It's the season for new beginnings! And many of us are trying to start (and keep!) new habits. At this time of the year, many people decide to eliminate one or more foods or food groups from their daily diet; some do it in pursuit of good health trying to "undo" the holiday overeating, some to get rid of annoying gastrointestinal symptoms like bloating, gas, unpredictable bowels, some others because it's a fresh start to the year and they have been waiting to implement their doctors' recommendations and many others in the hope of losing some weight. No matter what the reason, after 3 weeks of an 'elimination diet', it can be frustrating if you do not notice any positive changes whatsoever!
There can be multiple reasons why you aren't seeing changes in your health. These are important to consider and address. Here I have listed these reasons in the order of most likely to least likely as I have observed in our clinical practice:
Reason#1: The eliminated foods/food groups aren’t problematic for you
Though this may sound like a very obvious reason it can often get ignored. Most elimination diets require you to leave out the “usual suspects” including:
However, in addition to these foods there are other foods that can be potential troublemakers. Since each of us is a genetically unique individual, besides functional deficits, some people may not have the ability to process all components of even seemingly healthy foods like fruits, vegetables, whole grains, nuts and seeds.
Consider getting a food sensitivity panel through your doctor. Food sensitivities are very different than food allergies and the one we offer at our practice tests for over 85 different foods! The information from that the test results reveal can be used to design a more specific elimination diet beneficial for you.
Reason#2: Increased intake of processed foods
In an effort to eliminate specific foods, people often start buying packaged foods that are labelled as being compliant to their diet. Labels such as gluten-free, dairy-free, low-fat, paleo etc. are very attractive but it is important not to overlook the actual ingredients list in any packaged food. Multiple chemical additives and preservatives often make their way into “special” packaged foods to help these foods taste and stay good. This is not always the case, but be sure to read the actual ingredients and rely more on fresh foods than packaged foods.
Reason#3: Food elimination is not enough!
Let’s say that you have persisted at least 4 weeks with an elimination diet designed based on a food sensitivity panel and have minimized use of packaged foods, and even then, you see no benefit or positive change in your symptoms or overall health- this most likely indicates that food may not be the root cause of your troubles. It is time to look at other factors influencing your health.
A weakened, diseased or sub-optimally functioning digestive system, adrenal or other endocrine imbalances or nutrient deficiencies are important factors to investigate when an elimination diet fails. Once these other factors are addressed, your practitioner may recommend repeating an elimination diet to assess if specific foods can aggravate or cause your symptoms to revert.
STOP AGONIZING OVER WHAT TO EAT AND GET ANSWERS!
If you or someone you know, has tried elimination diets and have had limited or zero success in improving your symptoms or actually identifying trigger foods, it is time to take alternate factors into consideration.
It is essential to know that food sensitivity tests are different than food allergy tests.A thorough food sensitivity panel must include not just the usual suspects, but even "innocent" fruits and veggies like avocados, mangoes, tomatoes, celery, spinach, kale to name a few, foods that you wouldn’t typically doubt of being problematic foods.
Food sensitivities are different from food allergies and can manifest in both obvious or subtle ways such as weight gain, lethargy, hormonal irregularities, migraines, skin disorders, mood swings and even anxiety. Repeated ingestion of such foods can lead to complications such as increased inflammation, especially in the digestive system, making you susceptible to nutrient deficiencies, which in turn can cause other symptoms. To summarize, it is as important to investigate food sensitivities as it is to investigate severe and life-threatening food allergies.
Here’s the best part---most food sensitivities can change over time and can also potentially be completely resolved (with a few exceptions)! In our practice, we make it our goal to help patients be able to narrow down their list of reactive or trigger foods to the smallest possible number so that they can stop agonizing over what or what not to eat and simply enjoy a meal!
If you would like to investigate food sensitivities and/or other aspects of your health with us, call our office for a free consult today or send in a request through our website. We will be happy to partner with you to investigate your food sensitivities and the root cause for your health concerns.
