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Fed Vitamin D Guidelines Off By Order of Magnitude

By Erik Goldman

The Federal RDAs for vitamin D are “grossly inadequate” for most ordinary people, let alone people with pronounced vitamin D deficiencies, according to a detailed analysis of 3,885 episodes of vitamin D supplementation in over 1,300 individuals.

Forget the 'Triptans, Treat Migraines Gingerly

By Meg Sinclair, Contributing Writer

A 250-mg dose of powdered ginger can be just as effective as sumatriptan in staving off the severity of acute migraines, according to a new study of 100 adult migraine patients.

Questioning a "Diseased Illusion:" An Interview with Jeff Bland

By Niki Gratrix, BA, Dip ION, mBANT, Contributing Writer

With his newest book, The Disease Delusion, functional medicine pioneer, Jeff Bland, PhD, endeavors to help practitioners and patients alike fundamentally change how we view illness, health, and healing. HPC correspondent, Niki Gratrix, caught up with Dr. Bland for an in-depth interview.

Probiotics Add Punch To Treatment of H. Pylori

By August West, Contributing Writer

Two new studies indicate that adding oral probiotics to the therapeutic mix boosts the efficacy of conventional drug protocols in eradicating Helicobacter pylori, the most common bacterial pathogen worldwide, and a main driver of peptic ulcers.

Lymphocyte Response Assay: A Window on Tissue Repair Capacity

By Russell Jaffe, MD | Contributing Writer - Vol. 15, No. 2. Summer, 2014

Though it is most often thought of as the body's defense department, the immune system also serves many important repair functions, identifying and neutralizing foreign substances and repairing the body's tissues from daily wear and tear.

Overmedication: An Underrated Problem Among Seniors

By Bettina Krasner | Contributing Writer - Vol. 15, No. 2. Summer, 2014

It's no secret that medication management is a major health concern for seniors.

Making Sense of Natural Non-Nutritive Sweeteners

By Contributing Writer - Vol. 15, No. 2. Summer, 2014

The following article is an excerpt from, Supplementing Dietary Nutrients—A Guide for Healthcare Professionals, a new book by Thomas G. Guilliams, PhD.

Tissue-Culture Cuisine: The Implications of Lab-Grown “Meat”

By Kristen Schepker | Contributing Writer - Vol. 15, No. 2. Summer, 2014

When the Oxford English Dictionary released a list of contenders for its prestigious 2013 Word of the Year award, among the runners-up was the word "schmeat." Defined as, "a form of meat produced synthetically from biological tissue" schmeat ultimately lost out to the far more ubiquitous "selfie."

“Tricorders Are Not Sci-Fi Anymore:” Tech Tips for Today’s Clinicians

By Contributing Writer - Vol. 15, No. 2. Summer, 2014

"In the near future, we won't just be prescribing drugs, we'll be prescribing apps," says physician-futurist Daniel Kraft, MD.

Mymee App Reveals Disease Clues Hidden in Daily Life

By Erik Goldman | Editor in Chief - Vol. 15, No. 2. Summer, 2014

Anyone involved in healthcare knows that patient self-reporting is the least reliable form of data collection. Yet in many cases, that—and a few lab measures—is all a clinician has to guide medical decisions.

European Ash Tree Holds New Key for Better Glucose Control

By Erik Goldman | Editor in Chief - Vol. 15, No. 2. Summer, 2014

The fruits and seeds of the European Ash tree, long used in traditional botanical medicine for their digestive, urinary and hepatic benefits, could be a valuable new herbal ally in the effort to stem the tide of diabetes.

Coconut Oil: From Food to Medicine and Back

By Kristen Schepker | Contributing Writer - Vol. 15, No. 2. Summer, 2014

For thousands of years, indigenous peoples in tropical regions have recognized the vast nutritional and medicinal value of the coconut palm. Referred to as the "tree of life" among tropical cultures, virtually all parts of the coconut palm have found use in traditional foods and medicines.

Coconut Oil: From Food to Medicine and Back

By Kristen Schepker | Contributing Writer - Vol. 15, No. 2. Summer, 2014

For thousands of years, indigenous peoples in tropical regions have recognized the vast nutritional and medicinal value of the coconut palm. Referred to as the "tree of life" among tropical cultures, virtually all parts of the coconut palm have found use in traditional foods and medicines.

Is Neuro-Regeneration a Reality?

By Erik Goldman | Editor in Chief - Vol. 15, No. 2. Summer, 2014

For generations, the prevailing medical wisdom has been that neurodegeneration is irreversible, and that adults simply cannot re-grow lost or damaged neurons.

Is Neuro-Regeneration a Reality?

By Erik Goldman | Editor in Chief - Vol. 15, No. 2. Summer, 2014

For generations, the prevailing medical wisdom has been that neurodegeneration is irreversible, and that adults simply cannot re-grow lost or damaged neurons.

HPC Readers on ObamaCare: So Far, So So

By August West | Contributing Writer - Vol. 15, No. 2. Summer, 2014

How is the rollout of the Affordable Care Act affecting holistically-minded primary care clinicians?

Errors in Heart Risk Assessment: All-Too-Common, Easily Avoided

By Mark J. Tager, MD | Contributing Writer - Vol. 15, No. 2. Summer, 2014

Ancient Chinese philosophy defines two basic types of error: "Near-error," characterized by a myopic focus on what is closest at hand to the exclusion of the bigger picture and; "Far-error," an obsession with the horizon at the expense of what is in proximity.

An Ancient Grain Eases A Modern Ailment

By Janet Gulland, Contributing Writer

Data from a randomized cross-over trial indicate that Khorasan wheat, an ancient Near Eastern grain better known by its commercial name, Kamut, appears to be a much better option than conventional wheat for people with irritable bowel syndrome.

Medical Marijuana for MS: “There’s a Place For It”

By Erik Goldman, Editor

New guidelines from the American Academy of Neurology hold that there is a place for cannabis and cannabis-derived compounds as therapies for multiple sclerosis. A comprehensive systematic review suggests that cannabis can attenuate muscle spasms, pain and bladder symptoms asssociated with the disease, though it does not appear to reduce frequency or severity of MS tremors.

Dr. Dog & Dr. Jenny Join the Diabetes Care Team

By August West, Contributing Writer

Specially trained Diabetes Alert Dogs and the commercial weight loss programs marketed by Jenny Craig are proving to be highly effective elements in comprehensive self care for people living with diabetes.

Rheumatoid Arthritis in Women: Looking Beyond Hormones

By Janet Gulland, Contributing Writer

New lines of research are prompting a re-think on the issue of gender disparities in incidence of rheumatoid arthritis. X-linked genetic factors, as well as greater thymic activity early in life, appear to play as much of a role as hormones.

Minty Fresh & Symptom-Free

By Erik Goldman

Peppermint can help take some of the “irritable” out of Irritable Bowel Syndrome, according to a recent metanalysis of 9 randomized trials.

In Praise of Alligator Pears

By Erik Goldman

There are many reasons to love avocados: they're tasty and satisfying; they're packed with healthy fats, B vitamins, potassium. lutein and zeaxanthin; and they fit nicely into a wide freshavocados logorange of culinary styles.

But did you know that inclusion of half an avocado in one's lunch can markedly increase satiety and reduce the desire to eat over the next 5 hours? Or that consumption of avocados can mitigate post-prandial insulin spikes, providing plenty of calories without substantially raising blood glucose levels? Or that they can increase the absorption of fat-soluble vitamins from other foods? Or that they're the only fruit source of monounsaturated fats?

Or how about the fact that addition of fresh avocado to a hamburger lunch will substantially reduce post-meal inflammatory cascades, improve peripheral vascular blood flow, and attenuate the triglyceride surge that usually follows consumption of guac-less burgers.

You can discover these and dozens of other reasons to eat more avocados on the brand new Avocado Central website, sponsored by the Hass Avocado Board (and note that it's "Hass" not "Haas"....named after a postman named Rudolph Hass, who began planting the small, black & bumpy variety in the 1930s).

recipe sweet-potato-and-avocado-empanadasUnder the banner "Fresh Avocados: Love One Today," the Avocado Central site amasses just about everything known to mankind about the versatile and delicious "alligator pear." There's a host of in-depth nutritional analysis, summaries of scientific studies aimed at healthcare professionals, avo-centric meal plans and culinary lessons, how-to videos, and of course bushels of recipes--many from renowned chefs--that go way beyond guacamole (who knew avocados could be combined with chocolate to make gluten-free fudgy bread?).

You can be sure that Avocado Central will have some impact here at the Upshots test kitchens, and we're looking forward to expanding our culinary "avocacy."

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Climate Panel: “Uncertainties Are Mostly on the Bad Side”

By Erik Goldman

A new report from the American Academy for the Advancement of Science strikes an urgent tone on climate change. The generally conservative organization holds that there's a near unanimous consensus among top climate scientists that: A) serious change is real and largely man-made; B) we’re pushing the limits of the planet’s adaptive capacity; and C) there’s much we can still do to avert disaster if we act right now.

There's a NAC to Treating COPD

By August West, Contributing Writer

Twice daily supplementation with N-Acetylcysteine improves respiratory function and markedly reduces morbidity in elderly people with chronic obstructive pulmonary disease (COPD), according to data from a large, year-long, placebo-controlled clinical trial.

“Tricorders Are Not Sci-Fi Anymore:” Ten Tech Tips for Today’s Clinicians

By Erik Goldman

In the near future, we wont just be prescribing drugs, well be prescribing apps, said physician-futurist Daniel Kraft, MD, at the recent NEXT Innovation Summit. Dr. Kraft said that a Star Trek-esque world of tricorder-enabled Dr. McCoys tailoring treatments and tweaking human biology based on real-time physiologic data is already here. Its just not evenly distributed.” Dr. Kraft also reviewed 10 essential tech advances that should be part of any practitioner's digital tool bag.

23 Skidoo: FDA’s Genomics Clampdown Gets Mixed Reviews

By Erik Goldman - Vol. 15, No. 1. Spring, 2014

skidoo-main-imageThe FDA’s recent regulatory action against popular genomic testing company, 23andMe, is generating mixed responses among integrative clinicians. While many share regulators' concerns over the validity of the tests and the public's unguided use of genomic information, they also believe in peoples' right to know how to read their genomic "Book of Life."

Clearing the Air? The Benefits & Risks Of Electronic Cigarettes

By Kristen Schepker - Vol. 15, No. 1. Spring, 2014

In recent years, there has been an explosion in the popularity of electronic cigarettes. Marketed as a trendy alternative to traditional tobacco products, electronic cigarettes--known as e-cigs--are often touted as a safer, healthier habit.

How One Physician Changed Aetna’s Attitudes on Holistic Medicine

By Erik Goldman - Vol. 15, No. 1. Spring, 2014

A few years ago, it would have been a pipe dream to suggest that a naturopathic physician might have a hand in shifting attitudes—and policies--of one of the nation's largest health insurers.

Homocysteine: Rethinking a Predictive Biomarker

By Russell Jaffe, MD, PhD - Vol. 15, No. 1. Spring, 2014

In 1968, Dr. Kilmer McCully, a Harvard researcher, reported that a genetic defect that caused sharp elevations in homocysteine led to early, aggressive atherosclerosis and coronary heart disease. This was the first of many studies that pointed to homocysteine as an independent risk factor for heart disease.

Restoring the Therapeutic Alliance

By Amber Vitse, LMT, CN - Vol. 15, No. 1. Spring, 2014

LONG BEACH, CA -- A wealth of new practice models are erupting in the field of integrative medicine, as more physicians and other practitioners seek ways of practicing that are more holistic and embracing of all aspects of their patients' lives.

Heart-Healthy Beverages: Think Before You Drink!

By Erik Goldman | Contributing Writer - Vol. 15, No. 1. Spring, 2014

When it comes to cardiovascular disease risk, what someone drinks can be as important as what he or she eats. But too often, clinicians overlook the beverage factor when making nutritional recommendations, says Steven Masley, MD, director of the Masley Optimal Health Center in St. Petersburg, FL, and author of the new book, "The 30-Day Heart Tune-Up (Hachette)."

Heart-Healthy Beverages: Think Before You Drink!

By Erik Goldman | Contributing Writer - Vol. 15, No. 1. Spring, 2014

When it comes to cardiovascular disease risk, what someone drinks can be as important as what he or she eats. But too often, clinicians overlook the beverage factor when making nutritional recommendations, says Steven Masley, MD, director of the Masley Optimal Health Center in St. Petersburg, FL, and author of the new book, "The 30-Day Heart Tune-Up (Hachette)."

“So What Is It, Exactly, That You Do?” Reflections on Hospital-Based Holistic Medicine

By Anita Boeninger, BSW, RYT - Vol. 15, No. 1. Spring, 2014

I didn't always know what response I would get from other health care practitioners when I showed up in a patient's room. A referral would come in from a nurse or doctor stating, "Patient in such-and-such room is really anxious, can someone from your team come up and work your magic?"

Curcumin Equals Fluoxetine for Major Depression

By Janet Gulland - Vol. 15, No. 1. Spring, 2014

In a head to head comparison trial, a standardized form of curcumin—a bioactive compound found in the spice, Turmeric--proved as effective as fluoxetine in reducing signs and symptoms of major depression.

Curcumin Equals Fluoxetine for Major Depression

By Janet Gulland - Vol. 15, No. 1. Spring, 2014

In a head to head comparison trial, a standardized form of curcumin—a bioactive compound found in the spice, Turmeric--proved as effective as fluoxetine in reducing signs and symptoms of major depression.

Lymphatic Enhancement Technology: Treating the “Other Circulatory System”

By Erik Goldman - Vol. 15, No. 1. Spring, 2014

let-therapy-2When physicians use the phrase "lymph node," it's more often than not followed by the word "excision" or "biopsy."

Lymphatic Enhancement Technology: Treating the “Other Circulatory System”

By Erik Goldman - Vol. 15, No. 1. Spring, 2014

let-therapy-2When physicians use the phrase "lymph node," it's more often than not followed by the word "excision" or "biopsy."

Clearing the Air? The Benefits & Risks Of Electronic Cigarettes

By Kristen Schepker - Vol. 15, No. 1. Spring, 2014

In recent years, there has been an explosion in the popularity of electronic cigarettes. Marketed as a trendy alternative to traditional tobacco products, electronic cigarettes--known as e-cigs--are often touted as a safer, healthier habit.

Empowerment is the New "Compliance"

By Erik Goldman, Editor

Facilitating lifestyle change can be one of the most frustrating aspects of clinical practiceor the most rewarding.  It all depends on how you approach it. A spirit of teamwork, and a few simple tools can make all the difference, says nutrition counselor Gabriel Hoffman.

Recognizing Subtle Signs of Early Stage Neurodegeneration

By Janet Gulland, Contributing Writer

A few simple physical tests can reveal a wealth of information about early-stage neurodegeneration and open up a window for lifestyle-based interventions.

Childhood Obesity Dip: Score One for the Nanny State?

By Erik Goldman

New data from the Centers for Disease Control offer a glimmer of hope in our national struggle with obesity. From 2004 to 2012, there was a 43% drop in prevalence of obesity in 2-5 year-old children, the CDC study says.

