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29 Oct Facts about Investing in Prevention

In 2006 the Washington Association of Naturopathic Physicians submitted excerpts from the Blue Ribbon Commission proposal: Evidence-based Chronic Disease Prevention. The following are facts excerpted from that proposal:

Adoption of a Health Lifestyle = Evidence-based, Chronic Disease Prevention (EBCDP).

  • 62% of coronary events are preventable by following a healthy lifestyle (The Health Professionals Follow-up Study (n=42,847) Circulation, 2006)
  • 58% of Type 2 diabetes is preventable by lifestyle modification (Diabetes Prevention Program (DPP); (New England Journal of Medicine, 2002)
  • Cardiovascular disease, diabetes, and cancer are all preventable through lifestyle practices (Preventing Cancer, Cardiovascular Disease and Diabetes: A Common Agenda American Cancer Society, American Heart Association, and the American Diabetes Association, Circulation, 2004)

EBCDP is more effective than early medication for disease prevention.

  • Lifestyle (58%) was superior to early metformin (34%) for the prevention of diabetes (New England Journal of Medicine, 2002)
  • Lifestyle change is the only intervention proven to reverse coronary artery disease (Ornish et al., JAMA, 1998)
  • Early TZD class medications were ineffective in diabetes prevention (Knowler et al. Diabetes, 2005)

Few WA State health care providers are making EBCDP recommendations in practice.

  • Only 16% of adult respondents said they were advised by their doctor, nurse, or other health professional to eat fewer high fat or high cholesterol foods
  • Only 20% were advised to eat more fruits and vegetables
  • Only 23% were advised to be more physically active (The Burden of Heart Disease and Stroke in Washington State 2004; WA State Dept. of Health)

EBCDP programs are cost-effective.

  • Chronic diseases currently accounts for 12% of all health care expenditures (Hogan, Diabetes Care, 2003)
  • Preventive services are widely accepted as a cost-effective strategy to reduce disease. Research supported by the U.S. Agency for Healthcare Research and Quality shows that health education and lifestyle modification reduce the negative impacts, including costs, associated with chronic disease (Research News. Agency for Healthcare Research and Quality No 02-0018 April 2002)
  • A recent demonstration project implemented the Diabetes Prevention Program lifestyle intervention in adults age 50 and prevented 37% of expected cases of diabetes over 15 years at a cost of $1288 per quality-adjusted life year (QALY). Private insurer investments in this EBCDP program showed recovery of costs in the form of medical expenses avoided after three years implementation. (Ackermann et al., Diabetes Care, 2006)
  • A private payer could reimburse $655 (24%) of the $2,715 in total discounted intervention costs during the first 3 intervention years and still recover all of these costs in the form of medical costs avoided. If Medicare paid up to $2,136 in intervention costs over the 15-year period before participants reached age 65, it could recover those costs in the form of future medical costs avoided beginning at age 65 (Ackermann, Diabetes Care. 2006).
  • Additional cost analysis of the Diabetes Prevention Program in high-risk populations resulted in a cost of $1,100 per QALY for the lifestyle program versus $31,300 per QALY for early prescription drug therapy (Herman, WH. Annals International Med 2005).
  • A recent study aimed at getting sedentary Americans active compared lifestyle recommendation to a structured program in the gym.  Results were equal but the 24 months costs were $17.15 vs. $49.31 per participant per month. Lifestyle intervention was more cost-effective than the structured intervention for most outcomes measures. (Sevick et al. American Journal Preventative Med 2000)

Ignoring EBCDP is very costly.

  • Almost 60% of Washington adults are overweight or obese. Obesity is one of the primary factors in many health problems, including diabetes and heart disease. In one year alone, diabetes-related hospitalizations cost about $1.27 billion
  • Escalating costs of chronic disease nationwide despite higher priced treatments
  • Avoidable medical costs of amputation, blindness, dialysis, kidney transplantation, cardiovascular surgeries, and long-term hospitalization
  • Avoidable human costs of blindness, amputation, work-time losses, and depression


As the above facts detail, the adoption of a healthy lifestyle would go a long way towards saving Americans a lot of money in the long term. Schedule an appointment with Dr. Naumes today to discuss what changes you can make in your life to move towards optimal wellness.



