The core stabilizing routine is nothing fancy: most of you will have performed all of these exercises before. The trick is to do them every single day without fail and in the order given. Once you have done this sequence a few times, you will have it memorized — and all you need is a little floor space. The first 7 exercises are done standing, the second 7 on the floor. Here they are:

1) Standing tall, pull the tailbone back and the heart forward, letting your arms and head dangle. If possible, keep the back of the legs straight, and reach for the floor. You can rest your hands on your thighs or shins, or, if your hamstrings are flexible, plop your palms on the floor. Breathe into the stretch for 4-5 breaths then roll up the spine, leaving the head to lift last.

2) Hold lightly onto the edge of a table or chair back and, one leg at a time, press the back of the leg away, pushing away from the back of the heel. Don’t sway to the side. Stay upright, as though you were toning your bottom on the side of the leg pressing back, which is in fact what you are doing. Go for about 15 push-backs on one side, then switch legs. Stay upright on the standing leg and push the working leg straight back.

3) Same idea, but now moving the leg to the side, leading with the baby-toe edge of the foot, one leg at a time. About 15 times on each side. Towards the end of the sequence you should feel a little burn in the working muscles.

4) Standing tall but with the knees slightly flexed, toes pointed straight forward, twist at the waist and punch both hands behind you at just above waist level. Look towards your punch. Repeat on the other side. Left and right counts as “one.” Repeat the 2-sided twist 10 times.

5) Standing tall feet slightly apart, knees slightly bent, push your hips right and lean your upper body over to the left as far as possible without making this a forward bend. It’s strictly a side bend. If possible, add the weight of your arm. So, if your body is side bending to the left, your right arm will reach up and over your right ear, reaching to the left. Repeat 5 times in a row on one side, then 5 times in a row on the other side.

6) Simple hamstring stretch: put one foot at a time up on a chair or table, turn your body square to the up-stretched leg, then reach forward for that foot with both hands. You can rest your hands on the shin too. Breathe a few times, always directing the breath to the area of the leg (usually the back or side) that feels tight. Repeat with the other leg.

7) Standing tall, bend one knee, heel towards the butt, and catch the foot with one or both hands. If not wanting to practice balance, keep the free hand on the table or chair back. If your quads are not tight, you can increase this stretch by pulling the heel into the butt and/or pressing the bend leg hip forward a bit. Repeat on the other leg.

8 ) Now to the floor. The next 2 exercises are crunches, and it’s all downhill from there! First, do NOT heave your chest up to the thighs with crunches. That is BAD for your low back. You are on your back, knees bent and feet at least hip width apart, not far from the buttocks. Lift your head and shoulder blades off the floor and place your fingertips behind and slightly above your ears. Try to keep your shoulder blades off the floor throughout this exercise. The idea is to tone the abdominal muscles, which means tightening them. This is a horizontal move. By that I mean you slide the bottom of your ribcage towards the hip bones on the exhale. Inhale relax but don’t lie down. Stay up and perform 20 to 80 of these sliding crunches. Towards the end of your sequence you should start to feel a little burn in the abs.

9) Stay in the crunch position and begin bicycling the legs, stretching way out through the heels. The more your feet point to the ceiling, the easier. As you lower your legs to the floor you will feel more strain. Do not strain! You want to challenge, but NOT re-injure yourself! If the bicycling is OK, you can then b ring the elbows to the opposite knees, one at a time. Left and right is one round. Go for 10 to 40 rounds. Then relax.

10) Hug your knees to your chest. Breathe several deep breaths.

11) Place your feet on the floor, at least hip width apart, and lift your hips to make a flat diagonal plane with your front body. Lower, and repeat for a total of 3-4 times.

12) Roll up to sitting and stretch out one leg long in front of you. Bend the other leg, placing that foot on the upper inner thigh of the long leg. Turn towards the long leg and reach for the foot or shin with both hands. Breathe a few times and repeat on the other side.

13) Find a comfortable cross-legged position, sit tall and twist to the right, putting your left hand on the outside of the right knee to help strengthen the twist. Repeat on the other side.

14) Both legs long in front of you on the floor, reach your hand up and, leading with your heart, reach for the feet or shins with both hands. On the inhale expand the ribcage, and on the exhale undulate your chest closer to the knees. Take several breaths here. That’s it! You are saving your low back! Good job!

Is your conventionally trained physician just telling you to take drugs?

Yikes! High triglycerides can usually be spotted even without lab tests because they look like belly fat, or the classic apple shape body. Ladies, if your waist is more than 34 inches, and gentlemen more than 40 inches, you almost certainly have high triglycerides.

The problem with high trigs is it means not only do you have subcutaneous fat around your torso, but you also have unhealthy fat packed around your heart, liver and lungs.  That reduces circulation to these organs and make them work harder.

If you have lab results handy, look at the ratio between the triglycerides and the so-called “good” cholesterol – HDL (high density lipoprotein).  A good ratio would be 4 or less.  For exampe if your triglycerides are 80 and your HDL is 40, then that’s good!  The ratio is 2. On the other hand, if your triglycerides are 300 and your HDL is 30 — that is not good at all: ratio 10.

There are 2 fairly reliable, non-drug, methods for raising the good cholesterol, HDL, which “travels” around the body gathering up cholesterol, bringing it back to the liver for re-use.  These methods are:

1) Avoid all white sugar, which is especially noxious in liquid form.   Don’t consume ANY high fructose corn syrup, Karo syrup, brown sugar (just white sugar stained with molasses) or maltodextrin.

2) Lift weights.   Go to the gymn, or buy some hand weights at a garage sale.   Start with 20 minutes once weekly for the lower body (squats, lunges, leg presses) plus 20 minutes once weekly for the upper body (push-ups, triceps dips, biceps curls, overhead flies lying on back).  When stronger move up to twice weekly for upper and lower musculature.