STRESSED OUT ABOUT HOME COOKING?CHECK OUT THIS 2-PART BLOG SERIES WITH STRATEGIES TO MAKE HEALTHY COOKING EFFICIENT & EFFORTLESS!
Part II: Tips for Efficient Meal Planning & Preparation
As a continuation of my previous blog, here is part 2 of the home cooking series. As a refresher, my goal with this blog series was to provide ideas and suggestions that can help save both time and energy while still keeping your home cooked meals healthy and tasty! Planning your meals 1 or 2 weeks at a time and preparing ingredients for those meals ahead of time takes the stress out of cooking at home. You can schedule your "meal prep time" on the weekends or on a day of your choosing based on these 2 factors:
The meal planning chart has all of the following information:
1) Chop/cut/marinate/prepare ingredients & store them for cooking
I hope by now you are excited about starting to cook at home! By using both meal planning, meal prepping and time-saving cooking gadgets, you will be dishing out delicious meals that you can enjoy in the comfort of your home. Do not be afraid to experiment with new recipes! I often look at recipes in books and online but end up using them as inspiration, ultimately modifying the recipes to meet the criteria that I consider most important in a meal: packed with nutrients, free of additives & unnecessary chemicals, tasty, can be made in 30 minutes or less!!
If you have enjoyed reading this series, please send me a note or add a comment to let me know! Until next time....hope you enjoy your home-cooked meals!
Stressed out about home cooking?check out this 2-part blog series with strategies to make healthy cooking efficient & effortless!
PART I: 4 Essential Gadgets in today's fast paced kitchen!
One of the first recommendations you will typically receive in my practice, is to start cooking your own food! There are many reasons for this recommendation,the first and foremost being: you have full control of what you eat! And what you eat is what fuels your body, and if your body is receiving the right "fuel", it is most likely to function efficiently, without trouble i.e. symptoms or illnesses. So if you are to take control of what you eat, you must put in the effort for making as many of your meals as possible. Of course, a trip to the restaurant or ordering take-out can be left for special occasions or for long days that you could not anticipate or for which you could not prep ahead. Last September, even the American Medical Association (AMA) released recommendations for home cooking. Based on the American College of Preventive Medicine's (ACPM) guidelines, the AMA recommends "prescribing" home cooking to patients to reduce the risk of obesity and type-2 diabetes since it helps with:
Knowing all of this helps the patients get motivated but very often, when they are not used to cooking at home, this simple prescription can be very daunting and often can increase patients' anxiety around meal preparation and planning; and if not given the right tools/resources, can ultimately result in patients sliding back into old, comfortable but not healthy, eating habits.
In this 2 -part series, I am excited to share ideas that I commonly discuss with patients to alleviate this type of anxiety & get them settled into cooking at home with ease! I hope these will be helpful in your efforts towards a healthier lifestyle! Let's begin!
If you have ever tried opening a wine bottle without a wine bottle opener or cutting veggies with a blunt knife, you already know the importance of having the right tools for the right job! Today's fast paced kitchens need gadgets & tools that can save us time AND energy. Here are my 4 of my favorites and "must-haves" in any kitchen with a summary of their most important features:
me tell you this: all my skepticism (and there was a huge chunk of it!) flew out the
window from day one of using it!...and now I am the proud owner or not one but
two of Instant Pots! Here's why I highly recommend it:
There are lot of choices when it comes to a good food processor. Choose one that
suits your family's needs. It is great for meal prepping and when cooking large
quantities. Here's what it can help with:
Again, there are many choices with brands and additional attachments for
whisking, batter mixer etc. A simple one will suffice & here's why:
This is a relatively new addition to my list of must-haves and I am still exploring
new recipes! Here are the main features:
Empowering patients to help them take charge of their health is the goal of naturopathic medicine and the constant effort in my practice. Please note, that I do not have any financial gains in any of the appliances listed above! I am passionate sharing ideas that help with living a healthy lifestyle and have received a lot of feedback from my patients, that specific tips like these help them in transitioning to cooking at home.
