What Do Naturopathic Doctors Do Anyway?

In my last post I talked about the differences between conventional and naturopathic medicine. If you didn’t get a chance to check it out, take a look!
While comparing treatment philosophies, I mentioned that the conventional model mainly relies on pharmaceuticals while the naturopathic model has multiple treatment options.  Was anyone curious on what those “multiple treatment options” are exactly? In this follow up post I’ll give you a run through on some of the most common and reliable treatment modalities. When you walk into a ND's clinic these are the main tools that will be used to help treat a condition or to aid in the maintenance of good health.
Asian Medicine and Acupuncture
Traditional Chinese Medicine has been around for centuries and is what is referred to as eastern medicine.  It looks at health, wellness as well as different disease states from a completely different perspective. It focuses on the energy or the Qi that flows through channels in our body. The organs of Asian medicine all represent different aspects of a person’s health and mental state. If the flow of Qi becomes obstructed a disease state may appear and can be treated with acupuncture or herbs to redirect the flow of energy. It is interesting to note that there exists many parallels between Asian medicine and conventional medicine.  For more information visit the recent post from guest blogger James Yoon.
Clinical Nutrition
Many people often underestimate proper nutrition. It is such a powerful modality and often many presenting conditions can be treated with nutritional changes alone, such as hypertension, high cholesterol or type 2 diabetes. NDs will guide you on a path to better eating that fits within your individual case. Clinical nutrition also involves the prescription of supplements, which in many cases can give the body the tools it needs to heal itself.  Supplementation becomes important when a person's diet, lifestyle (ie. athletes), or genetic factors require higher intakes of vitamins, minerals, and other nutrients. 
Botanical Medicine
Did you know that many pharmaceutical drugs originated from plants and herbs? Active constituents in herbs have varying physiological effects in the body and can be extracted into an alcoholic mixture called a tincture. NDs can create a tincture formulation, which contains active compounds from various herbs that are specific to your individual case.  Tinctures are the main form in which NDs will prescribe botanicals but they may also be taken in other forms such as teas, pills or ointments.  Botanical medicine is much gentler on your body than traditional pharmaceuticals while producing far less side effects.
Physical Medicine
Physical medicine involves the treatment of any musculoskeletal issue. Many different techniques can be used such as ultrasound, hydrotherapy, massage, manipulations and acupuncture. Exercise or stretching prescriptions may be given to work on specific issues or can even be designed for the maintenance of general health. Physical medicine also involves the therapeutic effect of simple human-to-human touch. Simply being massaged or touched by someone else can have great relaxing and calming effects. The power behind simple touch is often underestimated.
 Homeopathic Medicine
Homeopathy is by far the most controversial modality taught in accredited naturopathic medical colleges. It has been around for centuries and involves dosing patients with remedies, which usually come in the form of little white pills. Homeopathic remedies can also come in other forms such as creams or sprays.  The remedy contains the essence from whatever its source may be, which can include anything from a common herb to the light of the North Star.  Simply put this modality involves treating like with like. In other words a homeopath would prescribe a remedy to a sick patient who is presenting with the same symptoms that a healthy patient would produce if they were given that same remedy.  My co-blogger Nadia has a great affinity for homeopathy and I am hoping she will post a more in depth description in future posts. I will give you one word of advice: do not mistake a naturopathic doctor for a homeopathic doctor--we tend not to respond well that.  Homeopathy is just one of many modalities NDs are trained in, while homeopathic doctors specialize in homeopathy.
Lifestyle Counselling
NDs receive a great amount of training in health psychology. Lifestyle counseling can involve anything from implementing current psychological theories to strategies to quit smoking. There is a big focus on the mind-body connection, as NDs believe that the body and mind work together as a whole and that the emotions and feelings you are experiencing can have a profound effect on how your body manages health and disease.
          As you can see, the tool belt that NDs possess to aid their patients is quite extensive. NDs are more than well enough equipped to act as primary health care givers and can even perform your yearly physical exam, including PAP smears and digital rectal exams. We are fully trained to do it all! It is also quite common for a ND to specialize in a certain area. Even though we all receive training in the core 6 modalities mentioned above, often NDs develop an affinity or a skill in a certain specialty. Specialties could include anything from naturopathic oncology or gynecology to mental disorders or homeopathy. 
          It is a good idea to discuss with your potential ND what their strengths are and if their form of practicing matches up with what you will expect from their services. Additional modalities do exist and are currently practiced by Naturopathic Doctors, but the naturopathic academic community doesn’t necessarily find them relevant or useful enough to teach to students.
          If you have any questions please feel free to leave a comment! We would also love to hear what you think our next topic should be!
Jamie Smellie

