Functional Medicine

In this video Dr Mark Hyman from the Institute of Functional Medicine discusses how the basic principles of Functional Medicine and nutrition apply to virtually every chronic illness we face today. The power of good nutrition and lifestyle changes is greatly unappreciated by most primary care physicians and specialists but is well documented in the medical literature. In fact articles on lifestyle and nutrition appear almost every day online. Dr. Yost is a graduate of the Institute of Functional Medicine and uses the principles discussed by Dr Hyman for people with a wide variety of chronic illnesses in his practice in Tucson. This includes digestive problems, diabetes, cholesterol, blood pressure, fatigue, arthritis, sinus problems and autoimmune disorders. Please see our website for success stories.

Integrative Medicine in Tucson

As more articles appear in medical journals about nutrition and lifestyle factors to both prevent and treat many chronic illnesses, the gap between Integrative Medicine and conventional medicine is beginning to narrow albeit slowly. Some examples are frequent studies about the benefits of probiotics for intestinal health, the importance of exercise and diet, the benefits of fish oil and mind body techniques to help decrease stress and anxiety.  These areas are just beginning to receive attention in medical school training. Lifestyle factors are also receiving serious attention. Dr. James Rippe of the Rippe Lifestyle Institute defines Lifestyle Medicine as “The study and practice of how to help individuals understand that their daily habits and practices have a profound impact on their short and long term health and quality of life.” Dr. Greenstone of the University of Michigan defines Lifestyle Medicine as “The study and practice of how simple lifestyle measures such as proper diet, proper exercise, and stress reduction are thoughtfully and comprehensively integrated into conventional Western medicine and practice.”  These physicians and many more are helping to narrow the gap between conventional medicine and Integrative Medicine.

There is the Program in Integrative Medicine in Tucson founded by Andrew Weil in the late 1990’s. It is associated with the medical school at the University of Arizona and the residency program in Family Medicine. I am an instructor with that program teaching my specialty of Functional Medicine. Programs like this are appearing at medical centers around the country. In medicine and science, attitudes change slowly. The Nobel Prize winner physicist Max Plank, one of the founders of quantum physics is quoted to have said in 1936, “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” Integrative Medicine  in Tucson is at the epicenter of this “quantum change” in medicine.

Foods that naturally lower blood sugar

If there was a drug that turned off all the diabetes genes and turned on all the good genes to help blood sugar and caused no side effects it would instantly become the highest selling drug of all time and we could be seeing and hearing about it 24/7 in the media. But the news is actually better than that because there is a food that naturally lowers blood sugar. It is rye bread. Did we hear about this on TV? No. Radio? No. From your doctor? No. That is because the research study appeared in the American Journal of Clinical Nutrition several years ago and the makers of rye bread (the good kind) can’t afford to advertise this on TV.

The study looked at two groups of people with metabolic syndrome (pre-diabetes) and gave each group a different diet. The first group had wheat, oats, and potatoes as the source of their carbohydrate.  The second group ate only rye as their source of carbohydrate.  After the 12 weeks, the researchers took a biopsy of fatty tissue to analyze how diabetes genes were affected. In the group assigned to eat wheat, oat, and potato group, 62 genes were activated that increased inflammation, oxidative stress and worsened blood sugar balance. This is what happens in our bodies in heart disease, Alzheimer’s, degenerative joint disease and osteoporosis. Eating these foods produced no positive effects. However in the rye only group, 71 genes were turned on that prevent diabetes, lower cholesterol, reduce inflammation, and improve blood sugar control, i.e. only beneficial effects were observed. This has never been true with  any medication invented by  man (and is unlikely to ever be invented).

Why wasn’t this front page news? Foods that naturally lower blood sugar aren’t nearly as exciting as the next “blockbuster drug” but they taste better!

Heart Disease and Lifestyle Medicine

In this short video Dr. Oz talks with Dean Ornish M.D. about how to reverse heart disease through diet, stress control, social support and exercise. In 2010 the Ornish heart disease reversal program was approved by Medicare for a 72 session intensive program. Dr. Ornish has proven his program over the past 30 years and reported reversal of heart disease in major medical journals. This is intended for the person who does not want to have coronary artery bypass surgery or stents placed in their heart arteries. Unfortunately there is no hospital yet in Tucson who is willing to start this program. The Ornish program is one of the best proven examples of the success of lifestyle medicine in the treatment of a serious illness.

