Common Household Pollutants

• Formaldehyde off-gasses (evaporates) from cushions, cosmetics, insulation, plywood, disinfectants, particleboard and adhesives used to manufacture most inexpensive wood-based products. Carpets and carpet cushions may also off-gas formaldehyde, causing eye and upper respiratory irritation. According to the EPA, formaldehyde may even cause cancer.
• Radon is the second-leading cause of lung cancer in the U.S., warns the Surgeon General. Radon is a natural, radioactive gas that can seep into homes through cracks in the basement, the surrounding foundation, and in well water. It enters the body quietly through the ai
• Lead, at levels once thought to be acceptable, is now known to contribute to learning disabilities and behavioral problems. Lead is found in paint in older houses, old plumbing, and soil near highways and busy roads. It can cause neurological and kidney damage, high blood pressure, disrupted blood cell production, and reproductive problems.
• Carbon monoxide will kill an estimated 660 Americans this year. The biggest culprit is the unserviced furnace burning propane, butane or oil. Attributed effects are headache and nausea.
• Arsenic is still laced in many household pesticides and is used as a wood preservative (“treated” wood for outdoor use). Low levels of inorganic arsenic “may increase lung cancer risk,” according to the CDC. The Department of Health and Human Services agrees added arsenic compounds to the list of known carcinogens.
• Vinyl chloride is the source of “new car smell”: The plastic interior of a new car off-gasses this known carcinogen. Water sitting in PVC pipes overnight may be steeping into a toxic tea. Very large exposures can lead to “vinyl chloride disease,” which causes severe liver damage and ballooning of the fingertips.
• Hydrofluoric acid can cause intense pain and damage to tissues and bone if the recommended gloves happen to have holes in them. This highly corrosive substance is the active ingredient in many household rust removers.
• House dust can include lead, cadmium, bacteria, mites, flea eggs, pesticides, asbestos, mold spores, and dust mites. Allergies including sneezing, itching eyes, runny nose, asthma, and headache can occur due to dust exposure.
• Asbestos is a fiber particle used in insulation that is linked to lung and stomach cancers.
• Methylene chloride in hair spray, decaffeinated coffee and insect spray can cause cancer.
• Electromagnetic fields emitted by electric cords and appliances can cause miscarriage.
• Volatile organic compounds have well-documented adverse effects.
• Solvents, disinfectants, antiseptics, perfumes, mouthwashes, glues and air fresheners can contain harmful phenols and other chemicals.
• Cleaning agents irritate skin, lungs, and eyes, and throw off the ecological environment of waterways that wash them away.
• Pesticides are poisons used to control insects, fungi, weeds, and rodents. Attributed effects are nervous system depression and childhood leukemia. Pesticides such as chlordane, aldrin, dieldrin, though all banned for nearly two decades, continue to show up airborne in older houses.

Resources
1. www.emagazine.com
2. Pearson, David. The Natural House Book. Fireside Pub. 1989.

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Coenzyme Q10

Coenzyme Q10 or “CoQ10”, also known as ubiquinone, is an anti-oxidant that is essential for mitochondrial energy production and may play a role in cellular defense against oxidative damage.

A growing body of research shows that using a coenzyme Q10 supplement alone or in combination with other therapies may be beneficial in the treatment of several health problems, including cardiac conditions and diseases, high blood pressure, high cholesterol, breast cancer, diabetes mellitus, immune deficiency, muscular dystrophy, and periodontal disease.

Dietary Sources
Most coenzyme Q10 is believed to be synthesized inside the body. Normal dietary intake is minimal, though primary food sources include oily fish, organ meats (such as liver), nuts, and whole grains.

Supplementation with higher doses of CoQ10 can be helpful in individuals with certain health conditions, and in the elderly, because levels can decline with advancing age. If taken as a supplement, coenzyme Q10 should be taken with a meal containing fat or oil since it is fat-soluble. The body does not absorb it as well in the absence of oil.

Consult your physician for specific recommendations CoQ10 supplementation.

Precautions
Coenzyme Q10 appears to be safe with no significant side effects. However, the safety of supplementation during pregnancy and breast-feeding is unknown.

Possible Interactions
Certain medications such as Adriamycin, lovastatin and other HMG CoA-reductase inhibitors, gemfibrozil, beta-blockers, tricyclic antidepressants, and phenothiazine may deplete the body of coenzyme Q10.

Resources
1. Combs, G.F., The Vitamins: Fundamental Aspects in Nutrition and Health. 2nd ed. 1998, San Diego, Calif.: Academic Press. xxii, 618.
2. Gaby, A.R. and J. Wright, Nutritional Therapy in Medical Practice. 2001, Seattle, WA: Nutrition Seminars.
3. MD Consult, Patient Handouts. 2002, http://www.mdconsult.com.

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Reasons To Consider Vitamin/Mineral Supplementation

All human beings need adequate micronutrients (vitamins, minerals, enzymes and trace elements) for good health. Ideally, we would be able to obtain all the necessary micronutrients from a well balanced diet. However, the nutritional quality of the food in our world has been steadily declining, particularly in the last century. In the past, people ate foods that were whole, fresh, in-season and grown locally in nutrient-dense soil. Now, most foods are refined, preserved and grown in nutrient-depleted soils, making it difficult for us to get all the nutrients we need solely from food, no matter how “nutritious” our diet may seem.

Many genetic, environmental and lifestyle factors also contribute to INCREASED nutrient requirements in certain cases. Just as there is genetic variability in hair or eye color, there is genetic variability in our requirements for, and abilities to absorb and use, certain nutrients. Some of us need more of certain vitamins or minerals in order to maintain optimal health. Another factor that affects our nutrient levels and requirements is pollution. Pollutants, pesticides and toxins are an unfortunate reality of our environment and the body’s ability to protect itself from these substances is often dependent on nutrient status. Pollutants have also been shown to interfere with specific vitamins, such as B6 and others, leading to an increased requirement so as to avoid deficiencies. Other factors including stress, activity level, medications and illnesses can elevate an individual’s requirements for vitamins and minerals.

Nutrients have also been shown to have many beneficial preventative and therapeutic actions in disease management. For some conditions, studies have shown that high doses of specific vitamins and minerals have effects comparable to, yet often less toxic than, prescription medications. Consult your physician for specific recommendations.

Summary of reasons to consider vitamin and mineral supplementation

1. To compensate for the declining nutrient content and increased refinement of our foods
2. To overcome increased nutrient requirements in some individuals due to genetic and biochemical individuality/variability, illness, pregnancy, high stress or high activity level
3. To counteract the deleterious effect of pollution and toxins (pesticides, environmental pollution)
4. To correct nutritional deficiencies induced by prescription drugs
5. To make use of direct therapeutic and health promoting effects of certain nutrients

Resources
1. LaValle, J.B.Natural Therapeutics Pocket Guide. 2000. Lexi-Comp. Hudson, OH. Pg. 680.
2. Wright, J.V. and Gaby, A. The Patient’s Book of Natural Healing. 1999. Prima Health. Rocklin, CA. Pp. xii, 388.
3. Fairfield MD DrPh, K. and Fletcher MD MSc, R.H. “Vitamins for Chronic Disease Prevention in Adults”. JAMA 2002; 287: Pp. 3116-3126, 3127-3129.

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Safety of Vitamins and Minerals

Over the past 20 years, there has been an abundance of data accumulating regarding the safety of vitamins and minerals. The data demonstrates that these nutrients are safe over a wide range of doses, though some nutrients can cause adverse reactions at high doses. However, few such cases have been reported. The FDA estimates that about 40% of the public uses nutritional supplements, a number that is growing yearly.

The most commonly used of all vitamin supplements is Vitamin C. Theoretically, very high doses of Vitamin C can cause the formation of oxalate kidney stones, but this happens rarely. The only real clinical side effect often observed with high doses of Vitamin C is a mild diarrhea, which is a good indicator of the dose that your body can tolerate. Some studies have shown that for illnesses that benefit from high doses of Vitamin C, the body can adapt to and tolerate higher and higher doses as its requirement for Vitamin C conditionally increases.

One of the vitamins most commonly discussed in relation to toxicity is Vitamin A. Many feel that doses should not exceed 25,000 IU (International Units) per day. However, for certain conditions, higher doses are recommended for brief periods of time. Studies have shown that high doses of Vitamin A can have beneficial effects against certain viruses. Your naturopathic doctor will be able to advise you as to the proper dose for you. Reports of serious adverse reactions to Vitamin A have been few. Acute toxicity occurred in Arctic explorers who consumed polar bear liver containing 2,000,000 IU of Vitamin A per 100 grams (3.5 ounces) of liver. Children given high doses have also shown symptoms of acute toxicity. Vitamin A should only be taken in small doses by pregnant women due to its ability to cause birth defects at normal adult doses. Toxic symptoms have been shown to occur with adult doses of 25,000 IU per day and child doses of 10,000 IU per day if there is no deficiency present. Early signs of toxicity include headaches, dry skin, nausea, diarrhea and hair loss.

The recommended daily allowance of Vitamin D is 400 IU per day, which is also the standard dose prescribed by naturopathic doctors. Extremely high doses of Vitamin D can cause an excess of calcium in the blood and urine, allowing calcium deposits to form in the body. Usually, this occurs with doses of 50,000 IU per day, much higher than the usual dose. Vitamin D toxicity is more likely to occur in infants and children. Acute overdosing can cause increased urination, nausea, diarrhea, loss of appetite, weakness, and dizziness.

Niacin is one of the B vitamins (vitamin B3). In general, there is little toxicity associated with water-soluble vitamins (B vitamins and Vitamin C) because the body can usually excrete excesses in the urine, as opposed to storing excess amounts in the body as with oil soluble vitamins (A, D, E, and K). However, large doses of some B vitamins can cause imbalances in others through excess excretion in the urine. In its nicotinic acid form, large doses of niacin can cause damage to the liver. This form can also cause a flushing of the skin accompanied by itching. The latter symptoms usually pass within 15 minutes and this reaction can be avoided completely by giving the niacinamide form of the vitamin.

Vitamin B6 (pyridoxine) appears to be safe at doses of 200 milligrams (mg) daily. Problems with the nervous system have been known to occur with daily doses of 2,000 mg, but have even been reported with daily doses as low as 500 mg.

Para-aminobenzoic acid (PABA) is a B vitamin, which has come to prominence for its usefulness in topical sun protection products, although it also has internal uses. Unlike most water-soluble vitamins, PABA can be stored in the tissues and chronic high doses of PABA can cause nausea or damage to liver, heart, and kidneys.

Evidence suggests that Vitamin E has a low level of toxicity. The main concern is that high doses of Vitamin E raise blood pressure. One should also consult one’s physician regarding Vitamin E dosage when taking anti-coagulant medications or prior to surgery.

Vitamin K has no symptoms of toxicity in its natural form. However, synthetic forms can cause red blood cells to break down, as well as cause flushing, sweating and chest constriction. It is felt that any form of Vitamin K can counteract anti-coagulant drugs because of its ability to cause calcium to be bound by glutamic acid.

