Premenstrual Syndrome, or PMS can come in a variety of patterns. A whirlwind of emotions, cravings and weight gain often come in tote with the monthly menstrual cycle. Better understand the impacts of the monthly swing in hormones and get the help you need to live a more balanced life.
Anxiety or irritability can come from estrogen excess or progesterone drops. This imbalance in the two major female hormones can make some feel like they want to crawl out of their own skin. Increased levels of estrogen in the second half of the period can allow adrenaline to build up and alter the serotonin balance. Natural treatment includes supportive measures for estrogen clearance, progesterone building herbs, regular moderate exercise, a healthy diet and stress management.
PMS-C: Carbohydrate Craving
Cravings for sweets and refined carbohydrates, feeling hangry, tired or having a headache all fall under the category of PMS-C. Abnormal variations in blood sugar may be a factor of magnesium levels – and this gives into the common cravings for chocolate as dark chocolate is high in magnesium. Noteworthy: a change in serotonin levels can also increase sugar cravings. Therefore, factors in insulin regulation are key and are a focus of treatment. Finally, herbal formulas are also available to reduce the satisfaction of sweets and crush the cravings.
In addition to anxiety, mood changes throughout the cycle can also lean towards depressive states. Symptoms that suggest the need to modify the stress response include crying, fatigue, headaches, feeling overwhelmed or out of control, and difficulty sleeping. Adaptogenic herbs may be helpful to support the stress response. Chinese formulas and botanical medicine formulas that include nerviness, anxiolytics and antidepressants can be very effective in PMS-D treatment. Certainly, nutraceuticals may also be helpful to modulate levels of serotonin, GABA, and dopamine and thyroid hormone levels should also be monitored, especially if the periods are heavy. Neurotransmitter hormones can be evaluated with take home urine tests called Organic Acid Tests (OATs).
Fluid retention is a common PMS complaint. Breast tenderness and distension, bloating, weight gain, swollen hands and feet can all be classified under PMS-H. An increase in circulating aldosterone levels is linked to decreased progesterone and magnesium with increased estrogen. Reduce salt and sodium intake (bread and cheese) and increase sources of potassium (bananas, baked potato with the skin, dandelion leaf tea). Treatment of Liver Qi stagnation with acupuncture and Chinese formulas are often very good at reducing PMS-H.
Naturally Navigate PMS
Naturopathic doctors can provide individualized treatment to manage hormones. The whole body is considered, the physical, emotional, cognitive and spiritual. When it comes to hormone balance, the naturopathic tool box is rich. Bring balance to your hormones and bring balance back into your life.
Dr. Laura M. Brown, ND is a Naturopathic Doctor, a Certified Gluten Practitioner, a HeartMathCertified Practitioner and is a graduate of Adapt Level 1 at KresserInstitute of Functional Medicine. Essentially, Dr. Brownhelps people better digest their food and the word around them.
When it comes to exercise, walking doesn’t always get the respect it deserves — and it’s time that changed. Before buying into the idea that walking isn’t a worthwhile workout, learn the truth behind these three common walking myths.
There is a great feeling of accomplishment when your fitness tracker buzzes to signal you hit 10,000 steps. But Carol Ewing Garber, PhD, professor of movement sciences at Columbia University, believes it might be an arbitrary target.
Yes, there are studies that show walking 10,000 steps per day is associated with lower blood pressure and improved glucose tolerance but the idea of walking the equivalent of five miles per day could feel overwhelming to new exercisers.
“[Walking 10,000 steps] will result in health benefits,” Garber says. “But it should be noted that … there is benefit even with small amounts of walking and the benefits increase with the more steps you walk each day.”
Garber suggests aiming for 150 minutes of moderate-intensity exercise each week instead of setting a step count goal.
If you want to count steps, consider this: Walking an additional 2,000 steps per day — even if your current step count is minimal — helps lower body mass index and boost insulin sensitivity, according to research published in the journal BMJ.
Leslie Sansone, fitness expert and creator of Walk at Home Workouts is adamant: “Walking works for weight loss!”
A slow stroll around the block isn’t going to move the needle on the scale (although it does burn more calories than binge watching legal dramas). To lose weight with a walking workout, Sansone suggests high-intensity interval training or HIIT.
Picking up the pace — without breaking into a run — at regular intervals during your walk has a major impact on weight loss.
In one small study, researchers at the University of Virginia found that overweight women who logged three 30-minute, high-intensity walks and two moderately-paced walks per week for 12 weeks lost six times more belly fat than women who went for a slow stroll five days per week. A second study found that varying speed burned up to 20 percent more calories than maintaining the same pace.
