Breast Health: Prevention, Empowerment, and Wellness

Breast health is a vital aspect of overall well-being for women of all ages. Did you know that breast cancer is the second-most diagnosed cancer in Canada and is the second leading cause of death among Canadian women over 50?[i] This October, as we honor Breast Cancer Awareness Month, we want to empower you to take proactive steps towards your breast health – because it’s never too early to start.

At Saskatoon Naturopathic Medicine, we believe in supporting you with an individualized approach looking at the body’s weaknesses and vulnerabilities that may make you susceptible to disease. Through optimizing nutrition, addressing environmental factors, or supporting your body’s natural defenses, we are committed to providing comprehensive care that treats the whole person.

Know the Risk Factors

Several factors can influence your risk of developing breast cancer. Some are within your control, while others – like family history or genetics – are not. Here are some key considerations:

• Nutrition : A balanced diet plays an essential role in reducing risks. Not only can a healthy diet directly improve our health, but it can also positively interact with many other factors involved in health like inflammation, body weight, hormone levels, and our gut microbiome. It is estimated that 30%-50% of cancers can be prevented through dietary changes.[ii] [iii] [iv]

• Exercise and healthy lifestyle: Lack of exercise contributes to obesity, which in itself is a risk factor for breast cancer. In breast cancer patients, physical activity - both before and after the cancer diagnosis - has been associated with a lower risk of disease recurrence and reduced overall cancer-specific mortality compared to their sedentary counterparts. [v]

• Family history and genetics: Understanding your genetic predispositions can guide proactive prevention.

• Environmental toxins: Exposure to harmful chemicals (including alcohol and tobacco) can contribute to increased risk.

• Dense breast tissue: Dense breasts not only elevate cancer risk but also make it difficult for cancerous lesions to be seen on a mammogram.

Being informed about these factors helps you take charge of your health, empowering you to make choices that align with your long-term wellness goals. Naturopathic doctors can break down these risk factors further to help you understand your vulnerabilities and strategize an individualized prevention plan.

Symptoms to Watch For

Breast cancer can manifest in various ways, some of which may be subtle. If you notice any of the following symptoms, it’s important to reach out to your healthcare provider for further evaluation:

• Changes in breast size, shape, or appearance

• New lumps, nodules, or cysts

• Nipple discharge when not breastfeeding

• Redness, pitting, or dimpling of the skin

• Peeling or flaking of the nipple

• Inverted nipples

Understanding Dense Breasts

Breast density[vi] is not about how your breasts look or feel – it is about tissue. Dense breasts have more glandular and fibrous tissue, making it harder for mammograms to detect cancer. However, having dense breasts is quite common, particularly in younger women. As women get older, their breasts typically become fattier and less dense (but this isn’t always the case). It is important to know your breast density so you can understand the risks and complications and make informed screening decisions.[vii]

You can learn more at www.densebreastscanada.ca.       

Screening: Early Detection Saves Lives

Early detection is crucial, and regular screening is an important part of taking care of your breast health. As of January 2025, you will be able to self-refer for a mammogram in Saskatchewan beginning at the age of 40 (currently, the minimum screening age is 50).[viii]

Read that again – you do not need a doctor’s referral to make an appointment for a screening mammogram!

Just call 1-855-584-8228 to book your screening through the Screening Program for Breast Cancer. With screening centres throughout Saskatchewan (including a mobile unit that serves rural and northern Saskatchewan) accessing this potentially life-saving service is available to you.

How We Can Help

We are dedicated to helping you navigate these complex factors, providing tailored recommendations that fit your unique situation. Whether you are seeking prevention or already managing a diagnosis, our collaborative model works alongside conventional approaches to give you the best outcomes. From optimizing your nutrition and lifestyle to helping you understand your risks, we’re here to empower you at every step of your health journey, You deserve to feel confident, supported, and in control of your health.

[i] https://cancer.ca/en/cancer-information/cancer-types/breast/statistics

[ii] Mentella MC, Scaldaferri F, Ricci C, Gasbarrini A, Miggiano GAD. Cancer and Mediterranean Diet: A Review. Nutrients. 2019; 11(9):2059. https://doi.org/10.3390/nu11092059

[iii] Monllor-Tormos A, García-Vigara A, Morgan O, García-Pérez MÁ, Mendoza N, Tarín JJ, Cano A. Mediterranean diet for cancer prevention and survivorship. Maturitas. 2023 Dec;178:107841. doi: 10.1016/j.maturitas.2023.107841. Epub 2023 Aug 24. PMID: 37660598.