Next week, in Part 2 of the home cooking series, I will share some tips & ideas for efficient meal planning & prepping.
Please feel free to share your comments & feedback below!
The psychosocial impact of acne is well-known and is severe enough to be the subject of several major studies in prominent journals. Acne is THE most common skin condition in the US affecting approximately 50 million Americans each year. Depression, anxiety and lack of self-confidence due to facial acne leads to time-off from school and work and the costs associated with this loss of productivity has been estimated to be as high as $400million (Statistics 2013)!! If that number is not staggering enough on its own, the total cost of acne treatments combined with the cost of lost productivity were approximated to be $1.2 billion!
Numbers aside, in my practice I have personally witnessed and documented the social difficulties experienced by patients suffering from varying degrees of acne. Besides the physical discomfort, the negative impact of persistent acne on a patient's overall well-being varies based on many factors including their perception and understanding of the disease, underlying self-esteem issues and extent of support from family and friends. In this era of social media, the age group of 10-20 years olds are affected the most. So while counseling and use of psychotherapy and can help with many of these self-esteem & confidence factors, it still remains important for the patient (in their own words) - to 'get rid of the acne'! Almost all these patients usually have been through some combination of the following conventional treatments for acne:
So what else can be done?
Most acne sufferers already know that acne is not just 'skin-deep' and there is more to it's story - i,e. cause and recurrence.There are many naturopathic herbal remedies that can help with acne symptoms, but I have observed for a long time now that there is one thing that seems to be the underlying root cause for the presence and persistence of acne vulgaris. The one thing that can be linked to all of the factors often listed as its cause such as:
What is that one thing?
If you follow my blog, it is likely that you have guessed the answer. It is in fact the state of your gut!
The gastrointestinal tract, the source of your nutrients also harbors a large percentage of your immune cells and major immune modulators - your intestinal flora of bacteria, archae and viruses. This microflora (also known as the microbiome) can change based on a person's diet, environmental factors, disease states, toxin exposure and yes, hormonal changes. The influence of the microbiome on our hormones and vice-versa is a major field of study in the scientific world right now and even though its implications are yet to be fully understood, current studies have sufficient data to define what a healthy microbiome constitutes and it's potential impact of an unhealthy one on various systems of your body.
In 2017, an interesting study by Clarke et al. was published in the International Journal of Molecular Sciences. It summarized how plant-based herbal supplements can influence the microbiome, which in turn influences the levels of inflammation and androgen production leading to a targeted impact on the skin. Following a diet that includes low-glycemic foods and lots of fiber rich plant-based foods does not just influence blood glucose levels, but also shifts the microbial balance in favor of lower inflammation and therefore, lower permeability of the gut. With a gut lining that is very selective about what is being absorbed into your bloodstream and then being transported to various organs including the skin, the rate of new lesions goes down significantly. Plus, older lesions and scars heal much more rapidly with the use of appropriate non-toxic cleansers and healing agents, when the gut microbiome is truly balanced- that is, topical treatments are more effective when combined with the treatment of the underlying cause.
The diagram below from the study mentioned above, provides an insight into the interconnected process :
Diagram credit:Ashley K. Clark 1, Kelly N. Haas 2 and Raja K. Sivamani 2,3,* Edible Plants and Their Influence on the Gut Microbiome and Acne. Int. J. Mol. Sci. 2017, 18, 1070
How do you know what needs correction/balancing in the gut and specifically the microbiome?
This is where the power of naturopathic medicine comes in. A thorough evaluation of a person's diet, bowel habits, all factors affecting the acne, i,e. cyclic changes, stress levels, travel etc combined with comprehensive testing can help determine the most appropriate dietary and lifestyle changes and list of herbal supplements that can help resolve the occurrence and recurrence of acne lesions. Time and again, I have seen this as a successful approach to treating acne in my practice; as the skin clears, patients report that their confidence and productivity at work/school/social settings increases dramatically.
