Change is not merely necessary to life – it is life.  Alvin Toffler

Change and transformation are part of every moment of all our lives.  Whether we recognize it or not, our bodies, our emotions, our minds, our spirits are changing every day:  cells are replicating, growing, performing their functions, and dying; our minds and hearts are perceiving, forming opinions and feelings, learning, and developing; our souls and spirits are experiencing this world, interacting with it, and evolving.  Our health is no different.  Whether we choose it or not, our body systems will alter over the course of our lives, gradually shifting in function and physiology as we mature, express the fullness of the life force, naturally decline and transform into non-physical energy as we leave this plane of existence.  What we do have influence over is the rate of change and the form this natural process will take  –  to a great extent, the trajectory of our health and the quality of our life experience are a matter of choice.  We can choose the path of “disease expectancy” our society has embraced, with declining health and an increase in medications and procedures starting in mid-life or even earlier; or we can follow the lead of cultures throughout the world (so-called “Blue Zones”) in which vitality and health persist far into the later years, and decline occurs only at the end of the lifespan.

Most people know, both instinctively and from available information, the outlines of the lifestyle that will create a healthier, more vital trajectory for their lives.  But as too many of us are aware, intellectual knowledge often submits to deeper, more powerful forces in the body and the psyche when real transformation appears on the horizon.  What is necessary is nothing less than a metamorphosis, a kind of death of the old self and emergence of a new one, and as we move closer to it this can bring up fears, resistance and encounters with parts of ourselves we have done our best to avoid, what the poet and writer Robert Bly calls the “human shadow”.

The shadow contains for each of us the parts of the personality that are hidden from us – we are often encouraged to turn away from shadow aspects of self by family, teachers, society, and cultural or religious institutions who themselves are uncomfortable with their shadows.  The shadow isn’t bad, however, it’s just human, and as Bly points out, the less we acknowledge it, the larger it grows.  Much as we would like to leave it behind, it is part of us and will follow us everywhere. When we embark on a plan of lifestyle change, shadow elements appear to whisper in our ears, urging us to do the very thing we have firmly resolved not to do: smoke a cigarette, take a drink, or eat that humongous piece of chocolate cake that has been beckoning us all evening.   This urge to sabotage our highest and healthiest intentions has been termed the “counter intention” by the life-coach Joe Vitale, and to persist in the work of successful lifestyle change we must engage with our counter intentions and shed light on our shadow.   Dialogue processes (such as Voice Dialogue techniques), journaling, working with a life-coach or therapist, and group support can give us tools to explore the underpinnings of such resistance to positive change.

It’s not that some people have willpower and some don’t.  It’s that some people are ready to change and others are not.  James Gordon, M.D.

Commitment to and patience with the process of change is integral to any serious program of lifestyle transformation.  After the “New Year’s resolution” phase has passed, we are left with the challenging and often merely tedious reality that many steps lie between us and the realization of the vision which first got us started on this path toward a healthier version of ourselves.   Rather than allow this to cause us to lose momentum (or give up on our dream entirely) it is helpful accept that behavioral change (which is what lifestyle transformation comes down to) takes time; it’s a process of learning how not to do what we have done habitually in the past, and instead learning new skills for living – eating, drinking, exercising, sleeping, resting, playing, thinking, working, interacting – that support a fuller, higher functioning life.

Change is a process, not an event.  James O. Prochaska, Ph.D.

Understanding more about how real change happens allows us to reframe the journey toward our vision from being goal-oriented to becoming process-oriented, from an unrealistic and perfectionist belief that our progress must be linear to an acceptance that movement “directionally in the right direction” may seem slower but is more aligned with realities of human nature and therefore ultimately more successful.  It allows us to take our dream out of the world of fantasy and the future and to bring it to earth in this moment and, step by step and over time, to make it real.

