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Increase Your Mobility in Just 7 to 10 Days NEM® (Natural Eggshell Membrane) provides the fastest, most effective natural solution for relieving osteoarthritis and other joint conditions. NEM was proven in clinical trials to reduce joint pain and improve mobility in just 7 to 10 days – without the potentially serious side effects of NSAIDs and other medications conventionally used to treat degenerative joint conditions. Whether your reduced mobility and joint pain is due to osteoarthritis, repetitive movement, trauma, or sportsrelated injuries, webber naturals® offers high quality, trusted products for joint health, protection, and repair. CLINICAL STRENGTH  NEM ® from webber naturals®, in a convenient one-per-day vegetarian capsule, provides a full strength dose of the same NEM formula proven in clinical trials. Ruff, K.J., DeVore, D.P., Leu, M.D., Robinson, M.A. (2009). Eggshell membrane: a possible new natural therapeutic for joint and connective tissue disorders. Results from two open-label human clinical studies. Clin Interv Aging, 4:235-40. Epub 2009 Jun 9. Ruff, K.J., Winkler, A., Jackson, R.W., DeVore, D.P., Ritz, B.W. (2009). Eggshell membrane in the treatment of pain and stiffness from osteoarthritis of the knee: a randomized, multicenter, doubleblind, placebo-controlled clinical study. Clin Rheumatol, 28(8):90714. Epub 2009 Apr 2.

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Leaf extract of Ginkgo biloba, the oldest known tree species, has been used in traditional Chinese medicine for centuries. Clinical studies have shown that Ginkgo biloba can help improve cognitive function and long-term memory recall, support brain and peripheral circulation, and mitigate age-related disorders including memory loss, Alzheimer’s disease, and dementia.

Synergistic Effect Bacopa - mentioned in Indian texts as early as the 6th century - has been linked by recent research to improved mental clarity, improved learning ability and clear thinking, decreased forgetfulness, and reducing the effect of stress on the brain. Green tea extract (Camellia sinensis), a staple of Asian diets for centuries, is a potent source of polyphenols, including the powerful antioxidant catechin epigallocatechin gallate (EGCG). Research has suggested that consumption of antioxidants can protect against some vascular disorders and neurodegenerative diseases that are thought to be caused by oxidative stress within the body.

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editor’s letter

Olivier Felicio Publisher/Editor-in-Chief

www.ihrmagazine.com Carol Crenna

Editor

TM

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IHRMAGAZINE.COM • FALL 2013


The Future of the Natural Health Industry THE HEALTH RETAIL ENVIRONMENT IS NOT WHAT IT ONCE WAS. It’s not for lack of consumer interest. In fact, the natural health industry has seen steady growth – in the double digits – every year for the last 10 years. It is predicted to stay the same for the foreseeable future. In spite of this growth, however, many health boutiques have seen shrinking sales,While the market is getting bigger, with everyone’s market share of the pie is shrinking. WHY INTEGRATION IS THE KEY TO SUCCESS The real issue doesn’t lie in American competition however. The real issue has always been the integrated health market – or the failure of the health businesses to integrate. The consumer is no longer isolated. They are savvy, fueled by the Internet and easy-to-access information on health care, nutrition and fitness. If the small health business owner wants to succeed, they need to tap into the consumers’ desire to learn about their health and to treat ailments what they are are and comfortable with while including natural health alternatives. They also need to provide information that consumers can’t get over the Internet alone. This means a network of professionals and retailers coming together to target the health issues people are facing. The retailers, pharmacists, naturopathic doctors, MDs, suppliers – even the manufactures – need to educate themselves on how food, supplements and pharmaceuticals can work together to provide the best health options for the consumer. People coming into a health food store or section of your store with a particular disorder should be able to find a employees willing to understand the needs and how to communicate the solution. Our cover story (page TK) profile, Farid Wassef, saw this need for integration two decades ago when he opened a clinic adjacent to his Stouffville, Ontario pharmacy so that he could educate consumers and become a more active part of their health care plan. “I became very frustrated with this model that only allows a couple of minutes to interact with a patient at the pharmacy counter,” stated Wassef when he spoke with IHR. “While a pharmacist may not be permitted the act of diagnosis, I found many MD’s in the Stouffville and the surrounding area were eager to collaborate

w an objective and evidence-based person with providing good information on natural medicines,” says Wassef. “Through these collaborations we were able to offer patients a broad array of integrative diagnostic techniques in addition to standard laboratory procedures.” Retailers need to think out of the box and interact with the consumers and the health care providers if they want to make it in today’s competitive market. Without that concept the individual health retailer’s slice in the Canadian market is going to continue to shrink, despite the growing market overall. SAVVY CONSUMERS The face of the consumer has changed. They have grown more savvy and want to know more about their health. The traditional retail experience is not working for them. That traditional retail experience is not reaching the new wave of shoppers and the core clients are slowly changing their buying behavior. The most promising aspect of competiveness and differentiation is the integrated health market. Each segment of our trade can’t operate separately in its own world. Similar to what the digital camera did to the photography world, we need to step up to the plate and work with change instead of against it. Consumer demand is aggressively expanding. The best example of integration working in a positive way is how the traditional supplement-based health boutique has been integrating with the professional market. Both sides have greatly benefited as one can feed the other. Professionals can now integrate with the supply chain. Many of the trendy ingredients today are ingredients that have been in the market for decades and whose benefits are extremely well documented – helpful for a regulatory aspect. A SOLUTION PROVIDER In the new model, you are the solution provider, not just a sales person. The human resources generation gap – very young or very mature clerks – doesn’t have to be an issue. As long as people know and understand the common language of health everyone can communicate and share This business vision is not restrictive to your size. Anyone can participate. All it takes is a willingness to adapt and share. FALL 2013 • IHRMAGAZINE.COM

11


New research may help put a stop to mosquito bites by imparing their sense of smell (p.48)

CONTENTS Volume 14 Issue 3 UP FRONT

Editor’s Letter...........................................................................................................10 Editorial Board.......................................................................................................... 15 Contributor’s............................................................................................................ 16 Get The Goods......................................................................................................... 17 SKU Review.............................................................................................................. 18

NEWS Industry News......................................................................................................... 26 Track the latest deals, industry trends and strategies Research News.........................................................................................................56 Get the latest on the cardioprotective effects of cocoa, fatty acids and more

How to awaken the Zentropreneur in You

Hibiscusan emerging new botanical medicine (p.60)

12

IHRMAGAZINE.COM • FALL 2013

(p.52)


section header

A pancea for Human Disease (p.43)

Walmart Urges Use of Greener Chemicals in Beauty and Household products (p.32)

F E AT U R E S Feature Story.......................................................................................................34 Farid Wassef on why intergrated medicine is the key to success Nigella Sativa............................................................................................................43 A panacea for Human Disease The End of Deet?.................................................................................................... 48 New research may help put a stop to mosquito bites by impairing their sense of smell. How to Awaken the Zentrepreneur in You..........................................................52 Four steps to manifest fearlessness and peak productivity in your work amd relationships. Hibiscus.................................................................................................................... 60 An emerging new botanical medicine The Death of the Vacation.................................................................................... 64 How to avoid the dreaded Emailinteruptus-smartphoneitus

END NOTES Fax Back.....................................................................................................................73

14

IHRMAGAZINE.COM • FALL 2013


editorial board We believe that you, the retailer, dictate the tone and direction of the magazine, which in turn, allows us to provide you with the most accurate information that is relevant to your business. IHR works with a knowledgeable group of industry leaders whose mandate is to ensure the relevance of the publication. Our editorial committee is comprised of thought-provokers who have shaped the industry and whose experience is vital in providing you with tools to succeed. The IHR editorial committee is led by the following individuals:

GET YOUR INDUSTRY NEWS DELIVERED EVERY DAY VIA E-MAIL

Olivier Felicio President The RGM Group

Andrew Betts Category Manager, Natural Foods Thrifty Foods

Sanjiv Jagota President Nature’s Source

Gilles Houde President and COO GNC Canada

Aaron Skelton, BSc (NNS) Sr. Category Manager, Health Food, Natural Value, Soins Naturels, Loblaw Companies Ltd.

Dean Mosca President Proprietary Nutritionals Inc.

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YOUR HEALTH CATEGORY SOURCE

FALL 2013 • IHRMAGAZINE.COM

15


contributors J O H N J . M U R P H Y is a mystic of management and sensei of strategy. For the past 30 years, Murphy has focused on teaching his corporate clients conscious business practices while improving their bottom lines. His clients include: GE, BMW, Target, Kraft, the CIA and currently ADP. Murphy has drawn on his diverse experiences as a corporate director, Notre Dame Quarterback, spiritual mystic and management coach. He is also the author of 15 books.

YOUR HEALTH CATEGORY SOURCE

ISSN 1197 - 1495 | V O L U M E 1 4

ISSUE 2

FOUNDER, PUBLISHER & EDITOR-IN-CHIEF

Olivier Felicio EDITOR

Nancy Ripton EDITORIAL INTERN

Marielle Torrefranca ART DIRECTOR

K E N V A N N U C C I is a Merchandise Manager for London Drugs, responsible for OTC, NHP, Vitamins, Baby and Grocery. Ken has a passion for retail, and has been with London Drugs since he graduated from UBC in 1989 with a Bachelor of Commerce specializing in marketing. He has a keen interest in product and package development and the marketing of products, with emphasis on consumer-packaged goods. Ken is from Trail, B.C. and is married with two sons.

Malcolm Brown

PRODUCTION MANAGER

Erin Booth

CONTRIBUTORS

John J. Murphy, Hiedi Fritz, Philip Rouchotas, Ken Vannucci

TheRGMGroup. Toronto

Paris

PRESIDENT

Olivier Felicio CEO

Cory Boisselle CHIEF MARKETING OFFICER

Zinnia Crawford

CONTROLLER & O P E R AT I O N S M A N AG E R

H E I D I F R I T Z has been a practicing naturopathic doctor since 2007. Her areas of clinical focus include: women’s health (fertility & pregnancy, menopause, endometriosis, PCOS, etc), children’s health (autism/ ASD, immune health, skin conditions, ear infections, allergies), and all types of cancer. Fritz serves as a Research Fellow at the Canadian College of Naturopathic Medicine (CCNM), responsible for conducting studies of natural medicine for various health concerns, with a focus on cancer therapy. She graduated from CCNM in 2007 and holds an honours undergraduate degree in Human physiology and a Masters of Arts degree, both from the University of Toronto. Heidi has also practiced as a registered practical nurse in Multi-Organ Transplant at Toronto General Hospital.

Melanie Seth

C R E AT I V E B U S I N E S S C O O R D I N ATO R

Erin Poredos

Subscription Rates Canada $50 (gst included) for nine issues (one year) USA $60 Change of Address email: ihr@publicationpartners.com telephone: 416-203-7900 fax: 416-703-6392 or send your cover label and new address to ihr c/o Rive Gauche Media 60 Bloor St., W., Suite 1106, Toronto, ON Canada M4W 3B8

A DV E R T I S I N G I N F O R M AT I O N

Olivier Felicio

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Deborah Taylor

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Paul Airut

P H I L I P R O U C H O T A S is a practicing naturopathic doctor since 2004. Rouchotas’ areas of clinical focus include metabolic syndrome, autoimmune conditions, and psychiatric concerns. Rouchotas serves as an associate professor at the Canadian College of Naturopathic Medicine (CCNM) and he is the Editor-in-Chief of Integrated Healthcare Practitioners, a peer-reviewed journal reaching naturopathic doctors, chiropractors, and medical doctors across Canada. Philip graduated from CCNM in 2004, preceded by an honours undergraduate degree in Nutritional Sciences and a Masters degree in Nutritional Sciences, both from the University of Guelph.

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IHRMAGAZINE.COM • FALL 2013

telephone: (416) 203-7900 x 6103 email: paul@gorgmgo.com

Jeff Yamaguchi

telephone: (416) 203-7900 x 6122 email: jeff@gorgmgo.com

Erin Poredos

telephone: (416) 203-7900 x 6128 email: erin@gorgmgo.com

Published by Rive Gauche Media Inc. Canada Post Canadian Publications Mail 4067800 The publisher does not assume any responsibility for the contents of any advertisement and any and all representations or warranties made in such advertising are those of the advertiser and not of the publisher. The publisher is not liable to any advertiser for any misprints in advertising not the fault of the publisher and in such an event the limit of the publisher’s liability shall not exceed the amount of the publisher’s charge for such advertising. No portion of this publication may be reproduced, in all or part, without the express written permission of the publisher. All rights reserved. ©Copyright 2013 Rive Gauche Media Inc. ihr magazine is pleased to review unsolicited submissions for editorial consideration under the following conditions: all material submitted for editorial consideration (photographs, illustrations, written text in electronic or hard copy format) may be used by ihr Media Inc. and their affiliates for editorial purposes in any media (whether printed, electronic, internet, disc, etc.) without the consent of, or the payment of compensation to, the party providing such material. Please direct submissions to the Editor, ihr magazine.