Incorporating HIIT into your walking workout is simple, according to Sansone. After a 5-minute warmup walk at a slow pace, walk at a brisk pace for 30 seconds and then a regular pace for 4 minutes. Repeat the interval four times. End with a 5-minute cooldown walk.
“Walkers have so many choices to get fit and stay fit for life,” Sansone says.
Walking can be a “gateway exercise” that helps new exercisers improve their cardiovascular fitness and stamina to transition to running but not all walkers want to run — and that’s OK.
“Walking is a good exercise for everyone,” Garber says.
A study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology found rates of hypertension, high cholesterol, heart disease and diabetes were lower for regular walkers than runners.
While a walk around the block is a good start, maximizing the benefits of a walking workout requires logging sufficient time in your sneakers. Garber suggests focusing on distance, duration or calorie expenditure (all viewable on your fitness tracker) noting that it’s the amount of exercise that counts — for both walkers and runners.
“If you start fitness walking today, you will instantly feel better and know you’re doing something good for your body, mind and soul,” Sansone says.
Screen time is quickly becoming one of the hottest topics for parents, healthcare practitioners, and educators. How much screen time should children and adolescents be allowed per day? Does screen time include the time spent on laptops to complete homework and reading assignments for classes? At what age should children begin to use screens? When is an appropriate developmental timeframe to buy your child a phone? Does the use of screens increase the risks of behavioral disorders and sleep problems in children and adolescents? The list of questions goes on and on.
Unfortunately, many of the answers to these questions are simply unknown at this time and some, honestly, are personal choices that each family has to make for themselves. Truly, there is no denying that the digital age is here to stay; screens are all around us, from televisions to smart watches, from iPods to smart phones, from tablets to laptops, there is literally a screen for everything. In 2017, 98% of homes in the US with young children had a mobile touch-screen device compared to 2011 when only 52% of households had such technology.1
Globally, the availability and usage of mobile touch-screen devices by children are at astonishingly high rates:1
In Australia, children under 2 years are reported to have an average weekly screen time of 14.2 hours, while those between 2-5 years old average 25.9 hours
In France, 78% of children were using a mobile touch-screen device by 14 months of age and 90% of children by 2 years of age
Across five countries in Southeast Asia, 66% of children between 3-8 years of age are reportedly using their parents’ mobile touch-screen device, while 14% of children already owned their own devices
In Britain, 21% of children aged 3-4 years of age are reported to own their own device
Interestingly enough, part of the dilemma of creating set guidelines on screen time in children is that there are various groups with sometimes competing and conflicting interests in this subject. Educational and tech focused organizations encourage the use of screen time for educational advantages and for enhanced benefits to long-term career and financial goals as children grow into adults. On the other hand, public health officials warn of the potential detriment to young minds and their still developing behaviors.
What is screen time displacing?
There are a variety of reasons cited by experts for keeping screen time to a minimum, particularly in young children.
Take for example the CDC, which states that children between the ages of 8-10 spend, on average, 6 hours per day in front of screens, including 4 hours of TV viewing.2 In children ages 11-14 this number skyrockets to 9 hours per day with approximately 5 of those being TV watching.2 Finally, in teenagers aged 15-18 the number of hours per day in front of a screen averages 7.5 with 4.5 being in front of a TV.2 These numbers are startling high when one realizes the activities which are NOT taking place when this much screen time is involved.
For instance –
Mentally and physically supportive health benefits which come from engaging in physical activity such as organized sports, neighborhood pick-up games, the unorganized activities of exploring and using imaginative play alone and in groups, and the quiet, downtime children and adolescents need to regroup and restore their bodies and minds
Social aspects of cultivating relationships with physically present individuals, learning how to read and empathize with emotional cues and needs, developing problem solving skills alone and in groups
Interconnectedness and responsibilities that come from supporting the family and local community networks through chores, volunteering, and taking part in events
Restful sleep and downtime to restore brain and body
Reading and engaging in learning opportunities not involving screens or directed education/learning
Mindful, present, and nutritious eating time with family, so as to avoid passive overconsumption of nutrient void foods
All of the above suffer when screen time overtakes the activities of unplugged healthful daily life.
