middle aged men and approximately 10% of women (Young et al, 1993).  This condition, which is noted by a lack of sufficient oxygen to the body and multiple waking/interruptions in the sleep cycle, can wreak havoc with the body’s ability to repair and regenerate during sleep and can actually leave people in considerable danger of being oxygen deprived for hours each night.  The risk of sleep apnea goes up with increasing body mass, so just another reason to focus on achieving ideal body weight and staying lean (Wolk et al, 2003).  If you or a loved one you know are suspicious you may have this or continually wake up exhausted after sleeping a full night’s sleep, it is certainly advisable to be screened for this underdiagnosed condition.  Some studies suggest that 90% of people with sleep apnea are those without a diagnosis (Young et al, 1993)!!

B)      The Issue of High Cortisol and Stress-related Neurotransmitters:  This is a MAJOR issue for many people nowadays, with ever-increasingly busy lives, demanding schedules, and multiple  job and home responsibilities.  Normally, when our bodies are in good rhythm and function, we have innate cyclical rhythms of cortisol production, which peaks early in the morning and then gradually wanes throughout the day until it reaches its nadir in the late evening and overnight hours.  However, this rhythm can become disturbed due to a variety of forces such as young infants requiring parents to wake at any hour of the night, abbreviated or irregular sleep schedules, and highly stressful periods where one is continuously in a ‘fight or flight’/panic mode (thus not allowing the body to ‘calm down’ and enter a sleep/low cortisol time).  So instead of staying low at night, for example, you may find an individual with disturbed, frequently waking at night type of sleep pattern showing multiple ‘peaks’ in cortisol during the night when they should be sleeping soundly.  Other neurotransmitters such as epinephrine (adrenaline) and norepinephrine (noradrenaline) could also be ‘kicking into gear’ during such episodes, further compounding the problem and the ability to stay asleep (or fall asleep or both for some individuals).

C)      Going to bed on a full stomach:  When eating too late, this gives the digestive system extra work to do, which contributes often to a less restful, less comfortable and often more interrupted sleep (also from increased urination).  Make sure to preferably finish eating at least 2 hours before bedtime to allow for digestion and to avoid going to bed with a full stomach.

D)     Increased Urinary Frequency:  This is a common problem for many aging men who may have enlarged prostates or with prostate cancer.  Being careful with your consumption of fluids past 5pm, minimizing fluid consumption with dinner, eating an anti-inflammatory diet, and also working on inflammation by incorporating potential supplements into the diet such as ginger, curcumin, fish oil, and boswellia can help to minimize these night-time interruptions.

 

 

 

 

 

SLEEP SUPPORTING SUPPLEMENTS

Of course it is always a good idea to discuss with your physician the appropriateness and safety of some of the following supplements in your individual case, but the following supplements may be worth exploring as possible sleep aids for those who continue to have difficulty with falling asleep, staying asleep, or both.

1)      Melatonin:  This important antioxidant is produced primarily in the first half of the night (again underscoring the importance of a relatively early bed time for optimal restoration) and helps to govern a regular sleep-wake cycle as well as promote deeper sleep (Reiter et al, 1995).  Additionally, it is noted for its immuno-supportive properties and its ability to quench free radicals, thus serving as an important supplement for countering the deleterious effects of aging.   Typically nighttime dosage may range from 500mcg—5 mg, typically taken 30-60 minutes prior to retiring for the evening (www.umm.edu, www.lef.org ).

2)      5HTP:  This serotonin precursor is commonly found in many natural sleep supports as it provides the raw material for our important neurotransmitter serotonin (which is involved in supporting deep sleep, your mood, and appetite/cravings, among other things).  Many people by middle-age have depleted their serotonin levels, thus they may benefit by taking 5HTP to support repletion.  Note, some individuals may respond better to 5HTP for sleep support while others may respond to L-Tryptophan (which is actually a precursor to 5HTP).  This is very individual and seems to be about half the population responding better to 5HTP vs L-Tryptophan.  Dosage may typically range in the 50-300 mg range, usually given in divided doses (for example, 100 mg 30 mins before evening dinner and another 100 mg 30 mins before bedtime) (www.5htpdosage.org, www.umm.edu ).

3)      Valerian:  Valerian root is perhaps the most popular herbal sleep support on the market.   Substantiated in clinical studies for improving the quality of sleep as well as expediting how quickly individuals fall asleep, Valerian contains the important amino acid GABA, which helps to calm the brain down from overexcitation and activity (thus preparing it for sleep).  Typical dose ranges from 300-600 mg again before bedtime (www.umm.edu ).

4)      Milk Peptides:  Used for years in Europe to support sustained deep sleep, these derivatives of milk have shown considerable clinical efficacy in clinical studies in improving sleep quality for many men and women as well as shortening the duration of time to fall asleep (www.lef.org  ).  Typical dosage for milk peptides (which can also be used during the daytime to counter effects of stress) is around 150 mg.

5)      Glycine:  Long used in treating a variety of mental health disorders, glycine tends to have a calming quality in the body, which of course can be helpful for those finding it difficult to ‘wind down’ and fall asleep.  Some clinical studies have suggested glycine may promote deeper sleep as well as improving immunity and countering the effects of stress in the body.  Dose range can vary widely depending on the issues being address, but for sleep support consider 1000-3000 mg before bedtime, although some individuals may find higher doses of greater benefit.  Glycine is also extremely safe, with studies showing all the way up to 90 grams/daily yielding no negative effects in the body (Heresco-Levy et al, 1999).

6)      GABA:  Another amino acid support, GABA stands as the chief ‘calming’ neurotransmitter in the Central Nervous System.   It plays an important role in controlling over excitability in the brain and helps us to again, wind down and calm ourselves in preparation for sleep.  Dosage for sleep support may typically range in the 500-1000 mg range, preferably divided into 2 doses, one before (30 mins) dinner and one before bedtime (again, 30 mins or so beforehand) (www.lef.org, www.neurorelief.com ).

7)      Chamomile:   Used for centuries as a mild sedative for anxiety and insomnia, the flowers of the chamomile plant can be used as a tea or in a capsule form.  Typically the dose may range between 400-1600 mgs and like milk peptides, this can be used with great success during the day also if suffering from anxiety (www.globinmed.com ).

8)      Hops:  Typically used in combination with other ingredients such as valerian, passionflower, and melatonin, Hops has been used in various forms, including teas, tinctures, or even as bath additives.  Studies are unclear as to whether hops acts as an independent sedative or as a synergistic aid with these other herbs, however a randomized double-blind study using hops as a bath additive did show considerable improvement for individuals re: their sleep (both objective and subjective reporting).  Dosage will depend upon the form used: As an infusion/decoction:  .5g/150 ml water; Tincture: 1-2.5 ml/day; or as a bath additive: 4gms in a concentrated extract (www.medicinalplants.us)

9)      Passionflower:  Another popular herbal sleep aid as well as potentially helpful in situations of anxiety and nervousness, Passionflower can be dosed as a tea, dried herb, tincture of capsules.   Dosage of the dried herbs may range in the 4-8 gram range whereas the capsule dosage range is typically 200-500 mg (www.raysahelian.com ).

10)   L-Tryptophan:  As mentioned earlier, L-Tryptophan is a close relative to 5HTP, actually being enzymatically converted into the latter in our bodies .  This amino acid has been well substantiated in the clinical literature for its supportive effects on sleep and unfortunately, the typical American diet often fails to provide enough of this important amino acid to sustain optimal serotonin levels into middle age and beyond.  Dose range of supplementation for tryptophan typically falls between 500-4000mg and some individuals may note they may need a stronger dose for the first week or two (a ‘loading period’) to induce optimal improvement in sleep quality and falling asleep (www.lef.org).

ON A FINAL NOTE:

Lastly, for those wanting to take it to the ‘next level’, you may wish to pursue specialized testing to see what may be going on with your stress hormones and neurotransmitters.  For those familiar with typical insomnia medications, this form of approach differs in several key ways.  Typically, with pharmaceutical medications, these medications may typically cause effect by ‘prolonging’ the effect of one or several extant neurotransmitters in the CNS, which allows one to have a better sleep experience (for example, serotonin).  However, this approach does nothing to rebalance or replete levels which may be imbalanced or insufficient for optimal sleep (or other things).  Specialized neurotransmitter testing allows one to actually look at reflections of CNS levels of these various chemical markers and see where they are at relative to ‘optimal’ values.  Furthermore, this testing also enables a physician to specifically target key vitamins and amino acids to replete these imbalanced or depleted levels.  This is typically only available through a physician, but it is something that can provide great specification as to the particular neuro-chemical imbalances that are going on for an individual and also give greater insight into what supplements may be most appropriate.   Talk to your licensed  integrative health care provider for more information should you wish to pursue this innovative approach to improving and balancing your sleep/wake cycles.

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DIET

It comes as little surprise to most people that diet really does matter to their health and wellbeing.  However, knowing what is truly healthy for them, what refined foods are, understanding the dangers of pesticides, GMOS, and other food additives, and knowing the importance of organic foods is not as commonly known (or practiced by many people).  The reality is is that there is no ‘drug’ or other chemical cocktail we consume more of in a given day that direct influences our cellular health and our overall wellbeing than the food that we eat.  As our body is constantly remodeling and rebuilding, we rely on a steady stream of nutrients on a regular basis to enable optimal repair and regeneration for our entire lifespan.  The food we eat can influence the pH chemistry of our bodies (tilting it more alkaline or more acidic), it can encourage or suppress our immune system’s activity, encourage or discourage healthy blood chemistry profiles (such as lipid, cholesterol, and blood sugar levels), encourage or discourage a healthy weight, and of course, much, much more.  The sad reality is that now more Americans than ever are overweight or obese and the vast majority of Americans are nutritionally deficient in one or many, many different nutrients, predisposing them for a host of illnesses, premature aging, and increased mortality.  The old adage of ‘you are what you eat’ has perhaps never been more important to take to heart now, as so
many individuals are compromising their own and their family’s health and longevity by their day to day dietary decisions.   To better understand some of the specifics when it comes to the diet, let’s begin by discussing the foundational building blocks of our foods: macronutrients!