If you feel that you or a friend need help with acne, please be sure to share this blog's link. As I always say, whether you are curious or concerned, come in for a 20-minute conversation to figure out if naturopathic medicine is right for you.
Go ahead, aim for that healthy, glowing skin!
Like each year, January is the month when we set our health goals for the year and are determined to follow through until...life's gets busy again! End of January is typically the time when your resolutions are being tested and how the rest of the year goes depends on what choices you make now. To help you with just one aspect of this year's resolution, that is, eating healthy, here is a checklist of 5 things to avoid when we must rely on processed and packaged foods, especially for snacks.
As a reminder, healthiest options such as fruits, veggies, nuts and seeds for snacks should be at the top of the list and processed & packaged foods should be used occasionally when hosting an event, travelling or just needing a change in taste. If you have children, you know the need to have a huge stack of snacks available at short notice for those sudden hunger pangs, last minute play dates or times when fruit just won't satisfy those tiny taste buds!
The golden rule when choosing packaged foods is of course: Read the Ingredients! Not just how many calories, fats or sugar is in each serving size. Know what exactly you are eating. To make this process quick and efficient (and less confusing) here are the 5 main ingredients/ingredient categories that should watch out for and avoid when choosing your packaged snacks:
This list not an an exhaustive list of ingredients or ingredient groups that you need to avoid, but a list with the important ones to get you started. When faced with nutritional challenges and dietary limitations such as being gluten or dairy free, it is even more crucial that the processed and packaged foods that you rely on, be free of unnecessary and harmful ingredients.
By consistently reading labels, eventually you will be able to narrow down your choices to a few favorite brands that you can trust. One of my favorite brands is #EnjoyLife- check it out here!
More questions? Please feel free to call our office and set up your Free Consultation.
Until next time!
IBS or irritable bowel syndrome is generally considered a diagnosis of exclusion by the medical community. What this means is that, the common pattern of symptoms associated with IBS such as, bloating, abdominal pain and cramping, loose and/or frequent stools, sometimes alternating with constipation, burping and /or passing gas do not seem to have an ‘organic’ or infectious cause, and these symptoms cannot be attributed to either of the following:
Since the symptoms are present with the absence of a plausible cause, a diagnosis cannot be established due to lack of apparent cause and therefore, the ‘diagnosis of exclusion’ i.e. IBS, is assigned to patients with such symptoms.
With no apparent cause, IBS patients are conventionally treated with prescription or over-the-counter medications such as antacids, laxatives, anti-diarrhea pills, anti-nausea pills and gas relievers such as Simethicone that provide symptom relief. Some patients are also referred to psychotherapy because of a well established correlation of mental anxiety with IBS. Note that this is correlation and not a causation. It can be a debilitating diagnosis as it affects family, work and social life for most patients with having to excuse oneself for urgent bathroom breaks or plan a family vacation around accessibility to the restrooms or simply face the embarrassment of “whodunit” when they pass odorous gas!
In naturopathic medicine, since the the focus the is on treating the root cause instead of symptom relief, I always begin with investigating these three main factors that may be responsible for irritating your bowel system:
1) Anything coming in contact with the lining of the bowels
Investigating foods that you eat on a regular basis to check for food sensitivities and delayed allergic reactions is critical. Most common culprits in this arena include dairy, gluten containing grains, corn, nuts, soy but you maybe sensitive to a food that is generally considered healthy and nutrition packed. Examples of such foods include:
irritating the intestinal lining and are reviewed as well.
2) Imbalance in the gut flora
Whether it is due to a recent course of antibiotics or an extended period of stress, the balance of normal friendly bacteria in the digestive system can be greatly affected. There are multiple species and strains of bacteria, viruses, fungi and archaea that live in the digestive tract and some have a much more beneficial presence than others. The beneficial strains assist in functions such as digestion, absorption, immune signaling and even neurotransmitter balance. The non-beneficial strains may not be pathogenic (i.e. disease causing) but still be contributing to IBS symptoms by competing for resources with the beneficial bugs.