Screen time duration impacts wellbeing
A study looked at the effects of screen time in 40,337 children and adolescents in the US between 12-17 years of age.3 For the purpose of this study, screen time included cell phones, computers, electronic devices, electronic games, and TV. The amounts of time spent on screens was compared to an array of psychological wellbeing measures.3
Results from this study found that the wellbeing of children and adolescents did not differ significantly (except in curiosity) between those spending no time on screens and those spending 1 hour or less per day on screens.3 However, after exceeding 1 hour of screen time, the risks to wellbeing increased– the researchers explained that increased screen time (> 1 hour/day), “was generally linked to progressively lower psychological well-being. In terms of relative risk (RR), high users of screens (≥ 7 hours/day) carried twice the risk of low well-being as low users (1 hour/day).”3 The low wellbeing measures included not staying calm (especially among 14- to 17-year-olds, RR 2.08), not finishing tasks (RR 2.53), not being curious (RR 2.72), and having less self-control and emotional stability.3 High users of screens compared to low users were described as more difficult to care for, while twice as many high (vs. low) users of screens had an anxiety or depression diagnosis.3 It was found that the effects of high screen time use on wellbeing was generally greater in adolescents than in children.3
Beyond psychological wellbeing, increased time spent on screens is also associated with increased risk of cardio-metabolic diseases and being overweight.4 It comes as no surprise that longer duration of reading and doing homework is associated with higher academic achievement.5 High use of screen time has also been linked to worsening sleep patterns in children and adolescents.6 In a review of 67 studies published from 1999 to early 2014, it was found that screen time was adversely associated with sleep outcomes (shortened duration and delayed timing) in children and adolescents in 90% of the studies.6 Knowing that restful and adequate sleep, particularly in children and adolescents, is associated with lower obesity risk, better psychological wellbeing, improved cognitive functioning, and lower risk-taking behaviors, it is important that the detrimental effects that screens have on sleep be minimized in this developing population.7
Managing & modeling healthy screen behaviors
A quick peak at the leading organizations’ recommendations on supporting healthy screen time in children and adolescents reveals similar guidelines across the groups which can be broken into 3 key areas:.
1. Model appropriate screen behavior. Modeling appropriate screen behavior begins with parents, guardians, caretakers, and educators. The authors in a BMC Obesity publication concluded that, “Mothers’ and fathers’ media parenting practices were associated with children’s screen time. Interventions aimed at reducing children’s screen time should address both mothers’ and fathers’ media parenting practices.”8 Screen time habits discussed in this article included, among other factors, screen use by parents during meal times.8
2. Limit screen time and limit to age-appropriate content. The American Academy of Pediatrics recommends the following guidelines:9
For children younger than 18 months, avoid use of screen media other than video chatting. Parents of children 18-24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they are seeing.
For children ages 2-5 years, limit screen use to 1 hour/day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
For children 6 years and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity, and other behaviors essential to health.
Some researchers and practitioners recommend limiting screen time to 2 hours/day after age 5, not including educational screen time such as what is used for school, studying, and work-related screen interactions.10
3. Encourage face-to-face interactions and physical activity on a regular basis. Be intentional about daily “screen-free” time, particularly during mealtime, conversations, play time, family time, and bedtime. Support daily exercise for all children and adolescents being especially cognizant that sedentary screen time does not become a part of a child’s habits before the age of 5.11
Straker L et al. Conflicting guidelines on young children’s screen time and use of digital technology create policy and practice dilemmas. J Pediatr. 2018;202:300–303.
When discussing bone health, we often talk about proper nutrition. Adequate vitamin D and calcium intake are usually recommended to enhance bone mineral density (BMD). What is not discussed as often is the role of exercise and weight training for increasing bone strength. A holistic approach looking at what we put IN our body as well as what we DO with our body is the key for building stronger bones.
As we age our body experiences several physiological changes. Our hormone levels change, muscle mass declines, and bones become less dense. Low bone density, otherwise known as osteopenia, increases our risk of fracture. Although we can bounce back from a slip or fall in our early years, a hip fracture in older individuals can have detrimental effects on quality of life. The good news is, there are important steps you can take to prevent or slow down the decline of BMD.
Research has demonstrated that healthy individuals and patients with osteoporosis can improve BMD with high-moderate impact activities and resistance training. A few examples of high impact exercises include step classes, jogging, and jumping jacks. Resistance or weight training on the other hand can include elastic band, pully, and free-weight based exercises. To put it simply, the more force you transmit through the bone, the more the bone will remodel and grow! Clinical judgment is needed to determine the intensity of force that each patient can tolerate.
Recent studies have found that high-intensity resistance training and impact training improves BMD and physical function in postmenopausal women. Low-intensity and light-resistance exercise programs are not enough to stimulate bone remodelling and improve BMD. Heavy multi-joint compound exercises such as squats and deadlifts induce extensive muscle recruitment and transmit greater force through the bones. In particular, these exercises will apply force through the lumbar spine and femoral neck, making them stronger and more resilient to fracture. Proper form and supervision are crucial when performing any high intensity or heavy loading activities.
