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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The Elimination Diet 101

27 08 2014

When it comes to food sensitivities, there are several ways to test for them. One that my patients might be familiar with is the elimination diet. This diet is designed to remove and systematically reintroduce the most common food sensitivities to determine whether a patients’ symptoms are caused by the foods they are eating. However, food sensitivities can also be tested using a blood draw and ELISA analysis for IgG and IgE anti-bodies. So why, you may ask, are so many of my patients familiar with this diet when a simple blood test could suffice? The answer lies in the fact that, in practice, this diet not only removes food sensitivities, but sources of inflammation, hormone disrupting foods, autoimmune triggers, headache/migraine triggers, etc. It has a tendency to, when followed strictly for 4 weeks, begin to treat those conditions which are impacted by today’s standard American diet (otherwise known as the SAD diet for short). If you don’t know which conditions those are, I’ll tell you a secret. Almost all health conditions are impacted by diet. Even the genes that control whether or not you develop a disease that runs in your family can often be turned on or off through dietary means! Amazing! In short, the elimination diet helps many of my patients see how large a role diet plays in their health and allows them to experience, in a relatively short period of time, what “healthy” feels like.

The details:
Basically, I can eat any foods that are not on the “avoid” list. I often tailor this list for individual patients but the following are the basic foods to avoid:

Avoid
– Dairy
– Eggs and red meat/processed meat and pork
– Soy
– Gluten
– Vegetables in the nightshade family
– Citrus fruits (except lemon)
– Foods with a potential for mould and fungus
– Caffeine
– Sugar (this includes maple syrup, agave, honey, cane sugar, etc.)

I’ve completed this diet once or twice in the past and I know that it can be tough if you don’t have resources for shopping lists, recipes, tips and tricks. There are several books I often recommend to help. Here are two:

– Delicious Detox by Carol Morley, ND – This book can be ordered online at http://www.deliciousdetoxcookbook.com or I also carry it at my clinic, Tier 1 Health, in Selkirk.

– Hypoallergenic Diet: A Complete Guide – by Dr. Saeid Mushtagh, ND – this book can also be ordered online in print form or ebook form at http://www.hypoallergenicdiet.com

Recently I decided to tackle the elimination diet again from a different perspective. I want to share my ideas, recipes, useful websites, and meal suggestions right here on my website. I also want to overhaul my own diet as somewhere along the way I let a lot of unhealthy foods sneak back in. Even naturopathic doctors develop bad habits! Lastly, I want to support my patients as several are planning to begin this diet at the same time as me.

So here I go! Follow along!

Your Health, My Priority

Dr. Amy Kroeker, ND

Photo: Preparation…stocking up on vegetables!

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Health Tip of the Week: Vegetables and Fruit

19 05 2014

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Did you know that eating vegetables and fruits can lower your risk of stroke? A meta-analysis study published May 2014 compiled the results of over 700,000 participants with 16,981 stroke events. Their conclusion was that for every 200 gram increase in fruit consumption there was a 32% decrease in the risk of stroke and for every 200 gram increase in vegetable consumption an 11% reduction of stroke risk. So how many fruits and vegetables do we need to eat? Well, 400 grams of fruit is approximately 5 servings. Canada’s Food Guide recommends that teens and adults eat between 7-10 servings of vegetables and fruits every day for optimal health. As a Naturopathic Doctor, I agree. Vegetable and fruit intake is one of the most singularly important prescriptions of preventative healthcare. Unhealthy foods get a whole lot of attention for substances that we are supposed to be avoiding. If we could talk more about what we should be eating rather than what we should be avoiding we could start switching our perspectives from reactive to preventative and from negative to positive.

So this week I challenge you to eat at least 7 servings of vegetables and fruits every single day. An apple, a tomato, 2 handfuls of spinach, 1/2 cup of blueberries, 1/2 cup of cucumber, 1/2 cup broccoli. That’s an example but choose the kinds you love. Focus on the positive. Enjoy the benefits of adding this preventative tip into your life!

 

 





Health Tip of the Week: Visit My Open House!

20 01 2014

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This week I have a special health tip. I’m having an open house and there will be so many health tips, recipes, and demos that I want you to come and check it out instead of focusing on one specific health tip for the week. It will be an event designed to motivate and inspire you towards better health in the year ahead so you don’t want to miss it!