photo courtesy of Janet Walker, osteopath (DOMP)

Before I had kids, I never gave much thought to sugar-free baking. I rarely baked anyways, and sugar-free was a temporary lifestyle change I only associated with my twice yearly detoxes. All that changed after kids, as I resolved to provide them with a completely sugar-free existence until they were at least 1 year old. During that first year, I experimented, transforming the recipes I had previously loved with sugar into sugar-free favourites. Nowadays I’m more relaxed about sugar ingestion, letting the kids self-moderate at events where sugar is served, primarily at birthday parties and at other people’s houses. Not that they don’t over indulge when given the chance. But they are also the first to declare, “My tummy hurts. I think I ate too much sugar.”

Some may find my no fruit juice, no sugar policy at home a tad extreme. (My adage: Eat fruit, drink water.) However, research supports the theory that sugar is actually a highly addictive toxin, contributing not only to the development of obesity and diabetes, but also high cholesterol, high blood pressure, and ultimately heart disease and cancer. For a comprehensive briefer on the science of sugar, watch this episode of 60 minutes “Is sugar toxic?”. Just say no to added sugar. But say yes to sugar-free baking.

This zucchini loaf is made with dates to provide a little sweetness. It was always a big hit at our co-operative day care. I hope you enjoy it too.

Ingredients:
2 eggs or egg substitute
1 cup chopped, pitted organic dates (no added sulfites, thanks)
½ cup oil
1 cup buckwheat flour
½ cup brown rice flour
½ tsp salt
1 tsp baking powder
½ tsp baking soda
1 tsp cinnamon
1 tsp vanilla
2 cups grated raw zucchini
½ cup chopped walnuts (optional)

Directions
Preheat over to 350ºF. Mix eggs or substitute with chopped dates and oil in a food processor until blended. Stir dry ingredients together in a bowl. Add in blended ingredients, beating until thoroughly mixed. Stir in vanilla, zucchini and nuts. Turn into greased loaf pan and bake at 350ºF for 1 hour or until a toothpick inserted in the centre comes out clean. Cool, slice, and serve. Freezes well. Can be used to make muffins too.

**Special thanks to Janet Walker, osteopath for baking and photographing this recipe.

Please help me welcome Jess, a naturopathic student intern in her 4th year of studies, who will be joining me in my practice on Tuesdays from May until August this year. During the fourth year of naturopathic college, senior clinic interns work under the direct supervision of regulated naturopathic doctors to provide primary health care. Most of this time is spent working in the Robert Schad Naturopathic Clinic, the teaching facility of the Canadian College of Naturopathic Medicine (CCNM) and its satellite clinics. Students may also apply to intern with naturopathic doctors outside of CCNM.

Some of you may have met Jess before as she observed, or preceptored, with me frequently last summer. Her role in the clinic will be both adjunctive and primary. She will observe and assist me during visits, and will also be available to see patients herself. In the case of the latter, I will be present in a supervisory capacity, providing teaching and guidance as needed to ensure that your care is consistently safe and effective. As always, you are free to withdraw your consent for her presence during part or all of your visit. You will continue to receive the naturopathic health care you need while Jess gains valuable clinical experience.

I am thrilled to have Jess join me in clinic, and hope to provide her with valuable clinical experience and mentorship while you continue to receive the naturopathic healthcare you need. In support of Jess’ education, we are pleased to offer treatments and services at reasonable rates for visits where Jess is leading your care and I am supervising. Please call 416–817-2385 to discuss this option.

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Hello friends and patients of Dr. Cyndi Gilbert!

My name is Jess Drury and I am a fourth year student at the Canadian College of Naturopathic Medicine (CCNM). I am currently completing the final term of my clinical internship at the Robert Schad Naturopathic Clinic. This summer, I will have the opportunity to work with, and learn from, Dr. Cyndi Gilbert. I will be spending one day a week (Tuesday) at Cyndi’s clinic beginning in May until August 2012. My goal is to observe how she creates a healing environment for her patients and to learn her techniques for developing individualized and wholistic treatment plans.

