Life is much easier if I plan out the meals for the week ahead of time. Now life doesn’t always go the way I planned it, so I allow for a couple of meals where I only have 15 to 20 minutes from the time I get home until the time food is on the table. It’s all about the preparation.
When I sit down to plan, I often choose a couple of new recipes to try. Nothing too complicated because I’m usually tired by the time supper rolls around. I have several favourite web sites: whfoods.org (really easy, fast and healthy recipes), 101cookbooks.com (these are a little more challenging, but always delicious), nourishingmeals.com, domesticaffair.blogspot.ca – and several favourite cookbooks: Get it Ripe by jae steele, Enlightened Eating by Caroline Dupont and refresh by Ruth Tal are my top three at the moment.
From these recipes write out all of the ingredients – and make a list of what you need to get! The easiest way to go grocery shopping and not forget half of what you need is to create a list – checking it against what you already have in the pantry. I find if I have a list, I’m more focussed and not as easily swayed by tempting prepared foods and treats.
Coming home from the store
Unpack everything and put the dry goods away. If you buy in bulk, transfer to mason jars for ease of use. I keep all of my flours, grains, nuts and seeds right where I do my food preparation so I have them right at hand. I put most of the bread in the freezer, taking out only what we will eat in three days. That way it doesn’t get wasted.
Right away, I get my veggies ready to use for the next couple of days. That way I don’t have to chop, grate and wash every night – it’s already done! Here are some suggestions:
Greens – wash and tear what you are going to be using for salads in the next couple of days. I usually put them in the salad spinner and spin them just once, leave the water in the container and put the whole thing in the fridge. My family uses more than a spinner full per day so I put the separate greens in a vented bag because they take up less space. If they are going to be there for more than a day, wrap them in wet towels.
Carrots – I usually wash and chop in large coins about 4 carrots, cut some into snack-sized pieces and grate 4 carrots in the food processor. I put them in separate containers and store in the fridge.
Sweet peppers – wash and chop half at a time into small enough pieces to throw into an omelette or salad at a moments notice. Cut the other half into snack-sized pieces for dipping.
Celery – wash, chop into snack-sized pieces, dry and place in a container.
Cruciferous vegetables (broccoli, cabbage, cauliflower, bok choy, etc) – chop into serving sizes, wash, dry and store in container.
Beets – I love beets and they are delicious grated in a salad, or throw a handful into your green smoothie. Grate some up after you’ve done your carrots and put them in a separate container.
Squash, turnip – I put off these until the last because I find them so hard to work with but peel them, cube them and store in container. Do it now or you won’t later!
Asparagus – wash, snap stems wherever they break and store upright in a glass of water. Somehow these always get knocked over in my fridge so push them to the back where they are out of the way but not out of mind!
Fresh herbs – make sure they are dry before you put them away, then wash only when you are about to use them. They don’t like to be prep’d ahead of time.
Parsley/cilantro – wash them, dry them, cut off the tips of the stems and store upright in water, lots of water.
Garlic – press a whole bulb at a time, that way you’ve always got it ready. Store in a jar.
Sprouts – I usually leave them in the carton they come in. They are so easy to make yourself and the kids enjoy watching them grow.
So now that you’ve got everything ready to go, adding vegetables to your meals will be easy and quick. I came across a great resource – The Periodic Table of Produce from Simple Life, Fall 2006 and here’s a link where you can print it out: http://www.slashfood.com/2006/09/22/periodic-table-of-storing-produce/. Slashfood is also a great recipe resource, just beware of the sugar content in some of the recipes!
Building a salad
Fresh greens
Sulfur veggies
Bright colours
Herbs
Toppings
Start with a bed of fresh greens (about 2 cups per serving). Choose organic if possible, I like a mix of spinach, arugula, romaine, red lettuce, radicchio.
Kale, swiss chard, broccoli, bok choy, cauliflower, cabbage (red and green)
Brighly coloured veggies and fruit add lots of phytonutrients to the mix. Try cucumber, tomatoes, carrots, beets, celery, fennel, fresh berries
Full of nutrients and vitamins: fresh mint, basil, parsley, chives, dill, cilantro, dandelion greens
Top off your salad with sprouts – like broccoli, mung bean, alfalfa, sunflower – and nuts and seeds (pumpkin, sesame, sunflower seeds, almonds, walnuts, pine nuts)
Don’t forget the dressing
A great way to get your daily dose of essential fatty acids (EFAs) for healthy cell membranes and immune function (among other things) is with a tasty dressing to pull all the flavours together. Here are a couple of quick and easy recipes.
House Dressing (from Get it Ripe by jae steele – this will quickly become your favourite!)
1 tbsp miso paste
1 tbsp nut butter
1 tbsp tamari soy sauce
1 tbsp maple syrup
3 medium cloves garlic, pressed
Freshly ground pepper
¾ cup flax seed oil (or olive oil, walnut oil – your choice)
1/3 cup apple cider vinegar
Mix everything together in a jam jar. Stores in the fridge for up to one week.
Easy Balsamic Vinegar Dressing
6 tbsp olive oil
3 tbsp balsamic vinegar
1 clove garlic, pressed
Pinch of sea salt and freshly ground black pepper
Mix everything together in a jam jar, then pour on salad!
Green Vegetable Smoothie (this smoothie is like having a salad in a glass – another easy and fast way to bring greens into your daily routine)
Reprinted with permission of Helen Papaconstantinos from www.insightfulnutrition.ca. I have included it here because of the brain supporting healing benefits of the nutritional support suggested here by Dr. Terry Wahls.
If you have a loved one with multiple sclerosis[1], (as I do), you’ll love what this next post is about. It features the inspiring story of Dr. Terry Wahls[2], who reversed her multiple sclerosis after seven years of deterioration — simply by changing her diet. That she did it within 8 months and went on to complete an 18 mile bicycle tour is nothing short of miraculous. No drug has ever been able to claim the same results. Coming across her story late last year was the best Christmas present ever.
Dr. Wahls is a professor of internal medicine at the University of Iowa, where she teaches, and does rounds in a traumatic brain injury clinic. This conventional medical doctor had the courage to step outside the medical paradigm and persisted until she found a way to literally get out of her chair. Initially diagnosed with relapsing-remitting MS in 2000, she went the conventional route and was taking chemotherapy drugs and other immune suppressants in an attempt to slow the disease.
By 2003, Dr Wahls transitioned to ‘Secondary Progressive Multiple Sclerosis’ (the more advanced form), and had to begin using a tilt-recline wheelchair because of weakness in her back muscles. In MS, the immune system becomes sensitized to and attacks proteins in the myelin sheath that protects the axons of the central nervous system.[3]
Like anyone with a degenerative condition, she wanted to forestall further deterioration as long as possible. Because of her medical training, Dr. Wahls knew that research in animal models of disease is often 20 or 30 years ahead of clinical practice. She stayed up late each night to scour through peer-reviewed research on www.PubMed.gov and read the latest articles on multiple sclerosis research.
She knew that most of the studies were testing drugs which would take years for FDA approval so turned instead to the research on vitamins and supplements important to mitochondrial and brain health. As she continued to research late into the nights, she came across studies showing that over time, the brains of MS patients tended to shrink. This spiked her curiosity and led her to research other diseases that share similar brain shrinkage, namely Huntington’s, Parkinson’s and Alzheimer’s diseases (and Chronic Traumatic Encephalopathy (CTE) caused by multiple concussions to the brain).
One thing that was common to all these degenerative conditions was poorly functioning mitochondria. Mitochondria are like little ‘batteries’ in your cells that manage the energy supply to the cell. If you forget to feed them the correct foods or nutrients, your cells wither and die. Muscles shrink, brain volume drops. All the other cells in the body are also compromised.
Getting Better but not Quite There
In doing her research, Dr, Wahls discovered that three nutrients in particular are essential for proper mitochondrial function: 1) animal-based omega-3 fats; 2) Creatine (a compound that is involved in the production of energy in the body); and 3) Coenzyme Q10 – preferably in the ‘reduced’, best-absorbed version known as Ubiquinol. After taking these supplements, her decline slowed somewhat but she was still in a state of declining health.
