Seeing through the fog…
My interest in medicine and nutrition is rooted in the contradiction between what I feel we are capable of, and what we have today. From my observations, we already have the tools, knowledge, therapies, and substances necessary to see drastic decreases in disease prevalence, healthcare costs and emergency room visits. Most urgently, however, is the need for the medical community as a whole to upgrade the priority on nutritional approaches to improving quality of life. Many preventative approaches to health care are viewed as obscure and lesser known, even when they are much older and safer than traditional Western protocols. How has this come to be?
It seems impossible to explain my experience and current take on medicine without some perspective, so I have chosen to offer some brief words about the path that lead me to Everglades University’s Evidence-Based Complementary Medicine Bachelor program. It will become clear that I view nutrition as the foundation for wellness, justified by it being one of the few principles of health mentioned by ALL medical systems. There is a mass deficit of knowledge about nutrition in society, and even many hospitals and clinics. The latter portion of the paper will summarize some strategies towards gaining critical mass of acceptance of prevention and balance by being engaged in one’s own healthcare, every day.
Why do I even care?
Even before I knew much about medicine, I was very intrigued by its mysterious abilities to heal. As a child with asthma and many food and environmental allergies, I was exposed to different approaches of medicine. I took an herbal syrup when I had an asthma attack which worked after about 10 minutes. Then later during childhood, steroidal inhalers were invented, and I enjoyed instant relief at any time. I learned very early that there are different ways to remedy a situation or condition.
Unfortunately, my options were limited to what I knew, which was not much. My family excelled at being a family, socially and psychologically, but we all suffered during my childhood years from too many of the wrong foods and sugary drinks. This continued, with only slight improvement, until the age of 25, when I first became connected to the internet as we know it today. I learned how vitamin C can help alleviate asthma, and certain kinds of seafood can exacerbate it. I tried it myself, and it seemed to be true. I read about herbs, nutritional therapies, acupuncture, and many more. The first question that came to mind was “why doesn’t anyone talk about this?” and then, “if there are all of these great remedies, why are people debilitated by so many diseases?”. I suppose I thought we had a better grasp on medicine that actually resolves conditions rather than simply suppressing symptoms. I was disappointed and saddened by all of the preventable suffering still happening in this new millennium.
How did I end up here?
It did not take long to see that medicine is far from “all figured out”, with claims of this natural therapy or that pill being better than the other. Some on the internet claimed that apricot seeds can destroy tumors by releasing its cyanide molecule only in the presence of a tumor cell. I discovered Gerson therapy and read all about it. I was skeptical of everything at that point. Are there really cures that just aren’t talked about, really? Suddenly the story became a mystery to solve. That was when I realized that I had stumbled onto a topic that really interested me, that needed help, and that I felt I could make a difference in. It seemed just unconventional enough to appease my desire to do something helpful and important that could make some kind of big, positive impact on the world. It is full of political intrigue and even a hint of conspiracy now and then. I decided to seek the truth behind all of this. I did not know what I would do with the information at the time, I was just intensely curious and felt compelled to see if I could help. Reflecting back on that time (2007) as I write this, I am struck by how much of a “calling” it was. I really dove right into it then, and I am still just as intrigued and determined as day one.
I began my studies in holistic nutrition at the age of 28, through a non-accredited entity. I learned priceless information through Elson Haas’ “Staying Healthy with Nutrition”. As Dr. Haas has a duel M.D., N.D., his perspective is full of detail, with a well-balanced, naturopathic philosophy. I read texts on antioxidants, enzymes, phytonutrients, inflammation, and more. When they closed their doors during the middle of my time there, I realized my naivety . . . it was a diploma mill. It was a hard lesson learned, but, on the bright side, I still set some great foundations in holistic nutrition, herbology, and naturopathy. I still wanted to go for it, but only through a fully accredited program.
I found out about Everglades University’s accredited Bachelor of Science degree program on a Facebook group of those of us who got burned by the last college. We were all sharing information about which schools in our field of interest are actually legitimate and accredited. I enrolled at EU in July of 2012 and graduated Summa Cum Laude just recently.
What’s the scoop?
In that time, I have learned and observed that healthcare has become a costly, frustrating, and confusing experience for patients in the West, and the information age of the internet has only contributed to this confusion. Many people now actively seek a different approach to maintaining well-being, or finding effective disease treatment and recovery options with lower risk of adverse side effects from pills or surgery. Why is Western medicine struggling to control heart disease, diabetes, hypertension, and other chronic illness?