Since I will be spending time getting to know some of you during your visits with Cyndi, I wanted to take a moment to share a little of my story with you. My journey toward Naturopathy began while studying psychology at the University of Toronto. I was introduced to the field of positive psychology and I became enamoured with the dynamic and fundamentally interconnected relationship between psychological health and physical health. In time, my interest in health deepened to include not only a thorough understanding of physiology, immunology and pathology, but also an exploration of meditation and spiritual wellbeing. Through my studies, I have realized that all the resources necessary to transform the human experience of dis-ease are found within nature and within us.

My four years at CCNM have taught me how to work with the healing power of nature. Through my training, I have learned to use counselling, nutrition, herbs, acupuncture and homeopathy to bring about significant and sustainable improvement in patients’ health. I believe every moment is an opportunity to change your life, and I am eager to work with Cyndi and to learn from her ability to support her patients on their journey back to wellness.

I look forward to meeting you.

Be well,

Jess

Tolle causam. Treat the cause. This directive seems so simple and obvious at first glance. Like any good detective, it implores us to search through the patient’s story, signs, and symptoms to seek out the root of ill health. Tolle causam urges us to uncover the source of disease, remove any obstacles to cure, and let the vis medicatrix naturae work its beautiful magic to restore health. If only it were so easy. Mercifully for both doctor and patient, sometimes it is.

Tolle causam is sometimes translated as “identify and treat the cause.” (1) Other definitions allow for more plurality: “Identify and treat the causes.” (2, 3) A direct translation says something a little different. The Latin imperative “tolle” commands us to remove, take away, destroy, and lift up the cause (causam in Latin). The use of the singular noun here implies there is one single cause to disease. Indeed, this is sometimes the case in practice where a single factor, such as lack of sleep, poor posture, or inadequate nutrition, is creating a health concern that is alleviated by removing the cause. More often than not however, there is no single cause to point to.

People, and their lives, are more complex than a singular event or cause. Another naturopathic principle serves to remind us to address the whole person. Tolle totum points out that the whole entire person must be taken into account during all stages of treatment, from intake to assessment, diagnosis, treatment, and beyond. Disease, in naturopathic medicine, is viewed as a process rather than a discrete entity. When we look at the whole picture, we rarely see a linear progression from health to illness where cause and effect are neatly related to each other like a flow chart. Instead, we must open our eyes to the complexity of non-linearity, where causes may exist on top of one another or side-by-side, creating overlapping and holographic layers of cause and effect. Looking at things holistically, requires both patients and doctors to become comfortable thinking in terms of interrelation within causation. This approach invites us to bring awareness to patterns of health and illness and explore the meaning of disease. A focus on patterns is necessary to help us understand the person who is grieving the loss of a loved one and experiences a chronic cough, or the person who has indigestion, acne, and allergies. It asks us to uncover how seemingly disparate symptoms, sensations, and feelings fit together, and how we might effect change in these patterns.

Tolle causam encourages us to approach our health story like a journalist and ask the “six Ws”. Why does she have anemia? How did he come to have this pain? When and where and what else was going on in their life when they began to feel unwell? As Hippocrates said: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.” This quote beautifully captures the essence of both Tolle causam and Tolle totum.

Coming back to definitions, what if we step back and first ask: Do we need a clear cut chicken or the egg answer as to what came first? Is understanding the interconnections and overall pattern enough, or do we need to break it down into specific factors and/or causes? What possible therapies might act as stimuli for this person’s vis medicatrix naturae, as catalysts for health? Does the order of treatment move in relation to the process of disease? Or, can the direction of cure be tangential to the disease process, presenting a third or fourth or fifth way of becoming?

Paraphrasing what many of my patients have said: “Great. I’ve identified that my health concerns are related to ___________ (e.g. not feeling unconditional love as a child, stunted creativity, repeated antibiotics, socio-economic strain, genetics, etc…). So now what?” Unfortunately, this is where Tolle causam often leaves us hanging. Sometimes, obstacles to health cannot be easily removed. Sometimes, new (or underlying) concerns/causes come up or are uncovered in the process. In the complexity of causes and patterns, there isn’t always an obvious direction for treatment. This complexity highlights an apparent paradox: naturopathic medicine may be concurrently reductionistic (searching for specific causes) and holistic (pattern-thinking). Nonetheless, it is always an art, and a practice.

