Results of the study showed no difference in pain and functional outcomes for both the NSAID and turmeric groups; there were also no significant difference in the adverse events between the groups; as such the authors reported that Curcuma domestica as being comparable in safety and efficacy to ibuprofen for the management of osteoarthritis of the knee (J Altern Complement Med. 2009 Aug;15(8):891-7.

Naturopathic Options:

While the aforementioned study reported no difference in the adverse events for either NSAID or turmeric, I would advise for subjects with a previous history of peptic or duodenal ulcer to avoid the former in consideration of the risk of gastrointestinal bleeding and ulceration. Secondly, the intake of NSAID with alcohol increases one’s risk for liver toxicity, of course, depending on the amount of NSAID and alcohol consumed.

While  turmeric is a great alternative for its anti-inflammatory effects, the herb is also used clinically to support the liver’s detoxification processes (it may alter metabolism of certain prescription drugs); additionally, it is a potent anti-oxidant as well as a blood thinner secondary to its antiplatelet aggregating activity (*Caution for those on Warfarin or Aspirin). Used in Asian and Middle Eastern cooking, this spice has been found to be useful in traditional medicine for relieving symptoms of irritable bowel syndrome and ulcerative colitis. Preclinical studies also indicate curcumin (the active ingredient in turmeric) has potent chemoprotective actions against a variety of tumors.

The subjects were healthy but untrained in physical activity, and received 500mg of Quercitin twice per day for 7 days. The authors concluded that supplementation enhanced aerobic capacity while delaying fatigue during prolonged exercise, but also extrapolated the results to implicate beneficial results in overall health promotion and disease prevention (1. Davis MJ, Carlstedt CJ, Chen S, et al. The dietary flavonoid quercetin increases VO₂max and endurance capacity. International Journal of Sports Nutrition and Exercise Metabolism [epub ahead of print June 24, 2009].

Last month, I wrote about energy drinks consumed by the public to help increase their energy throughout the day. I alluded to the use of herbs like adrenal adaptogens such as Licorice root extract and Ashwaganda or Siberian ginseng as excellent alternatives to these energy drinks that contain a lot of sugar. From the study above, Quercitin might also be a good consideration especially when starting a new exercise regimen.

Essentially, it’s about supporting an increase in oxygenation of your tissues for optimizing your health. Tissue oxygenation promotes a reduction in lactic acid accumulation post-exertion (hence reduced muscle aches and pain), but also helps to maintain a relatively alkaline tissue environment (this has implications in the prevention of cancer). Furthermore, increased oxygenation of tissues helps to promote prolonged exercise tolerance and increased muscle regeneration post exertion.

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When we consider how many endurance athletes consume energy drinks to provide them with the stamina required to compete, it is certainly plausible that the findings of the study provide clues as to the correlation between energy drinks and sudden cardiac deaths and heart attacks.

The controlled trial examined whether energy drink consumption altered platelet and endothelial (the inner lining of blood vessels) function. Fifty healthy volunteers (34 male/16 female average age 22) participated in the study. Platelet aggregation (this makes your red blood cells stick together) and endothelial function were tested prior to and an hour following the intake of a 250ml sugar-free energy drink.

Compared with baseline values, there was a significant increase in platelet aggregation following energy drink consumption with no change found in the control group. Additionally, endothelial function decreased following energy drink consumption. The authors also noted a significant increase in the mean arterial blood pressure following energy drink consumption vs. control.  Since heart attacks are associated with both platelet and endothelial dysfunction, the authors concluded that energy drink consumption acutely increases the risk of sudden cardiac death and myocardial infarcts.

Source

Some of the ingredients listed in Slow Cow include melatonin (a naturally occurring hormone for sleep maintenance), valerian root (a common herbal sleep aid) and L-theanine (an ingredient found in green tea which balances the effects of caffeine). Due to the natural health ingredients within the product, Health Canada is likely looking to regulate it as a natural health product although this has not yet transpired.

As the article did not convey the concentration of the active ingredients, it is difficult to determine what kind of an effect each can of Slow Cow will have for the individual, however, representatives from iChill and Slow Cow have noted that the product is “not recommended for children under 13 [and advises against] operating heavy machinery as the product can make people sleepy”.

