Thursday, June 16, 2011
Wednesday, May 11, 2011
Friday, June 11, 2010
Eggs: What do the labels mean?
As a naturopathic doctor I see it as my job to educate my patients and give them the facts about food production. Unfortunately I see so many marketing schemes which are fooling people into purchasing the "wrong" product.
When it comes to eggs, we often see this as a very important part of many diets. Eggs contain protein and high quality fats. The fats found in egg yolk are very important for a developing child's brain. The proteins in egg whites are very important for a balanced diet.
Please find below some information on eggs. I hope that you find it useful!
If you are looking for eggs from hens not raised in cages (cage-free), here are a few helpful tips:
Certified Organic:
Hens raised free-range (access to roam outdoors, weather permitting). Hens are given perches, nest boxes and dust bathing areas. Provides the most space per bird. Farms are independently audited for animal welfare.
SPCA Certified:
Hens raised either free-range (access to roam outdoors, weather permitting) or free-run (roam freely inside a barn - no outdoor access). Hens are given perches, nest boxes and dust bathing areas. Farms are independently audited for animal welfare.
Free-Range:
Hens have access to the outdoors (weather permitting). If not "certified", farm is not independently audited for animal welfare standards. Visit the farm or check references for guarantees.
Free-Run:
Hens roam freely inside a barn - no outdoor access. If not "certified", farm is not independently audited for animal welfare standards. Visit the farm or check references for guarantees.
All other eggs:
Are from battery-caged hens. These hens are crammed 5 hens per cage into tiny wire cages so small they can barely move, let alone flap even one wing.
Watch out for misleading labels that only say "Omega-3", "Farm fresh", "Natural", or "Vegetarian Feed", as they all come from battery-caged hens.
Even though cage-free hens are not kept in cages, it does not mean that egg production is completely humane.
When egg production declines - after approximately one year - all hens are slaughtered or killed on farm and used for compost. Because of this, some people choose not to buy eggs at all.
What are your options? Find out more at www.chickenout.ca.
THIS POST IS FROM Chicken Out! at THE VANCOUVER HUMANE SOCIETY. For more information please contact info@chickenout.ca or visit their website at www.chickenout.ca.
THANX FOR READING!
When it comes to eggs, we often see this as a very important part of many diets. Eggs contain protein and high quality fats. The fats found in egg yolk are very important for a developing child's brain. The proteins in egg whites are very important for a balanced diet.
Please find below some information on eggs. I hope that you find it useful!
If you are looking for eggs from hens not raised in cages (cage-free), here are a few helpful tips:
Certified Organic:
Hens raised free-range (access to roam outdoors, weather permitting). Hens are given perches, nest boxes and dust bathing areas. Provides the most space per bird. Farms are independently audited for animal welfare.
SPCA Certified:
Hens raised either free-range (access to roam outdoors, weather permitting) or free-run (roam freely inside a barn - no outdoor access). Hens are given perches, nest boxes and dust bathing areas. Farms are independently audited for animal welfare.
Free-Range:
Hens have access to the outdoors (weather permitting). If not "certified", farm is not independently audited for animal welfare standards. Visit the farm or check references for guarantees.
Free-Run:
Hens roam freely inside a barn - no outdoor access. If not "certified", farm is not independently audited for animal welfare standards. Visit the farm or check references for guarantees.
All other eggs:
Are from battery-caged hens. These hens are crammed 5 hens per cage into tiny wire cages so small they can barely move, let alone flap even one wing.
Watch out for misleading labels that only say "Omega-3", "Farm fresh", "Natural", or "Vegetarian Feed", as they all come from battery-caged hens.
Even though cage-free hens are not kept in cages, it does not mean that egg production is completely humane.
When egg production declines - after approximately one year - all hens are slaughtered or killed on farm and used for compost. Because of this, some people choose not to buy eggs at all.
What are your options? Find out more at www.chickenout.ca.
THIS POST IS FROM Chicken Out! at THE VANCOUVER HUMANE SOCIETY. For more information please contact info@chickenout.ca or visit their website at www.chickenout.ca.
THANX FOR READING!
Thursday, May 27, 2010
United School of Self Defence: Nutrition Lecture Notes
Nutrition Lecture – United Studios of Self Defense
QUIZ
• Complete this sentence..... You are what __EAT_______
• What is better for you and why? Skim Milk or Whole Milk (3.25%)
• Which is better for you and why? Watermelon or an apple?
• What % of the calories in spinach come from protein alone? 30%
• True or False? A vegetarian diet can be complete with all the necessary nutrients required for optimal health.
• What are the key nutrients which a vegetarian/vegan must be ultra conscious to get? Calcium, iron, zinc, protein, omega-3
• True or False? You need to supplement with vitamins in order to maximize your exercise routine?
• True or False? All fish, no matter where it comes from is good for you. Farmed salmon contains up to 40 times more PCB’s per serving than other foods.
• True or False? All tuna is bad. Best: canned chunk light (<6 servings per month), canned albacore (<3 servings per mo.), bigeye, and ahi tuna (avoid completely)
• What are the vegetables and fruits that comprise the “dirty dozen”? Peaches, strawberries, apples, domestic blueberries, nectarines, cherries, imported grapes, celery, sweet bell peppers, spinach, kale, collard greens, potatoes, and lettuce
• What are the fruits and vegetables that comprise the “Clean Fifteen”? Onions, sweet corn, sweet peas, asparagus, cabbage, eggplant, sweet potatoes, avocadoes, pineapples, mango, kiwi, domestic cantaloupe, watermelon, honeydew, and grapefruit
• What is the key mineral required for muscle contraction? Calcium. Leafy greens, almonds, soy, tahini, blackstrap molasses, broccoli
• What is the key mineral required for oxygen transport? Iron. Soy, lentils, spinach, quinoa, blackstrap molasses
• What is the most important spice for controlling blood sugar? Cinnamon • What is the most researched spice for it’s antioxidant potential? Turmeric
• What is the most important meal of the day? Breakfast
• What are the three keys to optimizing your martial arts practice? Strength, flexibility, and endurance.
• How do I avoid muscle fatigue during practice? Hydration, Alkaline diet, high in calcium, and adequate carbohydrate stores
• Which of the following will benefit your martial arts practice? Stress, low blood sugar, food allergies, adequate sleep, excess estrogen, viral infections
• How much sleep should you get and when during the day is sleep most important? Varies from 6-9 hours per night. Sleep before midnight is most important.
• How many times per day should you eat? 3 meals and 2 snacks per day. Breakfast at 7AM, Snack at 10AM, Lunch at 12 noon, Snack at 3PM, Dinner at 6PM. If you are in a martial arts class in the evening, you will require a third snack before bed.
• How many calories should you eat per day? Varies with activity and muscle mass. On average, men require more calories than women.
• Who determines organic certification of food in Canada?
