Saturday Appointments

25 05 2017

Saturday appointments are now available by request if needed. Please email amykroekernd@gmail.com to set up this type of appointment if our weekday hours do not work for your schedule.

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Making Home a Healthy Supportive Food Environment

7 01 2017

Recently I moved into a new apartment and I decided that I wanted to make a few changes to support my long-term health and wellness. One of these changes involved designing my kitchen to be an environment supportive of health and wellness. When I counsel patients to make changes to their everyday nutrition, I recommend getting rid of the foods that will be unsupportive of their goals. There are enough places outside of our homes that will tempt us without bringing that temptation right into our own homes. I don’t want to be restrictive in saying “I will never eat sugar or fast food ever again” but I do want to be able to come home and know that the things in my home will benefit me and allow me to nourish my full potential in energy and brain clarity. This way I can have a bit of freedom when I leave and eat elsewhere. I decided I would not bring foods into my apartment that are unhealthy for me. For me personally (everyone is a bit different) that means no dairy (other than grass-fed butter), no sugar (except for just enough to make my fermented kombucha tea), no eggs (they are a food sensitivity for me specifically), and no gluten (I am trialing this for a time).

My one other goal this year is to start transitioning to organic produce. I know the research on chemicals and pesticides in foods but I’ve never actually tried consistently eating organically. It is important that I know how to eat this way since many of my patients are required to eat this way due to being negatively affected by chemicals or pesticides. I also believe it is important for my health and the health of the environment even if I have no noticeable adverse effects from eating non-organic. And really, I’ve never given organic a proper trial so who am I to say organic won’t benefit me? Without a comparison, I do myself a disservice considering the research on endocrine disruptors in food and my tendency to hormonally imbalanced skin.

One of the best resources for environmental toxins and chemicals in food (they also have resources and guides for household cleaners, sunscreens, personal care products, etc.) is the Environmental Working Group (www.EWG.org). Each year they test fruits and vegetables to see which ones contain the most chemicals and pesticides and toxins and which ones are relatively low in these compounds. Their list is referred to as the Dirty Dozen, Clean Fifteen. The dirty dozen are the 12 most important foods to eat organically. The clean fifteen are the safest produce to eat conventional versions. Because organic foods can be expensive, this list helps me make the most critical choices as well as the most cost effective choices.

I have really been enjoying my new space. It’s beautiful, albeit tiny. I feel supported, energized, and healthy when I’m at home and knowing I can walk in the door and not have anything to tempt me in my resolutions is incredibly freeing. Of course, I know it would be more difficult if living with a family, but small changes add up and I believe it is extra important to train children to have healthy lifetime habits that will optimize their potential. It’s not that certain foods are off limits, it’s that the available foods in the home are those that support optimal health. Moderation and making healthy choices when unhealthy foods are available can be taught in other ways. A healthy home environment that fosters health and wellness in nutrition and lifestyle allows kids to be their best selves at school, with friends, and in the future at their workplaces and careers. This is why I wanted to put into practice what I talk about every day with patients. And someday I will be able to carry these habits forward into my own family life.

Challenge: Join me! Peruse through your kitchen cupboards, fridge, freezer, and pantry and mark any foods that list sugar (cane syrup, honey, rice syrup, maple sugar, glucose, fructose, sucrose, agave, etc.) in the first 5 ingredients on the ingredient list. When these foods are used up (or you may decide to get rid of some right away rather than eating them), do not replace them. Search for healthier alternatives or simply add more vegetables and fruits to your diet. I don’t typically replace unhealthy foods with alternatives; I just choose a different meal selection. For example, I’ve never tried gluten free bread. It’s never crossed my mind as an alternative. I simply don’t eat bread or toast or sandwiches. I eat whole grains instead like quinoa and wild rice. I do, however, use a small amount of stevia as a sugar replacement occasionally and I do indulge in gluten free crackers as a carrier to transport delicious guacamole from bowl to mouth. Lol. Mmmmm…guacamole. Let me know what works for you!

I bet you want to know what I have in my kitchen cupboards, fridge, and freezer! Stay tuned for the next post: What Does My Crazy Licensed Naturopathic Doctor’s Kitchen Look Like?