“Food Flags” Tell Tales About Global Nutrition & Health

By Erik Goldman

A recent photo exhibit at the Sydney International Food Festival tells an interesting tale about culture, cuisine and by extension, health.

A SANE Approach to Chronic Pain

By John Otrompke, Contributing Writer

Better sleep, physical activity, good nutrition and reducing stress and environmental toxins are the keys to reducing chronic pain, especially in women, said Dr. Robert Bonakdar, at the 2nd annual Lifestyle Medicine Summit in Chicago.

Functional Blood Chemistry Sheds Light on Patients with Non-Specific Symptoms

By Datis Kharrazian, DC - Vol. 14, No. 1. Spring, 2013

Routine blood chemistry analysis can be useful to rule out overt pathology, but it is not much help to us in dealing with patients who have complex but non-specific symptom patterns. Functional blood chemistry (FBC) analysis is an emerging approach that provides functional reference ranges that identify problems not yet pathological.

The Obesity Epidemic: It's a Guy Thing

By Erik Goldman

obesity-epidemic-in-men-smThe current obesity epidemic is really an epidemic among men, said John La Puma, MD, at Holistic Primary Care's fifth annual Heal Thy Practice conference in Long Beach earlier this month.Though the attention is most often focused on women, overweight is more common in men and has devastating long-term consequences.

 

Inflammation Revealed, Tamed and Resolved

By Russell Jaffe, MD, Contributing Writer - Vol. 14, No. 3. Fall, 2013

To make good clinical use of the last half-century's scientific study of inflammation, we need to re-think inflammation and understand it more correctly as a repair deficit--something blocking the innate ability of the body to heal.

Root Veggies, Not Other Produce, Cut Diabetes Risk

By Kristen Schepker | Contributing Writer

It's common knowledge that a healthy intake of fresh fruits and vegetables may reduce the risk of developing type 2 diabetes. A recent prospective study and meta-analysis takes this piece of advice one step further, claiming that a specific type of produce may take the (sugar-free) cake when it comes to diabetes prevention.

Hemoglobin A1C: The “Swiss Army Knife” Of Diabetes Assessment

By Russell Jaffe, MD, PhD | Contributing Writer

Hemoglobin A1c (HgbA1c) is one of the most useful and important biomarkers available to us as clinicians. It accurately predicts the risk of diabetes long before the disease advances, and it can be used to assess the impact of any form of therapy aimed at regulating blood sugar and insulin sensitivity.

Vitamin D Deficiency Raises Obesity Risk

By August West | Contributing Writer

Researchers in Spain have shown a definitive link between low serum vitamin D and the prevalence of obesity. Rather than being a consequence of obesity, the vitamin deficiency may play a causative role.

Link Between Gluten and Obesity Challenges “Classic” Picture

By Kristen Schepker | Contributing Writer

Historically, medical textbooks have presented Celiac disease patients as small, thin, anemic individuals--a depiction that still dominates many physicians' views of gluten intolerance and the people who have it.

D-Ribose Improves QOL For People with Chronic Fatigue

By Kristen Schepker | Contributing Writer

D-ribose, a naturally occurring pentose carbohydrate, has great potential as a remedy for CFS.

Fructose-Sweetened Beverages Drive Significant Lipid Changes

By John Otrompke | Contributing Writer

CHICAGO -- Researchers are nearing completion of a multi-year study that they hope will further our understanding of the physiological impact of fructose and glucose in the human diet.

NANP Fosters Interdisciplinary Forum on Nutrition

By Danielle Hart, Contributing Writer

Last Spring, over 250 holistic health professionals gathered for the National Association of Nutrition Professionals' annual conference in Del Mar, CA. The organization is committed to building bridges between various healthcare professionals, to improve public access to effective nutritional guidance.

"Odd Omegas" an Important Part of the Heart Health Picture

By John Otrompke | Contributing Writer

The Cleveland Clinic is beginning a series of clinical trials to assess the potential cardiovascular effects of Omega-7 fatty acids, a category of unsaturated fatty acids scientists are just beginning to understand.

Chelation Vindicated for CVD Risk Reduction in Diabetes

By Erik Goldman

New data from the NIH-funded Trial to Assess Chelation Therapy (TACT), has vindicated this controversial treatment as a method for preventing cardiovascular events in people with diabetes. The data show a clear 15% reduction in index events among treated patients.

Cardio-Chaos: New Statin Guidelines Cause Consternation

By August West, Contributing Writer

For decades, the American Heart Association, the American College of Cardiology, and other guardians of conventional wisdom about heart disease have urged physicians to follow rigorous "evidence-based" protocols based on defining treatment targets for LDL cholesterol, and then focusing statin prescriptions to reach these goals.

Autologous Serum Therapy Offers New Option for Osteoarthritis

By Bianca Garilli, ND, Contributing Writer - Vol. 14, No. 3. Fall, 2013

A new injection-based modality that uses the body’s own cytokines to reduce joint inflammation was recently introduced in the US, and it has great promise for relieving joint pain, back pain, tendonitis and other symptoms of osteoarthritis (OA).

Blue Mamma, Big Baby

By Marijke Vroomen Durning, Contributing Writer

New research suggests that maternal mental health is a significant influence on childhood obesity. In particular, maternal depression seems to correlate with overweight in young children.

Blue Mamma, Big Baby

By Marijke Vroomen Durning, Contributing Writer

New research suggests that maternal mental health is a significant influence on childhood obesity. In particular, maternal depression seems to correlate with overweight in young children.

Blue Mamma, Big Baby

By Marijke Vroomen Durning, Contributing Writer

New research suggests that maternal mental health is a significant influence on childhood obesity. In particular, maternal depression seems to correlate with overweight in young children.

The Obesity Epidemic: It's a Guy Thing

By Erik Goldman

The current obesity epidemic is really an epidemic among men, said John La Puma, MD, at Holistic Primary Care’s fifth annual Heal Thy Practice conference in Long Beach earlier this month.Though the attention is most often focused on women, overweight is more common in men and has devastating long-term consequences.

For Women with CVD, Lipid-Centric Strategies Often Fail

By John Otrompke, Contributing Writer

Cardiovascular disease manifests itself very differently in women compared with men, and in many cases, the cholesterol-centric approach results in a “treatment gap,” failing to prevent cardiac events in women, said Mark Houston, MD, at the recent Lifestyle Medicine Summit.

Sound Medicine: How “Harmonic Listening” Affects Healing

By Erik Goldman
For vocalist & composer David Hykes, the connection between chanting and medicine is very natural. For nearly 40 years, Hykes has been exploring and teaching Harmonic Chant--a non-dual sacred vocal music practice based on the natural harmonics found in all voices, music, and throughout the vibratory universe.

How to Craft Effective Patient Ed Videos

By Erik Goldman

Good go-to video resources for patient education can help you make much better use of their limited face-to-face time with patients, says practice development consultant James Maskell.

Healthcare Globalization in the "Land of Smiles"

By Gabrielle Zastrocky, Contributing Writer
A growing number of people are now visiting the Southeast Asian paradise not for a swim at Phuket or trek in Chiang Mai, but for another commodity: Thailand's low-cost and high-quality health care options. HPC offers an inside look at the opportunities & drawbacks of globalized medicine.

Oral Vitamin C No Remedy for Gout

By John Otrompke, Contributing Writer
High doses of vitamin C taken orally will increase the excretion of uric acid, but not enough to significantly reduce the symptoms of gout, according to a recent study from New Zealand.

For Integrative Doctors, a New Turn On the Road to Specialty Recognition

By Gabrielle Zastrocky, Contributing Writer

The long and winding road toward creation of a widely recognized medical specialty in holistic medicine has taken a new turn, one that leaders of the effort believe can take physicians a lot farther toward that goal.

Holistic Marketing Mentors: Creating Systems to Beat the System!

By Erik Goldman

Clinicians think a lot about organ systems, but far fewer think systematically about their own practices. That's unfortunate, because well-designed practice systems can greatly improve clinical outcomes and fiscal health, say consultants Gail Sophia Edgell & Traci Brosman.

Beyond Balance: T'ai Chi Dramatically Improves Seniors' Overall Health

By Kathy Capobianco, Contributing Writer

The practice of T'ai Chi is one of the safest and most beneficial forms of exercise for elderly people. It builds muscle strength and bone density, reduces CVD risk, improves sleep, and prevents neurocognitive problems. Plus, it's fun!

Are Grains Destroying Our Brains?

By Erik Goldman - Vol. 14, No. 3. Fall, 2013
In his forthcoming book, Grain Brain, functional neurologist David Perlmutter contends that America's grain-heavy diet is a prime driver of dementia. That means dementia's preventable, but it requires eliminating grain foods.

Are Grains Destroying Our Brains?

By Erik Goldman - Vol. 14, No. 3. Fall, 2013
In his forthcoming book, Grain Brain, functional neurologist David Perlmutter contends that America's grain-heavy diet is a prime driver of dementia. That means dementia's preventable, but it requires eliminating grain foods.

New T-Cell Test a “Game-Changer” for Lyme

By Erik Goldman - Vol. 14, No. 3. Fall, 2013

A new test that measures T-cell response Borrelia burgdorferi has the potential to vastly improve Lyme disease diagnosis—especially in the early phases. Physicians who've used the test say it's a game-changer.

 

Bringing the Genomics Revolution Into Patient Care

By Erik Goldman - Vol. 14, No. 3. Fall, 2013
As companies like 23andMe take sophisticated genomic testing directly to the consumer market, a growing number of people are seeking guidance on how to respond to the test results. According to Dr. Deanna Minich, that spells major opportunity for holistically-minded clinicians.

Glycation: Tackling an Underlying Driver of Chronic Disease

By Gaetano Morello, ND, Contributing Writer - Vol. 14, No. 3. Fall, 2013

Glycation--a process by which sugars bind to proteins forming inflammatory compounds--is at the center of the chronic disease storm. Clinicians need to understand as much as possible about this process and the interventions that can be used to attenuate it.

Escape Fire's Dr. Erin Martin on Reverse-Engineering Healtcare

By Erik Goldman
Holistic physicians often start out by trying to cram things like nutrition counseling, stress management or herbal medicine into conventional care frameworks--with limited success. Erin Martin, DO, a physician profiled in the popular film, Escape Fire, took the opposite route. At her new clinic she made lifestyle-based medicine the core and gradually adds conventional primary care services.

Helping Men Get Proactive About Health: A Conversation with John La Puma, MD

By August West, Contributing Writer - Vol. 14, No. 3. Fall, 2013

It's no secret that women tend to be a lot more proactive about their health than men. Dr. John La Puma, author of the forthcoming book "Men Don't Diet, Men...Refuel" hopes to change this. HPC's August West caught up with the "Chef MD" and got his thoughts on how to engage more guys in prevention & self-care.

Low Vitamin D Raises Obesity Risk

By Erik Goldman
Researchers in Spain have shown a definitive link between low serum vitamin D and the prevalence of obesity. Rather than being a consequence, the vitamin deficiency may play a causative role.

Group Visits are a Great Fit for Functional Medicine Practice

By Erik Goldman
Shilpa Saxena, MD, has tailored the basic group visit model--increasingly popular in family practice--to fit the principles of functional medicine. The result is a big win for patients, for the doctor herself, and even for the insurers.

Overcoming Fear of Change on Path to Practice Transformation

By Erik Goldman

More than anything else, it is fear that keeps many doctors from building the kinds of practices they really want to have. Heal Thy Practice conference chairman Jeff Gladd, MD, who's built a thriving cash-pay practice in Ft. Wayne, IN, has the remedies for those fears.

Bring a Little PEACE to Your Practice

By Erik Goldman

A five-step method called the PEACE Process, developed by Heal Thy Practice speaker, Miriam Zacharias, can help clinicians develop thriving integrative practices, "without losing your shirt, your sanity, or your soul!"

The Concierge Journey: Tips for Successful Transition

By Erik Goldman

The concierge model is a great option for physicians seeking more control over their personal and professional lives. But it won't cure financial woes overnight, says Marcela Dominguez, MD, a featured speaker at HPC's upcoming Heal Thy Practice conference.

Weight Loss Improves Health, But Not CVD Risk in Diabetics

By Erik Goldman
Lifestyle interventions that help diabetic people lose weigh confer many health benefits—including marked reductions in depression, retinopathy, renal disease, hospitalization, healthcare costs. But they may not reduce cardiovascular events, according to a massive new study.

Calcium for Women: Moderate Doses Are Safe, Beneficial

By John Otrompke, Contributing Writer

A new long-term Canadian study of over 6,000 women suggests that calcium intake of up to 1,000 mg per day is not only safe, but it can reduce all-cause mortality by as much as 22%.

Drug-Resistant TB “Extraordinarily Sensitive” to Vitamin C

By John Otrompke, Contributing Writer

Researchers looking for options to control multi-drug resistant tuberculosis were surprised to learn that many strains can be eradicated with vitamin C given along with iron--at least in vitro.

When Questioning Clinical Dogma Is a Doctor’s Duty

By Erik Goldman | Contributing Writer - Vol. 15, No. 2. Summer, 2013

Twenty years ago, Dr. Stephen Sinatra was like most American cardiologists: firmly convinced that elevated cholesterol was the key driver of heart disease, and that thanks to statin drugs, he and his colleagues would soon be cutting the nation’s number one killer down to size.

When Questioning Clinical Dogma Is a Doctor’s Duty

By Erik Goldman | Contributing Writer - Vol. 15, No. 2. Summer, 2013

Twenty years ago, Dr. Stephen Sinatra was like most American cardiologists: firmly convinced that elevated cholesterol was the key driver of heart disease, and that thanks to statin drugs, he and his colleagues would soon be cutting the nation’s number one killer down to size.

Blood Pressure & CVD Risk: Are We Measuring the Right Thing?

By Peter Bottemanne | Contributing Writer - Vol. 15, No. 2. Summer, 2013

Despite our nation’s best effort to treat all forms of cardiovascular disease aggressively, we seem to be losing the struggle.

Blood Pressure & CVD Risk: Are We Measuring the Right Thing?

By Peter Bottemanne | Contributing Writer - Vol. 15, No. 2. Summer, 2013

Despite our nation’s best effort to treat all forms of cardiovascular disease aggressively, we seem to be losing the struggle.

Vitamin D Deficiency Widespread Among Elders with Hip Fractures

By John Otrompke | Contributing Writer - Vol. 15, No. 2. Summer, 2013
CHICAGO-- Living in a southern, sunny climate is no safeguard against hip fractures, according to a new study by researchers at Kaiser Permanente showing that Vitamin D insufficiency is rampant among people hospitalized for hip fractures.

Avoidance of Toxins Helps Couples Wishing to Conceive

By Lauren Brandstadter | Contributing Writer - Vol. 15, No. 2. Summer, 2013
All too often, couples struggling to conceive a child undergo expensive, complicated and unsuccessful fertility treatments. Careful assessment of environmental toxin loads and nutritional status of both partners, and judicious implementation of lifestyle change strategies could avert the need for these treatments in some cases.  

