New to 2010 is Dr Oughtred’s annual health assessment: a comprehensive health assessment that includes a medical assessment, a physical therapy type of assessment, and a fitness and lifestyle assessment. Patients will receive a 15 page booklet outlining and explaining their results, and it comes complete with a comprehensive plan that includes dietary recommendations, supplement and medication recommendations, exercise programs and tips, stretching advice, or recommendations for physical therapies or other hands on techniques.

The center piece of your assessment is the summary page, which quickly displays and colour codes your results alongside your recommended goals for the following year. This page gives you a comprehensive, yet simple ‘snapshot’ of your current state of health and fitness, and can act as a great motivator for the future.

For those of you who have extended medical insurance, your coverage will likely cover you for all, if not part of the assessment.

Assessment overview:

• Review and assessment of your current and past health concerns
• Relevant physical examination
• Orthopedic Assessment (Joint Alignment, Range of Motion, Posture, Strength, Stability)
• Fitness Assessment (Everything from grip strength and body fat to cardiorespiratory fitness and lactate threshold testing)
• Nutritional and Lifestyle Assessment
• Disease Risk Assessment (Framingham score, diet, biometrics, other)
• When indicated, referral to other health professionals, physicians or laboratories.

Your assessment acts like an annual membership, and you will be reminded when you are due for follow ups and important preventive medical screening tests and visits.

For fitness enthusiasts, the process involves measurement of lactate thresholds for precise assessment of endurance over time and selection of future training intensities. For those who want to manage their disease risk over time, the assessment gives you a framingham score, estimating your 10 year risk for developing coronary artery disease. This is the perfect annual health screen for someone who is looking for an executive health assessment with a strong focus on fitness, lifestyle, and athletic performance. Together with the advice and medical testing of your family doctor, your assessment will leave you feeling as though no ’stone is left unturned’ with regard to your health.

Aside from your assessments with your medical doctor, all parts of your annual assessment are performed by Dr Oughtred himself which provides for a 5-star professional experience which you won’t forget. Take the time for your assessment now, and see what new avenues of health open up for you.

The 2 supplements that I recommend the most are Fish Oil and Vitamin D. Lately, its seems that the evidence for supplemental Vitamin D is mounting at a rapid rate, and I thought it would be appropriate to write about it.

Vitamins are called vitamins because our body’s cannot function without them – they are vital to life. Almost all of them have to be consumed in the food we eat, or we will get deficiency syndromes and die. Vitamin D is different; our primary source of vitamin D is from the sun.

Vitamin D functions as a hormone in the body, which makes it unique from other vitamins. The human body can make it, but unfortunately it needs a little help to be switched on. This is the where sunlight comes in; circulating vitamin D close to the surface of the skin is altered by the sun’s radiation, converting it from D2 to D3, the active form of the vitamin.

The active form of Vitamin D governs the absorption and metabolism of Calcium in the body, and calcium is used by all cells in the body. Thus it allows for proper functioning of the entire body, but in particular the immune system, the nervous system and the skeletal system allowing for strong bones and teeth.

Right now, research is demonstrating that lower levels of Vitamin D are associated with a variety of problems. For instance, experts agree that the increased incidence of Multiple Sclerosis and other autoimmune conditions at higher latitudes is at least partly due to a lower supply of Vitamin D from the sun. People with darker skin who live in higher latitudes are more susceptable to deficiency because dark skin acts as natural sunblock, and prevents the activation of Vit D. It is no coincidence that people with lighter skin live at higher latitudes.

It’s a catch 22: direct sunlight can lead to skin cancer, and the lack of direct sunlight can lead to more cancer, weak bones, insomnia, dementia, autoimmune disease and who knows what else. I don’t recommend tanning beds because it is too easy to burn your skin with them. Dietary sources of Vitamin D are usually not adequate on their own.

The solution is to either supplement your sunlight or supplement your diet. You would need at least 30 minutes of direct sunlight sunlight on at least 3 days of the week to get it from the sun, and even with that amount you are not guaranteed optimal intake. Because I live in Vancouver, where sun is hard to find in the winter, I recommend supplementation for most patients. Walter Willet from Harvard’s school of public health recommends 1000 IU for all people, regardless of where they live, and he says that the recommendation may increase pending further research. I recommend 1500 IU per day during the dark winter months and 1000 IU per day during the brighter/ sunnier months. When in doubt with your dosage, you can have your blood tested to fine tune your optimal dosage. I shoot for 60-100 pmol/L with my patients.