I suppose one could argue for or against the introduction of these drinks on the market; one might consider the effects of caffeine in caffeinated beverages – it certainly is legal (and unregulated by Health Canada) to sell them, and it is well documented to have effects akin to stimulating the sympathetic nervous system. As such, it would seem natural to have drinks on the market which support the parasympathetic nervous system by promoting calm and relaxation.

That said, the concern lies with the presence of the hormone melatonin. Just because something is natural does not mean that it is completely safe. The same goes for the presence of valerian root and L-theanine. These ingredients may cause interactions or potentiations with pharmaceutical drugs when drunk in high enough amounts. Ultimately, it behooves the consumer to consider the possible risks when drinking these “relaxation drinks” in the presence of certain pharmaceutical medications – it would be prudent to check with their healthcare provider to discuss the possible risks.

In summary, I think these drinks have been marketed beautifully, aiming to target those who seem too busy to slow down. That said, it might be better just to go for a long walk along Vancouver’s seawall.

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This landmark decision puts British Columbia as the first Canadian province that recognizes the role Naturopathic Doctors (NDs) play as primary health care providers; furthermore, it underscores the benefits to patients when NDs are permitted to practice according to the comprehensive extent of their education and training. According to Dr. Christoph Kind, ND and president of the BC Naturopathic Association, “The BC Government has recognized the value of enhancing naturopathic services as a choice in the health care system for primary care to patients….[this] allows for more effective multi-disciplinary treatment of patients and reduces the impact to and costs on the health care system.”

The new regulations are timely as previously, many “traditional” substances such as some herbs, amino acids, hormones and high dose vitamins (all of which had been utilized by NDs for decades in the treatment of patients) were being “scheduled” by Health Canada, thereby limiting their availability to NDs. As drug laws changed through the decades, the scheduling of preparations effectively reduced the traditional naturopathic formulary of available medicines. This would be analogous to a medical doctor losing his/her ability to prescribe antibiotics or to order diagnostic tests, thereby severely affecting their ability to practice medicine effectively.

In essence, NDs are educated to diagnose and treat patients effectively, including the use of clinical judgment as to when to prescribe certain prescription medications. Ultimately, the changes are the culmination of extensive reviews of the benefits and evidence of science-based naturopathic treatments with the bottom line being improved patient care and reduction of health-care costs to taxpayers.

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Restore electrolytes and water (essential electrolytes being: sodium, potassium, magnesium) in the form of a sports re-hydration drink. Electrolyte repletion is essential as minerals such as sodium, potassium and magnesium promotes post-exercise recovery while ingredients such as citric acid and malic acid are essential factors required for energy production. Drinking plenty of water before during and after your run will prevent dehydration as well as overheating, both of which may lead to nausea and lightheadedness. It is recommended to drink about 150-200 milliliters every 15 minutes during your training but take into consideration the daily temperature and intensity of your run.

Replenish glycogen (glucose stores) rapidly to promote muscle/protein rebuilding; research indicates a 4:1 carbohydrate to protein ratio optimizes glycogen replenishment and enhances aerobic endurance performance by 24%. Carbohydrate is the most efficient source of energy and endurance athletes maintain a high carbohydrate diet. Carbohydrate-rich foods include pasta, rice, bread, crackers and bagels. While carbohydrate loading is great for providing energy for the race, remember to include some protein to provide the building blocks for muscle. Protein sources include fish, chicken, legumes and dairy.

Reduce muscle injury and oxidative stress with antioxidants like Vitamin C. Antioxidants such as vitamin C are essential for both muscle energy and recovery as well as for immune support during physical stress and exercise. In general, endurance athletes are more susceptible to infections especially after heavy or prolonged exercise. This susceptibility is often up to 72 hours after a marathon. Immunity can also be supported by ensuring adequate intake of amino acids like L-glutamine which is the primary source of fuel for the cells in the intestinal tract. Protecting the integrity of this lining is important as components within the intestinal tract make up about 60% of your immune system, known as the mucosal-associated lymphoid tissue (MALT) or the gut-associated lymphoid tissue (GALT).