MACRONUTRIENTS

A macronutrient refers to one of the key nutrients needed in large amounts in the diet for basic health and sustenance (in contrast to micronutrients, which are typically many different minerals and vitamins needed in much smaller amounts).  This list is arguably small, comprised of just 4 primary items:  1) Carbohydrates; 2) Proteins; 3) Fats; and 4) Water.   Each is an essential nutrient and plays key roles in many bodily processes and functions.  Let’s explore each of these in more depth and also discuss the relationship of the nutrients to one another:

1)      Carbohydrates:   Typically the most voluminous part of a person’s diet, carbohydrates are ubiquitous in the American dietary landscape, ranging from chips to pastas to veggies to fruits.  Of course within the large category of carbohydrates, there are different types of carbs with different nutritional values.   Some of these include:

  1.  Simple (and sometimes ‘refined’) carbs: these are often found in  things such as  ‘snack foods’, such as potato chips, cookies, candies, but also natural things like many fruits, honey, vegetables, milk and dairy products.
  2.  Complex carbs:  also found in many vegetables, these are found in greatest abundance in many legumes and whole grain items such as breads, cereals, some pastas, and unrefined, minimal processed natural grain items such as rice, buckwheat, quinoa, oats, and others.
  3. Fiber: while this also can be considered as a complex carb, fiber is a very important ‘class’ of carbohydrates in itself, as it serves important purposes to bind toxins, cholesterol, move waste products through the bowels, and more.  Common sources of fiber will include many fruits and vegetables and unrefined, minimally processed grains such as whole oats, brown rice, and others.

2)      Proteins:  Most people have a sense of at least some foods that are typically considered proteins or protein –rich foods.  These include all kinds of meat and fish as well as nuts and cheeses, tofu, tempeh, and to lesser extents beans, legumes, and some grains.  Proteins provide the building block materials for our cells all over our bodies as well as contribute important amino acids to the nervous system, the immune system, and more.  Without dietary consumption of key ‘essential ‘ amino acids (i.e. those our body cannot produce on its own), we would eventually die as our body wouldn’t have the raw materials to repair and replace cells across the body.   Of course the quality of proteins, like any other macronutrient, makes a big difference.  Some key points one may wish to familiarize themselves with when it comes to quality-issues regarding proteins (and other macronutrients too) include the following ideas:

A)     The importance of free-range, organic and antibiotic free animal products:  In many ways, it is unfortunate that agricultural practices have changed so dramatically in the last 40 years or so.  It is now common that animals receive growth hormones to speed their maturity and development as well as antibiotics (to offset increased risk of diseases due to close proximity living quarters).  Also common is the risk that animals and humans incur from other sprayed chemicals (such as insecticides in feed and pesticides on crops) which our modern produce and feed is now commonly laden with.  There are various health implications of consuming low-grade levels of these chemicals and drugs, which may include the following:

1)      Digestive difficulties

2)      Increased risk of many kinds of cancer

3)      Fertility problems

4)      Impaired immunity in self or in children

5)      Autoimmune illnesses

6)      Parkinsons (www.mercola.com)

7)      Developmental delays and influence on intelligence in children (www.nihrecord.od.nih.gov/newsletters/2011/03_18_2011/st)

Thus our commitment to minimizing our exposure to such things is critical in shielding us from increased risk of many health problems.   Animal flesh and products that are clearly labeled ‘free-range’, ‘antibiotic-free’, and ‘organic’ will not have been exposed to such practices.  They will have been allowed to roam freely (and more naturally), and thus will be much healthier for us and the environment overall.

B)      The importance of non-GMO:   Genetically modified foods have been increasingly on the American food landscape in the last several decades.  While long-term research is still in its beginnings, initial research studies suggest some very disturbing trends with animals regularly fed with GMO foods (which include beets, corn, tomatoes, soy, papaya, some forms of rice, dairy products, some potatoes, and some pea varieties).  Some of these reported health issues include:

1)      Digestive difficulties

2)      Smaller and less developed offspring

3)      Bacterial toxins extant in the gut

4)      Immune problems

5)      Allergic reactions

6)      Fertility problems

7)      Higher rates of mortality  (www.naturalnews.com)

For those unfamiliar, genetic modification occurs when scientists literally ‘insert’ other genes from another plant, animal, or microorganism into the particular item at hand, creating a new ‘hybrid’ organism that has this added quality to it from the newly incorporated DNA.  This is typically done to increase agricultural yields, often because this new ‘gene’ or ‘genes’ may counter or kill unwanted pests and plant diseases.   Understandably, there are many potential repercussions of this which we are still learning about, but in the meantime, from a safety standpoint, one may be best advised to avoid all GMO foods as much as possible.

3)      FATS:  Fats in years past have typically gotten a ‘bad rap’, but like carbohydrates and proteins, all fats are not created equal!  In fact, it is essential for our body to have certain types of fats in the diet, such as omega 3 fatty acids, for particular bodily needs such as repairing and insulating our nerves and organs, providing energy, and more.   Some of the important distinctions and categories of fats to keep in mind include:

  1. a.       Unsaturated Fats:  Typically these fats are liquid oils at room temperature and tend to be good for our health.  These are comprised of several types, including:

                                                              i.      Polyunsaturated: these kinds of fats feature more than one double bond and they number and vary greatly in the diet.  Common good, health-promoting sources of these many individuals may be familiar with include: hemp oil, evening primrose oil, borage oil, black currant oil, fish oil (containing those important omega 3 fatty acids!).  Other sources which are typically not healthy Poly-fats include: margarine, shortening, arachidonic acid (if in excess), and trans fats.

                                                            ii.      Monounsaturated:  chemically-speaking, these unsaturated fats have one double bond (hence the reference of ‘mono’ in the name) and can vary in length in their chemical structures.  They are found in diverse foods and sources, including milk, olive, almond, peanut, pistachio, pecan, canola, avocado, hazelnut, cashew, and macadamia nut oils, and in the fats of land animals.  Interestingly, a type of monosaturated fats called oleic acid, is the major fatty acid produced by our skin that keeps it supple and moist (Erasmus, 1994).

  1. b.      Saturated Fats: found in many different foods and oils, these are especially abundant in fats that are hard at room temperatures.  Foods that will typically contain a substantial amount of saturated fat include: butter, milk fat, lard, coconut and palm kernel oils.  Having some saturated fat in the diet is generally regarded as healthy, but excessive amounts can contribute to the development of cardiovascular disease, weight gain, and other assorted health problems.
  2. c.       Medium Chain fatty acids:  These unique fatty acids are used to produce energy in the body rather than to be used or stored as fat.  They can be especially helpful to those with digestive and liver problems and to athletes looking to boost their performance before a workout.  Too many of these however can cause throat irritation, so it may best be advised to limit consumption to no more than 2 tablespoons daily.  These can be bought specifically or can also be found in foods such as coconut oil, palm kernel oil, and butter (Erasmus, 1994).

 

4)      WATER:  In some ways, our most important macronutrient, water is also the nutrient we can live without the least amount of time.   While most humans could survive weeks without food, without water, most individuals would die within 72 hours, as the majority of our bodies are also made of water!  Like all the other nutrients, the quality of the water you consume is also very important.  Some of the important issues to be aware of when it comes to your water quality include:

  1. a.       Purity/Contamination:  typically more of an issue in developing countries, this is primarily related to good sanitation and water purification plants destroying any traces of microbes in the public water supply
  2. b.      Chlorination and Fluoridation:  increasingly hot topics, recent months have shown more and more communities across North America banning the use of fluoride in their local water supplies as information has continue to mount detailing the potential dangers of fluoride consumption (www.mercola.com ).  Interestingly most of Europe already outlaws the use of Fluoride as an additive in the public water supply (www.fluoridation.com/c-country.htm) .   Chlorination is also a hotly debated issue, as chlorine in ‘high’ amounts is a known, potent carcinogen.  As to what is ‘safe’ in the water supply, is currently at debate.  However, given that Chlorine serves no nutritional benefit to individuals as a water additive, it is highly suggested for this and other reasons to purify your water to minimize any exposure.

Various systems of water purification currently exist, ranging from the inexpensive $10-20 filters (such as Brita filters) to more expensive, home based units such as reverse osmosis or Kangen water systems.  There are pros and cons of all systems, but doing at least some water purification to ensure purity and minimal contamination from chlorine and fluorine additives may be best advised for those health-conscious, pro-active types.   While more sophisticated analysis is possible, a general principle for guiding one’s water consumption on a daily basis is to take their weight in pounds and divide by 2 (www.wikihow.com/Drink-More-Water-Every-Day).  This resultant number will be the number of non-caffeinated, water-based clear fluids one should be consuming daily (so this primarily includes water and herbal teas as well as coconut water).  Keep in mind that caffeinated drinks typically deplete the body of water and as such are diuretics (such as coffee).   Generally, it is advised, for optimal digestion, to consume more of your fluids AWAY from your meals (as too much liquid while eating can dilute your stomach’s hydrochloric acid, which is needed to breakdown your food).  So, keep that in mind when planning your daily food and fluid intake!

 

GUIDING CONCEPTS: HOW TO BUILD A SUCCESSFUL DAY TO DAY EATING PLAN FOR AN INDIVIDUAL

Now that we have gone over key points regarding macronutrients, that brings us to discuss a number of other important issues when it comes to the diet.  Many people wonder: ‘Well, what should I ideally eat on a daily basis?’  ‘What foods are healthy for me?’  ‘What is the glycemic index and is it important?’   ‘Is there one diet best for everyone?’  ‘Does it matter when I eat’?  ‘I think I have food allergies/sensitivities, but I’m not sure.  How do I find out?’

These are all great questions and important ones to be addressed to truly better understand how to craft a better day-to-day plan for an individual who just wants to generally feel good, know that they are being well-nourished, and maintaining a healthy body weight.  So, let’s begin by discussing the issues at play in all of these areas:

1)      WHAT TO EAT?  Well, while there will always be individual differences as to the exact proportion of macro- and micro-nutrient requirements, there are some guiding principles that for many individuals may be helpful.  Keep in mind there are many existing theories and approaches currently being discussed in field (such as metabolic typing, genotyping, acid/base balancing, and many others) that may influence and inform each individual’s decisions and perspectives on further refining their choices.  That said, let’s begin on some core principles:

1)      Fiber!   The importance of adequate fiber in an individual’s diet should not be underestimated, as fiber plays many important roles in the body such as absorbing toxins, providing bulk to the stool, improving digestive transit, absorbing cholesterol, helping to balance blood sugar, increasing satiation earlier (and afterwards) in a meal, and more.   Many Americans do not consumer enough fiber, which again is typically found in many fruits, vegetables, and unrefined grains.    Some sources suggest women should aim for 25-30 grams of fiber daily while men in the range of 35-40 grams for optimal health (www.lpi.oregonstate.edu/infocenter/phytochemicals/fiber) .

