Medicine to Move You

Death by chocolate?  Well, maybe not so.  You may have heard that there is a saving grace in that luxurious, seemingly sinful, guilty pleasure called chocolate.  Well, here’s the latest scoop but I’ve kept it kiddie size.

Chocolate goodness starts as a sparkle in a cacao tree’s eye.  Cacao beans are carefully fermented, as they have been for thousands of years, to yield the less bitter, much better tasting cocoa.  Now, the next steps are what make it or break it for the health-promoting goodness of your favorite chocolate delight.  Dairy fat and sugar can be added in varying amounts by our ‘friends’ in the food industry changing the balance of power from the healing cocoa to the dangerous effects of the refined sugar and hydrogenated fats and oils.

So, the more pure the cocoa stays, the better it wards off high blood pressure and insulin resistance (conditions that 40% of American adults have and don’t even know about most likely).  The best advice is to select dark chocolates with a minimum of 70% cocoa and chocolates that list cocoa or chocolate as the first ingredient, and not sugar!  Also, since both white and milk chocolate have dairy fat added to the chocolate, the amount of goodness (polyphenols) in a given amount of chocolate gets diluted and the amount of saturated fat, of course, goes up.

Now, I know I did title the post so that I would be able to rationalize your chocolate, but remember balance is key.  As with any energy-dense food, cocoa and its derivatives should be eaten in moderation.  So, enjoy one ounce of dark chocolate a day and here’s a tip to make it last.  Take your rich piece of 70%+ cocoa goodness and place it on your tongue and press it to the roof of your mouth.  Then, let it just sit there and feel how your brain becomes saturated with the flavor of the overwhelming chocolaty taste.  Do not try to chew, bite, nibble or inhale any bit of this piece of chocolate.  Otherwise, your brain won’t have it’s time to get its chocolate fill.  Once you complete your mission, you might just notice that you don’t need more because you just took care of business (health and craving) in just a few pleasurable minutes!

Some of the greatest pioneers in medicine work to find ways to highlight lifestyle-based solutions for the most devastating diseases.  Of course, nothing strikes fear into the heart and, literally, the chests of women than the diagnosis of breast cancer.  Luckily for us, these trendsetting docs have uncovered some research truths about what we can do to help ourselves.  Up until now, many women have supported the cause by wearing pink ribbons, getting mammograms and doing monthly self-breast exams believing they are practicing prevention.  First point I must make and, think about this one… getting a mammogram and doing a self-breast exam is NOT prevention, it’s early detection, right?  Those two concepts are worlds apart.  And even though finding a breast cancer early through these methods is valuable, preventing the breast cancer altogether is priceless!

These are some of the recommendations given to me by a leading researcher in Integrative Oncology, Dr. Donald Abrams, and I humbly pass these on to you for the women you love and care for in your community.  Share these tips about breast health and pearls about improving breast cancer survival the next time you meet.

1.  Eating a single serving of a cruciferous vegetable a day can reduce your risk of getting breast cancer (and other cancers as well!).  Examples of these life-saving veggies include broccoli, cauliflower, arugula, Brussels sprouts, bok choy, cabbage, collard greens, daikon, kale, kohlrabi, mustard greens, radish, rutabaga, watercress and wasabi.

2.  Women with estrogen receptor positive breast cancer should not drink more than 3 alcoholic drinks per week.  One drink is equal to 12 oz beer, 4-5 oz of wine or 1.5 oz of hard liquor to be precise.

3.  Eating a diet rich in healthy soy early in life could reduce your risk of breast cancer.  Intake after menopause could also favorably affect osteoporosis, heart disease and menopausal symptoms with no increased risk of breast cancer.   Avoid soy protein isolate and other ‘manufactured’ soy like those in veggie burgers.  (Learn more about the impact of soy on your body at Living Wellness

4.  There is newer research that intake of whole soy foods and natural soybean-derived products (~0.5 serving/day) does not contribute to breast cancer recurrence and it might actually reduce your risk of a recurrent breast cancer.  This is a significant shift from previous recommendations, just in case you were left a little confused by this one.