The other part of the equation is to lower triglycerides.   This type of “fat” is actually a storage form of sugar. Whenever you eat sugar, or highly glycemic food which turns into glucose quickly in the bloodstream, it becomes available for quick energy.  However, if you are sitting around watching TV, or about to go to sleep, this energy is not needed, and will be converted to the storage form, triglycerides, which literally means three (3) glycerine molecules.  With very few exceptions, when a patient has high triglycerides (or a ratio of Trigs:HDL more than 4) I know they are not active enough and eating too many sweets.  This is also called “metabolic syndrome,” which is a leading cause of cardiovascular disease.

So, your diet needs adjusting.  Here are some dietary ideas to reduce triglycerides:

Eat less of/ Replace with
Red meat / fish or turkey
Hamburgersand hot dogs/ fish or turkey
Eggs/ egg substitute
High fat dairy products/ low fat dairy
butter/ olive oil
Ice cream, cake, cookies/ fruits
Refined cereals/ whole grains
Fried foods/ fresh veggies; steamed or raw
Coffee and soft drinks/ herbal teas, dilute fruit juice

Plus, do add 2-3 tablespoons of fish oil (or 2000-3000 mg mixed EPA and DHA Omega 3 oils, from fish) to your daily diet.  New research shows that fish oil definitively helps to lower triglycerides.

To help reduce sugar cravings take 200 mcg of chromium picolinate (insulin’s little helper) 3 times daily. You can take all 600 mcg at once if that’s more convenient.  Insulin is the molecule produced in the pancreas that accompanies glucose (sugar) INTO the cell, where it is useful for energy.  Sugar is NOT helpful floating around the bloodstream, where it literally rots out blood vessels, causing all sorts of damage including kidney failure and blindness.

Use SPICES to replace sugar — anise seed, fennel seed and cinnamon are all delicious and naturally sweet.  Use STEVIA as a substitute sweetener.  Avoid Nutrasweet, Splenda, Equal and all those fake sugars — they disrupt brain chemistry and have been linked with seizures and attention deficit.

Walk down any street in America and you’ll see the effects of the “obesity epidemic”. Two-thirds of adults, more than 130 million people, are now considered overweight, and nearly half of these are classified as obese. Those who are overweight by 45 kilograms or more are the fastest-growing group of the overweight in the US.   Accompanying these skyrocketing figures are increases in diabetes, heart problems and deaths.

In print and on the airwaves there are numerous stories about how fast food, large portions, sedentary lifestyles and poverty are playing big parts in weight gain, while government bodies desperately throw together public health programmes to educate people about the dangers their lifestyles bring.

Yet one culprit is rarely mentioned: the broad range of psychiatric drugs that can cause substantial weight gain.  They include drugs marketed as antidepressants (such as amitriptyline, doxepin and imipramine), mood stabilisers (including lithium and valproate) and antipsychotics (including clozapine, olanzapine and chlorpromazine).

After 10 years on lithium, for example, two-thirds of patients put on around 10 kilograms.  And in December 2006, The New York Times published an article based on internal documents from the drug company Eli Lilly which indicated that it had intentionally downplayed the side effects of olanzapine, which it sells as Zyprexa.

The company’s data showed that one-third of patients who have taken the drug for a year gain at least 10 kilograms, and half of these gain at least 30 kilograms.  The mechanisms behind this weight gain appear complex and are certainly poorly understood.  Some psychiatric drugs may impair the central nervous system’s control of energy intake, leading to food cravings, whereas others, such as selective serotonin reuptake inhibitors (SSRIs), may alter a patient’s metabolic rate.

Worryingly, doctors are increasingly prescribing multiple psychiatric drugs for the same patient at the same time, even though many effects of doing so, including the effect on weight, have not been investigated.  Doctors often fail to warn patients that the drugs they prescribe may increase their appetites.

We don’t know how much these drugs are adding to Americans’ waistlines, but the number of people affected is likely to be high.  Prescriptions in the US for Zyprexa alone run into millions.  In 2004, 32.6 million Americans purchased outpatient prescriptions for antidepressants, stimulants, antipsychotics and tranquillisers, up from 21 million in 1997.  Overall, around 50 million Americans – that’s 1 in 6 of the population – currently take at least one psychotropic drug.

From a crude look at the numbers, it seems that they could potentially be causing a significant – and growing – portion of America’s obesity problem.

It seems surprising then that commentators rarely make the link between psychiatric drugs and the obesity epidemic.  For example, a report broadcast last year by the PBS TV network called Fat: What no one is telling you included a vast array of lifestyle and physiological factors that could be contributing to weight gain.  Psychiatric drugs were not mentioned.

Another factor that the media and governments have failed to publicise is that rising obesity in teenagers and even young children over the past 10 to 15 years coincides with a fivefold increase in prescriptions of antipsychotic drugs in those age groups, and that children taking these drugs are even more likely to gain weight than adults are.  We don’t know how much of this increase in obesity is due to the drugs, but shouldn’t somebody be finding out?

Though drug-induced weight gain is potentially a worldwide problem, it is a particular concern in the US because American culture is so eager to label negative feelings and problems as evidence that a person is mentally ill – and to push drugs as a supposedly quick fix.  Furthermore, doctors often fail to warn patients that the drugs they prescribe may increase their appetites, and people labelled as mentally ill often learn to attribute all their problems – including eating more – to their psychological disorder.

In a curious article last May in the American Journal of Psychiatry (vol 164, p 708), two doctors even proposed that obesity be classified as a mental illness.  One likely consequence of that would be another massive increase in the prescribing of psychotropic drugs, resulting, no doubt, in another upsurge in obesity statistics.