The Big Change – Getting Nutrients from food
By the fall of 2007, Wahls had an important ‘aha’ moment. She wondered what would happen if she changed her diet so that she was getting these important brain nutrients not from supplements, but from the foods she was eating. Dr. Wahls wanted to eat all the foods that helped to make myelin – notably B1 (Thiamine), B9 (Folate) and B12 (Cobalamin). For her mitochondria to thrive at their peak efficiency she needed B vitamins, sulphur and antioxidants.
To accomplish all of this, she adapted a standard hunter-gatherer diet (basically eating what a caveman would eat) included roots, seeds, nuts, oily fish, grass-fed meats, organ meats and natural iodine from sea weeds. Iodine is good for many things including myelin repair. She also ate 9 cups of non-starchy vegetables and berries each day (3 cups each of greens, sulphur-containing vegetables, and colourful vegetables).
In case you are wondering, sulphurous vegetables include kale, broccoli, cabbage, Brussels sprouts, cauliflower, garlic, onions, chives, leeks, mushrooms, asparagus, etc. Starchy vegetables such as potatoes or grains such as rice were not eaten unless her 9 cups of other vegetables were eaten first. Tips on eating ‘the Wahls way’ can be found on her website: http://www.terrywahls.com/eating-the-wahls-way?EID=18923451&CID=3395727 You can also purchase Wahl’s book, Minding my Mitochondria, to find not only research but recipe and menu suggestions.
She called this way of eating ‘Intensive Directed Nutrition’ and it is easy to see why. She soon found she had more energy and felt better. Within 3 months she was able to get out of her wheelchair and walk down the halls at work using one cane. Later, by adding exercise and other therapies she progressively got better.
Why Cruciferous Vegetables and Sulphur?
Sulphur is responsible for hundreds of biochemical reactions in the human body. Together with antioxidants, sulphur helps the mitochondria to survive. By weight, sulphur is one of the most abundant minerals in the body – the average person contains about 140 grams of it at any one time. Sulphurous vegetables also help with creation of a potent antioxidant – glutathione – which could help prevent further damage to neurotransmitters. Sulfur is also necessary for the synthesis of Taurine, an amino acid needed for proper functioning of the muscles and central nervous system.
Foods to Avoid
The diet of the typical North American is so poor in nutrients that they do not have the building blocks to feed the mitochondria or to make/repair myelin, a protective covering on nerves that becomes destroyed over time in people with multiple sclerosis.
It is very important to remove from the diet all refined or pre-packaged foods and Omega 6 oils and fats. You find Omega 6 fatty acids in corn fed meat, corn oil, safflower and vegetable oils, soybean oil, margarines and fried foods. That does not mean that one must remove all fats and oils from the diet however. ‘Healthy fats’ such as fish oils, flax seed oils and extra-virgin coconut and olive oils are encouraged.
Anything inflammatory and processed must be removed – so no sugar, high fructose corn syrup, aspartame, allergens, dairy (including raw dairy), grains, or legumes, including soy beans. Dairy, grains and legumes, especially, are implicated in auto-immune reactions for people with MS.[4] Small amounts of high-antioxidant raw cacao beans, and raw honey are allowed occasionally. Those who cannot manage going grain-free are encouraged to try going gluten-free first, but faster results are expected when the guidelines are strictly followed.
MS and Eggs
Organic, free-range, antibiotic-free eggs (if tolerated), are recommended because they contain choline – which together with inositol – is critical for myelin sheath repair. Synergistically they work to create natural lecithin in the body. Making it this way means that one does not have to rely on soy-derived lecithin.
Generally, people with autoimmune diseases should not have egg whites due to a problematic protein in the egg white called ‘lysozyme’. Usually it is harmless, but it can bind with some proteins and inhibit trypsin and prevent it from doing its job to digest protein. Some of its compounds can pass through the gut wall and aggravate damaged guts. Avidin, another substance found in egg whites, binds to a B vitamin called Biotin, which is responsible for fatty acid synthesis and blood sugar regulation. Even when well-cooked, Avidin continued to inhibit Biotin absorption by about 30 percent.
So how do you know if you are sensitive to egg whites? One way to find out is to eliminate eggs at first and add them back after a few weeks. They may be eaten if there is no reaction to them. The same thing can be tried with tomatoes and eggplants, which cause joint pain in some people. If you find you cannot get your choline from egg yolks, food sources of choline include beef liver (highest source), chicken and turkey, scallops and shrimp, salmon, collard greens, Swiss chard and cauliflower.[5] You will also find choline in sesame and flax seeds. Inositol is found in high amounts in legumes (not allowed in this diet), however you can find it in high amounts in grapefruits, oranges, mandarin oranges, cantaloupe, rutabaga, blackberries, artichokes, okra, kiwi fruit, and nectarines.
How else can you Rebuild Myelin and prevent its Destruction? The term ‘balanced diet’ is the key. The myelin sheath is composed of about 75 percent fats and cholesterol and the rest is protein[6]. The first building block needed to make myelin is Omega 3 fatty acid, which you get from pure fish oils, wild fish and grass fed meats. The 3 cups of greens daily provide B vitamins and folate, which you need for your brain to keep it from shrinking. (Indeed, many people on this diet report marked clear-thinking and removal of the ‘brain fog’ they had earlier).
Vitamin B1 (Thiamine) helps to get energy into the muscles but it also helps with myelin repair. Organ meats – which traditional societies have always eaten – are recommended once a week to get natural cobalamin or B12 into the body. Organic liver is very good for that. Natural iodine from sea vegetables not only helps with myelin repair but would also aids the liver and brain to clear out mercury and other heavy metals from the body.
Bone broths are also recommended daily because they are full of minerals and help to heal any loose ‘tight junctions’ in the gut, which might be contributing to auto-immune reactions generally. Another way to rebuild lost myelin is to submit the muscles to the ‘stress’ of daily exercise – more on this later.
The Use of Fats and Oils with Multiple Sclerosis Unlike others who suggest drastically reducing saturated fats in an MS diet, Wahls is saying that healthy fats – from cod liver and salmon fish and oils, walnuts, chia seeds, ghee from a grass-fed, pastured animal, extra virgin olive and coconut oils … and even lard… are fine. Ghee, or clarified butter, by the way, has had the milk proteins poured off. Keep in mind that you need trace amounts of copper to activate these healthy fats so that they can go to work repairing the myelin. Food sources of copper include dried oregano and thyme, pumpkin seeds and sesame seeds.
Cod liver oil is high in vitamin D. A study published in The Journal of the American Medical Association in 2006 found that Vitamin D significantly reduced the risk of demyelination. Wahls believes that Vitamin D should be over 50 ng/ml but under 100 ng/ml to obtain the best benefits – lowered risk for autoimmune disease, cancer, cardiovascular disease and high blood pressure. How do you know how much you need to get there? Take a test every 1- 3 months and take 4000 IU vitamin D3 daily, or more if needed. At levels over 150 there is an increased risk of excessive calcium in the blood, hallucinations, psychosis, and kidney damage.
For some unknown reason, the concentration of oleic acid (a type of healthy saturated omega 9 oil found in olive oil and avocados), is lower in the myelin of people with MS. Oleic acid promotes the production of antioxidants in the body and slows the development of heart disease. In other myelin-destroying diseases, oleic acid is used to formulate ‘Lorenzo’s oil’, which helps patients with adrenoleukodystrophy.
Creation of New Neurons and Synapses plus More Energy
With properly functioning mitochondria, Dr. Wahls hoped that her body would also get maximum energy from glucose, a key factor in reducing or eliminating the fatigue so common with MS. With more energy you can exercise and do more. She also wanted her diet to be high in antioxidant capacity because that would not only increase protection of her neurons but also increase production of neurotrophic factors – a family of proteins responsible for the growth and maturation of new neurons and synapses.[7]
Antioxidants from spices such as turmeric were also added because of the wealth of animal and human studies showing that its curcumin component helps to prevent oxidative damage.[8] Just how curcumin might work to prevent demyelinization remains unclear, but researchers at Vanderbilt University believe it may be interrupting the production of IL-12, a protein that plays a key role in the destruction of the myelin by signaling for the development of neural antigen-specific Th1 cells, immune cells that then launch an attack on the myelin sheath.[9]
A Synergistic Approach: Hitting MS with many things at once With her intensive daily nutrition foundation in place, Dr Wahls continued to do research into additional supplements that might help to feed the mitochondria. Supplements, she points out, can be helpful, but a nutrient-intense diet must always come first. There is wisdom in this — brightly coloured vegetables and berries may contain beneficial cofactors and compounds not included in supplements which scientists may not discover or name for years, even though they work.