Keep in mind that lack of fiber is a major risk factor for certain types of digestive orders such as diverticulosis, so just this simple addition many reap considerable dividends and reduce your risk for various digestive ailments.  Great examples of high fiber foods include:  split peas, raspberries, whole oats,  black beans, kidney beans, pinto beans, dark rye bread, buckwheat, bulgar, chickpeas, dried figs, red lentils, spinach, and yams (to name just a few) (www.wehealny.org/healthinfo/dietaryfiber/fibercontentchart.html)

 

2)      Balancing Carbs, Proteins, and Fats:  This is a complex question with no definitive answers, as there currently are various streams of thought and perspective on this (for example, looking at blood sugar balancing vs. food combining for optimal digestability).  Various diets and authors put forth a wide array of varying opinions, making it difficult to establish a definitive answer on the balance of macronutrients (for a good overview and some reasonable conclusions, see: www.laurapower.com) However, some key points to keep in mind to guide the overall dietary construction include:

a)      Protein will help to stabilize blood sugar levels: In a society where many convenience foods are filled with refined carbohydrates with little to no protein, incorporating modestly protein rich snacks as well as meal sources may go a long ways to encouraging satiety and a more balanced blood sugar (i.e. avoiding rapid blood sugar spikes).  This has to do with the fact that protein helps to stimulate the release of glucagon which helps to keep blood sugar more stable and encourage fat burning.   Consider incorporating 10-15 grams of protein at least 4 times daily into your meals and snacks to ensure this better balance.  Some sources suggest .8grams/kg of body weight as a general ‘rule of thumb’ for protein consumption, but this level will vary dependent upon activity level (more may be needed with intense exercise), age (as we age, we actually need more protein to counter faster muscle breakdown (www.lef.org) ), and pH status (if we are too acidic, decreasing protein consumption (especially animal protein) can help to remedy this.  Good quality protein sources for many people may include:  organic tofu or tempeh, many types of nuts and seeds (including almonds, walnuts, pecans, hempseeds, chia seeds, brazilnuts, hazelnuts, and pumpkin seeds), free-range animal meats, goat dairy products (more later on why I generally suggest to avoid cow dairy products, unless from a quality raw dairy supplier), wild fish, beans and legumes, and quality protein powders (including a well-formulated whey, hemp, pea, rice, and/or whole soy powders).

b)      Fats will help you stay full longer:  Keep in mind, we want these to be healthy, good quality fats and not trans-fats, too much saturated fats, and those typically found in many fast food items.  Typical good sources of quality fats in one’s diet include: avocado, coconut oil, raw olive oil, raw walnut oil, raw avocado oil, almonds, walnuts, pistachios, pecans, hazelnuts, brazil nuts, pumpkin seeds, chia seeds, flaxseeds, sunflower seeds, and also potentially grass-fed animal meats and wild fish.  The consumption of some fat in a meal sends signals to the brain that trigger a sense of ‘fullness’ and thus encourages us not to overeat (unlike when we may eat some carbohydrate only, low-fat snacks) (Woods et al, 2008).  So, ironically, in order to lose weight, individuals may be advised to incorporate more, healthy quality fat in their diet!  A variety of sources typically suggest somewhere in the range of 20-30% of daily calories may be from fat sources (again, we primarily want good quality fats here!), but this again will vary to some extent based on a given individual’s needs and caloric needs.

 

3)      Eat Lower on the Glycemic Index and watch the Glycemic Load:  These points, in part, relate back to the importance of incorporating protein into the diet regularly to balance blood sugar levels.  The Glycemic index refers to a devised scale of how rapidly a particular food item will convert into ‘sugar’ in the body upon consumption.  Those foods that convertly quickly will typically cause a rapid influx of sugar which must be compensated by rising insulin levels in the body.  Foods high on this index typically are many refined, processed foods but also some other surprising items such as: doughnuts, baguettes, potatoes, rice cakes, cornflakes, pretzels, and waffles (www.southbeach-diet-plan.com/glycemicfoodcharthtml ).    To more completely understand this concept, we must also understand what is meant by the glycemic load.  While the glycemic index refers to how fast an item converts to sugar in the body, the glycemic load refers to actually how much food ‘mass’ there is to convert and thus make an impact on the blood sugar.  A good example of a food with very different values of glycemic index vs glycemic load is watermelon.  Ranking high on the glycemic index at 72 (typically on a 1-100 scale, serving size 120 grams), watermelon’s glycemic load is actually quite low at a 4 (high glycemic load foods are considered those over 20; mid-range foods are 10-20 and low GL foods are under 10) (www.alsearsmd.com ).   So, while it may be higher on the glycemic index, in reality watermelon will really have a small impact on the glycemic load, unless one has a very large serving size.  So, in this instance, you could reasonably enjoy some watermelon regularly without worrying about likely causing excessive glycemic index spikes (this may be different for pre-diabetics or diabetics however).  Many foods however with high glycemic indices may also have high glycemic loads and this is when individuals need to be especially careful.  For more information and lists of the glycemic index and loads of common foods, refer to: www.health.harvard.edu/newsweek/glycemic_index_and_glycemic_load_for_100_foods.html)

4).  Watch the Serving Size!  For those of you over 40, you may quite readily remember that portion sizes used to be quite different in restaurants.  It is not uncommon now to see many meals “super-sized” at many fast-food and cheaper establishments.  The problem is (well, one of many), is that the American lifestyle has been growing increasingly sedentary over the last 50 years, which means less of these calories are being ‘worked off’ on a daily basis, contributing to the obesity epidemic we are now facing.  Becoming familiar with what an actual ‘serving’ of vegetables, fruits, grains or meat can actually be a very useful tool in recalibrating our nutrient intake on the plates before us.  A general useful tip is that half of your plate (if the plate is full of food, for example), should be vegetables.   Note some helpful ‘reminders’ as to a one serving size of vegetables or fruit include: 1) ½  cup of cooked/raw vegetables; 2) 1 cup leafy raw vegetables; 3) ½  cup of cooked peas/beans/legumes; 4) ¾ cup of vegetable juice; 5) One medium apple, banana, or orange; 6) ½ grapefruit; 7) ½ cup chopped fruit; and 8) ¾ cup of fruit juice (www.fitup.org/PDF/UPOMPPortionSizes.pdf ).  Keep in mind that rather conservative estimates suggest you eat at LEAST 5 servings of fruits and vegetables daily.  Likely this number is too low for optimal benefit for many, so feel free to pile on the vegetables, as they are nutrient dense, low calorie, and fiber rich!  A great print resource for a more list of portion/serving sizes as well as guidance on how to become more mindful in portion control is The Portion Teller, by Dr Lisa Young.

5) It does matter when you eat:  The timing of when you eat and what you eat indeed can make a difference to our feeling of well-being and energy levels (see below in sample menu ideas for more on this point).  Remember, in the morning, it is likely you have gone without food for at least 10 hours (especially if you have remembered to get your 8+ hours of sleep and having dinner at least 2 hours before bedtime!) and thus you need to ‘break’ your ‘fast’ with breakfast.  Our body will be ready for protein and will want carbohydrates also to fuel our activities for the day, so it is advisable to incorporate all these macronutrients in the diet in healthy quantities.

6) Food sensitivities and one diet for all?  This is an easy one to answer: no, there is not just one diet for everyone!  This ties into the concept of biochemical individuality, which notes that each of us will have slightly different metabolic needs due to our unique genetics, histories, and day to day activities that require different nutrients in different amounts for each of us (www.montanaim.com/pubs/Biochemical_Individuality–patient_handout.pdf ; Williams, 1998).  Also, it is likely that many of us have or will develop at different times, particular sensitivities to specific foods (for example, wheat, cow dairy, and gluten intolerances are some of the most common).  So, while one food may ‘nourish’ one individual, it may in fact be another’s ‘poison’, or at least, to their detriment.  Thus, this is where specialized food sensitivity testing may come in hand.  This is something that, through the help of your integrative health practitioner, those who are interested in further refining their eating habits may wish to explore.  This is different than the more common ‘skin prick’ allergy tests that many may be accustomed to as this involves taking a blood sample for analysis in conjunction with many common, everyday foods.   In contrast to those skin prick tests that are testing for an ‘immediate allergic reaction’ (typically occurring within 10-15 minutes of consuming the food), this kind of testing assesses for Delayed Hypersensitivity Reactions to foods that may take up to 96 hours to manifest in a given individual.

Signs that you or someone you know may be dealing with food sensitivities (i.e. “delayed hypersensitivity reactions”) causing what we call ‘Leaky Gut Syndrome’ may include the following (typically occuring with 96 hours of eating the offending food(s)):  bloating, cramping, gas, skin rashes, acne, eczema, psoriasis, diarrhea/constipation, ‘brain fog’, and fatigue (www.nationalcandidacenter.com/leaky-gut).

HOW TO ADDRESS FOOD SENSITIVITIES: Typically, if one is dealing with food sensitivities, they may have to go through a period of avoiding the offending foods and take some supplements to support the gut flora, better digestion, and repair of the intestinal wall (for example, supplements such as probiotics, digestive enzymes, and glutamine).  After a sufficient period of time has passed to enable this healing process to complete and the inflammation to subside (this may range from 3-4 weeks to many months), then individuals may go through a period of “reintroduction”: i.e reintroducing some or many of those various eliminated foods to determine your own ability to ‘tolerate’ this foods regularly or semi-regularly in your diet.  Obviously this is a process that can get quite complex, thus it is highly advisable you discuss this with your integrated healthcare practitioner for further information.  In the meantime, also see: www.alcat.com  for more information.