Recipe: Portobello and Goat Cheese Salad

This recipe is one of Christine’s favorite salads.  The warm mushrooms and roasted garlic on top of the cool and crisp romaine makes a great and flavorful combo!  The herbed goat cheese ties everything together when mixed with the mustard-balsamic dressing and adds for a creamy finish.  Hope you enjoy this as much as we do!

Salad:  Serves 1
½ bulb of garlic
1 heaping handful of romaine lettuce (or favorite green)
1 large portobello mushroom
1 medium tomato or ½ cup of cherry tomatoes
2 tbsp herbed goat cheese
1/2 tbsp olive oil
Sea salt and black pepper (to taste)
*Feel free to add in any other vegetables, nuts, or other toppings!

Preheat oven to 425 degrees Fahrenheit
Drizzle garlic with olive oil and season lightly with sea salt and black pepper
Wrap garlic in aluminum foil and roast in oven for 20-25 min (or until soft)
Wash and chop lettuce/greens; place into serving bowl
Chop tomatoes (or slice cherry tomatoes in half); place in bowl with lettuce
Season whole portobello mushroom lightly with sea salt and pepper
Cook portobello mushroom over medium heat for 2 min on each side; remove from heat
Slice the mushroom and place on top of salad
Add crumbled goat cheese

1 tbsp grainy mustard (with seeds)
1 tbsp olive oil
2 tbsp balsamic vinegar

Put ingredients into a small bowl
Mix well with a fork
Place dressing on top of salad

Stopping Colds and Flus Before They Happen

A lot of things are going on this time of year that place extra stress on our immune systems—midterms, assignments, work deadlines, colder weather...

Year after year we go through the same thing and without adequate rest, proper nutrition, and in many cases supplementation of key nutrients, our immune systems slowly but surely start to break down. I know it is difficult for most of us to maintain an optimal diet and lifestyle, there are some things we can do to boost or at least maintain the function of the immune system.
  • Vitamin C 
    • Although most research shows that vitamin C is best for treating the common cold, some studies suggest that taking vitamin C (especially those exposed to high amounts of physical stress) may help prevent it as well.
  • Vitamin D3
    • Vitamin D is an important immune system modulator that stimulates anti-microbial particles in different cells in our bodies.
    • Since sunlight is becoming scarce and time spent outdoors is decreasing so vitamin D3 stores are likely to start depleting.   
  • Echinacea
    • Echinacea acts as an immunostimulant and antimicrobial and has been shown to reduce the incidence of colds by 58%.  It has also been shown to be effective in the treatment of colds.
  •  Green tea extract
    • One study demonstrated that green tea extract prevented the onset of flu symptoms by 32% and also decreased the amount of symptom days.
    •   This benefit was seen with taking green tea extract (with L-theanine and EGCG) at the equivalent of 10 cups of green tea per day.
As always, there are also some very basic things we can do to make sure our bodies are ready for the stress that comes with fall and winter:
  • Hand hygiene:
    • It’s true what they say: washing your hands frequently is the easiest way we can stop the spread of viruses.
  •  Fruits and vegetables:   
    • Eating just an apple (or avocado!) a day for your fruit and vegetable intake is not enough to keep the doctor away.  Make sure your body is constantly receiving the vitamins and minerals that are in fruits and vegetables by eating at least 5-6 servings a day.
  • Sleep:
    • Not getting enough sleep makes your immune system less effective when trying to fight off microbes we encounter on a daily basis.
Lastly, if you think you are at high risk of getting and spreading the flu, talk to your doctor to see if the flu shot is a good option for you.  Remember that it’s also important to begin your flu prevention protocol well before cold weather hits and to maintain it through the end of winter.

