What is infertility…technically?

Infertility is defined as “lack of conception after 12 months of regular unprotected intercourse (at least two times per week) with the same male partner and in the absence of male causes of infertility.” For women over 35 years old, diagnosis can be made at six months and after 40 years old at three months.

What are the odds?

According to “The Textbook of Natural Medicine,” the “optimal ages for reproduction are believed to be between 18 and 35 years for a female and 16 and 40 years for a male.” However, with preconception care and assisted reproductive technology women are successfully achieving pregnancy at older ages. Bear in mind that these are statistics based on a broad spectrum of individuals; where you fit in to that range is very individual.

Oregon Reproductive Medicine gives these statistics for ovulating women achieving pregnancy in six months:

• 25-30 yo – 80%
• 35 yo – 60%
• 38 yo – 40%
• 40 yo – 20%

It is important to note that optimizing fertility should focus on the health of both partners. Remember your child’s DNA is 50/50 from Mom and Dad. The following are the main factors affecting fertility.

What affects fertility?

AGE

This is the main variable and one that we cannot change. Women are born with a fixed number of eggs (oocytes), which develop while they are in their mother’s womb. With each period, eggs are expelled into the uterus for fertilization, decreasing the overall count. The number of eggs a woman has left or her “ovarian reserve” is often measured in older women trying to conceive. Egg quality is also compromised with age and affects probability of conception. Improving egg quality in women struggling with infertility is an important aspect of preconception care.

WEIGHT

A body fat percentage of 20-25% is recommended for optimal conception, however, many women conceive just fine at higher levels. However, it is important to point out that being overweight and underweight both present risks for infertility. A body fat less than 17% can cause anovulation (no egg is released each month). In this case it can take up to two years before conception occurs, even after body fat is corrected. A healthy weight is extremely important for optimal pregnancy and should be addressed in those experiencing infertility.

Check out the BMI (body mass index) Calculator Plus on WebMD to determine your ideal weight. http://www.webmd.com/diet/calc-bmi-plus

TOXIN EXPOSURE

Tobacco use- commercial tobacco products contain a litany of carcinogens and chemicals that in no way help optimize fertility. What’s more, smoking directly affects the uterus, eggs and embryo. Smoking is also associated with infertility, increased incidence of miscarriage, placental problems, low birth weight babies and sudden infant death syndrome (SIDS). For free help to quit call 1-800-QUIT-NOW.

Alcohol- research shows that consuming more than one drink per day is associated with a 50% reduction in fertility. Woman struggling with infertility may want to reconsider their nightly glass of wine, cocktail or beer.

Caffeine- research shows that consuming caffeine is safe under 200 mg per day. In general, plain drip coffee has around 95 mg per 8-ounce cup, so the limit would be about two cups per day.

Environmental toxins- exposure to radiation, pesticides and heavy metals can all adversely affect fertility. Take measures in your life to avoid these chemicals. Examine ingredients in makeup and beauty products and try to purchase organic food when possible. Check out the article on Xenoestrogens for more information or go to www.ewg.org.

How can I improve my chances of having a baby?

Preconception care is a practice that involves priming the body for pregnancy. Practitioners usually recommend a minimum of three months and up to one year to get the body in shape for pregnancy. Your doctor will likely run basic lab work to assess where you are on the road to optimal pregnancy health and develop a plan based on those results. The following are great places to start if you want improve your overall health and enhance your chances of conceiving:

The Fertility Diet

• Choose organic, local produce and organic, grass-fed meat and dairy products when possible.
• Eliminate trans fats and increase monounsaturated fats (olive oil, nuts, seeds and avocados).
• Lower intake of animal protein and increase vegetable protein (beans and nuts).
• Increase intake of vegetables and fiber.
• Eat lower glycemic index carbohydrates.
• Consume full fat dairy products as opposed to low fat or fat free.
• Check out the book, “The Fertility Diet” by Jorge E. Chavarro, M.D., Walter Willett, M.D., and Patrick J. Skerrett for more information.