As mentioned earlier, excessive levels of calcium in the presence of excessive levels of Vitamin D can cause calcium deposits in the body. It can also interfere with nerve and muscle function in excess, although it is required in adequate amounts for the healthy function of these organs.

Copper is a mineral necessary for the formation of hemoglobin, the compound that transports oxygen in red blood cells, but high levels can inhibit the body’s usage of zinc, a mineral required for many enzymatic reactions. Excess can also cause various mental illnesses, high blood pressure, insomnia, senility and hypoglycemia. The recommended daily allowance is 2 milligrams, which is usually adequately provided by diet. Copper is also stored in the body. The main concern for supplementation is with infants who are being given cows’ milk rather than being breast-fed.

Iodine is a mineral required for the synthesis of thyroid hormones. It also has antibacterial activity. However, large amounts of iodine can shut down the thyroid gland, causing symptoms such as weight gain, constipation, dry skin and hair and excessive menstrual bleeding.

Iron is required for the formation of healthy red blood cells and is another mineral that is safe within its therapeutic range, but can create problems if given in high amounts. More benign symptoms of excessive iron include constipation, headache, fatigue and weight loss. On a more serious level, excessive amounts can be stored in various tissues and damage heart, liver and pancreas. Some feel that iron should only be supplemented if there is a need, as in excessive menstrual bleeding or other forms of blood loss. Only certain anemias require or benefit from iron supplementation, although iron is often mistakenly prescribed for all anemias. It is also thought that bacteria benefit from iron, so supplementation should be avoided during bacterial infections, upholding the body’s own natural response of sequestering iron away during such infections.

Phosphorous does not directly cause toxicity symptoms, but high intake (common in diets high in animal products and soft drinks) can impair the body’s ability to use calcium, which is necessary for bones, muscles, nerves and blood clotting.

Selenium is a very valuable mineral, primarily because of its antioxidant capabilities. However, it is only needed in small amounts, although the required amount usually exceeds dietary intake. In the U.S., 12 cases of toxicity were reported when a manufacturer accidentally used 100 times the standard dose. However, the product was recalled and the error quickly corrected. The form of selenium also makes a difference, sodium selenite being the most problematic. Symptoms include problems with hair, teeth, nails, skin and energy levels.

All of these vitamins and minerals are safe and beneficial within their respective therapeutic ranges. While many nutrients have possible adverse reactions, these usually occur at dosages far surpassing amounts usually prescribed. In terms of fatalities due to poisoning, there has been only one possible occurrence of a fatality due to nutrient poisoning reported to a poison control center from 1983-1987, as compared to the 1132 reported cases of fatalities due to prescription and over-the-counter drugs during those years. Of course, that does not even begin to cover the vast number of adverse reactions people can have to almost every drug in existence. With that in mind, although it is certainly advisable to consult a knowledgeable health care provider regarding dosages of nutrients, for the most part, vitamins and minerals are very safe therapeutic agents.

Resources
Gaby, Alan. Nutritional Therapy in Medical Practice. Nutrition Seminars, Seattle, WA. 2001.

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Lactobacillus Acidophilus/Bifidus

Commonly known as “friendly flora” or “probiotics”, Lactobacillus acidophilus and bifidus species are microorganisms that live in the human intestinal tract. These “good” bacteria assist with digestion of food and produce natural antibiotic substances. They also play a role in normal immune function, cholesterol metabolism, digestion and absorption, and cancer prevention. Interestingly, when adequate fiber is present in the intestines, these bacteria synthesize short chain fatty acids such as butyrate, etc. that inhibit the key enzyme (HMG CoA Reductase) involved in the liver’s synthesis of cholesterol. This is the mechanism by which they help to modify blood cholesterol levels. Normally these bacteria coexist in balance with other organisms such as E. coli and yeast. However, antibiotic drugs may kill some of the good bacteria along with the harmful ones, resulting in an imbalance in the bacterial species in the intestines. This, in turn, can lead to overgrowth of one or more types of disease-causing organisms. This process is known as intestinal dysbiosis.

In any form of supplementation, in order to be effective, the bacteria must be alive, so it is important to find good quality sources. “Acidophilus” means “acid-loving”, indicating that these bacteria thrive in acidic conditions and require a food source to survive such as lactose or fructooligosaccharides (FOS). Acidophilus may be found in food sources such as fresh, unpasteurized yogurt (pasteurization kills all bacteria) or in acidophilus milk. Check the label to make sure the yogurt or milk was cultured with acidophilus after pasteurization. Acidophilus and bifidus are also available in capsule or powder forms.

Quality products will be refrigerated at the store and should be kept refrigerated at home as well. Good packaging of these products also utilizes dark glass or plastic bottles and is dated. The label should also indicate the number of total organisms present (which should be >3 billion acidophilus organisms per cfu or colony-forming unit, plus >1 billion bifidus organisms per cfu). Some brands are more reliable than others in regards to content of specific bacterial species. This point is especially important for immune compromised individuals.

Acidophilus and bifidus supplementation is used to restore a normal, healthy population of intestinal organisms in various situations or conditions including intestinal dysbiosis following antibiotic treatment or following various intestinal infections/infestations, vaginitis and urinary tract infections. Supplementation may be taken by mouth or in the form of a douche or vaginal suppository depending on the specific condition. Sometimes a combination of treatments is used.

Acidophilus and bifidus are killed by alcohol and antibiotics. Avoid alcohol while taking these probiotics in any form for therapeutic purposes. If you are taking antibiotics, wait until you have finished the course of treatment before starting acidophilus/bifidus. Although fresh yogurt containing live microorganisms may be more digestible than pasteurized yogurt, opt for capsules if you have an allergy or intolerance to milk products.

Resources
1. Pizzorno, JE, Murray, Michael. Textbook of Natural Medicine, 2nd Ed. Philadelphia: Churchill Livingstone, 1999.
2. Hentges, DJ, ed. Health and Disease. New York: Academic Press, 1983.
3. Shahni, KM, Friend BA. Nutritional and therapeutic aspects of lactobacilli. J Appl Nutr 1984; 36:125-52.

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Bioflavonoids and Flavonoids

Bioflavonoids (or flavonoids) are a class of water-soluble plant pigments that bring color to many fruits and vegetables. Citrus fruits are a rich source of bioflavonoids, including disomin, hesperidin, rutin, and naringenin. Flavonoids are broken down into categories. One system breaks flavonoids into isoflavones, anthocyanidins, flavans, flavonols, flavones, and flavanones. Although they are all structurally related, their functions are different.

Citrus bioflavonoids and related substances are widely used in Europe to treat diseases of the blood vessels and lymph system, including hemorrhoids, chronic venous insufficiency, easy bruising, nosebleeds, and lymphedema following breast cancer surgery. These compounds are thought to work by strengthening the walls of blood.

While they are not considered essential, some flavonoids act as anti-inflammatory, antihistaminic, and antiviral agents. Quercetin can block the “sorbitol pathway” that is linked to many problems associated with diabetes. Rutin and several other flavonoids may also protect blood vessels and act as antioxidants, protecting LDL-cholesterol from oxidative damage, a goal for anyone with concerns about developing heart disease.

Others, such as the anthocyanidins from bilberry, may help protect the lens of the eye from cataracts. Animal research suggests that naringenin may have anticancer activity while soy isoflavones are also currently being studied to see if they help fight cancer.

FOOD SOURCES
Flavonoids are found in a wide range of foods. For example, flavanones are in citrus, isoflavones are in soy products, anthocyanidins in grapes and berries, while flavans are in apples and tea. In addition to supplying vitamin C, citrus fruits also supply a wide variety of bioflavonoids including diosmin, hesperidin, rutin, naringenin, tangeretin, diosmetin, narirutin, neohesperidin, nobiletin, and quercetin.

NATUROPATHIC USES OF BIOFLAVONOIDS AND FLAVONOIDS

Proven effective
• Capillary fragility (hesperidin, quercetin, rutin)
• Chronic venous insufficiency (rutin)
• Night blindness (bilberry)
• Nosebleeds (citrus)
• Hepatitis (catechin)
• Minor injury prevention (quercetin, anthocyanidins)
• Varicose veins (anthocyanidins, bilberry)

Likely effective
• Hemorrhoids (various citrus bioflavonoids, anthocyanidins)
• Macular degeneration (bilberry)
• Bruising (various citrus bioflavonoids, anthocyanidins)
• Chronic venous insufficiency (hesperidin/buckwheat tea)
• Cold sores (various citrus bioflavonoids)
• Diabetes (bilberry, blueberry, blackberry, etc.)
• Retinopathy (bilberry)

Possibly effective
• Atherosclerosis (quercetin, bilberry)
• Cataracts (quercetin, bilberry)
• Hay fever (quercetin, hesperidin, rutin)
• High cholesterol (quercetin)
• Menopause (hesperidin, isoflavones)
• Heavy menstruation (various citrus bioflavonoids, anthocyanidins, isoflavones)
• Peptic ulcer (quercetin)
• Diabetes (quercetin)
• Edema (quercetin, rutin)
• Gingivitis (hesperidin, rutin)
• Glaucoma (rutin)

DOSAGE
A typical dosage of citrus bioflavonoids is 600 to 1,200 milligrams per day.

SAFETY ISSUES
Citrus bioflavonoids appear to be quite safe. However, bioflavonoids may have some anticoagulant properties when taken in high doses, and therefore should be used only under medical supervision by individuals on blood-thinner drugs, such as warfarin (Coumadin) and heparin.

