Food Sensitivities Explained

Adverse food reactions are a very common, often unrecognized cause of ill health. It is important to know the differences between the two main types of food reactions to bring light to what’s going on in your body (and your child’s!)

Firstly, there are two types of antibodies (immune cells) that are commonly produced in response to foods; they are IgE (immunoglobulin E) and IgG. IgE reactions are immediate and are associated with full blown food allergies – these are the reactions most people associate with food allergies. These foods need to be avoided because they create life threatening allergies. On the other hand, IgG reactions develop hours to days after a food and are often termed food sensitivities or food intolerances. The symptoms they create are a lot more subtle.

Summary of Types of Food Reactions

Antibody	Reaction time	Common Symptoms	Common triggers
IgE	Immediate	Life threatening: breathing difficulties, hives, itchy eyes	Peanuts, inhalants (e.g. dust, pollens)
IgG	Hours à 5 days	More subtle conditions: digestive disorders, skin conditions, weight gain, headaches, low energy (see below)	Dairy, gluten, sugar, caffeine, alcohol, soy, nuts, citrus, bananas

The bottom line is that IgE reactions are easier to spot than IgG ones. Since they are immediate you can usually boil the threat down to a couple of items. Since IgG reactions typically take days to develop they are infinitely more difficult to determine. This is the reason why most people don’t realize they have food sensitivities!

Not noticing something doesn’t mean that it’s not immensly important. These IgG food sensitivities are truly clouding the picture of health as they are triggering mild systemic inflammation leading to symptoms throughout the body. Below are just a few symptoms that are related to these reactions – do you or your child have any of these?

Symptoms and diseases commonly associated with food sensitivities (Pizzorno 2006).

System	Symptoms and diseases
Gastrointestinal	Canker sores, celiac disease, chronic diarrhea, duodenal ulcer, gastritis, irritable colon, malabsorption, ulcerative colitis, vomiting
Genitourinary	Bed-wetting, chronic bladder infections, nephrosis
Immune	Chronic infections, frequent ear infections
Mental/emotional	Anxiety, depression, hyperactivity, inability to concentrate, insomnia, irritability, mental confusion, personality change, seizures
Musculoskeletal	Bursitis, joint pain, low back pain
Respiratory	Asthma, chronic bronchitis, wheezing
Skin	Acne, eczema, hives, itching, rash
Miscellaneous	Arrhythmia, edema, fainting, fatigue, headache, hypoglycemia, itchy nose or throat, migraines, sinusitis

Since many people answer ‘yes’ to having some complaints above, the next step is to take action. There are 2 main ways to uncover IgG food sensitivities.

1. Easy, expensive route: A simple finger-prick blood test. Many labs now offer a comprehensive food panel done through a blood sample. Naturopathic Doctors offer this testing done in office. Cost is usually $220+.
2. Harder, inexpensive route: Hypoallergenic diet. Simply remove all common allergens (listed above) for a minimum of 2 weeks. This way you can feel how your body responds to a very clean diet. Then, you challenge your body by introducing foods one at a time and playing close attention to overall health. To complete this properly it is recommended to utilize the guidance of a Naturopathic Doctor.

After you determine your sensitivities it is best to avoid them for a period of 2-3 months to allow your digestive tract time to heal. Stay positive, these IgG reactions are not always permanent! Your body can heal if you give it time. Please note as well that other factors play into why you have these food sensitivities: digestive enzymes and healthy gut flora are just a couple. The first step is to avoid the allergen, the second step is to promote healing (another shameless plug: Naturopathic Doctors can expidite the healing process).

With children, this is a lot easier if they are breasfed and you have not yet introduced foods. You simply to the ‘challenge’ part of the diet. Introducing one food every 2-3 days and looking for any changes in behaviour/skin/digestion will enable you to decifer if your child is having food reactions.

Best of luck in taking the first step to health - uncovering your food sensitivities!

Yours in health,

Sarah Oulahen HBHSc, ND

www.SowHealth.ca

416.901.2000

The Facts about Vitamin D - Your Sunshine Vitamin!