DISCLAIMER: Dr. Kate Naumes holds a Doctorate in Naturopathy and a Certificate in Midwifery from Bastyr University. The state of Texas does not license Naturopathic Doctors. As such, she holds her license in California and acts in Texas as a wellness consultant, not as a physician.

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15 Oct Naturopathic Qualifications and Training

Licensed Naturopathic Doctor

Dr. Naumes holds a Doctorate in Naturopathy and a Certificate in Midwifery from Bastyr University; she holds a BA in Biochemistry from Mt. Holyoke.  Dr. Naumes is a member of the American Association of Naturopathic Physicians and the Texas Association of Naturopathic Doctors. As a Naturopathic Doctor licensed by the State of Vermont, she is educated in all of the same basic sciences as an MD, but has also been trained in holistic and nontoxic approaches to therapy with a strong emphasis on disease prevention and optimizing wellness.

The Council on Naturopathic Medical Education and the Association of Accredited Naturopathic Medical Colleges have accredited six colleges of Naturopathic Medicine approved by the U.S. Department of Education. All six doctoral programs require a bachelor’s degree for admission. These Naturopathic medical programs consist of four-year, graduate-level naturopathic medical curriculum that begin with a focus on Biochemistry, Human Physiology, Histology, Anatomy, Macrobiology, Microbiology, Immunology, Human Pathology, Neuroscience, and Pharmacology. The final two years of the medical program include clinical setting internships under the close supervision of licensed professionals in addition to studying the medical sciences, clinical nutrition, classical homeopathy, lifestyle counseling, botanical medicine, acupuncture and traditional Chinese medicine, minor surgery, and obstetrics. According to an article in Midwifery Today, a Naturopathic Midwife completes “approximately 37 additional classroom and lab credits (425 hours) and approximately 1300 clinical hours” in addition to the Naturopathic medicine training. This program is “fully accredited by the American Midwifery Education Accreditation Council (MEAC).”

Naturopathic Doctors then sit for rigorous professional board exams and may also need to pass local state exams to become licensed. The North American Board of Naturopathic Examiners require two exams that include the five basic medical science exams: anatomy and histology, physiology, biochemistry, microbiology, and pathology; and the 10 clinical science exams: physical and clinical diagnosis, laboratory diagnosis and diagnostic imaging, clinical nutrition, botanical medicine and pharmacology, emergency medicine, minor surgery, traditional Chinese medicine and acupuncture, classical homeopathy, physical medicine and counseling psychology.

Graduates from online programs are not recognized as Naturopathic Doctors in any jurisdiction that licenses Naturopathic physicians. These programs are not accredited and lack approval by the Department of Education. According to AANMC “graduates of such programs are neither qualified nor eligible to sit for the Naturopathic Physicians Licensing Examinations (NPLEX), so they have no means of becoming licensed physicians upon graduation.” “Practitioners who hold licenses have received degrees from accredited medical programs, abide by legal and ethical standards, and fulfill yearly continuing education requirements in order to provide optimal patient care.” The Texas Association of Naturopathic Doctors only lists licensed NDs in good standing who maintain their license in a licensed state.

*The state of Texas does not yet license Naturopathic Doctors. As such, Dr. Naumes holds her license in Vermont and acts in Texas as a wellness consultant, not as a physician.  Our goal for this website is that it acts as a resource for current and future clients by providing an introduction to Naturopathic Medicine.  If you think our practice is a perfect fit for you or someone you know, we hope to hear from you soon and we appreciate the referral.