The Organic Products Regulations (OPR) require mandatory certification, by a CFIA accredited Certification Body, to the Canadian Organic Standards (Canadian Organic Production Systems Standards: General Principles and Management Standards and the Permitted Substances Lists) for agricultural products represented as organic in import, export and inter-provincial trade, or that bear the federal organic agricultural product legend (or logo). Imported organic products may also meet the requirements of the Organic Products Regulations by being certified to a standard deemed to be equivalent under an equivalency determination agreement with a foreign country by a Certification Body accredited by that foreign country. [Part 2, Part 4, OPR] The Canada Organic Regime is the Government of Canada's response to requests by the organic sector and consumers to develop a regulated system for organic agricultural products. The Organic Products Regulations are designed to protect consumers against false and misleading organic claims and govern the use of the new organic logo. The Canadian Food Inspection Agency: www.inpection.gc.ca
Basic
• Intake
o Requirements vary according to age, weight, body fat, sex, activity
o Limiting intake can lead to hormonal imbalances and weight gain
Med Sci Sports Exerc. 2009 Mar;41(3):709-31. American College of Sports Medicine position stand. Nutrition and athletic performance.
Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density may require supplements
FLUIDS • Water: 1oz/kg body weight per day (does not include teas, caffeine)
o Note: for every glass caffeine, must have twice amount in water
J Int Soc Sports Nutr. 2010 Jan 27;7(1):5. International society of sports nutrition position stand: caffeine and performance.
ABSTRACT: Position Statement: The position of The Society regarding caffeine supplementation and sport performance is summarized by the following seven points: 1.) Caffeine is effective for enhancing sport performance in trained athletes when consumed in low-to-moderate dosages (~3-6 mg/kg) and overall does not result in further enhancement in performance when consumed in higher dosages (>/= 9 mg/kg). 2.) Caffeine exerts a greater ergogenic effect when consumed in an anhydrous state as compared to coffee. 3.) It has been shown that caffeine can enhance vigilance during bouts of extended exhaustive exercise, as well as periods of sustained sleep deprivation. 4.) Caffeine is ergogenic for sustained maximal endurance exercise, and has been shown to be highly effective for time-trial performance. 5.) Caffeine supplementation is beneficial for high-intensity exercise, including team sports such as soccer and rugby, both of which are categorized by intermittent activity within a period of prolonged duration. 6.) The literature is equivocal when considering the effects of caffeine supplementation on strength-power performance, and additional research in this area is warranted. 7.) The scientific literature does not support caffeine-induced diuresis during exercise, or any harmful change in fluid balance that would negatively affect performance. Int
J Sport Nutr Exerc Metab. 2009 Dec;19(6):624-44.
The effects of EGCG on fat oxidation and endurance performance in male cyclists. Researchers have long been investigating strategies that can increase athletes' ability to oxidize fatty acids and spare carbohydrate, thus potentially improving endurance capacity. Green-tea extract (epigallocatechin-3-gallate; EGCG) has been shown to improve endurance capacity in mice. If a green-tea extract can stimulate fat oxidation and as a result spare glycogen stores, then athletes may benefit through improved endurance performance. Eight male cyclists completed a study incorporating a 3-way crossover, randomized, placebo-controlled, double-blinded, diet-controlled research design. All participants received 3 different treatments (placebo 270 mg, EGCG 270 mg, and placebo 270 mg + caffeine 3 mg/kg) over a 6-day period and 1 hr before exercise testing. Each participant completed 3 exercise trials consisting of 60 min of cycling at 60% maximum oxygen uptake (VO2(max)) immediately followed by a self-paced 40-km cycling time trial. The study found little benefit in consuming green-tea extract on fat oxidation or cycling performance, unlike caffeine, which did benefit cycling performance. The physiological responses observed during submaximal cycling after caffeine ingestion were similar to those reported previously, including an increase in heart rate (EGCG 147 +/- 17, caffeine 146 +/- 19, and placebo 144 +/- 15 beats/min), glucose at the 40-min exercise time point (placebo 5.0 +/- 0.8, EGCG 5.4 +/- 1.0, and caffeine 5.8 +/- 1.0 mmol/L), and resting plasma free fatty acids and no change in the amount of carbohydrate and fat being oxidized. Therefore, it was concluded that green-tea extract offers no additional benefit to cyclists over and above those achieved by using caffeine. Nutrients Snack and meals should be of the following proportion: 25% lean protein, 25% complex carbohydrates, 50% leafy green vegetables. Portions are individualized: 25% is equivalent to the size of your palm and one thumb thick. 50% vegetables is equal to the size of both hands, including fingers, if raw and one hand, including fingers if cooked. Never overcook your vegetables as they will loose key enzymes and vitamins required for optimal health.
Fiber:
Importance: regularity facilitates elimination of body’s waste products Swamp Water Recipe o
Recipe: mix 1 cup each of ground flax, psyllium husks, and oat bran. Add 1.5 tbsp ground turmeric and 1.5 tbsp cinnamon. Take 1 tbsp 2 x per day in 3-5 oz water or sprinkle on salads, oatmeal, or rice/pasta.
o Store in airtight glass container in your refrigerator. Buy whole flax seeds and grind at home in your coffee grinder.
Carbohydrates:
Be very mindful of complex vs. simple carbs (avoid simple carbs). Examples of complex carbohydrates: Squash, Quinoa, Brown Rice, Oatmeal (Whole, not quick), Amaranth, Kashi, Millet, Yams. Examples of simple carbohydrates: White rice, white flour, sugar (indluding fruit sugar and honey)
Int J Sport Nutr Exerc Metab. 2010 Apr;20(2):154-65.
Glycemic index and endurance performance. Initial research investigating the impact of GI on postexercise recovery indicated consuming high-GI (HGI) CHO increased muscle glycogen resynthesis. However, recent studies indicate an interaction between LGI CHO and fat oxidation, which may play a role in enhancing performance in subsequent exercise. Despite the fact that the relationship between GI and sporting performance has been a topic of research for more than 15 yr, there is no consensus on whether consuming CHO of differing GI improves endurance performance. Until further well-designed research is carried out, athletes are encouraged to follow standard recommendations for CHO consumption and let practical issues and individual experience dictate the use of HGI or LGI meals and supplements before, during, and after exercise.
Fats:
Be very mindful of good and bad fats. Also, be mindful of oxidized fats and fats from seafood. Caution with nuts: eat raw and/or soaked (minimum 6 hours). Do not fry with olive oil. Note that fats carry PCB’s and dioxins, hormones, and other chemicals. Organic fats are important.
Protein:
Take home message: Do not overdo it! 0.7g/kg body weight/day 10 essential amino acids. These do not all have to be consumed at the same time. Cooking denatures amino acids making them less bio-available. Meat protein is more acidic and more difficult to digest.
After intense anaerobic exercise, where lactic acid accumulation is high, and adrenaline is high, you want to avoid acidic foods which are difficult to digest.
Side note on pH: consume alkaline diet, especially after anaerobic exercise. Grains, meat, fish, dairy and beans are very acidic. Foods which are alkaline and high in protein include: cottage cheese, fermented soy, soaked grains, and soaked nuts.
Alcohol: 8kcal/g alcohol (note that fat contains 9kcal/g); affects blood sugar, B vitamin status, appetite etc...