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OSTEO CAL:MAG

Building your strength inside out, Osteo Cal:Mag uses the ideal 1:1 ratio of Calcium to Magnesium in a base of raw, organic kale for increased mineral absorption coupled with Vitamins D & K2, boron, and Bamboo Silica for superior assimilation and bone building abilities.

NEM® NATURAL EGGSHELL MEMBRANE, CLINICAL STRENGTH

500 mg | 30 capsules NEM® Natural Eggshell Membrane reduces joint pain and improves mobility in just 7–10 days. NEM® is clinically proven to be the fastest, most effective nutritional formula for relieving osteoarthritis and other joint conditions. Clinical Strength NEM® from webber naturals® provides a full-strength dose of the same NEM formula proven in clinical trials.

HOLISTA® TEA TREE OIL 100% PURE

Tea tree oil has many uses: fighting fungal infections on fingernails and toenails; treating acne; or treating and preventing head lice. Use Holista tea tree oil as a first aid remedy for infections, minor skin ailments and abrasions or you can even add it to household cleaning solutions to boost antibacterial activity. You might say it’s nature’s first aid kit in a bottle!

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SKU Review

NE M® NATUR A L EGGSHELL ME MBR A NE , CLINIC A L STRENGTH

500 mg | 30 capsules NEM® Natural Eggshell Membrane reduces joint pain and improves mobility in just 7–10 days. NEM® is clinically proven to be the fastest, most effective nutritional formula for relieving osteoarthritis and other joint conditions. Clinical Strength NEM® from webber naturals® provides a full-strength dose of the same NEM formula proven in clinical trials.

DIABE TE X IMPROVE | A LPHA LIP OIC ACID, MULBERRY, CINNA MON A ND BLUEBERRY

120 capsules Diabetex Improve from webber naturals® brings together rich sources of beneficial compounds, such as anthocyanins, fagomine, and cinnamaldehyde, for management of healthy blood glucose. These potent phytochemicals also offer antioxidant protection against oxidative damage, as well as reducing the production of reactive oxygen species at the mitochondrial level, helping to reduce the effects and progression of diabetes.

ADRENERGY PROVIDE S A DRENA L SUPP ORT ( ADA P TOGENIC FOR MUL A )

The adaptogenic plants used for Adrenergy reduce the damage that can be caused by stress by modulating the hypothalamic-pituitary axis and the sympathetic adrenal system. The main property of these plants is that they allow the body to modify its reactions so that it functions optimally while expending the minimum amount of energy. Adaptation reactions occur during experiences such as trauma, overstress, shock, infection or intoxication. The ability to adapt well makes it possible for the body to endure these negative effects. • Improves physical resistance
 • Supports the body both physically and mentally particularly during periods of stress and or chronic stress • Increases concentration and mental clarity
 • One of a select group of products containing adrenal glandular to have been awarded an NPN number.

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IHRMAGAZINE.COM • FALL 2013


SKU Review

HOLISTA® A RNIC A GEL

Arnica Muscle and Joint Gel helps to reduce soreness and inflammation in muscles and joints. The medicinal herbal gel is ideal for the relief of minor pain and inflammation due to minor injury, bruises, sprain, arthritis or overexertion. It’s non greasy and fragrance free; a must-have for your herbal first–aid kit!

X Y LOS W EE T ®

XyloSweet is 100% pure xylitol—an all natural sweetener that has the same sweetness as regular sugar without any aftertaste. Since XyloSweet is 40% lower in calories with zero net carbs and safe for diabetic usage, it is an ideal sugar replacement for any sugar-controlled diet. • Sugar-sweet with no aftertaste • Glycemic index: 7 (Table sugar: 85; Glucose:100) • Non-GMO • Gluten-free • Highest quality (pharmaceutical grade) • Safe for usage with any sugar-controlled diet • zero net carbs

HOLISTA® TE A TREE OIL 100 % PURE

Tea tree oil has many uses: fighting fungal infections on fingernails and toenails; treating acne; or treating and preventing head lice. Use Holista tea tree oil as a first aid remedy for infections, minor skin ailments and abrasions or you can even add it to household cleaning solutions to boost antibacterial activity. You might say it’s nature’s first aid kit in a bottle!

FALL 2013 • IHRMAGAZINE.COM

19


SKU Review HHC0550

HEAVY METAL DETOX

This exclusive formula from Europe contains both humic and fulvic acids, highly effective mineral chelators that help to decrease blood levels of heavy metals such as lead, mercury, and cadmium resulting in better digestion, immune function ,sleep, skin, and energy levels.

OSTEO CAL:MAG

Building your strength inside out, Osteo Cal:Mag uses the ideal 1:1 ratio of Calcium to Magnesium in a base of raw, organic kale for increased mineral absorption coupled with Vitamins D & K2, boron, and Bamboo Silica for superior assimilation and bone building abilities.

SILIC A

Silica is one of collagen’s principal constituents and in time deteriorates and looses elasticity, resulting in the skin loosening, hair thinning out, and nails becoming brittle. Because of the refinement and transformation of today’s foods, our daily diet offers less and less silica, a supplement is therefore a good a way to compensate. Land Art developed SILICA, a gel made from 100% pure silicon retrieved from diatoms, fossilized plant cells found on the ocean floors. Prepared as a colloidal emulsion (suspended in a gel composed of water and natural gum), it is bioavailable and possesses a better assimilation for the system. Orange oil is added for flavor enhancement. Land art does not use any chemical substance or solvent in the extracting process of its silica, preferring water as its unique vehicle.

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IHRMAGAZINE.COM • FALL 2013


SKU Review

BRONKOTUX S Y RUP

Bronkotux syrup is the ideal family remedy (from young to old). When the afflections of the coming fall and winter season threaten it’s action can be counted on to safely, effectively and quickly relieve and treat upper and lower respiratory infections as well as symptoms of asthmatic cough and flu. This herbal formula will work to restore the fluidity and normalize bronchial elasticity to properly mobilize and expectorate mucus. The bronchial epithelium regains its ability to secrete a protective mucous coating(not excessive or dried out) which will not hinder the movement of the ciliary . The cough reflex thus disappears. Indications : Wheezing,whistling,rattling in the chest. Cough suppressant and cough soother. Expectorant. Bronchitis. Chest pain when coughing.

PROBIOM A X

Probiotics can have many benefits when taken in adequate amounts and must contain a wide variety of strains in order to be compatible with the largest spectrum of individuals and ensure complete coverage of the intestinal tract. Thus, multi-strain probiotics have an increased efficiency compared to single strains ones. Probiomax contains the largest variety of bacterial strains (up to 10 different strains) and a higher concentration in its product category. Benefits include shortened duration of infections or decreased susceptibility to pathogens and viruses. Wampole Probiomax also offers 4 unique and complete formulas to stimulate the immune system and relieve digestive discomforts.

TR A NS HERBE

Warm up your sales during the chilly season with the New Four O’clock Winter Collections ! Four O’clock the tea and herbal tea specialist, have concocted four new Authentic, Intense and Delicious recipes. A limited edition of four collection boxes created by a Canadian Artist.Gingerbread Herbal Tea, Banana Cinnamon Spice Black Tea Almond Biscotti White Tea and Truffle Mint Herbal Tea. Enjoy a new flavor !

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SKU Review

HOLISTA® DE TOX K IT

The Body Clean Detox Kit provides two natural products, Clear Digest and Milk Thistle, to help promote overall health of the digestive tract and to support and eliminate toxins from the liver. Directions and diet recommendations are included in the kit.

ARGAN OIL

Argan Oil, a magic potion for your skin. Its high content in unsaturated fatty acids, vitamins A and E makes it an excellent restructuring elixir. It softens the skin and hands, strengthens nails and leaves hair silky. 100% organic, Nafha Cosmetic Virgin Oil reveals its restructuring and sensual secrets to your body.

MIGR AINE FOR MUL A

90 capsules Research shows the herb feverfew helps prevent migraines. Migraine Formula from webber naturals® contains standardized feverfew to ensure an effective, consistent dose. It also provides a gentle, easily absorbed form of magnesium because low magnesium levels are linked with migraines. Take Migraine Formula every day to reduce the frequency and severity of migraines.

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IHRMAGAZINE.COM • FALL 2013


Four O’Clock® teas, an original, bold, and intense experience in every cup!

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NEW!

Preventing Migraines feverfew · magnesium · ginger For centuries, feverfew (Tanacetum parthenium) has been used in traditional medicine to treat headaches, and scientific studies confirm its effectiveness in reducing the frequency and severity of migraine attacks. Researchers have found that magnesium deficiency is common in people who suffer from migraines, and that supplementation can bring relief. Ginger root (Zingiber officinale) has also been used in clinical practice because it reduces inflammation and platelet aggregation, factors linked to migraine. It also helps relieve digestive upset. Natural Migraine Formula from webber naturals ® provides daily nutritional support to help prevent migraine headaches. The feverfew is standardized and of the same form and dosage used in successful clinical trials. Migraine Formula also provides a gentle, easily absorbed form of magnesium, plus ginger root to help relieve nausea.

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Johnson, E.S., Kadam, N.P., Hylands, D.M., Hylands, P.J. (1985). Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed), 291(6495):569-73. Mauskop, A., Altura, B.T., Cracco, R.Q., Altura, B.M. (1995). Intravenous magnesium sulphate relieves migraine attacks in patients with low serum ionized magnesium levels: a pilot study. Clin Sci (Lond), 89(6):633-6. Pareek, A., Suthar, M., Rathore, G.S., Bansal, V. (2011). Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacogn Rev, 5(9):103-10. doi: 10.4103/0973-7847.79105.

AM001865_IHR-Sept13-fp-Migraine_E.indd 1

13-09-30 10:50 AM


industry news

Metro to reorganize Ontario store network and partner with Target in Quebec Metro is reorganizing its Ontario grocery store network and will become the exclusive operator of Target’s pharmacies in Quebec as it continues to adjust to intense competition and dramatic changes in the Canadian supermarket and pharmacy businesses. The Montreal-based company – one of Canada’s largest grocery retailers – said 15 stores would be affected including six Metro stores in Ontario that will be converted to the Food Basics discount banner and up to three underperforming locations that will be closed over the coming months. Metro said it will also offer buy outs to an unspecified number unionized employees at the other affected Ontario stores as it aims to reduce labour costs. It declined to say how much will be saved or how many people will be let go.

PRICE OF WHEY CONTINUES TO RISE

Gym regulars will have to pay even more to fuel their muscles. The price of whey increased to seven euros per kilogram or $9.62 Canadian dollars/kg. The price of whey has been on a steady increase due to commodity shortages and demand by china. The price of whey starts with the milk supply, as whey is made from whole milk. The demand for milk has become so high in countries like China and Russia that independent farmers are now outsourcing and doing less business with American companies. As the North American milk supply continues to shrink, the price increases are passed on all dairy products. Moreover, the price of removing lactose and fat to make whey protein isolates is expensive, further driving up costs. Looks like the price of whey has only one way to go – up.