Have you been wondering why you're feeling so good lately? You probably realize that it's due to the beautiful weather outside! Did you know that this sunny weather is doing more than just uplift your spirits by being able to sit on a patio? It's creating the sunshine vitamin - Vitamin D.

Vitamin D is important for you for so many reasons. Here are just a few that we know about:

• Vitamin D prevents infections: it strengthens the immune system and prevents you from getting sick (this is why we tend to get sick in the fall when we are spending less time outdoors)
• Vitamin D prevents and fights cancers
• Vitamin D stabilizes blood sugar and helps prevent diabetes
• Vitamin D in pregnancy prevents pre-term labour, infections, and conditions in pregnancy such as gestational diabetes and pre-eclampsia
• Vitamin D stabilizes the immune system in autoimmune conditions such as psoriasis, rheumatoid arthritis, and multiple sclerosis
• Vitamin D strengthens your bones. It prevents rickets in childhood and helps you absorb calcium to prevent osteoporosis as you age.
• Vitamin D helps with mood, depression, and seasonal affective disorder
• Vitamin D prevents heart disease and hypertension

The list truly goes on and on! The more we research vitamin D, the more we realize how important it truly is.

Are you getting enough Vitamin D?

The summer really is the only time you are likely to be getting enough vitamin D. In fair skinned individuals, in 20-30 minutes of peak sun exposure you body makes 20,000IU of vitamin D. That's a good amount. But are you getting outside enough? This needs to happen at least 5 times a week.

It is known that darker skinned individuals need a lot more sun exposure to create this amount. They tend to be more deficient in vitamin D. The only true way to know is to have your levels tested (a simple blood test run through my clinic or any medical or naturopathic doctor's office). Recent studies show that approx 2/3 of Canadians are deficient in vitamin D.

My recommendation would be to still supplement in the summer, approximately 2,000IU/day for an adult. In the fall and winter months you can increase this to 3,000-5,000IU/day. I like liquid supplements that you can take at once with food (like D drops). You can get vitamin D toxicity, so make sure not to take too much more than this. Toxicity is a lot more rare than we once thought.

Bottom line, enjoy the sun and be thankful when your body is able to produce it's own vitamin D. Be careful not to get burnt! Remember your vitamin D on the days you aren't able to get outside.

Yours in health,

Sarah Oulahen, HBHSc, ND

Am I covered?! Deciphering your insurance coverage for Naturopathic and Chiropody Services

A lot of us have extended health care benefits through work or a family member – sometimes more than we know about!

We frequently receive questions regarding insurance benefits so we thought we would take the opportunity to share what we know about Naturopathic and Chiropody coverage so you can better understand and utilize the benefits you have when you need to.

Do I have to pay upfront?

Unfortunately only specific health care professionals (i.e., medical doctors, dentists) are allowed to directly bill insurance companies. For others, such as Naturopaths and Chiropodists, personal payment is made at the time of the appointment. A claim form along with the necessary paperwork (i.e., official receipt) is then submitted by you to your insurance company who will send you your reimbursement if eligible.

There are a few insurance companies that may allow direct billing upon request for ‘preferred providers’.

Can you call and check my insurance coverage for me?

Yes – we can! However, the information about your insurance coverage is considered personal. Often times, if health care professionals call your insurance company, you have to be present to verify your identity and that you are allowing us to inquire about your plan on your behalf.

Naturopathic Doctors (Designation: ND)

Visits: Visits to your Naturopathic Doctor may include your initial assessment, follow up visits/treatments, and acupuncture sessions. If eligible, you may have an allotted dollar amount per year (i.e., $200 per year), an allotted dollar amount per visit ($35 dollars per visit) or an allotted percentage of covered cost per visit (i.e., 80% of each visit cost). Since Naturopathic Doctors are primary care physicians, a referral is not needed to claim visit fees.

Laboratory Studies & Supplements: These may also be covered by your insurance plan if recommended/prescribed by a Naturopathic Doctor. Your benefits plan would outline this specifically if this is the case. Coverage for items such as supplements may also be available if you have a ‘Health Spending Account’.

