Whether we exercise or not, intuitively we all know that it benefits our overall health and well being. A recent study looking at the link between exercise and stroke found that regular physical exercise is associated with a decreased risk of stroke and transient ischemic attacks.⁽¹⁾ They found most benefit in men and specifically those that exercised at a moderate to vigorous intensity (enough to break a sweat) ≥4 times a week. When these men were compared to inactive men, they found those that were inactive were 20% more likely to experience a stroke. Interestingly, the relationship between stroke and activity is less clear in women; the researchers postulate that women may get benefit with less vigorous exercise such as walking. The stroke lowering benefits of exercise are indirectly related to addressing risk factors such as elevated blood pressure, weight, cholesterol and diabetes. Previous studies have found similar results, moderate to high levels of physical activity being associated with reductions of total ischemic and hemorrhagic strokes⁽²⁾ and managing hypertension which can typically prevent such cardiovascular events.⁽³⁾ With stroke being a leading cause of death and disability in Canada perhaps we should all be re-evaluating our exercise habits and start moving!

How concerned should you be about the level of arsenic in your diet? That depends on a number of factors but surprisingly one of these includes how much rice and rice products you are consuming. Inorganic arsenic is a known carcinogen and toxin that is found in a number of items. It easily passes the placenta increasing risk of miscarriage and impaired fetal growth.⁽¹⁾ It also increases the risk of a number of cancers and contributes to cardiovascular disease, neurologic deficits, and neurologic developmental issues in children.⁽²⁾ Research over the past few years has brought to light that there is a significant and potentially dangerous amount of inorganic arsenic found in rice and rice based products. Some of this arsenic comes from pesticide use, however in areas such as South and South East Asia, a significant amount appears to come from arsenic contaminated ground water being used for rice cultivation.⁽³⁾ A recently published study in the journal Scientific Reports looked at the impact of such exposure directly on human health.⁽⁴⁾ It involved over 400 individuals from West Bengal, India, otherwise not significantly exposed to arsenic through drinking water and found a significant association between rice arsenic levels >200ug/kg and genetic damage, which was measured through micronuclei in cells of the participants. After taking into account confounding factors such as age, gender and tobacco use, the findings remained. With the large number of people in the world consuming rice as a staple, there are serious and legitimate concerns over its impact on human health. If you currently consume a significant amount of rice you may want to consider getting more informed as well as exploring alternative grains. Consumer Reports tested over 200 commonly used rice products commercially available in North America purchased in April, May and August 2012 and assessed them for total arsenic, inorganic arsenic and organic arsenic. Their result can be helpful in making healthier decisions and are available at: http://www.consumerreports.org/cro/magazine/2012/11/arsenic-in-your-food/index.htm.

The past few years has seen an increase in requests by expectant mothers for delayed cord clamping at birth. Delayed clamping refers to waiting at least 2-3 minutes, or until cord pulsation has ceased, after birth before clamping and cutting the umbilical cord, whereas early clamping is done within the first minute. Although research accumulating over the past decade shows this delay has significant health benefits for the baby, many maternity wards still routinely clamp and cut immediately after the baby is born. A Cochrane Systematic Review is putting this practice into question, comparing the effects of early versus late cord clamping on both mother and baby.⁽¹⁾ They included fifteen trails that involved nearly 4000 women and their newborns. No effect was found in the women however benefit to the newborn was substantial, including higher birth weight, higher initial hemoglobin concentrations and most importantly increased iron storage that persisted for up to six months after birth. A delay of at least 2 minutes allows between 20-40mls of additional blood to pass form the placenta to the newborn, providing roughly 30-35mg of iron.⁽²⁾ These benefits appear even more important for preterm infants, benefiting not only blood parameters but also reducing the need for blood transfusion during the first 6 weeks of life^{(3, 4)} Delayed clamping in preterm deliveries, including caesareans, is feasible unless the baby is in distress and should be encouraged when possible.⁽⁴⁾ Although the Cochrane review indicates that delayed cord clamping may increase the risk of neonatal jaundice and need for phototherapy, other research does not support this.^{(2, 5)} From the mounting evidence, it is becoming clear that a shift in practice guidelines is needed in order to afford these health benefits to more infants.