Talk to a primary health care provider about your BMD and if an exercise program for developing BMD is right for you. Not only will exercise strengthen your bones, but it will have profound impacts on many other systems of the body as well. As always, if you have any question do not hesitate to contact me at firstname.lastname@example.org or visit my Instagram page @drkylearam!
Sinaki M. Exercise for patients with established osteoporosis. InNon-Pharmacological Management of Osteoporosis 2017 (pp. 75-96). Springer, Cham.
Mounsey A, Jones A, Tybout C. Does a formal exercise program in postmenopausal women decrease osteoporosis and fracture risk?. Evidence-Based Practice. 2019 Apr 1;22(4):29-31.
The chiropractor. A lot of people swear by chiropractic treatments as the only way they get relief from back pain, neck pain, headaches, and a host of joint problems. Others aren’t so sure about this holistic wellness discipline. Regardless of what camp you’re in, allow us to demystify this type of care for you.
Chiropractors Train as Long as MDs Do
That’s right, a Doctor of Chiropractic (DC) studies for four years of undergraduate and four years of chiropractic school, using similar books that MDs use for study, says Scott Bautch, DC, president of the council on occupational health for the American Chiropractic Association. Chiropractors must also pass a licensure test and take continuing education courses to stay abreast of the latest trends in their field and maintain their credentials.
Chiropractors Can Help with Overall Wellness
People mostly see chiropractors for pain relief, but it’s becoming more popular to see a chiropractor for general wellness. “Chiropractors are increasingly becoming overall wellness advisors — advising patients about their eating , exercise, and sleeping habits,” Bautch says. Since chiropractors focus on the health of the nervous system, particularly the spinal cord, they are treating the entire body. Therefore, they are addressing both acute injuries (such as low back pain), as well as general, chronic issues (such as fatigue).
The First Appointment Will be Really Thorough
Chiropractors use comprehensive intake screenings to learn not just about what ails you, but also to get a complete picture of your overall health (hence the “holistic” descriptor). This will include health history questionnaires as well as functional and neurological assessments to see how your body moves, how well you can balance, etc. The doctor may also take x-rays. Finally, there will be a discussion about cost and course of treatment.
This thorough first appointment was experienced by New York City resident Karl Burns. In a tennis game, Burns swung his racket too forcefully and injured his low back. He was referred to chiropractor Cory Gold, DC. “At first, I thought, ‘I’ve never been injured before, I don’t need a voodoo doctor,’” says Burns. “But Dr. Gold and I immediately gelled. After many tests and questions, he told me, ‘Your treatment plan will be three times a week for a couple weeks, then two times a week for a couple weeks, then once a week — this is not a lifetime injury.’”
You’ll Likely Be a Regular, Initially
In most cases, people see chiropractors for acute injuries (like throwing your back out) or chronic conditions (like headaches), so it may take a few of weeks of multiple visits to stabilize the problem. After a few weeks of multiple treatments per week, treatment tapers gradually to once per week, then once per month for maintenance, until the spine is able to stay in alignment without the chiropractor’s adjustments. The course of treatment and length of time until stabilization vary from person to person.
That said, visits are often quite short — an average of 15 to 20 minutes — of hands-on manipulation. “Chiropractors aren’t trying to fight an internal battle against infection the way medical doctors are,” says Burns. “The treatment consists of much smaller movements and adjustments to your body and alignment of the spine.” Burns points out that he experienced pretty significant pain relief from the get-go. “Every time I walked out of there, I felt amazing,” he says. “The benefits are instant and can be perceived better [than with conventional doctors].”
You Won’t Be a Patient Forever
There’s a general belief that chiropractors want to make you reliant on them, but Bautch and Burns believe otherwise. “There are three phase of care,” Bautch says. “Acute — let’s get you functional; corrective — let’s adjust you so that it doesn’t happen again or as frequently; and then maintenance — maybe down to once a month.” Indeed, this is what Burns experienced — but he also learned the hard way the importance of self-maintenance. “Chiropractors take the approach of ‘let me teach you how to fish,’ not ‘let me just give you the fish,’” says Burns. He, like most patients, was given exercises to compliment and maintain his recovery — and he only ran into trouble again once he stopped doing them. “If I skip my exercises, sure enough, my lower back gets tight,” Burns says.
Bananas are an excellent source of vitamins, fibre, and Potassium!