Last but certainly not least, we must remember to support our musculoskeletal system which includes our bones, muscles, ligaments, tendons and cartilage. Without a healthy musculoskeletal system, endurance athletes are often prone to injury and or debilitating pain. For example, weak tendons and ligaments may contribute to structural instability and spinal misalignment. Nourishing the various tissues with nutritional supplements like glucosamine and chondroitin sulfate as well as zinc, manganese and silica support the ability of these tissues to heal and prolong their vitality. In addition, maintaining a healthy diet with essential fatty acids like fish oil or flax seed oil can not only reduce inflammation but also provide the nourishment for cells to maintain their optimal health status.

In essence, maintaining a healthy balanced diet with adequate rest in between your runs will help prevent injury, reduce muscle recovery time and allow you to meet your marathon goals with confidence.

Best food choices for energy

Carbohydrate (CHO) is the most efficient form of energy and all athletes are recommended to follow a high carbohydrate diet. Carbohydrate-rich foods include bread, crackers and bagels; pasta, noodles, rice and couscous; breakfast cereals; fruit and milk.

The longer you spend training the more carbohydrate you need. The table below will help you calculate your daily carbohydrate needs.

Duration of Training CHO needs

1-2 hours/day – 6-7g CHO/Kg body weight/day
2-4 hours/day – 7-8g CHO/Kg body weight/day
4+ hours/day – 8-10g CHO/Kg body weight/day

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Naturopathic Options

You can lower your blood pressure by minimizing your intake of salt to no more than 2.5g (2500mg) per day. Remember that salt is added to processed foods in the form of preservatives and additives, and sauces. Intake of magnesium rich foods like soy, buckwheat, rye, and figs contain about 100-300mg of soy per cup. Magnesium supplementation in the form of tablets may also appropriate to help lower your blood pressure by dilating your vessels. Daily intake of fish oils is essential, not only to lower LDL (“bad”) cholesterol, but also to reduce inflammation that can further damage the lining of your blood vessels and thereby contribute to atherosclerosis.

Advice from Dr. Aaron Hoo

If you or someone you know has high blood pressure or other forms of heart disease, I encourage you to discuss it with your healthcare provider in order to treat and manage the underlying causes. While it is essential that modifying lifestyle and dietary factors to reduce heart disease risks, studies have also shown that certain peptides (proteins) from bonito fish (same family as tuna), the very same flakes drizzled over some sushi rolls, have excellent blood pressure lowering capacity by affecting enzymes in the kidneys which regulate blood volume. Clinical trials with bonito fish peptides suggest a 64% efficacy rate in lowering blood pressure in mild and moderate high blood pressure.

Additional lifestyle considerations include: weight reduction for those who are overweight or obese, increase in physical activity, moderation of alcohol intake, and adopting the DASH (Dietary Approaches to Stop Hypertension) diet which is rich in potassium and calcium.

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Oil an 8×8 inch square pan. Cut a square of wax paper to fit bottom, lay it in place and oil it. Put egg whites in a separate bowl from yolks and set aside. Put yolks in a medium bowl and add salt, vanilla and Vitamin C crystals. Whisk a few minutes until light. Gradually add juice, then carob powder, while whisking. Using a spoon, stir in seed meal and nuts for 1 minute. Preheat oven to 350 degrees. Beat egg whites with a mixer from low to high until stiff & shiny. Spoon ¼ of whites into batter with spatula until all white is gone. Scrape batter into prepared pan and bake for 20 minutes or until top springs back when touched lightly.  Use a knife to loosen the edges, and then turn out onto a cooling rack. Peel off wax paper before continuing to cool. Cut into squares when cool.

(serves 16)

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Dr. Hoo’s Advice: I’ve formulated a special blend of herbs called “Dr Hoo’s Stress Buster Formula” This blend includes Bacopa, Schisandra, Passionflower and Skullcap. Together, this potent formula is designed to tonify your adrenal glands (this helps you to manage stress), reduces anxiety, improves physical performance and mental concentration, reduces tension headaches, and reduces insomnia.

Saute quinoa, carrots, celery, onions, green pepper, and garlic in oil until golden brown. Add water, tomatoes, and cabbage and bring to a boil. Simmer 20 to 30 minutes or until tender. Season to taste and garnish with parsley. For variation, try adding some of your other favourite vegetables, chopped and sautéed.

(Serves 4-6)

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