By Dr. Shawna Darou, ND
One thing that I’m very passionate about is preventative healthcare. There is so much we can do with nutrition, exercise, stress reduction, targeted supplements and understanding your personal risk factors. On a very basic level, something as simple as how you fill your grocery cart is part of preventative medicine.
For example, one clear area where preventive care is often missed is with diabetes. Medical testing includes your weight, and blood tests for fasting glucose and HbA1C (a marker of your blood sugar stability over the past 3 months). This will detect diabetes and what is called “pre-diabetes”, both of which indicate significant impairment of blood sugar control. What’s interesting is that we can detect changes and risk of diabetes 5-10 years earlier with the addition of measurement of waist circumference, and simple, inexpensive tests of fasting insulin. The earlier blood sugar issues are detected, the better chance we have of completely reversing the trend.
Here are the top factors that I look at in creating a PERSONALIZED preventative health plan:
1) Detailed family history
Knowing what types of health issues run in your family, and age of onset can be very helpful in looking at what conditions to put special focus on for prevention. For example of most women on your maternal line had hypothyroidism, regular screening and steps for prevention are highly recommended. This also applies to cancer risk, heart disease, high blood pressure, Alzheimer’s and more.
2) How are the basic lifestyle factors: nutrition, exercise, smoking, alcohol, stress?
Did you know that basic lifestyle changes such as nutrition, regular exercise, stress reduction, and smoking cessation have been shown to dramatically reduce risk of the top three chronic health conditions. These numbers are impressive:
- Reduce cancer risk by 40-60% (1,2)
- Reduce heart attack risk by more than 80% (lifestyle changes are incredibly powerful here!)(3)
- 60% reduced incidence of diabetes in ‘high risk individuals’ (4)
3) Lab testing:
I’m a big proponent of lab testing for several reasons:
- Testing for absolute abnormals: lab testing can show the onset of thyroid disease, heart issues, diabetes and more
- Watching for trends: when we follow lab results over a period of time, we can watch for trends that provide clues for prevention
- Preventative screening: such as PAP tests, colonoscopies, ultrasounds, mammograms, are all useful for disease prevention and early detection.
- Having a healthy baseline: this is maybe less obvious, but if we have a baseline of your levels when you are currently feeling well and healthy, we can track trends and changes more easily, and also have a goal for optimizing your treatment. This is especially relevant for hormone levels where the reference ranges for ‘normal’ are very broad.
For example, let’s look at thyroid function. If today, your TSH test which is a marker of thyroid function came back today at a level of 3.5 mIU/L, where your previous baseline range was 1.2 mIU/L, and you also had many low-thyroid symptoms (feeling cold, weight gain, constipation, hair loss). This level would not flag as abnormal, but is certainly not optimal for you, is causing symptoms, and requires some treatment to optimize thyroid function. If we wait until it flags as abnormal, you may be suffering unnecessarily for many months or years.
There are more advanced testing that as a naturopath we may recommend. These tests include:
- food intolerance testing (looking for inflammatory foods)
- hormone testing (blood, saliva or urine) for more in-depth look at hormone balance
- stress hormone testing (blood, saliva or urine) for more detailed look at your stress response
- Organic acid urine testing (testing for various metabolic clues including gut flora imbalance, mitochondria function, nutrient absorption and detoxification pathways)
- personal genomic testing (looking at actionable genes, especially methylation pathways for clues with nutrition needs, extra supplement requirements, and long-term preventative strategies).
4) Blood sugar regulation:
One of the most important things to look at with nutrition is blood sugar regulation and a diabetes prevention plan. Diabetes and insulin resistance are associated with increased risk of cardiovascular disease, certain cancers (breast, pancreatic and prostate), obesity and more. Given that this is a condition that in most cases can be prevented with nutrition and exercise, it goes a long way in reducing your risk of chronic disease. Thorough testing for blood sugar and insulin resistance is recommended.
