Some background info
Obesity is on the rise. Over the last 40 years, obesity in children and adolescents has increased significantly. From 1978-1979, 1 in 4 children were overweight or obese. Now, it’s closer to 1 in 3. One study of over 3000 Canadian youth found that those adolescents with lower fitness levels had increased estimates of CVD risk factors (we’re talking triglycerides, cholesterol, and blood pressure). We know that physical activity is great for keeping the pounds off, but it’s also important for metabolizing sugar properly, keeping our blood pressure in check, and preventing diabetes. But here’s the shocker: only 16% of Canadians are meeting physical activity guidelines of 150 minutes per week. That means 84% of adults are letting only 21 minutes of activity per day increase their risk of cardiovascular disease.

Why does it matter?
Obesity is directly related to metabolic conditions- type 2 diabetes, hypertension, sleep disorders, mental health disorders, and even joint problems. If we’re not enforcing some form of movement in children while they’re young, they’re less likely to be active as adults. The same goes for healthy eating. Instilling healthy exercise & eating habits from a young age is crucial in creating healthy adolescents- who will go on to be healthy adults. 

So what should we do?
We need to encourage physical activity in a way kids enjoy. Letting kids pick which sports they’re involved in allows them to feel like they have control, making them more likely to continue the sport as they age. Limiting screen time is also important, as increased screen time has led to declines in physical activity. 

By 3 months of age, babies should have a total of 60 minutes of tummy time per day- broken up into smaller chunks. Infants younger than 18 months should not be exposed to screens, unless video calling with a family member. 

Children age 3-5 should be active throughout the day to encourage proper growth & development. Screen time should be limited to 1 hour per day (or less), and should be educational programs or video calling with family members.

Children age 6-17 should be active for a minimum of 60 minutes every day. This should include a mixture of aerobic exercises (like playing soccer, swimming, or running), climbing or pushing objects, and jumping. This combination of exercises ensures healthy hearts and proper bone development- preventing cardiovascular disease & osteoporosis as they become adults. Screen time will differ depending on your child & their needs, but a firm no-screens in the bedroom rule works for many families, and encourages proper sleep function.

For all ages-childhood to adulthood-incorporating enough vegetables, fruit, protein, and healthy fats is a key factor in reducing the risk of many chronic diseases.


Why work with both your pediatrician and your ND
Your pediatrician plays a vital role in your child’s health. However, NDs who have experience & training in pediatrics have a strong focus & background in prevention of disease . Not only are NDs focused on treating illness and preventing deficiencies, but they are also trained in optimal health & nutrition. Optimal health is often neglected in the Canadian public healthcare system because the focus is on preventing deficiency- not obtaining optimal health. Medical doctors often don't have enough allocated time to discuss your child's diet in depth during the visit, but NDs will take a thorough history & discuss specific nutrition goals that might benefit your child. Naturopathic Doctors can also diagnose common childhood conditions, and treat them using gentler options. Some common conditions NDs can help your child with include eczema, constipation, respiratory infections, sleep issues, ADHD & autism. 

Overall, ND's offer a more individualized approach to prevention of chronic disease & promotion of optimal health from infancy to adulthood. 

References (in case you still believe naturopathic medicine isn’t evidence based):
https://pubmed.ncbi.nlm.nih.gov/22301031/
https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000973
https://www.phac-aspc.gc.ca/publicat/hpcdp-pspmc/36-9/assets/pdf/ar-03-eng.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2066158/
https://www.participaction.com/en-ca/resources/pulse-report#:~:text=On%20average%2C%20Canadians%20think%2034,%25%20according%20to%20Statistics%20Canada

IBS, or Irritable Bowel Syndrome, is often the diagnosis given to children & adults when they experience bloating, flatulence, and loose stools or constipation. Your bowels certainly are irritable, but the real question remains: WHY?

    A diagnosis that is being used more frequently by healthcare providers is something called SIBO, or Small Intestinal Bacterial Overgrowth. It is estimated that 65-70% of people with a diagnosis of IBS actually have SIBO. Essentially what’s happening in SIBO is that way too much of certain types of bacteria are living in the small intestine, and they are fermenting the carbohydrates you’re eating. This causes the production of gas, causing bloating and flatulence. People with SIBO feel like they're always bloated- and often feel like they're pregnant! These bacteria also create by-products in the small intestine, which irritates the lining of the gut, which can cause diarrhea. 