New Expanded Hours

5 11 2016

Tier 1 Health is expanding! We have recently added a new office assistant, Renata, to our team to help serve you better and decrease delays on prescription orders and refills. She will be doing appointment reminders, filling orders, and re-scheduling appointments. She is already doing an amazing job!

New hours are also an exciting part of the growth of Tier 1 Health. See more details under the “Appointments” page but we are now open Tuesday and Wednesday 9am-4pm and Thursday noon-6pm.

Watch for Saturday hours to begin soon! So many patients are busy working or at school during regular office hours. To make sure we can help as many people as possible achieve optimal health, weekend hours will begin soon.





Individualized Medicine

13 03 2016

Ask my friends and they will tell you that I’m famous for saying, “it depends”. Why? Because very rarely is there a one size fits all answer. This is especially true when it comes to YOUR health. What supplements should you take to maintain good health? It depends. What type of exercise should you do? It depends. How can you treat that cold or flu? It depends.

What does it depend on? It depends on YOU! What is your health history and your family health history? What is your personality like? What type of diet and lifestyle habits do you follow? What are your environmental stressors? What combination of the above led you to become sick or are predisposing you to developing illness in the first place?

This may sound overwhelming at first. If everything has so many variables, how can anyone hope to figure their health out? You may ask, “can’t I just take some fish oil and a multivitamin and vitamin D and be done with it?” I think deep down you know the answer to that question…it depends.

This complexity is why healthcare and research in the last hundred years has focused on which remedies and which medications will be beneficial for the most diverse range of people. And medicine has advanced in leaps and bounds due to this focus. Because we can treat more people in less time with better results. This is awesome! We need these types of treatments. When you are seriously ill, you need to know that the treatment given will work for most people including (most likely) you. Yes, there are always a few clinical decisions your doctor has to make in order to make sure you are getting the right treatment. Age, weight, other health conditions or medications you are taking, etc. all play a role in what your doctor prescribes. This is why we have doctors and don’t just go to the store and ask for a medication for lowering blood pressure or getting rid of anxiety. But often, especially with a time pressured medical system, the treatments end up being based on your condition and each individual symptom rather than the whole. Outliers to the norm are overlooked and mismanaged. This style of medicine, in short, has a tendency to leave out the most valuable piece of clinical information…YOU!

How do we clear up the confusion then? How do we seamlessly integrate individualized medicine with streamlined protocols that work for the majority? And most importantly, how do we make your health less confusing for you?

The answer lies in knowledge and education. Knowing your specific health history and combining that with education on how your body works as a whole. Symptoms are rarely separate issues within the body. Your hormones talk to your gut and your gut talks to your brain and your brain talks to your immune system, etc. If we know that you generally have a weak gut and suddenly you start to show signs of hormone imbalance, your individualized treatment plan will most likely address the gut primarily and only secondarily the hormone issue. With this type of individualized treatment, you will have better resolution of your symptoms and a better understanding of how to prevent it from recurring.

When you come to see me, I want you to leave not only with a treatment plan but with a better understanding of why you got the symptom in the first place and how you can prevent getting it next time. This takes a bit of time, usually more than one visit. This is why I spend 60-90 minutes on an initial appointment before giving a treatment plan. This is why I follow up more frequently at first to learn how you are responding. The key piece is education. The word doctor actually means teacher. I want you to be the expert on YOU and your health. In many ways you may be very similar to everyone else, but in a few areas your body may respond very differently. This is what I aim to understand about each one of my patients and communicate/educate them about. So that you can take back control of your own health. So that you know the answer to “which diet and exercise and supplements should I take for good health?” So that the answer is no longer…it depends.