Hope this helps!

Christine Cho

Acupuncture: Getting to the Point

We are officially in the thick of exams so we decided this would be the perfect time to introduce our first guest blogger: James Yoon, a fellow colleague from CCNM who has a strong interest in sports medicine. He played varsity basketball at the University of Western Ontario where he graduated from in 2007 with an Honors in Kinesiology.   

We would love to hear your feedback! 
The Difference Between Contemporary Medical and Traditional Chinese Medicine (TCM) Acupuncture.
A chiropractor friend of mine, Evan Durnin, recently posted an article comparing Contemporary/Medical acupuncture with Traditional Chinese Medical acupuncture.  It was very informative, especially for the patient, to help distinguish the differences.  While he was very familiar with the medical/contemporary use of acupuncture, I found the TCM explanation needed a couple “holes” to be filled (no pun intended).  So naturally, I responded to his post and provided some information that could be useful for anyone interested in understanding each respective modality.

Contemporary Medical Acupuncture:
This form of acupuncture takes the traditional form of acupuncture and modifies it using modern day scientific understandings of human physiology and anatomy. At first glance this form of acupuncture will look quite similar to the traditional approach, as the same small, thin needles are places in specific points on the body for an extended period of time and removed.
In contemporary medical acupuncture, treatment is rendered after a conventional medical/neuro-functional diagnosis has been made. The practitioner will use acupuncture as a treatment modality along with other therapeutic approaches, which at our clinic includes: ART, Graston, manual manipulation, electrotherapy, ultrasound, exercise, stretching, and taping.
The contemporary acupuncture practitioner applies treatment following a conventional (scientific) view and regards the acupuncture as having certain local tissue effects as well as providing spinal segmental analgesia, extra-segmental analgesia, as well as central regulatory effects on the nervous system.  
In summary the points used in this form or acupuncture are chosen based on their specific neuroanatomical, and neuromuscular location related to your specific pain or dysfunction.  

Traditional Chinese Acupuncture:
A traditional Chinese acupuncturist will obviously also do a very comprehensive history/physical combination and make a diagnosis based on complex theories regarding disturbance in the body’s balance (energy ect.) that needs to be addressed with treatment. The imbalances previously mentioned will be quantified by excess or deficiency with respect to what are considered the five elements: water, fire, earth, metal and wood. Traditional Chinese acupuncturists believe that certain points in the body correlate with one of these elements and that treatment via acupuncture can correct imbalances, and this is how they select their highly proven and anatomically specific points.

My Response on TCM Acupuncture:
A Traditional Chinese Medicine (TCM) approach goes beyond acupuncture alone. Acupuncture in TCM is just one part of the therapeutic approach, similarly to conventional medical acupuncture. In addition to nutrition and lifestyle recommendations, the use of medicinal herbs, electrostimulation, or moxaibustion are used to address these issues. For example, Astragalus (aka Dang Shen in Chinese medicine), is an adaptogenic herb and immune system modulator/enhancer. That is, during times of stress or illness, it would be considered to use to help strengthen the immune system. In the TCM approach it's considered strengthening "wei qi", which is synonymous with your immune system. And while TCM diagnosis does involve the general foundation of the 5 elements theory, diagnosing goes into much more detail. For example, there are paired organs under each element, and a variety of conditions related to that organ. An example would be "spleen qi deficiency" which is commonly seen in students. Its symptoms are characterized by poor appetite, abdominal distension (bloating), loose stools, and fatigue, just to name a few. While it is treated with acupuncture as an adjuvant therapy, the main cause is poor nutrition and timing, paired with "over thinking". That is, the body is not getting the nutrient it needs to supply the demands of a studious lifestyle. Therefore a TCM approach would typically address this issue through nutritional supplementation/changes with acupuncture aiming to strengthen your digestive system (the spleen qi).