Pharmaceutical drugs, surgery, acupuncture, homeopathy, Ayurveda, nutrition therapy… How can so many contradicting philosophies and methods exist, where all of the systems work for some people, some of the time? Why isn’t there a system that works most of the time for everyone? Our DNA is 99.9% identical, yet there are major contradictions in healing modalities. My gut tells me that the pieces fit together, somehow.
It appears from my research and observation that no system works for everything, yet all major systems excel at their respective dimensions of healing the mind, body, and spirit. It seems logical that we would offer blind loyalty to no particular therapy or method as the “one true way”. There is more benefit to exploring the approaches that are appropriate for a specific individual with a specific symptom profile and history.
A traditional M.D., for example, may not be able to do anything about your chronic issue, other than prescribe drugs to manage the symptoms, but if you are experiencing a heart attack, major injury, or life threatening condition, then there’s not much an acupuncturist or Naturopath could do. Telling a primary care physician about your “leaky gut” will be met with anything from an audible snicker, to some sort of prescription, while nutrition therapists, Ayurvedic practitioners, Naturopathic physicians, and other “alternative” professionals are well versed and equipped (more-so than the allopathic physician, commonly) to see them to full resolution of the condition. When wider knowledge of the various approaches to health is achieved, we will be more likely to entertain the possibility that our chosen profession does not offer the best solution, and to refer our patients to the practitioner who may help them the most.
For the sake of humanity – a way forward…
To be of best service to patients, all general practitioners could be educated in the basics of all of the major philosophies (nutritional therapy, herbology, Ayurveda, Acupuncture, Pharmacology, etc), myself included. I would benefit from some pharmacology or other pre-med classes, even though it is far from my chosen path, so I could have a well-rounded understanding of all of the best approaches. I believe Western medicine is dominant for good reason with its many strengths, and I am happy to recommend it when it seems to be the most effective option or the least risky. But when does someone need this pill, or that nutrient, or these herbs, or acupuncture? We are here to most effectively facilitate resolution of dis-ease for all patients, and any and all information to that end should be considered on equal grounds until proven otherwise, as I see it.
There are some striking similarities among the “natural” health systems (Ayurveda, Herbology, Nutrition Therapy, Traditional Chinese Medicine) which make a strong case for their time tested, cumulative effectiveness. The themes of balance, prevention, and mindfulness of mind-body interactions are across the board. It cannot be denied that conventional Western medicine, which views health as simply “lack of disease”, is not engaged in prevention and general wellness to the degree that all of the major natural systems are. There are so many ways that a condition can go undetected in a lab, and even more situations where you clearly don’t feel good but the tests are negative. Is your doctor asking the right questions with these labs?
Roots of a disease-free life…
Another common thread in natural protocols is the concept of our innate ability to heal and regenerate. This principle rejects the idea that a patient can always be healed simply by administering a substance, without addressing likely contributors by offering in-depth solutions. This is perhaps natural medicine’s largest contribution to healthcare because it focuses on resolving the causes of a condition and educating the patient on how to maintain themselves to avoid it in the future. Rather than generic and ineffective dietary advice, or vague recommendations like “avoid stress”, the natural medicine protocols generally guide the patient to acquiring the skills and knowledge needed to manage and recover from their condition.
By consulting in-depth and developing a patient-provider relationship of trust, understanding and mutual respect, the acupuncturists, nutritionists, Ayurvedic practitioners, naturopaths, and others guide patients to a real understanding of their condition and the factors that led to it, albeit through much different philosophies. The physician teaches, rather than dictates, creating sustainable positive change in their patients. Our society would benefit greatly and instantly by taking notes from nature and those philosophies who have spent millennia observing it closely in the context of physiology.
Oh boy, here we go…
Why isn’t this already happening? There are numerous complexities that explain why we are in such a position with healthcare in this society, and most of them involve entangling financial, political, and institutional structures set up for private gain. They are so complex and interwoven, in fact, that they would make a good topic for a book.
It may not be widely known, but there already exists plenty of evidence for many alternative therapies, particularly nutrition therapy. They are proven by patient and provider experience, time, and cohort, case-controlled, observational, as well as double-blind, placebo controlled studies. Unfortunately, the established hierarchy of evidence in research places the randomized control trial as the gold standard, but there are major shortcomings in evidence-based medicine due to relying too heavily on these trials, while ignoring and sometimes suppressing the numerous case-studies and outcome-intervention trials.