Available statistics show that infertility is on the rise among men and women in the US. According to the Centers for Disease Control, the numbers of US women aged 15-44 who have “impaired fecundity” topped 6.7 million in 2010. Researchers at the National Institutes of Health, studying data from 7,600 women, estimate that as many as one in six couples seeking to have a child were unable to conceive after 1 year of contraception-free sex (Thoma ME, et al. Fertility Sterility. 2013: 99(5): 1324-31).

The trend is attributable to far more than later marriage and deferred childbearing. There are many factors in our environment, and in the products we use daily, that could be contributing to infertility.

Xenoestrogens, drug residues, pesticides, bioactive compounds in personal care products, and toxins in our environment are interfering with fertility levels. How does one peel back all the layers of information (and misinformation) about the myriad of toxins and their effects?

“Environment is definitely a factor in rising infertility rates”, says Victoria Maizes, MD, Executive Director of the University of Arizona Center for Integrative Medicine, and author of Be Fruitful, The Essential Guide To Maximizing Fertility and Giving Birth to a Healthy Child. In her new book, she stresses the importance of minimizing toxin loads.

“Avoiding fruits and vegetables that have been sprayed with toxic pesticides, foods grown from GMO seeds, and packaged foods containing ingredients that originate from GMOs, and processed foods, should be at the top of the list of “do’s” when trying to conceive,” Dr. Maizes told Holistic Primary Care.

The organophosphates in pesticides have been shown to be endocrine disruptors. While there is not yet a definitive prospective study showing that exposure to pesticides causes infertility, the available science does provide cause for strong suspicion.

Roundup Risks

There’s good reason to believe that glyphosate, the main compound in the widely used Roundup herbicide, is interfering with human reproductive function.

One study found that glyphosate is increasing the number of birth defects in vertebrates, contributing to stillbirths and miscarriages (Paganelli A, et al. Chem Res Toxicol. 2010, 23(10): 1586-95). The data suggest that glyphosate alters retinoic acid signaling in developing embryos.

“The direct effect of glyphosate on early mechanisms of morphogenesis in vertebrate embryos opens concerns about the clinical findings from human offspring in populations exposed to glyphosate-based herbicides in agricultural fields,” the authors note.

Well over a decade ago, Canadian researchers published a study showing that exposure to this herbicide increased the risk of spontaneous abortion among female agricultural workers exposed to glyphosate (Arbuckle TE, et al. Environ Health Perspect. 2001; 109(8): 851–857). “For late abortions, preconception exposure to glyphosate….was associated with elevated risks. Postconception exposures were generally associated with late spontaneous abortions. Older maternal age (> 34 years of age) was the strongest risk factor for spontaneous abortions, and we observed several interactions between pesticides in the older age group.”

Investigators around the world have looked at possible mechanisms by which glyphosate interferes with reproductive function. Richard and colleagues at the University of Caen, France, showed that the compound is toxic to human placental cells at concentrations lower than those found with agricultural use. The toxic effect increases with duration of exposure and concentration (Richard S, et al. Environ Health Perspect. 2005 June; 113(6): 716–720)

In 2009, another group based in Caen looked at the toxicity of four glyphosate-based herbicides at dilutions corresponding to residue levels found in common foods. They found that the compounds could induce apoptosis and necrosis in human umbilical, embryonic, and placental cells (Benachour N, et al. Chem. Res. Toxicol., 2009, 22 (1), pp 97–105).

Also in 2009, a team at Indiana University tracked agrichemical residues in surface water, and found a strong correlation between elevated concentrations during the months of April to July, and higher risk of birth defects among women whose last menstrual periods were in the period from April to July (Winchester PD, et al. Acta Paediatr. 2009; 98(4): 664-91).

A New Threat?

Glyphosate is just one of 84,000 known toxins in our environment. Only a few thousand have been studied thoroughly with regard to their effect on human biology.

According to Dr. Maizes, it makes good sense for couples trying to conceive to minimize exposures as much as possible. “An organic diet is the best way to increase your ability to conceive. Eating organic grains, fruits, and vegetables, washing them with filtered water, and avoiding GMOs are very important factors in a person’s fertility.”

She contends that GMO foods are as dangerous as the pesticides that are sprayed on them. GMO foods have been shown to contribute to changes in the number and size of offspring in rats. They may also be contributing to the evolution of new animal and human pathogens.

Two years ago, Dr. Don Huber, emeritus professor of plant pathology at Purdue University, stated that he had discovered a previously unknown pathogenic microorganism associated with Roundup Ready GMO crops. The organism seemed to be linked to infertility and miscarriage among cattle, swine and horses. In an open letter to USDA Secretary Tom Vilsack, Dr. Huber described the organism as having, “an approximate size range equal to a medium-sized virus…able to reproduce and appears to be a micro-fungal like organism.”

Dr. Huber, a long-standing and outspoken critic of GMO technology, claims that the organism is found in much higher concentrations on Roundup Ready soybeans, corn and alfalfa, and that it is also linked to several plant diseases.

“For the past 40 years, I have been a scientist in the professional and military agencies that evaluate and prepare for natural and manmade biological threats, including germ warfare and disease outbreaks. Based on this experience, I believe the threat we are facing from this pathogen is unique and of a high-risk status. In layman's terms, it should be treated as an emergency,” he wrote.

Several scientists at Purdue have challenged the “doomsday scenario” outlined by Dr. Huber. However, none has claimed that his discovery is fallacious. His work has yet to be replicated by other researchers, and the organism he believes he has found has not yet been further characterized. Predictably, the USDA has taken no action in response to his letter.

Avoid Processed Foods

Couples trying to conceive should eliminate—or at least minimize consumption of processed foods. This includes some foods that most people regard as “healthy.” Low-fat milk, for example, is very popular with reproductive-age women who believe it is a healthy alternative to full-fat milk.

Dr. Maizes says that’s highly questionable. “When the fat is removed from the milk, the product has less taste and a bluish hue. So the dairy company puts in powdered whey protein, which is technically milk, so they don’t have to put it on the label (as an additive).  The end result is a processed food - far from what the cow, and nature, intended.”

She added that regular consumption of low-fat milk actually promotes weight gain in many people – not the other way around. “If you’re going to drink milk, drink it whole, unprocessed, with all the nutrients intact.  In some cases, dairy companies add sugar (to low-fat milk) for a better taste. The more processed sugar someone consumes, the lower the production of the sex hormone binding globulin, which influences the body’s production and regulation of hormones.”

In general, she advises patients to avoid “low-fat” foods: they are usually heavily processed, and no longer “whole” foods.  

Dr. Amos Grunebaum, a gynecologist with over 30 years experience with high-risk pregnancies, had this to offer about environmental toxins.  “Yes. There is now scientific evidence that environmental toxins such as pesticides and exogenous hormones are potentially interfering with fertility in the United States.  Research shows that male and female reproductive health is especially susceptible to the impact of these chemicals.”  

He went on to say that reproductive toxicologists are constantly uncovering new evidence about how environmental toxins are contributing to suboptimal sperm health, reduced egg quality in women, menstrual disorders, pregnancy complications, low-birth weight and child development issues.

Minimizing Toxin Loads

“There is scientific evidence to support this claim that exposure to agents such as BPA affects fertility.”  The most dangerous compounds in plastics (BPA), pesticides (dioxins and organophosphates), and drug-residues are definitely endocrine disruptors.

Some can mimic the action of a certain hormone (such as estrogen) by binding to that hormone’s receptor and activating the same response that would be triggered by the natural hormone. Others prevent hormonal action by binding to hormone receptors, thereby leaving no room for the real hormones.  Still others bind to carrier proteins, thereby reducing the availability of these proteins to transport hormones like estrogen and testosterone through the blood stream to target tissues.

Some endocrine disruptors negatively impact hormone levels by either accelerating the breakdown of hormones or by deactivating the enzymes that facilitate their breakdown.


Dr. Grunebaum says avoiding canned foods, unless the can has a BPA-free liner, is a simple way to begin minimizing exposure to endocrine-disrupting compounds like phthalates and BPA. The website, www.treehugger.com has posted a guide to canned products rated for likelihood of containing BPA. Purchasing jellies, jams, sauces, and prepared vegetables in glass containers, whenever possible, is a safer alternative.

Other toxins affecting fertility are right in our homes. Chemicals in beauty and skin care products, shampoos and other hair care products, toothpastes, oral products, as well as deodorants, contain toxins that inhibit fertility. Dr. Grunebaum and Dr. Maizes both suggest using only non-toxic cleaning supplies.  To learn more about potential toxins in common household products, visit http://www.ewg.org/skindeep/.

A Bit About Fish

For many reproductive-age women, the subject of fish consumption has become cause for confusion. On the one hand, they hear the message that ocean fish are a healthy, lean protein source rich in omega-3s. On the other, there are the frightening reports of mercury and other toxic metals found in some types of fish.  

Dr. Maizes suggests that fish should not be eliminated from the diet of women wishing to conceive. Omega-3’s found in wild caught salmon, herring and other oily fish help raise fertility levels, and also aid in averting or lessening postpartum depression after childbirth.  Trout, though a fresh water fish, is also high in Omega-3s.

People should avoid wild fish that are known to have high levels of mercury, such as tuna, swordfish, mackerel and shark. The best fish to eat with the highest levels of Omega 3’s are wild-caught salmon, trout, herring and anchovies – and no more than 2-3 servings a week of about 6 ounces per serving, says Dr. Maizes.

The key, she says, is “wild caught.” Farm-raised fish are also eating processed foods – not algae—and this creates an imbalance in the ratios of omega-3 and omega-6’s. She recommends against eating a lot of farmed fish, as they produce higher omega-6 levels, which are inflammatory.

While it is true that we need both types of omega fats, Americans in general tend to be imbalanced in the omega-6 direction. There’s certainly no benefit in pushing this imbalance even further.

She noted that elevated omega-6 is a common finding among infertile men. Men with low sperm counts should also be taking Omega 3 oils, which are an important determinant for fertility (Saferinejad MR, et al. Clin Nutr. 2010: 29(1): 100-5).

Both Dr. Grunebaum and Dr. Maizes suggest incorporating detox programs into the care of couples trying to conceive. This is especially true if either or both partners are trying to lose weight. As people shed weight, they release toxins stored in the adipose tissue, and this can have a detrimental effect on the odds of conception.

The shedding of fat cells and release of toxins should be eliminated before conception occurs. It is important to ensure that calorie restriction is not too severe and that all nutrient requirements are met.

Trying to conceive can be very stressful, and any treatments that improve a couple’s sense of wellbeing and increase the partners’ energy levels should be encouraged.  Women who are having difficulty conceiving might also inquire about other approaches such as acupuncture and acupressure, which can increase the body’s ability to naturally balance energy and organ processes.

Avoidance of Toxins Helps Couples Wishing to Conceive

By Lauren Brandstadter | Contributing Writer - Vol. 15, No. 2. Summer, 2013
All too often, couples struggling to conceive a child undergo expensive, complicated and unsuccessful fertility treatments. Careful assessment of environmental toxin loads and nutritional status of both partners, and judicious implementation of lifestyle change strategies could avert the need for these treatments in some cases.  

Available statistics show that infertility is on the rise among men and women in the US. According to the Centers for Disease Control, the numbers of US women aged 15-44 who have “impaired fecundity” topped 6.7 million in 2010. Researchers at the National Institutes of Health, studying data from 7,600 women, estimate that as many as one in six couples seeking to have a child were unable to conceive after 1 year of contraception-free sex (Thoma ME, et al. Fertility Sterility. 2013: 99(5): 1324-31).

The trend is attributable to far more than later marriage and deferred childbearing. There are many factors in our environment, and in the products we use daily, that could be contributing to infertility.

Xenoestrogens, drug residues, pesticides, bioactive compounds in personal care products, and toxins in our environment are interfering with fertility levels. How does one peel back all the layers of information (and misinformation) about the myriad of toxins and their effects?

“Environment is definitely a factor in rising infertility rates”, says Victoria Maizes, MD, Executive Director of the University of Arizona Center for Integrative Medicine, and author of Be Fruitful, The Essential Guide To Maximizing Fertility and Giving Birth to a Healthy Child. In her new book, she stresses the importance of minimizing toxin loads.

“Avoiding fruits and vegetables that have been sprayed with toxic pesticides, foods grown from GMO seeds, and packaged foods containing ingredients that originate from GMOs, and processed foods, should be at the top of the list of “do’s” when trying to conceive,” Dr. Maizes told Holistic Primary Care.

The organophosphates in pesticides have been shown to be endocrine disruptors. While there is not yet a definitive prospective study showing that exposure to pesticides causes infertility, the available science does provide cause for strong suspicion.

Roundup Risks

There’s good reason to believe that glyphosate, the main compound in the widely used Roundup herbicide, is interfering with human reproductive function.

One study found that glyphosate is increasing the number of birth defects in vertebrates, contributing to stillbirths and miscarriages (Paganelli A, et al. Chem Res Toxicol. 2010, 23(10): 1586-95). The data suggest that glyphosate alters retinoic acid signaling in developing embryos.

“The direct effect of glyphosate on early mechanisms of morphogenesis in vertebrate embryos opens concerns about the clinical findings from human offspring in populations exposed to glyphosate-based herbicides in agricultural fields,” the authors note.

Well over a decade ago, Canadian researchers published a study showing that exposure to this herbicide increased the risk of spontaneous abortion among female agricultural workers exposed to glyphosate (Arbuckle TE, et al. Environ Health Perspect. 2001; 109(8): 851–857). “For late abortions, preconception exposure to glyphosate….was associated with elevated risks. Postconception exposures were generally associated with late spontaneous abortions. Older maternal age (> 34 years of age) was the strongest risk factor for spontaneous abortions, and we observed several interactions between pesticides in the older age group.”

Investigators around the world have looked at possible mechanisms by which glyphosate interferes with reproductive function. Richard and colleagues at the University of Caen, France, showed that the compound is toxic to human placental cells at concentrations lower than those found with agricultural use. The toxic effect increases with duration of exposure and concentration (Richard S, et al. Environ Health Perspect. 2005 June; 113(6): 716–720)

In 2009, another group based in Caen looked at the toxicity of four glyphosate-based herbicides at dilutions corresponding to residue levels found in common foods. They found that the compounds could induce apoptosis and necrosis in human umbilical, embryonic, and placental cells (Benachour N, et al. Chem. Res. Toxicol., 2009, 22 (1), pp 97–105).

Also in 2009, a team at Indiana University tracked agrichemical residues in surface water, and found a strong correlation between elevated concentrations during the months of April to July, and higher risk of birth defects among women whose last menstrual periods were in the period from April to July (Winchester PD, et al. Acta Paediatr. 2009; 98(4): 664-91).

A New Threat?

Glyphosate is just one of 84,000 known toxins in our environment. Only a few thousand have been studied thoroughly with regard to their effect on human biology.

According to Dr. Maizes, it makes good sense for couples trying to conceive to minimize exposures as much as possible. “An organic diet is the best way to increase your ability to conceive. Eating organic grains, fruits, and vegetables, washing them with filtered water, and avoiding GMOs are very important factors in a person’s fertility.”