'Can't Live Withouts': Supplement Savvy

As naturopathic medical students we get a lot of information thrown at us everyday and sometimes it is hard not to think we should be taking every supplement under the sun. There are so many different treatments and supplements for all sorts of conditions that it is hard to keep track! We thought that it would be a good idea to make a quick essential list of what we think are the top four supplements that you can take everyday for the maintenance of a healthy body and mind.  

1) Multi-vitamins
Taking a multi-vitamin can be a great way to supplement your diet if you are not getting enough variety in your day to day eating. It is obvious that in this day and age many people are on the go and eating a diet varied in a broad range of fruits and vegetables is difficult. Studies have shown that people consuming less than adequate amounts of essential vitamins and minerals are much more likely to develop chronic diseases. Ideally we should be getting these essential vitamins and minerals from whole foods in our diet but when that isn't possible a good quality multi-vitamin can help us reach the necessary daily amount. It is especially advised to be taking a multi-vitamin if you are an elderly person as this demographic is prone to malabsorption. Also, with increasing age your metabolic rate decreases which in turn requires you to eat less food while your body still craves the same level of micronutrients. Taking a multi-vitamin on a daily basis is a great strategy to improve overall health and can keep your mind at ease on those days when you just can't fit in enough fruits and vegetables.
Remember, if your pee turns neon yellow it means it is working!   

2) Probiotics
Probiotics, also known as the “good bacteria”, are live microorganisms that have a proven beneficial effect on health. Most commonly probiotics belong to the Lactobacillus and Bifidobacterium species, which are part of the natural intestinal flora. 
  • Probiotics are commonly found in yogurt, miso, tempeh and soy products. 
  • They compete with "harmful bacteria" for nutrients 
  • Can be used to treat intestinal problems such as constipation, diarrhea or IBS
  • Help maintain the integrity of your gut. 
  • Help preserve an anti-inflammatory environment for the colon 
  • Aid in immune function and increasing the protective barrier of the digestive tract. 
It is important to note that a prebiotic is not the same thing has a probiotic. A prebiotic is a non-digestible food that stimulates the growth of helpful microorganisms that are already in the gut. 
It is also noteworthy to always refrigerate your probiotics, as the successfulness of the probiotic is highly associated with refrigeration. A study conducted in 2003 found that, “viability was significantly associated with refrigeration status; 100% of the refrigerated samples proved viable compared to 50% of the non-refrigerated.”

3) Vitamin D-3 
Vitamin D is a heavy hitter when it comes to the fat soluble vitamins. Although it is called a vitamin it actually acts more like a hormone as it is a compound that is made in one part of the body but causes another part of the body to respond! Vitamin D plays a part in the following processes:
  • Bone growth and development
    • helps to maintain blood concentrations of calcium and phosphorus, two other key players in bone growth
    • allows calcium absorption in the gut
  • Immune and neuromuscular function
  • Reduction of inflammation
  • Mental health
    • people in more northern latitudes (like us in Canada!) are at risk for not getting enough daily ultraviolet light especially in the winter months which has been correlated to higher levels of depression
  • Menstruation regulation
    • there have been studies showing decreased vitamin D levels and its effects on women’s menstrual cycle (ie. dysfunctional bleeding, irregular cycle lengths)
  • Insulin and obesity
    • a few studies have shown that low vitamin D levels are associated with obesity and insulin resistance
After all of that important involvement in our body systems, it’s hard to think of a reason why NOT to start taking some Vitamin D-3!  Remember that this vitamin is fat soluble, so if you are taking a Vit D-3 supplement make sure to take it with a meal containing some fats to allow for best absorption. Vit D-3 is also available as liquid drops that come in many different flavours. The benefit of the drops is that the vitamin D is pre-dissolved in an oil so you don't need to worry as much about taking it with a fatty meal. Personally, I love the lemon-lime flavour!

4) Fish Oil

Fish oil (aka EPA/DHA, omega 3 fatty acids) is one of the most well-studied natural health products to date. I’m sure many of you can remember your mom trying to shove cod liver oil down your throat, proclaiming that “it’s good for you.” Well, it turns out she was right!