This is what is referred to in research as ‘efficacy’. It works because it works, and waiting for ‘evidence-based research’ to prove they work is not always helpful since experience tells you there is little risk in eating vegetables and fruits, together with a myriad of benefits. Today Dr. Wahls uses 200 mg B complex, 200 mg of Coenzyme Q 10, 1 g of Alpha Lipoic Acid, 600 mg of Acetyl L Carnitine, 120 mg of Gingko, 2 g of N Acetyl Cysteine, 2 g of Taurine, 2 g of Glutathione, 200 mg of Resveratrol, and enough Lithium Orotate to yield 13 mg of elemental lithium, on a daily basis.
Putting it all together By December 2007 she had combined intensive directed nutrition with a program of progressive exercise, electro-stimulation of muscles[10], and daily exercise. Daily exercise, even for those who cannot walk, is excellent because any ‘stress’ to the muscle causes the body to produce new myelin and development of new neurological pathways. Exercise also leads to decreased production of inflammatory proteins. Various animal experiments have shown that exercise increases ‘neurotrophins’, a family of proteins induce the survival, development and function of neurons.
The results stunned her physician, her family, and even herself. Within a year, she was able to walk through the hospital without a cane and even complete an 18-mile bicycle tour. Instead of becoming dependent on others, Wahls regained the ability to commute to work on her bicycle, and to do her rounds on foot without the need for canes or a wheelchair.
Up from the Chair and Helping Others Grateful to have her energy back, Dr. Wahls has spent the last three years researching, lecturing and speaking about her journey to wellness and shares how others may help themselves with intensive directed nutrition. Dr Wahls now has enough energy left over to start writing up research grants again. She has brought together an interdisciplinary team to conduct clinical trials using intensive, directed nutrition and neuromuscular electrical stimulation to combat advanced Parkinson’s disease and both secondary and primary progressive multiple sclerosis.
To help raise awareness and funds for her research and her non-profit foundation, Dr Wahls has recorded many of her public lectures. Fifty percent of the profits from the sales of the lecture DVDs and audio CDs are used to support clinical nutrition in the area of nutrition, massage, exercise, and neuromuscular stimulation. These resources are available on Dr. Wahl’s website: http://www.mindingmymitochondria.com/
In the meantime, here are a few words from Dr. Wahls:
“There is a lot we can do to restore our health without needing a physician. Here are ten suggestions for how you can help spread the word.
1. Talk about Minding My Mitochondria on Facebook and Twitter.
2. Tell your friends that you have read this fabulous book that is changing your life.
3. Tell your co-workers the reason you have so much more energy is due to Minding My Mitochondria.
4. Tell your family that Minding My Mitochondria is changing your life and could change theirs too.
5. Write a review for Amazon. It is easy. Just a paragraph, written from the heart, will be fine.
6. Write a review for your local paper. Or a letter to the editor.
7. Buy the book for a friend or a member of your family whose health you’d like to see improve.
8. Interview Dr. Wahls for your local newsletter, club, or paper.
9. Follow the suggestions Dr. Wahls makes in Minding My Mitochondria. As you become a healthier, more vibrant you, others will ask what your secret is.
10. When others ask what led to your looking 6 months younger than the last time they saw you, tell them why. That your mitochondria are healthy again, thanks to Minding My Mitochondria. Be healthier, more vibrant, more energetic.”
[1] Multiple sclerosis (MS) is a chronic, degenerative disease of the nerves in your brain and spinal column, caused through a demyelization process. Myelin is the insulating, waxy substance around the nerves in your central nervous system. When the myelin is damaged by an autoimmune disease or self-destructive process in your body, the function of those nerves deteriorate over time, resulting in a number of symptoms, including: muscle weakness, imbalance, or loss of coordination, astigmatism and vision loss, and muscle tremors.
[2] Dr Wahls is a clinical professor of medicine at the University of Carver’s College of Medicine, where she teaches Internal Medicine. She has published over 60 peer-reviewed scientific abstracts, posters and papers and is currently conducting clinical trials on how a nutrient-intensive diet can help to reverse MS symptoms.
[3] Research has shown that fragments from foreign proteins (i.e., from infectious agents and foods) can activate myelin-sensitive immune cells through cross-reactions. Many new foreign proteins were introduced into the human environment by the agricultural revolution, 10,000 to 5000 years ago. Some new proteins have crossed over to humans from domesticated animals (e.g. Epstein Barr virus) and from completely new food types such as dairy, grains and legumes. Humans have been around a lot longer than 5,000 years, and our gut flora has not evolved enough or become sophisticated enough to know what to do with some of these grains and legumes.
[4] The role of lectins and legumes in MS is interesting. According to Dr Loren Cordain PhD, a top nutrition researcher, lectins from grains, legumes and tomatoes may be involved in activation of the myelin-sensitive T cells. It has been long known that protein fragments derived from various foods such as milk and from gut bacteria can activate myelin-sensitive T cells through molecular mimicry. For this to happen, however, the foreign protein fragments must get across the intestinal barrier. One possible way for this to happen is by way of disrupted cell junctures or a “leaky gut”. Even if one does not have a ‘leaky gut’, various lectins will still attach themselves to various protein fragments in the gut from foods and gut bacteria and then transport themselves across the intestinal barrier by means of the Epidermal Growth Factor receptor. In this way they act like a “Trojan Horse” by bringing the “enemy” past the protection of the gut wall. Epidermal Growth Factor was discovered by Stanley Cohen of Vanderbilt University along with Rita Levi-Montalcini. Both received the Nobel prize in Physiology or Medicine in 1986.
[6] Schmidt, Michael A, PhD., Brain Building Nutrition: How dietary fats and oils affect mental, physical, and emotional Intelligence. Frog Books, Colorado, December 2006.
[7] In the brain these factors are important for learning, long-term memory as well as regeneration and growth of nerves. Studies suggest these brain-derived factors play a protective role against amyloid beta toxicity – a type of plaque that seems to build up in the brain as we get older.
[8] Natarajan C, Bright JJ. Curcumin inhibits experimental allergic encephalomyelitis by blocking IL-12 signaling through Janus kinase-STAT pathway in T lymphocytes.J Immunol2002;168;6506-6513. Available at: http://www.jimmunol.org/content/168/12/6506.full.pdfResearchers gave injections of 50- and 100-microgram doses of curcumin, three times per week over a period of 30 days, to a group of mice bred to develop the experimental form of MS known as EAE, and then watched the mice for signs of developing MS-like neurological impairment. By day 15, the mice that did not received curcumin developed EAE to such an extent that they developed complete paralysis of both hind limbs. By contrast, the mice given the 50-microgram dose of the curcumin showed only minor symptoms, such as a temporarily stiff tail. Mice given the 100-microgram dose fared best of all; they appeared completely unimpaired throughout the 30 days of the study.
[9] Natarajan C, Bright JJ. Peroxisome proliferator-activated receptor-gamma agonists inhibit experimental allergic encephalomyelitis by blocking IL-12 production, IL-12 signaling and Th1 differentiation. Genes Immun 2002;3(2):59-70. 2003. Available at: Natarajan C, Bright JJ. Genes Immun. 2002 Apr; 3(2):59-70J Immunol. 2002 Jun 15; 168(12):6506-13. J Immunol. 2002 Jun 15; 168(12):6506-13. http://www.ncbi.nlm.nih.gov/pubmed/11960303.
[10]Neuromuscular Electrical Stimulation involves the application of electrodes and electrical input to various muscle groups over the body with goal of strengthening the muscles. The technique was pioneered in the Soviet Union to improve athletic performance and is still commonly used by athletes, especially for healing muscle damage. Today portable NEMS machines are available and it is a do-it-yourself therapy.
Reprinted with permission of Helen Papaconstantinos from www.insightfulnutrition.ca. My reason for including it here is that many of my clients with post-concussive syndrome exhibit severe depression symptoms and this information can support them.
Originally published on October 29, 2011.