Recent revelations that some antidepressants may work little better than placebo in most cases (see “Mindfields: Talking down antidepressants”) make the potential scale of the side effects more worrying than ever.  Anyone taking psychiatric drugs who is concerned about weight gain and its associated ill effects should be reminded that to stop taking them suddenly – and what is gradual enough for one person may be far too sudden for another – can precipitate serious withdrawal symptoms.  But at the very least, every person considering taking these drugs needs to be able to make a fully informed decision about whether to get their prescription filled.

The government and the media must take the lead in ensuring that drug companies disclose the extent of the weight gain that their drugs cause and in educating the public about the risks.

Paula J. Caplan is a clinical and research psychologist at Harvard University and author of  “They Say You’re Crazy,”

Vitamin deficiencies are common with celiac disease: especially the B vitamins (lack of which cause an easy stress response, and tingling, then numbing of the extremities), and also the fat-soluble vitamins A, D, E and K can be in short supply.  Bone density can be reduced because celiac disease causes calcium malabsorption.  What is going on in true celiac disease is that part of the gluten molecule (gliadin) destroys the absorptive surface of the small intestine, normally covered in a lush “brush border.”  These myriad tiny finger-like projections, like millions of tiny sea-anemones, become abraded and flattened, thus greatly reducing the surface area for nutrient absorption. 

This is reversible — the body is, in general, naturally self-healing — once the offending substances are removed.  However, untreated, celiac can lead to osteoporosis, profound anemia and seizures.  Celiac disease is particularly prominent among those with Irish heritage.  It is estimated that 3-6% of the Irish population is afflicted with celiac.  Celiac is also more common in families with thyroid disorders and mental illness, particularly schizophrenia.  Although 40% of the US population are thought to carry the celiac HLA DQ2 or DQ8 genes, only 1% ever has a triggering event that leads to activation of these genes and the development of celiac. 

There is a new finger-prick test to screen for celiac which is available in most medical offices.  However, the gold standard to confirm the diagnosis remains small intestine biopsy if the blood test is positive for the tTg and antigliaden IgA markers.  Since the treatment is complete avoidance of gluten, it seems reasonable to me that trying a gluten-free diet for 3-6 months is just as good a confirmatory as a biopsy. 

It can be tricky, however, to completely avoid gluten.  Wheat, spelt, kamut, triticale, barley, millet, amaranth and rye contain gluten. Other words meaning “wheat” are cous-cous, semolina and durum.  Oats don’t contain gluten, but are often contaminated with gluten in the fields or silos.  There are sources of gluten-free oats.  Trace contamination can cause symptoms to come roaring back in sensitive patients.  In families where some folks can eat gluten and others must avoid it completely, it may be impossible to share kitchen utensils.  For example, two separate colanders are essential — one for gluten-containing pasta and another for rice pasta.  Also, the silverware drawer can become contaminated with tiny specks of gluten, which can trigger a reaction in the celiac patients. 

Luckily, most folks do not have celiac disease.  However, wheat sensitivity is extremely common.  Anyone who is fully or half (from one parent only) bloodtype O, or is a non-celiac member of a family with a celiac patient, is advised to consider 12 weeks strictly off wheat, if their health has room for improvement.  Please remember that mental health is equal in importance to physical health.  Wheat sensitivity will often manifest as grumpiness, or desire for binge eating, or mania, or moody PMS.  While avoiding wheat, and certainly all gluten-containing grains, can seem impossible at first glance, there are many foods, and many world-wide cultures, who are not dependent on cheap processed flour. 

In fact, once you delve into the world of non-processed food, and begin to regularly enjoy luscious, organic fruits and vegetables as the staples of your diet, all those cookies and crackers and cheese spreads become quickly unappealing.  Check it out!  You might as well live this life as radiantly healthy as possible!
 

Best book for celiac/gluten intolerance:
“Living Gluten Free for Dummies” by Danna Korn — helpful, user friendly, very funny
 
Gluten-free food and cooking supply sources:
Pamelas (415) 952-4546
Miss Roben’s (800) 891-0083
Gluten-Free Pantry (800) 291-8386
Ener-G-Foods Inc (800) 331-5222
Sylvan Border Farm (800) 297-5399
Celiac Disease Foundation (818) 990-2354
Van’s International Foods (waffles) (310) 320-8611
Authentic Foods (800) 797-5090
The Great Valley Mills (800) 688-6455
 
foods unexpectedly containing wheat:
Grape Nuts
Bouillon cubes
lunch meats
cooked sausages (weiners, bologna, hot dogs)
most gravies
candy bars
ice cream (thickenings)
many thickening agents (use kudzu or guar gum)
any alcoholic drink made with grain: beer, gin, non-potato vodka, whiskey
malted milk
ovaltine
many chocolate drinks
synthetic pepper
some yeasts

More resources:
One brand of yeast that DOES NOT contain any gluten is Red Star Active Dry Yeast               (800) 423-5422.
To make a delicious gluten-free sourdough bread, you need to make a good “starter.”  Rice flour has the ability to ferment easily, creating a wonderful base for delicious breads with a slightly sour flavor.  Once made, the sourdough starter can be used over and over again.  Replenish it each time it is used to nourish the yeast and keep the starter alive.  As the starter gets older, the flavor will become tangier.  Therefore, baked products made with “aged” starters will have more sourdough flavor.  The starter serves as the leavening, so no additional yeast is needed.  To make a starter: in a 4-cup glass or stainless steel container, combine 1 cup water (110-115 degrees F) with 1 package (2 1/4 teaspoons) of Red Star Active Dry Yeast and 1 1/2 cups of white rice flour.  The mixture will be thick.  Cover loosely with plastic wrap or foil.  Let stand in a warm place for 1 to 3 days, stirring 2 or 3 times each day.  The starter will “rise and fall” during the fermentation period; it becomes thinner as it stands.  When the starter is developed, it is bubbly and may have a liquid layer on top.  Stir this liquid into the whole starter before using.  The starter can then be used for baking, or placed in the refrigerator to use later.