Prenatal Supplements

Begin taking a high quality prenatal supplement about one year before you would like to get pregnant and continue throughout the postpartum time period. Discuss which supplement is best for you with your Naturopathic doctor.

Stress management

Find ways to relax and de-stress through meditation, prayer, acupuncture, gentle exercise, stretching, baths or whatever you find relaxing. Research shows that “trying too hard” to get pregnant may be related to up to 30% of infertility cases.

Sex

Avoid lubricants because they inhibit sperm motility and activity. The best option is good old-fashioned canola oil or Pre-Seed lubricant.

Increase frequency of intercourse in the days leading up to, during and after ovulation. An ovulation predictor kit can help you determine when you ovulate. Intercourse every other day during this time is sufficient.

Avoid toxin exposure for reasons stated above.

**Allow about 120 days to improve egg and sperm quality.

If you are struggling to get pregnant, discuss preconception care with your naturopathic doctor. It’s never too early to get your body in tiptop shape for pregnancy. Go to www.naturopathic.org to find a doctor near you.

Resources

The National Infertility Alliance- www.resolve.org

Natural Fertility Info- http://natural-fertility-info.com

Getting Pregnant Directory by WebMD- http://www.webmd.com/baby/getting-pregnant-directory

Murray, M.T., Pizzorno, J.E. (2012). Infertility, Female. In Textbook of Natural Medicine (chapter 179). Retrieved from www.mdconsult.com

By Amy LaRue, fourth year medical student.  Edited by Dr Elise Schroeder

1)  Given my age, what screening tests are appropriate?

There are many regular screening exams that women of all ages should be getting. What tests are recommended depends on your age and your unique health history. These exams can help detect early pre-cancerous changes to tissue as with a pap smear, cancers in their earliest stages as in mammograms and colonoscopies, or help you determine what your risk of developing osteoporosis is as in a Dexa scan.

Make sure to check in with your doctor about this to be sure you are getting all of your recommended screening tests.

2)  How is my blood pressure?

By the time a woman reaches menopause, her cardiovascular disease risk actually surpasses that of her male counterparts. And chronically elevated blood pressure is a serious condition that may potentially lead to stroke, heart attack, peripheral artery disease, and kidney failure. It is important to monitor your blood pressure regularly and note any changes you see over time.  If your blood pressure is only mildly elevated and your doctor does not feel that medication is warranted, check in with your naturopathic doctor or nutritionist to see what you can do with your diet and lifestyle to promote healthy circulation.

3)  Am I at a healthy weight?

With the juxtaposition between our fast-food culture and Hollywood ethos, it can be challenging to determine what a healthy weight actually is. Asking your primary care provider directly will help initiate a conversation about what an ideal weight for your particular body type is. Having a healthy body mass index (BMI – the measurement used to determine obesity) can help decrease your risk for many diseases including diabetes, heart disease and cancer. Ask for specific weight loss (or weight gain) recommendations if your weight falls outside of the recommended range.

4)  Are all of my current medications still necessary and am I taking the correct dose?

We are dynamic creatures and over time as we age, change our habits, switch providers, we may find that not all of our medications are still medically necessary. Make sure to fully review ALL of your prescribed medications (with dosages), even if your primary care provider was not the prescribing physician. They may recommend dose changes or medication changes based on your entire picture. It is often helpful to bring your prescription bottles in with you. Make sure to mention to your physician if you are taking any over-the-counter medications or herbal and dietary supplements.

5)  Should I be tested for any sexually transmitted infections?

Your well woman exam is the perfect time to be screened for sexually transmitted infections (STIs). Unfortunately, many STIs are asymptomatic and often people are unaware if they are carrying them.  If you are sexually active at all, it is important to regularly be screened for STIs. Make sure to ask for a herpes screening test as well, as 30% of the US female population over age 30 has herpes and it is not generally included on the standard STI screening test.

A few other notes: It is okay, in fact encouraged, to bring a pen and paper with you to your appointment. Make sure to jot down any questions that arise during your appointment if you do not get the opportunity to ask them, as well as any recommendations that your doctor makes. It is okayto talk to your doctor about sensitive issues like urinary incontinence, uterine prolapse or bowel changes. These are important symptoms that often people are shy about discussing. Don’t worry, doctors want to know about your poop.