What’s more, blinded, randomized control studies are best suited for pharmacological interventions where the effects of one isolated substance is monitored against a control group with a placebo, or competing drug, for its effects. It is a sturdy and reliable method for those specific questions, but ill equipped at times to grasp the complexities of interventions in diet, lifestyle, mental health. There are simply too many interconnected variables to study and prove the effectiveness of lifestyle overhauls, yet only trying one intervention at a time isn’t an overhaul at all and is not how the body works in many cases. So, here we are . . .
How dare I say such a thing?
Regardless of its high regard in research, the gold standard in clinical research has its own inherent flaws. In many cases, it is the difference in efficacy that is studied and analyzed. This means that, hypothetically, a trial of a pharmaceutical therapy versus acupuncture for depression could show no difference, meaning they both were equally as effective or ineffective. This is typically reported in such a way as to say that since acupuncture was no more effective than the pill, it is not recommended. In truth, it should be reported that BOTH the pharmaceutical preparation and acupuncture are effective and could be recommended options for depression. A change of perspective is in order.
There are plenty of “simple but wrong” answers to illness touted by healing systems across the board. That’s what science is for… but we have to ask the right questions!!!
Asking the right questions…
Out of all of the prevailing definitions of Science in the various dictionaries, there is no mention of it needing to be a randomized trial in order to be useful. The scientific method promotes discovery by learning how to ask the right questions, and not solely by looking for specific answers.
I am in no way proposing that we stop using randomized control trials or that they are not useful. I am only suggesting that they be weighted along-side the other methods of research that help paint a much more accurate and detailed picture that can be the key to full resolution of a patient’s condition. Some researchers are calling for a new perspective on the old hierarchy of research. Instead of a pyramid with superiority of one method over another, we could adopt a circular, round-table view of research where the weakness of one is supported by the strength of another. The different methods ask and answer different questions. It should. The same exact principle can be applied to incorporating the different systems and philosophies into some kind of Universal Medicine (the penultimate form of a truly integrated medicine).
The elephant in the room…
Influencing the political-scientific climate to appreciate the value of prevention and education is one of the major challenges of our time. From a purely economic standpoint, there just isn’t much financial profit in people actually taking care of themselves, not for the established players in the system, that is. Think, for a moment, who would benefit and who would lose in a society that focuses on maintaining optimal health, rather than scrambling to recover health after it has been lost. It is obvious which approach benefits the patient and which benefits the medical-industrial complex.
I often joke that one way to make the much needed overhaul in nutrition policy would be to raise the price of vegetables to that of a pill. Just watch the funding and investment pour in from industry when we push the prevention agenda to a critical mass. Pharmaceutical companies and big food industries like DuPont, Coca Cola, and the others are already scrambling to add more “natural” or “healthy” products into their portfolio, so it is not a stretch to imagine them doing everything they can to stay at the top of the health market, even if they have to change core aspects of their goods. Until that day comes, they need to maintain their research ties to perpetuate their current dominance in their respective markets.
If society knew even a quarter of what I and other researchers know about nutrition, the industries that are not serving our best interests would starve to oblivion or to a much weaker state through attrition. One day, people simply won’t need them as much anymore because they will be better educated to make better decisions, hopefully without the cloud of doubt that conflicts of interest inject into the body of research.
I’d like to state for the record once again that I am not against Western science or medicine, and I have deep respect for the doctors, nurses, and others on the front lines every day. It seems to me that the lack of prevention focus and heavy drug prescription reliance is no fault of the doctors. The disconnect is higher up the chain.
For example, if you are never taught as a medical student that Non-Steroidal Anti Inflammatory drugs come with serious side effects that may even exacerbate the inflammatory condition they are prescribed for, then it is completely understandable and forgivable that you would prescribe them more frequently, without addressing the causes of inflammation in the patient’s diet, or trying a powerful anti-inflammatory such as Turmeric, which carries a considerably lower risk. You may have been taught to automatically refer patients with mental disorders to a psychiatrist for Xanax, Prozac, or another drug with side effects, if you have never been taught that there is evidence that Omega 3 supplementation, acupuncture, and/or meditation have been used successfully, with no side effects or withdrawal, for the same conditions. It makes sense to try the risk-free interventions first, no? I’m only proposing common sense over here.