Adrenaline is the “fight and flight” neurotransmitter and causes numerous physical responses such as narrowed peripheral blood vessels, shunting blood to the internal vessels, such as in the big leg muscles and the heart and away from the digestive organs.  An adrenaline rush might feel like a strong shot of caffeine, or the heart-twanging scare of a near-miss on a busy highway. 

Humans evolved, for many thousands of years, in an environment much less cozy than what many of us enjoy today.  We were built to outwit and kill larger mammals, and to use our brains to choose between running away when we couldn’t win a fight, or intense spurts of fighting.  Early humans had many protracted periods of significant inactivity, relative to today’s standards of business. 

Whereas we once had occasional, horrific stress, we now tend to have chronic, low-grade stress.  Low-grade stress day after day (bad boss, poor diet, sedentary lifestyle, insufficient sleep, drugs) will build to a point of exhaustion or dysfunctional anxiety.  This is what is meant by adrenal “burnout.” 

What is actually happening is adrenal atrophy.  The glands literally “wear down” and secrete adrenaline on a hair trigger — with no buffering capacity.  There are varying degrees of burnout, which can be measured. 

I have found most success in my naturopathic medical practice in using saliva tests to measure levels of cortisol during 4 periods of the day.  Cortisol is a type of sugar, and doubles for blood sugar maintenance overnight when typically we are not eating.  Cortisol levels should be highest in the morning, then decrease steadily to a low at the end of the day. 

People in adrenal burnout typically show no decrease in cortisol after breakfast, or display some other abnormal variation.  The specific cortisol pattern can provide insight for therapy. 

Some of my favorite techniques to restore adrenal function are centered around getting enough sleep, which often means avoiding stimulants, avoiding unnecessary stressors (such as white flour and white sugar, mean people and too much time on the computer) and committing to finding fun in life, on a daily basis. 

For nutrient support, Licorice (Glycerrhiza glabra) is specific for restoration of the adrenal glands.  Fringe benefit: licorice is also a potent anti-viral.  I strongly recommend licorice tea, or solid extract (sort of a syrupy goo, which is really tasty if you like the strong taste of licorice) or in capsule form if you don’t care for the taste.  Aim for about 2 grams worth of Licorice daily.  Licorice is also very helpful for gastric stress ulcers, which sometimes plague stressed people, particularly men.  Sorry, the red and black candy sticks don’t count!

If you have high blood pressure, Licorice theoretically can worsen hypertension because it acts as a mild potassium-wasting diuretic.  I have rarely seen this to be true, however you can get a special type of Licorice (deglycerinated glycerrhiza – or DGL) which has the diuretic part stripped out. 

Another wonderful supplement for adrenal stress is Vitamin B-5, or pantothenic acid.  You can take a high potency B-multi along with an additional separate dose of B-5 each morning.  Aim to get 200-250 mg of B-5 for 6-12 months, while implementing the lifestyle changes.

Heart disease kills six times more women than breast cancer (Heart Disease and Stroke Statistics 2006 Update. Dallas, Texas: American Heart Association; 2005) but only 30% of women (from a 1997 national survey) recognized CVD as a leading cause of death.  The Red Dress Campaign, kicked off in 2005, raised this awareness to 55% although disproportionately more of this increased awareness was in white or well educated folks.  Help spread the word.  Focus on cardiac health.

Until Bernadette Healy, M.D., became medical director of the National Institutes of Health (NIH) in 1990, most clinical trials studying heart disease did not include women subjects.  Thanks to her, we are now approaching nearly 20 years of clinical trials with women.  Patterns are emerging, such as:

1) Women tend to develop cardiovascular disease 10-15 years later than men; possibly estrogen is protective, although this is controversial.  By age 60, a woman’s risk for CVD equals a man’s risk.  Certainly ingesting hormones increases clotting risk for some women.  On the other hand, smoking lowers estrogen levels and this is thought by some to play a role in why women smokers are more at risk for CVD than comparable male smoking cohorts.

2) In general women are more vulnerable to toxins. Our lungs, livers, and hearts are smaller.

3) Women’s smaller hearts beat faster, even when asleep.  Women have different cardiovascular disease risk factors and manifestation patterns than men.  For example, women are more likely to have MIs not preceded by angina.  (Canto JG, Shlipak MG, Rogers JF, et al. “Prevalence, Clinical Infarction Presenting Without Chest Pain.” JAMA. 2000;283:3223-3229) Women are more likely than men to die from their first heart attack.  Prevention is therefore particularly urgent for women.

4) Women are less likely to develop atherosclerosis, and are likely to have lower blood pressure.  Thus the cholesterol issue is less pertinent for women and the number 200 probably should not be applied to women.  Over half of women presenting with their first heart attack have so-called normal cholesterol levels.  (Burke AP, Farb A, Malcom GT, et al. “Effect of risk factors on the mechanism of acute thrombosis and sudden coronary death in women.” Circulation. 1998;97:2110-2116) A younger woman with high cholesterol may be more at risk for CVD.  However, after age 65, low cholesterol confers increased mortality risk for all diseases, including cardiovascular disease.

5) Daily aspirin has been definitively proven to not prevent the first MI in women, which it may it men, though it can also kill men from provoking bleeding gastric ulcers.  So, ladies, unless you’ve already had a stroke, clot or MI, aspirin is unlikely to help prevent these killer diseases. Watch for women patients unnecessarily taking a baby aspirin a day because some docs are still not up to speed with this concept. (Ridker PM, Cook NR, Lee IM, et al. “A Randomized Trial of Low-Dose Aspirin in the Primary Care Prevention of Cardiovascular Disease in Women.” N Engl J Med. 2005:352:1293-1304)

6) Conventional risk factors affect men and women differently.  For example, high total cholesterol to HDL ratio is more likely to mean atherosclerosis in men.  Women are less likely to build up plaque; they are more likely to have peripheral artery, as opposed to coronary artery, disease.

