Movement - but not the kind of we usually talk about. 
 
Movement is a foundational pillar of health that is almost always discussed as part of a healthy lifestyle. 

When we say the word “movement”, what do you think about?  
 
When asked to describe movement, the answer usually revolves around INTENTIONAL movement (i.e. a run, a bootcamp class or a yoga practice) for the purpose of living and maintaining a healthy lifestyle. But what about the activities of daily living and how they can influence our health? What benefits do these not-so “micro” movements have on our bodies? 
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This is where N.E.A.T comes into play (non-exercise activity thermogenesis). N.E.A.T refers to our bodies’ function of expending and burning energy in all of the little movements that we never really consider, especially pre-pandemic. It’s the energy expended for everything we do that is not sleeping, eating or sports-like exercise. This includes activities such as walking to work, typing, performing yard work, and other daily step count contributions. 
 
This is also the type of movement that has had the most dramatic loss during the pandemic. I know at least for myself, my step count decreased by over 50% during the initial phases of the pandemic. We have become more sedentary and our lifestyles took a dramatic shift. 
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Curiosity about the impact of step counting lead to discovering research which demonstrated how even increasing your step count by 1000 steps per day can have a significant impact on decreasing overall mortality, regardless of the intensity1. That's basically a walk around the block every morning.  
 
The purpose of this conversation is not to micromanage every step of your movement, but to have an awareness on how little changes can positively impact your wellbeing. Everything right now is basically sedentary and at our finger tips, so we need to involve our activities of daily living into the movement conversation. 
 
A few ways and ideas of how to increase movement are: 

1. Taking the stairs instead of the elevator  
   
2. Going for a leisurely walk once per day 
3. Finding at-home based low-intensity exercises that require little to no equipment 

 
These are just a few suggestions and can modified depending on personal preferences and activity levels. These small-scale changes can lead to big scale impact in the long term. 
 
When it comes to setting movement goals, anything above baseline is a positive outcome! SMART goals are a great way to start making small but positive changes to create long-term habits. Here’s the framework to get started:  
 
S - specific 
M - measureable 
A - attainable 
R - realistic 
T - timely 
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Here are some reflection questions for you: 

~ During the pandemic, what caused your activity to shift the most?  
~ What is one sedentary hour that you can change?  
~ Try making a SMART goal for yourself  
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We are creatures of habit, but I know time can be a barrier. So let's show up for ourselves like we show up for others.  
 
References:  
 
Hall KS, Hyde ET, Bassett DR, et al. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. Int J Behav Nutr Phys Act. 2020;17(1):78. Published 2020 Jun 20. doi:10.1186/s12966-020-00978-9 ​

The stress response, also known as "fight or flight" is a physiological process that occurs when we are in danger, or faced with a threat. In our everyday lives, we come across situations that trigger this stress response, whether it is when we are coming up to a big deadline, running late for an appointment, or preparing to have a difficult conversation. As a short-term reaction, this response is important because it makes us alert, improves performance, and provides us with motivation to complete the task at hand. If these moments are short lived, we are able to return back to a relaxed state, and our body can recuperate from the experience. However if these situations are prolonged or we continuously perceive experiences as threats, we start to live in a chronic state of fight or flight, which can start to negatively impact our overall health. To understand the process in which chronic stress evolves, we can break it down into 3 stages:

1. Alarm: there is a perceived threat that triggers the fight or flight response, which alarms our body to release cortisol (a stress hormone) and adrenaline. The body starts to experience physical symptoms of stress such as increased heart rate, muscle tension, perspiration, and shortness of breath, all of which increase alertness. To ensure that all of our energy is going towards dealing with this stressor, the body inhibits digestive activity. After the stressful event is over, the body can start to repair itself. Cortisol and adrenaline decrease, and we see the heart rate and breathing rate normalize. Digestion can pick back up and the body can enter a relaxed, healthy functioning state.
2. Resistance stage: If the stressful state extends for an abnormal amount of time, or if there are repeated stressful events that closely follow each other, the body adapts and develops an increased capacity to respond to the stressor. The body undergoes changes that we are not consciously aware of and so this chronically stressed state starts to become the new normal. At this point we may see changes in our mental health, such as irritability and cognitive dysfunction. If there is no intervention to reduce stress levels, it can lead to exhaustion.
3. Exhaustion stage: After a prolonged period of time where the body is trying to function under high levels of cortisol, it reaches a threshold and can no longer support this state. The immune system becomes compromised and we see a decline in bodily function. Our emotional, mental, and physical health starts to decline from the wear and tear that chronic cortisol has had on the body. At this point, the possible signs and symptoms that might be experienced are extensive, ranging from sleep issues, digestive concerns, anxiety, depression, high blood pressure, systemic inflammation, and more.