Resources
1. Ross SA, Ziska DS, Zhoa K, et al. Variance of common flavonoids by brand of grapefruit juice. Fitoterapia. 2000; 71:154–161.
2. Godeberge P. Daflon 500 mg in the treatment of hemorrhoidal disease: a demonstrated efficacy in comparison with placebo. Angiology. 1994; 45:574–578.
3. Cospite M. Double blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology. 1994; 45:566–573.
4. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon®) in the treatment of hemorrhoids. Dis Colon Rectum. 1992; 35:1085–1088.
5. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal hemorrhoids. Br J Surg. 2000; 87:868–872.
6. Ho YH, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids: randomized controlled trial. Dis Colon Rectum. 2000; 43:66–69.
7. Tsouderos Y. Venous tone: are the phlebotonic properties predictive of a therapeutic benefit? A comprehensive view of our experience with Daflon 500 mg. Z Kardiol. 1991; 80(suppl 7): 95–101.
8. Ihme N, Kiesewetter H, Jung F, et al. Leg edema protection from a buckwheat herb tea in patients with chronic venous insufficiency: a single-center, randomized, double-blind, placebo-controlled clinical trial. Eur J Clin Pharmacol. 1996; 50:443–447.
9. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology. 1997; 48:77–85.
10. Guilhou JJ, Fevrier F, Debure C, et al. Benefit of a 2-month treatment with a micronized, purified flavonoidic fraction on venous ulcer healing. A randomized, double blind, controlled versus placebo trial. Int J Microcirc Clin Exp. 1997; 17(Suppl 1): 21–26.
11. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology. 1997; 48:77–85.
12. Guilhou JJ, Fevrier F, Debure C, et al. Benefit of a 2-month treatment with a micronized, purified flavonoidic fraction on venous ulcer healing. A randomized, double blind, controlled versus placebo trial. Int J Microcirc Clin Exp. 1997; 17(Suppl 1): 21–26.
13. Galley P, Thiollet M. A double blind, placebo-controlled trial of a new veno-active flavonoid fraction (S 5682) in the treatment of symptomatic capillary fragility. Int Angiol. 1993; 12:69–72.
14. Pecking AP, Fevrier B, Wargon C, et al. Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Angiology. 1997; 48:93–98.
15. Lee SH, Park YB, Bae KH, et al. Cholesterol-lowering activity of naringenin via inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase and acyl coenzyme A: cholesterol acyltransferase in rats. Ann Nutr Metab. 1999; 43:173–180.
16. Shin YW, Bok SH, Jeong TS, et al. Hypocholesterolemic effect of naringenin associated with hepatic cholesterol regulating enzyme changes in rats. Int J Vitam Nutr Res. 1999; 69:341–347.
17. Emim JA, Oliveira AB, Lapa AJ. Pharmacological evaluation of the anti-inflammatory activity of a citrus bioflavonoid, hesperidin, and the isoflavonoids, duartin and claussequinone, in rats and mice. J Pharm Pharmacol. 1994; 46:118–122.
18. Manuel y Keenoy B, Vertommen J, De Leeuw I. The effect of flavonoid treatment on the glycation and antioxidant status in Type 1 diabetic patients. Diabetes Nutr Metab. 1999; 12:256–263.
19. Middleton E Jr, Drzewiecki G, Tatum J. The effects of citrus flavonoids on human basophil and neutrophil function. Planta Med. 1987; 53:325–328.
20. So FV, Guthrie N, Chambers AF, et al. Inhibition of human breast cancer cell proliferation and delay of mammary tumorigenesis by flavonoids and citrus juices. Nutr Cancer. 1996; 26:167–181.
21. Godeberge P. Daflon 500 mg in the treatment of hemorrhoidal disease: a demonstrated efficacy in comparison with placebo. Angiology. 1994; 45:574–578.
22. Cospite M. Double blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology. 1994; 45:566–573.
23. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal hemorrhoids. Br J Surg. 2000; 87:868–872.
24. Ho YH, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids: randomized controlled trial. Dis Colon Rectum. 2000; 43:66–69.
25. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon®) in the treatment of hemorrhoids. Dis Colon Rectum. 1992; 35:1085–1088.
26. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology. 1997; 48:77–85.
27. Ihme N, Kiesewetter H, Jung F, et al. Leg oedema protection from a buckwheat herb tea in patients with chronic venous insufficiency: a single-center, randomized, double-blind, placebo-controlled clinical trial. Eur J Clin Pharmacol. 1996; 50:443–447.
28. Galley P, Thiollet M. A double blind, placebo-controlled trial of a new veno-active flavonoid fraction (S 5682) in the treatment of symptomatic capillary fragility. Int Angiol. 1993; 12:69–72.
29. Miller MJ. Injuries to athletes. Evaluation of ascorbic acid and water-soluble citrus bioflavonoids in the prophylaxis of injuries in athletes. Med Times. 1960; 88:313–314.
30. Meyer OC. Safety and security of Daflon 500 mg in venous insufficiency and in hemorrhoidal disease. Angiology. 1994; 45:579–584.
31. Buckshee K, Takkar D, Aggarwal N. Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet. 1997; 57:145–151.
32. Bracke ME, Depypere HT, Boterberg T, et al. Influence of tangeretin on tamoxifen’s therapeutic benefit in mammary cancer. J Natl Cancer Inst. 1999; 91:354–359.
33. Strick R, Strissel PL, Borgers S, et al. Dietary bioflavonoids induce cleavage in the MLL gene and may contribute to infant leukemia. Proc Natl Acad Sci. 2000; 97:4790–4795.
34. Dr. William Mitchell ND

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Bowel Tolerance and Vitamin C Supplementation

Vitamin C has many important effects in the body. Its effects on enhancing the immune system are notable. In people with certain health conditions, it is desirable to give the body as much vitamin C as it needs. Each person, due to their own unique biochemical differences, has different vitamin C requirements. Also, a person’s vitamin C requirements can vary depending on their state of health. For example, a person in good state of health may only require 3 grams of vitamin C per day; however, when that same person gets a cold, their requirements may rise to combat infection.

Currently, there is no way to test how much vitamin C a person needs. One way to estimate your current vitamin C needs is based on bowel tolerance. The method for determining this is outlined below:

• Begin by taking ½ teaspoon (1000 mg) of powdered vitamin C per day, or one 1000 mg vitamin C capsule.
• Each subsequent day, increase your vitamin C dosage by ½ teaspoon or one capsule (1000 mg).
• Be sure to spread your doses of vitamin C throughout the day.
• Continue increasing your vitamin C dose by ½ teaspoon or one capsule until you experience loose stools. At this point, you have reached your tolerance of vitamin C and have taken too much.
• Decrease your dosage of vitamin C by ½ teaspoon or one capsule. If loose stools do not reoccur, this is your maximal dosage of vitamin C.
• If loose stools continue, decrease your dosage of vitamin C until they stop.

Please keep in mind that if you take vitamin C to tolerance when you are sick, your need for it may decrease as you recover. You will then experience bowel tolerance at a much lower dose. You will need to slowly lower your dosage until you find your new maximum dosage of vitamin C.

1000 mg = 1 gram of vitamin C

Resources
1. Mahan, Kathleen. Food, Nutrition and Diet Therapy. 1996. Saunders. Philadelphia PA.
2. Murray, Michael and Pizzorno, Joseph. Textbook of Natural Medicine.

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What is Naturopathic Medicine?

Naturopathic medicine is a distinct form of primary health care.

Naturopathic physicians are primary health care practitioners, whose diverse techniques include both modern and traditional methods of treatment.

The principles of naturopathic medicine are part of what distinguishes the naturopathic approach to health care from the conventional approach; and are based on objective observation of the nature of health and disease.

The following principles are the foundation of naturopathic medical practice:

The Healing Power of Nature “Vis Medicatrix Naturae”
Naturopathic medicine recognizes an inherent self healing process in the body which is ordered and intelligent. Naturopathic physicians act to identify and remove obstacles to recovery and to facilitate and augment this healing ability

First Do No Harm Primum Non Nocere
Naturopathic medicine follows three principles to avoid harming the patient: 1) utilize methods and medical substances which minimize the risk of harmful side effects; 2) avoid, when possible, the harmful suppression of symptoms; 3) acknowledge and respect the individual’s healing process, using the least force necessary to diagnose and treat illness

Find the Cause Tolle Causam
Underlying causes of illness must be identified and removed before complete recovery can occur. The naturopathic physician seeks to identify and remove the underlying causes of illness, rather than to eliminate or merely suppress symptoms

Treat the Whole Person
Naturopathic physicians treat each individual by taking into account physical, mental, emotional, genetic, environmental, social and other factors. Since total health also includes spiritual health, naturopathic physicians encourage individuals to pursue their personal spiritual development.

Prevention
Naturopathic physicians emphasize disease prevention, assessment of risk factors and hereditary susceptibility to disease and making appropriate interventions to prevent illness. Naturopathic medicine strives to create a healthy world in which humanity may thrive

Doctor as Teacher (Docere)
The original meaning of the word “doctor” is teacher. One of the main objectives of naturopathic medicine is to educate the patient and emphasize self –responsibility for health. Naturopathic physicians also acknowledge the therapeutic value of the doctor-patient relationship.

Wellness
Wellness follows the establishment and maintenance of optimum health and balance. Wellness is a state of being healthy, characterized by positive emotion, thought and action. Wellness is inherent in everyone, no matter what des-ease(s) is/are being experienced. If wellness is really recognized and experienced by and individual, it will more quickly heal a given dis-ease than direct treatment of the dis-ease alone. (This principle was adopted by Bastyr University and added to the original six principles)

Resources
1. Bastyr University 2001 / 2002 catalog
2. Position Papers and Organizational Documents or the AANP

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The Best Diet for Those with Depression

The term depression has several meanings:

(1) As a human affect, it arises from the disruption of life’s normal balance, usually following a loss, conflict or trauma

(2) It can be a symptom of an underlying medical condition or the side effect of a medication

(3) It’s also a clinical syndrome of varying severity, based on brain chemical (neurotransmitter) disturbances and

(4) Finally, depression can result from any combination of all three processes. The causes are not fully understood, but are many and varied.

Depression affects the entire body. In addition to the more noticeable affects on the nervous system, moods, thoughts and behavior, numerous studies in a field of research known as psychoneuroimmunology have shown that depression affects the functioning of every type of body cell. Immune functioning, allergies, bone density, cardiac and vascular functioning, endocrine balance, digestion, fertility, ageing and longevity—any and all aspects of our physiology are inextricably tied to our mental, emotional and spiritual health (or lack of).

People from all walks of life and of all ages suffer from depression and its prevalence seems to be increasing. It’s estimated that 5-12% of men and 10-20% of women in the U.S. will suffer from a major depressive episode at some time in their life. The percentage of teenagers diagnosed with clinical depression has increased five-fold over the past forty years.

Symptoms of depression typically include chronic fatigue, sleep disturbances, changes in appetite, headaches, backaches, digestive problems, irritability, loss of interest or pleasure in everything in general and feelings of worthlessness or inadequacy. Commonly there can be a preoccupation with death that sometimes results in suicidal ideation and/or attempts. Treatment options vary widely, though any given treatment does not necessarily work for everyone.

The Role of Diet in Depression
Diet greatly influences the brain’s behavior. The levels of brain chemicals known as neurotransmitters, which regulate our behavior and are closely linked to mood, are controlled by what we eat. The neurotransmitters most commonly associated with mood are dopamine, serotonin and norepinephrine. Deficiencies, excesses or imbalances of these cause mental and emotional disturbances and affect our perception of pain and pleasure. Neurotransmitters carry electrochemical impulses between cells. Serotonin plays a role in mood, sleep, relaxation and appetite. Dopamine and norepinephrine play a role in hunger, thirst, digestion, blood pressure regulation, heart rate, respiration, thermoregulation, aggression and sexuality.

Adequate protein consumption and absorption (requiring proper digestion) is essential in order to have enough precursor amino acid building blocks in order to synthesize any neurotransmitters. Their production also requires nutrients such as fatty acids, Vitamin B3, iron, folate, Vitamin B6, copper, calcium, magnesium and lecithin, among others. The absorption of precursor amino acids depends on the consumption of adequate complex carbohydrates.

Note: The dietary recommendations and guidelines below include foods to which some individuals may have allergies, intolerances and sensitivities. In those cases, those foods should be avoided. Persons taking medications should not consume any of the herbal teas described without first consulting your physician/clinician regarding potential interactions. Dietary choices should be modified to meet your personal dietary needs. Consult your physician/clinician for further information regarding nutrition and your individual medical condition.

