Gastroesophageal Reflux Disease (GERD) Many people in the Western world suffer from heartburn on a daily basis. Of those individuals, approximately 20-40% of them have GERD (Gastrointestinal Reflux Disease). The symptoms result from exposure to gastric contents causing esophageal irritation. For most people, the lower esophageal sphincter (LES) is often weakened or other interfering factors can prevent it from closing properly.
Conventional Treatment Typical treatment of heartburn symptoms is the use of antacids (eg. Tums) or stronger medications that can block or suppress the production of hydrochloric acid (HCl). Naturopathic Treatment Usually a combination of nutritional, dietary and lifestyle treatment is used to address GERD. If the patient is compliant, usually treatment is very effective. Almost every GERD patient will need to identify and avoid foods and medications that trigger symptoms. Most people also find eating smaller meals with more frequency (6 small meals as opposed to 3 larger meals) and not lying down immediately following a meal is also beneficial. Dietary and Drug Triggers of GERD
Nutrients and Herbs
Melatonin: Found to be capable of protecting the esophagus and mitigating the effects of many inflammatory mediators. One study where individuals were treated with melatonin and a few other nutrients (l-tryptophan, Vitamin B6, folic acid, Vitamin B12, methionine, and betaine) or omeprazole, and those treated with melatonin experienced 100% resolution of symptoms compared to 65.7% in those treated with omeprazole. Phosphatidylcholine (PC): Cell membranes are typically rich sources of endogenous PC, which usually acts as a reservoir for free choline. Free choline is important for acetylcholine synthesis, and acetylcholine has been linked to increased closure of the LES. Licorice Root (Glycyrrhiza glabra): Considered a demulcent, meaning it coats, soothes and protects tissue. Commonly used for a number of gastric concerns including GERD. Marshmallow (Althaea officinalis): Another good demulcent and anti-inflammatory herb that is particularly known for soothing inflamed or irritated mucous membranes. There is no one set formula for preventing GERD, but through proper treatment and working with your health care provider you can learn to manage this condition well. Talk to your Naturopathic Doctor today about getting assessed and treated if needed, and as always talk to your health care provider before beginning any new medication or supplement. Note: There are many possible causes of chest pain, including more severe conditions such as a heart attack. If you are uncertain of the cause of your chest pain make sure you see your doctor to get it evaluated as soon as possible. References: Godfrey A. & Saunders P.R. (2010) Principles & Practices of Naturopathic Botanical Medicine: Volume I: Botanical Monographs. Central Nervous System, pg. 161-163. CCNM Press. Prousky J. (2008) Principles & Practices of Naturopathic Clinical Nutrition. Gastroesophageal Reflux Disease (GERD), pg. 126-129. CCNM Press.
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Iron One of the nutrients I get a lot of questions about in general is iron. Newly pregnant women are particularly concerned about their iron status and what impact that may have on their baby. In this blog, I will discuss why you don't need to worry too much about baby and how to ensure you both get enough. First thing to remember about the growing fetus is that it is very good at getting what it needs. Baby will stock pile as much iron as it needs in utero. Even for mothers with iron deficiency anemia, which affects almost 50% of pregnant women, studies have found that their babies were still born with sufficient iron. In general, healthy full term babies have enough iron stores to last for the first 6-12 months of life, especially exclusively breastfed babies. However, if you are found to be iron deficient it's still important to supplement because you need sufficient iron just as much as your growing baby. Why is Iron Important? During pregnancy, iron requirements double in order to build new red blood cells (RBCs) in Mom and the developing fetus. Iron also plays a role in cognitive and behavioural maturity, making hemoglobin and protein in RBCs that delivers oxygen to the body’s organs, muscles and tissues. Babies at risk for low iron stores: premature born (biggest grab for iron is in the third trimester), low birth weight babies (less than 6 lbs, 6 oz), babies born to mothers with poorly controlled diabetes during pregnancy, and babies fed cow’s milk instead of breast milk or formula during the first year. Iron Sources and Requirements If you look at the following, you will see that the daily requirement for iron is not a huge amount. The problem is, many people do not reach it daily and over time this will create a deficiency. Iron can be divided into two forms, heme and non-heme. Our bodies can absorb heme sources (15-35%) better than non-heme (2-20%). Dietary sources of heme are meat, chicken, and fish. Non-heme is in these and non meat foods (eggs, dairy, fruits and veggies). For the little ones iron has it’s highest absorption rate from breast milk (50-70%) due to the presence of Vitamin C and high levels of lactose in breast milk, as well as proteins lactoferrin and transferrin, help to increase absorption.