Seasonal allergies are a common problem for many, with symptoms ranging from slightly bothersome to debilitating. Many sufferers often reach for the common over the counter antihistamines not realizing alternatives exist that work as effectively without some of the unpleasant side effects that these over the counter drugs often entail. Common butterbur (Petasites hybridus) is one such alternative with very positive clinical research backing up its use in humans. Standardized extract from the butterbur plant has been studied and shown to be as effective in alleviating allergy symptoms as Fexofenadine, commonly known as Allegra⁽¹⁾ and Cetirizine, commonly known as Zyrtec or Reactin.⁽²⁾ One study looking at the mechanism of action gave patients two tablets three times a day of the standardized extract of butterbur and found after 5 days not only significant improvement in nasal symptoms but also found decreased levels of histamine and leukotrienes in the blood (both chemicals involved in the inflammatory reactions of asthma and allergies).⁽³⁾ Similarly it has shown promise as a natural alternative treatment for asthma.⁽⁴⁾ Common dosage of butterbur extract for seasonal allergies is 1-2 tablets of the standardized extract, 8 mg Petasins, 2-6 times daily. Based on the research thus far it appears well tolerated and without the sedative effects normally experienced with antihistamines.

Athletes are always looking for ways to improve their performance. Sadly, some take it to such extremes that they end up compromising their integrity. New research suggests Co-enzyme Q10 supplementation may be able to provide that edge while remaining safe and legal to take. Researchers recruited 100 healthy, well- trained athletes preparing for the 2012 London Olympic games and gave them either 300mg of active CoQ10 (Ubiquinol) daily or placebo for 6 weeks.⁽¹⁾ Athletic performance was assessed through assessing maximum power output via a cycling ergometer prior to supplementation, after 3 weeks and after 6 weeks of supplementation. Although the training regimen itself resulted in improved performance, Ubiquinol supplementation enhanced it even more significantly. Additional benefits of CoQ10 for athletes include its ability to reduce muscle damage by reducing oxidative stress and inflammation.^{(2, 3)} Athletes training for any sport typically put their bodies through a significant amount of stress and finding ways to combat the effects of it would only improve their game. From the mounting research on CoQ10 and its many health benefits it seems a natural choice not only for this elite group of individuals but for anyone with a strenuous exercise regimen.

It has been known for some time now that exposure to ionizing radiation, such as from x-rays and CT scans, is carcinogenic. Our risk of developing cancer as a result of this exposure depends on many factors including frequency of use, dose, as well as age, with children being much more susceptible than adults. Alarmingly, the frequency of CT scans being performed in children has significantly increased in the last two decades. One study found a fivefold increase in pediatric CT exams in the Emergency Department between 1995-2008 for concerns such as head injury, abdominal pain and headache.⁽¹⁾ Some of these scans are no question justified but many others are likely debatable. A more recent study looking at the data of CT scans found that between 1996 and 2005 there was a doubling of CT scans in children under 5 and a tripling of scans in those 5-14.⁽²⁾ Even though these rates have begun to decline since 2007, these researchers project that with four million pediatric CT scans of the head, abdomen/pelvis, chest or spine performed each year, 4870 future cancers will result.⁽²⁾ Additional research published in the journal Lancet found an increased risk of developing leukemia and brain cancer with exposure to multiple CT scans.⁽³⁾ Taking all this into account makes one question if perhaps we are overusing this tool. Although a CT scan can provide a physician with valuable information, there are occasions where other diagnostic tools are a viable option. Reasons for ordering CT scans vary, however it appears that reassessing the manner in which children are screened for them is definitely warranted. Parents too need to educate themselves in order to ask the right questions and make sure that if a CT scan is being used the benefits well outweigh the risks.

