Thursday, December 23, 2010

Winter Squash, A Healthy Choice for Cold Weather

Late in the summer and early in the fall my favorite fruit of all begin to ripen on the vine. In my early 20’s, I was a member of a CSA farm in my home town, and it was there that I acquired my love for this beautiful plant. I loved walking in the fields and seeing these last holdouts, when all the glory of the summer months had been cut down, the sun threw longer shadows, and the wind began to bring a bite. As one of the foods that inevitably begs the question, ‘Is it a fruit or a vegetable?’* winter squash is one of my favorites because it seems the perfect food for winter.

First of all, winter squash keeps well when put in a root cellar. While this is no longer a concern for us in the age of refrigeration, for our ancestors this was a blessing, as it meant they would have full bellies until spring. Even for us, winter squash is the gift that keeps on giving, as it will stay fresh in a refrigerator for months, thus providing last summer’s bounty deep into the new year.

Secondly, squash is hearty. Heavy and dense, rich in fiber, a good winter squash pairs well with dairy and can easily find its way into soups or savory pies. Again, though this was more necessary in ages past, when you needed rich foods to survive a harsh, snowy winter, it can keep us modern folk warm and satisfied throughout the winter. There’s truly nothing like a bowl of hot butternut squash soup when you come inside from the biting cold.

Finally, winter squash is rich in beta-carotene, a plant compound that your body turns into vitamin A. I think that this is one of the truly brilliant features of squash. Traditionally, winter is a time to store fat, and vitamin A is a fat-soluble nutrient, which helps to protect those fats from oxidation, as well as being on hand for other uses. Additionally, as beta carotene is water-soluble, your body simply gets rid what it does not need.

To further interest and inform, let me mention that winter squash comes in a stunning variety of shapes and sizes. Butternut squash is the best known, of course. The little green Acorn squash is a New England favorite and roast or stuff well, as does the striped Delicata squash. People often think of Pumpkin for nothing except pie and jackolanterns, but the humble orange fruit makes an excellent soup. Finally, the Hubbard squash is for me an example of the prototypical squash; large, hearty, bumpy and rough, tough when raw but tender when cooked, the Hubbard squash is a beautiful example of nature’s bounty. Keep your eye out for others as well as you feast your way through the winter.

(*There are seeds inside, so therefore it’s a fruit.)

Friday, December 17, 2010

Health and the Holidays

For many Americans, December is for holiday parties, family gatherings, and then New Year’s celebrations. Unfortunately, it’s also a time that is stressful for a lot of them. For some, being with family brings up old issues and disagreements. For others, it’s being away from family that is so stressful. For still others, December is a constant fight with a rapidly expanding waistline.

What does this have to do with health? Funny you should ask… Health isn’t just physical, but emotional and psychological as well. The holidays (be they now, or at other times of the year) provide us with an opportunity to promote emotional health in the midst of the challenges. In some ways, the challenges remind us of the need for emotional health.

A teacher of mine gave all of his emotionally stressed patients the simple prescription, “Treat yourself gently.” This is has since become a mantra for me in my personal and professional life, and is never more applicable than at the holidays. A walk in the park, a quiet cup of tea, a moment to meditate, or playing an instrument are examples of what he meant. During the rush of travel, the chaos of a kitchen or the strife across the dinner table, these specific things may be hard to find, but there’s an easy solution – Treat yourself gently. Make allowances for your shortcomings and circumstances. Forgive yourself. Find something that works for you in your life and make time to enjoy it.

Friday, December 10, 2010

First in a Series

December 9, 2010

As my first ‘real’ post on my blog, I’ve decided to write on a subject that I plan on returning to many times in the future, that of evidence-based medicine (EBM) and naturopathic practice. While this is certainly a huge topic, and one that can hardly be laid to rest by a single clinician, I’d like to put my thoughts out there to encourage discussion and reflection.

I am asked about this topic very frequently, usually by people questioning the efficacy of naturopathic medicine and citing a relative lack of evidence. Over time, my response has developed and matured, and where once I would have brushed the question aside, citing the inherent superiority of naturopathic medicine, I have developed a much more ‘middle of the road’ approach to EBM, seeking to balance published evidence with clinical experience. This is a shift that I have seen many naturopathic students undergo. As one of my teachers loves to say, ‘There’s no place for dogma in medicine’.

The point I’d like to make today is this: I don’t think that the question ‘Is naturopathic medicine evidence-based?’ can be applied across the board. For example, naturopaths have long been advocates for healthy eating, including high fiber, low fat, low sugar, moderate animal protein, and above all, whole foods. In light of this, it is almost ironic to accuse naturopaths of operating without evidence, because this approach has been shown to be preventive against a broad range of diseases by some of the best-documented studies in the entirety of medicine.

On the other hand, some naturopathic methods, such as homeopathy, have traditionally performed poorly in scientific trials, despite considerable success in clinical care. Taking up the middle ground between these two extremes, we have both herbal medicine and nutritional supplementation. Supplementation is a bit of a battleground for research, with recommendations going back and forth with some regularity; a supplement is shown beneficial one year, then falls out of favor the next. Herbal medicine is an interesting case, because many herbs are now being studied for their effects at the cellular level, providing a level of knowledge similar to pharmaceuticals, but clinical trials still have not caught up. Because of this uneven-ness of evidence, many naturopaths simultaneously practice at both polar ends of the evidence spectrum, and all the way in between.

As I’ve tried to illustrate here, I don’t believe that evidence-based medicine is not an all-or-nothing situation, instead being a spectrum of evidence. This is true of traditional medicine just as it is of naturopathic medicine. In the future, I’ll talk more about my own approach to integrating evidence-based medicine into practice and the principles I use to guide me. The scientific method provides information, but it is ultimately up to the clinician to apply it in practice.

A Brief Note about the Picture

Earlier this year, I had the pleasure to travel in Eastern Europe, where I was able to visit a number of prominent sites in the history of medicine, including this beautiful spot, Lake Bled in Slovenia. Lake Bled, pronounced 'blayd', was the site of a spa established by Swiss naturopath Arnold Rikli in the 1850's. Currently, there are still a number of hot springs in the area, along with the iconic castle on a cliff. Here are a few pics:

Sunday, December 5, 2010


Welcome to the inaugural post of my blog, 'Meditations on Medicine'. I plan on posting here on a weekly basis on a variety of topics in medicine, spanning the width and breadth of this vast field. As a naturopathic doctor, I will be writing from the perspective of someone concerned with promoting the body's innate healing ability and traditional healing methods, but with a broad view, taking in the latest medical advances in treatment and diagnostics. I hope to make this helpful for both laypeople and medical professionals, and it will grow in time, as I learn and grow in my practice. Thanks for reading and stay tuned!