Chiropodists (Desginations: DCh, D.Pod.M)

Visits: Visits to your Chiropodists may include your initial assessment, biomechanical and gait analysis, annual diabetic foot screening, and follow up/routine visits/treatments. If eligible, you may have an allotted dollar amount per year (i.e., $500 per year), an allotted dollar amount per visit ($35 dollars per visit) or an allotted percentage of covered cost per visit (i.e., 80% of each visit cost). A prescription/referral from your family doctor is not required to see a Chiropodist and thereby not required to receive coverage – unless specified.

Custom Made Foot Orthotics/Orthotic Appliances/Orthoses: Coverage for custom made foot orthotics are often under a separate category of coverage from Chiropody visits. It can be found in the medical items/devices/supplies/equipment section of your benefits plan. Coverage may be an allotted dollar amount or allotted number of pairs per year or specified number of years (i.e., 1 pair per year, 2 pairs every 2 years). There may be “maximums” applied to the amount covered. This may be a maximum dollar amount covered (i.e., 1 pair covered up to $500) or a maximum percentage covered (i.e., 1 pair covered up to 80%). In some cases, coverage may be listed as an “Orthotic Case Fee” where the allotted dollar amount includes the cost of the your biomechanical/gait analysis (assessment), orthotic devices and follow up appointments.

Orthotics are medical devices that require a prescription. Your insurance provider will outline from whom they will receive a prescription from (i.e., Chiropodist/Podiatrist, family doctor). Chiropodists are licensed to provide prescriptions for orthotics and a large majority of insurance companies accept prescriptions for orthotics from Chiropodists.

Insurance companies have become very specific with the paperwork required for claim submission. Chiropodists are familiar with what is required can provide you with all the necessary paperwork.

Footwear:Footwear is considered ‘Orthopaedic’ when it possesses specifically defined characteristics that make it appropriate for medical use/application. There are 3 general categories of orthopaedic footwear:

(1) Stock item/Off the shelf - Generic orthopaedic footwear that is ready to wear and can be purchased off the shelf from a clinic or a store from which receipts are accepted by your insurance company.

(2) Customized – When as off the shelf orthopaedic shoe is modified in some fundamental way (i.e., a lift is added to one shoe, additional materials are adding on to the sole to make it wider, the upper material are cut and replaced with another etc) because it is medically necessary and off the shelf shoes are not suitable to your needs. Some insurance companies specify what they accept as a modification. In this case, it may be “internal” (i.e., a pad placed inside the shoe to make the fit or function of the shoe better) or “external” (i.e., outer sole or upper material is changed in some way to accommodate your foot). If you have this type of footwear coverage, be sure to check with your insurance company what they consider a ‘modification’ to be.

(3) Custom-made – These are shoes made specifically for an individual from raw materials from a custom mold of your foot and lower leg. To be eligible, a custom made shoe must be medically necessary. In a majority of cases, these are medically necessary when one’s foot condition makes it difficult to wear shoes that are off the shelf or customized (i.e., amputation, gross deformity).

Your insurance plan should specify which category of orthopaedic footwear they provide coverage for. Regardless of the category, orthopaedic footwear is also considered a medical device and requires a prescription from a licensed health care practitioner (i.e., Chiropodist/Podiatrist, family doctor).

Ultimately, all insurance plans are individualized and can vary greatly from person to person. We hope this helps you better understand your benefits coverage. If you have any specific questions about your insurance coverage – we would be happy to help you! Feel free to contact us anytime!

Yours in health,

Alison Chow, BPHE, Dip.Pedorthics, D.Pod.M
(Chiropodist)
e-mail: alison@sowhealth.ca

Sarah Oulahen, HBHSc, ND (Naturopathic Doctor)
e-mail: sarah@sowhealth.ca

What is a Doula?

Since today is International Women's Day, I thought it would be appropriate to bring awareness to a uniquely female experience: becoming a mother. Becoming a mother includes pregnancy, labour and delivery, as well as the postpartum period.

