Publication of The Pacific Wellness Institute

www.pacificwellness.ca

Send this newsletter to your friends and contacts to spread the message of good health!

How Dis-stress Affects Us
Emily Crown-Robinson RMT, CST, Dipl.ST, CR

Life’s challenge for us is the balance between too little and too much stress.  Dr. Hans Selye – a Canadian endocrinologist and leading authority on stress and it effects,
believes stress is a normal physiological activity required to maintain homeostasis and that healthy emotional stress gives our life variety.

He differentiates ‘distress’ as the harmful aspects of emotional and physical stress.  Distress is created by triggers or stressors that switch on the sympathetic nervous system with a ‘fight or flight response’.  Stressors take on many forms:  environmental, hunger, temperature, management of time, your relationships, your job, yourself (i.e.: grief, anxiety, fear, performance, change, frustration), fatigue, and mental and physical effort.  The degree and duration of the stressor varies greatly and affects the person’s reactivity to it. 

Dr. Selye also founded the idea of ‘General Adaptation Syndrome’, or, GAS. The GAS response is basically universal when it is triggered, however, the same stressor will affect different people in different ways.  The first stage of GAS is alarm.   During this ‘alarm’ phase, the body releases high levels of cortisol, the stress hormone from the adrenals, in response to the stressor.  The sympathetic nervous system response has been triggered to give the individual strength, speed and alertness. The ‘resistance and/or adaptation’ phase is next.  The levels of cortisol start to decrease as the individual’s body tries to resist the stressor- trying to adapt to it.  The intensity and duration of stress will influence the length of time it takes for the body’s inherent ability to adapt to the scenario.  The third and final phase is ‘exhaustion’.  The adaptive energy reserves are drained from the fight to adapt to long time exposure to the same stressor.

Poor diet, health risks, poor sleep, excess consumption of alcoholic drinks, as well as overwork will encourage illness as they deplete our limited reserves of energy that help us adapt to and deal with stress.  The more chronic the stressor- the more chance of receiving negative physical side effects.  Chronic stress has been linked to anxiety, panic attacks, high blood pressure, heart attacks, gastro-intestinal disorders, allergies and asthma stimulated by panic, just to name a few. 

It is important to recognize our stressors early on and deal with them before they get out of hand and grow into something larger and less easy to cope with.  It is also important to try and put stressful situations in perspective so that they don’t consume us and make us sick.  Treating yourself to one of the many complimentary therapies at our clinic can help to relax the nervous system, calm the mind and the body– granting you a bit more control over the situation as well as helping to lower the stress response.  Take the time to take care of yourself!

Body Symetries and Muscle Coordination
Tim H. Tanaka, Ph.D., D.Ac., RMT, RNCP, BCIAC
Director

1. Our muscle mass and strength declines as we age. True or False?

2. Low back pain is very common among the elderly and less common among young and athletic individuals.  True or False?

3. Weakening back muscles are the cause of most back pain and the core of a back pain treatment program should be based on general back strengthening exercises. True or False?

#1 is true.  As we get older, we gradually lose muscle and thus, our physical strength also decreases. 

#2 is false.  Previous studies conducted in different regions and countries show almost uniform trends of low back pain occurrence in relation to age distribution: the prevalence of low back pain in children is very low, increases rapidly in the adolescent population, then peaks somewhere between the ages of 40 to 60. The prevalence of low back pain substantially declines after the fifth or sixth decade of life, despite weakening muscle strength, deterioration of bones, disks, and other tissues which are a part of the aging process.

#3 is false in my opinion.  In most cases, while some muscles are indeed weak and require strengthening, some other muscles are actually too strong and over-acting leading to structural and functional distortion.  Imbalanced strength and function of muscles results in unsmooth, non-coordinated movement which places excessive stress on our bones, ligaments, tendons, and other tissues. Thus, some muscles require rather relaxation to calm down in order to maintain fluent coordination and movement with other muscles. This is the main reason, I believe, why standardized, non-targeted back exercises commonly prescribed for low back pain fails to be the solution for many sufferers.

I believe that most back pain (including back conditions usually considered structural in nature such as disk herniation) is closely associated with both emotional stress* and functionality of our physical mechanics (muscle coordination), rather than structural strength of the body.  The issue of muscle coordination is further explained below as well as the importance of minimizing muscle distortions for preventing back problems.