Dietary Recommendations and Guidelines

• Avoid sugar and both artificial and natural sweeteners of all types, even honey, molasses and fruit juice. Stevia is an acceptable “sweetener”.
• Avoid alcohol, caffeine and soft drinks.
• Avoid junk food, processed and refined foods, foods high in saturated fats or hydrogenated (trans) fats. Healthy fat choices include polyunsaturated and monounsaturated fats and oils that are organic and cold-pressed.
• Identify and eliminate food allergies, intolerances and sensitivities. Gluten found in some grains has been linked to depressive disorders. Gluten-containing grains include wheat, spelt, rye, triticale, oats, barley and kamut.
• Eat adequate lean sources of protein (0.8 g/kg body weight daily). Emphasize wild, cold-water fish (salmon, halibut, mackerel, etc.), legumes, nuts and seeds. Organically raised poultry and eggs are also good protein sources. Fermented dairy products are also acceptable (yogurt, kefir, cheeses, etc.)
• Every meal and snack should be balanced, containing some protein, fat and complex carbohydrates.
• Food choices should be whole foods (unprocessed and unrefined), organic whenever possible, including at least five servings daily of vegetables and fruits. Grains should be whole and unrefined, especially rice, corn, quinoa, millet and amaranth. Fresh food is always preferable to frozen and frozen is always preferable to canned.

Note: In addition to dietary interventions, adequate daily exercise, sleep, full-spectrum lighting and counseling or other mental/emotional support are important factors in reversing depression and are prescribed in conjunction with supplements, botanicals and homeopathy.

Work on things gradually one at a time. Pick the improvements that you can easily make and start with those first. Inform your friends and family that you are trying to eat differently so that you will feel better. Ask for their support while making these changes. Depression is a serious condition that requires support from a physician, counselor, or other qualified therapist. Be sure to check with your health care provider before making any changes to your health care routine to ensure that you get the best care possible.

Resources
Balch, Phyllis and James. Prescriptions for Nutritional Healing, 3rd edition. 2000. Avery.
Brown, Kathleen. Herbal Teas: 101 Nourishing Blends for Daily Health and Vitality. 1999. Storey Books.
Hafen, Brent, et al. Mind/Body Health. 1996. Simon and Schuster.
McIntyre, Anne. Drink To Your Health: Delicious Juices, Teas, Soups and Smoothies That Help You Look and Feel Great. 2000. Gaia Books.

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Garlic’s Many Uses

Garlic, botanically known as Allium Sativum, is used for reducing high blood pressure, preventing age-related vascular changes, reducing reinfarction and mortality post-MI, decreasing LDL (bad) and VLDL cholesterol, and increasing HDL (good) cholesterol for coronary heart disease.

Garlic is also used in Chinese medicine for diarrhea, amoebic and bacterial dysentery, tuberculosis, bloody urine, diphtheria, whooping cough, scalp ringworm, hypersensitive teeth and vaginal trichomoniasis.

Traditionally, garlic has had many other uses as well, including the treatment of colds and flu, fever, cough, headache, stomach ache, sinus congestion, athlete’s foot, gout, rheumatism, hemorrhoids, asthma, bronchitis, shortness of breath, arteriosclerosis, low blood pressure, hypoglycemia, hyperglycemia, cancer, old ulcers, snakebites and as an aphrodisiac. In foods and beverages, garlic and its components are used for flavoring.

Effectiveness

The bulb and clove are the applicable parts of garlic. Garlic has proven effects that include antibacterial, antihelmintic (worms), antimycotic (fungal), antiviral, antispasmodic, diaphoretic, expectorant, fibrinolytic, hypotensive, promoting leukocytosis, lipid-lowering (total serum cholesterol, LDL cholesterol and triglycerides) and inhibiting platelet aggregation.

Possible Mechanism of Action and Active Ingredients

An odorless amino acid, alliin, is contained in intact garlic cells. When the intact cells are broken, alliin comes into contact with an enzyme called allinase and produces an unstable and odiferous compound called allicin (antibacterial). Further conversion of allicin yields the components E-ajoene and Z-ajoene (antithrombotic). Another constituent, allylpropyl disulfide, can reduce blood sugar while increasing insulin.

Safety

Typically, garlic is taken orally as a component of food or as a dietary supplement. This would be the equivalent of 1 clove fresh garlic taken 1-2 times daily. Garlic is safe in adults when ingested in amounts commonly found in foods and when used orally and appropriately in medicinal amounts. In larger amounts and topically, it is possibly unsafe. In children, large amounts taken orally can be dangerous or even fatal. There is insufficient reliable information available regarding topical use in children or in pregnancy and lactation. During pregnancy, when used in amounts typically found in foods, it is likely safe. However, larger amounts might predispose the onset of menstruation or uterine contractions. In lactation, it is contraindicated in amounts greater than is typically found in foods.

Adverse Reactions

Garlic has dose-related effects when taken orally that include breath odor, mouth and gastrointestinal burning or irritation, heartburn, flatulence, nausea, vomiting and diarrhea. It can produce changes in intestinal flora. There is one report of spinal epidural hematoma and platelet dysfunction with ingestion of fresh garlic and one report of post-operative bleeding and prolonged bleeding with high dietary garlic consumption. Topically, exposure can result in contact dermatitis and blistering.

Possible Interactions with Herbs and Other Dietary Supplements

EPA (Eicosapentanoic acid) in fish oil, when taken concomitantly with garlic, can enhance antithrombotic effects. The concomitant use of herbs that affect platelet aggregation and could theoretically increase the risk of bleeding in some people include angelica, anise, arnica, asafetida, bog bean, boldo, capsicum, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng (Panax), horse chestnut, horseradish, licorice, meadowsweet, prickly ash, onion, papain, passionflower, poplar, quassia, red clover, turmeric, wild carrot, wild lettuce, willow and others.

Possible Interactions with Drugs

ANTICOAGULANT DRUGS – can enhance the effects of Coumadin (warfarin)
ANTIPLATELET DRUGS – concomitant use may increase risk of bleeding with these drugs
HYPOGLYCEMIC DRUGS – concomitant use may increase the effects and adverse effects of these drugs
INSULIN – insulin dosage adjustments may be necessary

Possible Interactions with Lab Tests

BLOOD GLUCOSE – can lower blood glucose levels resulting in lower test results
BLOOD INSULIN – can increase blood insulin levels resulting in higher test results
INTERNATIONAL NORMALIZATION RATIO (INR) – there are two cases of increased INR associated with concomitant use of garlic and warfarin

Use garlic with caution in bleeding disorders, diabetes and infectious or inflammatory gastrointestinal conditions.

Note: The effectiveness of garlic dietary supplements is determined by their ability to yield allicin (which leads to the production of other active principles). To be effective, dried garlic preparations should be enterically coated to protect the constituents from stomach acid. Some products do not generate the amount of allicin equivalent to one clove of fresh garlic or contain no active compounds at all.

Resources

1. Blumenthal, M., et al. ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines.
2. Trans. S. Klein. Boston, MA: American Botanical Council. 1998.
3. Brinker, F. Herb Contraindications and Drug Interactions, 2nd edition. Sandy, OR: Eclectic Medical Publications, 1998.
4. Foster, S and Tyler, VE. Tyler’s Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies, 3rd edition. Binghamton, NY: Haworth Herbal Press, 1996.
5. Garty, BZ. “Garlic burns.” Pediatrics, 1993 Mar; 91: 658-59.
6. Gruenwald, J. et al. PDR for Herbal Medicines, 1st edition. Montvale, NJ: Medical Economics Company, Inc., 1998.
7. Incorporated Society, Nittendorf, West Germany. “Hypertension and hyperlipidemia: garlic helps in mild cases.” Br J Clin Pract Suppl, 1990; 69:3-6.
8. Jellin, JM, Batz, F, and Hitchens, K. Pharmacist’s Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. Stockton, CA: Therapeutic Research Faculty; 1999: pg. 407-409.
9. Leung, AY and Foster, S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 2nd edition. New York, NY: John Wiley & Sons, 1996.
10. McGuffin, M, et al., ed. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997.
11. McMahon, FG and Vargas, R. “Can garlic lower blood pressure? A pilot study.” Pharmacotherapy, 1993; 13(4): 406-407.
12. Newall, CA, Anderson, LA and Philpson, JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1994.
13. Robbers, JE, Speedie, MK and Tyler, VE. Pharmacognosy and Pharmabiotechnology. Baltimore, MD: Williams & Wilkins, 1996.
14. Silagy, CA and Neil, HA. “A meta-analysis of the effect of garlic on blood pressure.” J Hypertension, 1994; 12(4): 463-68.
15. Sunter, WH. “Warfarin and garlic.” Pharm J, 1991; 246: 722.

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What Was That I Should Take For My Memory Again?

Gingko is a medicinal herb from the leaves of the Gingko biloba or maidenhair tree. The gingko tree is an ancient plant, dating back at least 250 million years. It is the oldest living species of tree in the world and it survived to modern times only in the mountain forests of Eastern China. The tree itself can live as long as one thousand years.

Most often the herb is taken as a 50:1 standardized leaf extract—this means that 50 grams of dried gingko leaves have been processed down into 1 gram of extract in a way that preserves a standard amount of the constituents believed to be the most important medicinally (22-27% flavonoids glycosides, 5-7% terpene lactones including 2.8-3.4% ginkgolides, 2.6-3.2% bilobalide, and less than 5 parts per million ginkgolic acids).

Gingko is best known for its ability to increase blood flow to the brain and improve impaired memory and mental performance, especially in the elderly. However, gingko is one of the most researched herbs available, and it also has a number of other uses. It can decrease platelet aggregation and prevent strokes and other diseases related to emboli. It has been used for migraines, to delay the mental deterioration in early Alzheimer’s, and in treating tinnitus, vertigo and cochlear deafness. It is also used for diabetic retinopathy, retinal insufficiency, macular degeneration, cataracts, intermittent claudication, Raynaud’s disease, varicose veins, generalized peripheral arteriopathy, and erectile dysfunction. It can also decrease asthma symptoms.

WHO SHOULD NOT TAKE GINGKO?

Gingko leaf extract is very safe and its side effects are almost nonexistent. However, patients who are anticoagulant or antiplatelet medication such as Warfarin or aspirin should use gingko with caution. Along the same lines, gingko probably should not be used in cases of excessive bleeding or hemorrhagic disorders. It also may be contraindicated in anovulatory amenorrhea and infertility. Other drug interactions include possible potentiation of MAO inhibitors and papverine. Ginkgo can increase blood pressure used concomitantly with thiazide diuretics. The RAW leaf, stem and seed can cause GI discomfort, headache, dizziness, and in severe cases convulsions. If you are on any medications or have any chronic health conditions you should check with your physician before starting the use of any herbal medicine such as Ginkgo.