Man can alter his life by altering his thinking.  William James

The psychotherapist James Prochaska and colleagues developed a theory of behavior change that has come to be known as the “Stages of Change” model.  Originally applied to the field of substance addiction treatment, it has been shown to be a successful tool for many areas of behavior transformation, from bullying prevention to weight management.  Determining where in the stages someone is guides the approach to helping them move through each stage, from a state of denial about the risks of their behavior, to the point at which the new, desired behavior has become a habit.  These stages are 1) Precontemplation: the person sees no need for change, despite negative effects of the behavior; 2) Contemplation: the behavior is recognized as undesirable. The person is not ready to change yet and focuses on the difficulty of changing, but is thinking about it; 3) Preparation: not ready to take action yet to change the behavior, but taking small steps in that direction: a smoker tells family and friends they intend to stop smoking, and starts thinking about the benefits of not smoking; 4) Action: the person has changed the behavior (ie. they have stopped smoking), but the change is recent (6 months or less) and they are at risk of returning to the old, unhealthy behavior; 5) Maintenance: the new, healthy behavior has been practiced for more than six months.  It has become a healthy habit, replacing the old, unhealthy one. The risk here is that stressful situations or an environment that  triggers the former behavior, can contribute to a relapse, so ways of reinforcing the new behavior are essential to its maintenance.

You always pass failure on the way to success.  Mickey Rooney

It is perhaps frustrating, but true to realize that just about everyone who undertakes a significant lifestyle change will move back and forth within these stages, sometimes many times in various permutations, before the new behavior and its benefits are firmly in place.  But there are strategies that can make progress more sustained, more “directionally in the right direction”, that abbreviate time spent in the inevitable relapses, and allow for a shorter road to successful transformation.  Prochaska calls these “Processes of Change”, and learning and practicing these tools is integral to many effective programs of addiction treatment and lifestyle change:

1)      Consciousness raising: becoming aware of and informed about the unhealthy behavior (the health risks of overweight, for example) and the positive aspects of the healthy behavior (such as the benefits of exercise).  Reading books on the subject, doing internet research, talking to people who have changed the behavior in question, getting feedback from people in your life about their feelings toward the change you are making, can bolster your motivation to change.

2)      Dramatic Relief:  feelings of fear and anxiety about the unhealthy behavior (for example, people who have had a close call with their health – a heart attack or cancer experience, are often highly motivated to replace unhealthy with healthier behaviors); conversely, feelings of hope and inspiration in learning about others’ successful journeys to healthy behavior deepens commitment and joins knowledge with desire and belief in the possibility of change. Twelve-Step and other group meetings are excellent ways to obtain this kind of support.

3)      Reevaluation:  realizing that the healthy behavior expresses who you really are and the person you want to become; also seeing how the unhealthy behavior affects those around you, and the positive effects on others of the new behavior.  Seeing that society as a whole supports the healthy behavior.

4)      Self-Liberation: belief in your power to change, and acting on that belief : “Yes, I Can!”

5)      Helping relationships: seeking out people who support your process of change.  In my work, I have observed that many people want to “go it alone” and resist the idea of joining groups or seeking the support of others in their lifestyle change programs; yet I have seen even the most adamant loners find such support to be invaluable and a source of compassionate camaraderie for every phase of their transformation.  And I have noted that those who insist on going it alone often lose momentum and when difficulties arise, they are less likely to persist and succeed in the desired change. So, depending on your area of needed lifestyle change, here are some options for finding helping relationships for your process:  join a twelve-step program, or a support group (or form your own – online groups are an option); find one or more “buddies” among friends or in your community for mutual encouragement in your change process; work with a counselor or therapist with expertise in the area of your behavioral change; take a class that supports the kind of lifestyle change you are working on, such as a healthy cooking class.

6)      Counter-conditioning: developing healthy ways of acting and thinking to replace unhealthy habitual thoughts and actions.  (Example: having a cup of chamomile tea and a hot bath when you get home from a stressful day instead of a glass of wine as you watch the anxiety-inducing evening news.  Or, take a meditation or mindfulness class and learn how to reduce stress and anxiety with your breathing and awareness instead of with a cigarette or pie a la mode.)

7)      Reinforcement: rewarding yourself for healthy behavior and letting go of rewards associated with the unhealthy behavior. (Example: recognizing how great it feels to once again fit into clothes from a slimmer past, vs. the temporary satisfaction of your favorite self-sabotaging “comfort food”.)