[iv] Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. doi: 10.3322/caac.21142. Epub 2012 Apr 26. Erratum in: CA Cancer J Clin. 2013 May;63(3):215. PMID: 22539238.

[v] Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016 Jun 1;176(6):816-25. doi: 10.1001/jamainternmed.2016.1548. PMID: 27183032; PMCID: PMC5812009.

[vi] https://cancer.ca/en/treatments/tests-and-procedures/mammography/breast-density

[vii] https://densebreastscanada.ca/faq/

[viii] https://densebreastscanada.ca/breast-cancer-screening-in-saskatchewan/

TIPS FOR A HAPPY, HEALTHY BACK-TO-SCHOOL

As the back-to-school season approaches, many parents are busy buying new clothes, school supplies, and signing their children up for activities. But there is also the transition of sleep schedules, planning for healthy lunches, and implementing some immune supports to help battle the inevitable cold and flu season to come. We get it - this time of year can be both exhilarating and a challenge.

With a few simple naturopathic strategies, you can set the stage for a successful school year. Here are some tips we hope you’ll find helpful.

Restoring Routine: Getting Your Children’s Schedule Back on Track

After long summer days, getting back into a school routine can be challenging, but so important for a great first week back – both mentally and physically. Here are some ways to make the transition smoother:

• Gradual adjustment - As fun as it is to spend the September long weekend enjoying some last few late nights, a week or two prior to back to school is a good time to start slowly moving the kids to an earlier bedtime. Gradually shift these times by about 15 minutes each day until they align with your school schedule. This helps reset your child’s internal clock without causing undue stress. The earlier sunsets are there to help us.

• Evening wind-down – Establish a calming bedtime routine to help your child relax before sleep. Activities such as reading, taking a warm bath, and practicing deep breathing can signal to your child’s body that it is time to wind down. And of course – screens off for an hour before bed.

Nutrition for Success: Easy Breakfast, Lunch, and Dinner Ideas

Proper nutrition is essential for your child’s cognitive function, energy levels, and overall health. There is no singular “right” way to eat depending on unique dietary needs, but here are some tips for balanced healthy meals which include protein, healthy fats, and lots of vegetables:

• Breakfast ideas - Granola and coconut yogurt, toast and a fried egg, banana with almond butter, almond flour blueberry muffins.

• Lunch ideas - Wraps made with leftover chicken or beef, pita pizzas with sausage, veggies and cheese, chicken Caesar salad (P.S. – invest in a kid-sized Thermos to keep leftovers nice and warm!)

• Smart snacks - Veggies and hummus, fruit and cheese, raisins and pumpkin seeds, dates stuffed with goat cheese, rice crackers and almond butter, quick energy balls (Nut-Free).

• Hydration – A cute water bottle can go a long way. You can make water more exciting by adding in lemon juice and liquid Stevia plus a mint leaf, or strawberries and cucumbers plus a squirt of lime juice. Biosteel is a healthy, sugar-free, color-free option as well. Be creative!

• Quick dinners - Meal prepping goes a long way towards a less stressful, balanced week of dinners. Sundays are a great time to get the kids involved in washing, chopping, bagging…which can also improve the likelihood of actually eating the healthy meals!

 Crockpot meals are a great way to have dinner ready for any time – beef stew, turkey chili, pasta with meat sauce, honey garlic chicken thighs, butter chicken, or chicken tortilla soup are all great options to start. As an added bonus – if you prefer to have the nicer finish of an oven-roasted meal with the slow cooker convenience, just quickly broil it up for a minute or two to add the brown and the crisp.

Naturopathic Immune System Support: Strengthening Your Child’s Defenses

• Probiotics – A strong immune system starts in the gut. Back to school is a great time to top up your kids’ healthy bacteria. Good bacteria is found in yogurt, kefir, sauerkraut, and cultured coconut. You might also consider a high-quality probiotic supplement in chewable form that has added vitamins.

• Vitamin D – Most children living in Saskatchewan have suboptimal vitamin D levels. A single drop of a vitamin D supplement goes a long way in supporting a healthy immune response.

• Vitamin C and Zinc – These nutrients are essential for immune health. Encourage your child to eat plenty of fruits and vegetables high in vitamin C such as oranges, strawberries, and bell peppers. Zinc is also anti-viral and found in foods like pumpkin seeds, chickpeas, and cashews.