Other sources and their absorption rates: o Iron fortified dairy formula: 3-12 % o Iron fortified soy formula: 1-7% o Iron fortified cereal: 4-10% o Cow’s milk: 4-10% When supplementing to correct iron deficiency use a non-ferrous sulphate supplement (ferrous gluconate, chelate, or fumarate form). Ferrous sulphate is one of the most commonly used in supplements because it’s inexpensive, but it’s not absorbed well (absorption rate is only 10%). Make sure you take your iron with Vitamin C, as it increases the uptake of iron, and between meals. Calcium, black tea and some herbals [chamomile and peppermint], coffee or cocoa, oxalates found in some dark leafy greens, and other minerals can bind with iron and decrease absorption. If you're concerned about your iron status then talk to your Naturopathic Doctor today about putting together a plan that addresses your individual needs. References: Phillipson-Webb, L. 2010. Sprout Right: Nutrition from Tummy to Toddler. Penguin Canada. Romm, A. 2003. Naturally Healthy Babies and Children: A Commonsense Guide to Herbal Remedies, Nutrition, and Health. Celestial Arts. Skowron, JM. 2009. Fundamentals of Naturopathic Pediatrics. CCNM Press. Print. Building Strong Bones Takes More Than Just Calcium One of the most common concerns I hear from people when they would benefit from avoiding dairy products is the fear of missing calcium. Calcium is an important mineral, but to build strong bones and healthy teeth it takes more than just calcium to achieve it. Also, dairy products, like cow's milk, are not the only source or even the best source of calcium. Foods with Calcium Food sources: Tahini or sesame seed butter, almonds (powerhouse of calcium), salmon and sardines (with bones), soy, navy beans, blackstrap molasses, amaranth, broccoli, and kale. Almost all leafy greens are high in calcium. Nuts and seeds, deliver more calcium than milk (and usually more absorbable because they’re often raw). Sesame seeds offer 2200 mg calcium per cup vs 228 mg of calcium per cup of milk. One tenth of a cup or 1 ½ tablespoons of sesame seeds, would be the same amount of calcium as 1 cup of milk. Another note on milk, it loses 50% of available calcium through pasteurization. Low fat and skim milk offer even less because the milk fat is used for transportation and absorption of calcium. Making Healthy Bones Main minerals needed for bone building: calcium, phosphorus, magnesium, boron, and manganese, as well as vitamins A, D, C and B12. The hard part of bones store calcium and phosphorus, the bone marrow in the middle makes red blood cells (RBCs) and immune cells, which are made of fat that is stored for energy. The bones are made of a matrix, which is 25% water, 25 % fiber, and 50% mineral salts. The mineral salts of calcium, magnesium, fluoride, and sulfate are deposited between the protein fibers of collagen, and crystalized into salts, making the bone hard. If bones are too mineralized they will become brittle and easily break. In order to make good strong bones, we need all of these things in our diet as well as a good amount of physical activity. The stress of muscles and tendons placed on bones from movement is integral to the balance of building bones. The matrix is in a constant state of building and breaking down, and this process is only performed properly when ALL the building blocks and the right conditions are in place. Foods to Avoid Just as there are good food sources for calcium, there are also foods to avoid. The following foods either decrease absorption of calcium or increase the excretion of calcium: o High caffeine coffee, tea, soft drinks, and chocolate o Sugar is similar to caffeine and decreases the amount of phosphorus in the blood o High phosphorus intake from meat, grains, and soft drinks can take calcium from bones. Phosphorus and calcium need to be in a certain balance to have a positive effect on bone mineralization. o Salt also has similar effects to sugar and caffeine o Low Vitamin D can lead to low levels of calcium o A high fiber diet (with most fiber coming from wheat) can lead to lowered calcium absorption as fiber binds calcium and is excreted from the body o Protein in excess depletes calcium substantially. Too much creates an acidic environment requiring alkaline minerals like calcium to re-establish balance. Junk foods, refined foods, and most cooked foods also have this acid forming effect on the body. Protein also acts as a diuretic in the body, causing the kidneys to send calcium and other minerals out in the urine. A Note about Infants and Children: To help decrease some of your fears for baby, they start off with a calcium store of about 30 g that they get from you mostly during the 3rd trimester (approximately 200-350 mg a day). You can recover most of this loss within a few months following the finishing of nursing by following a calcium-rich diet. Whether you're breastfeeding or formula feeding getting enough calcium is important for you and baby, and dairy is not the only place to find it. General guidelines for protein: There is approximately 0.9 g of protein per 100 mL of breast milk and as breast milk intake decreases, protein content increases. It can be difficult to tell how much the baby is drinking in a day, but generally they get what they need. For formula fed babies, look at the