8)      Controlling stimuli:  replacing reminders for unhealthy behavior with cues for healthy behavior.  (Example: Clearing your kitchen counter of sweets; replacing them with a bowl of fruit.)

One should eat to live, not live to eat.  Benjamin Franklin

Just as our psychology can help or hinder our motivation for lifestyle change, so can our biology and biochemistry support or undermine our commitment.  Unhealthy lifestyle behaviors do more than limit our enjoyment of life and put us at risk for chronic disease later – for everything from atherosclerosis and arthritis to diabetes and dementia has roots in lifestyle choices – they insidiously drive the very behaviors we want to change, skewing the healthy function of body systems designed to keep us in balance.

So one of the most important aspects of sustainable lifestyle change is regaining and supporting balanced body function and biochemistry.  Whether the goal is to put the smoking habit in your past, to lose weight, or to maintain sobriety, proactively using healthy eating, exercise, nutrition and stress reduction eases the transition to healthier behavior and raises the threshold for relapse.  In my work I use a program of therapeutic lifestyle change (TLC) which features a low Glycemic Index, modified Mediterranean-style diet and incorporates exercise, stress reduction, detoxification and nutritional support for balanced movement toward healthier lifestyle habits.

In addition, I evaluate and treat imbalances in systems whose proper function is crucial to supporting a particular lifestyle change:  for the overweight, we may look at insulin and thyroid function, test for food sensitivities (whose addictive component can sabotage dietary change), and measure stress hormones and neurotransmitters (brain biochemicals which modulate impulse control, mood, and motivation). We evaluate body composition (the percentages of fat and lean muscle) at the program’s start and throughout, to objectively track change and provide motivation to continue.  Nutritional support tailored to the individual helps to normalize biochemistry thrown off-balance by years of poor diet and depleted by the increased nutrient demands of unhealthy habits.

The only person we can truly change is our self.  L. Hunter Louins

By the time people present themselves in my office looking for guidance for lifestyle change, they’re often demoralized by repeated, failed past attempts. One of the questions I ask them is, “What do you think will make this time different?”   I ask this somewhat provocative question in order to confront and activate their core desire for authentic change.  If we keep using strategies which have been unsuccessful in the past, it’s unrealistic to expect a different outcome.  To create successful, sustainable lifestyle transformation we first need the touchstone of a deep desire for change; then we need to learn from our relapses, get support for each stage of the change process, and practice doing things differently long enough for a desired, healthy behavior to become a habit.

Resources

www.bluezones.com Tips for health and happiness from the world’s most vital cultures.

A Little Book on the Human Shadow, by Robert Bly

Zero Limits, by Joe Vitale, Ph.D.

www.delos-inc.com for information and books on Hal and Sidra Stone’s Voice Dialogue technique

Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your life Positively Forward, by J.O. Prochaska, J. Norcross, and C. Di Clemente

The Pathway: Follow the Road to Health and Happiness, by Laurel Mellin

Each year as Spring arrives, the world outside renews itself with greening rains and cleansing breezes that carry juicy smells of thawing earth and growing things.  Springtime can also inspire us to take time for self-renewal: to clear the stale and stuffy air of winter from our lungs, to take in the sights, sounds and scents of new life all around, to move with Nature’s own rhythm of renewal and rejuvenate our bodies, minds and spirits.  A springtime detoxification program is a great way to “go with Nature’s flow”, by letting go of accumulated toxins to awaken the vibrant energy and life force lying dormant within every cell of our bodies.

Why don’t more of us do a detox?  One of the reasons people put off such a program is the association of detoxification with unpleasant “detox symptoms”, such as fatigue, rashes, aches and pains, headaches, and changes in digestive function.  It can be discouraging and inhibiting to contemplate undertaking a program that might cause us to feel lousy for an indefinite period of time.  What many people don’t realize is that these unpleasant manifestations of toxin release can be reduced or eliminated simply by using nutrient and herbal support to help your body more easily clear toxic compounds.

