Resiliency by Adam Rinde, ND

The quality most indicative of getting through a health crisis or concern is resiliency. It is true that the mind is involved in healing process. Is the mind the only thing that matters in healing? NO. Are our thoughts entirely responsible for our illness? NO! Are thoughts or mind process involved with of our ability to overcome the obstacles we face? I believe so. My patients show me this every day. It is truly remarkable to hear healing stories of patients who absolutely, unequivocally, were not going to let their illness win. Through every set back these folks just dust themselves off and keep moving forward.

Giving up on Dairy?

Giving up on Dairy?

By Adam Rinde, ND

Many people over time develop intolerance to lactose and begin what's called a dairy elimination. This would be fairly easy except, dairy and milk proteins are ubiquitous in much of the diet. There are few alternatives that will keep us from feeling deprived. My favorite is an Ice Cream substitute called Coconut Bliss; and bliss-full it is. You will likely not miss ice-cream if you try Coconut Bliss. Not only is it dairy free but it also gluten free, soy free, vegan, and its maid from organic coconut milk. I've seen it sold at Whole Foods and other health food stores. Other alternatives are almond milk, hazelnut milk, and hemp milk. Personally I think that there many ways to overcome intolerance to dairy and it's not a life sentence! If you try Coconut Bliss write me and tell me what your favorite flavor is.

Mind over Mattress by Adam Rinde, ND

Mind over Mattress

When is your personal time? My magic hour is 5:00 am. It's all mine for the taking. The battle of the mind vs. the mattress is my first challenge of the day. If the mind wins then I get to exercise, meditate, practice yoga or do whatever I want. If the mattress wins then the consequence is clear. I love to sleep especially on those cozy Northwest mornings, but there is a major cost associated with the extra hour of sleep. What do you battle with for personal time? My guess there is probably 1 hour a day that could be all yours. How do you want to spend it?

Slow Cooked Food by Adam Rinde, ND

Who ever invented Crock Pots is a genius. I have been hesitant to use a crock pot because I was afraid I was becoming too much like my parents. Well, I decided to get over that especially since I believe strongly in eating foods and meals that are less inflammatory. What I have found is the crock pot is a very healthful way to prepare foods and reducing the inflammatory load derived from food.

Some of the proponents of the Raw Food Movement talk about Advanced Glycation End Products (AGES) which form when foods are cooked at high temperatures. These AGES are said to wreak havoc on organs because they bind places where they shouldn't and cause oxidative stress and damage. I enjoy a cooked meal too much to join the Raw Food Movement, so I am incorporating slow-low-temp cooked meals into my diet.

Today I made a Gumbo that cooked all day for 9 hours! The temperature never went above 180 degrees. By the way the Nutrition Data Website had an excellent list of foods based on their inflammatory load. It will rank the anti-inflammatory effect of food. This worth looking at.

Sports Performance Supplements

Sports Performance Supplements:

This article appeared in Outdoors Sports Northwest Magazine

Have you ever been engaged in a tug of war between your mind and your body? The mind pushes but the body pushes back more, and suddenly you need to stop. This phenomenon, called "bonking," occurs when you have depleted your stores of the ready-to-use fuel glycogen. This normally occurs after two hours of continuous endurance exercise without any carbohydrate replenishment.

Endurance, and other concerns in exercise performance such as, strength, power, lean body mass, speed and aerobic capacity have lead to the development of ergogenic aids. Defined as, any external influence which can positively affect physical or mental performance, ergogenic aids are on the forefront of sports performance research.

Below is a list of the better-researched ergogenic supplements for sports performance.

Conjugated Linoleic Acid (CLA) is a form of linoeleic acid; an essential fatty acid found in certain foods. CLA is currently being studied for its purported ability to utilize fat stores for fuel and thereby improve lean body composition. In some studies, it has led to fat loss, which may be helpful in improving exercise performance. Diabetics should take special precautions when using this supplement due to its potential effects on blood sugar.

Creatine is a naturally occurring substance that plays a role in energy production in the body when it is converted to phosphocreatine. When used as a supplement, it is thought to increase the ability to recover after short bursts of intense exercise, such as that seen in cycling, weightlifting, and sprinting.

There has been marginal proof of creatine's effectiveness in helping to decrease recovery time in athletes and to improve their strength. Special precautions when using creatine are advised for those with kidney disorders due to the processing of creatine by the kidney.