7) Gut health:
More and more research is coming out about the importance of gastrointestinal health, especially the balance of the gut microbiome. In addition to causing direct digestive symptoms and problems with nutrition absorption, it has been linked to obesity (5,6), cardiovascular risk (7,8), mood disorders (9), hormone regulation (10,11), brain health & cognition (12, 13), and more. There are many strategies to restore balance to the gut microbiome, through nutrition, probiotics, addressing medications that affect gut flora balance, and treatment for intestinal permeability. The impact of improving gastrointestinal health and balance can truly be profound.
8) Managing inflammation:
Inflammation is at the root of almost all chronic disease. When we have inflammation there is swelling, pain, fatigue, and sometimes also flu-like symptoms, depression, altered immune function, and more. The first step is identifying causes of inflammation that may include specific foods, gut microbiome imbalance, chronic infections (ex. Lyme or Epstein Barr virus), toxins (ex. environmental chemicals, heavy metals), disruption in circadian rhythm, stress, and medications. Remember that almost all chronic illness has a component of inflammation – cardiovascular disease, cancer, Alzheimer’s, diabetes, arthritis, autoimmune disease to name a few.
9) Paying attention to warning signs:
I can’t stress enough the importance of paying attention to early warning signs with your health. The sooner they are addressed, the more completely you can reverse them. For example a new onset of joint pain, weight gain, sudden change in energy or mood, memory challenges, sleeplessness, menstrual cycle shifts, blood pressure or others.
Remember from point (2) above, that the basics of lifestyle: nutrition, exercise, sleep and stress management are at the core of reversing and preventing disease.
I hope this brief article has given you some insight into the preventative medicine part of Naturopathic care. Our goal is to identify and treat imbalances in your health early on, to prevent the progression to chronic disease. Please ask questions, speak up about new health changes and let’s work together to create the best long-term health plan possible. It is perfectly acceptable and encouraged to book an appointment while you are currently well to discuss a long-term preventative health plan.
- Son Mingyan, Giovannucci E. Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States. JAMA Oncol:2016; 2(9): 1154-1161. doi:10.1001/jamaoncol.2016.0843
- Anand P, Kunnumakara AB, Sundaram C, et al. Cancer is a Preventable Disease that Requires Major Lifestyle Changes. Pharm Res. 2008 Sep; 25(9): 2097-2116. doi: 10.1007/s11095-008-9661-9
- Akesson A, Larsson SC, Discacciati A, Wolk A. Low-Risk Diet and Lifestyle Habits in the Primary Prevention of Myocardial Infarction in Men: A Population-Based Prospective Cohort Study. Journal of the American College of Cardiology. 2014 Sep; 64(13).
- Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med 2002; 346:393-403. DOI: 10.1056/NEJMoa012512.
- Tilg H, Kaser A. Gut microbiome, obesity, and metabolic dysfunction. J Clin Invest. 2011; 121(6): 2126-2132.
- Turnbaugh PJ, Gordon JI. The core gut microbiome, energy balance and obesity. The Journal of Physiology. 2009; 587: 4153-4158.
- Tang WHW, Hazen SL. The contributory role of gut microbiota in cardiovascular disease. J Clin Invest. 2014; 124(10): 4204-4211.
- Tang WHW, Kitai T, Hazen SL. Gut microbiota in Cardiovascular Health and Disease. Circulatory Research. 2017; 120: 1183-1196.
- Foster JA, McVey Neufelt KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends in Neurosicences. 2013; 36(15): 305-312.
- Sandrine S, Aldriswish M, Slruways M, Freestone P. Microbial endocrinology: host-bacteria communication within the gut microbiome. J Endorcinol. 2015; 225: R21-R34.
- Evans JM, Morris LS, Marchesi JR. The gut microbiome: the role of a virtual organ in the endocrinology of the host. J Endrocrinol. 2013; 218: R37-R47.
- Galland L. The gut microbiome and the brain. Journal of Medicinal Food. 2014; 17(12): 1261-1272.
- Samsel A, Seneff S. Glyphosate’s suppression of cytochrome P450 enzymes and amino acid biosynthesis by the gut microbiome: pathways to modern disease. Entropy. 2013; 15(4): 1416-1463.
- Hill JM, Bhattacharjee S, Pogue AI, Lukiw WJ. The gastrointestinal tract microbial and potential link to Alzheimer’s disease. Front Neurol. 2014; 5:43.
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