Factors affecting weight
• Sex hormones
• Blood sugar
• Stress
• Toxins
• Food sensitivities/allergies: artificial sweetners, corn, dairy, wheat, soy and gluten, yeast are the most common food allergens. These evoke immune response causing inflammation.
Food ideas
• Canada’s Food Guide – Review
• Fish – Review good choices
• Special foods / herbs
o Cinnamon
o Bitter melon
o Garlic
o Blueberries
o Oolong tea
o Turmeric
o Ginger
o Licorice
Foods to include
Recommended fats (3-4 of the following per day):
Avocado, Sunflower seeds, pumpkin seeds, Cold-water fish, Natural Nut Butters, Cheese (Goat, Sheep), Nut/seed oils, Olives o
Recommended proteins (4-6 of the following per day):
Beans (dried or fresh), Extra lean ground turkey, Chili, Chicken breast (organic, white meat), Crab (sparingly), Extra extra lean ground beef, Egg whites (only 2-6 egg yolks per week), Haddock, Red snapper, Liver, Lobster (sparingly), Extra hard tofu, Natural nut butters, Nuts (sparingly) – almonds are best, Cottage cheese, Wild salmon, Yogurt, Milk, Soy beans, Soy foods (*Tempeh), Swordfish, Shrimp, Turkey breast, Trout, Tuna (NOPE!), Veggie burgers, Wild game (venison, rabbit, buffalo)
Recommended starches – before 1 PM (2-3 of the following per day):
Brown or green pasta, steamed brown rice, steamed wild rice, Whole grains (see other handout) o Recommended Fruits – before 1 PM (2-3 of the following per day): Apples, Bananas, Blueberries (anytime), Blackberries, Cantaloupe (anytime), Grapefruit (anytime), Peaches, Pears, Plums, Pumpkin, Squash, Watermelon (anytime), Pineapple, Raspberries, Strawberries, Tropical fruits o
Recommended Vegetables – anytime (4-6 of the following per day):
Arugula, Asparagus, Artichoke, Beans (string), Beets, Broccoli, Brussels sprouts, Cabbage, Celery, Cucumbers, Eggplant, Kale, Kohlrabi, Lettuce, Mushrooms, Parsley, Parsnips, Peas, Peppers, Radishes, Rutabagas, Snow peas, Spinach, Tomato, Turnips, Watercress, Yams/Sweet potato, Zucchini •
Foods to avoid
All Processed foods, Cakes, Candy, Cream dressings / sauces, Chips, Dried Fruits, Ice Cream, Processed Cereals, Flour gravy, Fried Foods, Fruit Juices, Mayonnaise, Margarine, Pop (Diet and Reg), Sugar added Jams/jellies, Pies and Pastries, White Pastas (processed), Sugar (white or brown), Rice cakes, Deli meats and bacon
Discussion:
Healthy Breakfasts:
• Whole Oats with 1 tbsp nuts, milk (or milk alternative), and 1⁄4 c organic berries.
• 2 Organic Eggs, Whole grain bread, Fruit
• Avocado and Whole grain bread
• Organic Yogurt and Muesli
• Baked organic chicken breast, or wild salmon with baked red peppers and cream cheese on whole grain toast.
Healthy Snacks:
• Vegetable sticks with tzatziki, or hummous, or baba ganouj
• 1⁄4 c raw nuts with vegetables or fruit
• Organic cheese and crackers with vegetable sticks
Healthy Lunches:
Healthy Dinners:
Grocery Stores:
• Famous Foods: 1595 Kingsway (@ King Edward Ave, i.e. 25th Ave)
• Donald’s Market: 2342 East Hastings Street (@ Nanaimo St), 2279 Commercial Drive (@ 6th Street)
Cookbooks:
• Veganomicon. Isa Chandra Moskowitz, Terry Hope Romero.
• How it all Vegan. Sarah Kramer and Tanya Barnard
• Jamie's Food Revolution: Rediscover How to Cook Simple, Delicious, Affordable Meals. Jamie Oliver
Resources:
• Environmental Working Group: for information on pesticide content of fruits and vegetables: www.ewg.org
• Health Canada Food and Nutrition: for a customized food pyramid for kids and adults and other information on health and food recalls. www.hc-sc.gc.ca/fnan/index-eng.php
• Organic Agriculture Center of Canada: for information on the policies and procedures governing Organic Farming: www.organicagcentre.ca
• The Cove Movie: for information on mercury content of fish: www.thecovemovie.com/educate.htm
• Pub Med: Online Medical Journal Site: www.ncbi.nlm.nih.gov/pubmed/
• David Suzuki Foundation: for information on health and wellbeing: www.davidsuzuki.org
• Calorie Counter: to assess food intake and requirements: www.my-calorie-counter.com
• Food Inc Movie: For information on farming practices and how it affects your health: www.foodincmovie.com
Thank-you for being a part of this nutrition lecture. I hope that you have learned something new which will enrich your martial arts practice and your life. Yours in health,
Dr. Jolene Kennett, B.Sc., N.D.
200-1401 Lonsdale Ave.
North Vancouver, BC
p. 604.986.9355
web: www.oceanwellness.ca
email: info@oceanwellness.ca
QUIZ
• Complete this sentence..... You are what __EAT_______
• What is better for you and why? Skim Milk or Whole Milk (3.25%)
• Which is better for you and why? Watermelon or an apple?
• What % of the calories in spinach come from protein alone? 30%
• True or False? A vegetarian diet can be complete with all the necessary nutrients required for optimal health.
• What are the key nutrients which a vegetarian/vegan must be ultra conscious to get? Calcium, iron, zinc, protein, omega-3
• True or False? You need to supplement with vitamins in order to maximize your exercise routine?
• True or False? All fish, no matter where it comes from is good for you. Farmed salmon contains up to 40 times more PCB’s per serving than other foods.
• True or False? All tuna is bad. Best: canned chunk light (<6 servings per month), canned albacore (<3 servings per mo.), bigeye, and ahi tuna (avoid completely)
• What are the vegetables and fruits that comprise the “dirty dozen”? Peaches, strawberries, apples, domestic blueberries, nectarines, cherries, imported grapes, celery, sweet bell peppers, spinach, kale, collard greens, potatoes, and lettuce
• What are the fruits and vegetables that comprise the “Clean Fifteen”? Onions, sweet corn, sweet peas, asparagus, cabbage, eggplant, sweet potatoes, avocadoes, pineapples, mango, kiwi, domestic cantaloupe, watermelon, honeydew, and grapefruit
• What is the key mineral required for muscle contraction? Calcium. Leafy greens, almonds, soy, tahini, blackstrap molasses, broccoli
• What is the key mineral required for oxygen transport? Iron. Soy, lentils, spinach, quinoa, blackstrap molasses
• What is the most important spice for controlling blood sugar? Cinnamon • What is the most researched spice for it’s antioxidant potential? Turmeric
• What is the most important meal of the day? Breakfast
• What are the three keys to optimizing your martial arts practice? Strength, flexibility, and endurance.