label on the formula. If you're concerned about calcium or the state of your bone health then talk to your Naturopathic Doctor today about putting together a plan that addresses your individual needs. References: Phillipson-Webb, L. 2010. Sprout Right: Nutrition from Tummy to Toddler. Penguin Canada. Romm, A. 2003. Naturally Healthy Babies and Children: A Commonsense Guide to Herbal Remedies, Nutrition, and Health. Celestial Arts. Skowron, JM. 2009. Fundamentals of Naturopathic Pediatrics. CCNM Press. Print. Looking for a quick and nutritious breakfast? Try some oatmeal with a little extra flavour with this recipe for blueberry almond oatmeal. The almonds and blueberries add more nutrients and brighten up those plain oats. Be sure to get the thick cut rolled oats as they are processed less than the quick cooking oats. Serves 3-4 2 cups thick rolled oats 4 cups water pinch of sea salt maple syrup or agave nectar blueberries, fresh or frozen raw almonds, ground cinnamon 1. Place oats, water and sea salt into a medium saucepan. Turn heat to medium, cook oatmeal until it begins to bubble then turn heat to low. 2. Continue stirring until oatmeal is thick and cooked, about 10 mins. 3. Grind raw almonds in a coffee grinder to a fine meal. 4. Place desired amount of oatmeal into a serving bowl, top with a little maple syrup or agave nectar, a handful of blueberries, and a tablespoon or two of ground almonds. Sprinkle with cinnamon if desired. Note: If you are gluten sensitive, be sure to check the label that the oats are gluten free. References: Segersten, A. & Malterre, T. The Whole Life Nutrition Cookbook. Blueberry Almond Oatmeal. 2nd Ed. Whole Life Press. We are seeing more people, especially children, with allergies these days. There are several thoughts about why this is happening, but overall it’s generally described as a hypersensitivity or oversensitivity of the body to an external stimuli. One such theory referred to as the 'hygiene hypothesis' proposes that many children do not get sufficient exposure to a wide variety of microbes, and as result of growing up in an extremely clean environment devoid of microbes the body does not learn how to modulate the immune response effectively. Thus creating a situation where later exposure to a substance causes a hyperactive response, or allergy. There seems to be some credibility for this theory since the significant increase in individuals suffering from allergies has been mainly in the western hemisphere, and we have not seen a corresponding increase in other parts of the globe. However, as more countries become more affluent and the number of people below the poverty line decreases we are seeing an associated rise in atopic conditions such allergy and asthma there as well. In the US: · Number of people in the U.S. who have either allergy or asthma symptoms: one in five. · Percentage of the U.S. population that tests positive to one or more allergens: 55%. Internationally: The prevalence of asthma in different countries varies widely, but the disparity is narrowing due to rising prevalence in low and middle income countries and plateauing in high income countries. Symptoms: · Postnasal drip · Sniffling · Dark circles under eyes (allergic shiners) · Puffiness beneath the eyes · Restlessness · Fatigue · Poor sleep · Headaches · Behavioural problems such as irritability, hyperactivity, poor concentration, whining, and pickiness about food Chronic allergies, especially those that cause allergic rhinitis, a persistent inflammation of the mucous membranes lining the nasal passages, can lead to constant head congestion, decreased hearing ability, reduced concentration, and difficulty remaining alert. Children with allergies may frequently feel tired and irritable. Hyperactive behavior may also emerge as a result of allergies due to nervous irritability from chronic inflammatory response or the need to keep moving to stimulate endogenous adrenaline supplies. While a tendency towards allergies may be inherited, the extent to which they manifest may have more to do with dietary, emotional and environmental factors than genetic factors.
Suffering from allergies can be a very irritating experience. If you or your child is suffering from allergies, it is best to take them to a Naturopathic Doctor who can perform a proper assessment and form a treatment plan that will address your/your child’s needs. Always speak to your health care provider before beginning any new medications or supplements. References: 1. Allergy Statistics and Facts. WebMD. Reviewed by Johnson, K. (2012). http://www.webmd.com/allergies/allergy-statistics 2. Asthma Statistics. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/about-the-aaaai/newsroom/asthma-statistics.aspx 3. Romm, A. 2003. Naturally Healthy Babies and Children: A Commonsense Guide to Herbal Remedies, Nutrition, and Health. Celestial Arts. 4. Skowron, JM. 2009. Fundamentals of Naturopathic Pediatrics. CCNM Press. Print. |
Sarah Connors
I am a Naturopathic Doctor and Doula providing care in the Kitchener-Waterloo area. I have a passion for helping people with their health issues and improving the birth experience for Moms, and their babies. I also have a life long love affair with soccer, curling, and the alto saxophone. Archives
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