Dr. James Greenblatt
Last night at the University of Toronto’s medical sciences auditorium, I attended a lecture entitled, Malnourished Minds: The Link between Nutrition and Depression, presented by Psychiatrist James M. Greenblatt, MD, based on his book, The Breakthrough Depression Solution available through the following on-line book sellers, as well as Dr. Greenblatt’s websites: http://www.comprehensivepsychiatricresources.com and http://www.jamesgreenblattmd.com.
Dr Greenblatt is a dually certified child and adult psychiatrist and pioneer in integrative medicine. He is the Founder and Medical Director of Comprehensive Psychiatric Resources (CPR), an integrative medical practice that uses a biologically-based approach to treat mental health disorder such eating disorders, anxiety and mood disorders, ADHD, and depression.
His Integrative Psychiatry approach addresses all of the factors that may incline an individual towards depression – genetics, nutrition deficiencies/excesses, and levels of stress. Where needed, he uses technology (rEEG) to ensure that medications and treatment are targeted towards individual biochemistry. His nutrition-based approach often reduces his patient’s use of medication and minimizes drug side-effects.
By identifying and addressing all the factors that contribute to depression, his experience has been that depression can be successfully treated, and the patient is less likely to relapse. As a young psychology undergraduate, decades ago, I had worked in clinical, classroom and group-home settings with young individuals who were on psychiatric medication for various disorders. How I wish we had this information way back then.
Why is this topic important? Why should we care? By 2020, depression is expected to be the leading cause of disability worldwide, second only to heart disease. And despite the dozens of antidepressants on the market, millions of people who seek treatment for depression fail to find relief from their symptoms. According to Greenblatt, standard treatment for depression successfully eliminates symptoms in only 33% of patients. In about 70% of cases, the symptoms recur.
Depression disrupts the lives of tens of millions of people is North America – women in particular. It is a leading cause of work disability. Each year in Canada, about 12% of the adult population has a diagnosable (i.e., clinically significant) mental disorder, with major depression being the most common. The costs – for medical care, lost work time, and loss of life – range in the region of $40 billion dollar annually, although one can never put a price on life. People who suffer from depression have much higher rates than average for various types of diseases, from heart ailments to alcoholism. Doctors estimate that as many as 8 million women and 4 million men in the United States are treated for clinical depression every year.
But could a simple blood test change all that?
Research has shown that an over-accumulation of homocysteine, (whether due to a deficiency in folate, B12, B6, or zinc), can lead to depression. In this way, testing for levels of homocysteine in the blood could be a very useful form of objective testing. It is about time because depression is one of the many psychiatric disorders that lack objective testing for diagnosis and treatment. Because of this, psychiatry is often referred to as a “measureless medicine.”
Homocysteine is a non-protein amino acid that is quickly converted to another amino acid called cysteine. If conversion of homocysteine to cysteine is somehow impaired, homocysteine levels rise and become harmful. Too much homocysteine may increase your risk of stroke, heart disease, free radical activity, and depression.
Several important, mood associated vitamins and minerals (folate, vitamins B12 and B6, and zinc) are responsible for the conversion of homocysteine into the non-harmful cysteine. Therefore, deficiencies in these nutrients can lead to an accumulation of homocysteine.
So elevated homocysteine levels can indicate early stage deficiency of folate or vitamins B6 or B12 before blood levels can detect deficiency! This means that checking homocysteine levels in the body is very important if you wish to maintain health.
Not so strangely, many drugs can cause Folate Deficiency States (and therefore lead to high homocystein, inflammation and Depression). Anti-depression drugs are among them:
Amazingly, the brain knows and the gut, knows how to make its own antidepressants (for example, serotonin), given the right conditions. If that is true, what causes neurotransmitter deficiencies, dysfunction, and depression? Integrative Psychiatry sees these anomalies as linked to many factors:
Genetics
Diet – for instance, junk food, caffeine and nicotine can lead to hypoglycaemia or not enough glucose/fuel supply to brain.
Stress – it was noticed that women were 2X as likely as men to be clinically depressed.
Inflammation – bad fats, refined sugars and carbohydrates, alcohol, cigarettes or drugs.
Taken altogether, genes, poor diet, stress, neurotoxins and inflammation can lead not only to depression, but suppression of the immune system.
Fortunately, Dr. Greenblatt has reintroduced a biological orthomolecular framework for the understanding, treatment and prevention of Mood Disorders. He summarizes his personalized treatment approach as THE ZEEBRA approach, an easy mnemomic that covers each of the critical factors that should be addressed in the diagnosis and treatment of depression. It’s so simple that it’s elegant.
T– Take care of yourself – Getting plenty of sleep, eating right, and choosing activities that help lower stress and promote well-being are important steps to recovering from depression.
H– Hormones – Correcting hormone imbalances can often relieve depression.
E– Exclude – Exclude certain foods from the diet as problems associated with digesting these foods, such as wheat and dairy, can exacerbate depressed moods.
Z – Zinc and Other Minerals – Ensure adequate zinc and mineral levels; insufficient zinc is a frequent culprit in depression.
E – Essential Fatty Acids – Monitoring essential fatty acid and cholesterol levels are important to cardiovascular and mental health as low levels of these substances are often implicated in depression.
E – Exercise – Participating in exercise is known to combat depression on multiple levels.
B – B vitamins and Other Vitamins – Restoring vitamin levels to their optimal range can reduce symptoms of depression.
R – rEEG—This means ‘references EEG, which is a way of measuring brain activity much in the way an EKG might measure the activity level of your heart. If psychiatric medications are needed, rEEG can guide medication selection and eliminate trial-and-error prescribing.
A – Amino Acids and Protein
Let’s look at this again, in more detail:
Depression and THE ZEEBRA
T – Take Care of Yourself
5 Blood Tests are needed if you suffer from depression : 1) Homocystein, 2) B12 & Folate, 3)Total Cholesterol, 4) Celiac Screen, and 5) Thyroid (free T3 and T4)
Hundreds of studies support the relationship between folate and depression.
NB: Low folate is associated with increased incidence of depression.
With low folate, there is a poor response to antidepressant medicationsand higher relapse rate.
Celiac disease is associated with depression (2X higher rate) due to problems with nutrient absorption. (Ludvigsson JF, et al , 2007).
Exercise: Regular exercise may work as well as medication in improving symptoms of major depression.
H – Hormones:
The brain is a cholesterol-rich organ and cholesterol is an important hormone as it is involved in the synthesis of all steroid hormones. Don’t be afraid to eat eggs! You can have a couple a day, especially if the yolks are soft-cooked.
You need cholesterol for serotonin (a feel-good chemical in your brain) to work optimally.
Cholesterol activates oxytocin (your cuddle and bonding hormones)
It is needed to make bile so that you can digest fat and absorb fat-soluble vitamins such as vitamins A, D, E, and K.
You need cholesterol to make vitamin D, which is responsible for turning on or off many of the functions in your body.
E – Exclude:
Food Allergies – make an appointment with an allergist of immunologist specializing in allergies to find out what you are sensitive to so that you can avoid them and the inflammation and dietary malabsorption that allergens bring.
Sugar – the higher your sugar intake, the higher your blood lactate levels become.
Lactic Acid binds with calcium, so less of this mineral is available to keep your brain from spiralling into excitement mode. Sugar, caffeine and alcohol all increase the lactate to pyruvate ratio in the body, resulting in anxiety.
Vitamin Deficiencies – For optimal neurotransmitter synthesis, you need adequate folate, vitamin B6, vitamin B12, vitamin C, vitamin D3, and vitamin B3 (Niacin) among other nutrients.
Mineral Deficiencies –A deficiency in say, magnesium, may manifest different symptoms, based on one’s own unique biochemistry and genes. In one person, a magnesium deficiency may manifest as irritability and depression, whereas in another person it may manifest as insomnia and anxiety. More on this below.
Amino Acid Deficiencies – Amino acids create sanity and well-being.
Amino Acids convert to brain neurotransmitters, which help it to function, have memory, emotions, thoughts, feelings, control depression, sleep, create energy and excitement.
You get amino acids from protein.
Heavy Metals –Vanadium toxicity can cause manic depression and melancholy.
Taking high-dose vitamin C (ascorbate) reduces damage from excess vanadium. Studies in the Lancet and British J of Psychiatry show that levels of vitamin C in bipolar patients are so low as to indicate actual or borderline scurvy.