In our busy world, there is no way to completely avoid stress; however, we have many ways that we can help our body not only deal with the repercussions of stress, but also make our body more resilient, so that we may learn to perceive situations as less of a threat going forward. Here are some evidence based ways to reduce and prevent chronic stress:

1. Exercise: arguably the single most effective intervention to reduce stress levels. Exercise works at many different angles to reduce perceived stress. It reduces cortisol levels, helps to improve sleep, clears the mind of anxiety, and improves mood by releasing endorphins. Find a form of exercise that you enjoy, as this will be the most sustainable over time. Daily walks, cycling, yoga, or team sports for 30 minutes a day, 3-5 times a week can provide significant improvements.
2. Diet: When we eat nutrient-rich foods, the body creates an environment that is resilient and optimally functioning, which allows the body to adapt and react more efficiently when we are faced with stress. Foods to focus on are vegetables, fruits, protein, and omega 3-rich foods such as salmon. Try to stay away from refined sugar and processed foods as these can spike blood sugar levels, bring on fatigue and brain fog, and wreak havoc on the digestive and immune system.
3. Deep breathing: so simple, yet so impactful. Taking a deep breath stimulates the vagus nerve, which then sends a message to the brain to activate the parasympathetic nervous system (our rest and digest state). Practicing "box breathing" or simply focusing on 10 deep breaths can significantly reduce symptoms of stress and anxiety.
4. Reduce/alter caffeine intake: Caffeine acts on the body by activating the stress response, leading to wakefulness and alertness. This also means that it may bring on jitters, increased heart rate, and symptoms of anxiety. When drinking coffee becomes a habit, these feelings may become normalized and it can be hard to attribute the symptoms to the caffeine. Consider eating food before your first cup of coffee or switching to a less caffeinated option such as green tea (which also has brain boosting benefits)
5. Mindfulness: there are a number of ways that we can practice mindfulness, whether that is through yoga, meditation, journaling, or grounding. Mindfulness allows us to be present in the current moment, paying no attention to the past or future. It influences different pathways in the brain, helping to rewire pathways and regulate emotion and attention. It is important to practice mindfulness in low stress moments, so that this tool is ready when it is needed the most.
6. Green space: spending time in nature has been shown to lower cortisol levels, improve mood, and reduce symptoms of anxiety. Going for a daily walk or taking a book to the park can be extremely beneficial.
7. Supplements: In botanical medicine, there are a group of plants called adaptogens that help the body adapt, and develop resilience to stress. The research on their impacts is impressive and continuously growing and they might be right for you. Book an appointment with us at the RSNC to see if this is the right fit for you.

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I am so excited to introduce the newest members of the Tuesday afternoon team!

Why book an appointment at our teaching clinic?

• We collaborate on the care of all individuals who seek our support; nine brains and perspectives instead of just one.
• You get the value of both experience (mine) and new practitioner energy (theirs); between us, we combine the latest evidence, and the skills to apply it individually.
• We offer (at least for now) both virtual and in-person visits when necessary.
• The clinic space is geographically (if you're in Toronto) and physically accessible.
• In exchange for your willingness to support the learning of our students, you pay less per visit (still eligible for extended health benefits) than you would elsewhere.

You can choose to book directly with any of the following senior interns (all under my supervision, and with the support of the rest of the team), or with our team in general.

​Without further ado, the team!

Cloe Franko

I stumbled upon naturopathic medicine during my own healing journey and was so inspired I changed careers to pursue it. I believe deeply in the naturopathic principle of identifying and treating the root cause of disease and work with patients to uncover barriers to healing. I am excited to work with you to understand your personal health puzzle and support your return to your most vital self.

Annaleeza Renzone
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I have always had a passion to help people. People deserve extraordinary health, and it's important to me to advocate for patients and let them see their full health potential. I want to create an open and safe space for people to prioritize themselves. 

Simone Pirita

While completing my university degree, I found a passion for all things natural. It was shortly after that I was introduced to naturopathic medicine and I realized it was my calling. I am so excited to continue on this journey and work with my patients to help them reach their health goals, whatever they may be. I want to encourage everyone to become advocates of their own health, while supporting them in creating an enjoyable and sustainable lifestyle.

Nora Fenton

I came into naturopathic medicine to educate and empower my patients so that they take their health into their own hands. I have a special interest in hormonal and reproductive health, but I’m here to address any and all of your health goals. I’m a strong believer that feeling “fine” isn’t good enough; you deserve to feel amazing. My mission will always be to meet you where you’re at so that we can achieve your health goals, together.​

When you are feeling that your body reactions are more intense than baseline here is a simple step by step approach that you can use to tune into your body. It is meant to be a non-judgmental practice where you can really focus on how your body and mind are coping. Follow these 5 BASIC steps in order to check in with your body and mind:  
 
B: Behaviours 

• When we experience something uncomfortable, we fall into specific behaviours. What behaviours do you notice in certain situations?  

• Example: When we are happy, we laugh or smile. When we are stressed, we can take shallow breaths, clench the jaw or pace. 