Most of us have been told from somewhere or other that breakfast is the most important meal of the day and should never be skipped. Yet so many people do just that! Recent research presented at The Endocrine Society’s 95th Annual Meeting in San Francisco provides sound rational for this commonly held perspective. They looked at nine non diabetic, overweight or obese, women averaging twenty nine years of age and assessed whether there were any differences in their insulin levels depending on whether they ate or skipped breakfast.⁽¹⁾ They were assessed on two separate occasions, separated by one month in between. Women were randomly assigned to either breakfast or no breakfast, followed by a standardized lunch four hours later. The following month they had the women switch assignment. Blood was collected every 30 minutes after lunch for three hours and tested insulin as well as glucose levels. The results were significantly higher increases of insulin and glucose after lunch in the women that skipped breakfast. These results suggest that skipping breakfast may contribute to chronic insulin resistance and may lead to the development of diabetes in the future. Others studies looking at how skipping breakfast affects human health have also found metabolic derangements.^(2,3) One of these assessed the diet of a group of 9-15year old and followed up nearly 20 years later finding that those that skipped breakfast in both childhood as well as adulthood had a larger waist circumference, higher fasting insulin, total cholesterol and LDL cholesterol concentrations than those who generally ate breakfast throughout their life.⁽²⁾ The other study followed a large group of men for 16 years, initially free of Type 2 diabetes, cardiovascular disease and cancer, and found men who skipped breakfast had a 21% higher risk of developing type 2 diabetes than men that consumed breakfast.⁽³⁾ Bottom line, breakfast is important to your health so start making time if you don’t already and for all you parents out there, do your best to encourage your kids to create a healthy eating routine at a young age.

Although diet and exercise are considered first line treatment for those with a risk of cardiovascular disease, statins continue to be recommended and prescribed as a primary form of treatment. Although they have been shown to be effective at reducing elevated cholesterol levels and are capable of reducing the risk of cardiovascular events in those with known cardiovascular disease, for others the potential benefit is questionable. Sadly, a large portion of prescriptions are written for those with no known cardiovascular disease solely based on laboratory numbers with a lack of regard of what the benefit to risk ratio is. Research paints an interesting picture to ponder. In those put on statins, over a 5 year period only 1.8% of them will avoid a major cardiovascular disease event.⁽¹⁾ Another study from 2010 looked at the results of 11 clinical trials and found that use of statin therapy in preventing cardiovascular disease in high risk groups did not show any benefit on all-cause mortality over placebo.⁽²⁾ The side effects on the other hand? A recent study looked at whether statin use was associated with developing musculoskeletal conditions. They looked at the medical records of 6967 statin uses and 6967 nonusers during the 2005 fiscal year and found a 19% increased likelihood of developing musculoskeletal disease, a 13% increased likelihood of experiencing an injury-related disease (such as dislocation, sprain, strain), and a 9% increased likelihood of experiencing musculoskeletal pain all in those receiving statin treatment.⁽³⁾ Additionally a risk of developing diabetes while on statins also exists especially for post-menopausal women.⁽⁴⁾ This cautions us to be more proactive in our own healthcare.

Lead has long been recognized as neurotoxic and dangerous to our health. Efforts to minimize exposure have been made by government bodies however its impact on the health but especially development of children remains. Increasing scientific evidence that low levels of lead even as low as 1-2ug/dL, have negative health effects particularly in children,⁽¹⁾ which include decreased IQ, cognition, behavioral issues but also the less often considered cardiovascular, immunological and endocrine effects.⁽²⁾ Studies thus far have focused on assessing IQ with respects to lead. A recently published study took a different perspective, looking at the impact of lead exposure on reading readiness in kindergarten.⁽³⁾ They argue that reading readiness is an early measure of a child’s capacity to integrate cognitive ability and skills learned. Health records, including blood lead levels, and corresponding kindergarten records were obtained for 3406 children in the Rhode Island Public School District.⁽³⁾ The study found that reading readiness is in fact independently associated with blood lead levels well below 10ug/dL. Increasing blood lead levels resulted in progressive decreases in test scores: 68% of children with blood lead levels <5ug/dL achieved the test standard, 62% with blood lead levels between 5-9ug/dL and only 49% with blood lead levels ≥10ug/dL. Data from the National Health and Nutrition Examination Survey (NHANES) obtained from 2007-2010 revealed that 2.5% or about 535,000 US children aged 1-5 had blood lead levels ≥5ug/dL.⁽⁴⁾ The statistics for this age group are likely comparable to Canadian children given that blood lead levels for other age groups are quite similar. It is pretty clear that lead is still very much a health concern and more needs to be done to address it.

