By Dr. Deanna McCrary, ND

Just as we are settling in to enjoy crisp, cool days and the festive times that the holiday season can bring, along comes an unwelcome visitor: cold-and-flu season.  Arriving when there are sharp changes in weather temperatures you notice this familiar presence: a sinus-y headache, feeling tired and run-down, a scratchy throat or maybe it's a runny nose letting you know sickness has arrived at your door.  How do you shut the door on this pesky, unwelcome guest, or better yet, have him pass right by your house?  Here's what I do to stay sniffle-free even when surrounded by others who are battling the cold-and-flu blues:

Be Aware and Well Rested.  I remain acutely aware that cold and flu season is upon us.  Wherever I go I encounter some people who are sniffling and sneezing throughout their day.  So I stay aware of my surroundings and take extra precautions to keep my hands washed and fingers away from nose, eyes or mouth.  But a naturopathic approach is more than being aware of "germs."  More importantly I make sure my body can handle whatever it may encounter.  I stay aware of my body and how it is feeling.  Am I getting a bit of a headache?  Do I feel extra tired or run down? Is my throat scratchy?  If anything seems to be "off" I immediately clear out some time in my schedule to make sure I get at least eight hours of uninterrupted sleep at night until the symptoms go away.  Sometimes this is all my body needs to resist an impending cold. Taking a bit of extra time to rest at the first sign of symptoms often prevents me from getting horribly run down and sick for a week or more and is worth it.  And when I am sleeping I am sure to...

Bundle Up.  Every fall I go through a mourning period a few weeks after Labor Day about the fact that the tank tops and sandals are going back into storage and the sweaters, scarves, wool socks, loafers and boots come back out.  Your mom was right: staying warm can help prevent a cold.  Getting too cold does not directly cause a cold infection—that is accomplished by a virus called a rhinovirus—but staying warm helps your body prevent the virus from taking hold by assisting the immune system.  Warm clothes, an extra blanket at night, warm herbal teas (ginger and licorice is my current favorite), hearty soups help me feel nourished and fortified on many levels.

Immune-boosting nutrients.  Flu season is when I start adding in supplements like Vitamin D3, Vitamin C and beta-carotene.  Eating a diet rich in colorful vegetables (especially leafy greens) and fruits can go far but if I feel run down I give my body that extra boost by adding in a high-quality multi-vitamin from a manufacturer I trust.  I also make the extra effort to avoid food allergy triggers, add in a quality probiotic and fish oil to give my body the best chance to run effectively so that my immune system's reserves are saved for what they need to work on: ridding my body of viruses and bad bacteria.

Immune-boosting foods.  Garlic is my number one anti-microbial wonder veggie!  I have it chopped raw, as well as thrown in with cooked dishes (it's immune-boosting property, allicin, is much more active in the raw state).  There is also some evidence that garlic can lower cholesterol and blood pressure as well.  Yay for synergies!  And when I'm keeping warm with my herbal teas I'll often add in a teaspoon or two of manuka honey which has a powerful anti-microbial effect. 

Nasal lavage.  Oh those little bugs love warm, moist places like our nasal passages to set up shop.  A few times a week I give them a formal eviction notice by cleaning out my sinuses with a neti pot and sea-salt rinse.  I resisted these for years fearing that I would somehow drown if I poured water into my nose (well, really, doesn't that fear make sense?)  Once I was assured that I would not drown as, done properly, the water flows out of the other nostril, I gave it a try and have been amazed at how it can lessen the effects of a drippy nose and clear up sinus pain.  It also just feels great. I now use a salt solution that has some anti-microbial essential oils added to it which further helps to keep the cold bugs at bay as well as smells really refreshing.

For prevention of a cold or flu, this is my basic strategy.  It will keep me sailing through flu season if i keep at it regularly.  If I neglect care and a cold hits, I add in several other therapies such as a specific herbal protocol and hydrotherapy techniques that often greatly reduce the length and severity of the cold. 

Not all of these strategies will be the best course of action for everyone and no one should read this article as a personal recommendation of care for themselves.  Sometimes your symptoms may indicate something more serious than a cold and a visit with a medical professional may be in order.  Consult a physician if any of the following apply: difficulty breathing, chills or dizziness, a fever above 101.5 degrees for two days, a severe headache or stiff neck along with a high fever, or if your symptoms have not improved after a week.

