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!
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!
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?
"Detox" is a word that gets thrown around these days with abandon. We are swimming in an environment laden with tens of thousands of untested and - in many cases - unregulated chemicals. And while your body has some really amazing mechanisms to process and eliminate the stuff that could harm you, in many cases, not only are we exposed to more chemicals than we evolved to deal with, we also tend to live lifestyles that impair our natural mechanisms to clear them. "Toxic burden" can result in conditions and symptoms ranging from eczema to headaches to chronic fatigue to behavioural or developmental concerns in kids. Children in particular are vulnerable to the impacts of toxin exposure due to their unique and immature biology and behaviour.
So what does "detox" mean? My goal with a detox is to minimize sources of chemicals in order to reduce what you're asking of your body, and to support the processes that it already has in place. Ideally, these strategies should be ongoing, and not necessarily only during an occasional "detox". Everyone in the family can participate in a gentle plan to promote detoxification and elimination, and spring is a great time to start! A comprehensive detox strategy includes four parts: reduction, diet, herbs and lifestyle. Let's start with the first part!
Imagine trying to clean out your garage while someone was dumping more clutter in through the back. It's not helpful to be putting more junk in while you're trying to clear it out! A household and lifestyle audit can help identify sources of chemicals.
1. Food: The Environmental Working Group’s “Dirty Dozen” and “Clean Fifteen” are excellent resources to support you in choosing what produce to buy organic. Ideally animal products should be organic, since many harmful chemicals bioaccumulate in higher amounts in animals than in produce. Eating more of a plant-based diet is also helpful for detox (more to come) and cheaper, making the more expensive organic selections easier to buy! Frequently eaten foods - especially for picky kids - should be prioritized as well. And make sure you check your local fish advisories!
2. Personal care products: Many products such as lotions, creams and soaps contain chemicals which are known to be problematic in humans. The EWG Skin Deep Cosmetic Database offers an accessible and user-friendly resource (mobile-friendly!) to rate your favourite products and select healthier options. The easiest offending ingredient to spot? Fragrance!
3. Cleaning: Household cleaning should be done with homemade cleaners or products identified as being of low toxic load. Dust should be removed via vacuum or wet-mop, and hands washed frequently (especially children’s) with soap and water (no "anti-microbial" products required!). Shoes should be removed when entering the home, and any solvents or chemicals used for occupation or hobbies (and clothes worn while using them) should be kept out of the home.
4. Household objects: Plastic toys and other items should be avoided, since plastics are a significant source of concerning chemicals - for us, and the rest of the planet! A simple strategy is to slowly start replacing all your plastic food containers and bottles with glass, Pyrex or stainless steel (done all at once, this can be pricey, but slowly over time, plastic can be squeezed out). Indoor spaces should be ventilated adequately and frequently (aka open up the windows and let the sunshine in!). Clothing (especially children’s) can be purchased second-hand to reduce exposure to flame-retardants - there are many terrific second-hand stores with a great selection at very affordable prices!
5. Transit and chores: Families can be encouraged to use cars less, and instead walk, bicycle or use public transit. This not only encourages physical activity (which promotes detoxification and elimination), but reduces emissions. Elbow grease should be encouraged, reducing the use of motor-powered mowers and blowers. On days identified as hiving high levels of particulate matter, it is advised to reduce outdoor activity during peak traffic hours.
Over the next few weeks, we'll explore the other elements of promoting optimal detoxification ... and if you just can't wait to learn more, pop by and see me or drop me a line!
We tend to think of weak bones as being a problem of old age. However, building strong bones is a job for youth. Bone mass is laid down in childhood - we reach our peak bone mass by about the age of 20 - so helping our kids optimize bone health is critical to prevent osteoporosis years later. The stronger our bones become when we're young, the better off we'll be when we're older. Most families know this, and (like the Canada Food Guide advises) diligently ensure their children consume their milk and dairy products.
However, the British medical journal recently released a study showing that boosting calcium intake did nothing to prevent fractures. How can this be? Haven't we always been told that milk "does a body good"??
Bone health relies on far more than just calcium. Although it's an important component of healthy bones, there are a range of other nutrients - including vitamin D - that affect the metabolism of bones, kind of like the mortar that holds a strong wall together. Fruit and vegetable consumption alone is an independent predictor of stronger bones. Weight-bearing physical activity puts muscular force onto bones that challenges them to become stronger. It's important to keep the activity to moderate levels during development - the stress of intense training can negatively impact bone development. Minimizing stress reduces cortisol, a hormone that weakens bones, among its other toxic effects.