7) Also, the impact of alcohol consumption worse in women: Alcohol is metabolized more quickly by women, making the immediate impact on heart, brain and liver more severe.  Men have a higher water to fat ratio in their body composition, and this extra water helps men to dilute the effect of alcohol.  Further, women are more likely than men to binge drink, which is the most dangerous way to consume this pickling poison.

From a whole body, naturopathic perspective, we can think of cardiovascular wellness as having both the plumbing and the electricity working well.  In women, the vasculature is less likely to get jammed up with plaque in the coronary vessels, although certainly this happens to women too.  More often, women suffer from peripheral artery disease due to vasospasm and low mineral status.  Not infrequently, patients are chronically dehydrated, and this contributes to preferential distribution of available fluids to the major vessels, at the expense of the periphery.  Plaque (comprised of cholesterol, calcium and bacteria) only adheres to damaged intima, which is why bioflavonoids and avoiding lipid peroxidation are keys to maintaining healthy arterial walls.  We have all seen patients with marginally elevated cholesterol on a statin drug.  Suspect statin side effects with any complaints of muscle fatigue, muscle weakness or muscle cramping.  Statins may also adversely affect the electrical system of the heart.

Women are more likely to have mitral valve prolapse than their male counterparts.  Sometimes this problem is readily fixed with adequate magnesium intake; rarely surgical repair or replacement of the valve is required.  Magnesium and caffeine elimination will also help mild arrythmias, although I recommend electrocautery of ectopic electrical tissue for pronounced tacchycardias such as PSVT and some Atrial fibrillation syndromes.  A pacemaker is generally implanted for chronic and profound bradycardic episodes, and not infrequently directly after the first episode, especially in an elderly patient where the concern is syncope.  You may be able to help your patient avoid a pacemaker by evaluating B vitamin absorption (homocysteine level) and providing nerve nutrients such as lecithin, omega 3 oils, Hypericum, Convallaria and Cactus.

Hypertension (140/90 or more) is possibly the most dangerous of the CVD risk factors, and one of the most difficult to resolve.  It remains a problem of westernized societies; rarely found in rural, agricultural or less developed communities.  Smoking tobacco significantly increases the risk for high blood pressure.  Please quit.  If you have a patient that still smokes, yet continues to seek your services, they are asking for help quitting (even though they may deny that!)  If you have hypertension, enroll in a local meditation class, or learn some other relaxation techniques.  There’s a new tool to improve hypertension via self-awareness called RESPeRATE (www.respearte.com) which is a home biofeedback device, and basically helps you lower blood pressure through breathing exercises.  Daily contrast hydrotherapy (chase your shower or bath with at least one cooler rinse) will also help alleviate circulatory insufficiency.

Find some kind of movement you enjoy: belly dancing, Aikido, ball-room dancing, contact improv, roller-blading, yoga, hula hoops, getting to 10,000 daily steps on your pedometer.  As long as it gets your heart rate up, and you’re having a good time, this is successful exercise.

The American College of Sports Medicine last published exercise guidelines in 1995.  These updates are more exact about the types and duration of exercise. They are based on recent scientific findings about the relationship between physical activity and health. The authors point out that an increase above the recommended minimum amount of exercise may provide further health benefits.

A companion guide is also available for adults ages 65 and over and adults 50 to 64 with chronic medical conditions.  These guidelines are similar but add important detail about flexibility, balance and how to stick with a plan.

Currently only about 25% of the US population follows these guidelines, according to the CDC.  Haskell states this percentage could increase to 50% over the next decade with the active support of the community agencies, medical personnel and, especially, employers.

Classifications of CVD:
Coronary heart disease (CHD) and coronary artery disease (CAD): disease of the blood vessels supplying the heart that may lead to:  

Angina
Myocardial infarction
Congestive heart failure

Cerebrovascular disease: disease of the blood vessels supplying the brain that may lead to:
Transient ischemic attacks (TIA) or mini strokes
Strokes

Peripheral vascular disease: disease of blood vessels supplying the arms and legs that can lead to:
Claudication – obstructed blood flow in arteries,   causing pain
Gangrene – death of tissues in legs due to poor   circulation
Aneurysms - bulges or enlargements in the aorta

Naturopathic protocol considerations:
1) Nattokinase or Lumbrikinase for IMT over 1 mm, for high fibrinogen, for history of or current thrombus.  Proteolytic enzymes not with food are also useful.
2) Hawthorne solid extract to improve lipid digestion and maintain or restore smooth healthy vasculature.  Anecdotally I have not found niacin to be particularly helpful for lipid profile improvement.
3) Rauwolfia serpentina tincture, up to 30 drops twice daily, for hypertension.  Watch for depression.  Anecdotally I have not found arginine to work reliably for HTN.
4) CoQ10 (as much as affordable) and exercise to reduce hypertension.
5) Vit E (not synthetic, mixed tocopherols) for overall cardiovascular health.
6) Vit C & D to promote tissue repair and reduce inflammation (high CRP).
7) To reduce inflammation, avoid white sugar and white flour; increase use of fresh garlic and ginger in the diet; eat less red meat (ideally fresh game only) and avoid fried foods.
8) Take adequate amounts of B6, B12 and folate to optimize homocysteine and reduce stroke risk.
9) Pantothene (B5) to improve systolic (adrenal) hypertension and raise HDL.
10) Magnesium at bedtime to reduce vasospasms, mild arrythmias and diastolic hypertension.
11) If you have high blood pressure, you may need antihypertensive drugs short-term, until the diet and lifestyle changes kick in.  If you are diabetic, avoid beta-blockers which tend to raise blood sugars.  If you are on a calcium channel blocker, magnesium may work just as well. ACE inhibitors often cause a chronic cough.                                                           12) Statin alternatives such as Vit D, red yeast rice or chitin, if warranted.
13) Sodium restriction if the you are salt sensitive.
14) Optimal hydration (avoid diuretics as the kidneys quickly become dependent).
15) Daily movement: know the options in your community.  (see Exercise sidebar)
16)  Avoid fried foods, but not high quality fats.  Fish oils, nuts, flax seed will reduce risk of premature cardiovascular disease.