Toxins – these can be environmental, viral, or toxins produced in the body when you eat foods that you are allergic to.
Ok, here’s the ZEEBRA, next:
Z – Zinc and other minerals:
Zinc – depletion leads to apathy and lethargy
Magnesium – in terms of mood disorders, magnesium deficiency may result in depression, anxiety, irritability or depression.
Iron –chronic deficiency can lead to depression, weakness, listlessness, exhaustion, lack of appetite, and headaches.
Copper – usually a copper dominance can lead to problems. Zinc should be in a higher ratio to zinc. Watch that your house does not have copper pipes.
Manganese – you need it for proper use of vitamin C and all the B vitamins, and to make folic acid.
Manganese also helps to stabilize blood sugars and prevents hypoglycaemic mood swings.
Potassium – depletion is frequently associated with depression, fearfulness, and fatigue. A 1981 study found patients low in potassium were more likely to be depressed than those who were not deficient in potassium.
E – Essential Fatty Acids:
EPA and DHA (found in fish oils), help to lift mood and address inflammation in the body, which is also linked to depression.
Flax seed oil does not convert well into EPA or DHA.
Can get vegetarian (Algae-sourced) EPA and DHA but it is not as strong.
Body clues to low Omega 3:
Dry Skin, dandruff, frequent urination, irritability, depression, attention-deficit disorder, soft nails, allergies, lowered immunity, fatigue, lethargy, dry, unmanageable hair, excessive thirst, brittle, easily frayed nails, hyperactivity, ‘chicken-skin’ on back of arms, dry eyes, learning problems, poor wound healing, frequent infections, patches of pale skin on cheeks, cracked skin on heels or fingertips, aggressiveness.
Add fish to diet (especially cold-water fish like mercury and PCB-free salmon, mackerel, sardines) to diet, several times weekly.
Use butter and coconut oil for cooking and olive oil, flax, and borage oils for sprinkling over food.
Read food labels carefully and avoid all trans-fats and hydrogenated oils, including margarine.
Eliminate sugar – it creates inflammation and your EFAs are used up to put the fire out.
Take daily capsules of cold-water marine fish oil.
E – Exercise:
Exercise boosts your circulation as well as your mood and production of serotonin, your ‘feel-good neurotransmitter (brain-chemical).
B- B vitamins, Folate, Vitamin D, and C:
Know that when you eat sugar, you are using your B-vitamins to metabolize the sugar. It is a no-win trade off. (Matthews-Larson, PhD, Random House Pub. Group, New York, 1999, p. 158.)
Your emotional stability depends on a protein snack, not a Twinkie. (ibid)
Low B12is associated with fatigue, panic disorders, anxiety, OCD, Depression and Paranoia
Other symptoms of B12 deficiency include pernicious anaemia, confused mental state, tingling or numb feeling in hands and feet, sore mouth/ swollen red tongue, pallor, shortness of breath, diarrhoea, memory loss, cessation of menstruation, and fatigue.
Low B1 (thiamine) deficiency results in mental confusion, apathy, depression, fatigue and increased sensitivity to noise. (ibid, p. 157)
Low B2 (riboflavin) deficiency causes nervous system changes and an inability to convert food into energy.(ibid)
B6 (pyroxidine) deficiency is the main culprit in neuropathy (needles and pins feeling) (ibid)
Low Folic Acid/Folate causes deterioration of the nervous system, withdrawal and irritability. It also makes it more likely that you will relapse on your anti-depression drugs.
Inositol has similar effects to the tranquilizer Librium. (1980s studies at Princeton Brain Bio Centre showed that brain waves were similar to those of Librium). (ibid, 157)
In 1996 Israeli researchers discovered that Inositol converts into a substance that regulated serotonin. (ibid, p. 158).
It has been used with OCD and panic disorder. At 18 grams/day it worked as well and as quickly as quickly as Serotonin Uptake Inhibitors (SSRIs) such as Prozac, and Luvox but without drug side effects.
Physical: Diminished sense of touch and pain, clumsiness, weakness, pernicious anaemia, chronic fatigue, tremors, Gastro-Intestinal problems
r- Referenced –rEEG
Physicians report significantly reduced trial and error medication selection after using rEEG data.
Referenced-EEG is an objective, physiologically-based measure that helps psychiatrists make better prescribing decisions. rEEG measures electrical brain activity similar to the way that an EKG measures electrical activity in your heart. EEGs have been used for many years to help neurologists treat seizures and other neurological disorders. Now they are being used in psychiatry. Research has shown that although patients may have similar symptoms, they often have very different abnormalities in their EEG signal, and so would require a more individualized approach.
A – Amino Acids and Protein
You need protein and fats to make the neurotransmitter ‘precursors’ that make serotonin (happiness hormone) and Norepinephrine helps to make Tyrosine (helps you focus), and Phenylalanine (helps you to feel calm).
BUT, you need stomach acid (hydrochloric acid) in order to break down protein properly.
If you are taking antacid medication, or medication for acid reflux, you can’t break down protein adequately.
Stomach acid helps you to:
Break down protein
Absorb minerals
Absorb B12
Resist infection
Communicate to the brain that you already feel full and can stop eating (satiety)
If you can break down protein, it is easier to get adequate Tryptophan, an amino acid which helps you to increase serotonin in the brain.
I was recently asked to speak at a Women’s Circle about three things that I think are most important to change from a nutritional perspective and I’ve outlined them below. As far as I’m concerned, the foundation of health and treatment of any health concerns revolves around three basic factors: nutrition [steps 1 and 2], elimination of toxins (nutritional [step 3], emotional [stress] and environmental) and exercise. If I could add anything more to my talk, I would have spoken on the importance of daily exercise and creating a daily meditation practice.
Step 1: Increase your daily water intake
Many common health complaints actually stem from chronic dehydration. The most common symptoms include thirst, dry skin, dark colored urine, headaches and fatigue. Other, less know symptoms of dehydration, can include:
Digestive disturbances such as heartburn and constipation
Urinary tract infections
Muscle cramps
High cholesterol
Irregular blood pressure
Kidney problems
What kind of water should I drink?
Tap water – From the tap, the Town of Newmarket has its water provided by the Region of York and is treated through chloramination (adding chlorine and ammonia). Visit (http://www.newmarket.ca/en/townhall/resourcelibrary/2011WaterQualityReport-Jan202012.pdf) for the full recent report of the contents of Newmarket’s water. Our water is alkaline (avg 8.1 – where neutral is between 6.5 and 7.5) and in addition to the chlorine and ammonia, contains many other chemicals.
Bottled water – If you choose instead to drink bottled water, you might want to know that 40% of bottled water is actually bottled tap water! What’s also concerning is that the plastic in the bottles contain a chemical called bisphenol A, a synthetic hormone disruptor that has been linked to serious health problems. When consumed, the plastic bottles themselves place a huge burden on our landfill.
Filtered water – The water in our home is filtered since that’s the most economical and environmentally sound choice. There are three main different types of filters: Reverse Osmosis, Ion Exchange and Carbon Filtration. There’s lots of information available on the benefits of each.
Living water – The ideal pH balance of your water should be between 6.5 to 7.5, which is neutral. Distilled water is too acidic and alkaline water is too alkaline (causing problems with low stomach acid pH). Spring water is in this ideal range. It is some of the healthiest water on the planet because it is “living water”. Living water, like living food is in its raw, natural state the way nature intended. We have unlimited access to a free spring located in Mount Albert – here’s the link http://www.findaspring.com/mount-alberts-communal-spring-mount-albert-ontario-canada/. The water is slightly sulphurous and a little murky but tastes delicious
How much water should I drink?
So, how much pure filtered or spring water should you drink per day? One litre? Two?
Here’s a good rule of thumb to determine proper hydration levels: Drink enough water to turn your urine a light-coloured yellow – no odour and very little colour!
Step 2: Increase the amount of veggies and fruit in your diet
Researchers have found that individuals with a high daily intake of vegetables and fruits (about 400 grams per day) demonstrate higher antioxidant levels, lower indicators of free radical-induced damage, and better cognitive performance. Notice that I mention vegetables first because they are FAR more important than fruits.