No disappointment or probable surprise to Northwesterners, Caffeine has actually been fairly well-documented to increase endurance and aerobic capacity during exercise. Caffeine likely mobilizes fat for fuel during exercise, thereby delaying the depletion of glycogen. It may also affect our psychological perception of pain. Before you get loaded up however, most research states that the amount necessary for beneficial impact is only about the size of two cups of coffee (grande). Because of caffeine's dehydrating qualities, it is always a good idea to drink one cup of water for every cup of coffee you drink during the day.

Whey protein powder is used as a means to enhance performance and decrease recovery time in active people. Whey is a type of protein found in dairy. It is not entirely understood how it works to aid in recovery. Protein is, however, the building block of muscles, and athletes tend to have slightly higher demand for protein than the average person. Upon the completion of exercise and even before exercise, whey protein has been found to be marginally effective in improving recovery.

Hydroxymethylbutyrate (otherwise known as HMB) is a metabolic breakdown byproduct of the amino acide leucine. It is found in small amounts in catfish and citrus fruits. As a supplement, it apparently signals the body to slow down muscle tissue breakdown, thereby slowing muscle recovery time. At this time, HMB appears to be relatively safe.

 

Other nutrients and herbs deserve mention, yet research has been less conclusive for sports performance. These include Glutamine, L-carnitine, Branch Chained Amino Acids, Ginseng, Phosphatidylserine, Rhodiola, CoQ-10, Vitamin C, Vitamin E. and D-ribose.

There are few substitutes in sports performance for effective physical and mental conditioning, proper nutrition, and adequate hydration. Nevertheless, some ergogenic aids may make some difference in performance.

Before considering supplementation, please discuss your considerations with a well-regarded health professional.

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Adam Rinde, ND, is a Naturopathic Physician practicing at Sound Integrative Health in Kirkland, WA. He is a graduate of Bastyr University, where he also completed a residency at the Bastyr Center of Natural Health in Seattle. Dr. Rinde focuses on General Practice. , Physical Medicine, and Preventive Medicine He can be reached at DrRinde@soundintegrative.com or at (425) 736-1252.

In The Stretch

In the Stretch by Adam Rinde, ND

Many exercisers think they get by without stretching. This belief is understandable as ongoing debates and research persist refuting the benefits of stretching to prevent injury, improve performance, or enhance muscle recovery. Regardless, there is still an important role that stretching and "warm-up" plays in your exercise conditioning.

The goal of stretching is to return hypertonic (tight) muscles to a normal tone and resting length, thus improving joint range of motion (termed flexibility). In theory, a joint moving within its normal range of motion will function better and less likely be injured. Pioneered by the work of Vladimir Janda, MD we know that certain muscle groups trend on being hypertonic, including, but not limited to: Latissimus dorsi muscles, Hamstrings, Iliotibial Band/Tensor Fasciae Latae mm, Erector Spinae muscles , Calf Muscles, and Hip Flexors. In most people these muscles are likely to benefit from some type of warm-up or stretching.

There are many different forms of stretching starting with basic to more advanced including:

• Static Stretching: The exerciser places a muscle at the end of its range of motion and holds the position for 20-30 seconds. This is a generally safe, easy to perform, and moderately effective way to stretch hypertonic muscles.
  
• Proprioceptive Neuromuscular Facilitation (PNF): Involves alternating brief contractions and brief stretches of a particular muscle group. This form of stretching has actually been shown to improve range of motion compared to static stretching.
  
• Dynamic Stretching: a type of stretching and warm-up that involves movement mimicking patterns performed in sport. This is a combination of a warm-up and flexibility training that is quite effective and used by many athletes.
  
• Self Myofascial Release: This technique releases trigger points on the surface layer of your muscles (myo-fascia). Trigger points indicate areas (fascia) which are surrounding the muscle tightly and reducing movement. Using a tennis ball or a foam roller, the exerciser places the roller/ball on certain pressure points for 20-30 seconds.
  

General tips for stretching and warming up:

• Warm up using a slow jog, brisk walk, elliptical trainer, or stationary bike for 5-10 minutes before stretching vigorously. A warm muscle is more responsive to stretching techniques.
  
• If performing a static stretch do not overstretch or stretch when pain is present. Report pain with stretching to your health professional
  
• Avoid advanced stretching techniques like ballistic stretching. While appropriate for certain elite athletes, they may not be appropriate for the general population.
  
• Master static stretching before moving onto more advanced stretching techniques. Static stretching allows you to gain an awareness of your tight muscle patterns and is relatively easy and safe to perform. Consider learning more advanced techniques like self-myofascial-release, dynamic stretching, or PNF to gain greater results.
  
• Have a Functional Movement Screen or Deep Squat Test performed so you can understand your unique flexibility training needs. Many trainers, physical therapist, or sports medicine minded physicians can perform this test.
  