Resources
1. Brinker F. Herb Contraindications and Drug Interactions. Eclectic Medical Publications, Sandy OR, 1998.
2. Mills S, Bone K. Principles and Practice of Phytotherapy. Churchill Livingstone, New York, NY, 1999.
3. Jellin JM, Batz F, Hitchens, K. Pharmacist’s Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. Stockton, CA: Therapeutic Research Faculty; 1999: pg. 419-421.
4. Pizzorno J., et. al., The Textbook of Natural Medicine, 2nd Edition. Churchill Livingstone, New York, NY, 2000.
5. Tilgner S. Herbal Medicine from the Heart of the Earth. Wise Acres Press, Creswell, OR, 1999.

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Constipation Dietary Guidelines

Constipation refers to the incomplete (small stools) or infrequent (fecal mass remains in colon longer than the normal 24-72 hours after meal ingestion) passage of stools, as well as difficulty passing stools.

The condition can be acute or chronic.

Most people experience constipation from time to time, but usually lifestyle changes and improved dietary habits can help relieve the symptoms and prevent recurrences.

There is no standard for frequency of bowel movements, but most physicians recommend 1-2 bowel movements daily (based upon the frequency that is generally observed among healthy people who eat a high-fiber diet).

There are four categories of constipation:

• Functional constipation: Caused by insufficient dietary fiber and water, inadequate exercise, etc.
• Neurogenic or “spastic” constipation: Increased narrowing of the colon with small, ribbon-like stools caused or exacerbated by obstruction, stress, nervousness or anxiety (as in cases of cold, pain, grief, fear, etc.). It can also result from a repeated voluntary resistance of the urge to move the bowels. There may be some food allergies, as to milk or wheat, associated with this type of constipation. Drugs and some medical conditions can also decrease the natural peristaltic motion of the gut smooth muscle and increase the tendency for constipation. Low back pain, exacerbated by straining, may contribute.
• Atonic constipation (“lazy bowel”): This is a muscular weakness in the rectum and sigmoid colon, caused most often by laxative abuse. Other medical conditions such as hypothyroidism, pregnancy, emphysema and electrolyte imbalances (in the blood that supplies the muscles of the rectum) may also result in this type of constipation.
• Mechanical or “obstructive” constipation: Can be caused by fecal impaction, lesions that obstruct the bowel (tumor, pregnant uterus), inflammation (irritable bowel disease) or spasm from pain in the colon, rectum or anus.

Constipation can give rise to many different ailments, including appendicitis, halitosis (bad breath), body odor, coated tongue, depression, diverticulitis, fatigue, gas, headaches, hemorrhoids, hernia, indigestion, insomnia, malabsorption, obesity, varicose veins and the development of intestinal cancer. Regular bowel movements are important in the body’s detoxification process, as the colon serves as a holding tank for waste matter. Antigens and toxins from an unbalanced gut flora population may play a role in the development of many types of chronic disease.

Note: Your naturopathic treatment for constipation will vary according to the type of constipation you have. The dietary recommendations and guidelines below contain foods to which some individuals may have allergies, intolerances and sensitivities. In those cases, those foods should be avoided. Dietary choices should be modified to meet your personal dietary needs. Consult your physician/clinician for further information regarding nutrition and your individual medical condition.

Dietary Recommendations and Considerations

• In general, eat a high-fiber whole foods diet that includes vegetables, fruits, whole grains, legumes, nuts and seeds. The most efficient colon movers contain a combination of soluble and insoluble fiber. Soluble fiber dissolves in water, forming a gel that coats the intestinal wall. Insoluble fiber does not dissolve in water, but rather soaks water up like a sponge as it passes through the intestine, helping to prevent constipation.
• Foods highest in soluble fiber include adzuki beans, barley, dried beans and peas, beets, cabbage, carrots, oats, okra and some fruits, especially apples, apricots, bananas, blackberries, blueberries, citrus, cranberries, figs, grapes, melons, peaches, pears and prunes. Psyllium, slippery elm (Ulmus Fulva) and marshmallow (Althaea Officinalis) are also high in soluble fiber.
• Foods highest in insoluble fiber include cereals and whole grains, brans, seeds (like ground flax or psyllium seed), and the skins or peels of many fruits and vegetables.
• Avoid dairy products, soft drinks, meat, refined carbohydrates, sugar and processed foods, salt, alcohol and coffee.
• Drink more water. This is particularly more important when adding more fiber to your diet. Drink at least 64 ounces daily. Rule-of-thumb for water consumption: one third of your body weight in ounces plus 8 ounces for each cup of coffee or tea (diuretics), plus 8 ounces for each one half hour of exercise daily.

Mango, Peach, and Grape Nectar: Blend together 1 peeled and sliced mango, 2 peeled and sliced peaches, 4 ounces white grapes, 1-1/4 cups soy milk/rice milk or nut milk, ½ teaspoon ground cinnamon.

Beet and Carrot Cleanser: Juice together 3 large carrots and 2 beets. Garnish with chopped fresh cilantro.

Can’t Beet It: ¼ cup raw grated beet, ¾ cup carrot juice, ¾ cup apple juice, 1-1/2 cups frozen diced papaya, 2 teaspoons fresh lime juice, ¼ teaspoon grated fresh ginger. Blend until smooth.
Almond Regulator: Blend together 2 ripe bananas, ½ cup ground almonds (almond butter), 2/3 cup fresh orange juice, 2/3 cup plain yogurt, and 1 Tablespoon honey. Serve sprinkled with nutmeg.
Fiber Burst: Blend together ½ cup maple yogurt, 2/3 cup buttermilk, 1/3 cup pitted chopped dates, 2 sliced frozen bananas, 2 Tablespoons bran, 2-3 crushed ice cubes.

Resources
Balch, Phyllis and James. Prescriptions for Nutritional Healing, 3rd edition. 2000. Avery.
Barber, Mary C. and Whiteford, Sara C. Super Smoothies. 2000. Chronicle Books.
Escott-Stump, Sylvia. Nutrition and Diagnosis-Related Care, 4th edition. 1998. Williams and Wilkins.
McIntyre, Anne. Drink To Your Health: Delicious Juices, Teas, Soups and Smoothies That Help You Look and Feel Great. 2000. Gaia Books Ltd.

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Gout Prevention Diet

Gout is a common type of arthritis that occurs when there is too much uric acid (sodium urate) in the blood, tissues and urine.

The uric acid that accumulates ultimately crystallizes and takes on a needle-like shape, jabbing into the joints (big toe, mid-foot, ankle, knees, wrists, and fingers).

Acute joint pain is usually the first symptom, then the joints become inflamed—red, hot, swollen and extremely sensitive to touch. Repeated gout attacks can eventually lead to joint damage.

The uric acid that accumulates is the end product of the metabolism of a class of compounds known as purines. If there is a physiological deficiency of the digestive enzyme uricase, then uric acid is not made sufficiently water-soluble and it accumulates and crystallizes, especially at lower temperatures, which may explain why joints in the extremities are most affected.

Approximately 70% of those who suffer from gout actually produce too much uric acid while the other 30% cannot properly make uric acid water-soluble and eliminate it. About 25% have a family history of gout. Poor kidney function can also play a role in the development of the disease.

Uric acid is the byproduct of certain foods, so there is a significant relationship between diet and the development of gout. Historical depictions of King Henry the VIII of England often illustrate him with his toe or foot bandaged and elevated, suffering the pain of gout.

Gout has been called the “rich man’s disease” since it is associated with obesity and the consumption of too much rich food and alcohol. However, it affects people from all walks of life, most commonly men (90%) between the ages of 40 and 50. Besides the propensity for developing gout that can be inherited, calorie-restrictive dieting, drinking, certain medications, overeating, stress, surgery or injury to a joint can also bring on attacks. Uric acid kidney stones may also be related to the condition.

Several other diseases, including rheumatoid arthritis, infections and pseudogout, can mimic the joint symptoms of gout. Pseudogout is another form of arthritis that occurs in the larger joints—usually knees, wrists or ankles—caused by the development or deposition of calcium pyrophosphate dihydrate crystals. The best method for getting a definitive diagnosis of gout is by taking a joint fluid sample by needle aspiration and examining the joint fluid for the characteristic uric acid crystals.

Note: The dietary recommendations and considerations described below contain foods to which some individuals may have food allergies, intolerances and sensitivities. In those cases, those foods should be avoided. Dietary choices should be modified to meet your personal dietary needs. Consult your physician/clinician for further information regarding nutrition and your individual medical condition and for a comprehensive gout prevention/management protocol.

The basic treatment goals involve: (1) dietary and herbal measures that maintain uric acid levels within the normal range (2) controlled weight loss in overweight individuals (3) avoidance of known precipitating factors (alcohol, diet, etc.) (4) the use of nutritional substances to prevent further attacks and (5) the use of herbal and nutritional substances to inhibit the inflammatory process. Urinary 24-hour uric acid levels can be used to monitor the effectiveness of dietary therapy.

Dietary Recommendations

• Avoid refined sugar, particularly sucrose and fructose, refined carbohydrates, alcohol.
• Avoid foods high or moderate in purines (organ meats and sweetbreads, meats, mincemeat, consommé, meat gravies and broths, shellfish, brewer’s and baker’s yeast, herring, sardines, mackerel, mussels, anchovies, legumes, peanuts, spinach, asparagus, fish, poultry and mushrooms). Thyme and thyroid extracts can also pose a problem if taken for extended periods of time.
• Increase complex carbohydrate and decrease fat ingestion. Protein intake should be moderate (not greater than 0.8g/kg body weight). Moderate consumption of cold-water fish as part of overall protein intake is indicated (see below). During an acute attack, rely on fruits and vegetables for two weeks. Juices are excellent, especially cherry juice.
• Also, drink celery juice diluted with filtered or distilled water. Blueberries, cherries and strawberries help to neutralize the uric acid and are full of antioxidant nutrients. Foods high in Vitamin C will also help to neutralize and eliminate uric acid (peppers, citrus). Omega-3 essential fatty acids that are found in cold water fish like halibut, salmon and tuna, for example, are anti-inflammatory and likely beneficial in this condition.
• Liberal fluid (water) intake dilutes the urine, reduces the risk of kidney stones and increases the excretion of uric acid. Drink at least 64 oz. of water daily. Rule-of-thumb for water consumption: One third of your body weight in ounces, plus 8 ounces for each cup of coffee or black tea and 8 ounces for each half hour of exercise.

Resources
1. Balch, Phyllis and James. Prescriptions for Nutritional Healing, 3rd edition. 2000. Avery.
2. Murray, Michael and Pizzorno, Joseph. Encyclopedia of Natural Medicine, Revised 2nd edition. 1998. Prima Health.

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The Mediterranean Diet

This diet is based on the diet typically consumed on the island of Crete that is high in omega-3 essential fatty acids, monounsaturated and polyunsaturated fats, healthy protein sources (fish, legumes, etc.) and complex carbohydrates. Fat calories account for 35-45% of total calories.

Omega-3 essential fatty acids have the potential to block and prevent all of the steps of the genesis and evolution of heart disease and heart attack: damage to the arterial wall, inflammation, plaque formation via oxidized LDL cholesterol, plaque accumulation, final blockage of the coronary artery and arrhythmia.