• Herbal supports – There are many herbs that support the immune system. There are many kid-friendly immune tonics which include astragalus for prevention.

 Back to school season is an excellent opportunity to re-establish healthy habits that will benefit your child all year long. By focusing on a consistent routine, healthy nutrition, and immune supports, you’re equipping your child with the tools for a fantastic year of learning and fun. We are here to help you with personalized, evidence-informed care so don’t hesitate to reach out if you have questions or need further guidance.

In good health,

Dr. Darlene Reid, ND

Clearing the Haze: Naturopathic Approaches to Addressing Postpartum Brain Fog

The journey from pregnancy to parenthood is a transformative experience, filled with joy, challenges, and profound changes within the body. During pregnancy and the postpartum period, the body undergoes significant hormonal changes that affect neurotransmitter levels within the body. Estrogen is a hormone that is known to influence our serotonin levels (ie. the natural “feel-good” chemical), which affects mood and cognition. Throughout pregnancy, estrogen levels are at an all-time high; during the postpartum period estrogen levels decrease, which leads to mood swings, symptoms of anxiety, and cognitive difficulties…commonly referred to as postpartum brain fog. However, other factors can contribute to a decrease in cognitive function (hello, sleep deprivation and stress!), so it is important to keep things in perspective.

As naturopathic doctors, we look at the intricate web of factors contributing to the postpartum brain fog phenomenon and offer holistic approaches to support cognitive function and overall wellbeing during this important time. One of our main goals is to address the root cause and support overall health through personalized, comprehensive care. Here are some ways we can help:

Addressing Hormonal Imbalances

This is a fundamental aspect of naturopathic medicine and care. Hormonal imbalances can include things like decreased estrogen levels, but also things like thyroid dysfunction or adrenal fatigue. It is important to discern where the impairment in cognitive function stems from so that an appropriate treatment plan can be formulated for your individualized needs. NDs can run functional lab testing to pinpoint the root causes of your brain fog; as well, we are also able to requisition common (and naturopathic-specific) blood tests to dig deeper and get a clearer picture of what is going on in your body.

Nutritional Support

Ensuring proper nutritional intake is essential to both maternal and child health during the pregnancy and postpartum period. Proper nutrition also plays a vital role in supporting cognitive function. When discussing nutrition for cognitive health we want to emphasize an anti-inflammatory diet and increase the consumption of whole grains, fruits, vegetables, and healthy fats to lower inflammation levels within the body. Omega-3 fatty acids (found in fish oil and flax seed) are particularly important for maintaining healthy neurotransmitter levels.

Lifestyle Changes

Cortisol is a stress hormone released by the adrenal glands and helps your body deal with stressful situations. Cortisol levels within the body tend to decrease during the postpartum period due to sleep deprivation and an increase in stress levels, so we want to find that sweet spot where you can function optimally without living in “fight-or-flight” mode.

• Practicing mindfulness and stress reduction techniques such as deep breathing exercises or meditation can help manage the mental load of parenting.

• Engaging in regular physical activity (with your medical provider’s clearance) can also help enhance mood levels and cognitive function by increasing blood flow to the brain. It doesn’t have to be complicated – walking, yoga, and impromptu dance parties are good for the body AND the spirit!

• Aiming to establish a sleep routine and seeking support from family and friends can also alleviate the burden of sleep deprivation and stress. Sleep during this period is undoubtedly unpredictable, so any measures you can take to create good sleep hygiene is essential for success. Harvard’s Stress and Development Lab has a useful checklist you can use to help set up better habits.

Parenthood is a very exciting and joyful time for most people, but it can also be a stressful and disheartening experience. We understand the underlying factors of postpartum brain fog and employ holistic approaches to help support new parents in reclaiming their cognitive function and enhance their overall well-being. In the simplest terms – we are here to help you survive AND thrive.