Stretching and warm-up is very important. They adequately "wake-up" your body and prepare it to perform and withstand the demands of exercise. My recommendation for stretching and warm-up integrates static stretching, dynamic stretching, PNF, and self myofascial release. Through this I find the body is aptly prepared to exercise. So, come on people lets stretch!

Adam Rinde, ND, ACSM-HFS. Is a Licensed Naturopathic Physician and Certified Health and Fitness Specialist. He practices in the Puget Sound area specializing in Family Medicine, Physical Medicine, Chronic Inflammatory Diseases, and Exercise. You can visit him at www.soundintegrative.com or email him at drrinde@soundintegrative.com.

Weight Loss Supplements

There are some basic strategies for encouraging weight loss including stimulating fat metabolism in the body, decreasing appetite, regulating blood sugar /insulin sensitivity, decreasing stress response, raising the basal metabolic rate, and normalizing sleep patterns.
Many pharmaceutical, over-the-counter, and natural supplements have been developed and are striving to be a "magic pill" for assisting in weight loss. Drugs are currently being developed that reduce Leptin (satiety hormone), elevate adiponectin (reduces insulin resistance), elevate cholecystokinin (appetite suppressant), or increase Ghrelin (appetite hormone). While some success has been derived in reaching weight loss between 5- 10% of overall body weight; there has been no documented long-term success for weight reduction greater the 10% of overall body weight using pills/supplements.

Nothing replaces an overall healthy diet and exercise program while striving to lose overall body weight, but some natural aids may "supplement" your overall weight loss program. Below are some supplement aids categorized by safety and effectiveness.

Safe and modestly effective

• Dietary fiber supplementation especially glucommanan (purified fiber from konjac root) especially when combined with caloric reduction. (Note a trained professional should advise supplementation as serious gastrointestinal side effects may occur) 2-3 grams of glucommanan per day in divided doses is the standard dose.
  
• Congjugated Lineoleic Acid. (found in dairy, beef, poultry, and eggs) shown to reduce body weight in doses of 2 to 3.4 grams per day. May support healthy glucose and insulin metabolism through its activation of PPAR alpha and PPAR gamma—potent insulin sensitizers.
  
• Hydroxycitric Acid from the plant Garcinia cambogia may delay glucose absorption thereby lowering insulin response and fat storage. Dose usually 500 mg. three ties per day.
  

Safe and marginally effective

• Chitosan: (from shrimp or crab). weight loss by blocking fat absorption from the intestine (mixed results). Dose is usually 3-6 grams per/meal with food. :
  
• Green Tea Extract especially on low calorie diet, and the equivalent of 300 mg of epigallocatechin gallate (EGCG's)/day. Please note there is approximately 50 mg of EGCG's per cup of green tea.
  
• Hoodia gordonii; No human studies done. Long tradition/anecdotal use as appetite suppression/
  
• Chromium Picolinate; is a component of glucose tolerance factor, said to reduce insulin resistance. Chromium has been proven infective in human studies Weight loss doses are usually200-300 mcg per day.
  

Possibly unsafe and should be avoided

• Citrum auruntinum (Biter Orange). Has been lined to stroke related events. Synephrine, an alpha-1 adrenoreceptor agonist, is the active agreement, which is said to speed up fat metabolism. Synephrine is linked to documented cases of vasospasm and stroke in users.
  
• Ephedra.(supplements banned by FDA, still available in Chinese medicine and teas)
  

Others often mentioned and nutrients to watch include: Stimulants Guarana and Mate. Appetite suppressants: 5-HTP, L-Glutamine, L-Tyrosine, DL Phenylalanine, pinoleic acid from pine nuts, and fucoxanthin (from sea weed). Fat Metabolism stimulation: Pyruvate, Omega-3 fatty acids, Coleus Forskohlii. Insulin sensitizers: paseolamin from kidney bean extract, Guar Gum. Fat Blockers: Nopal Cactus Leaf.

Summary/recommendations: It is first important to determine the cause of weight gain before deciding to take supplements. If your weight has changed for no known cause, be sure to visit your naturopath, osteopath, or allopathic physician for an evaluation. When choosing supplements to aid in your weight loss program; choose safe and likely effective supplements like conjugated lineoleic acid, green tea, hydroxycitric acid and fiber supplementation. When combined with low energy density, high fiber diet, and a moderate intensity exercise program; the success of a weight loss program may increase. Having a naturopathic physician, nutritionist, personal trainer, and mental health professional can strengthen your success. Please realize emotional causes to weight gain must be addressed uniquely.