The company, which has 263 Metro and Food Basics stores in Ontario, said it will take a $40-million restructuring charge in its next quarter related to the reorganization. Meanwhile, Target Corp. will partner with a Metro subsidiary under an agreement that will see Brunet own and operate 18 pharmacies that Target will open next summer in Quebec. The deal will raise its Brunet store count to 168 and nearly double its presence on the island of Montreal. Metro has said it is interested in growing its pharmacy division, especially in Quebec. La Fleche said it will consider other expansion opportunities should they become available. Minneapolis-based Target, which has acquired much of the space formerly occupied by Zellers, said it plans to open its first 25 stores in Quebec this fall. Only 18 will have pharmacies, but Metro will have the exclusive right to add other Brunet locations as Target expands its presence in the province. Under Quebec law pharmacies must be owned by individual pharmacists. The Brunet locations inside Target stores

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will be run by independent pharmacists supplied by Metro’s McMahon subsidiary, which also distributes pharmaceutical products. McMahon will supply the prescription drugs and over-the-counter medicines while Target will provide its private-label brands. Financial details were not disclosed. Metro is facing increased pressure to expand following recent deals by Loblaw to purchase Shoppers Drug Mart and Sobeys to buy Safeway Canada based in Western Canada. Quebec-based Jean Coutu Group has been named as one of the likely takeover targets. Metro’s changes were announced Wednesday as it reported a third-quarter profit of $149.8 million or $1.55 per share, up from $144.4 million or $1.43 per diluted share a year ago. However, sales slipped to $3.57 billion for the quarter ended July 6 compared with $3.6 billion a year ago. Same-store sales decreased 0.9 per cent, but were flat excluding the loss of a day of business because Canada Day was in the third quarter this year. Metro’s banners include Metro, Metro Plus, GP, Super C and Food Basics, as well as Brunet, Brunet Plus, Clini Plus, The Pharmacy and Drug Basics. – The Montreal Gazette


industry news

Ontario Natural Food Co-op Ontario Natural Food Co-op Acquires Black River Juice Company Ltd. Ontario Natural Food Co-op (ONFC), one of Ontario’s largest distributors of Natural and Organic foods and products, announced in July that it has purchased the assets of one of Canada’s leading juice brands - Black River Juice Company. Aligned in their business values, Black River and ONFC bring to market natural, organic and local foods and products that deliver on the highest standards of quality and service. The strategic focus of both companies are dedicated to building a local food system that keeps sustainability and closely forged relationships with their farming partners and vendors at the forefront. The purchase of the Black River assets continues to grow ONFC’s own brand portfolio and distribution model building their leadership presence within the Ontario marketplace. “Black River is a venerable Canadian Company that has a heritage which is built on similar guiding principles as ONFC’s. Bringing these products within the ONFC family allows us to expand our delivery of quality locally produced, natural and organic products to our members and customers” commented Randy Whitteker, General Manager ONFC. Canadian owned and incorporated, Black River Juice Company started its humble beginning in Prince Edward County. Enterprising local farmers introduced the premium juices using their own fruit crops, and soon found their workloads were increasing as demand grew rapidly. Preferring to concentrate on farming, they partnered with Keith Wallace and Grant Keane of Toronto to carry forward the mission of pressing and marketing their juices. Industry leaders in specialty fruit juices for more than 30 years, Black River’s experience in selecting, buying, ripening and blending fruit, connections with local growers, and exacting standards promise and deliver the highest quality and selection. ONFC will continue to produce to the same rigorous standards, nurturing the long-standing relationships with their local

farming communities. “We are very pleased that Black River will continue to make quality fruit juices in Ontario with ONFC. It is an excellent fit and we take comfort that our brand and product line will reside within a co-operative environment that shares our beliefs,” says Keith Wallace, President at Black River Juice Company Limited. Black River products can be found across the country in National Grocery Chains as well as small and large Natural Food Retailers. Partnerships with existing Canadian Distributors will continue to grow and expand building the brand’s market share. Who is Black River Juice Company? Black River Juice Company Limited, a certified organic producer, has been an industry leader in specialty fruit juices for more than 25 years. Black River juices are made from the finest ingredients available producing a premium line of un-clarified fruit juices and juice blends that possess the natural qualities of the original fruit. About Ontario Natural Food Co-op (ONFC): Ontario Natural Food Co-op is a cooperative headquartered in Mississauga, Ontario. ONFC has led the distribution of natural and organic food in the region since its inception in 1976. A member-owned and directed wholesaler, ONFC distributes over 4,500 grocery, refrigerated, frozen, bulk, and household items to natural and organic retailers in the eastern half of Canada. ONFC also produces and distributes a line of locally produced Natural and Organic products under the Ontario Natural Food Co-op brand. The company has established itself as the preferred supplier to small and large natural food stores, wellness clinics, daycare centres, buying clubs, and independent grocery stores. It consistently provides its members and customers with a high product fulfillment rate and unparalleled service levels in the industry.

WhiteWave Foods WHITEWAVE FOODS SETTLES HORIZON ORGANIC LABELING LAWSUIT.

WhiteWave Foods has settled a class action lawsuit that alleged it misled consumers by listing “evaporated cane juice” rather than “sugar” on a variety of products including: Horizon Low-Fat Milk Box’s in strawberry, vanilla, and chocolate; Horizon Organic Low-Fat Chocolate Milk plus DHA Omega-3; Horizon Fat-Free Vanilla Yogurt; and Horizon Tuberz yogurts. The lawsuit was filed in April 2013 in the US District Court in the Southern District of Florida. It alleged that several WhiteWave products were misleading because they listed “evaporated cane juice” on the label instead of sugar. The Broomfield, Colorado-based firm has settled the claim out of court but has denied any wrongdoing. They have, however, agreed to modify their labels. WhiteWave Foods will also be offering members of the class action a 75 per cent cash refund with proof of purchase up to $50 per household. Class members without proof of purchase can still claim a refund of 25 per cent under the terms of the settlement. Estimates are that the final cost to WhiteWave Foods could be $800,000. Who knew evaporated cane juice could be so controversial?

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industry news

Target Goodbye Zellers. Hello, Target. U.S.-based retail giant Target Corp. ended months of speculation Friday over its expansion into Quebec in spaces vacated by defunct Canadian giant Zellers. Target said it will open 16 stores here this fall: seven on Sept. 17, including one in Montreal’s Place Vertu mall, and another nine on Oct. 18. Since opening its first Canadian outlets last March in Ontario, Target has 68 stores nationwide. It plans to have 124 by the end of 2013. The chain bought the leases to about 220 of Hudson’s Bay Co.’s Zellers stores in January 2011, planning to renovate about half of them and re-open them as Target stores.

said, “and we look forward to serving our new guests and engaging with these great communities.” Fisher is booked to tour the new Target store in Laval with journalists on Sept. 16 and address his company’s Quebec expansion on Sept. 24 to the Board of Trade of Metropolitan Montreal. Through his Quebec spokesperson last week, the Toronto-based CEO declined a Gazette request for an interview. Here’s a list of new Quebec stores that opened September 17, 2013:

Based in Minneapolis, Minn., Target is North America’s biggest discount retailer after Wal-Mart.

• Montreal - Place Vertu

It has had growing pains since expanding into Canada in spring 2013. Sales of groceries, cosmetics, paper and health-care products have lagged; other items have run out of stock, and prices haven’t been as low as expected.

• Lévis - Galeries Chagnon

Last month, a Forum Research consumer survey of 1,500 Canadians found only 27 per cent were “very satisfied” with their experience at Target, down from 32 per cent in April. By contrast, in August, Costco rated 62 per cent and HBC 40 per cent.

• Brossard - Place Portobello • Laval - Méga Centre Autoroute 13 • Saint-Georges - Carrefour SaintGeorges • Saint-Jérôme - Carrefour du Nord • Trois-Rivières - Centre Commercial Les Rivières Quebec stores opening October 18 include: • Montreal - Place Versailles

In its second quarter, which ended Aug. 3, Target Canada ran a deficit of $169 million (U.S.) on sales of $275 million, mostly because of $256 million in expansion costs, and helped drive down the parent company’s stock price.

• Anjou - Galeries d’Anjou

Besides Quebec — where it intends to have 25 stores in all — the chain is opening stores in Nova Scotia and several more in the Ottawa area this fall.

• Saint-Bruno-de-Montarville - Les

In a news release, Target Canada president Tony Fisher called it an “unprecedented retail expansion covering all 10 provinces across Canada this year.”

• Saint- Eustache - Carrefour Saint-

“Quebec, Nova Scotia and Ontario offer a variety of culturally diverse markets,” he

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• Boisbriand - Faubourg Boisbriand • Gatineau - Les Galeries Gatineau • Joliette - Les Galeries Joliette • Quebec City - Place Fleur de Lys Promenades Saint-Bruno • Sainte-Foy - Place Laurier Eustache-Montreal Gazette

HAIN CELESTIAL HAS NEW CHIEF FINANCIAL OFFICER

Perfume maker Elizabeth Arden Inc.’s Chief Financial Officer (CFO) Stephen Smith has left his position with Arden to become the CFO at Hain Celestial Group Inc. effective September 3, 2013. Smith was CFO with Arden since 2001

ANOTHER VOLUNTARY RECALL BY VITA HEALTH

Since December 2011, Vita Health has been voluntarily recalling various Rexall, Compliments, Safeway, Life brand and other over-the-counter cold medications because of labelling errors. Some of the pain and cold relief packages are labeled as having childproof caps when they don’t, while others are missing allergy warnings or alerts about not taking the pills if you have certain medical conditions. The latest recall for Vita Health overthe-counter cold and flu medications is Personnelle Cold and Flu-in-One Extra Strength Convenience Pack because the product is missing a reference to important information. There is no information suggesting the quality of the products has been affected, only that their labels are misleading or incomplete.


industry news

Walgreens Walgreens Shifts Execs to Continue Collaboration with Alliance Boots LORNA VANDERHAEGHE HEALTH SOLUTIONS, INC. CONTINUES TO GROW IN AMERICA.

Lorna Vanderhaeghe Health Solutions, Inc. offers a premier line of science-backed nutritional supplements designed for women. The company creates high quality, research-proven nutritional supplements that promote optimal health and beauty. Their products are available across Canada and their business continues to grow within the United States and Canada. For the third year in a row they made Profit Magazine’s fastest growing company list. In 2012 they were ranked number 35 out of the top 500 companies in Canada.

VITORY BRANDS SIGN WITH VPX AND REDLINE SPORTS PRODUCTS

Canadian distribution giant VICTORY Brands has acquired the rights to distribute VPX and Redline Sports Products in Canada. VPX and Redline Sports Nutrition and Performance Beverages was founded in 1993 with the goal of producing the highestgrade, university proven sports nutrition supplements and performance beverages in the world. VPX has since funded over 15 landmark studies at top universities and continues to update and release new nutrition products.

Walgreens announced an enhanced daily living business organization with the promotion and leadership expansion of key marketing and merchandising executives to further accelerate the company’s strategic growth drivers and advance its vision to be the first choice in health and daily living for everyone in America, and beyond. The promotions and other changes in Walgreens’ daily living organization – which are effective October 1, 2013 – accompany the announcement by Walgreens and Alliance Boots GmbH that Alex Gourlay, chief executive of Alliance Boots’ health and beauty division, has been named Walgreens’ executive vice president, president of customer experience and daily living. Reporting to Walgreens president and CEO Greg Wasson, Gourlay will lead the enhanced Walgreens daily living organization overseeing U.S. merchandising, marketing, customer insights, customer experience and daily living products and promotions. “With our enhanced daily living and merchandising organization, combined with Alex Gourlay’s experience and expertise in global health and beauty, we are further expanding and complementing Walgreens already strong leadership team including Mark Wagner, president of operations and community management; Kermit Crawford, president of pharmacy, health and wellness; Graham Atkinson, our chief marketing officer and the creator of our 79-million member Balance Rewards loyalty program; and Sona Chawla, president of e-commerce and our omni-channel strategy,” said Walgreens president and CEO Greg Wasson. “By combining the best marketing and merchandising practices of Walgreens and Alliance Boots, we are accelerating our ‘Well Experience’ strategy to step out of the traditional drugstore format and create a truly differentiated experience for customers and patients.” The announcement includes a number of promotions and expansion of leadership roles of Walgreens daily living and merchandising executives:

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BRYAN PUGH becomes corporate vice president, U.S. merchandising program development and execution. As Walgreens continues to hone and expand transformational merchandise programs and prepares for further joint merchandise initiatives with Alliance Boots across beauty, personal care, health and wellness, Pugh’s newly created role will bridge operations and merchandising functions and oversee rollout of new merchandising initiatives to the field, including operating standards, cross-functional deployment and flagship rollout. MOE ALKEMADE becomes group vice president, global sourcing. With his deep experience in developing and marketing consumer-packaged goods programs, Alkemade successfully led the restructuring and strong growth trajectory of Walgreens private brand portfolio, and established the foundation for Walgreens global sourcing capabilities. In his newly created role, Alkemade will focus on optimizing global sourcing and daily living buying synergies with Alliance Boots and AmerisourceBergen.


industry news

iLevel Management Inc. ILEVEL MANAGEMENT HAS A NEW ONTARIO ACCOUNT MANAGER. Sean Crockett is the newest member of the iLevel Management team, taking the position of Ontario Account Manager. Crockett has owned two thriving holistic health centers in Ontario and sold them to enter the grocery business. He worked as a Nature’s Treasure manger in the early days of natural products growth at Fortinos Supermarkets (LCL).