Medical education, events, scholarships, equipment, and anything else you could imagine, are heavily funded by pharmaceutical industries. One study, in 2006, showed that “ . . . 65 percent of clinical departments received industry support for continuing medical education, 37 percent received industry support for residency or fellowship training, 17 percent received industry support for research equipment, and 19 percent received unrestricted funds from industry for department operations” (Campbell et al., 2007b). It would be foolish and naïve to assume these industry funds are purely charitable, and that this doesn’t create painfully obvious conflicts of interest in what is being taught to our nations doctors. Jorgensen (2013) points out that “ . . . the pharmaceutical industry has convinced legislators to define policy problems in ways that protect its profit margin. It reinforces this framework by selectively providing information and by targeting campaign contributions to influential legislators and allies”.
Could they really get away with this?
This is not a new tactic, as we have seen (with much documentation) the power of industry over public health policy and information before. We can learn some lessons from the years of deceit and manipulation by the tobacco industry, which paid to publish their “Frank Statement to Cigarette smokers”, in 1954. It stated that “. . . the public’s health was the industry’s concern above all others and promised a variety of good-faith changes. What followed were decades of deceit and actions that cost millions of lives” (Brandt, 2012).
The study reviewed and analyzed the strategies used by the tobacco industry to influence not only public opinion, but also “ . . . legislation and regulation, litigation, and the conduct of science. The tobacco industry had a playbook, a script, that emphasized personal responsibility, paying scientists who delivered research that instilled doubt, criticizing the “junk” science that found harms associated with smoking, making self-regulatory pledges, lobbying with massive resources to stifle government action, introducing “safer” products, and simultaneously manipulating and denying both the addictive nature of their products and their marketing to children” (Brandt, 2012).
Of course, tobacco and food are two very different things, but they are similar in that they are both massive industries who have an incalculable impact on public health. It is important to pay attention to the “ . . . significant similarities in the actions that these industries have taken in response to concern that their products cause harm. Because obesity is now a major global problem, the world cannot afford a repeat of the tobacco history, in which industry talks about the moral high ground but does not occupy it” (Brandt, 2012).
There is a noticeable pattern of an industry growing to a point where it can devote massive resources to manipulating public-institutional opinion of its products. We pointed out but a few of many examples of pharmaceutical influences on healthcare, as well as the important lessons learned by deceitful tobacco research and policies, but it is not as widely known that the food industry and their relationship with research is just as widespread.
First hand experience – the beast rears it’s ugly head…
In our Exercise Science class at Everglades University, I learned about the existence of the American Society for Nutrition (ASN). I eagerly joined them, as they are on the front lines of nutrition and food research policy. In December of 2014, I attended my first ASN conference, titled Advances and Controversies in Clinical Nutrition.
My first observation was that the majority of attendees were either practicing physicians, or PhD research students, and here I was still a year away from my undergraduate. I felt a bit more comfortable, however, when I noticed the amazement of the PhD students sitting at my table when they brought out the dinners each night. I would identify the food and talk about its benefits or parts to avoid (like the cheesecake). No one could understand how I knew we were eating sea bass, or how I knew how much cheesecake raised blood sugar… yet they were the ones about to go and research isolated food compounds for a living. I can see how being a lab assistant would not require you to know what a sea bass filet looks or tastes like, but it struck me how disconnected food researchers are from actual food. There is an opportunity for improvement there.
Then, on day two, was the big sugar debate I was waiting for. It touted that a panel of researchers would be debating the effect of free sugars on obesity, insulin resistance, etc. (Free sugars refer to added sugars, not naturally occurring sugars in fruits or grains). The researchers on both “sides” of this debate presented their conflicts of interest first, per protocol. Both of them received funding from Coca-Cola, Mars Co., Pepsi-Co, and the list went on.
Wait… Both sides of this debate on the effect of sugar are effectively sponsored by companies that sell sugary junk foods? I looked around the room to see if anyone else was as disturbed by this as I was. No sign of concern in the audience, it seemed. Were they just used to this, or was I simply overreacting?
Sadly, I was not overreacting one bit. The debaters reached a consensus that it wasn’t the sugary drinks leading to obesity, or insulin resistance, rather, it was the extra calories added that were the culprit. They agreed that any free sugars up to 100 grams a day did not pose any health risks, other than dental. This dangerous conclusion basically says you can eat sweet junk food, without negative effects, so long as you remove some of the other food from your diet and keep your calories within range. Seriously?