By Malea MacOdrum fourth year medical student, edited by Dr Elise Schroeder

1. Heart Disease
2. Cancer
3. Chronic airway disease

This is in contrast to 100 years ago, when the top three causes of death were Pneumonia,  Tuberculosis and Diarrhea–all infectious disease. Death rates from infectious disease began to decline in the 1920’swith the introduction of medical interventions including antibiotics and public health measures. At the same time, the incidence of heart disease started to rise which coincided with the development of processed food and fast foods, such a white bread,  candy bars, kool-aid and popsicles. Americans started eating processed foods, working in factories, driving cars, increasing exposure to toxins and reducing their exposure to sunlight,  pure water and vitamin-packed fresh produce: the perfect combination for chronic disease to take a foot hold.

Today the four common causes of chronic disease according to the CDC are*:

1. Lack of aerobic physical activity
2. Diet–particularly eating too few fruits and vegetables
3. Smoking
4. Excessive alcohol consumption and binge drinking  (binge drinking is considered consuming more than four drinks on any one occasion for women or five drinks for men)

How might we reduce these causes of mortality among Americans?  The answer is through preventative health care.  Some of the top preventative health strategies are listed below:

1. Eat a healthy well balance diet
2. Get adequate sleep
3. Regular exercise
4. Balance your hormones
5. Reduce your stressors or learn ways to reduce the effects of stress on your body

In honor of National Women’s Health Week, please call or use an online scheduler to book an appointment with your health care provider. Talk with them about your best health and longevity strategies.  What are your risks?

For more information about what to ask your provider, please see Five Things You Should Ask Your Doctor at Your Annual Check-up another article in this month’s newsletter.

*http://www.cdc.gov/chronicdisease/overview/index.htm

• Visit a health care professional to receive regular checkups and preventative screenings
• Get active
• Eat healthy
• Pay attention to mental health, including getting enough sleep and managing stress
• Avoid unhealthy behaviors, such as smoking, not wearing a seatbelt or bike helmet, or texting while driving

Preventive screenings are an important aspect to our health.  Many women avoid the annual gynecologic exam.  According to research, reasons cited by women for not having an annual gynecological exam include embarrassment, dislike of one’s physician and lack of money. However, the most common reason cited is, ironically, the idea that an exam is not necessary unless one is experiencing some type of problem.  “It is so ironic that a number of women are under the impression that they don’t need to see their physician unless they have a problem, when in fact, it’s often through a routine examination that a problem is first found,” Dr. Jan Furniss, MD, Obstetrician/Gynecologist.

The annual gynecological exam is not just a time to get a pap smear and bimanual exam.  According to the new guidelines, these may not actually be performed for several years at a time depending on your age, previous pap results, and your current health status.  Visit Do I Need A Pap for more details regarding the current screening guidelines. For adolescent and young adults, it is an opportunity to discuss birth control options, sexually transmitted diseases, hormonal changes and strategies to manage menstrual concerns.  For women preparing to conceive, it is an opportunity to discuss diet and nutrition, optimize the body in preparation of a pregnancy, and discuss fertility concerns.  For women who are experiencing menopause and pre-menopausal symptoms, the annual exam is an important opportunity to talk about managing symptoms and hormone treatment options in addition to supplements and prevention of osteoporosis.

Beyond reproductive health concerns, the annual exam is an opportunity to review heart health, gastrointestinal conditions, weight management concerns, thyroid function status, and to complete preventive lab tests such as cholesterol, blood sugar, metabolic panels, and blood count tests.  All of the organ systems within the body need a check up on a regular basis.  The annual gynecological exam is the perfect opportunity to discuss any concerns within your body on a regular basis, regardless of reproductive status.