3) Lack of adequate enzymes leading to improper digestion
Chronic stress, antimicrobials and medications can negatively affect the production of the natural digestive “juices” such as enzymes and hydrochloric acid (HCL), that are crucial for the appropriate break down of foods into the macro and micro nutrients. These macronutrients such as carbohydrates, proteins and fats need to be further broken down into the building blocks for our body to assimilate and utilize for its various functions. When foods are improperly digested, symptoms such as gas, bloating, pain can result in the short-term but can have a much more serious long-term impact due to resulting nutrient deficiencies and chronic disease.
Identifying and correcting these three factors frequently result in both immediate symptom relief and the long lasting benefit of ‘calmer’ and ‘not so irritable’ bowels. With such a multifactorial approach, patients often report that their bowels appear to be less affected by their mental-emotional state, indicating a much more resilient digestive system.
If you or someone you know, suffer through the inconvenience and social withdrawal associated with IBS, please contact our office to set up a free consultation.
"An ounce of prevention is worth a pound of cure" This quote attributed to Benjamin Franklin, was not in the context of medicine, but it surely reflects the 6th principle applied in the practice of naturopathic medicine: Prevention.
This principle has many layers of meaning similar to to our 1st principle, First, do no harm! It permeates through all of the first 5 principles and therefore, is automatically incorporated in practice, if the first 5 principles are sustained.
The three most important aspects of this principle include:
Throughout this week, my goal has been to provide an insight into the mind of a naturopathic doctor and the various intricacies that I try to address why creating a detailed treatment plan for our patients. NDs are trained as all doctors, to follow an evidence-based approach to treatment and continually update their knowledge about the latest research in nutrition, pharmacology, pharmacognosy and environmental medicine. What I enjoy most is the challenge of figuring out how evidenced-based information can be applied individually to each patient, while still keeping in line with naturopathic principles.
I hope that I have at least partially achieved my goal this past week. Thanks for reading and please be sure to leave comments and feedback.
Wrapping up #NatMedWeek2018!
Continuing my series of blogs on the principles of naturopathic medicine, our next principle, which explains why NDs make an effort at every single visit to educate their patients: Doctor as Teacher.
The origin of the word ‘doctor’ comes from the Latin word ‘doctor’ which means ‘teacher’, which in fact originates from the Latin verb ‘docere’ = “to teach”. I was not aware of this fact until my undergrad years, when I chose a course purely out of interest, about the Latin and Greek origins of English words. What a fascinating fact this was! However, I only truly understood the meaning of the word doctor and this principle, once I had joined naturopathic school.
Now, having been in clinical practice for over 10 years, it is obvious to me why my duties as a doctor are intertwined with that of an educator. And for you see it as obviously as me, I just listed the primary responsibilities of a traditional teacher inspired from my daughter’s wonderful school teachers:
Now, if you were to go back and read those responsibilities and replace the word ‘student’ with ‘patient’, it easily explains the why the Doctor is also a Teacher. The curriculum and goals are unique to each patient!
As a naturopathic doctor, I educate my patients about their health, actions they can take to correct a deficiency, to improve their energy, to reduce the risk of a heart attack or stroke and sometimes about something as simple as home care remedies for fighting off a cold. I allow them to ask questions and provide answers when I can, or refer them to specialists when necessary. I make them aware of various health resources available to them and how they can be used to their benefit. It is also my role to monitor their progress and explain what they need to change. Besides providing a treatment solution, I also provide ongoing support and coaching, so they can implement their treatment plans and achieve their health objectives.
I would like to end this blog, with a special note for my patients. As much as I am a ‘teacher’ for them, each & every patient has been a teacher for me! I have learned from my patients about resilience, inner strength, happiness, the ability to fail and yet keep going and most importantly, the importance of being compassionate and need for constant learning. Thank you for giving me an opportunity to be part of your healthcare team.
Sign off for today – the real Day# 4 (yesterday was a typo!)