• How do I avoid muscle fatigue during practice? Hydration, Alkaline diet, high in calcium, and adequate carbohydrate stores
• Which of the following will benefit your martial arts practice? Stress, low blood sugar, food allergies, adequate sleep, excess estrogen, viral infections
• How much sleep should you get and when during the day is sleep most important? Varies from 6-9 hours per night. Sleep before midnight is most important.
• How many times per day should you eat? 3 meals and 2 snacks per day. Breakfast at 7AM, Snack at 10AM, Lunch at 12 noon, Snack at 3PM, Dinner at 6PM. If you are in a martial arts class in the evening, you will require a third snack before bed.
• How many calories should you eat per day? Varies with activity and muscle mass. On average, men require more calories than women.
• Who determines organic certification of food in Canada?
The Organic Products Regulations (OPR) require mandatory certification, by a CFIA accredited Certification Body, to the Canadian Organic Standards (Canadian Organic Production Systems Standards: General Principles and Management Standards and the Permitted Substances Lists) for agricultural products represented as organic in import, export and inter-provincial trade, or that bear the federal organic agricultural product legend (or logo). Imported organic products may also meet the requirements of the Organic Products Regulations by being certified to a standard deemed to be equivalent under an equivalency determination agreement with a foreign country by a Certification Body accredited by that foreign country. [Part 2, Part 4, OPR] The Canada Organic Regime is the Government of Canada's response to requests by the organic sector and consumers to develop a regulated system for organic agricultural products. The Organic Products Regulations are designed to protect consumers against false and misleading organic claims and govern the use of the new organic logo. The Canadian Food Inspection Agency: www.inpection.gc.ca
Basic
• Intake
o Requirements vary according to age, weight, body fat, sex, activity
o Limiting intake can lead to hormonal imbalances and weight gain
Med Sci Sports Exerc. 2009 Mar;41(3):709-31. American College of Sports Medicine position stand. Nutrition and athletic performance.
Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density may require supplements
FLUIDS • Water: 1oz/kg body weight per day (does not include teas, caffeine)
o Note: for every glass caffeine, must have twice amount in water
J Int Soc Sports Nutr. 2010 Jan 27;7(1):5. International society of sports nutrition position stand: caffeine and performance.
ABSTRACT: Position Statement: The position of The Society regarding caffeine supplementation and sport performance is summarized by the following seven points: 1.) Caffeine is effective for enhancing sport performance in trained athletes when consumed in low-to-moderate dosages (~3-6 mg/kg) and overall does not result in further enhancement in performance when consumed in higher dosages (>/= 9 mg/kg). 2.) Caffeine exerts a greater ergogenic effect when consumed in an anhydrous state as compared to coffee. 3.) It has been shown that caffeine can enhance vigilance during bouts of extended exhaustive exercise, as well as periods of sustained sleep deprivation. 4.) Caffeine is ergogenic for sustained maximal endurance exercise, and has been shown to be highly effective for time-trial performance. 5.) Caffeine supplementation is beneficial for high-intensity exercise, including team sports such as soccer and rugby, both of which are categorized by intermittent activity within a period of prolonged duration. 6.) The literature is equivocal when considering the effects of caffeine supplementation on strength-power performance, and additional research in this area is warranted. 7.) The scientific literature does not support caffeine-induced diuresis during exercise, or any harmful change in fluid balance that would negatively affect performance. Int
J Sport Nutr Exerc Metab. 2009 Dec;19(6):624-44.
The effects of EGCG on fat oxidation and endurance performance in male cyclists. Researchers have long been investigating strategies that can increase athletes' ability to oxidize fatty acids and spare carbohydrate, thus potentially improving endurance capacity. Green-tea extract (epigallocatechin-3-gallate; EGCG) has been shown to improve endurance capacity in mice. If a green-tea extract can stimulate fat oxidation and as a result spare glycogen stores, then athletes may benefit through improved endurance performance. Eight male cyclists completed a study incorporating a 3-way crossover, randomized, placebo-controlled, double-blinded, diet-controlled research design. All participants received 3 different treatments (placebo 270 mg, EGCG 270 mg, and placebo 270 mg + caffeine 3 mg/kg) over a 6-day period and 1 hr before exercise testing. Each participant completed 3 exercise trials consisting of 60 min of cycling at 60% maximum oxygen uptake (VO2(max)) immediately followed by a self-paced 40-km cycling time trial. The study found little benefit in consuming green-tea extract on fat oxidation or cycling performance, unlike caffeine, which did benefit cycling performance. The physiological responses observed during submaximal cycling after caffeine ingestion were similar to those reported previously, including an increase in heart rate (EGCG 147 +/- 17, caffeine 146 +/- 19, and placebo 144 +/- 15 beats/min), glucose at the 40-min exercise time point (placebo 5.0 +/- 0.8, EGCG 5.4 +/- 1.0, and caffeine 5.8 +/- 1.0 mmol/L), and resting plasma free fatty acids and no change in the amount of carbohydrate and fat being oxidized. Therefore, it was concluded that green-tea extract offers no additional benefit to cyclists over and above those achieved by using caffeine. Nutrients Snack and meals should be of the following proportion: 25% lean protein, 25% complex carbohydrates, 50% leafy green vegetables. Portions are individualized: 25% is equivalent to the size of your palm and one thumb thick. 50% vegetables is equal to the size of both hands, including fingers, if raw and one hand, including fingers if cooked. Never overcook your vegetables as they will loose key enzymes and vitamins required for optimal health.
Fiber:
Importance: regularity facilitates elimination of body’s waste products Swamp Water Recipe o
Recipe: mix 1 cup each of ground flax, psyllium husks, and oat bran. Add 1.5 tbsp ground turmeric and 1.5 tbsp cinnamon. Take 1 tbsp 2 x per day in 3-5 oz water or sprinkle on salads, oatmeal, or rice/pasta.
o Store in airtight glass container in your refrigerator. Buy whole flax seeds and grind at home in your coffee grinder.
Carbohydrates:
Be very mindful of complex vs. simple carbs (avoid simple carbs). Examples of complex carbohydrates: Squash, Quinoa, Brown Rice, Oatmeal (Whole, not quick), Amaranth, Kashi, Millet, Yams. Examples of simple carbohydrates: White rice, white flour, sugar (indluding fruit sugar and honey)
Int J Sport Nutr Exerc Metab. 2010 Apr;20(2):154-65.
Glycemic index and endurance performance. Initial research investigating the impact of GI on postexercise recovery indicated consuming high-GI (HGI) CHO increased muscle glycogen resynthesis. However, recent studies indicate an interaction between LGI CHO and fat oxidation, which may play a role in enhancing performance in subsequent exercise. Despite the fact that the relationship between GI and sporting performance has been a topic of research for more than 15 yr, there is no consensus on whether consuming CHO of differing GI improves endurance performance. Until further well-designed research is carried out, athletes are encouraged to follow standard recommendations for CHO consumption and let practical issues and individual experience dictate the use of HGI or LGI meals and supplements before, during, and after exercise.