She contends that GMO foods are as dangerous as the pesticides that are sprayed on them. GMO foods have been shown to contribute to changes in the number and size of offspring in rats. They may also be contributing to the evolution of new animal and human pathogens.

Two years ago, Dr. Don Huber, emeritus professor of plant pathology at Purdue University, stated that he had discovered a previously unknown pathogenic microorganism associated with Roundup Ready GMO crops. The organism seemed to be linked to infertility and miscarriage among cattle, swine and horses. In an open letter to USDA Secretary Tom Vilsack, Dr. Huber described the organism as having, “an approximate size range equal to a medium-sized virus…able to reproduce and appears to be a micro-fungal like organism.”

Dr. Huber, a long-standing and outspoken critic of GMO technology, claims that the organism is found in much higher concentrations on Roundup Ready soybeans, corn and alfalfa, and that it is also linked to several plant diseases.

“For the past 40 years, I have been a scientist in the professional and military agencies that evaluate and prepare for natural and manmade biological threats, including germ warfare and disease outbreaks. Based on this experience, I believe the threat we are facing from this pathogen is unique and of a high-risk status. In layman's terms, it should be treated as an emergency,” he wrote.

Several scientists at Purdue have challenged the “doomsday scenario” outlined by Dr. Huber. However, none has claimed that his discovery is fallacious. His work has yet to be replicated by other researchers, and the organism he believes he has found has not yet been further characterized. Predictably, the USDA has taken no action in response to his letter.

Avoid Processed Foods

Couples trying to conceive should eliminate—or at least minimize consumption of processed foods. This includes some foods that most people regard as “healthy.” Low-fat milk, for example, is very popular with reproductive-age women who believe it is a healthy alternative to full-fat milk.

Dr. Maizes says that’s highly questionable. “When the fat is removed from the milk, the product has less taste and a bluish hue. So the dairy company puts in powdered whey protein, which is technically milk, so they don’t have to put it on the label (as an additive).  The end result is a processed food - far from what the cow, and nature, intended.”

She added that regular consumption of low-fat milk actually promotes weight gain in many people – not the other way around. “If you’re going to drink milk, drink it whole, unprocessed, with all the nutrients intact.  In some cases, dairy companies add sugar (to low-fat milk) for a better taste. The more processed sugar someone consumes, the lower the production of the sex hormone binding globulin, which influences the body’s production and regulation of hormones.”

In general, she advises patients to avoid “low-fat” foods: they are usually heavily processed, and no longer “whole” foods.  

Dr. Amos Grunebaum, a gynecologist with over 30 years experience with high-risk pregnancies, had this to offer about environmental toxins.  “Yes. There is now scientific evidence that environmental toxins such as pesticides and exogenous hormones are potentially interfering with fertility in the United States.  Research shows that male and female reproductive health is especially susceptible to the impact of these chemicals.”  

He went on to say that reproductive toxicologists are constantly uncovering new evidence about how environmental toxins are contributing to suboptimal sperm health, reduced egg quality in women, menstrual disorders, pregnancy complications, low-birth weight and child development issues.

Minimizing Toxin Loads

“There is scientific evidence to support this claim that exposure to agents such as BPA affects fertility.”  The most dangerous compounds in plastics (BPA), pesticides (dioxins and organophosphates), and drug-residues are definitely endocrine disruptors.

Some can mimic the action of a certain hormone (such as estrogen) by binding to that hormone’s receptor and activating the same response that would be triggered by the natural hormone. Others prevent hormonal action by binding to hormone receptors, thereby leaving no room for the real hormones.  Still others bind to carrier proteins, thereby reducing the availability of these proteins to transport hormones like estrogen and testosterone through the blood stream to target tissues.

Some endocrine disruptors negatively impact hormone levels by either accelerating the breakdown of hormones or by deactivating the enzymes that facilitate their breakdown.


Dr. Grunebaum says avoiding canned foods, unless the can has a BPA-free liner, is a simple way to begin minimizing exposure to endocrine-disrupting compounds like phthalates and BPA. The website, www.treehugger.com has posted a guide to canned products rated for likelihood of containing BPA. Purchasing jellies, jams, sauces, and prepared vegetables in glass containers, whenever possible, is a safer alternative.

Other toxins affecting fertility are right in our homes. Chemicals in beauty and skin care products, shampoos and other hair care products, toothpastes, oral products, as well as deodorants, contain toxins that inhibit fertility. Dr. Grunebaum and Dr. Maizes both suggest using only non-toxic cleaning supplies.  To learn more about potential toxins in common household products, visit http://www.ewg.org/skindeep/.

A Bit About Fish

For many reproductive-age women, the subject of fish consumption has become cause for confusion. On the one hand, they hear the message that ocean fish are a healthy, lean protein source rich in omega-3s. On the other, there are the frightening reports of mercury and other toxic metals found in some types of fish.  

Dr. Maizes suggests that fish should not be eliminated from the diet of women wishing to conceive. Omega-3’s found in wild caught salmon, herring and other oily fish help raise fertility levels, and also aid in averting or lessening postpartum depression after childbirth.  Trout, though a fresh water fish, is also high in Omega-3s.

People should avoid wild fish that are known to have high levels of mercury, such as tuna, swordfish, mackerel and shark. The best fish to eat with the highest levels of Omega 3’s are wild-caught salmon, trout, herring and anchovies – and no more than 2-3 servings a week of about 6 ounces per serving, says Dr. Maizes.

The key, she says, is “wild caught.” Farm-raised fish are also eating processed foods – not algae—and this creates an imbalance in the ratios of omega-3 and omega-6’s. She recommends against eating a lot of farmed fish, as they produce higher omega-6 levels, which are inflammatory.

While it is true that we need both types of omega fats, Americans in general tend to be imbalanced in the omega-6 direction. There’s certainly no benefit in pushing this imbalance even further.

She noted that elevated omega-6 is a common finding among infertile men. Men with low sperm counts should also be taking Omega 3 oils, which are an important determinant for fertility (Saferinejad MR, et al. Clin Nutr. 2010: 29(1): 100-5).

Both Dr. Grunebaum and Dr. Maizes suggest incorporating detox programs into the care of couples trying to conceive. This is especially true if either or both partners are trying to lose weight. As people shed weight, they release toxins stored in the adipose tissue, and this can have a detrimental effect on the odds of conception.

The shedding of fat cells and release of toxins should be eliminated before conception occurs. It is important to ensure that calorie restriction is not too severe and that all nutrient requirements are met.

Trying to conceive can be very stressful, and any treatments that improve a couple’s sense of wellbeing and increase the partners’ energy levels should be encouraged.  Women who are having difficulty conceiving might also inquire about other approaches such as acupuncture and acupressure, which can increase the body’s ability to naturally balance energy and organ processes.

Bad to the Bone: Smoking Compromises Outcomes of Orthopedic Surgery

By John Otrompke | Contributing Writer - Vol. 15, No. 3. Fall, 2013
CHICAGO-- Among its many evils, smoking is detrimental to bone and connective tissue. Several studies presented at this year’s annual meeting of the American Academy of Orthopedic Surgeons show that smoking raises the odds of poor outcomes in common orthopedic procedures.

In short, smokers are much less likely to benefit from orthopedic surgeries like hip replacements and fracture repairs, and more likely to have complications.

Hip replacement patients who smoked experienced a higher rate of surgical revision, according to one study presented at AAOS. In a second paper, researchers found that smokers undergoing orthopedic treatment for pain experienced no benefit. A third study concluded that smokers had a higher rate of non-union and longer healing times after surgery.

“Nicotine-mediated vasoconstriction is considered to be the primary etiology of these effects, and we can postulate that decreased blood flow to the operative site results in decreased oxygenation of tissue, which can subsequently lead to soft-tissue and wound-healing complications,” said Bhaveen H. Kapadia, MD, orthopedic research fellow in the Center for Joint Preservation and Replacement at Sinai Hospital, Baltimore. Dr. Kapadia presented the hip replacement study.

Do-Overs

Dr. Kapadia and colleagues reviewed record for all hip replacements performed at Sinai between 2007 and 2009, and found that 110 of the patients were former or current tobacco users, with a mean age of 55. These patients were compared to a control group of non-smokers.  

They found that 8% of the smoking patients required a surgical revision within 46 months of the original procedures, compared to 1% of those who did not smoke. In five of the smoking patients, surgical revisions were required because of infection, while four revisions were done to address pain and component loosening. Of those patients who continued to smoke, six out of 65, or 9.2%, had revisions; in former smokers the number was two out of 45, or 4.4%.

Caleb J. Behrend, MD, a resident in training at the University of Rochester, New York presented data from large study of 6,779 patients who received treatment for painful spinal disorders. Nearly 9% of the patients over age 55, and 23.9% of those under 55 were smokers at the time they sought treatment.

The patients were asked to subjectively assess their pain during treatment. Researchers found that non-smokers had less pain than patients who smoked, regardless of age. In addition, non-smokers and patients who quit smoking during treatment experienced clinically meaningful reduction in pain, but those who continued smoking during treatment had no such improvements.

Those patients in the Rochester study who quit experienced an average reduction of pain by 1.5 points on a ten-point scale, which was statistically and clinically significant.  

“There’s kind of a myth that smoking makes smokers feel better,” said Dr. Behrend. “They may think so, but it certainly isn’t helping them if you actually look at the data. The clinical science shows very profound association between smoking and other chronic pain problems, such as leg and central back pain.”

Fracture Complications

Smoking had a negative effect on rates of bone union following fracture repair procedures, as well as recovery time following surgery, according to a metanalysis presented at the AAOS meeting.

The adjusted odds of non-union was 2.3 times higher in smoking patients than in non-smokers, and mean healing time for all fracture types was 30.2 weeks in smokers, compared to 24.1 weeks in non-smokers. However, this metanalysis did not show a significantly higher rate of infection among smokers.

The report was based on data from 18 studies between 1993 and 2011, representing 6,480 patients, 1,457 of whom were smokers at the time of surgery.

“The main direction for future research is to look at the effects of smoking cessation programs which can be instituted at the time of fractures,” said Mara L. Schenker, MD, an orthopedic surgery resident at the University of Pennsylvania in Philadelphia, who presented the metanalysis.

“This context is not like elective surgery where we can say to the patients in advance that they need to quit smoking. In this case, the patients come in and they’re injured, so we want to look at the effects of implementing a smoking cessation program at the time of surgery,” explained Dr. Schenker.

In general, orthopedic surgeons have recognized the detrimental effects of smoking on the musculoskeletal system, and many of them strongly recommend that whenever possible, patients should participate in smoking cessation programs prior to orthopedic surgery.

Environmental Toxins: A Hidden Factor in the Obesity Epidemic

By Linda Clark, MA, CNC | Contributing Writer - Vol. 15, No. 2. Summer, 2013
It is no secret that as a nation, the United States is getting fatter.

Over the past 50 years, the prevalence of obesity in adults has nearly tripled, from 13.4% in 1962 to 35.7% in 20101-3. The economic, social, and medical burden this places on our society cannot be overstated.  It is a healthcare crisis of immense proportions.  

For good reason, we have become a nation obsessed with weight. We now have weight loss programs of all types and we are inundated with information from the media about trimming our waistlines.  With all of this attention, one would think that obesity would be on the decline. Clearly it is not.

It may be that we’re focused on the wrong thing.

For decades, the prevailing thought has been that Americans are obese because we eat and drink too much, exercise too little, and are destined by genetics to gain weight.  Even though these are factors, emerging science is pointing to another equally important driver of the obesity epidemic: the change in our environment and the prevalence of toxins that adversely affect metabolism.  

A better reckoning with environmental factors could help us understand a phenomenon we’ve all observed in clinical practice: the individual who simply cannot lose weight despite diligent adherence to appropriate dietary regimens, vigilance against over-eating, and careful attention to food choices and regular exercise.

The old rule of “calories in, calories out” simply doesn’t apply to many individuals: something other than caloric consumption and burn rates is affecting their metabolism.

Culture of Chemicals

top-window-4-environmental-toxinsMore than 80,000 chemicals are currently used in U.S. commerce,4  with 22,000 of these being introduced in the last four decades.5  Only 200 of these chemicals have been tested for safety, and only five are partially regulated through the Toxic Substances Control Act.4  Yet dozens of studies have shown the deleterious effects of these environmental pollutants, pesticides, plastics, and food additives.6  

The CDC regularly assesses Americans’ exposure to environmental chemicals through the National Health and Nutrition Examination Survey (NHANES).  Its fourth report (published in 2009) found there was “widespread exposure” among study participants to industrial chemicals, such as flame retardants.7 Bisphenol A (found in plastics) and perfluorooctanoic acid (found in non-stick coatings) were also present in most of the participants’ blood and urine samples.7

The EPA also conducted a study on the US population’s exposure to toxic chemicals.  Run from 1970-1989, this study tested adipose tissue, because many chemical toxins are fat-soluble and will accumulate in this kind of tissue. The survey documented a “significant prevalence of pesticide residues in the general population”8 of all ages.9-10

Our “culture of chemicals” even affects newborns. In 2004, the Environmental Working Group led a study that examined umbilical cord blood from 10 babies at U.S. hospitals.11 They found at least 287 chemicals in the cord blood, including pesticides, flame retardants, perfluorochemicals, and waste from burning coal, gasoline, and garbage.11

Looking at these study results, it is easy to conclude that we are all carrying a significant toxic load.  Because toxins are stored in adipose tissue, overweight and obese individuals are carrying an even greater toxic burden than those who are lean.

Altered Adipogenesis

A new understanding has emerged in the past few years that this burden of toxicity may explain the rise in obesity, and the problem that many people have with losing weight.

Researchers have found that certain environmental chemicals act as endocrine disruptors that alter fat production and energy balance, leaving some people more susceptible to weight gain.12-16 These compounds work in different ways. Some alter adipogenesis—the process of creating fat cells—causing people to have a greater numbers of fat cells, a larger size of their existing fat cells, or abnormal fat cell distribution.15  Other toxins alter levels of the appetite-regulating hormone leptin, or  increase the activity of estrogen.13,15

One of the first statements of this toxin-obesity hypothesis emerged from a meta-analysis published in 2002 in the Journal of Alternative and Complementary Medicine.12 The author concluded that the obesity epidemic can’t entirely be explained by changes in food intake, exercise, or even genetics.  

She argued that calorie consumption has actually declined throughout the 20th century and that decreases in physical activity do not statistically correlate with the extreme rise in obesity in the past few decades.12 Concluding that human exposure to chemicals “may have damaged many of the body’s natural weight-control mechanisms,” she noted that this impact, “may play a significant role in the worldwide obesity epidemic.”12

Another seminal article examined specific cases where an association had already been shown between environmental chemical exposure and obesity13—such as studies linking childhood obesity with maternal smoking during pregnancy.17-18 The author also highlighted the potent endocrine-disrupting capabilities of tributyltin, a chemical compound that causes female marine invertebrates to take on male sex characteristics.19-20  

Weight Gain & Weight Loss Resistance

The altering of fat cells and the disruption of hormone levels are just two of many mechanisms by which environmental toxins can act as endocrine disruptors. They can also increase inflammatory cytokine activity, cause oxidative stress, and impact energy metabolism.