Yours in good health,

Dr. Sami Leung, ND

1. Aparicio, E., Jardí, C., Bedmar, C., Pallejà, M., Basora, J., & Arija, V. (2020). Nutrient Intake During Pregnancy and Post-Partum: ECLIPSES Study. Nutrients, 12(5), 1325. https://doi.org/10.3390/nu12051325

2. Ball, L., De Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum Nutrition: Guidance for General Practitioners to Support High-Quality Care. Australian Journal of General Practice, 51(3), 123–128. https://doi.org/10.31128/ajgp-09-21-6151

3. Barba-Müller, E., Craddock, S., Carmona, S., & Hoekzema, E. (2018). Brain Plasticity in Pregnancy and the Postpartum Period: Links to Maternal Caregiving and Mental Health. Archives of Women’s Mental Health, 22(2), 289–299. https://doi.org/10.1007/s00737-018-0889-z

4. Buckwalter, J. G., Buckwalter, D. K., Bluestein, B. W., & Stanczyk, F. Z. (2001). Chapter 22 Pregnancy and Postpartum: Changes in Cognition and Mood. Progress in Brain Research, 303–319. https://doi.org/10.1016/s0079-6123(01)33023-6

5. Deems, N. P., & Leuner, B. (2020). Pregnancy, Postpartum and Parity: Resilience and Vulnerability in Brain Health and Disease. Frontiers in Neuroendocrinology, 57, 100820. https://doi.org/10.1016/j.yfrne.2020.100820

6. Guo, Y., Kehoe, P., Pimentel, P., Rousseau, J., Axelin, A., Rahmani, A. M., & Dutt, N. (2021). Exercise and Stress in At-Risk Women During Pregnancy and Postpartum. MCN: The American Journal of Maternal/Child Nursing, 46(4), 217–222. https://doi.org/10.1097/nmc.0000000000000722

7. McGrattan, A. M., McGuinness, B., McKinley, M. C., Kee, F., Passmore, P., Woodside, J. V., & McEvoy, C. T. (2019). Diet and Inflammation in Cognitive Ageing and Alzheimer’s Disease. Current Nutrition Reports, 8(2), 53–65. https://doi.org/10.1007/s13668-019-0271-4

8. Qiu, T., Wen, H., Liu, Z.-X., Pan, X.-P., & Zeng, T. (2021). Investigation Regarding Early Cognitive Function of Women in the Postpartum Period and the Analysis of Influencing Factors. Risk Management and Healthcare Policy, Volume 14, 3747–3754. https://doi.org/10.2147/rmhp.s309553

Recipes For Happiness

The foods we eat give us the nutrients necessary for good health. Our body runs on biochemical machinery (like the engine of a car) which requires the right fuel for optimal function. The neurotransmitters in our brain that contribute to our well-being and happiness require the right nutrient raw materials for their synthesis and conversion to help us stay happy, calm, and motivated to live our best lives.

We’ve gathered some recipes for happiness that have all the right nutrients to support these neurotransmitters and keep you fueled for wellness and success!

serotonin

Serotonin contributes to well-being and happiness, and helps with sleep cycles and digestive system regulation. Serotonin is made from the amino acid tryptophan, which can be found in high amounts in chia seeds, whole milk, sesame seeds, yogurt, pumpkin seeds, prunes, spirulina, raw cacao, wheat bread, and edamame beans.

Image source - Oh She Glows website

(Happy) health chia seed pudding:

https://ohsheglows.com/healthy-chocolate-chia-pudding/

*This recipe is made with chia seeds and cacao, which are both rich in tryptophan. Chia seeds have 202mg of tryptophan per ounce, and cacao has 18mg per ounce. Top with pumpkin seeds (121mg/oz) and sesame seeds (189mg/oz) for a tryptophan-packed snack when you need a serotonin boost!

dopamine

Dopamine is associated with feelings of pleasure and motivation; people tend to repeat behaviours that lead to dopamine release, so it is also associated with addiction. Dopamine is made from the amino acid tyrosine (which our bodies are able to make), but they require another amino acid - phenylalanine - in order to do so. Phenylalanine is an amino acid our bodies don’t make, so we need to obtain it through diet. Phenylalanine is found in high amounts in many high-protein animal products such as chicken, beef, eggs, fatty fish, dairy products, legumes, nuts, seeds, and spinach.

Image source - Against All Grain website

(dopamine-driven) healthy chicken parmesan

https://againstallgrain.com/2011/04/21/chicken-parmesan-with-spaghetti-squash/

*This recipe is made with chicken (1310mg of phenylalanine per 100g) and parmesan cheese (1870mg/100g). Add in some spinach and get ready to take on the day!

GABA

GABA is the calming neurotransmitter. GABA is made from the amino acid glutamate, which is excitatory and can actually increase feelings of anxiety. Vitamin B6 is necessary in the conversion of glutamate (excitatory) to GABA (calming) to help you maintain a relaxed and balanced mood.