While all of the studies they cited did seem to point to this conclusion, they were all meta-analyses and systemic reviews of randomized control trials only. If you fed people 100 grams of sugar a day and simply met up with them once a month, I’m sure there would be pretty obvious changes, as I’ve had many clients who lost over 20 pounds of weight when all they did was stop drinking soda, even if their total caloric intake remained unchanged. Don’t get me wrong, calories-in vs calories-out is king for weight loss, but spikes in blood sugar have consequences on circulating insulin levels, free radical formation, and fat storage, even in a caloric deficit. 100 grams of added sugar is 400 calories, or almost 1/4th of total daily calories. Where one could have had fiber, nutrients and protein along with some carbs in a 400 calorie meal, these researchers think it’s just fine to have 2 sodas instead. Any yes, the research did back them up, but it was research carefully crafted to ask a scientific question in such a way as to end up with favorable results.
A picture emerges…
This is a great case for the circular model of research methods mentioned earlier, rather than the hierarchical one we have today. Industry clings to these meta-analyses and systematic reviews of randomized control trials because the data is very easy to spin in such a way that it makes their products seem healthy, or less unhealthy. Free sugar doesn’t just affect the 2 or 3 biomarkers the researchers were monitoring, it affects many systems of the body, even psychological behaviors and conditions. Don’t mention this to the researchers that were on the stage that day, though, for they even laughed WITH each other and made fun of the concept of sugar being addictive… even though it is and has been demonstrated to affect opioid receptors, much like nicotine and heroin do. But hey, I only hold a Bachelor’s degree and hold no license, so what do I know? Unfortunately, no license or certification exists for a chef/nutritionist/practitioner/investigator, so feel free to completely ignore all of my warnings (especially those of you in academia, where it is all about credentials).
It seems the game is rigged. There are good actors publishing wonderful studies that ask the right questions, and they are funded by the National Institutes of Health. But researchers are forced to accept funding from elsewhere due to scarcity at the NIH. We are left with a research environment where most health and food research is funded, in large part, by industry. Industry does not care about your health. Business is business and the bottom line must be protected and grown. So, what if we could humble the scientific community to accept observations and case studies, or outcome-intervention trials?
What does science actually know that we are never told?
Nutrition research has uncovered some downright miraculous abilities in nature and in our bodies. I have always been struck by how much evidence already exists for the disease preventing and even life-extending qualities of antioxidants, phytonutrients, and proper amounts of vitamins, minerals, and the right fats. I wholly acknowledge the importance of lifestyle, exercise, and an individual’s genetic makeup in disease prevention and recovery, but it seems there is no non-communicable disease that the right proportions of nutrients cannot overcome, or at least help control.
The antioxidants class at Everglades University had a whole section of the book dedicated to citing thousands well designed studies proving their power, but what did I see at the ASN conference? The opposite. One researcher conducted a meta-analysis on antioxidants and found that there was no sufficient evidence available to develop guidelines for antioxidant intake. The problem is, the meta-analysis reviewed randomized control trials using one antioxidant at a time. Why, as the only pre-undergrad in the room, was I the only one who seemed to know that antioxidants only work in support of each other, never alone, and therefore cannot be studied in isolation?
The researcher even cited the infamous beta-carotene study, where cancer patients were given isolated beta carotene. The trial was cut short because many of the patients became increasingly ill while taking it and their cancer grew or spread quicker than before the beta-carotene. She used this as one of the reasons why we shouldn’t recommend anti-oxidants to the general population. Turning the mirror onto herself, she would see that, instead, we SHOULD use this as one of the reasons why we shouldn’t test the natural world by isolating one small part of it in a lab. I realized that not only was I the only one without a degree at the conference, but it was also highly likely that I was the only one with any education in natural medicine.
Since this was my first conference, I did not have the gall to stand up and question the researchers too heavily. Every time I did ask a question, they seemed to be quite adept at either side-stepping the important aspects of it, or waving off my concern as no big deal. When I make it to my next one, I will come prepared with an onslaught of studies contradicting their conflicted ones. I feel that doing so is one of my duties, because it appears to be an Achilles Heel of all that is wrong with nutrition research. Someone’s got to do it, and I didn’t see anyone else there waving the flag.
I ended up emailing the researcher who stated that anti-oxidants should not be recommended. She was kind enough to reply with the following message:
I think your observations are on target and the fact that you are providing healthful meals rather than supplements aligns well with the message I was attempting to convey. You’re absolutely right, funding is a huge issue and many of us in academia, particularly those of us who heretofore relied on NCI funding are just trying to survive (not a great time to enter the field of nutrition and cancer). I think you are on target as far as we need to be more aware of nutritional status (and part of that would be status as far as antioxidants) at baseline and use better screening criteria (probably a reason why the WHEL study didn’t work). Those assays however are quite expensive and thus very few people do them. Best wishes to you on your work!