On the other hand, the Migrating Motor Complex, aka MMC, can be compromised in SIBO. The MMC is responsible for contracting the intestines to continue moving the bolus through, so a bowel movement can be expelled. If the MMC isn’t working optimally, constipation can occur.

SIBO still isn’t fully researched, but the general consensus is that the best & safest way to diagnose SIBO is through a breath test. The breath test will evaluate what types of gas and how much is being produced by the intestines. Once we know if the results from the test are positive for SIBO, we can begin treatment.

Conventionally, Rifaximin is the antibiotic of choice for SIBO for both children & adults. However, strong antimicrobials (such as garlic, berberine, oregano, neem, and more) have been shown to be just as effective, yet come with fewer side effects! However, one should not self-treat for SIBO as treatment will differ based on the results of your breath test. Children also need to be monitored by an ND if choosing the natural route for treatment, because dosing for children is much different than adults.

If you end up treating for SIBO and feel much better after (yay!), you aren’t in the clear yet. Now that we’ve eradicated the bacteria in the gut, we need to replenish the gut with good bacteria and optimize the digestive tract to prevent a re-occurrence. Unfortunately, the re-occurrence rate for SIBO is quite high, so prevention is the key!

If you experience IBS and haven't seen a naturopathic doctor about it, it might be time to find one. You may have SIBO or another condition that can be treated to get you feeling your best!

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What is Vitamin D?
Vitamin D is a fat soluble vitamin found in many types of fish, egg yolks, mushrooms, and fortified foods, and can be created in the body from sun exposure. While  water soluble vitamins will be excreted through the urine and sweat,  fat soluble vitamins get stored in fat tissue. This is good when we want vitamins to be accessible for long periods of time, but can cause toxicity if we have too much of it.

Vitamin D plays an active and important role in your health:
~ it maintains strong bones in both children and adults, which prevents osteoporosis and the risk of fractures as we age
~it plays an important role in our immune function, helping to prevent disease
~low levels have been associated with autoimmune disease, cancer, diabetes, asthma, and heart failure

Do I need to take a supplement?
As with every supplemental nutrient , your individual health history needs to be taken into account when deciding on your treatment plan. When discussing the possibility of supplementing your normal diet with your naturopathic doctor, they will identify things such as:

~ skin colour (skin with darker pigmentation has more difficulty absorbing vitamin D from sun exposure)
~how much sun exposure do you get? Do you consistently apply sunscreen?
~do you have a history ofor are you at risk for osteoporosis or other bone-related diseases?
~have you had your Vitamin D levels tested on blood work before? If so, what were the results?
~do you have any gut disorders (Crohn’s or celiac, as examples) that may inhibit the absorption of Vitamin D from food or supplements?

Should I get tested?
If you have a medical condition that impacts your vitamin D levels, your doctor has probably already tested it for you. This test will be covered by OHIP. The test will measure 25-(OH)D, which is a blood marker of the precursor to active vitamin D. If you do not have a disorder, you can still request your vitamin D to be tested on your next bloodwork; however, you will most likely need to pay out of pocket for the test (on average around $50). 

What do my results mean?
There is still some disagreement when it comes to what optimal levels of 25(OH)D are. Anything less than 30nmol/L is considered deficient, and there is evidence that there may be potential risk at more than 75 nmol/L. Most health professionals will be satisfied seeing 40-60 nmol/L as this is both safe and effective. Remember to get re-tested in 3-4 months after you start supplementing to verify that you aren’t overdoing it.

“I don’t want to get tested, I just want to take vitamin D because I feel like I need it”
I hear this all the time from customers at the health food store I work at, and I try my best to educate them on the risks of supplementing (with anything, but especially fat soluble vitamins!) without an overseeing healthcare provider. Supplementing Vitamin D daily when your levels are already high in the body can cause toxicity, which may result in heart attack, stroke, kidney stones, headache, nausea, vomiting, diarrhea, or unintentional weight loss. 

What do you recommend?
As always, I recommend seeing a practitioner who can evaluate your vitamin D levels and provide you with proper education based on your health history and risk factors. This is the best way to save your money while improving your health and avoiding health scares due to over-supplementation. Many people do not need to supplement with Vitamin D due to the factors listed above, and knowing this is going to save you money in the long run.

For more information about Vitamin D, you can visit the Health Canada website here:
https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/vitamin-calcium-updated-dietary-reference-intakes-nutrition.html