Inage source - Nadia’s Healthy Kitchen website

crunchy (calm) pistachio bars

https://nadiashealthykitchen.com/5-ingredient-crunchy-pistachio-bars/

*This recipe is made with pistachios, which have 2.1mg per cup, which is the highest amount of Vitamin B6 per 100g - even compared to animal products. With a bit of serotonin-promoting chocolate, this is a happy snack!

Happy, healthy eating!

Dr. Jacalyn Sieben, ND

resources:

1. Mosconi, L. (2018). Brain Food.

2. https://ohsheglows.com/healthy-chocolate-chia-pudding/

3. https://againstallgrain.com/2011/04/21/chicken-parmesan-with-spaghetti-squash/

4. https://nadiashealthykitchen.com/5-ingredient-crunchy-pistachio-bars/

Don’t Settle For Just “Getting By”

understanding and addressing depression

Now that spring is well on its way, is your mood picking up? If you’re still feeling the “blahs” – low energy, persistent sadness, changes in appetite or sleep patterns, and a loss of interest in activities you once enjoyed – this might be more than the winter blues.

While Seasonal Affective Disorder (SAD) is a well-known culprit for winter blues, it’s crucial not to overlook other underlying issues that may contribute to depressive symptoms. Booking an appointment with your ND can provide valuable insights into your mental and physical well-being. During your visit, we can explore various factors contributing to depression, including hormonal imbalances, nutritional deficiencies, lifestyle habits, and environmental stressors.

By taking a comprehensive approach, we can tailor a treatment plan to address your unique needs. This may include a combination of dietary adjustments, supplementation, herbal remedies, lifestyle modifications, and acupuncture. Additionally, we will work collaboratively with you to uncover any potential root causes and develop strategies for long-term wellness.

Here a few tips to consider as we hop into spring…

Protein

Foods that are rich in protein contain amino acids that help produce neurotransmitters like dopamine and serotonin. If your protein intake is low, you may experience low mood. Most adults require 1g of protein per kilogram of body weight. Fortunately, it is easy to increase your protein intake – here are some easy ideas to snack on:

• A handful of unsalted almonds, walnuts, and/or pecans

• A hard-boiled egg

• No-bake energy balls

• An apple with 2 tbsp nut butter of your choice

• Sausage sticks or jerky (aim for ones with no fillers)

• Edamame

Mediterranean Diet

The Mediterranean Diet is a diet high in fish, legumes, whole grains, vegetables, fruits, seeds, and olive oil. It is low in high fat meats and dairy products. Following the Mediterranean Diet has been shown to be protective against depression at all ages throughout a person’s lifespan. For more information, check out our past blog post.

Exercise

Adults (including seniors) should get at least 150 minutes of moderate to vigorous physical activity per week[i]. Think that’s a stretch? Here are some ways to incorporate more movement into your day:

• Do squats or lunges while you brush your teeth

• Park farther away from stores or work

• Take the stairs

• Spontaneous dancing (at home OR in public 😊)

• Deep clean something

• Get up and move your body during commercial breaks – marching in place, jumping jacks, walking lunges across the room…be creative!

Sunshine

Exposure to sunlight increases serotonin levels in the brain. While you may be taking a Vitamin D supplement to keep your levels up, being in the sunshine is the best source of natural Vitamin D[ii]. In order to optimize your exposure, we recommend spending anywhere between 5-30 minutes each day outside[iii] – and while you’re out there, why don’t you get in that little extra bit of exercise and take a walk around the block?

Did you know that Vitamin D is not typically tested when you have bloodwork completed by your physician? Many people may be deficient in this important vitamin and not even know it. If this is something you are concerned about or would like to know more, bring it up with your naturopathic doctor - it may be worth investigating!

Don’t forget…

You don’t have to navigate depression alone. Your mental health matters every day and every season of the year.

[i] https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

[ii] Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023 May 5;15(5):e38578. doi: 10.7759/cureus.38578. PMID: 37284402; PMCID: PMC10239563.

[iii] Srivastava SB. Vitamin D: Do We Need More Than Sunshine? Am J Lifestyle Med. 2021 Apr 3;15(4):397-401. doi: 10.1177/15598276211005689. PMID: 34366736; PMCID: PMC8299926.

Naturopathic Supports for Alzheimer's Disease

naturopathic medicine can provide a great deal of support for patients dealing with alzheimer’s disease and other cognitive conditions.