Wendy Demark-Wahnefried, PhD, RD
Professor and Webb Endowed Chair of Nutrition Sciences
Associate Director, UAB Comprehensive Cancer Center
American Cancer Society Clinical Research Professor
Knowledge is power…
Even some of the researchers agree that their field of interest is broken. In the meantime, the only recourse is to get solid data out to the general public in such a way that it will be digestible to the masses. If industry influences research, then we must influence industry. Nothing influences industry quite like the almighty dollar. It all starts with compiling the data that shows the true importance of healthful eating, and then finding a way to simplify without removing important information. Too often, the message is “dumbed down” to a point where it is no longer convincing or exciting, yet the public is already weary of sensational health claims from health product manufactures and the overuse of the words “natural” and “healthy” on goods that really aren’t what they claim. This is why I believe people are ready to hear the science behind their food.
For example, diabetics commonly experience renal (kidney) disease as a result of their condition. The commonly prescribed medications for managing diabetes only exacerbate kidney damage, but ” . . . the renoprotective, anti-oxidative and anti-apoptotic effects of the flavonoid quercetin . . . caused a reduction in polyuria (~45%) and glycemia (~35%), abolished the hypertriglyceridemia and had significant effects on renal function including, decreased proteinuria and high plasma levels of uric acid, urea and creatinine, which were accompanied by beneficial effects on the structural changes of the kidney including glomerulosclerosis” (Gomes, 2014).
Quercetin is a flavonol found in many fruits, vegetables, leaves and grains. It can be used as an ingredient in supplements, beverages, or foods.
Ok, so how do we tell people that? Because, if myself or a loved one was suffering renal disease, I would be pretty excited to learn of this. I’m sure others would be, too, but it is so dense with data and words unfamiliar to the general public. The messaging needs to be framed in a digestible, perhaps even entertaining, manner.
Further down the rabbit hole…
What about the “mysterious” inflammatory conditions, which apparently have no cure, but plenty of drugs to manage the symptoms? The fundamental integrative approach of diet, stress management and physical therapy should take highest priority in the education of RA patients. There is evidence of nutritional intervention, acupuncture, chiropractic, massage therapy, and pharmacology, but to begin at the true root of the issue, we must understand the pathophysiology of the small intestine and the resulting circulating immune complexes. (I wrote a blog on this topic in 2014, and here it is)
What could the small intestine have to do with inflammation of the joints? The answer is Circulating Immune Complexes, which are formed from the integral binding of an antibody to a soluble antigen. This act in itself is normal and crucial to immune function. Immune complexes may themselves cause disease when they are deposited in organs and are a prominent feature of several autoimmune diseases, including systemic lupus erythematosus, cryoglobulinemia, rheumatoid arthritis, scleroderma and Sjögren’s syndrome. Studies have shown that CICs and “. . . immunological abnormalities typically found in established RA are found in the earliest phase of the disease we were able to investigate” (Hay, et al. 1983).
One places where these CICs can originate is in the epithelial cells of a damaged small intestine. The simple columnar epithelial cells of the small intestine play a very important role in the breakdown and absorption of molecules from food. These cells are the final disassembly line before molecules enter the bloodstream. Partially degraded proteins and other substances enter through endocytosis at the apical membrane, encapsulated in lysosomes, broken down, and released as amino acids and fully hydrolyzed molecules into the bloodstream that can be used as raw material for the body. They are fully broken down and cannot be recognized as foreign cells. Some molecules, such as water and glucose, can pass through the tight junctions between these cells. In other words, intestinal permeability is normal. (Vojdani, 2013)
When the epithelial cells fail to fully breakdown proteins and/or the tight junctions between these cells lose integrity, the permeability of this membrane is increased and macromolecules make it through to the bloodstream, where the immune system identifies the proteins as foreign and responds accordingly. This is ground zero for the production of CICs, and it has been demonstrated in numerous studies. Chronic intestinal permeability “. . . may permit the excessive absorption of many food proteins, leading to the formation of antigen-antibody complexes and autoimmunity” (Cunnigham-Rundles, 1981).