Calcium is still an essential mineral, for bone health and other important bodily functions. However, while dairy is a great source of calcium, despite the best efforts of the Dairy Board to convince us otherwise, dairy need not be its own food group. The Mediterranean dietary guidelines minimize dairy as its own food group, as does the Harvard School of Public Health - note the conspicuous inclusion of healthy oils in both images as well - important for metabolic and immune system function.
Nuts and seeds are a great source of calcium; eaten whole, or in their "butter" form, they're a delicious way to boost intake. Try almond butter on your toast, or add tahini (sesame seed butter) to your dips, soups and sauces. Green leafy vegetables contain calcium, and provide additional benefits of fiber and vitamin K, both helpful to bone health. Tofu (made from organic, non-GMO soy) is an excellent source of calcium; the phytoestrogenic effect of the soy may also benefit bone health after menopause. Stir-fried kale and tofu with a tahini sauce gives a powerful hit of not only calcium, but many other nutrients necessary for bone health.
Although I'm not generally an advocate of canned foods, I do like canned wild salmon or other cold-water fish with bones as a source of both calcium and omega-3 fatty acids - use it to make delicious salmon burgers, or mix into a green salad. Strong bones require minimal inflammation, and the healthy fats from wild fish are a helpful way to reduce it in the body.
If you or your child do well with dairy (signs that you don't might include eczema, sinus congestion, frequent ear infections, digestive difficulties, or behaviour struggles - come see me to discuss if a trial elimination might be a good idea), it can definitely be included in a balanced diet. Goat and sheep products are often better tolerated than cow, and have a pleasant flavour. There are many delicious varieties of cheese from around the world to try. Our family loves fermented dairy in the form of yogurt as an excellent way to support healthy gut bacteria - it's super easy to make at home, and you'll get more bacteria bang for your buck! See below for instructions how!
So get out with your kids to jump on a trampoline, swing around the playground, skip rope or have a dance party! Adults can go for a run or hit the gym for the same physical benefits, but it's not always as fun for some folks. The activity loads your bones to make them stronger, and helps to reduce the negative impacts of stress. Being outside while you do it gives that extra vitamin D that is so important. Eating a Mediterranean-style diet (lots of fruits and vegetables, whole grains, plant-based proteins, healthy oils) will create the best possible nutritional environment for bones. It's so important to create an opportunity for kids' bones to develop properly, and for those of us who are past that prime time, we can keep our bones as strong as possible using the same principles. Have fun!
We just got back from a week on the French River (an historic waterway and stunning bit of land and river about three hours north of Toronto). My kids have done a lot of camping with me, and we've paddled, but I've never challenged them to do an extended trip that required them to work in quite this way. They were game from the start, and I was super excited about our adventure!
However, everyone was a bit grouchy on the first day. There was general grumbling about paddling and living in tents for the next week; there was the predictable bickering between the kids; I was edgy and distracted after the drive and with mental reviewing of gear and food. We were on the river for less than an hour (in fairness, paddling into a stiff headwind) when I brought the hammer down. I launched into a tirade about how lucky we were to live in such a beautiful country. To have clean water to swim and paddle in (and drink, with a bit of help from a great filter). I lectured that our country (the colonial version) was built on canoe trips along this very river. These were skills that they had the responsibility to learn as Canadians. It was a privilege to be here and I had had just about enough complaining.
My lectures rarely have a great impact (who's do?). I'm sure they tuned me out. But they stopped grumbling. And it stayed that way! Over the next five days these two city kids learned to shit in the woods (properly), pitch their tent, use a compass, read a map, paddle a boat efficiently, and portage gear. They rediscovered one another, worked as a team, solved problems and spent time together - by choice! They swam, built fires, jumped off cliffs, ate in the rain, and were tougher than many adults I know. We saw otters and turtles, eagles and herons. We talked religion and politics, worked through various forms of angst, made up stories, and learned new songs. We got scraped and tanned and dirty and tired. Our circadian rhythms adjusted to the rising and setting of the sun. We snuggled and laughed. We filled our lungs and we filled our souls.
We're back in the city now. Time will tell how quickly we'll all revert back to itching for digital distractions. I'm already up waaay past when my body tells me I should be. The bickering has begun again. I think we're already looking forward to next summer ...