Nutrition Thoughts in a Constantly Changing Research World

13 01 2016

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As a Licensed Naturopathic Doctor with a background Bachelor of Science in Human Nutritional Sciences as well as currently being a high performance athlete I’ve experimented a LOT with different diets! Low carb, slow carb, low fat, paleo, anti-inflammatory, train low carb and compete high carb, food timing, juicing, calorie counting, point counting, detoxes, various book diets named after their authors, and of course my fair share of time eating the standard American diet (SAD diet). Fads are constantly changing. Research consistently seems to contradict itself if you wait long enough. All in all, nutrition can become a confusing mess. Hence, I felt the need to write this post. Because what we eat shouldn’t be confusing, but it is.
Recently, I watched the Michael Pollan documentary “In Defence of Food”. Michael Pollan is not a doctor or a scientist. He is famous for saying, “Eat food. Not too much. Mostly plants.” And you know what? He’s right. It’s simple. Eat real food that hasn’t been processed and it becomes much less important whether it’s high or low carb or high or low in calories. All the science makes food an inaccessible entity requiring a professional’s advice before consuming when actually people have been eating without the help of a professional for, well, all time. You don’t need a doctor or a scientist or a dietitian to tell you what to eat. You know. I highly recommend you watch this documentary if you want to restore your sense of balance around the topic of food.
So why am I telling you it’s easy when clearly, it hasn’t been easy for me and I know it’s not always easy for you?
This is the twist. We have to change our habits to eat that easy way. And habits are hard to change. And people are individual with individual health complaints that may or may not have developed from poor dietary choices in their lifetime. For many individuals, seeing a documentary like the one above is enough. They see what they need to eat and they change to eat those things. They are balanced and moderate and will enjoy long healthy lives. I’m not here to help those people. If you are one of them, you don’t need my professional help. I’m here to help those individuals who need specialized nutrition. An athlete needs exponentially more nutrients than an average consumer. Individuals with fibromyalgia need to make sure the foods they eat do not cause excessive inflammation. Some individuals cannot tolerate certain foods the way most can. Reversing atherosclerosis and heart disease requires a different approach to diet than the approach for arthritis which is different than the approach for diabetes. I’m here to help those people who find it difficult to change their habits even though they know what they should be eating. And for me, nutrition will continue to be confusing. Because I will be the one filtering through the research and trying the fads and changing with updated knowledge. Let me handle the complexity. For you, nutrition should be simple.





New Clinic Hours – Tier 1 Health Selkirk

12 01 2015

Welcome to 2015! The biggest change I’ve made that affects you, my patients, is that my Selkirk Tier 1 Health clinic hours have changed.  Due to teaching a nutrition class at Robertson College for their massage therapy program on Tuesdays, I now work Wednesdays and Thursdays from 9:30am-5pm in Selkirk. I still work Mondays and Fridays in Winnipeg at Centre for Natural Medicine.





Elimination Diet 102: Diet of Abundance

27 08 2014

Welcome to the diet of abundance!! Maybe you saw the list of foods to be eliminated in my last post and thought, “there is nothing left to eat. This will be the worst diet ever!” Well, I’m here to shift your gaze towards all the amazing, delicious, colourful foods you can eat on the elimination diet. Ready?? First, a list. Then a picture of my lunch prep on day 1!

Eat these foods:

– Fruits: apples, blueberries, cherries, nectarines, lemons, grapes, peaches, mangos, raspberries…
– Vegetables: carrots, beets, onions, garlic, celery, broccoli, spinach, lettuce, kale, cabbage, asparagus, leeks, bok choy, cauliflower, brussel sprouts, sweet potatoes, yams…
– Herbs and spices: oregano, parsley, dill, basil, cinnamon, nutmeg, turmeric/curcumin, cilantro, mint, this list is endless so I’ll stop here
– Grains: brown rice, wild rice, buckwheat, quinoa, millet, amaranth, teff, crackers and pasta made from these grains
– Legumes: black beans, Lima beans, lentils, green peas, split peas, snap peas, green beans
– Nuts and seeds: sesame seeds, almonds, cashews, pecans, walnuts, sunflower seeds, hazelnuts, coconut (a coconut is not technically a nut but rather a fruit or a seed), pumpkin seeds
– Animal products: chicken, turkey, wild game, lamb, deep water fish (salmon, cod, halibut, sardines), pickerel
– Condiments: tahini paste, nut butters, apple butter, hummus, mustard, pesto, vinegar
– Oils: olive oil, flax oil, coconut oil
– Sweeteners: apple butter, stevia
– Beverages: green tea, rooibos tea, herbal tea, rice or nut milks (unsweetened), water

As you can see, there are lots of foods to eat from all the foods groups. These are the focus of the elimination diet and should be the emphasis of any diet.

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