Muscle function analysis using Dynamic EMG Technique

Muscles emanate an electrical signal upon contraction.  We are able to observe muscle firing patterns in real-time through surface electrodes attached to the skin using dynamic electromyographic (EMG) technique and analysis. 

Top graph shows low back (left and right paraspinals) EMG activity of a male who performed the action of bending his trunk forward and returning to the upright position with his knees straight.  Trunk flexion return movement is a symmetrical movement of both left and right side muscles and therefore, each side of paraspinal muscles is supposed to fire synergistically at an approximately 1 to 1 ratio.  In this case, however, there is noticeable asymmetry between the left and right sides (the vertical axis indicates how intense the muscles are contracting).  Is it simply that the left side muscle is working harder and the right side muscle is taking advantage and being lazy?  In this particular instance, the reason for the asymmetrical use of two synergistic muscles is that the patient was experiencing low back pain on the side of low EMG activity (painful inhibition), therefore the paraspinal muscle on the other side was compensating during the movement.  This type of asymmetrical EMG pattern is quite commonly seen among patients with back pain, however it can also be observed among individuals who are not presently having back pain.  It may be attributed to prolonged, repetitive asymmetrical use of back muscles in a specific uniform way related to occupation, sports or simply lifestyle habits. If the situation continues, it may lead to injuries due to an excessive load on a particular muscle.  Analogous to a game of tug of war, it is like having a person on your team not participating while another is doing all the work. Bottom graph is an example of a synergistic muscle contracting pattern during trunk flexion and return movements with appearance of normal flexion-relaxation (FL) phenomenon (see the January 2006 newsletter regarding flexion-relaxation, http://www.pacificwellness.ca/newsletters/jan2006.html).

It is also important that muscles are able to relax during certain movements.  For example, when you bend your elbow to lift an object with your palm upwards, the biceps muscle is the primary mover and on the opposite side of the upper arm, the triceps (antagonist) should be relaxed (reciprocal inhibition).  When we monitor EMG activity during various movements, we sometimes see two muscles of different roles fire simultaneously (co-contraction), which places a tremendous amount of physical strain on the bones, tendons, and ligaments.  This is similar to two people holding an object but pulling in opposite directions (examples of co-contraction and reciprocal inhibition firing patterns are available at: http://www.pacificwellness.ca/influence.html).

These are two simplified examples of muscle coordination and it is important to keep them in mind when doing any strengthening or stretching exercises.  Some muscles may indeed be weak (or too lazy) and require strengthening but some other muscles may actually be too strong or unable to relax due to spasms or underlying neurological problems.

Enhancement of muscle coordination using acupuncture

I have demonstrated the efficacy of acupuncture on muscle coordination in the study published in the International Journal of Neuroscience in 1998. 

Decrease in left-right muscle activity asymmetries (relative values) during lumbar flexion-return movements was seen immediately following acupuncture in 9 out of 10 cases.  This was expected.  An interesting part of the findings however, was that the EMG of the lumbar muscle on the opposite side of acupuncture administration changed in an unexpected way (in this study, acupuncture was administered on only one side of low back muscle).  On the non-stimulated side, the absolute EMG values decreased for subjects with initially high baseline absolute EMG readings and increased for subjects with initially low baseline absolute EMG readings.  Those changes were robust and statistically significant.  This data suggests that acupuncture affects not only localized muscles where needles are inserted but also influences the muscle activities in other areas.  The exact mechanism was not determined by this study, however, I hypothesize that it is related to acupuncture having a specific influence on the sensitivity of muscle spindles (stretch receptor – sensor in the muscle which is part of an important reflex mechanism controlling the tonicity of muscle).  This intriguing result triggered new insights for treatment and prevention in sports related injuries using acupuncture.  When muscles fire in a more coordinated pattern, the movement becomes more smooth and efficient, which not only minimizes the chances of injury but can also greatly enhance overall performance.

Tips: Here is how you can prevent muscle distortion and imbalance:

Many popular sports such as tennis, golf, and baseball involve dominance on one side or unidirectional movements. If you are actively playing those one sided dominant sports, it is a good idea to also practice opposite directional movements as a part of your routine warm up and cool down exercises.  It is also a good idea to minimize one sided activities during your everyday activities.  It is important to check your workstation for proper ergonomics.  Some workstations are configured so that a worker tends to shift his/her body in one particular direction for many hours on a daily basis.  It is also best to avoid wearing a shoulder bag only on one side. Constant asymmetrical use of our bodies causes imbalance and distortion of muscles which places additional stress on our body structure, which can lead to injuries.