Sample Dietary Planning and Dietary Meal Suggestions for the Busy Individual

Before moving on to discuss the importance of exercise, let’s first go over some helpful menu ideas and importance of timing our meals throughout the day for optimal wellbeing and energy.   Keep in mind it is best to eat more of our carbohydrates earlier in the day and also to eat more of our food also earlier in the day so that we ‘burn’ most of our calories well before retiring for the day (again, to help keep an ideal weight) (www.webmd.com).  Protein should be, as mentioned earlier, interspersed in modest amounts regularly throughout the day to support balanced blood sugar and avoid those insulin spikes, which are typically brought on by too many, often refined carbs at one time.  Thus, a good rule of thumb for most individuals is to have something with some protein, some fat, and some complex carbohydrates every 3-4 hours.  Therefore, most individuals will ideally have 3 meals and 1-2 snacks daily for optimal blood sugar balancing and energy levels.  Depending on one’s schedule this may vary to some extent, but suggested timings of these could be approximated at: 1) Breakfast: 6:30-7am; 2) Late morning snack: 10am; 3) Lunch: 1pm; 4) Afternoon snack: 4pm; and 5) Dinner: 7pm.

Breakfast can encompass a wide array of possible recipes, but some key good food combinations to consider could include (keep in mind to add some choice of protein to some of these primarily carbohydrate choices, such as #2, #6, and #8):

1)Free range, organic eggs (potentially with vegetables and goat cheese in an omelette)

2) Fresh, preferably organic fruit (rather than fruit juice)

3) Whole grain or even better, sprouted grain toast with nuts butters such as hazelnut, almond, or cashew butter(s)

4) Free-range, organic turkey bacon or turkey sausage links (soy sausage links are also possible)

5) Goat yogurt or kefir with chia, flax, or hemp seeds.  Goat dairy is typically more digestible and less allergenic than cow dairy, making it a better choice for most people wanting some dairy still in their diet.

6) Whole grain, buckwheat pancakes with fresh fruit and fresh maple syrup

7) Smoothies containing almond, rice, coconut or soy milk (preferably sugar-free) with pure cocoa powder, fresh fruit, flaxseed, protein powder, coconut, and/or nut butters (many possibilities here!)

8) Whole oats with protein powder, fresh fruit, walnuts and pecans, and chia seeds

A great website resource for all sorts of recipe ideas for all meals of the day is the World’s 100 Healthiest Foods (see: www.whfoods.com ).  There, one can find an array of possibilities way too numerous to list here for recipe ideas that are generally very healthy (you can even find the nutrition information right there for each recipe), easy to prepare (20 mins or less) and quite tasty!

SNACK IDEAS:

Many possibilities exist here, but some great ideas that combine some protein, good fats, and good carbs include:

1)      Fresh Fruit (such as an apple or banana) with a handful of almonds, walnuts, pistachios or pecans (or nut butters)

2)      Goat cheese with multigrain crackers

3)      Almond or Coconut milk-based smoothie with protein powder and fresh fruit and a scoop of chia seeds

4)      Cut vegetables with hummus

5)      Stone ground organic corn chips with guacamole and string cheese

6)      Brown rice cakes with almond butter

These snacks are meant as essentially ‘stop-gaps’ between the larger meals to provide some additional nutrients as well as to help maintain stable blood sugar levels by providing some protein, fat, and carbs all in one sitting.  Remember the goal is generally not to go more than 4 hours between eating to again foster better blood sugar balance.

LUNCH AND DINNER:

Many of the potential many choices for lunch and dinner will be similar, with one key difference: Lunch should have a higher percentage of carbohydrates than dinner should for most individuals.  This is due to the time of the day when you are consuming them: by eating more of your carbs earlier in the day, you are more likely to burn them in entirety by the end of the day (encouraging a stable weight and no gain/storage into fat) and they will fuel the activities of the afternoon and early evening.  Dinner should be comprised of a lean protein, vegetables, a smaller serving of carbs (again will depend on the individual’s caloric and metabolic needs to some extent), with a modest amount of fat again in the meal (such as olive oil, avocado in a salad, real butter on a half of yam, etc).  For those trying to determine their ideal caloric needs, you can actually determine this via a mathematical equation (called “The  Harris Benedict Equation”).  For more information about this see:  www.en.wikipedia.org/wiki/Harris-Benedict_equation.

Sample Lunch and Dinner ideas include:

(For complete recipe details, please go to: www.whfoods.com)

1)Asian-Flavored Broccoli with Tofu

2) Quick Black Bean Chili

3) Rosemary Chicken over Pureed Lentils and Swiss Chard

4) Indian Style Lamb with Sweet Potatoes

5) Turkey and Vegetable Chili Verde

6) Quick Broiled Salmon with Ginger Mint Salsa

7) Sweet N’ Sour Cod with Cabbage and Broccoli

**Also, you can find many, many other ideas at www.whfoods.com

ADDITIONAL SIDES THAT YOU COULD CONSIDER TO INCORPORATE INCLUDE:

1)      Fruit Salad with Papaya Seed Dressing

2)      Gifs, Walnuts, and Spinach Salad

3)      Healthy Mashed Sweet Potatoes

4)      Minted Carrots with Pumpkin Seeds

5)      Fiesta Brown Rice Salad

Again, the complete recipes and  many other choices are available at: www.whfoods.com

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PHYSICAL ACTIVITY & EXERCISE

What a difference a century makes!  In the early 20th century, many more individuals were engaged in regular physical activity, whether due to living on farms, very few people yet driving cars, or involved with other labor intense jobs.  Nowadays, most individuals have sedentary jobs which require little to no physical exertion, and this coupled with poor diets and little exercise outside of the workplace is creating major problems with obesity, premature aging, and all sorts of health problems.  Our bodies indeed were designed to be active and the less we stay active, the more we incur the side effects of this inactivity.   In this section we will discuss some of the key benefits of exercise and then discuss some key areas of exercise, different kinds of exercise/activity, and ideas on how to incorporate more regularly in our day-to-day lives for optimal well-being and energy!

THE IMPACTS OF EXERCISE & PHYSICAL ACTIVITY:

The possible benefits of exercise are so many that they truly are too lengthy to list in entirety here.   That said, some core benefits many be interested in noting include the following: (www.cdc.gov/physicalactivity/everyone/health/index.html)

1)      Controlling weight:  given that approximately 65% of the American population is now overweight, this is a major issue for many to address

2)      Reducing risk of cardiovascular disease:  Heart disease and heart attacks are still the number one killer of Americans (closely followed by cancer), so this continues to be an issue many battle

3)      Reduce risk for type 2 diabetes and metabolic syndrome

4)      Reduce risk of some kinds of cancer

5)      Strengthen bones and muscles

6)      Improve mental health and mood

7)      Improve your ability to daily activities

8)      Minimize chance of falling (elderly)

9)      Increase life expectancy

10)   Improve body composition markers (i.e. lean muscle to fat percentage)

Types of Exercise:

While not quite as lengthy as the possible benefits of exercise, this list is also quite considerable.  Essentially, for those generally exercise adverse, you may really want to think of this category as “planned, sustained movement.”  Subsequently, it really can encompass a wide variety of activities from running to swimming, tennis, weight training, aerobics, many forms of yoga, brisk walking, various organized sports, more intense forms of yard work (where you are getting the heart rate up and sweating), biking, and more.  For many people, activities that either combine aerobic exercise with anaerobic exercise or at least alternating between these activities may be most beneficial for optimal health benefits.  Aerobic activities are those that require extra oxygen for performance and typically involve longer, sustained activities such as running or jogging or biking.  Anaerobic activities may require shorter bursts of energy or strength, just as weight lifting.  That said, a number of common exercises and activities may combine both anaerobic and aerobic features in the exercise, such as intense weightlifting, swimming, yoga, pilates, and more.

Thus the options are many for those wishing to either spice up their exercise routines or to initiate one consistently into their day to day lifestyle.   Alternating running and weight lifting on different days could be one way of doing a regimen during the week, perhaps with something on the weekends for diversity or interest, such as golfing, swimming, biking, tennis, or whatever one likes to do and/or interests them.

For those unfamiliar exercising in a health club or fitness facility, working with a  personal trainer can often be incredibly helpful for helping one learn proper form on a particular exercise, setting and working towards exercise goals, and helping a novice put together an exercise regimen that works different muscle groups in good sequential order (for example working antagonist muscle groups on opposite days, such as chest and triceps on one day and back and biceps on another day).  Trainers can also be great ways to help one minimize training or exercise ‘plateaus’—i.e. points where your health markers or physical performance seem to be leveling off and not improving anymore.

Many sources suggest that doing at least twenty minutes of aerobic exercise at a given time is ideal to get the most benefit and also to instigate fat burning.  For those in a hurry or looking for a way to supercharge their workout benefits, interval training is gaining more attention due the number of benefits it may provide an individual.  Compared to more routine methods of anaerobic exercise, interval training has been noted comparatively to: (www.en.wikipedia.org/wiki/high-intesntiy_interval_training.htm )

  • Increase your body’s natural output of growth hormone (thus facilitating better recovery and repair from exercise and just day to day wear and tear)
  • Increase maximal VO2 output and cardiac efficiency
  • Encourage better heart rate variability (associated with youth and fitness)
  • Encourage greater fat loss compared to the same amount of time when doing sustained speed aerobic exercise
  • Improved glucose metabolism
  • Improved resting metabolic rate
  • Improves insulin resistance

Interval training can also be done with weight lifting as well, for example, in the style of training called “Super-Slow Weight Training.”  In this procedure, one begins by “lifting the weight as slowly and gradually as one can.  The first inch of movement should take approximately two seconds to do.  Because you will have no momentum with you at this slow speed, the exercise will be very difficult to complete in less than 7-10 seconds.  If an exercise is a pushing exercise, one should stop about 10 to 15 degrees before fully straightening one’s limb and then smoothly reverse directions and lower the weight down” (www.fitness.mercola.com/sites/fitness/arichive/2012/01/25/cardio-may-damage-heart.aspx) .

A Few Tips about Weight Training

For those unfamiliar with weight training, some general guiding principles may help you consider how to construct your workouts.  First off, it is important to understand the concept of working agonist muscles together vs antagonist muscles.  This would encompass involving muscles that work together and/or are used in particular motions, so for example working your triceps muscles with your chest muscles and working your biceps muscles with your back muscles.  This way, you allow those muscles that have worked one day to rest another and vice versa and optimize your workout efficiency and intensity and minimize redundancy  and ‘reworking’ of muscles you just worked out the last time you did weight training.  For beginners, often doing several ‘sets’ of an exercise such as ‘chest press’ or ‘leg press’ of 8-12 repetitions followed by a rest period of 90-120 seconds may be a good, general guideline to start with.  For more detailed information about weight training, consider consulting with a qualified personal trainer at your local health club.