Traditionally, women in villages would support one another through this process. Today, these women are called 'Doulas' which comes from ancient Greek meaning "Woman's Servant." This means that a doula provides emotional support, knowledge, and comfort techniques to a birth. Examples of what a birth doula can do for you during a birth:

• Give information regarding where you are in labour and determine when you need to go to the hospital
• Keep you and your partner hydrated and fed
• Give tips to your birth partner
• Provide massage, acupressure, hot/cold packs and towels and other comfort techniques

Unlike Obstetricians and Midwives, a birth doula rarely leaves your side. Numerous clinical trials have demonstrated that a doula's presence at birth:

• Tends to result in shorter labors with fewer complications
• Reduces negative feelings about one’s childbirth experience
• Reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction
• Reduces the requests for pain medication and epidurals, as well as the incidence of cesareans
• Babies have shorter hospital stays and breastfeed more easily

Beyond birth, there are also postpartum doulas. These women come to your house to help you be the best mom you can be. They give information regarding breastfeeding and caring for your baby, and do light housework. Postpartum doulas nurture both parents into their new roles.

A doula does not diagnose or prescribe any medication or supplements. They can pass on resources and send you to people who do!

It is extremely exciting being both a Naturopathic Doctor and a Doula ('Naturopathic Doula.') This allows me to use acupuncture (especially pre-labour acupuncture which is immensely helpful). I can also use homeopathics and other remedies to ease labour. I have now attended 4 births and have 3 in the next month and a half. I'm looking forward to each and every special moment.

The company that I have been doing my doula work with is Bebo Mia. They are a great resource for fertility, pregnancy and parenting!

Here is a great video on why a doula is The Essential Ingredient (from Dona International).

Yours in health,

Sarah Oulahen HBHSc, ND

Is milk an essential part of your diet?

Milk has long been advertised as an essential component of a healthy diet. Children are taught to drink 'three glasses of milk a day' by parents believing that this is best practice for healthy bone formation. Is this true?

My simple answer is no. Milk is a highly processed food which causes much concern. Humans are the only mammal that drinks milk beyond breastfeeding - and the only mammal that drinks the milk of another animal. When you think about this, does it make sense that we NEED 3 glasses a day? How are all the other mammals healthy?

Here are some reasons why you should rethink your milk consumption:

• The countries that drink the least amount of milk have lower rates of osteoporosis
• There may be a link between milk and cancer, in particular ovarian and prostate
• Milk could potentially be one of the causes of childhood obesity
• Many people are sensitive to milk! As we age our body naturally decreases its ability to digest milk. Children with milk sensitivities may have an impaired immune system and so they are constantly prone to ear and upper respiratory infections.

My recommendations:

• Everything in moderation. Many people are ok with small amounts of milk in their diet. When buying milk I always promote buying it organic just to make sure that it is hormone and antibiotic free.
• Try different kinds of milk. Almond and rice milk are great options for smoothies and cereal. They taste great and they are also fortified with calcium.

What about your bones. There's a lot you can do for your bones beyond the calcium found solely in milk. Tips for healthy bones are:

• Eat calcium rich whole foods. These include: Fresh, dark-green vegetables like spinach, kale, turnips, and collard greens; Dry beans; Sesame seeds and almonds; Wild salmon and sardines; Rhubarb & Okra
• Increase magnesium levels. Magnesium helps make your calcium more soluble - it helps your calcium work better. Magnesium is just as important as calcium in regards to bone health.
• Get vitamin D. This vitamin is essential for overall health. In the summer it's best to simply be outside for min 20 minutes for the day. In the winter, it is best to supplement with vitamin D (a safe dose would be 2,000 IU/day)
• Healthy fats. Omega 3 essential fatty acids are great at reducing inflammation and increasing bone strength. Most people should consider supplementing with a high quality fish oil.
• Exercise. Exercise is the key to bone density, in particular weight-bearing exercise. Exercising at the time of puberty can set you up for a lifetime of healthy bones.

Yours in health,

Sarah Oulahen HBHSc, ND