SHANNON CURTIN is promoted to group vice president and general merchandise manager, beauty. Curtin will accelerate development and growth of Walgreens beauty proposition and customer experience across the United States, particularly underserved U.S. markets, and collaborate with the Alliance Boots and global partnership teams in maximizing U.S. opportunities for the Boots beauty proposition. ROBERT TOMPKINS is promoted to group vice president and general merchandise manager, health and wellness. Tompkins will accelerate development of innovative health and wellness products and programs for the U.S., collaborating with Alliance Boots and global partnership teams on joint program development.

JIM JENSEN becomes divisional vice president and general merchandise manager, seasonal and general merchandise, providing high-level, single-accountability focus on seasonal daily living products and promotions that are a key driver in Walgreens monthly daily living sales. BETH STILLER is promoted to group vice president, category planning, formats and innovation, and takes on an expanded role in merchandising with responsibility for category development, space planning, merchandise formats and program innovation, and private brands.

Crockett left Fortinos after many successes to take a position of regional manager for a national broker specializing in natural foods. This offered the opportunity to use his skills to help independent retailers compete in the open market. After many years of brand management and brokering Crockett took a position that offered him the ability to manage brands on a national level and to call upon retailers of many channels at the national level. Crockett has developed a keen eye and sense of trends in the marketplace and has identified new brands and products and successfully launched and built them in the Canadian marketplace.

AND LINDA SEVERIN, formerly of Kroger, where she led the redevelopment of its private brand portfolio, joins Walgreens as divisional vice president, private brands, responsible for product development, brand management and program execution of Walgreens private brands.

FALL 2013 • IHRMAGAZINE.COM

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industry news

Pacific Foods Look for a new line of premium, organic beans from Pacific Foods. Pacific Foods is introducing a new line of savory organic baked and refried beans, packed with premium ingredients and seasoned with chef-inspired flavours like garlic, sea salt and cilantro along with other spices. Packaged in BPA-free Recart cartons, the beans better retain their natural texture and fresh flavors when compared to canned competitors. Three versatile varieties will be rolling out to Canadian retailers

in September including: Organic Refried Pinto Beans Vegetarian, Organic Refried Black Beans, and Organic Baked Beans Vegetarian. Pacific’s line of beans ($2.99 - $3.23 for 13.6 oz.), both rich in protein and high in fiber, features simple non-GMO ingredients, slow-cooked to perfection. From a traditional barbeque side to a must-have ingredient for Mexican dishes, baked and refried beans are a true pantry staple.

Walmart Walmart Urges Use of Greener Chemicals in Beauty and Household Products. At its recent Global Sustainability Milestone Meeting, Walmart highlighted its progress with the Sustainability Index and outlined key initiatives where it can use its size and scale to help address hot spots and accelerate progress in supply chain sustainability, including in the beauty marketplace. “We’ve reached an acceleration point where we are moving from measurement to results. We’re starting to really drive progress with the Index,” Walmart president and CEO Mike Duke said. “This is about trust and value. Using less energy, greener chemicals, fewer fertilizers and more recycled materials—all of this is the right thing to do for the planet, and it’s right for our customers and our business.” Among its five new sustainability initiatives, Walmart is offering

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products with “greener” chemicals. Walmart provided an overview of its new Consumables Chemicals initiative, describing how it is working with suppliers to reduce or eliminate the use of priority chemicals used in consumables products in favour of greener alternatives. It will begin with household cleaning, personal care, beauty and cosmetic products, asking suppliers to transition to greener substitutes for priority chemicals.

LESLEE KLINEBERG FROM SIGNATURE SUPPLEMENTS INC. IS NOMINATED FOR ENTREPRENEUR OF THE YEAR. Leslee Klineberg, the owner and president of Signature Supplements Inc. ,was nominated for the 2013 RBC Canadian Women Entrepreneur Awards. Klineberg is a licensed, practicing naturopath based in Dartmouth, Nova Scotia. Her company is 100 per cent Canadian owned and operated and offers professional-only custom compounding.

BRIANNE ARNOTT JOINED SHANDIZ NATURAL FOOD AS BRAND MANAGER

Brianne Arnott is the new brand manager at the Shandiz Natural Foods team, joining in August 2013. Arnott was previously at Valeant Canada Consumer Products and Swiss Herbal Remedies.

ILEVEL MANAGEMENT INC. HAS NEW WESTERN CANADA ACCOUNT MANAGER iLevel Management Inc. is pleased to announce Richard Williams as the newest member of their team. Williams joined the iLevel Management team as the Western Canada Account Manager.


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Is integration the key to success

?

Farid Wassef is not your typical pharmacist. Here’s a look at how he developed his store and practice and why he’s now running for office to try to make positive changes to the health care system By Nancy Ripton

Photography by John Milios

FALL 2013 • IHRMAGAZINE.COM

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“When you act in the interest of the patient – and put their interest before your own – you provide optimal health care,” says Farid Wassef. It was this thinking that encouraged Wassef to open a clinic adjacent to his Stouffville, Ontario pharmacy practice 20 years ago. In fact, Wassef has always felt that integrated medicine is in the best interest of everyone involved in health care. BORN INTO PHARMACY

Wassef is a second-generation pharmacist who has worked and lived in Stouffville, Ontario for over 40 years. The family pharmacy was first owned by Wassef’s father Lou Wassef who purchased the pharmacy in 1974 after emigrating from Egypt in 1968 when Farid was just four years old. Growing up, Wassef helped out in the family pharmacy and saw at an early age the need for alternative forms of health care. “Even then I could see the effect the environment, stress, diet, lack of exercise – so many things – were contributing to people getting chronic illness. They just weren’t being addressed,” says Wassef. After graduation from the Massachusetts College of Pharmacy in 1989, Wassef took over management of the family pharmacy and his disillusionment with traditional medicine continued to grow.

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“The pharmacist typically has two or three minutes to spend with a patient when they are giving them their prescription,” says Wassef. “I became very frustrated with this model that only allows a couple of minutes to interact with a patient at the pharmacy counter.” Wassef felt he had more to share than that amount of time could afford.


His patient consultation practice involved integrating lifestyle changes, nutrition, and natural health products with pharmaceutical CHANGING THE DEFINITION OF care. “Within the scope of the practice of PHARMACIST pharmacy, a pharmacist is permitted to In 1993, Wassef decided to set up a clinical counsel on prevention and treatment of practice to support his pharmacy. “When disease, counsel on diet, lifestyle, nutritional I started there was a very narrow view and nutraceutical supplements, botanical that people got sick because of genetics,” medicines, and – of course – pharmaceutical says Wassef. “I took a lot of pain and drugs,” says Wassef. “While a pharmacist inflammation syndromes that went un- or may not be permitted the act of diagnosis, over-treated with medications and helped I found many MD’s in the Stouffville patients understand that they had other and the surrounding area were eager to options.” collaborate with an objective and evidencebased person THE PRACTICE OF INTEGRATIVE MEDICINE BEGINS, providing good GROWS, AND THRIVES THROUGH ONE COMMON information on SEED – PASSION. PASSION TO HELP OTHERS, TO SOLVE natural medicines. MYSTERIES COMMONPLACE ANSWERS SIMPLY DON’T Through these collaborations we MAKE SENSE FOR AND, ULTIMATELY, TO ACHIEVE were able to offer MAXIMUM POSITIVE IMPACT FOR PEOPLE USING THE patients a broad LEAST INVASIVE STRATEGY AVAILABLE. array of integrative diagnostic techniques in addition to standard laboratory procedures.” Of course, it wasn’t easy finding doctors to collaborate with at first. “People started singing praises to their physicians,” says Wassef. “People were getting better and it was a threat to physicians at first until they realized we could work together.” The idea of a pharmacist talking about alternatives to prescriptions may at first seem counterintuitive but in addition to being best for the patients it is also a great business decision.

FALL 2013 • IHRMAGAZINE.COM

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“Pharmaceutical companies realized that they can’t over market to the point where their product becomes misused and is taken off market,” says Wassef. “They want to make sure the drugs are taken appropriately.” The discontinuation rates for most drugs are high after six months. If you give less medication (to people who are healthier and eating right) they are more likely to stay on it for longer and have better results. “There is a pharmaceutical shift to promoting exercise, diet and fish oil,” says Wassef. Even Pfizer now owns Emergen-C. The pharmaceutical companies are becoming integrated and more patient centered and focused on health. Wassef’s father (who passed away in 2004) was supportive of his son from the beginning. “Coming from Egypt the idea of alternative medicine wasn’t foreign to him,” says Wassef. “He would compound Echinacea

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and ginseng in 50s and 60s.” He adds that “Ultimately, it’s about good medicine and good outcomes for the patient.” EXTENDING HIS REACH

Wassef was not satisfied with his role as pharmacist and practitioner. He was driven to spread the word to other pharmacists, doctors and anyone else who would listen as to the power of diet and lifestyle in health promotion, disease prevention and disease treatment. He was also eager to educate his fellow pharmacists as to the role they could and should be playing in their patients’ care. Working with the Institute of Functional Medicine (whom Wassef credits with providing most of the training he relies upon as a practitioner of integrative medicine), Wassef created a continuing education curriculum for pharmacists to receive training in integrative medicine. He also lectures across North America


to pharmacists and doctors regarding application of integrative medicine, and methods through which integrative minded pharmacists can successfully collaborate with MD’s in their community. His immense efforts to move the discipline of integrative medicine forward earned him the 2006 award for Canadian Pharmacist of the Year. While juggling the roles of a pharmacy manager, seeing 80-plus patients per week, authoring over 200 articles, CE courses, and books (including Breaking the Age Barrier –

WEIGHT LOSS, PREVENTION OF COLD AND FLU, ARTHRITIS AND SLEEP ISSUES ARE THE FOUR MOST COMMON COMPLAINTS WASSEF HEARS. NATURAL ALTERNATIVES CAN HELP WITH ALL OF THEM. Strategies for Optimal Health, Longevity, and Energy published by Penguin in 2003), and his ongoing industry consulting and speaking engagements, yet another intriguing path caught Wassef’s eye – politics. The idea of impacting healthcare from a “top down” approach made a lot of sense to Wassef. “I’ve been a strong advocate for my profession for last 20 years,” he says. “I got tired of hearing I had lovely ideas, but there’s no money. There is money! It’s just being wasted. Our current health care system is not in the best interest of the public.” Wassef slowly molded his career to be able to take on the workload politics would entail. He sold ownership of his pharmacy and

merged with the local IDA team, where he maintains an office and his practice to this day. He cut back on time with patients, yet maintains an important practice within the Stouffville IDA pharmacy, and continues to welcome public speaking arrangements. It was 2009 when Wassef first actively participated in a political role, attempting to block proposed cuts to the healthcare system (that subsequently came into effect in 2010). The final straw that brought Wassef to action was the interpretation that the $1.2 billion e-health scandal is what necessitated healthcare cuts in the first place. (They’ve now spent two billion.) The PC party of Ontario approached Wassef in 2010 after witnessing his passion and determination to change the system. In 2011 he secured his nomination as the PC candidate for the riding of Stouffville, Markham, Richmond Hill, and King townships. He lost the 2011 election to the incumbent Liberal candidate, but Wassef has been re-nominated and will stand in the next general election as the PC Candidate for Oak Ridges-Markham for Member of Provincial Parliament. Wassef is determined to improve our healthcare system, which he believes should focus more on disease prevention and extending an individual’s functional health. He wants the money to go where it can be most effective. To move the system more towards preventative care and to stop over- and mis-appropriate prescriptions. Now that’s something we can all cast our vote for. FALL 2013 • IHRMAGAZINE.COM

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Nigella Sativa A Panacea for Human Disease

by Philip Rouchots MSC, ND, and Heidi Fritz MA, ND NIGELLA SATIVA, ALSO KNOWN AS BLACK cumin, is a highly regarded and prominent herb that has been used in traditional Middle Eastern and Indian systems of medicine. The Prophet Muhammad was recorded
as stating that the herb can cure any disease, other than death. It is part of the Ranunculaceae family and an herb with a long history of traditional use in southeast Asia, Egypt, Greece, and the Middle East.