Fats:
Be very mindful of good and bad fats. Also, be mindful of oxidized fats and fats from seafood. Caution with nuts: eat raw and/or soaked (minimum 6 hours). Do not fry with olive oil. Note that fats carry PCB’s and dioxins, hormones, and other chemicals. Organic fats are important.
Protein:
Take home message: Do not overdo it! 0.7g/kg body weight/day 10 essential amino acids. These do not all have to be consumed at the same time. Cooking denatures amino acids making them less bio-available. Meat protein is more acidic and more difficult to digest.
After intense anaerobic exercise, where lactic acid accumulation is high, and adrenaline is high, you want to avoid acidic foods which are difficult to digest.
Side note on pH: consume alkaline diet, especially after anaerobic exercise. Grains, meat, fish, dairy and beans are very acidic. Foods which are alkaline and high in protein include: cottage cheese, fermented soy, soaked grains, and soaked nuts.
Alcohol: 8kcal/g alcohol (note that fat contains 9kcal/g); affects blood sugar, B vitamin status, appetite etc...
Factors affecting weight
• Sex hormones
• Blood sugar
• Stress
• Toxins
• Food sensitivities/allergies: artificial sweetners, corn, dairy, wheat, soy and gluten, yeast are the most common food allergens. These evoke immune response causing inflammation.
Food ideas
• Canada’s Food Guide – Review
• Fish – Review good choices
• Special foods / herbs
o Cinnamon
o Bitter melon
o Garlic
o Blueberries
o Oolong tea
o Turmeric
o Ginger
o Licorice
Foods to include
Recommended fats (3-4 of the following per day):
Avocado, Sunflower seeds, pumpkin seeds, Cold-water fish, Natural Nut Butters, Cheese (Goat, Sheep), Nut/seed oils, Olives o
Recommended proteins (4-6 of the following per day):
Beans (dried or fresh), Extra lean ground turkey, Chili, Chicken breast (organic, white meat), Crab (sparingly), Extra extra lean ground beef, Egg whites (only 2-6 egg yolks per week), Haddock, Red snapper, Liver, Lobster (sparingly), Extra hard tofu, Natural nut butters, Nuts (sparingly) – almonds are best, Cottage cheese, Wild salmon, Yogurt, Milk, Soy beans, Soy foods (*Tempeh), Swordfish, Shrimp, Turkey breast, Trout, Tuna (NOPE!), Veggie burgers, Wild game (venison, rabbit, buffalo)
Recommended starches – before 1 PM (2-3 of the following per day):
Brown or green pasta, steamed brown rice, steamed wild rice, Whole grains (see other handout) o Recommended Fruits – before 1 PM (2-3 of the following per day): Apples, Bananas, Blueberries (anytime), Blackberries, Cantaloupe (anytime), Grapefruit (anytime), Peaches, Pears, Plums, Pumpkin, Squash, Watermelon (anytime), Pineapple, Raspberries, Strawberries, Tropical fruits o
Recommended Vegetables – anytime (4-6 of the following per day):
Arugula, Asparagus, Artichoke, Beans (string), Beets, Broccoli, Brussels sprouts, Cabbage, Celery, Cucumbers, Eggplant, Kale, Kohlrabi, Lettuce, Mushrooms, Parsley, Parsnips, Peas, Peppers, Radishes, Rutabagas, Snow peas, Spinach, Tomato, Turnips, Watercress, Yams/Sweet potato, Zucchini •
Foods to avoid
All Processed foods, Cakes, Candy, Cream dressings / sauces, Chips, Dried Fruits, Ice Cream, Processed Cereals, Flour gravy, Fried Foods, Fruit Juices, Mayonnaise, Margarine, Pop (Diet and Reg), Sugar added Jams/jellies, Pies and Pastries, White Pastas (processed), Sugar (white or brown), Rice cakes, Deli meats and bacon
Discussion:
Healthy Breakfasts:
• Whole Oats with 1 tbsp nuts, milk (or milk alternative), and 1⁄4 c organic berries.
• 2 Organic Eggs, Whole grain bread, Fruit
• Avocado and Whole grain bread
• Organic Yogurt and Muesli
• Baked organic chicken breast, or wild salmon with baked red peppers and cream cheese on whole grain toast.
Healthy Snacks:
• Vegetable sticks with tzatziki, or hummous, or baba ganouj
• 1⁄4 c raw nuts with vegetables or fruit
• Organic cheese and crackers with vegetable sticks
Healthy Lunches:
Healthy Dinners:
Grocery Stores:
• Famous Foods: 1595 Kingsway (@ King Edward Ave, i.e. 25th Ave)
• Donald’s Market: 2342 East Hastings Street (@ Nanaimo St), 2279 Commercial Drive (@ 6th Street)
Cookbooks:
• Veganomicon. Isa Chandra Moskowitz, Terry Hope Romero.
• How it all Vegan. Sarah Kramer and Tanya Barnard
• Jamie's Food Revolution: Rediscover How to Cook Simple, Delicious, Affordable Meals. Jamie Oliver
Resources:
• Environmental Working Group: for information on pesticide content of fruits and vegetables: www.ewg.org
• Health Canada Food and Nutrition: for a customized food pyramid for kids and adults and other information on health and food recalls. www.hc-sc.gc.ca/fnan/index-eng.php
• Organic Agriculture Center of Canada: for information on the policies and procedures governing Organic Farming: www.organicagcentre.ca
• The Cove Movie: for information on mercury content of fish: www.thecovemovie.com/educate.htm
• Pub Med: Online Medical Journal Site: www.ncbi.nlm.nih.gov/pubmed/
• David Suzuki Foundation: for information on health and wellbeing: www.davidsuzuki.org
• Calorie Counter: to assess food intake and requirements: www.my-calorie-counter.com
• Food Inc Movie: For information on farming practices and how it affects your health: www.foodincmovie.com
Thank-you for being a part of this nutrition lecture. I hope that you have learned something new which will enrich your martial arts practice and your life. Yours in health,
Dr. Jolene Kennett, B.Sc., N.D.
200-1401 Lonsdale Ave.
North Vancouver, BC
p. 604.986.9355
web: www.oceanwellness.ca
email: info@oceanwellness.ca
Thursday, April 15, 2010
Cardiac Life Support Training for Naturopathic Doctors
Naturopathic Doctors who preform intravenous and chelation therapy require additional certification in 2010 called ACLS - Advanced Cardiac Life Support.
I have recently been granted certification in ACLS and wanted to share with my patients that I am now able to identify and manage cardiac arrest situations. But... just a little side note: After learning that cardiac arrest outcome depends on excellent CPR skills and early defibrillation, I encourage all my patients to update their CPR skills. CPR courses are available through St. John's Ambulance (www.sja.ca) and Red Cross (www.redcross.ca).
Cardiac defibrillators, machines that deliver electrical impulses to the heart, are now being found in sports arenas, shopping centers and public places.
If you are close to someone who is has an increased risk of heart attack, it may be worthwhile to purchase an automatic electrical defibrillator (AED) and keep it in your car, or bring it with you camping, or leave it at your holiday cabin in the woods, or take it with you anywhere that you may have a delay before paramedic arrival.