An excerpt from First Lady Michelle Obama from the 2012 National Women’s Health Week does a great job of conveying the importance of women’s health:

“So, here’s the bottom line for us women: No more excuses. Today, we’re more empowered than ever before to take control of our lives and our health. Whether it’s pushing ourselves a little harder at the gym, calling our doctors to make sure we’re up to date on our screenings, or reminding our girlfriends that they can access these preventive health care services without a co-pay—we can all truly make a difference, not just for ourselves, but for our mothers and daughters, our grandmothers and granddaughters, and all the women in our lives who we love.”

Resources

www.acog.org

http://www.och.org/index.php?option=com_content&task=view&id=75&Itemid=79

http://womenshealth.gov/nwhw/

 By Jamie Fields fourth year medical student  edited by Dr Elise Schroeder

You’re not in menopause yet, you still get your period every month, but certain things are changing.

Perimenopause can start 10 years before true menopause hits. Some women start to experience hormones changes as early as 35 years old. During this pre- menopause time, periods are still occurring and pregnancy is possible, however, hormone production fluctuates and can be normal one month and sub par the next.

Changes in Estrogen and Progesterone production can cause symptoms like anxiety, sleep disruption, irritability, occasional hot flashes, libido changes and period changes. These changes start slowly and sort of creep up when suddenly the realization hits-

“I don’t feel like myself! What’s going on? I’m too young for menopause!”

Well first off, don’t worry! There is a solution. The silver lining is that these years provide an opportunity to focus on optimizing health to maintaining youthful vibrancy now and until the last period has come and gone. Perimenopause can last a long time, up to 10 years. During this time, women have a chance to influence the quality of their health for the rest of their lives.

• Insomnia, Mood Changes and Headaches – These are some of the uncomfortable symptoms of hormone imbalance. By optimizing hormone production in the body, these symptoms can simply slip away.

• Bone health- during the transition to menopause, women can lose a significant amount of bone density. This is preventable by taking care to get the right vitamins and minerals, doing the right kind of exercise and maintaining hormone balance.

• Prevent weight gain in menopause- Once menopause hits, it’s much harder to lose weight and much easier to gain. Fat cells are a source of estrogen in the body, so it is common to hold on to weight more easily. Unwanted weight gain can be prevented by taking care of your metabolism in Perimenopause.

• Reduce severity of menopause symptoms and ease the transition – Uncomfortable symptoms in perimenopause are a warning sign of what is to come. Taking care to balance hormones during these years can ease this transition and help avoid unwanted symptoms from occurring.

Ok, its perimenopause, now what?

To help balance hormones, I use a natural approach in my practice with a combination of lifestyle changes, dietary modifications, herbs, and sometimes low dose bio-identical hormone replacement. With each individual the treatment plan is unique. The common thread being improved wellbeing, vitality, reduction in unwanted symptoms and a big sigh of relief. There is a solution!

For more information on solutions to perimenopause check out this blog from the WIBI website http://womeninbalance.org/2012/10/26/natural-symptom-relief-for-menopause/

By Dr Elise Schroeder

Do you garden for pleasure, beauty, food or just because you love it?

In fact, horticulture therapy (HT) is a modality that some hospitals use to help patients have fewer complications, recover more quickly and take less pain medication. The American Horticulture Therapy Association states that HT “helps improve memory, cognitive abilities, task initiation, language skills, and socialization.” Assisted living and long-term care facilities for the elderly frequently utilize HT as it can decrease agitation, lower need for medications and reduce falls. Additionally, in dementia patients HT can improve cognition because it requires patients to learn new skills or to regain lost skills.

The restorative and healing properties of growing plants, digging in the dirt and relaxing in nature may be motivation enough for you to buy an indoor plant, start a vegetable garden or simply buy a nature calendar for your desk.