Nigella was regarded as a panacea by the ancients, and played a central role in the medical practice of Middle Eastern and South Asian societies for over two thousand years, where it was used for the treatment of a range of conditions including asthma, headache, dysentery, infection, back pain, dermatological and gastrointestinal conditions. In traditional Indian medicine, Nigella seeds are astringent, bitter, stimulant, diuretic, emmenagogue, anthelmintic, galactogogue, carminative, anodyne, sudorific, febrifuge, expectorant, purgative, and abortifacient. The medieval Islamic philosopher Avicenna wrote of Nigella in his Canon of Medicine, that it stimulates the body’s energy and helps recovery from fatigue and dispiritedness. Medicinally, Nigella has been used in the form of crushed seed, oil, and water extract. The activity of Nigella has been attributed in to its thymoquinone content, which is present in both the fixed and essential oils of Nigella; thymoquinone has been extracted and used therapeutically in isolation. Nigella oil also contains plant sterols, as well as 25 per cent oleic acid / 55 per cent linoleic acid, nigellone, and volatile oils including thymol, limonene, and carvacrol. It is also possible that fibre content may mediate part of the metabolic effects of Nigella. MECHANISM OF ACTION: PRECLINICAL EVIDENCE There is a wealth of information on Nigella and thymoquinione derived from preclinical research. Thymoquinone appears to be capable of protecting tissues and organs from various types of damage due to anti-inflammatory and antioxidant activity, and has also been investigated for its anticancer effects. In animal models of diabetes, thymoquinone was shown to inhibit cellular expression of the COX-2 enzyme and increased levels of the antioxidant enzyme superoxide dismutase. In models of hyperlipidemia, Nigella sativa volatile oil and methanol extract have both been shown to reduce triglyceride and increase

HDL, as well as decrease hepatic HMG-CoA reductase activity. In smooth muscle tissue, including intestinal and bronchial tissue, thymoquinone has been shown to inhibit spontaneous contraction via inhibition of voltage-gated calcium channels. Thymoquinone has also been shown to inhibit liver fibrosis; attenuate lung injury and fibrosis; attenuate diabetic nephropathy; prevent E. coli induced tissue damage in bacterial prostatitis; and prevent dextran sulfate sodium-induced colitis. In an animal model of epilepsy, thymoquinone was shown to have antioxidant effects in attenuating malondialdehyde (a marker of lipid peroxidation), reduced neurodegenerative changes and neuron loss, and decreased the number of reactive astrocytes (astrogliosis). Thymoquinone has also been shown to have protective effects against amyloidinduced neurotoxicity, leading to the suggestion that Nigella may have therapeutic potential in Alzheimer’s disease. Nigella and its constituent thymoquinone have also been extensively studied in lab models for its anticancer effects. Thymoquinonehas been shown to have proapoptotic effects in breast cancer, including synergistically with tamoxifen; and has been shown to inhibit cancer cell growth and invasiveness in lung, liver, colon, melanoma, and breast cancer cells. This is an area where further research is needed to investigate these promising activities. CLINICAL TRIALS
 There is a well-developed body of evidence investigating Nigella in humans. Nigella has been shown to have antidiabetic, blood pressure and cholesterol lowering effects. It also has activity against specific types of infection, possesses anti-allergic effects, and improves rheumatoid arthritis as well as pediatric seizures. Table 1 summarizes all available evidence from human intervention trials concerning the herb as identified through Pubmed and Google Scholar. In metabolic syndrome, Nigella seed has been shown to significantly decrease total cholesterol, LDL, and triglyceride, improve fasting and post-prandial glucose and HbA1C, decrease systolic blood pressure by almost 10 points in one study, as well as promote reduction of body weight and waist circumference. In the area of allergy and asthma, Nigella oil or extract has been shown to significantly reduce symptoms of allergic rhinitis, as well as reduce the severity and frequency of asthma symptoms, improve lung function tests, and reduce FALL 2013 • IHRMAGAZINE.COM

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the need for asthma medications. Also related to respiratory function are two studies showing that Nigella can act as an antimicrobial agent in acute pharyngitis, and improve lung function, respiratory symptoms, as well as medication requirements in patients who were victims of chemical warfare. One study found that Nigella seed in combination with omeprazole was equal to triple therapy in the eradication of H. pylori. Finally, one study each showed that Nigella was effective in reducing disease activity of rheumatoid arthritis, and reduce the frequency of seizures in patients with refractory epilepsy. DOSAGE

The effective dosage forms and quantities of Nigella used include 2g of ground seeds in metabolic syndrome or syndrome components (Sabzghabaee 2012); 1-4g seed oil for inflammatory conditions such as allergy and arthritis (Gheita 2012, Kalus 2003); 1mg/kg thymoquinone in pediatric seizure (Akhondian 2011); and varying doses of a boiled aqueous extract (Boskabady 2007, Boskabady 2008). SAFETY

Based on the studies in Table 1 as well as the impressive range of activities demonstrated in preclinical research, Nigella appears to possess powerful disease modifying potential in a range of conditions. The only adverse events reported with

any consistency among the trials were mild gastrointestinal upset (Akhondion 2011, Bamosa 2010, Salem 2010). Overall, Nigella and/ or thymoquinone appears to have a good safety profile (Al-Ali 2008). In animals, toxicity was demonstrated only at dosages of 250 mg/kg thymoquinone by oral route (maximum tolerated dose) (Abukhader 2012). When given by intraperitoneal injection, toxicity occurred at a dose of between 15-20mg/kg thymoquinone, more than 10-fold the dose used in human trials (Abukhader 2012). Signs of toxicity were acute pancreatitis and peritonitis (Abukhader 2012). In another study, the LD50 of thymoquinone by oral administration was 870.9 mg/kg, more than 100 to 150-fold higher than the therapeutic dose (Al-Ali 2008). CONCLUSION

Nigella sativa is a highly regarded herb with a long tradition of use for infection, conditions of inflammation, respiratory and gastrointestinal conditions, and more. Human trials have demonstrated benefits from Nigella seed in metabolic conditions such as dyslipidemia, type 2 diabetes, and hypertension; and Nigella oil or extract in allergy and asthma, inflammatory conditions, infections including pharyngitis and H. pylori, as well as refractory epilepsy. Further research is needed to elucidate the potential anticancer effects of Nigella suggested by preclinical findings.

TABLE 1. Human clinical trials of Nigella sativa Indication

Design

Dose

Outcome

Ref

Metabolic syndrome Hyperlipidemia

RPCT; N=88 subjects with TC>200 mg/dL

• 2g crushed Nigella seeds or placebo (in 500mg caps) x4wk

• Significant decreases in: • TC by 4.78%; LDL by 7.6%; TG by 16.65%. No change in fasting glucose or HDL.

Sabzghabaee 2012 [Abstr]

Metabolic syndrome

RDBPCT; N=40 obese men with no more than stage I hypertension and normal or impaired glucose

• 1.5g Nigella seed or placebo twice daily x 3mo

• Body weight, waist circumference, and systolic blood pressure decreased in the Nigella group only (p<0.05 for all compared to baseline), while these increased in the placebo group: • body weight 77kg à 72 kg at 3 months; • waist circumference 101 à 99.8cm; and systolic BP 130 à121.

Datau 2010

Metabolic syndrome components

RDBPCT; N=123 patients

• 2g crushed Nigella seed, or placebo x6wk

• “Favorable impact of powdered N. sativa (Kalonji) seed in capsule was noted on almost all variables [body-mass index, waist-hip ratio, blood pressure, fasting blood sugar, lipids, ALT, and creatinine], but results were not statistically significant because of small sample size.”

Qidwai 2009

Hypertension

RDBPCT; N=119 patients with hypertension below 160/100

• 100 or 200mg Nigella boiled seed extract twice daily x8wk, or placebo

• There was a reduction in systolic and diastolic blood pressure in both Nigella groups, in a dose-dependent manner, that was significant compared to placebo (p<0.05 for all). In addition, there was a significant reduction in TC and LDL compared to baseline in the Nigella group (p<0.05 for all).

Dehkordi 2008

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Allergy Allergic rhinitis

DBPCT; N=66 patients

• Nigella oil 0.5mL x 30d, or placebo

• N. sativa reduced the presence of the nasal mucosal congestion, nasal itching, runny nose, sneezing attacks, turbinate hypertrophy, and mucosal pallor within the first 2 weeks of treatment.

Nikakhlagh 2011 [Abstr]

Asthma

RPCT; N= 29 asthma patients

• 15 mL/kg of 0.1 g% boiled aqueous seed extract daily x 3mo, or placebo solution

• In the Nigella group the following symptoms improved significantly 3 months compared with baseline and with placebo: asthma symptoms, frequency of asthma symptoms per week, chest wheezing, and pulmonary function tests. • Requirements for medications decreased in the Nigella but not in the placebo group.

Boskabady 2007 [Abstr]

Allergy

Report of 4 trials; N= 152 patients with allergic diseases (allergic rhinitis, bronchial asthma, atopic eczema

• Nigella seed oil: 1.5-4.0g per day in 500mg caps

• Subjective report of symptoms severity improved with Nigella treatment.

Kalus 2003

H. pylori & dyspepsia

RCT; N=88 patients with non-ulcer dyspepsia and positive H. pylori breath test

• 4 groups: • i) triple therapy OR • ii) 1, 2, or 3g Nigella in addition to omeprazole x4wk; • Nigella as ground seed.

• H. pylori eradication was 82.6, 47.6, 66.7 and 47.8% with triple therapy, and 1g, 2g, and 3g Nigella, respectively. Eradication rates (based on H pylori antibody presence in the stool) with 2g Nigella + omeprazole and triple therapy were not statistically different. • Dyspepsia symptoms improved in all groups to a similar extent.

Salem 2010

Acute tonsillopharyngitis

RDBPCT; N=200 patients with acute tonsillopharyngitis

• Combination of Nigella sativa 360mg and Phyllanthus niruri 50mg extract 3x/d x7d, or placebo

• The Nigella extract led to relief of the pain and difficulty of swallowing within a few hours after the first dose. After 7 days, a significantly greater proportion of patients in the Nigella group had their sore throat completely relieved.

Dirjomuljono 2008 [Abstr]

Rheumatoid arthritis

PCT, x-over; N=40 female RA patients; all were on combined drug therapy.

• 1g Nigella seed oil or placebo (in 500mg caps) x 1mo

• Disease activity improved in 42.5% and 30% of the patients respectively after Nigella. • The number of swollen joints and the duration of morning stiffness also improved.

Gheita 2012

Pediatric seizure

DBPCT x-over; N=22 children with refractory epilepsy

• 1mg/kg • Thymoquinone treatment resulted in a significant thymoquinone reduction in seizure frequency compared to placebo from Nigella seed (P=0.04). or placebo x 4wk

Akhondian 2011 [Abstr]

Pulmonary function

RDBPCT; N=40 chemical war victims with respiratory symptoms

• 0.375 mL/kg • At study end,pulmonary function tests and respiratory of 50g% boiled symptoms were significantly improved in the Nigella aqueous Nigella group compared to the control group (p < 0.01 to p < seed extract daily 0.001). Requirements for medication were decreased x 2mo, or placebo in the Nigella but not the placebo group.

Boskabady 2008 [Abstr]

Infection

Miscellaneous

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The End of DEET?

New research may help put a stop to mosquito bites by impairing their sense of smell By Nancy Ripton MOSQUITOS ARE A NUISANCE TO ALL OF US. Whether it’s being forced indoors on a beautiful evening to avoid bites or more serious risks like malaria and West Nile virus, these tiny bugs are pests at best and, at their worst, can be deadly. In fact, mosquitoes are among the most deadly diseasecarrying creatures in the world. According to the World Health Organization (WHO) malaria caused by mosquito bites kills 660,000 people a year. MOSQUITO REPELLENTS The United States Department of Agriculture (USDA) has worked at developing repellents and insecticides since 1942. Only a small part of this research has been targeted at discovering attractants that can be used to produce mosquito lures. Instead, repellents have been the main line of defense against mosquito bites. The most widely used and effective of these repellents is DEET.

was discovered that some compounds on human skin inhibit the ability of mosquitoes to find hosts. Basically a group of compounds have the ability to block mosquitoes’ ability to smell potential targets. These compounds are only present on human skin at trace levels; however, when larger quantities of these attraction-inhibitors are presented with human odors to mosquitoes, they produce anosmia and hyposmia in test mosquitoes. Ultimately the chemical compounds could help render people “invisible” to insects.

“It will likely take a few more years of research to commercialize the smell blocking compounds.”