A paper published in Obesity Review in 2003 looked at the effects of organochlorines (pesticides and plastics) on metabolic rate and weight regulation.21 The authors reviewed 63 studies and found many mechanisms related to weight loss resistance.  Primarily, they noted that organochlorines, “have been associated with altered immune and thyroid functions, particularly decreased triiodothyronine (T3) concentrations.”21

Other mechanisms included:
  • Inhibition of enzymes in the mitochondrial electron transport chain (which can decrease energy)
  • Decreased capacity for fatty acid utilization in skeletal muscle
  • Decrease in thyroxine concentrations (as the toxins compete for the same thyroid receptors)
  • Inflammation and oxidative stress as a cause-and-effect of toxin release

Furthermore, some herbicides induce hormonal shifts, leading to estrogen excesses and increased fat deposition. These herbicides, including the widely used atrazine, induce aromatase activity by as much as 250%.22 Aromatase is the key enzyme involved in converting androgens to estrogen.

Why Can’t I Lose More Weight?

Many people who are trying to lose weight find that they can lose the first 20 or 30 pounds, but then hit a plateau where it is difficult to lose more. Part of this problem stems from the fact that when people do lose weight, toxins stored in fat tissue are released into circulation.  

An increase in toxic load during weight loss—added to an already-substantial toxic burden—can create an inflammatory cascade that inhibits the body’s inherent, highly sophisticated detoxification system.23 This inflammatory process can also deplete reserves of glutathione, an important antioxidant, which alters the liver’s detoxification efficiency.23-25

In order to support healthy weight loss and lower the toxic load, we need to ask whether these released toxins can be effectively neutralized, so that they don’t compromise metabolic and hormonal mechanisms?  

Maximize Detoxification

This may seem like a vicious cycle—the body gains weight because it’s natural metabolism has been disrupted by chemicals, but the process of losing this weight only releases more chemicals to further alter the body’s natural functions.

The important leverage point here is that we can increase the efficiency of liver detoxification. Targeted use of a specialized array of nutrients that act as cofactors for phase I and phase II liver detoxification, can support the liver’s detoxifying abilities while at the same time providing antioxidants to deal with oxidative stress.

Herbs such as milk thistle, dandelion root, and gotu kola; dietary fibers like inulin, and nutrients such as vitamin C, bioflavanoids, B vitamins, and amino acids—to name just a few—should be included as supplemental detoxification support.

A low-allergenic, whole foods diet can also support the body’s natural detoxification processes by reducing immune system activation. Since weight gain is an inflammatory process, it is essential to lower the inflammatory load in the diet, not just by reducing the amount of chemical toxins consumed, but also by eliminating the most allergenic foods. This, in turn, lowers systemic inflammation and improves metabolic efficiency.

I recommend a diet that emphasizes wholesome, fresh foods (preferably organically grown) that includes lean protein, vegetables, vegetable starches and fruit. I also advise elimination of all grains, legumes, nuts, seeds, dairy and eggs. I generally recommend lean sources of proteins, vegetables, vegetable starches and fruit.

Over the years, I have tried many dietary approaches to support detoxification and optimize the body’s natural metabolic system, and I have found this approach to be the most successful.  What I particularly like about this approach is that it supports the healthy functioning of a number of body functions, not just detoxification and metabolism.

People can also lower their toxic load through specific lifestyle changes. Some of these include detox baths, skin brushing, drinking filtered water, and changing to stainless steel (rather than coated “non-stick”) cookware. I also recommend switching to more natural, allergen-free household and personal care products.

Self-care cannot be overlooked—developing healthy sleep habits, adding relaxation to the daily routine, and engaging in physical activity all allow for more effective detoxification and improve overall quality of life.

A well-designed detoxification program should not only foster short-term weight loss, but also encourage long-term lifestyle and dietary changes.

The benefits of weight loss cannot be overstated—a reduction in risk for heart disease, obesity, diabetes, and cancer.  Yes, we must address the issues of overeating, lack of physical activity, poor food choices, and genetic metabolic issues. However, we can no longer ignore the impact of environmental toxins on weight loss, weight gain, and obesity.

What this means for the clinical picture is to develop and undertake strategies to reduce the toxic burden and optimize detoxification capacity. I have found over the years that a dietary and lifestyle-based detoxification program can produce dramatic shifts in body composition, along with better blood sugar balance, healthier lipid levels, and improved liver enzyme function. People who had previously been unable to lose weight may find that they’re able to break through the weight loss resistance.


Linda Clark, MA, CNC, is an adjunct professor at John F. Kennedy University and teaches graduate courses in holistic nutrition, functional endocrinology, nutrition consulting, diet and meal planning, and functional testing for the holistic health master’s program. She holds a master’s degree in holistic health education from John F. Kennedy University and a nutrition consultant certification from Bauman College.

Ms. Clark owns Universal Wellness Associates, a holistic nutrition and wellness practice located in Fair Oaks, California. For the past six years, she has conducted seminars throughout the Western United States as a speaker for Apex Energetics™. She is the author of a booklet called Gluten-Free Life, which is distributed to healthcare professionals across the country. She has also developed the Detox 360™ diet and lifestyle program, distributed by Apex Energetics.


REFERENCES
1.    Weight-control Information Network. Overweight and Obesity Statistics. Bethesda, MD: National Institute of Diabetes and Digestive Kidney Diseases;October 2012.
2.    Ogden CL, Carroll MD. Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960-1962 through 2007-2008. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention; June 2010.
3.     Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999-2010. JAMA. 2012 Feb;307(5):491-497.  
4.      Hearings Before the Subcommittee on Commerce, Trade, and Consumer Protection Committee on Energy and Commerce, U.S. House of Representatives.  July 29, 2010. (testimony of Steve Owens, Assistant Administrator, Office of Chemical Safety and Pollution Prevention, U.S. Environmental Protection Agency).  
5.     Schierow L. The Toxic Substances Control Act (TSCA): Implementation and New Challenges.  Washington, DC: Congressional Research Service; July 28, 2009.
6.     Wilding BC, Curtis K, Welker-Hood K.  Hazardous Chemicals in Health Care: A Snapshot of Chemicals in Doctors and Nurses. Washington, DC: Physicians for Social Responsibility; 2009.  
7.     Centers for Disease Control and Prevention, National Center for Environmental Health. Fourth National Report on Human Exposure to Environmental Chemicals. Atlanta, GA: Centers for Disease Control and Prevention; 2009.  
8.     Committee on National Monitoring of Human Tissues, Board on Environmental Studies and Toxicology, National Research Council.  Monitoring Human Tissues for Toxic Substances. Washington, DC: The National Academies Press, 1991.
9.     Kutz FW, Strassman SC, Sperling JF. Survey of selected organochlorine pesticides in the general population of the United States: Fiscal years 1970-1975. Ann N Y Acad Sci. 1979 May 31;320:60-68.
10.     Strassman SC, Kutz FW. Trends of organochlorine pesticide residues in human tissue. In: Khan MAQ, Stanton RH eds. Toxicology of Halogenated Hydrocarbons: Health & Ecological Effects. New York: Pergamon Press; 1981,
11.      Environmental Working Group. Body Burden—The Pollution in Newborns. Washington, DC: Environmental Working Group; July 2005.
12.      Baillie-Hamilton PF. Chemical toxins: a hypothesis to explain the global obesity epidemic. J Altern Complement Med.  2002 Apr;8(2):185-192.
13.     Blumberg B, Grün F. Environmental obesogens: organotins and endocrine disruption via nuclear receptor signaling.  Endocrinology. 2006 Jun;147(6 Suppl):S50-S55.
14.      Heindel JJ. Endocrine disruptors and the obesity epidemic. Toxicol Sci. 2003 Dec;76(2):247-249.  
15.      Holtcamp W. Obesogens: Environmental link to obesity?  Environ Health Perspect. 2012 Feb;120(2):a62-a68.  
16.      Newbold RR, Padilla-Banks E, Snyder RJ, Jefferson WN. Perinatal exposure to environmental estrogens and the development of obesity. Mol Nutr Food Res. 2007;51:912-917.
17.     Toschke AM, Koletzko B, Slikker Jr W, Hermann M, von Kries R. Childhood obesity is associated with maternal smoking in pregnancy. Eur J Pediatr. 161:445-448.
18.     Hill SY, Shen S, Locke Wellman J, Rickin E, Lowers L.  Offspring from families at high risk for alcohol dependence: increased body mass index in association with prenatal exposure to cigarettes but not alcohol. Psychiatry Res;135:203-216.
19.      Blaber SJM. The occurrence of a penis-like outgrowth behind the right tentacle in spent females of Nucella lapillus. Proc Malacol Soc Lond. 1970;39:231-233.
20.     Matthiessen P, Gibbs P. Critical appraisal of the evidence for tributyltin-mediated endocrine disruption in mollusks. Environ Toxicol Chem. 1998;17:37-43.  
21.      Pelletier C, Imbeault P, Tremblay A. Energy balance and pollution by organochlorines and polychlorinated biphenyls. Obes Rev. 2003 Feb;4(1):17-24.  
22.     Sanderson JT, Seinen W, Giesy JP, van den Berg M. 2-Chloro-s-triazine herbicides induce aromatase (CYP19) activity in H295R human adrenocortical carcinoma cells: a novel mechanism for estrogenicity? Toxicol Sci. 2000 Mar;54(1):121-127.
23.     Mecdad AA, Ahmed MH, El Halwagy MEA, Afify MMM. A study on oxidative stress biomarkers and immunomodulatory effects of pesticides in pesticide-sprayers. Egypt Jour Forens Sci. 2011 Jun;1(2):93-98.
24.     Agrawal A, Sharma B. Pesticides induced oxidative stress in mammalian systems: a review. Int J Biol Med Res. 2010;1(3):90-104.
25.     Zordoky BN, El-Kadi AO. Role of NF-kappaB in the regulation of cytochrome P450 enzymes. Curr Drug Metab. 2009 Feb;10(2):164-178.

Environmental Toxins: A Hidden Factor in the Obesity Epidemic

By Linda Clark, MA, CNC | Contributing Writer - Vol. 15, No. 2. Summer, 2013
It is no secret that as a nation, the United States is getting fatter.

Over the past 50 years, the prevalence of obesity in adults has nearly tripled, from 13.4% in 1962 to 35.7% in 20101-3. The economic, social, and medical burden this places on our society cannot be overstated.  It is a healthcare crisis of immense proportions.  

For good reason, we have become a nation obsessed with weight. We now have weight loss programs of all types and we are inundated with information from the media about trimming our waistlines.  With all of this attention, one would think that obesity would be on the decline. Clearly it is not.

It may be that we’re focused on the wrong thing.

For decades, the prevailing thought has been that Americans are obese because we eat and drink too much, exercise too little, and are destined by genetics to gain weight.  Even though these are factors, emerging science is pointing to another equally important driver of the obesity epidemic: the change in our environment and the prevalence of toxins that adversely affect metabolism.  

A better reckoning with environmental factors could help us understand a phenomenon we’ve all observed in clinical practice: the individual who simply cannot lose weight despite diligent adherence to appropriate dietary regimens, vigilance against over-eating, and careful attention to food choices and regular exercise.

The old rule of “calories in, calories out” simply doesn’t apply to many individuals: something other than caloric consumption and burn rates is affecting their metabolism.

Culture of Chemicals

top-window-4-environmental-toxinsMore than 80,000 chemicals are currently used in U.S. commerce,4  with 22,000 of these being introduced in the last four decades.5  Only 200 of these chemicals have been tested for safety, and only five are partially regulated through the Toxic Substances Control Act.4  Yet dozens of studies have shown the deleterious effects of these environmental pollutants, pesticides, plastics, and food additives.6  

The CDC regularly assesses Americans’ exposure to environmental chemicals through the National Health and Nutrition Examination Survey (NHANES).  Its fourth report (published in 2009) found there was “widespread exposure” among study participants to industrial chemicals, such as flame retardants.7 Bisphenol A (found in plastics) and perfluorooctanoic acid (found in non-stick coatings) were also present in most of the participants’ blood and urine samples.7

The EPA also conducted a study on the US population’s exposure to toxic chemicals.  Run from 1970-1989, this study tested adipose tissue, because many chemical toxins are fat-soluble and will accumulate in this kind of tissue. The survey documented a “significant prevalence of pesticide residues in the general population”8 of all ages.9-10

Our “culture of chemicals” even affects newborns. In 2004, the Environmental Working Group led a study that examined umbilical cord blood from 10 babies at U.S. hospitals.11 They found at least 287 chemicals in the cord blood, including pesticides, flame retardants, perfluorochemicals, and waste from burning coal, gasoline, and garbage.11

Looking at these study results, it is easy to conclude that we are all carrying a significant toxic load.  Because toxins are stored in adipose tissue, overweight and obese individuals are carrying an even greater toxic burden than those who are lean.

Altered Adipogenesis

A new understanding has emerged in the past few years that this burden of toxicity may explain the rise in obesity, and the problem that many people have with losing weight.

Researchers have found that certain environmental chemicals act as endocrine disruptors that alter fat production and energy balance, leaving some people more susceptible to weight gain.12-16 These compounds work in different ways. Some alter adipogenesis—the process of creating fat cells—causing people to have a greater numbers of fat cells, a larger size of their existing fat cells, or abnormal fat cell distribution.15  Other toxins alter levels of the appetite-regulating hormone leptin, or  increase the activity of estrogen.13,15

One of the first statements of this toxin-obesity hypothesis emerged from a meta-analysis published in 2002 in the Journal of Alternative and Complementary Medicine.12 The author concluded that the obesity epidemic can’t entirely be explained by changes in food intake, exercise, or even genetics.  

She argued that calorie consumption has actually declined throughout the 20th century and that decreases in physical activity do not statistically correlate with the extreme rise in obesity in the past few decades.12 Concluding that human exposure to chemicals “may have damaged many of the body’s natural weight-control mechanisms,” she noted that this impact, “may play a significant role in the worldwide obesity epidemic.”12

Another seminal article examined specific cases where an association had already been shown between environmental chemical exposure and obesity13—such as studies linking childhood obesity with maternal smoking during pregnancy.17-18 The author also highlighted the potent endocrine-disrupting capabilities of tributyltin, a chemical compound that causes female marine invertebrates to take on male sex characteristics.19-20  

Weight Gain & Weight Loss Resistance

The altering of fat cells and the disruption of hormone levels are just two of many mechanisms by which environmental toxins can act as endocrine disruptors. They can also increase inflammatory cytokine activity, cause oxidative stress, and impact energy metabolism.

