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Article[6] A MODEL FOR A WELLNESS PROGRAM Dr. Devin McKay, in his presentation at the 3rd Annual Functional Medicine Sunshine Conference, October 10, 2000,discussing a model for a wellness and prevention program, cited Dr. Mark Percival's Health Coach International work. Dr. Percival has created an extensive wellness program in his medical practice. The following are several aspects of the program:
Since a person's health is held in the balance between opposing
forces of distress on the one hand and adaptability on the other, the main
objectives of a good wellness program are to decrease the distress factors -
toxicity, trauma, and insufficiency, and to increase resiliency by improving
function.
Physical stress and trauma can be reduced by improving work
habits and posture and restoring adequate rest.
Chemical stress and toxicity can be reduced by improving air and
water quality, improving food quality with more organically grown and less
processed foods, and by avoiding unnecessary use of drugs (over the counter or
Rx), and avoiding foods that cause sensitivities or allergies.
Some ways to reduce emotional stress are to improve personal,
family, and community relationships and career satisfaction, to reduce negative "self-talk,"
and to remove the misinterpretations of past events (example: holding grudges
and blaming).
Electromagnetic stress can be reduced by limiting time spent
indoors with artificial light, by limiting TV, cell phone, and computer time,
and by reducing proximity to electrical appliances and power lines.
To improve a person's resiliency and ability to respond to
stress, several areas are important: Improving detoxification, getting
proper macronutrient balance and micronutrient supplementation, better rest and
relaxation, and exercise.
Improving detoxification function is of paramount importance.
First in priority is to preserve the gastrointestinal barrier to prevent
unnecessary entrance of toxins into the bloodstream and to ensure good colon
elimination.
Intestinal health depends on good digestion. This includes
a favorable eating environment and schedule, proper chewing, and limiting non
steroidal anti-inflammatory drugs such as ibuprofen, aspirin, etc. Special
support nutrient supplementation can help to aid digestion, to restore balance
in disrupted bowel ecology, and to support the gut lining to heal from damage
caused by unfriendly or "dysbiotic" bacteria, yeast, and parasites.
The next part of improving the detoxification process is to
support the liver and other organs in their detoxifying work. Foremost in
this support is to avoid overloading the detoxifying efforts by adding too many
chemicals such as caffeine, alcohol, tobacco, and foreign chemicals (xenobiotics)
such as chemical food additives, pesticide-laden foods, and drugs (prescription
and non-prescription). Also to be avoided, although less toxic, would be
too many herbs taken together.
Next is to provide proper protein intake to support the liver's
detoxifying work, including sulfur-containing amino acids. Antioxidant
support with supplements and foods high in antioxidants such as colored
vegetables is important to handle the free radicals produced in the oxidative
reactions in the liver's detoxification phase I process. Also important is
to take in enough of the proper kinds of fats (omega 3 oils) which reduce pro
inflammatory immune activation (which causes oxidative stress). Alkaline
vegetable broths are sused to improve extra cellular environment to support
detoxification. Some programs use hot baths and moderate temperature saunas
to increase removal of toxins through perspiration.
The important aspects of restoring optimum function and
adaptability are macronutrient balance (ratio of carbohydrates, fats, and
proteins, adapted to each individual); micronutrient supplementation to enhance
nutrient sufficiency; aerobic training, strength training, rest and relaxation
training; and special restorative medical foods and supplements.
To implement this program, it is important to do testing and
monitoring of function by means of questionnnaires, chemical testing,
biomechanical testing, assessing digestion and detoxification functions,
assessing physical fitness, % body fat, % lean muscle mass, muscle strength, and
aerobic capacity.
Educational and training programs to improve these areas of
function and to improve the participants understanding of the how and why of
these activities are implemented by providing classes, audiotapes, videotapes,
printed material, and individual coaching. Some information about these
programs can be obtained through Health Coach International, mentioned in the
previous articles about prevention.
CANCER, GENES OR ENVIRONMENT?
In the current trend toward explaining diseases genetically with
high enthusiasm for the Human Genome Project, the question arises, what is the
role of heredity in human disease, in contradistinction to the role of environment?
Dr. Jeffrey Bland, Ph.D., in his recent presentation of
Functional Medicine Update, quotes a study reported in the New England Journal
of Medicine 2000;343(2)7885 about 44,788 pairs of identical twins in Sweden,
Denmark, and Finland. They were assessed for risk of cancer. If one
had a cancer, what was the risk that the other twin would develop it?
Twenty-eight anatomical types of cancer were assessed. It was found
that heredity played a minor role, significant in only 10-25% of the cases.