The more common benefits and therapeutic uses of fish oil include:

  • General anti-inflammatory action
  • The ability to help prevent heart disease
  • The ability to lower triglyceride levels in the blood
  • Aid in the prevention and treatment of depression
The American Heart Association recommends consuming two servings of fatty fish per week. So why supplement? Firstly, the majority of the population in North America is likely not eating enough fish per week to maintain good levels of DHA and EPA. Furthermore, there is much debate on the quality of fish these days and the potential for ingesting harmful toxins (ie mercury, PCBs, dioxins). The good news is that there are now several high quality fish oils manufactured in a capsule so you don’t have to plug your nose while you try to swallow the oil! They also come in great flavours such as apple and lemon, which helps cut down on the dreaded "fish burp".  Remember, it is important to note that like probiotics, fish oil is best kept refrigerated to preserve quality.
As always, whenever thinking about starting a new supplement, be sure to consult your ND or MD!

The an avocado a day Team!



1.  Girodon et al.  Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. 1997;41(2):98-107.
2.  Hersberg et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004 Nov 22;164(21):2335-42.

1.  Berman, S., and Spicer, D. Safety and Reliability ofLactobacillus Supplements in Seattle, Washington (A Pilot Study). The Internet Journal of Alternative Medicine.2003. Volume 1 Number 2
2.  Isolauri, E.Probiotics, Gut Inflammation and Barrier Function. Gastroenterol Clinics of North America. 2005. Volume 34 p. 437-450.

Vit D-3:
1.  Prousky, Jonathan. Principles & practices of naturopathic clinical nutrition. Toronto: Ccnm Press, 2008. Print.
2.  Whitney, Eleanor Noss, and Sharon Rady Rolfes. Understanding nutrition. 10th ed. Belmont, CA: Thomson/Wadsworth, 2005. Print.
3.  Office of Dietary Supplements: http://ods.od.nih.gov/

Fish Oil:

1.  Kris-Etherton P, Harris W, Appel L. Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease. Circulation. 2002; 106: 2747-2757. DOI: 10.1161/ 01.CIR.0000038493.65177.94
2.  Lin PY, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry. 2010 Jul 15;68(2):140-7.
3.  Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. Journal of the American College of Nutrition. 2009 Oct;28(5):525-42.

A Fresh Take on Classic Cider

Last week Kate and I made the executive decision to take some personal pampering time by going for massages at our local RMT clinic.  Not only were our bodies made into a fantastic jelly by our masseuses but when we first walked into the clinic there was the most delightful water being offered.  It was ‘Apple Cinnamon Water' in a beautiful big glass pitcher. We took one sip and were blown away… how could this be just water with apples and cinnamon, it was so flavourful!  We had to ask the receptionist what the inside scoop was and this was literally what she said:

Apple Cinnamon Water
1 x apple of your choice
2 x cinnamon sticks
1 x lemon
1 x pitcher of fresh water

1) Slice up your apple and treat each slice with a bit of lemon juice to avoid browning. 
2) Throw in the sliced apple and two cinnamon sticks and leave over night to infuse.
3) Voila! Flavourful, calorie free apple cinnamon water!

Of course we had to try it out for ourselves, and it was just too easy; we’re addicted. 

So if you are looking for a fun fall way to spruce up your water try out this fun and easy idea!


A long time athlete and health advocate,  Dr. Kumentas’ goal is to help her patients become excited about making positive lifestyle choices in order to enjoy healthier, happier lives.  Her driving force is a passion for healing the whole person on a physical, emotional, and spiritual level using carefully selected natural therapies, fitness, and integrated medicine.  She truly believes in the importance of practising what you preach and investing in your health.  
Dr. Nadia Kumentas practices at Zen Beginnings Wellness Centre in Toronto and has a special interest in dermatology, woman’s health, and pain management.