5.  Weight gain and lack of exercise are easy traps to fall into during ongoing breast cancer treatment, but it remains prudent to advise women to eat right and exercise daily.  So, don’t take your breast cancer just sitting down and eating your comfort food.  Getting going might just help you survive not only your breast cancer, but also all-cause mortality (translation: all major causes of death).

Remember, the next time you see a Susan G. Komen race T-shirt, a TV announcement about getting a breast check buddy or getting your annual squeeze at the radiology center, you can do so much more to fight the battle against breast cancer by practicing true prevention tips today.

Today we’re continuing the ‘burning discussion’ on acid reflux.  Called by many names, acid reflux is one relatively new condition which is on the rise mostly due to our culture’s lifestyle habits, particularly overeating and increasing weight gain.  The excess belly fat creates both structural ‘blockage’ of acid flow and fuels inflammation lending to more digestive drama.

This is Part II of the Acid Reflux topic, so if you haven’t read ‘Fire In The Hole’, I encourage you to begin there as this discussion builds from that post, mostly that acid reflux is not a condition of TOO MUCH stomach acid, but rather a situation of TOO LITTLE stomach acid.

In fact, once you understand the physiology of how and why, you’ll likely recognize the long-term implications of treating this issue of TOO LITTLE stomach acid with conventional means, namely Proton Pump Inhibitors (PPIs) might not be the best choice for most of us.

Let’s jump in and talk about how it could be that too little acid could result in acid reflux?  The answer is fairly simple.  Our stomach is designed to work optimally at a pH of 1-3.  When the food enters the stomach, it causes the pH to rise (become less acidic).  This rising pH causes the stomach to release more hydrochloric acid.  As the stomach becomes acidic again, the valve at the opening of the stomach (the esophageal sphincter) will close to prevent the acid from escaping back up.  It is this action of the esophageal sphincter, in response to rising acid levels that prevents acid reflux.  Now let’s look at another scenario.  If the stomach does not produce enough acid in response to food intake, the esophageal sphincter will remain open.  An open esophageal sphincter allows what little acid that exists in the stomach to rise up into the esophagus, thus causing the burning sensation associated with heartburn.  So, you can see that there exists a possibility that your acid reflux medication could be worsening your issues or explains why they might not be working for you.  That’s the beauty of science in action.  That’s a Functional Medicine approach to acid reflux.

Now that we’ve covered another cause of acid reflux, it’s time to test out the theory.  There is a simple litmus test of whether a person could be experiencing hypochlorhydria (low stomach acid) as the cause of their acid reflux.  I recommend they perform a trial of taking 2-3 tablespoons of apple cider vinegar right before their meals.  Yes!  That’s right!  We add a mild acid to the stomach (the vinegar) with a meal.  If this works to reduce/eliminate acid reflux, and it does so about 85% of the time, we initiate a therapeutic path to retrain the stomach to produce its own hydrochloric acid.  I just want to be clear, the apple cider vinegar is just a test to determine if the issue is low stomach acid (hypochlorhydria).  If it helps improve symptoms, it is an indication that we likely have identified the real root cause of the acid reflux problem.  Apple cider vinegar is a not a long-term remedy, but an old-fashioned, natural ‘lab test’ of sorts.  Some of my patients do use it to help with those occasional bouts of heartburn.

Caution:  There are situations where it is not appropriate to test with apple cider vinegar.  Anyone with the following diagnoses should not attempt the vinegar test: hiatal hernia, erosive esophagitis, peptic ulcers, or Barrett’s esophagitis.  These conditions could be worsening by adding an acid to the mix.

It would be an incomplete discussion if I didn’t address another common cause of acid reflux and related symptoms…Food sensitivities.  You might be wondering, “Haven’t I heard this tune before?”  Yes, I talk about food allergy/sensitivity often, but that’s because we eat very often.  And if we continue to eat foods that irritate our immune system, our body is going to let us know about it.  Sometimes it’s through chronic sinus congestion, eczema, headaches or even acid reflux.  I discuss how to determine possible food allergies/sensitivities in several online lectures at

So, if you’re one of the 22 million people suffering with acid reflux, I recommend you seek out the root causes of your symptoms and work to improve them through lifestyle modification and a thoughtful (and sometimes supervised) application of common sense and science!