A Few Tips About Cardiovascular Exercise:

For those interested in or do already do specific exercise activities such as running or biking, it is generally recommended to do both a warm up and cool down post exercise.  These activities serve several important purposes including:

Warmups:

  • Increased muscle temperature: this facilitates both the enhancement of muscle speed and strength.   Moreover, it decreases the probability of overstretching a muscle and causing injury.
  • Increased body temperature: this improves muscle elasticity, and also reduces the risk of strains and pulls
  • Blood Vessel Dilation:  This reduces the resistance to blood flow and lowers the stress on the heart.  It also helps the body to cool more efficiently through sweating and more heat loss through vessel dilation.
  • Increased Blood Temperature:  The temperature of blood increases as it travels through the muscles and as blood temperature rises, the amount of oxygen it can hold reduces.  This facilitates a greater volume of oxygen made available to the working muscles, enhancing endurance and performance.
  • Improved Range of Motion:   that range of motion around the joint is increased
  • Hormonal Changes:  Your body increases its production of various hormones responsible for regulating energy production.  During the warmup this balance of hormones makes more carbohydrates and fatty acids available for energy production
  • Mental preparation:  For those undergoing an intense exercise session especially, this warmup time allows one to clear the mind, increase your focus on your upcoming exercise(s), and build concentration.  (www.sportsmedicine.about.com/cs/injuryprevention/a/aa071003a.htm )

Many kinds of warm-ups can be done, depending on the exercise(s) you do and/or like.  These could include:

1)      Flexibility exercises: i.e. lightly stretching.  Intense stretching before exercising is generally not suggested as the ‘cold’ muscles may be more prone to injury or tear if too intense of stretching is performed.

2)      Lightly jogging or slowly swimming laps

3)      Calisthenics (i.e. rhythmic , simple movements without the use of any equipment or sports apparatus—such as jumping jacks, lunges, situps, pushups, etc.)

Cooldowns:

Similar to warm-ups, cool-downs serve important purposes for the exerciser, namely:

  • Aiding in the dissipation of waste products, including lactic acid
  • Allows the heart rate to return to its resting rate
  • Reducing the level of adrenaline in the blood
  • Improving oxygenation in the body and thus reducing the chances of dizziness or fainting caused by pooling of venous blood in the extremities
  • Minimize muscle soreness post-workout (or “DOMS”—delayed onset of muscle soreness)

In most cases, 5 to 10 minutes of a cool-down period should suffice for most individuals.  Common cool-down exercises include some of the same kinds of warm-up exercises, including:

1)      Slow jogging or walking

2)      Stretching exercises of various sorts (one may now be able to stretch ‘deeper’ as the warms have been ‘warmed up’ due to the previous activity)

Last but not least: STRETCHING and FLEXIBILITY!!

Most people, on at least a basic level, are familiar with the importance of stretching and at least a few basic ways to ‘stretch’.  Most people, however, don’t realize all of the benefits stretching provides and also that stretching can enable one to actually gain strength, minimize chance for injury, maximize athletic performance, and much more.

Some good points to keep in mind about stretching and flexibility include:

  • Every joint has an ideal range of motion to maintain stability while moving freely
  • Too much Range of Motion (ROM) can be a bad thing as it can decrease joint stability
  • One ideally should strive for balanced flexibility on both the right and left sides of the body and in opposing muscle groups and adjacent joints
  • If your ROM is far from the norms, consider strengthening the loose areas and stretching the tight areas
  • Many  will benefit from increasing strength and stability in the core (lumbar spine, pelvis and gluteal muscles) as well as the shoulder joint
  • Many will also benefit from increasing the range of motion in the thoracic spine and shoulder girdle (scapula), the hip joint and the ankles (www.sportsmedicine.about.com/od/flexibilityandstretching/a/stretching-flexibility.htm)

There are almost a limitless number of ways to stretch.  For specific examples to incorporate into your workout routine, please see:  www.workout-planet.com/stretching-for-a-better-workout/.  Always remember to gently stretch and do simple flexibility exercises prior to exercises and to save deeper stretching for after a workout to minimize chance of injury or muscle pulls.  Specifically, your flexibility refers to the ability to move joints through their entire range of motions, from a flexed to an extended position.  The flexibility of your joints depend on many different factors including your muscle and ligament length and supplements as well as the shape of the bones and cartilage that forms the joint.  To some extent this will be genetic but it can also be enhanced through regular stretching.

There are a couple different kinds of ‘approaches’ when it comes to stretching and these include static and dynamic stretches.  Static stretches, which refer to slow, gentle stretches of muscles that are held in a lengthened position for 10 to 60 seconds and often repeated several times, are generally safe for most people.  Dynamic stretches however involve gradual increases in your range or motion and speed of movement by doing a controlled swing that allows one to reach the limits of your range of motion in a controlled way.  These stretches are never forced and good examples of these include torso twists, arm swings, or leg swings.  Often times individuals may repeat these movements 10-12 times for optimal ROM benefit.

Some people may also be familiar with ‘bouncing-types’ of stretches, also known as ballistic stretching.  This attempts to use momentum to force a joint beyond its normal range of motion.  As one might expect, this is NOT recommended as it could invoke injury and weaken the stability of a respective joint(s).

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STRESS MANAGEMENT

The last of our four ‘legs’ of health to explore is the issue of stress and how we deal with it in our day to day lives.  While we have considerable influence over what we may choose to do in a given day and the situations we put ourselves in, we are indeed limited over how much stress we can control that comes ‘at us’—i.e. a traffic jam on the highway, sick children needing extra care, office politics, etc.  That is why is critical for us to have important stress ‘diffusing’ and ‘destressing’ techniques that we can readily employ regularly in our lives, as much as we need to help us cope and meet the needs of our stresses while minimizing their negative impacts on our health and wellbeing.  In this section we will discuss techniques outside of healthy eating, sleep, and exercise (which are all, in themselves, important strategies to employ to mitigate stressors) that may aid in our amelioration and management of our stress including:

1)      Deep breathing techniques

2)      Progressive Muscle Relaxation

3)      Meditation

4)      Energy medicine/East Asian healing art practices: Qi Gong, Tai Chi, & Yoga

Then, at the conclusion of this section, we will put together the whole program in a succinct overview on how to integrate all of these suggestions in a step-by-step approach for you to start truly taking control over your life and your health!  But first, let’s begin discussing how we can rein in the hold that stress has in our day-to-day lives!

  1. Deep Breathing Techniques & Progressive Relaxation

To begin, we must not underestimate the power of intention of the mind on the rest of our body.  The fact that we now know that just certain thought patterns and thoughts may actually impact the shape and circuitry of our brain lends credence to the fact that we can indeed  choose how we feel physically by choosing to think certain ways (and conversely, NOT other ways).   Until the last few decades, we didn’t have the scientific data to validate this, but this is no longer the case due to scientific advancements.  One of the great things about these techniques in this section is that they are absolutely free (or perhaps at most the cost of a book to help guide one unfamiliar with them) to do and can be done in a wide array of situations!  There are also many different ways that many of these techniques can be done, enabling those individuals interested to experiment and try what they feel works best for them (or mix it up from time to time)!  Due to the sheer number of possible variations in these techniques, we will focus on describing the basic principles of how to each of these things: deep breathing, progressive relaxation, and meditation and then also provide you several references to further explore should you wish to investigate more deeply.  Let’s begin!

DEEP BREATHING TECHNIQUES:

1)      Although this exercise can be practiced in a variety of poses, the following is recommended: Lie down on a blanket or rug on the floor.  Bend your knees and move your feet about eight inches apart, with your toes turned slightly outward.  Make sure that your spine is straight.

2)      Scan your body for tension

3)      Place one hand on your abdomen and one on your chest

4)      Inhale slowly and deeply through your nose into your abdomen to push up your hand as much as feels comfortable.  Your chest should move only a little and only with your abdomen.

5)      When you feel at ease with step 4, smile slightly and inhale through your nose and exhale through your mouth, making a quiet, relaxing, whooshing sound like the wind as you blow gently out.  Your mouth, tongue, and jaw will be relaxed.  Take long, slow, deep breaths that raise and lower your abdomen.  Focus on the sound and feeling of breathing as you become more and more relaxed.

6)      Continue deep breathing for about five or ten minutes at a time, once or twice a day.  Then, if you like, gradually extend this period to twenty minutes.

7)      At the end of each deep-breathing session, take a little time to once more scan your body for tension.  Compare the tension you feel at the conclusion of the exercise with that which you experienced when you began.  Use the Record of General Tension in chapter 2 to monitor your progress.

8)      When you become at ease with breathing into your abdomen, practice it any time during the day when you feel like it and you are sitting down or standing still.  Concentrate on your abdomen moving up and down, the air moving in and out of your lungs, and the feeling of relaxation that deep breathing gives you.

9)      When you have learned to relax yourself using deep breathing, practice it whenever you feel yourself getting tense.

 

Progressive Relaxation:

Progressive muscle relaxation has been in use and described in the literature since the 1920s.  Progressive relaxation of your muscles has been noted in the literature to reduce pulse rate, blood pressure, perspiration, and respiration rates.  In a sense, subsequently, it can be used almost like an ‘anti-anxiety/tension pill.’    Literature has also suggested its efficacy in the treatment of muscular tension, anxiety, insomnia, depression, fatigue, IBS, muscle spasms, neck and bac pain, high blood pressure, mild phobias, and stuttering.

Progressive muscle relaxation can be practiced lying down or in a chair.  Essentially, each muscle or muscle group is tensed from five to seven seconds and then relaxed for twenty to thirty seconds.  This procedure is repeated at least once.  If a particular muscle is difficult to relax, you can practice tensing and releasing it up to five times.  Once the procedure is familiar enough to be remember, keep your eyes closed and focus your attention on specific individual muscle groups, one at a time.

