My top 10 ways to promote health, wellness, and disease risk reduction (part 1).
Subject: Health (Methods)
Pub Date: 04/01/2012
Publication: Name: CANNT Journal Publisher: Canadian Association of Nephrology Nurses & Technologists Audience: Trade Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2012 Canadian Association of Nephrology Nurses & Technologists ISSN: 1498-5136
Issue: Date: April-June, 2012 Source Volume: 22 Source Issue: 2
Geographic: Geographic Scope: Canada Geographic Code: 1CANA Canada
Accession Number: 295433795
Full Text: Dear Green Tech,

At last year's CANNT conference you did a presentation about your mean, green vegan diet and lifestyle, and your reasons for becoming a vegan. I was wondering if there was anything else lifestyle-wise that you could add in order to improve my current state of health and wellness, and reduce my risks of disease.

Sincerely, Val from Vaughn

Dear Val,

Spring is here and what better way to kick-start the season of blooming buds and sunshine than with a cleansing detox? When we last met up with our fearless healthy superhero, he was presenting at CANNT 2011 (an awe-some conference for those who missed out). He spoke about his life, his reasons for becoming a vegan, and how that life-style has changed the lives of countless others by eliminating disease. I know it's odd speaking about myself in the third person, but Reg does know a thing or two about green living. Instead of revisiting the entire presentation, I will use it as a springboard for this column and provide you with a top 10 list of ways to improve your life and health, starting immediately.

The term vegan has long been associated with animal rights and the avoidance of any animal-based products (food, clothing, etc.). But there is a new focus on the term, one based on eating a diet composed mainly of plant-based and whole foods. Experts such as Dr. Neal Barnard, Dr. Colin Campbell, Dr. Caldwell Esselstyn, Dr. Joel Fuhrman, Dr. John McDougall and Dr. Dean Ornish believe that the majority of the degenerative diseases we see in the 21st century are linked to the consumption of animal-based and processed foods. By removing these foods from your diet, they would argue that you can reverse and even eliminate diseases. This was the subject of the recent film documentary, Forks over Knives. In this film, Doctors Esselstyn and Campbell prove their point that conditions such as cardiovascular disease can, in fact, be reversed through diet. Living this new lifestyle brings its own term--a nutritarian. The body is an amazing thing. It truly has the ability to heal itself, but can only do so if given the right ingredients to function.

In dialysis populations, diabetes is a very predominant chronic disease. Why does this play a huge factor for us in nephrology? Well, nearly half of new patients in every dialysis clinic have come our way as a result of having diabetes. That equates to one in three people with kidney failure having diabetes. Based on a new report from the Canadian Institute for Health Information (CIHI) in January 2011, our population of dialysis patients has tripled over a decade from 11,000 in the year 2000 to 38,000 in 2009. Diabetes is a disease with its primary cause centred on diet and life-style, and prevention is key. The evidence is clear on the fact that diabetes can be managed, in part, through changes in our diet (Barnard et al., 2006). The great thing is that this can be done quite simply and without taxing an already burdened health care system here in Canada.

It's not only diabetes we see on the rise as a result of our lifestyles. The incidence of many diseases such as cancer, Alzheimer's, obesity, and cardiovascular disease are on the rise and also have a direct link to lifestyle and diet. It has been suggested that small diet changes can make an impact on cancer prevalence. We encounter toxins every day through the things we drink, the air we breathe, and the foods we eat. Our bodies become completely burdened and overwhelmed by this toxic overload, leading to inflammation, one of the main factors that has been implicated in disease.

Now it's time for the drum roll please (cue the drummer DDRDRDRRDR). Here are the Green Tech's Top 10 ways of detoxifying your life and improving your overall health.

1. Drink more water:

Our body is made of up to 60% water, so it's a no brainer that we need it in our lives and without it, well, we wouldn't last long. We need it for burning calories (it takes one millilitre of water to burn one calorie), and for every single chemical reaction and function our body carries out. Sadly, many of us are in a constant state of dehydration. Is this you? Always tired, sluggish, always needing that caffeine high to get out the door, always opting for your comfort foods in place of fruit, and you just can't seem to lose those last 20 pounds? Well thankfully, there is a way out and a way for you to iumpstart your day.