Keeping our bodily "terrain" in tip-top shape is the best course of action to prevent infections from taking up residence and spoiling our holiday fun. 

Keep warm and carry on!

© Deanna McCrary, ND and LifeJOY Natural Medicine, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Deanna McCrary, ND and LifeJOY Natural Medicine with appropriate and specific direction to the original content.

The herbs and flowers are in full bloom at LifeJOY Natural Medicine!  Botanical medicine is one of my favorite treatment modalities.  I love it not only because it has been used for thousands of years to treat just about every condition one can imagine but also because there is solid, scientific research behind its effectiveness.  And let's face it: on a purely sensory level, medicinal plants are thrilling!  Their scents are rich and intoxicating, their colors vibrant and alluring, their tastes, er, well, sometimes they're not so bad.  Even though some herbs can be a bit bracing and bitter (usually they're the ones that are SUPER good for us), others are simply a marvel to the palate.  For instance, did you know there is an herb with flowers that taste exactly like root beer?  And another with leaves that taste so much like lemons your face may pucker a bit when chewing them!

Join me on Saturday, September 7th at 1 pm for a tour of our little herb garden and learn all about some common botanical medicines.  You will be able to taste, touch and smell a variety of herbs, partake of some fantastic medicinal herbal teas & treats and learn how to safely incorporate the healing properties of medicinal plants into your life.  Class time approximately 2 hours, suggested donation: $10 (no one turned away).  See you in the garden!

by Dr. Deanna McCrary, ND

Recently the American Medical Association (AMA) declared that having a fat body makes one "diseased."  To reach the criteria to be declared diseased one must have a body mass index (BMI) of 30 or above.  There is valid criticism—even within conventional medicine—of the AMA's decision and especially of the use of the BMI to declare someone "obese."

To read more about the pitfalls of using BMI as a diagnostic criteria please read my fact sheet, "BMI: Obesity-Detecting Bullet or Bunk?"

    The AMA is the nation's largest physician group and currently is the spearhead for determining medical diagnostic criteria in the US.  Ironically, the AMA's decision to declare obesity a disease actually went against the recommendation of their own Council on Science and Public Health, which studied the issue for a year prior to the AMA's decision. The council determined that obesity should NOT be considered a disease mainly due to the inherent flaws in using BMI as a diagnostic criteria.  According to the counsel,  “Given the existing limitations of BMI to diagnose obesity in clinical practice, it is unclear that recognizing obesity as a disease, as opposed to a ‘condition’ or ‘disorder,’ will result in improved health outcomes."  Think about it: if someone has a BMI of 29 and gains two or so pounds, giving them a BMI of 30, does it really make sense that they then are "diseased"?  It seems pretty absurd.  BMI does not distinguish between weight that is due to muscle, bone or fat.  According to their reported BMIs muscle-bound actors Sylvester Stallone, Tom Cruise and Mel Gibson are all technically "obese." 
    It's not clear why the AMA ignored the advice of their own committee, though the decision will no doubt promote pharmaceutical interventions and surgeries such as gastric by-pass (stomach amputations) and lap bands as a "cure."  Some have speculated that the multi-billion dollar economic interests of parties who provide "weight loss" interventions may have influenced the decision.  
    But is excess body fat really a disease?  It is true that excess adipose (fat) tissue has been linked (correlated) to metabolic disorders such as diabetes, high blood pressure as well as liver problems and certain cancers.  However I would like to strongly note that not one study has proven that excess fat is the cause of any disease.   Correlation is NOT causation.  This is great news!  It means that even if lack of activity or inadequate nutrition intake resulted in excess fat, the diseases that those choices can lead to can be reversed even if the person does not lose one single pound.  For example, there is solid evidence that regular vigorous physical activity can make cells more sensitive to insulin thereby reversing the effects of type 2 diabetes.  Optimal intake of fiber, essential fatty acids and antioxidants can lower cholesterol and help to reduce high blood pressure—no matter one's size.  In keeping with the AMA's logic of using correlation instead of causation, we must conclude that very thin people are diseased as well because very low BMIs are correlated with an increased risk for bone disorders such as osteopenia and osteoporosis as well as fertility troubles.  Who's left?
       This point is brought home dramatically on each season of the TV show "The Biggest Loser."  I'm not a fan of this show for many reasons but one thing has stood out to me the few times I have watched it: the metabolic disorders (high blood pressure, diabetes, etc) that some of the contestants start the show with are often greatly reduced or even completely eliminated after just a few weeks on the show's extreme exercise and nutrition protocols—and this occurs while the contestants are still 100+ pounds above their goal weight!  It wasn't the weight loss that reversed the condition but rather the metabolic re-conditioning of the contestants.  I would never recommend the extreme measures that the TV show subjects people to as they are not sustainable and can cause injuries, create eating disorders and other health problems in the long run, but the point is made clear, though it is sadly overlooked:  one can reduce, prevent or even reverse the conditions associated with obesity and still be very fat.  This is Health at Every Size® in action!
    What is further confounding about the AMA's decision is that it flies in the face of the robust pattern in recent epidemiological literature which has been named the "obesity paradox“ wherein obesity is associated with longer survival in many diseases.  For example, obese persons with type 2 diabetes, hypertension, cardiovascular disease, and chronic kidney disease all have greater longevity than thinner people with these conditions. Also, obese people who have had heart attacks, coronary bypass, angioplasty or hemodialysis  live longer than thinner people with these histories. In addition, obese senior citizens live longer than thinner senior citizens.  And let's not overlook a 2008 study that showed one quarter of “normal weight” people also have metabolic abnormalities, and more than half of “overweight” and almost one third of “obese” people have normal profiles, as reported by Abigal Saguy for Time Magazine online.
    All of this makes one wonder: is the AMA's concern for the health of fat folks genuine or is it the result of something else such as innate prejudice against larger-bodied people or caving into pressure from outside economic interests ... or maybe both?
    I do believe the AMA is very misguided in their decision.  To call fat a "disease" creates even more of a stigma on a population that already battles prejudice in the medical community.  Promoting health regardless of one's size, understanding, loving and appreciating the bodies we have right now can lead directly to a cultivation of compassionate self-care.  That is sustainable health.


