A recent publication in the journal of the Ontario Association of Naturopathic Doctors; a meander through the evolution of my understanding of cultural sensitivity.
While paddling out of Algonquin Park today (what a blessing that beautiful territory is), I was thinking about the value of preventative care. This is definitely not a novel analogy, and please forgive me if you've heard it before, but I thought it worthy of reconsideration, particularly as we spy fall on the horizon (sorry!).
We take our cars and bikes in for preventative care. Even if it's a simple oil change or chain cleaning, it's an opportunity for the mechanic to give it a good once over ... making sure the brakes are working, advising us on routine maintenance, etc. Certainly if we hear a funny noise, we'll take it in to get it checked out - sometimes choosing to live with the problem if it's not severe, other times investing in doing something to make the vehicle run better. And sometimes the mechanic might have some advice on how to avoid that problem in the future.
Many of us use our dentists in a similar way ... the semi-annual cleaning and check-up keeps us accountable (do you notice an increased frequency of flossing immediately before and after dentist appointments? I do!), and catches problems before they become bigger. Perhaps we need to adjust our brushing technique, or maybe a different toothpaste would work better. Or perhaps a little filling is called for instead of a huge root canal if we let it go.
Naturopathic care can serve the same purpose. Although most of my clients come to see me when there's a problem - and I'm always happy to support people's pursuit of healing from a concern, whether acute, recurring or chronic - preventative maintenance helps to keep concerns from emerging or exploding. Like seeing the dentist, or taking your car or bike in for a tune-up, investing in a seasonal or semi-annual hour with a naturopathic doctor can keep good habits on track. By reviewing the "pillars of health" - diet, exercise and sleep habits, and sources of stress (and strategies of managing it effectively) - and setting individualized goals, you are more able to commit to maintaining a healthy lifestyle. Going through a "review of systems" - a head-to-toe overview of your body's functions ... much like a mechanic's once over of your car or bicycle - can bring attention to niggling little things that may be more easily addressed when not full-blown. An adjustment of supplements or herbs based on shifting seasons and individual susceptibility keeps you from rotely taking the same thing for months and months - never a good idea.
My job is not only to keep you from being sick, but to help you to optimize your health so you can live as full and rich a life as possible. Preventative visits allow me the opportunity to support you in this goal ... one of my favourite aspects of my work! Seasonal transitions are a great time for these ... I look forward to seeing you and your family in the clinic!
lYesterday was the first really summer-like day of the year ... and while my family and I reveled in the warmth and the sun, it prompted discussions of sunscreens. My kids were asking questions about the chemicals in the sunscreens, exploring the risks of the gunk vs. the risks of sun damage - they are the children of a naturopathic doctor afterall ... they know to inquire about such things! So here are some thoughts and resources:
Sun exposure is clearly linked to the risk of skin cancer, which is the most common type of cancer in Canada. While all types of skin cancer are treatable, they can also be aggressive and deadly. Malignant melanoma is one of the most aggressive types of cancer. Here is more info on melanoma; bottom line: talk to your doctor if you have any new skin spots. The earlier skin cancer is identified, the better the prognosis.
Sun exposure is also beneficial for a couple of reasons. Vitamin D is made in the body in response to sun exposure. Canadians are notoriously deficient in vitamin D due to lack of sun exposure during long stretches of shorter, colder days. This is possibly complicated by active efforts to reduce sun exposure, since efforts to reduce UV exposure may contribute to vitamin D deficiencies (though this is controversial); however, some studies have demonstrated that Canadians are spending more time in the sun, not less, and not necessarily with a corresponding increase in sunscreen use. Ironically, vitamin D deficiency itself is a risk factor for malignant melanoma; it has thus been suggested that inadequate exposure to the sun may also be a risk factor for skin cancer. It's hard to elucidate exactly what the ideal amount of exposure might be, since individuals have unique susceptibilities to both sun damage and vitamin D deficiency based on pigmentation, age, latitude and genetic variations. Vitamin D needs can also be met through food and supplementation.