I have recently been granted certification in ACLS and wanted to share with my patients that I am now able to identify and manage cardiac arrest situations. But... just a little side note: After learning that cardiac arrest outcome depends on excellent CPR skills and early defibrillation, I encourage all my patients to update their CPR skills. CPR courses are available through St. John's Ambulance (www.sja.ca) and Red Cross (www.redcross.ca).
Cardiac defibrillators, machines that deliver electrical impulses to the heart, are now being found in sports arenas, shopping centers and public places.
If you are close to someone who is has an increased risk of heart attack, it may be worthwhile to purchase an automatic electrical defibrillator (AED) and keep it in your car, or bring it with you camping, or leave it at your holiday cabin in the woods, or take it with you anywhere that you may have a delay before paramedic arrival.
Friday, March 19, 2010
Vitamin B3 and Statins
Studies show an improvement in lipid profiles when statin drugs are combined with Vitamin B3. The mechanism is unknown yet marked reduction in thickness of vessel walls were noted.
See New England Journal of Medicine, 362:1046-1048, Vol 11, 18Mar10
See New England Journal of Medicine, 362:1046-1048, Vol 11, 18Mar10
Friday, January 1, 2010
Questions and Answers about Perscribing rights for ND's in BC
For many decades, BC’s naturopathic physicians have been seeking from government recognition for a scope of practice in keeping with the contemporary and historical practice of NDs. In the 2008 Throne Speech, the BC Liberals made a commitment to proceed with two facets of naturopathic medical care: prescriptive rights and diagnostic facility access. The process leading to this announcement involved many years of negotiation, research, and collaborative assessment. The government’s commitment is based on this lengthy and detailed process; it is a commitment based on sound judgement having reviewed the educational criteria, current and historical practice of NDs, and, most importantly, ensuring the highest levels of patient-centred health care are available to all British Columbians. The BCNA believes that this commitment is the right choice for British Columbians: It reduces the existing burden on MDs while ensuring the provision of safe and effective primary health care in a measured fashion. This document addresses some of the questions that have arisen during the negotiation process.
Why Seek Prescribing Rights Now?
Access to a “schedule of preparations” is an issue that has been in negotiation with government for over 50 years. The naturopathic profession was in fact regulated by the College of Physicians and Surgeons from 1921 until 1936 when the Naturopathic Physicians Act was proclaimed. Prior to 1936 all naturopathic physicians were given the ability to prescribe exactly the same substances as allopathic physicians; however, with the new Act, prescribing ability was left undefined. Since 1936 the naturopathic profession has been waiting patiently for their formulary to be formally approved by government, yet all previous governments have failed to act. Naturopathic physicians have continued to prescribe traditional substances to the benefit of our patients and without harm to the public. We expect this government to be bold and step up to the plate and solve this issue. When the BC Liberals made a Throne Speech commitment in 2008, the BCNA applauded the government’s willingness to take this important and essential step to providing a better health care system for all British Columbians.
Why do Naturopathic Doctors Need Prescription Medications?
Making a prescription is fundamental to the practice of medicine in any and all forms. Another element, however, is that over the decades NDs have lost access to many botanical medicines and natural therapeutics. These “traditional” substances, such as high dose vitamins, some amino acids, hormones, botanicals and herbs, which NDs have used for decades, have slowly become “scheduled”—right here in B.C. But more importantly, NDs are providing primary care without the capacity to practice at the full extent of their skills and expertise. Naturopathic physicians have traditionally acted as primary care practitioners and continue to do so today. As such, it is imperative that NDs be allowed to retain their historical right to prescribe. The existing bias is further exacerbated by allowing other professions schedules without addressing the issue in this profession. And in some cases, as with MDs, core competency, education and training were not required for theuse of the naturopathic pharmacopoeia. One example is that MDs are free to practice all forms of complementary medicine without constraint or oversight.
How Does Prescribing Impact Patients?
At present, the lack of access to some pharmaceuticals puts naturopathic physicians in a position of ambiguity. It leads to confusion both on the part of the practicing ND and the patient, vis-à-vis patient protocols. Worse, it impairs the College of Naturopathic Physicians, the licensing body, from fulfilling its regulatory function. This issue has been outstanding for decades, and has been continually perpetuated by successive governments. As drug laws have changed, and as natural items have become scheduled, the historical naturopathic formulary is now seriously eroded. As this process drags on and governments change the cycle repeats itself. The naturopathic profession is between a rock and a hard place. On one hand NDs are bound by the same legal duties and obligations as MDs. On the other hand, NDs lack, due to government neglect, the supporting legislative mandate that would allow us to fulfill these proscribed legal duties and obligations. This discrepancy carries with it an inherent danger to the public and to the naturopathic profession. A case in point is bronchial pneumonia where the naturopathic physician deems antibiotics are required, yet cannot prescribe them. This inability to prescribe places the patient at risk due to the delay in receiving proper medical treatment.
Do Naturopathic Physicians (NDs) have the Education Required to Prescribe Medicines? NDs already prescribe pharmaceuticals in many jurisdictions across North America. They could not prescribe if their education excluded pharmacology and pharmacognosy training. [Pharmacognosy is the study of medicines derived from natural sources. The American Society of Pharmacognosy defines pharmacognosy as “the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well as the search for new drugs from natural sources.’] All licensed naturopathic physicians complete a minimum of three-years university level pre-medical training, then four years at an accredited naturopathic medical college. [There are two in Canada and four in the USA.] Following pre-med, the fouryear ND program covers many of the same science courses as at “conventional” medical school. Drug education is of course a core part of pharmacology training, but also an inherent part of biochemistry, microbiology, physiology, botanical medicine, pathology and other core science courses in the ND curricula. Pharmacology training for NDs is similar to the training MDs receive: It is focussed on the principles of pharmacodynamics, including drug absorption, metabolism, distribution, excretion and mechanism of action. All students must be able to classify and describe the pharmacodynamics, side effects and therapeutic uses of drug prototypes from the myriad conventional drug classes. In addition, the ND must thoroughly understand the pharmacology of all natural substances. Upon graduation from the four-year ND program, each doctor must pass internationally standardized licensing exams. Pharmacology is one specific exam—as well, pharmacology as a subject is covered in many other exams, including the clinical therapeutic courses such as botanical medicine and nutritional medicine, physical, clinical, and lab diagnosis, diagnostic imaging, minor surgery and emergency medicine.