In closing, evidence is emerging that the long-held “truth” linking saturated fats and high cholesterol levels to cardiovascular disease was based on inaccurate tabulation of data.  For a comprehensive and fascinating discussion of this issue see Volk, MG, “An Examination of the Evidence Supporting the Association of Dietary Cholesterol and Saturated Fats with Serum Cholesterol and Development of Coronary Heart Disease” Alt Med Review: Sept 2007, Vol 12:3; 228-245.  Despite widespread use of statin drugs, cardiovascular mortality in the US has not improved.  In fact, more cases of nerve damage, TIAs, rapid progression to Alzheimer’s, chronic fatigue and depression have been reported in the population taking statins (sample reference: Li G, Higdon R, Kukull WA, Peskind E, Van Valen Moore K, Tsuang D, van Belle G, McCormick W, Bowen JD, Teri L, Schellenberg GD, Larson EB. “Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study.” Neurology. 2005 Apr 12;64(7):1319 . 

It is by now well known that statins deplete CoQ10, and thus produce their array of muscle cramping/muscle wasting side effects.  What has yet to be fully appreciated is the additional devastation caused by artificially lowering cholesterol levels.  Statins may be contributing to the widespread disruption of hormone synthesis (including pandemic hypothyroidism), demyelination of nerves (more depression in the elderly, more dementia, more ALS) and weaker immune response (more colds and flus).  Instead of reflexively reducing cholesterol, clinicians would do well to focus on reducing inflammation instead, using natural therapeutics.  This will provide you with a safer and more effective approach to improved cardiovascular health.  Drink a green smoothie, put your face in the sun, and dance for joy today!

Yes, if you:
Smoke
Are regularly exposed to environmental toxins
Drink less than a litre of water daily
Drink soda pop, coffee or alcohol
Eat processed foods such as white flour baked goods and candy
Crave junk food
Are tired, constipated, bloated and lack focus
Have sticky or malodorous bowel movements
Have pasty skin or dark circles under your eyes
Have blood sugar problems
Have unstable emotions
Have unsatisfactory libido or sleep
Are over or under-weight
Use prescription or recreational drugs regularly

If you peruse natural health news, you certainly have read the word “detox” lately.  You may have heard about how “body burden” of unnatural chemicals is higher than ever before. Industrial run-off into our rivers, pharmaceutical pollution flushed down toilets, burning fossil fuels belching into the air, fake food, plastic everywhere — all of this and more comprises an enormous burden for our internal self-cleansing systems.

The amazing human body has several mechanisms by which to rid itself of non-nutrients which come in daily through our nose and mouth.We process food across the entire mucous membrane from the mouth to the rectum.  The enzymes in our saliva, the all-important stomach acid, the pancreatic enzymes, and the bile from the liver all prepare our food for digestion then absorption into the bloodstream.  Elements of our meals which are deemed unsatisfactory for absorption will be eliminated, via the large intestine.  In case you haven’t heard: pooping at least once daily is crucial to optimal health.  It is unhealthy to allow waste products to linger in the colon. Once in the bloodstream, we have several other methods of screening for “toxins” which is defined as anything our cells can’t use for energy.  As the blood passes through the kidneys, they are “strained” by hundreds of super fine sieves.  Of important job of the kidneys is to remove nitrogen from the blood, which we pee out as ammonia. The lymphatic system, which has a vast network traveling alongside the blood vessels all over the body, also picks up “goop” in the blood and funnels it to the “master” lymph node, called the cisterna chyle, which is located between the heart and the left kidney.  From there, the lymphatic fluid passes into the renal system (kidneys). Last, but not least, the skin is a large and important organ of elimination embedded with sweat glands.  Ideally, strenuous exercise would induce free-flowing and non-odorous perspiration.  Smelly sweat and drenching sweats at rest are signs of elimination difficulties.

Other signs of toxic congestion (and therefore need for “detox”) include constipation, bad breath, irritable skin, fatigue after eating, poor sleep quality and moodiness. A body which eliminates properly will stay healthy.  It’s as simple as that.  I approach “detox” with my patients as an opportunity to change bad dietary habits, and to become enamored of feeling great.  The first order of business is to open the “emunctories” which is an old naturopathic word meaning the portals of elimination.

Start with the skin: I encourage everyone to take up the habit of dry skin brushing every morning.  This is a marvelous “bath” which removes the outer layer of dead skin and not only cleanses but invigorates.  Brush the entire body, fairly firmly, except the face, always towards the heart.  See the sidebar for a more detailed description.

Next, the renal system:  during cleansing it is advisable to drink lots of water.  Pure water is the very best drink.  I don’t agree with the idea of alcohol being “therapeutic”.  It is toxic to the heart, liver and kidneys.  Sure, it will help some folks relax — but there are better ways to relax!  And if you are after the deep pigments of red wine, for example, you can take resveratrol in capsule form or simply eat lots of deeply colored fruits and vegetables.