Pathways of toxin clearance

In order to understand how this support works, it helps to know a little about how the body deals with toxins.  The liver, kidneys, intestines, lymph system, lungs and skin all participate in toxin elimination, and have very individual and specific ways of interacting with, neutralizing and clearing the various toxins we encounter.  When the body is healthy, our detox systems run smoothly, and toxins are transformed into neutral compounds and completely eliminated through appropriate channels. Together these systems represent a  sophisticated series of interlocking parts that work interdependently to maintain metabolic equilibrium by neutralizing external toxins from our increasingly toxic food supply, environment, and from medications; and internal toxins produced as a consequence of both natural bodily processes and unhealthy functional imbalances.  When we store toxins instead of clearing them, it may mean that one or more of the factors necessary to keep this complex machinery running well are not available.  When we embark on a program of detoxification, the idea is to release stored toxins from cells and tissues, so it becomes crucial to compensate for any inadequacies in the clearance pathways; otherwise not only will the process be more uncomfortable, but some toxins may re-circulate, exerting toxic effects as they do so, and then be stored again.

Move ‘em out

A simple way to help out the body with toxin removal is to promote a 1-3X daily bowel movement.  Increasing fluid intake may help, but adding a high-quality fiber supplement normalizes the bowel habit and in addition binds toxins released into the intestines and promotes the growth of healthy intestinal microbes.  Detoxification can disrupt bowel movements in either direction (diarrhea and constipation are both common detox symptoms) and different kinds of fiber absorb fluid to reduce diarrhea and provide roughage to improve constipation.  A supplement which contains more than one source of fiber is beneficial – arabinogalactans, ground flax seed, apple pectin, carrot or beet fiber, psyllium husk, oat or rice bran – these are fiber sources which may be included in better-quality formulas.  If you are unused to taking a fiber supplement, start with a small amount (perhaps 1 tsp. daily in water) and increase gradually to 1 Tbs. 2X daily over the course of several days.

Raise your pH

The acidity or alkalinity of the blood influences whether the products of detoxification are cleared from the body through proper channels.  An acidic systemic pH (pH is the scale for measuring acidity and alkalinity; for healthy detoxification, urine pH should be above 6.6) will obstruct healthy routes of elimination, leading to build-up of toxins in the blood and creating unpleasant “detox symptoms”.  Just as fresh vegetables, berries and fruits in the diet or in juiced form have an alkalinizing effect on internal body systems, concentrated greens formulas (which often contain a carefully chosen mix of veggies, berries and fruits) can be used during detoxification to improve systemic pH and encourage elimination of toxins.  Choose a greens formula that is attentive to organic sources of the ingredients (the last thing you want is pesticide residues in your detox program!), avoids bulking agents such as alfalfa and grain components, and uses primarily freeze-drying rather than spray-drying in the manufacturing process.  A greens product should be packaged to provide protection from the damaging effects of heat, light and moisture.  For purposes of detox support, I often recommend 1 Tbs. of the powder twice or three times daily mixed with water.

Balance Phase 1 & 2

Another reason for impaired detoxification and its negative effects is a mismatch between the two phases of liver detoxification.  The liver processes toxins in two steps, which are designated Phase 1 and Phase 2.  Toxins are first worked on by Phase 1 (cytochrome P450 enzyme systems) and then passed to Phase 2 to complete the detox process.  But what if Phase 2 can’t “catch” all that is passed to it?  When this happens, the partially metabolized toxins can’t be eliminated and they continue to circulate through the body; they are eventually stored in cells and tissues if Phase 2 just can’t finish the job.  Unfortunately, many of these intermediary metabolites are even more harmful than the original toxin.

It makes sense that many people who have symptoms and health issues that lead them to detoxification programs may already have impaired clearance pathways – so when they begin the work of releasing quantities of stored toxins, it is not surprising that the detox pathways become overwhelmed.  These “pathologic detoxifiers” often experience the most severe detox symptoms, but almost everyone who takes on a serious detox would benefit by addressing the nutrient requirements of the liver’s Phase 2 clearance pathways. In this way, Phase 1 and Phase 2 work with greater synergy and toxins are more effectively neutralized.