 Here are the top reasons to get outside and start growing:

1. Stress reduction
   Research shows that the effects on the mind are similar to meditation; inducing calm and relaxation. Even just gazing at pictures of nature has been shown to decrease stress levels, but why not take full advantage and get some exercise while you are at it.
2. Exercise
   Gardening can be as labor intensive as you would like it to be. Some may want to embark on a large vegetable garden and others may decide to stick to potted plants. Either way the activity burns more calories than sitting on the couch.
3. Vitamin D and Sunlight
   Studies show that even people living in areas with plenty of sunlight may suffer from vitamin D deficiency because they work indoors all day. Getting outside after work and on the weekends to care for a garden or plants helps motivate people to spend time in nature.
4. Improved Attention & Mood
   Most Americans lead a fairly busy lifestyle, spending large amounts of their time in front of computers, televisions and cellphones, which can lead to “attention fatigue.” Colors, motion and the contrast of a garden setting only requires involuntary attention, which can be rejuvenating to an overworked brain.

Resources:

• Horticulture Therapy. Retrieved March 31, 2013 from www.ahta.org
• Detweiler, M.B, Sharma, T., Detweiler, J.G., Murphy, P.F., Lane, S., Carman, J., Chudhary, A.S., Halling, M.H., Kim, K.Y. (2012). What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly? Psychiatry Investig, 9:100-110.
• Gardening for Health. Retrieved March 30, 2013 from http://www.webmd.com/healthy-aging/features/gardening-health
• Why Gardening Is Good for your Health. Retrieved March 30, 2013 from http://www.cnn.com/2011/HEALTH/07/08/why.gardening.good/index.html
• Horticulture Therapy. Retrieved March 30, 2013 from http://www.legacyhealth.org/en/health-services-and-information/health-services/for-adults-a-z/horticultural-therapy.aspx

 By Amy LaRue, 4th year medical student edited by Dr Elise Schroeder

Another top priority for optimal health is good sleep. To round out this month’s WIBI newsletter we have a great article on Sleep hygiene (in other words, healthy sleep habits).

Finally our women’s health symposium is fast approaching.  The conference takes place in Portland OR March 15-17 for medical professionals and March 16 for the public.  We are very excited about this inaugural event. The speaker lineup is impressive; our women’s health vendors are getting ready to share their women’s health product and disgnostic tools,  and we are gearing up for a fabulous weekend of sharing and learning. Because KNOWLEDGE IS POWER and BALANCE IS EVERYTHING.

Thanks for your continued support of the Women in Balance Institute. If you have any questions, shoot us an email at info@womeninbalance.org

In health

Dr Elise Schroeder

Women In Balance Institute

But alas, Spring is in the air!  Flowers are starting to bloom, birds are singing, and the air is crisp and clean.  For many, this time of year signifies a time to open the windows and deep clean the house.  We want to remove the darkness and dampness of winter and allow spring freshness to permeate.  The same can be done for our body.  “Spring clean our body”…sounds like a great way to ditch the heavy winter meals, kick start our energy, and shed those winter blues.  But where to start?

There are many “detox diets” in modern culture – the master cleanse, the clean diet, the clean green and lean diet, fat flush diet, Martha’s Vineyard diet, the super cleanse, or the you are what you eat diet.  Many claim to help you lose 30 pounds in 30 days, or clean your liver to help you process body fat better.  Most detox diets are ineffective and potentially dangerous.  They are based on rapid weight loss in the first few days, which generally signifies a loss of water.  They are not intended to be sustainable, safe, or healthy methods to support the body through a healthy cleansing cycle.  Often with many detox diets and fasting programs, the toxins stored within fat tissue are suddenly released into the bloodstream.  This can add undue stress to the body and the detoxification system, and ultimately lead to an inflammatory process.  Many times, people can feel worse after a detox diet than they did before.

To support an ongoing, effective detoxification, consider making a vow for the month of March (and ideally more often throughout the year) to follow the guidelines within this article.  This information is neither novel nor complicated; however it can make drastic improvements to your health.

Follow the Mediterranean diet.

Eat mostly vegetables, some healthy protein like fish or hormone free meats, and healthy fats. Use whole grains, sweets and alcohol sparingly.

A great eating guideline to follow is the Mediterranean diet.  The Mediterranean diet is a powerful anti-inflammatory diet proven to support heart health, prevent cancer, and manage weight.  It is based mainly on fruits, vegetables, whole grains and seafood.  Other meats, dairy, eggs, and sweets are eaten infrequently.  The most important component of any healthy diet is to focus on whole foods (fruits, vegetables, whole grains) and limit meats, dairy, sweets and treats.