DEET has strong smell and is considered a poison making it less than ideal for regular use. When you spray DEET on your skin, it gets absorbed and eventually enters the bloodstream. It pumps through your nervous system and has been proven to kill brain cells, causing neurological damage. If you have heavy exposure to DEET, you may experience memory loss, headache, fatigue, muscle and joint pain, and shortness of breath.

Head researcher Ulrich Bernier, Ph.D, a research chemist with the mosquito and fly research unit, and his team looked at compounds, such as 1-methylpiperazine, that didn’t attract any mosquitoes. They are looking for a way to enhance these compounds in order to mask human smell from mosquitoes.

Some people are more attractive to mosquitoes than others. Just go out camping with a group of people and witness how some people will be attacked by mosquitos while others will be spared a single bite.

says Bernier. “The best strategy for their use may not be a topical formulation but rather the release of chemicals from devices in proximity of (human) hosts.”

IMPAIR A MOSQUITO’S SENSE OF SMELL There are hundreds of compounds on the human skin that make up a person’s smell. In the mid to late 1990s, research by the United States Department of Agriculture led to the discovery of 277 compounds present on human skin that can act as a lure for mosquitos. As a result of these studies, it

The compounds could be added to many cosmetics and lotions to help ward off bug bites.

“For the chemicals to work, they must first impinge upon the adult female mosquitoes,” says Bernier. Currently chemical repellents such as DEET remain the best kind of active to add to a lotion or cream since the action of these kinds of contact repellents occurs from direct contact with the chemical on the skin’s surface. Things look like they may soon change, so stay tuned. FALL 2013 • IHRMAGAZINE.COM

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HOW TO

Awaken the Zentrepreneur in you Four steps to manifest fearlessness and peak productivity in your work and relationships By John J. Murphy WHATEVER IT IS WE DO, whether we run a household, our own business, or work for a company, there is a “zentrepreneur” within us all–a soul seeking release and a creative idea seeking expression and manifestation. This is the heart and soul of our being–our human being! It is our innate desire to grow, to explore, and to be creative. Zentrepreneurs know this as nirvana, here and now, heaven on earth.

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We know that we are meant to be free and flow fearlessly. We came to this earth to express ourselves, to interact with one another, to learn, and to make this world a better place. Yet many souls have become trapped; imprisoned by fear and doubt and insecurity. Rather than embrace change and uncertainty with poise and confidence, the timid allow it to

hold them back. Indeed, we can be our own worst enemy. We can get in our own way. The secret to getting past this fear is in tapping our inner zentreprenuer and applying four fundamental steps to inspiration and success–the ring of peace

“The people who challenge us or annoy us

most might be among our greatest teachers.

1. LET BE

The first step to freedom is “Let Be.” Zentrepreneurs know that we cannot change what already exists. We have to accept it–like it or not. We have to learn from it. Why? Because it already is; it happened. This includes people, problems, circumstances, weather, long lines, slow computers, traffic, difficult bosses, and painful losses. There is no value in complaining about the past or getting upset. There is no undoing it. There is no wisdom to be gained in letting it bring us down. Stress only makes things worse. The Law of Attraction delivers to us manifestations that match our emotional vibration. Complaining, stressing and being anxious only call more of the same into our lives to complain and stress about. How wise is that? The sage zentrepreneur within us offers us an alternative–the capacity to transcend these emotional temptations. We just have to recognize them when we see them and avoid the trap. Rather than becoming anxious and fearful, we can choose to think differently. We can learn to see what “is” as simply a blessing in disguise; a lesson to be learned. For example, the people who challenge us or annoy us most might be among our greatest teachers. They give us an opportunity to learn patience, wisdom and spiritual presence.

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2. LET GO

The second step in the Ring of Peace is “Let Go.” Rather than resist what is, we accept it, feel it, examine it, learn from it, and then let it go. Resistance only makes that which we are resisting stronger. Why strengthen the enemy? Push back invites push back. Force meets force. Try dancing with the problem instead. Embrace it and then let it go. Admit there is a problem and then release it. Denial will get you nowhere. Rationalization and defensiveness obstruct flow and attach you to the problem. Learn to let it go. There are many proven techniques to assist with this, including EFT (Emotional Freedom Technique), Meditation, TRE (Trauma and Tension Release Exercises), yoga, tai chi, and healing sounds. Identify and choose a practice that resonates with you; then practice it! The only obstacle to releasing fears, phobias and limiting beliefs is you. When we accept what is and learn to let go of any emotional distress drawing destructive drama into our lives, we experience step three.


3. LET SEE

The third step involves a shift in our perception. We see the world very differently. The people who used to annoy us now appear differently. We feel compassion for them. We recognize their suffering or ignorance. We forgive them “for they know not what they do.” We offer a helping hand. We reach out from a higher place–a higher frequency and vibration–knowing that this is really the only way we can be of any true assistance.

4. LET FLOW

The fourth step in the Ring of Peace often results in experiencing a sense of awe and wonder. When we let be, let go, let see and experience “Let Flow,” it is as if we are living a dream come true. We are “in the zone” as some athletes like to put it. We experience a sense of fearlessness, timelessness and peak productivity. We make ourselves available to a much higher frequency of spiritual energy and we channel this into our work and relationships. We literally light up the room.

Misery may love company, but zentrepreneurs know that this match in frequencies does not solve problems. It compounds them. The only way to really help someone in pain is to help them change the channel and see things differently.

People feel our presence. They are inspired by our energy– or zenergy! In return, we reap what we sow. By giving unto others, we are given more to give. We become an instrument of peace, a fountain of love, a beacon of light. By emptying our bowl, we receive more. We channel spiritual wisdom, sacred joy and emotional intelligence. This powerful inner peace then reveals itself to the rest of the world as “good ideas” resulting in positive changes. We make the world a better place. Have you ready to awaken the zentrepreneur in you?

IHRMAGAZINE.COM • FALL 2013

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research news

IS DEPRESSION GENETIC?

ACUPUNCTURE AND DEPRESSION

A G E N E VA R I A N T

PEOPLE WITH

HAS BEEN FOUND

D E P R E S S I O N M AY

T H AT I N C R E A S E S T H E

BENEFIT AS MUCH FROM

RISK OF DEVELOPING

ACUPUNCTURE AS THEY

DEPRESSION, ANXIETY

DO FROM COUNSELING.

AND MEMORY LOSS

Researchers at Weill Cornell Medical College have discovered why a tiny alteration in a brain gene (found in 20 per cent of the population) contributes to an increased risk for anxiety, depression and memory loss.  A gene alteration appears to induce shrinkage of neurons from the hippocampus (an important region for memory and emotion), reducing connectivity between brain cells. The findings offer insight into why some depression and anxiety runs in families. “There can be a heritable component to these diseases and it makes sense that a common variant in a gene could be involved,” says Dr. Francis Lee, a lead researcher on the study. “Just like hypertension contributes to the risk for heart disease, the BDNF alteration increases the risk of depression, anxiety and memory disorders – but is not the sole reason why they occur.”  According to the research published in Nature Communications, targeted treatment for the genetic alteration could provide the first true benefit for affected patients, who often don’t respond to traditional treatments. “We can easily test patients for the mutation by using a simple blood test,” says Lee.

months of acupuncture or counseling, compared to one in five who received neither treatment. The study recruited 755 people with moderate or severe depression. Researchers split participants into three groups: 302 were randomly assigned to receive 12 weekly acupuncture sessions, another 302 received weekly counseling sessions and 151 received usual care only. About 70 per cent of people had taken antidepressants in the three months before the study and about half reported taking pain medications. People did not have to stop taking their medicine to participate in the study. Participants who received acupuncture or counseling saw larger improvements over three months than those who had neither treatment. Those benefits remained for an additional three months after the treatments stopped. Counseling and acupuncture are not replacements for medication. The majority of study participants were still taking antidepressants at the end of the three months. They are simply aids to improve results. –Reuters

SIDE EFFECTS A NEW STUDY HAS FOUND THAT WARNING CONSUMERS OF POTENTIAL SIDE EFFECTS OF A PRODUCT CAN ACTUALLY INCREASE SALES

Drug ads often warn of serious side effects, but new research shows that, rather than scaring consumers away, these warnings can actually increase product sales. Many medical warnings are extremely detailed, clear, and scary in terms of potential negative side-effects. A study published in the September 2013 issue of Psychological Science found that such warnings might perversely boost rather than detract from the appeal of the risky product. This hypothesis was tested in four experiments. In one experiment, smokers saw an ad for a brand of cigarettes. One version of the ad included a warning that smoking causes lung cancer, heart disease, and emphysema, while another version did not include the warning. Participants who had the opportunity to purchase the cigarettes soon after seeing the ad bought less if the ad they saw included the warning. In contrast, participants who were given the opportunity to purchase the cigarettes a few days later bought more if the ad included the warning. The same outcome emerged when the researchers ran a similar experiment with ads for artificial sweeteners. According to the study, the warnings backfired because the psychological distance created by the delay between exposure to the ad and the customer decision made the side effects seem abstract – participants came to see the warning as an indication of the firm’s honesty and trustworthiness. In fact, participants evaluated drugs for erectile dysfunction and hair loss that had potentially serious side effects more favorably, and as more trustworthy, when they were told the products weren’t on the shelves yet. While conventional wisdom suggests that explicit warnings about dangerous side effect will make people think twice before taking medical risks, these findings suggests otherwise.

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research news SIMPLE, SOLO AND SHORT

A NEW WAY TO TARGET CANDIDA

WHEN IT COMES TO EXERCISE, NORTH AMERICANS FOLLOW THE THREE S’S: SIMPLE, SOLO AND SHORT

Exercise trends come and go. When it comes to exercise habits, however, Americans prefer to stick to what’s simple, solo and short. A recent survey by Timex found that 77 per cent of adults ages 24 to 44 said prefer work out alone. Running was the most popular type of exercise followed by lifting weights, then biking, hiking and other outdoor activities. The survey also found that 61 per cent of people questioned said they don’t exercise in a gym, and just 27 per cent find time to squeeze in a workout from Monday to Friday. Twenty-nine per cent said they spend between 30 and 60 minutes a week on physical activities and 18 percent claim between one to two hours.

A N E W S T U DY F RO M J O H N S H O P K I N S A N D H A RVA R D M E D I C A L S C H O O L S H O W S H O W TA R G E T I N G A S P E C I F I C FUNGAL COMPONENT OF CANDIDA ALBICANS MIGHT TURN THIS FUNGUS FROM FOE TO FRIEND.

Treatment options for Candida infections are limited because finding new drug to target fungi that are closely related to us risk hurting the patient as much as the pathogen. A new study, however, published in The Journal of Biological Chemistry has identified is a function that is critical for virulence. If scientists can block this function through medication, it would leave both the fungus and the host healthy while taking away Candida’s ability to harm.

CANCER NEWS I N F L A M M AT I O N C A N F U E L T H E S P R E A D O F C A N C E R .

According to a study by the Division of Hepatology and Gene Therapy at the CIMA-Universidad de Navarra in Spain many tumors occur in association with persistent inflammation. Inflammation also promotes the spreading and mutating of cancer cells while continuing to push the mutations within the cancer cells’ development. Inflammation can enhance tumors ability to recruit blood supply. One of the most highly expressed receptors is called Epidermal Growth Factor Receptor (EGFR), which is normally used to tell cells to grow. It is also found in all cancer cells. EGFR over-expression has been linked to numerous cancers, such as lung, prostate, anal and many others. The greater the expression of EGFR means faster growth and enhanced spreading. Inflammation can contribute to EGFR over-expression. This increased expression is also associated with increased chemotherapy resistance, leading to tumors that are untreatable. When you combine chronic inflammation, these misused signaling pathways and overgrowth, you get a cancer that becomes immortalized. Currently there is no singular drug that can treat all of these pathways. However, there are some integrative approaches that, when used properly, can impact these inflamed targets from a multi-dimensional approach. One of the most common ways for inflammation to occur is when an enzyme called lipoxygenase turns essential fatty acids into a compound called leukotriene that is produced in white blood cells. Leukotriene tells the cells to respond to trauma, but when they don’t stop ringing the alarm bells, it leads to chronic inflammation. However, if you take a drug that is a lipoxygenase inhibitor, it aids in turning off these pathways, stopping the growth and spread of cells, including helping to slow down cancer cells. These are many other ways inflammation can be targeted in treatment. When these pathways to inflammation are understood, it makes it that much easier to prevent cancer from growing, spreading or outgrowing treatment via resistance. Helping enhance cancer treatment as a whole involves strong comprehensive anti-inflammatory and signaling treatments. Treating inflammation is only one part of a complete treatment plan – there are many other aspects to consider, including nutrition, building the immune system, targeting chemotherapy and much more. However, if you can slow down the growth of cancer, it makes it much easier to maintain and hopefully, overcome. Otherwise, if it keeps growing, the cancer can outgrow any treatment. It becomes a race to slow down the metabolic growth and spread of cancer enough for other therapies to do their job effectively. The best part about these treatments is they are helpful for most, if not all cancers.