Sunlight is also important for regulation of both mood and circadian rhythms. This may not require direct exposure of the skin to UV radiation, although some studies have acknowledged the presence of a circadian clock in the skin, a fascinating mechanism by which organisms (including humans) may regulate behaviour and immune function. This neat study convincingly shows that an indoor lifestyle disrupts our natural circadian pathways, with implications on cognitive function and mental health; more exposure to natural (vs. artificial) light may be a more appropriate approach to circadian regulation.
Acknowledging that some sun exposure has benefit, the connection of excessive exposure - particularly the kind that results in burns - with skin cancer should prompt caution. Kids are particularly vulnerable, so caregivers should both be vigilant about protecting them AND setting a good example of safe sun practices themselves (not cool to wrestle sunscreen on your child if you're not wearing it too!). There are a variety of excellent ways to minimize the risk of skin damage from UV radiation, including avoiding midday sun, covering up with long sleeves, hats, sunglasses and umbrellas, and wearing sunscreen!
But what about those chemicals?? The Canadian Cancer Society argues that chemicals in sunscreens are safe, and they very well may be. But perhaps there are some options that are better than others? A quick guide of things to consider:
- Oxybenzone: this is a common active ingredient in sunscreens; the concern with this one is allergy or immunosensitivity; best to avoid if an alternative is available
- Octinoxate: another common UV-filter with concern of toxicity; this one more concerning for its potential hormone disruption
- Fragrance: while not specific to sunscreens, fragrance is a catch-all term for any artificial scent added to personal care products; because there is no requirement to be more precise in labeling, a consumer has no way of knowing if the chemicals used are safe or not; best to always avoid
Mineral sunscreens work differently than chemical ones. Zinc oxide and titanium dioxide sit on the surface of the skin and reflect radiation off, rather than being absorbed the way chemical filters are. It means that sunscreens containing these ingredients are thick and white, and not always appreciated by the wearer, to which my kids can attest! One option is to look for sunscreens that contain a blend of chemical and mineral ingredients, and that do not use oxybenzone or octinoxate. The Environmental Working Group has a very comprehensive review of options if you're looking for more guidance!
Be careful too of SPF claims - regardless of how high your SPF is, if you're using sunscreen, apply a lot and apply often ... there is some suggestion that folks who wear sunscreen may actually be at a higher risk of skin cancer ... not because the sunscreen causes cancer, but because it is applied incorrectly and causes a false sense of security (resulting in more time spent in the sun inadequately protected).
One more thing to ponder ... UV exposure causes skin cancer by damaging the genetic material of skin cells. This occurs in part due to the generation of free radicals and reactive oxygen species. Our cells have mechanisms to neutralize these free radicals before they cause irreparable damage, particularly when we provide the right ingredients for these mechanisms in the form of nutritional antioxidants! A diet rich in antioxidants, including brightly coloured fruits and veggies, abundant herbs and spices, and flavonoid-rich green tea - even dark chocolate! - may protect our skin from damage due to UV radiation (along with other lifestyle-induced cancer promoters). So in addition to moderate sun exposure and thoughtful selection and use of sunscreens, here is even more rationale for eating a great diet!
Have fun in the sun!
When building a spring detox support program, it's important to start by reducing sources of chemicals, and optimizing your diet. Layering in herbs that are supportive of detoxification can take your plan to the next level.
While it's not helpful to think of our bodies as unclean, many traditions have honoured the value of "blood-cleansing" herbs for routine health maintenance, as well as treatment of conditions associated with "toxicity" (think skin conditions like eczema, or inflammatory conditions like rheumatoid arthritis). Whether from Ayurvedic, Chinese, or Western botanical tradition, these medicines tend to be bitter or pungent in flavour, cooling and invigorating in nature. Pharmacologically they support the actions of the liver, kidneys, colon and lymphatic tissues, precisely the organs primarily responsible for the critical functions of detoxification and elimination.