They will also assist in reversing the process that may already be advanced.(1)

Clinically speaking, this amounts to lowering blood levels of total and LDL cholesterol and triglycerides, maintaining or raising blood HDL cholesterol levels, improving blood insulin and glucose levels and decreasing blood pressure. Proof of the diet’s efficacy comes from two main studies: the Lyon Diet Heart Study and the Diet and Reinfarction Trial (DART). (2, 3)

In the 1989 DART study in England, two thousand men who were recovering from recent heart attacks were assigned to one of three quite different diets:

1. High fiber
2. Low saturated fat and high in omega-6 oils (standard heart diet)
3. A diet high in omega-3 fatty acids from fatty fish or supplements.

The patients on the high omega-3 fatty acids diet had a 29% lower death rate, which at the time was the greatest reduction in mortality from any heart diet.(4)

In a study of heart attack patients, those on the Mediterranean diet had a 76% lower risk for major cardiovascular events (subsequent heart attack, unstable angina and stroke) compared to a similar group of heart attack patients on a standard American diet.(5)

Concerns regarding the Mediterranean diet are the extra calories from the high olive oil intake, decreased iron and decreased calcium because of decreased dairy intake. Cooking in cast iron pans, consuming foods high in iron, calcium and Vitamin C or supplementing these nutrients will avoid these deficiencies.(6)

Note: The following dietary guidelines may include foods to which some individuals may have allergies, sensitivities or intolerances and in those cases those foods should be avoided. Dietary choices should be made according to your own individual needs.

Consult your physician for nutritional information pertaining to your specific medical condition(s). In the case of patients with heart disease, your naturopathic team will design a comprehensive treatment protocol that will likely include diet, exercise, stress management, supplements and other modalities.

DIETARY GUIDELINES FOR THE MEDITERRANEAN (OMEGA) DIET

• Eat foods rich in omega-3 fatty acids such as fatty fish (salmon, tuna, trout, herring, mackerel), walnuts, canola oil, flaxseeds and green leafy vegetables. Omega-3 fatty acids can also be supplemented.
• Use olive oil and canola oil as your primary fat sources.
• Eat seven or more servings of fresh vegetables and fruits daily.
• For protein sources, rely on fish and vegetable protein including legumes, beans, peas and nuts.
• Avoid saturated fat by choosing lean meat over fatty meat. Eat red meat only a few times a month, if at all.
• Choose nonfat or low fat over full-fat dairy products.
• Avoid oils that are high in omega-6 fatty acids including corn, safflower, sunflower, soybean and cottonseed oils.
• Minimize your intake of trans-fats by avoiding margarine, vegetable shortening, commercial pastries, deep fat fried foods and most prepared snacks, mixes and convenience food.
• Season with garlic, onions, herbs.
• Focus on high fiber from whole fruits, vegetables and whole grains.
• Enjoy a glass of red wine occasionally.

Resources
1. Simopoulos, Artemis P. MD and Robinson, Jo. The Omega Diet: The Lifesaving Nutritional Program Based on the Diet of the Island of Crete. 1999. HarperCollins, NY.
2. Renaud S and Paul T. “Cretan Mediterranean diet for prevention of coronary heart disease.” Am J Clin Nutr, 1995; 61 (supp) 1360S-7S.
3. Burr ML, Gilbert JF and Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial infarction: Diet and Reinfarction Trial (DART). The Lancet, 1989. September 30, 1989: 757-761.

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Natural Treatments for Arthritis

The most common form of arthritis is osteoarthritis. The term ‘osteoarthritis’ refers to local or general degeneration of the articular cartilage and the formation of bone “lips” and “spurs” at the margin of joints. Affected joints typically have symptoms of unilateral or bilateral stiffness, pain and reduced range of motion that worsen over time. Joints that are most commonly affected include the first joints of the fingers and toes, the spine, the knees and hips. The onset is gradual and typically occurs in people over the age of 45.

NATUROPATHIC TREATMENT GOALS AND CONSIDERATIONS

• Focusing on the naturopathic principles (Vis Medicatrix Naturae/The Healing Power of Nature, Primum Non Noncere/First Do No Harm, Docere/Doctor as Teacher, Tolle Causam/Find and Treat the Cause, Wellness, Treat the Whole Person, Prevention)
• Being mindful of the hierarchy of therapeutics (foundations of health, stimulate the vital force, most gentle to more aggressive treatment approaches, etc.)
• Achievement and maintenance of normal body weight
• A whole foods diet that involves the elimination of simple and refined carbohydrates, increasing complex carbohydrates (fresh vegetables and fruits) with adequate whole grains, minimizing saturated fats, optimizing essential fatty acid ratio (omega-3: omega-6) and containing adequate protein
• Elimination of the Solanacea family foods (nightshades) such as tomatoes, potatoes, eggplant, peppers and tobacco
• Avoiding processed foods, food additives and preservatives
• Elimination of food allergens and intolerances
• Healing inflammation in the gastrointestinal tract, optimizing the intestinal microorganisms, restoring optimal functioning throughout, etc.
• Restoring a healthy balance of alkalinity/acidity to the body tissues
• Maintaining adequate hydration by eliminating diuretic beverages (coffee, tea, sodas, etc.) and increasing filtered water intake (general goal is 8-8ounce glasses daily).
• Ensuring adequate intake of vitamins, minerals and essential fatty acids via diet and supplementation
• General detoxification and five system elimination (skin, lungs, colon, kidneys, liver)
• Further supplementation and/or treatment with various nutrients, botanicals and homeopathy (glucosamine and chondroitin sulfate, SAMe, MSM, Yucca, Sarsaparilla, Devil’s claw, Turmeric, Hawthorne, cherries and blueberries (bioflavanoids), grape skin extract, Black cohosh, Crampbark, Willow, Dandelion, Nettles, Burdock, etc.)
• Regular physical exercise including aerobics, flexibility, strength training, isometrics, etc.
• Physical medicine treatments including peat baths and packs, short wave diathermy, moist and dry heat applications, hydrotherapy, hyperthermia, therapeutic ultrasound, etc.

Resources
Alschuler ND, Lise
Groven ND, Mark
Little ND, John
Zeff ND, Jared

©KitchenTableMedicine.com, LLC ™

Osteoporosis Prevention and Management Diet,

Read all of our articles on osteoporosis.

Osteoporosis is a disease characterized by low bone mass and the deterioration of bone tissue, both mineral and nonmineral matrix, leading to enhanced bone fragility and a consequential increase in fracture risk.

In these patients, bone density has been reduced to 2.5 (or more) standard deviations below the young adult mean bone density.

Diminished bone mass can result from a failure to reach optimal bone mass early in adulthood, from increased bone resorption, or from decreased bone formation after peak bone mass has been achieved.

Presumably, in osteoporosis, the rate of bone formation is inadequate compared to the rate of bone resorption and so there is an inability to maintain the structural integrity of the bones of the skeleton.

In the United States, the estimated prevalence of osteoporosis is high, affecting 20-30 million people.

The major risk factors for osteoporosis are increased age, female gender, white or Asian race, positive family history of osteoporosis and thin body build. Other risk factors include decreased lifelong exposure to estrogen, low calcium intake (affected also by low stomach acid and Vitamin D deficiency), sedentary lifestyle (lack of weight-bearing exercise), cigarette smoking, chronic alcohol and drug use, and diet.

The primary goals in the treatment and prevention of osteoporosis are to:

(1) Preserve adequate mineral mass.

(2) Prevent loss of the protein matrix and other structural bone component.

(3) Assure optimal repair mechanisms to repair damaged areas of bone.

Note: At present, there is conflicting scientific information available regarding the benefits and/or risks of soy (or other phytoestrogen-containing foods) consumption by individuals with estrogen receptor positive breast cancer lesions. In such cases, consumption of phytoestrogen-containing foods (such as soy) by these individuals is a personal decision that their physician/clinician can guide them in making.

In addition, the dietary suggestions below include foods to which some individuals may have allergies, intolerances or sensitivities and, in those cases, those foods should be avoided. Dietary choices should be modified to meet your personal dietary needs.

Persons taking medications should not consume any of the herbal teas described without first consulting your physician/clinician regarding potential interactions. See your physician/clinician for further information regarding nutrition and your individual medical condition.

Dietary Considerations

• Avoid sugar, refined carbohydrates, coffee, soft drinks and alcohol.
• Choose whole foods, especially organic, whenever possible. Eat a variety of them, vegetables and fruits especially, paying special attention to those foods that are high in bone-supporting nutrients: calcium, magnesium, boron and other minerals, Vitamins A, D, E and K, B vitamins, C, etc. The boron in pears, for example, helps to prevent osteoporosis. The vitamin E and calcium in almonds, for example, also make this food a good choice.
• Fresh foods are always preferable to frozen and frozen foods are always preferable to canned.
• Avoid excessive intake of animal protein as well as overall protein deficiency. Daily protein goal is 0.8g/kg body weight.
• Excess protein can lead to a high metabolic production of acids that can leach minerals from the bones.Rely more on plant protein sources such as legumes, nuts and seeds, as opposed to meat, poultry, eggs and dairy products. Cold-water fish (halibut, mackerel, salmon, tuna, etc.), in moderation, is still a good protein source and has other nutritional benefits, such as omega-3 essential fatty acids and Vitamin D.
• A diet high in vegetables and fruits favors an optimal physiological phosphorus/calcium ratio and acid/alkaline balance, preventing the accelerated calcium loss that is observed in individuals who consume a diet high in meat, dairy products and grains.
• Use organic low-fat or non-fat dairy products and dark green leafy vegetables that are high in absorbable calcium. The vegetables highest in calcium (in order of calcium content) include turnip greens, lambs quarters (herb), collard greens, rhubarb, spinach, broccoli, dandelion greens, mustard greens and kale.
• Other non-dairy foods that contain significant calcium include oatmeal, fortified rice milk/soy milk/nut milk, soybeans and tofu, sesame seeds and tahini, sea vegetables, chick peas, molasses, almonds, filberts, chestnuts, baked beans, oranges, halibut, flounder, clams, oysters, shrimp, canned sardines or salmon with bones.
• Eat salads and dark green leafy vegetables with lemon juice or cider vinegar to help increase calcium absorption.
• Some studies indicate that foods such as spinach, chard, beet greens and chocolate contain oxalates that bind with calcium, preventing its absorption.
• Phytic acid found in wheat and oats will bind calcium and prevent its absorption.
• Drink two to four cups daily of Amanda’s Bone-Building Tonic Tea (recipe below).

Amanda’s Bone-Building Tonic Tea

• 3 parts wild oats
• 2 parts horsetail stalks
• 2 parts dandelion leaves
• 2 parts dandelion root
• 2 parts nettle leaves
• 2 parts chickweed plant (whole plant)
• 1 part yellow dock root

Combine all herbs and make a decoction by simmering one ounce of this mixture in one quart of water, covered for 20-30 minutes. Strain and drink 2-4 cups daily.

Consult your physician/clinician for a comprehensive osteoporosis prevention or management plan that is tailored to fit your individual medical and personal needs.