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Hibiscus

An emerging new botanical medicine By Leigha Saunders, ND (Cand.) and Philip Rouchotas MSc, ND

THE HIBISCUS GENUS (FAMILY MALVACEAE) is comprised of several species, many of which have been used historically for their culinary and medicinal properties. The species Hibiscus sabdariffa is an important medicinal plant grown in Africa, the Middle East, South East Asia and Central America (Ojeda 2010). Traditionally, the aqueous extract of H. sabdariffa, colloquially known as sour tea, has been used to treat hypertension, liver disease and fever (Mozaffari-Khosravi 2009). More recently, the anti-oxidant, lipid and blood pressure lowering effects of Hibiscus sabdariffa have been investigated. H. sabdariffa extracts have demonstrated anti-oxidant properties, hypolipidemic effects, ACE inhibition and inhibition of vascular smooth muscle cell proliferation and migration secondary to hyperglycemia (Huang 2009, Kao 2009, Ojeda 2010, Yang 2010). Considering its nutritional profile, pharmacological properties and safety, H. sabdariffa shows promise as a cardio-protective agent and potential diabetic therapy (Mozaffari- Khosravi 2009). CHEMISTRY

PRECLINICAL EVIDENCE

H. sabdariffa contains various phytochemicals, including phenolics, organic acids, sterols, terpenoids, polysaccharides and some minerals (Ojeda 2010). The phenolic content is composed mainly of anthocyanins delphinidin-3-O-sambubioside (85%) and cyanindin-3-O-sambubioside, plant pigments that are isolated from dried calyces (Frank 2005). Anthocyanins, a subgroup of flavonoids, are water-soluble glycosides and acylglycosides of anthocyanidins (Frank 2005). Other phenols include protocatechuic acid, catechin, gallocatechins, caffeic acid and gallocatechin gallates (Yang 2010).

Anti-oxidant Effects Oxidation of low-density lipoprotein (oxLDL) occurs in the early stages of atherosclerotic lesion formation. Scavenger receptors have been identified that bind and internalize oxLDL, mediating its uptake into macrophages and leading to the formation of macrophage-derived foam cells. CD36 has been identified as the predominant scavenger receptor for oxidized LDL and its regulation plays an essential role in the formation of macrophage foam cells and atherosclerosis (Kao 2009).

An aqueous extract of H. sabdariffa (HSE) contains varying concentrations of anthocyanins and polyphenols depending on the processing method and storage time (Frank 2005). Regardless, HSEs contain effective antioxidants, radical scavengers and ferric-reducing compounds, the properties which likely impart their therapeutic benefit (Frank 2005).

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The most recent study investigating the anti-oxidant activity of H. sabdariffa and LDL oxidation was completed by Kao et al (2009). Hibiscus anthocyanin-rich extracts (HAs) prevented lipid accumulation, significantly decreased CD36 mRNA gene and protein expression and significantly decreased PPARÎł protein levels, the CD36 upstream transcription factor, in mouse cells treated with oxidized LDL. The study demonstrated that the antioxidant activity of HAs may ultimately inhibit the formation of oxLDL-foam cells.


“We identified seven controlled human clinical trials evaluating hibiscus preparations. Five of the trials evaluated impact on blood pressure, three trials evaluated impact on serum lipid profiles, and one trial evaluated impact on plasma glucose levels.” Hypolidemic Effects The hypolipidemic effect of a Hibiscus sabdariffa 74% polyphenol extract (HPE), composed mostly of protocatechuic acid (PCA), caffeic acid and gallocatechin gallate (GCG) were investigated in an animal model (Yang 2010). Hamsters were fed a high fat diet for 10 weeks with or without HSE or HPE; both HSE and HPE fed hamsters experienced a decrease in serum triglycerides and total cholesterol in a dose-dependent manner. However, the HPE had a greater effect on decreasing plasma and LDL cholesterol and increasing HDL than a crude extract (HSE) containing only 2% polyphenols. At 0.5 mg/mL, HPE decreased fatty acid synthase and HMG-CoA reductase 75% and 69% respectively. The HSE did not alter the protein expression of fatty acid synthase, but rather altered the phosphorylation of AMP-activated protein kinase (AMPK). Previous reports have outlined the importance of AMPK in regulating lipid metabolism; activation (phosphorylation) of AMPK simultaneously inhibits fatty acid and cholesterol synthesis in rat hepatocytes by inactivating the acetyl CoA carboxylase and HMG CoA reductase, respectively (Yang 2010). In addition the activation of AMPK by HPE decreased the expression of sterol regulatory element binding protein (SREBP), a membrane bound transcription factor which regulates lipid metabolism, and the transcription of its target genes, HMG CoA reductase and fatty acid synthase. Further investigation revealed that HPE also enhances the expression of the LDL-receptor, increasing LDL uptake and hepatic clearance (Yang 2010). ACE-Inhibition Effects The inhibition of angiotensin I converting enzyme (ACE) by H. sabdariffa has been demonstrated in vitro with a crude hydroethanol extract from the plant calyces (Ojeda 2010). Using an aqueous extract of H. sabdariffa, delphinidin-3-Osambubioside and cyanidin-3-O-sambuioside were identified as the two most abundant anthocyanins. Evaluation of in vitro ACE inhibition was completed by quantifying the hydrolysis of N-[3-(2-furyl)acryloyl]-L-phenylalanylglycylglycine (FAPGG) by ACE, both of which were isolated from rabbit lung. A combined anthocyanin-rich fraction, as well as isolated extracts of each anthocyanin were used to inhibit ACE activity in a dose-dependent manner. Both anthocyanins were more effective on their own than the combined extract, and delphinidin3-O-sambubioside was more effective than cyanidin-3-Osambubioside, likely owing to the fact that it has more hydroxyl groups. Kinetic analysis suggested ACE was inhibited by the anthocyanins via competition for the enzyme’s active site, most

likely due to the rigid planar structure of the anthocyanins and the presence of ortho-dihydroxylation on the aromatic ring. INHIBITION OF VASCULAR SMOOTH MUSCLE CELL PROLIFERATION

In hyperglycemia of metabolic syndrome or diabetes mellitus, high-glucose conditions mediate the growth and extracellular matrix (ECM) gene expression of vascular smooth muscle cells (VSMC) to promote anti-apoptotic signalling, chemotaxis and migration. Hyperglycemia also promotes the formation of advanced glycation end (AGE) products, which is believed to play a role in atherosclerotic plaque formation when they interact with their specific receptor (Receptor for Advanced Glycation End Products- RAGE) (Huang 2009). A polyphenolic extract of H. sabdariffa was examined for its protective activity against high-glucose-treated VSMC. The extract reduced the high-glucose-stimulated cell proliferation and migration in a dose and time dependent manner (Huang 2009). Proliferating cell nuclear antigen (PCNA), a marker of proliferation, and activation of matrix metalloproteinase (MMMP)-2, the ECM-degrading enzyme during the process of migration, were suppressed by treatment with the H. sabdariffa extract. Furthermore, expression of connective tissue growth factor (CTGF) and RAGE, usually enhanced by hyperglycemia, were also suppressed by treatment with the extract. PHARMACOLOGY

In a study examining the pharmacokinetics of monomeric anthocyanins after consumption of H. sabdariffa extracts, the anthocyanins were incorporated and excreted in urine in their intact glycosidic forms. 147.4 mg of total anthocyanins were administered to six healthy subjects and maximum excretion rates occurred at 1.5-2.0 hours after ingestion. While oral absorption of H. sabdariffa anthocyanins was fast, maximum plasma concentrations were low, between 1.3-3.4 ng/ml. Peak plasma concentrations occurred almost simultaneously as urinary excretion rates, with maximum excretion rates occurring at 1.5-2.0 hours after ingestion (Frank 2005). Some evidence suggests that deglycosylation is the rate-limiting step for the absorption of dietary flavonoid glycosides in the small intestine. β-glucosidases, lactase-phlorizin hydrolase (LPH), and the cytosolic β-glucosidase (CBG) are found in the epithelial cells of the small intestine and normally function to deglycosylate flavonoid glycosides during passage across the gut wall (Nemeth 2003). Anthocyanins are not substrates for these β-glucosidases and this may explain the low bioavailability of these compounds, FALL 2013 • IHRMAGAZINE.COM

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TABLE 1. HUMAN TRIALS OF HIBISCUS Methods

Outcome

References

A double-blind, placebo controlled trial (n=57) enrolled subjects with LDL-c levels of 130-190 mg/dl divided into groups receiving either HSE capsules (500 mg bid) or placebo for 90 days. Overweight patients were advised to achieve weight loss of 5%.

Body weight and serum LDL significantly decreased in both groups from baseline with no difference between groups. LDL decreased 18% in the hibiscus group and 12% in the control group. The difference between groups was not significant. Serum triglycerides were reduced a significant 10% in the hibiscus group and not significantly impacted in the control group.

Kuriyan 2010

A double-blind, randomized, placebo controlled trial (n=65) recruited pre- and mildly hypertensive adults (SBP 120-150 mmHg, DBP < 95 mmHg, BMI 18.5-35) and divided them into two groups. Participants received 3 x 240 ml servings/day of brewed Hibiscus tea steeped for 6 minutes (1.25 g dried H. sabdariffa per tea bag) or placebo for six weeks.

In the treatment group, SBP, DBP and MAP significantly decreased by 5.5%, 4.0% and 4.7% respectively. The magnitude of effect was higher in individuals with higher baseline SBP. There was no significant difference in these measurements in the placebo group. Between group differences were only significant for SBP.

McKay 2010

A follow-up study carried out in a factorial, randomized design (n=124) divided participants into two groups, those with and without metabolic syndrome (MeSy). Subjects in both groups were randomly allocated into three treatment groups: preventative diet, HSE capsules (100 mg qd) or diet combined with HSE capsules for 31 days.

Among patients without metabolic syndrome hibiscus achieved significant reductions in fasting glucose (6.7%) and triglyceride (23%), and increased HDL-C (10%). Among patients with metabolic syndrome hibiscus significantly reduced fasting glucose (8.4%), total cholesterol (10%), and LDL-C (20%), and increased HDL-C (39%).

Gurrola-Diaz 2010

A sequential randomized controlled clinical trial (n=53) enrolled subjects with type II diabetes mellitus. Subjects were divided into two groups and received either Hibiscus tea (sour tea) or black tea as treatment (2 g bid) for 30 days. The tea was prepared by adding 240 ml of water, steeping for 20-30 minutes and adding one cube (5g) of sugar. Fasting cholesterol levels were assessed on day zero and day 30. Blood pressure was assessed on day zero, day 15, and day 30.

- In the treatment group, total cholesterol, LDL-c, triglycerides and Apo-B100 decreased by 7.6%, 8.0%, 14.9% and 3.4%, respectively, and HDL-c increased 16.7% (p=0.002). Only the changes in triglycerides, Apo-B100 and HDL-c were significant. - In the treatment group, mean SBP significantly decreased from 134.4 + 11.8 mmHg at day 0 to 112.7 + 5.7 mmHg at day 30 (p < 0.001), while it significantly increased in the black tea group (from 118.6 + 14.9 mmHg to 127.3 + 8.7 mmHg). Similarly, the mean PP decreased in the HSE group (p < 0.001) and increased in the black tea group (p = 0.01). No significant changes were observed in DBP in either group.

MozaffariKhosravi 2009a

A randomized controlled, double-blind clinical trial (n=171) comparing Hibiscus sabdariffa dried extract (standardized to 250 mg of total anthocyanins qd) and lisinopril (10 mg qd) in patients with stage I or II hypertension for four weeks.

In the group treated with Hibiscus, systolic and diastolic blood pressure was reduced 11.58% and 12.21% (p < 0.05). Although BP reductions and therapeutic effectiveness were significantly less than the lisinopril group (15.79% reduction to systole and 15.68% reduction to diastole), patients treated with HSE showed decreased plasma ACE activity (p = 0.0001) and reduced serum sodium levels without changes in serum potassium levels. The authors concluded that HSE seems to exert an antihypertensive action through dieresis and ACE inhibition.