* To read more on how emotional stress can affect back pain, see http://www.acupuncture-treatment.com/lower_back_pain_sciatica.html.

Diabetes:Be Aware of Your Risk
EeVon Ling ND

We may worry about bird flu, terrorist attacks and E. coli contaminating our food, but there is an even bigger and more insidious epidemic that affects more Canadians than all of these threats combined: Diabetes. Over two and a quarter million Canadians are estimated to have diabetes with about a third of adults with diabetes unaware that they even have it. Every year over 600,000 individuals are newly diagnosed. And eventually forty percent of all diabetics will develop long-term complications that will contribute towards significantly shortened lifespan and reduced quality of life.

What is Diabetes?

Diabetes is a medical syndrome of abnormally high blood glucose resulting from impaired insulin production or action. Insulin is a hormone that is produced by the islet cells of the pancreas. After we ingest carbohydrates during a meal or snack (from fruits, vegetables, starches, candy, etc.) our digestive enzymes break down the complex sugars into glucose molecules. Our intestinal tract absorbs the glucose into the blood stream causing a rise in levels of blood glucose which signals insulin release. The insulin then binds to the glucose molecule and delivers it to the cells where it attaches to receptors on the cell. The glucose can now enter the cell and be used to fuel cellular functions or be stored as fat.

In diabetes there may not be enough insulin produced, or, the insulin receptors on the cells are not sensitive enough to the insulin in the blood.  Without the action of insulin, the cells do not receive the fuel they need to function, leading to eventual organ failure. Subsequently, the glucose circulating in the blood causes damage to vessels and nerves.

Type 1 diabetes, also known as insulin dependent diabetes or juvenile diabetes (although it can come on in adulthood), is a condition in which absolutely no insulin is being made by the individual, thus the person must inject insulin after every meal.  Type 1 usually develops suddenly and may be associated with an auto-immune disease that destroys the pancreas islet cells.

Type 2 diabetes, also known as non-insulin dependent diabetes or late onset or adult onset (although new cases are being seen in teens) is much more common and is at the heart of the diabetic epidemic. Usually in Type 2 diabetes, the cells are insensitive to insulin (also called “insulin resistance”) which can result in too much insulin being produced (“hyperinsulinemia”).  Unlike type 1 diabetes, type 2 diabetes is largely preventable and controllable, if not reversible.

What are the long term complications of diabetes?

Kidney failure and higher rates of bladder and urinary tract infections
Peripheral nerve damage (in hands and feet)
Poor wound healing and higher risks of infections which can lead to amputation
Blindness
Cardiovascular disease and stroke
Erectile dysfunction

Why is there an epidemic?

Diabetes is a disease of our modern western diet and lifestyle. Our limitless access to highly processed foods and sedentary lifestyles are reflected in increasing obesity rates, a major risk factor. Our population is aging which also increases the risk, and our “western diet and lifestyle” is reaching populations that normally don’t consume these types of foods. Asian, African and Latin immigrants and Aboriginal populations that adopt a western diet and lifestyle have much higher rates of diabetes compared to their ethnic counterparts that have maintained the traditional diet and lifestyle of their culture.

What are the risk factors?

1. Obesity: Having a BMI of 30 or higher.

To calculate: BMI= your weight (kg) divided by your (height in metres)2.

2. Apple shaped figure: You gain most of your weight in your midsection.
3. Age: 10% of persons 65+ have diabetes compared to 3% of persons 35-64 years of age.
4. Lack of exercise: Exercise helps your cells be more sensitive to insulin.
5. Family history.
6. Personal history of diabetes while pregnant or giving birth to a baby weighing 4 kg (8 ½ pounds) or more.
7. Abnormal blood glucose tolerance (blood glucose is higher than normal between meals) or reactive hypoglycemia (blood sugar quickly drops after eating a meal – feel sleepy, irritable, foggy, anxious).
8. Ethnicity: Aboriginal, Latin American, African, Asian ethnicities have higher rates of developing diabetes, even without being significantly overweight.
9. High blood pressure.
10. High cholesterol or blood fats.

How does my doctor or naturopathic doctor test for diabetes?