Prostate and colorectal cancer had a higher hereditary factor, but for the other
common major forms of cancer, environment was most important.
Dr. Bland quoted other studies from mainstream nutrition journals
and the New England Journal of Medicine, showing how important the dietary part
of the environmental factor is in the development or prevention of cancer.
Heterocyclic amines on the surface of fried and broiled foods are carcinogenic
(cancer causing) in animals. Aflatoxin found often on peanuts are highly
carcinogenic, and other molds on poorly stored grain contribute to cancer.
Of course, foods that have more chemical residues such as pesticides are at
higher risk than organically grown foods.
Dietary factors that protect against cancer, (termed dietary
anticarcinogens by Dr. Bruce Ames), are 5-9 servings of vegetables and fruit per
day which provide the antioxidants quercetin and isothiocyanates: high fiber
intake; liquids - 1 1/2 to 2 1/2 quarts/day; black and green tea polyphenols;
and fish which have omega-3 oils.
Whole grains were found to be more protective than refined
grain products. The Journal of the American College of Nutrition made a review
of the factors in whole grains. A whole array of anticarcinogenic photochemical,
fiber, resistant starch (oligosaccharides), phenolic compounds, antioxidants,
and trace minerals. These substances in whole grains can boost immune
function, support cellular repair systems, and decrease inflammatory stress
reactions and oxidative stress. These functions all oppose the development of
cancers in their various stages.
In Dr. Bland's lecture at the symposium on Nutritional Management
of the Underlying causes of Chronic Disease, he explained that genes have
switches that can be turned on or off by the nutritional and hormonal
environment of the cells. Furthermore the switching mechanism is not just
on/of, but acts more like a rheostat, with a whole range of phenotypic
extression, the variability being affected moment by moment by a multitude of nutritional
factors.
Dr. Bland has written a whole book entitled Genetic Nutritioneering,
all about how we can reprogram our genes with nutrition.
So we see that not only cancer genes but all of our other genes
are profoundly affected in their expression by our lifestyle choices in the
grand uncontrolled experiment called our life.
COMPREHENSIVE CANCER CARE
If nutrition can prevent cancer, the next question is, can
nutrition reverse cancer? Dr. Dean Ornish asked that question about heart
disease a time when it was unthinkable that lifestyle factors alone could
reverse heart disease. His research has well proven that point now for
over a decade, and he is working on a lifestyle program to reverse prostate
cancer, with a strong emphasis on nutrition. The results of the study are
not available yet but the statistical trends up to now are very favorable for
reversal of cancer.
Dr. James S Gordon, M.D. Harvard Medical School graduate, is
president of the Center for Body-Mind medicine in Washington, D.C., is on the
Cancer Advisory Board for the National Institutes of Health, and was recently
appointed Chairman of the President's Commission on Complimentary and
Alternative Medicine Policy. He is also author of Manifesto For a New
Medicine. Dr. Gordon has now authored a new book, Comprehensive Cancer
Care, Integrating Alternative, Complimentary, and Conventional Therapies.
Dr. Gordon was recently interviewed by Dr. Jeffrey Bland in the
October 2000 issue of Functional Medicine Update. He points out that
striking evidence of effectiveness of nutritional and other
"alternative" therapies for cancer is continually growing. He
emphasizes that nutrition affects the genes involved in cancer development.
He urges that studies need to be done to evaluate whole programs for treatment
that include many therapies, not just one treatment by itself.
Dr. Gordon advocates that patients do not have to "put
all their eggs into one basket" of treatment, but need to be fully informed
at the outset when the diagnosis of cancer is first made, of the many therapeutic
choices that are available, not just after radiation and chemotherapy have
failed, as is so often the case.
The areas of body-mind medicine, group support, exercise,
nutrition, Chinese herbal medicine, and many other therapies have already shown
their effectiveness in improving well-being and survival time.
Dr. Gordon advocates a model for the future of Cancer Care in
which drugs and surgery are peripheral, self care is central, in which decisions
are made in partnership between patients and physicians. Now too often,
patients are told what they need to have done, and they fearfully follow orders,
or they surreptitiously do alternative therapies on the side. Now 70% of
cancer patients already do some alternative therapies, whether they inform their
oncologists or not.
Some of the most outstanding programs that Dr. Gordon notes as successful
are those of Dr. Nicholas Gonzales and of Dr. Stanislov Brudzinsky.
Dr. James Gordon is promoting the growth of good solid research
to prove the effectiveness of many of the complimentary and alternative
treatments so that in the future these treatments will be integrated into whole
programs right from the start. More information about his book and his
center can be obtained at www.cmbm.org.
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