3 Cups mashed bananas 1 ½ Cups brewed coffee 6 Cups flour 6 Tsp baking powder 1 ½ Tsp baking soda 1 ½ Tsp salt (use less if you are using salted butter) 1 ½ Tsp nutmeg 1 ½ Cups unsalted butter melted and at room temperature 2 ¼ Cups granulated sugar 6 Eggs 6 Tsp vanilla 1 ½ Cups toffee bits Instructions:
Preheat oven 350 degrees. Grease 3 9×5 loaf pans. Stir coffee and banana together. Wisk dry ingredients together. Stir butter and sugar together, add eggs one at a time, then add banana mixture. Gradually add flour mixture and ½ the toffee bits. Pour batter into pans and place in centre of oven. Bake for 25 minutes then add the remaining toffee bits to the top of the loafs and bake for a further 20 minutes.
For individuals who are obese and trying to lose weight, or anyone looking to keep the weight off, the ACSM recommends bumping this number up to 200–300 minutes per week (3.3–5 hours). Breaking this down, a one-hour walk 4–5 days per week will be sufficient to achieve your weight-loss goals. Any additional time you spend exercising on top of this adds to your overall calorie burn and fitness level.
If you decide to up the intensity — either by adding resistance training in the form of weights or including short periods of running — exercising at a vigorous activity level (70–85% of your maximum heart rate) requires the duration of your walk to be cut in half to achieve the same benefits. In other words, a 60-minute moderate-intensity walk is the same as a 30-minute walk/run at a vigorous intensity level.
The most accurate way to measure intensity level is to use a heart rate monitor, but you can also keep track of perceived exertion. On a scale of 0–10 (0 is sitting, 10 is the highest exertion possible), moderate intensity is a 5–6, and vigorous activity begins at 7.
Calculating and recording your daily steps, mileage, time and exercise intensity is all important when you’re trying to lose weight. But the last part of the equation — nutrition — is equally crucial. Logging your food intake with MyFitnessPal as well as your workouts can help you get a more accurate picture of the quantity and types of foods you’re consuming. That way you can make informed decisions regarding smarter portion sizes and where you can cut excess calories to find a healthy deficit that allows you to lose weight and keep it off.
THE BOTTOM LINE
Start by walking a little more than you normally do each day until you can do an hour or more 4–5 times per week. If you keep to a brisk pace and pay attention to your nutrition, you’ll set yourself up for effective weight loss.
An estimated 66% of the population will suffer from neck pain in their lifetime (1). Neck pain is one of the most common musculoskeletal conditions treated by healthcare professionals. Often patients will report pain due to sleeping awkwardly, turning their head too fast, or reaching for something overhead. Whatever the mechanism, neck pain accounts for a significant proportion of sick leave, healthcare costs and lost productivity. Chiropractors have been at the forefront of treating neck pain for decades, and the results speak for themselves.
What does the evidence suggest?
Previous systematic reviews on chronic mechanical neck pain have provided substantial evidence for the effectiveness of chiropractic care. Both spinal manipulation and mobilization have been shown to be a viable option of care as compared to other standard treatment methods (2).
A recent systematic review by Coulter et. al. compared spinal manipulation and mobilization to other active modalities such as acupuncture, massage, and exercise to name a few (3). The study looked at patient outcomes such as pain, disability and health related quality of life (HRQol). They found that many previous reviews regarding non-specific neck pain reported evidence in favor of manipulation and mobilization. Other reviews concluded that manual therapies in conjunction with exercise provided superior results as compared to manual therapy alone (4).
As with many musculoskeletal conditions, it appears that a multi-modal approach is best. At this point in time, there is moderate evidence to support manipulation and mobilization for the treatment of chronic nonspecific neck pain in terms of pain and function. It appears that some movement and active rehabilitation is better for patient recovery then complete rest. More studies are still required to look at the benefits of chiropractic manual therapies long term.
To some, these conclusions may not be overwhelming, but research like this is what continues to carry the chiropractic profession in a positive direction. It is exciting to know that chiropractors and researchers alike are looking into the efficacy and safety of chiropractic care so we can better treat our patients and our community.
If you or someone you love is suffering with lingering neck pain, it may be time to schedule a comprehensive chiropractic exam to get to the root of the problem. As always, if you have any questions please do not hesitate to contact me at email@example.com or visit my professional Instagram page @drkylearam.
1. Cote P, Cassidy JD, Carroll L; The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976) 1998; 23:1689-1698
2. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: A systematic review and best evidence synthesis. Spine J 2004; 4:335-356.
3. Herman, P. M. (2019). Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician, 22, E55-E70.
4. Brison RJ, Hartling L, Dostaler S, LegerA, Rowe BH, Stiell I, Pickett W. A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine 2005; 30:1799-1807.