A note about supplements: Dietary supplements are largely un-regulated. Although the FDA has some involvement when supplements are developed, there is no consistent guarantee for quality control. This is slowly changing. Some examples exist where dietary supplements have included pharmaceutical medications in there formulations to strengthen the therapeutic effect of the natural supplements. Because of this it is important to purchase supplements who participate in Current Good Manufacturing Practices (CGMP) which use strict guidelines for supplement manufacturing. Most Naturopathic Physicians supply supplements that have gone through this process, as do natural food stores like Whole Foods and PCC.

The Big Picture

The pressure to succeed and meet daily demands intercepts the view of the big picture. What do they mean by the big picture? It means, if life ended today, what would be the net value of life. What would would be the overall assets (ie. health, financial, relationships, family, etc.) compared to the overall debts (relationships lost, financial loss, opportunity lost, dreams lost, health lost, etc.). The small picture view focuses on one or two areas of life to gauge the value of life. Sacrificing health for the gain of short term assets is very common. Sure, pills can help keep lab values and health numbers to appear fine, but over time sacrificing sleep, a healthy diet, exercise, stress management, and good relationships will ultimately impact the net value of life. What does the big picture look like? What is the overall net value of life?

Achooo! Allergies

Sneezing, scratching through, runny nose, itching, post-nasal drip, and eye irritation. Allergy Season never fails to arrive. Tree pollens are floating around and causing allergic reactions in nearly 20% of North Americans. The technical term of this scenario is Allergic Rhinitis. Most people know it as seasonal allergies or hay fever. You may be spared by trees, but later in the season you may react to grasses and/or weeds. If the plants don't effect you, Allergic Rhinitis can also be caused by smoke, dust, mites, and dander.

Aren't sure what you are allergic to? You can be tested by blood (RAST) or skin (Skin Prick Test). This is normally done through an Allergist, but any PCP can order it.

Alternative treatment options such as Vitamin C, Butterbur, Probiotics, Freeze-Dried Nettles, Quercetin, and Bromelain do exist and are often effective. The doses and amounts vary so please talk with a licensed Naturopathic Physician who is trained in the proper application of these nutrients and herbs.

Also, consider a Nasal Irrigation system. This can range from a Neti Pot to NeilMed to a high end nasal irrigation system like SinuPulse see: http://www.achooallergy.com/sinupulse.asp .

Another option to consider is to purchase a High Efficiency Particulate Air Filter (HEPA). These clear the air of the majority of particulate matter. A great thing to have in your bedroom as we generally spend 1/3 of our life in our bedroom. These are widely available. I have been told that this is a good place to buy one: www.needs.com .

Of course other options are pharmacotherapy or immunotherapy. Its important to discuss the pro's and con's of each.

Set up a time to speak with me @ 425-736-1252 or DrRinde@soundintegrative.com

Metabolic Syndrome

Syndrome X, Insulin Resistance, and Metabolic Syndrome. (same name for the same thing) AND its preventable in most people with healthy diet and lifestyle choices.

Metabolic Syndrome is an assortment of risk factors for developing diabetes and/or cardiovascular disease. Including any three of the following a) increased abdominal circumference (greater then 40 inches in men or greater then 35 inches in woman) b) Elevated Fasting Triglycerides (greater then 150 mg/dl) c) elevated Blood Pressure (greater then or equal to 130/85 mmHG or documented use of antihypertensive medications) d) Early signs of insulin resistance(fasting glucose >110 ng/dl), and e) low High density lipoproteins (HDL less then 40 mg/dl in men and less then 50 mg/dl in women).

What can you do? I know you have heard the same old blah, blah , blah about losing weight and exercising, so i will not repeat it. I am not saying its not true, but you know it already. Two dietary approaches that will prevent and treat metabolic syndrome are a low inflammatory diet and a low glycemic index diet.

Low inflammatory foods include fish, fruits, nuts, healthy oils, healthy fats, and vegetables. Low glycemic diet avoids processed snacks, sweets, sodas, and high-carbohydrate meals.

Here are some foods to let hit the road ...Bagels, donuts, chips, sweets, coca-cola (do you get the picture? )

Welcome in salmon, sardines, legumes, green vegetables, soy, flax, berries, bell peppers, almonds, and olive oil. And much more.

If you have metabolic syndrome supplements like Fish Oil, Red Rice Yeast, Hawthorne Berry, Cinnamon, and Chromium may be beneficial.

When was the last time you felt well?

What was your lifestyle like the last time you felt well? This a good question to ask yourself when striving to reclaim your health. Share your thoughts here with the other readers. I bet will find some interesting responses.....