A paper published in Obesity Review in 2003 looked at the effects of organochlorines (pesticides and plastics) on metabolic rate and weight regulation.21 The authors reviewed 63 studies and found many mechanisms related to weight loss resistance.  Primarily, they noted that organochlorines, “have been associated with altered immune and thyroid functions, particularly decreased triiodothyronine (T3) concentrations.”21

Other mechanisms included:
  • Inhibition of enzymes in the mitochondrial electron transport chain (which can decrease energy)
  • Decreased capacity for fatty acid utilization in skeletal muscle
  • Decrease in thyroxine concentrations (as the toxins compete for the same thyroid receptors)
  • Inflammation and oxidative stress as a cause-and-effect of toxin release

Furthermore, some herbicides induce hormonal shifts, leading to estrogen excesses and increased fat deposition. These herbicides, including the widely used atrazine, induce aromatase activity by as much as 250%.22 Aromatase is the key enzyme involved in converting androgens to estrogen.

Why Can’t I Lose More Weight?

Many people who are trying to lose weight find that they can lose the first 20 or 30 pounds, but then hit a plateau where it is difficult to lose more. Part of this problem stems from the fact that when people do lose weight, toxins stored in fat tissue are released into circulation.  

An increase in toxic load during weight loss—added to an already-substantial toxic burden—can create an inflammatory cascade that inhibits the body’s inherent, highly sophisticated detoxification system.23 This inflammatory process can also deplete reserves of glutathione, an important antioxidant, which alters the liver’s detoxification efficiency.23-25

In order to support healthy weight loss and lower the toxic load, we need to ask whether these released toxins can be effectively neutralized, so that they don’t compromise metabolic and hormonal mechanisms?  

Maximize Detoxification

This may seem like a vicious cycle—the body gains weight because it’s natural metabolism has been disrupted by chemicals, but the process of losing this weight only releases more chemicals to further alter the body’s natural functions.

The important leverage point here is that we can increase the efficiency of liver detoxification. Targeted use of a specialized array of nutrients that act as cofactors for phase I and phase II liver detoxification, can support the liver’s detoxifying abilities while at the same time providing antioxidants to deal with oxidative stress.

Herbs such as milk thistle, dandelion root, and gotu kola; dietary fibers like inulin, and nutrients such as vitamin C, bioflavanoids, B vitamins, and amino acids—to name just a few—should be included as supplemental detoxification support.

A low-allergenic, whole foods diet can also support the body’s natural detoxification processes by reducing immune system activation. Since weight gain is an inflammatory process, it is essential to lower the inflammatory load in the diet, not just by reducing the amount of chemical toxins consumed, but also by eliminating the most allergenic foods. This, in turn, lowers systemic inflammation and improves metabolic efficiency.

I recommend a diet that emphasizes wholesome, fresh foods (preferably organically grown) that includes lean protein, vegetables, vegetable starches and fruit. I also advise elimination of all grains, legumes, nuts, seeds, dairy and eggs. I generally recommend lean sources of proteins, vegetables, vegetable starches and fruit.

Over the years, I have tried many dietary approaches to support detoxification and optimize the body’s natural metabolic system, and I have found this approach to be the most successful.  What I particularly like about this approach is that it supports the healthy functioning of a number of body functions, not just detoxification and metabolism.

People can also lower their toxic load through specific lifestyle changes. Some of these include detox baths, skin brushing, drinking filtered water, and changing to stainless steel (rather than coated “non-stick”) cookware. I also recommend switching to more natural, allergen-free household and personal care products.

Self-care cannot be overlooked—developing healthy sleep habits, adding relaxation to the daily routine, and engaging in physical activity all allow for more effective detoxification and improve overall quality of life.

A well-designed detoxification program should not only foster short-term weight loss, but also encourage long-term lifestyle and dietary changes.

The benefits of weight loss cannot be overstated—a reduction in risk for heart disease, obesity, diabetes, and cancer.  Yes, we must address the issues of overeating, lack of physical activity, poor food choices, and genetic metabolic issues. However, we can no longer ignore the impact of environmental toxins on weight loss, weight gain, and obesity.

What this means for the clinical picture is to develop and undertake strategies to reduce the toxic burden and optimize detoxification capacity. I have found over the years that a dietary and lifestyle-based detoxification program can produce dramatic shifts in body composition, along with better blood sugar balance, healthier lipid levels, and improved liver enzyme function. People who had previously been unable to lose weight may find that they’re able to break through the weight loss resistance.


Linda Clark, MA, CNC, is an adjunct professor at John F. Kennedy University and teaches graduate courses in holistic nutrition, functional endocrinology, nutrition consulting, diet and meal planning, and functional testing for the holistic health master’s program. She holds a master’s degree in holistic health education from John F. Kennedy University and a nutrition consultant certification from Bauman College.

Ms. Clark owns Universal Wellness Associates, a holistic nutrition and wellness practice located in Fair Oaks, California. For the past six years, she has conducted seminars throughout the Western United States as a speaker for Apex Energetics™. She is the author of a booklet called Gluten-Free Life, which is distributed to healthcare professionals across the country. She has also developed the Detox 360™ diet and lifestyle program, distributed by Apex Energetics.


REFERENCES
1.    Weight-control Information Network. Overweight and Obesity Statistics. Bethesda, MD: National Institute of Diabetes and Digestive Kidney Diseases;October 2012.
2.    Ogden CL, Carroll MD. Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960-1962 through 2007-2008. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention; June 2010.
3.     Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999-2010. JAMA. 2012 Feb;307(5):491-497.  
4.      Hearings Before the Subcommittee on Commerce, Trade, and Consumer Protection Committee on Energy and Commerce, U.S. House of Representatives.  July 29, 2010. (testimony of Steve Owens, Assistant Administrator, Office of Chemical Safety and Pollution Prevention, U.S. Environmental Protection Agency).  
5.     Schierow L. The Toxic Substances Control Act (TSCA): Implementation and New Challenges.  Washington, DC: Congressional Research Service; July 28, 2009.
6.     Wilding BC, Curtis K, Welker-Hood K.  Hazardous Chemicals in Health Care: A Snapshot of Chemicals in Doctors and Nurses. Washington, DC: Physicians for Social Responsibility; 2009.  
7.     Centers for Disease Control and Prevention, National Center for Environmental Health. Fourth National Report on Human Exposure to Environmental Chemicals. Atlanta, GA: Centers for Disease Control and Prevention; 2009.  
8.     Committee on National Monitoring of Human Tissues, Board on Environmental Studies and Toxicology, National Research Council.  Monitoring Human Tissues for Toxic Substances. Washington, DC: The National Academies Press, 1991.
9.     Kutz FW, Strassman SC, Sperling JF. Survey of selected organochlorine pesticides in the general population of the United States: Fiscal years 1970-1975. Ann N Y Acad Sci. 1979 May 31;320:60-68.
10.     Strassman SC, Kutz FW. Trends of organochlorine pesticide residues in human tissue. In: Khan MAQ, Stanton RH eds. Toxicology of Halogenated Hydrocarbons: Health & Ecological Effects. New York: Pergamon Press; 1981,
11.      Environmental Working Group. Body Burden—The Pollution in Newborns. Washington, DC: Environmental Working Group; July 2005.
12.      Baillie-Hamilton PF. Chemical toxins: a hypothesis to explain the global obesity epidemic. J Altern Complement Med.  2002 Apr;8(2):185-192.
13.     Blumberg B, Grün F. Environmental obesogens: organotins and endocrine disruption via nuclear receptor signaling.  Endocrinology. 2006 Jun;147(6 Suppl):S50-S55.
14.      Heindel JJ. Endocrine disruptors and the obesity epidemic. Toxicol Sci. 2003 Dec;76(2):247-249.  
15.      Holtcamp W. Obesogens: Environmental link to obesity?  Environ Health Perspect. 2012 Feb;120(2):a62-a68.  
16.      Newbold RR, Padilla-Banks E, Snyder RJ, Jefferson WN. Perinatal exposure to environmental estrogens and the development of obesity. Mol Nutr Food Res. 2007;51:912-917.
17.     Toschke AM, Koletzko B, Slikker Jr W, Hermann M, von Kries R. Childhood obesity is associated with maternal smoking in pregnancy. Eur J Pediatr. 161:445-448.
18.     Hill SY, Shen S, Locke Wellman J, Rickin E, Lowers L.  Offspring from families at high risk for alcohol dependence: increased body mass index in association with prenatal exposure to cigarettes but not alcohol. Psychiatry Res;135:203-216.
19.      Blaber SJM. The occurrence of a penis-like outgrowth behind the right tentacle in spent females of Nucella lapillus. Proc Malacol Soc Lond. 1970;39:231-233.
20.     Matthiessen P, Gibbs P. Critical appraisal of the evidence for tributyltin-mediated endocrine disruption in mollusks. Environ Toxicol Chem. 1998;17:37-43.  
21.      Pelletier C, Imbeault P, Tremblay A. Energy balance and pollution by organochlorines and polychlorinated biphenyls. Obes Rev. 2003 Feb;4(1):17-24.  
22.     Sanderson JT, Seinen W, Giesy JP, van den Berg M. 2-Chloro-s-triazine herbicides induce aromatase (CYP19) activity in H295R human adrenocortical carcinoma cells: a novel mechanism for estrogenicity? Toxicol Sci. 2000 Mar;54(1):121-127.
23.     Mecdad AA, Ahmed MH, El Halwagy MEA, Afify MMM. A study on oxidative stress biomarkers and immunomodulatory effects of pesticides in pesticide-sprayers. Egypt Jour Forens Sci. 2011 Jun;1(2):93-98.
24.     Agrawal A, Sharma B. Pesticides induced oxidative stress in mammalian systems: a review. Int J Biol Med Res. 2010;1(3):90-104.
25.     Zordoky BN, El-Kadi AO. Role of NF-kappaB in the regulation of cytochrome P450 enzymes. Curr Drug Metab. 2009 Feb;10(2):164-178.

Covering Your Ass(ets): Wealth Protection for Clinicians

By Erik Goldman
Many health care practitioners have no clue how vulnerable their assets may be. But a few simple, inexpensive steps can make a world of difference in terms of asset protection, according to Michael Gaeta, LAc, a featured speaker at HPC's upcoming Heal Thy Practice conference.

Cannabis: A Remedy for Crohn's?

By Janet Gulland, Contributing Writer

Medical cannabis, while certainly not a "cure" for Crohn's disease, produced marked symptom  reductions in  a small but compelling study of patients who did not obtain relief from steroids and other conventional drugs.

Omega-3s Reduce Breast Cancer Risk Factors

By John Otrompke, Contributing Writer - Vol. 14, No. 2. Summer, 2013

Daily supplementation with high doses of omega-3 fatty acids markedly reduces breast tissue hyperplasia and key biomarkers for breast cancer in pre- and post-menopausal women.

A New Angle on Nitric Oxide & CVD Prevention

By Erik Goldman - Vol. 14, No. 2. Summer, 2013
It's been more than two decades since nitric oxide was named "Molecule of the Year" by the journal, Science.

Glutathione Shots Reverse Vocal Cord Polyps—Quickly!

By Erik Goldman
Glutathione given intravenously can quickly resolve vocal cord polyps and may have a role in the management of other respiratory tract disorders.

For Crohn’s Patients, Splenda’s Not So Splendid, Equal Equals Trouble

By Erik Goldman

Artificial sweeteners Splenda and Equal may be problematic for people with Crohn's disease because they appear to promote the growth and adherence of E. coli.

Bifido Probiotic Quells Pollen Allergies

By Erik Goldman

Oral supplementation with a specific strain of Bifidobacterium lactis (NCC2818) markedly reduced clinical symptoms as well as inflammatory cytokine concentrations and basophil activation in people with seasonal allergic rhinitis and grass pollen allergies.

How Hyperglycemia Drives Cognitive Dysfunction

By Erik Goldman

Hyperglycemia and insulin resistance cause actual structural changes to key brain regions involved in cognition, greatly increasing the risk of cognitive dysfunction.

Skinny, But Sick

By Erik Goldman

Nearly 40% of normal-weight teenagers in the US show metabolic evidence of diabesity and increased cardiovascular risk.

“Electronic Health Revenue” is Key To Independent Practice Success

By Erik Goldman - Vol. 14, No. 1. Spring, 2013

Integrative medicine in an independent private practice can still fly, even in a difficult economy, as Dr. Jeff Gladd of Ft. Wayne, IN has effectively proven. The key, says Dr. Gladd, is to develop new income streams and to get paid for currently uncompensated practice time.

In Approving GM Salmon, FDA Treads into Fishy Waters

By Kristen Schepker, Contributing Writer - Vol. 14, No. 3. Spring, 2013

Inan unprecedented step, the Food and Drug Administration recently announced that it is about to approve a fast-growing genetically engineered salmon. The fish will become the first-ever GM animal approved for human consumption, marking the start of a controversial journey into uncharted waters of our food supply.

Thylakoids in Leafy Greens May Help Regulate Appetite

By Lauren Brandstadter - Vol. 14, No. 1. Spring, 2013

Everyone knows spinach and other leafy greens are packed with important nutrients. What's less known is that these veggies come with built-in appetite regulators. Thylakoids—the membrane-enclosed photosynthetic "pouches" inside the chloroplasts of green leaves—trigger satiety signals and slow lipid absorption in humans & other mammals.

The Daniel Plan: A Merger of Faith & Functional Medicine

By Gabrielle Zastrocky, Contributing Writer - Vol. 14, No. 1. Spring, 2013

The Daniel Plan, a holistic health initiative co-developed by a mega-church pastor and some of the pioneers in functional medicine is proving highly effective in motivating people to make meaningful and lasting lifestyle changes.

The Daniel Plan: A Merger of Faith & Functional Medicine

By Gabrielle Zastrocky, Contributing Writer - Vol. 14, No. 1. Spring, 2013

The Daniel Plan, a holistic health initiative co-developed by a mega-church pastor and some of the pioneers in functional medicine is proving highly effective in motivating people to make meaningful and lasting lifestyle changes.

Perinatal Choline May Reduce Risk of Schizophrenia

By Gabrielle Zastrocky, Contributing Writer - Vol. 14, No. 1. Spring, 2013
While it is too soon to make clinical recommendations, new research shows that choline supplementation during pregnancy and after may help attenuate one of the key brain changes characteristic of schizophrenia,

Consider Gastrointestinal Problems in Patients with Osteoporosis, Arthritis

By Erik Goldman - Vol. 14, No. 1. Spring, 2013

There are strong correlations between celiac disease and other causes of intestinal permeability and common disorders of the bones and joints. Autoimmune reactions, facilitated by increased intestinal permeability, is sometimes an underlying cause of arthritis and osteoporosis.

Top Tips for Preventing and Treating Childhood Colds & Flu

By Janet Gulland, Contributing Writer - Vol. 13, No. 4. Winter, 2013
With cold and flu season in full swing across much of the US, many parents are seeking safe-non pharma options for protecting and treating their children. Holistic Primary Care asked several prominent integrative pediatricians what they recommend to the families they treat.

Top Herbs for Immune Support

By Kerry Bone, Contributing Writer - Vol. 13, No. 4. Winter, 2012

In the current era of increasing pathogen resistance to antibiotic drugs, there is a great need for new approaches for preventing colds, flu and other common infectious conditions. Key immune support herbs like Echinacea, Andrographis, and Astragalus can be valuable allies.

 

Vitamin D Reduces Fatigue in Cancer Patients

By John Otrompke, Contributing Writer - Vol. 13, No. 4. Winter, 2012

A new study shows that Vitamin D supplementation, at a dose of 2,000 IU per day, reduced the symptoms of fatigue in a cohort of people with various types of cancer.