Resources
1. Brown, Kathleen. Herbal Teas: 101 Nourishing Blends for Daily Health and Vitality. 1999. Storey Books, Inc.
2. Marz, Russell B. Medical Nutrition From Marz, 2nd edition. 1999. Omni-Press.
3. McIntyre, Anne. Drink to Your Health: Delicious Juices, Teas, Soups and Smoothies That Help You Look and Feel Great. 2000. Gaia Books Ltd.
4. Pollack, Jeanine. Healing Tonics. 2000. Storey Books, Inc.

©KitchenTableMedicine.com, LLC ™

Immune Support Diet

The single, most important thing that we can do to support our immunity and prevent disease is to eat a balanced, whole foods diet. For most people, this means eating more fruits, vegetables, beans, nuts and whole grains.

These foods contain literally thousands of named and unnamed compounds that influence the composition of all of our body’s cells and enhance cell-to-cell communication. Some of these compounds reduce inflammation and some detoxify the body. Other compounds make it easier for nutrients to pass in and out of cells, while still others activate the enzymes that block uncontrolled cell division (as in cancer cells).

Most of these foods are also great sources of compounds called “antioxidants” that protect our cells from attack by neutralizing harmful molecules called free radicals that have been implicated in causing cancer, heart disease, stroke, and other ills.

Of course, many factors contribute to the development of these ills, including poor eating habits, but it is now believed that a high-fat, high-calorie diet is as harmful as smoking is, in the development of cancer, triggering up to 75% of colorectal and 50% of breast cancer cases. Numerous studies have now made clear that the more fruits and vegetables you consume, the lower your risk of disease will be. Eating the minimum of five servings of fruits and vegetables daily can lower your cancer risk by 20%. Eating more than five servings will benefit you more still.

It is believed that nutrients are better absorbed from food than from pills and that foods work synergistically—their health benefits being greater when eaten together than when the foods are eaten separately. Perhaps supplements can never replicate the benefits of a healthful, varied diet. Of course, absorption of any nutrients depends first upon good digestion.

AN IMMUNE-BOOSTING EATING PLAN*

*Note: The following 7-day menu plan is intended to strengthen the immune system and is not designed to be hypoallergenic. It may contain foods to which some individuals have food allergies, intolerances or sensitivities and, in those cases, those foods should be avoided. (For example, individuals with gluten (gliadin) intolerance should avoid wheat, spelt, rye, triticale, oats, barley and kamut. Individuals with Herpes simplex should routinely avoid peanuts, nuts, seeds, chocolate, wheat germ, granola and coconut. During active outbreaks, many other foods such as whole grains, legumes, sprouts, carob, vegetables with edible seeds and citrus fruits should also be avoided.)

This diet should be modified to meet your personal dietary needs. See your clinician for further information regarding nutrition and your individual medical condition.

Day 1

Breakfast

• Phyto-Cocktail: Place in a blender 2 cups frozen blueberries, 1 cup silken tofu, 1 cup calcium enriched soy milk or nonfat milk, 1 tablespoon honey, 1 tablespoon ground flaxseed, ¼ teaspoon grated lemon zest. Puree.

Lunch

• Broccoli-Stuffed Baked Potato: In a small nonstick skillet heat 1 teaspoon olive oil. Add 1/8 teaspoon red pepper flakes. Cook for 1 minute. Add 1-1/2 cups broccoli and ½ cup chicken broth, cover. Simmer until tender-crisp. Cut 1 baked potato in half lengthwise. Scoop out pulp, leaving skin intact. Mash and combine with broccoli mixture, ¼ cup plain nonfat yogurt and 2 teaspoons grated Parmesan. Refill skins. Bake 30 minutes at 350 F.

• Crunchy Salad: In a medium bowl, combine 1 cup cauliflower florets, ¼ cup grape tomatoes, 2 tablespoons diced red bell pepper, 1 tablespoon finely chopped cilantro and 1 scallion. Add 1 tablespoon lemon juice mixed with 2 teaspoons olive oil. Salt to taste.
• One cup Vegetable Juice

Snacks

• 1 orange
• 1 ounce dark chocolate

Dinner

• Fish in Wine Sauce: Place a 5-ounce mackerel or tuna fillet on a 12-inch piece of foil. Top with 1 tomato, chopped; 1 red pepper, sliced; 1 tablespoon white wine; 2 teaspoons fresh tarragon, chopped. Season with salt and pepper. Top with a lemon slice. Fold the foil into a pouch to enclose the fish. Bake at 475 F for 10 minutes or until the fish flakes easily.

Dessert

• Strawberry Shortcake: Top 1 piece angel food cake with ½ cup nonfat yogurt, flavored with 1 teaspoon vanilla extract and 1 tablespoon honey, and ½ cup sliced strawberries.
• One cup calcium-enriched soy milk, rice milk, nut milk or nonfat milk

Day 2

Breakfast

• French Toast: In a blender, puree ¼ cup silken tofu and combine with ¼ cup calcium-enriched vanilla soy milk or nonfat milk. Add 1/8 teaspoon ground cinnamon and 1/8 teaspoon ginger. Heat a nonstick skillet coated with cooking spray over medium-high heat. Dip 2 pieces whole-grain bread in mixture, soaking both sides. Cook in skillet until browned on both sides, about 5 minutes. Drizzle with honey.

• One whole orange or ½ cup orange juice

Lunch

• Tuna-Tofu Caesar Salad: Make dressing by pureeing ¼ cup silken tofu, 2 teaspoons red wine vinegar, 1 teaspoon olive oil, 1 tablespoon water, ¼ teaspoon Worcestershire sauce, ¼ teaspoon Dijon mustard and ¼ teaspoon anchovy paste. Toss with salad consisting of 2 cups torn romaine lettuce leaves and 4 ounces canned, water-packed tuna, drained; 1 tomato, sliced; ¼ cup red onion, thinly sliced; ¼ cup cucumber, sliced; and ¼ cup croutons

Snacks

• 2 cups cubed watermelon
• 1 ounce raw cashew nuts

Dinner

• Shiitake Chicken: In a medium nonstick skillet coated with cooking spray, brown 4 ounces of boneless, skinless chicken breast, cut into 1-inch strips, seasoned with salt and pepper. Add 1 cup sliced fresh shiitake mushrooms, ¼ teaspoon dried thyme, 2 teaspoons olive oil and a pinch of salt. Stir, browning for 5 minutes. Add 2 tablespoons red wine to skillet. Simmer 2-3 minutes.
• Steamed ½ acorn squash, sprinkled with 1/8 teaspoon ground cinnamon

Dessert

• 1 cup flavored nonfat yogurt with 1 ounce raisins

Day 3

Breakfast

• 1 cup tomato juice
• 1 whole wheat bagel, toasted, drizzled with ½ teaspoon olive oil and topped with tomato slices
• ½ cup nonfat yogurt with 1 tablespoon walnuts and ¼ cup diced papaya

Lunch

• Gazpacho: In a food processor or blender, finely chop 1 scallion, ½ red bell pepper, ¼ cucumber, 1 teaspoon minced basil, and 1 teaspoon snipped dill. Mix with 2 cups spicy vegetable juice, 1 teaspoon olive oil, and 1 tablespoon red wine vinegar.
• 1 piece crusty whole-grain bread topped with 1 tablespoon goat cheese

Snacks

• Cherries Jubilee: In a blender, puree 1 cup frozen cherries, 1 cup calcium-enriched vanilla soy milk, 1 tablespoon honey, and 1/8 teaspoon cinnamon. Blend until smooth.
• 1 pink grapefruit
• 1 cup green tea

Dinner

• Lemon-Garlic Grilled Salmon: Combine 1 tablespoon soy sauce, 1 tablespoon olive oil, 2 teaspoons fresh minced ginger, 1 teaspoon chopped garlic, and ½ teaspoon grated lemon zest. Marinate a 5-ounce salmon fillet in this mixture for 30 minutes. Grill until fish flakes easily.

Dessert

• Sweet Potato Delight: Cut 1 baked sweet potato in half lengthwise. Top with 2 tablespoons walnuts, 2 tablespoons mini marshmallows, and 1 tablespoon semi-sweet chocolate chips. Broil 6 inches from heat, until marshmallows are golden brown.

Day 4

Breakfast

• Top 1 cup nonfat yogurt with ½ cup sliced strawberries, ¼ cup diced kiwi, and 2 tablespoons bran.
• 1 cup green teaLunch
• Sardine Sandwich: Combine 2 tablespoons nonfat sour cream, 1 tablespoon Dijon mustard, 1 teaspoon snipped dill, and ¼ teaspoon grated lemon zest. Spread mixture on two pieces pumpernickel bread and top with 2 tomato slices, 2 slices red onion, and 4 cucumber slices. Top each half with 3 canned sardines.
• Watercress Salad: Combine 2 teaspoons olive oil, 2 teaspoons orange juice, 1 teaspoon mustard, and a ½ teaspoon honey. Toss with 2 cups watercress.

Snacks

• 1 ounce dark chocolate
• 1 cup green tea

Dinner

• Tuna with Corn Salsa: Combine ½ cup frozen corn kernels, thawed; ½ cup canned black beans, drained; and ¼ cup roasted red peppers, chopped. Add 1 teaspoon orange juice, 1 teaspoon olive oil, and 1 teaspoon chopped cilantro. Season 5 ounces of fresh tuna with salt and pepper. Grill or broil 4 inches from heat for 6-8 minutes. Top with corn salsa.
• Spinach Salad: Combine 2 teaspoons chopped onion, 1 tablespoon olive oil, 2 teaspoons balsamic vinegar, and 1/8 teaspoon poppy seeds. Toss with 2 cups torn spinach leaves.

Dessert

• Old-Fashioned Baked Apple: Place 1 Granny Smith apple, cored, in a small baking dish. Fill hole with 2 tablespoons raisins, 1 tablespoon chopped walnuts, and 1/8 teaspoon cinnamon. Pour 1 tablespoon orange juice in bottom of baking dish. Cover. Bake at 350 F until tender. Top with nonfat vanilla yogurt.

Day 5

Breakfast

• 1-1/2 cups wheat bran flakes topped with ¼ cup raisins and 1 cup calcium-enriched soy milk, rice milk, nut milk or nonfat milk
• 1 cup cubed cantaloupe

Lunch

• Shrimp Salad Pita: Combine 5 ounces cooked shrimp, chopped, with 1 tablespoon mayonnaise, 2 tablespoons diced celery, ½ teaspoon snipped dill, ¼ teaspoon grated lemon zest, and 1/8 teaspoon chopped garlic. Fill 1 whole-wheat pita with shrimp salad mixture and 1 cup watercress.