So here is how you can determine how much water you need to consume. Take your body weight (in my case 162 lbs), divide that in half (81). This is the number of ounces of water needed daily.

Finally, divide that by eight, giving you the number of glasses needed daily--for me, that works out to approximately 10 glasses. You may need to warn your manager that you may need extra bathroom breaks as a result, but you will feel like a million bucks.

[ILLUSTRATION OMITTED]

But what if you hate the taste of water? Here are a few tips: Within 15 minutes of waking each morning, drink a glass of warm water with freshly squeezed lemon juice, which helps to detoxify your liver and kick-start your body. You can also add frozen fruit to your water to add flavour. You can drink herbal teas, many of which are fabulous. Try having fruit daily, many of which are 90% water this will also help you meet your daily requirements. If you have to drink coffee, keep in mind that even though coffee and black teas are high in antioxidants, they are diuretics and you need to replenish the water loss that they will cause.

2. Eat more raw, organic, plant-based foods

In order to be healthy you have to eat healthy. Eating foods high in antioxidants like fruits and vegetables reduces the oxidative stresses of daily life on our bodies. Consuming alkaline vegetables like spinach and kale, or really any green vegetable, will help improve your pH, for, as some believe, those of us who are suffering from an illness are likely in an acidotic state.

The biggest area of concern when eating vegetables and fruits is where they come from, i.e., how they are farmed. Eating organic foods will help reduce your exposure to toxic pesticides and herbicides due to the fact that they have not been sprayed with commercially used toxic chemicals to keep away the pesky bugs and weeds. As a line from the iconic Joni Mitchell tune Big Yellow Taxi says, "Hey Farmer, put away that DDT now, give me spots on my apples, but leave me the birds and the bees. Please!" (1970).

There is reportedly a link to chronic diseases and the consumption of foods sprayed with synthetic fertilizers and pesticides. The use of organophosphates like parathion, malathion and diazinon as insecticides have a direct link to diseases such as ADHD in children, Alzheimer's disease, and various other neurological disorders due to their neurotoxic effects. Ever heard of the nerve agents sarin gas and VX? The same chemicals used in chemical warfare and terrorist attacks? Well they are in that same family of chemicals. This group of chemicals inhibits the enzyme acetylcholinesterase from doing its job with respect to nerve function. Once it deactivates, unfortunately, you can't switch it back on. So if it's used to kill bugs, what do you think it will do to us? Commonly sprayed produce are: corn, apples, pears, grapes, and peaches. Keep reading, as I have a special surprise below.

Now that we have covered the nasty bits of conventional agriculture, let's look a bit more into organic farming. It utilizes a variety of ecological farming practices that work to conserve the soil's nutrients and effective growing capacity. Here is the Wikipedia definition of organic farming: "Organic farming is the form of agriculture that relies on techniques such as crop rotation, green manure, compost and biological pest control.

Organic farming uses fertilizers and pesticides but excludes or strictly limits the use of manufactured (synthetic) fertilizers, pesticides (which include herbicides, insecticides and fungicides), plant growth regulators such as hormones, livestock antibiotics, food additives, genetically modified organisms, human sewage sludge, and nanomaterials" (Wikipedia, n.d.).

Over the years, we have seen huge problems with soil erosion and desertification as a result of conventional farming practices, which organic farming helps to prevent. In addition, organic farming promotes and protects our crop biodiversity, something that has been under attack since the creation of genetically modified/engineered foods, which I will further discuss in section five.

By eating organic foods, you are also helping promote a local economy. Purchasing organic foods pays the farmer directly and, in theory, it's like the WestJet model of business. Everyone is an owner. You do pay a little more for organic foods, but they are well worth the price. You pay the true cost of the item. An everyday deal is likely not a deal at all. Cheap food is cheap for a reason!

Eating more raw and organic foods also helps us with intake of vitamins, minerals, macro nutrients and amino acids at their highest levels, as a great deal of nutrition is lost when heating foods. Try to incorporate some raw foods with every meal, such as fresh fruits, salads and smoothies. One easy way to remember this is to eat a rainbow every day--incorporate vegetables and fruits of different colours in your diet.