To learn more about Dr. Nadia Kumentas visit www.DrNadiaKumentas.com or contact her at nadia@zenbeginnings.com.

sugar...how sweet it is

After a Thanksgiving weekend filled with eating I am feeling the effects of all the sugar I consumed, which got me thinking about sweeteners. My go to sweetener is honey except when baking, where I tend to use maple syrup. So here is a breakdown of the pros and cons of commonly used sweeteners. 

my top 4 sweeteners:

my favorite sweetener! Is easily utilized and absorbed by the body and it also contains minerals (calcium, copper, iron, magnesium and potassium), vitamins (riboflavin, niacin, vitamin C and folate), proteins, fatty acids, glucose and fructose. Honey also has an antibacterial agent so it can also be used for burns, dandruff, ulcers and other wounds. 
However do not use honey if there is a known pollen or bee-related allergy.

there are different types of honey made from different flowers or from honeydew but your best choice is a 100% pure, raw, unpasteurized honey.

unpasteurized honey should never be given to infants under 1 year of age as honey contaminated with Clostridium botulinum may cause botulism poisoning. However, this is not a danger for older children or adults.

stevia (Reb-A)
this sweetener also comes from a plant, Stevia rebaudiana Bertoni, and is 250 times as sweet as sucrose. Stevia is calorie free! But it has a distinct taste that some may not be too fond of. Stevia has also shown benefit for lowering blood pressure and decreasing glucose levels. Overall, it is a well-tolerated sweetener. 

another natural and “good-for-you” sweetener is blackstrap molasses as it contains calcium, copper, iron, manganese, magnesium, potassium and vitamin B6. When buying blackstrap molasses look for un-sulphurated, as it does not contain any chemicals. 

maple syrup
my second favorite sweetener! Maple syrup has fewer calories than honey and contains manganese and zinc. Manganese and zinc offer many benefits including: decreasing progression of atherosclerosis, increasing immune responses and decreasing inflammation. Once again, when looking for the perfect maple syrup always buy pure maple syrup.

nutritionally inferior sweeteners:

agave comes from the plant family Agavaceae and is composed mostly of fructose. There are no known standardizations for agave, meaning the preparations of agave can vary and the clinical effects of different brands may not be comparable. However, there is no sufficient scientific evidence proving the benefits of agave. Nonetheless, it has a low glycemic index and is a lot sweeter than sugar so much less needs to be used to obtain the same sweetness. Agave is easily substituted in most recipes.

sugar alcohols
other popular sweeteners found in packaged foods are sugar alcohols liks sorbitol, xylitol and malitol. One easy way to determine if a sugar substitute is a sugar alcohol is to remember that basically anything ending with “-ol” is a sugar alcohol. These are better for you than sucralose and aspartame as sugar alcohols contain dietary fiber and increase satiety (feeling full). Sugar alcohols are not a whole-food and they provide no nutritional benefit so I tend to avoid these as well.

sucralose and aspartame 
there has been a lot of controversy surrounding sucralose (eg. Splenda) and aspartame (eg. NutraSweet) as they were previously believed to be carcinogenic (cancer causing). In 2007, the FDA reported that aspartame and sucralose are safe as sweeteners in food. So if you enjoy these artificial sweeteners there is supposedly no harm associated with their use but I believe in eating a whole-food diet and anything artificial does not make the cut for me!

when in doubt try to choose sweeteners that come from a whole food source and are not chemically produced in a lab. It is important to choose foods that have nutritional value to keep your body and mind healthy and happy. This definitely applies to the sweeteners you choose to include in your diet.

remember to always consult a healthcare practitioner before introducing or removing sweeteners from your diet as some can elicit certain side effects.  

best in health, 

kate kokoski 


(2011). Natural Standard. Retrieved October 10, 2011. 

Recipe: Meredith's Guacamole

Assignments and exams are beginning to pile up and rear their ugly heads. We are all in need of some great comfort food and thought this would be the perfect time to procrastinate and post our first recipe!

A few days ago was Kate’s birthday and while we were all starving from a long day of class we were discussing how we haven’t had an evening out with all of our friends this semester. This got us to thinking about our fellow colleague, Meredith. She always brings the most delicious guacamole to parties and gatherings. We also definitely wanted our first recipe post to be avocado related and this was the perfect fit!