Hope for “Pathologic Detoxifiers”

A number of supplement formulations are specifically designed to provide broad support for Phase 2 reactions.  Phase 2 co-factors include amino acids such as N-Acetyl L-Cysteine, Glutathione, Glycine, Glutamine, MSM (Methylsulfonylmethane), Taurine, Ornithine and Methionine; B-vitamins, including folic acid, thiamine, riboflavin, niacin, pyridoxine/ pyridoxine 5-phosphate and vitamin B12; vitamin C; and minerals such as magnesium, manganese, zinc, molybdenum and selenium.  No single formulation will provide all these nutrients, so it may be appropriate to augment a Phase 2 support formula with an additional B-Complex or a high-potency multiple vitamin & mineral complex to fill in gaps.  Depending on the degree of co-factor deficiency or toxin overload, multiple doses through the day may be appropriate.  Essential fatty acids such as those from fish oil and borage oil are used in Phase 2 reactions, so doubling or even tripling your usual daily dose may be helpful; dry skin is often a sign of EFA deficiency, so increase intake if this appears during a detox.

The herbal flavonoids silymarin (derived from  Milk Thistle) and curcumin (a component of the spice turmeric)  have been found to increase levels of the Phase 2 enzyme glutathione S-transferase,  and are excellent additions to a detox supplement program.  I recommend phytosomal preparations, which enhance absorbtion, up to two or three times daily of Milk Thistle (standardized to 80% silymarin) 100 mg. and/ or Curcumin 250mg..

Easy = Effective

Years ago, detoxification programs seemed to align themselves with the “No pain, no gain” philosophy – if you weren’t miserable for at least some of your detox, you weren’t doing it right.  Time, experience and research have shown, however, that a gentler, well-supported approach to toxin clearance is not only more pleasant, it’s more effective.  The most successful detox processes are those which honor the needs of the body, mind and spirit.

By now the many benefits of fish oil and the essential fatty acids (EFAs) in it are common knowledge; in particular, the importance of specific EFAs, particularly DHA (docosahexaenoic acid) for infants and children is so widely acknowledged that it is now added to infant formula and has been a continuous focus of research  for a couple of decades.  The more we learn about these healthy fish oil fats, though, the more clear it becomes that they aren’t just for the littlest ones: ensuring an abundant supply for you and your child, from the moment you even think about conceiving, during pregnancy and throughout all the childhood years, is an intelligent – and intelligence-enhancing – gift that will keep on giving throughout their lives.

DHA in Pregnancy and after – the gift of a “better brain”

During pregnancy the only source of DHA is the mother’s intake from diet and supplements, and many diets are deficient in this nutrient – daily intake of DHA in U.S. women is estimated at about 50 mg., compared to 600-1200 mg. per day for Japanese women.    Several studies have affirmed the ”essential” nature of this fish oil fat for optimal brain growth and function (and for healthy retinal and vision development): mothers who supplemented their diets with DHA during pregnancy gave birth to children who scored higher on early childhood tests of mental processing and had greater head circumference (a measure of brain development), according to one study;  a 2008 Australian study looked at the effects of fish oil supplementation during pregnancy from 20 weeks to delivery, and found significant improvement in eye-hand coordination (a measure of brain function in young children) for these children at age 2 ½; in a third study, children of mothers who took DHA during pregnancy had better neurologic function at age 5.  Infants of mothers supplemented with DHA were calmer and had better sleep, too.

What’s the link between DHA and your baby’s brain?   During the last three months in the womb and during the first months of infancy, the brain has a “growth spurt”, requiring large amounts of the essential fatty acid DHA for incorporation into its tissues.  The more DHA is available to the child from the mother’s blood supply (in utero) and breast milk, the more the brain can soak up, and the better that brain develops and functions.  For mothers-to-be, a good daily dosage is 600-1200 mg. of DHA (there appears to be no toxicity) from dietary and supplemental sources (enteric-coated formulations can be easier on the digestive tract).