Alzheimer’s Disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is the most common form of dementia. Risks for AD can include smoking, diabetes, hypertension, alcohol consumption, obesity, and increasing age as these can cause neuroinflammation within the body. While there is no cure for AD, naturopathic approaches offer a holistic perspective by focusing on lifestyle, nutrition, and complementary therapies.

As it is never too early to begin thinking about your cognitive health, here are some things you can start doing today to reduce your risk of developing Alzheimer’s disease.

Mediterranean Diet

Studies have shown that individuals who adhered to a Mediterranean diet were associated with a reduced risk of dementia and cognitive decline in comparison to individuals who did not adhere to the diet. The Mediterranean diet is a diet that emphasizes the consumption of whole grains, fruits, vegetables, and healthy fats to lower inflammation within the body thus lowering the risk of developing AD.

Omega-3 Fatty Acids

Dietary intake or supplementation of omga-3 fatty acids has also been shown to help reduce risk of cognitive decline due to their anti-inflammatory properties. Foods rich in omega-3 include nuts and seeds including flaxseeds, walnuts and chia seeds or cold-water fish including salmon, mackerel, sardines, and herring.

Vitamin D

Patients with AD have a higher prevalence of Vitamin D deficiency, low mood and impaired cognitive performance so ensuring that Vitamin D levels are being tested and supplemented accordingly with foods and fats is beneficial.

Yours in good health,

Sami Leung

1. Lu’o’ng, K. V., & Nguyên, L. T. (2011). The beneficial role of vitamin D in Alzheimer’s disease. American Journal of Alzheimer’s Disease & Other Dementias, 26(7), 511–520. https://doi.org/10.1177/1533317511429321

2. Scarmeas, N., Stern, Y., Tang, M. X., Mayeux, R., & Luchsinger, J. A. (2006). Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology, 59(6), 912–921. https://doi.org/10.1002/ana.20854

3. Sobue, A., Komine, O. & Yamanaka, K. Neuroinflammation in Alzheimer’s disease: microglial signature and their relevance to disease. Inflamm Regenen 43, 26 (2023). https://doi.org/10.1186/s41232-023-00277-3

4. Wei, B. Z., Li, L., Dong, C. W., Tan, C. C., Alzheimer’s Disease Neuroimaging Initiative, & Xu, W. (2023). The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. The American Journal of Clinical Nutrition, 117(6), 1096–1109. https://doi.org/10.1016/j.ajcnut.2023.04.001

5. Welty F. K. (2023). Omega-3 fatty acids and cognitive function. Current Opinion in Lipidology, 34(1), 12–21. https://doi.org/10.1097/MOL.0000000000000862

Does Sugar Impact Our Immune System?

We all know it’s not ideal to have a diet high in sugar. Most of us know this with respect to managing our weight – but what about the immune system? What about colds, flus, autoimmune conditions, diabetes, cancer – does sugar consumption make us more susceptible? And if it does, how much does it take to make a difference?  Before we dive in, lets do a quick review of the immune system.

Above you’ll notice two main subdivisions of our immune system. We have our innate immunity, which can be thought of as the offense players and the adaptive immunity which could be considered the defence players. The innate immune system is first to respond (within minutes to hours) when there is a foreign invader. It’s the part of our immune system responsible for mounting a fever and initiating inflammation. Inflammation is useful in the short term for acute injuries or illnesses. Long term however, inflammation plays a strong role in the development of several diseases such as autoimmune diseases, cardiovascular disease, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and neurodegenerative disorders3. The innate immune response has no memory which means it responds the same way to all encountered pathogens. The adaptive immune system, also known as “acquired immunity” takes days to weeks to kick in. It is very specific and diverse to each type of pathogen it encounters which means it mounts a unique response to each pathogen after it has been “primed” or exposed to that pathogen. The adaptive immune system does have a memory which means it will respond faster the next time you are exposed to that pathogen.

How does sugar affect the immune system?

When we consume foods high in simple sugars, we get a post prandial (post meal) spike in the amount of sugar and triglycerides in our blood[1]. This is also known as “post prandial dysmetabolism” and it induces a wide variety of negative changes in the body. Just one high sugar meal can trigger transient effects such as:

Inhibition of neutrophils[2]

o  Neutrophils are part of the innate (first response) immune system. They patrol for foreign invaders and then trap and kill pathogens when discovered. High blood sugar prevents neutrophils from being able to get to the site of microbial infection (inhibition of migration), decreases their ability to trap pathogens (phagocytosis), and furthermore inhibits their ability to kill microbes2.