© Deanna McCrary, ND and LifeJOY Natural Medicine, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Deanna McCrary, ND and LifeJOY Natural Medicine with appropriate and specific direction to the original content.

By Dr. Deanna McCrary, ND

You may be familiar with the word terrain from geography where it describes the physical features of a piece of land.   The terrain tells us whether or not crops will grow successfully there.  It tells us if the landscape is rocky, cavernous or if there is access to a lot -- or very little -- sunshine, water and minerals.  All of these things determine the types of plants or animals that will flourish on the land.  Layers of rock may reveal the history of the land -- fossils, floods or the type of vegetation that has grown there in the past.  When the land is healthy and fertile, when the soil has just the right mixture of minerals and nutrients it can be a source of sustenance, allowing many life forms to thrive.  What does this have to do with our bodies?   A lot!
               Just like the land, our bodies have a terrain – the sum of our genetic history, our personal history and choices, and our exposure to toxins. Our terrain reflects not only our inheritances but also how much access our bodies have had to sunshine, water, vitamins, protein, fats and minerals as well as pollutants, chemicals and pharmaceutical drugs.  Just as toxic waste dumps are often devoid of vegetation, a body's terrain will be affected by accumulations of toxins -- whether ingested, breathed in or absorbed through the skin.  All of these things affect how readily our bodies will resist infections, allow beneficial or harmful bacteria to flourish, prevent or allow cancer cells to grow and increase or decrease our susceptibility to any disease state.
    The concept of bodily terrain is often talked about in modern-day naturopathic medicine, however the idea has been around since the 1800s and was popular among French homeopathic doctors of the day.  The "germ theory" of health was developed in this era by Louis Pasteur (who developed pasteurization) which claims that external microbes invade the body and cause illness and that health can be regained when the germs are killed off.  Conventional medicine today ascribes to this idea and uses drugs such as antibiotics, to counteract the "offending" microbe.  A contemporary of Pasteur, Antoine Bechamp, a medical doctor put forth the idea that whether or not a disease state occurred was greatly influenced by the environment that the organism found itself in.  We are walking vessels of bacteria -- throughout our lives, all of us have germs such as staph or strep bacteria colonizing in us at one time or another.  We carry up to five pounds of bacteria in our gut alone! And yet these microbes only become problems when they are hosted in a body that supports their overgrowth or invasion into tissues where they don't normally reside.  Our bodies have their own ecosystems and will or will not support pathological organisms based on our nutritional status , genetic susceptibility and levels of toxicity.
    Be a caring, passionate gardener of your inner terrain.  Sunshine, fresh air, sleep and rest, nutrient-dense foods, pure water, laughter, surrounding yourself as much as possible with positive, affirming people and movement that brings you pleasure will fortify your inner lands and keep your garden free of any nasty bugs.
    Just as we look to maps or guides to help us navigate difficult or unknown terrain, naturopathic medical doctors can help you discover and cultivate your own inner landscape. 

