Dr. Ashley Riskin BSc, MD, CCFPFunctional Medicine, Goals, Stress

If healthspan is the goal, then one of our principal strategies is to thwart chronic diseases of aging — namely vascular disease (Cardiovascular disease), cancer, cognitive decline and metabolic dysregulation (Diabetes and obesity).
In my practice, I promote the philosophy that small changes over multiple lifestyle categories can have a profound overall impact — because they can.

Dr Ashley E Riskin

Make sleep an absolute priority
Sleep is non-negotiable in our practice with our patients. Throughout evolution, we have maintained the requirement for sleep to approximate 1/3 of our lives. We haven’t developed the ability to bank it or go without it for long. This is for good reason- sleep has a deep impact on hormone regulation, cognitive function, metabolism, and immune function. Unfortunately, you can’t make it up if you miss too much on a regular basis. Society has become chronically sleep deprived. Whether it be from screen time or artificial light, to shift work or stimulants, we’ve lost a lot of our connections to circadian living. If you’re like many, you’re on a average 1 to 2 hours short on nightly sleep. Finding out by tracking slept to see your patterns. Consider a digital device such as a Oura Ring or FitBit if you like data. Otherwise, simply note bed and wake times and the subjective quality of your sleep. Be sure to rule out sleep apnea, as it’s linked to all cause mortality and many conditions we’re trying to avoid. If in doubt, get screened. It’s a simple take home test. If you’re like most, you’d benefit from more restorative sleep. Consider limited screen time by 1 to 2 hours before bed and turning on screen dimming or colour filters. Try blue-blocking glasses around bright and artificial lights. Limit electronics in general including social medial and email at night. Get help if you are struggling. Several herbs and supplements and other strategies can be used safely. Consider looking at the work of sleep expert and neuroscientist Dr Matthew Walker, PhD.

Get Screened We’ve entered an era of more advanced and precise diagnostics with, among others, the omics revolution. We can look at genes and small molecules to get a sense of what is going on in the body in a deeper way. Whether you’re on board with these emerging technologies or not, it makes sense to ensure you’re being adequately screened. My first principal in helping patients improve health and lifespan is to do my best to rule out active disease and assess for risk. Ensure you’re getting the basics covered, surprisingly, many do not. Check your blood pressure, cholesterol profile, kidney function and fasting glucose. If sexually active, screen for STIs regularly. Check that your cancer screening is up to date (ie. cervical, breast, colon, prostate). Admittedly, our ability to pick up early cancers needs to improve – and it will. In our practice, for the appropriate patient, we’re using MRI as a cancer screening tool. There are novel blood tests coming soon that may offer a better glimps at overall cancer status (ie. liquid biopsies). Patients can also refer to the Provincial Health Services Authority guide on screening found online at www.phsa.ca/health-info/staying-healthy/health-screening.

Test and take Omega-3s
I’ll expand in future columns on our go-to tests, but one that you may choose to look at this year is your Omega-3 status. Omega-3 fatty acids are found in fish and fish oil, along with other plant-based sources such as flax. Data seems convincing that having increased Omega-3 levels can be of benefit to your cardiovascular system, brain and overall levels of inflammation among others. Much has been made of Omega-6 fatty acids being ‘bad’ but this isn’t exactly the case and they make up an important part of our diet. Fatty acids are vital for human physiology; they make up a crucial part of the membrane of each of our cells. It may be worth getting your Omega-3 fatty acid status checked. We have chosen to use the RBC (red blood cell) Omega-3 index that looks at how much Omega-3, in the form of EPA + DHA, is in the membrane of the red blood cell. We aim for 8 to 12%. If you are low, you can supplement with both fish and non-fish sources from food or supplements.

Start Fasting When it comes to food consumption, the advice is endlessly confusing. The bottom line is that there are only three variables when it comes to eating: what you eat, how much you eat and when you eat. While studies have demonstrated aging benefits with calorie-restriction, there are concerns with chronically depriving oneself of nutrients — and few would enjoy this way of life. In terms of what to eat, this topic has previously been covered and the specifics are beyond the scope of this article. But when we eat is at the forefront of the fasting trend and the science is compelling. From metabolic regulation, to potential gut healing, to immune resetting, to potentially chronic disease prevention, my top 2020 pick for you is to dive into the world of fasting — at least in some capacity. I’ve previously covered this topic in LivePure too. Let’s suffice to say, I think this is the most powerful tool in our arsenal for delaying the onset of chronic diseases of aging and improving healthspan. If you’re new to the concept, simply try skipping breakfast or dinner a few times per week and see how you feel. Work your way up to an 8-hour eating window (16-hour fasting window); which would mean, for example, not eating until 1pm and not eating after 7pm. If you’re more experienced, consider adding in 20- to 24-hour fasts into your week on a regular basis. It appears that there are deeper benefits to pushing some of these fasts out even further – with permission from your health professional, consider trying it.

Get into a sauna on a regular basis It turns out that the ancient practice of exposing oneself to extreme heat may very well have health benefits that would serve us well to consider. Emerging data suggests that regular sauna therapy appears to improve cardiovascular health, reduce inflammation, and improve brain health and mood, as well as other hormone functions, while it reduces effects from environmental toxins. The molecular mechanism for these findings is the subject of current research but appears the stress from high heat induces several molecular pathways that serve to regulate immune function, cell repair and cell-cycle regulation. This is certainly a modality that I’ll personally use more in 2020! In particular, I’m impressed by the potential benefit on blood pressure and endothelial function (health of arteries). And keeping our arteries happy and healthy is vitally important if healthspan and longevity is your goal. Sitting in a sauna also provides an opportunity to be present and mindful, something we could all use more of.
Photo by Jason Hogan

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