A couple of great tips when shopping for your produce are to recognize fruit and vegetable label numbers, and to remember the dirty dozen. Starting with product labels--there is a sticker affixed to every produce item, upon which a code is listed. It's that code that either you or the cashier will use to key in that item upon point of sale. The code will either be a four-or five-digit code. If it is a four-digit number, the food is conventionally produced. If it is a five-digit number beginning with an eight, it is genetically engineered (GE). If it is a five-digit number beginning with a nine, it is organic. But be forewarned that GE produce has voluntary labelling. Therefore, they may not, in fact, be labelled as such. The same applies to products that contain any sort of GE ingredients. Remember that point, as I will be bringing this up again in section five.

Secondly, I mentioned the dirty dozen. No, I'm not talking about the awesome 1967 war movie starring Lee Marvin, Charles "Death Wish" Bronson, and Ernest Borgnine. The dirty dozen I am referring to is the list of 12 produce items that you should buy organic no matter what. Now I know that I mentioned that organic foods cost more, but the cost saver with the plan is that there is a secondary list of produce items that you don't need to buy organic, therefore saving cash. The Environmental Working Group, a U.S.-based environmental advocacy group, has compiled a shopping guide that you can use when purchasing produce and what to purchase either organic or conventionally grown. This guide can be found and downloaded at the following website: http://vvww.ewg.org/foodnews/summary/

A few items that are not listed in the dirty dozen that should also be mentioned due to their extremely high level of pesticide residues are coffee, chocolate, conventionally-raised meat, dairy, and wine. So when you can, try to purchase organic versions of those items as well. For more information on the EWG and your food choices, visit http://www.ewg.org/foodnews/. A very wise man once said, "Let thy food be thy medicine and thy medicine thy food." You may have heard of him Hippocrates.

3. Stop cooking in non-stick pans and no microwaving:

How cool is it to not have to scrub your pans after cooking those scrambled eggs? Well, not really cool at all. Many manufacturers of non-stick cookware use a chemical called perfluorooctanoic acid or PFOA. It is branded as a healthier alternative to cooking with oil. Sadly, however, it is another lab creation gone wrong and one that has put us at serious risk of cancer. The U.S. Environmental Protection Agency (EPA) has listed PFOA as a likely carcinogen and has asked the makers of the Teflon brand product line (DuPont) and others to remove it from their products. PFOA has also been linked to immune system dysfunction and a variety of other conditions like reproductive disorders and infertility. The EPA did a study and found that nearly all Americans have PFOA in their body (Calafat, Wong, Kuklenyik, Reidy, & Needham, 2007).

The other big concern is that PFOA is not just in cookware, but is also found in many other areas of our lives. We find it in many items that are being sold as waterproof or a water repellent like Teflon [R], Scotchguard [R], and Gore-Tex [R]. There are many alternatives to PFOA such as stainless cookware, new ceramic coated greenware, and even the old-school cast iron plates (also a great way to get some daily iron). For more information on the various cookware options available and their pros and cons, visit this Health Canada link: http://vvvvw.hc-sc.gc.ca/hl-vs/iyh-vsv/prod/cook-cuisinier-eng.php. Keep your cooking green and you'll be infusing so much more love in that food than ever before!

Microwave ovens have been around for decades and can be found in almost every kitchen today. Originally designed for the military, microwaves were branded as a way to reheat yesterday's supper and to help those busy families prepare food on the go. Sadly, whatever convenience it may give us, some argue that we lose more in the end with respect to nutrition. And while there are differing opinions on this topic, if you ask me, the best thing to do is to disconnect that microwave and store it in the garage. Plug it in and use it to disinfect your washcloths and sponges, and nothing else. How do you do without the convenience? A few tips to keep in mind are to try and cook enough food for the mouths you are feeding and not more, or just throw all those leftovers in a pan and create a fantastic new supper creation. Try to pack lunches that don't need reheating, opting for more raw options like salads, veggies and dip and wraps, just to name a few. If you need to eat on the go, why not quickly mix up a protein shake with some great Vega protein powder or another whole-food brand to hold you over until you can grab something more nutritious.