Do Naturopathic Physicians Licenced In Other Jurisdictions Prescribe? Yes. Naturopathic physicians in various US jurisdictions with similar education and training and identical licensing requirements as in BC already use “scheduled” substances in their naturopathic practices on a daily basis. But a more important point is that many “traditional” substances, such as high dose vitamins, some amino acids, hormones, botanicals and herbs, which NDs have used for decades, have slowly become “scheduled”—right here in B.C. Imagine a medical doctor losing the ability to run diagnostic tests or prescribe an antibiotic, or a surgeon unable to use anaesthetics. That’s exactly what’s happened over the years to naturopathic doctors in terms of many traditional medicines. In addition, naturopathic physicians have demonstrated extensive education and training as well as historical and contemporary safe and effective usage of scheduled substances, especially those items which have been moved from over-the-counter status to prescription only. The safety record speaks for itself. Naturopathic medicine, like allopathic medicine, is an evolving art and science and as such requires a formulary and legislation that reflects the changing nature of medicine and healthcare. Further, being granted the right to prescribe represents the trend in most health care professions. Examples include pharmacists, psychologists, nurse practitioners, midwives, optometrists, etc.; some of whom have considerably less clinical education than NDs.
Will There Be Conflict Between MDs and NDs? There is no reason or rationale for conflict. Naturopathic doctors are already using various therapeutics to treat patients, as are MDs. The only change would be that some additional therapeutics will become available to NDs. Dentists, for example, have access to all scheduled substances yet the vast majority of practicing dentists use only a very small number of items: antibiotics, analgesics and local anaesthetics. There is no conflict between dentist and doctor, just as there would be no conflict between MD and ND. It’s important to remember that in BC we have a “shared scopes of practice” model whereby, for example, MDs, NDs, acupuncturists and physiotherapists all have the ability to obtain licensure in acupuncture. Many elements of scope of practice are common amongst two or more health professions. This is just another element of the existing medical model.
What Will Occur if the Government Fails to Act?
Health care for all British Columbians will suffer. The current shortage of primary care practitioners will be further impaired. The unique skills that NDs bring to the health care table—a focus on disease prevention, patient-centred health care, and extensive expertise in the compounding and dispensing of natural therapeutics—will be eroded or lost.
What About Patient Safety? If Naturopathic Physicians Haven’t Dealt With Prescription Drugs in the Past, How are they Eligible for the Added Responsibility?
Naturopathic doctors deal with prescription medicines on a daily basis: With patients already on a drug regime, considering pharmaceuticals and/or an alternative, drug/non-drug interactions, and myriad other interconnected health issues. The substantial change with new regulations won’t be so much an added responsibility, but rather the ability to improve patient care. Currently, hundreds of thousands of BC residents see naturopathic doctors for care, many for primary care, and BC’s licensed NDs attend to over a million patient visits each year.
Won’t it Confuse Patients Already on Prescription Medications?
Given the shared scopes of model already in existence, there should be no confusion. Many patients may see, for example, an ND, physiotherapist, chiropractor, acupuncturist and MD over the course of a year, sometimes simultaneously. Shared scopes of practice is the status quo in BC. Even for a patient seeing both a general practitioner and specialist, they may be under two different “traditional” protocols without confusion or error. But this question also begs a further clarification. There is a difference between prescriptions for chronic and acute conditions. A patient on medication for, say, depression, and seeing an ND, would require immediate attention for an acute condition such as bronchitis. The provision for access to scheduled drugs allows for more effective, timely and appropriate medical care.
Why do Naturopathic Physicians Want This Change in Regulation?
Strictly speaking, naturopathic doctors don’t “want” the change in regulation, they require it—to provide safe, effective, economical preventative health care. The regulation changes are in keeping with a “shared scopes of practice” model being implemented across the province—whereby many health professions have access to prescription items relevant to their respective practice. The change is in keeping with the record of safety and effectiveness of this profession, and ensuring that modalities arbitrarily removed, over time, continue to be used appropriately and in a timely fashion.
Don’t Naturopathic Doctors Only Use “Natural” Medicines?
No and yes. Even to this day many prescription drugs are derived from natural sources—where there is overlap and emphasis in naturopathic medical training. Some “natural” medicines are prescription only (e.g., amino acids, high-dose vitamins). But really this is a question about employing basic medical diagnosis and laboratory analysis. Naturopathic doctors’ primary focus is on treating the underlying nature or cause of disease. Put simply, naturopathic medicine is the “nature” of the “pathos” or disease, not simply “natural” medicines. This focus is about supporting the natural healing processes of the patient, not simply using a product. Thus, naturopathic medicine is about the removal of any impediment to the healing process; the prevention and treatment of physical and mental disease, disorders and conditions; and the promotion of good health using not only natural methods but methods that support and enhance a patient’s overall health. Unfortunately, even those “natural” medicines naturopathic doctors have used for many decades are often, now, by prescription only.
The BCNA believes that the government’s commitment to providing a schedule of preparations for licensed naturopathic physicians is in keeping with a public responsibility to: Ensure shared scopes of practice; improve access to primary health providers; enhancing disease prevention from qualified health professionals; providing greater public choice while not increasing health care costs.
Why Seek Prescribing Rights Now?
Access to a “schedule of preparations” is an issue that has been in negotiation with government for over 50 years. The naturopathic profession was in fact regulated by the College of Physicians and Surgeons from 1921 until 1936 when the Naturopathic Physicians Act was proclaimed. Prior to 1936 all naturopathic physicians were given the ability to prescribe exactly the same substances as allopathic physicians; however, with the new Act, prescribing ability was left undefined. Since 1936 the naturopathic profession has been waiting patiently for their formulary to be formally approved by government, yet all previous governments have failed to act. Naturopathic physicians have continued to prescribe traditional substances to the benefit of our patients and without harm to the public. We expect this government to be bold and step up to the plate and solve this issue. When the BC Liberals made a Throne Speech commitment in 2008, the BCNA applauded the government’s willingness to take this important and essential step to providing a better health care system for all British Columbians.
Why do Naturopathic Doctors Need Prescription Medications?
Making a prescription is fundamental to the practice of medicine in any and all forms. Another element, however, is that over the decades NDs have lost access to many botanical medicines and natural therapeutics. These “traditional” substances, such as high dose vitamins, some amino acids, hormones, botanicals and herbs, which NDs have used for decades, have slowly become “scheduled”—right here in B.C. But more importantly, NDs are providing primary care without the capacity to practice at the full extent of their skills and expertise. Naturopathic physicians have traditionally acted as primary care practitioners and continue to do so today. As such, it is imperative that NDs be allowed to retain their historical right to prescribe. The existing bias is further exacerbated by allowing other professions schedules without addressing the issue in this profession. And in some cases, as with MDs, core competency, education and training were not required for theuse of the naturopathic pharmacopoeia. One example is that MDs are free to practice all forms of complementary medicine without constraint or oversight.
How Does Prescribing Impact Patients?
At present, the lack of access to some pharmaceuticals puts naturopathic physicians in a position of ambiguity. It leads to confusion both on the part of the practicing ND and the patient, vis-à-vis patient protocols. Worse, it impairs the College of Naturopathic Physicians, the licensing body, from fulfilling its regulatory function. This issue has been outstanding for decades, and has been continually perpetuated by successive governments. As drug laws have changed, and as natural items have become scheduled, the historical naturopathic formulary is now seriously eroded. As this process drags on and governments change the cycle repeats itself. The naturopathic profession is between a rock and a hard place. On one hand NDs are bound by the same legal duties and obligations as MDs. On the other hand, NDs lack, due to government neglect, the supporting legislative mandate that would allow us to fulfill these proscribed legal duties and obligations. This discrepancy carries with it an inherent danger to the public and to the naturopathic profession. A case in point is bronchial pneumonia where the naturopathic physician deems antibiotics are required, yet cannot prescribe them. This inability to prescribe places the patient at risk due to the delay in receiving proper medical treatment.