Integrative Medical Doctors

Hunter Yost M.D. is an instructor with the Program in Integrative Medicine at the University of Arizona in Tucson founded by Andrew Weil M.D. The program has trained hundreds of doctors  over the past 14 years in Integrative Medicine. Integrative Medicine combines treatments from conventional medicine and complementary and alternative or CAM for which there is some high-quality evidence of safety and effectiveness. It is also called integrated medicine. Many health care institutions have begun integrating therapies that aren’t part of mainstream medicine into their treatment programs. A number of medical schools now include education on nontraditional techniques. As complementary and alternative therapies prove effective, they’re being combined more often with conventional care. This is known as integrative medicine. After their training in Tucson, these integrative medical doctors return to their home states to practice.

Dr. Yost specifically teaches his area of Functional Medicine. Functional Medicine is a patient-centered approach that goes beyond a typical holistic model to balance core functional processes in the body such as cellular metabolism, digestive function, detoxification, and control of oxidative stress. A combination of elements comes together in the functional medicine model:

• A thorough understanding of physiological and biochemical function, from cellular to organ levels.
• Knowledge of well-established interventions for altering gene expression; and
• An intensive study of the fundamental biological processes that can cut across organ systems and medical specialties.
• Produces a unique approach to health care that focuses on achieving health through optimizing physiological function.

Functional Medicine can be thought of as a specialized area under the broader context of Integrative Medicine. Closely associated with Integrative and Functional medicine is Mind Body Medicine which focuses on the interactions among the brain, mind, body, and behavior, and on the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health.  It regards as fundamental an approach that respects and enhances each person’s capacity for self-knowledge and self-care, and it emphasizes techniques that are grounded in this approach.  Mind body medicine Includes relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, tai chi, spirituality, etc. Well trained integrative medical doctors will be familiar with all of these areas.

Help Me Lose Weight

In parts I and II I covered two hidden causes of weight loss frustration, lack of adequate sleep and disruptions of bacteria in the intestinal tract. The next hidden cause of weight loss frustration is toxic chemicals stored in our fatty tissues. These are called Obesogens. Some of the most common obesogens are pesticides and other chemicals called POP’s or persistent organic pollutants such as PCBs (dry cleaning fluid), DDE (a break down product o DDT), hexachlorocyclohexane (pesticide), Pthalates and Bisphenol A (both in some plastic bottles and packaged foods). These chemicals disrupt normal weight loss signals in the body. In your quest to “Help me lose weight” we have to consider these toxins.

In an article entitled: “Chemical toxins: a hypothesis to explain the global obesity epidemic” in the Journal of Alternative and Complementary Medicine in 2002 the authors state, ”Because the obesity epidemic occurred relatively quickly, it has been suggested that environmental causes instead of genetic factors may be largely responsible. What has, up to now, been overlooked is that the earth’s environment has changed significantly during the last few decades because of the exponential production and usage of synthetic organic and inorganic chemicals. Many of these chemicals are better known for causing weight loss at high levels of exposure but much lower concentrations of these same chemicals have powerful weight-promoting actions. This property has already been widely exploited commercially to produce growth hormones that fatten livestock and pharmaceuticals that induce weight gain in grossly underweight patients. This paper presents a hypothesis that the current level of human exposure to these chemicals may have damaged many of the body’s natural weight-control mechanisms. Furthermore, it is posited here that these effects, together with a wide range of additional, possibly synergistic, factors may play a significant role in the worldwide obesity epidemic.”

A strong correlation was seen between increased levels of specific POPs and insulin resistance and Body Mass Index reported in the journal Obesity in 2010. Research from Diabetes Care 2007 suggest that persistent organic pollutants (POPs) may be associated with type 2 diabetes risk by increasing insulin resistance in obese individuals.

See our video about our 10 day metabolic detoxification program and ask us to “Help me lose weight”.

In Help Me Lose Weight Part One, I discussed how lack of sleep can create a hormonal imbalance to slow down weight loss. In today’s blog here is a question I ask everyone who is struggling to lose weight, “How often have you taken antibiotics in your life?” I ask this question because antibiotics disrupt the intestinal environment of bacterial we all have which is about 3 pounds. Yes, we all carry several pounds of life sustaining bacteria which starts growing at birth. In addition to antibiotics, a fast food diet high in fat and sugar can also disrupt the gut bacteria by starting a low grade inflammatory process that disrupts the chemical signals of glucose and insulin regulation by gut hormones. These individuals are screaming. “Help me lose weight.”

The evidence is growing. Cecil Lewis of the University of Oklahoma a member of a team of scientists studying the DNA of ancient gut bacteria says, “My first hypothesis would be that chlorinated water and antibiotics fundamentally changed human microbiomes (i.e. gut bacteria).” Other research on gut bacteria has found that obese individuals tend to have a makeup of pathogens in their intestines different from that of people who are of normal weight. In one experiment, researchers found that an obese mouse’s gut microbes extracted more of the calories from a given piece of food than did those of non-obese mice. This caused the obese mice to gain more body fat than the non-obese mice did. But even stranger, in a type of mouse with a different mutation that leads to obesity, transferring gut microbes from the obese mice into other mice led the non-obese mice to eat more.