So here it is: a tasty guacamole recipe by Meredith!


Serves 4-6

2-3 ripe avocados
1 medium onion, diced
1-2 garlic cloves, minced
1 lime
1 tsp Worcestershire sauce
1 tsp chili powder
1/2 tsp cumin
1/2 tsp salt
Pepper to taste
Optional add-ins: cilantro, ripe tomatoes, sour cream.

Peel and pit avocados and place in a medium bowl. Add onion, garlic and the juice from the lime. Mash ingredients together to a chunky consistency using a fork.

Add Worcestershire sauce, chili powder, cumin and salt. Stir to mix everything up. Adjust seasonings to taste.

Cover guacamole and refrigerate until serving.
Grab some tortilla chips, crackers or anything else dip-able and enjoy!

Caffeination Nation

It’s 8:30am, how many of you have already had your morning caffeine fix? (I have!) According to research caffeine is probably the most frequently ingested pharmacologically active substance in the world. That's pretty understandable considering it's found in so many common beverages and products we encounter and drink on a daily basis. Coffee, tea, soft drinks, energy drinks, products containing cocoa or chocolate, medications and nutraceutical supplements all contain caffeine in varying dosages.

It seems as though caffeine is now so ingrained in our social culture that most have forgotten that it is in fact a drug. Strain et al. states “a recent medical study confirms that caffeine is strongly addictive, with subjects exhibiting syndromes of intoxication, withdrawal and dependence”. I can surely attest to this. One of my closest friends is almost impossible to have a conversation with in the morning before she has had her morning coffee--it's like trying to talk to an irritable zombie that's hungry for human brains (ok well maybe that's a BIT of an over exaggeration…). She would routinely try and wean herself off of coffee only to be struck with headaches and fatigue that would bring her crawling back to the magic beans.

Interestingly, Gilliland K. and Bullock W. refer to this as “caffeinism, a syndrome which includes increased anxiety, depression, frequency of psychophysiological disorders and possibly degraded performance” in their article Caffeine: a potential drug of abuse. Furthermore, chronic heavy caffeine ingestion has been said to potentially “cause or exacerbate anxiety and may be associated with depression” and actually aggravate the symptoms associated with PMS. (Clementz GL and Dailey JW: Psycotropic Effects of Caffeine)

So do you know how much caffeine you are having on a daily basis? Health Canada gives the following general caffeine contents in milligrams (mg):
  • 1 cup coffee – 76-179 mg
  • 1 cup “average blend” tea – 43 mg
  • 1 cup green tea – 30 mg
  • 1 can cola (regular) – 36-46 mg
Interestingly after visiting Starbucks' nutritional information page I’ve gathered the following information:
  • Grande Caffe Americano – 225 mg
  • Grande Bold Pick of the Day (brewed coffee) – 330 mg
  • Grande Flavored Latte – 150 mg
à Keep in mind that a Grande is actually 16oz (so 2 cups) however, that is generally the standard size most people are consuming.

Hold on, coffee can’t be all THAT bad right? It MUST have some redeeming qualities… and it does! The health-promoting properties of coffee are often attributed to its rich phytochemistry, including chlorogenic acid, caffeic acid, hydroxyhydroquinone (HHQ), etc. According to a 2011 review done by Sultan MT “Many research investigations, epidemiological studies and meta-analyses regarding coffee consumption revealed its inverse correlation with that of diabetes mellitus, various cancer lines, Parkinsonism and Alzheimer's disease.” Also, coffee containing cafestol and kahweol may act as a safeguard against some malignant cells and decrease oxidative stress. Another group of studies state that in non-chronic caffeine users there have been significant improvements in cognitive performance noted in those who are not affected by caffeine withdrawal.

On the other hand, it has been stated that higher levels of caffeine raise cholesterol, posing a possible threat to heart health, for example, heart attack, stroke, insomnia and cardiovascular complications.

So what are the safe daily recommendations of caffeine intake and how can you stay reaping the positive effects?