Do whatever it takes to enjoy the daily poop.  Three times a day, after each meal, is ideal, but many of us just can’t make time for that.  I like using a stool, or “Welles step”, under my feet while at the toilet because it helps simulate a squatting position, which is how we were designed to poop. Cold stewed prunes (just put some prunes and water in a small covered jar and keep in the fridge) or 500 mg of Magnesium at bedtime are simple, non-addictive laxatives.  Avoid cascara sagrada — it is too harsh.  Digestive aides such as fennel seed, ginger root and mint leaves, in teas or whole form, can help improve digestion and elimination.

I advise my patients to avoid cleansing or fasting during cold weather, when we are directing energy towards staying warm..

It’s a good idea to cleanse or fast with at least one “buddy” if possible — so you can cheer each other and help maintain your mutual commitment to optimal health.  I advise against advertising to all your friends and family that you are undertaking a cleansing project because they might not all be supportive.  If they ask, you can tell.  Figure out a good time and how much time you can commit.  Remember, this is not a crash diet.  It’s a chance to open the emunctories, enjoy some deep internal cleansing, and explore the possibility of healthy eating and healthy living every day for the rest of your life.  The most important part of detox is coming off the program.  Your stomach will be smaller and your internal organs more sensitive to “junk.”

Please go slowly in the week after a detox program.  Do not plan or attend a gastronomic extravaganza soon after cleansing.

Three Day Plan
This is an all-fresh fruit cleanse.  Fruits are high in water, fiber and slow-releasing sugars.  They are tasty!  Neither juice nor dried fruit is allowed — too concentrated.  Eat whatever fruits appeal to you, one serving every two hours while awake.  A serving means 1 large or 2 small apples, 6 apricots, 1 medium banana, 1-2 cups berries, cherries or grapes, 2 oranges or nectarines, 1 cup of pineapple, 1 large pear, 2 kiwis, 3 plums or tomatoes, 2 cups of cubed melon.  Mix it up!  Eat only fruit.  For a complete description see “Fruit Flush” by Jay Robb.

Seven Day Plan
This involves 2 days of preparation, 3 days of “fasting” and 2 more days of slowly re-introducing your regular (but hopefully transformed) diet.  During the first 2 days, eat only raw food: mixed salads, fruit, steamed veggies.  Drink plenty of water between fruit or veggie meals.  Avoid juices.  However, during the 3 “fasting” days you will drink diluted juices and broths and tea and plenty of water.  No solid food because the idea is to give the digestive system a rest.  Sip on fluids all day long.  Fresh juices are best.  Green drinks or protein powders are fine.  The last 2 days are like the first 2: raw fruits and veggies only.  I recommend fruit only in the morning and veggies after noon.  For a complete description, see “Prescription for Nutritional Healing” by James and Phyllis Balch.

Fourteen Day Plan
This allows 3 days of preparation with raw food only, and also using a bulking drink (1 T psyllium husk or other fiber such as ground flax seeds, mixed with water) three times daily, ½ hour before eating.  Next follows 5 days of liquid only: broths, fresh juices, tea, water.  You should be able to go to work and do your normal day, you will have good energy, but don’t plan extra activities.  Allow for more rest in your schedule.  If no stool is produced during the liquid-only days, an enema is strongly recommended.  Colonics are fine too if you are squeamish about giving yourself the treatment!  The last 6 days are the most important.  You will SLOWLY re-introduce foods one day at a time.  For a complete description of this plan see “The Fasting Diet” by Dr. Steven Bailey.

Twenty Day Plan
This is a slightly longer but less rigorous cleansing plan.  The rules are simply to eat foods high in beta-carotene (sweet potato, carrots, spinach, cantaloupe, pumpkin, kale, winter squash) and high in Vitamin C (citrus fruits, broccoli, strawberries, tomatoes, melons, potatoes, bell peppers, Brussels sprouts, cabbage) for 20 days.  Additionally you will drink plenty of water between meals and snacks.  You are allowed to eat anything in moderation except for the following:
Wheat and other gluten-containing grains        
Milk and dairy products        
Eggs, meats or farmed fish        
Sugar        
Artificial sweeteners        
Alcohol        
Caffeine        
Soft drinks        
Foods containing artificial flavorings, colorants or preservatives        
High-fat foods        
Salty foods

The idea is, you will feel so good after this program that you’ll decide to eat this way for the rest of your life!  For a complete description see “The 20-Day Rejuvenation Diet Program” by Dr. Jeffrey Bland.
Detox Super-Tool:

Skin Brushing

Brushing your skin with a long handled dry skin brush (I like Bass or Yerba Prima brushes) each morning before or instead of showering is the finest “bath” your body could ask for.  Nearly 80% of ordinary household dust is shed skin cells from the outermost layer, a completely natural process.  Brush in long firm strokes towards the heart.  I start standing next to a chair or bathtub so I can put one foot up at a time.  Brush firmly under the sole of the foot then up and all around the leg.  Repeat on the other foot and leg.  Then gently brush the hips and buttocks, which should turn a bit pink.  Brush the hands and up the arms.  Stroke the belly in a clockwise direction (to follow the flow of the colon) and up the side ribs.  Brush up under the breasts (and, ladies, be aware of the consistency of your breasts as you do this).  Brush under the chin and down the top ribs, then reach behind with the long handle and scrub the back as thoroughly as possible.  Don’t forget the shoulders.  You may want to get a small soft brush for your face.  This feels absolutely divine and is marvelous for your skin.
Detox Reactions

When you give your body a rest from the daily onslaught of processed food, elimination begins to progress immediately.  This can “stir up” toxins that have been stored in the colon or in fat cells and create a variety of reactions such as depression, headaches and fatigue.  Your skin may break out as toxins are eliminated.  Here are several ideas that can help:

1) drink more water to flush toxins through the kidneys more quickly

2) increase Vit C to up to 10 grams for tissue repair and to hasten the ridding of toxins

3) use bentonite (clay) baths to pull toxins out through the skin.  These baths may be taken twice daily: use ½  cup liquid clay in a tub of warm (not hot) water and soak for 20 minutes

4) eat steamed organic beets, which will turn your stool deep purplish.