Fish Oil: Brain Food for Every Child

While the connection between DHA and brain development in infancy and early childhood is well documented, a 2011 study demonstrates that even at the age of 11, children whose moms take DHA during pregnancy  perform better on memory function and behavioral tests – pointing to a much more extended beneficial effect than has previously been recognized.  Another significant finding of this study was that those 11-year-olds who had higher blood levels of DHA at the time of testing scored even higher – which suggests that continuing to provide plenty of DHA throughout childhood is a very bright idea.  In my practice, I often prescribe child-oriented formulations which provide DHA in amounts of 100-200 mg. per day.

Mood, Behavior,  the “Alphabet Disorders” and EFAs

Brain health isn’t only about IQ, though; the brain is also the center of feeling and behavior – it’s where we “live” as humans.  The poet John Milton spoke of this most eloquently, in Paradise Lost: “The mind is its own place, and in itself/ Can make a Heav’n of Hell, a Hell of Heav’n.”  Too many children’s minds are bleak, unhealthy places where no one should have to live – driven in part by chaotic biochemistry, these beleaguered brains trigger poor behavior and foster emotional climates of chronic anxiety, depression, low self-esteem, mood instability, even rage reactions – an unfortunate recipe for misery in childhood and beyond.  These issues should be the exception in our youngsters but tragically, they are far too commonplace.  Depression, anxiety, dyslexia, OCD, ADD, ADHD, PDDNOS, ASD – there is a growing lexicon of names and acronyms for brain imbalances which, to a greater or lesser degree, have roots in disturbances of biochemistry and metabolism.  An incredible web of interconnection exists between brain centers, stress hormones, neurotransmitters, inflammatory substances and nutritional factors – and EFAs from fish oil are among the most important nutrients for maintaining equilibrium throughout this complex web.  Accumulated research evidence has clearly established the efficacy of fish oil/ EFAs for improving learning, behavior, and social interaction in children with developmental and psychosocial problems.

Supplementing with fish oil is a simple and effective way to begin to heal your child’s brain chemistry.  When prescribing for the vulnerable young groups described above, I may suggest dosages of DHA and its sibling, the anti-inflammatory Omega-3 EPA, which are several times the usual supplemental amounts.

Deficiency Signs

What are some hints that your child is deficient in the Omega-3 fatty acids?  Does s/he have dry skin? Rough elbows?  Even if these signs are only noticeable in winter (when the lubricating effects of the EFAs are most needed), they are telling you that your child’s EFA levels are marginal at best.  Eye irritation, blinking frequently, rubbing the eyes, can all indicate a lack of the lubricating EFAs from fish oil.  Skin problems, from cradle cap to eczema, from seborrheic dermatitis to acne, have a connection to EFA deficiency and warrant supplementation.  Allergies and asthma, similarly, benefit from EFA supplementation and suggest deficiency states.

Does your child have learning, behavioral, developmental or mood issues that may not meet criteria for a specific diagnosis, but are nevertheless limiting his or her potential and negatively affecting your family?  Think EFA deficiency.   And, because the diets & lifestyles which promote such deficiency tend to be familial, think EFAs for the entire family!

Finally, if you really want to get a precise picture of your child’s fatty acid status, testing is available through special laboratories which provide this kind of analysis for naturopathic and other functional medicine physicians.

How to Choose a Fish Oil Product

If there were one supplement I could prescribe for every child, it would be an excellent fish oil, made by a manufacturer using high standards of quality control.  A high-quality fish oil/ EFA supplement will probably cost more than many, but do take care to choose one manufactured in a facility which adheres to pharmaceutical-level production practices; which is third-party assayed for contaminants (mercury, arsenic, cadmium, dioxins, PCBs); and is stabilized with natural antioxidants (such as tocopherol [vitamin E], ascorbyl palmitate [a form of vitamin C], rosemary) to reduce the rate of deterioration in the bottle.  Quality supplements meet or exceed standards for fish oil purity set by IFOS (International Fish Oil Standards), GOED (Global Organization for EPA and DHA), U.S. EPA, and CRN (Council for Responsible Nutrition) organizations.  These products are often molecularly distilled, pharmaceutical-grade, and sustainably sourced; their labels are specific as to the marine animals from which the oils are extracted (eg. salmon, cod, mackerel, calamari, sardines, herring, krill).  A good fish oil supplement can have a slight seafood smell but, in the same way that the fish you buy for dinner can smell cleanly of the ocean but should not smell very “fishy”, it should not smell or taste (or burp) excessively of fish – this suggests rancidity.  And most children’s formulas add natural fruit flavors which make them quite tasty.