Drink plenty of water daily

Over 75% of our body is made of water; it is vital to maintain a continual supply. Water keeps your body hydrated, flushes unwanted waste material out of the body, and improves communication abilities between the cells of your body.  Improved cellular communication equals improved bodily functions.

Avoid all processed, packaged, and fried food

Here is a rule of thumb: If you can’t pronounce most of the ingredients on a label, choose something else. 

Buy whole foods as much as possible.  Most packaged and processed foods contain additives and preservatives that are unnecessary and potentially harmful to the body.  Additionally, most of these foods are full of sugar, salt, saturated fat, and trans fat.

Limit alcohol to one serving daily

Although various studies have shown that moderate amounts of alcohol can have health benefits, it is important to keep in mind the definition of moderate.  For men, moderate is two servings daily, for women just one.  The liver is responsible for the breakdown of alcohol; this is also the main organ that detoxifies the body.

Move your body daily

Exercise is a powerful tool to support the body.  It protects the heart, manages weight, and powers the circulation of blood, nutrients, and lymphatic tissue throughout the body.  Having a strong circulation enables the body to heal, have access to vital nutrients for growth, and removes toxins and waste products from around the body.  Exercising also encourages the body to sweat, which is a vital method of eliminating toxins from the body. 

Manage stress levels

Stress can wreck havoc in our body.  Chronic stress can lead to heart disease, sleeping problems, digestive issues, depression, obesity, memory impairment, skin conditions, and reproductive issues.  It creates an inflammatory environment within our body.  Figure out ways to manage your stress levels.  Ideas include exercise, relaxation techniques, yoga or Pilates, meditation, journaling, spending time with friends, laughing and having a sense of humor, or seeking professional counseling. Consider downloading some meditations onto your ipad or ipod or other MP3 player.  You can listen before bed, or while resting on your lunch hour.  Here is a link to Tara Brachs meditation which you can download for free. 

Go outside

Most of us have camped out inside our houses and our places of work for most of the winter.  It is time to get outside, soak up what sunshine is available, and feel the fresh air on our face.  If possible, play in the dirt, prepare the garden, tidy up the lawn, or go for a walk in the woods.  Nature is a part of us, and we are a part of nature.  Re-establish this relationship as the weather improves.  Not only does it feel good to be outside in the fresh air, but also nature is a powerful antioxidant.  There is a layer of electrons on the surface of the earth, trees, grass, plants, and dirt.  When our skin comes in contact with them, we absorb them and they become antioxidants within our body.  Mother Nature is important to our health.

Have fun

Life is supposed to be enjoyable, mysterious, challenging, a wild ride.  Have fun!  Find something everyday that you enjoy doing, and do it.  And be sure to laugh.  Not only is laughing fun, and a sign of having a good time, it stimulates the immune system (specifically natural killer cells, which recognized stressed cells and can kill bacteria or viruses on contact).

Looking for a more personalized approach?

If you think you would benefit from a more personalized approach to detoxification or are interested in “spring cleanse,” please contact a naturopathic doctor.  Not everyone will benefit from the same detoxification protocol.  It is important to discuss your goals, your health history with a qualified professional who can guide you through the process.  To find a naturopathic doctor please see our provider locator tool.

Another reputable resource for a fully supported and personalized cleanse is Cleanse Organic. This program is the only cleanse available that has been created by a naturopathic physician and a chef. NCNM alum Dr. Aimée Shunney designed the program to not only help you cleanse and detoxify safely, but to teach you how to shop, cook, eat and enjoy an anti-inflammatory diet – skills that will promote optimal health long after your cleanse is over.  Check out Cleanse Organic.