© Deanna McCrary, ND and LifeJOY Natural Medicine, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Deanna McCrary, ND and LifeJOY Natural Medicine with appropriate and specific direction to the original content.

by Dr. Deanna McCrary, ND

What is body-positive medicine? Isn’t all medicine body positive? Sadly, not always.  The medical community often over-emphasizes lower body weight as a goal to reach and maintain in order to “achieve” health.  Patients are encouraged to reach this goal by restrictive dieting and regimented exercise plans. The idea that a person can achieve metabolic health while being at a weight outside of the accepted norms is often viewed as suspect at best and medical heresy at worst. But is there a way to overall health other than by focusing on body weight?

Fortunately, the old views are starting to change—slowly. More and more research is showing that traditional dieting does not work in the long-term and, often leads directly to even more weight gain.  Also, patients are more likely to engage in physical activity if it is something that they already do that feels fun and pleasurable, and can be part of their daily life.

Further, recent studies have shown that excess body weight may actually have a protective health effect and prolong life rather than shorten it.  “In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments. The accumulation of evidence is inspiring some experts to re-examine long-held assumptions about the association between body fat and disease,” states Harriet Brown in a September 17, 2012 New York Times article titled “In ‘Obesity Paradox,’ Thinner May Mean Sicker.”

What Does “Body-Positive” mean?

To define the phrase “body positive” I will paraphrase the principles of Health at Every Size® (HAES®) as coined by the Association for Size Diversity and Health.  HAES is a health-care movement that is synonymous with body positivity and in this article I will use the terms interchangeably. To be body-positive one accepts and respects that there is natural diversity in body size and shape.  Recognizing that health and well-being are multi-dimensional and include physical, social, spiritual, occupational, emotional, and intellectual aspects, a body positive person promotes all aspects of health and well-being for people of all sizes.  A body-positive person eats in a manner which balances individual nutritional needs with hunger, satiety, appetite, and pleasure.  They engage in individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise focused on a goal of weight loss. 

To be body-positive does not mean that one has reached some blissful state of 100% body-acceptance or intuitive-eating nirvana without a shred of judgment toward oneself or others, but we are on the road, reading about it, talking with others, putting some of these ideas into practice, and increasing our awareness.

What traits do health care providers who embrace these tenets have in common?  
Here are a few:

Patients Are Treated Equally
Body-positive providers are “weight neutral” and recognize that people naturally come in many different shapes and sizes and that size alone is not an indicator of overall health.  They will not immediately assume a patient has a certain health condition because of their size. They make an appropriate assessment of a patient’s health and risk factors only after getting a full history from the patient including a physical exam and any lab work or imaging studies.  For example, when meeting a patient for the first time, a HAES-focused provider would never immediately assume that a fat person binges on fast food, never exercises, has diabetes or high blood pressure, nor would they immediately assume that a thin person eats healthfully, exercises regularly, is anorexic, has brittle bones or could not have diabetes or high blood pressure.  Some of these things may end up being true but they are uncovered as a result of doing an impartial intake and not before. All patients are treated equally and are offered the same treatment and examinations given to anyone with similar symptoms or lab results, regardless of body size. 

Also, a body-positive health care provider uses weight-neutral, non-stigmatizing language.  Terms such as “obesity” or “overweight” are highly charged with negative connotations that reflect a perceived disease state rather than a normal body type that may be perfectly healthy. A HAES-focused provider would not use such terms.