Earlier this week while shopping at Fiesta Farms, my kids declared themselves chefs and started gathering vegetables for their version of “Red Pepper Soup.” Nevermind that they have always disliked all bell peppers, which I have long suspected is actually a food intolerance to Solanaceae, or nightshade, family vegetables (peppers, tomato, potato, eggplant). Regardless, they began dumping a variety of vegetables in the cart and teaching me how to make their recipe. I confess I made a few adjustments. I wasn’t convinced that sardines were a good idea, although I reserve the right to be wrong. Maybe they would have made the soup extra delicious. Anyways, I present to you my version of K & E’s recipe. (Sorry, I forgot to take a picture. Dinner at our house is often both busy and delicious. Instead, I offer you the cover of the book that likely inspired it all: Growing Vegetable Soup by Lois Ehlert)

Ingredients:
1 tsp coconut oil, butter, oil, or just water
1/2 butternut squash, peeled and chopped
1 large carrot, chopped
2 stalks celery, chopped
1/2 cauliflower, chopped
1 red pepper, chopped (optional)
1 medium onion or 2–3 leeks, chopped
6–10 garlic cloves, chopped
water
1/2 bunch of kale, chopped
1 BPA-free can of cannellini, or other white, beans
1 tbsp each fresh dill, basil, and marjoram
salt & pepper to taste
sour cream or yogurt (optional as garnish)

Directions:
In a stock pot or dutch oven, saute vegetables in oil or water (all those listed up to and including garlic) over medium heat for 5 minutes. Add enough water to cover all the vegetables in the pot. Bring to a boil and simmer for 20 minutes. Add kale, beans, herbs and spices and cook for another 5 minutes. In a blender, mix until smooth, adding water until desired consistency is reached. Serve, topped with sour cream or yogurt if desired.

You could easily switch up the root vegetables for others you have on hand like parsnips, turnip, celery root, jerusalem artichoke, rutabaga or burdock. Play around and have fun with the recipe. And definitely let me know if you try this soup with sardines.

A couple of weeks ago, I presented at the Ontario Forestry Association’s Annual Conference. This year’s theme was “Prescription for Nature: Healthy Forests for Healthy People”. It was an inspiring conference, with great speakers from the Back to Nature Network, Tree Canada, and the Kinark Outdoor Centre amongst others. I was asked to speak from a clinical perspective about the relationship between forests and human health, a topic I am very passionate about, as it speaks to the vis medicatrix naturae, or the healing power of nature. It was also a pleasure to present to a different audience than the usual naturopathic students I lecture to on a weekly basis.

A defining principle of naturopathic medicine is the notion of the vis medicatrix naturae. This vitalistic concept, which dates back to Hippocrates, argues that there is an inherent and ordered tendency in nature towards balance, homeodynamism, and thus the restoration of health — health of the individual, health of the ecosystem, and health of the planet. Implicit in this idea, is that there is a self-organizing and self-healing force that exists both within individual living things but also between them, where the whole system is greater than the sum of its parts and the vis is understood to be an emergent property, increasing in complexity at each level of being.

Presented in sometimes very different words, similar core values regarding humans’ relationship to nature can be seen in cultural, spiritual and religious traditions around the world. This drive toward connecting with nature has also been described by biologist Edward O. Wilson as biophilia, the idea that an instinctive bond exists between humans and other living systems. We can see it again echoed in the cultural practices of friluftsliv, the Scandinavian philosophy of open air living, and in shinrin-yoku, Japanese forest bathing.

Intrinsically, most people know that they feel better in a natural setting, whether that’s in the woods, on the beach, or on a mountaintop. That’s why so many people gravitate to nature to relax and take a break from their daily routine. Even still, many people find it difficult to find the motivation, time and resources to get outside. In Richard Louv’s words, many of us are suffering from “nature deficit disorder”. Thankfully, for those who want scientific evidence to prove the importance of taking a walk in the woods, many studies have been conducted showing how contact with nature is beneficial to health, even in the absence of exercise.