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01 Oct Naturopathic Approach to Fertility, Pregnancy, & Postpartum: Achieving Positive Birth Outcomes

Naturopathic Doctors Achieve Positive Birth Outcomes

In the Autumn 2008 Issue of Midwifery Today there appears an incredibly thorough article by Lisa Doran and Nora Pope outlining a naturopathic view of perinatal health. In the article, they discuss naturopathic support during pre-conception, conception, pregnancy, labor, birth and the postpartum period.

The authors point out that “when both parents are working hard to achieve optimal health before conception, the health of both parents is reflected in healthy pregnancies and healthy babies”  and that naturopathic doctors (NDs)  “work very closely with couples before conception to optimize health and nutrition and to address any health concerns or imbalances that may create obstacles to a healthy pregnancy.” The authors also refer to NDs’ practice of  “closely monitor[ing] normal hormonal peaks in order to evaluate health and balance of the menstrual cycle” going on to mention that “a female hormonal imbalance is a common issue a ND will encounter… Hormonal levels are very important and an ND will employ the use of nutrition, identification of environmental estrogen exposure or use of specific female harmonizing botanicals”. During conception the authors point out that “in addition to helping to regulate hormone levels and working with the natural physiology of the body, NDs also teach their clients to observe external signs and symptoms of fertility.”

Furthermore, “ [i]n the first trimester [of pregnancy], nutrition coaching is the number one indicator for lessening the complications in labor, birth and postpartum….During the second trimester, central concerns are fetal brain development and iron deficiency anemia…The third trimester involves preparing for labor and birth, as well as preventing issues that may arise from an overloaded metabolic and hepatobiliary system. Clients who have been through a previous detoxification program find this stage of pregnancy far less demanding.” (We should note here that Dr. Naumes does provide guided detoxification programs for her clients.)

Later the authors remark that “[NDs] and midwives are able to support women as they do the hard work of labor.” …..and “are able to support and protect [the] immediate postpartum period by assisting with perineal healing, providing support for breastfeeding initiation and challenges, and using homeopathy, nutrition and botanical medicine to assist with maternal recovery.”

Finally we want to be sure to mention that Dr. Naumes (being the very rare naturopathic doctor also holding a Certificate in Midwifery) exclusively offers doula services for her members. Use the button below to schedule your First Visit to start optimizing your pregnancy, birth, and postpartum experience.

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17 Sep Fertility Optimization and the Benefits of Naturopathic Care

Naturopathic Fertility Optimization

Naturopathic Medicine’s approach to improving fertility focuses on establishing healthy hormone balance for both partners, minimizing the body’s reaction to stress, ensuring optimal nutritional status for the mother-to-be, establishing a healthy exercise routine, and teaching fertility awareness techniques to better understand the optimal fertile times in a woman’s cycle.

The Foresight Study, conducted in England, shows the effects that proper preconception care has on fertility. Out of 300 couples who had previously been declared “infertile”, over 89% were pregnant within 2 years, without the assistance of IUI or other similar fertility interventions.

Naturopathic doctors are highly trained in both the Western and Eastern medical systems. Naturopathic Doctors have the ability to integrate a western diagnosis with nutrition, exercise, herbal medicine, acupuncture and Chinese medicine, as well as counseling and stress management techniques.

A study by the department of obstetrics and gynecology at Stanford University to determine the impact of nutritional supplements containing vitex, green tea, vitamins, and minerals on female fertility found that the supplement group helped improve women’s menstrual cycles. Herbal medicine can also be used to regulate menstrual cycles, normalize hormones, maintain a pregnancy, prevent miscarriage, improve sperm quality and help with stress. Herbs can be very effective but like any therapy may have side effects or drug interactions. For this reason it is recommended that you consult a licensed Naturopathic Doctor.

It is well known that infertility causes stress, and stress reduction may, in turn, improve fertility. Stress may lead to the release of hormones and influence mechanisms responsible for a normal ovulatory menstrual cycle through its impact on the hypothalamic-pituitary-ovarian axis.  Many Naturopathic Therapies successfully address stress.  Naturopathic Medicine also addresses environmental toxicity and its potential impact on fertility.