This ‘high daily intake’ really isn’t much – 400 grams – that’s approximately 4-5 servings of vegetables and fruit. A cup of shredded lettuce, for instance, will weigh about 55 grams. A cup of diced pineapple will weigh about 155 grams.
In my mind the main reason why eating raw, organic vegetables is important is because these “living foods” contain biophotons, small units of light stored by all organic organisms. Vital sun energy finds its way into your cells via the food you eat, in the form of these biophotons. They contain important bio-information, which controls complex vital processes in your body. When you take this vital energy into your body, you are re-charging it with health and encouraging it to return to a whole and balanced state.
Dr. Oz recently did a show that discussed Biophotonic scanning, a testing form that determines the amount of Biophotonic ability of cells (via measuring the level of carotenoids in the skin) – watch the video: http://www.doctoroz.com/videos/cancer-fighting-antioxidants-pt-1.
With a bit of planning, it’s relatively easy to get plenty of fresh vegetables into your diet. You can snack on celery filled with raw almond butter, nibble on asparagus, cucumbers, carrots, sweet potato rounds, cherry tomatoes or red peppers dipped in hummus made from chick peas, and add leafy greens like spinach and kale to any meal. In the mornings, I make one huge salad for my whole family to take for our lunches. That way I know that between that and whatever fruit I send with them they are getting at least 2 servings of vegetables and fruit for lunch. And I top my salads with herbs (like parsley, cilantro, lemon balm, peppermint) and sprouts like broccoli and sunflower seed – they add a huge micronutrient burst as well as great flavour.
Other vegetables, like zucchini and turnips, are mild tasting and can be blended into soups and sauces and you’ll never even know they’re there. Grated carrots and lentils can be completely hidden in a tomato sauce that’s delicious over spaghetti squash, or even your favourite rice pasta.
Probably the easiest way to increase your vegetable intake is to juice your vegetables. Fresh, organic, raw vegetable juice is easily digestible by the body and doesn’t damage either the micronutrients or the biophotons. I usually add a source of fat like flax oil or walnut oil to my juice to make it more filling. You may also find that adding some, or even all, of the vegetable pulp into your juice helps to make drinking the juiced vegetables more satisfying. I don’t have a juicer, so will process my veggies and fruits in the blender with some filtered water then filter some of the pulp out with a strainer or cheese cloth. Try adding ginger and lemon too.
Whatever method you choose, juiced or whole, raw or cooked, add at least one more serving of veggies and one of fruit to your meals today.
Step 3: Reduce your sugar, processed foods and grain carbohydrates intake
65% of Americans are overweight and 27% clinically obese. Most of the chronic disease that we see rampant in today’s society is the result of a diet that focuses heavily on sugar and grains. Processed foods are a key cause of the problem. We are addicted to a fast-paced life where hamburgers, fries and a soft drink are a regular meal choice. Not only are they full of preservatives and chemical agents, but they are also full of sugars and starch.
Consuming sugar throws off the body’s equilibrium and cause a variety of harmful metabolic consequences. Some of the most harmful include: suppressing your immune system; feeding cancer cells; causing heightened levels of glucose leading to reactive hypoglycaemia and potentially diabetes, producing a significant rise in bad cholesterol and causing a rapid rise in adrenaline, hyperactivity, anxiety, difficulty concentrating, and crankiness in children.
Grains, even whole unprocessed organic grains, are rapidly broken down by the body and drive insulin and leptin levels up. Spikes of insulin and leptin cause cravings and surges then quick drops in energy that make it difficult for our body to remain in balance.
Any meal or snack high in starchy carbohydrates generates a rapid rise in blood glucose. To adjust for this rise, the pancreas secretes the hormone insulin into the bloodstream, which lowers the blood glucose level. Insulin is, though, essentially a storage hormone, developed over millions of years to store the excess calories from carbohydrates in the form of fat in case of famine. With no famine, fortunately, in sight, this storage mechanism has become an important cause of bulging stomachs and fat rolls in thighs and chins. Making matters even worse, high insulin levels suppress two other important hormones — glucagons and growth hormones — that are responsible for burning fat and sugar and promoting muscle development, respectively.
So, take a hard look at what you’re eating meal by meal. Look at making changes that take your meal decisions away from boxed and packaged foods, and move you over to the fresh produce aisle. Fresh produce is much less expensive not only today, but for the health of your tomorrows.
I find getting back into the swing of things difficult after taking time off! But today the kids are back at school, everything is getting back to normal around me, all the Christmas decorations are packed away, and I’m ready to start writing again.
While enjoying the holidays, we stopped by the LCBO for some wine and picked up the Food & Drink magazine (page 278 of Holiday 2011) – love this edition. In it I found several recipes that can easily be adjusted to a healthier version and I’m including the one I made on Saturday here for you. I’m making another one tonight, and if it works out, I’ll post it too.
We served this dish with lightly steamed bok-choy. In a deep cast-iron pan, I heated a tablespoon of coconut oil and added a minced clove of garlic. Once the garlic was smelling wonderful, I added about a cup of vegetable stock (or water would be fine too) then the coarsely chopped bok choy. I steamed it for about 5 minutes until it was bright green and fragrant, then took it out of the pan with a slotted spoon and squeezed lemon over top and sprinkled with sesame seeds. This is a delicious side dish packed with exceptional sources of iron, vitamins A and C, folic acid and anti-cancer compounds including glucosinolates.
Stir-Fried Beef with Black Beans and Rice Noodles
12 oz (375 g) flank steak
1 tsp honey
2 tsp flour (I used spelt, but arrowroot would also be good – to thicken the sauce)
1 Tbsp tamari
1 tsp sesame oil
1 Tbsp water
Noodles
1 small dried chili, chopped (I used chili flakes – 1/2 tsp)
1 Tbsp finely chopped ginger – you could use more as this was just enough
1 Tbsp finely chopped garlic
3 Tbsp black beans, rinsed and mashed (you could just use the beans and leave out the flank steak for a vegetarian option)
1 cup snow peas, strings removed
1 red pepper, thinly sliced
8 oz (250 g) rice noodles, rinsed (if using dried noodles, just submerge them in boiling water to soften first – otherwise they can’t pick up the delicious sauce)
1 tsp sesame oil
1. Slice the flank steak against the grain into thin slices. In a medium bowl, combine the first set of ingredients and add to meat and marinate for 30 minutes.
2. In a small bowl, combine all seasoning sauce ingredients.
3. Heat wok over medium heat (I don’t have a wok, so used my Le Creuset pot). Add oil and stock. When hot, drain the meat from the marinate and stir-fry until browned (this doesn’t take long – about 30 sec to 1 minute depending on how thinly you cut the steak). Remove meat and reserve.
4. Stir in the chili, ginger, garlic and black beans. Add the vegetables and noodles. Stir-fry for about a minute until the pepper softens and the ginger and garlic become fragrant. Add in the seasoning sauce and bring to a boil, stirring. Return the meat and any juice and mix well. Before serving, add 1 tsp of sesame oil to the wok then pour contents onto a large serving platter.
5. Serve with bok choy for a delicious, nutritious dinner!
Serves 3 to 4 as a main course.
Source: Food & Drink, Holiday 2011, page 278
What does it really mean to nourish your body? You feed yourself every day, whenever you feel hunger. But how do the decisions you make about what you eat, how much, the quality of the food, where you eat – affect you?
The diagnosis of cancer is terrifying – it puts most people into the foetal position, where they just want to block everything and everyone out. Feeling that life is over does NOT serve you. So stand up and really take a good look at yourself. Because right now you’ve been offered an opportunity to really make change to how you live your life.
What do you really hunger for? I can guarantee that it has nothing to do with the sweet, highly-processed foods that many of us consume. They contain so few nutrients that our bodies do not call out for them. But they do fill us, all those empty cracks and crevices aching to be filled, for a moment until the next crack appears. I suggest that this hunger has nothing to do with food – it’s an emotional, spiritual need to find meaning in our lives. To feel like an important part of something bigger than this daily, painful grind that we get stuck in.
Nourishing your body is different from feeding yourself. It’s taking the time to really listen to what your body needs. If it hungers, don’t fill it with more empty, sugar-filled calories. Give it life-supporting nutrients in the form of raw, or lightly steamed vegetables.