Drug addiction and various forms of pathological gambling has widely ruined personal finances, family cohesiveness and health.  Relapse rates are extremely high.  These studies offer much hope for an inexpensive, non-toxic option for healing.

N-acetylcysteine, a form of the sulfur-containing amino acid cysteine is a precursor to the brain neurotransmitter glutamate.  There is observational evidence that low levels of glutamate in the brain will increase compulsive and addictive behaviors and intensify cravings. Taking NAC by mouth has been shown to increase glutamate concentrations in the regions of the brain (the nucleus accumbens) which, when low in glutamate, promotes addictive behavior.

In the first study, 15 volunteers with a history of cocaine addiction received either 600 mg of NAC
or placebo every 12 hours for 2 days.  The test subjects taking NAC were significantly less likely to scan the internet for cocaine-related news than those on placebo, and the NAC group also revealed in a questionnaire an impressive reduction in cocaine craving (1).

A second study conducted by the same investigators, gave 23 cocaine addicts who were seeking treatment 600, 1200, or 1800 mg of NAC twice daily for 4 weeks.  Sixteen patients completed this study and cocaine use dropped dramatically.  The amount of NAC didn’t seem to matter, and no side effects were noted.  Before seeking help, the 16 patients who stuck with the 4 week program, on average, decreased their cocaine use from 8 days out of the month before starting the NAC, to only 1 day during the month taking NAC (2).

This sounds great (85% reduction in cocaine use) but keep in mind that these patients sought treatment.  The will to arrest a destructive behavior is key to successful therapy.  NAC may help correct brain chemistry, for less than $2 per day, and cement the desire to quit with the ability to
modify behavior.

The third study looked at offering up to 1800 mg daily of NAC to those wanting to relieve themselves of their addiction to gambling.  A positive response to treatment was defined as at least a 30% decrease in parameters measured by a tool called “Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling.”  The average effective dose of NAC was 1500 mg daily.  Sixteen gamblers completed the study and their scores improved 42% (3).

Earlier studies have suggested that there is a biochemical component to addiction.  The beneficial effects of glutamine, B vitamins, lithium, and dietary modifications have been shown for people addicted to alcohol. The field of optimizing brain chemistry is in its infancy.  Hopefully future research will continue to focus on safe, natural, inexpensive and effective nutrients to provide much-needed help for the millions of people who want to quit, but haven’t yet.

References:

1. LaRowe SD, Myrick H, Hedden S, Mardikian P, Saladin M, McRae A, et al. Is cocaine desire reduced by N-acetylcysteine? Am J Psychiatry 2007;164:1115-1117.

2. Mardikian PN, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ. An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study. Prog Neuropsychopharmacol Biol Psychiatry 2007;31:389-394.

3. Grant JE, Kim SW, Odlaug BL. N-Acetyl cysteine, a glutamate-modulating agent, in the treatment of pathological gambling: a pilot study. Biol Psychiatry 2007;62:652-657.

than indicated by previous research (Arch Intern Med 2005; 165: 265–72).

Previous research that compared death rates in vaccinated and unvaccinated groups of elderly people have shown that flu vaccination reduces all winter deaths by 50%. “But it’s really hard to find out who died of influenza because it’s not a reportable disease and few people are tested”, says lead NIH researcher Lone Simonsen.  Some research has tested the efficacy of flu vaccines on illness but has not evaluated the effect of flu vaccines on influenza death rates in elderly people.

Over the past 25 years, the proportion of those aged 65 years or more who receive flu shots has climbed from 15% to 65% in the US.  Previous research that compared death rates in vaccinated and unvaccinated groups of elderly people concluded that flu vaccination reduces all winter deaths by 50%. Yet current estimates of winter death causes suggest that flu-related mortality has actually risen since 1980.

Simonsen’s team took into account an ageing population and the exceptional virulence of a flu strain prevalent in the 1990s.  When her team analyzed the available data for causes of death in the elderly during the past 25 years, she says that about 10% of winter deaths could be
attributable to influenza, and more during the “pandemics” of the 1990s.  The older study estimating 50% reduction of deaths in the winter was evidently “overestimating the mortality benefit of vaccination.”  This is because the “endpoint” in these studies (death) wasn’t limited to death from the flu.  Many winter deaths in the elderly are from pneumonia, and getting a flu shot would have no bearing on preventing death from pneumonia.

More older folks were getting flu shots, yet more of them were dying of the flu.  It doesn’t add up.

Publication of Simonsen’s new study provoked strong reactions. The Centers for Disease Control and Prevention (CDC) reiterated its faith in existing studies, and questioned the methodology of the NIH study. Concerned by the impact of official disagreements on public confidence, the CDC
and NIH released a joint statement, saying that annual vaccinations continue to provide the best protection for elderly people.

Despite that official statement, other researchers, such as Dr. Ira Longini (Emory University, Atlanta, GA) maintains, “it is clear that increasing vaccination of the elderly has not resulted in a decrease in pneumonia and influenza mortality in that age group.” He points to a mix of robust
and frail immune systems in the population as an explanation for why some folks succumb to the flu, and why vaccination status doesn’t seem to matter. “As we increase vaccine coverage, a proportion of the elderly do not respond to vaccination and will get sick and die from flu whether they are vaccinated or not.”

Another way of saying this is: vaccinations may not impact death rates in the elderly at all.  Further, given that the flu shot is still preserved with a mercury product (thimerosol), and that mercury toxicity has been linked to more rapid progression of Alzheimer’s in the elderly, one hopes that a future study will explore whether the elderly are actually better off without flu vaccines at all.