In numerous studies, forest bathing resulted in reductions in pulse, blood pressure, heart rate variability, and cortisol levels; it increased the number of natural killer cells and other intracellular anti-cancer activity; and it improved insulin sensitivity, decreased blood glucose, and hemoglobin A1C in diabetics. Even just looking at photographs of natural landscapes correlated to reduced sensation of pain during painful procedures such as biopsies. In children, time spent in unstructured natural settings has been linked to less severe ADHD (attention deficit hyperactivity disorder) symptoms, better focus and concentration, improved asthma, increased self-esteem, reduction in near-sightedness, lower risk of obesity, decreased fears, and better social relationships with peers. Many of these health benefits persisted for over a week afterwards, suggesting that even infrequent time in nature has potentially significant health benefits.

Some healthcare providers and organizations have looked at the available research and responded by introducing “green prescriptions”, prescribing more outdoor time in nature as part of an overall treatment plan or wellness approach. Spending time in nature is something that I often suggest to patients in my clinical practice for loads of different reasons and in many different ways: walking, hiking, biking, contemplating, meditating, gardening, bird watching, canoeing, or just plain being in nature.

While Japanese researchers theorize that the essential oils, or phytoncides, in the forest air are responsible for many of the health benefits associated with forest bathing, I believe that phytoncides (and sunlight and vitamin D and oxygen…) only tell part of the story. There is something more going on in our time spent outdoors — a sense of groundedness and interconnectedness that results from an attunement to the rhythm of nature, and an awakening of the vis medicatrix naturae in each of us.

Although we don’t have all the words or tools to explain our connections, we understand instinctively that our health, from the biopsychosocial to the spiritual, is a reflection of the health of the Earth. If we accept that human health and planetary health are one, then our moral and social obligations to restore a healthy and healing connection to our environment become imperative; they challenge us to rethink many of the ways in which we live, eat, work, and play. In so doing, we can foster and renew a mutually respectful relationship with nature. As nature heals us, we, in turn, can nurture and heal the planet; we can begin to truly appreciate the healing power of nature.

The restorative powers of hydrotherapy may not be well known outside the spa environment in our time, but the use of hydrotherapy is well documented throughout history in Egyptian, Roman, Chinese, Japanese, and many other cultures. Hippocrates, an ancient Greek physician, prescribed bathing in spring water as a medical treatment. These traditions have continued and can be found in the practice of bathing in hot springs and cold water baths around the world today.

Constitutional hydrotherapy, a technique developed by Dr. O.G. Carroll, is particularly effective at stimulating the immune system, achieving total body detoxification, and stimulating the body’s own innate capacity to heal itself. The word “constitutional” refers to the whole-body effects of this treatment. Although useful in almost any condition, it has been found specifically well suited for the treatment of digestive concerns, respiratory diseases, female reproductive problems, immune system balancing, circulatory conditions, neurological conditions, and environmental toxicity.

What to Expect

The treatment of constitutional hydrotherapy involves the placement of alternating hot and cold moist towels over the upper torso. The person is then wrapped in a sheet and covered with blankets. Gentle electrical muscle stimulation is applied to the back and stomach to enhance the circulatory effects.

How it Works

Hydrotherapy works so well because it acts to stimulate the body’s own healing force. The combination of alternating hot and cold applications with the use of physiotherapy devices enhances the immune response, improves the body’s capacity to absorb and utilize nutrients, encourages the removal of cellular and environmental wastes. It also promotes a healthy balance between the two parts of our autonomic nervous system, the “fight or flight” or sympathetic system and the “rest and digest” or parasympathetic systems, which regulate all our bodily processes. As such it both detoxifies and tonifies at the same time.

A lymphatic and circulatory pump is created by successively dilating and constricting blood vessels in response to the alternating application of hot and cold water. A reflexive increase in blood flow occurs in internal organs when the circulation to the overlying skin is stimulated in this manner. This process increases circulation through the liver, skin, kidneys, lungs, abdominal, and pelvic organs. It is this internal response to the alternating towels which is responsible for the long lasting and cumulative effects of a series of hydrotherapy treatments.

Research studies conducted at the National College of Naturopathic Medicine and Windrose Naturopathic Clinic have shown that constitutional hydrotherapy can raise a low basal body temperature, moderate low or high blood sugar, and moderate high or low blood pressure. Remarkably, a significant increase in white blood cell counts is seen within 2 to 8 hours after only 1 hydrotherapy session. This is a rapid and natural way to boost your immune function.