Snacks

• 1-1/2 cups frozen red grapes
• 1 cup green tea

Dinner

• Pork with Carmelized Onions: In a nonstick skilled coated lightly with olive oil, brown 4 ounces boneless pork loin (one inch thick) seasoned with salt and pepper, then remove. In same skillet, cook 2 medium onions, sliced, and ½ teaspoon thyme in 2 teaspoons olive oil over medium-low heat until golden brown, about 20 minutes. Increase heat to
medium; add pork, 2 tablespoons balsamic vinegar, and 2 tablespoons chicken broth. Cover. Cook 8-10 minutes.
• Savory Pumpkin Puree: In a small saucepan, mix ½ cup canned pumpkin puree, 1 tablespoon chicken broth, 2 teaspoons honey or sugar, 1/8 teaspoon cinnamon, and 1/8 teaspoon grated fresh ginger. Cook, stirring, 5 minutes.
• Cheesy Cauliflower: Steam 2 cups cauliflower florets until tender. In a medium bowl, toss cauliflower with 1 tablespoon grated Parmesan cheese, 1 teaspoon olive oil, ¼ teaspoon grated lemon zest, a pinch of salt, and a pinch of cayenne.

Dessert

• Peanut Butter and Honey Crunch: Stir 2 tablespoons of peanut butter in 1 cup nonfat yogurt. Sprinkle with sunflower seeds. Drizzle with honey.

Day 6

Breakfast

• Honey Raisin Oatmeal: Cook 1 cup oatmeal in 2 cups nonfat soy milk, rice milk, nut milk or nonfat milk. Mix in ¼ teaspoon cinnamon and 2 tablespoons raisins.
• 1 cup green tea

Lunch

• Salmon-Chickpea Salad: Crumble 4 ounces cooked salmon over 1-1/2 cups baby greens and ½ cup cooked chickpeas. Toss with ½ tomato, diced; ¼ red onion, diced; and ½ teaspoon chopped fresh mint. Toss again with 1 teaspoon olive oil and 1 teaspoon cider vinegar.

Snacks

• 1 cup baby carrots dipped in 2 tablespoons low-fat blue cheese dressing
• 1 apple

Dinner

• Garlicky Pesto Pasta: In a blender, finely grind 1 teaspoon pine nuts and a pinch of salt. Add ¼ cup packed basil leaves, ¼ cup packed parsley leaves, and 1 clove garlic, peeled. Blend well. Add 1 tablespoon olive oil and process until smooth. Add 2 teaspoons grated Parmesan. Blend well. Toss with 1-1/2 cups cooked, warm whole wheat or high protein (lentil) pasta.
• Pepper-Tomato Salsa: In a large bowl, combine 1 cup diced red, yellow, or orange bell peppers; ½ tomato, seeded and diced; ½ tablespoon lemon juice, ½ tablespoon chopped fresh green chilies, ½ tablespoon minced cilantro, 1 teaspoon minced onion, and ½ tablespoon balsamic vinegar. Let stand one hour.
• 1 cup red wine or sparkling grape juice

Dessert

• Tropical Sundae: Top 1 cup diced mango with a dollop of nonfat yogurt, flavored with 1 teaspoon vanilla extract and 1 tablespoon honey. Sprinkle with 2 teaspoons chocolate chips and 2 teaspoons crushed walnuts.

Day 7

Breakfast

• Top 1 whole grain frozen waffle with ¼ cup blueberries and ¼ cup sliced strawberries. Sprinkle with cinnamon.
• 1 cup unsweetened grapefruit juice

Lunch

• Pepper-Garlic Pizza: Drizzle one 5-inch whole grain prepared pizza crust with ½ teaspoon olive oil. Spread ½ cup seasoned tomato sauce over crust. Top with ½ cup sliced red or yellow bell pepper, 2 tablespoons chopped onion, ¼ teaspoon minced garlic, 1/8 teaspoon dried basil, 1/8 teaspoon dried oregano, and ¼ cup shredded part-skin mozzarella cheese. Bake in 350 F oven until cheese bubbles.
• 1 whole orange or ½ cup orange juice

Snacks

• Banana S’More: In a microwave-safe bowl, cover 2 graham crackers with 1 sliced banana. Top with 2 tablespoons mini-marshmallows and microwave on high for 30-second intervals until marshmallows begin to melt. Drizzle with 1 tablespoon chocolate syrup or sauce.
• 1 cup calcium-enriched soy milk, rice milk, nut milk or nonfat milk

Dinner

• Lentils with Couscous: In a medium saucepan over medium-high heat, combine 1 cup cooked red lentils with ½ teaspoon olive oil, ½ teaspoon minced fresh garlic, 1/8 teaspoon turmeric, ¼ teaspoon grated lemon zest, 1 tablespoon chopped onion, and 1 tablespoon chopped celery. Heat through and toss with 1-1/2 cups cooked couscous.
• 1 cup chopped broccoli, steamed with 1 teaspoon lemon zest and 1 clove garlic, peeled and sliced

Dessert

• Fruit and Yogurt Parfait: In a small glass, alternate ½ cup nonfat yogurt (flavored with 1 teaspoon vanilla extract and 1 tablespoon honey) with ¼ cup sliced kiwi and ¼ cup diced pears. Top with a dollop of nonfat yogurt and 1 tablespoon slivered almonds.

Resources
Cavanaugh, Christopher (Editor-in-Chief). Strengthen Your Immune System. 2001. The Reader’s Digest Association, Pleasantville, NY.

©KitchenTableMedicine.com, LLC ™

What is Ayurvedic Medicine?

Ayurveda, which literally means “the science of life”, is the natural healing system of India. This traditional medicine was practiced as early as 4,000 BC. It was established by holy people and visionaries of this culture as a method to enhance spiritual evolution and promote physical well-being and vitality.

Practitioners of Aurveda refer to a life force “Prana” that runs through everything and is manifested in many different forms. Additionally, Ayurveda states that there are 5 primary elements of which all things are made: Water, Air, Earth, Fire, and Ether. Ayurvedic medicine also observes that there are three basic constitutions that are combinations of these 5 basic elements. Most people fit into one of these constitutional categories or are a combination of one or more of these basic constitutional types, they are:

Vata, which is made up of Air and Ether
Pitta, which is made up of Fire and Water
Kapha, which is made up of Earth and Water

By their balance or imbalance they determine the life processes of growth or decay. When a person’s constitution is out of balance, they may be prone to disease processes characteristic of that constitutional type. The goal of Ayurveda is to provide people with an understanding of their individual nature. With this awareness, people can make lifestyle choices that maintain balance within their constitution and improve their over-all health.

Because Ayurveda is a holistic medicine, practitioners will ask many questions about general health and constitution before addressing the symptoms of a particular patient.

Examples of these questions include:

• Do you more often feel hot or cold?
• Does your skin and hair tend to be dry or oily?
• Do you stay focused easily or do you tend to drift from task to task / thought to thought?
• Is your general pace sharp and quick or slow and steady?
• Are your bowel movements easy or difficult? Dry, hard or soft?
• How is your appetite?
• What are your favorite foods or flavors?

In addition to questions, the Ayurvedic practitioner will look at the overall form of your body, hair, nails, skin tone, and will probably feel your pulse as well. All these factors go together to help with the assessment of your constitution, and the source of imbalance that is causing disease symptoms.

Methods to ensure or reestablish health focus on restoring and maintaining balance and include:

• Proper diet
• Herbs
• Daily routine
• Seasonal routine
• Therapies that rejuvenate

Ayurvedic Recipes!

Resources
1. Maya Tiwari. Ayurveda: A Life of Balance. Healing Arts Press. 1995.
2. Dr. Vasant Lad. Ayurveda: The Science of Self-Healing. Lotus Press.1984.
3. Robert E. Svoboda. Ayurveda: Life, Health, and Longevity. Penguin press. 1992.

©KitchenTableMedicine.com, LLC ™

What is Acupuncture?

Chinese medicine is a complex and sophisticated approach to healing. It has been developed over a period of at least 3,000 years and is based on ancient Chinese medical texts, clinical observation, as well as modern empirical research. Principles of Chinese medicine are based on the fundamental concept that the physical, spiritual and emotional body are connected in their function, and that a network of energy called Qi (pronounced “chee”) flows thru all aspects of the body. Chinese medicine is, thus, holistic in its nature, and focuses on the individual instead of the disease.

Because of its holistic nature, Chinese medicine focuses on a patient’s entire bodily pattern and the presence or absence of harmony between systems and energies in the body. It also focuses on the harmony between the body and the outside environment. When a person is ill, the symptoms experienced are only one part of a complete bodily imbalance. Chinese medicine considers concepts of deficiency and excess, seeking to balance heat and cold, dry and damp, and ultimately, Yin and Yang within the body.

Energy called Qi flows through the body in channels called “meridians”. Most of these channels are named for a physical organ (lung, liver, stomach, etc.) to which it is correlated, though some are named for more abstract concepts or systems in the body. The energy or Qi in each of these channels is associated with specific tissues, areas, and functions of the body, as well as with certain emotions, colors, tastes and smells.

Acupuncture is only one branch of Chinese medicine, which is a complete medical system. Chinese medicine includes diet and lifestyle counseling, herbal therapies, physical medicine (similar to massage and physical therapy), acupuncture and therapeutic exercise. Acupuncture uses very thin stainless steel needles to stimulate specific points along meridians. This stimulation can be directed to unblock energy that is “stuck” or to bring energy into areas that are lacking energy, thus assisting the body to move back into balance. In addition to needles, various other methods used to stimulate acupuncture points include electricity, heat, massage and suction created by special cups.

Practitioners of Chinese medicine will begin by asking many questions about a patient’s general constitution, body function, as well as details about their current symptoms. They will also look at the tone and health of the skin, hair, teeth and nails. The practitioner will feel the pulse in three spots on each wrist to feel the energy of each of the meridians that is represented there. They will also look closely at the tongue, as its color and quality reflect many things about the balance of energy in the body. After collecting information by questions and observation, the practitioner will choose a treatment that is specific for the patient at that time.

If a patient receives an herbal treatment, the practitioner will assemble a specific combination of herbs for their current condition and constitution. The herbs will either be in a whole herb form, like a bulk tea that the patient prepares, or the herbs will be “granules” that just need to be added to water. If the patient is receiving an acupuncture treatment, the practitioner will clean the acupuncture points to be treated and then will insert the needles.

Acupuncture is generally considered very safe. While it is a medical procedure that punctures the skin and underlying tissues, injuries and side effects are very rare and when they do occur, they are usually minor. All acupuncture needles are, by law, sterile. Most acupuncture clinics (including Bastyr) use sterile, one-use, disposable needles. These needles come prepackaged and sterilized and are disposed of after one use.

Acupuncture is considered to be relatively painless, however, with correct stimulation the movement of Qi may be felt by the patient. Qi sensations vary widely and may be described as heaviness, distention, tingling or electric. These sensations may be only at the location of the needle or they may travel up or down the meridian (energy pathway). These sensations are a sign that the patient’s Qi is adjusting towards balance.

Resources
1. Connelly, Dianne M. Traditional Acupuncture: The Law of the Five Elements, 2nd Edition. Traditional Acupuncture Institute. 1994.
2. Kaptchuk, Ted J. The Web That Has No Weaver. 1983. Congden & Weed.
3. Beinfield, H. and Korngold, E. Between Heaven and Earth. 1991. Ballantine Books.

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