Three of my favourite blood-cleansing herbs are burdock, dandelion and stinging nettles. Let me tell you why!
Arctium lappa (burdock) - this is the giant thistle plant with the beautiful purple flowers which become the stubborn burrs that are so fun to pull off of kids' sweaters and dogs' coats; the root of this plant supports lymphatic circulation, and is a gentle diuretic (encourages filtration of blood by the kidneys).
Arctium lappa (burdock, thistle)
Taraxacum officinale (dandelion) - this is such an incredibly useful (and happy!) plant; the root of the common dandelion encourages optimal liver function, while the leaves support the kidneys; other parts of the dandelion are useful as well, including for both wine and wish-making ... and how smart they are to stay closed when it's cloudy and open in the sunlight! Malign no more!
Taraxacum officinale (common dandelion)
Urtica dioca (stinging nettles) - among other redeeming qualities, stinging nettle leaves are mineral-rich and diuretic, gently supporting kidney function and tonifying the body overall; nettle leaf tea is anti-histaminic, and exceptionally helpful to reduce symptoms of spring allergies. Just be careful harvesting them!
Urtica dioca (stinging nettles)
Notice a theme? These are all local North American plants that are typically seen as troublesome weeds. Amazing how our perspective shifts when we consider their value! They were all used by First Nations people, whose practices greatly influenced the evolution of herbal medicine in colonial North America. The preparation of herbs for medicinal use requires some practice and awareness of sustainability principles, but harvesting your own burdock, dandelion and nettles is certainly a viable option, and a good reason to not spray them! In the meantime, preparations of these plants are available at most herbal dispensaries and natural health product stores.
A combination of these three herbs is very supportive of a routine spring detox plan. Make a strong tea with equal parts of each plant, aiming for 3 cups per day (warm or cold) for the duration of the plan, and beyond if you like! Roots are best prepared as a decoction, while aerial portions of plants are best made as infusions, so getting the most from this formula requires a two step process:
1. Place 1 Tbsp each of prepared dried burdock and dandelion root in a pot with 1 litre of water. Bring to a boil; reduce heat and simmer for 10 minutes.
2. Bring mixture to a boil again and pour the entire contents into a glass pitcher containing 1 Tbsp each of prepared dried nettles and dandelion leaf. Let steep until the tea is at your desired temperature. (I prefer my teas cold, so I let this steep until cool, then poor the tea through a mesh strainer into my water bottle and drink over the course of a day.)
In addition to teas, herbs can be delivered as capsules or tablets (often combined with nutrients that are also supportive of detoxification processes), or as alcohol-based extractions (tinctures or solid extracts). All three of these herbs can even be eaten as food! There are pros and cons to each method, related to price, convenience, tolerance to flavour, and the method that is best at getting the most value from the plant. I can help you navigate what form/brand/method might be best suited to your goals, and advise whether there are other plants that might be a better fit for you! Let's chat!
I recently held a workshop at my clinic and my local library to chat about the top habits that can promote good health (and thanks to all of you who responded to my survey!). None of this is rocket science, but these behaviours go a really long way to keeping everyone in your family at their best. It can be tricky sometimes to stay on top of making good lifestyle choices; for each of these habits, I encourage you to consider if you're doing well, or if you could use some work. Consider how motivated you are to make a change - even a small one. What's in your way? How could you overcome whatever obstacles are preventing you from being at your best? Start small - make one small, tangible and measurable change for the better and see how it feels! Enjoy!
1. Eat more fruits and veggies
Increasing fruits, vegetables and other plant-based foods increases fiber (critical for good digestive function), improves satiety (helpful for moderate caloric intake), increases anti-oxidants (necessary to reduce cell damage and aging), and offsets the consumption of less healthy options. Aim for at least 7 servings of brightly-coloured fruits and veggies daily!
2. Drink more water (or herbal tea)
Minor dehydration leads to sluggishness, brain fog, constipation and irritability. Drinking more water (coffee, juice, pop and alcohol don’t count) boosts cognitive and physical performance, clears the mind, elevates energy, promotes detoxification and helps maintain a healthy weight. Try keeping a refillable water bottle with you that you aim to drain at least twice per day. Check out my recent post on the subject for more inspiration!