Escape Fire Highlights Holistic Medicine As Remedy for Nation’s Healthcare Woes

By Walter Alexander, Contributing Writer - Vol. 13, No. 4. Winter, 2012
Escape Fire: The Fight to Rescue American Healthcare is not the first documentary to bemoan the inadequacies of healthcare here in the US. But it is unique and commendable for the way it looks at potential solutions already known in "real world" practice.

Organic Labels & Fables

By Kristen Schepker - Vol. 13, No. 4. Winter, 2012
The number of products carrying claims like "all natural" and "all organic" on their packaging has grown rapidly in recent years. In this changing food landscape, it is important for consumers and healthcare providers alike to understand the real meaning behind such terms.

Predictive Antibody Testing Facilitates Early Detection of Autoimmune Disorders

By Erik Goldman - Vol. 13, No. 4. Winter, 2012
Advances in immunology are translating into an array of new tests that enable clinicians to detect  diseases like rheumatoid arthritis, lupus, celiac, Crohn's, and autoimmune thyroid disorders at the earliest stages when they are most responsive to lifestyle-based treatment.

Healthcare Reform “No Birthday” For Holistic Medicine

By Gaby Zastrocky, Contributing Writer - Vol. 13, No. 4. Winter , 2013

With the re-election of President Obama, the Patient Protection and Affordable Care Act, aka ObamaCare, will continue to roll out. In the trenches, holistic practitioners are struggling to understand exactly how the reform plan will affect them. Some are optimistic about greater inclusion of holistic modalities; others see trouble ahead.

GMO Truths, Consequences, & the Right to Know

By Kristen Schepker - Vol. 13, No. 4. Winter, 2012
California's Proposition 37, which would have required labeling for foods containing genetically-modified ingredients, was defeated on November 6, but in many ways, the proposition was still a victory for the movement to raise awareness about the potential health consequences of GMO food consumption.

Pantethine a Safe Option for Patients “On the Cusp” of Cardiac Risk

By Erik Goldman - Vol. 13, No. 4. Winter, 2012

Pantethine, a derivative of vitamin B5, offers a safe option for improving lipid profiles and reducing cardiovascular risk beyond what can be obtained with a low-fat diet and lifestyle modification alone.

Hip Hop & Health

By August West
Hip hop heavy-hitters Method Man and Redman have gone vegetarian, following the lead of their Wu Tang Clan bandmate, GZA, who's been a raw foodie for years. They're part of a wave of health-conscious rappers trying to bring a positive, holistic message to young people.

Probiotics Reduce C. difficile After Antibiotic Treatment

By Erik Goldman
A new systematic review shows that probiotic prophylaxis can prevent Clostridium difficile-associated diarrhea, one of the most problematic side-effects antibiotic drugs.

Endothelial Glycocalyx: A New Focus for Cardiovascular Risk Reduction

By Erik Goldman
The endothelial glycocalyx, a gel-like glycoprotein layer that coats the inner surface of the endothelium throughout the vascular tree, has become a new focus for reducing risk of atherosclerosis and cardiovascular events.

Massive Survey Shows Many Clinicians at a Breaking Point

By Erik Goldman
According to a new survey of more than 13,500 US doctors by the Physicians' Foundation, over 80% feel medicine is in decline, 77% are pessimistic about the future, and over half are planning major changes in their practices. That's a poor prognosis for the future health of the nation's healthcare systems.

Breast Milk May Protect Infants From Deadly Intestinal Condition

By John Otrompke, Contributing Writer

Human breast milk contains a unique substance that may protect newborn infants from necrotizing enterocolitis (NEC), an often lethal inflammatory condition that commonly affects premature and low birth weight babies.

 

Breast Milk May Protect Infants From Deadly Intestinal Condition

By John Otrompke, Contributing Writer

Human breast milk contains a unique substance that may protect newborn infants from necrotizing enterocolitis (NEC), an often lethal inflammatory condition that commonly affects premature and low birth weight babies.

 

Breast Milk May Protect Infants From Deadly Intestinal Condition

By John Otrompke, Contributing Writer

Human breast milk contains a unique substance that may protect newborn infants from necrotizing enterocolitis (NEC), an often lethal inflammatory condition that commonly affects premature and low birth weight babies.

 

Chlorinated Water Increases Risk of Asthma, Respiratory Distress

By John Otrompke, Contributing Writer
Swimming in chlorinated water increases risk of asthma and respiratory problems in children, says Alfred Bernard, PhD, research director at the Catholic University of Leuven, Belgium. In a study of nearly 2,000 children, those who spent 30 or more hours in chlorinated pools before age 3 had triple the risk of respiratory problems.

Chlorinated Water Increases Risk of Asthma, Respiratory Distress

By John Otrompke, Contributing Writer
Swimming in chlorinated water increases risk of asthma and respiratory problems in children, says Alfred Bernard, PhD, research director at the Catholic University of Leuven, Belgium. In a study of nearly 2,000 children, those who spent 30 or more hours in chlorinated pools before age 3 had triple the risk of respiratory problems.

Chlorinated Water Increases Risk of Asthma, Respiratory Distress

By John Otrompke, Contributing Writer
Swimming in chlorinated water increases risk of asthma and respiratory problems in children, says Alfred Bernard, PhD, research director at the Catholic University of Leuven, Belgium. In a study of nearly 2,000 children, those who spent 30 or more hours in chlorinated pools before age 3 had triple the risk of respiratory problems.

“A Burning Desire to Fix the System” Catching Up with Matthew Heineman, Director of “Escape Fire”

By Erik Goldman

Filmmakers Matthew Heineman and Susan Froemke spent the last 3 years creating "Escape Fire: The Fight to Rescue American Healthcare," the most thorough and engaging healthcare documentary yet produced.

Holistic Primary Care caught up with Mr. Heineman, on the eve of Escape Fire's 12-city theatrical release, and prior to a pecial screening for attendees at HPC's 2012 Heal Thy Practice conference.

 

Drug Therapy Has Little Value In Early Stage Hypertension

By Erik Goldman
Amid the clamor over metanalyses suggesting that organic veggies are no more nutritious than conventional, and that omega-3's don't reverse heart disease, another important metanalysis got totally overlooked: the one showing that anti-hypertensive drugs are largely ineffective in people with Stage 1 hypertension.

Drug Therapy Has Little Value In Early Stage Hypertension

By Erik Goldman
Amid the clamor over metanalyses suggesting that organic veggies are no more nutritious than conventional, and that omega-3's don't reverse heart disease, another important metanalysis got totally overlooked: the one showing that anti-hypertensive drugs are largely ineffective in people with Stage 1 hypertension.

The Delusion of “Pre-Diabetes”

By Janet Gulland, Contributing Writer - Vol. 13, No. 3. Fall, 2012
The idea of "pre-diabetes" is a comforting delusion, says functional medicine pioneer, Mark Hyman, MD. In metabolic reality, the condition so described is not "pre" anything; it is dysregulated glucose metabolism that will eventually cause serious problems. Doctors and patients alike would do well to rid themselves of this naive notion.

What Every Doctor Should Know About Glutathione

By Tim Guilford, MD, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Glutathione, a powerful endogenous antioxidant, has been the subject of growing scientific interest. Deficiency is increasingly recognized as a risk factor in heart disease, asthma, neurodegenerative disorders and various types of cancer. Supplementation can greatly improve management of many of these conditions.

Creating Mind-Body Coherence in the Context of Depression

By Shawn Casey, Contributing Writer - Vol. 13, No. 3. Fall, 2012
Antidepressant drugs, while sometimes helpful, certainly did not solve the problem of depression. For many patients, a comprehensive holistic program incorporating nutritional changes, botanicals and mind-body techniques like HeartMath's "Quick Coherence" system, is a better option.

Massive Study Finds Link Between Allergies & Hematologic Cancers

By John Otrompke, Contributing Writer - Vol. 13, No. 3. 2012,
A cohort study of over 64,000 people found that those with allergies to grass, plants and trees were more likely to develop hematologic malignancies compared with people who don't have allergies. The surprising observation runs contrary to studies, and has investigators and clinicians scratching their heads.

Massive Study Finds Link Between Allergies & Hematologic Cancers

By John Otrompke, Contributing Writer - Vol. 13, No. 3. 2012,
A cohort study of over 64,000 people found that those with allergies to grass, plants and trees were more likely to develop hematologic malignancies compared with people who don't have allergies. The surprising observation runs contrary to studies, and has investigators and clinicians scratching their heads.

Massive Study Finds Link Between Allergies & Hematologic Cancers

By John Otrompke, Contributing Writer - Vol. 13, No. 3. 2012,
A cohort study of over 64,000 people found that those with allergies to grass, plants and trees were more likely to develop hematologic malignancies compared with people who don't have allergies. The surprising observation runs contrary to studies, and has investigators and clinicians scratching their heads.

Reckoning with Statin-Induced Diabetes and Metformin Resistance

By Thomas G. Guilliams, PhD, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Drug therapies to reduce cardiovascular risk and prevent the onset of diabetes may be effective in the short term, but as people age, the efficacy of drugs like statins and metformin tends to diminish, while the risk of adverse effects increases. The benefit of nutritional and lifestyle interventions, on the other hand, remains robust even as people enter their final decades.

 

Of Coaches & Credentials

By Brittany Cushman, Contributing Writer - Vol. 13, No. 3. Fall, 2012
The field of personal fitness coaching is growing rapidly, as more people seek professional guidance for getting into shape. Like any emerging field, the coaching world is also facing issues of credentialing.

Consider Adding "Pre-Habilitation" to Your Exercise Recommendations

By Brittany Cushman, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Exercise programs that bridge the gap between rehabilitation and conditioning, and focus on restoring range of motion, can provide a good measure of "pre-habilitation" to prevent musculoskeletal pain, injury and long-term disability.

Consider Adding "Pre-Habilitation" to Your Exercise Recommendations

By Brittany Cushman, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Exercise programs that bridge the gap between rehabilitation and conditioning, and focus on restoring range of motion, can provide a good measure of "pre-habilitation" to prevent musculoskeletal pain, injury and long-term disability.

Consider Adding "Pre-Habilitation" to Your Exercise Recommendations

By Brittany Cushman, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Exercise programs that bridge the gap between rehabilitation and conditioning, and focus on restoring range of motion, can provide a good measure of "pre-habilitation" to prevent musculoskeletal pain, injury and long-term disability.

To Improve Weight Loss Outcomes, Consult “Dr. Sandman”

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Getting less than forty winks has a profound effect on metabolic processes that determine not only how we seek out and utilize food, but also how adept our bodies are at burning or storing calories.

To Improve Weight Loss Outcomes, Consult “Dr. Sandman”

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Getting less than forty winks has a profound effect on metabolic processes that determine not only how we seek out and utilize food, but also how adept our bodies are at burning or storing calories.

To Improve Weight Loss Outcomes, Consult “Dr. Sandman”

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Getting less than forty winks has a profound effect on metabolic processes that determine not only how we seek out and utilize food, but also how adept our bodies are at burning or storing calories.

Reckoning with Statin-Induced Diabetes and Metformin Resistance

By Thomas G. Guilliams, PhD, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Drug therapies to reduce cardiovascular risk and prevent the onset of diabetes may be effective in the short term, but as people age, the efficacy of drugs like statins and metformin tends to diminish, while the risk of adverse effects increases. The benefit of nutritional and lifestyle interventions, on the other hand, remains robust even as people enter their final decades.

Reckoning with Statin-Induced Diabetes and Metformin Resistance

By Thomas G. Guilliams, PhD, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Drug therapies to reduce cardiovascular risk and prevent the onset of diabetes may be effective in the short term, but as people age, the efficacy of drugs like statins and metformin tends to diminish, while the risk of adverse effects increases. The benefit of nutritional and lifestyle interventions, on the other hand, remains robust even as people enter their final decades.

Reckoning with Statin-Induced Diabetes and Metformin Resistance

By Thomas G. Guilliams, PhD, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Drug therapies to reduce cardiovascular risk and prevent the onset of diabetes may be effective in the short term, but as people age, the efficacy of drugs like statins and metformin tends to diminish, while the risk of adverse effects increases. The benefit of nutritional and lifestyle interventions, on the other hand, remains robust even as people enter their final decades.

Reckoning with Statin-Induced Diabetes and Metformin Resistance

By Meg Sinclair, Contributing Writer - Vol. 13, No. 3. Fall, 2012

Drug therapies to reduce cardiovascular risk and prevent the onset of diabetes may be effective in the short term, but as people age, the efficacy of drugs like statins and metformin tends to diminish, while the risk of adverse effects increases. The benefit of nutritional and lifestyle interventions, on the other hand, remains robust even as people enter their final decades.

 

Yoga Improves Muscle Pain, Memory Problems in Cancer Survivors

By John Otrompke, Contributing Writer
Two new studies of an innovative yoga program specifically designed for cancer survivors add to existing data showing that yoga can improve sleep, reduce "chemo-fog" and ameliorate a variety of chronic problems that often follow conventional cancer care.

Yoga Improves Muscle Pain, Memory Problems in Cancer Survivors

By John Otrompke, Contributing Writer
Two new studies of an innovative yoga program specifically designed for cancer survivors add to existing data showing that yoga can improve sleep, reduce "chemo-fog" and ameliorate a variety of chronic problems that often follow conventional cancer care.

Yoga Improves Muscle Pain, Memory Problems in Cancer Survivors

By John Otrompke, Contributing Writer
Two new studies of an innovative yoga program specifically designed for cancer survivors add to existing data showing that yoga can improve sleep, reduce "chemo-fog" and ameliorate a variety of chronic problems that often follow conventional cancer care.

Yoga Improves Muscle Pain, Memory Problems in Cancer Survivors

By John Otrompke, Contributing Writer
Two new studies of an innovative yoga program specifically designed for cancer survivors add to existing data showing that yoga can improve sleep, reduce "chemo-fog" and ameliorate a variety of chronic problems that often follow conventional cancer care.

Crowd-Sourcing Health: The Intersection of Social-Media and Medicine

By Sarah Showalter, Contributing Writer
In a world where free Wi-Fi and portable handheld devices give us access to a technologically enabled collective-consciousness, practitioners and patients alike are able to tap an unprecedented amount of published research, expert opinion, and anecdotal experience. There's no doubt that the social media revolution is influencing healthcare---for better and for worse!

Influential Herbal Researcher Faces Blog-Prompted Academic Inquiry

By John Otrompke
A prominent and widely respected scientist who has published milestone articles on the healing properties of herbs such as turmeric, is facing a university investigation partially as a result of criticism by bloggers from websites like Retraction Watch. The case underscores the ambiguous role of unrefereed blogs in mediating science and influencing scientific reputations.

Influential Herbal Researcher Faces Blog-Prompted Academic Inquiry

By John Otrompke
A prominent and widely respected scientist who has published milestone articles on the healing properties of herbs such as turmeric, is facing a university investigation partially as a result of criticism by bloggers from websites like Retraction Watch. The case underscores the ambiguous role of unrefereed blogs in mediating science and influencing scientific reputations.