Resources

http://www.webmd.com/food-recipes/guide/detox-diets-purging-myths

http://fivetothriveplan.com/thrive-thoughts/category/considering-a-detox-diet-or-cleanse

http://www.mayoclinic.com/health/detox-diets/AN01334

http://www.everydiet.org/detox_diet.htm

http://www.huffingtonpost.com/dr-michelle-callahan/spring-cleaning_b_1455277.html

http://drlindsey.com/nutritional-philosophy-spring-clean-your-diet-routine/

by Jamie Fields 4th year medical student edited by Elise Schroeder ND

The diets discussed below include, the Mediterranean, Paleo and Anti-inflammatory diets. Each of these diets may work for different people and have slightly different benefits. These diets were chosen based on the latest research in nutrition that indicates certain diets help to reduce risk of chronic disease more than others. The days of low-fat diets and sugar-free, processed foods are over, so find out what changes you can make to improve your health and prevent disease.

Basic Rules

• Divide your plate into thirds. one-third vegetable, one-third protein and one-third whole grain/fruit/starchy vegetables.
• Eat breakfast everyday!
• Eat protein and healthy fats at each meal to feel full longer.
• Stay hydrated throughout the day. Sometimes dehydration can feel like hunger.

Set the Scene

• Eat sitting down in a calm, relaxed environment without electronics distracting you.
• Chew your food thoroughly- 11 times is a good rule of thumb.
• Avoid drinking fluids with meals (it dilutes stomach acid needed to properly break down food). Ideally, drink 20 minutes before or after meals.
• Use smaller plates for better portion control.

Food Choices

• Choose fresh, organic and in-season produce as often as possible.
• Make homemade meals from scratch; avoiding packaged food
• Make a plan for the week. Cook several dishes on Sunday if you are strapped for time during the week or put ingredients into a Ziploc bag and freeze it to cook later in the week.
• Have fun cooking and trying new foods!

Eating Plans

The Paleo Diet = Caveman Diet = Stone Age Diet = Hunter-Gatherer Diet

The basic premise is that we should eat foods that we are genetically programmed to consume. The diet is based on the hunter-gatherer’s diets from the Paleolithic era before agriculture. Research shows that this way of eating prevents obesity, metabolic syndrome, diabetes and possibly cardiovascular disease. This diet is low in dairy products, so it may not be appropriate for individuals with low calcium.

Foods to eat:

• Fresh meats (preferably grass-fed or free-range beef, pork, lamb, poultry, and game)
• Fish and other seafood
• Fresh fruits
• Vegetables
• Seeds and nuts
• Healthy oils (olive, coconut, avocado, macadamia, walnut and flax seed)

*Dairy products, cereal grains, legumes, refined sugars and processed foods were not part of our ancestral menu.

Information adapted from:  http://thepaleodiet.com

Mediterranean Diet

The diet endemic to the Mediterranean region has been well studied for many years. Research shows that following this diet protects against heart disease, obesity, type 2 Diabetes, Alzheimer’s, Parkinson’s and some cancers. Note that the health benefits of this diet are attributed to the food choices, but lifestyle is incorporated as well.

Foods to eat:

• Plant-based meals, with small amounts of meat & chicken, when they are used
• Increased servings of grains, fresh fruits and vegetables, nuts, and legumes
• Naturally high fiber foods
• Fish and other seafood at least 2 times/ month, weekly is preferable.
• Olive oil as the main source of fat used to flavor and prepare foods
• Food that is prepared and seasoned simply, without sauces and gravies
• Fresh, seasonal, whole foods with little to no processed foods.

Foods eaten in small amounts:

• Red meat eaten a few times per month
• Sweets and dessert
• Eggs
• Butter

Others aspects of this diet are leisurely eating, plenty of exercise and red wine in moderation.

Adapted from: http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000110.htm

Anti-inflammatory Diet

The idea behind this diet is that chronic inflammation is the basis for many diseases, from cancer to heart disease to arthritis. The goal of this diet is to reduce overall inflammation, thus reducing risk for chronic diseases. One the most well known advocates for this diet is, Dr. Weil, who created the following food guide pyramid to reflect this eating plan.

From:  http://www.drweil.com/drw/ecs/pyramid/press-foodpyramid.html

Which diet is best for you?