4. Ditch the cans and other plastics:

Canned beans and your favourite canned sudsy beverage are mandatory items for your summer camp-out. However, there are some real problems with those cans and their linings. Nearly all cans contain a chemical called bisphenol-A or BPA, which is one of the key ingredients in the epoxy resin used to create the protective lining. BPA is also used in the manufacturing of polycarbonate plastics (plastics with the #7) those found in clear, hard beverage bottles such as water and baby bottles. It is also found in the toner coatings of cash register receipts, on drinking glasses and many more items. In the dialysis world, it is found in every dialyzer, contained in the epoxy resin glue for the potting compound and headers and the polycarbonate housing. (Until recently that is but more on that later).

A few years back, Health Canada listed BPA as a health toxin, and was the first country to do so worldwide. This led to the ban and the recall of thousands of baby bottles. It also resulted in the recall of many plastic sports water bottles during that time. This single-handedly eliminated polycarbonate plastics from food and beverage containers. In addition, last year Canada released findings of its health measures survey and discovered that nearly all Canadians aged six to 79, (about 91% of us), had measurable levels of bisphenol-A in their urine. That means we are all at risk!

I know I have provided the "what happened" and the "what it is", but you want to know the "why it's so bad" and, more importantly, "how do we ingest it". Well, the big issue with BPA is that it has been linked to numerous adverse health effects, the most serious being that of birth and developmental effects in infants and children. It has also been linked to obesity, diabetes and many other diseases. It is an endocrine disruptor, as it is an artificial estrogen. So, by exposing ourselves to BPA we may put our endocrine system out of whack. BPA is ingested either by heating of food or contact with fats. For example, when we heat up a baby bottle in polycarbonate plastics, the BPA leaches out due to the heat, and since baby formula contains milk ingredients, which contain various fats and oils, they also act to leach the BPA into the food. A double-whammy! You can find all the information relating to the health risks of BPA at this Health Canada link: http://www.hc-sc.gc.caffn-an/securit/packag-emball/bpa/index-eng.php

The other nasty plastic, which is even more of a concern than polycarbonate, is polyvinyl chloride or PVC (#3 plastics). PVC is found in everything from flooring, dialysis chairs, dialysis tubing, saline bags, shower curtains to toys and more. PVC and polycarbonate plastics have a direct link to one another in that they both contain chemicals that are known endocrine disruptors. In the case of PVC we have another group of plasticizers called phthalates. Phthalates are used in making of PVC, to allow it to be softer and more flexible. They are also used in personal care products, and are typically part of the "fragrance". The most common bad dude we run into in our line of work is DEHP. It is what gives our saline bags and blood that flexibility. Phthalates have been linked to organ system toxicity, reproductive and fertility issues in men, brain and nervous system, and immune system dysfunction (Environmental Working Group, n.d.).

The other big issue with PVC is that the base chemical--vinyl chloride--is a known carcinogen. Most of the products we come across in health care and in our dialysis units are deemed biohazard products and, when incinerated produce a new problem called dioxins--another carcinogen--that pollute the air we breathe. Luckily it is illegal to incinerate PVC in Ontario, so our biomedical waste is autoclaved and landfilled instead.

We have discussed how PVC can affect us. What about dialysis patients? To them, this is even a much greater concern since they come into direct contact with these items via the dialyzer and blood tubing for countless hours with dialysis. Moreover, without urine output, patients are more at risk of accumulation. Things are a-changin' in the world of blood lines and dialyzers. We now have DEHP-free blood lines for use on nearly every model of dialysis machine. We also have an option for dialyzers. as this was the missing link for years. Baxter's new Xenium+ line of dialyzers are North America's only DEHP-and BPA-free dialyzer. When I heard this news I freaked out and did my totally awesome green dance. So, do your due diligence and make these items "must haves" as part of your unit's ancillary product list, and consider this when negotiating contracts and future RFPs if you haven't already done so. Consider your patients' well-being--they are part of our extended family and should be treated as such.

The health risks aren't just with #7 plastics, but with all plastics. The term "microwave safe" just means it won't melt. Have you ever noticed the stained colour or rough surface of those Ziploc containers that contained spaghetti and meatballs? That is your evidence that they have leached out plasticizers. The biggest thing to keep in mind is that all plastics are made from oil and oil of any kind that comes into contact with them will leach out plasticizers. Recycle those plastic containers, or reuse them for other things like nails or dry goods.