With Naturopathic Fertility Services from Dr. Naumes, you will learn more about how to positively impact nutrition, body composition and environmental exposure to substances that can decrease fertility and harm a developing baby for both partners. Your family will benefit from the simple, non-invasive, cost-effective tools that naturopathic medicine has to offer.

References:

1. http://www.foresight-preconception.org.uk/

2. Al-Inany, H. (n.d). Issues of bioequivalence and cost (vol 78, pg 438, 2002). Fertility And Sterility, 78(6), 1356.

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13 Sep Have you wondered whether Naturopathic Care is a good investment?

The Scientific Affairs Committee of the American Association of Naturopathic Physicians compiled data and released the following paper earlier this year:

Naturopathic Medicine:
A Key Part to Healing the Nation’s Financial Health Care Crisis

Increasing levels of chronic disease including: diabetes, heart disease, chronic pain, cancer and obesity, have created a multi-trillion dollar financial burden on the medical system. Naturopathic medicine may reduce the need for expensive conventional care by promoting health and decreasing the need for medical interventions over the long term.  Naturopathic doctors are primary care providers that treat acute and chronic conditions as well as address health promotion and disease prevention.

Naturopathic medicine costs less than conventional care.

  • Use of natural health products has the potential to improve health outcomes and reduce cost compared to conventional treatment by anywhere from 3.7- 73%. (1)
  • A 2006 University of Washington study found that in WA State, naturopathic care cost insurers $9.00 per enrollee vs. $686.00 for conventional care. (2)
  • Manual therapy cost less than primary care for neck pain and decreases recovery time, thereby also improving productivity. (3)
  • One year of a lifestyle intervention program (similar to that recommended by naturopathic physicians) for patients with coronary artery disease not only improved all health outcomes and reduced the need for surgery but also cost significantly less then conventional treatment ($7,000 vs $31,000 –$46,000). (4)
  • Naturopathic care, when used for reduction of cardiovascular risk factors (high blood pressure and cholesterol, for example) improved health and increased job productivity, and was determined to actually be a cost-saver for an employer. (5)
  • Naturopathic care used for chronic low back pain, not only cost less than a standard physical therapy regimen but also decreased absenteeism by up to 7 days in a worker’s year. (6)

Naturopathic medicine decreases the need for medical interventions by improving patient wellbeing, preventing disease and treating disease by improving health.

  • The naturopathic emphasis on prevention and health promotion saves lives and dollars. Lifestyle modification counseling prevented more cases of diabetes than drug treatment. (7)
  • It is estimated that if the current level of medical intervention continues the US will end up spending $9.5 trillion dollars over the next 30 years caring for cardiovascular disease, diabetes and congestive heart disease alone. By adding preventive strategies to improve patients’ health, total cost could be reduced approx. $904 billion or almost 10%. (8)
  • Although the initial cost of prevention and treatment using natural medicine is sometimes similar to conventional care the benefits gained by avoiding disease and their associated costs are invaluable and much preferred by patients. (9)
  • Patients who received intensive lifestyle modification and naturopathic therapy for type II diabetes improved all health scores (lipid levels, body fat percentage, etc.) and decreased medication requirements compared to those on standard therapy, in just one year. (10)

The use of naturopathic medicine decreases total medical expenditure.

  • Total expenditure on health care by insured complementary and alternative medicine (CAM) users is less than non-CAM users ($3,797 vs $4,153); this is an approximate $9.4 million saving for just 26,466 CAM-users (11)
  • Patients with the greatest disease burden, which tend to be the most expensive patients, show the most significant reduction in total medical expenditures when utilizing CAM.(12)
  • Naturopathic doctors are the bridge between alternative and conventional care and model true integrative care. Patients who receive care from an integrative primary care physician have reduced medical costs and need of medical intervention when compared to those receiving conventional primary care. (11)
  • Naturopathic care in Canada reduces the use of prescription medications by 53%. (13)
  • Reduction in drug prescriptions (61% less) and use of conventional medical care (55% less) are substantial among CAM users. (14)