No Weight-Loss Lectures
“Prescriptions to lose weight set people up for feelings of failure and deprivation and a lot of other difficulties, including teaching [patients] not to trust their bodies,” states Linda Bacon, PhD, a nutrition professor and author of the book, “Health at Every Size: The Surprising Truth About Your Weight.”  And she should know.  Bacon conducted a randomized, controlled-trial of the HAES® approach and found it is “… associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus,” according to Bacon’s paper in Nutrition Journal, “Weight Science: Evaluating the Evidence for a Paradigm Shift.”

Patients Are Not Weighed at Each Visit (Generally) and BMI Is Not Used
Although there are times when it may be medically necessary to track a patient’s body weight, for example if the patient has a body-wasting disease such as cancer or anorexia, or, conversely a condition that may cause rapid weight gain such as certain thyroid conditions or Cushing’s disease, a body-positive health care practitioner will not weigh a patient at each visit.  If they are required to do so by the patient’s insurance company, they will be discreet and empower the patient with the option to know the number or not.

The Body-Mass Index, or BMI, is commonly used in the medical community as a measure of fatness in patients. The BMI was developed to be used on adult male populations only and not individuals.  Further, it does not distinguish between fat, bone and muscle when determining body weight, so its usefulness in clinical assessment has been called in to question. You can read more about the BMI here.  

Their Offices Accommodate and Welcome All Sizes
Health care providers who operate from a Health At Every Size® perspective strive to make their offices friendly and accommodating to persons of any size.  They will have a variety of blood pressure cuff sizes, sturdy chairs that don’t sit too low to the ground, patient gowns that comfortably fit both large and small bodies and an examination table with a wide, stable step-up. 

They have books or magazines in the waiting area that celebrate the variety of sizes that people come in and refrain from having books or periodicals that are about restrictive diets, weight loss schemes or that glorify one body type while disparaging others (whether directly or implied).                

They Empower Patients
Being weight-neutral and body positive doesn’t mean that discussions about good nutrition or the benefits of exercise are never discussed.  However, such providers speak more about adding in nutrient dense foods that will specifically help a condition, and less about restricting foods.  Traditional diets or food restriction with a goal of weight loss can easily back-fire.  It is human nature to want what we can’t have.  A person who feels forced by someone else to restrict certain foods (often ones they really enjoy) or a whole food group can develop an even greater desire for it than before.  This, along with the fact that our bodies are designed to keep a weight equilibrium (referred to as "set point"), are the main reasons why diets don’t work and often result in weight gain in the long-term.  A body-positive health care provider is aware of these phenomena and will help a patient release the “food police” from duty, celebrate with them the habits they already have that contribute to good health and help them uncover and remove obstacles to health.  They assist a patient in learning to cue in to hunger and satiety cues that may have been long-lost after years of restrictive dieting, and find reasonable, enjoyable physical activity in their natural body size—whatever that may be. 

They work with the patient as a team, giving the patient a voice and a role in their treatment options.  Rather than lecturing patients by blaming or shaming them for previous choices, they seek to empower by offering knowledge, guidance, acceptance, inspiration and overall provide a place of safety where a patient can feel free to be exactly who they are and explore and play with new approaches to their health.

They Have Examined Their Own Prejudices
It is virtually impossible for anyone in our society not to have culturally conditioned assumptions and biases regarding body weight.  The popularity of shows such as “The Biggest Loser” which reinforce simplistic and extreme “calories in-calories out” models of weight management are testament to our country’s obsession with weight loss not only as a health cure-all but also as catharsis to our collective fears about the social and economic consequences of weight and the perceived redemptive qualities of releasing it.  Body-positive providers have examined their own relationship to food, weight and exercise and continually seek to recognize and challenge their own internal biases when they come up.

A body-positive provider has educated themselves about the social and psychological stressors for people who fall at either extreme in the weight spectrum.  They have found ways to be accepting and compassionate about such a patient’s experiences.  They also recognize that people within the average weight spectrum may have negative views about their bodies, their relationship with food or exercise and may perceive flaws in themselves that others might not see.  This is the heritage most of us have from living in a fat-phobic, weight-obsessed culture.

Body-positive providers have educated themselves about eating disorders and are able to identify and respond to the conditions in their patient’s lives that contribute to body image and disordered eating.

Based on the criteria above do you feel your health-care providers are body positive?  We would love to hear about your experiences.

© Deanna McCrary, ND and LifeJOY Natural Medicine, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Deanna McCrary, ND and LifeJOY Natural Medicine with appropriate and specific direction to the original content.