Although for some individuals genetic predisposition increases their risk of cardiovascular disease, for most diet and lifestyle choices are the main contributors. Dietary counseling and lifestyle modification should be the first line prescription for those with cardiovascular disease, however effective nutritional counseling is rarely provided. For Naturopathic doctors this is the first thing that is addressed, with nutritional supplementation often prescribed in addition to this staple. A recent study by researchers at the Canadian College of Naturopathic Medicine measured the efficacy of Naturopathic care in reducing the risk of cardiovascular disease. 246 postal workers aged 25-65 years of age with an increased risk of cardiovascular disease were included in the study and randomly assigned to either a treatment group of Naturopathic care or control.⁽¹⁾ The Naturopathic group received 7 visits and their treatments were individualized based on their particular needs; both groups were encouraged to continue receiving care from their medical physicians. Treatments were chosen from a list of predetermined interventions that included regular exercise, natural health products such as omega 3 fatty acids, soluble fiber, coenzyme Q10, plant sterols and dietary recommendations based on the Mediterranean and Portfolio diet. The Mediterranean⁽²⁾ and Portfolio diet⁽³⁾ have a track record of being two of the most beneficial in reducing cardiovascular disease risk. Both intervention and control group had the following measurements taken at baseline, 26 weeks and 52 weeks: body weight, waist circumference, lipid profile, fasting glucose and blood pressure. What they found was a significant reduction in metabolic syndrome and risk of cardiovascular disease in the treatment group compared to the control. This study reiterates the benefit of seeking Naturopathic care in addition to conventional treatment for disorders such as cardiovascular disease which is so prevalent and can be so detrimental.

The omega 3 fatty acids, EPA & DHA, have established themselves as essential fats for good health but have a number of therapeutic uses including in treating cardiovascular disease. Hundreds of clinical trials have shown their importance in this area. A recent study published in the Journal of Nutrition is confirming what other studies have found in recent years, that the EPA component may be more important in reducing coronary artery disease in men while the DHA component may be more important in women.⁽¹⁾ They took 94 healthy men and women, not taking any omega 3 supplementation and consuming less than 2 servings of fish per week, and gave them either an EPA rich supplement (1000mgEPA: 200mg DHA), DHA rich supplement (200mg EPA: 1000mgDHA) or placebo for 4 weeks. Blood was tested for blood clotting proteins before and at the end of the study. Both the EPA and DHA groups saw a reduction in blood clotting compared to the placebo group, however when analyzed for gender, men had a larger reduction when in the EPA group than did the women while women had a larger reduction when in the DHA group. This is not the first study to show this relationship. Two clinical trials published in 2012 found the same relationship. ^{(2, 3)} In one of the studies, the researchers discovered an inverse relationship between testosterone and clotting after EPA supplementation. Although larger clinical trials are necessary to determine if these findings are statistically significant, it may necessary to tailor the EPA/DHA formula according to gender in order to achieve optimal prevention of coronary artery disease. We know for other conditions such as depression the EPA content is more important.⁽⁴⁾ There are many factors to consider when dosing omega-3 fatty acids appropriately. For general health promotion 1000mg of combined EPA + DHA each day gives you a good dose of these essential fatty acids.

Found in virtually every cell in our body but especially at high amounts in cells of the heart, liver and kidney, CoenzymeQ10 is a powerful antioxidant and essential to our body’s energy production. Although levels naturally decline with age, statin medications are known to decrease this even further and since low levels are an independent predictor of mortality in those with chronic heart failure⁽¹⁾ it seems a logical choice for treatment. A recently completed study presented at the 2013 Heart Failure Congress in Lisbon, Portugal is the first study of its kind to show CoQ10 improving survival in those with chronic heart failure. 420 patients classified with stage III or IV level heart failure currently receiving pharmaceutical treatment were randomly assigned to either receive 100mg CoQ10 three times per day or placebo.⁽²⁾ Assessment after three months showed a reduced level of NT-proBNP, a marker used to establish prognosis in heart failure, in the CoQ10 group. On 2 year follow up, the CoQ10 group had significantly less major adverse cardiovascular events, a significantly lower rate of cardiovascular mortality, lower number of hospitalizations for heart failure as well as lower mortality from all causes! In addition to these findings, they also found that fewer adverse events were reported in the CoQ10 group.A number of studies on CoQ10 and heart failure in the past have yielded positive results with virtually no side effects.^{(3, 4, and 5)} Already a standard treatment by most Naturopathic Doctors in treating cardiovascular disease, the latest piece of evidence provides even more support for its current use. Standard dose is 100mg 1-2x/day however higher doses may be recommended depending on the condition being treated.