Review:

Supplement 1000 IU – 1500 IU Vit D per day, or ensure > 30 minutes of direct sunlight on 3 or more days of the week.

If in doubt, have your Vit D levels tested to see what your optimal intake is.

Professor Gilbert Welch, MD, wrote a very interesting article in the New York Times recently about the current state of preventive medicine and how it pertains to the US presidential campagnes.

Today, Preventive Medicine should really be called early disease detection.  People are encouraged to come in to see the doctor at various ages in order to make sure they don’t have an illness that they are unaware of.  This approach is effective at detecting some diseases before they are out of control, but it does little to prevent disease and it ends up costing us more money.

In contrast, health promotion prevents disease.  The best preventive medicine involves educating patients (the word doctor means teacher) about how to care for their bodies, eat properly, exercise properly, and encouraging them to adopt healthy lifestyle habits and a positive outlook on life.

So next time you hear someone talking about preventive medicine, you may want to clarify: are they talking about disease detection or are they talking about promoting health so that disease is less likely to occur.

At his medical practice at the Sage Clinic in Vancouver, Dr Oughtred emphasizes health promotion, disease prevention and the enhancement of athletic performance.

St John’s Wort Shown shown to be effective for depression

-The herb St John’s Wort has shown to be better than placebo, comparable to pharmaceutical antidepressants in effectiveness, and has less side effects than standard antidepressant medications.  This from a recent Cochrane review that compared 29 scientific studies with over 5,000 patients.

Ginko may offer protection from the damaging effects of Stroke

-The herb Ginko Biloba, well known for its ability to promote vascular health, has been shown to mitigate the brain damage in mice who have had a stroke.  Researches showed the herb to be effective if used both before or after a stroke.  This recently from the journal, Stroke.

Pregnant women may be gaining too much weight

-A recent study published in the Journal of the American Dietetic Association suggests that habitual dieters and overweight women were more likely to put on too much weight during pregancy.  The authors suggested that these women may be looking at pregnancy as an excuse to eat whatever they want, and should be instructed not to increase their caloric intake during the first trimester of pregnancy.

Topical Antioxidants may Prevent Skin Cancer

-In September’s issue of the American Academy of Dermatology, an antioxidant cream containing Vitamin C, E and ferulic acid prevented skin from burning, an established cause of skin cancer.

More Links Between Low Vit D and MS

-The evidence for supplementing with Vit D is becoming overwhelming.  Now the question is, how much should you take?  Your health care provider can do diagnostic tests as well as functional tests to help you choose your best dose.

Acupuncture More Effective than Medications for Hot Flashes

-Dr. Eleanor Walker and researchers of Henry Ford Hospital in Detroit found that acupuncture was just as effective as medications used to treat hot flashes in breast cancer patients, and the effects lasted longer without the negative side effects.

Eating fish can prevent eczema in children

-A recent finding the British Medical Journal states that fish consumption in children before the age of 9 months is associated with less cases of eczema.  Fish, a common aldult allergen, is often avoided at such an early age in infants because it is thought that allergies to fish could be result in later life.  Whatever the reasons, it appears that small amounts of fish before the age of 1 may be a good idea for your infant.

Do doctors have time for empathy?  Does it improve outcomes?

-The answers are yes, and yes.  This was an interesting article in the New York Times written by a medical doctor, reviewing the benefits of taking short periods to express empathy for their patients in their busy schedule.  This article is a reminder the of the importance of the doctor-patient relationship, and the positive effects that it can have for the health of patients.

Health on the Web

-An interesting article in the New York Times that outlines 6 intersting, online health resources.

Cortisol Levels Linked to Antisocial Behavior

-University of Cambridge researchers have been able to show that teenaged boys who lack the normal surge in the stress hormone cortisol, experience more antisocial behaviors.  This is an interesting finding because Naturopathic Physicians have been marginalized over the years by the medical community for its philosophies and treatment strategies around this hormone.  The idea that the adrenal gland (the main producer of cortisol in humans) could be weak in some patients, seemed to be far fetched.  I look forward to more research on Corticol and behavior.

Aerobic exercise may prevent age related changes in the brain

- The research to support the benefits of exercise continues to mount, this time in support of enhanced cognition and executive function in the aging brain.  With all of the positive research findings for exercise, you would think people would become more active, but that is not the case.  Perhaps some of that research should move toward discovering the best methods to get our society more active; telling people that exercise is good for them is clearly not enough.