Tired of “McMedicine?” Heal Thy Practice Will Highlight Paths to Healthier Healthcare

By Erik Goldman - Vol. 13, No. 3. Fall, 2012
Now, more than ever, it's essential to come to grips with the business aspects of health care--especially if you want to practice holistically. Holistic Primary Care's fourth annual Heal Thy Practice conference, Nov 9-11, 2012, is primed to help you meet today's challenges with practical, field-ready strategies for implementing holistic modalities, strengthening your fiscal health, and delivering a genuine healing experience.

Ginseng and Curcumin: Herbal Allies in Cancer Care

By John Otrompke, Contributing Writer
Ginseng and curcumin, two herbs with long histories of use in traditional Asian herbal medicine, have beneficial effects in people with cancer, according to new studies presented at this year's annual meeting of the American Society of Clinical Oncology (ASCO).

Ginseng and Curcumin: Herbal Allies in Cancer Care

By John Otrompke, Contributing Writer
Ginseng and curcumin, two herbs with long histories of use in traditional Asian herbal medicine, have beneficial effects in people with cancer, according to new studies presented at this year's annual meeting of the American Society of Clinical Oncology (ASCO).

FDA Curtails Antibiotic Overuse in Livestock, But US Still Trails Global Standards

By John Otrompke, Contributing Writer
A Food & Drug Administration order prohibiting the use of certain antibiotics in livestock finally went into effect this summer, but according to some public health advocates, the FDA's move is too little, too late.

FDA Curtails Antibiotic Overuse in Livestock, But US Still Trails Global Standards

By John Otrompke, Contributing Writer
A Food & Drug Administration order prohibiting the use of certain antibiotics in livestock finally went into effect this summer, but according to some public health advocates, the FDA's move is too little, too late.

FDA Curtails Antibiotic Overuse in Livestock, But US Still Trails Global Standards

By John Otrompke, Contributing Writer
A Food & Drug Administration order prohibiting the use of certain antibiotics in livestock finally went into effect this summer, but according to some public health advocates, the FDA's move is too little, too late.

Mid-Life Marathoners: Doing Themselves More Harm Than Good?

By Erik Goldman
While many Americans suffer from a complete lack of exercise, others are pushing the opposite extreme, and the consequences can be just as dire. They're participating in triathlons, marathons, and other endurance competitions, often causing themselves serious harm along the way.

Low Vitamin D Levels May Trigger Weight Gain

By Erik Goldman

A new and interesting angle on the vitamin D story is emerging from research on weight gain in older women. The vitamin, it seems, is an important metabolic signal that indirectly regulates the propensity to store fat.

Low Vitamin D Levels May Trigger Weight Gain

By Erik Goldman
A new and interesting angle on the vitamin D story is emerging from research on weight gain in older women. The vitamin, it seems, is an important metabolic signal that indirectly regulates the propensity to store fat.

Low Vitamin D Levels May Trigger Weight Gain

By Erik Goldman
A new and interesting angle on the vitamin D story is emerging from research on weight gain in older women. The vitamin, it seems, is an important metabolic signal that indirectly regulates the propensity to store fat.

Obama's Supreme Court "Victory" Could Cost Him in November

By Erik Goldman
Chief Justice John G. Roberts' decision to uphold the Obama administration's healthcare reform may very well have handed the President a "victory" that could cost him dearly in November.

Not-So-Obvious Cardiometabolic Risk Factors Worth Considering

By Erik Goldman - Vol. 12, No. 3. Fall, 2012

Elevated cholesterol and high blood glucose are the obvious features of diabetes and heart disease but they're hardly the whole picture. Other, less obvious factors including environmental toxins like BPA and lead, gastrointestinal disorders, and frequent use of artificial sweeteners are also important drivers of disease. According to Dr. Mark Hyman, author of the popular book, The Blood Sugar Solution, these oft-overlooked factors warrant closer attention.

Not-So-Obvious Cardiometabolic Risk Factors Worth Considering

By Erik Goldman - Vol. 12, No. 3. Fall, 2012

Elevated cholesterol and high blood glucose are the obvious features of diabetes and heart disease but they're hardly the whole picture. Other, less obvious factors including environmental toxins like BPA and lead, gastrointestinal disorders, and frequent use of artificial sweeteners are also important drivers of disease. According to Dr. Mark Hyman, author of the popular book, The Blood Sugar Solution, these oft-overlooked factors warrant closer attention.

Not-So-Obvious Cardiometabolic Risk Factors Worth Considering

By Erik Goldman - Vol. 12, No. 3. Fall, 2012

Elevated cholesterol and high blood glucose are the obvious features of diabetes and heart disease but they're hardly the whole picture. Other, less obvious factors including environmental toxins like BPA and lead, gastrointestinal disorders, and frequent use of artificial sweeteners are also important drivers of disease. According to Dr. Mark Hyman, author of the popular book, The Blood Sugar Solution, these oft-overlooked factors warrant closer attention.

Not-So-Obvious Cardiometabolic Risk Factors Worth Considering

By Erik Goldman - Vol. 12, No. 3. Fall, 2012

Elevated cholesterol and high blood glucose are the obvious features of diabetes and heart disease but they're hardly the whole picture. Other, less obvious factors including environmental toxins like BPA and lead, gastrointestinal disorders, and frequent use of artificial sweeteners are also important drivers of disease. According to Dr. Mark Hyman, author of the popular book, The Blood Sugar Solution, these oft-overlooked factors warrant closer attention.

Heal Thy Practice 2012 to Highlight “Lessons Learned” from Leading Integrative Clinics

By Janet Gulland,, Contributing Writer - Vol. 13, No. 2. Summer, 2012

A thriving, economically-viable integrative practice is the dream of many clinicians. Reaching that ideal can be very challenging. Fortunately, road maps are emerging from holistic clinics, large and small, all over the country.  HPC's fourth annual Heal Thy Practice conference at the Renaissance Long Beach Hotel, Nov. 9-11, 2012, will provide a valuable opportunity to learn from clinicians who’ve found ways to create and maintain healthy and health-centric practices.

 

Blood Viscosity: The Role of Blood Flow in Cognitive Function

By Ralph E. Holsworth, DO, and Jonathan V. Wright, MD - Vol. 13, No. 2. Summer, 2012

High blood viscosity, a robust predictor of cardiovascular disease risk, is also predictive of cognitive dysfunction in older people, and may be an early indicator of the risk of Alzheimer's disease.

Blood Viscosity: The Role of Blood Flow in Cognitive Function

By Ralph E. Holsworth, DO, and Jonathan V. Wright, MD - Vol. 13, No. 2. Summer, 2012

High blood viscosity, a robust predictor of cardiovascular disease risk, is also predictive of cognitive dysfunction in older people, and may be an early indicator of the risk of Alzheimer's disease.

Herbal Allies Offer Non-Invasive Options for Couples Struggling to Conceive

By Michael Greer, MD, Contributing Writer - Vol. 13, No. 2. Summer, 2012
Herbs like Shatavari, Tribulus and Rhodiola can play a valuable role in supporting women's reproductive health, establishing normal hormonal function, nourishing and toning the uterus, helping to reduce stress level, relax the nervous system, and increase sexual desire.

Herbal Allies Offer Non-Invasive Options for Couples Struggling to Conceive

By Michael Greer, MD, Contributing Writer - Vol. 13, No. 2. Summer, 2012
Herbs like Shatavari, Tribulus and Rhodiola can play a valuable role in supporting women's reproductive health, establishing normal hormonal function, nourishing and toning the uterus, helping to reduce stress level, relax the nervous system, and increase sexual desire.

Thyroid Problems Often Underlie Infertility, Pregnancy Complications

By Rhesa Napoli, Contributing Writer - Vol. 13, No. 2. Summer, 2012

Thyroid dysfunction is a well documented, but often overlooked, factor in both male and female infertility, leading to miscarriages, premature birth, fetal death, low birth weight, gestational hypertension and developmental problems for offspring. Thyroid function screening makes good sense as a standard practice during preconception planning and prenatal care.

MTHFR Mutation: A Missing Piece in the Chronic Disease Puzzle

By Bianca Garilli, ND, Contributing Writer - Vol. 13, No. 2. Summer, 2012

Methylenetetrahydrofolate reductase (MTHFR) is one of the most important enzymes in human physiology, having influence on at least as many biochemical processes as it has syllables in its name. Deficiencies in this enzyme increase the risk of CVD, several types of cancer, congenital defects, and inflammatory bowel disease. Fortunately, deficiencies are correctable with targeted supplementation.

Can Probiotics Influence Fertility? It’s Conceivable!

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 2. Summer, 2012
Presence or absence of particular strains of beneficial bacteria in the female digestive and reproductive tracts have a much greater influence on fertility than most people realize.

Can Probiotics Influence Fertility? It’s Conceivable!

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 2. Summer, 2012
Presence or absence of particular strains of beneficial bacteria in the female digestive and reproductive tracts have a much greater influence on fertility than most people realize.

Can Probiotics Influence Fertility? It’s Conceivable!

By Ciel Patenaude, Contributing Writer - Vol. 13, No. 2. Summer, 2012
Presence or absence of particular strains of beneficial bacteria in the female digestive and reproductive tracts have a much greater influence on fertility than most people realize.

Ayurvedic Tips for Staying Balanced in a Medical Life

By Amber Lynn Vitse - Vol. 13, No. 2. Summer, 2012
it is no big secret that many health care professionals put their own health far down on their priority list. The culture of medicine puts enormous pressures on practitioners, and in many ways, fosters unhealthy imbalances. Ayurvedic medicine is an excellent place to look for wisdom on rediscovering balance in a fast-paced medical life.

Ayurvedic Tips for Staying Balanced in a Medical Life

By Amber Lynn Vitse - Vol. 13, No. 2. Summer, 2012
it is no big secret that many health care professionals put their own health far down on their priority list. The culture of medicine puts enormous pressures on practitioners, and in many ways, fosters unhealthy imbalances. Ayurvedic medicine is an excellent place to look for wisdom on rediscovering balance in a fast-paced medical life.

Ayurvedic Tips for Staying Balanced in a Medical Life

By Amber Lynn Vitse - Vol. 13, No. 2. Summer, 2012
it is no big secret that many health care professionals put their own health far down on their priority list. The culture of medicine puts enormous pressures on practitioners, and in many ways, fosters unhealthy imbalances. Ayurvedic medicine is an excellent place to look for wisdom on rediscovering balance in a fast-paced medical life.

Dietitians vs. Nutritionists: Licensure Battles Underscore Growth of the Field

By Kristen Schepker, Contributing Writer - Vol. 13, No. 2. Summer, 2012
As more Americans seek professional nutrition guidance, a contentious turf battle has heated up between registered dietitians and other non-RD nutrition counsellors. RD organizations in several states are pushing for legislation that would restrict practice of nutrition counseling only to those professionals who meet RD credentials.

Asthma-cetaminophen

By August West, Contributing Writer
Almost every study that has looked at the relationship between acetaminophen use and childhood asthma--and there are now over 20 such studies--has found a significant association. The notion that use of this common OTC drug might trigger asthma was first posited 14 years ago. It took science this long to catch up.

Asthma-cetaminophen

By August West, Contributing Writer
Almost every study that has looked at the relationship between acetaminophen use and childhood asthma--and there are now over 20 such studies--has found a significant association. The notion that use of this common OTC drug might trigger asthma was first posited 14 years ago. It took science this long to catch up.

Healing the NSAID Nation: Finding Safer Alternatives for Chronic Inflammation

By Erik Goldman - Vol. 13, No. 2. Summer, 2012
Each year, tens of thousands of Americans die unnecessarily from complications of overuse of non-steroidal anti-inflammatory drugs (NSAIDs). Hundreds of thousands are hospitalized. Yet these medications continue to be routinely prescribed by physicians, and are readily available over the counter at very low prices. Botanical medicines derived from Curcumin, Ginger and other spices offer much safer alternatives.

Three GI Ecosystems

By Leo Galland, MD - Vol. 13, No. 2. Summer, 2012
The GI microbial world is comprised of 3 very different compartments: Gastric, Small Intestinal & Colonic. Each has a distinct biochemical and physiologic "climate." Digestive heatlh--and by extension, overall health--depends on the relationships between these diverse microbial worlds.

Must We Always Eradicate H. Pylori?

By Leo Galland, MD - Vol. 13, No. 2. Summer, 2012

Helicobacter pylori, one of the most common microorganisms found in the human GI tract, can definitely be pathogenic, but in many people it is not. In some, it may even be helpful: gastric colonization with H. pylori inhibits ghrelin, an appetite stimulating molecule. Some researchers argue that eradicating H. pylori actually promotes obesity. Dr. Leo Galland, a pioneer in functional medicine, opts to take the middle ground between total eradication and total tolerance of this bug.

Strategies for Establishing a Healthy Gut Microbiome

By Leo Galland, MD - Vol. 13, No. 2. Summer, 2012

With the growing popularity of probiotics and concerns about antibiotic overuse, there has been a lot of attention on the importance of maintaining healthy gut flora. This is certainly a positive step, but what often gets lost in the dialog is the true complexity of the gut microbiome. Dr. Leo Galland, one of the nation's leading functional medicine physicians, offers insights on how to cultivate a healthy relationship with the microbial world within.

Holistic Medicine is Military’s New Marching Order

By Erik Goldman
In an effort to improve the wellbeing of active duty personnel and returning veterans, the three branches of the armed forces and the Department of Veterans Affairs (VA) have made a firm commitment to the integration of holistic modalities into military medicine.

Foul Air, Fast Rx's Fuel Childhood Obesity

By Erik Goldman
Exposure to air pollution and overuse of antibiotics may be important risk factors for childhood obesity, according to recent studies. The findings suggest that there's more to the obesity equation than excess calories & lack of exercise.

Foul Air, Fast Rx's Fuel Childhood Obesity

By Erik Goldman
Exposure to air pollution and overuse of antibiotics may be important risk factors for childhood obesity, according to recent studies. The findings suggest that there's more to the obesity equation than excess calories & lack of exercise.

Foul Air, Fast Rx's Fuel Childhood Obesity

By Erik Goldman
Exposure to air pollution and overuse of antibiotics may be important risk factors for childhood obesity, according to recent studies. The findings suggest that there's more to the obesity equation than excess calories & lack of exercise.

Concierge vs Insurance? Many Practices are Doing Both

By Erik Goldman

The relationship between concierge practice models and standard insurance-based practice is often presented as an all-or-nothing, either-or dichotomy. In reality, many practices are doing both, according to a recent survey.

 

I'm Just Mad About Saffron....

By Erik Goldman

Saffron aromatherapy can produce measurable and potentially meaningful changes in young womens' hormonal chemistry, suggesting the possibility that it might be a useful remedy for PMS and dysmenorrhea.

 

I'm Just Mad About Saffron....

By Erik Goldman

Saffron aromatherapy can produce measurable and potentially meaningful changes in young womens' hormonal chemistry, suggesting the possibility that it might be a useful remedy for PMS and dysmenorrhea.

 

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