  
A: Affect (emotions) 

• What emotions are you experiencing at this time?  

• Example: Are you feeling sadness, joy, fear, anger, worry? 

  
S: Sensation 

• Your body may have some physical sensations. 

• Example: Muscle tension in the neck, feeling of a lump in the throat. 

  
I: Imagery 

• You may have certain images in your mind that come about in certain situations. Tune into these and think of when you see them 

• Example: Wanting to run outside to scream when stressed, seeing the colour red when angry. 

  
C: Cognition 

• You may have thoughts that come about. What do these thoughts say about how you process situations? What do they say about the environment you are in?  

• Example: When we are anxious, we may think that everything is going to fall apart. When we are angry, we focus on negative thoughts.  

  
Remember, be patient with yourself and non-judgmental. The goal is to notice, not to change.  Being mindful of these reactions of your body and mind will help to understand how you cope in these situations. This is a simple way to begin practicing mindfulness.  

An essential primer to autoimmune conditions - starting with rheumatoid arthritis ... check it out!

Painful periods – otherwise known as “dysmenorrhea” in the medical world – are extremely common, so when should you worry about an underlying condition?
 
Over 60% of women in Canada suffer from dysmenorrhea, while 10-15% of reproductive age women are affected by a condition called endometriosis which often presents with painful menses. 

What is endometriosis? 

Endometriosis is a condition where endometrial tissue, which is normally limited to the inside of the uterus, grows elsewhere. This can result in uterine tissue on the fallopian tubes and ovaries, and can even extend to other areas within the abdomen. Uterine tissue is sensitive to hormonal changes throughout the cycle so that it can grow and be shed each month. When this tissue grows and sheds outside the uterus, this can lead to immensely painful periods. As endometriosis progresses, pain can also occur throughout the whole month.  
 
Additional symptoms can include pain with intercourse, painful defecation, painful urination, and intermenstrual bleeding (bleeding between periods), as well as infertility. Women with endometriosis can vary in presentation, with some having all of the above symptoms, and others having none. Women who are asymptomatic often only discover their endometriosis when they begin to struggle with infertility. 
 
Fertility is often disrupted with endometriosis because the tissue deposits on fallopian tubes and ovaries can interfere with their optimal function. Hormone irregularity can also contribute to infertility. 

What causes endometriosis?

The cause of endometriosis is still unknown but there are a couple current hypotheses. One possible explanation is called retrograde menstruation, where the endometrial lining flows back through the fallopian tubes and into the pelvic space, instead of out through the vagina. Another hypothesis is that the endometrial tissue deposits are from tissue remnants that did not properly differentiate during fetal development. 
 
How is endometriosis diagnosed?

The process of diagnosis will include ruling out other conditions that can cause pelvic pain, and likely a transvaginal ultrasound. Diagnosis of endometriosis can be challenging because currently the only way to confirm its presence is by surgical laparoscopy and visualization of the abdominal cavity. There is a protein called CA-125 that can be measure in blood, which can be indicative of endometriosis. Levels tend to be significantly higher in those with endometriosis, but not consistently enough to be used for diagnosis. 

Who is at risk for endometriosis? 

However, there are certain risk factors that can increase the likelihood of having endometriosis. A younger age at first menstruation, short menstrual cycle lengths, and lack of pregnancy have all been correlated to an increased risk for the disease. This suggests a role of estrogen dominance in the development of endometriosis, as estrogen levels are higher than normal in these women. Inflammation has also been seen as a contributing factor in endometriosis. Physical activity and omega-3 fatty acids can help decrease inflammation, and furthermore decrease risk. 

How is endometriosis treated?

Conventional treatment for endometriosis usually consists of non-steroidal anti-inflammatory drugs (NSAIDs) to control pain and oral contraceptive pills (OCPs). There is a decreased risk of endometriosis with current use of OCPs, but an increased risk with past use. This suggests a suppression of symptoms that reappear with discontinuation of OCPs. Naturopathic treatments focus on reducing oxidative stress, inflammation, and balancing hormones. Dietary changes, acupuncture, botanicals and nutritional supplements can all be used to effectively manage endometriosis. 
 
If you are struggling with painful periods or any of the symptoms listed above, consult your naturopathic or family doctor to see if endometriosis could be the cause. 
 
References 

• Adamko, D., Arnason, T., Bailey, B., Barkun, A., Basson, R., Beleznay, K., … Zigman, D. (2018). Endometriosis. In C. Sanger (Ed.), Compendium of Therapeutic Choices(pp. 1224-1246). Ottawa, ON: Canadain Pharmacists Association. 
• Burnett MA, Antao V, et al. (2005). Prevalence of primary dysmenorrhea in Canada. J Obstet Gynaecol Can, 27(8): 765-70. 
• Parasar P, Ozcan P, Terry K. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep, 6(1): 34-41. doi:10.1007/s13669-017-0187-1.
• Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand 2017;96:659–67.