References

  1. Kennedy, Deborah A. et al. Cost Effectiveness of Natural Health Products: A Systematic Review of Randomized Clinical Trials. eCAM 2009; 6(3) 297-304 (5).
  2. Lafferty WE, et al. Insurance Coverage and Subsequent Utilization of Complementary and Alternative Medicine Providers. Am J Manag Care 2006; 12(7): 397-404 (7).
  3. Korthals-de Bos, Ingeborg B. C. Cost Effectiveness of Physiotherapy, Manual Therapy, and General Practitioner Care For Neck Pain: Economic Evaluation Alongside A Randomised Control Trial. BMJ 2005; 326: 911-917.
  4. Ornish, Dean. Avoiding Revascularization with Lifestyle Changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol 1998;82:72T–76T.
  5. Seely D, Herman P. Presented at 2010 AANP Conference. Model Whole Practice Study Finds Naturopathic Care Effective, Cost Saving for Canadian Employer. Unpublished. http://theintegratorblog.com/index.php?option=com_content&task=view&id=682&Itemid=189
  6. Herman PM, Szczurko O, Cooley K, Mills EJ. Cost-effectiveness of naturopathic care for chronic low back pain. Altern Ther Health Med. 2008 Mar-Apr;14(2):32-9.
  7. Williamson DF. Primary prevention of type 2 diabetes mellitus by lifestyle intervention: implications for health policy. Ann Intern Med 2004; 140(11):951-7.
  8. Kahn, Richard. The Impact of Prevention on Reducing the Burden of Cardiovascular Disease. Circulation 2008, 118:576-585.
  9. Woolf, Steeve.  A Closer Look at the Economic Argument for Disease Prevention. JAMA 2009; 301 (5) 356-3.
  10. Hernan WH. Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program. Diabetes Care. 2003; 26(1):36-47.
  11. Lind, Bonnie K. et al: Comparison of Health Care Expenditures Among Insured Users and Nonusers of Complementary and Alternative Medicine in Washington State: A Cost Minimization Analysis. J Alternative and Complementary Med 2010; 16: 411-417.
  12. Sarnat, Richard L.  et al. Clinical Utilization and Cost Outcomes From and Integrative Medicine Independent Physician Association: An Additional 3- Year Update. J Manipulative Physiol Ther 2007; 30: 263-269.
  13. http://www.ccnm.edu/sites/ccnm/files/pdfs/news_events/press_releases/attitudes_towards.pdf
  14. Stewart D. Utilization, Patient Satisfaction, and Cost Implications of Acupuncture, Massage, and Naturopathic Medicine As Covered Health Benefits; A Comparison of Two Delivery Models. Alternative Therapies in Health & Med. 2001.

DISCLAIMER: Dr. Kate Naumes holds a Doctorate in Naturopathy and a Certificate in Midwifery from Bastyr University. The state of Texas does not license Naturopathic Doctors. As such, she holds her license in California and acts in Texas as a wellness consultant, not as a physician.

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19 Aug Natural Solutions for Helping Prevent Mosquito Bites

Name of Expedition: Panama Canal Zone Participants: Seth E. Meek, Samuel F. Hildebrand Expedition Start Date: 1911 Expedition End Date: 1912  Purpose or Aims: Zoology (Fishes) Location: Central America, Panama, Canal Zone  Original material: album print Digital Identifier: CSZ33983

As you may already be aware, the Texas Department of State Health Services has commissioned aerial spraying of the chemical Duet. The most up to date information regarding the spraying can be found at the City of Dallas’ website.

The City of Dallas has issued the following recommendations:

  • Minimize exposure. Avoid being outside, close windows and consider keeping pets inside while spraying occurs.
  • If skin or clothes are exposed, wash them with soap and water.
  • Rinse homegrown fruits and vegetables with water as a general precautionary measure.
  • Cover small ornamental fish ponds.
  • Because the chemical breaks down quickly in sunlight and water, no special precautions are suggested for outdoor swimming areas.