Progressive Relaxation procedure:

Begin by assuming a comfortable position in a quiet room where you won’t be disturbed.  You may want to loosen your clothing and remove your shoes.    Begin to relax as you take a few slow, deep breaths.  Now aw you let the rest of your body relax, clench your fists and bend them back at the wrist…tighter and tighter…..feel the tension in your fists and forearms… Now relax and feel the looseness in your hands and forearms.  Notice the contrast with the tension.  Now, bend your elbows and tense your biceps.  Tense them as hard as you can and observe the feeling of tautness.  Let your hands drop down and relax.  Feel the difference.  Turn your attention to your head and wrinkle your forehead as tight as you can.  Feel the tension in your forehead and scalp.  Now relax and smooth it out.  Imagine your entire forehead and scalp becoming smooth and at rest.  Now frown and notice the strain spreading throughout your forehead.  Let go.  Allow your brow to become smooth again.  Squeeze your eyes closed tighter.  Relax your eyes.  Let them remain closed gently and comfortably.   Now open your mouth wide and feel the tension in your jaw.  Relax your jaw.  When the jaw is relaxed, your lips will be slightly parted.  Notice the contrast between tension and relaxation.   Now press your tongue against the roof of your mouth.  Experience the ache in the back of your mouth.  Relax.  Press your lips now, purse them into an “O” shape.  Relax your lips.   Feel the relaxation in your forehead, scalp, eyes, jaw, tongue, and lips.  Let go more and more.

Roll your head slowly around on your neck, feeling the point of tension shifting as your head moves and then slowly roll your head the other way.  Relax, allowing your head to return to a comfortable upright position.  Now shrug your shoulders; bring your shoulders up toward your ears….hold it.  Drop your shoulders back down and feel the relaxation spreading through your neck, throat, and shoulders.   Pure relaxation….going deeper and deeper…

Now breathe in and fill your lungs completely.  Hold your breath.  Experience the tension.  Now exhale and let your chest become loose.  Continue relaxing, letting your breath come freely and gently.  Notice the tension draining out of your muscles with each exhalation.  Next, tighten your stomach and hold.  Feel the tension… Relax… now place your hand on your stomach.  Breathe deeply into your stomach, pushing your hand up.  Hold…and relax.  Feel the contrast of relaxation as the air rushes out.   Now arch your back, without straining.   Keep the rest of your body as relaxed as possible.  Focus on the tension in your lower back.   Now relax.   Let the tension dissolve away.

Next, tighten your buttocks and thighs.  Relax and feel the difference…Now straighten and tense your legs and curl your toes downward.  Experience the tension.   Relax.  Straighten and tense your legs and bend your toes toward your face.   Relax.

Feel the comfortable warmth and heaviness of deep relaxation throughout your entire body as you continue to breathe slowly and deeply.  You can relax even more as you move up through your body, letting go of the last bit of tension in your body.  Relax your feet….relax your ankles…relax your calves….relax your shins.   Relax your knees…relax your thighs …relax your buttocks….   Let the relaxation spread to your stomach, to your lower back, to your chest….letting it go more and more.   Feel the relaxation deepening in your shoulders in your arms….in your hands.   Deeper and deeper.  Notice the feeling of looseness and relaxation in your neck…your jaw…your face….and your scalp.   Continue to breathe slowly and deeply.  Your entire body is comfortably loose and relaxed, calm and rested.

Meditation

As with the previous exercises, there are many different ways to meditate, so this section will essentially again provide a basic template to meditate, upon which many modifications, adaptations, etc. can be made.  For those unfamiliar with mediation, it is essentially the practice of uncritically attempting to focus your attention on one thing at a time.  Exactly what the thing is is relatively unimportant and varies from one tradition to the next.  Often the meditator repeats, either aloud or silently, a syllable, word, or group of words.  This is known as mantra meditation.  Focusing on a fixed object such as a flame or flower can also anchor the attention.  Many meditators find that a convenient and relaxing point of focus is the rising and falling of their own breath.  But, essentially anything can be used as an object of meditation.

For those beginning meditation, it is important to note that the essence of meditation doesn’t lie in simply focusing on one object to the exclusion of all other thought but rather in the attempt to achieve this type of focus.  Our minds will have a tendency to wander and an array of thoughts may appear and seemingly ‘interfere’ with the meditation.  In this case, it is important for one to notice the thought and then gently bring back their focus to the object or thought in focus, with ease.  So, essentially when this happens, the meditator will return their focus on the original object of attention.  By repeating this one moment of awareness, a moment that consists of noticing the thought and then refocusing the attention, over time a number of surprising realizations will become apparent, including:

  • It is impossible to worry, fear, or hate when your mind is thinking about something other than the object of these emotions
  • It isn’t necessary to think about everything that pops into your head.  You have the ability to choose which thoughts you will think about.
  • The diverse contents of your mind can usually be distilled into a few different categories:
    • Grudging thoughts
    • Fearful thoughts
    • Angry thoughts
    • Wanting thoughts
    • Planning thoughts
    • Memories
    • You act in certain ways because you have certain thoughts that over your lifetime have become habitual (whether they are good or bad habits).  Habitual patterns of thought and perception will begin to lose their influence over your life once you become aware of them.
    • Emotion, aside from the thoughts and pictures in your mind, consists entirely of physical sensations in your body.
    • Even the strongest emotion will become manageable if you concentrate on the sensations in your body and not the content of the thought that produced the emotion.
    • Thoughts and emotions aren’t necessarily permanent.  They can pass in and out of your body and mind without leaving traces.
    • By focusing in the ‘now’, you will be less victim to the push and pull of emotional lows and highs and thus live truly more ‘balanced.’

The Physical Benefits and Effects of Meditation:

Pioneering researcher Dr. Herbert Benson at Harvard Medical School, amongst others, noted more than 40 years ago that meditation elicits a number of physical responses including:

  • Slowed heartbeat and breathing rates
  • Lowered oxygen consumption
  • Lowered blood lactate levels (i.e. counters the acidifying tendencies of stress and fatigue)
  • EEGS ratings of brain wave patterns indicate increased alpha activity, another sign of relaxation
  • Changes in circulatory patterns and extremity body temperature (i.e. better circulation to the extremities, resulting in higher temperature in the extremities). (www.massgeneral.org/bhi)

Meditation has been noted to be effective for depression, anxiety, hostility, OCD, high blood pressure, heart disease, migraines, and even conditions such as diabetes and arthritis.  Another added benefit of meditation is that the effects are cumulative, allowing one to reach deeper levels of relaxation and more focused attention in the present moment.

 

Adopting your Meditation Pose and Process

While many postures can be adopted, a simple pose for beginners would be sitting in a chair with your knees comfortably apart, your legs uncrossed, and your hands resting in your lap, palms up.

To begin: Centering Yourself

Grounding:  Begin by closing your eyes and focus on the place where your body touches the cushion or chair.  Note the sensations you may feel.  Next, note the places where your body touches itself.  Are your hands crossed?  Are your legs crossed?  Finally, focus on the way your body takes up space.  Does it take up a lot of space?  A small amount?  Can you feel the boundary between your body and space?  Notice the feelings there.

Breathing:  With your eyes closed, take several deep breaths and notice the quality of your breathing.  Is it fast or slow?  Deep or shallow?  Notice where your breath rests in your body.  Is it up high in your chest?  Is it in the midsection around your stomach?  Down low in your belly?  Try moving your breath from one area to the other.  Breathe into your upper chest, then into your stomach, then drop your breath into your lower belly.  Feel your abdomen expand and contract as the air goes in and out.  Notice how the upper chest and stomach areas are almost still.  This ‘deep breath’ or ‘dropped breath’ stance in the most relaxing one to meditate in.

Attitude:

Maintaining a passive attitude during meditation is perhaps the most important element in eliciting relaxation.  It is important to realize that, especially as a beginner, you will have many thoughts and relatively few moments of clear concentration.  This is natural and to be expected.  Realize that your thoughts are not really interruptions but rather are an integral part of meditation.  Without thoughts, you wouldn’t be able to develop the ability to let them go.    A passive attitude includes a lack of concern about whether you are doing things correctly, whether you are ‘accomplishing any goals’ or whether this meditation  is ‘right for you.’  Instead, you may want to adopt the attitude of “I’m going to put in some time here, devoted to myself, just sitting, and whatever happens is exactly what should happen.”

Time:  In general, when you first begin practice, maintaining the meditation for only as long as is comfortable, even if this is only for five minutes a day, may be all you may be able to do.  If you feel that you are forcing yourself to sit, you may develop an aversion to practicing meditation at all.   As you progress in your practice and meditation becomes easier, you will find yourself likely wanting to extend your time in meditation.  In terms of optimal amounts of relaxation, twenty to thirty minutes once or twice daily will often be sufficient.

A Sample Meditation:

Mantra Meditation is the most common form of meditation throughout the world.  Before beginning, one must decide on a word, short phrase or syllable that you like.  Perhaps there’s a word that has special meaning for you.  Or you could use nonsense syllables, the sound of which you find pleasant.  Many meditators prefer the universal mantra, “OM.”

To begin:

1)      Find your posture and center yourself.  Take several deep breaths.

2)      Chant your mantra silently to yourself.  Say the word or syllables over and over within your mind.  When your thought strays, note that, then bring your attention back to your mantra.  If you notice any sensations in your body, note the feeling, then return to the repetition of your own special word.  You needn’t force it.  Let your mantra find its own rhythm as you repeat it over and over again.

3)      If you have the opportunity, you may want to try chanting your mantra aloud.  Let the sound of your voice fill you as you relax.  Notice whether the sensations in your body are different from those you felt when you chanted silently.  Note what is more relaxing to you.

4)      Remember that mediation is to be practiced with mindfulness, or in other words, awareness.  You may find that the repetition of a mantra, especially when repeated silently, can easily become mechanical.  When this happens, you may have the sense that an inner voice is repeating your mantra while you are actually lost in thought or rapidly approaching sleep.  Try to stay aware of each repetition of each syllable.