Grandma’s tales of being dosed as a child with cod liver oil speak to the long-recognized, powerful benefits of fish oil in many areas of children’s health and growth.  By taking the simple step of adding fish oil supplements to your child’s diet, you are supporting them in becoming the very best they can be.

Is your diet as healthy as you think?

One of the most frequently asked questions in my work as a naturopathic physician is “I eat pretty well, doesn’t my diet give me the nutrition I need?”  The answer is, it all depends:  is your diet really as healthy as you think it is?  What standard are you using to gauge the quality of your food intake?  We now have ample evidence confirming that a nutrient dense, low glycemic burden (blood-sugar stabilizing) diet, rich in plant nutrients, healthy fats and fiber, supports good nutritional status, health and vitality; in contrast, the standard American diet (the so-called SAD diet of refined, adulterated foods which have journeyed from distant processing facilities to reach your table, losing nutrient value along the way) is more and more associated in medical research with the chronic health issues which have unfortunately come to be accepted as part of the aging process.

To the extent that your otherwise good diet contains elements that require your body to make withdrawals from its nutrient supply to metabolize them (the white-flour bagel you grabbed on the way to work this morning, the mid-afternoon cookie to lift your energy, that glass of wine with dinner), nutrient deficits can develop over time. No matter how your diet would measure up on close examination, even the most health-conscious among us has difficulty maintaining dietary perfection 100% of the time (and the pursuit of perfection carries health risks of its own!) – so supplementation to cover our nutritional bases has value from this point of view.

Toxins and Nutrition

Another consideration is the additional burden of toxins we encounter daily in modern times, a nutrient-depleting phenomenon of proportions for which we humans were never physiologically designed.  From the phthalates in  body lotion to the lead in lipstick to the styrene packaging beneath (even organic) chicken breasts and the acetaminophen we may take for aches and pains, each chemical requires a constellation of vitamins, minerals, amino acids and nutrient cofactors to complete its journey through and out of our bodies.  When we lack the nutrient support to make these detoxifying pathways run well, we store toxins in our body tissues, where they can impact health now and over the entire course of our lives.  Supplemental nutrients can support better toxin temoval from the body, providing proactive protection from our brave new toxic world.

How’s your digestion?

Our digestive tracts are beautifully designed to transform your breakfast, lunch and dinner from macronutrients (proteins, carbohydrates and fats) into micronutrients (such as vitamins, minerals, amino acids, and essential fatty acids), and to convey them by elegant mechanisms from your intestines into your blood stream and lymph channels.  “White foods” such as refined sugars and flours, alcohol, food allergens, inflammation, and stress compromise the effectiveness of digestion.  If you belch, or experience odorous flatulence and/ or abdominal bloating, one reason may be maldigestion, or ineffective breakdown of foods into usable nutrients.  If you have had your gall bladder removed, whose function is to store bile for fat digestion, you may not thoroughly digest fat-soluble vitamins (vitamins A, D, E and K),  important fatty acids and other fat-containing nutrients such as phospholipids, essential for healthy brain neuron and cell membrane receptor function.  If like many, your stomach acid production has declined over the decades, if you take antacids or a proton-pump inhibitor, the reduction in gastric acid changes the pH (acid-base balance) not only in the stomach, but throughout the “downstream” digestive tract, interfering with normal activation of digestive enzymes and the breakdown of foods.  Any of these digestion-compromising factors can create significant, multiple nutrient deficiencies.

How’s your absorption?

You may have heard the saying, “You are what you eat.”  This is true, but equally as important, we are what we digest – and what we absorb.

Part of the elegant design of the digestive tract is the refinement of the absorbtive processes for specific nutrients.  An example is the narrow range of acidity required for absorbtion of minerals such as calcium and magnesium, and amino acids such as tryptophan, which in the body is used to make the anti-depressant neurotransmitter serotonin.  Health issues or medications which reduce stomach acid levels (as discussed above) affect not only digestion, but also absorbtion of these and other nutrients.