Homocysteine (Hcy) has come to be known as a reliable marker for cardiovascular disease risk. Elevated levels are associated with coronary heart disease and especially stroke.^{(1, 2)} We know that suboptimal intake of folate, B12, B6 elevates plasma Hcy⁽²⁾ while supplementing with them can reduce it. Although controversy exists around whether supplementation with these reduces the risk of cardiovascular disease, there are several studies that show that folate supplementation and/or the combination of folate, B12 and B6 not only reduces Hcy but also significantly reduces the risk of stroke.^{(3, 4)} A recently published study took a look at how dietary folate compared with supplemental forms of folate in reducing homocysteine levels. They took 149 people with mild hyperhomocysteinemia and prescribed either a 200mcg folate rich diet per day, 200mcg of 5-methytetrahydrofolate, 200mcg of folic acid or placebo⁽²⁾ Interestingly all three treatment groups had a significant reduction in Hcy levels to equal amounts. A folate rich diet has benefits over single ingredient supplementation, as foods high in folate also come packed with a number of other beneficial nutrients. This study illustrates that a folate rich diet can be as effective as supplementation in reducing Hcy levels and thereby lowering our risk of stroke. Daily recommendations for folate are 400mcg for adults, 600mcg in pregnancy and 500-600mcg during lactation. Although many foods are enriched with folate in the form of folic acid; we should always strive to look towards fresh foods to get our fill. A diet rich in fruits and vegetables can provide us with all the folate we truly need. For women that are considering getting pregnant, or are pregnant, a supplement of folic acid in addition to a healthy diet is essential in order to ensure sufficient amounts for proper fetal development. Foods naturally high in folate include: cooked edamame, cooked spinach, cooked artichoke, cooked asparagus, cooked beans (kidney, adzuki, pinto etc), and cooked lentils to name just a few.

Palm oil is the worlds most consumed vegetable oil, being a component of thousands of common products. A recently published human clinical trial in the journal Nutrition Journal shows positive preliminary results in the use of a leaf extract from the palm oil plant, Elaeis guineensis, in reducing elevated blood glucose levels.⁽¹⁾ Thirty willing participants diagnosed with pre-diabetes were included in the study and placed into one of three groups for 8 weeks: 500mg Oil Palm Leaf Extract (OPLE)/day, 1000mg OPLE/day and 1000mg Ficus deltoidae (FICUS), the other herb under investigation in this study. The findings showed a clinically significant positive effect on lowering fasting plasma glucose levels in those with pre-diabetes using OPLE but not with FICUS. The 500mg/day dose showed a more consistent lowering effect than did the 1000mg dose. No serious adverse reactions were reported during this study.This is the first human trail performed on this plant extract, following several promising animal studies done on rats. One of these showed both statistically significant hypoglycemic and anti-oxidant effects with the use of OPLE.⁽²⁾ The other study, although not showing a glucose lowering effect did show significant anti-oxidant benefit which resulted in a protective effect against kidney damage, often a consequence of improperly controlled diabetes.⁽³⁾ With further research, this once discarded part of the plant may become a useful source for a supplement in the management of pre-diabetes and diabetes.

Attachment parenting is thought of by many as a new ‘fad’. Simply put, it is a parenting philosophy that encourages parents to form strong emotional bonds with their child early in life in order to foster social/emotional development and overall well-being. It involves the committed parents to respond to each of their child’s needs in a loving, gentle and non-confrontational manner; and though can be quite demanding at times research is showing it is definitely worth the effort.

An interesting article published this past April in the journal Health Psychology shows an indirect link between attachment relationships in infancy and physical health years later.⁽¹⁾ The researchers followed 163 individuals over a 32 year period. They assessed attachment at ages 12 and 18 months using Ainsoworth Strange Situation Procedure ASSP) and then at age 32 assessed their physical health via a questionnaire. The findings: those with insecure attachment early in life were more likely to suffer with inflammatory illness as an adult than those with secure attachment. Other research shows insecure child-parent bonds experienced in infancy/childhood tends to set the stage for anti-social tendencies, negative self-view and personal distress later on in life.^(2,3) Contrary to what some may still believe, the health and wellbeing of a child begins very early on in life and prevention of various health conditions can and should begin as early as infancy. As Benjamin Franklin so aptly put, “An ounce of prevention is worth a pound of cure”.