Exercise rehabilitation for cancer patients: Basis and anticipated impact

Exercise rehabilitation for cancer patients
Basis and anticipated impact

By: Caryl Russell, MSc
Issue: August/September 2011

Introduction

Chronic diseases are the most serious public health burden in Canada and the leading cause of death and disability worldwide. In Canada, about two-thirds of total deaths are due to chronic diseases; about 16 million Canadians live with a chronic disease (Chronic Disease Prevention Alliance of Canada 2011). These people are often at risk for several comorbidities because of the similarity in underlying risk factors. Physical inactivity is one lifestyle risk factor for many of these diseases and, at the same time, it is routinely prescribed in the rehabilitation for these diseases. Exercise (a form of physical activity that is deliberate and performed repeatedly over a period of time) has consistently been used in the prevention, treatment and rehabilitation of cardiovascular disease, type 2 diabetes, metabolic syndrome, musculoskeletal disease, hypertension, neuropsychiatric diseases, respiratory diseases, and now, cancer (Durstines 2009).

Phospholipids choline, serine, and inositol: Effects on Major Depressive Disorder

Phospholipids choline, serine, and inositol
Effects on Major Depressive Disorder

By: Jordan Robertson, BHSc, ND and Hammam A Alotaibi, HBSc (Cand)
Issue: August/September 2011

Introduction

Depression or Major Depressive Disorder (MDD) is a serious illness that interferes with a patient’s mental, physical and cognitive well being (Soleimani 2011). It is described as “a broad and heterogeneous diagnostic grouping, central to which is depressed mood or loss of pleasure in most activities” (Middleton 2005). Since depression affects the quality of life and productivity of the patient, an early diagnosis is crucial for effective treatment. It has been reported that 60-70% of patients with depression will respond to treatment if diagnosed early and appropriately treated (Shah 1999). The annual prevalence of depression in Canada is estimated at 4.8% (Patten 2006). According to the National Comorbidity survey, the average lifetime estimate of depression in the United States is 12% for males and 26% for females with an average lifetime prevalence of 17% (Shah 1999). The World Health Organization (WHO) in the 1990s ranked depression to be the fourth cause of global disease burden. In 2001, depression rose to be the third leading cause of Global Disease Burden (GDB) worldwide (Murray 1997).

Age Related Insomnia: Nutraceutical and botanical management strategies

Age Related Insomnia
Nutraceutical and botanical management strategies

By: Ronald G Reichert, ND
Issue: August/September 2011

Insomnia represents one of the most frequent types of complaints seen in the elderly (Buysse 2008). One large epidemiological survey involving over 9000 adults aged 60 years and older found that 23 to 34% had symptoms of insomnia while a further 7 to 15% stated they did not awake feeling refreshed (Foley 1995). Most elderly report sleeping on average seven hours a night suggesting that although the total amount of sleep time does not change as we age, alterations in sleep architecture are common (Neikrug 2010). This includes a decrease in both deep sleep (stages 3 and 4 slow wave sleep) and rapid eye movement (REM sleep) as well as an increase in stage 1 (light) sleep (Fetveit 2009). Older individuals also have a reduction in endogenous melatonin production (likely due to a deterioration in the neuronal functioning of the suprachiasmatic nucleus-SCN) that in turn disrupts the normal wake sleep cycle (Pandi- Perumal 2005).

Intestinal Permeability: Clinical Implications

Intestinal Permeability
Clinical Implications

By: Angela MacNeil, MSc, ND
Issue: August/September 2011

The Intestinal Epithelial Barrier

The intestinal epithelium is the largest mucosal surface and provides an interface between the external environment and the human’s internal environment. Healthy, mature gut mucosa provide an essential epithelial barrier that permits the absorption of nutrients, electrolytes, and water but restricts the passage of larger, potentially toxic compounds from the lumen into systemic circulation. The intestinal epithelium mediates selective permeability through two major routes: transcellular and paracellular pathways. Transcellular permeability is predominantly regulated by selective transporters for amino acids, electrolytes, short-chain fatty acids, and sugars (Broer 2008, Ferraris 1997, Kunzelmann 2002). The paracellular route is the dominant pathway for passive solute flow across the intestinal epithelial barrier, and its functional state depends on the regulation of intercellular tight junctions (TJ) (Yu 2009). TJ are dynamic, multiprotein complexes that function as a selective/semipermeable paracellular barrier, which facilitates the passage of ions and solutes through the intercellular space while preventing the translocation of luminal antigens, microorganisms, and their toxins.

Homeopathy: An introduction to application in pediatrics

Homeopathy
An introduction to application in pediatrics

By: Denisa Hrncirik-Maruyama, ND and Paul Theriault, ND

Issue: June/July 2011

The use of complementary and alternative medicine (CAM) in pediatric primary care is common, with homeopathy being one of the most widely used CAM modalities in the world. In a recent survey done in the UK, the rate of homeopathic use in children amongst GPs is 22%, with most prescribing taking place for infants less than one year old with minor self-limiting conditions at a relatively low rate of approximately one per month. A smaller number of GPs report prescribing much more frequently (Ekins-Daukes 2005). In Germany, homeopathy is the most frequently used CAM treatment for childhood ailments, where nearly 50% of the homeopathic medicines are prescribed by medical doctors and Heilpraktiker, and used to treat a wide range of conditions with a greater rate of use for self limiting conditions (Du 2009). The publications on the use of CAM in pediatric primary care and oncology indicate that homeopathy plays a complimentary but largely unofficial role in pediatric oncology in Israel (Ben Arush 2006), Canada (Fernandez 1998), Italy (Steinsbekk 2006), and Netherlands (Grootenhuis 1998). In the US, it is estimated that over 900 000 children are administered homeopathic medicines on a yearly basis (Barnes 2008). In India, homeopathy is widely used in pediatric care, as it is incorporated as a system of primary care within the established medical system (Ghosh 2010).