So the answer is a change in the diet to whole fresh foods, minimally processed, high in fiber, low in fat and sugar. It may also be necessary to rebuild the good bacteria through probiotics containing live cultures of lactobacillus and bifidobacterium. In part III of ‘Help Me lose Weight’ I will cover another hidden cause of weight loss frustration. See our success story video.

Help Me Lose Weight

Frequently it is necessary to look beyond diet and exercise for the hidden obstacles that make weight loss a frustrating experience. I see some patients who limit their calories too much and exercise too much to “force” the weight off. Sometimes I hear, “If I eat over 1000 calories per day I gain weight.” There is more to weight loss than just calories in and calories off. What is in between is your own biochemistry including hormones you probably have never heard of…but more on that in a minute. I recently saw a woman in her early 40’s who was frustrated with lack of weight loss even though she had been following the dietary plan in our FirstLine Therapy program and being active. At her last visit I asked her about her sleep. She said she goes to bed around 10 or 11 but gets up at 3 am when her husband goes to work and does not go back to sleep. She gets up just to see him off not because he needs anything done for him. So her main concern is “Help me lose weight.”

Researchers in the long term nurses study in 2006 found that the women sleeping 5 or fewer hours per night were 32% more likely to experience major weight gain, defined as an increase of 33 lb or more, and 15% more likely to become obese during the 16-year study period than the women who slept at least 7 hours per night. In addition, women who slept for 6 hours were 12% more likely to have major weight gain and 6% more likely to become obese compared with women who slept at least 7 hours per night.

The key result was that sleep deprivation decreases the levels of leptin (a hormone produced in our white fat cells) which signals to the brain that the body has had enough to eat, producing a feeling of satiety with a corresponding increase in the levels of ghrelin (a hormone produced in the stomach and pancreas) which increases the sensations of appetite and hunger.

So for my patient, it will be necessary to make a lifestyle change to better “regulate her hormones” and have an easier time of losing weight. In my next Help Me Lose Weight blog I will cover another hidden cause of weight loss frustration.

Functional Medicine

Mark Hyman M.D., bestselling author, is the current chairman of the board of the Institute of Functional Medicine. Through his appearances, books and his website Dr. Hyman promotes Functional Medicine for the chronic illness crisis in  our country and the world. Functional medicine can be thought of as a new “operating system” for chronic illnesses. This is because our society is experiencing a sharp increase in the number of people who suffer from complex, chronic diseases such as diabetes, heart disease, cancer, mental illness, and autoimmune disorders like rheumatoid arthritis. Functional Medicine is based on theses principals:

• Patient-centered care. The focus of functional medicine is on patient-centered care, promoting health as a positive vitality, beyond just the absence of disease. By listening to the patient and learning his or her story, the practitioner brings the patient into the discovery process and tailors treatments that address the individual’s unique needs.

• An integrative, science-based healthcare approach. Functional medicine practitioners look “upstream” to consider the complex web of interactions in the patient’s history, physiology, and lifestyle that can lead to illness. The unique genetic makeup of each patient is considered, along with both internal (mind, body, and spirit) and external (physical and social environment) factors that affect total functioning.

• Integrating best medical practices. Functional medicine integrates traditional Western medical practices with what is sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.

Mehmet Oz M.D., known commonly as Dr. Oz,  is referenced on the website for the Institute of functional Medicine saying that Functional Medicine has had a great influence on his thinking. In fact Dr. Hyman has been a guest on his show. Dr. Yost is a graduate of the Applied Functional Medicine in Clinical Practice training program (AFMCP) through the Institute of Functional Medicine.

Decrease Risk of Diabetes

In this video Mark Hyman M.D. of the Institute of Functional Medicine, reviews some easy common sense steps to decrease risk of diabetes and pre-diabetes. Did you know that rye bread contains special fibers that decrease blood sugar? So rye bread can be thought of as a “medical food” to help people with blood sugar problems. But don’t get the packaged rye bread from the grocery store that is mixed with white flour. Go to a local specialty bakery and ask for the dark pumpernickel rye.

Just like with any medicine dosage is important. For rye bread or any whole grain the recommended amount is one slice per day. As Hippocrates is quoted: ‘Let food be thy medicine and Let food be thy medicine and medicine be thy food”. Dr. Hyman also discusses the basic components of the Mediterranean Diet, the most highly researched diet in medical literature for diabetes and the Metabolic Syndrome.

We incorporate the same dietary and lifestyle changes he mentions in our therapeutic lifestyle program called FirstLine Therapy. See our success story video.