If food isn’t what you hunger for, take the time and space to find out what is. Meditation can take you deep into the heart of your personal self and will reveal to you the beautiful human being you are. It takes time, and practice, practice, practice, but the rewards far outweigh the initial frustration.
If you find yourself bored with life, then get outside. Experience this world. Enjoy walking around your neighbourhood and peeking through windows into the lives of those around you. You are not alone. Or go to the woods – there you will find real peace and serenity.
I realize this information seems quite intangible, but it is important that you realize that you are being asked to change the way you live your life. It isn’t working. So what’s wrong? Where does your pain lie? Where is your grief or fear buried layer, upon layer deep within your cells? Find it, bless it (for it has served you), and give it to the Divine unifying force for healing and removal. Trust that it is possible and it will be so.
Helen and I have just started helping a client recently diagnosed with cancer. We wanted to outline the steps that we take as we go, so that everyone has access to the information.
The most important thing to do is to go online and do some preliminary research about your cancer, so that you understand what’s going on in your body and can formulate questions for when you next see your doctor. My go-to place is www.lef.org and in the search box, I type in Protocol for … Cancer. Usually I get lots of information. Print it out and put it aside.
Next, pick up a 2 or 3″ binder and many tabs to go inside it. This will become your Wellness Binder and it’s where you’ll keep everything you’ll need to reference along your journey. You’ll put your preliminary research here (okay, you can put it in the binder now), information about diets, supplements, lifestyle changes, detoxification strategies, contact information about your cancer care team, questions that come up between appointments and whatever else you can think of.
The article below is the next piece that you’ll add to your binder. You’ll find it a valuable tool for helping you to keep track of your health care (especially when visiting the hospital).
10 WAYS TO PREVENT MEDICAL ERRORS
by Karen Garloch, The Charlotte Observer, N.C.
10-17-11
Expect mistakes and have an advocate with you in the hospital.
Check every medicine. Make sure the dose is right. If you don’t know the correct dose – ASK.
Be assertive. “Being nice can get you killed.”
When in doubt, “say No.” Demand an explanation.
Be vigilant during transitions, from one floor to another, or when shifts change.
Alert the nurse or “rapid response team,” if something seems wrong.
When discharged from the hospital, get detailed instructions and contact information. Know what symptoms might signal a worsening situation or infection.
Hospital doctors may never speak to your primary care physician. Take your records and don’t assume doctors already know what’s in them.
Double-check everything. Don’t assume no news is good news or that test results are always correct. Get copies of lab results in a timely fashion. If something seems wrong, request a repeat.
Take a friend or family member to doctor’s visits. Nearly every error made in the hospital can also be made in the outpatient setting. A second pair of eyes and ears can be very useful in getting instructions and spotting problems.
PATIENT CHECKLIST
Take a list of your top health concerns/symptoms.
Ask your doctor for a recap to make sure you’ve been heard.
Take notes or record the conversation so you can remember.
Carry a list of all your medicines and supplements.
Find out about the most common and serious side effects your medicines may cause (a great resource for chemotherapy drug information is www.chemocare.com).
Ask the doctor how confident he is about your diagnosis. Find out what else could be causing your symptoms.
Get a second opinion.
Ask health care providers to wash their hands before they examine you.
Keep track of your progress: Keep a diary of relevant measurements such as weight, blood pressure, blood sugar.
Be vigilant when moving from one health care setting to another. Mistakes and oversights are especially common during transitions.
Ask how to get in touch with health care providers. Get phone numbers or email addresses, and learn when to report problems.
(c)2011 The Charlotte Observer (Charlotte, N.C.) Distributed by Mclatchy-Tribune News Service.
I realize these lists make it seem like the medical establishment is out to get you. That isn’t the case at all. Most medical staff really care about your health and well-being. But in a hospital there are so many people working with you that important pieces of information can be lost in the shuffle.
You are the only one who can be responsible for yourself. And for keeping track of all of the information you need to return to health.
Be your own advocate. Make sure that your needs are met however uncomfortable it makes you feel to ask for clarification. Studies have found that the patient who refuses to take NO for an answer is the one most likely to get better (see #3 above).
This afternoon I received a request for information about alternative cancer care treatment options in Brantford, ON. I put the call out to all of my online contacts and this is what we have found out to this point. I’m posting it here so that anyone else looking for this help will be able to access it. Thanks to Lee Overton for providing most of this research here!
Nutritionist – Julie Daniluk of the Big Carrot recommended
Irene Yaychuk-Arabei, DNM
Holistique
Brantford, ON
(519) 752-7373
shakti1@rogers.com http://www.brant.net/holistique/bios.htm
One of the only Traditional Chinese Medicine (TCM) practioners in Brantford is Monica Wecklein. She’s wonderful and very effective. She recently opened up her own place at her home (converted her garage to a wellness spa equipped with a Hydro Therapy tub). She also trained in natural therapies and consulted clients for 10 years in Ottawa before moving to Brantford and becoming a TCM practioner. She also holds a degree in Psychology. Monica Wecklein
48 Tutela Heights Rd.
Brantford, ON N3T 1A1 519 752-0305
Chiropractic
Harmony Chiropractic recently hired a holistic nutritionist. I haven’t heard of any others so far or tried this one. However, we have experienced their chiropractic services (Sublaxation) which is the same as the typical Chiropractor treatments. They understand overall wellness and seem to be building their business to support this. http://www.harmonychiropractic.ca/
124 Charing Cross St
Brantford, ON N3R 2J1 (519) 756-1303
Kathleen Gorden is a very experienced yoga teacher who has started a Restorative yoga in her home studio. I was very happy to see this as it’s hard to find Restorative yoga in Brantford. If you are not familar with Restorative yoga it’s very healing and and a form of gentle exercise. She’s had lots of experience with people living with Cancer. She is also does wonderful meditationwhich is so healing. She does private classes too and is very reasonable.kathleen.yoga@rogers.com
Naturopaths
As far as Naturopaths go I’m currently in transition. Amy Tweedle my former one moved so I’m meeting a new one in Cambridge this week. Dr. Reid is his name and I’ve heard great things about him and the centre. He partners and consults with an MD so they can do all kinds of tests that regular Naturopaths can’t. They also work with a compounding pharmacy which is sweet and hard to find. They also have a nutritionist on staff.There is also Holistic Healing Arts. Dr. Alfred Hauk the owner would be the one I’d explore as some of the others are pretty fresh out of school http://www.ndoc.ca/about-us/who-we-are. He’s got a pre-med background from Germany and has been doing this for a long time. We’re also investigating Complimentary Healing Arts (a.k.a The Anello Clinic). They do have a waiting list but that might be waived in a cancer situation. http://www.anelloclinic.com/services/index.html
401 Laurel Street,
Cambridge (Preston), ON
N3H 3Y7 519 653 3731The Canadian Association of Naturopathic Doctors also has this listing available of ND’s in Brantford, but no information about their areas of specialty: http://www.cand.ca/Find_an_ND.findnd.0.html?&no_cache=1&L=0&no_cache=1
Acupuncture – Ryan Ess suggests Dr. Tom McChesney who is located in Ancaster nearby. He does Contemporary Medical Acupuncture.
For supplements try Tip Top Health Shop (Colborne and Clarence) or S&H Health Store (in the Galaxy Cinema plaza) as they are the more inexpensive options. Both will order things in.
This is not a complete list and as we find more treatment options available to people in Brantford, ON we will post them here. Turning Point Nutrition has not worked with any of these therapists but has worked with the people who provided their names to us.
If you know me, you know that I’m a hockey mom. The recent surge of interest in concussions in the media has started many organizations to develop protocols for getting athletes back to their game – various “return to play” rules have been written and are starting to be enforced. The OATA (Ontario Athletic Therapists Association) is also working on some protocols and asked if I might be interested in doing some research on nutrition for concussion (the # tags are for twitter.com as there is quite a group following information about #concussion for their children).
So here’s the first step in the process, writing about what I’ve found so far and outlining some of the questions I am hoping to find answers to. If you know the answers, or a great resouce where I might find the answers, to any of the questions PLEASE comment below. The more people involved, the better the results!