Be aware that this is just one of many, many different possible meditations you could reference.  A great web resource for instruction on meditation is the Massachussetts General Hospital website link to the Harvard University Mind Body Medicine institute.  They have an online store there where interested individuals can purchase various meditation materials, CDs, DVDS, mp3’s, etc. for personal use (see: www.massgeneral.org/bhi/store)

Energetic Medicine and The Healing Arts:  Yoga

This section essentially is just meant to be a brief introduction to a couple of forms of traditional Asian meditation type practices that also involve sequential movements and patterns.  Perhaps the most familiar to many in the US is yoga, of which there are many, many styles and traditions.  For those unfamiliar with yoga, essentially yoga is a a mental, physical, and spiritual discipline that originated in ancient India.  Meaning in Sanskrit ‘to join’ or ‘to unite’, yoga has grown tremendously in the USA over recent years to approximately 20 million current yoga devotees.  Most in the West associate with yoga with a series of particular poses or postures (asanas) that is most associated with the branch of Hatha Yoga.  In recent decades, yoga has received scientific validation as an aid for a number of medical ailments and conditions including:

  • Depression
  • Insomnia
  • Fatigue
  • Anxiety
  • Schizophrenia
  • Asthma

For those interested in pursuing yoga, thankfully nowadays there are many qualified instructors and centers around the country.  Before beginning, one would be advised to find out the qualifications of the instructors at the center, the type(s) of yoga that they offer (and thus determine what may be most appropriate for you, the individual), and the duration of the class.   Another good thing to determine is whether the room may be super-heated or not (as some kinds of yoga, such as Bikram, heat up the room to deepen muscle relaxation and the physicality of the session).   For a good resource detailing more about the types and styles of various yoga, consider visiting:  www.yogasite.com/yogastyles.html

 

 

Qi Gong

Less familiar to most Americans than yoga, Qi Gong literally translates to “Life Energy Cultivation”.  It is a practice that aligns the breath, movement, and awareness for exercise, healing, and meditation.  It has roots in Chinese medicine, martial arts, and philosophy and tradiationally is viewed as a practice to cultivate and balance qi (chi), which in Asian Medicine and cultures is known as the “life energy” or “life force.”   Qigong typically involves rhythmic breathing coordinated with slow stylized repetition of fluid movements, a calm mindful state, and a visualization of guiding qi through the body.

Like yoga, Qigong has in recent years, gained scientific validation for supporting health and improvement re: a number of medical conditions and issues.  These include:

  • Bone density improvement
  • Decreased blood pressure and pulse
  • Increased heart rate variability (typically associated with youth and fitness)
  • Increased physical strength
  • Improved quality of life
  • Improved immune blood markers
  • Decreased inflammation markers
  • Decreased anxiety, depression, perceived stressed and mood
  • Lowered cortisol levels

Qigong is best studied in a class setting in the beginning or with a pace- and ability-appropriate good DVD.  For further information in pursuing Qigong practice, see:  www.medicalqigong.org/resources   or www.qigongdharma.com/index.html

Tai Chi:

Tai chi is actually considered a form of martial arts but is also associated with a number of health benefits.    In the West, we are generally more familiar with some more of the slower, more meditative styles of tai chi, of which there are many.  Some scholars and practitioners actually consider tai chi to be a form of qigong but regardless of the perspective they are closely related practices, with Qigong training playing an important role in training for Tai chi and with many tai chi movements performed as part of Qigong practice.

Also similar to Qigong are Tai Chi’s associated health benefits.  These, in controlled scientific studies, have included the following:

  • Improves balance
  • Improves flexibility
  • Improves cardio fitness
  • Reduces risk of falls in elderly patients
  • Fibromyalgia
  • Lowered Blood pressure
  • Improved recovery from Heart Attacks
  • Improvement in MS, Parkinson’s and Alzheimer’s
  • Improved markers of cell-mediated immunity
  • Reduced impact of stress, anxiety, and depression
  • Reduction in symptoms of ADHD (in adolescents specifically)

As with Qigong, in order to learn this art, it is advised one pursue a reputable teacher, class and/or instructional DVD to facilitate their education.  Please see the following sites for more information: www.beginnerstaichi.com/beginners-tai-chi-resources.html  or  www.amfoundation.org/relaxation.htm

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CONCLUSION: PUTTING IT ALL TOGETHER

So, we’ve now come to the end.  We’ve discussed key points re: your diet, exercising, sleeping, and stress management habits.  Now is the time to put it all together so that you can begin to reap more and more benefits from your new and improved lifestyle!    A few key things to keep in mind may help you better succeed in accomplishing this for the long-term, so this doesn’t become like many a New Year’s resolutions, which quickly fall by the way-side by February or March:

1)      Pace yourself.  Don’t expect to be perfect on everything immediately.  There are likely MANY things to work on here, so like many big goals and/or accomplishments, small, consistent steps of progress are key to achieving the big goal and change.  Breaking down these steps into smaller, more manageable tasks and lifestyle ‘shifts’ is much more likely to lead to more long-term, sustainable successful for individuals.

2)      Allow for some breathing room:  This builds off of point one.  These suggestions are for the long-haul—i.e. your life, so keep in mind, one still has to find a balance between taking care of themselves and also still living.  Enjoying a piece of birthday cake at your child’s birthday party won’t be the end of you or your good initiatives, so remember to cut yourself some ‘slack’ from time.  A good principle to keep in mind may be the 85/15 rule developed by some holistic nutritionists.  Essentially this suggests that if you eat and care for yourself very well 85% of the time, your body can handle 15% of ‘non-perfection’ without major consequence.

3)      Chart your progress:  Sometimes when making big adjustments and changes, the sense of being overwhelmed may overshadow the concrete accomplishments you may have already achieved.  Thus, keeping a health journal of changes, goals, and other things you notice on a daily or weekly basis may help you keep your motivation up as well as highlight for yourself the ‘good’ things that have already happened (for example, losing those nagging 5 lbs, not needing your sleeping pills anymore, not needing that afternoon cup of coffee anymore, etc).   Appreciating the small ‘victories’ will allow you to start seeing them add to something much larger—the overall  ‘big victories’ that are being accomplished, bit by bit.

4)      Set realistic, smart goals:  This is another tool used by many holistic physicians and wellness coaches—use the “S.M.A.R.T.” goal system as you track, evaluate, and pursue your progress.  The S.M.A.R.T. system stands for the following:

  1. a.       “S”:   Stands for ‘specific’: this means identifying in detail what you want to accomplish/achieve/do/avoid etc.  A good specific goal will typically answer “What”, “Why,” “Who,” Where”, and “Which”.
  2. b.      “M”:  Stands for ‘measurable’.  Your goal needs to be quantifiable in some way.  Thus a good measurable goal will usually answer questions such as “How many”, “How much”, and/or “How will I know when it has been accomplished?”
  3. c.       “A”:  Stands for ‘attainable’:  This essentially means “Can you make your goal?”  “How will you achieve it, realistically?”
  4. d.      “R”: Stands for ‘realistic’: Following the previous example, the goal, in order to be attained, has to be ‘realistic’.
  5. e.      “T”:  Stands for ‘timely’ or ‘time-bound’: This means you need to set a specific time frame within which the goal will actually be achieved in.  Thus there will be an established target date.  This goal will typically answer the questions: “When”? “What can I do 6 months from now?” “What can I do/accomplish today”? (www.en.wikipedia.org/wiki/SMART_criteria)

Subsequently, when sitting down with some of this information, there will need to be some planning, consideration, and careful thought given.  Every individual’s given circumstances, health challenges, and issues will be different, so for one person, they may want to first start working on sleep issues as their top priority and start putting all of these good ‘sleep hygiene’ practices and aids to good use.  Someone else make have great difficulty with their diet and thus that may be priority one for them.  As one gradually implements many suggestions from one area (or some from multiple areas), then you will likely be able to “handle” adding others in.  The key is sustainability—can you keep with what you are doing already and not be overwhelmed if you try to do even more.  Everyone may have a different “threshold” at which they feel they can feasibly do or not.  So, I encourage each and every one of you to sit down, make a list of your pressing health issues and/or concerns and prioritize them to begin working on, with the help of these many suggestions.  Once this has been identified, a structured outline for you, the individual, may be drawn up (perhaps in conjunction with your integrated health care provider’s input) as to what to begin focusing on in your health and wellness plan.

 

One sample plan, for a 40-something woman struggling with low energy and a few extra lbs might look something like this:

Weeks 1 -3:

1)      Grocery Shopping & Cooking:

  1. Pick up healthier food choices, including low sugar, high fiber choices, lots of fresh produce
  2. Review healthy recipes in this plan and also from www.whfoods.com  and any other sites that you may found as great cooking resources to try new recipes and get guidance in new ways of preparing some old favorites and new choices
  3. If in a time crunch during the week, do some cooking on the weekend and freeze meals for readily made healthy meals during the week
  4. Start keeping a log of what you notice re: energy levels with your new styles of cooking and eating and what recipes you like, don’t like for future reference

2)      Exercise:

  1. If already exercising, continue with your good habits and look for ways to increase your intensity, diversity, and/or frequency (if exercising 3 or less times a week especially)
  2. If not exercising, begin exploring some activities perhaps that you have been curious about but have never explored ( for example, joining a tennis league, taking up jogging, etc.).  Start slowly and chart your response of how you feel and how you do in your sessions
  3. Consider exploring with a personal trainer and perhaps book your first session to explore new and improved ways of cross-training, weight-training etc.

3)      Sleep:

  1. If having no real issues with sleeping, then look for ways to just tweak your sleep hygiene to sleep even deeper or  sleep at perhaps more ideal times (for example, getting to bed by 10pm instead of 11pm)
  2. If having sleep problems, then look at evaluating your sleep environment and make adjustments accordingly, re: temperature, light exposure, clothing, bedding, room set-up, etc.
  3. Consider buying a couple of natural sleep supports (again if needed) and begin charting how you feel/sleep after beginning use

4)      Stress Management:

  1. If currently stressed, look at exploring some of the tips in this plan to start “antidoting” your stress overload…whether that is deep breathing, meditation, Qi Gong, or whatever most interests you
  2. Start penciling into your schedule regular “de-stressing” times in your schedule multiple times a week (or daily, if possible), even if just 10 or 20 minutes at a time.  Something is always better than nothing!
  3. If in need, consider purchasing a DVD, CD or mp3’s to help guide you to meditate, progressively relax, etc (see Stress Management section for resources)
  4. Start charting your observations about you feel emotionally, mentally, and physically after beginning some of your interventions.

Weeks  4  and beyond:

At this point, the structures should have begun to be put into place.  At this point, you should hopefully be beginning to see some changes in your various parameters of health—energy levels, sleeping habits, digestion, etc.  Everyone, depending on their very unique issues, will of course have many different possibilities as to what may be changing, improving, etc.  But as the plan continues, this will be the plan to continue to evaluate and “tune into” your body’s signs and symptoms to further refine your choices, interventions etc.  After a month or so, this may be the time where you want to speak with your doctor about how you are feeling and discuss what you’ve noticed and see what he or she may have to add on what is starting to change, etc.  This is where diagnostic testing may be very useful as a monitoring tool for you to also chart—for example, for someone struggling with high blood sugar, after a month of healthy, low-carb eating, you could test to see what has changed with your fasting blood sugar.   Talk with your doctor about what other lab tests might be great markers for you, specifically, to track as you continue to move forward with your new lifestyle habits.