To find out which diet you will benefit from the most, consult which a qualified heath care provider who can help you figure out your unique dietary needs.  To find a Naturopathic doctor or other specialist near you, check out our provider locator tool http://providers.womeninbalance.org/

Evaluations of the latest diets

http://www.webmd.com/diet/evaluate-latest-diets

For more information on nutrition check out these websites.

http://lpi.oregonstate.edu/

http://www.mayoclinic.com/health/healthy-diet/NU00200

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/

References

1. Klonoff, D.C. (2009). The Beneficial Effects of a Paleolithic Diet on Type 2 Diabetes and Other Factors for Cardiovascular Disease. Diabetes Sci Technol. November, 3(6): 1229-1232.
2. Sofi, F., Cesari, F., Abbate, R., Gensini, G.F., Casini, A. (2008). Adherence to Mediterranean Diet and Health Status: meta-analysis. BMJ. 337:a1344. DOI: 10.1136/bmj.a1344.

By: Amy LaRue, ND 4th year medical student edited by Elise Schroeder ND

Basics of Sleep Hygiene

Practicing good sleep hygiene helps to train your body to recognize signals for sleep. The main premise is to create a sleep ritual (like taking a warm bath) that you perform every night at the same time. Over several weeks to months, these rituals become programmed into your brain as external signals that sleep is coming, which allows the brain to slow down and begin the process of relaxation.

Do

1. Go to bed at the same time each night.
2. Get up from bed at the same time each morning.
3. Get regular exercise each day, preferably in the morning. There is good evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise.
4. Get regular exposure to outdoor or bright lights during the day. This helps to support your circadian rhythm, which tells your body when it is daytime (giving you more energy) and nighttime (moving you into restfulness).
5. Keep the temperature in your bedroom comfortable
6. Keep the bedroom quiet when sleeping. If you have noisy neighbors, make sure to keep your doors closed or move your bed. If you live on a busy street, make sure to keep your windows closed.
7. Keep the bedroom dark enough to facilitate sleep. The release of melatonin by the pineal gland (your natural sleep aid) is inhibited by light, so the darker the better. Even the lights from your alarm clock, a charging computer, or light from under you door can affect sleep.
8. Use your bed only for sleep and sex.
9. Do a relaxation practice just before going to sleep.

• Muscle relaxation, imagery, massage, warm bath, etc.
• You can find guided relaxation audio tools online (iTunes) or at your local music store.

Avoid

1. Exercise just before going to bed. Exercise stimulates metabolic activity, exactly the things we would like to begin slowing down before bed.
2. Engage in stimulating activity just before bed such as playing a competitive game, watching an exciting program on television or movie, or having an important discussion with a loved one.
3. Have caffeine in the evening (coffee, many teas, chocolate, sodas, etc.)
4. Read or watch television in bed. These activities tend to stimulate the brain. We want your bedroom to be a sanctuary, not a place where you get revved up.
5. Use alcohol to help you sleep. Alcohol disrupts the body’s natural circadian rhythm and over time can make it much more difficult to get a good night’s rest
6. Go to bed too hungry or too full.
7. Take over-the-counter sleeping pills, without your doctor’s knowledge. Tolerance can develop rapidly with these medications.
8. Extended (more than 30 minute) daytime naps.
9. Command yourself to go to sleep. This only makes your mind and body more alert.

If you lie in bed awake for more than 20–30 minutes, get up, go to a different room (or different part of the bedroom), participate in a quiet activity (e.g. non–excitable reading, listening to a relaxation tape), and then return to bed when you feel sleepy. Do this as many times during the night as needed.

After practicing these techniques every night for two weeks, if you have seen no change in your sleep, contact your doctor as you may require a more in depth medical workup.

Resources

• The National Sleep Foundation – http://www.sleepfoundation.org/
• University of Maryland Sleep Disorders Center – http://www.umm.edu/sleep/sleep_hyg.htm
• Mayo Clinic Sleep Tips – http://www.mayoclinic.com/health/sleep/HQ01387

By: Malea MacOdrum 4th year medical student  edited by Elise Schroeder ND