The following nutritional interventions were identified for review:
Ketogenic Diets and/or Fasting for short periods – Ketogenic diets were originally developed in 1921 to treat epileptic children. They mimic biochemical changes associated with starvation or periods of limited food availability, and are composed of 80-90% fat, 10% protein and limited carbohydrates. In normal metabolism, carbohydrates in food are converted into glucose, which is the body’s preferred source of energy. Under some circumstances, like fasting, glucose is not available because the diet contains insufficient amounts of carbohydrates to meet metabolic needs. Consequently, fatty acid oxidation becomes favored, and the liver converts fat into fatty acids and ketone bodies that serve as an alternative fuel for brain cells. Based on the evidence presented, the ketogenic diet does hold some promise of effectiveness in improving the outcomes of TBI. There are indications that ketones may provide an alternative and readily usable energy source for the brain that might reduce its dependence on glucose metabolism, which may be impaired immediately following TBI. There is an absence of information on which forms of TBI – mild/concussion, moderate, severe, and penetrating – might benefit from such therapy. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, pp. 140-156) (More information available in this document:Neuroprotectice and Disease-modifying effects of the ketogenic diet)
Questions: Duration? Long-term use in pediatric population has been associated with growth retardation, kidney stones, bone fractures (p. 141) Possible intermittent timing schedule? Effects of short-term fasting? For more info about ketogenic diets, click here.
Antioxidants – During a TBI, damage to the brain can occur because of the generation of reactive oxygen species (which can be offset by the use of antioxidant therapy). Oxidative stress is identified early after the initial injury, and compounds that intercept the production of reactive oxygen species could be beneficial for TBI outcomes. The use of single antioxidants has not been successful in treating oxidative-related diseases, so only consider a combination of vitamins A, C, E, all the B vitamins along with the minerals selenium and zinc.
(Source: Nutritional Considerations in Traumatic Brain Injury, p. 608 [also pages 88-107 of the Department of Defence document above]) Questions: Optimal dosage? and efficacy for children?
Omega 3 fatty acids – fish oils and purified omega-3 fatty acids have been proven to reduce inflammation within hours of continuous administration. For acute cases of TBI, it should be noted that there are intravenous fish oil formulations available in Europe, but these are not approved by the FDA. Continuous enteral (a way to provide food through a tube placed in the nose,the stomach, or the small intestine) feeding with a feeding formula containing fish oil should provide equivalent effects for this purpose in the early phase of severe TBI when enteral access becomes available. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, p. 188-204)
Questions: Should dosage be determined by weight, age, severity of TBI – or a combination of factors?
CDP-Choline – Choline has been shown to act as an anti-inflammatory and antioxidant in other diseases, and also to decrease calcium-mediated cell death, a feature of TBI. Choline has a critical role in neurotransmitter function because of its impact on acetycholine and dopaminergic function. Currently studies have only been done on animals, but they suggest that CDP-choline supplements increase dopamine receptor densities and can ameliorate memory impairment. It is suggested that CDP-choline may exert neuroprotective effects in an injured brain through its ability to improve phosphatidylcholine synthesis. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, p. 115-129)
Questions: Optimal clinical dosage and duration of treatment? Further, the DoD will be monitoring the results of the Citicoline Brain Injury Treatment (COBRIT) trial, a human experimental trial examining the effect of CDP-choline and genomic factors on cognition and functional measures in severe, moderate, and complicated mild TBI. We’ll keep our eye on results from this trial.
Creatine– Creatine, which is found in meat but is common in athletes’ dietary supplements, helps give the brain an intense and immediate hit of energy needed to help cells heal right after an injury. (Source: http://www.theglobeandmail.com/news/world/americas/starve-a-fever-feed-a-concussion-speedy-feeding-offers-hope-of-better-healing/article1994021/)
Military personnel are using creatine in the form of dietary supplements to increase strength and muscle mass. In the context of TBI, the committee found good evidence of improvements in cognition and behaviour from trials with creatine in children and adolescents. Although this evidence comes from long-term studies, treatment with creatine was started early after injury and may have influenced disease processes during the acute phase. In fact, creatine is thought to maintain mitochondrial energetics and improve cerebral vascular function, both of which are disrupted during the acute phase of TBI. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, pp. 130-139)
Questions: Timing of administration? Optimal dosage?
Magnesium – Magnesium has a role in inhibiting the actions of the excitatory neurotransmitter glutamate by regulating calcium entry into the postsynaptic neuron, a process intimately related to a TBI event. Despite this seemingly neuroprotective action, there is no clear evidence that magnesium supplementation will affect TBI outcomes. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, pp. 157-187)
Vitamin D – The role of vitamin D in the brain has only recently been recognized and is not well understood. Vitamin D and its receptor are thought to act by binding to DNA response elements that regulate gene transcription involved in cell proliferation, differentiation, and neural function in the brain. Vitamin D’s potential to increase resilience to TBI is supported by findings that vitamin D alone was also neuroprotective against animal models of stroke. Although there are only a few studies on vitamin D’s benefits for TBI treatment, the findings are promising and need to be evaluated further. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, pp. 227-232) Questions: Optimal dosage?
Zinc – Zinc is an essential nutrient required for the function of many enzymes in the CNS. In the brain, zinc is released in the synaptic cleft where it modulates the activity of neuroreceptors. An excessive release of zinc can result in neural cell death. In the context of TBI, zinc deficiency might exacerbate the oxidative cascade that results in cell death. (Source: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, pp. 233-246) Questions: Optimal dosage?
I hope that this has given you a starting point for finding answers to your questions about nutrition for concussion. I have skimmed most of the document, but only found the pdf of the entire document available online this morning! Many of the pieces will be hidden in here no doubt.
Dosage information as well as information for children, and adult timing and efficacy need to be researched further. As soon as I have answers, I’ll let you know. But much of the research is only available for these supplements regarding other neurological diseases, especially epilepsy.
There seems to be plenty of information about ketogenic diets for brain-disorders. While I think that immediately following the TBI, the focus should be on drinking water (which I just realized I didn’t mention at all above – every source recommends “Drinking plenty of water” – but give no idea of how much “plenty” is!) and eating glucose foods, once glucose metabolism starts to break down then ketones seem like the option for brain energy. Question, when does glucose metabolism break down after a TBI?
Quinoa, Roasted Beet and Walnut Salad - spring version!
This is my favourite salad – originally from Ricki’s Kitchen (http://www.dietdessertndogs.com/)- but I’ve made it so many times now that it has evolved (or devolved as the case may be). Anyway I found out that it wasn’t available on my site when I tried to find it for @SandiKrakowski a twitter friend. Imagine my embarrassment!
Quinoa, Roasted Beet and Walnut Salad
The brilliant crimson of roasted beets lends a gorgeous hue to this mineral- and protein-rich salad. Roasting the beets brings out their true sweetness and tender texture in contrast to the chewy quinoa and crunchy walnuts.
3-4 medium beets, washed and trimmed (do not peel)
1 cup dry quinoa
2 cups water
½ cup walnuts, lightly roasted and cooled (or you can use the spicy pecan recipe here)
2-3 cloves garlic, minced or grated
Grated rind of one lemon
Juice of one lemon (about ¼ cup)
2 Tbsp balsamic vinegar
¼ cup extra-virgin olive oil
2 tsp Dijon mustard
1 tsp. Maple syrup
1/3 cup fresh cilantro, chopped
Pepper to taste
Preheat oven to 425F. Wrap beets in foil and bake until extremely tender, about 45 minutes to 1 hour. Let cool, then slip off the skins and dice into 2 cm cubes. Set aside.
Bring water to boil in a small heavy saucepan. Rinse quinoa well and add to water. Return to boil, then reduce heat to low and cover. Allow to simmer, untouched, for 25 minutes, then check to see if water has been absorbed. If not, continue simmering until all water is absorbed, then uncover and allow to cool. (If you are in a hurry, you can turn the hot quinoa into a glass bowl at this point and place it in the fridge for about 30 minutes).
In a nonstick frypan, heat oil and add garlic and lemon rind. Cook and stir for 2 minutes, then add balsamic vinegar, lemon juice and maple syrup. Remove from heat.
Add beets to cooled quinoa. Break walnuts into pieces and add to the bowl. Pour dressing over and toss well until quinoa becomes pink. Add cilantro and combine well. Season to taste with pepper. This salad is even better the second day, after flavours meld.
