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June Health News
Michelle Crowder, ND - Licensed Naturopathic Physician
Hello all! As you make your way into summer, I encourage you to contemplate ways to promote health this season. A few ideas to get started-
Dr. Dimpi Patel and I are co-sponsors for the Growing Up Green Festival in Shelby Township on July 26! We will have a booth set up and will give a talk in the morning - topic and specifics to be announced. It would be great to see you there.
If you have not already, please "like" my page on Facebook to get more frequent updates on classes and presentations, local events, and of course the various health-related articles I find on the web each week. I am still on Twitter, as well. Thank you for your support!
Click here to view the last newsletter from May 2014.
Click here to view archive of past newsletters.
To share this newsletter with friends and family, you may forward it from your email, or use this web link.
En salud,
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75 Barclay Circle, Suite 225
Rochester Hills MI 48307
248-299-1892
michellecrowder.com
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MTHFR - what did you say?
Earlier this month, I announced on Facebook and Twitter that I can now be found in the physician listings at MTHFR.net. This means that I have completed training (and continue to train) with Dr. Ben Lynch, one of the foremost experts in methylation defects and nutrigenomics.
MTHFR stands for methylene-tetra-hydro-folate reductase, which is a gene and an enzyme involved in folate (Vitamin B9) metabolism. People with mutations in this gene have reduced capacity to make active folate from folic acid found in fortified foods and many supplements. Mutations in this and related genes are generally referred to as "methylation defects" and can be at the root of health conditions such as heart disease, miscarriage, autism, mood disorders including anxiety and depression, attention deficits, dementia, cervical dysplasia, and chronic fatigue syndrome. It is important to find a practitioner trained in the diagnostic and therapeutic approach to people with methylation defects. This is an emerging field and a very active area of research.
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10 Ways to Balance Blood Sugar
For Everyone!
Nearly 30 million Americans (that's almost 10% of the population) have type 2 diabetes, and of these, 8 million are unaware. Another 79 million (one third of all adults) have pre-diabetes; the incidence has tripled over the last 8 years. Each year, 11% of people with prediabetes who do not make the necessary lifestyle changes progress to type 2 diabetes. Diabetes can lead to blindness, kidney failure, permanent nerve damage requiring limb amputation, and is associated with increased risk of heart disease, stroke, dementia, and cancer. Between 2001 and 2009, prevalence of type 2 diabetes in children increased by 30%, which is very concerning.
Lifestyle measures are essential in the prevention, treatment, and reversal (yes, it is possible!) of blood sugar imbalances. Lifestyle changes have been shown to be more effective than the drug metformin in prediabetes. Naturopathic care (which includes medications if necessary) has been shown to be superior to conventional care alone in the treatment of type 2 diabetes. Because blood sugar influences energy, mood, weight control, and inflammation, it is important for everyone to regulate, even those without diabetes.
So what are some of the best things you can do to control blood sugar?
1. Eat To Minimize Spikes in Blood Sugar and Insulin
First a bit of physiology... (skip if you don’t like science talk!)
Carbohydrates (found in plant foods like grains, fruit, vegetables, legumes, nuts and seeds) are composed of sugar molecules, including glucose. When we eat carbohydrates, they are broken down into sugars by enzymes in our mouth, stomach, and small intestine, and then absorbed into the blood stream. When sugar levels rise in the blood stream, insulin is released by the pancreas, which serves as a “key” to allow sugar into our cells, where it can be used as energy. A few things happen in response to high blood sugar and insulin:
- High insulin levels signal to the body that our energy needs have been met, and that we can store excess sugar as a reserve for future use. This happens whether diabetes is present or not. Some sugar is stored as glycogen in liver and muscle for short-term use, but the majority is stored as fat for long-term use. So, the longer insulin is elevated in response to a carbohydrate meal, the more fat is stored. Fat, or adipose tissue, can secrete its own hormones called adipokines that further promote diabetes.
- The more quickly blood sugar rises, the more insulin will be released, and the more quickly blood sugar will decrease in response. Thus, simple sugars cause fluctuations in blood sugar that can be at the root of fatigue and mood swings.
- When blood sugar and insulin have been elevated for too long, our cells stop responding to the signal. They no longer take up sugar in response to insulin. This is called “insulin resistance” and is a main feature of type 2 diabetes.
In short, we want to eat in a way that promotes a slow, minimal rise in blood sugar that is stable over several hours. This will reduce spikes in blood sugar and insulin, make cells more sensitive to insulin, promote fat burning, and reduce risk of diabetes. How To:
- Avoid Sugars, Artificial Sweeteners, soda, fruit juice, alcohol, baked goods, pasta, bread (anything made from flour). Depending on the severity of blood sugar imbalance, it may be recommended that you avoid whole grains and starchy fruits and vegetables such as banana, winter squash, potato, carrot, and other root vegetables. These foods are quickly broken down into sugars.
- Focus instead on Fibrous, Non-starchy carbohydrates like nuts, seeds, beans, asparagus, avocado, peppers, broccoli and cabbage family veggies, celery, cucumber, lettuce, okra, onion, radish, spinach, swiss chard, and summer squash.
- Be sure to eat plenty of Healthy Fats (olive oil, avocado, nuts and seeds, coconut, pasture-raised butter) and Proteins (wild cold-water fish, pasture-raised eggs and meats) that slow the emptying of food from stomach to intestine, blunting the rise of blood sugar. Eat protein within an hour of waking to set the stage for good blood sugar control throughout the day.
- Eat Fiber. Although fiber is a carbohydrate, it slows the passage of food through the digestive tract like fat and protein do, promoting stable blood sugar. A high fiber diet has been shown to reduce levels of fasting glucose and insulin. Ground flax seed and chia seed are great sources. Flax seed is high in lignans, which when digested by gut bacteria, create compounds that are associated with decreased risk of type 2 diabetes.