—————–
Now, everyone knows that taking precautions to reduce the risk of mosquito bites and possible disease spread is very important, but excessive exposure to synthetic, chemically-based insect repellents can cause long term harm.  Furthermore, the most common ingredient used in commercial insect repellents, DEET (N,N-Diethyl-meta-toluidine), is not recommended for use on children under two months of age or on pregnant women.

If you do use DEET-based repellents, read the label and make sure you use them according to the manufacturer’s’ guidelines. A certain amount of DEET can be absorbed through your skin and into your bloodstream, and in large doses it can make you seriously ill. DEET can act as an irritant, and has been reported to be the cause of seizures, insomnia, mood disturbances and impaired cognitive function. The NHS and the Health Protection Agency (HPA) say that products containing 50 percent DEET are safe to use while pregnant, however we don’t know much about the possible harmful effects on the developing baby.

Beware of misting systems that contain permethrin, a neurotoxin that is dangerously toxic to cats, and potentially dangerous to humans. Also of concern is the new Off! Clip-on, which contains the chemical Metofluthrin, known to cause severe neurotoxic symptoms in dogs, rabbits, and rats. To minimize your exposure,  replace any old air filters in your home in addition to using an additional air purification system, if you own one.

Fortunately, there are many safer options to help ward off the pesky suckers:

  • Wear protective clothing that is loose-fitting and light in color.
  • Avoid wearing bright or floral patterns.
  • Use unscented shampoo, soap, deodorant, laundry detergent, etc.
  • Refrain from wearing perfume.
  • High quality garlic capsules can work wonders in preventing mosquito bites.
  • Use mosquito netting when outside for prolonged periods, especially over strollers, baby carriers and car seats when the baby is sitting in them outside.
  • Eliminate standing water around your home.
  • Plant mosquito repellent herbs such as rosemary, lemon balm, lavender, basil and catnip.

Try one of the following more natural mosquito repellents:

  • Skeeter Screen’s Patio Eggs and reed diffusers utilize bug-deterring essential oils to repel mosquitoes over a space of about 200 square feet.
  • Adults and older children can apply undiluted vanilla essential oil to pulse points (wrists, neck, ankles) to repel mosquitoes with a pleasant smell.
  • A homemade repellent can be made using a low (2-4 percent) dilution of essential oils such as eucalyptus and/or lemon eucalyptus with a base, such as jojoba, or almond oil mixed in a spray bottle.  This can be applied to children over the age of two and is safe for pregnant women.  Spray only on children’s clothes away from their eyes, like the backs of shirts and shorts and on socks and shoes.
  • Cinnamon and peppermint are also effective in warding off mosquitoes. Cinnamon can burn, so it is not advised to use with small children.
  • Look for safer repellent sprays available for purchase that contain P-menthane-3,8-diol (PMD). PMD is the active ingredient in oil of lemon eucalyptus and is in the most widely-used Chinese insect repellent, quwenling.  Repel Lemon Eucalyptus Insect Repellent Lotion and Spray Lotion, Survivor Lemon Eucalyptus Insect Repellent, Off! Botanical Insect Repellent are good choices. However, PMD is roughly half as effective as DEET, so reapply as necessary.
  • Repellents that contain picaridin, a plant-derived compound, have an excellent tolerability profile, in contrast to DEET. Picaridin is odorless, non-sticky, and non-greasy; it also does not irritate skin, stain fabrics, or degrade plastics. Look for Sawyer Insect Repellent, Cutter Advanced, and Cutter Advanced Sport.

The risks and benefits DEET, Duet and other pesticides will likely be debated for some time. In the meantime, at least for Dallas residents, the aerial spraying continues. Have further questions? Schedule an appointment to set up a cleanse to optimize your detoxification system so that your body can best eliminate DEET and other environmental toxins. As Alejandro Junger MD so beautifully explains, “cleansing is turning up the intensity and effectiveness of the detoxification system.”

written by Kate Naumes ND and Andrea Kavanaugh

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