Cautions

Please consult your naturopathic doctor to see if this type of treatment is an appropriate part of your health treatment plan. During a course of hydrotherapy, some people may experience fever, aches, pains, fatigue, and/or other discomforts as part of their healing process. If any of these symptoms occur, please inform your naturopathic doctor immediately so that they may adjust your treatments as necessary.

Runny nose? Sore throat? Chills? Fever? Sneezing? Congestion? Headache? Any or all of the above? Use the warming socks treatment.

Warming socks works by stimulating the body’s natural healing responses during acute infections. In hydrotherapy terms, the technique is a kind of “warming compress”, which encourages the body to increase overall blood circulation in order to warm up the cold socks. In doing so, it draws preferentially from areas of congestion in the upper respiratory passages, head, and throat. It is also effective for pain relief.

A safe treatment for the whole family, including the youngest of kids, warming socks is perfect at bedtime, or nap time, as it has a soothing and sedating effect, helping you to sleep through the night even when you’re feeling less than par.

Lovingly referred to in my hydrotherapy class as “cold wet socks”, this treatment isn’t nearly as bad as it sounds. In fact, many people find it relaxing once both pairs of socks are on and you’re lying in bed under the covers.

Besides, it’s a powerful, cheap, and easy way to treat the common cold, influenza, sore throats, sinus infections, upper respiratory tract infections, congestion, sinusitis, coughs, and headaches. Anytime there’s heat and congestion in the head and chest, it’s your go-to treatment, especially alongside individualized and integrated care that includes rest, hydration, breathing techniques, nutritional strategies, and the use of specific botanicals and/or homeopathics.

What you need

1 pair of medium weight 100% cotton socks
1 pair of thick 100% wool socks
access to cold water, maybe warm water and a towel

How to do it

1. If your feet are cool or cold, warm them by running under warm water for a few minutes and dry off with a towel.
2. Soak cotton socks in cold water. Wring out excess water until wet but not dripping.
3. Put on wet cotton socks.
4. Put dry wool socks on top.
5. Cover well with blankets and go to bed. Stay warm in bed with feet covered overnight.  When you wake in the morning, your feet will be warm and the socks will be dry.
6. Repeat for 3 nights in a row or as directed by your naturopathic doctor.

*Caution: People with chronic health concerns or conditions, or those with compromised immune systems, should consult with a health professional before starting this treatment.  Consultation with a naturopathic doctor or other primary care provider is recommended for anyone interested in the state of their health.

Although this time of year is about gift-giving and receiving for many people, we don’t always think about those who are very much in need all year round. As my kids are thinking about what they want for Chanukah, I’m thinking about ways to mitigate the rampant consumerism so obvious in December with a greater sense of generosity, charity, and a respect for people and our planet that is balanced all year round.

Recent events highlight the need for a more holistic approach to our personal and universal problems. Talks in my household have been as much about poverty and other socioeconomic issues as raised by the Occupy movement, as well as the inadequate promises to curb climate change made in Durban this week, as they are about planning and decorating for holiday celebrations. Coming from a place of respect and empathy, and extending the naturopathic principle of Tolle Totum (treat the whole) from the individual person to the community, society, planet and universe, we can help bring balance and healing into the forefront. The etymology of the word ‘contribution’ best reveals this holistic, all-encompassing nature of both charity and activism. Coming from the words ‘com’ and ‘tribus’, meaning ‘add together’ and ‘tribe’ respectively, contribution can be seen as the work of building communities, both small and large.

Many individuals already incorporate a ritual of giving into this time of year. If this isn’t a practice that you and your family already engage in on a regular basis, this month is a great time to start a new tradition that you can carry through into 2012.

Set some time aside for this process — volunteer, sit on a board, help create positive change, and/or research where you want to focus your energy, money, etc… If you are looking for research, and consolidated information about organizations you are considering donating to, visit Charity Intelligence.