- Combine Foods Properly. Anytime you eat a carbohydrate-rich food, make sure to balance it with a healthy fat, protein, and/or fiber. For example, top a sweet potato with grass-fed butter and serve with baked wild salmon and a green salad. For snacks, consider combinations like celery sticks and almond butter, cucumber rounds with hummus, or fresh berries with raw nuts.
2. Exercise, At Least 30 Minutes Per Day
If you can't fit it all in at one time, don't worry. New research indicates that brief bursts of intense exercise before meals help control blood sugar in people with insulin resistance more effectively than one daily 30-minute session of moderate exercise. In the study, “bursts” were comprised of six 1-minute intense intervals, with 1 minute gentle walking recovery after each burst.
3. Stop Smoking
Nicotine elevates Hemoglobin A1c values, leading to a worsening of blood sugar control and increasing risk of complications.
4. Get Good Sleep
Sleep loss leads to increased appetite and calorie intake and is linked to type 2 diabetes. If you do happen to wake at night, avoid turning on a light or looking at your phone – artificial light at night is linked to circadian rhythm dysregulation and may influence type 2 diabetes risk.
5. Manage Stress
There are countless ways to reduce stress - I encourage you to find those that work for you. Consider Qi Gong, a form of exercise and meditation used in Chinese Medicine, which has been shown to improve blood glucose control, benefit stress and depression, reduce insulin resistance, and aid weight loss in people with type 2 diabetes.
6. Reduce Your Exposure to Chemicals in the Environment
Pesticides, heavy metals, bisphenol-A (BPA), phthalates, dioxins, and perfluorinated chemicals used to make nonstick pans are all associated with blood sugar imbalance and/or diabetes, even in small doses below the EPA limit. To avoid these chemicals, purchase organic foods whenever possible, eat low-mercury fish, avoid plastics and instead use glass or stainless steel containers for food and water, avoid vinyl shower curtains and nonstick cookware.
7. Use Spices and Herbs Liberally
Cinnamon, cayenne, garlic, onion, fenugreek, ginger, turmeric, cilantro, and parsley have all been shown to improve markers of diabetes.
8. Drink Coffee?
Long-term coffee consumption (both caffeinated and decaffeinated) is associated with improved glucose metabolism and lower risk of type 2 diabetes in multiple studies ( 1, 2). Antioxidants in coffee likely play a role, so if you are not already a coffee drinker, perhaps you could get your antioxidants elsewhere - try green tea, berries, and turmeric. Keep in mind that coffee is not good for everyone - it can worsen anxiety and adrenal fatigue, for example - so I recommend discussing it with your physician.
9. Don't Forget Digestive Health
The health of your digestive tract and the organisms that reside there (your "gut microbiota") have been shown to influence blood sugar control, insulin resistance, obesity, and diabetes risk. I address digestive health with every patient - it is that important.
10. Talk To Your Doctor About Supplements
Certain nutrients are associated with better blood sugar control, including chromium, essential fatty acids, and some botanical medicines.
Note: Consult your physician for guidance. These tips are not a substitute for medical care.
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Principles of Naturopathic Medicine Series
In 1989, a group of Naturopathic Doctors met to define our profession. The Six Principles of Naturopathic Medicine were born out of these meetings. The principles have been refined over time, most recently in 2011, and serve as a framework for both defining our medicine and influencing clinical decision-making. As a way to further relate what I do, I will be reviewing one principle per newsletter for the next several months. 4. Treat the Whole Person
5. Doctor as Teacher
6. Prevention
Treat the Whole Person
As Naturopathic Physicians, we do not just look at one small aspect of your health, such as your lungs or your digestive tract - we look at them all. We take a step back, considering all of your symptoms and your health history as a unified whole. We look at the chronology of your symptoms, and how they may have coincided with important life events. We search for patterns of imbalance. Sometimes we even create diagrams to help us piece together the puzzle.
Naturopathic medicine recognizes the harmonious functioning of all aspects of the individual as being essential to overall health. This includes physical health, but also mental, emotional, and spiritual health, as well as social and genetic factors.
The multifactorial nature of health and disease requires a comprehensive, individualized approach to diagnosis and treatment. This is where Naturopathic Physicians excel - we treat the whole person, taking all of these factors into account.
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What is Naturopathic Medicine?
In short, Naturopathic Medicine combines the best of conventional and alternative medicine into an individualized, whole-person approach to primary health care. NDs are trained as primary care providers with an emphasis on natural and common sense approaches including clinical nutrition, lifestyle counseling, and botanical medicine.
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What to Expect from Your Visit
I work with my clients to identify the root causes of disease, taking into account the various factors that influence health, including lifestyle, genetics, physiology, and mental-emotional state. First visits are 90 minutes and include a thorough health history, followed by discussion of my preliminary assessment and recommendations. I may order conventional or specialty lab work to aid in my understanding of your condition. We work together to devise a plan that will meet your health goals.
Follow-up visits generally last 30-45 minutes and are important so that I can better get to know your unique physiology, track your progress, and refine my recommendations. I can consult with your other health providers and make referrals as necessary.
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Integrative Medicine
I am fortunate to work in an integrative primary care practice, alongside a D.O. (Doctor of Osteopathy), N.P. (Nurse Practitioner), and P.A. (Physician's Assistant). We share patients and regularly consult with each other to coordinate care.
I believe this approach benefits patients by offering them the best of both worlds - conventional and natural. These two worlds are not mutually exclusive; in fact, many health concerns are best addressed by a multifaceted approach. The power of Integrative Medicine is backed by research, especially for chronic conditions such as heart disease.
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