If you’re interested in learning more about this topic, visit our Education Beyond Medication online medical community, to watch the following Dr. Saxena Speaks! educational videos which also relate to this topic:

  • Acid Reflux:  It Keeps Coming Up!
  • Heal Your Gut, Heal Your Body
  • Digestive Rehabilitation
  • Allergies:  It’s Not Just Snot
  • Testing Yourself for Food Allergies

Fire in The Hole!  That’s one way we describe heartburn/acid reflux.  Whether you call it heartburn, acid reflux, gastrointestinal reflux disease (GERD), or dyspepsia, one thing is for sure, it usually begins with a warm, burning sensation that rises up the esophagus.  Some people report experiencing an acidic taste, frequent burping and/or a hoarse, raspy voice.

Acid reflux is big business for the pharmaceutical industry considering that nearly 7% of the US population reaches for prescription and over-the-counter medications to relieve their symptoms.  Insurance companies have even realized the billion dollar expense associated with treating acid reflux symptoms and have dramatically reduced their coverage of prescriptive medications forcing patients to purchase these medication ‘band-aids’ over-the-counter and out of their own pockets.

Most physicians treat acid reflux the only way we were taught in medical school.  This is basically the same way the last several generations of doctors were taught…if someone has acid reflux, it must mean that they have TOO MUCH stomach acid.  That’s probably what you have been told but there is another whole side of this hot story.  In the world of functional medicine, acid reflux is many times a sign of TOO LITTLE stomach acid!  When acid levels are too low, the condition is called hypochlorhydria (hypo = low, chlorhydria=hydrochloric acid).  How crazy is it that acid could come up into your esophagus and throat because there is TOO LITTLE of it?

Well, here comes the science facts… (1) the body produces its own hydrochloric acid (and it takes a bunch of energy to make it) (2) as we age, our bodies slow down overall and we tend to produce ‘less’ of everything- hormones, muscle, STOMACH ACID, etc.  (3) the majority of people who suffer from acid reflux are over the age of 50.  So, how could it be that as we age, we make less stomach acid but have so many people suffering from ‘too much acid’ problems like GERD?  The simple answer:  it doesn’t.  We make less hydrochloric acid as we age.  This low acid state makes the valve between the stomach and esophagus open up too quick (for reasons too long for this post, but trust me), the acid shoots up because the trap door is open and you experience your heartburn.  Said simpler with an analogy, the acid (air conditioned air) is escaping because someone left the door open, not because the  your acid (air conditioned air) all of sudden got so strong that it flew the door open and escaped out.

To really throw you off, the most popular medications used for acid reflux called proton pump inhibitors (PPI) actually lower the low acid levels even more.  This might help temporarily because the drug really dropped the stomach acid level, but the problem now is that there is too little acid left to digest the food, to kill the bacteria on the food, to activate your digestive enzymes, and do the many other vital functions of proper amounts of stomach acid.

Said more medically, by taking a PPI, we’re stopping the body from beginning the appropriate digestion of food.  If this happens, food enters the small intestine in a less broken down form than it should.  The small intestine is not prepared for food in this form and is not always able to fully utilize these undigested foods (btw, animal protein tends to be a big culprit).  It gets worse as it goes downstream.  The undigested food in the small intestine can trigger constipation, intestinal pain, severe bloating, and also can feed unhealthy bacteria and yeast leading to intestinal infections.  What a mess and all could have been remedied with the right diagnosis!

If you’re interested in learning more about this topic, visit our Education Beyond Medication online medical community, to watch the following Dr. Saxena Speaks! educational videos which also relate to this topic:

Acid Reflux:  It Keeps Coming Up!
Heal Your Gut, Heal Your Body
Digestive Rehabilitation