My tips: Use glass, ceramic or stainless steel containers. Glass will forever and ever be the "in" thing. Glass has thankfully made a huge resurgence, and bottles, jars and storage containers are perfect for storing your juices and left-overs. When you are out getting your groceries, purchase as many items as possible in glass beer and wine included. Never buy PVC again and if you need plastics around the house, make sure that you only see the numbers 1, 2, 4 or 5 listed the fewer the better. Be a well-informed shopper. Ridding yourself of all plastics is impossible but, as someone who has done their homework and knows all the facts before going out and purchasing items, you are now provided with the tools to make much better purchasing decisions for yourself, your family and your unit.

So that covers sections one through four. Stay tuned for more with sections five to 10 in the next issue.

For more information on any of the above diets or lifestyle changes, or if you need support, feel free to contact me at regq101@gmaiLcom.

Thanks and remember to keep it green, eh! You'll thank me for it!

Sincerely, Rejean "Green Tech" Quesnelle

References

Barnard, N.D., Cohen, J., Jenkins, D.J.A, Turner-McGrievy, G., Gloede, L., Jaster, B., ... Talpers, S. (2006). A low fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with Type 2 Diabetes. Diabetes Care, 29(8), 1777-83.

Calafat, A.M., Wong, L., Kuklenyik, Z., Reidy, J. A., Needham, L.L. (2007). Polyfluoroalkyl chemicals in the U.S. population: Data from the national health and nutrition examination survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000.

Environmental Health Perspectives, 115(11), 1596-1602.

Environmental Working Group (n.d.). Chemical families: Phthalates. Retrieved from http://vvww.ewg.org/chemindex/term/480

Mitchell, J. (1970). Big Yellow Taxi. On Ladies of the Canyon. [Vinyl] Los Angeles: Reprise.

Wikipedia online (n.d.). Organic farming. Retrieved from http://en.wikipedia.org/wiki/Organic_farming

RELATED ARTICLE: Notice board

* Ottawa Supper Clubs Contact Janet Graham, Nephrology Unit, Ottawa Hospital, jgraham@ottawahospital.on.ca

* September 1, 2012. Registration time begins for the Nephrology Certification Exam. Contact Canadian Nurses Association Certification Program, e-mail: lvachon@cna-aiic.ca. Website: www.cna-aiic.ca. Toll-free phone number: 1-800-450-5206

* September 9-12, 2012. 14th Congress of the International Society of Peritoneal Dialysis (ISPD), Kuala Lumpur, Malaysia. Website: www.ispd2012.org.my

* September 15-18, 2012. 41st EDTNA/ERCA International Conference, Convention Centre, Strasbourg, France. Website: www.edtna-erca-conference2012.com

* September 19, 2012. Nephrology Health Care Professionals Day.

* September 28-30, 2012. ANNA Fall Meeting for Nephrology Nurses, Managers, and Advanced Practice Nurses, Palmer House Hilton, Chicago, IL. Website: www.annanurse.org

* October 15, 2012. Deadline for applications for Allied Health Research Grants, Kidney Foundation of Canada. Contact: Coordinator, Research Grants and Awards, 1-800-361-7494, ext. 232. E-mail: research kidney.ca. Website: www.kidney.ca

* October 25-27, 2012. CANNT 45th National Symposium. Ottawa, Ontario. Conference Planner: Heather Reid. E-mail: hreid@innovcc.ca. Website: www.cannt.ca

* March 10-12, 2013. Annual Dialysis Conference 2013, Seattle, WA. Website: http://som.missouri.edu/Dialysis/

* April 21-24, 2013. ANNA 44th National Symposium, Rio All-Suite Hotel Casino, Las Vegas, NV. Phone (888) 600-2662, Fax (856) 589-7463, Website: www.annanurse.org

* April 20, 2013. Exam date for CNeph(C) certification examination.

Contact Canadian Nurses Association Certification Program, E-mail: certification@cna-aiic.ca. Website: www.cna-aiic.ca. Toll-free phone number: (800) 361-8404

* September 27-29, 2013. 15th Congress of the International Society of Peritoneal Dialysis (ISPD), Taipei City, Taiwan. Website: www.ispd2012.org.my

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