Here are a few ideas to get you started:

• Children’s Book Bank — provides free books and literacy support to children in low-income neighbourhoods; a great place to drop off your gently-used children’s books
• The Stop Community Centre — works to increase access to healthy food in a manner that maintains dignity, builds community and challenges inequality
• June Callwood Centre — one of North America’s first centres for teen parents and their children, they offer health services, counselling, education, housing, prenatal classes and parenting groups and many types of practical support
• Evergreen — makes cities more livable by deepening the connection between people and nature, and empowering Canadians to take a hands-on approach to their urban environments
• Boundless Adventures — helps youth-at-risk attain their high school diplomas and provide leadership in their communities through counselling, social rehabilitation, alternative education and outdoor adventure
• Distress Centres Toronto — provides 24-hour, year-round telephone support to those experiencing emotional distress or in need of crisis intervention and suicide prevention, as well as face-to-face support and counseling to people dealing with the effects of suicide and homicide
• Kiva — connects people through lending and microfinancing to provide safe, affordable access to capital to those in need, helping people create better lives for themselves and their families

Four years old is a big milestone. First it was finding out from his friends that Halloween actually involved candy, and not just parading through the neighbourhood in costume. The following week, K declared that a birthday party was all about friends bringing you presents (It’s ok, kids are supposed to be this narcissistic.) and cupcakes. His specific request was chocolate cupcakes with vanilla icing and sprinkles. You can’t blame a kid for having a vision. Being both a naturopath and a mother, I revised some recipes to create a (relatively) whole food and gluten-free version of what he wanted.

Two weeks later, K’s birthday has come and gone, and he’s still talking about when I’m going to make them again. I can safely say that my gluten-free chocolate cupcakes were a huge success. Here’s the recipe so you can make them too.

Gluten-free chocolate cupcakes
2 bananas
1/2 cup pure maple syrup
1 egg
1/3 cup oil
1 tsp pure vanilla extract
1 cup gluten-free flour mix (I used Bob’s Red Mill Gluten-free All Purpose Baking Flour)
1/2 cup cocoa (I used fair trade and organic Camino cocoa powder)
1/2 tsp salt
1 tsp baking powder
1 tsp baking soda

Preheat oven to 350ºF. Blend bananas, maple syrup, egg, oil and vanilla in a blender. Mix dry ingredients well in a bowl. Combine with wet ingredients from the blender. Pour into greased or paper-lined muffin tins and bake for approximately 25 minutes or until a toothpick comes out clean.

Makes 12 cupcakes or 24 mini-cupcakes.

Tip: I used If You Care 100% unbleached baking cups with muffin tins but you can use these baking cups without a muffin pan too!

Cool muffins and top with maple cream cheese icing (recipe below) and shaved dark chocolate “sprinkles” which I made by grating a Camino Panama Extra Dark chocolate bar.

Maple cream cheese icing
4 oz cream cheese, softened
2 tbsp unsalted butter, softened
1 tbsp pure maple syrup
1 tsp pure vanilla extract

Cream together cream cheese and butter in a large bowl until fluffy. Gradually add maple syrup and vanilla extract and beat until well combined.

On my way to drop off the kids this morning, I noticed frost on the ground for the first time this season, a signal to finally put away our fall rain coats and make sure that all our winter gear is front and center in the hall. It’s also a good reminder to make sure that everyone has got their wind gate covered when they’re going outside.

Although the name “wind gate” is the literal translation of a specific point on the bladder channel (UB 12, Feng Men, or 風門 to be exact) in Traditional Chinese Medicine (TCM), it is often used to talk about the entire back of the neck and upper back. According to TCM, external pathogens enter the body through the wind gate. In other words, we are most susceptible to environmental forces such as wind when our necks are exposed to the elements.

Invasion by wind can lead to those all-too-familiar cold and flu symptoms — chills, fever, body aches, runny nose, congestion, and cough. This vulnerability is increased if we also go outside with damp hair or do other things to impair our immune system responses (poor diet, inadequate rest, lack of exercise, drink too much alcohol, etc…) Parents everywhere can rejoice in a moment of “I told you so” about all those times they implored you to wear a scarf, or not to go outside with wet hair.

If it wasn’t already obvious, it’s officially cold and flu season out there. And in a couple of days, it’s Halloween. Be sure to figure out how to incorporate a scarf or a hood into your costume and cover up that wind gate. Especially if you’re planning on indulging in some Halloween treats.