Increased inflammation and inflammatory markers such as C-reactive protein1

o  Long term inflammation (such as with repeated exposure to a diet high in sugar) can cause a breakdown of immune tolerance which may lead to major alterations in all tissues and organs, as well as normal cellular physiology, which can increase the risk for various non-communicable diseases in both young and older individuals[3]. It can also impair normal immune function leading to increased susceptibility to infections and tumors as well as poor response to vaccines3.

Immediate oxidant stress (free radical production)1

o  Oxidant stress acutely triggers inflammation which negatively impacts the immune system3. In addition, this oxidant stress also increases LDL oxidation, vessel constriction and clot formation, all of which contribute to cardiovascular disease1.

Endothelial (blood vessel) dysfunction1 2

o  High blood sugar decreases blood vessel dilation (reducing blood flow) while simultaneously increasing leakiness of the blood vessels and how quickly the blood clots due to the inflammatory response. This reaction is similar to how a viral infection would trigger vascular inflammation leading to endothelial dysfunction, coagulation and cardiovascular disease[4]. Long term vessel “hyperpermeability” has been associated with increased aging and diseases such as Parkinson’s and Alzheimer’s[5].

Glycosylation of proteins and alteration of tertiary structures of complement2

o  While this might sound complicated, what is important to understand is that these changes make it difficult for the body to recognize foreign pathogens and eliminate them2. Changes in glycosylation may increase the inflammatory response, enable viral immune evasion (ability to escape), and promote cancer cell metastasis[6]. Auto-immune disease development such as lupus and irritable bowel disease involve glycosylation of one or more glycoproteins6.

This diagram shows a summary of how systemic chronic inflammation (SCI) develops and what it can lead to. 

How much sugar does it take?

To provide a little bit of context, the chart below shows the immediate effects of consuming a beverage containing 75g of glucose. This amount of sugar is similar to a cup and a half of white rice (68g). You will notice that within a few hours the amount of glucose and triglycerides increase significantly which leads to immediate oxidant stress (nitrotyrosine), inflammation (C reactive protein [CRP]) and endothelial dysfunction via decreased blood flow via reduction in the diameter of blood vessels (FMD).

Another study looking at the immediate effects of sugar consumption found that people who consumed 40 grams of added sugar from just one 375ml can of soda experienced an increase in inflammatory markers, insulin resistance and LDL cholesterol[7].

In addition to the above, high sugar containing meals can alter our gut barrier function and drive gut bacteria imbalances (also known as dysbiosis). This can lead to what is referred to as “leaky gut” or intestinal permeability which fuels inflammation and taxes the immune system further[8]. In addition, altered gut bacteria has been suggested to contribute to a multitude of immune-mediated disorders such as irritable bowel disease [9]. Furthermore, as mentioned above, diets high in sugar have been implicated in the development of all kinds of diseases such as cardiovascular disease, type two diabetes, obesity, non alcoholic fatty liver disease, gout and autoimmune conditions such as rheumatoid arthritis[10].

How much sugar should we have and how can we reduce the negative impacts of sugar on our immune system and overall health?

The Heart and Stroke Foundation recommends that you consume no more than 10% of your total calories per day from added sugar – ideally less than 5%[11]. This means for someone with a 2000 calorie/day diet you should consume less than 48g (10%) of sugar. This is slightly more than one can of pop. The following are some key things you can consider doing to reduce the impact of high sugar foods on your immune system and overall health:

Fiber and low glycemic carbohydrates:

o  When eating carbohydrates, try to choose high fiber, low glycemic index (glycemic index <55) foods such as whole grains, beans and legumes, vegetables and berries. Carbohydrates in these forms are much harder to digest thus slowing the rate sugar enters the blood stream.

Protein and fat

o  Ensure you consume a healthy source of protein and/or fat with each meal or snack. The addition of protein and fat also helps to slow the rate sugar is released into the blood stream which prevents a spike in blood sugar. An example might be having almond butter with your banana.

o  Below on the left is an example of how adding whey protein to the same glucose drink reduced the increase of blood sugar after drinking1. On the right we have an example of how adding 90g of almonds to a high glycemic index meal reduced the area under the curve for glucose by 58%1.

Vinegar:

o  Research suggests that 1-2 tablespoons of vinegar added to a meal can lower post prandial glucose by 25%-35% as well as increase post meal satiety by more than two-fold1.