There are a few tests that can determine if you have diabetes or irregular blood sugar control.  Usually during your regular physical, your family doctor or naturopathic doctor will test fasting blood glucose and urine. If your fasting blood glucose is too high or if there is glucose in your urine, you will be asked to do other tests to confirm that you have diabetes.  As a naturopathic doctor, I prefer to test blood glucose 2 hours after eating a regular meal, which is the interval that your blood glucose should return to normal.  Testing your blood sugar between meals gives me a more realistic idea of how your body is functioning and we may even detect the early stages of diabetes or irregular blood glucose control. Another test is a glucose tolerance test.  During this test you are asked to drink a glucose drink and then your blood glucose is measured at different intervals after consumption. 

For those with diabetes or signs of irregular blood sugar control, your doctor should test your HbA1C levels.  This is a protein on the red blood cell that can reveal your blood glucose control over the last 3-4 months (the lifespan of the red blood cell). This test also helps determine how a well a diabetic patient is able to control his or her glucose levels.

How can naturopathic medicine help me prevent or manage my diabetes?

The goal in treating or preventing diabetes is make sure your body is functioning properly with respect to digestion, metabolism, insulin production and insulin action. Because diabetes results from a combination of diet, lifestyle, personal and family health history, a naturopathic doctor can assess and address your personal risks, test your blood glucose and urine, measure your body composition and then develop an action plan that may involve exercise, diet, supplements, herbs and stress management.  Even if you are required to take medication for your diabetes, naturopathic medicine can help improve your response to those medications and reduce your risks for developing long tem complications. 

If you are concerned about your risk for developing diabetes, or, you are concerned about your current diabetes control, please make an appointment to see a naturopathic doctor.

Recipe: Strawberry Sensation
Karen Nguyen BSc, ND (Candidate)

The best part about spring is not only the flowers that begin to make their appearance everywhere, but also the various fruits that start to come into season.  One of the first berries to blossom during this time is none other than strawberries.  Rated as the most favorite and popular berry, strawberries average about 200 seeds per berry and are the only fruit to contain seeds on the outside.  They are full of an abundance of vitamin C, fiber, potassium, and folic acid.  Eight strawberries will have more vitamin C than a medium sized orange and they also contain more per comparable serving of folic acid than any other fruit.  A recent study has stated that they may also be effective at slowing down the growth of cancer cells, a benefit that may be attributed to their high level of antioxidant activity and phytonutrient content.  Strawberries can be found year round but the best ones come around this time of year so keep your eyes open for this bright, plump, juicy red berry to make its appearance in your garden or your local grocery.
Strawberry Shortcake
Dry Ingredients:

1 ¾ cup flour, sifted
½ tsp salt
2 ½ tsp baking powder
1 tbsp sugar

2 tbsp trans-free margarine
¾ cup skim milk

Topping:

6 cups of fresh strawberries, hulled and sliced
¾ cup plain fat free yogurt or whipped cream

Directions:
Preheat oven to 450 F.
In a large mixing bowl, mix all the dry ingredients together.  Then using a fork, cut the margarine into the dry ingredients until the mixture resembles coarse crumbs. Add the milk and stir just until a moist dough forms.
Pour the mixture into a greased pan about 1” thick and bake until golden, about 12 minutes, or until the cake springs back when touched.  As an alternative, you can cut out smaller cakes to bake.  Makes six servings.  When ready to serve, top each slice with 1 cup of strawberries and yogurt.  Serve warm and enjoy!

Nutritional Content (Per serving):

Calories	250
Protein	7 g
Carbohydrates	45 g
Total fat	5 g
Fiber	4 g
Sodium	486 mg
Potassium	368 mg
Calcium	220 mg
Vitamin C	80 mg
Folic Acid	20 mcg
Vitamin B6	0.06 mg

 

---

PUBLISHER The Pacific Wellness Institute, Tim H. Tanaka Ph.D., Director
CONTRIBUTORS FOR THIS ISSUE EeVon Ling BSc, ND, Karen Nguyen BSc, ND (Candidate), Emily Crown-Robinson RMT, CST, Dipl.ST, CR
EDITORIAL ASSISTANT Noah Bunnett ST
GRAPHIC DESIGNER Yayoi Mizuno
THE PACIFIC WELLNESS INSTITUTE
80 Bloor Street West, Suite 1100, Toronto, Ontario M5S 2V1
T.416 929 6958 F.416 929 6365
info@pacificwellness.ca
www.pacificwellness.ca