The lining of the small and large intestine is the interface across which nutrients must travel to be used by the body to nourish cells, manufacture molecules, build muscle, bone and tissue, and help us live our lives energetically and healthfully. If the lining of the intestine becomes damaged or chronically irritated by inflammatory effects of toxic foods (an example of this is gluten intolerance or celiac disease, but any food has the potential to exert inflammatory effects on the membranes of the digestive tract); by immoderate alcohol consumption; stress; medications (such as non-steroidal anti-inflammatory medications and aspirin; or steroid drugs); microbe imbalance in the form of unhealthy bacterial, fungal, or parasite overgrowth; or any combination of these – nutrient malabsorbtion and nutrient deficiency are common effects.  It should be noted that malabsorbtion and the causes for it often exist below the level of our awareness, unless and until the process of inflammation becomes well advanced.

Biochemical individuality and nutrient needs

The biochemist Roger J. Williams, Ph.D. used the term “Biochemical Individuality” in his 1956 book of the same title to describe the uniqueness of each person’s nutrient requirements, based on genetics and other influences.   In contrast to the concept of RDA (Recommended Daily Allowance), which uses a generic calculation based on a review of currently available scientific literature to determine nutrient needs for “most people”, the principle underlying biochemical individuality disputes the idea of an average person, and says that biological diversity even between people who seem physically similar would dictate an individualized approach to determining and meeting nutritional needs.

Even within a given individual’s lifetime, nutrient needs vary widely as circumstances change.   Acute and chronic illness, stress, medications, injury or surgery, dietary changes, and environmental exposure present different nutritional requirements for healthy body function.  If you are fighting a cold or flu, or if you burned your hand making dinner last night, your nutrient requirements increase.  If you have been working longer hours, have been taking a cholesterol-lowering agent, are worried about finances or your child heading off to college, have undergone chemotherapy or radiation, your nutrient requirements are altered.  If in the past there was an extended period of time when your nutritional status was compromised – let’s say in college years when poor diet may combine with “recreational” drug and/or alcohol use – you may have created a “pothole” of ongoing nutritional deficit in the road of your life.  It can be difficult to repair such damage to nutrient status without intensive, “super-dietary” nutrient intake from supplements.

Nutritional Supplements as Therapeutic Tools

Using nutritional supplements in these ways, to repair the effects of present or past deficiency, or to protect against negative health consequences of current dietary insufficiency, digestive incompetence, environmental stressors, or medications, is part of my role as a naturopathic physician.  Beyond prevention and repair, though, is the realm of using nutrients with therapeutic intent, to improve health outcomes in acute illness and chronic disease.  Evaluating current nutritional status using physical signs and symptoms and laboratory testing, identifies of areas of need and appropriate supplementation.

Most of my work with nutritional supplements is in this area, grounded in the extensive and growing body of scientific evidence for the clinical benefits of such use, and the deep awareness that as humans, our physiology is based on biochemistry, not chemistry.  Nutritional approaches to treatment work in alignment with our biology and honor our human nature as biochemical beings.

How healthy do you want to be?

This may seem like a silly question with an obvious answer, but years of working with people and their health concerns has taught me that not everyone has the goal of “optimal health”.  Some seem fairly content with the assortment of illnesses, aches and pains, medications and procedures, and limited “vitality expectancy” which have come to be part of our cultural health standard.  If we define health as “the absence of disease”, nutritional supplements may seem expensive and unnecessary.  If the World Health Organization’s description of health as “a state of complete physical, mental and social well-being” is more compatible with our beliefs, we are more likely to consider nutrient supplementation as one way to preserve and increase our well-being.  For some, the idea of taking supplements feels too much like taking medication, and they prefer to focus on optimizing diet to create wellness.  Certainly, to eat and drink well, exercise, and develop strategies for healing from the stresses and toxic influences of our lives today – these are essential elements to create health and well-being, and supplements alone will not replace them.   However, to use supplements in conjunction with a healthy lifestyle can provide the benefits of each and the synergy of all for greater wellness.