Avoid low glycemic and highly processed foods/beverages

o  Avoid highly processed foods and beverages which often contain high amounts of simple sugars, high fructose corn syrup and white flour.

Walk/Exercise

o  Walk for 10-30 minutes after each meal[12]. Short walks after each meal were found to be more effective for blood sugar control than one-time daily exercise regimes or the use of metformin alone[13] [14].

Reading food labels can help you make an informed decision on the foods you are eating. Remember, the daily recommended amount of sugar is less than 48g.

Ex: Tropicana – One serving of Tropicana juice is 34g of sugar. This is 72% of the recommended daily intake of sugar. In addition, orange juice in general is considered to have a glycemic index of 66-76 which is considered moderately to very high in regard to how much it will raise our blood sugar. 

Another example is BBQ sauce. Bulls Eye BBQ sauce has 12g of sugar/2tbsp. This means that just two tablespoons equal to 25% of the daily recommended sugar intake. However often in meals with BBQ sauce (such as a burger) we are having a bun, and ketchup and french-fries as well. This one meal quickly throws us far over the daily recommended intake.

Working with a healthcare provider can help you pinpoint which risk factors you have and how to safely reduce your risk and support better overall immune health. Be sure to talk with your health care provider before making any drastic lifestyle or dietary changes.

In health,

Dr. Brittany Pearce, RHN., ND.

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[2] Jafar N, Edriss H, Nugent K. The Effect of Short-Term Hyperglycemia on the Innate Immune System. Am J Med Sci. 2016 Feb;351(2):201-11. doi: 10.1016/j.amjms.2015.11.011. PMID: 26897277.

[3] Furman, D., Campisi, J., Verdin, E. et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 25, 1822–1832 (2019). https://doi.org/10.1038/s41591-019-0675-0

[4] Xu S, Jin T, Weng J. Endothelial Cells as a Key Cell Type for Innate Immunity: A Focused Review on RIG-I Signaling Pathway. Front Immunol. 2022 Jul 5;13:951614. doi: 10.3389/fimmu.2022.951614. PMID: 35865527; PMCID: PMC9294349.

[5] Oakley R, Tharakan B. Vascular hyperpermeability and aging. Aging Dis. 2014;5(2):114-125. Published 2014 Apr 1. doi:10.14336/AD.2014.0500114

[6] Reily C, Stewart TJ, Renfrow MB, Novak J. Glycosylation in health and disease. Nat Rev Nephrol. 2019 Jun;15(6):346-366. doi: 10.1038/s41581-019-0129-4. PMID: 30858582; PMCID: PMC6590709.

[7] Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, Berthold HK, Spinas GA, Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr. 2011 Aug;94(2):479-85. doi: 10.3945/ajcn.111.013540. Epub 2011 Jun 15. PMID: 21677052.

[8] Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019 Aug;68(8):1516-1526. doi: 10.1136/gutjnl-2019-318427. Epub 2019 May 10. PMID: 31076401; PMCID: PMC6790068.

[9] Zheng, D., Liwinski, T. & Elinav, E. Interaction between microbiota and immunity in health and disease. Cell Res 30, 492–506 (2020). https://doi.org/10.1038/s41422-020-0332-7

[10] Moling O, Gandini L. Sugar and the Mosaic of Autoimmunity. Am J Case Rep. 2019;20:1364-1368. Published 2019 Sep 15. doi:10.12659/AJCR.915703

[11] https://www.heartandstroke.ca/healthy-living/healthy-eating/reduce-sugar

[12] Bellini A, Nicolò A, Bazzucchi I, Sacchetti M. The Effects of Postprandial Walking on the Glucose Response after Meals with Different Characteristics. Nutrients. 2022;14(5):1080. Published 2022 Mar 4. doi:10.3390/nu14051080

[13] Pahra D, Sharma N, Ghai S, Hajela A, Bhansali S, Bhansali A. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr. 2017;9:64. Published 2017 Aug 31. doi:10.1186/s13098-017-0263-8

[14] Erickson ML, Little JP, Gay JL, McCully KK, Jenkins NT. Postmeal exercise blunts postprandial glucose excursions in people on metformin monotherapy. J Appl Physiol (1985). 2017 Aug 1;123(2):444-450. doi: 10.1152/japplphysiol.00213.2017. Epub 2017 May 18. PMID: 28522762.