I encourage each and every one of you to discuss your plans with your holistic health care provider for more input and also to involve other loved ones to help you stay “accountable” with your new healthy eating/sleeping/exercising/de-stressing habits!  The more structures and means of support you can court to help facilitate this to happen, the better.   Best wishes and here’s to you and your brand new, improved health!!

Could this one thing be making you sick?

So, you have found the right health care provider. He spent an hour with you on the first visit and really seemed to listen. He seemed thorough, as well. He ordered a battery of lab tests, and performed what appeared to be a thorough physical examination. He says he has found a possible diagnosis that explains your symptoms. Up until this point he has built up a high level of confidence and hope with you. Then the doctor leans in and, with total sincerity, indicates the lab tests were negative and your physical exam was negative. You are thinking, “Now what?  I really thought this guy would be the doctor to help me. I have been to so many for my condition.  Then, not to purposely interrupt your moment of despair, he exclaims, “However, I think I may have a diagnosis that is treatable and may alleviate most, if not all, your symptoms.” “Wow,” you are thinking, “How could he come up with such a diagnosis, especially with all the negative tests; can I believe him?” With a sense of hopeful wonderment you ask him what your diagnosis is. He explains, “You may be gluten intolerant.” But, what is “gluten intolerant” and how can it affect your health so negatively.

What is gluten?

Gluten is a protein found in wheat, barley, rye and other grains that some people have difficulty processing. The question I am often asked as a health care provider is, “How can I have a problem with wheat? Wheat has been part of our staple diet for the past 10,000 years.” The truth is that no one knows the answer to that question. Not yet. However, there are some theories about this. One theory is that a virus mutated a gene in the body to cause a defect in the enzyme that breaks down gluten. Another thought is that gluten, in evolutionary terms, has been introduced on a large scale in just a short period of time and that humans were never meant to eat it. Whatever the reason, some people should definitely avoid it.

Symptoms

People with symptoms of gluten intolerance that are related to digestion are often associated with having celiac sprue or celiac disease. These symptoms may include abdominal pain, bloating, diarrhea, constipation, greasy stool, alternating diarrhea/constipation, nausea, and  vomiting. Gluten intolerance in children may lead to stunted growth, weight loss, delayed puberty, and lack of energy. People who are gluten intolerant with symptoms that are typically not associated with the gastrointestinal system are said to be gluten sensitive. Gluten sensitive symptoms may include, but are not limited to, migraine headaches, depression, anxiety, fatigue, osteoporosis, joint/bone pain, muscle cramping, infertility, canker sores, anemia, and deficiency of vital nutrients. People with Celiac may have these symptoms as well. Sometimes a person may not have any symptoms at all. This is the worst case because if gluten intolerance goes unnoticed it can be associated with leading to other medical conditions including autoimmune disorders, diabetes mellitus type 1, autoimmune thyroiditis, and biliary cirrhosis.

How many people have it?

The incidence of celiac disease in America is reported to be 1 in 133 according to the University of  Maryland Center for Celiac Research. Although this number does not take into account the incidence of people who have gluten intolerance with no GI-type symptoms. That number may be higher as gluten intolerance is often misdiagnosed and may be present with no symptoms at all.  To make matters worse, there is no definitive lab test that rules out gluten intolerance.

So why is gluten or the avoidance of gluten so important to those folks who are intolerant to gluten and how is this condition treated? Before we begin this story, let -998upus first visit some structures of the body and how they function normally.

A brief overview of the digestive system

When we swallow food it travels through the gastrointestinal tract (GI tract). The food travels from the mouth, continuing to the esophagus which then leads to the stomach. Following the stomach, the food then ends up in the small intestine. Nutrient absorption takes place predominantly in this area of the GI tract. Before the food particles are absorbed into the blood stream from the small intestine it has to be broken down further by enzymes. Enzyme secretion and nutrient absorption in the small intestine occur at the level of the villi. The villi are tightly packed, small finger-like extensions that extend into the small intestine. Lining the small intestine like small blades of grass, the villi are also responsible for excreting antibodies into the small intestine. Antibodies are part of the body’s army to fight off infection. To recap, the villi are responsible for the movement of nutrients into the blood stream, the production of enzymes  to break down nutrients for utilization by the body, the inhibition of  undigested material from entering the blood stream, and antibody excretion, specifically secretory IgA or sIgA, to fight infection.

The undigested material then travels into the large intestine were water and salt are reabsorbed and the remaining material is eliminated out of the body.

Now that we have the characters and know some key attributes, here is the gluten story.

The gluten story

In gluten sensitive individuals, gluten is not fully broken down in the small intestine by the enzyme transglutaminase. The body then mounts an attack on the partially broken down gluten creating inflammation. This inflammation is not only specific for gluten it can also wear down the villi, like grass blades being cut with a lawn mower.

As the villi are destroyed, nutrient absorption, enzyme production, and GI immunity are compromised.

Gluten as it affects GI enzyme production

The destruction of villi can lead to lactose intolerance. The reason behind this is that as the villi are eroded due to gluten intolerance, their ability to secrete enzymes becomes decreased. The enzyme involved in the process of breaking down the sugar in milk (lactose) is lactase. If lactase production is inhibited due to villi destruction then the amount of lactose broken down for absorption is decreased. This allows the lactose sugar to continue down the GI tract causing lactose intolerant associated symptoms of gas, bloating, and stomach cramping.

Gluten as it affects GI absorption

As absorption is impaired, so is nutrient transportation across the GI barrier into the blood stream, causing associated symptoms. For example, if iron is not adequately absorbed, a person may feel excessively tired. If amino acid absorption decreases then chemicals such as neurotransmitters, which are chemical messengers in the brain, may become imbalanced. In the case of compromised neurotransmitter formation, symptoms such as depression and anxiety can arise.

Gluten as it affects GI immunity

Another part of the gluten story lies within the GI tract’s ability to fight off infection. As the microvilli are destroyed, so are the cells that compose them. One of  the cells that make up the villi are Plasma Cells. These cells produce the antibody sIgA. SIgA is a large part of the body’s first line of defense against invaders. It is found normally throughout the GI tract. Parasites that would normally be hindered by sIgA can have a stronger foot hold in the GI tract with decreased sIgA amounts. The presence of one type, or several types, of parasites can further compound the destruction of the villi by creating more inflammation which leads to more negative effects on the immune system,  enzyme production and absorption, and the development of “Leaky Gut”.

Leaky Gut

If the previous issues are not bad enough, their lies another villain in this story. “Leaky Gut” is a result of increased permeability of  the GI tract. The spaces between the cells that line the intestine are caledl gap junctions. Gap junctions are normally closed off tight. Gluten intolerance can cause the gap junctions to loosen and become open. This allows the flow of undigested material, along with gluten, to pass into the blood stream to be carried to various areas of the body. This undigested material and gluten is viewed by the body as an invader and is attacked by the body’s defenses. This can create inflammation in the body outside the GI tract. I will repeat this: Leaky Gut can cause inflammation in the body outside the GI tract. It is important because as these particles that do not belong in the blood stream settle in different areas of the body, they can create inflammation in that area. For example, if it travels to the joints it can create joint pain. If it travels to the muscles it can create muscle aches and pain. This may be why gluten intolerance is associated with autoimmune disorders such as Hoshimoto’s Thyroiditis. The liver has to clean out these undigested particles as well, leaving the liver over worked. This may show up with blood work as elevated liver enzymes. This can lead to toxin build up in the body as the liver’s detoxification systems become overburdened. In turn, this build up can lead to weight gain as toxins that would normally be excreted in bile out into the GI tract to be eliminated build up in fat cells causing weight gain.

How do I know if I am gluten intolerant?

The “gold standard” is an intestinal biopsy. Unfortunately, this test carries with it a high false negative rate; in other words, this test is not very accurate for people who are gluten intolerant. Blood, stool and saliva testing also carry a high false negative rate. These tests can be useful following elimination of gluten for 6 to 8 weeks as the immune system reestablishes itself in the gut. The key to gluten intolerance is the way a person feels after being off gluten for 6 to 8 weeks.

Treatment is the same as the test.

The most definitive test for gluten intolerance is to completely eliminate gluten from the diet for 6 to 8 weeks. It takes 6 to 8 weeks for the villi to heal. During the 6 to 8 weeks a person’s symptoms may increase at times, decrease, or stay the same. As the small intestine heals there may be periods when symptoms worsen periodically. This is caused by areas within the wall of the small intestine that were previously closed off due to damage caused by long standing inflammation. These closed off areas open up, allowing their long standing contents (sometimes parasites) out into the GI tract. These contents can make a person feel sick. As these areas heal the flare ups of symptoms should diminish. This is why a person on a gluten-free diet may exclaim that the gluten-free diet isn’t working for them. However, at the 6 to 8 week mark symptoms should be improved significantly or disappear in a gluten intolerant person. The person should be tested for intestinal parasites at the end of the 6 to 8 week time period off gluten with their healthcare practitioner. After being gluten-free for 6 to 8 weeks, reintroduce gluten with a gluten-rich meal. If symptoms return or if GI type symptoms such as gas, bloating, belching, stomach pain, diarrhea, and vomiting occur then a gluten- free diet needs to be part of your life from then on. This can be difficult because aside from the more known sources of gluten like wheat, barley, rye, spelt, and oats, there are less apparent sources of gluten found in items such as salad dressings, soy sauce, imitation sea food, beer and many other unlikely, but regularly consumed food items.  A person who is gluten intolerant may want to avoid soy as some practitioners believe soy protein mimics the molecular make-up of gluten in gluten sensitive individuals. A gluten intolerant person should only consume grain type products from rice, millet, buckwheat, and corn. Also, to confuse the consumer more, products labeled “wheat free” are not the same as gluten-free. One must read nutrition and ingredient labels very carefully to discern gluten content.

There are currently no drugs or procedures to treat gluten intolerant individuals. The good news is that a gluten sensitive person can live a healthier life by avoiding gluten. In addition, there are more available resources than ever before that teach people how to live a gluten free lifestyle as gluten intolerance becomes more recognized. Also, gluten free product variety and taste continue improve as well.

If you think you are gluten intolerant or someone you know may be, I invite you to do your own research on gluten intolerance and Celiac disease.

I sincerely hope this information helps you on the path to optimal health.

Yours in Health,

Sean Ripp, D.C.