3. Get outside
Time spent outside reduces stress, increases physical activity, and nourishes environmental stewardship. It may also support our natural symbiosis with microorganisms, which is good for our immune systems - especially the kids’. Aim for at least 30 minutes outside daily. Check out David Suzuki's 30x30 Challenge!
4. Go to bed
We all have different needs for sleep, but getting what our bodies need is important for stress management, immune system function, healthy body composition, mood and mental health. Try to have a consistent bed- and wake-time, create an optimal sleep environment (dark, comfortable, quiet), and keep screens out of the bedroom! Take a look at the recommendations from the National Sleep Foundation for your sweet spot!
5. Move your body
Nothing is more critical to good health than physical activity. From promoting healthy body composition, to encouraging detoxification and elimination, to improving cognitive function, it’s tough to do too much. Aim for 30-60 min of moderate to vigorous physical activity (get your heartrate up, break a sweat) every day, and increase from there. Check out the Canadian guidelines - how are you doing??
6. Detoxify your stuff
We are swimming in sea of over 80,000 industry-made chemicals, many of which are known to be harmful to our bodies, and many more which have not even been tested for safety. Children are particularly vulnerable to the effects of environmental toxins. Choosing alternatives to plastics (think food packaging and toys), fragranced personal-care items (visit www.ewg.org/skindeep/ for more), and industrial-strength cleaning products (vinegar and baking soda work miracles!), you’ll be giving your body an enormous break! Once again, Suzuki for the win!
7. Create space for mindfulness
In a world bombarded by social media, sensationalized news reports and high-paced schedules, a little bit of mindfulness goes a long way. Purposefully paying attention to the present experience has myriad benefits to all facets of health. Practice moving/eating/sitting/breathing mindfully every day until it becomes a more natural and automatic part of daily being. Kids respond really well to this - try youtubing “mindfulness”, with or without “kids” and see what pops up!
8. Touch someone
We all need physical contact. We take it for granted in infants and children, but our need for touch doesn’t decrease as we get older. Touch impacts our hormones and immune systems in important ways that are necessary for good health. Hold hands. Hug someone. Caress a shoulder. Go for a massage.
9. Have a sense of purpose
Purpose is one of the most important aspects of psychological well-being. Stress is more tolerable when we feel there is a point to the task. Feeling appreciated and like we are making a difference in the world actually bolsters the immune system and positively impacts mood. Caring for children, volunteering, contributing to your community, and engaging in fulfilling paid work can all satisfy the need for purpose. If you are lacking a sense of purpose, consider engaging in inventory of your values and attributes, and brainstorm how you are or could be sharing them with others.
10. Be grateful
Gratitude is one of the most impactful practices on happiness, stress management and well-being. Overwhelmed with the pressures of work? Be grateful you have a job that pays the bills. Tired of the cold winter? Be grateful you live in a country that is (generally) safe, democratic and … cold. Seek opportunities to be (genuinely) thankful to shift your outlook and increase happiness and health.
And a bonus ... Be moderate
It’s possible to go to extremes on either end of the healthy behaviour spectrum. Certainly there are some things that are just never a good idea, but some less-than-healthy behaviours are often balanced by the pleasure they bring. On the flip side, exercise, extreme diets and environmentalism can be taken too far. Unless there are unique concerns, enjoy a glass of wine or a piece of cake mindfully and intentionally - savour the pleasure of the experience. Creating space for some flexibility and compassion for yourself is important for a balanced existence.
Let me know how you're doing!
Here's a recent publication (written with a student) on when to worry about your child's fever, and what to do to help them get better ... better!
Next week I will be offering two workshops on the top 10 healthy habits for families. I have ideas about what I think are the most important behaviours to make routine, but I'm curious about others' experiences. Let me know - what behaviours are important to you, and what makes it difficult to make them habitual? I will work your responses into my workshop - where I hope you'll join me!