Herrera-Arellano 2007

A randomized controlled clinical trial (n=75) compared the antihypertensive effectiveness and tolerability of HSE (10g of dry calyx prepared in 500 mL water and steeped for 10 minutes, 9.6 mg anthocyanins qd) and 25 mg of captopril bid for 4 weeks.

Significant reductions in blood pressure values were observed in both groups; hibiscus group -10.2% SBP, -12.3% DBP, captopril group -11.4% SBP, -14.3% DBP. The differences between the hibiscus group and the captopril group were not significant.

Herrera-Arellano 2004

A randomized controlled clinical trial (n=54) evaluated the effect of HSE on essential hypertension (SBP 160-180 mmHg, DBP 100-114 mmHg) compared with regular tea. Patients were instructed to consume one glass of decoction (two spoonfuls of tea boiled in one glass of water for 20-30 minutes) at least one hour before measuring blood pressure. Blood pressure was measured at days four, eight, 12 and three days after stopping treatment. Patients were also advised to exercise, abstain from excessive salt intake, saturated fats and smoking.

Blood pressure was lowest on the 12th day in the treatment group, with an 11.2% decrease in SBP and 10.7% decrease in DBP. Three days after cessation of drinking tea, SBP increased and DBP increased to pre- treatment levels.

Faraji 1999

MozaffariKhosravi 2009b

HSE = Hibiscus sabdariffa extract (unless otherwise stated), SBP = systolic blood pressure, DBP = diastolic blood pressure, LDL-c = low density lipoprotein cholesterol, HDL-c = high density lipoprotein cholesterol, PP = pulse pressure

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as they were not hydrolyzed to their aglycones and were absorbed only as intact glycosides in small amounts (Frank 2005). However, it is known that most polyphenols ingested from flavonoid-rich beverages are metabolised in the colon (Rechner 2002). The half-life of total anthocyanins from the H. sabdariffa extract was derived from urinary excretion and was determined to be 2.63 hours (Frank 2005). In a separate study, H. sabdariffa calyx extracts demonstrated a very low degree of toxicity, with an LD50 above 5000 mg/kg in rats (Onyenekwe 1999). Further studies are needed on human plasma and urinary intact glycosides and their in vivo metabolites and/or conjugates in order to fully characterize the pharmacokinetics of H. sabdariffa (Frank 2005). HUMAN EVIDENCE

We identified seven controlled human clinical trials evaluating hibiscus preparations. See Table 1. Five of the trials evaluated impact on blood pressure, three trials evaluated impact on serum lipid profiles, and one trial evaluated impact on plasma glucose levels. Only one trial failed to demonstrate a positive outcome; the trial evaluated impact to cholesterol levels and was compounded by recommendations to achieve reductions in body weight. Therefore both the hibiscus group and the control group experienced significant improvement in cholesterol profiles, with no significant difference between the two groups (Kuriyan 2010).

All five trials evaluating blood pressure demonstrated significant benefit, with a magnitude of effect ranging from 5-15% for reductions to systole and diastole (Faraji 1999, Herrera-Arellano 2007, Herrera-Arellano 2004, Mozaffari-Khosravi 2009b, McKay 2010). The two trials demonstrating positive impact to cholesterol levels revealed reductions in total cholesterol, LDLcholesterol and triglyceride, as well as increased HDL-C levels (Gurrola-Diaz 2010, Mozaffari-Khosravi 2009a). The only trial to evaluate glucose levels likewise demonstrated significant improvement to glucose control (Gurrola- Diaz 2010). DISCUSSION

Hibiscus, delivered in an array of dosage forms (standardized extracts, teas, decoctions), has demonstrated an impressive magnitude of benefit to key metabolic abnormalities, notably the constellation of abnormalities comprising the diagnostic criteria of the metabolic syndrome; glucose control, blood pressure, and plasma cholesterol levels, specifically triglyceride and HDLcholesterol (as defined by Grundy 2004). The ease of delivery, the marginal cost of the medicine (especially in tea or decoction dosage forms), and an impressive safety profile make hibiscus a promising medicine for an array of very common clinical presentations. Longer- term trials are needed to determine if the effects of hibiscus are sustained beyond 30 days. Also, impact to blood glucose control deserves more research attention.

References: Faraji MH, Tarkhani AHH. The effect of sour tea (Hibiscus sabdariffa) on essential hypertension. J Ethnopharmacol. 1999 Jun;65(3):231-6.

Kuriyan R, Kumar DR, R R, Kurpad AV. An evaluation of the hypolipidemic effect of an extract of Hibiscus Sabdariffa leaves in hyperlipidemic Indians: a double blind, placebo controlled trial. BMC Complement Altern Med. 2010 Jun 17;10:27.

Frank T, Janben M, Netzel M, Strab G, Kler A, Kriesl E, Bitsch I. Pharmacokinetics of anthocyanidin-3-glycosides following consumption of Hibiscus sabdariffa L. extract. J Clin Pharmacol 2005 Feb;45(2):203-10.

McKay DL, Oliver Chen CY, Saltzman E, Blumberg JB. Hibiscus sabdariffa L. tea (Tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr 2010 Feb;140(2):298-303.

Gurrola-Diaz CM, Garcia-Lopez PM, Sanchez-Enriquez S, Troyo-Sanroman R, Andrade-Gonzalex I, Gomez-Leyva JF. Effects of Hibiscus sabdariffa extract powder and prevention treatment (diet) on the lipid profiles of patients with metabolic syndrome (MeSy). Phytomedicine 2010 Jun;17(7):500-5.

Mozaffari-Khosravi H, Jalali-Khanabadi BA, Afkhami-Ardekani M, Fatehi F. Effects of sour tea (Hibiscus sabdariffa) on lipid profile and lipoproteins in patients with type II diabetes. J Altern Complement Med 2009a Aug;15(8):899-903.

Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004 Jan 27;109(3):433-8. Herrera-Arellano A, Flores-Romero S, Chavez-Soto MA, Tortoiello J. Effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa in patients with mild to moderate hypertension: a controlled and randomized clinical trial. Phytomedicine 2004 Jul;11(5):375-82. Herrera-Arellano A, Miranda-Sanchez J, Avila-Castro P, Herrera-Alvarez S, JimenezFerrer JE, Zamilpa A, Roman-Ramos R, Ponce-Monter H, Tortoriello J. Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension. A randomized, double-blind, lisinopril-controlled clinical trial. Planta Med 2007 Jan; 73(1): 6-12. Huang CN, Chan KC, Lin WT, Su SL, Wang CJ, Peng CH. Hibiscus sabdariffa inhibits vascular smooth muscle cell proliferation and migration induced by high glucose – a mechanism involves connective tissue growth factor signals. J Agric Food Chem 2009 Apr 22;57(8):3073-9. Kao ES, Tseng TH, Lee HJ, Chan KC, Wang CJ. Anthocyanin extracted from Hibiscus attenuate oxidized LDL-mediated foam cell formation involving regulation of CD36 gene. Chem Biol Interact 2009 May 15;179(2-3):212-8.

Mozaffari-Khosravi H, Jalali-Khanabadi BA, Afkhami-Ardekani M, Fatehi F, NooriShadkam M. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. J Hum Hypertens 2009b Jan;23(1):48-54. Nemeth K, Plumb GW, Berrin JG, Juge N, Jacob R, Naim HY, Williamson G, Swallow DM, Kroon PA. Deglycosylation by small intestinal epithelial cell betaglucosidases is a critical step in the absorption and metabolism of dietary flavonoid glycosides in humans. Eur J Nutr. 2003 Jan;42(1):29-42. Ojeda D, Jimenez-Ferrer E, Zamilpa A, Herrera-Arellano A, Tortoriello J, Alvarez L. Inhibition of angiotensin converting enzyme (ACE) activity by the anthocyanins delphinidin- and cyaniding-3-O-sambubiosides from Hibiscus sabdariffa. J Ethnopharmacol 2010 Jan 8;127(1):7-10. Onyenekwe PC, Ajani EO, Ameh DA, Gamammiel KS. Antihypertensive effect of roselle (Hibiscus sabdariffa) calyx infusion in spontaneously hypertensive rats and a comparison of its toxicity with that in Wistar rats. Cell Biochem Func 1999 17: 199–206. Rechner AR, Kuhnle G, Hu H, Roedig-Penman S, van den Braak MH, Moore KP, Rice-Evans CA. The metabolism of dietary polyphenols and the relevance to circulating levels of conjugated metabolites. Free Radic Res. 2002 Nov;36(11):122941. Yang MY, Peng CH, Chan KC, Yang YS, Huang CN, Wang CJ. The hypolipidemic effect of Hibiscus sabdariffa polyphenols via inhibiting lipogenesis and promoting hepatic lipid clearance. J Agric Food Chem 2010 Jan 27;58(2):850-9.

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Columnist Ken Vannucci Merchandise manager for London Drugs and a social media advocate.

R.I.P . VACATION How to avoid the dreaded Emailinteruptus-smartphoneitus that is becoming an epidemic in our modern society. By Ken Vannucci

This column is written in loving memory of our dearly beloved “Old Fashioned Holiday” or, more casually and affectionately known by friends and family as “The Vacation.” TODAY IS A SAD DAY. For today we mark the passing of our dear friend, “The Vacation.” The Vacation unfortunately passed away far too quickly, and far too quietly, with too little a fight, from the dreaded Emailinteruptus-smartphoneitus –that scourge that is becoming an epidemic in our modern society. Health care providers see no cure in the future for this terrible ailment that took our dear friend, The Vacation. The Vacation was no match for this wily and cunning plague that is spreading silently, yet rampantly, across modern society.

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The Vacation started its life off as a means for spiritual growth and Sabbath rest some two centuries ago, and grew into what it was just a short time ago – an opportunity to get away for a period of time to rest, reflect, relax, and perhaps travel. A time to forget the day to day; to forget work, and to enjoy time alone or with family. The Vacation grew to be a favourite within all circles – a true “best friend” to all. As noted scholar, Dr. V.A. Funculo-Work, of the “University of Just Take a Break” and Dean of the “Faculty of The World Will Still Turn Without You” says: “There should be nothing that is that important, that we should destroy our fond memories of what The Vacation was. Let’s let The Vacation survive and thrive within us by doing what The Vacation wanted us to do – relax, enjoy, rest and spend time with ourselves, family and friends. Drinking, eating, laughing, reading, sleeping, and enjoying our time off, and making sure that we too do not succumb to the awful Emailinteruptus-smartphoneitus. Let’s make sure we are not the last generation that actually remembers and admires what The Vacation was all about and what it tried so hard to give up to it’s final days. The Vacation is survived by: “The Happy Employer,” “The Stress Leave,” “The Heart Attack,” “The Stroke,” “The Unhappy Family,” “The Unrested,” “The Tired,” and many others – too many to mention. In lieu of flowers or donations, the deceased had asked that we all take time to reflect, remember, and to understand that the Emailinteruptussmartphoneitus outbreak does not have to be the death of us all. We don’t need to die, as The Vacation died. Take some time off. Shut off the Wi-Fi, the 3g, and all other noises. Go for a walk, sit with a friend, read a book – do what makes you feel best. Nothing should be that important that it can’t wait until you are finished “Your Vacation.” If it is, you may want to reconsider other things in your world. In closing, let’s quote and reflect upon what the great philosopher, Trooper, once said: “We are here for a good time, not a long time, so have a good time, as the sun can’t shine everyday.”

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Diabetex

Webber Naturals® Diabetes Program Nutritional Support and Risk Reduction for Type 2 Diabetes Diabetes is a growing health concern. In Canada and the United States, 113.8 million people* are living with diabetes or prediabetes – nearly one third of our population! If left untreated, diabetes can lead to serious health problems. Type 2 diabetes is a metabolic disorder where the body either doesn’t produce enough insulin or can’t utilize it properly, leading to unstable blood sugar (glucose) levels. Blood sugar levels that are unstable for a long period of time can cause complications such as heart disease and stroke, blindness, kidney problems, nerve damage, and erectile dysfunction. Difficulty falling asleep or staying asleep is also associated with diabetes, and chronic sleep deprivation aggravates problems with insulin resistance. For many people, the onset of type 2 diabetes can be prevented or delayed by making important lifestyle changes – including proper nutritional support – that reduce the risk factors for developing diabetes. Even if you already have type 2 diabetes, something can be done to minimize your chance of developing additional complications. The Diabetex line from webber naturals® is designed to provide nutritional support and reduce your chance of developing type 2 diabetes or its risk factors.

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