Health Canada recommends the following:
  • 4 - 6 years: 45 mg/day

  • 7 - 9 years: 62.5 mg/day

  • 10 - 12 years: 85 mg/day
Women (who are planning to become pregnant, pregnant women and breast feeding mothers):
  • 300 mg/day
General population:
  • 400mg/day
From a preventative standpoint, Health Canada suggests that getting an adequate daily amount of calcium and staying within the range of about 400mg/day of caffeine can provide greater protection against the possible adverse effects of caffeine on bone health. Also, never underestimate the power and importance of a good night’s sleep or the mighty power nap!


A long time athlete and health advocate,  Dr. Kumentas’ goal is to help her patients become excited about making positive lifestyle choices in order to enjoy healthier, happier lives.  Her driving force is a passion for healing the whole person on a physical, emotional, and spiritual level using carefully selected natural therapies, fitness, and integrated medicine.  She truly believes in the importance of practising what you preach and investing in your health.  
Dr. Nadia Kumentas practices at Zen Beginnings Wellness Centre in Toronto and has a special interest in dermatology, woman’s health, and pain management.

To learn more about Dr. Nadia Kumentas visit www.DrNadiaKumentas.com or contact her at nadia@zenbeginnings.com.

Additional References:
Pictures: corbis.com
Starbucks: http://www.starbucks.com/menu/catalog/nutrition?food=all#view_control=nutrition
Health Canada: http://www.hc-sc.gc.ca/

Conventional VS Naturopathic Medicine

Have you ever wondered what some of the core differences are between a conventional and naturopathic doctor? Did you know that naturopathic doctors use many of the same tools to diagnose conditions but simply differ on how they may treat and manage their patients?

During my practice management class a few days ago, I was presented with this comparison chart and thought it was a great way to directly compare both medical models.
Conventional medical model
Naturopathic medical model

1. Human beings as individual parts (Biomedical model)

2. Dualism (mind and body seen as separate & individuals seen as separate from their environment)

3. Assessment includes:
- Medical intake
- Conventional Physical Exam
- Laboratory testing, as required
- Diagnosis is categorical (what the body is doing)

4. Treatment philosophy:
- Treat the bug
- Fix / remove / control / manage the part / system that is broken
- Symptom Management
- Reliance on pharmaceuticals

“What do you take?”

1. Human beings as complex dynamic systems

2. Holism (all parts are integrated and integrated with their environment)

3. Assessment includes:
- Patient’s subjective experience
- Holistic intake
- Conventional Physical Exam
- Naturopathic Physical Exam
- Laboratory testing, as required
- Diagnosis is explanatory (causal factors and physiological outcomes)

4. Treatment philosophy:
- Treat the individual
- Remove obstacles to cure and stimulate inherent healing
- Treat the cause
- Multiple treatment options

“What do you change?”

On top of the varying differences in assessments and treatment philosophies, the last line of each table, "What do you take?" and "What do you change" struck me the most. I believe this is a simple way to show how NDs may stand out from conventional medical treatments. It is so important to recognize that your health isn't up to anyone else but yourself and that being healthy and happy may require you to alter how you live your life. NDs work at the same level as their patients while guiding them to a more desirable state of health and wellness.

All comparisons aside, I wonder what would happen if both of these models came together to treat and manage patients as a whole? Integrative health care is the direction things are headed and some doctors are already onboard. The Cancer Treatment Centres of America are great examples of integrative health care. Each centre has a wide array of health care professionals including MDs, NDs, chiropractors and registered dieticians all working together to give cancer patients a more complete and whole-person treatment protocol. Patients enter the clinic and receive care from each medical professional who are all working together under one roof. The patient doesn't even have to leave their treatment room, the doctors rotate around them! This is the ultimate form of patient centred treatment and really simplifies the process. Patients can come to one place and get everything done at once, eliminating a lot of running around to various appointments and disconnect between practitioners. I for one am really excited to one day be part of such a great way of practicing medicine.

What are your thoughts on this? Please leave a question or comment!

Jamie Smellie


Table taken from Iva Lloyd, BScH, RPE, ND's lecture during practice management NMS 310 at the canadian college of naturopathic medicine.

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