NAFLD: Clinical application of betaine and L-carnitine

NAFLD
Clinical application of betaine and L-carnitine

By: Rochelle Fernandes, ND (Cand.)

Issue: June/July 2011

Introduction

Alarming trends have emerged for non alcoholic fatty liver disease (NAFLD). The diagnosis of NAFLD is associated with a higher all cause mortality than the general population. The prevalence of NAFLD has been estimated to be as high as 17-33% in certain countries. Furthermore, a subset (approximately 33%) of NAFLD patients develop non alcoholic steatohepatitis (NASH). Increasing concerns have stemmed from the fact that 20-25% of NASH patients could develop severe cirrhosis (Raszeja-Wyszomirska 2008). Once cirrhosis occurs, detrimental effects follow, such as portal hypertension, esophageal varices, ascites, encephalopathy and hepatorenal syndrome (Rahn 2010). The most important factor to consider is the clinically silent nature of disease in its early phases, making effective preventative and therapeutic measures all the more essential.

HPA Axis Dysregulation and Human Health: What is the evidence?

HPA Axis Dysregulation and Human Health
What is the evidence?

By: Heidi Fritz, MA, ND
Issue: June/July 2011

Introduction

Regulation of hypothalamus-pituitary-adrenal (HPA) axis activity has far reaching implications for many areas of human health. Abnormalities in HPA axis reactivity and secretion of its primary effector, cortisol, have been observed in various autoimmune diseases, chronic fatigue syndrome (CFS) and fibromyalgia (FM), as well as in patients with major depression and cancer (Brivio 2010, Chrousos 1995, Nussey 2001, Romer 2009). Cortisol exerts widespread anti-inflammatory, immunosuppressive, catabolic, hyperglycemic, and anti-reproductive effects that may modulate these disease processes; strategies that modulate cortisol activity either through direct hormone replacement, or herbal/ nutritional/ lifestyle strategies, may be useful as therapy for such conditions (Chrousos 1995). This article reviews determinants of the HPA stress response, the concept of hypoadrenalism/ adrenal fatigue, and existing human trials of low-dose hydrocortisone replacement. HPA axis function in specific conditions, adrenal function testing, and nutritional/ herbal interventions strategies are to be discussed in future articles.

Inflammatory Bowel Disease: A sampling of targeted integrative therapies

Inflammatory Bowel Disease
A sampling of targeted integrative therapies

By: Aoife Earls, MSc, ND
Issue: June/July 2011

Inflammatory Bowel Diseases (IBD) such as Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, relapsing-remitting inflammatory diseases with several hallmarks of dysfunction, including a breakdown in intestinal barrier function and intestinal permeability, unchecked chronic inflammation, and an exaggerated immune response characterized by imbalanced anti-inflammatory and proinflammatory cytokines. Proinflammatory cytokines such as IL-1, IL-6, IL-12, IFN-gamma and TNF-alpha are increased with lowered anti-inflammatory and regulatory cytokines like IL-10 and TGF-beta. When diagnosed with IBD later in life, aside from regular check-ups with gastroenterologists between procedures and to monitor efficacy of pharmaceutical interventions, many adults have questions about their specific needs and are looking for additional support. However, many patients are reluctant to seek out integrative healthcare as they are concerned they will be encouraged not to take their medications which are helping to reduce their symptoms and provide quality of life. Naturopathic doctors have a unique opportunity to support patients with IBD by using the most appropriate treatments during different stages of the disease process.

Cognitive Behavioural Therapy: Application in clinical practice

Cognitive Behavioural Therapy
Application in clinical practice

By: Allison Creech, MEd, ND
Issue: April/May 2011

Most health practitioners are aware of cognitive-behavioural therapy (CBT). CBT is one of the most studied and most relevant treatments in psychotherapy, with very positive research outcomes. It is short term, focused in the present, and evidence based. Cognitive-behavioural techniques can be quite specific but they are also highly adaptable, making them an important component of many different treatment approaches and applicable in a variety of conditions. CBT is well established as a core treatment for many psychiatric disorders (Butler 2006); however, the usefulness of CBT is not limited to mental health concerns. CBT has been shown to reduce distress and improve outcomes related to a number of medical conditions, including chronic fatigue (Malouff 2007), type 2 diabetes (Gonzalez 2009), HIV (Safren 2009), and cancer (Osborn 2006). Cognitive-behavioural therapies can also be applied to help a healthy person optimize their wellbeing. Using CBT to identify and challenge the specific belief systems that perpetuate disturbance can help to both shift physiologic experience and promote self-empowerment. These goals are inherently a part of our naturopathic philosophy and an expression of the mind-body connection.  

Bacopa monnieri: Application for cognitive enhancement

Bacopa monnieri
Application for cognitive enhancement

By: Theresa Jahn, ND
Issue: April/May 2011

Our population demographics are changing - Statistics Canada has projected that by 2056 between 25 - 30 % of the Canadian population will be over the age of 65 (up from 13.7% in 2006) (Statistics Canada 2010). This has both social and economic implications - from the stand point of cognitive health and performance; it is plausible that cognitive enhancing agents may become increasingly sought after by the otherwise healthy aging adult (Calabrese 2008). A recent (2004) community survey of 2551 adults between 60-64 years of age conducted in Australia showed that 2.8% of the sample reported using a non-prescription drug for memory aid or cognitive enhancement. Bacopa monnieri (B. monnieri) was amongst the top three agents used (Jorm 2004).