Increased intestinal permeability leads to increased antigen uptake. Once the immune system has identified a protein as a foreign invader, it creates an antigen to destroy it. These antigens do not simply disappear when they are done doing their job, with many of them congregating in the connective tissues around the joints. The macromolecules circulating in the bloodstream trigger the response, and these antigens become active, leading to inflammation in the areas in which they are present.
Amongst the debate between scientists on how to diagnose this issue, one consistency has emerged; maintaining a healthy gut, or healing a damaged one is paramount to one’s health. Some substances that damage the membrane include “. . .antibiotics, alcohol, caffeine, parasites, bacteria, some food preservatives and additives, and allergic states such as gluten sensitivity and lactose intolerance, corticosteroids, non-steroidal anti-inflammatory drugs, refined carbohydrates, oral contraceptives, and fungi” (MLO, 2007).
Do they make a pill for that?
Most Western physicians have no idea that this exists, and many alternative practitioners are not educated on this, either. Once again, this could be life-changing information for the millions of people suffering from chronic inflammatory conditions, but how do we spread the message? Why is no one talking about this? The research is there, so what’s the excuse?
I feel that there never would have been a need to pass the Affordable Care Act if a comprehensive, and much less costly, public education campaign was attempted first. In a time when our healthcare costs are so out of control that the Affordable Care Act mandates every American adult pay into it, we still serve pizza and fries for lunch to our kids at schools, and flake-based mashed potatoes and cold cuts on white bread to people trying to recover from diseases in hospitals (one of the reasons why I veered away from a conventional nutrition degree).
Hospital food – Too big to fail?
High risk populations are the ones who need help the most, nutritionally speaking. We are approaching 2016, yet the food systems at hospitals are serving the same menu, from the same gigantic food processing companies, like Aramark, as they were in 1980. Once again, this is a rigged game, as Aramark and the hospitals both receive governmental subsidies to offset costs. So, when someone comes along with a food delivery service that serves mega nutritious meals without anything bad in them, people simply can’t afford it, because it comes at a true, unsubsidized cost. Patients aren’t used to paying out-of-pocket for hospital food, and they aren’t used to budgeting that much of their income to meals.
Ironically, the general public and patients alike would end up saving money if nutritional standards were raised to a higher priority. People would recover and leave hospitals faster, not as many people would enter in the first place, and there would be fewer re-admittance’s. In addition, more people would retain full control and use of their organs and systems as to not require expensive procedures, drugs, or maintenance therapies. Less suffering, more quality of life. Less dying, more living.
I have intimate experience working with high risk populations through my nutritional consultations and my time in the kitchen at retirement homes, where the nutritional conditions are also deplorable. The main observation of mine is the lack of fresh vegetables in these environments. I realize that stubborn taste buds can be a problem, and that chewing food is difficult for many elderly, but I know first-hand that some basic cooking skills and creativity can please palates of all sort while supplying high risk populations the components to healing that their bodies need, and removing the chemicals, added sugars, etc. that distract the immune system, among others, from doing their job at the most crucial time.
Options for Seniors…
The established elderly nutrition service in Cincinnati is Cincinnati Area Senior Services (CASS). In addition to offering organic foods in the future, CASS has ample opportunities to improve the nutrient profile of its meals, which can have a major impact in the well-being of the elderly, who require less calories yet better nutritional support in prevention, management, and recovery from disease.
Margarine is automatically included with bread, which is included in every meal. Add this to the cake, pie, and cookies offered for dessert, along with the sugar and sodium in the main entrée, which typically comes with a gravy, bbq sauce, fruit sauce, etc. and the result may be an enjoyable meal (which is debatable), but at what cost? CASS is a wonderful service staffed by dedicated, caring people who are in it for the right reasons, but I would have words with their nutritional director.
Is someone bitter?
No. This paper would not have been written if there wasn’t a problem. Our system alone is not keeping up with the top killers, which have plagued us for centuries. The top two causes, heart disease and cancer, accounted for 46.5% of all deaths in 2012. Stroke and diabetes are two other preventable diseases we seem to be having a time getting under control, adding another 20% of all deaths in America. Then there are chronic inflammatory conditions, which typically result in polypharmacy treatment for the duration of life, with little to no resolution of the condition, with costs rising rapidly.
Speaking of costs, In 2010, heart disease and stroke cost us $444 Billion dollars, and that’s only considering immediate, emergency care. It has been estimated that a lifetime of drugs to maintain conditions such as coronary heart disease is another $1 million per person, just for drugs alone.