Do Naturopathic Physicians (NDs) have the Education Required to Prescribe Medicines? NDs already prescribe pharmaceuticals in many jurisdictions across North America. They could not prescribe if their education excluded pharmacology and pharmacognosy training. [Pharmacognosy is the study of medicines derived from natural sources. The American Society of Pharmacognosy defines pharmacognosy as “the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well as the search for new drugs from natural sources.’] All licensed naturopathic physicians complete a minimum of three-years university level pre-medical training, then four years at an accredited naturopathic medical college. [There are two in Canada and four in the USA.] Following pre-med, the fouryear ND program covers many of the same science courses as at “conventional” medical school. Drug education is of course a core part of pharmacology training, but also an inherent part of biochemistry, microbiology, physiology, botanical medicine, pathology and other core science courses in the ND curricula. Pharmacology training for NDs is similar to the training MDs receive: It is focussed on the principles of pharmacodynamics, including drug absorption, metabolism, distribution, excretion and mechanism of action. All students must be able to classify and describe the pharmacodynamics, side effects and therapeutic uses of drug prototypes from the myriad conventional drug classes. In addition, the ND must thoroughly understand the pharmacology of all natural substances. Upon graduation from the four-year ND program, each doctor must pass internationally standardized licensing exams. Pharmacology is one specific exam—as well, pharmacology as a subject is covered in many other exams, including the clinical therapeutic courses such as botanical medicine and nutritional medicine, physical, clinical, and lab diagnosis, diagnostic imaging, minor surgery and emergency medicine.
Do Naturopathic Physicians Licenced In Other Jurisdictions Prescribe? Yes. Naturopathic physicians in various US jurisdictions with similar education and training and identical licensing requirements as in BC already use “scheduled” substances in their naturopathic practices on a daily basis. But a more important point is that many “traditional” substances, such as high dose vitamins, some amino acids, hormones, botanicals and herbs, which NDs have used for decades, have slowly become “scheduled”—right here in B.C. Imagine a medical doctor losing the ability to run diagnostic tests or prescribe an antibiotic, or a surgeon unable to use anaesthetics. That’s exactly what’s happened over the years to naturopathic doctors in terms of many traditional medicines. In addition, naturopathic physicians have demonstrated extensive education and training as well as historical and contemporary safe and effective usage of scheduled substances, especially those items which have been moved from over-the-counter status to prescription only. The safety record speaks for itself. Naturopathic medicine, like allopathic medicine, is an evolving art and science and as such requires a formulary and legislation that reflects the changing nature of medicine and healthcare. Further, being granted the right to prescribe represents the trend in most health care professions. Examples include pharmacists, psychologists, nurse practitioners, midwives, optometrists, etc.; some of whom have considerably less clinical education than NDs.
Will There Be Conflict Between MDs and NDs? There is no reason or rationale for conflict. Naturopathic doctors are already using various therapeutics to treat patients, as are MDs. The only change would be that some additional therapeutics will become available to NDs. Dentists, for example, have access to all scheduled substances yet the vast majority of practicing dentists use only a very small number of items: antibiotics, analgesics and local anaesthetics. There is no conflict between dentist and doctor, just as there would be no conflict between MD and ND. It’s important to remember that in BC we have a “shared scopes of practice” model whereby, for example, MDs, NDs, acupuncturists and physiotherapists all have the ability to obtain licensure in acupuncture. Many elements of scope of practice are common amongst two or more health professions. This is just another element of the existing medical model.
What Will Occur if the Government Fails to Act?
Health care for all British Columbians will suffer. The current shortage of primary care practitioners will be further impaired. The unique skills that NDs bring to the health care table—a focus on disease prevention, patient-centred health care, and extensive expertise in the compounding and dispensing of natural therapeutics—will be eroded or lost.
What About Patient Safety? If Naturopathic Physicians Haven’t Dealt With Prescription Drugs in the Past, How are they Eligible for the Added Responsibility?
Naturopathic doctors deal with prescription medicines on a daily basis: With patients already on a drug regime, considering pharmaceuticals and/or an alternative, drug/non-drug interactions, and myriad other interconnected health issues. The substantial change with new regulations won’t be so much an added responsibility, but rather the ability to improve patient care. Currently, hundreds of thousands of BC residents see naturopathic doctors for care, many for primary care, and BC’s licensed NDs attend to over a million patient visits each year.
Won’t it Confuse Patients Already on Prescription Medications?
Given the shared scopes of model already in existence, there should be no confusion. Many patients may see, for example, an ND, physiotherapist, chiropractor, acupuncturist and MD over the course of a year, sometimes simultaneously. Shared scopes of practice is the status quo in BC. Even for a patient seeing both a general practitioner and specialist, they may be under two different “traditional” protocols without confusion or error. But this question also begs a further clarification. There is a difference between prescriptions for chronic and acute conditions. A patient on medication for, say, depression, and seeing an ND, would require immediate attention for an acute condition such as bronchitis. The provision for access to scheduled drugs allows for more effective, timely and appropriate medical care.
Why do Naturopathic Physicians Want This Change in Regulation?
Strictly speaking, naturopathic doctors don’t “want” the change in regulation, they require it—to provide safe, effective, economical preventative health care. The regulation changes are in keeping with a “shared scopes of practice” model being implemented across the province—whereby many health professions have access to prescription items relevant to their respective practice. The change is in keeping with the record of safety and effectiveness of this profession, and ensuring that modalities arbitrarily removed, over time, continue to be used appropriately and in a timely fashion.
Don’t Naturopathic Doctors Only Use “Natural” Medicines?
No and yes. Even to this day many prescription drugs are derived from natural sources—where there is overlap and emphasis in naturopathic medical training. Some “natural” medicines are prescription only (e.g., amino acids, high-dose vitamins). But really this is a question about employing basic medical diagnosis and laboratory analysis. Naturopathic doctors’ primary focus is on treating the underlying nature or cause of disease. Put simply, naturopathic medicine is the “nature” of the “pathos” or disease, not simply “natural” medicines. This focus is about supporting the natural healing processes of the patient, not simply using a product. Thus, naturopathic medicine is about the removal of any impediment to the healing process; the prevention and treatment of physical and mental disease, disorders and conditions; and the promotion of good health using not only natural methods but methods that support and enhance a patient’s overall health. Unfortunately, even those “natural” medicines naturopathic doctors have used for many decades are often, now, by prescription only.
The BCNA believes that the government’s commitment to providing a schedule of preparations for licensed naturopathic physicians is in keeping with a public responsibility to: Ensure shared scopes of practice; improve access to primary health providers; enhancing disease prevention from qualified health professionals; providing greater public choice while not increasing health care costs.
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