It’s that time of year! We’re supposed to feel in love, sexy, horny, romantic - right? Hallmark expectations aside, I hear from women in my practice ALL THE TIME that they’re not that into having sex. Their libido isn’t where they’d like it to be. They love their partners (and I find this happens more typically among women who are in committed, long-term relationships), they want to be intimate, but they’re just not feeling it. So here are some ideas to consider … just in time for Valentine’s Day!
(Sexual function is a complex topic; if you have concerns about yours, consider this article that I wrote about exploring and managing low sexual desire in women, and talk to your healthcare provider. Or me :)
Think of intimacy as a holistic concept.
When partners are vulnerable with one another in general - sharing their imperfections, their emotions, their experiences - and ACT with love, they are more likely to feel close to one another, enhancing relationship satisfaction, and naturally fueling a desire for physical connection. (I love this article about the research of John Gottman’s “Love Lab”). One of my most important life lessons is that love is an action, not a feeling … but I know that choosing to act with love can deepen the feeling … the trust and appreciation and deep connection that enhances sexual desire.
Broaden your definition of “sex”.
Particularly for heterosexual couples, “sex” often means “penis-in-vagina”. But there are so many ways to explore sex! And so many ways to give and receive sexual pleasure. When the need and expectation for orgasm is set aside, and space is created for mindfulness, “sex” can be many different things. “Guide to Getting it on” is a great primer. It is heteronormative, and it won’t make everyone happy (is that even possible??) AND there are many great books out there for folks of all orientations/kinks/persuasions. Explore! And comment with your favourites!
While familiarity is comfortable, and knowing and trusting your partner(s) builds intimacy, our brains seek novelty in order to stimulate reward centers. If sex is the same all the time, and predictable, it can get boring and less inticing. Consider talking to your partner about shaking things up a bit! There are many questionnaires available online that can facilitate the potentially awkward conversation and stimulate creativity - try this one! AND couples that engage in new experiences outside of the bedroom (or wherevever else you like to get it on - good for you!) are more likely to connect sexually as well. Try a dance class! Pottery (channeling Patrick Swayze and Demi Moore)! Eating in the dark! See what happens.
Make space for sexual intimacy.
As Dan Savage says, “Fuck first”. We often get busy, put other priorities ahead of our connection with our partner, and end up tired and sapped. Even if you're not exactly in the mood to begin with, being willing to dip in your toe can get the juices flowing. It could be argued that scheduling sex is contrived BUT imagine the turn-on when you sext one another all day in anticipation of what’s to come! Have sex before going for dinner, before catching up on Netflix, before your workout. Don’t succumb to not having time for … business time!
Be good to yourself!
Many conditions including (but definitely not limited to!) hypertension, diabetes, depression, and multiple sclerosis are associated with lower libido. Stress and fatigue can damage our desire. Eating well, exercising most days, getting sufficient sleep, managing stress effectively, and looking after any health concerns can make a big difference. Some medications can dampen libido - touch base with your healthcare provider to explore strategies to navigate this possibility.
And sometimes we just don’t feel like it. And that’s okay too. Especially mothers - we often feel touched out, particularly when our kids are small (and breastfeeding!). When we feel drained and needed, it can be overwhelming to know that our partners need us too. It may be okay to ask your partner to look after YOU … a foot rub, a back tickle, a head massage, more … without the expectation (today anyway) of reciprocity. It will pay long term dividends.
(Full disclosure: I am not a sex goddess, and am working through all of this myself. Just as I am doing with pretty much everything I recommend. As always, a work in progress.)