The above quote gives an insight into the next two principles of naturopathic medicine: Treat the Whole Person and Treat the Root Cause.
The same disease can manifest as different symptoms for different patients. If you identify why the patient has a particular disease, that is, why this patient and not another, you may be able to treat them much more effectively. I thought the best way to illustrate these two principles would be through patient stories as case examples.
Both patients A & B in the stories below had identical major concerns and official diagnoses at their initial intake visits but since the root cause of the problem and the patients were very unlike each other, so were their treatment plans and corresponding results:
MAIN CONCERN: Difficulty losing weight and keeping it off, tried many diets/ programs
MAIN DIAGNOSIS: Obesity
Other official diagnosis common to both cases: Type 2 Diabetes, Hypertension, High Cholesterol
Root Cause Assessed to be:
Result in 6 months:
**He went on to lose over 200lbs by the end of his complete treatment and is now an animal rights activist and marathon runner. Yes, you read that right- not a typo, You can read more about him and his complete weight loss journey in his book named, Walking with Peety.
Root Cause Assessed to be:
Counseling provided on healthy, balanced vegan diet and frequency of visits set at every 2 weeks.
Result in 6 months:
Patient B is still an active patient is continuing to lose weight at her steady rate of 3 lbs/month. She has recently been diagnosed with Sleep apnea and upon correcting that she lost > 5lbs in one month and no longer has elevated BP.
As you realized, both patients were very different: male vs. female, single vs. in long term relationship, lonely vs. socially active and more. Therefore, the investigation was very different for both even with the exact same diagnoses! Both had positive outcomes, though with varying degrees, and were content with their results. That is the power of Naturopathic Medicine!
Signing off for today! Day4 #NatMedWeek.
Be sure to call us if you need help with your weight loss journey
Yes, you do. You just don’t think of it as a ‘machine’ and maybe surprised to know that I am referring to the human body! In today’s post, I am going to compare the functioning of the human body to that of a device, with the aim of highlighting it’s tremendous power to self-correct or heal, when allowed to do so. This will help me illustrate the second principle of Naturopathic Medicine: Vis Medicatrix Naturae (Latin) or Stimulating the Healing Power of Nature.
To illustrate how amazing the healing power of nature is and to make things interesting, I am going to compare it’s functioning to some common electronic devices we use daily. Viewing the the nature-made human body to man-made devices, may make it easier to provide a better understanding of the tremendous healing power of nature.
See what happens in case of minor injuries (Scenario1) and major injuries (Scenario2) in this situation: Device falls on hard tiled floor.
As you can see, even our smartest devices are unable to repair themselves for smallest of problems. Whereas the human body has a tremendous capacity fro healing and full recovery, when given the adequate support and care. There are limitations of course and the extent recovery depends on several factors including, genetics, a person’s nutritional status, ability to follow self-care instructions and follow through with rehabilitation.
Naturopathic Doctors focus on removing any obstacles to full recovery such as improper diet, lack of sleep routine and lifestyle modifications and providing additional support with healing herbs and supplements. Symptomatic relief such as for pain in the case of injuries, is given equal importance and typically treated with homeopathic and herbal supplements that are more effective, not addictive and have less side-effects than OTC or prescription medications. Pain or symptom relief is particularly important from the perspective of supporting mental-emotional health that can contribute majorly to the healing power of the body.
As a Naturopathic Doctor, when I think about the healing power of the body, elaborate diagrams of immune cells, long lists of pro-inflammatory versus anti-inflammatory cytokines and all the nutrients involved in the process that we studied in naturopathic medical school, flash across my mind all at the same time. Yet, for the human body, it is a simple, well-defined process.
My respect for this healing power increases daily as I realize that all of that "simple complexity" has not yet been duplicated in man-made devices even with seemingly rapid progress in the field of AI (Artificial Intelligence).
Leaving you with those thoughts, until tomorrow, Happy Day2 of #NatMedWeek2018!
Dr.Kulkarni will be writing on various health topics. Please sign up to receive updates.