In 2014, “ . . . U.S. prescription drug spend increased 13.1% in 2014 – the largest annual increase since 2003 – and this was largely driven by an unprecedented 30.9% increase in spending on specialty medications. . . While specialty medications represent only 1% of all U.S. prescriptions, these medications represented 31.8% of all 2014 drug spend – an increase from 27.7% in 2013” (The Drug Trend Report, 2014). These “specialty medications” consisted primarily of anti-inflammatories. People are inflamed from their diets and lifestyles, not because their bodies need pills.
Polypharmacy, a current retirement plan for many Americans…
One study, which reviewed qualitative data collected from primary care clinics, found that polypharmacy was “common among patients, with more than one-half taking 5 or more medications. Patient interviews indicated that heavy reliance on pharmaceuticals presents challenges to patient well-being, including financial costs and experiences of adverse health effects” (Hunt, et al. 2012).
How could it be that we are spending more than ever, yet failing to provide the patient with what they truly desire, which is not a lifetime of polypharmacy and symptom management, but actual healing, cures, and true resolution of symptoms and their underlying causes? Recommended lifestyle changes pose their own costs and challenges, yet they are likely the most important predictor of incidence, recovery, and maintenance success. This makes spending a bit more on good, clean foods and a gym membership seem like a more logical approach with the bonus of improved quality of life.
At risk of sounding blunt, putting someone on a pill with adverse side effects for the remainder of their lives is not healthcare, it’s sick-care. We can do better, and we already have the knowledge we need to make it happen.
Even the playing field and end the medical monopoly…
All systems have their limitations and weaknesses, and the same goes for research methodology. Some are better at answering the question at hand than others. Western medicine is just another “alternative” to preventing disease and maintaining health.
I will hence-forth refer to all approaches as, simply, “medicine”, holding the realistic view that they can all support each other’s weaknesses with their unique strengths. May the most effective, least risky, and logistically feasible therapy carry the day, for that particular individual, at that particular time. No hard feelings, anyone, please.
Truth has a way of misleading us in that it can be viewed from many perspectives, allowing two or more seemingly contradictory philosophies to exist simultaneously. An example of this would be the “higher power” theory of religion, which is now being met by “quantum consciousness” theory of science. They are coming to the same conclusion, but via much different and even contradictory language and philosophical base.
The same is true for medicine in the West, which is beginning to realize its own limitations, particularly in quality of life and patient satisfaction. As one of the most advanced countries in the world with the most expensive drugs, medical equipment, and medical research standards, we should be living long, healthy lives, free from disease and thriving well into old age. It does not take very long to observe, however, that this is not the case. This explains recent efforts, which should be encouraged and applauded, by our nation’s leading healthcare providers to integrate therapies whose philosophical roots are “unconventional” to the West, such as acupuncture, holistic nutrition therapy, massage therapy, guided meditation, yoga, and more.
I’d also like to give a Cincinnati shout out to the many local practitioners and the Alliance Institute for Integrative Medicine, as well as UC’s Center for Integrative Wellness for helping push this forward right here in my hometown of Cincinnati. I enjoy working with all of them and look forward to many years of collaboration!
Providing improved nutritional education to the public, and better services to high risk populations will drastically improve all of our health statistics. We can start from there and keep pushing science and the public to accept that prevention, balance, and moderation are more powerful than any magic pill, and empower them to take control of their own health. Once people see the true power of the things provided by nature and of their own bodies to recover from disease, they will be primed to reject the old model of symptom suppressing and embrace the new way of true healing. Traditions may need to be updated, and all growth seems awkward at first, but I think the public is ready to step up and take ownership and control of their health. Is there really any alternative?
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About Chef Braedon
Nutritionist-Chef Braedon Firebrand is the creator of Temptology, an elite-yet-accessible general health, sports nutrition, disease prevention meal-prep program focused around delicious recipes he creates for his celebrity clients. Braedon was also founder and co-owner of HealthSavor, a Cincinnati Ohio based healthy, organic, gluten-free meal delivery service, created to help busy families, individuals and children eat nutritious meals easily and affordably (2010-2017). Chef Braedon focuses on helping his customers lose weight, optimize performance on field or in gym, lower their blood sugar/blood pressure, control chronic conditions and feels very honored to have earned the trust of many doctors, students, parents, actors, musician, athletes, and on-the-go businessmen and women all over the country. Chef B also enjoys hanging out with his daughter, fiance, and rescue dogs, as well as playing music, strength training, and continuing his education in nutrition.Join The Journal Of Temptologists here ORDER TODAY!