One of the simplest things many of us can do to improve our health is drink more water. It need not be from a bottle (though it's a great idea to carry a re-fillable glass or stainless steel one!). It need not have gone through reverse osmosis. We are blessed in this part of the world to have cold, clean water that comes out of a tap - inexpensive, life-giving, miraculous. And yet many of us don't drink enough. The consequences? We are sluggish (water is necessary to deliver nutrients to our cells and tissues); our brains are foggy (our brain cells depend on water to bring them essential oxygen and glucose); our bodies ache (water helps to clear away waste from our natural metabolic reactions); we are constipated (water bulks up our stool, making it easier to eliminate); we are DRY (cracked lips and knuckles, anyone??). Drinking more water might even help maintain a healthy weight! Kids in particular are vulnerable to dehydration, and may not recognize when they are thirsty.
I'm not talking coffee. I'm not talking juice. I'm not talking pop - diet or otherwise. I'm talking the real deal. BUT there is no magic volume - that "eight cups a day" rule doesn't hold much ... water. How much we need depends on how much physical activity we're getting, how dry/hot the environment is, whether we're struggling with an illness, and how big our bodies are. It also depends on how much moisture there is in our diets. A person who eats a diet rich in fresh fruits, veggies and water-based foods (think soups, stews, porridges) needs less water straight-up. Being mindful of our thirst and taking a quick peek at our urine after going (kids love this) should give us a clue ... healthy urine should be see-through and pale yellow ... not perfectly clear, and not as dark as apple juice. Unless you are really going overboard, particularly if you're an endurance athlete, there's rarely harm in working in more water. Ready for some tips?
1. Just drink it! Cold or warm, flat or fizzy (just watch the sodium content) ... find what turns you on. Savour it!
2. If plain water bores you, jazz it up with some added fruits or veggies! Sliced cucumber or lemon, or a handful of berries look lovely in a pitcher of agua and add a touch of flavour. When that beautiful pitcher is at the front of the fridge, or in a prominent place on the counter, who can resist??
3. Teas (the non-caffeinated version*) count! The bonus is that they can be individualized to your health needs. That's an entirely other blog post (stay tuned!), but start with these suggestions: chamomile when someone needs to chill; peppermint for an after-meal digestif; ginger with lemon for a refreshing pick-me-up; or nettles for an extra hit of iron. I suggest making a big vat of your family's favourite and drink it room-temperature or cold.
4. If your kids are used to drinking something else (milk, juice ... or even pop), and refuse to drink the plain stuff, slowly dilute what they will drink (with or without their cooperation) over time until it is mostly or completely unadulterated water. Then work on the other strategies mentioned above!
* black and especially green teas are full of amazing antioxidants and can definitely be enjoyed; however, the caffeine can be a bit dehydrating if that's all that's being consumed, and may be too stimulating for some
As my daughter and I were walking the other day, she - somewhat randomly - inquired about how people become blind. I told her there were many ways, but there were a few that were most commonly responsible in Canada. She asked me if there was any way of preventing blindness, and I told her that yes, most cases of blindness in Canada are preventable (think diabetes, macular degeneration) or treatable (visit http://www.cnib.ca for more info). I told her that the best way of keeping her eyes as healthy as possible was to eat her fruits and vegetables and move her body lots. She gave a huge sigh and we both laughed, because that's what she always hears from me. Eat your fruits and veggies. Move your body. Get enough sleep.
She's kind of tired of hearing it, but I hope that with the regular prompts - and even more powerfully, modelling by the adults in her life - it will seep into her consciousness and her habits. Because it's not just her naturopath mom who thinks this is important. This article in the journal Cureus is an excellent overview of the importance of establishing these lifestyle behaviours in childhood. If we want our population to be healthy, if we want the adults of tomorrow to be capable of being productive members of society, then these are the foundational habits that are critical to foster in our young people today.
The recipe for a healthier kid, and the adult they will become? Independent of all other factors (with acknowledgement of the challenges inherent in achieving some of these habits influenced by the social determinants of health):
1. Lots of fruits and veggies (and other good nutritional practices that go along with this).
2. Lots of movement (also tied to awareness around time engaged in sedentary activities like media use).
3. Lots of sleep (acknowledging its impact on stress reduction, growth, and immune system function).
How is your kid doing? How are you doing?